Knowledge and Practice Of Peripheral Intravenous Catheter Among Nurses in a Teaching Hospital in Malaysia: Universiti Kebangsaan Malaysia Medical Centre

@#Introduction: Insertion of Peripheral intravenous catheter (PIVC) is a common invasive procedure performed on patients that may contribute to several complications. Nurses are required to have adequate knowledge and practice to ensure the successful of the procedure. The objective of this study was to determine the knowledge and practice of nurses towards PIVC insertion procedures. Methods: A descriptive cross-sectional study design was conducted at Universiti Kebangsaan Malaysia Medical Centre. A total of seventy- seven nurses working in the emergency department, obstetrics & gynecology patient admission centre, daycare oncology were participated in this study. The data was gathered using a modified questionnaire and standard PIVC insertion guidelines. Results: 21 (27.3%) nurses had high knowledge and 56 (72.7%) had low knowledge of PIVC insertion (M=7.77, SD=1.87). All 77 (100%) nurses performed insertion of PIVC according to the standard of practice (M=23.16, SD=1.51). A positive correlation between age and knowledge (rho=0.123) but a negative correlation towards practice (rho=-0.413). A positive correlation between working experience and knowledge (rho=0.094) but a negative correlation towards practice (rho=-0.047). There was a positive correlation between nurses’ knowledge and practice (rho=0.038). Conclusion: Nurses with good knowledge of PIVC insertion performed better as they were aware of the negative consequences of the procedure if conducted incorrectly. Knowledgeable and competent nurses are essential to ensure the quality of nursing care and safe practice towards patients. Future studies with larger samples of nurses involved in more hospitals in Malaysia are recommended.

Identification of underlying causes of chronic unspecific upper gastrointestinal-related symptoms in children, a pilot study

Upper gastrointestinal tract [GIT] symptoms are not disease specific and of limited value in the differentiation of GIT disorders. The present study aimed to determine the etiology of chronic unspecific symptoms in children and to test the need for upper endoscopy in diagnosis

This is a prospective study for 30 Egyptian children presented with chronic upper GIT symptoms for at least 2 months. History regarding severity and frequency of GIT symptoms were asked for. Children with known disorder that explains presenting symptoms were excluded. Upper GIT endoscopy was performed and 5 biopsies were obtained for pathological examination and for H pylori testing

The results showed that children age ranged between 2.5-18 years with mean +/- SD of 13.6 +/- 3.4 and 63.3% were females. The main complaints were epigastric pain in 43.3%, hematemesis in 30% and vomiting in 26.7%. Motility disorders were diagnosed in 66.7% children; in the form of GERD in 63.3% and achalasia in one. Complication of GERD in the form of erosive esophagitis was present in 15.8% children, while Barrett's esophagus was not observed. H. pylori infection was diagnosed in 80% histologically. Eosinophilic esophagitis was not detected

Control of malaria outbreak due to Plasmodium vivax in Aswan governorate, Egypt

In 2014, after several years of maintaining zero malaria indigenous cases, Egypt had an outbreak of Plasmodium vivax: 21 confirmed cases during May-June 2014. In response to the outbreak, the Ministry of Health and Population [MoHP] launched an emergency response through early detection and prompt treatment of cases, vector control, public education and intersectoral collaboration. Twenty cases [95.2%] were residents of El-Sheikh Mostafa village, Edfu district, Aswan governorate, southern Egypt. All cases, consequent to the index case were identified through house-to-house surveillance visits. One P. falciparum-infected case was also identified in the same village. Treatment of all infected cases was initiated following laboratory confirmation. The MoHP's rapid response to and containment of the outbreak demonstrates the institutional capacity for detection and control of outbreaks which can occur after elimination

Measurement of superior vena cava from changes in full term newborn with perinatal hypoxia

Background: Perinatal asphyxia is an important cause for neonatal morbidity and mortality which affects multiple body organs. Myocardium is one of the organs which could be severely affected and this can leads to compromise of the systemic blood flow. Recently Superior vena cava [SVC] flow is usecl to asses' systemic blood flow

Aim of the work: The aim of this work was to study cardiac output changes using SVC flow in neonates with perinatal hypoxia

