Prostate volume and PSA cutoff values as predictive indices for success of doxazocin treatment in BPH in GHRDS

Benign prostatic hyperplasia [BPH] is a non malignant enlargement of the prostate. This study was conducted to determine the pattern of presentation of BPH with and without acute urinary retention [AUR] and to determine the risk factors for acute urinary retention, in addition, to assess the results of doxazosin in the treatment of BPH with and without AUR. Ninety two patients were enrolled in this study. All patients presented to the emergency department and the referred clinic of the Gezira Hospital for Renal Disease and Surgery [GHRDS] with lower urinary tract symptoms with and without acute urinary retention suggestive of BPH were evaluated according to the European guidelines. All of them underwent transrectal ultrasound and measurement for the prostatic volume. Serum PSA level was estimated. Doxazosin was given to all patients and they were followed for twelve weeks. A trial without a catheter at the end of the first week was attempted for patients with acute urinary retention. The patients' mean age +/- SD at baseline was 67.8 +/- 7.7 and 69.4 +/- 9.9 for Non-AUR/BPH and AUR/BPH respectively. Comparing baseline clinical parameters of patients with and without acute urinary retention revealed that IPSS, prostate volume and PSA level are significantly different between the two groups with P< 0.01, 0.01 and 0.00 respectively. In the TWOC, 65% of patients passed urine spontaneously. By the end of the study, the overall response of patients showed 78.9% successful rate [n = 73] and 21.1% failure rate [n = 19]. Prostatic volume and PSA level were found to affect doxazosin treatment significantly. With cutoff values of 41cc and [3.45] ng/ml, prostatic volume and PSA level influenced doxazosin treatment failure. Serum PSA and prostate volume are powerful predictors of the risk of AUR. Alpha blockers are efficacious in treating retaining and non-retaining BPH patients. Knowledge of baseline serum PSA and/or prostate volume are useful tools to aid physicians and decision makers in predicting the risk of BPH-related outcomes and choosing dexazosin as therapy for BPH

Knowledge, practices and beliefs of women regarding hormonal replacement therapy [HRT] during perimenopausal period

Hormonal Replacement Therapy [HRT] has an established role in improving menopausal symptoms reducing cardiovascular risk and preventing osteoporosis. Therefore, an exploratory descriptive study was carried out to identify women's knowledge, practices and beliefs regarding HRT during perimenopausal period. A questionnaire sheet was designed, validated and utilized by the researchers to collect the necessary data from a convenient sample of 100 perimenopausal employee women. A scoring system was adopted for women's knowledge, practices and beliefs regarding HRT. The results revealed that a sizeable proportion of perimenopausal women had lack of knowledge about HRT Sources of perimenopausal women's knowledge about HRT were mainly from mass media [63.8%]. In relation to practices of HRT, the results clarified that only 13% of perimenopausal women used HRT. Although most of HRT users [92.3%] used it to relieve their perimenopausal symptoms, yet, 76.9% of them reported that it didn't affect their perimenopausal symptoms. Perimenopausal women's practices of HRT were affected by their age, marital status and education, while their beliefs were affected by education and menstruation. A negative correlation was found between knowledge and practices [r =- 0.152], while a moderate positive correlation was found between knowledge and beliefs [r. = 0.416]. On the other hand, no correlation was found between practices and beliefs [r= 0.000]. Therefore, there is a need to incorporate the health care of perimenopausal women within the reproductive health care system

Soluble L-selectin, vascular endothelial growth factor and endothelin-1 in patients with ulcerative colitis

