ABSTRACT
Background: cognitive control refers to the ability to regulate, coordinate, and sequence thoughts/actions in accordance with the current task goals. It comprises a set of components including task switching, updating and response inhibition and coordinating multiple simultaneous operations. The fronto parietal network has been suggested as a neural basis for cognitive control. Liver transplantation is one of the most dynamic fields in modern medicine and is a lifesaving option for patients with end stage liver disease. Since the first successful transplantation in 1967, liver transplantation has been performed in many centers worldwide saving thousands of liver failure patients
Aim of the Work: based on that, our study aimed to assess cognitive functions, depression, and anxiety in patients with end stage liver disease before and after liver transplantation, then compare between both
Patients and Methods: the study involved convenience sample of 44 recipients with ESLD prepared for liver transplant, 30 of which completed the study and 14 cases dropped out
Results: all data were recorded and statistical analysis was done using the Statistical Package for Social Science SPSS- 20th version. The results were tabulated, grouped and statistically analyzed using the suitable statistical parameters. For description analysis
Conclusion: more liver impairment as estimated by Child Pugh score and MELD score associated with more impairment in cognitive tasks. In the current study the presence or absence of hepatic encephalopathy had no relation to cognitive function
ABSTRACT
Immune thrombocytopenia [ITP] is an autoimmune disease characterized by a decreased platelet count [Less than 100*109/L] due to destruction of antibody - senitized platelets in the reticuloendothelial system [RES]. ITP in children has a varied course and according to duration is distinguished as newly diadnosed [<3 months], persistent [3-12], and chronic [>12] types. Several studies have evaluated the prognostic factors for the progression of the disease. We aimed in this prospective study to identify prognostic parameters for the disease in 44 children in the period from October 2015 to November 2016 at Mansoura University Children Hospital [ MUCH] and Mansoura health Insurance Hospital [MHIH]. Information regarding age, gender, preceding infection, bleeding type, duration of symptoms and platelet count at diasgnosis, treatment type, and antiglycoprotien antibodies was recorded. This study is degined to determine, the prognostic, that could predict the disease course at diagnosi, estimate the presence of antibodies at disease onset and evaluate whether the antibody pattern at disease onset can predict the course of the disease, i.e. acute or chronic and evaluate treatment types and outcome in children with ITP from the studied cases 33 children had newly diagnosed and 11 chronic disease. Chronic ITP children had gradual initiation of the disease, higher initial platelet count compared to newly diagnosed group. Cutaneous bleeding was found in all cases. None of the children exhibited life threatening bleeding. Primary immune thrombocytopenic purpura [ITP] in childhood is usually a self - limiting disorder lasting a few weeks or months, but in approximately 25% of the children, the condition becomes chronic, defined as thrombocytopenia [platelet count less than 150*109/L] persisting for longer than 12 months from the onset of illness. In conclusion, even though ITP in children usually has a self-limited course, with rare serious bleeding complications, the chronic from of the disease in characterized by different predictive parameters, which can be used in clinical practice
ABSTRACT
Background: Near miss cases share many characteristics with maternal deaths and can directly inform about obstacles that had to be overcome after the onset of an acute complication, hence providing valuable information on obstetric care. This allows for corrective action to be taken on identified problems to reduce related mortality and long-term morbidity
Objective: The purpose of this study was to determine the efficacy of possible interventions [in the form of monthly clinical audit for new near miss cases and feedback strategy] in reducing maternal near miss cases in El Galaa Teaching Hospital in Egypt and improving WHO indicators of maternal health
Methods: The study was conducted over 3 stages: Stage I [Formative Stage]: Is a retrospective study of maternal near miss cases over 1 year period, based on WHO criteria from 1/1/2016 to 1/1/2017. Stage II [Intervention stage]: This incorporated a monthly clinical audit for new near-miss cases and feedback strategy, using WHO case report forms, as well as engagement of opinion leaders for 1 year from 1/1/2017 to 1/1 2018 with 2 to 3 cases discussed monthly. Stage III [Assessment Stage]: Evaluating the clinical performance and frequency of near miss cases after intervention
Results: In this study, the majority of women with potentially life threatening conditions were referred from private obstetrician clinic, private hospitals and Ministry of Health to El Galaa hospital. The majority of Maternal near miss cases [67.9%] gave birth by Caesarean section, this was because of the severity of these patients' obstetric conditions usually requires urgent action. The main life threatening conditions among women in this study were hypertensive disorders of pregnancy 41% [24% Pre-eclampsia, 15% Eclampsia, 2% chronic hypertension]
Conclusion: Our intervention [near miss clinical audit] helped to improve the performance and quality of care provided to women with complications during pregnancy, as reflected on the maternal health outcome indicators. Therefore we recommend incorporating clinical audit process in all health facilities. The Maternal mortality index and Maternal near miss mortality ratio, two of the indicators recommended by WHO, can be used to monitor and assess the performance and health care level. Health managers and policy makers should use maternal health outcome indicators for allocation of resources and prioritization of investments
ABSTRACT
