Assessing health staff practices that influence continuity of breastfeeding

Summary: Baby Friendly practices that support breastfeeding initiation and continuity save lives. The aim of this study is to assess the factors affecting the warm chain for supporting breastfeeding continuity. A survey for Baby Friendly practices was conducted in 7 maternity services, 5 of which were previously designated as Baby friendly in the early 1990s. Both staff and mother were interviewed. The results showed that although some practices related to early separation and prelacteal feeding have been maintained, yet they do not fully meet the global BFHI criteria. Absence of prolonged skin to skin contact and prevailing infant milk formula feeding practices in neonatal and pediatrics wards are the challenges that face success in these hospitals. It is concluded that achievement of full support for successful breastfeeding depends on identifying the loops in the warm chain for breastfeeding support. This chain begins with antenatal preparation in primary health care then initiation in maternity wards and continues to the support provided in neonatal and pediatric wards then in primary care during vaccination and growth monitoring. The chain can break at any point by the uncontrolled marketing practices of infant milk formula companies

assessment of mother friendly in maternity services in Egypt

The aim of the study was to assess mother friendly practices and satisfaction of mothers with services they received in maternity facilities. The study was conducted in 5 hospitals with 1145 mothers and 120 staff who attend labor. Overall findings revealed that mothers were not allowed to have preferred family companion at birth, non-pharmacological pain relief methods were ho encouraged and mothers were not allowed to assume position of her choice at birth. This reflected on mothers1 dissatisfaction with the quality of services. It is concluded that there is a need to encourage mother friendly practices at birth

Effectiveness of a computerized monitoring tool for the baby friendly hospital initiative in Egyptian settings

This study is an intervention study aimed at promoting the quality of Services delivered to mothers and babies in birthing facilities, by monitoring the Global Criteria set for the Baby Friendly Hospital Initiative [BFHI]. This study was carried out in Damanhour Teaching Hospital. The obstetric and neonatal intensive care [NICU] practices were periodically assessed by sampling twenty mother-infant pairs at three weeks intervals over 6 monitoring Sessions with a total of 120 mother-infant Pairs over the entire period of study from August to November 2008. Two weeks after the last monitoring session, we sampled a total of 80 mother- infant pairs from maternity services of four neighboring hospitals as a Comparison group with the intervention hospital. The results showed that there was a significant improvement in the practice of the Ten Steps using the monitoring technique. We recommend that future BFHI implementation in Egypt should adopt monitoring as a tool to reinforce training and ensure sustainability

Needlestick injuries among health care workers of University of Alexandria hospitals

The aims of tiis cross-sectiona sffi and circumstances of needlestick injury [NSI] among heath care workers at University of Alexandria teaching hospitals and to assess the effectiveness of the existing control measures and standard precautions Data were obtained by anonymous, self-reporting questionnaire from 645 staff in 2007. Around two-thirds of workers [67.9%] had suffered at least 1 NSI in the last 12 months. High-risk patients [with history of HIV, hepatitis B virus or, hepatitis C virus infection or injecting drug use] were involved in 8.2% of injuries. On evaluating the effectiveness j of existing control measures, significant were: using devices with safety features [OR 0.41], adherence to infection control guidelines [OR 0.42] tranining in injection safety [OR 0.14], comfortable room temperature [OR 0.32] and availability of a written protocol for prompt reporting [OR 0.37]

Gene expression of vasopressin receptor type 2 and aquaporin 2 in acute renal failure versus chronic renal failure in rats

