Predictors of asymptomatic cardiac events and prognostic value of cardiac biomarkers in chronic kidney disease patients

Patients with chronic kidney disease [CKD] are at increased risk of cardiovascular events; cardiovascular disease is a leading cause of death in patients with chronic kidney disease; Circulating biomarkers play a major role in the early detection of cardiovascular disease in those patients. To clarify the prevalence of asymptomatic different cardiac events in CKD and to explore the degree of elevation of N- terminal-pro-B-type Natriuretic Peptide [NT-pro-BNP] in asymptomatic cardiac patients with varying degree of CKD and the relationship between the elevation of this biomarker and the occurrence of these cardiac complications. This case-control study included 40 CKD patients and 40 controls; patients were recruited from nephrology unit of internal medicine department; Assiut university hospital; known to have chronic kidney disease in different grades [grade I- grade V]. Resting transthoracic echocardiography [TTE] and plasma NT-pro-BNP concentrations were measured in patients who were asymptomatic for clinical evidence of any cardiac events, [n=40; mean age 47.63 +/- 17.93 years; 52.5%were males] as well as healthy volunteers n=40; mean age 42.00 +/- 13.25; 62% were males]. In addition, the correlation between plasma NT-pro-BNP concentration and parameters of echocardiography was examined. Increased prevalence of left ventricular hypertrophy [LVH] [70%]; left ventricular diastolic dysfunction [77.5%], left ventricular systolic dysfunction [17.5%] and coronary artery disease [27.5%] in CKD patients as well as serum NT-pro-BNP levels in the patients were significantly higher [6703.75 +/- 2947.68 pg/ml] than those in healthy volunteers [124.83 +/- 140.40 pg/ml] [p=0.000]. NT-pro-BNP level was higher also in patients who had hypertension [p=0.002]; anemia [p-0.004]; hypoalbuminamia [p=0.000];left ventricular hypertrophy [LVH] [7873. 57 +/- 2719. 31 pg/ml] [p = 0.000], diastolic dysfunction [7524. 52 +/- 2824.74 pg/ml] [p= 0.000]; systolic dysfunction [10371.43 +/- 2771.71] [p=0.000] and patients who had segmental wall motion abnormality [SWMA] [8709.0.9 +/- 3512.3.9] [p=0.000] and correlate Positively with C reactive protein [CRP] level [r-0.751 p=0.000]; left ventricular mass [LVM] [r=0.772 p=0.000] and left ventricular mass index [LVMI] [r=0.715 p=0.000] and negatively with ejection fraction [EF] by echocardiography [r=-0.483 p=0.000]. NT-pro-BNP level elevation in asymptomatic patients with CKD reflects underlying cardiac dysfunction, ischemic heart disease and hypertrophy independent of renal function

Nailfold capilloroscopy in systemic lupus erythematosus

Nailfold capillaroscopy is a non-invasive technique to recognize peripheral microangiopathy, which is an important feature in SLE. To study the prevalence of nailfold capillaroscopy [NFC] changes in patients with systemic lupus erythematosus [SLE], find out the patterns of these changes and to correlate these findings with different clinical and laboratory parameters. Forty patients with SLE, all fulfilling the 1997 revised criteria for the classification of SLE were included. All patients included in this study were subjected to full history taking, clinical examination, laboratory investigations as well as nailfold capillaroscopy [NFC] examination. The prevalence of nailfold capilloroscopic [NFC] changes in SLE patients was 75%. Nailfold capillaroscopic abnormalities were significantly more frequent in SLE patients than in controls [P < 0.05]. Different abnormal NFC changes were seen with the meandering pattern more frequently seen. The afferent and efferent capillary loops diameters were significantly increased in the SLE patients than in the control group [P < 0.05]. Some of the NFC abnormalities showed statistical significant correlations with different clinical and laboratory parameters. Capillary loop afferent and efferent diameters were significantly correlated with disease duration [P < 0.05] as well as the occurrence of digital gangrene [P < 0.05]. Also the capillary loop afferent diameter was found to be correlated with the intake of cyclophosphamide [P < 0.05]. Significant microcirculatory changes occur in systemic lupus erythematosus [SLE] patients as proved by the high prevalence of capillary abnormalities in lupus patients compared to controls by means of nailfold capillaroscopy. Some nailfold capillaroscopy changes e.g. meandering capillaries may complete picture of SLE diagnosis. Duration of SLE disease may have an impact on microcirculation of these patients. The presence of some nailfold capillaroscopy changes in SLE patients may be an alarming sign to fatal ischemia of the digits

