Interleukin-37 has A Promising Cardioprotective Effect on Isoproterenol-Induced Myocardial Infarction / La Interleucina-37 tiene un Efecto Cardioprotector Prometedor sobre el Infarto de Miocardio Inducido por Isoproterenol

SUMMARY: The main cause of mortality and disability globally is myocardial infarction (MI). Isoproterenol (ISO), a β-adrenoceptor agonist, has been used to induce rat myocardial necrosis. Whereas interleukin-37 (IL-37) has anti-inflammatory and cytoprotective properties. The study aimed to investigate the potential protective effects of IL-37 administration on cardiac architecture, oxidative stress, and inflammatory markers during ISO-induced MI in rats. Three groups of adult male rats were used in this study, the normal control group (n=8), ISO-induced MI group (n=8) that received isoproterenol hydrochloride (ISO) (100 mg/kg/day, SC, for the first 2 consecutive days), and IL-37-treated group (ISO+IL-37) (n=8) that received recombinant human IL-37 (40 µg/kg /day, intraperitoneally, for 2 weeks during and after ISO injections. Heart rate (HR.) and ECG changes were monitored. Some oxidative stress markers such as superoxide dismutase (SOD), nitric oxide (NOx), malondialdehyde (MDA), and glutathione (GSH) tissue levels in the tissue homogenate were assayed. Interleukin- 6 (IL-6), tumor necrosis factor- α (TNF-α), caspase-8, P53, and C- reactive protein (CRP) were among the inflammatory markers examined. In addition, serum levels of creatinine kinase (CK-MB) and lactate dehydrogenase (LDH) were analyzed to evaluate the myocardial injury. For histological analysis, tissues were sectioned, fixed in paraffin, and stained with hematoxylin and eosin (H&E), Masson Trichrome and, immunohistochemical against NF-kB, TNF-α, and Caspase-9. IL-37 improved ECG changes, cardiac enzyme markers, and some inflammatory markers of oxidative stress in ISO-induced MI. It also improved the histopathological and immunohistochemical changes in MI. In conclusion: IL-37 might be a promising therapeutic modality in myocardial infarction.

La principal causa de mortalidad y discapacidad a nivel mundial es el infarto de miocardio (IM). El isoproterenol (ISO), un agonista de los receptores adrenérgicos β, se ha utilizado para inducir necrosis miocárdica en ratas. Mientras que la interleucina-37 (IL-37) tiene propiedades antiinflamatorias y citoprotectoras. El estudio tuvo como objetivo investigar los posibles efectos protectores de la administración de IL-37 en la arquitectura cardíaca, el estrés oxidativo y los marcadores inflamatorios durante el infarto de miocardio inducido por ISO en ratas. En este estudio se utilizaron tres grupos de ratas macho adultas, el grupo control normal (n=8), el grupo con IM inducido por ISO (n=8) que recibió clorhidrato de isoproterenol (ISO) (100 mg/kg/día, SC, durante los primeros 2 días consecutivos) y el grupo tratado con IL-37 (ISO+IL- 37) (n=8) que recibió IL-37 humana recombinante (40 µg/kg/día, por vía intraperitoneal, durante 2 semanas durante y después de las inyecciones de ISO. Se monitorearon la frecuencia cardíaca (FC) y los cambios en el ECG. Se analizaron algunos marcadores de estrés oxidativo como la superóxido dismutasa (SOD), el óxido nítrico (NOx), el malondialdehído (MDA) y los niveles tisulares de glutatión (GSH) en el homogeneizado de tejido. La interleucina-6 (IL-6), el factor de necrosis tumoral-α (TNF-α), la caspasa-8, la P53 y la proteína C reactiva (CRP) se encontraban entre los marcadores inflamatorios examinados. Se analizaron los niveles de creatinoquinasa (CK-MB) y lactato deshidrogenasa (LDH) para evaluar la lesión miocárdica; para el análisis histológico se seccionaron los tejidos, se fijaron en parafina y se tiñeron con hematoxilina y eosina (H&E), Tricromo de Masson e inmunohistoquímica contra NF-kB, TNF-α y Caspasa-9. IL-37 mejoró los cambios de ECG, los marcadores de enzimas cardíacas y algunos marcadores inflamatorios de estrés oxidativo en el IM inducido por ISO. Además mejoró los cambios histopatológicos e inmunohistoquímicos en MI. En conclusión: la IL-37 podría ser una modalidad terapéutica prometedora en el infarto de miocardio.

