Dumbbells and ankle-wrist weight training leads to changes in body composition and anthropometric parameters with potential cardiovascular disease risk reduction

Objectives: Promoting physical activity is a global strategy to reduce the burden of cardiovascular disease. This study aimed to determine and compare the effect of light resistance training using either dumbbells or ankle-wrist weights on the anthropometric parameters and body composition of adults in Kelantan

Malaysia. Methods: This randomized community trial was conducted in Kelantan, Malaysia, from March through August 2012. Adults with a body mass index [BMI] of more than 23 kg/m2 were randomized into dumbbell [N ¼ 69] and ankle-wrist [N ¼ 69] weight groups. Participants in the dumbbell group performed structured group exercises three times per week using a pair of onekilogram dumbbells. Participants in the ankle-wrist weight group were given one pair of 500 gm ankle weights and one pair of 500 gm wrist weights to be worn during the activities of daily living three days per week for at least 20 min. BMI, waist circumference [WC], waist-tohip ratio [WHR], body fat percentage [BF%] and skeletal muscle percentage [SM%] were measured at baseline, week 6, month 3 and month 6

Results: Eighty-nine participants completed this study. There were significant reductions in BMI only at week six for the dumbbell group. No significant BMI changes were observed for the ankle-wrist weight group. Significant improvements of WC, WHR, BF%, and SM% were observed in both intervention groups from baseline at week 6, month 3, and month 6

Conclusion: Resistance exercise using either dumbbells or ankle-wrist weights produced significant improvements in certain components of body composition and anthropometric parameters

Comparison of adults with insulin resistance (IR) in latent autoimmune diabetes versus IR in glutamic acid decarboxylase antibody-negative diabetes

<p><b>INTRODUCTION</b>Insulin resistance in latent autoimmune diabetes in adults (LADA) patients is controversial. The aim of this study was to evaluate insulin resistance and its related factors (metabolic syndrome parameters) among subjects with LADA and glutamic acid decarboxylase antibodies (GADA) negative diabetes, as well as the impact of these factors on insulin resistance.</p><p><b>MATERIALS AND METHODS</b>GADA levels were investigated in 1140 diabetic patients aged between 30 and 70 years. Insulin resistance and metabolic syndrome parameters were assessed in LADA and GAD-negative diabetic patients by general linear model. In addition, the impact of metabolic syndrome factors on insulin resistance was assessed in LADA and glutamic acid decarboxylase (GAD)-negative diabetic patients.</p><p><b>RESULTS</b>LADA was diagnosed in 33 subjects from 1140 Malaysian diabetic patients (prevalence = 2.9%). The results showed that LADA patients had higher insulin resistance and high density lipoprotein cholesterol (HDLc) (P = 0.003 and 0.00017 respectively) and lower body mass index (BMI) (P = 0.007) compared to GAD-negative diabetic patients. The HDLc was associated with decreased insulin resistance in LADA patients (P = 0.041), whereas HbA1c, triacylglycerides (TG) and waist were associated with increased insulin resistance in GAD-negative diabetic patients (P = 3.6×10⁻¹², 1.01×10⁻⁵ and 0.004 respectively). HbA1c was highly associated with decreasing β-cell function in both LADA (P = 0.009) and GAD-negative diabetic subjects (P = 2.2×10⁻²⁸).</p><p><b>CONCLUSION</b>Insulin resistance is significantly higher in LADA than GAD-negative diabetic Malaysian subjects.</p>

Initial experience of surgical microwave f issue precoagulation in liver resection for hepatocellular carcinoma in cirrhotic liver

