Histological and Physiological Studies of the Effect of Bone Marrow-Derived Mesenchymal Stem Cells on Bleomycin Induced Lung Fibrosis in Adult Albino Rats

BACKGROUND@#Lung fibrosis is considered as an end stage for many lung diseases including lung inflammatory disease, autoimmune diseases and malignancy. There are limited therapeutic options with bad prognostic outcome. The aim of this study was to explore the effect of mesenchymal stem cells (MSCs) derived from bone marrow on Bleomycin (BLM) induced lung fibrosis in albino rats. @*METHODS@#30 adult female albino rats were distributed randomly into 4 groups; negative control group, Bleomycin induced lung fibrosis group, lung fibrosis treated with bone marrow-MSCs (BM-MSCs) and lung fibrosis treated with cell free media. Lung fibrosis was induced with a single dose of intratracheal instillation of BLM. BM-MSCs or cell free media were injected intravenously 28 days after induction and rats were sacrificed after another 28 days for assessment. Minute respiratory volume (MRV), forced vital capacity (FVC) and forced expiratory volume 1 (FEV1) were recorded using spirometer (Power lab data acquisition system). Histological assessment was performed by light microscopic examination of H&E, and Masson’s trichrome stained sections and was further supported by morphometric studies. In addition, electron microscopic examination to assess ultra-structural changes was done. Confocal Laser microscopy and PCR were used as tools to ensure MSCs homing in the lung. @*RESULTS@#Induction of lung fibrosis was confirmed by histological examination, which revealed disorganized lung architecture, thickened inter-alveolar septa due excessive collagen deposition together with inflammatory cellular infiltration. Moreover, pneumocytes depicted variable degenerative changes. Reduction in MRV, FVC and FEV1 were recorded. BM-MSCs treatment showed marked structural improvement with minimal cellular infiltration and collagen deposition and hence restored lung architecture, together with lung functions. @*CONCLUSION@#MSCs are promising potential therapy for lung fibrosis that could restore the normal structure and function of BLM induced lung fibrosis.

Histological and Physiological Studies of the Effect of Bone Marrow-Derived Mesenchymal Stem Cells on Bleomycin Induced Lung Fibrosis in Adult Albino Rats

BACKGROUND@#Lung fibrosis is considered as an end stage for many lung diseases including lung inflammatory disease, autoimmune diseases and malignancy. There are limited therapeutic options with bad prognostic outcome. The aim of this study was to explore the effect of mesenchymal stem cells (MSCs) derived from bone marrow on Bleomycin (BLM) induced lung fibrosis in albino rats. @*METHODS@#30 adult female albino rats were distributed randomly into 4 groups; negative control group, Bleomycin induced lung fibrosis group, lung fibrosis treated with bone marrow-MSCs (BM-MSCs) and lung fibrosis treated with cell free media. Lung fibrosis was induced with a single dose of intratracheal instillation of BLM. BM-MSCs or cell free media were injected intravenously 28 days after induction and rats were sacrificed after another 28 days for assessment. Minute respiratory volume (MRV), forced vital capacity (FVC) and forced expiratory volume 1 (FEV1) were recorded using spirometer (Power lab data acquisition system). Histological assessment was performed by light microscopic examination of H&E, and Masson’s trichrome stained sections and was further supported by morphometric studies. In addition, electron microscopic examination to assess ultra-structural changes was done. Confocal Laser microscopy and PCR were used as tools to ensure MSCs homing in the lung. @*RESULTS@#Induction of lung fibrosis was confirmed by histological examination, which revealed disorganized lung architecture, thickened inter-alveolar septa due excessive collagen deposition together with inflammatory cellular infiltration. Moreover, pneumocytes depicted variable degenerative changes. Reduction in MRV, FVC and FEV1 were recorded. BM-MSCs treatment showed marked structural improvement with minimal cellular infiltration and collagen deposition and hence restored lung architecture, together with lung functions. @*CONCLUSION@#MSCs are promising potential therapy for lung fibrosis that could restore the normal structure and function of BLM induced lung fibrosis.

