[Impact of educational intervention on physiological and psychological problems for menopausal women]

Menopause, known as climacteric, is the time in a woman's life when her menstrual period stop and she is no longer able to have children. It is said to have occurred when a woman has not had a period for a year

Objective: This study aimed to identify the physiological and psychological problems; for menopausal women at Al Dawadmi, Riyadh, Saudi Arabia and to evaluate the effect of an educational intervention on the improvement of physiological and psychological health problems

Methods: A quasi-experimental design was utilized for the study [i.e. pre and posttest design]. Setting A convenient sample conduction of 40 women at 2 dispensary "Sharq and Gharb dispensary" Al Dawadmi, Riyadh, Saudi Arabia, was included in the study at the time of research conduction. Where a pre and posttest with no control group was designed and adopted. The study was conducted from [October 2014 to April 2015]. A total of 40 menopausal women were selected in the study, all of them were interviewed, and descriptive analysis was used for demographic data. The investigators assess menopausal woman knowledge and practices regarding the menopause before giving the educational booklet

Results: the study revealed that category of [51-56] years of old age of menopause women were more than third of the sample [40 %]. According marital status about half [52.5%] of the sample were married. It was found that majority of physical symptoms improved post program and there was a highly significant differences pre and post program specifically for hot flushes [0.025*], night sweeting [0.000*], difficult sleeping [0.016*] and dry skin [0.045*]. Also study indicated that knowledge of menopause women improved and became more enough post program than preprogram. In addition, the study revealed that the Majority of psychological symtpoms improved post program.

Conclusions: This study was conducted to assess the physiological and psychological needs for menopausal women at Al Dawadmi, Riyadh, Saudi Arabia. In addition, to evaluate effect of an educational intervention on the improvement of physiological and psychological health problems in menopausal women at Al Dawadmi, Riyadh, Saudi Arabia. The study revealed that the majority of physical and psychological symptoms improved post program and there was a highly signficant differences pre and post program. Also study indicated that knowledge of menopause women improved and became more enough post program than preprogram. The study findings showed that an appropriate training to menopausal women could improve health standards in menopausal women and promote their health

Effect of malathion on pars distalis of the pituitary gland and the possible protective role of vitamin C in adult female albino rats: a histological, immunohistochemical, and ultrastructural study

Malathion is one of the organophosphorus insecticides that are widely used in agriculture and have been reported to cause multiple organ damage. Vitamin C has been proposed as an antioxidant because it reduces oxidative stress. This work aimed to study the possible histological, immunohistochemical, and ultrastructural changes of gonadotrophs and somatotrophs of the pars distalis of the anterior pituitary gland associated with chronic sublethal malathion administration and assess the possible beneficial role of vitamin C in ameliorating these possible changes. Forty adult female albino rats were divided into four groups. Group I served as the control group. Group II received vitamin C at a dose of 20 mg/100 g/day. Group III animals were treated with malathion at a dose of 100 mg/kg/day. Groups IV animals received vitamin C and then malathion after 2 h at the previous doses. The treatments were given orally to the rats for 2 months. The rats were then sacrificed and specimens from the anterior pituitary gland were taken for light and electron microscopic examination. Light microscopic examination of rats treated with malathion revealed that gonadotrophs exhibited vacuolated degranulated cytoplasm and pyknotic nuclei, whereas somatotrophs appeared shrunken with dense nuclei. Immunohistochemically, there was a decrease in the immunoreactivity of follicle stimulating hormone, luteinizing hormone, and growth hormone-secreting cells. Ultrastructurally, gonadotrophs and somatotrophs showed disintegration of cellular organelles and apoptosis of the nuclei. Coadministration of malathion with vitamin C showed a slight improvement in some gonadotrophs and somatotrophs that looked normal in both light microscopic and electron microscopic examination; however, still others were markedly affected, showing signs of degeneration and apoptosis. The results showed that malathion in chronic doses induces histological, immunohistochemical, and ultrastructural changes in gonadotrophs and somatotrophs because of oxidative stress, and the use of vitamin C partially improves the malathion-induced toxicity