Surgical hepatic resection has been considered as the first-line treatment which is most effective and radical treatment for HCC, however, HCC is usually associated with poor liver function owing to chronic hepatitis or liver cirrhosis. Techniques that can eradicate the tumor and also preserve liver function are needed. Moreover, hepatic resection, in the presence of cirrhosis, raises special problem of high risk as hemorrhage and liver failure, thus, good clinical results can only be achieved by minimizing operative blood loss, time of the intervention as well as the hepatic reserve. The tremendous progress in microwave technology has recently attracted considerable attention. This study evaluated the feasibility of this new liver transection technique demonstrating the high performance of this procedure, the accuracy in terms of squeeze effect on veins and portal branch and in terms of reducing the intra operative blood loss, and minimizing the operative time for safe hepatectomy.Twenty-six consecutive patients a first-time diagnosis of hepatocellular carcinoma [HCC] on top of liver cirrhosis were recruited for the study, from August 2011 to January 2013.A11 patients were subjected to full clinical examination, laboratory investigations, abdomen ultrasound [U/S], triphasic computed tomographic liver scan [CT] and dynamic magnetic resonance imaging [MRI] in some doubtful cases. Inclusion requirements were presence of resec-table disease without vascular invasion or extrahepatic spread at imaging, Child-Pugh class A and B [Score 7] liver cirrhosis, [INR]< 1.6or platelet count >60 000/mm3 with no previous treatment. Patients were treated by applying pre-coagulation of the liver transection lines using microwave probe positioned in parallel to the line of resection by open approach after intra-operative U/S assessment for localization of the tumor and line of resection.The procedures were performed under general anesthesia. Mobilization of the liver was not necessary to be done in all cases. Intra-operative ultrasound [Aloka, Tokyo, Japan] was used to exclude lesions not detected pre-operatively [operative surprise], to define the location, number and size of the tumor and to identify large intra-hepatic large vascular and biliary structures, and guide insertion of the microwave applicator. Intraoperative ultrasound was used again, to assess that the line of resection was done. Primary endpoints documented were total operative time, time for liver parenchyma transection, intraoperative blood loss and blood transfusion requirements. Secondary endpoints included postoperative complications, mortality and intensive care unit [ICU] together with hospital stay

Formulation and evaluation of some selected timolol maleate ophthalmic preparations

The purpose of this study was to prepare and evaluate certain Timolol maleate [TM] polymeric formulations including viscous solutions, hydrogels and in-situ gels aiming to improve its ocular bioavailability and decrease its side effects. In this study, Chitosan [CS], hydroxyehtylcellulose [HEC], hydroxypropylmethylcellulose [HPMC] and sodium carboxymethylcellulose [NaCMC] were used to prepare TM viscous solutions and hydrogels. In-situ gels of Gelrite and Pluronic F-127 [Pl F-127] were prepared at different concentrations. Mucoadhesives namely CS or HEC were incorporated to Pl F-127 to produce mucoadhesive/insitu gel. The prepared formulations were evaluated for their in-vitro drug release, viscosity, gelation temperature and mucoadhesive force. The selected TM formulations were tested for their effect on intraocular pressure [IOP] and systemic side effects based on blood pressure [BP], heart rate [HR] and respiration rate [RR]. The results revealed that, TM in situ-gels F25 [containing Pl F-127 20% and CS 1.5% w/w] and F31[containing Gelrite 0.6% w/w] showed reasonable in-vitro results, and a marked IOP lowering activity without systemic side effects compared to TM marketed eye drops

Metabolic syndrome among obese Qataris attending primary health care centers in Doha, 2010

To determine the prevalence of metabolic syndrome among obese patients using the IDF definition and to identify factors that are associated with it. A cross-sectional randomized study was conducted at four primary care centers inside Doha, Qatar. One hundred and thirty-six Adults, >/= 18 Qatari obese patients, were chosen by systematic random sampling. They were interviewed and screened for the presence of metabolic syndrome, which was diagnosed according to the International Diabetes Federation criteria: an abdominal circumference >/= 94 cm in males or >/= 80 cm in females, plus any two of the following: HDL cholesterol < 1.03 mmol/ mL [< 40 mg / dL] [males or <1.3 mmol / mL [<50 mg/ dL] [females], triglycerides treatment and baseline glycemia > 5.6 mmol / mL [> 100 mg/ dL], or previously-diagnosed type 2 diabetes mellitus. The overall prevalence of the metabolic syndrome among obese patients was 46.3%. The prevalence was higher in females [50%] than in males [42.4%]. It was seen to increase with increasing body mass index class, from class 1 to class 2. The prevalence of metabolic comorbidities of abnormal waist circumference, raised blood pressure, raised fasting blood glucose, high triglycerides, and reduced high density lipoprotein was 88.2, 42.6, 32.4, 31.6, and 27.9%, respectively. Based on the logistic regression multivariable analysis, increasing age and being diabetic were the only significant associated factors that influenced the risk of having the metabolic syndrome. The prevalence of the metabolic syndrome was high, and the highest comorbidities were abnormal waist circumference and high blood pressure. Diabetes and increasing age were the only significant risk factors of having this syndrome