Dendritic Cells in Hepatitis C Virus Infection

Background: The global prevalence of chronic hepatitis C is estimated at 2.8%. There is markedly higher prevalence in the Middle East about 14.7% in Egypt. Dendritic cells (DCs) are one of the major Antigen presenting cells in the body. They bridge innate and adaptive immunity and impact priming of HCVspecific immune responses. The current study was aimed to investigate the DC activation status, and their role in interaction with natural killer (NK) cells utilizing different setups with healthy NK and HCV+ DC, HCV+ NK and healthy DC, healthy DC and healthy NK and finally HCV+ NK and HCV+ DC in the presence of HCV peptides and a ratio of 5 NK: 1DC. Results: DC-NK interaction in chronic HCV infection is mainly affected by the affection of DCs by HCV leading to a maturation defect (decreased expression of HLA DR, CD 86 and CD 83). Healthy NK cells were able to stimulate the maturation of DCs particularly with core peptide whereas NS3-4 had no effect. When DCs were healthy, all peptides were able to produce significant maturation of DCs even when cocultured with HCV+ NK cells. Co-cultured HCV+ NK cells and HCV+ DCs showed significantly higher apoptosis of both cells. This could be attributed to the immature moDCs more with chronic HCV infection due to the fact that immature DCs typically under express HLA-class I molecules that would protect from NK-mediated lysis. Conclusion: Cross-talk between DCs and NK cells plays an important role in the induction of both the innate and adaptive immune systems. HCV infection was found to impair the maturation of DCs. Thus consequently affecting its antigen presentation and T cell allostimulatory capacity and rendering them more liable to NK mediated lysis which could explain the persistence of infection and chronicity

Role of water soluble contrast agents in assigning patients to a non-operative course in adhesive small bowel obstruction

Adhesive small bowel obstruction [SBO] is a common surgical emergency. It is estimated that at least 60% of SBO are due to post-operative adhesions. Water soluble contrast agents [gastrografin] have been used to identify patients who might be treated non-operatively. This study aims to determine the role of gastrografin in adhesive intestinal obstruction patients. In this prospective study, 27 patients admitted between 1[st] August 2004 and 1[st] July 2006 with clinical signs suggestive of postoperative adhesive SBO met the inclusion criteria. After intravenous hydration, nasogastric tube insertion and complete suctioning of the gastric fluid, 100 ml of gastrograsfin was given and plain abdominal radiography was taken 6 hours and 24 hours if the contrast is not seen in the colon. Those in whom the contrast reached the colon in 24 hours were considered to have partial SBO and started oral intake. If gastrografin failed to reach the colon in 24 hours and the patient did not improve in the following 24 hours, laparotomy was performed. Conservative treatment was successful in 31 cases [91%] and 3 [9%] required operation. Patients treated conservatively had short hospital stay [mean=4 days] and tolerated oral feeding with no morbidity or mortality. Oral gastrografin helps in the management of patients with postoperative adhesive SBO

Effect of ozone on some blood coagulation patterns in male albino rats

In this study forty adult male albino rats were used to investigate the effect of ozone on some coagulation patterns. Rats were divided into four equal groups, i.e. control group, immobilization stress group, immobilization plus small dose ozone group and immobilization plus large dose ozone group. In each group prothrombin time [PT], partial prothrombin time [PPT], platelet count, malonyldialdehyde, and catalase enzymes were measured. The results showed that immobilization stress led to significant increase in prothrombin time, partial prothrombin time and malonyldialdehyde with significant decrease in platelet count and catalase enzyme as compared to control group. Ozone in small dose led to significant decrease in prothrombin time, partial prothrombin time and malonyldialdehyde with significant increase in platelet count and catalase enzyme as compared to immobilization stress group. Ozone in large dose led to significant decrease in prothrombin time, partial prothrombin time and malonyldialdehyde with significant increase in platelet count and catalase enzyme as compared to immobilization stress group. The results of this study showed that immobilization stress had hypocoagulability effects and that ozone in large and small doses had improved these immobilization-induced hypocoagulability changes