Subjects and Methods: This observational prospective study was conducted between March 2015 and August 2[]15 at the Neonatal Intensive Care Unit [NICU] and the normal neonaral ward of Alexandria University Hospital [Al-Shatby] on 30 asphyxiated full term neonates [Group I] and 30 healthy full term neonates [Group Il].Superior yena cava [SVC] flow was measured in the first 3 days of life by Doppler echocardiography using Kluckow and Evans method

Results: Superior yena cava [SVC] flow at 12, 24, 48, 72 hours of Group I was significantly lower than that of Group II. The pattern of change in Superior vena cava[SVC] flow in Group l [asphyxiated] was the slow gradual increase over the period of the study in Superior vena cava [SVC] flow in Group II [normal] is the decrease in mean SVC flow from 91.4 ml/kg/min at Day 1 to 80.8 ml/kg/min at Day 3

Conclusion: In conclusion, the assessment Superior vena cava [SVC] flow changes in the early neonatal period is likely to be of great importance in predicting rnyocardial dysfunction. Developing a functional echocardiography [fEHO] service will provide the important hemodynamic information which is critical in the management of asphyxiated infants

Detection of Helicobacter antigen in stool samples and its relation to H. Pylori positive cholecystitis in Egyptian patients with chronic calcular cholecystitis

Evidences supporting the association between H. pylori infection and chronic cholecystitis could be found by using direct culture or staining of H. pylori in gallbladder tissues as well as indirect techniques. Stool antigen test has been widely used due to its non-invasive nature. Various stool antigen tests were developed to detect H. pylori using an enzyme immunoassay [EIA] based on monoclonal or polyclonal antibodies This study evaluated the frequency of H. pylori antigen in stool samples of patients with chronic calcular cholecystitis as regard gall bladder histopathological changes. -Fifty patients were included presented with symptomatic cholecystolithiasis recruited from the outpatient clinic of National Hepatology and Tropical Medicine Research Institute during 2014-2015. Full history and clinical examination and abdominal ultrasonography were performed. Stool samples were collected, prepared and examined for detection of H. pylori antigen. Cholecystectomy was done for all patients; 45 patients [90%] by laparoscopic Cholecystectomy and 5 patients [10%] by open surgery and removed gallbladders were submitted to pathology department for detection of H. pylori in tissue under microscope using Giemsa stain. The results showed that [82%] were females with mean age [42.6+1years]. The mean BMI was [29+7.2] H. pylori-specific antigen in stool samples was detected in 40% of patients and38% were detected in patients; tissue, with significant correlation between H. pylori-specific antigen in stool and in tissue. Histopathological pictures infection in tissue were 68.4% mucosal erosions, 63.2% mucosal atrophy, 57.9% mucosal hyperplasia, 26.3% metaplasia, 42.1% musculosa hypertrophy, 26.3% fibrosis, but lymphoid aggregates were in 42.1% of cases

Any possible association between Behcet's disease and retinitis pigmentosa

Behcet's disease is a rare multisystem disease; it has many ocular features, and it is not known to be associated with dystrophic conditions such as retinitis pigmentosa [RP]. This is a case report of a Sudanese patient with Behcet's disease with ocular features and RP. A 28-year-old female with nyctalopia, skin hyper-pigmentation, and oral and genital ulcers was diagnosed as RP with Behcet's disease. She received a high dose of steroids and Azathioprine. She developed bilateral cataract and glaucoma. Pathergy test is negative. The patient is fulfilling the diagnostic criteria of both RP and Behcet's diseases. Behcet's disease is a rare condition; it is not common among Sudanese patients, and it has not been known to co-exist with RP