Knowledge, attitude and practices regarding cervical cancer and screening among women visiting primary health care in Qatar

There are no data on the knowledge, attitude and practices of Qatari women about this cancer. Therefore this cross-sectional interview-based study was conducted in 2008 among 500 women at 5 randomly selected primary health care centres in Qatar to determine their knowledge, attitude and practices regarding cervical cancer and screening. Just over 85% had heard of cervical cancer and 76% had heard about the Pap smear. Knowledge of cervical cancer was significantly greater among women aged 30-49 years, and those employed, married for > 15 years, with a university degree, or who had had 4 births or 3 miscarriages. Almost 40% had had a Pap smear test at least once and 85.5% of the rest would have a test if they were told that the procedure was painless and simple. Over half wanted the test to be done in the well-woman clinic at the primary health care centre. Knowledge and practice was inadequate among those under 30 years old, those recently married and those with a lower education level

Knowledge, attitudes and practice of general practitioners towards complementary and alternative medicine in Doha, Qatar

A cross-sectional study of knowledge, attitudes and practice of general practitioners [GPs] towards complementary and alternative medicine [CAM] was conducted in Doha, Qatar. Out of 119 respondents, 39.1% reported poor knowledge about CAM. Self-reported knowledge was highest for counselling and psychotherapy [69.0%], diet and supplements [68.1%], acupuncture [45.2%], herbal medicine [47.3%] and massage [42.5%]. While 83.8% described their attitude to CAM as welcoming and 97.5% were interested to learn more about it, fewer [30.1%] had practised it before, referred patients [24.8%] or asked patients' about their use of CAM [34.8%]. Their own lack of knowledge and training in CAM was seen as a barrier to its use by 60.0% of the GPs

On the electrodeposition of reactive metals from ionic liquids

In this paper we show that ionic liquids can be used for the electrodeposition of highly reactive elements, which can not be obtained from aqueous solutions, such as aluminium, magnesium and lithium as well as of refractory metals such as tantalum and titanium. The development of ionic liquids, especially air and water stable ones, has opened the door for the electrodeposition of reactive elements which in the past were only accessible using high temperature molten salts or, in part, organic solvents. Due to their high stability, ionic liquids can be regarded as the missing link to high temperature molten salts. Currently, ionic liquids can not yet replace molten salts in the electrowinning of reactive and refractory metals. Nevertheless, they can be employed efficiently for the coating of other metals with thin layers of tantalum, aluminum and presumably many other ones at reasonable temperatures. From a practical point of view, molten salts are hardly suited for the coating of sensitive materials like NiTi shape memory alloy with other metals since the electrolysis process is performed usually at temperatures above 400 C. With ionic liquids a technical electroplating process might be performed at moderate or even at room temperature

Enhancement of solubility and dissolution of nimesulide using solubilization, solid dispersion and complexation techniques

