Device-associated infection rates in adult and pediatric intensive care units of hospitals in Egypt. International nosocomial infection control consortium [INICC] findings

To determine the rate of device-associated healthcare-associated infections [DA-HAIs] at a respiratory intensive care unit [RICU] and in the pediatric intensive care units [PICUs] of member hospitals of the International Nosocomial Infection Control Consortium [INICC] in Egypt. A prospective cohort DA-HAI surveillance study was conducted from December 2008 to July 2010 by applying the methodology of the INICC and the definitions of the NHSN-CDC. In the RICU, 473 patients were hospitalized for 2930 d and acquired 155 DA-HAIs, with an overall rate of 32.8%. There were 52.9 DA-HAIs per 1000 ICU-days. In the PICUs, 143 patients were hospitalized for 1535 d and acquired 35 DA-HAIs, with an overall rate of 24.5%. There were 22.8 DA-HAIs per 1000 ICU-days. The central line-associated blood stream infection [CLABSI] rate was 22.5 per 1000 line-days in the RICU and 18.8 in the PICUs; the ventilator-associated pneumonia [VAP] rate was 73.4 per 1000 ventilator-days in the RICU and 31.8 in the PICUs; and the catheter-associated urinary tract infection [CAUTI] rate was 34.2 per 1000 catheter-days in the RICU. DA-HAIs in the ICUs in Egypt pose greater threats to patient safety than in industrialized countries, and infection control programs, including surveillance and guidelines, must become a priority

Spectrophotometric analysis of cefepime through its Hg [I] complex

A spectrophotometric procedure -was developed for determination of cefepime depending on the complexation of the drug with Hg[2][NO[3]]2 in acid medium [pH 3.5] and measuring the absorbance at 263 nm. Different variables affecting the reaction were studied and optimized. Under the optimized conditions, linear relationship with good correlation coefficient [0.999] was found between the absorbance and the concentration in the range of 3.65-40 microg ml[1] . The limits of detection and quantitation were 1.20 and 3.65 microg mt[1] respectively. The stoichiometry of the reaction was studied using Yoe and Jones method and was found to be 1:2 ratio for cefepime: Hg [I]. The method was successfully applied for determination of cefepime in its vial with average percentage recovery of 98.95 +/- 1.079. The results were favorably compared with those of reference method. The IR study of the formed complex was done and different probabilities of the formed complexes were suggested

Analysis of paracetaiiviol and ascorbic acid in pharmaceutical binary mixture

Two simple and sensitive spectrophotometric methods were developed for the determinagion of paracetamol [I] and ascorbic acid [II] in pharmaceutical binary mixture. The first method depends on the use of the first-derivative spectrophotometric technique for the slinultaneons determination of components of the mixture. The second method depends on the reaction of the studied drugs with 5-diazo-1, 2, 4-triazol-3-carboxylic acid [DTCA] reagent to give colored products measured at 480 nm and 580 nm for [I] and [II] respectively. All variables affecting reaction conditions were optimized The proposed methods were successfully applied for the analysis of the studied drugs in their pare and commercial dosage forms and are in good agreement with those obtained from the reported methods. No significant difference in the acuracy and precision as revealed by the accepted values of t- and F-tests, respectively. Molar ratios of the drugs with the colorimetric reagent [DTCA] were determined and the reaction mechanisms were suggested

Spectrofluorimetric method for determination of some oxicams using potassium bromate

A sensitive and selective spectrofluorimetric method has been developed for the determination of some non-steroidal anti-inflammatory oxicams derivatives namely; tenoxicam [Tx], piroxicam [Px] and lornoxicam [Lx] after their complete oxidative acidic hydrolysis to 2-aminopyridine. The hydrolytic product 2-aminopyridine exhibits fluorescence emission at 365 nm [excitation at 305 nm]. The optimal conditions of the reaction were investigated. The method was found to be linear in the ranges of [0.015-0.500 micro g/ml] for Tx [0.006-0.300 micro g/ml] for Px and [0.060-0.200 micro g/ml] for Lx. The suggested method was successively applied for the determination of the studied drugs in different dosage forms with a recovery percentages ranged 96.82-102.79 +/- 0.614-2.578. The method was also applied for the determination of the drugs in spiked urine with a recovery percentages ranged 80.51-105.35 +/- 1.067-/+5.338. The validity of the method was assessed according to USP guidelines > Statistical analysis of the results reveled high accuracy and good precision