Imipenem consumption and metallo beta-lactamase producing pseudomonas aeruginosa resistance to it

Pseudomonas aeruginosa is a leading cause ofnosocomial infections. Carbapenems are highly effective antibiotics against multidrug-resistant Gram-negative bacteria. High intrinsic resistance to antibiotics and the ability to develop multidnig resistance pose serious therapeutic problems. Resistance to carbapenems can be mediated by several mechanisms and production of metallo-beta-lactamases [MBL] has assumed increasing importance in recent years Increased mortality rates have been documented for patients infected with MBL producing Pseudomonas aeruginosa, Therefore, early detection of MBL -producing organisms is crucial . The current study measured the susceptibility patterns of pseudomonas aeruginosa and used one of the phenotyping tests the Imipenem - EDTA disk method, for detection of MBL production strains. 394 consecutive P. aeruginosa isolates were recovered

The great majority of the isolateswas obtained from the wounds [33.5%], sputum [27.9%], urine [7.6%], trachea! aspirate [7.1%], blood [6.1%] and other sources including eye swab, ear swab [17.8%].Most of the sources of infection were obtained from the intensive care unit [2 4.1%] followed by male surgical [10.4%], female surgical [8.9%], male medical [7.6%], female medical [7.4%], and lastly vip ward [0.5%]. High resistance rates were observed for all antibiotic studies

Postpartum health problems encountered among women undergoing cesarean section and nursing implication

The WHO estimates the rate of Caesarean sections between 10% and 15% of all births in developed countries. In Egypt, a significant rise in C.S deliveries occurred for all births, from a low of 4.6% in 1992 to 10.3% in 2000. The aim of this study was to identify postnatal health problems experienced by women delivered by C.S and their newborn, and to propose a nursing protocol to meet the needs of the post cesarean women during the puerperium. A prospective study design was adopted in this study to achieve the stated aim. This study was conducted in the postpartum wards of Obstetrics Department, Women's Health Hospital. Assiut University, Egypt. A purposive sample of all puerperal women [n=330] and their newborns' who had C.S, Repeated CS was the most common indication with the highest percentage [33.6%], followed by fetal distress [21.5%]. more than one fourth of the studied women [25.4%] complained of major health problems during their second postnatal visit

Association of chemokine and chemokine receptor polymorphisms with activity degree of IBD in Tunisian patients

Crohn's disease [CD] and ulcerative colitis [UC] have complex genetic background that is characterised by more than one susceptibility locus. To detect a possible association between the functional polymorphisms of the chemokine receptors CCR5, CCR2 and MCP-1 genes and susceptibility to CD and UC in Tunisian population, polymorphisms of CCR5-delta 32, CCR5-59029-A/G, CCR2-V64I and MCP-1-2518- G/A were analysed in 194 Inflammatory bowel disease [IBD] patients and 169 healthy blood donors using PCR-RFLP and PCR-SSP methods. The patients were classified in 126 patients with CD and 68 patients with UC. The genotypic and allelic frequencies of all polymorphisms studied, did not reveal significant differences between patients and controls, and among CD and UC patients. However, analysis of CD patients revealed that those without homozygosous G/G genotype are more frequently in remission compared to those with this genotype [OR: 0.4; 95%CI: [0.174-0.928]; p=0.03]. Also, the frequency of the CCR2-64I muted allele was statistically higher in CD patients in remission disease than those in active form [OR: 0.267; 95%CI: [0.09-0.78]; p=0.01]. Adjustment for known covariates factors [age, gender and immunosuppressive regimen] confirmed these univariate findings and revealed that the CCR5-59029-A/G and CCR2-V64I genotype were associated to remission form of CD [OR: 2.63; 95%CI: [1.01-6.80]; p=0.047 and OR: 4.64; 95%CI: [1.01-21.31]; p=0.049 respectively]. In conclusion, the present study supports the involvement of chemokine receptor [CCR2 and CCR5] polymorphisms in activity degree of the IBD disease in Tunisian patients

Histological and immunohistochemical studies on the effect of malathion and the protective role of vitamin [C] on the ovary of adult female albino rats

