Effect of Patient Empowerment Model on Smoking Cessation: Randomized Controlled Trial / 가정의학회지

Background@#Smoking is a preventable cause of chronic morbidity. Patient empowerment is a process through which people establish greater control over their health-related decisions and actions. To assess the effect of patient empowerment versus health education on the nicotine dependence score and progress of patients under different stages of smoking cessation. @*Methods@#This was a single-blinded randomized controlled clinical trial that included 76 smokers attending family medicine clinics. Participants were divided into two groups: empowerment and health education groups. Their nicotine-dependence score and smoking cessation stage were identified. All study participants were subjected to five health education sessions with a 3-month follow-up period. @*Results@#The mean nicotine-dependence score decreased significantly in both groups after the intervention. This decrease was slightly higher in the empowerment group; however, the difference was not statistically significant. After the intervention, 16.7% of the health education and 30.0% of the empowerment group transitioned from stage 1 to stages 2–4 of smoking cessation, with the change being statistically significant only in the empowerment group. There was no statistically significant difference in the number of study participants who stopped smoking between the health education and empowerment groups. @*Conclusion@#Both the empowerment model and traditional health education have similar positive effects on decreasing the nicotine-dependence level. There was a significant improvement in the stage of change for patients under the empowerment model, although there was no statistically significant difference between the groups regarding the number of participants who stopped smoking.

Effect of the Monthly Injectable Combined Contraceptives versus Oral Contraceptive Pills on Mood / 가정의학회지

Background@#Contraceptive agents are widely used by women of reproductive age, and resulting depression is the most common side effect of this usage. This study aimed to study the effect of monthly injectable combined contraceptives versus that of combined oral contraceptive pills (COC) on patients’ mood. @*Methods@#A prospective cohort study was conducted on 124 females aged 18–45 years attending the Kom-Ashfeen Family Medicine Unit, El-Kalyubia, Egypt. Participants were divided into three groups according to their choice: group A included 44 participants who received monthly combined injectable contraceptives (CIC); group B included 40 participants who took COC; and group C included 40 participants who used the copper intrauterine device (IUD). The Patient Health Questionnaire-9 (PHQ-9) score was assessed at the beginning of the study and after 6 months of follow-up. @*Results@#After 6 months of follow-up, there were mild but statistically significant increases in the PHQ-9 score in groups A and B, with group A (CIC users) showing the highest increase. Approximately 34.1%, 27.5%, and 15% of CIC, COC, and IUD users, respectively, moved from the non-depression stage to mild depression after 6 months; this change was statistically significant in groups A and B only. @*Conclusion@#Monthly injectable combined contraceptives and oral contraceptive pills were associated with an increased risk of developing mild depression; this risk was higher in users of CICs, although the difference was not statistically significant. Thus, it is crucial to counsel patients about this possible risk and to follow them up. However, further studies are required to confirm our results.

Effect of Patient Empowerment Model on Smoking Cessation: Randomized Controlled Trial / 가정의학회지

Background@#Smoking is a preventable cause of chronic morbidity. Patient empowerment is a process through which people establish greater control over their health-related decisions and actions. To assess the effect of patient empowerment versus health education on the nicotine dependence score and progress of patients under different stages of smoking cessation. @*Methods@#This was a single-blinded randomized controlled clinical trial that included 76 smokers attending family medicine clinics. Participants were divided into two groups: empowerment and health education groups. Their nicotine-dependence score and smoking cessation stage were identified. All study participants were subjected to five health education sessions with a 3-month follow-up period. @*Results@#The mean nicotine-dependence score decreased significantly in both groups after the intervention. This decrease was slightly higher in the empowerment group; however, the difference was not statistically significant. After the intervention, 16.7% of the health education and 30.0% of the empowerment group transitioned from stage 1 to stages 2–4 of smoking cessation, with the change being statistically significant only in the empowerment group. There was no statistically significant difference in the number of study participants who stopped smoking between the health education and empowerment groups. @*Conclusion@#Both the empowerment model and traditional health education have similar positive effects on decreasing the nicotine-dependence level. There was a significant improvement in the stage of change for patients under the empowerment model, although there was no statistically significant difference between the groups regarding the number of participants who stopped smoking.

Mannose-binding lectin deficiency in preterm neonates

Mannose-binding lectin [MBL] is a collagenous protein that plays a role in innate immunity. MBL deficiency is associated with an opsonization defect and has been associated with recurrent infections, especially in immunocompromised individuals. Neonates are considered to be immunocompromised because adaptive immunity has not yet been developed. This study was done to evaluate the levels of MBL in premature neonates and to determine the relation between MBL deficiency and development of sepsis. This case- control study was conducted on 64 neonates classified into 2 groups; 39 preterm neonates with gestational age [G.A] <36 weeks and 25 healthy full term neonates. Measurement of mannose-binding lectin [MBL] serum level was done on the first day of life using ELISA technique. Mean MBL plasma level was found to be lower in preterm than full term neonates, yet this difference did not reach statistical significance. There was a negative correlation albeit an insignificant one, between MBL level and GA. The deficient group [those with MBL level

