[Evaluation of training competency of health care workers in training clients and patients]

Examining the training competency of the health care workers in training their clients and patients can lead to identification of the training problems, improving training qualities, and promoting the health of society as a whole. The current study which was conducted in the city of Mashhad aimed to determine the training competency of the urban health care workers in training the clients referring to these centers. In this cross sectional-descriptive study, 250 health care workers at Mashhad s' urban health care centers were enrolled in the study using probability sampling. Data collection instrument was a researcher-made questionnaire consisting of two parts; demographic data and training competency status. Data were analyzed using SPSSv.16 software and descriptive statistical tests [Frequency and cumulative frequency] and analytical tests [Spearman, correlative tests, Independent t-test, one way variance analysis]. Significant level of difference was considered for measuring difference between demographic and training competency [P<0.05]. The results of the study indicated that the training competency of 159 workers [5.63%] in health care centers were good and acceptable, and there was a significant difference between training competency of workers and individual differences such as work experience, age, educational degree, employment status, and job satisfaction of health workers. There were also significant differences between courses taken by the health workers to promote their educational level and educational workshops based on promoting educational skills and training competency [P<0.05]. Although the training competency of health workers were very good, competency in areas such as training skills, development, performance, and professional responsibility were not satisfactory. Results of the current study provided appropriate data about training competency of the workers for managers of health care centers. Since the status of training competency of the workers can be assessed by managers and clients, it is suggested that for gaining more comprehensive information, training competency of the health workers be examined from the managers and clients point of view

Patient effective dose evaluation for chest x-ray examination in three digital radiography centers

The radiation doses resulting from diagnostic X-ray examinations are routinely measured in terms of entrance surface dose [ESD] and effective dose [ED]. In this study, for the purpose of radiation protection, the radiation doses received from Digital chest X-ray examination were evaluated in terms of ESD and ED. The ED was calculated by using the MCNP Monte Carlo code and an adult hermaphrodite mathematical phantom. The effects of both operating high voltage and projection geometry on the effective dose were investigated. The absolute values of the ED were calculated for digital and conventional Posterior-Anterior [PA] and Lateral [LAT] projections of chest radiography. The results show ED for PA projection in digital chest radiography in some major hospitals is higher than National Diagnostic Reference Level [NDRL]. Therefore optimization process should be considered seriously at national level to reduce patient exposure in digital chest radiography in Iran

Mycological microscopic and culture examination of 400 bronchoalveolar lavage [BAL] samples

The frequency of invasive opportunistic mycoses has increased significantly over the past decades especially in immunocompromised patients. Invasive aspergillosis [IA] has become a major cause of morbidity and mortality among these patients. As bronchoalveolar lavage [BAL] fluid samples are generally useful specimens in the diagnosis of invasive pulmonary aspergillosis [IPA], this study was designed to evaluate the incidence of fungal elements in at-risk patients by direct microscopy and culture of BAL samples. In a 16-month period, 400 BAL samples were obtained from several groups of different patients with pulmonary and respiratory disorders and examined by using both direct microscopy and culture. Of the 400 samples, 16 [4%] were positive direct examination with branching septate hyphae and 46 [11.5%] were positive culture: 25 [54%] Aspergillus flavus, 6 [13%] A. fumigatus, 5 [10.9%] A. niger, 1 [2.2%] A. terreus, 3 [6.5%] Penicillium spp. and 6 [13%] mixed A. flavus/A. niger. A. flavus was the most common cause of Aspergillus infection or colonization. Bone marrow transplant [BMT] recipients were the most susceptible group to fungal infection and/or colonization. Among Aspergillus species, A. flavus was the most common isolate in both infections and colonization in Iran. More studies are needed to clarify the epidemiological aspect of aspergillosis in Iran

Preparation and evaluation of killed NDV vaccine using new oil adjuvant

Preparation of inactivated oil Newcastle disease virus [NDV] vaccine using different new oil adjuvant Montonide ISA 70 VG, ISA 763A VG and ISA 775 as oil adjuvants in comparison with paraffin oil was carried out. The prepared vaccines with Montanide ISA 70 VG, 763 A VG and 775 VG induced high antibody titers than that induced by vaccines prepared with paraffin oil when determined by serological tests [HI and SNT]. The highest titer observed in prepared vaccine by ISA 70 VG oil adjuvant after 3 weeks post vaccination and remained high till 12 weeks post vaccination and has long duration of immunity reached to 12 month with a protective antibody titer and protection against challenge while prepared vaccine by Montonide ISA 763 A VG oil adjuvant reached 10 month with Montanide ISA 775 reached to 9 months, but in paraffin protective antibody titer reached only till 5 month

