Alexandria Governorate Research Articles

Characterization and control of Rhizoctonia solani affecting lucky bamboo (Dracaena sanderiana hort. ex. Mast.) using some bioagents

In a survey conducted during the period of March–May 2019 in nurseries, warehouses, and shops at three governorates (Alexandria, El-Behera, and Giza governorates, Egypt), symptoms of root rot, basal stem rot, and wilt disease complex were observed in the lucky bamboo (Dracaena sanderiana hort. ex. Mast.). The highest disease infection percentage was found in lucky bamboo collected from Alexandria City (47.67%), while the highest disease severity was in lucky bamboo collected from El-Behera Governorate (35.19%). Rhizoctonia solani, Fusarium oxysporum, F. solani, Aspergillus niger, and Alternaria alternate were isolated and identified in the infected lucky bamboo samples. R. solani isolates were the most dominant among the recovered fungal species with a percentage of 80.89% of the total isolates (246). Pathogenicity tests showed that R. solani was the most pathogen with 100% disease infection and 76.67% disease severity. Molecular identification characterized R. solani isolate as R. solani AUMC 15120, MZ723906. Meanwhile, four biological control agents (bioagents) were isolated from the healthy lucky bamboo samples and identified based on cultural, morphological, microscopic characteristics, and the molecular phylogenetic analysis as Clonostachys rosea AUMC 15121, OL461708; Bacillus circulans TAG1, MW441316; B. siamensis TAP1, MW441318 and Ochrobactrum anthropi TAM1, MW441317. The four bioagents showed potential inhibition of R. solani in vitro as well as in vivo on lucky bamboo plants in vase treatments compared to the untreated inoculated control as well as certain fungicides and biocides used (Moncut, Rizolex-T, Topsin-M, Bio-Zeid, and Bio-Arc). The bioagent O. anthropi showed the highest inhibition growth (85.11%) of the in vitro R. solani colony, which was not significantly different from the biocide Bio-Arc (83.78%). However, C. rosea, B. siamensis and B. circulans showed inhibition values of 65.33, 64.44, and 60.44%, respectively. On the other hand, the biocide Bio-Zeid showed less inhibitory effect (43.11%), while the lowest growth inhibition was recorded by Rizolex-T (34.22%) and Topsin-M (28.67%). Furthermore, the in vivo experiment supported the in vitro results for the most effective treatments, where all the treatments significantly decreased the percentage of infection and disease severity compared to the inoculated untreated control. Additionally, the bioagent O. anthropi showed the highest effect, i.e., the lowest disease incidence and disease severity being 13.33% and 10%, compared to 100% and 75%, respectively, in the untreated inoculated control. This was not significantly different from the fungicide Moncut (13.33% and 21%) and from the bioagent C. rosea (20% and 15%) treatments for both parameters, respectively. In conclusion, the bioagents O. anthropi MW441317 at 1 × 108 CFU/ml as well as C. rosea AUMC15121 at 1 × 107/ml proved to be efficient to control R. solani causing root rot, and basal stem rot on lucky bamboo, compared to fungicide Moncut and can be used for disease management without the negative impact of the chemical control. Furthermore, this is the first report of the isolation and identification of Rhizoctonia solani, a pathogenic fungus, and four biocontrol agents (Bacillus circulans, B. siamensis, Ochrobactrum anthropi and Clonostachys rosea) associated with the healthy lucky bamboo plants.

Prevalence of Infective and Non-Infective Hepatitis in a Tertiary Fever Hospital: Alexandria Governorate, Egypt

Prevalence of Infective and Non-Infective Hepatitis in a Tertiary Fever Hospital: Alexandria Governorate, Egypt

The prevalence of parasitic infections among slaughtered animals in mechanical abattoir