Association Between the Prevalence of Schistosomiasis in Elementary School Students and Their Parental Occupation in Sudan

Global efforts to identify groups at high risk for schistosomiasis have mainly concentrated on identifying their geographical distribution. Investigations on the socioeconomic characteristics of high-risk groups are relatively scarce. This study aimed to explore the associations between schistosomiasis among students and their parents’ occupations. A nationwide cross-sectional survey was conducted targeting 105,167 students in 1,772 primary schools across Sudan in 2017. From these students, 100,726 urine and 96,634 stool samples were collected to test for Schistosoma haematobium and S. mansoni infection. A multi-level mixed effect analysis was used with age and sex as fixed factors, and school as a random factor. The odd ratios (ORs) of practicing open defecation among farmers’ children were almost 5 times higher than their counterparts whose parents were government officials (OR=4.97, 95% confidence intervals (CIs): 4.57-5.42, P<0.001). The ORs of contacting water bodies for watering livestock among farmers’ children were more than 4 times higher than those of children whose parents were government officials (OR=4.59, 95% CIs: 4.02-5.24, P<0.001). This study shows that schistosomiasis represents a disease of poverty and that farmers’ children constituted a high-risk group.

The SARS-COV2 (COVID-19) Pandemic: What Clinicians should Know

In late 2019, a novel coronavirus, now designated SARS-CoV-2, emerged and was identified as the cause of an outbreak of acute respiratory illness in Wuhan, a city in China, named as COVID-19. Since then the waves of the virus exponentially hit many countries around the globe with high rates of spread associated with variable degrees of morbidity and mortality. The WHO announced the pandemic state of the infection in March 2020 and by June 1st 2020 more than 6 million individuals and more than 370 thousands case fatalities were documented worldwide. In this article, we discussed many aspects regarding this emerged infection based on the available evidence aiming to help clinician to improve not only their knowledge but also their practices toward this infection.

The SARS-COV2 (COVID-19) Pandemic: What Clinicians should Know

In late 2019, a novel coronavirus, now designated SARS-CoV-2, emerged and was identified as the cause of an outbreak of acute respiratory illness in Wuhan, a city in China, named as COVID-19. Since then the waves of the virus exponentially hit many countries around the globe with high rates of spread associated with variable degrees of morbidity and mortality. The WHO announced the pandemic state of the infection in March 2020 and by June 1st 2020 more than 6 million individuals and more than 370 thousands case fatalities were documented worldwide. In this article, we discussed many aspects regarding this emerged infection based on the available evidence aiming to help clinician to improve not only their knowledge but also their practices toward this infection.

Adherence to Immunosuppressive Medications in Kidney Transplant Patients at Three Centers in Khartoum State, Sudan: A Cross-sectional Hospital Study

Background: Graft survival post-kidney transplantation is of paramount importance to patients and nephrologists. Nonadherence to immunosuppressive therapy can be associated with deterioration of renal function and graft rejection. This study aimed to evaluate the adherence to immunosuppressive medications in kidney transplant patients at three centers in Khartoum, Sudan. Methods: In this descriptive cross-sectional hospital-based survey, 277 post-kidneytransplant patients were recruited. Data were collected using a questionnaire and analyzed using the SPSS v.23. Our scoring method was calculated based on Morisky Medication Adherence Scale (MMAS-8) related to immunosuppressive medications and was expressed as questions in the questionnaire; every correct answer was given one mark, then the marks were gathered and their summation was expressed. Results: Overall, 33% ,45%, and 22% of the studied participants reported high, medium, and low adherence, respectively. The major factor for nonadherence was forgetfulness affecting 36.1% of those who did not adhere. The cost of the immunosuppressive medications did not negatively affect any of the participants' adherence (100%). However, a significant association was seen between adherence and occupational status, duration of transplantation, shortage of immunosuppressants, recognizing the name of immunosuppressant, side effect, and forgetfulness (P-values = 0.002, 0.01, 0.006 , 0.000, 0.022, and 0.000, respectively). Logistic regression analysis showed a significant association with occupational status, side effects, and forgetfulness.