Nimesulide is a preferential COX-2 inhibitor. It has high anti-inflammatory, antipyretic and analgesic activities. It has poor aqueous solubility [0.01mg/ml]. Solubility of nimesulide was studied using different cosolveni mixtures and various classes of nonionic surfactants. Dimethylacetamide [DMA,]; at 10% v/v exhibited the highest solubilizing effect [10-fold] towards nimesulide as compared with other cosolvents. Among the tested nonionic surfactants at 10% W/V, brij 58 which exhibited the highest solubilization effect [39-fold]. The dissolution of nimesulide from solid dispersions was also studied Solid inclusion complexes of nimesulide with beta-cyclodextrin [beta-CD] and hydroxypropyl beta-cyclodextrin [HP beta-CD] were prepared at a molar ratio of 1:1. Eutectic mixtures were obtained at weight ratio of 1:9 binary systems as confirmed by DSC studies. The dissolution studies indicated that the highest relative amounts dissolved were obtained from solid dispersions as compared with physical mixtures or pure nimesulide. Also higher relative amounts dissolved were obtained with polyvinylpyrrolidones [PVPs] at weight ratio of nimesulide/PVP 40000 1.7. Physicochemical characterization of pure drug, PVP 40000, nimesulide/PVP 40000 solid dispersion and the physical mixture at this ratio were conducted by DSC, FTIR, X-RPD and SEM. The DSC thermograms and X-RPD patterns demonstrated that nimesulide existed in an amorphous form and there is an intermolecular hydrogen bond between the drug and the carrier as shown from FTIR analysis. SEM images confirmed the absence of the crystalline structure of nimesulide in the solid dispersion

Role of MDCT colonography and conventional colonoscopy in evaluation of colo-rectal neoplasms

The study was conducted to evaluate the role of MDCT colonography in diagnosis of cob-rectal neoplasms compared to conventional colonoscopy. Fifty patients were included in the present study 28 males and 22 females with age ranged from 2 1-75 years old. Patients were presented with variable-size large bowel masses examined by MDCT colonography and conventional colonoscopy. Twenty three-cases were diagnosed by CT colonography as colonic malignancy, 18 cases diagnosed by colonoscopy as colorectal benign polyps "8 polyps measured less than 5mm, 6polyps from 5-10mm and 4 more than 10mm", those were correlated with findings of CT colonography which revealed only 12 benign polyps with size ranged from 6mm to more than 10 mm. The other 9 cases proved to be extra colonic metastases. MDCT colonography allows more definitive evaluation of the different cob-rectal and extra-colonic masses as it is anon-invasive modality. It has a higher sensitivity for detecting a clinically suspected colonic neoplastic mass. The conventional colonoscopy may still have an advantage of detecting very small and superficial mucosal lesions and taking biopsy from the suspected superficial areas

Emergency head CT scan ordering and yield: a Malaysian experience

The aims of this study were to determine the emergency brain CT scan ordering rate in our emergency department and its positive yield rate; identify significant clinical factors as predictors for scan yield; and evaluate the need for a CT scanner in the emergency department and implementation of guidelines for emergency brain CT scan. This was retrospective study. The study was carried out in UKM hospital, Malaysia from the 1st of January to the 31st of December 2003. The study included all emergency brain CT scans done to 1,687 patients who visited the emergency department of the hospital. Of these patients, 1,088 samples with complete and clear clinical data were studied. The medical records were reviewed retrospectively for selecting these samples. Samples were grouped into trauma and non-trauma. The ordering rate and positive yield rate were calculated and clinical predictors for positive yield were analyzed using Chi-square test. From the total 59,575 patients who visited the emergency department, head CT scan was likely to be helpful in 1,687 patients. A head CT study was requested for these patients. This resulted in an ordering rate of 2.83%. Of the 1,088 samples reviewed, 716 scans showed positive findings, giving the overall scan yield of 65.8%. Non-trauma vases had significant higher scan yield [70.5%]. Age >55 years was noted to have higher risk of positive scans in both groups, especially those presented with seizures. Other significant factors were dysarthria, limb weakness and facial asymmetry in non-trauma cases [all p< 0.05]. The 2.83% ordering rate with 65.8% scan yield signifies the fact that emergency physicians in the study do not order unnecessary CT scan of the head. These findings were noteworthy and might suggest that we revise the request criteria for head CT. however, validated and locally applied CT scan guidelines should be developed and used in order to further enhance its cost-effectiveness in developing countries where resources are limited but its benefits in current and future settings can well be foreseen

Rule of the ilizarov method in treatment of congenital pseudoarthrosis of the tibia