Gastrointestinal parasites, such as helminths and protozoa, are abundant parasitic agents of livestock, particularly ruminants. The current study aims to determine the prevalence rate of parasitic infections in large ruminate animals slaughtered in the mechanical abattoir in Alexandria governorate, Egypt. The prevalence was identified through the records of parasitic infections detected in the fecal matter of large ruminate animals in addition to the recorded postmortem examination findings. Three hundred sixty-four slaughtered large ruminant animals were selected, labeled, and subjected to fecal sampling and postmortem examination. Each fecal sample was tested by three different techniques; the formalin-ether concentration, Ziehl-Neelsen hot-stained, and saturated saline flotation to diagnose all parasite types. One hundred thirty positive cases (35.71%) were determined during the fecal sample examination, and 76 cases (20.87%) were found in postmortem examination. Formalin-ether processing of fecal samples yielded the highest number of pathogens; Entamoeba species were detected in 98 fecal samples (26.69%), and Fasciola species eggs were detected in 14 samples (3.84%). The postmortem examination revealed Fasciola hepatica and F. gigantica in 13 animals (3.57%), mixed lung and liver hydatid cysts in 32 animals (8.79%), whereas liver hydatid cysts only were identified in 15 animals (4.12%). Finally, Sarcocystosis infection was detected in 3.57%. In conclusion, the parasitic infections of large ruminant animals are a leading cause of pathogenicity in large animals, leading to economic losses. Prevention and control measures must be implemented by mechanical abattoirs according to the Hazard Analysis Critical Control Point system.

Prevalence and associated risk factors of Toxoplasma gondii infection in sheep and aborted women in Egypt

Toxoplasmosis has been associated with economic and public health concerns due to abortion in humans and animals. Detection for the presence of anti-Toxoplasma gondii antibodies in sera of 174 healthy sheep (IgG) and sera of 89 aborted women (IgG, IgM, and IgG avidity) using enzyme-linked immunosorbent assay and T. gondii in 59 sheep milk samples identified by PCR. The primary risk factors for sheep and women seropositive samples were also analyzed. Relatively higher seroprevalence of T. gondii, 62.6%, was recorded in sheep than 57.3% in aborted women. The IgM/IgG antibody responses in aborted women were 42.7%, 41.6%, 15.7%, and 0% for IgM -ve/IgG -ve (negative toxoplasmosis), IgM -ve/IgG +ve (chronic toxoplasmosis), IgM +ve/IgG +ve (maternal infection) and IgM +ve/IgG -ve (acute infection), respectively. IgM and IgG-positive samples showed a low avidity rate 14.3%, denoting acute maternal infection, while a much higher rate 78.6%, denoting chronic maternal infection. Molecular investigation of T. gondii in sheep milk samples revealed that 28.8% were positive by PCR at 470-bp. The respectable significant association between many risk factors and the seroprevalence of T. gondii in humans and sheep was recorded. The current study indicates elevated toxoplasmosis antibodies in sheep and aborted women from El-Beheira and Alexandria governorates, Egypt. Additionally, it demonstrates a correlation between age, mutton intake, miscarriage, cat exposure, drinking water source, and breeding practices with seropositivity to T. gondii. These results largely confirm the need for greater in-depth toxoplasmosis epidemiological research and public health education initiatives.

Effective production of bacterial cellulose using acidic dairy industry by-products and agro wastes

The study aimed to evaluate the production of bacterial cellulose (BC) by specialized bacteria using raw acidic dairy wastewater and milk whey as well as evaluating the bioremediation ability of the tested bacteria for the purification of polluted wastewater. Raw dairy wastewater samples were collected from Milk Factory in Alexandria Governorate, Egypt. Three bacterial isolates were isolated from spoiled Tomato (T0) and Pomegranate (R01 &R02), and investigated as free-living and fixed individual and mixed cultures in batch mode bioassays. BC was extracted, determined and characterized. T0, R01 &R02 were molecularly identified as Bacillus velezensis strain FZB42 (T0), Klebsiella quasipneumoniae subsp. similipneumoniae strain 07A044 (R01 and R02). T0 achieved the maximum BC yield of 31.9 g/L compared to 13.18 g/L produced by the standard synthetic Hestrin-Schramm (HS) medium. It also showed the highest growth stimulation (7.78-fold higher density than its initial density). All strains showed the highest removals of the TSS, TDS, COD and BOD reaching residual concentrations (RCs) of 12, 2050, 75 and 25 mg/L, respectively, all of which were much lower levels than their limits stated by environmental laws (60, 5000, 80 and 60 mg/L, respectively). BC production by the tested bacteria grown in the raw dairy wastewater is considered an excellent achievement, feasible and value-added technology. The tested bacteria are remarkably efficient for the treatment of dairy effluents in a very short time. Therefore, it is highly recommended to use the proposed bacterial system for feasible BC production and purification of highly polluted dairy wastewater.