Malathinon is an organophoshorus insecticide [OPI] widely used in agriculture to disinfect crops and stored gains and in some medicine to treat lice and scabies. In this way it can reach to general population and not only to persons working with it. Malathion low dose is toxic to many organs/system of the body and it has been observed that oxidative stress may have a role in malathin toxic action. Many researches have been done on its effect on male genital system. Meanwhile studies on the female reproductive system especially the ovary are limited and need further investigation. Is to the effect of chronic exposure to malathion on the ovary and the role of vitamin C in ameliorating the possible changes induced by malathion. A total number of 70 young adult female rats were used divided into three groups. Group I: 10 animals were kept as control groups. Group II: 30 animals treated with malathion at a dose of 100 mg/kg/day by intragastric tube for two months. Group III: 30 animals treated with vitamin C in a dose of 20 mg/100gm/day given two hours earlier before the dose of malathion for two months. Animals were sacrificed and their ovaries were processed and examined using histological and immunohistochemical [PCNA and Caspase 3] and morphometric techniques. After malathion treatment. The ovary showed significant decrease in the number and size of various types of follicles associated with a significant increase in the atretic follicles. Oocytes looked shrunken with irregular ZP and ill defined nucleolus. Immunohistochemically, there was an increase in the intensity of caspase 3 [maker of apoptosis] reaction and decrease in the PCNA [maker for cell proliferation] immunostaining. Treatment with vitamin C as antioxidant showed some improvement in the ovary. Malathine induced direct ovarian damage that will affect the fertilitry and the coadministration with vitamin C can partially ameliorate these changes. So it is not completely protective

Histological, immunohistochemical and electron microscopic studies on the effect of melatonin on pituitary-testicular axis in aged male albino rat

Aging is a biological process affecting mammalian tissues and organs at different rates. The present work was done to study the effect of melatonin as anti-aging therapy on the structure of the testis and the pars distalis. A total number of 25 male albino rats were used. The animals were divided into three groups: group [I] served as a control adult group [6 months age], group [II] was the control aged group [20-months age] and group [III] was treated with melatonin. The specimens of the testis and pituitary glands were prepared for light and electron microscopy. Histological and immunohistochemical techniques were used to examine these organs. It was found that age-related changes occur in the histological immunohistochemistry and ultrastructure of the testis and pituitary gland. Also, treatment with melatonin as anti-oxidant and free radical scavenger caused improvement of these changes in the pituitary gland as well as the testis. The age-related changes that occurred in the testis included progressive involution and germ cells depletion in the seminiferous tubules which contained only Sertoli cells. Ultrastructural apoptotic changes of germ cells increased with aging and abnormal morphology of the resulting sperms were found. This might result in decapacitating sperm function increase in interstitial tissue. Leydig cells exhibited ultrastructural changes which might lead to a decrease in their activity and testosterone production. As regard the pituitary gland; different utrastructural changes occurred in the somatotrophs or GH cells. The ultrastructrual and immunohistochemical studies of gonadotrophs or LH/FSH cells showed marked deterioration with progression of age. Treatment with melatonin from the adult state improved the morphological and ultrastructural changes that occurred with aging

Polymerase chain reaction versus conventional methods in the diagnosis of vaginal trichomoniasis

A total of 200 females of whom 120 had manifestations of vaginal trichomoniasis and 80 asymptomatic ones were studied. In 54/120 symptomatic female [45%] and in 28/80 asymptomatic ones [35%], T. vaginalis was diagnosed by wet mount of bedside vaginal swab samples of 120 samples from symptomatic females, T. vaginalis was detected in 93 [77.5%] when cultured onto InPouch and 95 [79.16%] in modified thioglycolate media. Culturing 80 samples of asymptomatic females showed T. vaginalis in 35 [43.75%] onto either media. T. vaginalis genomic DNAs was amplified by PCR from 130 [65%] by using TVA5-TVA6 primer pair in 95 [79.16%] samples of 120 symptomatic females, and in 35 [43.75%] samples of 80 asymptomatic ones. Difference between groups was statistically significant. The motile trichomonads was detected by wet mount in 82/130 positive cultures giving 63.07% sensitivity and 100% positive predictive value [PPV]. Flagellates were not detected by wet mount in any negative culture, giving 100% specificity and 59.32% negative predictive value [NPV]. The wet mount diagnostic accuracy [DA] was 76%, without false-positive, but false negative was 48/130 [36.93%]. DNA was amplified from 129/130 positive culture by TVA5-TVA6 primer pair, giving 99.23% sensitivity. No amplification was detected from one positive culture. DNA was not amplified from 69/70 negative culture using TVA5-TVA6 primer pair, giving 98.57% specificity, 99.23% PPV, 98.57% NPV and 99% DA

