Angiotensin-converting enzyme gene insertion/deletion polymorphism in Saudi patients with rheumatic heart disease

To investigate the association between angiotensin-converting enzyme [ACE] insertion/deletion [I/D] polymorphism and rheumatic heart disease [RHD] in Saudi patients. A case-control study was conducted in Saudi RHD patients. Genomic DNA was isolated from 99 RHD patients attending the Pediatric Cardiology Clinic at the Maternity and Children Hospital, Al-Madinah, Saudi Arabia from March 2013 to June 2014, and from 145 age- and gender-matched controls. Patient clinical records were reviewed to report major and minor modified Jones' criteria for diagnosis. The diagnosis was confirmed by echocardiography. The ACE I/D polymorphism was identified by polymerase chain reaction. A significant difference in ACE D allele carriage [DD+ID] distribution between RHD cases and controls was identified [p=0.02, odds ratio = 3.6, 95% confidence interval: 1.2-10.8]. The D allele carriage was significantly associated with development of mitral valve lesions alone [p=0.03]. The ACE I/D polymorphism is associated with an increased risk of RHD in the Saudi population. Further studies are needed to confirm our findings and to understand the molecular mechanisms underlying this association

Overall adequacy of antenatal care in Oman: secondary analysis of national reproductive health survey data, 2008

Despite the good health status of women and children in Oman, there are still some gaps to be filled. This study explored the adequacy of antenatal care [ANC] utilization of Omani ever-married women and the sociodemographic and health service determinants of adequate and sufficient ANC. In a secondary analysis of a national dataset [N=1852 women], the percentages of women who had 4+ ANC visits, attended ANC in the 1st trimester and received care by trained personnel were 96.8%, 74.9% and 99.1% respectively. Overall adequacy of ANC [use and sufficiency of recommended basic services] for the surveyed women was 53.8%. After adjustment of other covariates, being pregnant with the 1st baby was the only significant predictor of overall adequacy of ANC [OR 2.2; 95% Cl: 1.6-3.2]. Greater awareness of the need for adequate ANC is required for mothers with more than one baby

Personal hygiene practices and safety measures among governmental hospitals' staff in Beni-Swief governorate

Personal hygiene is one of the most effective ways to protect ourselves and others from illness. Safety measures also include application of standard precautions, education and training for protection of health care workers. The aim of this study was to assess personal hygiene practices and safety measures of health care workers [HCWs] in all governmental, teaching, and non-teaching, Hospitals in Beni-Sweif Governorate. The study was conducted in Beni-Sweif University Hospital, Insurance I hospital, and Ministry of Health and Population Hospital in Beni Sweif Governorate using a descriptive design. It included all nurses [n=421], physicians [n=132], and housekeeping personnel [n=73]. Data collection tools were a structured interview questionnaire form and an observation checklist. The results revealed that, most nurses were females [91.0%], compared to 22.7% of the doctors. More than half of the doctors [53.0%] received the three full doses of HBV, compared 10 41.8% of the nurses [p-0.024]. Overall, 63.2% of the nurses had adequate practice in personal safety compared to 81.1% of the doctors [p<0.001]. The University Hospital nurses had the highest performance in personal safety [79.5%], while the Insurance Hospital had the lowest [42.5%], [p=0.001]. The workers had highest performance with gloving and personal hygiene, and lowest in personal protection measures. The study recommended implementation of a healthcare workers' vaccination program which must be mandatory with provision of all needed equipment and supplies for infection control. Continuing and in-service training programs are needed to improve skills of personal hygiene and safety measures especially for nurses. Workers need training in the use of personal protective equipment, which should be made available to them

Screening for metabolic liver diseases crucial to increase SVR to patients with CHC