FEAR Regarding Research among Health Professionals

Purpose: Evidence-based medicine practice is now inevitable and health professionals are bound to understand researchconcept thoroughly to practice based on evidence. When we are talking about research, usually health professionals avoidinvolving in researches for many reasons. This study was designed to assess the fear regarding health professionals basedon a small scale designed focusing on scoring system and assess having some avoidance behavior.Methods: It was a cross-sectional study design. Between July and September 2019, a self-administered questionnaire wasdistributed through online after getting data regarding contacts details of health professionals. We have approached 600subjects in total, these participants were doctors, nurses, and allied health professionals. This health professional’s works allover the country (e.g., Ministry of Health, ministry centers, university, and private sectors). The inclusion criteria were all healthprofessionals work as registered health professionals. The Research Ethics Committee of the university approved the study.Results: The results depict out of total, 26.2% of male and 26.4% of female have high FEAR scores, and 29% of male havelow FEAR score in comparison to 18.4% of female. Health-care providers with bachelor show the highest FEAR score about27.7%, while those with postgraduate degrees show the lowest fear with 22.2%. A bivariate logistic regression analysis doneshows a statistically significant (P = 0.027) association seen with high fear score and age group, especially the youngestbetween 19 and 30 years and educational level (P = 0.024). Whereas, no statistically significant difference (P = 0.290) seen inthe FEAR score with working experience. No statistically significant difference (P = 0.251) seen in the FEAR score with living.Conclusion: Conclusively, the health professionals have fear about researches so need to assess its reasons for the rectificationof the problem.

Comparison of the Change in the Prevalence and Intensity of Schistosoma haematobium Infection Between High and Low Prevalence Areas of White Nile State, Sudan

This study aimed to investigate whether mass drug administration (MDA) intervention has an equivalent effect on reducing the prevalence and intensity of Schistosoma haematobium infection regardless of the baseline values. A repeated cross-sectional survey was performed targeting students of 12 primary schools in Al Jabalain and El Salam districts of White Nile State, Sudan, at both 1 week before and 8 months after the MDA. Prior to the baseline survey, school-aged children in Al Jabalain had received MDA interventions twice in 4 years, while those in El Salam had not. The baseline prevalence was 9.1% in Al Jabalain and 35.2% in El Salam, which were reduced to 1.8% and 5.5% at 8 months after the MDA, respectively. The corresponding reduction rates were 80.3% and 84.4%, not significant difference between both districts. However, changes in the geometric mean intensity (GMI) of egg counts were significantly different between both districts. The baseline GMIs were 14.5 eggs per 10 ml of urine (EP10) in Al Jabalain and 18.5 EP10 in El Salam, which were reduced to 7.1 and 11.2 EP10 after treatment, respectively. The corresponding reduction rates were 51.0% and 39.5%. In conclusion, MDA interventions were found to bring about similar relative reduction in prevalence regardless of the baseline value; however, the relative reduction in infection intensity was more salient in the district with a low baseline value for both prevalence and intensity. This clearly points to the importance of repeated MDA interventions in endemic areas, which will eventually contribute to schistosomiasis elimination.

Literature Review on Pathogenesis and Treatment of Depression

Background: Among various psychiatric disorders, depression is one of the most frequently encountered intoday’s world. Depression confers a significant risk of recurrence in the subsequent years following the firstepisode. In order to deal this disorder, it is crucial to comprehend the pathogenesis and properly implement theavailable management options. Objectives: We intend to explore the pathogenesis and patho-physiology ofdepression and highlight the available methods to treat and manage this psychiatric disorder including bothpharmacotherapy and psychotherapy. Methods: A review of relevant articles published from 1988 till date inEnglish language was done using the electronic databases of PubMed, Pico and, Google Scholar with presetkeywords. Conclusion: Depression is a highly prevalent psychiatric disorder that requires a multidimensionalapproach. The pathogenesis of depression comprises of 30-40% genetic contribution and about 60-70%environmental factors. Environmental factors include stressful life events at any point in an individual’s lifetimeand alter the stress response by the hypothalamic-pituitary-adrenal axis. The patho-physiology of depressioninvolves altered brain structure and function in addition to modified levels of neurotransmitters. Serotonin andits precursor tryptophan are decreased in the brain in depression in addition to various changes incatecholamines i.e. dopamine and norepinephrine. The treatment of depression is recommended by acombination of psychotherapy and pharmacotherapy which has higher efficacy than either therapy alone. Thepreferred forms of psychotherapy include interpersonal psychotherapy and cognitive behavioral therapy. Themost commonly used pharmacotherapy include SSRIs, which are the most efficacious and tolerableantidepressants while other second generation antidepressants such as SNRI, TCA and MOA inhibitors,mirtazapine and trazodone are chosen on the basis of patient preference, cost, comorbidities and side effectprofile.