Milk yield and growth performance of baladi and crossbred cows under north of nile delta conditions

Twenty four healthy lactating Baladi cows [local breed] and Friesian x Baladi cows [1[st] group] and their calves [2[nd] group] were studied during summer and winter seasons in North of Nile Delta of Egypt to investigate the effects of summer and winter conditions on the production efficiency. Milk yield [kg] during summer was lowest in the two breeds of cows when compared to values observed during winter. Lactating period was longer in crossbred than Baladi cows. Milk yield/day was higher in Friesian x Baladi than that in Baladi cows during both summer and winter. Milk components [fat, protein and total solids] were higher during winter than during summer at all times of testing, while an opposite trend was observed in milk lactose and solid non-fat [SNF] in the two breeds. Birth weight of calf and calf/dam percentage in Baladi breed was lower than the crossbreds during the two seasons. Breed of dam exerted a pronounced effect on birth weight, where purebred Baladi calves averaged 22.2, 24.8 kg which were lower than that crossbreds [31.0, 31.5 kg] during summer and winter, respectively that is not a maternal effect only it included the individual genetic effect as well. The calf/dam weight percentage in crossbred scored the highest percentage [7.36 and 7.32%] while the purebred Baladi calves means were 6.04 and 6.48% during summer and winter, respectively. The average weight of the animals in the two breeds increased as the animal grew with age; the increased weight during winter was greater than that during summer. The daily average growth rates during winter and summer were [0.487 vs 0.563 kg] and [0.475 vs 0.515 kg] in Baladi and crossbreds, respectively. In both breeds, live weight of calves at six months of age showed that, the calves which were heavier at birth [crossbred calves] were also heavier at six months of age. The means of calf weight at six months which were born during winter were greater than those born during summer. On the other hand, dam weight at calving, birth weight of calf, weaning weight for calf, average daily gain, lactation period and total milk yield were studied using records for Baladi and their crossbred cows covering the period from 1998 till 2007. Data were analysed for the effect of season and breed on milk production and growth performance

Microbiological assessment of sludge treatment at the 6[th] October wastewater treatment plant, Giza, Egypt

This study was carried out to assess the sludge treatment processes applied at the 6[th] October wastewater treatment plant [WWTP], Giza, Egypt. The applied processes included aerobic digestion followed by gravity thickening, filter-pressing and drying beds [in emergency cases]. Bacteriological, virological and parasitological evaluation was carried out. Results showed that aerobic digestion removed two log units of total and faecal coliforms and one log unit of Escherichia coli [E. coli] and feacal streptococci. The removal percentages of coliphage and enteroviruses after aerobic digestion were 97.0 and 58.3%, resectively. The salmonellae disappeared from sludge after aerobic digestion. Qualitative and quantitative decrease in helminth ova [Ascaris, Trichuris, Trichostrongylus, Taenia and Hymenoleois] was observed after aerobic digestion and thickening stages. An average decreae of 4 log units for total and faecal coliforms, 3 log units for each of faecal streptococci and coliphage and 2 log units for E. coli through sludge treatment process was observed. Enteroviruses, helminth ova and enteric protozoa were completely eliminated from sludge after 6 months in drying beds. The loads of faecal coliform, E coli, faecal streptococci and coliphage in the dried sludge were 6.5 x 10[2], 1.6 x10[2], 4.5 x 10[2], 4.56 x 10[2] cfu and 8.5 x 10[1] pfu/g, respectively. Microbiological quality of the final treated sludge complied with the regulations of Untied States Environmental Protection Agency