Psychological distress and quality of life among diabetic pregnant women

Pregnant women may experience specific and intense fears such as fear of incompetence and concerns about pain and loss of control during delivery, fear for their own life and the life of their baby and worries about changes in their personal life due to pregnancy and childbirth. Diabetes is categorized into two groups, preexisting diabetes and gestational diabetes. This study is concerned with assessing and identifying psychological distress and quality of life among diabetic and nondiabetic pregnant women. It was conducted at the obstetric and gynecological department at Assiut university hospital. The study consisted 200 pregnant women, among the subjects, 100 were diabetics and 100 nondiabetics as a control group. Data were collected through two tools, depression anxiety stress scale and quality of life scale. The results of this study yielded that diabetic pregnant women had severe and extreme depression than nondiabetics [X[2] = 29. 32], Also they had severe and extreme anxiety and stress. Diabetic pregnant women had a moderate quality of life than nondiabetics. The study recommended developing strategies to improve quality of life and emotional support for diabetic pregnant women

effect of lead acetate on testicular structure and protective effect of vitamin E in adult albino rat

Lead is considered an important cause of the infertility among occupational workers. The present work was done to study the histological changes in the testicles of adult albino rats after lead treatment for different periods, and the role of vitamin E in minimizing these changes. Forty five adult rats were used in this study. They divided equally into three groups; Group I:-[control]. Group II, was subdivided into subgroups IIa, IIb, and IIc that received lead acetate for one, two and three months respectively. Group III, was subdivided into subgroups IIIa and IIIb and IIIc that received prophylactic vitamin E followed by lead acetate for one, two and three months respectively. The testis was dissected out, processed for examination by light and electron microscope. Lead treatment induced shrinkage in some tubules and loss of germ cells while the remaining cells exhibited pyknotic nuclei with vacuolated cytoplasm. Also proliferation of the interstitial tissue. With increase the duration of lead acetate treatment there was progression in all previous changes in addition to the appearance of multinucleated giant cells. Ultrastructurally, the most characteristic features observed were the apoptosis of the germ cells and Sertoli cells as well as Leydig cells, also degenerative changes specially in mitochondria Combined treatment of vitamin E and lead exhibited marked improvement in most of the previously mentioned changes. Oxidative stress is a major cause of lead induced testicular damage. Using an antioxidant as vitamin E interferes with the reactive oxygen species production and improves lead toxicity

study of overweight and obesity among secondary school students in Dubai: knowledge, attitude, and practice

The prevalence of overweight and obesity among children and adolescents in UAE was dramatically increased in the last few years, which has major public health implications. The aim of the present study was to assess knowledge, attitude, and practice towards overweight and obesity among secondary school students in Dubai. A cross sectional study was carried out in private secondary schools in Dubai using a multistage stratified random sample technique. Self administrated questionnaire was utilized to collect data about socio-demographic characteristics, knowledge, and attitude towards obesity, perception of the students about their weight, methods, and barriers of practicing weight reduction. Results revealed that 33.5% of the students had good knowledge about obesity and its complications while 44.8% had poor level. Positive attitude towards obesity and its treatment was found among 57.0% of the students with no significant gender difference. More than half of the students [56.7%] agreed that obesity is a disease and 72.1% agreed that obesity needs treatment. Self perception of being obese was found among 58.5% of the students, and the majority [72.6%] did not practice any weight reduction before. Females had significantly higher rate of practicing weight reduction compared to males. The most common barriers against practicing weight reduction were lack of knowledge about the methods [47%], lack of time [25%], and lake of interest or support [23.2%]. Female gender and higher education of the mother were independent predictors of good knowledge about obesity, while higher education of the mother was an independent predictor for students positive attitude towards obesity. Utilization of the mass media to enhance the level of community knowledge about obesity and its complications was recommended. Health education materials should be delivered to present and future mothers. School health programs should include interventions to improve knowledge, attitude, and practice of the students towards obesity