Evaluation of Some Okra and Molokhia Landraces under Irrigation Water Salinity Stress

Aims: Evaluate eight landraces of okra and five landraces of molokhia, collected from different region of Egypt, under different levels of irrigation water salinity.
 Study Design: The experimental design used was a split-plot in a randomized complete blocks design with three replicates, where the four irrigation water salinity concentrations were arranged in the main plots, whereas, landraces of okra or molokhia were arranged in the sub plots.
 Place and Duration of Study: This investigation was carried out during the two successive summer seasons of 2021 and 2022 at Soil Salinity Laboratory Research, Alexandria Governorate, Agricultural Research Center.
 Methodology: Four levels of saline irrigation water were applied having EC of 625 (tap water as a control), 2000, 4000 and 6000 ppm which was applied as necessary according to soil field capacity (27.85%).
 Results: Generally, all the studied traits, of okra and molokhia, decreased as the salinity level increased except for the spines of edible pods which was in contrast, in both seasons. There were significant differences among the studied eight landraces of okra and the studied five landraces of molokhia for all the studied traits in both seasons. Edible pods yield/plant of Behera landrace was not significantly affect by irrigation at salinity levels up to 2000 ppm of salinity level in 2022 season. Moreover, Alexandria and Gharbya landraces were the least affected by increasing salinity levels comparing with the rest of landraces in both seasons. With respect to molokhia, Fresh leafy yield/plot of Alexandria landrace was not significantly affected by irrigation at salinity levels up to 2000 ppm of salinity level in the first seasons.
 Conclusion: It can be recommended to cultivate Behera, Alexandria and Gharbya landraces of okra and Alexandria and Kafr Elsheikh landraces of molokhia when irrigation with relatively high levels of salinity, as these landraces were relatively less affected by increasing salinity concentration. These landraces can also be introduced into breeding programs to improve them or develop new varieties that are more salt-tolerant.

Tobacco Smoking: Knowledge of Primary School Children and Impact of Educational Intervention in Alexandria Governorate, Egypt

window.dataLayer = window.dataLayer || []; function gtag(){dataLayer.push(arguments);} gtag("js", new Date()); gtag("config", "UA-72322659-1");

Spatiotemporal Monitoring of Urban Sprawl in a Coastal City Using GIS-Based Markov Chain and Artificial Neural Network (ANN)

Over the last two decades, globally coastal areas have urbanized rapidly due to various socioeconomic and demographic driving forces. However, urban expansion in towns and cities of the developing world has been characterized by entangled structures and trends exacerbating numerous negative consequences such as pollution, ecological degradation, loss of agricultural land and green areas, and deprived settlements. Substantially, spatial simulation of urban growth and their consequences on coastal areas particularly in Egypt is still very rare. Geospatial modelling coastal urban growth is crucial and has enormous potential for coastal land use transformation and urban sustainability. The key aim of this study was to analyze spatiotemporal changes (2010–2020) and simulate future dynamics (2030 to 2050) of land use/land cover (LULC) in Alexandria Governorate, Egypt. Artificial Neural Network–Multiple Layer Perceptron (ANN-MLP) and Markov Chain techniques were employed within the GIS platform to assess processes of land transitions and predict urban growth trends, patterns and dimensions. The forecasting process was based on three maps of LULC derived from classified Landsat images of 2000, 2010 and 2020. In addition, topographical, demographic, accessibility, proximity factors were generated and developed in the form of raster spatial parameters of urbanization driving forces. The findings revealed that the observed expansion of the built-up area during one decade (2010–2020) was 12,477.51 ha, with a decline in agricultural area (7440.39 ha) and bare land (4904.91 ha). The projected change was forecasted to be 71,544 ha by 2030 and 81,983 ha in 2040 with a total of 35,998 ha increase in the built-up area and residential expansion by 2050. Despite this expected pattern of rapid changes, urban growth will be shaped by the key drivers of proximity to coastline and agricultural land transformation. The analysis indicates that the vertical urban growth will be most likely dominant along the coastal zone due to the lack of vacant lands, whereas the horizontal urban expansion will primarily take place towards the east-northeastern and south-southeastern directions of the city. The present work provides a holistic framework for establishing initial coastal land use plans not only for planners and urban administrators in Alexandria but also for policymakers and coastal municipalities in developing nations.