Anatomical variations of congenital diaphragmatic hernia during thoracoscopic repair :a two Egyptian centers experience

Background: Congenital diaphragmatic hernia is a major problem in pediatric patients specially neonates with subsequent high morbidity and mortality. Thoracoscopic repair is now being considered the primary choice in management of such patients. The present work aims at evaluating the different anatomical characteristics and variations of congenital diaphragmatic defects during thoracoscopic repair.Methods: Thirty patients with congenital diaphragmatic hernia were included in the study. Thoracoscopic inspection of the defect and its anatomical characters was followed by repair. Data were recorded regarding symptoms, radiological findings, anatomic landmarks and variations during the procedure itself.Results: A higher incidence of congenital diaphragmatic hernia in infantile male population was documented with a higher incidence of left sided defect (96.7%). Postero-lateraldefects were common (86.7%) compared to lateral defect. Hernial sac was absent in 90% of cases. Most of cases had anterolateral muscular rim (86.7%). Liver herniation occurred in only two cases (6.7%). The majority of patients had moderate organ displacement (70%). Thoracoscopic repair was successful in 90% of cases. Primary repair was done in all cases with no need of synthetic patches.Conclusion: The use of thoracoscope helps in creation of a strict phenotyping system that will enhance the ability to predict the clinical course of diaphragmatic defects and will aid in identifying developmental pathways responsible for the disease

Modulated Gene Expression of Toxoplasma gondii Infected Retinal Pigment Epithelial Cell Line (ARPE-19) via PI3K/Akt or mTOR Signal Pathway

Due to the critical location and physiological activities of the retinal pigment epithelial (RPE) cell, it is constantly subjected to contact with various infectious agents and inflammatory mediators. However, little is known about the signaling events in RPE involved in Toxoplasma gondii infection and development. The aim of the study is to screen the host mRNA transcriptional change of 3 inflammation-related gene categories, PI3K/Akt pathway regulatory components, blood vessel development factors and ROS regulators, to prove that PI3K/Akt or mTOR signaling pathway play an essential role in regulating the selected inflammation-related genes. The selected genes include PH domain and leucine- rich-repeat protein phosphatases (PHLPP), casein kinase2 (CK2), vascular endothelial growth factor (VEGF), pigment epithelium-derived factor (PEDF), glutamate-cysteine ligase (GCL), glutathione S-transferase (GST), and NAD(P)H: quinone oxidoreductase (NQO1). Using reverse transcription polymerase chain reaction (RT-PCR) and quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR), we found that T. gondii up-regulates PHLPP2, CK2β, VEGF, GCL, GST, and NQO1 gene expression levels, but down-regulates PHLPP1 and PEDF mRNA transcription levels. PI3K inhibition and mTOR inhibition by specific inhibitors showed that most of these host gene expression patterns were due to activation of PI3K/Akt or mTOR pathways with some exceptional cases. Taken together, our results reveal a new molecular mechanism of these gene expression change dependent on PI3K/Akt or mTOR pathways and highlight more systematical insight of how an intracellular T. gondii can manipulate host genes to avoid host defense.