Utility of certain spectrofluorimetric methods for analysis of two pharmaceutical binary mixtures

Simple and very sensitive spectrofluorimetric methods were developed for determination of adrenaline [I] -procaine hydrochloride [II] mixture and salbutamol sulfate [III] - guaifenesin [IV] mixture. adrenaline [I] in the first mixture was determined by coupling with 5-diazo-l,2,4-triazolo-3-carboxylic acid [DTCA] reagent in alkaline medium forming fluorigenic product which can be measured at 340 nm [lambda ex. 245 nm], while procaine hydrochloride [II] gave no fluorescence. salbutamol sulfate [III] was analyzed by reaction with ethyl acetoacetate [eaa] forming coumarin derivative, which can be measured at 320 nm lambda ex. 280 nm]. guaifenesin [iv], the second drug in mixture has a considerable native fluorescence in methanol was measured at 310 nm [lambda ex. 230 nm]. all variables affecting reaction conditions were optimized. linear correlations were obtained over the range of 19-100, 37-400 and 22-150 ng/ml for [I], [III] and [IV], respectively. the proposed methods were successfully applied for the analysis of the studied drugs in their pure and commercial dosage forms and the obtained results were in good agreement with those obtained from the reported methods; no significant difference in the accuracy and precision as revealed by the accepted values of t-and f-tests, respectively

Spectrophotometric determination of certain drugs using ammonium cerium [IV] sulfate and p-dimethylaminobenzaldehyde

A spectrophotometric method for the determination of acetylcysteine, captopril carbimazole propylthiouracel and thiopental sodium is described. The method was based on the oxidation of the studied drugs with excess ammonium cerium [IV] sulfate. Followed by measuring the excess unreacted ammonium cerium [IV] sulfate, through reaction with p-DMAB into the corresponding p-dimethylaminobenzoquinone, which has a red colour can be measured at 464 nm. The decrease in the absorption intensity at 464 nm caused by the presence of the investigated drugs is directly proportional to their concentration. Investigations were carried out to study all variables and a validation study for the proposed procedure according to USP 2002 was also performed. Beer's law was obeyed in the range of 1-40 micro.g/ml. The detection limit ranged from 0.22-1.22 micro g/ml, while the quantitation limit ranged from 0.73-4.06 micro g/ml. The proposed method was successfully applied for the analysis of the studied drugs in pharmaceutical preparations with good recoveries in the range of 98.12-100.02%. Results were compared with those obtained from the pharmacopoeial or reported methods

Oxidized diphenylamine as a spectrophotometrec reagent for the determination of some pharmaceutical thiols and thioamides

Oxidized diphenylamine is newly utilized as a redox spectrophotometric reagent for the determination of six pharmaceutically important thiol and thioamide drugs named: acetylcystiene, captopril, carbimazole, propylthiouracil, thiopental sodium, and tiopronin. The method is based on measurement of the decrease in absorption intensity of the oxidized diphenylamine [diphenylbenzidine violet, lambda max = 580 nm] reagent as a result of the reduction effect of the analysed drugs This reagent was instantaneously prepared by the oxidation of diphenylamine using ferric sulphate in sulphuric acid medium. The molar ratio of the chromogen reagent was determined to be 2:1; diphenylamine: iron [III]. The decrease in colour intensity was found to be quantitatively dependent on drug concentration. Experimental variables including reagent concentration, acid type and concentration, dilution solvent, reaction time, temperature and stability were studied and optimized. Validation parameters including linearity range, detection and quantitation limits, precision, selectivity and robustness were evaluated. The proposed method was found to be simple, sensitive and accurate one indicated by the studied validation parameters. Good recoveries [98.0 +/- 0.14 - 100%, +/- 0.98] were obtained by the suggested method and it was applied for the determination of the studied drugs in many pharmaceutical dosage forms available in the local market. Good agreement, indicated by acceptable t- and F- tests, was found between results obtained by the suggested method and those obtained by the reported or pharmacopoeial methods

