use of self management skills in improving pediatric asthma outcomes

Asthma is a common lung disease of childhood throughout the world. It may be regarded as a diffuse obstructive lung disease with hyper reactivity of the airway to a variety of stimuli Educating asthmatic children and their mothers about self-management skills including nebulizer, inhaler, and peak flow meter, breathing and coughing exercise help in controlling asthma. This study aims to improve the pediatric asthma outcomes by educating children and their mothers' self-management skills. The study was conducted at In-patient Pediatric Chest Unit at Tanta University Hospital Patients were followed up in the Outpatient Pediatric Chest Clinic of the same hospital A convenient sample of 80 asthmatic children and their mothers were included in the study. Three fools were used to collect the necessary data: two questionnaire sheets: one to obtain demographic data and history of asthma, the other to access mothers1 knowledge about asthma and an observation check list to measure the children's practices regarding self management skills. The program was carried out through four sessions. The results showed that children's, and their mothers' knowledge, practice and bronchial asthma outcome improved after the program. There were high statistical significant differences in using nebulizer, inhaler usage and cleaning peak flow meter before and after program. It is recommended to develop an asthma action plan with Instructions on when to change the medication plan and when to call for help. Developing a training program for the pediatric nurses is mandatory

Hepatitis C virus genotypes among chronic hepatitis C Egyptian patients

Several studies revealed that there is certain geographical distribution of HCV genotypes. The aim of the present study was the detection of hepatitis C virus genotypes among Egyptian patients sufferring from chronic virus C hepatitis. Forty two patients diagnosed as chronic virus C Hepatitis were the subject of this study. The diagnosis was based on history taking, clinical examination, liver function tests, determination of virus C antibodies using second generation enzyme immunoassay [ELA-2]. Confirmatory testing for the anti-HCV seropositive results was done using the third generation line immunoassay. HCV RNA detection was done using PCR. Histopathological examination for liver biopsies was done for 22 cases. Genotypes of HCV were determined by line-probe assay. The results revealed that genotype 4 was found in 85% [36 cases] and coinfections of types 4 and 1 and 4 and 2 in 9.53% [4 cases] and 4.76% [2 cases] respectively. The severity of the disease tended to be worse in patients who had mixed infection

Epidermal growth factor [EGF] receptors expression in myometrium and leiomyomas

Fifty patients were included in this work, they all were premenopausal women who underwent hysterectomy at Ain Shams University Maternity Hospital. They were divided into two main groups Group [1] [The study group] : 30 patients who underwent hysterectomy for symptomatic uterine fibroids; Group [2] [The control group] : 20 patients who underwent hysterectomy for other gynecological problems than myoma. After pathological examination, tissue samples of myomas and myometria were collected for immunohisto-chemical study for epidermal growth factor receptors assay. As regards the relation between age of women distributed according to their groups and the EGF receptors expression; it was found that there was no relation between age of women and the expression of EGF receptors. Also for the relation between parity and the expression of EGF receptors; it was found that there was a relation between parity of women in the study group [with leiomyoma] and the expression of EGF receptors [P < 0.01] i.e. highly significant difference, and this may be attributed to the elevated estrogen regulated genes in leiomyomas when the uterus is exposed to circulating levels of estrogen that are many-fold higher through subsequent pregnancies than those seen during menstrual cycle As regards the relation between the receptor level and the phase of menstrual cycle; it was found that there was no cyclic variation of EGF receptors either in the proliferative phase or in the secretory phase and hence estrogen and progesterone play an important equal role in the expression of EGF receptors whether in myometrium or in the growth of leiomyomas. As regards the relation between the receptors level with different pathological subtypes of leiomyomas; it was found that there was no significant difference between these types and the expression of EGF receptors. Concerning the relation between EGF receptors expression in leiomyomas compared to normal myometrium; it was found that although both leiomyomas and myometria showed expression for EGF receptors and may be the expression was slightly elevated in leiomyoma, but we could not find any significant difference [P > 0.05] between EGF receptors expression in leiomyoma compared to myometrium. These findings suggest EGF receptors as a potential regulator for uterine leiomyoma and also suggest that estrogen and progesterone effects on leiomyomas may be partly mediated by EGF receptors

Impact of vulval warts on uterine cervix-new colposcopic finding

There is a growing interest in human papilloma virus [HPV] infection of the cervix. The aim of, this work, is to study the impact of vulval warts on HPV related cervical disease and to compare, the results with findings in women without vulva warts. Seventy women paticipated in this work: 30 cases with vulval warts [study group] and 40 cases withhout vulval warts [control group]. All cases were subjected for full medical history, cervicovaginal cytology, colposcopy and biopsy from colposcopically abnormal areas. Cytological examination revealed 7 cases with cervical HPV infection [23.3%] in the study group, compared to 2 cases in the control group [5%] [P<0.01]. Three study cases showed dyskaryosis [2 mild and one moderate]. Abnormal colposcopic findings were detected in 13 cases of the study group [43.2%], compared to 3 cases [7.5%] of the control group [P<0.01]. The finding of micropapillary aceto - white epithelium with partial iodine uptake was prominently associated with cervical HPV infection in cases of vulval warts. Histopathology of the colposcopically directed biopsies revealed 5 cases with HPV infection [Flat condyloma in 2 cases and flat condyloma with CINI in 3 cases] and 2 cases with CIN, [one CINI I and one CIN II] in the study group, compared to only one cases of flat condyloma in the control group. The importance of these findings are discussed

Diathermy large loop excision of thansformation zone [LLETZ] as a treatment of cervical intraepithelial neoplasia [CIN]: the use of a cheap, locally made, replacable loop

In selectcd cases with CIN, outpatient excisional procedures represent a readily accepted and highly effective modality of treatment The aim of this work is to evaluate the efficacy of a cheap, locally made, replacable stainless steel loop electrode used with an ordinary diathermy generator and local anaesthesia using a dental syringe, in LLETZ procedure. 18 patients with histologically proved CIN were selected for this study. The mean duration of the procedure was 3.94 +/- 0.72 minutes [range 3 to 5 minutes]. The procedure was well tolerated by the patients, only 2 [11.2%] experienced mild discomfort. Haemorrhagic morbidity was not a problem. one patient [5.6%] had mild operative bleeding and 2 [11.2%] had mild postoperative bleeding after 2 hours that was easily controlled. All the LLETZ specimens were adequate for histopathological diagnosis and there was a good correlation between pretreatment and LLETZ specimens, with undercall diagnosis in only one case [5.6%]. After 3 months 17 patients and 6 months 15 patients, returned for follow up. Cytological follow up was completely normal after 3 months. but showed one case of HPV after 6 months. Colposcopy was normal after 3 months with 2 unsatisfactory Colposcopy but it showed one case with acetowhite epithelium [flat condyloma on pathology] and one unsatisfactory colposcopy after 6 months. Our patient diathermy LLETZ with cheap, replacable loops and dental syringe local anaesthesia, are cost effective, and well tolerated alternative to other modalities for treatment of CIN