Impact of Hazard Analysis Critical Control Point System (HACCP) Application for Production of High Quality and Safe Table Eggs at Alexandria Governorate

HACCP is an important system for producing safe eggs from poultry farms. Also, HACCP helps to reduce the risk of foodborne illnesses associated with eggs by ensuring that they are produced in a hygienic environment with proper sanitation practices. Therefore, 120 eggs representing 24 groups (5 eggs group) were collected from one poultry farm before and after the application of the HACCP system (12 groups before and 12 groups after application of HACCP system) located in Alexandria governorate. The obtained results revealed that the poultry farm after application of HACCP system produced safe eggs with lower aerobic bacterial count and yeast & mould counts than the results of the same farm before application of HACCP system. In addition, egg content from the farm after application of HACCP system is free from pathogenic microorganisms (Salmonella species and Escherichia coli), free from toxic elements (Lead and Cadmium) and free from veterinary drug residues. While the results from the same farm before application of HACCP system produced eggs with a higher incidence of total bacterial, yeast & mould count. Besides, two groups of egg from the same farm before application HACCP system were contaminated with Salmonella species which serological identified into Salmonella enteritidis; also, three groups contaminated with Escherichia coli which serologically identified into O91: H21 (EHEC) (2 isolates) and O2: H6 (EPEC) (1 isolate); In addition, egg content from this farm before application HACCP is contaminated with toxic elements such as lead and cadmium with incidence level 75 % and 66.7%, respectively. Finally, examination of veterinary drug residues in the farm before application of HACCP system indicated presence of Tylosin and Oxytetracycline residues in 7 egg groups. Therefore, the application of the HACCP system in poultry farms is essential for ensuring the safety of the eggs produced.

Chemical and Microbiological Spoilage of Canned Meat Products

Canned meats are a popular food source that provides protein and the advantage of extended shelf life. However, these products are carbohydrates, fats, vitamins to chemical and microbiological spoilage that can cause changes in their texture, flavor, and odor. Therefore, 60 random samples of locally manufactured canned food were collected from different supermarkets in Alexandria governorate, which were divided into three groups 20 each of canned beef, canned chicken, and canned fish. The obtained results revealed that the mean values of FFA, TVN, and TBA of canned beef, chicken, and fish were 1.17±0.08, 1.07±0.08 & 1.27±0.01; 0.12±0.05, 0.13±0.05 & 0.12±0.04 and 13.4±0.89, 12.75±0.44 & 14.52±0.73, respectively, while the mean of TMA in canned fish was 0.64±0.04 mg/100g. Regarding microbiological quality, the mean values of the aerobic bacterial count were 1.85×104±0.49×104, 1.1×104± 0.47×104, and 7.84×103±2.13×103 Cfu/g in examined canned beef, chicken, and fish products; the mean values of anaerobic bacterial count in the same products were 1.02×104±1.23×104, 0.52×104±0.70×104, and 6.0×103±9.01×103 Cfu/g, respectively. All chemical and bacteriological parameters compared with Egyptian and international standards. Bacillus cereus was detected in 25, 20 and 15% of examined canned beef, chicken, and fish products. On the other hand, Clostridium perfringens couldn’t be detected in any examined canned meat products. Contaminated canned meat products highlighted the need to implement food safety systems such as HACCP during the manufacturing of meat meals.

Spatial Distribution Patterns and Relative Abundance of Culex Mosquito Larvae in Alexandria Governorate, Egypt

Spatial Distribution Patterns and Relative Abundance of Culex Mosquito Larvae in Alexandria Governorate, Egypt

Diseases problems in cluttered sea bass Dicentrarchus Labrax reared in cages from Fingerlings until marketing size in Mariout Valley at King Mariout in Alexandria province