Pathological, immunohistochemical and toxicological studies on thallium in albino rats and the role of potassium in protection

The current study was carried out to evaluate the toxic effect of thallium on fertility of male albino rats as well as possible inhibition of adverse effects by using potassium as a prophylactic drug. The oral LD50 value of thallium was determined as 15.49 mg/kg B.wt.. In reproductive toxicity experiment, 90 male rats were divided into 6 groups the first group was a control group, the second group was given potassium chloride daily at a concentration level of 0.36% in feed as a positive control group. The third and fourth groups [A, B] were administrated orally thallium at a concentration level 1/20 and 1/10 LD50 daily. The fifth and sixth groups [C, D] were intubated with 1/20 and 1/10 LD50 daily with the addition of potassium containing diet [0.36%] for two months. The clinical symptoms observed were recorded. Five male rats were sacrificed at monthly intervals. The results revealed that thallium induced adverse effects in male reproduction in all thallium treated rats with or without potassium, whereas animals received thallium with potassium showed lesser effect. The effect was dose and time dependent and the most affection appeared in group [B] which was given 1/10 LD50. These adverse effects were in the form of decrease in relative testes' weights; however, seminal vesicles and prostate glands weights were significantly increased in comparison to controls. Testicular sperm count, sperm motility, alive sperm percentages were significantly reduced, meanwhile, sperm cell abnormalities increased. Fertility was significantly reduced in groups' dosed thallium with or without potassium in that the number of females impregnated by them was significantly reduced to record 0% in group [B]. Abortion was observed in group [A]; resorption, significant drop in number of implants/litters and a live percent were noticed. Fetal values indicated a significant decrease in their body weight and length However an increase in malformations percentage in group A and D was recorded; meanwhile, placental weights showed non significant variation. The positive control group showed non, significant changes in comparison to negative control group. Pathological studies revealed dose and time dependent lesions in the male reproductive system. The male rats in group [A] at one month exhibited disorganization of the germ cells in the seminiferous tubules with release of immature germ cells into the tubular lumina, degeneration of the Sertoli cells and degenerative changes of the germ cells. Moreover, vacuolation in the epithelial linings of the epididymal ducts, prostatic acini and seminal vesicle alveoli were also detected. In group [B] at one month, severe degenerative changes were detected in both Sertoli and germ cells with the formation of multinucleated syncytial giant cells. Moreover, necrobiotic changes were observed in the epithelial linings of the epididymal ducts, prostatic acini and seminal vesicle alveoli. The group [A] at two months of intoxication showed maturation arrest of spermatogonial cells in most tubules with total exfoliation of germ cells into the tubular lumina and focal depletion of germ cells. In the group [B] at two months severe necrotic changes were seen in the germ cells and spermiostasis in the seminiferous tubules and rete testes with calcinosis in one case. Popillary hyperplasia of the prestatic acini and haemorrhage in the lumen of the seminal vesicle lobules and alveoli were also seen. In the group of male rats intoxicated with thallium plus potassium a relatively detectable reduction in tissue lesions were evident. Immunohistochemical demonstration of P53 protein in normal and intoxicated rat testes revealed both cytoplasmic and nuclear detectable moderate immunoreactivity in degenerated germ cells and Sertoli cells with intense immunostaining reactions in necrotic and dead elongated spermatids meanwhile lack of immunoreactivity in both germ cells and Sertoli cells were observed in the testes of normal control rats. In conclusion, these results strongly suggested that exposure to thallium showed overt disorders in male reproductive performance and induced testicular damage which corrupt spermatogenesis process. Potassium as a protective drug minimizes the deleterious effects of thallium but it couldn't give complete protection