Liver diseases and its complications is common health problem worldwide. The emergence of metabolic disorders as a cause after exclusion of viral hepatitis nowadays is important. This is retrospective study on 200 patient's age range from 6 months to 18 years old [50 females and 150 males]. The patients divided into 2 groups according to age < 5 years and >5 years and all investigations done was collected and statistically processed. Abdominal enlargement was observed in 166/200 of all patients, 48/166 [67.6%] in patients <5 years old and 118/166 [91.5%] in patients >5years old with statistical significant, jaundice was present in 34/200 of patients, 23/34 [32.4%] in patients <5 years old and 11/34 [8.5%] in patients >5 years old, with statistical significant difference, CBC was normal in 58/200 of all age groups. 10/58 [14.1%] in patients <5 years old, 48/58 [73.2%] in patients <5 years old, with statistical significant difference and abnormal CBC in 142/200 [61/142, 62.8%] in age group > 5 years old, 81/142 [85.9%] in age group <5 years. Metabolic disorders was normal in 124/200 of all age groups, 23/124 [32.4%] in patients <5 years old. Metabolic disorders was abnormal in 76/200 of all, 48/76 [67.6%] in patients >5 years old and 28/76 [21.7%] in patients < 5 years old, with statistical significant difference and for both age groups. The sensitivity of modalities used in the diagnosis of liver disease was as follow for US, study of metabolic profile, abnormal liver functions and abnormal CBC, 83.1%, 65.2%, 61.6% and 66.1% consequently

Nursing and medical students views regarding the nurses' role in Tanta university

The role of the nurses is one of the challenges facing nursing and medical students entering the clinical phase of their education. This study designed to assess and compare between the views of nursing and medical students about the nursing' roles. This study used descriptive and comparative design. The study carried out at Nursing and Medicine Faculties in Tanta University. The subject constitute of 100 nursing students and 100 medical students, both of them were undergraduates belonging Tanta University. Data were collected randomly from the last year program of both nursing and medical students. One tool was used to collect necessary data to measure nursing and medical student's views about nurses' role. The result indicated that, the majority of nursing and medical students have negative view about nurses' roles. The study recommended that, there is need to identify the nursing faculty program and joint objectives that can be measured and evaluated to minimize the gap between the views of nurses and medical staff

Perception of head nurses regarding the importance of team building elements among nurses at main Assuit university hospitals

The care and service teams are the new imperative in health care, as a matter of survival. High performance teams are essential to an organization efficiency and effectiveness. This study was conducted at the Main Assiut University Hospital; in the following departments: Medical, surgical, I.C.U, obstetric, pediatric, orthopedic, psychiatric departments. To assess the head nurses perceptions regarding the importance and willingness for application of team building elements among head nurses at Main Assuit University Hospitals. The study sample included all the available head nurses [65] currently assigned to work in the selected units. The tool of the study was a questionnaire sheet consisted of two parts: The first part was related to socio-demographic characteristics of the study sample including department, years of experience, qualifications, social status and number of children. The second part consisted of 39 items which were categorized into 5 domains: goals and objectives [4 items], job roles [3 items], communications [15 items], teams activities [2 items] and finally, environments [15 items]. The present study concluded that defining goals and objectives, clarifying the rules and responsibilities, the role model of assertive communication and, encouraging the team work to develop and experiment new approaches in their work were important elements of team building. The study revealed that there were strongest positive relations between importance of team building elements and willingness of head nurses to apply in team activities, communication and finally environments. It is recommended that the more emphasis is needed for encouragement of every head nurse to share in developing objectives of team work to achieve their goals and create positive work environment to satisfy nurses needs, maintain an enthusiastic team, and allocate rewards based on quality of the work team, and reinforce competitive attitude among team work

Assessment of factors affecting clinical teaching as perceived by nurse-teachers and nursing students in secondary technical nursing schools in Assiut City

Clinical training provides the nurse-students with knowledge skills and attitudes to provide patient's care with high quality in different settings. Clinical practice provides the opportunit for students to become skillful in the use of theories of action and provides a fertile experience in learning how to learn. The objectives of this study were to assess the factors affecting clinical teaching experience as perceived by nurse-teachers and nurse students. The study was done in three females' secondary nursing schools in Ass jut City. The subjects included in the study were 28 nurse teachers and 212 nurse-students. The data collection tool, which used consisted of questionnaire sheet for nurse-teachers and students, nurse. This questionnaire was aimed at identifying teachers and students perception about the factors that influence student's acquisition of clinical experience; the questionnaire was composed of three parts: 1-Structure factors: This part included hospital and external units [10 factors], school laboratory [6 factors], nursing team [13 factors], physician's team [8 factors] patients and their families [8 factors], and administration [7 factors]. The qualification needed for the clinical teaching [4 factors] and interpersonal traits of the clinical teacher [5 factors].2-Process factors: this part included interpersonal relationship of clinical teacher [6 factors], nursing competence of the clinical teacher [14 factors] and teaching competence of the clinical teacher [10 factors]. 3-Out come factors: this part included [12 factors]. In the light of the findings of this study, it can be concluded that the students and teachers gave priority to the importance of the process factors. There were statistically significant differences between students and teachers opinions regarding structure, process and outcome factor