Developing nursing blood borne pathogen control plan for Mansoura university hospital

Blood borne infections pose a serious threat to health and well-being of health care workers in Egypt. Hepatitis B, Hepatitis C and HIV have in common the blood borne pathway of transmission and severity of their outcome Occupational health and safety aims at prevention of such transmission at different levels eg. vaccination prevention for Hepatitis, post exposure prophylaxis and follow up after exposure. Also OSHA's final rule made it mandatory that health care facilities assumed responsibility for protection of their employees from exposure to Blood borne pathogen by eight components such as person protective equipment, universal precaution engineering control, work practice control, Hepatitis B prophylaxis training and education record keeping. The aim of this study was to design a blood borne pathogen control plan for Mansoura University hospital through assessing nurses knowledge and awareness related to Blood borne pathogen control, assessing the viability of equipment and supplies in various department in the designated hospital, designing the blood borne pathogen control plan based on the assumed data, and examining the validity of the designated plan. The study was conducted in Surgical and Obstetric units at Mansoura University hospital in ten departments. The subjects of this study were composed of two groups, namely a nursing group, and a jury group. Nursing group included 104 subjects were chosen from the above mentioned hospital departments. Jury group consisted of 50 subjects, divided into two subgroups which include 25 medical and 25 nurses Study tools included, questionnaire format aimed to assessing nurse's knowledge related to blood borne pathogen control. Checklist aimed to checking the Blood borne pathogen control plan in the studied hospital and opinionative sheet aimed to test the validity of the developing Blood borne pathogen control plan. The results revealed that nurses knowledge about the blood borne pathogen control plan was low Meanwhile, nurses knowledge was high [59 %] in relation to getting and staying vaccinated while the knowledge was low [34 %] in relation to report and get help with any needle stick accidents. Whereas nurse leaders, awareness about the Blood borne pathogen control plan was very low in addition to all the nurses leader [100.0%] were aware about the absence of training programs and an explanation of exposure control plan. All the nurses [100%] were aware about the lack of clear duties and responsibility for nursing staff in the Blood borne pathogen department. Equipments and supplies for Blood borne Pathogen control as observed in various departments were mostly observed to be available, and in a working state, and good storage. As far as the validation of the blood borne pathogen control plan presented in the study, the majority of the members of the two groups of jury agreed upon all items regarding form of the plan and upon the general evaluation items of the plan. No statistically significant differences could be detected between the two groups. It is concluded from the study that health care workers are at risk of exposure to different occupational hazards especially blood borne infection which may have a direct or cumulative deleterious effect on their health as a result of many factors such as lack of staff nurses knowledge related to blood borne pathogen prevention, lack of hospital policy and system related to blood borne prevention, lack of nurses adherence to blood borne prevention and absence of Blood borne pathogen control plan. The study recommend that report the percentage of Blood borne infection among health care working in Egypt, increase nurses' knowledge related to Blood borne infection prevention, apply control plan in different departments in different hospitals and governorate, develop policies and regulations adherent to Blood borne prevention, mandatory testing of health care workers is not justified on the basis of current scientific evidence strategies for preventing transmission of blood borne pathogens should be reviewed as new information becomes available and re-evaluated as to their effectiveness and standards for infection control practices in health care settings and mechanisms to implement and evaluate these standards should be developed

Developing student evaluation of the clinical learning environment scale for female college of health science Kingdom of Saudi Arabia

