Influence of the perceived educational environment on future career planning among nursing students in Egypt

Purpose@#The aim of this study was to examine attitudes and knowledge regarding career planning after graduation, as well as the perceived educational environment of a pediatric clinical course, among nursing students at Menoufia University in Egypt. This study also investigated the influence of the perceived educational environment on future career planning among nursing students. @*Methods@#A descriptive cross-sectional study was used, with a structured interview questionnaire that included demographic characteristics, a section that measured students' attitudes and knowledge toward their career planning, and the Dundee Ready Educational Environment Measure Scale (DREEM). @*Results@#The mean total score for the DREEM scale was 109.61, and most students perceived many areas within the program as more positive than negative. However, they had low levels of knowledge regarding career planning. @*Conclusion@#Based on the findings of this study, further efforts should be made to stimulate students' interest in pediatric nursing, to integrate theoretical content with practice, and to improve their planning activities early during their study. It is important to engage students in discussions concerning their ideas and worries about factors they perceive as less enhancing and more threatening in clinical settings.

Right ventricular diastolic dysfunction in asthmatic patients

Asthmatic patients develop right heart affection from early stages through different mechanisms. The current study was performed aiming to assess the right ventricular diastolic dysfunction in different asthmatic stages. The study population was fifty persons subdivided into 30 asthmatic adults and 20 healthy control subjects. Results showed that the prevalence of right ventricular dilatation was statistically higher among asthmatic adults [66%] than controls [0%]. Also, there was a significant elevation of the mean value of ESPAP among asthmatic adults [24 +/- 7.18] than the control group [17.8 +/- 4.98] [P < 0.05]. In addition the mean value of RVEDD was significantly higher among asthmatic adults [17.47 +/- 4.51 cm] compared to control subjects [14.54 +/- 3.15 cm] [P < 0.05]. Also, a more deleterious effect was found that severe asthmatic cases suffered more impairment in diastolic functions of the right ventricle than mild and moderate cases, which means that patients with bronchial asthma have right ventricular diastolic dysfunction and the degree of this dysfunction is related to the severity of the disease

plasma level of selenium and tumor necrosis factor-alpha and the activities of glutathione peroxidase lsoenzymes in colorectal cancer patients

Colorectal cancer represents a significant cause of morbidity and mortality worldwide. It is known that reactive oxygen species [ROS] are formed in excess in chronic diseases of the colon but the precise mechanisms of oxidative stress being induced in cancer cell and the role of ROS in colorectal cancer progression are still not exactly understood. The present study aimed to investigate the oxidative status of plasma as lipid peroxidation end products and the level of glutathione [GSH] in colorectal patients. The level of Selenium was also assessed by atomic absorption in association with the activities of GSH peroxidase isoenzymes [total, Se-dependent and non-Se-dependent]. Also the level of tumor necrosis factor-alpha [TNF-alpha] in plasma was assessed. The study was carried out on 30 colorectal cancer patients at different stages and grades and 10 healthy control subjects of matched age and sex. The results demonstrate that, colorectal cancer patients suffer from oxidative stress which is dependent on the grade and stage of the disease as indicated by elevated levels of lipid peroxidation end products, TNF-alpha and oxidized glutathione and by decreased levels of total and reduced GSH. Also, Se was significantly decreased in patients compared to control with the lowest level observed in grade III patients. This decrease in Se was associated with inhibited activities of total and Se-dependent GSH peroxidase while no change was observed in the activity of non-Se-dependent isoenzyme. Colorectal carcinogenesis is associated with serious oxidative stress and depletion of Selenium

Effect of vitamin E on blood glucose, insulin, lipid peroxides, and antioxidant system of streptozotocin-induced diabetes in rats