High institute of nursing students perception of nursing as a career choice

The present study was done to assess the perception of the students of the first year, of the High Institutes of Nursing of the universities of Alexandria and Tanta of nursing as a career choice. The sample consisted of 200 students, 100 students randomly selected from each institute. A questionnaire was designed to collect the necessary data about the study subjects as well as their perception of nursing as a career choice, reasons for choosing it, their opinions regarding the advantages of nursing as a career, their opinions about reasons that induce "active nurses" to leave the profession, and their opinions regarding encouragement of a return to nursing profession. The findings revealed that the majority of the study sample in Alexandria and Tanta Universities [85%] perceived nursing as a career, while the minority of them did not perceive it as such. Nursing offers opportunities to manage a large group of people and to care for individuals, families and communities. Some students had misperception about nursing in the areas of considering nursing as a prestigious profession and designing and directing health programs. The findings also revealed that most of the study sample, both in Alexandria and Tanta choose nursing because they want to work with people. It is a job without a routine and a job with responsibility. The whole sample in Alexandria and Tanta stressed that they were put in the institute according to their total of marks attained in their GCE. They thought that the bad image of nursing, the nurses poor self-image, their low salary levels and other reasons induced "active nurses" to leave the nursing profession. Furthermore, the findings illustrated that it is very important to improve the nursing image both in hospitals and the community and to encourage a return to nursing profession

High Institute of Nursing [HIN] graduates' awareness regarding genetic counseling

The aim of this study is to assess graduate nurses awareness about genetic counseling. The sample consisted of 100 nurses from the University Maternity and Pediatric hospitals. A questionnaire was designed to collect the necessary data about the study subjects as well as about their awareness regarding genetic counseling, its definition, objectives, types, who seek help through genetic counseling, the proper time to diagnose genetic defects, where genetic counseling should be done, high risk groups, and role of the nurse in preventive intervention. The findings revealed that the H.I.N. graduates lacked the basic and essential information about genetic counseling as none of them had fair scores and 70% of nurses had poor scores. The lack of knowledge was great in certain aspects such as the objectives of genetic counseling, settings, high risk groups and finally the role of the H.I.N. graduate in preventive intervention. The factors that were significantly related to the H.I.N. nurses knowledge were age, occupation, marital status and years of experience. Discussion of results was done in the light of current literature and recommendations were made

Effect of a training programme on nurses knowledge of aspects of maternity care

The study was done to inquire about nurse knowledge, attitudes and practices that tanta nurse have regarding the preventive aspects of maternity care [BSE, pap smear and pelvic examination] and to find out the effect of training programme on their knowledge and attitides. The study was conducted on a selective basis, 50 nurses of different categories were selected for this study. The samples covered the different hospitals in Tanta and El Mahalla El Kobra. Of the fifty nurses who attended this programme, 26 were working in El Mabarrah hospital in El Mahalla El Kobra. The rest [24] were working in El Mabarrah and El Helal hospital and its related O.P. clinics in Tanta. They were equally divided into two groups. A structured pretest was designed and administrated to the nurses at the begining of the programme to collect hasic data, nurse's knowledge attitude and practices of BSE, pap smear and pelvic examination. The post test was administrated immediately after conducting the training programme to test the improvement in their knowledge and attitudes. The study revealed that most of nurses lacked the basic and essential knowledge in relation to BSE, pap smear and pelvic examination especially before the training programme. It also revealed that giving information and demonstration was significantly effective. It was also noticed that nurses who had correct and complete knowledge had favourable attitude toward BSE especially after performing the programme. The study also revealed that the main source of nurses' knowledge was gynaecologist, friends magazine, study and T.V.

Prevalence of premenstrual symptoms among HIN graduates

This study was done to find out the prevalence of perimenstrual symptoms among nurses and to find out the extent to which perimenstrual symptoms affect their work capacity and performance. The study was carried out at two different settings, on a randomly selected sample of 112 Higher Institute of Nursing graduates. They were interviewed according to a predesigned interview schedule. The results of this study revealed that premenstrual physical symptoms were quite prevalent and more severe among the study sample than psychologjcal perimenstrual symptoms. It was also observed that severe physical and psychological perimenstrual symptoms lead to undesirable consequences as lack of concentration and decreased work capacity and performance among nurses