Urinary concentration decreases in response to a reduction of functioning renal mass. Although a variety of factors have been implicated, the pathogenesis of impaired urinary concentration ability in acute renal failure [ARF] and in chronic renal failure [CRF] especially the cellular and molecular defects, were poorly understood. Our study therefore aimed to present a possible explanation for the pathogenesis of impaired urinary concentration and the molecular defect in kidney tissue of experimental ARF and CRF rat models and aimed to find and compare any molecular defect difference between ARF and CRF. Thirty albino adult male rats were used in our study and the animals were divided into three groups. Group I: Sham-operated controls [n=10]. Group II: Renal ischemia-reperfusion injury group [n=10] in which the renal artery and vein were bilaterally exposed and occluded for 30min with vascular clamps to produce renal ischemia-induced acute renal failure [ARF], the clamps were removed to allow kidney reperfusion then the animal sacrified after 24H. Group III: Chronic renal failure group [n=10], this group of animals underwent right total nephrectomy and removal of 2/3 of the left kidney and the experimental protocol lasted about one month then the animals were sacrified. Blood, urine and kidney tissue samples were collected from the three groups to measure serum urea and creatinine and 24 hour-urinary albumin for evaluation of kidney function and to measure aquaporin 2 water channel and vasopressin-receptor type 2 [V[2]] gene expressions in kidney tissue. Kidney function tests as regards serum urea, serum creatinine and 24 hour-urinary albumin in group II and group III showed a significant [p<0.05] increase in comparison to control group [group I]. Ischemic-reperfusion rats [group II] showed the highest of these parameters indicating that, they had the worst kidney function. A significant [p<0.05] decrease in vasopressin-receptor type 2 [V[2]] mRNA expression in kidney tissue was shown in group II [ARF] and group III in comparison to the control rats [group I] with the highest reduction in group II. A similar result was found as regards Aquaporin 2 water channel mRNA expression with a significant [p<0.05] reduction in group II and group III in comparison to group I, and the highest reduction was seen in group II among the three studied groups. In both ischemia-reperfusion rats and CRF rats, the ischemic and nephrectomy insults were associated with decreased mRNA expression of the aquaporin 2 and vasopressin-receptors type 2 [V[2]] in the kidney tissue, coinciding with the impairment of kidney function. This may contribute to the impairment in urinary concentration in the post-ischemic period and the urinary concentration defect associated with CRF

Annexin V as index of apoptosis in aorta of STZ induced diabetic rats

Diabetes mellitus [DM] is a chronic disease associated with hyperglycemia and the production of reactive oxidative intermediates and a disturbed antioxidant defense mechanism. Apoptosis or programmed cell death is a fundamental component of tissue differentiation and development, it also plays a central role in DM. The highly regulated mechanism of apoptosis involves an externalization process of phosphatidylserine [Ps]. Annexin V binds with high affinity to Ps-exposing apoptotic cell and can inhibit thereby the procoagulant and proinflammatory activities of the dying cell. Heat shock proteins have been shown to protect organism in vitro and in vivo against oxidative stress which plays a role in apoptosis in DM. HSP72 inhibits mitochondria! cytochrome release and subsequent caspase activation that leads to apoptosis. Fifty male albino rats weighing 170-200gm were used in this study. They were divided in to 5 equal groups, each of 10 rats. Group I: Control group. Group II: Diabetic group. Type 2 diabetes mellitus was induced by intraperitoneal injection of streptozotocin at a dose of 40mg/kg body weight. Group III: Diabetic group, treated with 1 unit insulin injected subcutaneously daily. Group IV: Diabetic group, receiving vit. E 600mg/kg B.Wt injected intramuscularly, 3 times/week, All groups were sacrified one month after the beginning of the experiment. Blood samples were obtained from retro-orbital vein for assessment of glucose and malondialdehyde [MDA], then Animals were sacrificed and aortic tissues were removed,PCR for Annexin V and for HsP72 were done. Compared to control group, fasting serum glucose is significantly higher in the diabetic group [group II] [p<0.05] and it decreased significantly with administration of insulin [group III]. MDA is significantly higher in the diabetic group II compared with control one [p<0.05]. It decreased significantly with administration of insulin [group III] or vitamin E [group IV] in comparison to diabetic group [group II]. Administration of vitamin E and insulin [group V] leads to significant reduction in MDA back to control level. The expression of Annexin V is significantly higher in the diabetic group [group II] compared to control group [p<0.05]. Administration of insulin [group III] or vitamin E [group IV] decreases it significantly. The expression of HSP72 is significantly lower in the diabetic group compared to control one [p<0.05]. It increased significantly with administration of insulin [group III] or vitamin E [group IV]. Serum MDA level rise in STZ induced diabetic rats as a marker of oxidative stress and administration of vitamin E was found to normalize this level, in addition a significant rise in expression of Annexin V as a marker of apoptosis in aorta of STZ induced diabetic rats with decreased expression of HSP72 which may be involved in cellular protection against oxidative stress in DM

Sex hormones and adrenocorticotropic hormone [ACTH] alterations during sleep deprivation and recovery in adult male rats