There is growing evidence that excess generation of highly reactive free radicals, largely due to hyperglycemia, causes oxidative stress which further exacerbates the development and progression of diabetes and its complications. There are multiple sources of oxidative stress in diabetes including non-enzymatic, enzymatic, and mitochondrial pathways. Vitamin E is a fat-soluble vitamin that prevents lipid peroxidation. The present study was carried out to test the effect of vitamin E on blood glucose, insulin, and lipid peroxides in blood and liver tissue of rats in relation to oxidative damage associated with diabetes induced by streptozotocin [STZ]. 24 male albino rats were randomly assigned to control [group I], streptozotocin [STZ]-induced diabetic rats [group II], the third group [vitamin E group] were STZ-induced diabetic rats fed 400 mg of vitamin E/kg diet. After 4 weeks of the induction of diabetes, rats were sacrificed and the following determinations were done on the blood, serum or plasma. Blood glucose, serum insulin, lipid peroxide concentration in plasma as malonyldialdehyde [MDA] level in nmol/g protein, the amount of thiobarbituricp acid reactive materials in plasma [TBARM], serum antioxidant capacity [assayed by measuring the total peroxy radical trapping capacity [TRAP] of serum, and serum superoxide dismutase, enzyme activity [SOD]. In the liver, the following parameters were determined: liver MDA, SOD and Glutathione peroxidase [GSH-Px] enzyme activaties, and Glutathione [GSH] concentration. Hyperglycemia, hypoinsulinemia were regarded in group II which were ameliorated by vitamin E administration. Oxidant stress was found in diabetic rats group II manifested by increase concentration of MDA-plasma and liver, increase TBARM concentration, and TRAP-plasma and serum respectively. Also increased serum SOD, liver SOD, and GSH-Px enzyme activities in these diabetic rats. Administration of vitamin E in the diet decreased the oxidant stress parameters [MDA, TBARM, and TRAP], increased the antioxidant defense parameter [increased GSH concentration in liver], and decreased the oxidant stress as manifested by the decrease in serum SOD enzyme activity; liver SOD; and GSH-Px enzyme activities. Vitamin E was found to be excellent for strengthening the antioxidant defense system in STZ-diabetic rats and it may therefore has a therapeutic role in combating the damaging effect of ROS in diabetes and preventing its complications

Pneumoslide-M test. As a diagnostic tool for atypical lower respiratory tract infections in pediatric patients

The diagnosis and clinical management of lower respiratory tract infections [LRTI] pose challenges to pediatricians as new technology is developed and new pathogens emerge in the spectrum of clinical diagnosis. This study aimed at rapid diagnosis of atypical lower respiratory tract infections in pediatric patients using Pneumoslide- M test. This study included 55 children with acute LRTI [pneumonia,bronchiolitis and croup[their age ranged from > one month to < two years with the mean age of [12.8 +/- 3.7]. All cases were subjected to complete history taking, thorough clinical examination and laboratory tests which included: Complete blood count, nasopharyngeal aspirates smear and culture. According to the microbiological results the studied patients were classified into two groups: Group I: The caustive pathogen was detected by the conventional microbiological methods,this includes 31 children and Group II: In which the caustive pathogen was not identified by the conventional microbiological methods [Atypical lower respiratory tract infections],this includes 24 children.Cases of group II only were subjected to Pneumoslide-M test. [Indirect immunofluorescence test for detection of serum IgM against respiratory viruses and atypical bacteria]. Pneumoslide M test could identify the causative pathogen in 91.7% [22 out of 24 cases] of group II patients and the diagnosis was as follows: respiratory syncytial virus [RSV] infection in 9 cases [37.5%], parainfluenza viruses [PIV] infection in 5 cases [20.8%], adenovirus infection in 4 cases [16.7%], influenza A virus infection in 3 cases [12.5%]. M. pneumonia infection was detected in only one case [4.2%] and 2 cases [8.3%] remained undiagnosed . Viruses and atypical bacteria constitute almost 43.6% of the causative agents of LRTI in young children especially in winter times. The use of Pneumoslide M test has great value in rapid diagnosis of this infection

Rapid detection of methicillin - resistant staphylococcus aureus [MRSA] by: disk diffusion, E-test, latex agglutination test and real -time PCR

Methicillin resistant Staphylococcus aureus [MRSA] is an important pathogen causing severe nosocomial infections whose prevalence has been increasing. The effectiveness of infection control measures is enhanced by early detection of resistant isolates and this is dependent on the time taken to isolate and identify MRSA In specimens taken from infected patients and in screening specimens taken to identify patients colonized with MRSA. So we aimed in this study to evaluate the abilities of phenotypic methods [Disk diffusion. E-test and Latex agglutination test] and genotypic method [real time PCR] for rapid detection of methicillin resistance in S. aureus. It was done on 220 patients [155 males and 65 females] at Benha University Hospital during the period from March to September 2005 to isolate any growth of S. aureus. Two hundred and twenty clinical samples were collected: they were 140 pus samples. 48 urine samples and 32 blood samples. Pus and urine samples and positive blood cultures were cultured to isolate any growth of S. aureus then the isolated colonies were examined for identification of MRSA isolates by disk diffusion method [Ox 1 micro g. Ox 5 micro g and Fox 30 micro g]. E-test. PBP2a latex agglutination test and detection of mecA gene by real time PCR. Two hundred isolates were detected in 220 clinical samples The frequency of S. aureus isolates was 28% [56 out of 200 isolates] they were mainly from wound pus [36 out of 56] The mec A PCR assay allowed us to classify 22[39.3%] of the isolates as S. aureus mec A-positive and they were mainly from pus [12 out of 22] and blood [6 out of 22]. and 34 [60.7%] as S aureus mecA negative. When phenotypic and genotypic identification was compared with PCR results it was found that by oxacillin 1 micro g disk, the sensitivity was 90.9% and the specificity was 94.1% by oxacillin 5 micro g disk, the sensitivity was 90.1% and the specificity was 76.5%, while cefoxittin 30 micro g disk yield 100% sensitivity and 94.1% specificity. Oxacillin E-test strips had the same sensitivity and specificity of oxacillin lmicrog disk. Latex agglutination test and real time PCR had the best sensitivity[100%] and specificity [100%] and they are able rapidly and reliably to detect MRSA isolates. the new molecular assay [real time PCR] was found to be rapid and robust because it is a largely automated assay. less hands on work is needed, consumes shorter time than conventional PCR and it can be used for direct detection of MRSA from non sterile clinical specimen, however, it is not yet available in the majority of routine diagnostic laboratories because of their elevated technical requirements. In absence of real time PCR. latex agglutination test is the best method for MRSA detection from isolated colonies

Influence of amphibian and reptile on the feeding preference, longevity and reproductive capacity of Egyptian culex [culex] pipens linneaus [dipera-culicidae]

Using Bufo regularis and ten reptile species as hosts for Culex pipiens under laboratory conditions revealed a great effect on feeding preference as a significant long feeding periods together with a significant reduction in the blood meal ratios were recorded. Female mosquitoes offered the experimental animals showed a short life span with different significant levels. A recognizable reduction in the reproductive fitness of Cx. pipiens females was recorded. Delayed oviposition and low ICI values was obtained. The percentage of egg hatching was not affected by the experimental animals

Laboratory studies on the possibility of culex [culex] pipiens L. to harbour and transmit hepatozoon matruhensis to the Egyptian snake psammophis schokari

A successful experimental infection of Psammophis schokari snake with Hepatozoon matruhensis through Culex [Culex] pipiens bites was carried out under laboratory condition of 20 +/- 1°C and 60-70% R.H. The period monitored for gametocyte maturation ranged from 38 to 42 days while the recorded prepatent period ranged from 28 to 35 days. The effect of infection was nonsignificant on longevity, incubation period and percenttage of egg hatching [P > 0.05]. Meanwhile a significant increase [P < 0.05] in the preoviposition period together with a significant reduction [P <0.001] in the number of eggs deposited of infected females were recorded

Merogony of toxoplasma gondii [apicomplexa: coccidia] and its effect on the mortality and histopathology in the house mouse musculus

The merogonic stages of Toxoplasma gondii and their effects on the mortality and histopathological changes in the orally-inoculated male house mice Mus musculus with low and high doses [LD and HD] of T. gondii sporulated oocysts were investigated. The mortality percentages in LD group were 16%, 20%, 28% and 72%; while, those in HD group was 36%, 56%, 72% and 100% in the 1st-4th week, respectively. Meanwhile, the maximum mortality percentage of the control group reached 6%. The histopathological changes induced by the parasite in different organs, such as kidney, liver, brain, spleen, heart, lungs and testes were discussed

Repair of acute patellar tendon rupture without a tension - relieving method

This prospective study was done on 11 patients with complete acute traumatic patellar tendon [PT] rupture treated by direct repair without using any tension-relieving method. Early passive range of motion [ROM] was initially allowed before immobilizing the knee. The average follow up was 18 months. All patients were satisfied with the outcome of surgery. ROM improved continuously in all patients. No patient was left with an extension lag and the average flexion deficit was 9 degree. No patient developed patella infera. The study suggested that the technique used is effective in holding the repair till healing of the tendon to the patella occurs and seems to restore the biomechanics of the extensor mechanism and the patellofemoral joint [PF] to as near normal as possible. Allowing passive ROM in the immediate postoperative [PO] period promotes articular cartilage nourishment and facilitates rehabilitation

Analytic study of laryngeal mask airway cuff pressure on the pharyngeal mucosa and postoperative adverse airway events

Sixty patients scheduled in order to calculate the pressure exerted by the cuff upon the pharyngeal mucosa and incidence of adverse airway events [hypoxia, hypercarbia, coughing, regurgitation, vomiting, airway obstruction, hiccup or biting]. At the end of surgery patients were interviewed about pharyngolaryngeal morbidity [sorethroat, dysphagia and dysphonia] immediately before leaving the post- anesthesia care unit and 24 hours following surgery. Patients were divided into three groups, each 20 patients were studied for each of the size 2, 3 and 4 laryngeal mask airway [LMA]. A noninvasive method was used to compare intracuff pressures. Cuff inflation with normal injection volumes recommended resulted in the residual volumes of the cuffs being exceeded. The intracuff pressures recorded with the mask in situ at these normal injection volume were in the range of 103-251 mmHg. The calculated transmitted mucosal pressures were substantial for all three sizes of the cuff and potentially exceeded the capillary perfusion pressure of the adjacent pharyngeal mucosa, despite apparent pharyngeal accommodation to the mask. Analysis showed more partial airway obstruction in the LMA size 2 group, also heart rate was slightly higher in LMA size 2 group upon arrival in the post- anesthetic care unit [PACU], otherwise there is no differences in cardio-respiratory responses. Sore throat and dysphagia were more common in the LMA size 2 group. The transmitted pharyngeal mucosal pressure were calculated over the clinical range of injection volumes. Study concluded that in general, emergence characteristics with the laryngeal mask airway are not influenced by volume of air used to inflate, but that postoperative sore throat and dysphagia are more likely at high initial cuff volumes

protective role of the angiotensin-converting enzyme inhibitor enalapril against gamma radiation induced organ toxicity in the rat

The present study was designed to evaluate the radioprotective efficacy of the angiotensin-converting enzyme inhibitor enalapril and the possible mechanisms of this radioprotection. This included the ability of prophylactic enalapril treatment to prevent or retard gamma radiation-induced organ toxicity and to protect tissue' antioxidant enzymes in the rat. Prior to irradiation rats were randomized to groups receiving enalapril or no treatment, in addition to a control group of non-irradiated, non-treated rats. Enalapril was administered intraperitoneally [0.1 mg/ kg body weight / day], 4 weeks before and 12 weeks after irradiation. Both groups were exposed to a single dose of 7GY gamma radiation. Irradiation induced significant elevations in the levels of blood urea nitrogen and serum creatinine and serum activities of lactate dehydrogenase [LDH], creatine kinase [CK], alanine amino transferase [ALT] and aspartate amino transferase [AST] compared to control values, indicative of renal, cardiac and hepatic injury. Also there was an increase in the serum levels of triglycerides, total cholessterol and LDL-cholesterol. On the contrary, HDL-cholesterol level was decreased. The heart, kidney and liver antioxidant enzymes including total glutathione peroxidase [total-GPX], glutathione reductase [GR] and superoxide dismutase [SOD] activities were inhibited, while malondialdehyde [MDA] level in these organs was elevated, indicative of increased lipid peroxidation. These data confirm the role of oxidative stress in radiation-induced organ toxicity and points to the possible antioxidative mechanisms of the radioprotective action of enalapril, which might be mediated by improving the balance between reactive oxygen species and antioxidant enzymes. Moreover, the beneficial effect of enalapril on serum lipid profile is suggested to be an additional mechanism of radioprotection

Assessement of patient-controlled analgesia using remifentanil as an effective and safe alternative to patient-controlled epiduralúanalgesia for labour

This study compared the administration of intravenous infusion of remifentanil using patient-controlled analgesia [PCA] device for analgesia in normal labour with that of 0.1% bupivacaine plus sufentanil 0.5 microg/ml via patient-controlled epidural analgesia [PCEA]. One hundred healthy pregnant women at term with a single fetus with a vertex fetal presentation were divided in two equal groups to receive either 0.25 microg to 1 microg/kg as bolus dose of remifentanil PCA in a stepwise manner with or without a background infusion [0.025-0.05 microg/kg] or 0.1% bupivacaine and 0.5 microg/ml sufentanil using PCEA. Pain Score on visual analog score [VAS]. Modified bromage scale [0-3]. Level of sensory block, drug use, supplemental boluses and side effects were recorded. Mode of delivery, duration of first and second stages of labour, umblical cord pH, Apger scores of the newborn and a measure of maternal satisfaction were recorded after delivery. VAS pain score during the progress of labour was significantly less in bupivacaine group PCEA [16.9 +/- 13.4mm] compared with the lowest pain scores in remifentanil group recorded at L[1]B[1] bolus 0.25 microg/kg [30.2 +/- 23 mm] and at L[1]B[2] bolus 0.5 microg/kg [24.4 +/- 18 mm] respectively, P<0.01, Maternal satisfaction with the relief of contraction pain was greater in bupivacaine group [90.8 +/- 10.8] than in remifentail group L[1]B[1] 70.20 +/- 20 mm, L[1]B[2] 50.2 +/- 12.8] P<0.0001, as with the relief of delivery pain [bupivacaine group 88.7 +/- 14.1 mm, L[1]B[1] 78.3 +/- 2.3 mm, L[1]B[2] 80.1 +/- 25.2 mm] P < 0.0001. On visual scale: 0 = not satisfied, 100 = fully satisfied. Motor and sensory block were assessed with the progress of labour in bupivacaine group. No differences were seen between the two groups for mode of delivery, maternal blood pressure, fetal heart rate, apger score 0, 5, 10 min and umblical pH. Patients in remifentanil group requested more supplemental boluses to achieve labour analgesia than those in bupivacaine group, adding background infusion at level two or three bolus doses not reduce pain scores but serves only to increase respiratory depression, sedation and opioid side effects [vomiting, nausea and itching]. Delivered as patient-controlled epidural analgesia 0.1% bupivacaine plus 0.5 microg/ml sufentanil are more potent than PCA remifentanil. Remifentanil PCA system [bolus doses 0.25-0.5 microg/kg without a background infusion] may safely provide worthwhile, although incomplete analgesia for labour

Neostigmine intrathecal and transdermal nitroglycerine augment intrathecal bupivacaine-fentanyl postoperative analgesia following lower limb surgery

Sixty patients were scheduled for lower limb operations. Their age ranged from 24 to 49 years [mean 41.7 +/- 6.4]. Patients were divided into four groups each group included 15 patients. All patients were given intrathecal bupivacaine - fentanyl, plus group [I] was given [non transdermal nitroglycerine patch] as placebo, group [II] transdermal nitroglycerine patch 5mg /24 hours, group [III] intrathecal neostigmine 10 ug and [non transdermal nitroglycerine patch] as placebo and group [IV] transdermal nitroglycerine patch 5mg /24 hours plus intrathecal neostigmine 10 ug. All groups were assessed for intraoperative and a period of postoperative 24 hours for vital parameters, postoperative analgesia and duration of effective analgesia as time from intrathecal drug administration to the patients first requested for analgesic medication, adverse side effects and total dose to control pain in 24 hours postoperative. Results of this study revealed multiple drug combination may be useful in extending postoperative analgesia of spinal bupivacaine - fentanyl associated with transdermal nitroglycerine patch and neostigmine intrathecal .Suggesting that transdermal nitroglycerine patch and neostigmine may enhance each other's antinociceptive effects at the dose studied

Growth in children with chronic renal faliure and after transplantation

This study aimed at studying the relation between height, glomerular filtration rate [GFR] and hormonal alteration in children with chronic renal failure [CRF] on regular hemodialysis [HD] and the possible role of normal graft function, after kidney transplantation, in this respect. The study population comprised 18 children with CRF on HD with mean age of 10.56 +/- 3.08 years and 16 children with normal graft function [mean age 11.06 +/- 3.19]. Mean duration on HD was 14.72 +/- 7.73 months for CRF group. Mean interval after transplantation was 1.97 +/- 0.9 years for the group of functioning grafts. Ten normal healthy children of matched age and sex served as controls. All patients were subjected to assessment of growth parameters including height, expressed as standard deviation scores [HtSDS] for chronological age, measurement of serum growth hormone [hGH] and serum parathormone [PTH] by radioimmunoassay. Growth performance was evaluated twice: at the start of the study and after a period of one year. The overall growth retardation in children with CRF on HD corresponded to -3.16 +/- 0.43 [mean SDS for height]. Children with normal graft function had a mean HtSDS of -2.54 +/- 0.29. Growth retardation remained a critical complication after kidney transplantation despite the statistically significant improvement observed compared to the group of children with CRF [P< 0.001]. Our results confirmed that impaired HtSDS with children with CRF correlates with the duration on hemodialysis [r = -0.728, P< 0.001]. There was a significant correlation between GFR and PTH level [r = -0.750, P< 0.001] in children with CRF. Our series of children with CRF had a positive correlation between their SDS for height and GFR [r =0.760 with P<0.001]. Both categories with CRF and with normal graft function had significantly higher levels of both serum hGH and PTH compared to controls [P<0.001], while CRF children had significantly higher serum levels of both hGH and PTH compared to those with normal graft function [P<0.008 and P<0.001 respectively]. Our results support the possibility that growth retardation in children with CRF despite the normal or elevated hGH level may be explained by the presence of peripheral insensitivity to the action of hGH

Study of some angiogenic stimulators in rheumatoid arthritis: impact of therapy with gold and methotrexate

The angiogenic stimulators; basic fibroblast growth factor [b-FGF], intercellular adhesion molecule [ICAM-I], tumor necrosis factor-alpha [TNF-alpha], interleukin-1 beta [IL-1 beta], cathepsins B and L and hyaluronan [HYA] were investigated to evaluate indirectly the angiogenic process in rheumatoid arthritis [X4]. Forty-four patients with active seropositive rheumatoid arthritis and fifteen healthy age and sex matched subjects were enrolled in this study. Significantly higher mean levels of b-FGF, ICAM-I, TNF-alpha, IL-1 beta, cathepsins R and D and HYA were found in sera of the patients compared with controls. These indices showed significant correlations with each other and with the clinical and laboratory parameters of disease activity. After 12 weeks of treatment with disease modifying antirheumatic drugs [DMARDs], gold or methotrexate, the mean levels of the studied angiogenic stimulators decreased significantly

Pattern of plasma gastrointestinal hormones in some gut diseases

The present work was conducted on 47 patients as well as 12 healthy controls aiming to investigate the plasma patterns of some gastrointestinal peptides including gastrin, cholecystokinin, vasoactive intestinal peptide and beta- endorphin in patients with some gastrointestinal disorders including gastric ulcer, duodenal ulcer, mild reflux esophagitis and severe reflux esophagitis for the evaluation of the diagnostic and therapeutic applications of these peptides in the diseased states of the gut. The statistical analysis of the results revealed a highly significant increase in the plasma gastrin and VIP levels and a highly significant decrease in the plasma beta-endorphin and CCK levels in gastric ulcer group when compared with the control group

Plasma free fatty acid levels in ischemic heart diseases

To evaluate the pattern of plasma free fatty acids [FFA] in ischemic heart diseases, we compared patients who had suffered a myocardial infarction with age matched control subjects free from clinically apparent ischemic heart diseases. We found significant low levels of serum palmitic. stearic. oleic, linoleic and linolenic acids in acute myocardial infarction [AMI] group as compared with healthy control one. Whereas no significant difference was found between chronic myocardial ischemia [CMI] and acute myocardial ischemia [AMI] groups On the other h and, there was significant low levels of palmitic, stearic and oleic acids in CMI group as compared to healthy control one. The positive ecological correlations between national intakes of total fat and saturated fatty acids and cardiovascular mortality found in earlier studies were questionable or absent in our recent study