Expression of the bovine coronavirus spike glycoprotein subunits in insect cells using recombinant baculoviruses

In the present study, the bovine coronavirus [BCV] spike glycoprotein cleavage products [S1 and S2] were individually expressed in Spodoptera frugiperda [Sf9] insect cells, using a baculovirus expression system. The coding sequence of S1 and S2 gene fragments were amplified by RT-PCR and cloned into the baculovirus shuttle vector pBlueBac4.5/V5-His TOPO [R] TA. The cloned fragments were inserted into the genome of Autographa californica nuclear polyhydrosis virus [AcMNPV] under control of the polyhedrin promoter, through a process of homologous recombination between the shuttle vector and a linearized replication-defective baculovirus DNA [Bac-N-Blue[TM]]. Recombinant baculoviruses were selected by plaque purification; verified for the presence of target sequences using PCR and propagated for generation of high-titer viral stocks. Infection of insect cells with the recombinant baculoviruses revealed high-level expression of the target proteins as indicated by immunofluoresent test and solid phase ELISA using BCV-specific polyclonal antiserum

[Prevalence of lung involvement due to rheumatoid arthritis based on clinical, radiographic and pulmonary functions test]

Background: Pulmonary involvement is a common and serious complication of rheumatoid arthritis. This cross sectional study sought to determine the prevalence of pulmonary disease in patients with rheumatoid arthritis on the basis of history, physical examination, chest X-ray and PFT

Materials and Methods: 103 patients [81 Women, 22 Men] fulfilling the ACR [American College of Rheumatology] criteria for RA [Rheumatoid arthritis] were consecutively included in a cross sectional study. Detailed medical [including respiratory symptoms and the disease activity symptoms] and drug and occupational histories and smoking were obtained. All patients underwent a complete pulmonary and rheumatologic examination and conventional chest radiography. All patients underwent PFT that comprised spirometry and body plethysmography. Results for PFTs were expressed as percentage of predicted values for each individual adjusted for age, sex, and height

Results: On the basis of history: Their mean age was 43.3 +/- 2.6 years [range: 17-74] and the mean duration of the disease was 69.3 +/- 15.6 months. Rheumatoid factor was positive in% 61.2. No patients were 0.5Pack/Year smoker in whole life. Prevalence of pulmonary involvement based on radiographic and pulmonary function test detected in 41 patients [39/7%]. The most frequent respiratory clinical finding was dyspnea [33%], [NYHA grade I in 17.5% and NYHA grade II in 15.5%], Cough [with or without sputum] in 13.6 %, Crackle was the most sign in pulmonary examination [5.8%]. Chest X-ray was abnormal in 13.3 % that the most common finding in this study was reticulonodular pattern in 20 patients [19.4 %], and pleural effusion detected in 7 patients [6.7%]. PFT was abnormal in 30 patients [29.1 %]. A significant decrease of FEF 25%-75% below 1.64 SD. Small airway involvements was the most abnormal finding of PFT. No relation between rheumatoid arthritis disease activity [ESR>30, Morning stiffness>30', Anemia, thrombocytosis] with pulmonary disease was seen

Conclusion: This study suggests a high prevalence of lung involvement in patients with rheumatoid arthritis. Therefore we recommend a complete investigation in patients with RA with any respiratory symptom

Role of clinician's speech characteristics in auditory training of post-lingual cochlear implant patients

Auditory training of cochlear implant patients is an integral part of the program aiming at the utmost benefit from the device. Speech perception with the implant has to be gradually taught through several sessions. The program improvised in this is composed of four levels. At the end of the last level, the patient should perceive and comprehend correctly connected speech without the use of visual cues. In Ain Shams University Hospitals, ten clinicians in the phoniatric unit share in the rehabilitation program. Each has different speech characteristies that were found to have an impact on the speech perception of the patients. Ten post-lingual cochlear implant patients were included in this research aiming at finding a correlation between the speech characteristics of each clinician and the degree of speech perception by the patients. The results have shown that the timing factor is very important in speech perception especially vowel duration

antigenic variation of foot and mouth disease virus of the last three isolates in Egypt