Within nursing, there is a strong demand for high-quality, cost-effective clinical education experiences that facilitate student learning in the clinical setting. The clinical learning environment is the interactive network of forces within the clinical setting that influence the students' clinical learning outcomes. The identification of factors that characterize clinical learning environment could lead to strategies that foster the factors most predictive of desirable student learning outcomes and ameliorate those which may have a negative impact on student outcomes. In order to make comparison between clinical learning environment and explain variations in out comes of clinical learning there is a growing need in nursing research for reliable and valid measures of the student clinical learning environment. This research developed the student evaluation of clinical learning environment scale which measures nursing student perceptions of their clinical learning environment. A quality student clinical experiences considered critical to nursing education. This paper describes the refinement and testing of the student evaluation of clinical learning environment scale, an instrument designed to measure nursing student perceptions of the clinical learning environment. The study was conducted in two Female colleges of health science [Unaizah and Aljouf].The subject composed of two groups of nursing students and clinical instructors. The student group A total of 120 second year nursing students from above mentioned college completed the student evaluation of the clinical learning environment questionnaire in March and April 2007 in the 2[nd] semester. In addition 82 second year nursing students completed three pretest questionnaires from Unaizah and Aljouf during December in the 1[st] semester 2006.The clinical instructor group: It comprised of 18 clinical instructors from above mentioned college. Four tools were used for data collection, namely a questionnaire format, to assess the important factors influencing student learning in the clinical setting. Questionnaire format, to assess aspects of the clinical setting that facilitate learning and that hinder learning. A questionnaire format for student evaluation of the clinical learning environment. It based on instructors and students input from the perceptions of important factors of the clinical setting and important aspect that hinder or help learning. It composed of 47 items with liker-based agreement response opinions, divided among four scales: Communication and feedback, learning opportunities, learning support, and department atmosphere [initial questionnaire] and a questionnaire format, for student evaluation of the clinical learning environment. It based on student input from the initial questionnaire. It composed of 44 items with liker-based agreement response opinions. [Final questionnaire]. Data analysis indicated that students responded consistently to the instrument as a whole and to the four scales. Test-retest correlations for all scales were statistically correlated between individual student evaluations. Three items were not significant correlated. Overall, the Student Evaluation of the Clinical Learning Environment scale appears to be a reasonably valid and reliable measure

Effects of body weight on some house works efficacy and some physiological parameters of females

In this work the effect of excess body weight on house works and some physiological parameters were conducted on twelve females' university students. The students were divided into a control [normal weight] group and experimental [overweight] group. The weakly cleaning of the living room was chosen as house work. A room was prepared as a living room with some furniture like tables, chairs, a sofa and cupboard in addition to a carpet on the ground and curtains on the walls. Observation of complexion, tremors, behavior reflecting boredom , level and time of performance as well as any complaint as tiredness, back pain, leg pain. Some physiological parameters as pulse, blood pressure, respiratory rate forced respiratory capacity and expiratory time were measured. The results showed that overweight has passive effect on time and level of performance; also it affects the circulatory functions more than the respiratory functions. So house works are not considered as hard work and not sufficient to reduce body weight in overweight women. Also house works can be tolerated and there is no need to restrict activity to guard against respiratory distress

Offline Controlling of Pseudomonas aeruginosa Resistant to protein Inhibitor Antibiotics Using Combination of EDTA and Na- citrate or Disinfectant (s) / 微生物学通报

Pseudomonas aeruginosa recognized as opportunistic pathogen causes severe infections for hospitalized patients, survive in and resist many antimicrobial agents like antibiotics and disinfectants. The aim of this study is to evaluate the role of EDTA in improving the sensitivity of resistant P. aeruginosa strains to disinfectants and Na-citrate. The strains used in this study were selected in house from Tanta University hospital, Egypt and tested for the synergistic effect of EDTA with Na-citrate or disinfectant (s). The results showed a significant effect ofEDTA in improving P. aeruginosa sensitivity. In conclusion, we proposed that using EDTA in combination with different sanitization compounds and antimicrobial agentsespecially in hospitals aiming to control the spreading of infections.