Positive association between sleep efficiency and plasma testosterone level in men was demonstrated by previous studies. Stresses in general and sleep deprivation in particular alter the male reproductive function and several studies indicate that sleep deprivation alters male sex hormones levels. Low sleep efficiency was associated with attenuated testosterone level. However, little information was available about the alterations of male sex hormones during the recovery period following the sleep deprivation. So, the purpose of the present study was to investigate the influence of 4-days recovery periods after 4-days sleep deprivation on male sex hormones and the role of ACTH hormone during both deprivation and recovery periods. Sixty four male albino rats weighing 200-250g each, were randomly distributed into three experimental sets: sleep deprived [SD] groups, recovery [R] groups and control group. The SD rats [n=24] were divided into 4 groups: SD1, SD2, SD3, and SD4 groups [each included 6 rats] that were subjected to SD for 1, 2, 3, and 4 days respectively. The recovery rats [n=24] were also divided into 4 groups [each included 6 rats] that were sleep deprived for 4 days and had left for recovery for 1, 2, 3, and 4 days; corresponding to R1, R2, R3 and R4 groups respectively. Finally, the control group included 16 rats. At the end of each group preparation, rats [control, SD and R] were sacrificed and plasma samples were collected for further measurement of testosterone, estradiol, progesterone and ACTH hormones. Compared to control rats, SD rats showed a significant [p

Diagnostic utility of viral load and biochemical markers in chronic hepatitis C viral infection associated with hepatic fibrosis

The role of liver biopsy in management of patients with chronic hepatitis C is currently being depated. A liver biopsy is most often preserved for those considering treatment in order to assess the grade and stage of hepatitis. Several non invasive markers of hepatic fibrosis have been evaluated for their ability to assess liver histology. The aim of this study is to assess the degree of hepatic fibrosis as evaluated by liver biopsy and ultrasonography in relation to serum HCV-RNA viral load, routine biochemical and haemotological markers. The study was carried out during the period 2005-2006 it included 20 chronic HCV out patient who attended the Out Clinic of Hepatology Unit Faculty of Medicine and Medical Research Institute Alexandria University. Patients were clinically evaluated and tested for the presence of anti-HCV by ELISA, HCV-RNA by quantitative Real Time PCR. A panel of routine biochemical tests includes [ALT, AST, GGT, serum albumin, serum cholesterol, prothrombin activity and platelet count was carried out. Core liver biopsies were taken from all 20 patients under U/S guidance. This study shows 11 [55%] out of 20 chronic HCV patients has no significant fibrosis by Metavir staging [F0-F2].while the remaining 9 [45%] had significant fibrosis [F3-F4] The viral load did not correlate with the degree of liver fibrosis. Platelets and albumin were significantly associated with the presence of significant fibrosis 90% of the HCV patients with no significant fibrosis and prothrombin activity act >/= 80%. A platelet count below 150x109/L was associated with significant fibrosis while or platelet count more than 150x109 does not exclude its presence. By using the APRI index [AST/platelet] all patients with significant fibrosis have a score less than one while a score more than 2 is associated with significant fibrosis. A score less than 2 in the API [Age/platelets] was favor of the absence of significant fibrosis while the score of 6 was associated with significant fibrosis by using Forns index 88.9% of patients with significant fibrosis has a cut-off value higher than 2 while all patients with no significant fibrosis has a cut-off value less than 6.9. By using [ALT/AST] ratio 72% of patients with no significant fibrosis had a ratio less than one. Our results confirm the NIH consensus status of 2002 had no single non invasive test or panel of serological markers can provide an accurate assessment of the intermediate stage of liver fibrosis indicating that non invasive tests could not replace the information provided by liver biopsy

Nitric oxide in gall bladder diseases

Nitric oxide is implicated in the physiological modulation of gastric and gall bladder motility during the inter and postprandial phases.In this study, we have investigated nitric oxide in the sera of 50 individuals, 10 healthy controls [Group I] and 40 randomly selected patients with chronic cholecystitis [Group II]. Patients were subdivided into 3 subgroups, 15 patients with calculous cholecystitis [Group IIa], 15 parients within non-calculous cholecystitis [Group IIb] and 10 cases with biliary sludge [Group llc]. Results of this study have demonstrated high concentrations of serum nitric oxide in patients with chronic cholecystitis particularly those with calculous cholecystitis and those with biliary sludge. These observations may suggest that, the increase in nitric oxide production impair gall bladder emptying leading to gall stasis and hence, together with other factors, may lead to gall stone formation. This study, has also shown that, obesity, smoking and gender don't affect nitric oxide serum level. Further studies are recommended especially on large number of patients to varify the effect of nitric oxide on gall bladder motility. It is recommended also to evaluate the benefits of using nitric oxide synthase inhibitors in high risk groups as obese females and patients using nitric oxide donar medications

Gastric mucosal superoxide dismutase activity in gastritis due to helicobacter pylori infection

