ABSTRACT
Background: Assessing the quality of care has become increasingly important to health care providers, regulators and purchasers of care.
Aims: This study assessed the quality of care provided to children with cerebral palsy attending Alexandria University Children's Hospital, Egypt.
Methods: Paediatric neurology residents [n = 15] who provided care to children with cerebral palsy at the hospital completed a structured checklist assessing their compliance with generic care standards. The medical records of 84 children with cerebral palsy who received care at the hospital were reviewed using the same checklist. Another checklist was completed by the head of the paediatric neurology unit, medical director of the hospital, head of physical medicine and head nurse to assess adherence to process and service improvement standards. Face-to-face interviews were conducted with the caregivers/parents of the children using a client satisfaction questionnaire.
Results: Based on what was reported by health care providers, most did not adhere to the recommended practices in the care of children with cerebral palsy. Review of the medical records also showed a lack of compliance with standards. The mean total satisfaction percentage score of parents/caregivers was 55.43% [SD 18.16]. Satisfaction was particularly low for waiting time, waiting area and availability of required facilities for their child's care.
Conclusions: There is a wide gap between the actual care provided to children with cerebral palsy and the recommended standards. Moreover, the documentation system in the hospital is poor. A quality improvement plan is needed for the provision of care to children with cerebral palsy
Subject(s)
Humans , Child , Quality of Health Care , Child , Child Care/standards , Surveys and Questionnaires , Cross-Sectional Studies , Medical RecordsABSTRACT
The aim of this research work was to identify and characterized the bacteriocins produced by soil-associated bacteria. Bacillocin from Bacillus brevis Bb and pyocin from Pseudomonas aeruginosa Pa were found bioactive only against gram-positive bacteria tested. Maximum production of both the bacteriocins was observed at 32°C in BHI medium. Production of both the bacteriocins started in the early exponential growth phase while the maximum production was observed during the stationary phase. Bacillocin Bb remained stable during 1-9 pH while pyocin Pa remained stable at pH 1-11. Both of the bacterocins were found resistant to high temperature [100°C for 30 min], detergents [1% solutions of EDTA, Tween 20, Tween 80 and SDS] and organic solvents [1% solutions of Ethanol, Butanol, Methanol, Propanol, Chloroform, and Acetone]. Activity of both was completely lost after proteinase K treatment suggesting their protein nature. Titre of bacillocin Bb was estimated to be 5280 AU/mL while the titre for pyocin Pa was calculated as 640 AU/mL. Both of the bacteriocins showed bacteriolytic mode of action against the indicator Bacillus strain BC31 and were found <10 KDa in their molecular mass
Subject(s)
Soil , Soil Microbiology , Pyocins , Pseudomonas aeruginosa , Bacteriolysis , BacteriaABSTRACT
This study aimed to detect the cellular, humoral immune responses and protection against schistosomes induced by cercarial [CAP], soluble worm [SWAP], soluble egg [SEA], and mixed [SEA + CAP], [SEA + SWAP] and [CAP + SWAP] antigens to Schistosoma mansoni infection in mice, and the improvement in the liver enzyme activities before and after challenge with S. mansoni. Each mouse was sensitized with an initial immunization of 0.6 ml of the extracted antigen [30µg protein/ml]. After one week, a second injection of 0.4 ml was given [20µg protein/ml]. Then, each mouse was exposed to 80 cercariae. Six weeks post challenge the protection percentage was 42.5, 58.33, 53.33, 60.91, 78.16 and 64.77% for CAP, SEA, SWAP, [SEA +CAP], [SEA+SWAP] and [CAP + SWAP], respectively. The results revealed a high significant interrelation between number of lymph node cells [MLN] [P
ABSTRACT
Bladder carcinoma is the most prevalent cancer in Egypt and in most African countries, where it causes 30.3% of all cancers. Bliharzial infestation causes bilharzial bladder cancer, a preventable malignant disease, which arises in a background of schistosomiasis. From this point of view, the aim of the present investigation is to select a good marker, which may be considered as a new trend to assess any disturbance that occurs in tissue insult and to differentiate between cancer bladder with and without schistosomiasis. Succinate dehydrogenase [SDH], glucose-6- phosphatase [G-6-Pase], lactate dehydrogenase [LDH] isoenzymes and 5-nucleotidase were detected in bladder tissue, while tyrosinase, tyrosine aminotransferase [TAT] and protein profile were detected in patients serum. The results showed that, patients with bilharzial bladder cancer disease recorded more significant inhibition values in both succinate dehydrogenase and glucose-6- phosphatase enzyme activities than in patients with cancer disease as compared to the normal bladder tissue, while higher significant elevation levels of 5-nucleotidase, tyrosinase and tyrosime aminotransferase were observed. Lactate dehydrogenase isoenzymes recorded variation in its subunits, where LDH-l, showed significant decreased level in patients with bilharzial bladder cancer disease, while significant increased level in patients with cancer was noticed and the reverse for LDH-4 and LDH-S. Concerning immunoelectrophoretic separation pattern of serum protein profile, it recorded higher significant depression level of albumin, prealbumin,alpha-lipoprotein,beta-lipoprotein, alpha-macroglobulin, alpha-acid glycoprotein, alpha-l-antitrypsin, cholinesterase, ceruloplasmin, haemopexin, hepatoglobin, transferrin as well as total protein in bilharzial bladder cancer cases than in bladder cancer only as compared to the control group. In conclusion, significant changes in all biochemical parameters studied were noticed especially in patients with bilharizial bladder cancer than bladder cancer only