Three FMD viral isolates had been isolated from different outbreaks at three governorates [Sharquia, Suez, and Agga locality] during 1972, 1987, and 1993 from cattle respectively. The isolates were tested by coinplement fixation test [CFT] angainst the seven serotypes and the results revealed that all strains were of the type [O] FMD virus. The studied isolates were adapted after the 3[rd] and 4[th] passages to BEK cell cultures, they yielded infective titers ranging between 4 and 5.5 log 10 TCID[50] and complement fixing titers between 1.37-1.75 log[10] CFU/ml. Antigenic relationship and dominating state studies for the three isolates using the crosswise C.F.T. revealed that isolates [O[1]/72 and O[1] /87] and [O[1]/72] and O[1]/93] showing a little antigenic variation and can be classified as [Subtype similar but still different] and have a percentage between [32% to 70%] while isolates [O[1]/87 and O[1] /93] classified as [Subtype Similar] and have percentage between [70%-100%]. The dominance determination for isolated strains showed that isolate strain [O[1]/87] is dominating strain [O[1]/72 and O[1] /93] and strain O[1]/72 is dominating strain O[1]/93. The nucleotide sequence data of VPI of the isolated strains [O[1]/72, O[1]/87 and O[1]/93] revealed that the homology% FMD virus [O[1]/72, O[1] 87 with O[1]/93] were 86% and 88% respectively, while the homology% between O/87 and O/93 was 94%. This indicates a closer relationship between O[1]/87 and O[1]/93 isolates thorn to O[1]/72. The variation of the results between CF test and nucleotide sequence homology may be attnbuted to the fact that CF test is carried on the whole FMDV while the nucleotide sequence homology carried out on the level of VPI gene. However, this difference is not of a significant value that necessitates the change of the already applicable vaccinal strain

growth behaviour of the local isolate of lumpy skin disease virus [LSD]

The aim of this study was to identify and evaluate the kinetics and growth characteristics of LSDV in MDBK cell culture. The growth curve of the virus on MDBK cells denoted that the highest titer of cell associated virus was 4.48 TCID50/ml obtained 48 hours post- inoculation. The highest titer of cell free virus was 4.63 TCID50/ml 48 hours post-inoculation. LSDV is more cell associated than cell free. It is observed that virus growth and release was usually correlated with progression of CPE. The form and sequential cytopathic changes in MDBK cell culture were described

Isolation, Identification and sero conversion studies on BRSV in Egypt

In the present survey 250 nasal swabs and 400 sera samples were collected from calves, feed lot and diary cattle with different ages, seasons and different degree of respiratory signs, for BRSV isolation, identification and serodiagnosis. In addition to 150 calves apparently normal contact animals were examined. The collected samples represented six farms distributed throughout five Egyptian governorates. The obtained results proved that, 5 out 7 virus isolates were from calves 1-6 months old and another 2 isolates from unweaned calves 2-3 weeks old, 6 isolates were detected in spring season while, only one during winter season. Only 3 out of 7 titrated viral isolates were identified as BRSV by SNT and one more by direct FAT. The isolated strains were designated as RBSV Salhai 1994 and RBSV Alexandria 1994. The serodiagnosis results of 400 examined sera samples by SNT and ELISA revealed that 65 [16.25%] and 110 [27.5%] sera samples were positive, respectively. The antibodies titer ranged from 1/8 to 1/64. Maternal immunity through seroconversion study showed a fading of passive immunity completely at 5th month of age

Selective management of liver injuries

Sixty patients with blunt and penetrating liver injuries were included in this study. Ten selected cases with blunt trauma were managed conservatively. The other 50 patients needed urgent laparotomy after resuscitation. Eighty percent of these patients needed simple techniques of haemostasis for bleeding control. These procedures were drainage alone in 16%, use of topical agents in 4% and selective vascular ligation with simple suture hepatorrhaphy in 6o%. In 10 patients [20%], the liver injury was severe and Pringle maneuver was needed to control bleeding. These patients needed difficult techniques of haemostosis including extensive hepatorrhaphy, hepatotomy and vascular ligation, left lateral segmentectomy, resectional debridment and right hepatic aartery ligation. Subphrenic collection was the commonest complication. It occured in 10% of cases after conservative management and in 14.6% of those who survived after laparotomy The mortality of the entire group was 10%. We concluded that most cases of liver injury need simple methods of repair. Selective ligation of bleeding vessels and injuried ducts in the edges of the laceration with simple repair is the preferred method. Conservative management of selected cases of blunt liver injury is a successful method provided scanning devices are available