Outcome of elerly patients enrolled in home health care program affiliated to A Hada and Al Tayef Military Hospital program in KSA

Home health care is a rapidly growing health care sector. An increasing older population and the desire to reduce acute health care costs have contributed to its growth. Moreover, older persons and their family members do prefer home care. A prospective cohort study was implemented to determine the outcome of elderly patients enrolled in the Home Health Care program affiliated to Al-Hada and Al-Tayef Military Hospitals program, KSA and investigate some factors associated with the outcome of those patients. A total of 131 elderly enrolled in the program were included. Sociodemographic and medical history were obtained, medical records were reviewed and full clinical assessment was conducted. The study extended for 19 months. All elderly were followed- up until discharge from services, readmission to hospital, death, or end of the study. Results revealed that by the end of the study, 65.5% of the elderly were still in the service, 6.9% died, and 17.6% were readmitted to the hospital and didn't' return back. The factors significantly associated with death or readmission to the hospital were the principal diagnosis, higher number of comorbidities, presence of chronic obstructive pulmonary disease [COPD], atrial fibrillation [AF], presence of associated problems, and higher number and earlier timing for emergency visits to hospitals. The independent predictors for death and readmission to hospitals were altered consciousness on admission, presence of AF, COPD, and higher number of emergency visits to hospitals. Further studies including control groups receiving different modalities of care are required to assess the effectiveness of the program. Also cost effective analysis of the service is recommended. Better selection of the patients for the service and assuring their stabilization before admission may improve the outcome of these patients and enhance the quality of care

Self-rated health and some of its determinants among the elderly in rural areas in Egypt

Self-rated health [SRH] is a subjective assessment of individual health status that has been well documented as a reliable predictor of functional disability and mortality in aged populations. A house to house survey conducted aiming to investigate self-rated health and some of its determinants among the elderly in two rural areas in Egypt; Dhayf and Carabigo Villages. A pre-designed interviewing questionnaire was utilized to collect information about socio-demographic data, social relations, health related variables, lifestyle, and functional abilities of the elderly. A single-item measure was utilized to assess SRH. The total number of the available elderly in the 2 villages was 99. Results revealed that poor SRH was reported among 41 .4% of all elderly in the 2 villages while good SRH was reported among 58.6%. The independent predictors of poor SRH among the elderly were being principally cared by others, higher number of utilized medications, insufficient income, and lack of practicing physical exercise. Being cared principally by others was independent predictor of poor SRH among both sexes, while insufficient income and dependency in one function or more of activities of daily living [ADL] were independent predictors among elderly females only. Further studies are recommended. Socioeconomic development, health promotion and protective interventions should be accomplished to enhance functional independence and physical activities among the elderly. Preventive activities should be adopted to deal with chronic diseases and to prevent polypharmacy among the elderly

INF-gamma, IL-5 and IGE profiles in chronic schistosomiasis mansoni Egyptian patients with or without hepatitis C infection

The immune response against clinical forms of chronic schistosomiasis mansoni patients with or without HCV infection was evaluated by assays the serum levels of IFN-gamma and IL- 5 for estimate the cell mediated immunity and IgE level to estimate the humoral immunity. This study included three patient groups. G.I included 25 patients with intestinal schistosomiasis, G.II included 15 patients with hepatosplenic schistosomiasis and G.III included 40 patients hepatosplenic schistosomiasis co-infected with HCV. Control G.IV included 15 healthy persons with matched age and sex. The intestinal group had high IFN-gamma [92%], normal level of IL-5 and IgE. The immune response was mainly 100% Th-1 response. The hepatosplenic patients had high IFN-gamma [26.7%], IL-5 [86.7%] and IgE [73.3%]. The immune response was 73.4% Th-0, 13.3% Th-l and 13.3% Th-2. The co-infected group had high IFN-gamma [62.7%], IL-5 [100%] and IgE [92.5%]. The immune response was 62.5% Th-0 and 37.5% Th-2 immunity. The shift to Th-0 and Th-2 immunity as well as associated depression of Th-1 in mixed group of patients may be playing a role in the persistence and severity of both diseases. Such immunity defects add to decrease challenge against HCV clearance