This study aimed to determine and identify the common bacterial infection in different stages of cultured sea bass during the different season. In addition Eexperimentally infected the sea bass with the Vibrio alginolyticus and Vibrio parahemolyticus. The aquarium trial was carried out with European seabass (Dicentrarchus labrax) in private fish farm at Borg El-Arab, Alexandria governorate Egypt. At total 50 of seabass was used during the study. The study lasted 10 weeks, starting with 50 ± 5 gram /fish. Prior to the start of the trial, the fish were fed with a commercial diet (45 percent CP, crude protein). Water quality parameters were monitored during fish acclimatization and throughout the trial. Water temperature, pH and dissolved oxygen remained within acceptable ranges for marine production during the trial. Our study concluded that, Vibrio alginolyticus and Vibrio parahemolyticus causes a great losses in cluttered sea bass Dicentrarchus Labrax reared in cages The presence of histopathological lesions in the internal organs clearly explained the septicemic nature of Vibrio infection. Altogether, the full confirmation of Vibrio infection ought to incorporate, examination of fishes for the visible clinical signs, postmortem examination, isolation of the causative agent using specific media and biochemical tests, and histopathological examination of the internal organs as a proof of septicemic nature of the Vibrio infection. The sensitivity test revealed sensitive to ciprofloxacin (Cipro 5μg), novobiocine (NV 30 μg), intermediate sensitivity was found to Oxytetracycline (OT 30 μg) while, the resistance was observed to amoxicillin (Aml 10 μg) and colisitine sulphate (CT 10 μg)

Predictors of progression to end-stage renal disease among patients with polycystic kidney disease type 1 in Alexandria Governorate Egypt

Predictors of progression to end-stage renal disease among patients with polycystic kidney disease type 1 in Alexandria Governorate Egypt

Streptococcosis in Sea Bream Sparus auratus with Special Reference to its Control by A Medicinal Plant

Isolation and identification of S. agalactiae from cultured sea bream by different microbiological methods, mortality rate, clinical signs, and postmortem lesions in sea bream in naturally and experimentally inoculated with a field sample of S. agalactiae. The aquarium trial was carried out with sea bream (Sparus auratus) in private fish farm at Borg El-Arab, Alexandria governorate Egypt. At total 50 of sea bream (Sparus auratus) was used during the study. The study lasted 10 weeks, starting with 50 ± 5 gram /fish. Prior to the start of the trial, the fish were fed with a commercial diet (45 percent CP, crude protein). Water quality parameters were monitored during fish acclimatization and throughout the trial. Water temperature, pH and dissolved oxygen remained within acceptable ranges for marine production during the trial. Our results concluded that, Streptococcus spp. (specifically S. agalactiae) is very pathogenic as they can affect sea bream which become a perfect host for Streptococcus infection. In addition, water quality parameter plays an important role in sea bream farming. In more specific, an optimum water quality parameter should be maintained to prevent “stress’’ in fish that can lead to outbreaks of disease. It can be concluded that the medicinal plant can help in prevention and control of bacterial infection in cultured fish, and because of their high resistance, to most antibiotics utilization in the prophylaxis or treatment of S. agalactiae infection should be avoided. The farmers must be used such approach to applied in the protocol of prevention of such infection in stead of chemotherapy.

An Economic Study of Fishing Boats of the Canary Type in the Waters of the Mediterranean Sea in Alexandria Governorate

An Economic Study of Fishing Boats of the Canary Type in the Waters of the Mediterranean Sea in Alexandria Governorate

Efficiency of Two Phytochemical Compounds and a Biopreparation on the Common Prevailing Land Snail Species in Alexandria Governorate, Egypt.

Efficiency of Two Phytochemical Compounds and a Biopreparation on the Common Prevailing Land Snail Species in Alexandria Governorate, Egypt.

Prevalence, Clinical Picture, and Risk Factors Associated with Diabetes Mellitus in Dogs in Alexandria Governorate, Egypt

Prevalence, Clinical Picture, and Risk Factors Associated with Diabetes Mellitus in Dogs in Alexandria Governorate, Egypt

Toxoplasma gondii and Neospora caninum Antibodies in Dogs and Cats from Egypt and Risk Factor Analysis.

Toxoplasma gondii and Neospora caninum are major protozoan parasites of worldwide distribution and significance in veterinary medicine and, for T. gondii, in public health. Cats and dogs, as final hosts for T. gondii and N. caninum, respectively, have a key function in environmental contamination with oocysts and, thus, in parasite transmission. Very little is known about the prevalence of T. gondii infections in dogs and cats in Egypt, and even less about the prevalence of N. caninum in the same hosts. In the current study, 223 serum samples of both dogs (n = 172) and cats (n = 51) were investigated for specific antibodies to T. gondii and N. caninum using commercially available ELISAs. A risk factor analysis was conducted to identify factors associated with seropositivity. Exposure to T. gondii was reported in 23.3% of the dogs and in 9.8% of the cats, respectively. In addition, N. caninum-specific antibodies were recorded in 5.8% of dogs and in 3.4% of cats. A mixed infection was found in two dogs (1.2%) and in one cat (2%). Antibodies to T. gondii in dogs were significantly more frequent in dogs aged 3 years or more and in male German Shepherds. As this breed is often used as watchdogs and was the most sampled breed in Alexandria governorate, the purpose "watchdog" (compared to "stray" or "companion"), the male sex, and the governorate "Alexandria" also had a significantly higher seroprevalence for T. gondii. No factors associated with antibodies to N. caninum could be identified in dogs, and no significant factors were determined in cats for either T. gondii or N. caninum infection. Our study substantially adds to the knowledge of T. gondii infection in dogs and cats and presents data on N. caninum infection in cats for the first and in dogs in Egypt for the second time.