Recent evidence increasingly suggests that ulcerative colitis [UC] is the result of dysfunctional immunoregulation manifested by an inappropriate production of mucosal cytokines. An abnormal microcirculatory system has also been implicated in its pathogenesis. The objective of this study was to assessed serum concentrations of soluble L-selectin [sL-selectin] and vascular endothelial growth factor [VEGF] and the plasma level of endothelin-1[ET-1] in the patients with UC, compared with healthy controls, and to analyze the results depending on the stage of the disease. This study was conducted on two groups of subjects, the patient group including 30 patients with active ulcerative colitis [UC], and the control group which included 15 healthy volunteers. We assessed serum sL-selectin, VEGF and Plasma ET-1 Level at the beginning of the study in patients and controls then measured again in patients after remission. The levels of sL-selectin, VEGF, and ET-1 were significantly higher in active UC than those in the controls [p < 0.001]. But in remission there was no significant difference between UC patients and controls in VEGF and ET-1 levels. We also found that serum Level of sL-selectin, VEGF, and Plasma Level of ET-1 were significantly higher in patients with active UC compared with patients in remission [p < 0.001]. In addition, it is shown that UC patients in remission have significantly lower levels of sL-selectin than controls. There was a significant positive correlation among the serum levels of VEGF and the plasma level of ET-1; that is, elevated VEGF, and ET-1 levels correlated well with each other in active UC patients [r= 0.631, p < 0.001]. The most common form of the disease observed in our patient population was of mild to moderate severity. Pro-inflammatory cytokines, including sL-selectin, VEGF, and ET-1 appear to play a significant role in the pathogenesis of ulcerative colitis [UC]. Their levels were higher during exacerbation while it is low in periods of remission in UC patients

Alcohol or traditional methods versus natural drying for newborn's cord care

This is a quasi-experimental study that aimed to compare the use of alcohol and traditional methods for newborn's cord care with a no-treatment approach, natural drying. The study also aimed to identify the factors associated with the occurrence of cord infection and time of cord separation. A convenient sample of 70 women with vaginal delivery, full-term and healthy babies was selected from postpartum departments of two university hospitals in Alexandria and Minia. A specially designed interview schedule was developed and utilized to collect data. Swabs were taken from the newborns' umbilical stumps on zero and 3rd day of birth to detect bacterial colonization. Follow-up was carried-out at home to assess methods used for cord care, babies' hygiene, cord infection and time of cord separation. The study revealed that traditional methods of cord care were used by women with higher mean age [30.8 +/- 7.8 years], from Minia [100%] or rural areas [71.4%], while alcohol and natural drying were used by women with lower mean age [27.7 +/- 4.8 and 24.8 +/- 6.5 years] respectively, from Alexandria [76% and 100%] respectively or urban areas [56% and 64.7%] respectively. Alcohol was used for male babies [76%], while traditional methods and natural drying were used for female babies [71.4% and 64.7%] respectively. Incidence of cord infection was Significantly lower among natural drying group [35.3%], and no Signs of systemic infection were observed among them. Rate of increase of bacterial colonization [from 0-3rd day of birth] was significantly higher in alcohol group [44%]. It was relatively similar with presence or absence of cord infection [33.3 and 32.1] respectively. Mean time of cord separation was longer among alcohol group [6.4 +/- 2.4 days], as compared with natural drying group [4.7 +/- 1.9 days] and traditional methods group [3.4 +/- 0.7 days]. Bathing baby while cord was attached was carried out by all women of alcohol and natural drying groups, Compared to only 28.6% of traditional methods group. Breast-feeding was significantly related to less incidence of cord infection [P= 0.008] and shorter time of cord separation [P= 0.002]. Incidence of cord infection was significantly related to using cloth diaper [P= 0.015], Using dry method for skin care [X2[2]=7.2917], giving tub bath [X2[1]= 4.1788] and delaying the bath to the 7th day of birth [P= 0.050]. Time of cord separation was significantly shorter with closed cord dressing [X2[2]=20.4028], in Minia, during spring, among male babies [X2[2]=15.0352], and in rural areas [X2[2]= 9.7608]. It was significantly longer with bathing the baby while cord was attached [X2[2]=27.9354], giving 2-3 baths/week or delaying the bath to the 7th day of birth [P= 0.049] and with Using cloth diaper [P= 0.0467]. So, moving from an intervention to a non- intervention, particularly in a healthy Population should be applied to the healthy naturalistic approach to care advocated in nursing. Also, only through Continuing efforts done to examine our assumptions about historic health Care routines, will we be able to demonstrate evidence based practice and to advance nursing care

Effect of obesity on respiratory functions

The present study included thirty obese subjects and ten controls. The obese subjects were classified into three groups of mild, moderate and severe obesity. The purpose of the present work was to evaluate the abnormalities in respiratory functions, flow rates and arterial blood gases as a consequence of obesity. All patients of the three obese groups exhibited marked reduction in ERV, VC, MVV, FEV, PEF, MEFR and MMFR. This denotes that there is no correlation between the degree of obesity and pulmonary complications. PaO2 and PaCO2 were within normal in all three obese groups denoting increased efficiency of inspiratory muscles to keep minute ventilation within normal