Crocin mitigates carbon tetrachloride-induced liver toxicity in rats

Carbon tetrachloride [CCl4] is one of the most dangerous hepatotoxic environmental pollutants thus this study aimed at investigating the potential preventive effect and mechanism of crocin against CCl4- induced hepatotoxicity. Forty Male rats were allocated for two weeks treatment with; corn oil, CCl4 in corn oil, crocin [100 mg/kg], or crocin plus CCl4. At time of euthanasia liver was removed, weighted and processed for histopathological evaluation and estimation of liver contents of active caspase3, lipid peroxidation [MDA] and reduced glutathione [GSH]. We also evaluated antioxidant enzymes activities [superoxide dismutase [SOD], glutathione peroxidase [GSH-Px] and catalase [CAT]], phase I metabolizing enzyme [cytochrome P450 sub family 2E1 [CYP2E1]] an Phase II metabolizing enzyme, [glutathione-S-transferase [GST]] in liver tissue. Blood samples were used for evaluation of liver function tests and inflammatory cytokines [interleukin 6 [IL-6] and tumor necrosis factor alpha [TNF-alpha]]. CCl4 induced significant [p < 0.001], increase in: relative liver weight to body weight, liver MDA content, liver active caspase-3 and plasma levels of IL-6 and TNF alpha. In addition, CCl4 disturbed liver histology, liver metabolizing enzymes [CYP2E1 and GST], and liver function tests [aspartate aminotransferase, alanine aminotransferase, total bilirubin and alkaline phosphatase]. CCl4 induced significant decrease in activities of SOD, CAT, GSH-Px and GSH content. Administration of crocin with CCl4 mitigated all CCl4-disturbed parameters and preserved liver histology close to normal. Crocin ameliorated CCl4-induced liver injury via inhibition of inflammatory cytokines, caspase3 and oxidative stress along with modulation of liver metabolizing enzymes favoring elimination of CCl4 toxic metabolite

Evaluation of the role of presepsin [soluble cd 14 subtype] in the diagnosis of neonatal sepsis in preterm newborns

Objective: The present study was conducted to evaluate the role of presepsin as an early and rapid predictor of bacterial infection in newborn infants

Methods: This study was carried out on 50 preterm newborn infants with clinically suspected early onset sepsis admitted to the neonatal intensive care unit at Alexandria University Maternity Hospital, All studied newborns were subjected to History taking, detailed physical examination and sepsis work -up, including complete blood count, blood culture, CRP, CSF analysis if indicated and quantitative measurement of preseason

Results: The mean birth weight of the studied newborn infants was 1520 g and the mean gestational age was 32.7 weeks with no statistically significant difference as regard the preseason results. Virginities was the main maternal risk factor for EOS, present in 80 % of the studied newborn infants. The majority of cases of positive culture for Klebsiella were negative for preseason, and this was statistically significant, Presence of toxic granules had the highest incidence among laboratory markers in the CBC in the studied group, Preseason was positive in 48% of newborns and the mean value of preseason was 1397.6 ng/L, Most cases with positive initial CRP readings were positive for preseason and this was statistically significant. There was no significant difference in preseason results as regard clinical score, total laboratory score and both laboratory and clinical scores. All cases that had meningitis were positive for preseason, and most cases that didn't have meningitis were negative for preseason and this was statistically significant. There was no statistically significant difference between preseason results and duration till admission, Apgar score or hospital stay

Conclusion: We concluded that preseason is a useful, quickly and easily performed marker for diagnosis of neonatal, sepsis. Its results are comparable to the CRP and seemed to be superior to conventional CBC tests. Furthermore, presepsin is a promising prognostic marker that could identify high risk newborns to severe sepsis, but it may not be elevated in response to infections caused by organisms like Klebsiella

Validity and reliability of an Arabic version of the modified dental anxiety scale in Saudi adults

To test the reliability and validity of an Arabic version of the modified dental anxiety scale [MDAS], and to correlate it with other demographic data. The original English version of the MDAS was translated into Arabic, and then translated back into English by experienced bilingual professionals. Four hundred and seventy-four patients referred to dental clinics for treatment at the Faculty of Dentistry Hospital, Jeddah, Kingdom of Saudi Arabia from November 2012 to June 2013 participated in the study. The assessment tool included questions regarding demographic characteristics, frequency of dental visits, the Arabic version of the MDAS, and the patient's rating of their current level of anxiety using a visual analogue scale [VAS]. The Arabic version of the MDAS had excellent internal consistency and reliability [Alpha coefficients >0.90]. The scale was unidimensional, and the percentage of patients with dental anxiety was 48.3% [using a cutoff total score of >15] and with dental phobia was 2.5% [using a cutoff total score of >16]. Younger patients, females, and infrequent visitors to the dentist were more anxious than those who were older, male, and frequent visitors. Visual analogue scale scores correlated significantly with individual items on the MDAS questionnaire and total anxiety score, supporting the criterion validity. The Arabic version of the MDAS presented adequate internal consistency reliability, allowing its safe use to assess levels of dental anxiety in Arabic-speaking populations