Congenital pseudoarthrosis tibia is relatively a rare condition, occurring in 1 in 190.000 to 1 in 250.000 live births but it is one of the most perplexing problems in pediatric orthopedics. After the fracture has occurred, it is refractory for union. A great number of different surgical procedures have been used to treat it. However, these methods had not been uniformly successful in obtaining and maintaining union. Recently, Ilizarov method had been introduced to treat such cases where it demonstrated by many authors satisfactory results. Nine cases of congenital pseudoarthrosis of the tibia were treated by Ilizarov method since January 2003 till December 2005. The mean follow-up after Ilizarov-device removal was 2.9 years [range 2-4, SD 0.7]. Consolidation was obtained in the all patients operated. The leg length discrepancy was corrected in all patients. Ilizarov technique is a successful method of treatment for congenital pseudoarthrosis of the tibia that tackles all problems of the disease

Synthesis of some new 4-[P-heterocyclo-substituted aniline] -2,7-dimethyl-l,8-naphthyridines of expected antimicrobial activity

The reaction of 4-chloro-2,7-dimethyl-l,8-naphthyridine [1] with benzocaine and/or aminophenol gives the corresponding ethyl naphthyridineaminobenzoate derivative 2a and/or p-hydroxy-anilinonaphthyridine derivative 2b depending upon the nature of the reactants used. The reaction of compound 2a with hydrazine hydrate gives the corresponding acid hydrazide 3 which was allowed to react with CS[2] at different conditions giving the oxadiazole 4 and / or the dithiocarbazate 5, and with a beta-diketone and a [3-dikctoester to give the corresponding pyrazole 9 and/or the pyrazolone 10. As well as, the reaction of the acid hydrazide 3 with different aromatic aldehydes afforded the Schiff bases 11a-d. which upon cyclization with thioglycolic acid afforded the thiazolidinones 12. On the other hand, the reaction of 1 with different amines, afforded 4-substituted 1,8-naphthyridines 13a-c, which gave the 2,7- distyrylnaphthyridines 14a-d upon reaction with different aromatic aldehydes. Moreover, reaction of 1 with p-hydroxy- acetophenone and/or p-aminophenol gave the corresponding 4-[p-acetylphenoxy] and/or 4-[p-aminophenoxy]-1,8-naphthyndine derivatives 15a and/or 15b, respectively. Reaction of 15a with different aldehydes afforded the chalcones 16a-d, 2-[lH] oxopyridines 17a-f, 2-[lH]iminopyndmes 19a,b, 2-[lH] thioxopyndincs 20a-c, while reaction of 15b with aromatic aldehydes gave the 1,8-naphthyridine-p-phenoxy Schiff bases 21a-c and other related compounds have been synthesized. Furthermore, some 1,8-naphthyridine Mannich bases 24a-d were produced by treatment of 2b with p-formaldchyde and secondary amines. In addition, reaction of 4 with ethanolic solution of paraformaldehyde and the appropriate secondary amine, afforded the corresponding 1,3,4-oxadiazole Mannich bases 25a-c. Some of the new compounds were evaluated for their antimicrobial activity

Investigations on the glucosinolates of lepidium sativum growing in Egypt and their biological activity

Fractionation of the glucosinolate contents of both the seeds and fresh herb of Lepidium sativum growing in Egypt were carried out. The study of the glucosinolate contents of L. sativum seeds revealed the isolation and identification of glucotropaeolin and 2- Phenyl ethyl glucosinolate while the study of glucosinolate contents of the fresh herb revealed the presence of 2- ethyl butyl glucosinolate, methyl glucosinolate, butyl glucosinolate and glucotropaeolin. The identification of the isolated glucosinolates were substantiated through using different chemical methods [enzymatic hydrolysis] and spectroscopic determinations [UV, MS and GC-MS for the corresponding isothiocyanates]. Acute toxicity studies of pet ether and alcoholic extracts of aerial parts of the plant showed that the alcoholic extract is more safe than that of pet ether extract and both extracts have a hepatoprotective activity on liver at the same concentration [50 micro g/ml]. The different extracts of the seeds and herbs of Lepidium sativum showed a potent effect against the White fly [Bemisia tabaci]. The total glucosinolate and in particular glucotropaeolin showed significant activity against the pest, which gave a highest mortality percentage on the adult stage