Influence of ammonium ions on the activity of nitrate reductase in the fresh water fern, azole Carolinian

The effect of NH[4]Cl either as a sole nitrogen source or together with NO[3], on nitrate reductase activity [NR] of the water fern, Azolla caroliniana was studied. Ammonium ions induced slightly the NR activity until 1.0 mM, then the activity decreased. When NH[+4]was added to the induction medium [2/5 N[2-]free Hoagland solution plus 5.0 mM N0[3]] a marked decrease in NR activity was -recorded. Nitrate uptake, assimilation and NR activity of Azolla plants pretreated with 1.0 mM NH[4]for 0,1,2,3 or 4 days were also studied. The uptake of NO[-3]was roughly the same, while NO[3]assimilation was greatly suppressed and, accordingly, accumulation of NO[3]was markedly increased. Maximum NR activity was shown with the non-treated Azolla plants. Ammonium uptake and NTR activity of previously induced or non-induced plants were also investigated. Induced Azolla plant showed a gradual increase in NH[-4]uptake and a marked decrease in NR activity throughout the whole experimental period. However, the non-induced plants absorbed much greater amounts of ammonia than did the induced ones

Selective treatment of blunt splenic trauma in adults

Controversies regarding management of splenic injuries aboud in the literatures. Every aspect of the trauma to this organ including the grading of the severity of injury, reliable diagnostic methods and the optimal management [Operative and non-operative] have been the subject of conflicting views. Observation without operation for the treatment of isolated blunt splenic trauma in children has been sucessful at one center and the results are duplicated at other centers. Application of the same priciples to adults has led to mixed results. While there is universal agreement that splenic preservation should be attempted in adults, the methods of achieving this goal, either by operative or non-operative means, remain unclear. We have reviewed our experience with the management of adults sustaining blunt splenic trauma in an attempt to determine the optimal method of management

Injection sclerotherapy versus splenectomy and devascularization for management of active bleeding varices

Bleeding Oesophageal varices represent the commonest cause of acute upper gastrointestinal bleeding in Egypt due to the prevalence not only of bilharziasis but also chronic hepatitis. In this study 60 patients with bleeding oesophageal varices were randomly allocated to injection sclerotherapy or to splenectomy and devascularization. The included patients were followed up for one year. In 30 patients treated by injection sclerotherapy as an emergency procedure bleeding was controlled but in 3 patients bleeding persisted. Sengstaken tube tamponade was effective in controlling bleeding in 2 patients and the third one needed urgent splenectomy and devascularization. Recurrent bleeding during the follow up period occurred in 5 cases [16.6%] and 3 patients died [10%]. Among 30 patients treated by splenectomy and devascularization, 12 patients underwent emergency surgery which was adequate for bleeding control except in one patient which needed in addition injection sclerotherapy following the operation. Elective splenectomy and devascularization was done for the remaining 18 patients after successful bleeding control by the conservative measures including Sengstaken tube tamponade. Recurrent bleeding occurred in 4 patients [13.3%]. Three patients [25%] died when the operation was done as an emergency procedure and another 3 patients [16.6%] died following elective surgery. These results indicate that injection sclerotherapy can be effective in controlling bleeding oesophageal varices but with less complications than splenectomy and devascularization specially when urgently done

Antimicrobial agents in Egyptian folk medicine

Aninvestigation was made into the presence of antimicrobia.l substances contained in certain Egyptian folk medicines. Seeds of cumin and caraway and leaves of guava, camphor, mint and tiliso and flowers of several herbaceous plants contained antimicrobial agents. These agents could be extracted from guava and camphor leaves by benzene, chloroform, ethyl ether and ethyl acetate and from cumin and caraway seeds by ethyl ether and alcohol and from the herbaceous flowers and mint leaves by benzene, ethyl ether and alcohol

presence of antimicrobial substances in certain green algae

The antimicrobial principles in three algae Chlorella vulgaris, Scenedesmus acutus and Colelastrurm probnscideum were extracted using a successive solvent system. The extracts were bioassayed against three different bacteria. The three algae contained different antimicrobial principles most of which were soluble in ethyl ether. The Gram negative Escherichia coli exhibited high tolerance to the antimicrobial principles compared to the Gram positive Staphylococcus aureus. No stimulating effects were recorded in the examined extracts