Nosocomial infections: Epidemiology, prevention, control and surveillance

Nosocomial infections or healthcare associated infections occur in patients under medical care. These infections occur worldwide both in developed and developing countries. Nosocomial infections accounts for 7% in developed and 10% in developing countries. As these infections occur during hospital stay, they cause prolonged stay, disability, and economic burden. Frequently prevalent infections include central line-associated bloodstream infections, catheter-associated urinary tract infections, surgical site infections and ventilator-associated pneumonia. Nosocomial pathogens include bacteria, viruses and fungal parasites. According to WHO estimates, approximately 15% of all hospitalized patients suffer from these infections. During hospitalization, patient is exposed to pathogens through different sources environment, healthcare staff, and other infected patients. Transmission of these infections should be restricted for prevention. Hospital waste serves as potential source of pathogens and about 20%–25% of hospital waste is termed as hazardous. Nosocomial infections can be controlled by practicing infection control programs, keep check on antimicrobial use and its resistance, adopting antibiotic control policy. Efficient surveillance system can play its part at national and international level. Efforts are required by all stakeholders to prevent and control nosocomial infections.

IL-12 and IL-23 Production in Toxoplasma gondii- or LPS-Treated Jurkat T Cells via PI3K and MAPK Signaling Pathways

IL-12 and IL-23 are closely related in structure, and have been shown to play crucial roles in regulation of immune responses. However, little is known about the regulation of these cytokines in T cells. Here, we investigated the roles of PI3K and MAPK pathways in IL-12 and IL-23 production in human Jurkat T cells in response to Toxoplasma gondii and LPS. IL-12 and IL-23 production was significantly increased in T cells after stimulation with T. gondii or LPS. T. gondii and LPS increased the phosphorylation of AKT, ERK1/2, p38 MAPK, and JNK1/2 in T cells from 10 min post-stimulation, and peaked at 30–60 min. Inhibition of the PI3K pathway reduced IL-12 and IL-23 production in T. gondii-infected cells, but increased in LPS-stimulated cells. IL-12 and IL-23 production was significantly reduced by ERK1/2 and p38 MAPK inhibitors in T. gondii- and LPS-stimulated cells, but not in cells treated with a JNK1/2 inhibitor. Collectively, IL-12 and IL-23 production was positively regulated by PI3K and JNK1/2 in T. gondii-infected Jurkat cells, but negatively regulated in LPS-stimulated cells. And ERK1/2 and p38 MAPK positively regulated IL-12 and IL-23 production in Jurkat T cells. These data indicate that T. gondii and LPS induced IL-12 and IL-23 production in Jurkat T cells through the regulation of the PI3K and MAPK pathways; however, the mechanism underlying the stimulation of IL-12 and IL-23 production by T. gondii in Jurkat T cells is different from that of LPS.

Nosocomial infections and their control strategies

Nosocomial infections are also known as hospital-acquired/associated infections. National Healthcare Safety Network along with Centers for Disease Control for surveillance has classified nosocomial infection sites into 13 types with 50 infection sites, which are specific on the basis of biological and clinical criteria. The agents that are usually involved in hospital-acquired infections include Streptococcus spp., Acinetobacter spp., enterococci, Pseudomonas aeruginosa, coagulase-negative staphylococci, Staphylococcus aureus, Bacillus cereus, Legionella and Enterobacteriaceae family members, namely, Proteus mirablis, Klebsiella pneumonia, Escherichia coli, Serratia marcescens. Nosocomial pathogens can be transmitted through person to person, environment or contaminated water and food, infected individuals, contaminated healthcare personnel's skin or contact via shared items and surfaces. Mainly, multi-drug-resistant nosocomial organisms include methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, Pseudomonas aeruginosa and Klebsiella pneumonia, whereas Clostridium difficile shows natural resistance. Excessive and improper use of broad-spectrum antibiotics, especially in healthcare settings, is elevating nosocomial infections, which not only becomes a big health care problem but also causes great economic and production loss in the community. Nosocomial infections can be controlled by measuring and comparing the infection rates within healthcare settings and sticking to the best healthcare practices. Centers for Disease Control and Prevention provides the methodology for surveillance of nosocomial infections along with investigation of major outbreaks. By means of this surveillance, hospitals can devise a strategy comprising of infection control practices.