@#Background: Improving awareness, knowledge and attittude (AKA) of teachers and students about epilepsy is an important step to reduce the stigma experienced by children with epilepsy. To date there are no studies evaluating effectiveness of an information technology based epilepsy education programme in improving AKA among teachers and students. Method: Cross-sectional study was to assess the baseline AKA of epilepsy among Malaysian teachers and secondary school students, and to examine effectiveness improving their AKA using the Interactive Animated Epilepsy Education Programme (IAEEP). AKA of teachers and students were assessed pre- and post-implementation of IAEEP. Results: Total of 54 teachers and 67 secondary students participated in this study. The baseline AKA on epilepsy among Malaysian teachers was low in the awareness domain, moderate in the knowledge domain, and positive in the attitude domain. The baseline AKA on epilepsy among students was very low in the awareness domain, low in the knowledge domain, and indifferent in the attitude domain. The AKA scores in all domains of teachers and students improved significantly after introduction of IAEEP (P<0.001). Post-IAEEP the AKA of teachers was moderate in the awareness domain, high in the knowledge domain, and very positive in the attitude domain; the AKA of students was low in the awareness domain, very high in the knowledge domain, and very positive in the attitude domain Conclusion: Our findings highlight a need for epilepsy educational programmes to be implemented in Malaysian schools. The IAEEP is an effective educational programme to improve the AKA particularly in the knowledge domain among teachers and students
ABSTRACT
Aim of the work: a descriptive study including analysis of HRCT chest done for patients known to have collagen diseases for diagnosis and classification of interstitial lung diseases
Patients and methods: forty five patients were included in our study [23 rheumatoid arthritis, 14 systemic lupus erythematosis and 8 scleroderma]. This was a retrospective study that included patients with collagen diseases either outpatients or referred from the Rheumatology Departement at Ain Shams University Hospitals to the Radiodiagnosis Department for HRCT chest examination. HRCT chest images were interpreted for identification of lung interstitium architectural abnormalities associated with collagen diseases and they were statistically analyzed
Results: the mean age of the selected patients was about 42 years old. Parenchymal involvement was noted in 30 cases that represented 66.6% of included cases in the study, 15 cases had normal HRCT of the chest representing 33.4% of the cases
Conclusion: HRCT of the chest has a reasonable role in the diagnosis of interstitial lung diseases and has the ability to be classifying according to the pattern of involvement, distribution and extent of the disease as well as to estimate the severity and help in prognosis of the disease process
ABSTRACT
Open oesophagectomy may be associated with significant morbidity and mortality. With the increa-sing experiences in laparoscopic and thoracoscopic techniques, minimal invasive approaches to oesophagectomy are being explored to determine the feasibility, results, and potential advantages. Pyloroplasty is performed during oesophagectomy to avoid delayed gastric emptying and hence reduces the risk of aspiration pneumonia. By contrast, it has been argued that pyloroplasty is unnecessary as gastric outlet obstruction is a rare occurrence following oesophagectomy and that the procedure itself is associated with a number of complications. Aim: The aim of this study is to assess the safety of minimally invasive oesophagectomy without pyloroplasty. Methods: Retrospective cohort study was carried out of 90 consecutive surgically fit oesophagogastric cancer patients irrespective to the age and gender having undergone minimally invasive oesophagectomy without pyloroplasty. The outcomes were measured in terms of developing postoperative gastric outlet obstruction or evidence of pyloric stenosis in endoscopy, operative time, intraoperative complications, in hospital and 30 days mortality rate. Results: 8/90 of minimally invasive oesophagectomy without pyloroplasty developed postoperative gastric outlet obstruction with endoscopic evidence of pyloric stenosis (8.9%). 7/8 with postoperative delayed gastric empyting had been managed conservatively with repeated endoscopic dilatation (87.5%) while one out of eight patient necessitated laparoscopic pyloroplasty (12.5%). Only one among 90 necessitated laparoscopic pyloroplasty .The mean operative time was 366 minutes. 11/90 had postoperative leak (12.2%) which was managed conservatively. The postoperative in hospital mortality was 4/90 (4.4%) and the 30 days mortality is 2/90 (2.2%). Conclusion: Routine pyrloroplasty is not advocated as the incidence of post operative complication delayed gastric empting, leak, aspiration pneumonia are comparable with pyroloplasty more over pyloroplasty is associated with increased operative time ,so not doing is a safe and a wise decision.
ABSTRACT
Congenital malformations lead to physiological and psychological disability. Early identification help in early intervention and management. This study was conducted on 3916 schoolchild in the period from may 2001 to may 2002 aged between 5-12 years, of both sexes. The aims of this study were: 1] Screening of some congenital malformation such as [preauricular fistula, protruding ears, microtia, and harelip with cleft palate]. 2] Effect of living area and gender in the prevalence of some congenital malformations. The results of its study show that prearicular fistulas was more in rural [0.24%] than urban areas [0.11%] and more in males [5 cases] than females [2 cases]. This study found that the incidence of microtia was [0.05%] only "i" child with unilateral microtia in rural area. Also 1 male child in rural area suffering from harelip with cleft palate. The incidence of protruding ears was more in urban area [6 children 0.33%] than rural area [5 children 0.24%] but with more male affection [8 cases] than female [3] cases. C.T. scan was done to all cases with congenital malformations showing normal middle ear and inner ear structures