Students' portfolio: a new trend to assess the fourth year nurse students' mastery of the administrative skills

This study was conducted at the Faculty of Nursing in Assiut University to apply students' portfolio as a new trend to assess the fourth year student's mastery of the administrative skills. The study sample consisted of 60 students classified as thirty experimental group and thirty control group. Data collected through students' assessment by applying students' portfolio as assessment tool. Data collection took about two months. The results revealed that using of students' portfolios leads to enhancement of student's personal and professional level. At the area of administrative skills they become able to achieve assignment sheet accurately, they become excellent in performing daily shift report, gain ability to completion of patient cards effectively, identify patient needs, and describe the proper nursing care according to priorities. They are able to use proper documentations at different types of hospital departments, while the control group improved at the assignment sheet, daily shift report and patient cards to some extent and did not have new skills as the experimental groups

Determination of antioxidant vitamins and chlamydia pneumoniae IgG antibodies in patients with atherosclerosis

Atherosclerotic coronary heart disease is a wide spread disease in the entire world causing death in most cases. Disorders of lipoproteins metabolism are of the most important modifiable risk factors for atherosclerosis. High intake of antioxidant vitamins e.g. vitamin E and A have been linked with a reduced risk of coronary vascular disease. Chlamydia pneumoniae infection has been associated with coronary vascular disease. The aim of the present work is to estimate serum levels of lipid profile; antioxidant vitamins A [retinol] and F [alpha-tocopherol] as well as Chlamydia pneumoniae lgG antibodies in Patients with Atherosclerosis. A case control study was conducted on fourty atherosclerotic patients aged 30-50 [40 +/- 10] years. The control group was another fourty healthy age and sex matched individuals. Fasting blood samples were collected from all subjects; serum was separated by centrifugation and was subjected to the determination of total cholesterol [TC], triglycerides [TG]. high density lipoprotein cholesterol [HDL-C] and low density lipoprotein cholesterol [LDL-C] concentrations. Retinol and alpha-tocopherol levels were estimated by high performance liquid chromatography. Chlamydia pneumoniae specific IgG antibodies were also measured by micro-immunofluorescence technique. Serum levels of TC, TG, LDL-C, TC/HDL-C ratio and LDL-C/HDL-C ratio were significantly higher, while serum levels of HDL and alpha-tocopherol were significantly lower in patients than their corresponding control. Chlamydiapneumoniae specific IgG antibodies were detected in 50% of patients and in 7.5% of control. The present study revealed that the decreased levels of vitamin A and E together with the increased prevalence of Chlamydia pneumoniae lgG antibodies may represent non-traditional risk factors for atherosclerosis

Relationship between assertiveness and leadership styles among nureses' managers at Assiut university hospitals

Of the study was to assess the relationship between the assertiveness and leadership styles among nurses managers at Assiut University Hospitals. The study sample including all the available nurses' managers [82] currently assigned to work in different units at Assiut University Hospitals; [1] director of nursing, [3] assistant director, [12] supervisors and [66] head nurses. The questionnaire sheet consisted of three parts: The first part related to sociodemographic characteristics of the study sample [age, qualifications, position and years of experience]. The second part of the tool consisted of 34 questions that measure the assertiveness of the nurse managers. The possible responses of this part were strongly agree scored [1], agree scored [2], sometimes scored [3], disagree scored [4] and strongly disagree scored [5]. The third part of the tool consisted of 16 questions that measure the leadership style of the nurses' managers. The possible responses of this part were yes scored [1] and no scored [0]. The questionnaire is divided into three parts [each part involves six questions] the first six questions detected the directive leadership style, the second six questions detected the participative leadership style and the last six questions detected the permissiveness leadership style. The result denoted that there were no statistically significant differences between leadership styles and assertiveness among the nurses' managers. On the light of the present findings the researchers recommended the necessity of sharing of the nurses in decision -making, policy making, informing the nurse managers with description of each position, the nurses' managers must have authority commensurate with their responsibilities and must have adequate opportunity for promotion, professional growth and in-service training opportunity about communication and leadership in nursing