Future Extension Needs for Fish cooperative Leaders and Fishermen in Alexandria and Beheira Governorates

Future Extension Needs for Fish cooperative Leaders and Fishermen in Alexandria and Beheira Governorates

Myeloproliferative Neoplasms in Three Governorates in Egypt: A Multicenter, Observational, Epidemiological Study

There is a scarcity of data on Philadelphia chromosome-negative myeloproliferative neoplasms (Ph-MPN): essential thrombocythemia (ET), polycythemia vera (PV), and primary myelofibrosis (PMF). This multicenter, observational, epidemiological study was conducted to collect data on patient characteristics, prevalence, incidence, treatment patterns, and impact of MPN on health-related quality of life (HRQoL) to identify the disease burden under routine medical practice in Egypt. During the period between March 2018 and December 2020, a total of 135 Ph-MPN patients from three Egyptian hospitals (one hospital in each of Cairo, Alexandria, and Assiut governorates) were included in the study: 41.5% from Lower Egypt, 39.3% from Greater Cairo, and 19.3% from Upper Egypt. About 62% were females and 57.8% were urban community residents. The majority (83.7%) did not have family history of cancer and none of the patients had family history of MPN. The prevalence and incidence of Ph-MPN were estimated to be 27-63 and 7-20 per 100,000 patients per year during 2008 and 2018, respectively (Figures 1 and 2, respectively). The predominant types of Ph-MPN reported were 34.8% of ET, 34.1% of PV, and 14.8% of PMF, with a median age of 44.4, 58, and 54.4 years, respectively. About 19% had thrombosis history: 7.4% with PV, 7.4% with ET, and 2.2% with MF. Splenomegaly was reported in 57% while hepatomegaly was reported in 13.3%. Cytogenetic and mutational analyses were done for 108 patients. Of which, 88% had JAK2V617F mutation. Fatigue was the most reported Ph-MPN-associated symptom as reported in 41.5%, followed by bone pain (25.9%), and abdominal discomfort (23.7%). Around 21% presented with co-morbidities, four of which had history of malignancy (prostate cancer; n=2, breast cancer; n=1, and acute myeloid leukemia secondary to MPN; n=1). Three patients (2.2%) died over the study duration. Hydroxyurea was the most commonly used medication for MPN (79.7%) followed by clopidogrel (11.4%). JAK2 inhibitors were used by 4.1% of the patients. At baseline, International Prognostic Scoring System (IPSS) scores indicated low risk, intermediate-1 risk, and high risk in 0.7%, 3%, and 0.7% of the MF group, respectively, while 10.3% of the MF group were unclassified. We found that IPSS did not change throughout the visits except for one patient who became high risk after being unclassified. At the end of the study, we found that Eastern Cooperative Oncology Group (ECOG) performance status significantly decreased throughout the visits (p=0.001); 31% had ECOG 0, 41.6% had ECOG 1, and 20.2% had ECOG 2, compared with 54.1% ECOG 0, 36.3% ECOG 1, and 7.4% ECOG 2 at baseline. HRQoL was assessed by the Myeloproliferative Neoplasm Symptom Assessment Form Total Symptom Score (MPN-SAF TSS). The TSS (median [interquartile range]) at baseline was 20 (24) and significantly increased to reach 24 (13) at the end of the study (p<0.001). Conclusion: This study showed that both prevalence and incidence of Ph-MPN in the catchment areas of Cairo, Alexandria, and Assiut increased from 2008 to 2018. In addition, patients with Ph-MPN have a severe disease burden and reduced HRQoL. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal