Arabic version of the Major Depression Inventory as a diagnostic tool: reliability and concurrent and discriminant validity

The Major Depression Inventory [MDI] is a brief questionnaire to assess the presence of a depressive disorder. We prepared an Arabic version of the MDi and tested its reliability and concurrent and discriminant validity as a diagnostic tool of major depressive disorder. A group of 50 Egyptian outpatients with major depressive disorder [assessed clinically and with the Structured Clinical Interview for DSM-IV-TR Axis 1 Disorders] were compared with 50 healthy controls using the MDI-A, Beck Depression Inventory [BDI] and Spielberger State-Trait Anxiety Inventory [STAI]. Cronbach a was 0.91 and intraclass correlation coefficient was 0.98 [95% Cl: 0.97-0.99]. Scores on the MDI-A strongly correlated with BDI scores [r - 0.81] but insignificantly correlated with STAI scores. Using the MDI scoring algorithm, the sensitivity was 88.4% and specificity 78.9%. We conclude that the MDI-A has an excellent reliability and an acceptable concurrent and discriminant validity

Use of airtraq, C-Mac, and glidescope laryngoscope is better than macintosh in novice medical students' hands: a manikin study

Obtaining patent airway is a crucial task for many physicians. When opportunities to practice intubations on patients are really limited, skill gaining methods are needed. We conducted a study among novice 6[th] year medical students to assess their ability to intubate the trachea in normal airway in manikin using four airway tools. Prospective, cohort study conducted at simulation center of university-based, tertiary care hospital. Fifty medical students performed either oral or nasal tracheal intubation using the following four intubating tools: C-Mac videolaryngoscope, Glidescope, and Airtraq in comparison with regular Macintosh laryngoscope. Intubation time, visualization of glottic opening, ease of intubation, satisfaction of participants, incidence of dental trauma, and the need for optimization manoeuvres' use among different airway tools were recorded. In oral intubation, Airtraq was better than others in regard to intubation time, glottic opening, ease of intubation, and the need for external laryngeal pressure application, followed by Glidescope, C-Mac, and finally Macintosh laryngoscope [P<0.001]. Airtraq and Glidescope associated with less dental trauma than C-Mac and Macintosh. In nasal route, fastest intubation time was reported with Airtraq followed by Glidescope, C-Mac, and lastly Macintosh. Airtraq, Glidescope, and C-Mac were similar to each other and better than the Macintosh in regard to ease of intubation, satisfaction, and number of attempts [P

Evaluation of polypeptide YY and ghrelin in complicated type 2 diabetic patients

The gut peptides polypeptide YY [PYY], [a potent satiety agent] and ghrelin [a potent hunger signal] are suggested to play a role in obesity. Obesity is commonly associated or complicated with hypertension [HT] and type 2 diabetes [T2D]. Thus, the current study aimed to: [i] estimate the fasting plasma levels of PYY and ghrelin in lean versus overweight subjects as well as overweight HT and T2D subjects, [ii] assess if PYY and ghrelin are affected by the glycemic state; and [iii] intercorrelate the levels of PYY and ghrehn considering insulin sensitivity, blood pressure values and lipid profile in HT and/or T2D subjects. Twelve lean healthy male subjects [group I] and fifty eight overweight, age and sex matched subjects [group II] were included in the present study. Group II [overweight group] was further sub classified into: [i] group IIa: normoglycemic normotensive subjects [n=14]; [ii] group IIb: T2D normotensive patients [n=18]; [iii] group IIc: normoglycemic HT patients [n=14]. Fasting plasma lipid profile, glucose [FG], insulin [Fl]. PYY, ghrelin and blood glycated hemoglobin A1C [HbA1C] were estimated. Insulin sensitivity was evaluated according to the homeostatic model assessment [HOMA] index. In the present study significantly lower mean plasma levels of both ghrelin and PYY were observed in all overweight groups versus the lean control group. The hypertensive and T2D groups, also, showed lower PYY and ghrelin levels compared to the over-weight normotensive normoglycemic group. Furthermore, in hypertension T2D group both present, both PYY and ghrelin levels showed further decrease. Ghrelin correlated positively with high density lipoprotein cholesterol, HDL-c [r=0.43, p<0.01]. Both ghrelin and PYY correlated negatively with BMI, FG, Fl, HbA1c, HOMA index, low density lipoprotein cholesterol [LDL-c] and mean arterial blood pressure [r=0.52, r=0.62, r=-0.73, r=-0.71, r=-0.76, r=-0.42, and r=-0.5. p<0.01 respectively for ghrelin: and r=-0.51, r=-0.61, r=-0.62, r=-0.39, and r=-0.48, p<0.05 respectively for PYY]. In controls, PYY and ghrelin were negatively correlated [r=-0.76, p<0.001]. However, in all groups of patients studied, they were positively correlated [r=0.64, p<0.001], Multiple regression analysis revealed that low ghrelin and PYY concentration were independently correlated to BMI [p=0.002, and p=0.009 respectively]. Low ghrelin was, also, independently correlated to FI [i.e., hyperinsulinemia] [p=0.04]. In the diabetic groups both PYY and ghrelun levels were lower in patients with poor glycemtc control versus controlled diabetics, as assessed byHbA1C. Thus, from the current study it could be concluded that low PYY and ghrelin levels may play a role in the pathogenesis of obesity, hypertension and T2D. Combination of a ghrelin antagonist [a hunger signal antagonist] and PYY [a satiety signal] is potentially and attractive therapeutic strategy for treatment of obesity and its complications

Safety of patient meals in 2 hospitals in Alexandria, Egypt before and after training of food handlers

We assessed the food safety knowledge and food handling practices of 23 food handlers in 2 hospitals in Alexandria, Egypt [Gamal Abdel Nasser [GAN] and Medical Research Institute [MRI]] before and after a food safety training programme, and also the bacteriological quality of patient meals and kitchen equipment. There was a significant improvement in all knowledge-associated parameters except for personal hygiene in GAN. There was an improvement in the food safety practices in both hospitals. The bacteriological quality of most patient meals and food preparation surfaces and utensils improved after training. The bacteriological quality of patients' meals served in GAN was generally better than that in MRI

efficacy of different regimens of chlorhexidine as an antimicrobial agent for a group of Egyptians

This study was conducted to evaluate different regimens of 0.12% chlohexidine [CHX] rinse on the salivary parameters and Mutans Streptococci [MS] for a group of Egyptians. Twenty one females were recruited based on inclusive exclusive criteria. They were assigned to three different groups according to the CHX regimen specified. Salivary parameters [unstimulated salivary flow rate, stimulated salivary flow rate, pH and buffering capacity] and salivary mutans streptococci were evaluated at base line for all participants. Diet recording was done for 4 days in a supplied chart. DMFS and DS scores were also determined. This was followed by the use of 0.12% CHX mouth rinse once daily for 60 seconds before bedtime for either 3, 7 or 14 days. Salivary parameters were re-evaluated in the early morning after the use of the mouth rinse, after 1 month and 3 months. Mutans Streptococci [MS] were also evaluated at the same intervals. The salivary parameters did not show any difference throughout the study. The majority of the participants belonged to the moderate low fermentable CHO diet content category and they consumed five meals of cariogenic intake per day. Their DMFS scores ranged between 2 and 50 whereas the DS scores ranged between 2 and 10. The 3 day regimen was not statistically significantly different from the 7 and 14 days regimens and the maximum efficacy of CHX was obtained immediately after its use and lasted throughout the first week after stopping it. The effect of the CHX disappeared after 1 month and gradually reached the base line and surpassed this level sometimes. A regimen of once daily use of 15 ml of 0.12% CHX mouth rinse for 3 days is effective in reducing MS below critical values. It is recommended to reuse the CHX rinse after 1 month owing to the cessation of its effect. Patients who start using CHX should not discontinue it

Effects of neonatal exposure of male rats to transient hypothyroidism, hemicastration or acute testicular irradiation on spermatogenesis at puberty

The aim of the study was to establish the profile of inhibit B in normal and in experimentally manipulated sertoli and germ cells by transient neonatal hypothyroidism [TNH], hemicastration and acute irradiation in prepubertal and pubertal rats. Material and After birth, pups were divided by sex and male pups were retained. For neonates designated as controls [group I] [10 rats]: mothers and litters remained untreated, received food and water adlibitum then pups of 21 days old were sham operated. Group II [Hypothyroid group]: neonates were made hypothyroid by the addition of 0.1% [wt/vol] propylthiouracil [PTU] to the mothers water immediately after birth from day 1 to day 21. Group III [hemicastrated group] [10 rats]: neonatal hemicastration was done on day 21. Group IV [irradiated group] [10 rats]: 21 day old rats were exposed to a low dose of 3 Grays of gamma ray. Serum was collected at prepuberty [4th week] and puberty [12th week] for estimation of inhibin B, follicle stimulating hormone [FSH] and testosterone levels.Semen analysis was done for pubertal rats. Inhibin B levels significantly declined at all groups II, III and IV compared to control rats aged 4 weeks. While in rats aged 12 weeks, significant increase at inhibin B level was observed at group II, while significantly declined at both groups III and IV. Comparing inhibin B levels at both age groups, there was significant decline in both control and hemicastrated rats with advancing age. While insignificant change was observed at both hypothyroid and irradiated groups. Prepubertal inhibin B level in control group correlated positively with its pubertal level, testosterone, sperm quality and pubertal testicular weight. It was negatively correlated with FSH both prepubutaly and at puberty. The study confirms the role that inhibin plays in the regulation of FSH secretion. Measurement of inhibin B prepubertally may give clinical clues about developmental deficiencies in the gonads that otherwise only become apparent around puberty or later in life

Assessment of safety of frozen foods

This cross-section study was conducted to assess the microbiological quality of 90 frozen food samples [50 samples of raw frozen vegetables including molokeya, okra green peas, peas + carrot and artichoke], 20 of frozen poultry products and 20 of frozen meat products as well as to assess the level of women practice during handling. The results showed that the mean aerobic mesophilic plate count of the frozen vegetables was 3.4 x 105 +or- 7.3 x 105 cfu/g. The mean mold and yeast count was 3.9 x 103 +/- 1.1 x 104 cfu/g. The mean coliform count was 3.9 x 10 +/- 6.6 x 10 m.o./g. In case of meat product, the mean aerobic count was 2.3 x 105 +/- 3.2 x 105, that of mold and yeast was 2.5 x 105 +/- 8.8 x 105 cfu/g and that of coliform was 3.2 x 102 +/- 3.8 x 102 m.o./g. On, the other hand, poultry products had a mean aerobic count of 6.8 x 105 +/- 1.6 x 106, a mean mold and yeast count of 3.5 x 105 +/- 7.4 x 105 cfu/g and a mean coliform count of 6.4 x 102 +/- 5.2 x 102 m.o./g. Fecal coliforms were detected only in 60.0% of meat product samples and in 45.0% of poultry product samples. On the other hand, Staph. aureus was detected only in 10.0% of poultry product samples. The difference between the five types of vegetables was statistically significant for total plate and mold and yeasts counts. Among the 113 interviewed women, 80 used frozen food products, 26 of them had scores <50%, those were classified as being bad as they were handling frozen food improperly which would contribute to the outbreaks of food borne diseases. Less than 4% of the users used satisfactory practice during handling frozen foods. Illiteracy affected significantly the level of practice

Rhomboidal flap and Z - plasty offer useful means for management of recurrent pilonidal sinus.

In this study, 20 patients with recurrent pilonidal sinus [1-4 times] were divided equally into two groups operated on by rhomboidal local flap for 10 cases and the other 10 by Z-plasty local flap and followed up for 1-2 years. The two groups were compared regarding hospital stay, postoperative complications, off-work time and recurrence rate. There was no statistical significant difference between the two modalities and the overall recurrence rate was 5%

Study of carpal tunnel syndrome [CTS] in uraemic patients on haemodialysis, its relation to B2 microglobulin and arterio-Venous shunt

to assess the prevalence of carpal tunnel syndrome [CTS] in patients with chronic renal failure [CRF] undergoing haemodialysis and to clarify the role of the various factors in its occurrence. Patients and two samples: patients sample: 20 patients with CRF undergoing haemodialysis in the main university hospital in Alexandria divided into two subgroups according to the duration of haemodialysis. subgroup A: less than 5 years and B: more than 5 years. The control sample: ten healthy persons with matched age and sex. All patients were subjected to history taking and neurological examination. Laboratory investigations included blood urea, haemoglobin and serum creatinine, calcium, phosphorus, sodium potassium and beta2-microglobulin concentrations. Electro-physological studies were done using Dantec Cantata machine. Motor and sensory conduction studies, and electromyography were performed to confirm diagnosis of the neuropathy. monoeuropathy in the form of CTS was diagnosed clinically in 55% of cases and electrophysiologicaly in 65% beta2M was significantly increased with prolonged duration of haemodialysis. However, there was no significant effect of age, sex, serum level of beta2M, the duration of haemodialysis or the side of the arterio-venous shunt when studied individually no the occurrence of CTS. However, there was no significant effect of the type of dialysis membranes. the presence of arteriovenous fistula was associated with the occurrence of CTS in a high% age of patients [65%]. Haemodailysis was associated with increased serum level of beta2-M especially in patients with prolonged duration of haemodialysis. No single variable is incriminated in the pathogenesis of CTs and it is more likely that many factors share in its occurrence i.e. it is multi-factorial. Electrophysiological assessment of uraemic patients on haemodialysis revealed subclinical CTS and hence early treatment may result in better prognosis

Adrenomedullin level in cirrhotic rats: relationship with renal functions and some vasoconstrictors

Purpose: to assess the role of endothelial factors as adrenomedullin [AM] and nitric oxide [NO] in modulating intrahepatic circulation and the role of NO inhibitors. Also, to investigate their relationship with some renal functions and some vasoconstrictors as norepinephrine [NE] and plasma rennin activity [PRA]. a significant increase of AM levels, plasma and urinary No was observed at both groups of cirrhosis. They significantly declined upon No inhibition. The levels were significantly elevated at cirrhosis with ascites than without ascites. PRA significantly increased in both cirrhotic groups with ascites but insignificantly changed at cirrhotic groups without ascites. NE significantly increased at cirrhotic groups [group II and III]. Both NE and PRA significantly declined upon NG nitro L-argenine methylester [L-NAME] administration. AM levels were negatively correlated to mean arterial pressure [MAP] and glomerular filtration rate [GFR]. While it was positively correlated to NE levels, PRA, plasma and urinary NO metabolites, serum Na+ level and urinary sodium excretion [UnaV]. at cirrhosis, there were significantly increased circulating levels of AM, plasma and urinary NO which could be responsible for the arterial vasodilatation. The mechanism of AM effects could be due to NO release. There were increased levels of NE and PRA due to arterial underfilling which activates a baroreceptor mediated neurohumoral response to counterregulate the vasodilatation. NO inhibition revered haemodynamic changes associated with cirrhosis. This raises the possibility of using long term NO inhibition to correct complications associated with cirrhosis and Bilharzial hepatic fibrosis [BHF]

TIVA: comparative study between different techniques

This study was carried out on 60 adult patients of both sexes with age ranged between 20 and 50 years, they underwent surgical procedures that were expected to last about one hour. Patients were allocated into three equal groups. Each group was subjected to a different anesthetic techniques. The concentration of cortisol and glucose increased in the three different groups during surgery and further significant increase was observed on recovery. This indicated that the three different groups were subjected to comparable stress. There was little difference in the recovery time between the three groups as assessed by Steward coma scale. Although the ketamine-midazolam group and the propofol-ketamine group showed a slightly longer duration for recovery, this is due to the re-entry of ketamine from the peripheral to the central compartment. Also, propofol was effective in eliminating the side effects of the subanesthetic doses of ketamine