Split cord malformation associated with spinal open neural tube defect

To illustrate the clinical and radiological findings of split cord malformation [SCM] in patients with spinal open neural tube defect [SONTD], and report the outcome of their treatment. A retrospective study of the clinical and radiological findings of 11 patients diagnosed with SCM, identified among 83 patients with SONTD at King Khalid University Hospital, in Riyadh, Saudi Arabia between 1995 and 2010. There were 6 girls and 5 boys; their age ranged from less than a year to 9 years [mean 4.2 years]. Six patients had type I SCM, and 5 patients type II SCM. The CT and MRI imaging showed characteristic bony, cartilaginous, or fibrous septum, and other SONTD-associated anomalies. Seven patients were graded A and B according to the Frankel grading score, and none of them required surgery, while worsening neurology led to surgical intervention in 3 patients, with clinical improvement after surgery, and one patient that underwent cord untethering remained stable. Split cord malformation is not uncommon among patients with SONTD. It tends to involve mainly the lumbar spine, and female predominance is more remarkable in type I. Neurological manifestations of SCM may be superimposed with SONTD. Surgery is effective for symptomatic patients, and not indicated in the severely disabled.

Agenesis of the corpus callosum associated with spinal open neural tube defect

To ascertain the incidence and clinical implications of agenesis of the corpus callosum [ACC] in spinal open neural tube defects [SONTD]. All cases of SONTD registered at the Spina Bifida Clinic in King Khalid University Hospital, Riyadh, Saudi Arabia between 1995 and 2010 were retrospectively reviewed, and mid-sagittal MRI of the corpus callosum [CC] area was analyzed in each case. Neurodevelopmental outcome was classified as poor in children with seizures, severe neurodevelopmental impairment, or death. Thirty-eight patients [45.8%] with ACC were identified among 83 cases with SONTD. Patients' age ranged between one and 16 years. Total ACC was found in 10 patients, partial ACC in 25, and in 3 patients, the CC was hypoplastic. Active hydrocephalus was an associated finding in 9 out of 10 patients with total ACC, 22 out of 25 with partial ACC, and in all patients with hypoplasia of the CC. Thirteen patients [34.2%] had normal intellectual function, whereas 24 patients presented with learning disability, epilepsy, or poor intellectual function; and one patient died of respiratory failure. Agenesis of the corpus callosum is found in a significant portion of patients with SONTD. When associated with hydrocephalus, its presence affects neuro-developmental outcome.

Skeletal and dental characteristics of subjects with incompetent lips

To evaluate the cephalometric features of subjects with incompetent lips, and to find the most discriminant variables for lip incompetence among the following: dental protrusion and proclination, antero-posterior and vertical skeletal relationships, and lip dimensions. This retrospective study was conducted at King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia, between 2011 and 2012. Cephalograms of 84 subjects [22 males and 62 females, aged 20.18 +/- 3.65 years] diagnosed as having incompetent lips were collected [incompetent group [IG]] and compared with the control group [CG], matching in age and gender distribution. Thirty-five measurements were compared between the 2 groups using independent t-test. Stepwise discriminant analysis of lip incompetence was performed. Compared to the CG, subjects in the IG had thinner upper lips, shorter upper and lower lips, more retrognathic facial types, greater angle between nasion-point A and nasion-point B, shorter anterior and posterior cranial bases, shorter palatal length, shorter mandibular body length, shorter ramal length, steeper mandibular plane, less prominent chin, bimaxillary dental protrusion, and smaller inter-incisal angle. The significant discriminant variables, in order, were inter-incisor angle, inclination of upper incisors, ramal height, anterior cranial base, palatal plane to Frankfort horizontal plane angle, lower and then upper anterior dental height, upper lip thickness, and length. The presence of incompetent lips can be attributed to more than one factor and not only bimaxillary protrusion. This should be considered during the treatment planning of such problem