Women health in poor urban settings in Alexandria

The aim of this paper is to investigate women health and status as well as to study gender gap in three poor urban settings in Alexandria. Poor families were identified and invited to participate in the study through the help of local informants. The study included 172 families, 53 from Abu- Kir, 57 from El-Dahreya and 62 from Wadi El-Kamar area. An interviewing questionnaire was used to collect data form the wives as well as their husbands about household family members. Wives and husbands who participated in the study were clinically examined. Their weight and height were measured. For those who accepted to participate, stool, urine and blood analyses were performed. Female to male comparison as well as sex ratio of some parameters were used to investigate gender gap. Results showed that females were the head of the family in 19.8% of the families. In 18% of the families, wives participated in the family income. Illiteracy represented 94.2% among females aged 45+ years, and unemployment was 97.4%. The rate of ill health increased with age from 36% for girls to 90% among older women [45+] compared to 71% among older males. Cardiovascular and orthopedic disorders represented the most reported problems among older females and males. Diarrhea and ARI episodes were rather more frequent among females than among males. About 60% of examined women suffered from obesity, 45% had gynecological problems, 38% had parasitic infections in stool, and 45% had anemia. Female to male sex ratio was low for <6 and 60+ years old. In conclusion, poor women suffer from high burden of socio-economic disadvantage, gender inequality and ill-health

Survival models for patients with acute myocardial infarction

Acute myocardial infarction [AMI] is one of the most dramatic illnesses that can afflict our patients. Almost two-thirds of heart attack patients do not make a complete recovery, and people who survive the acute phase have a chance of related illness and death that is 2 to 9 times higher than that of the general population. The present work aimed at determining factors that may affect in-hospital mortality of patients with myocardial infarction, at calculating the 30-days survival rates, and at constructing different models of survival rates according to different factors. A 30 days follow up study was carried out on 340 patients with acute myocardial infarction who were admitted to the Main Alexandria University Hospital and Gamal Abd EI-Naser Hospital. The present study revealed a case fatality rate of 11.8% at hospital, while 78% survived up to 30 days. Stepwise discriminant analysis yielded that, occurrence of complications and lack of prescription of B-blockers were the two main predictors for in-hospital deaths. Kaplan-Meier survival curves displayed that significant lower probability of 30-days survival was detected among the elderly, those with high blood sugar, with high or low systolic or diastolic blood pressure on admission, those who had complications at hospital, and those with no prescription of beta-blockers [B-blockers], Angiotensin Converting Enzyme inhibitors [ACE-I], aspirin, and streptokinase medications. A multivariate stepwise Cox regression revealed three predictors of 30-days survival, the first one was age of the patients, those aged 60- <75 or 75 years or more demonstrated a higher risk of deaths compared to those aged <45 years, the second and third predictors were lack of prescription of B-blockers and ACE-I medication, those who didn't receive these medications had the risk of about two times of deaths compared to those who received such medication. Primary prevention of coronary artery disease and AMI should be emphasized. It is important to effectively implement preventive actions in all high risk individuals and to expand delivery of acute treatment in a timely fashion for all eligible patients. It is essential that the primary care physician be fully informed and actively involved in the implementation of treatment strategies designed for secondary prevention of myocardial infarction