Evaluation of rose bengal test, standard tube agglutination test and nested PCR for the diagnosis of human brucellosis

Brucellosis affects human populations in many developing countries including the Middle East where it is still endemic. The clinical diagnosis of human brucellosis is difficult so, physicians depend upon laboratory confirmation. Peripheral blood specimens were taken from 40 patients having compatible signs and symptoms that were clinically diagnosed to have brucellosis. They were 23 males and 17 females, and their ages range between 21and 74. They were tested by Rose Bengal test [RBT], Standard tube agglutination test [STA] and nested PCR using four primers to amplify 677bp fragments. 23 patients [57.5%] were positive by [RBT]. 25 patients [62.5%] were positive by [STA]. 28 patients [70%] were positive by nested PCR assay. our results show that the PCR assay is more sensitive than conventional serological methods and this coupled with its speed and reduction in risk to laboratory workers. So, PCR technique is a very useful tool for the diagnosis and follow-up of human brucellosis

Troponin T as a useful marker for myocardial damage in neonates with perinatal asphyxia

This study was designed to delineate the role of cardiac troponin T in neonates with perinatal asphyxia as a marker for myocardial damage. It included 25 neonates suffering from per/natal asphyxia. They were 15 males and 10 females and their gestational age ranged from 37 to 41 weeks [group I]. Also 15 apparently healthy neonates of age and sex matched to group/were taken as control group [group II]. All neonates in the study were subjected to laboratory investigations as CBC, C-reactive protein; arterial blood gases [ABGS], blood glucose level and serum level of cardiac troponin T [TNT]. The mean serum level of [TNT] among asphyxiated neonates was 0.027 +/- 0.01 7ng/ml and was 0.011 +/- 0. 002ng/m/in control and there was statistical significant difference between both groups. There were 7 cases [28%] with tachycardia, 3 cases of them [%12] had irregular rhythm and heart failure. The mean level of [TNT] in patients with HF was 0.062 +/- 0. 048ng/ml and the mean level in the rest of asphyxiated newborns was 0.020 +/- 0.0033ng/ml. In this study there was high statistical significant negative correlation between TNT level and arterial PH, Po[2], HCO[3] and base excess [BE]. There was also high significant positive correlation between the mean TNT level and PCo2. This means that TNT mean level correlate with severity of perinatal asphyxia. In It would be useful to measure cardiac troponin T in all asphyxiated neonates. Then these patients with high level of TNT can then submitted to electrocardiographic and echocardiographic examination for detection of cardiac affection and to offer apportune treatment when required

Measuring quality of nursing services for type II diabetic patient in University Hospital

High quality care is a right for all patients and the responsibility of all nurses who deliver it. The aim of the study is to assess structural standard in University Hospital, to assess process standard as provided to type II diabetic patients, and to assess patient satisfaction as an outcome standard of quality of nursing care. The study conducted in Mansoura University Hospital. The structural standards had good quality, also, patients' satisfaction as an outcome of quality of nursing care was good. While, process standards applied to diabetic patients type II had poor quality, the study findings pointed to that there are a positive correlation between structure components and care process of quality of patient care as well as between structure components and outcomes measurement. While this correlation was not found between care process provided to diabetic patient Type II and outcome measurements. It is recommended that nursing standards must be communicated with the nursing staff in each hospital which will help them to improve the quality of care rendered