role of organizational climate in conflict management among nursing personnel working at Assiut university hospital

Building a positive work climate, where trust and participation are hallmarks and where conflict and changes are seen as productive, can produce a dynamic and flexible organization. Of this study was identifying the factual organizational climate as perceived by nurses, determining the causes and effects of conflict, management strategies, positive and negative effects of conflict and assessing the employees for the chosen strategy for conflict management. It was conducted in Assiut University Hospital usuig a cross-sectional design. Included 195 staff nurses, 107 head nurses and 2 assistant nursing directors and the director of nursing services administration. Data were collected using the organizational climate questionnaire and the organizational conflict questionnaire. Revealed [hat 73.4% of nurses considered organizational climate as positive. Inter-group conflict was the highest [72.8%]. Almost all nurses were for confrontational resolution strategy [97.0%], while avoiding was the lowest [80.7%]. Most nurses considered conflict resolution strategies effective [83.3%]. Statistically significant relations were shown between inter-group conflict and nurses' age [p=0.002], qualification [p=0.04], experience years [p=0.006] and job position [p=0.03]. Positive organizational climate was associated with higher percentage of effective resolution, p<0.001. Positive statistically significant correlations were found between organizational climate and effective resolution [r=0.64] and positive effect of conflict [r=0.47 and between positive effect of conflict and effectiveness of resolution [r=0.46]. It is concluded that most studied nurses considered organizational climate as positive. Positive organizational climate was associated with higher percentage of effective resolution and more positive effect of conflict. To improve the organizational climate through increasing the effectiveness of the communication system, reconsidering the reward system, with emphasis on recognition and support

efficacy of turmeric to alleviate chlorinated solvents-induced oxidative status on rats

Purpose is to examine the possible influence of turmeric as natural antioxidant on 1,2-dichloroethane [1,2DCE] induced oxidative status in rats. Thirty five adult male albino rats Sprague-Dawley strain were divided into five groups [7rats each]. Group A served as negative control fed basal diet. Group B [positive control] fed standard diet and 1,2DCE added [313mg / 100 g diet] for 4 weeks. Group C fed standard diet + 1,2DCE + curcumin 0.5% for 4 weeks as a protective group. Group D fed standard diet + curcumin 0.5% for 4 weeks after that added 1,2 DCE to 4 weeks as a preventive group. Group E fed standard diet + 1,2DCE for 4 weeks after that added turmeric 0.5% for 4 weeks as a curative group. Levels of Glutathione [GSH], Superoxide dismutase [SOD] and Malondialdehyde [MDA] were determined in homogenate kidneys, brain, and lungs of rats. RNA and DNA were extracted from brain homogenate. Determination of serum: total protein, urea, uric acid and creatinine. The results showed that both of GSH, SOD, RNA and DNA increased in rats' tissue for treated groups with turmeric but MDA is decreased versus positive groups. The analysis of serum explains alleviating the adverse effect of chlorinated solvents on rats that fed turmeric. kidney, lung and brain, these organs representing important target organs of chlorinated solvents toxicity and the turmeric as a natural antioxidants alleviated effect of these pollutant