[ case report of isolated radial nerve palsy physiotherapy]

Isolated radial nerve palsy is caused by pressing this nerve and it is usually caused by the excessive pressure either in the uterus or during the labor. Isolated radial nerve palsy should be considered different from brachial plexus damages. In brachial plexus damages depending on the damage degree and involved spinal roots, different disorders such as disability in brachial abduction, disability in elbow, wrist and digital flexion and extension may be observed, however, in isolated radial nerve palsy weakness is only reported in extension power. In isolated radial nerve palsy depending on the level of pressure and damage, different symptoms are suspected but the most common symptom is inability in extension of wrist and fingers, which is called wrist drop. This phenomenon is a rare condition and usually recuperates by itself. In the present case report, we have described a newborn case with isolated radial nerve palsy. This male newborn was born after a long labor during which his radial nerve was pressed, so he was born with wrist drop. By prescribing Physical therapy modalities including IR [Infrared], Gentle Massage, Electrical Stimulation [IDC], Gentle Rang of Motion, the patient was completely revealed from the disease

Gossypiboma presenting as a sterile abscess

We present a case of a chronic abdominal pain which was due to a retained surgical sponge 4 years after an open cholecystectomy. A review of literature was done with emphasis on the incidence and factors contributing to such entity. The medicolegal aspect was discussed

[Polyneuropathy in gasoline addiction, a report of three cases]

The polyneuropathy caused by chronic Gasoline Sniffing is reported to be a gradually progressive, symmetric, sensorimotor polyneuropathy. The report of gasoline sniffing by three 12, 16 and18 years old brothers [Respectively 5, 8 and 11 years of gasoline inhalation addiction] that referred with peripheral neuropathy was studied. The conditions were characterized by relatively small reduction in nerve conduction velocity [depending on the severity of nerve involvement] and to some degree in all four limbs with moderate to severe sensory and motor involvement, lower limbs had worse conditions than upper limbs. The neuropathy was attributed to the N-hexane and tetraethyl, the lead components of gasoline. Educational efforts about the dangers of gasoline sniffing are essential

Effect of different growth conditions on certain biochemical parameters of different cyanobacterial strains

Aims: Variation in the traditional growth medium conditions to enhance the production of lipids, carbohydrates, protein and the free amino acids content of three cyanobacterial species. Methodology and Results: Three species of cyanobacteria (Anabaena laxa, Anabaena fertilissima and Nostoc muscorum) were collected from the culture collection of Soils, Water and Environment Research Institute, Agriculture Research Center, Giza, Egypt, to investigate their biochemical composition under different growth conditions, using BG110 (nitrogen free) as growth medium. These conditions were represented by control medium, static glucose medium with (1%, w/v), aerated medium (aerated by bubbling technique depending on CO2 normally existed in air with a concentration of 0.03%), molasses medium (0.7%, v/v) and aerated medium enriched with glucose (1%, w/v). Lipid content, total carbohydrates, soluble proteins and free amino acids were determined at the previous conditions. Glucose at 0.7% (w/v) was the most favorable for lipid production in A. laxa, where it exhibited the highest lipid content (427 μg/g fresh wt.). Increasing molasses concentration up to 0.7% (v/v) produced an increase in lipid contents of the tested cyanobacterial strains. The highest lipid content of both N. muscorum (366.2 μg/g fresh wt.) and A. laxa (357.4 μg/g fresh wt.) were recorded at molasses concentrations of 0.1 and 0.7% (v/v), respectively. A. laxa expressed high significant values for both proteins (31.6 μg/mL) and free amino acids (40.5 mg/g dry wt.) after 6 days of incubation period under aerated enriched glucose condition (1%, w/v). Also, at the same growth conditions, A. fertilissima exhibited high significant values for carbohydrates at 4th day (876.8 mg/g dry wt.). Conclusion, significance and impact of study: Aerated enriched glucose medium (1%, w/v) was the best growth medium condition used in the present study.