Maternal serum biochemical markers as a predictor for adverse pregnancy outcome

To establish reference values of assaying some maternal serum biochemical markers, namely; MSAFP. MSHCG, uE3 and PAPP-A: at 10-20 weeks gestation; among healthy pregnant women and observe the relationship of such markers to predict adverse pregnancy outcome. This is a prospective randomized controlled study conducted in the Obstetrics and Gynecology Departments at AL-Azhar and Cairo University Hospitals during a period of two and half years starting January 2003. Three hundreds healthy pregnant women from those attending the antenatal clinics were participated in this study. Their age ranged between 20-38 years. They all had a spontaneous pregnancy in singleton with gestational age of 10-20 weeks gestation at the time of study. This was confirmed by ultrasonic scanning. Pregnancy outcomes were obtained for all women. The incidence of adverse pregnancy outcome namely: miscarnage, preterm delivery, intrauterine growth restriction [IUGR], intrauterine fetal death [IUFD]. pregnancy induced hypertension [PIH] and congenital malformation were evaluated. Blood samples were withdrawn and sera were separated for estimation of levels of maternal serum alpha fetoprotein [MSAFP], unconjugated estriol [uE3], free 3-human chorionic gonadotropin [beta-hCG] and pregnancy associated plasma protein-A [PAPP-A]; using time resolved flouroi mmunoassay technique. Our study showed, unexplained significant elevations of MSAFP and serum 3hCG levels with adverse pregnancy outcome [miscarriage, preterm delivery, IUGR, IUFD]. Low unconjugated estriol levels, was associated with adverse pregnancy outcome except for preterm delivery. Maternal serum levels of PAPP-A were found to be significantly decreased in all adverse pregnancy outcome except in PIH. Combinations of maternal serum markers for prediction of adverse pregnancy outcome were compared. Increased maternal serum AFP and 3hCG were significant only for miscarriage and preterm delivery, whereas increased MSAFP and decreased uE, was significant for all adverse pregnancy outcome except for preterm delivery. Increased levels of MSAFP and decreased levels of PAPP-A was only significant with PIH. Whereas increased levels of beta hCG with decreased uE3 levels was significant for all adverse pregnancy outcome except for preterm delivery and PIH. The combination of increased beta hCG levels and PAPP-A were not significant correlated to adverse pregnancy outcomes. combined maternal serum four markers can be used not only for the detection of fetal structural and chromosomal anomalies but also for early prediction and detection of high risk pregnancies

Evaluation of the nutrition status of locomotors handicaps in Jeddah

Less information is available on the nutritional status of disabled children in developing countries, the work aimed to assess the nutritional status of I's handicaps. The studied sample included one hundred forty four handicaps aged 2-23 years; the demographic data, anthropometric measurements and dietary information were collected. The results revealed that the mean weight and height for age groups l-<4y, 4-<7y and7-lly were normal. About a half of sample [47.2%] were illiterate. 34.7% from parent were consanguineous, while 100% of handicap's mother did not receive any drugs during pregnancy, for 47.2% of children the impairment occrued after delivery. The handicaps aged l-<3y take adequate energy and fat, [1542kcal/d, 37.3g/d respectively], but low consumption from iron [5.2mg/d]. While the children aged 4->7y consumed enough amount from all nutrient except energy, protein and vt. A, but children aged 7->11y also consumed enough amount from all nutrient except protein and vt. C, the male aged 11-<15y consumed low energy, fat vt. A and C [1187kcal, 39.5g, 220.5 micro, 18.2mg respectively], but the females in the same age intake adequate amount from all nutrients. The male aged 15-<19y intake a low vt. A [208.4 micro g] and C [31.5mg]. Male aged 19-23y consumed inadequate amount from energy, fat, vt. A and C and calcium 1819.2kcal, 36.9g, 96.5 micro g, 57.3mg and 192.3mg respectively while the female in the same age consumed adequate amount from all nutrient except iron which is 10.4mg/d. The results clear that food intake was imbalanced there fore, they needed much attention to improve their diet and having important way to develop eating practices by using special tools, cooking method to suitable their ability for Chewing and swallowing