Turmeric may protect cells from oxidative stress by acrylamide in-vivo

Turmeric is a perennial herb; the rhizome is the portion of the plant that is used medicinally. It is the source of the spice turmeric with characteristic yellow color. Acrylamide is found in some foods that are cooked at high temperatures. It appears to be formed as a by product of the Maillard reaction. Maillard reaction is a type of non -enzymatic browning, which involves the reaction of simple sugars [carbonyl groups] and amino acids. Only the acrylamide monomer is toxic. Present work is focused on turmeric's antioxidant activity against acrylarnide toxicity. Rats were divided into three groups [7 rats/ group]. Group A served as negative control that was fed on standard diet [commercial diet] for 11 days. Group B was fed for 11 days on standard diet containing 0.34g acrylamide / kg diet as a positive control. Group C received standard diet with turmeric [0.5%] and same concentration 0.34g acrylamide/ kg diet for 11 days as a protective group. Results revealed that kidney, brain and lung tissues were disturbed when rats were fed on acrylamide diet. Turmeric had ameliorated the antioxidant status in these organs. It is concluded that turmeric as a natural antioxidant has protected from acrylamide toxicity

Alteration of oxidative status in rats following administration of acrylamide

Acrylamide [ACR] is a known industrial neurotoxic and carcinogenic chemical in rodents. The recent discovery of acrylamide in wide variety of commonly consumed foods has energized research efforts worldwide to define toxic mechanisms. The present study is carried out to investigate the effect of acrylamide administration on in vivo malondialdehyde [MDA, a product of lipid peroxidation], reduced glutathione [GSH] as well as copper and zinc superoxide dismutase enzyme activity [Cu/Zn SOD] of rats. Fourteen adult male Sprague Dawley rats were divided into two groups each containing "7" rats. Group I served as negative control fed on basal diet and group 2 [positive control] received basal diet and acrylamide [0.34 g/ kg diet] for 11 days. Levels of MDA, GSH and activity of SOD were determined in liver, kidneys, brain, heart, testes, spleen and lungs of rats. ACR treatment significantly increased MDA in all organs; the highest increase was detected in testis [87.9%] and heart [71.5%] while the lowest one was found in kidneys [28.2%]. On the other hand, GSH levels and SOD activities were significantly reduced in ACR treated rats. However, the reduction of GSH level ranged from 10.2% to 36.5%.The inhibition of SOD activities were higher in testis [57.3%] and lungs [38.5%]. The present study showed that ACR exerts deteriorated effects on oxidative status of rats

pathophysiology of hemodialysis-induced hypotension in end stage renal [ESRD] disease patients

The upsurge in the renal failure patients undergoing haemodyalisis has attracted the researcher to figure out the possible mechanism of the haemodyalysis associated with hypotension. the purpose of this study was to determine plasma levels of ghrelin, leptin, insulin, and nitric oxide in renal failure patients with and without haemodialysis-induced hypotension, and to examine the potential correlation between these parameters and mean blood pressure in those patients. Sixty-four renal patients were included in the study and, were divided into three groups The first group consisted of 21 patients with renal insufficiency who were not on dialysis [NHD], the second group consisted of 23 patients on regular maintenance hemodialysis with normal blood pressure [HDNT] and, the third group consisted of 20 patients on regular maintenance hemodialysis with hypotension [HDHT]. The control group consisted of 20 healthy volunteers. Body mass index [BMI] and waist-hip ratio [WHR] were assessed. Blood pressure was measured three times within an interval of 5 min and the average was estimated. Mean blood pressure [MBP] was calculated. Nitric oxide metabolites [nitrates + nitrites, NO[X]], plasma ghrelin, leptin and insulin levels were assayed. BMI was significantly lower in HDHT group than the control, NHD, and HDNT groups. While the waist/hip ratio was significantly higher in HDHT group than NDH group. Both systolic and diastolic blood pressures were significantly lower in HDHT group than the other groups. Regarding the HDNT group, the systolic blood pressure was significantly lower than control and NHD group, while the diastolic one was significantly lower than the NDH group. Serum albumin was significantly lower in both HDHT and HDNT groups compared with NHD and control groups, however, it was significantly lower in HDHT compared with HDNT group. In addition, serum urea and creatinine, were significantly higher in the both HDHT, and HDNT groups compared with NHD and control groups, and it was significantly lower in HDHT compared with HDNT group. Plasma levels of Ghrelin, nitrate/nitrite [NO[X]] and leptin were significantly higher in patients compared with the control groups. Moreover, they were significantly higher in HDHT than HDNT and NHD groups, and in HDNT than NHD group. Regarding plasma levels of insulin it was significantly higher in the renal patients compared with the control group. However, there was no significant difference in insulin level between NHD and DHNT groups, while it was significantly higher in HDHT group compared with the two other renal patient groups [NHD, and HDNT. There was a significant negative correlation between changes of mean artrial blood pressure and ghrelin, leptin, insulin levels in both HDNT and HDHT patients. Our data suggest that excessive production of ghrelin, leptin, insulin and NOX contributes to HD-related hypotension in renal dialysis patients. The significantly elevated plasma levels of leptin and ghrelin is probably, at least in part, caused by impairment of their clearance by the kidney. Although being produced by the kidney, the physiological role of ghrelin in the kidney under normal and pathological conditions remains not fully elucidated. The elevated plasma insulin level may be caused by impaired glucose metabolism in uremic patients with alterations in insulin degradation and insulin secretion. The elevated NO[X] may be due to elevated serum leptin that modulates endothelial NO production, and /or elevated serum insulin that enhances NO release. However, we need to study the correlation between NO production and leptin and insulin levels in HD-related hypotension in renal dialysis patients to confirm this hypothesis