Association between placental apoptosis and preeclampsia

to determine whether preeclampsia is associated with an increase in placental apoptosis than in uncomplicated pregnancies, and whether the amount of this apoptosis is related to the severity of this disease and the presence of IUGR with it. Cross sectional clinicopathological study. Department of Obstetrics and Gynecology and Department of Pathology, Assiut University Hospital. Placentas complicated by preeclampsia from a singleton pregnancy between 34 and 40 weeks of gestation were obtained from each of 40 patients. Normal placentas between 35 and 40 weeks of singleton pregnancy were obtained from 44 women as control. A sample of placenta was collected from maternal fetal interface and placed in 10% formalin solution. Apoptosis was quantified by means of light microscopy on 4-um sections of fixed placental tissues. The total nuclei and apoptotic ones in ten high power field for each sample were calculated, for stromal and trophoblastic cells. Expression of bcl-2 protein [an apoptosis-inhibiting gene product] in trophoblastic cells was analyzed monoclonal antibody bcl-2 [clone 124, Dako]. The rate of apoptosis was significantly higher in preeclamptic patients than in control [p < 0.001]. The rate of apoptosis was also significantly higher in severe preeclampsia than in mild cases [p < 0.01]. The apoptosis was significantly higher in pregnancies complicated with IUGR than in those with normal fetuses, bcl-2 protein expression was completely absent in 80% of preeclamptic cases [32], while in all control cases, the antiapoptotic bcl-12 protein was expressed diffusely throughout the cytoplasm of the synctiotrophoblastic cells. Increased placental apoptosis may represent a primary pathologic event in preeclampsia and intrauterine growth restriction. Least expression of Bcl-2 protein in the preeclamptic placentas may result in the increased apoptosis in those placentas. Further studies to determine facton responsible for regulating apoptosis of trophoblasts should provide new insight into understanding of the molecular basis of pathophysiology of the placentas complicated by either preeclampsia or IUGR

Vascular endothelial growth factor level in chronic liver diseases

Ninety individuals [76 males and 14 females] were classified into four groups. G1 [control group] included 20 healthy individuals, G2 [chronic hepatitis group] included 20 patients, G3 [liver cirrhosis group] included 30 patients and G4 included 20 patients with HCC. All groups were subjected to clinical examination, abdominal ultrasonography, complete blood picture, HCV antibodies, HRs Ag and function tests [total and direct bilirubin, total plasma proteins and albumin, prothrombin time and concentration and liver enzymes AST, ALT and ALP]. Patients of G3 and G4 were classified according to Child Pugh classification into A, B and C. Upper endoscopic examination was done for 36/50 patients with chronic hepatitis or HCC. Circulating VEGF levels were determined by ELISA. There was statistically higher significant levels of circulating VEGF in G1, G2 and G3 than in the controls. There was a statistically significant higher level of circulating VEGF in G4 than in G3 and G4 and a statistically negative significant correlation between VEGF levels and platelet count in G2. There were no significant correlation between VEGF and the grade of esophageal varices in G3 and G4 and no significant correlation between VEGF and upper GIT bleeding or spider naevi [vascular skin changes] in G2. A statistically significant correlation was found between VEGF and degree of hepatic dysfunction

Histological study on the effect of aging on the pineal gland of male albino rat

In the present study, it was found that the pineal gland of male albino rat consists of three types of cells; light pinealocytes, dark pinealocytes and neuroglial cells. The light cells are the dominant type of cells, their nuclei are large rounded and vesicular. They have slightly basophilic granular cytoplasm with one or two cellular processes. The dark cells are characterized by more basophilic cytoplasm. The neuroglial cells are smaller in size with deeply stained nuclei and the cytoplasm has numerous irregular large processes. In EM it was found that the light and dark cells have large nuclei with abundant euchromatin and prominent nucleoli. The cytoplasm of dark cells is more electron dense and both types contain abundant RER around the nucleus, large Golgi, many ribosomes, few lipid droplets and neurofilaments. There is a cell-to-cell contact at many sites. Both types of cells were considered active secretary cells. The neuroglial cells have irregular outlines and many branches that extend to surround the pinealocytes. The nucleus is large, dense and contains clumps of heterochromatin. With increasing age, there was an increase in the size of the cells. The pinealocyte nuclear membrane becomes deeply indented and the cytoplasm become more electron lucent and rarify from most of the all organoids except few mitochondria. The lipid contents increased. There was a deposition of many electron dense concretions both inter and intracellularly. The chemical nature of these concretions requires more histochemical studies. The neuroglial cells became very large in size and their cytoplasm became vacuolated. All the previous histological and ultras true tural changes of aged pineal gland of male albino rat represent a decline in the secretary activity of the gland