All-Age Group Polio Supplementary Immunization Activities; Garissa County; Kenya

The Polio Eradication Initiative (PEI) has made significant progress towards attaining the poliomyelitis targets in the African Region and research; among other activities; has played a critical role. An overview of the contribution of a select few operational research (OR) activities undertaken is given in this article. These mainly concern social research targeted at understanding and changing behaviour to enhance effective intervention uptake. Lessons learned from this research for the planning and implementation of interventions are also discussed

Genetic Diversity of Schistosoma haematobium Eggs Isolated from Human Urine in Sudan

The genetic diversity of Schistosoma haematobium remains largely unstudied in comparison to that of Schistosoma mansoni. To characterize the extent of genetic diversity in S. haematobium among its definitive host (humans), we collected S. haematobium eggs from the urine of 73 infected schoolchildren at 5 primary schools in White Nile State, Sudan, and then performed a randomly amplified polymorphic DNA marker ITS2 by PCR-RFLP analysis. Among 73 S. haematobium egg-positive cases, 13 were selected based on the presence of the S. haematobium satellite markers A4 and B2 in their genomic DNA, and used for RFLP analysis. The 13 samples were subjected to an RFLP analysis of the S. haematobium ITS2 region; however, there was no variation in size among the fragments. Compared to the ITS2 sequences obtained for S. haematobium from Kenya, the nucleotide sequences of the ITS2 regions of S. haematobium from 4 areas in Sudan were consistent with those from Kenya (> 99%). In this study, we demonstrate for the first time that most of the S. haematobium population in Sudan consists of a pan-African S. haematobium genotype; however, we also report the discovery of Kenyan strain inflow into White Nile, Sudan.

Fasciola hepatica in Snails Collected from Water-Dropwort Fields using PCR

Fasciola hepatica is a trematode that causes zoonosis mainly in cattle and sheep and occasionally in humans. Fascioliasis has been reported in Korea; however, determining F. hepatica infection in snails has not been done recently. Thus, using PCR, we evaluated the prevalence of F. hepatica infection in snails at 4 large water-dropwort fields. Among 349 examined snails, F. hepatica-specific internal transcribed space 1 (ITS-1) and/or ITS-2 markers were detected in 12 snails and confirmed using sequence analysis. Morphologically, 213 of 349 collected snails were dextral shelled, which is the same aperture as the lymnaeid snail, the vectorial host for F. hepatica. Among the 12 F. hepatica-infected snails, 6 were known first intermediate hosts in Korea (Lymnaea viridis and L. ollula) and the remaining 6 (Lymnaea sp.) were potentially a new first intermediate host in Korea. It has been shown that the overall prevalence of the snails contaminated with F. hepatica in water-dropwort fields was 3.4%; however, the prevalence varied among the fields. This is the first study to estimate the prevalence of F. hepatica infection using the vectorial capacity of the snails in Korea.

Effect of buteyko breathing technique on patients with bronchial asthma

A new dawn is emerging by recognizing that correct breathing volume is fundamental to maintaining good health, the new beginning is based on the life's work of Russian scientist professor Konstantin Buteyko. The Buteyko breathing technique method as suggested by Professor Buteyko helps to decrease the number and severity of attacks as well as the dosage of medication. As a result of this therapy, the indicators of acid-alkali balance and lung ventilation improved. The aim of this study was to assess the effect of Buteyko breathing technique on patients with bronchial asthma. Forty patients with bronchial asthma participated in this study, their age ranged between 30 and 50 years. They were divided into two equal groups, group [A] received Buteyko breathing technique [BBT], and the medications prescribed by the physician, while group, [B] did not perform any physical therapy program just their medications prescribed by the physician. The program continued for 6 weeks [2 sessions per week except the 1st week was 4 sessions per week]. Peak expiratory flow rates [PEFR], Control pause test and asthma daily symptoms [asthma control questionnaire] were measured at the beginning and after the treatment program for both groups. Revealed a significant decrease in asthma daily symptoms, a significant improvement in PEFR, and Control pause test in group [A], while there was insignificant change in group [B]. It can be concluded that BBT produce a significant improvement for patients with bronchial asthma as regard daily symptoms, PEFR and Control pause test

Malpractices of hand hygiene in nursing staff: a global threat for increasing incidence of infections