Normal virtual endoscopic anatomy of the upper airway

Virtual endoscopic examination is an easy, accurate and non-invasive tool for evaluation of the endoluminal airway. Normal anatomy of the generated views should be studied by heart for any radiologist who wants to enter this challenging and amazing field. Twenty patients were selected with normal airway and they were examined by helical CT with a pitch factor of 1.5 and axial overlapped cuts were obtained. The raw data were transferred via a local area network to the [Easy Vision] workstation where the virtual endoscopic views were generated. Comparison with the normal conventional endoscopic examination was done. The data obtained from the virtual endoscopic were identical to that obtained from the conventional endoscopic examination. The aim of this work is to emphasis upon the normal virtual endoscopic anatomy of the upper airway for the radiologists going to enter this interesting field for better orientation and easy picking up of the pathological lesions

MRCP as compared to ERCP in patients with obstructive jaundice

Magnetic resonance cholangiopancreatography MRCP was performed in 300 consecutive patients with clinical diagnosis of obstructive jaundice. These patients were divided into three groups. Group one included 120 patients in whom ERCP was performed within 72 hours prior or after MRCP. Group two included 20 patients in whom ERCP was failed [12 patients] and patients refused the procedure [8 patients]. Group three included 160 patients in whom MRCP was done as the primary diagnostic modality. Ultrasonography was done in conjunction with MRCP in all groups. The results of MRCP matched that of ERCP as regards to the determination of presence or absence of obstruction and its level. ERCP has a major advantage of its ability to perform a therapeutic drainage procedure simultaneously with imaging which was not possible with MRCP

role of distribution of malasezia furfur serovars, propionibacteria and micrococcaceae in the pathogenesis of tinea versicolor and seborrhoeic dermatitis

This study was designed to compare the distribution of M. Furfur serovars [A, B and C], Propionibacteria and Micrococcaceae on the chest, face, back and scalp of 40 patients with tinea versicolor [TV] and ten matched controls and 40 patients with seborrhoeic dermatitis [SD] and ten matched controls. The patients and controls were sampled from the mentioned sites and cultured aerobically for Micrococcaceae and M. furfur and anaerobically for Propionibacteria. Serotyping of M. Furfur was carried out to identify the three serovars A, B and C. There was no difference in either the Micrococcaceae or Propionibacteria results in patients groups compared with control skin. Regarding the results of M. furfur, serovar A predominated in the back lesions in both patients groups when compared with the control. Serovar A was also predominant in the face lesions but only in seborrhoeic dermatitis patients, serovar C predominated in all sites [in both patient groups] and serovar B predominated in all lesions of TV patients and in the back, face and neck in SD patients

Detection of some types of human papillomaviruses in skin tags

Human papilloma virus [HPV] DNA of types 6, 11, 16, 18, 31, 33, 52b and 58 was searched by polymerase chain reaction in skin tag biopsies, mononuclear cells, sera and normal skin of 28 patients with multiple skin tags and in 10 normal subjects. Histopathological examination of skin biopsies was done. Fasting blood glucose, serum cholesterol and triglycerides were determined in patients and controls. The results showed that 96% of the patients had HPV DNA in their skin tags, 71% had HPV types 6 and 11 and 25% had HPV types 16 and 18, in addition to type 6 and 11. The histopathological examination revealed an increasing epithelial hyperplasia, hyperkeratosis and parakeratosis and increasing epidermal cells with perinuclear membrane irregularities in 25% of the cases with mixed viral infections. Only HPV DNA of types 6 and 11 was detected in mononuclear cells of the patients and in their sera