Assessment of nutritional status of obesity- women

Diet is becoming an increasingly important determinate of body weight in any community. The variations in body mass index are partly variation by energy intake; whereas regional variations in obesity are related to the educational level of the populatipn. The aim of this study was evaluation the nutrition status and nutrition pattern of obese women. The results reveled that the mean of weight and the height for all sample was 68.8kg +/- 17.3 and 155cm +/- 9.5 respectively, 50.4% of the participant reported that doing the housekeeping activity without servant, while the high percent showed in women with overweigh and obese women don't doing physical activity 55.2% and 57.4% rerpectively. 47.9% from all sample eat three meals per day, while 37.8% eat the breakfast meal and 29.4% did not eat breakfast, but 62.9% from the participant consider that the breakfast meal not important, while 42.3% from the overweigh women did not eat the breakfast because they make a diet to loss weight. 47.1% and 47.0% eat light food and fatty food outside the home respectively. The obese women take a large amount from the energy, protein and fat [2323.38kcal, 93.67g and 82.12g] respectively, and both of women who have overweigh and obesity showed high percent for excess amount from RDA for energy, protein, fat and carbohydrate. Both of obese women and women who have overweigh take high energy from fat. Statistical there was a significant different p<0.05 between the level of education and overweigh and obesity, while a significant different p<0.01 between work and level of income with overweigh and obesity

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

Serum ANCA versus endoscopic histopathological findings in diagnosis of patients with ulcerative colitis

Ulcerative colitis [UC] is defined as continuous idiopathic inflammation of colonic mucosa that begins in the rectal area and may extend through the entire large bowel. The diagnosis of UC depends on clinical picture, stool analysis, endoscopie appearance and histopathological assessment of endoscopic biopsy. The aim of this work was to assess the value of pANCA in the diagnosis of UC as a non-invasive diagnostic tool versus the endoscopie and histoapathological examinations This study included seventy patients which were grouped into three groups: Group [I]: Included 20 patients with UC [13 males and 7 females with mean age of 28, 7 +/- 9.83 years], Group[II]: Included 20 patients with nonspecific colitis [8 males and 12 females with mean age of 40.4 +/- 10.8 years] and Group[III] that Included 30 subjects with normal lower endoscopy as control group [18 males and 12 females with mean of age 27l +/- 6.llyears]. All patients were subjected to thorough history taking. full clinical examination, urine analysis. stool examination and culture, ESR, CRP, complete blood picture. serum iron, liver function tests, renal function tests, abdominal plain X-ray, abdominal ultrasound, lower endoscopic and histopathological examinations, pANCA detection by ELISA and confirmed by IF technique Perinuclear anti nuetrophil cytoplasmic antibodies [pANCA] detected by ELISA were positive in 75% of UC patients and in 10% of non specific colitis patients while all control group subjects were negative. pANCA detected by ELISA had 75% sensitivity. 95% specificity, 88.2°/a positive predictive value and 90.5% negative predictive value for ulcerative colitis patients pANCA detected by IF technique were positive in 85% of UC patients and 25% of non specific colitis patients while none of control group was positive. pANCA by I had 85% sensitivity, 90% specificity. 77.3% positive predictive value and 93.7% negative predictive value for ulcerative colitis patients Conclusion pANCA is a beneficial senomarker detected in 75%-85% of patients with ulcerative colitis. pANCA detected by ELISA technique has high specificity and relatively low sensitivity for ulcerative colitis. Combined ELISA and IF technique for detection of pANCA may add higher sensitivity for pANCA as a seromaker for diagnosis of ulcerative colitis and can be used as a non invasive tool for diagnosis of ulcerative colitis especially when lower cndoscopy is contraindieated