Breast conserving therapy for early breast cancer: long term follow-up

Breast conserving surgery followed by breast irradiation for appropriately selected patients with early stage breast cancer gives the same long term survival rates as radical mastectomy. The large breast volume of female Egyptian patients allows for a wide resection margin during wide local excision without a marked alteration in the aesthetic breast contour. Between 1995 and 2004, 101 female patients with early stage breast cancer were diagnosed and treated, at the Cairo National Cancer Institute hospital, by breast conserving surgery followed by postoperative radiotherapy and adjuvant systemic therapy. Patients were regulary followed up till the end of the study. Mean age of patients was 47.1 years [SD +/- 10.2]. The median time of follow-up of patients was 34 months [range: 3-127]. Kaplan-Meier estimate of 5-year local recurrence rate was 11.5% [95% confidence interval]. There was no axillary nodal recurrence. The cumulative 5 year disease tree survival was 80%. 44.5% of patients showed a good cosmetic results while 40.6% showed a fair cosmetic result. It is concluded that, inappropriately selected patients with an early stage breast cancer, they should be offered breast conserving surgery followed by breast radiation. BCT do not affect patient's survival, it preserves the breast in an acceptable cosmetic result and avoid the mutilating result of mastectomy

Nerve sparing radical cystectomy for stage T2 bilharzial bladder cancer: surgical technique and outcome

The exact anatomy and the precise topographic anatomy of the nervi erigents became well established. This technique of nerve sparing radical cystectomy is based on the principle of do not disrupt or interrupt the pathway of the neural fibres of the nervi erigents, that will conform the cavernous nerves. Throughout the steps of this procedure, the integrity of these nerves was protected without compromising the principles of oncologic surgery. Between January 1999 and December 2003, 40 male patients [median age: 50 years, range: 30-67] with stage T[2] bilharzial bladder cancer were treated by this technique of nerve sparing radical cystectomy and urinary diversion at Cairo National Cancer Institute hospital and in the Pyramid hospital at Cairo. The patients were followed up for 3 years after surgery to detect any local or distant recurrence of the disease and to evaluate their potency. Assessment of potency began one month after hospital discharge. All specimens showed a negative prostatic urethral surgical margin. Sixteen [40%] out of 40 patients reported early normal erections to occur in the period from 1 to 6 weeks after hospital discharge. Seventeen patients [42.5%] reported weak unsatisfactory erections and were helped by Sildenafil tablets and gained normal erections and satisfactory sexual activity. Seven [17.5%] out of 40 patients reported no erection to occur up to 12 months after surgery. They were considered to be impotent due to lack of sparing of the neural fibres that supply the corpora cavernosa. The median follow-up period was 53 months [range: 25-84]. For all the forty patients, there were no clinical or radiological evidence of Val or nodal recurrence of the disease. We can conclude that the described modifications of the technique of standard radical cystectony reduced the morbidity of radical cystectomy without altering its therapeutic efficacy

DR polymorphism in chronic active hepatitis C

The aims of this study were to evaluate the association between DR antigens and chronic active hepatitis patients [CAH] and to seek correlations between these antigens and chronicity, disease severity and auto- antibodies in this condition. The frequency of different HLA-DRB I alleles was studied in 30 patient with chronic active hepatitis C [CAH] and 15 cross-matched control group. Both groups were subjected to HLA-DRBI typing using reversed hybridization technique, detection of Sjogren Syndrome Antibody RNA-A [SSA] and Sjogren syndrome antibody RNA-B [SSB] antibodies and detection of ANA, ASMA and AMA antibodies by immunofluorescent technique. Results showed that chronic hepatitis C may be genetically determined as DR3 is significantly higher in patients as compared to controls and DR5, DR2 and DR52 may be protective genes being more frequent in controls. The presence of auto-antibodies with HCV infection may also be genetically determined as it is associated with certain DR alleles. Certain auto-antibodies SSA and ANA are associated with disease severity being more common in patients with chronic active hepatitis C associated with cirrhotic changes

Determination of the flavonoidal content of ricinus communis L and euphoria terracina L

The flavone glycosides [hyperoside, quercetin-3-glucoside and rutin] of Ricinus communis L. and Euphorbia terracina L. are individually determined using the conventional and differential spectrophotometric methods. The glycosides are first extracted with methanol, then separated on silica gel chromatoplates and eluted with methanol [80%]. The absorbance of the glycosidal solutions are measured

Crystalline principles from the leaves of ricinus communis L

Ricinus communis L. was investigated. B-amyrin, stigmasterol and B-sitosterol were isolated from the light petroleum extract of the leaves. Ricinine and quercetin were isolated from the etherial extract. Rutin and hyperoside were isolated from the alcoholic extract

Partial laryngectomy for carcinoma of the larynx: a study of 12 cases

Twelve patients underwent partial laryngectomy for carcinoma of the larynx. Transverse partial laryngectomy was done in three supraglottic tumours. Two of these patients were radiotherapy failures. The vocal cord was fixed in six patients and in three cases the tumour involved the anterior commissural with a mobile cord. The subglottic extension in cordial lesions was less than 1 cm anteriorly to allow for radical excision of the tumour. A satisfactory result with preservation of phonation, deglutition and respiration was achieved in ten patients. In two patients, laryngeal stenosis necessitated traceostomy. Post-operative radiotherapy was administered after excision of a carcinoma of the epiglottis, and to another patient in whom the surgical margin was found involved with tumour after a frontolateral hemilaryngectomy. Local recurrence of tumour occurred in one patient who underwent a subsequent total laryngectomy, and cervical node metastases occurred in another, for whom a radical neck dissection was performed