Effect of Grewia asiatica and peganum harmala on blood glucose levels of normal and alloxan-diabetic rabbits

The alcoholic extracts of the stem of Grewia asiatica and seeds of Peganum harmala were administered in doses A 250 mg/kg, 300 mg/kg and 350 mg/kg body weight to normal and alloxan - diabetic rabbits. The blood glucam levels were estimated before and 2, 4, 6 and 8 hours after the administration of the extract. The extract of Grewia asiatica exerted a significant [P<0.05] hypoglycaemic effect in normal rabbits. The hypoglycaemic effect was nil significant [P>0.01] in alloxan-diabetic rabbits. The extract of Peganum harmala did not produce any significant [P>0.01] hypoglycaemic effect in normal as well as in alloxan-treated-diabetic rabbits. From this study it may 6e concluded that the extract of Grewia asiatica acts by initiating the release of insulin from pancreatic Beta cells d normal rabbits. Moreover, Peganum harmala, which is used as an anti-diabetic in folk medicine, did not show any hypoglycaemic effect in normal as well as in diabetic rabbits

Antidiabetic activity of indigenous plants

This study deals with the effects of alcoholic extracts of seven indigenous plants on blood glucose levels of normal and alloxan induced diabetic rabbits. The blood glucose levels were estimated before and 2, 4, 6 and 8 hours after the administration of a single oral dose [500 mg/kg] of each extract. The extracts of six plants did notproduce significant hypoglycaemic effect in normal or alloxan treated diabetic rabbits. except the extract of one plant, Ficus bengalensis which exerted a significant hypoglycaemic effect [P < 0.05] in both normal and alloxan induced diabetic u rabbits. From this study, it can be concluded that Ficus bengalensis can be effective in the control of diabetes mellitus at least in animel models. Study for human use and safety need to be carried out

comparative study of effects of gymnema sylvestre extract, tolbutamide and metformin on blood glucose levels of normoglycaemic and hyperglycemic rabbits

The watery extract of the leaves of Gymnema sylvestre was administered in doses of50, 100, 150 and 200 mg/kg body weight to normo-glycaemic and ACTH induced hyperglycaemic rabbits. The blood glucose levels were estimated before and after two, four and six hours of the administration of the extract. The extract exerted a significant [P < 0.001] hypoglycaemic effect in normolglycaemic and hyperglycaemic rabbits. The mean percent decreases in blood glucose levels produced by Gymnema sylvestre in normoglycaemic rabbits were compared with those produced in hyperglycaemic rabbits at various time intervals and the differences were highly significant [P< 0.001]. The maximum decrease in blood glucose, at all dosage levels, in normoglycaemic and hypergylcaemic rabbits was observed at six hours. Gymnema sylvestre extract in a dose of 150 mg/kg produced maximum decrease in blood levels of both normoglycaemic and hyperglycaemic rabbits. The mean percent decreases in blood glucose levels produced by 150 mg/kg of Gymnema sylvestre were compared with those produced by 250 mg/kg of tolbutamide at respective time intervals in normoglycaemic and hyperglycaemic rabbits. In normoglycaemic rabbits, the differences were not significant [P > 0.01]. In hyperglycaemic rabbits, however, the differences were highly significant [P< 0.001]. The mean percent decreases in blood glucose levels, produced by 150 mg/kg of Gymnema sylvestre were also compared with those produced by 250 mg/kg of tolbutamide at respective time intervals in normoglycaemic and hyperglycaemic rabbits. In normoglycaemic rabbits, the differences were not signifiacant [P> 0.01]. In hyperglycaemic rabbits, however, the differences were highly significant [P < 0.001]. From, this study, it may be concluded that extract of Gymnema sylevestre possesses a significant and consistent hypoglycaemic effect in normoglycaemic and hyperglycaemic rabbits. Thus it may be recommended in the treatment of hyperglycaemia due to diabetes mellitus