This study assessed the knowledge, practice of standard hand hygiene in nursing staff to identify the causes of not adapting hand hygiene techniques during routine patient care. A cross sectional study. This study was carried out in Karachi in various public sector hospitals i.e. Jinnah Postgraduate and Medical Centre, National Institute of Child Health, Civil Hospital Karachi, Sindh Institute of Urology Transplantation, National Institute of Cardiovascular Diseases. The study completed in six months from May to November 2010. A sample of 335 nursing staff was selected, convenient sampling was used, consent was taken. They were asked about their practices of hand hygiene through structured questionnaire at five major public sector hospitals of Karachi, Pakistan. Out of 335 nursing personnel. 71.9% were unaware that washing hands under running water for 30sec to 1min remove most of the germs. 74.62% knows that hand washing is necessary. Regarding practices, 35.5% use sanitizers while 47.2% use antiseptic, normal soap for washing hands. 67.1% practice hand washing before and after coming in contact with patients. 43.7% took some treatment after needle prick while others [56.3%] didn't feel the necessity to take any treatment, regardless of the risk of Hepatitis, IHV. 36.1% adopted sterile techniques after hand washing. Surveillance was below average [46.6%]. Hand hygiene knowledge, practices of nursing staff is part and parcel for minimizing infections. Adequate hand washing facilities, positive attitude towards hand hygiene, adherence to practice, strict surveillance system for hand hygiene is essential to combat increasing incidence of infections

Gene Expression Profiles in Genetically Different Mice Infected with Toxoplasma gondii: ALDH1A2, BEX2, EGR2, CCL3 and PLAU

Toxoplasma gondii can modulate host cell gene expression; however, determining gene expression levels in intermediate hosts after T. gondii infection is not known much. We selected 5 genes (ALDH1A2, BEX2, CCL3, EGR2 and PLAU) and compared the mRNA expression levels in the spleen, liver, lung and small intestine of genetically different mice infected with T. gondii. ALDH1A2 mRNA expressions of both mouse strains were markedly increased at day 1-4 postinfection (PI) and then decreased, and its expressions in the spleen and lung were significantly higher in C57BL/6 mice than those of BALB/c mice. BEX2 and CCR3 mRNA expressions of both mouse strains were significantly increased from day 7 PI and peaked at day 15-30 PI (P<0.05), especially high in the spleen liver or small intestine of C57BL/6 mice. EGR2 and PLAU mRNA expressions of both mouse strains were significantly increased after infection, especially high in the spleen and liver. However, their expression patterns were varied depending on the tissue and mouse strain. Taken together, T. gondii-susceptible C57BL/6 mice expressed higher levels of these 5 genes than did T. gondii-resistant BALB/c mice, particularly in the spleen and liver. And ALDH1A2 and PLAU expressions were increased acutely, whereas BEX2, CCL3 and EGR2 expressions were increased lately. Thus, these demonstrate that host genetic factors exert a strong impact on the expression of these 5 genes and their expression patterns were varied depending on the gene or tissue.

Daily living activities of physically disabled children in ismailia city

The present study is descriptive study that aiming to assess daily living activities of physically disabled children. The study was conducted at the available established settings in Ismailia city including Handicapped Comprehensive Rehabilitation Center, Rheumatology and Rehabilitation Unit in Suez Canal University Hospitals and Physiotherapy Unit in Health Insurance Hospitals. The sample included 76 physically disabled children and their accompanying mothers. Data were obtained through an interview with the studied children and their accompanying mothers using three tools, structured interview questionnaire, physical assessment sheet to assess the physically disabled children's daily living activities and rating scale to assess the psychological aspects of the studied children. The results of the study revealed that the studied children were partially dependent in relation to eating and drinking, personal hygiene, toileting and studying their lessons, while they were independent in relation to their motor activities and using both telephone and money. Physical disability has negative physical, financial, social and psychological impact on the studied children's families as found in 65.8%, 59.2%, 46.1% and 75% respectively. Slightly more than three quarters of the studied mothers had unsatisfactory knowledge regarding the physical disability of their children [76.3%]. The study recommends applying an educational program to enable the physically disabled children to achieve their daily living activities independently. Further researches should be done aiming to increase the knowledge of mothers of the physically disabled children through experimental programs and assigning pamphlets on different types of disabilities