Work-related stress, burnout and coping among nurses in University Hospitals

To investigate the extent of burnout among nurses, to ascertain which aspects of nursing work were related to burnout and to examine the relative contribution to burnout made by these different variables [demographic factors, stress and coping strategies]. This study included a total of 200 nurses working at medical and surgical wards, in Man-soura and Zagazig University Hospitals [100 nurses from each hospital]. The study tools included a demographic interview data sheet, a Nursing Stress Scale, Modified Jalowiec and Powers Coping Scale and The Burnout Potential Inventory. Nurses stress in Mansoura and Zagazig University Hospitals were mainly in the form of physical stresses, mainly due to workload. Total stress scores were significantly higher among nurses in Mansoura University Hospital than those among Nurses in Zagazig University Hospital. Affective-oriented coping was higher than the problem-oriented coping. Nurses in Mansoura showed significantly higher scores for coping than those in Zagazig. In both University Hospitals, conflict and overload mean scores were high. Nurses in Mansoura University Hospital sustained significantly higher conflict and poor teamwork while those in Zagazig University Hospital sustained significantly higher punishment. Age, income, and years of experience in nursing had significantly negative correlation with stress scores and burnout and significantly positive correlation with coping scale. There was a positive significant correlation of stress with burnout in both Mansoura and Zagazig and a negative significant correlation of coping with burnout. Stress and coping scores were significantly higher among nurses having Diploma with specialty than those with Diploma in nursing only. Nurses in University Hospitals experience occupational stress. With less age, salary and years of experience in nursing work-related stress becomes more perceived. Affective-oriented coping strategies are resorted to more than the problem-oriented coping. Nurses in Mansoura cope better than those in Zagazig. The hospital organization should monitor staff conflict and must ensure that workloads correspond to workers capabilities and resources. Training places should put more emphasis on preparing nurses to deal with the emotional needs of their patients, with detached concern. Stress inoculation training which teaches nurses appropriate coping skills could be implemented. Particularly, vulnerable groups of nurses, such as those with diploma with specialty, should be monitored regularly for signs of burnout. They should be the primary targets for ongoing training and/or preventive interventions such as stress inoculation training

Diagnosis of regional enrteritis [Crohn disease]

Regional enteritis [Crohn disease] may present a diagnostic problem that needs to be solved by clinicians practicing in areas known to be endemic for tuberculosis. The similarity in clinical presentation between the two disorders makes it difficult to reach a diagnosis. Furthermore, the use of steroids in treating patients with Crohn disease may be harmful if the underlying diagnosis is Tuberculosis. This article is aimed to help physicians to distinguish Crohn disease from diagnostic modalities tailored to the history and physical examination. The use of ASCA, a new serological marker, in the diagnosis of Crohn disease may facilitate the management of such patients

Polymerase chain reaction in pulmonary tuberculosis: Sputum versus blood

- The aim of this work is to study the role of polymerase chain reaction [PCR] in the diagnosis of pulmonary tuberculosis and to compare the sensitiviity of its utility in sputum and blood of patients with pulmonary tuberculosis. The present study entailed 25 patients with recently diagnosed pulmonary tuberculosis. All patients were subjected to sputum culture on Lownstein Jensen Medium. Radiological investigation, PCR assay for deteection of mycobacterial DNA in sputum and peripheral blood. The current study revealed that sputum PCR assay for mycobacterium tuberculosis was positive in 24 patients out of 25 patients positive ZN stain and culture with sensitivity 96%. As regard blood PCR assay comparing to positive sputum culture. 20 cases were positive out of 25 positive cases by ZN stain and culture with sensitive 80%. The sensitivity of blood PCR as compared sputum PCR was 80.33% while specificity of blood PCR to sputum PCR was 100%. Sputum PCR was found to be a rapid and sensitive technique for the diagnosis of pulmonary tuberculosis. Blood PCR in patients with mycobacterium tuberculosis may be considered as an additional effective diagnosis tool with results comparable with sputum PCR

Synovial fluid collagenase and acid prosphatase in rheumatoid arthritis and osteoarthritis

Svnovial fluid from the knee joints of 3l rheumatoid arthritis [RA] patients [17 active and 14 inactive] and 27 patients with osteoarthritis [OA] were studied to detect the enzymatic activity of collagenase and acid phosphatase. The activity of both enzymes showed a significant increase in patients with active RA than those with inactive disease synovial fluid collagenase and acid phosphatase in RA patients Showed a significant correlation with ESR, morning stiffness, Pain Score, articular index and grip strength while an insignificant correlation with age and disease duration was recorded. There was a significant increase in the activity of both enzymes in RA patients when compared with OA patients