ABSTRACT
Background: Human papillomaviruses [HPVs] are small epitheliotropic DNA viruses that can induce cutaneous and mucosal lesions and appear to be closely linked to skin cancers. A broad variety of HPV types which have been referred to as epidermodysplasia verruciformis [EV] HPVs. It was found that patients with psoriasis revealed high prevalence of EV-associated HPV, suggesting that EV-HPV can act as putative antigen contributing to the pathogenesis of psoriasis. In particular, some viral genotypes HPV-5 and HPV-36 have been associated with psoriasis
Objective: To assess the presence of HPV-5 DNA in skin of psoriatic patients, its relation to disease severity by using PASI score and correlation with phototherapy treatment. Design: Screening for the presence of HPV-5 DNA sequences in skin biopsies and scrapings from psoriatic patients without treatment [group A], with history of Psoralen-ultraviolet A [PUVA] treatment [group B], with narrow band ultraviolet B [NB-UVB] [group C] and skin biopsies from control [group D]
Patients and methods: Samples were taken from 54 patients with plaque type psoriasis [39 men and 15 women, mean age 52.8 years] including 25 patients in group A, 15 patients in group B [mean number of PUVA exposure 140], 14 patients in group C [mean number of NB UVB exposure 60] and 15 subjects in group D. DNA was isolated from skin samples and analyzed by polymerase chain reaction with the use of 2 nested primer systems specific for HPV type 5
Results: The rate of HPV DNA positivity was significantly higher in patient groups than control group with a percentage of 24% [6/25] in group A, 33.33% [5/15] in group B, 28.5% [4/14] in group C and 6.6% [1/15] in group D [P=0.003 and X[2]=25.9]. There was a significant difference between lesional and non-lesional areas of psoriatic patients regarding HPV-DNA positivity with P < 0.0001 and X[2]= 16.98. PASI score was highly significant P < 0.001 between HPV-5 DNA negative, positive and double positive psoriatic patients
Conclusion: Skin of psoriatic patients was a reservoir for HPV-5. The prevalence was high in lesional than non-lesional areas, while HPV-5 negative subjects seemed to have a less severe disease. PUVA and NB UVB treatment for psoriasis in optimum doses are not associated with increasing HPV-5 in psoriatic patients
ABSTRACT
The issue of healthcare error is one of great importance to the nursing profession. Identifying nurse's medication administration errors is assumed to improve patient care. Aim: to identify medication administration errors among nurses, and to develop guidelines to control medication administration errors. Subjects AND
Methods: This descriptive cross-sectional study was conducted at Ain Shams and El Demardash University Hospitals in 14 Internal Medicine units. The subjects were 100 nurses responsible for transcription, storage, and giving medications. Data were collected using a self-administered questionnaire for knowledge, an audit form of medication prescription and transcription, an observation checklist for nurses' performance, an attitude scale, and the Institute of Safe Medication Practice [ISMP] rating scale to assess hospitals environment in medication administration
Results: nurses in surgical departments had statistically significantly higher percentage of unsatisfactory knowledge related to pharmacology [100.0%], while nurses in ICU had statistically significantly lower percentages of unsatisfactory knowledge related to medication calculation [56.7%], route of administration [23.3%], preparation [80.0%], and administration of medications [76.7%]. Nurses' total performance was unsatisfactory among all of them in the three departments. ICU nurses had statistically significantly lower percentages of performance errors in prescription [60.0%] and transcription [80.0%]. All nurses in the three departments had errors with calculation of IV rates. Nurses in the ICU had statistically significantly lower percentages of errors related to omission, and wrong medication/solution, 16.7% and 0.0%, respectively. Internal medicine nurses had statistically significantly higher percentage of errors related to extra-dose [100.0%]. All nurses had errors related to dose and route. Nurses in the ICU had statistically significantly lower percentages of errors related to wrong time [30.0%]. All nurses in the three departments had total negative attitudes related to medication administration, safety, and accountability. Assessment of safety of medication stock and environment showed no errors related to human resources in all the three departments. Conversely, all of them, had errors related to physical resources. A moderate statistically significant positive correlation [r = 0.55] was revealed between attitude and practice, while knowledge was weakly correlated to attitude [r = 0.23] and performance [r = 0.28]
Conclusion: it is concluded that all nurses showed medication administration errors, and were having inadequate practice during medication administration, and the majority had unsatisfactory knowledge, and negative attitudes. It is recommended that hospitals should establish policies concerning medication administration, and each nurse should be clearly acquainted with such policies. In-service training programs for continuous upgrading of nurses' knowledge and skills related to medication administration are urgently needed. Lastly, hospitals should establish Medication Errors Identification Teams
ABSTRACT
The present study comprised 48 vitiligo patients; 31 of them were not treated and the remaining 17 patients were on PUVA treatment for 6 months. They were subjected to thorough history taking and clinical examination. Vitiligo was associated with other autoimmune diseases in six patients in the form of alopecia areata [three patients], diabetes mellitus [two patients] and thyroid disease [one patient]. The melanocyte cultures were used as an antigen in the immunofluorescence [IF] and ELISA test using sera from the vitiligo patients and 20 control subjects. IF was positive in 54.2% in vitiligo sera in comparison with 5% positivity in the control sera. ELISA was positive in 77.1% in the vitiligo sera and in 20% of the control sera. Patients who were treated with PUVA had lower positive results to both IF and ELISA with a significant decrease in the optical density [OD] than the untreated patients. Thus, the IF is more specific for the detection of antibody in vitiligo serum against melanocytes whereas ELISA is more sensitive and more accurate