Synthesis of polyfunctionally substituted 5,6,7,8 tetrahydroquinolines and several condensed azines

2-amino-3-cyano-4-phenyl-5,6,7,8-tetrahydroquanoline [3] and other related new quinolones were synthesized and submitted to evaluation for their anti-microbial activity. Compound [3] was prepared by reaction of cyclohexanone, arylidines malononitrile and amm. acetate. Other reagents were studied as the nature of the nuceolophile and reaction conditions. The behaviour of some products towards carbon electrophiles, e.g. acid chlorides, acid anhydrides and alkylating agents has been discussed

Postoperative outcomes among cancer patients undergoing colorectal diversion at Assiut University Hospital: suggested nursing intervention protocol

Colorectal cancer is one of the leading causes of cancer death in both developed and developing nations. Early and late problems may be faced by patients after colostomy surgery. Assessment and management of stoma complications are the responsibility of nurses across the continuum of care and played a central role in the clinical appreciation and postoperative management as evidenced by interest in managing postoperative outcomes and treating the complications. Therefore, the aim of this study was to identify the postoperative outcomes among patients undergoing permanent colorectal diversion, sixty patients were selected from the General Surgical Units in Assiut University Hospital and Upper Egypt Cancer Institute, their age ranged between 30-70 years with mean age of 50.30 +/- 11.28 yrs. Tools used for data collection were Socio-demographic and Medical Data Sheet; Physical and Social Assessment Sheet; Nutritional Assessment Form and Rosenberg's Global Self Esteem scale [RGSLs]. Structured interview was utilized for data collection. The results of the study showed that, 5% had stoma retraction, stoma fistula and mucocutaneous separation and 8.3% had stoma infection and 21.7% had skin breakdown and skin irritation. Half of the sample had gases, and 23.3% suffered from leakage. Social problems and low self-esteem were found among more than half of study subjects. The most of the patients had underweight, subnormal values of hemoglobin, albumin and white blood cells were found. The study concluded that, patients undergoing permanent colorectal diversion exhibited different physical, social, self esteem and nutritional changes and need effective measures to prevent/ reduce these complications Another further study on a larger sample and for 6 months to one year as a minim time for follow up is recommended, encourage preoperative physical, social, psychological and nutritional preparation for colostomy's patient and design a rehabilitation program for patients with permanent colostomy

Predictors of treatment failure among tuberculosis patients under DOTS strategy in Egypt

Treatment failure is a serious problem facing some national tuberculosis [TB] control programmes. Irregularity of treatment is a factor that can lead to treatment failure. A case-control study was carried out in TB centres in Egypt during April 2001-December 2002 aimed at investigating the predictors of treatment failure. We interviewed 119 people with treatment failure and an equal number of cured cases [controls] and their families regarding sociodemographic characteristics, information about TB, information about drugs, treatment compliance, family support and patient-family interaction. Significant risk factors for treatment failure were non-compliance to treatment, deficient health education to the patient, poor patient knowledge regarding the disease and diabetes mellitus as co-morbid condition