Antiulcer activity of methanol extract of melastoma malabathricum leaves in rats

To determine the potential antiulcer activity of methanol extract of Melastoma malabathricum leaves [MEMM] using various established rat models. Ten groups of rats were used and orally administered 10% DMSO [negative control], 100 mg/kg ranitidine [positive control] or MEMM [50,250 and 500 mg/kg] followed by gastric ulcer induction either using ethanol or in-domethacin. The stomachs were collected and subjected to macroscopic and microscopic analyses. MEMM exhibited significant [p < 0.05] antiulcer activity in the ethanol, but not in the indomethacin-induced gastric ulcer model. The percentage of antiulcer activity for 50-500 mg/kg MEMM ranged between 3 and 75%, respectively. The gross observations were supported by histological findings. MEMM also aggravated the indomethacin-induced gastric ulcer, leading toan increasein ulcer area formation and ulcer score. The M. malabathricum leaves showed antiulcer activity, which could be attributed to their antioxidant and anti-inflammatory activities. This requires further in-depth studies

Association of cluster of differentiation 36 gene variant rs1761667 [G>A] with metabolic syndrome in Egyptian adults

To investigate the relationship between cluster of differentiation [CD]36 gene variant rs1761667 [G>A] and metabolic syndrome [MetS] and its components in Egyptian patients. This case-control study was conducted on MetS patients attending Suez Canal University Hospital, Egypt from November 2010 to October 2011. Peripheral blood was collected from 100 patients and 100 healthy controls for DNA extraction. The single nucleotide polymorphism [SNP] CD36 gene rs1761667 G>A was genotyped using realtime polymerase chain reaction, and the allele discrimination technique. Distribution of CD36 genotypes in the patient group was AA [n=25], AG [n=70], and GG [n=5], while in the control group it was AA [n=51], AG [n=48], and GG [n=1]. Both AG and GG genotypes were significantly more prevalent among MetS patients [p<0.001]. The odds ratio [OR] for the high risk allele [G] is 2 with 95% confidence interval from 1.30-3.07 [p<0.001]. Patients with genotypes AG and GG had significantly higher systolic blood pressure, wider waist circumstance, and higher degree of dyslipidemia [p<0.001] than patients with genotype AA. Our findings show that CD36 rs1761667 SNP is positively associated with increased risk of MetS and its components with genotype AG heterozygotes showing highest frequency among MetS patients.

Mandibular cephalometric characteristics of a Saudi sample of patients having impacted third molars

To evaluate the cephalometric characteristics of mandibles of Saudi patients having impacted third molars and to compare them to those of patients having normally erupted third molars. One hundred and twenty-one Saudi adult subjects [59 females and 62 males; age: 20-40 years] were divided into two groups based on the status of the mandibular third molars: [1] impaction group and [2] normal group. Means and standard deviations of 21 cephalometric measurements related to mandibular geometry were measured and compared between the two groups using the unpaired t-test. Males and females in the impaction group were also compared with their equivalent subgroups in the normal group using the unpaired t-test. Anteroposteriorly, space distal to second molar, ramal width and mandibular body length were significantly less in the impaction group. Vertically, posterior alveolar height was significantly less in the impaction group. The Y-axis was significantly increased in the impaction group. The significance of these measurements was variable between males and females. Third-molar impactions in the Saudis living in the Western region of Saudi Arabia were more likely to occur when inadequate retromolar space is present. This can be attributed to certain mandibular skeletal and dental features, among which the increased width of mandibular ramus and backward inclination of posterior teeth seem to be the most influencing factors in both sexes

Optimization of polymerase chain reaction for direct detection of colibacillosis in infected chickens

A total of 33 local E. coli isolates were used in this study. These isolates were biochemically and serologically identified as O1, O2, O6, O78 and O126. Four sets of oligonucleotide primer sequences were designed specifically for 16SrRNA, STX, Sth and eaeA genes. DNA and Plasmids were extracted and polymerase chain reaction was optimized for each. 16SrRNA gene primer successfully amplified with all serotypes giving rise a product mass of 204 bp, while STX gene primer was amplified with O1, O2 an dO78 serotypes in a specific band at 323 bp. At the same time the specific primers of Sth gene get a 171 bp molecular weight product only with O6 serotype meanwhile the eaeA gene primers successfully amplified only with O126 serotype giving rise a molecular weight band at 200 bp. In conclusion, PCR assay was able to differentiate between the different serotypes of E. coli in the suspected samples saving time, money and effort