Helicobacter pylori infection is now known to be the most common cause of histological gastritis. The mucosal pathology of H. pylori infection may in part be due to excessive production of reactive oxygen metabolites [ROMs] by phagocytes. To study the influence of H. pylori infection on mucosal superoxide dismutase, the major scavenger enzyme of ROM, was investigated.The activity of superoxide dismutase was measured by spectrophotometrical enzyme activity assay, in gastric biopsy homogenates of persons with normal mucosa [n = 10], in patients with H. pylori related gastritis [n = 45] and in patients with non H. pylori related gastritis [n = 10]. Infection and gastritis were confirmed by a combination of biochemical, serology [ELISA] and histology.The activity of superoxide dismutase was increased by about 5 - 6 fold in H. pylori related gastritis more than the healthy mucosae of normal control group [P < 0.001]. At the same time the activity of superoxide dismutase was increased by about twofold to threefold in Non - H. pylori gastritis in comparison with the control group [P < 0.01]. Still there was twofold increase in the activity of SOD in H. pylori gastritis in comparison with the patients of gastritis with negative H. pylori infection [P < 0.05]. Reactive oxygen metabolites [ROMs] may have an important role in the pathogenesis of H. pylori gastritis

Hematological picture and some histopathological changes of albino rats experimentally treated with propofol [diprivan]

Forty adult albino rats were divided into two groups each of twenty. The first group was used as control. The second group was injected intraperitoneally with 2 mg propofol daily for 2 months. At the end of experiment blood was collected on EDTA for investigation and specimens from liver and kidneys were processed for histopathological examination. There were a significant reduction in the amount of haemoglobin, PCV and number of erythrocytes and insignificant increase in the total leukocytic count. The histopathological examination revealed congested hepatic central veins, vacuolar degeneration and leukocytic infiltration in the portal areas in liver while kidneys there were leukocytic infiltration in cortex and medulla

Some aspects of drug interaction: C-immunological studies of rabbits treated with progesterone and diazinon

The immune status of rabbits treated with 1.5 mg progesteron and 2.5 mg/kg body weight diazinon were investigated. There was a sharp decrease in spleen plaque forming cells, revealed concentration of plasma cells, antibody titres detected by passive haemagglutination test and delayed skin hypersensitivity reaction in rabbits treated with diazinon only and in rabbits treated with progesteron and diazinon. It was noticed that the progresteron and diazinon act as antagonists and they induce immunosuppressive effects

Effects of prostaglandins F2a on sperm cell characteristics and histopathological changes of testes and accessory genitalia in rats

Three hundred and thirty mature male albino rats were used for studying the effect of prostaglandins F[2] alpha on the sperm cell characteristics and the histopathological changes of their genital organs. Sperm cell concentration and their motility percentage were significantly increased in rats injected with 10 and 20 micro g PGF[2]a. The same parameters were decreased in rats injected with 75 and 125 micro g PGF[2]za. Activation of most of the seminiferous tubules and decrease in the secretions of the seminal vesicles and prostate were observed in rats subjected to 10 micro g of PGF [2]a. Higher doses 75 and 125 micro g PFG[2]a induced atrophy of the seminiferous tubules, hyperplasia of the epithelium lining the seminal vesicles and decrease of secretions in the prostate and seminal vesicles

Some aspects of drug interaction A Hematological and histopathological changes of rabbit's uteri experimentally treated with progesterone and diazinon

The haematological picture and the histopathological changes of rabbit's uteri treated with 1.5mg progesterone and 10 25, 50 mg/ Kg B.W.diazinon were investigated. There was a decrease in the amount of haemoglobin, and the number of red cells, leucocytes, heterophils and lymphocytosis in rabbits treated with diazinon and with progesteron and the higher doses of diazinon. The uteri of the latter treated animals showed atrophy of the endometrium. There was an antagonistic action between prgesterone and diazinon

Blood picture of albino rats experimentally injected with prostaglandin F2 alpha [PCG2a]

Three hundreds mature male albino rats were used in this study. They were divided into 6 groups each of 50 the first group was kept as control and injected with 0.2 ml of saline daily. The second, third, fourth, fifth and sixth were injected with PGF[2] alpha in doses of 10, 20, 50, 75 and 125 ug respectively. The control and treated groups were injected subcutaneously for 7 days. At each chosen different intervals viz.1, 7, 14, 21, 28, 35, 42, 49, 56, and 70 days from the last injection, five rats from each group were randomly taken and subjected to haematological examination. The result obtained were as follows: a significant increased in blood haemoglobin and red blood corpuscles was seen in rats obtaining low doses of PGF[2] alpha. Rats receiving the high doses of the drug, there was a significant decrease in heamoglobin, red blood corpuscles and packed cell volume. Leucocytosis and lymphocytopenia was observed in all rats. Inhibitory effect of platelets in rats with low doses and stimulatory effect in groups with the high doses