Assessment of health related life quality in type 2 diabetic patients in zagazig university hospitals

Background: The fourth leading cause of death is type 2 Diabetes Mellitus (DM). Attention to the QOL of the patient is increasing today rather than the longevity of the patient. Therefore, to prevent aggravation of metabolic disorders, the quality of life of diabetic patients should be maintained. There is a growing awareness that patient QOL and satisfaction with treatment have been improved after good glycemic control. The aim of this study was to assess health related quality of life in patients with type 2 diabetes attending Zagazig University hospital plus associations between HRQOL scores and some variables playing role in scenario of DM were also studied.Methods:A cross sectional study included 100 type 2 diabetic patients, They were subdivided according to glycemic control into 2 groups and 50 non-diabetic participants as control. This study was conducted in Internal Medicine department and diabetes outpatient clinic in Zagazig University hospital in period from July 2016 to July 2018. The QOL was measured using SF-36 questionnaire. Results: Our results revealed that there was highly significant difference regarding physical health component among groups of study (p <0.001). There was also highly significant difference regarding mental health component among groups of study (p <0.001). There was highly significant negative correlation between QOL components and age & BMI & duration of DM & HBA1c and fasting blood sugar in diabetic patients (p <0.001). Conclusions: Type 2 diabetes mellitus in both the physical health and mental health domains is associated with a lower quality of life. Advanced age, obesity and poor glycemic control were factors related to lower quality of life in this study; therefore glycemic control is highly needed to improve the quality of life of diabetic patients

Mini-open reconstruction of rotator cuff of the shoulder

Background: shoulder pain is one of the most common musculoskeletal [MSK] disorder affecting a large portion of the population. It is estimated that one in three persons will have at least only one episode of shoulder pain within their lifetime. Rotator cuff tears are very common in the general population. Radiographic studies have shown the prevalence of rotator cuff tears to be 4-13% in the population aged between 40-60 years and 20% in population whom age between 60-70 years and 30-50% in population above 70 years. Rotator cuff tears are a common pathology associated with degenerative changes in the shoulder joint. They cause significant disability, pain, dysfunction and poor health status and their prevalence is currently increasing within an aging population

Aim of the Work: the aim of this work was to study the results of mini open rotator cuff repair of the shoulder joint

Patients and Methods: this study was conducted on ten patients presented to Al-Azhar University Hospital with rotator cuff tear of the shoulder. They are treated with mini-open repair technique. All our patients completed a period of at least one year of follow up

Results: a clinical success rate was found in ten patients treated by mini open technique, 70% had excellent and good results according to Constant and Murly score after one year of follow up

Conclusion: repair of rotator cuff tears by mini-open technique is one of the good viable options providing improvement in pain and function of the shoulder joint. Also it is more economic than arthroscopic repair and it does not need high learning curve as arthroscopic repair

Outcome of restrictive versus liberal blood transfusion strategies in intensive care unit admitted patients

Background: Anemia is a very common disease in critically ill patients. Approximately 29% of patients have lower than normal hemoglobin levels when admitted to an ICU, and about 95% develop anemia within 3 days of admission

Aim of the Work: The purpose of this study was to evaluate the effects of restrictive and liberal red blood cell transfusion strategies on mortality and morbidity in critically ill patients. And as a result, recommend the more beneficial and the less deleterious strategy for critically ill patients

Patients and Methods: This clinical interventional study was carried out at Intensive Care Unit, Benha Teaching Hospital, Egypt, during a period from July 2017 to November 2017. This study was approved by Ethical Committee of Faculty of Medicine, Ain Shams University, including the informed consents which were obtained from either the patient or the closest family member

Results: Mortality rates in ICU were 16 % and 20% in group A and B respectively, 24% and 28% within 60 days respectively. There were lower mortality rates with group A but with no statistically significant difference between groups according to mortality during ICU Stay and mortality within 60 days

Conclusion: Comparison between the effect of restrictive and liberal strategies of blood transfusion on mortality and morbidity in critically ill patients showed no significant differences. Restrictive strategy is at least as effective to liberal strategy in critically ill patients. Blood transfusion may be hazardous and cost-effective

Recommendations: Anemia is associated with adverse clinical outcomes. However, randomized clinical trials are required to establish if transfusion is beneficial or harmful in anemic patients. A restrictive transfusion strategy should be recommended within the well-studied patient populations and clinical conditions, and the clinicians must continue to use their experience and bedside clinical judgment to advocate the best management for their patients

Effect of Viscum schimperi on advanced glycation endproducts formation

Diabetes is a disease characterized by elevated uncontrolled glucose level. Hyperglycemia results in diabetic complication due to a reaction between sugar and amino acid of proteins to form advanced glycation endproducts [AGEs] in different tissues. Medicinal plants are considered as a great source of bioactive compounds that affect many ailments. In this regard; AGEs formation could be inhibited by many bioactive compounds isolated from medicinal plants. Viscum schimperi Engl. is a plant belongs to Loranthaceae and known for its antidiabetic activity. In this study; total methanol extract of V. schimperi [VT] was prepared, suspended in water and subjected to fractionation with chloroform followed by n-butanol to give [VC] and [VB] fractions respectively. The aqueous mother liquor was evaporated to form [VA] fraction. The inhibitory effect of all prepared fraction on the formation of advanced glycation endproducts [AGEs] was studied. The results revealed that V. schimperi extract and its different fractions inhibited protein glycation and oxidation of BSA induced by ribose together with decrease of protein aggregation. In conclusion; V. schimperi will be useful in management of diabetic complications based on its inhibition of advanced glycation endproduct formation

Efficacy of carbamazepine in treatment of bronchial asthma

The real break-throw in asthma treatment is still unreachable. In many cases drugs are not effective for reaching the control state. To investigate the efficacy of Carbamazepine in treatment of bronchial asthma. A randomized, parallel 6-month trial. Hundred patients fulfilled the inclusion criteria and divided into two groups. Group [1] received Carbamazepine [600-1600 mg/day] in addition to their usual anti-asthmatic treatment and group [2] received only the usual anti-asthmatic therapy. Baseline electroencephalography [EEG] study was done for all patients. Assessment of asthma control according to GINA classification was done before, 3 and 6 months after therapy. The mean age of studied patients was [37.9 +/- 9.47 and 28.6 +/- 11.06], in group 1 and 2 respectively. Two cases in group 1 showed abnormal EEG and no abnormality in group 2. As regards level of asthma control, there was statistically significant difference between first visit and third visit in both groups with high value in group 1 [P value 0.001, 0.04]. In comparing spirometric data of both groups at each visit it revealed statistically significant P value in all parameters [FEV1 0.001, FVC 0.003, PEF 0.01, FEE 25-75 0.001] except FEV1/FVC [P value was 0.264]. The frequency of acute asthma exacerbation in both groups was [0.5 +/- 0.57 and 3.2 +/- 0.98] in group 1 and 2, respectively [95% CI 2.4-3.1] with highly significant P value 0.003. In the Carbamazepine group dizziness was recorded in 6 cases 12%, itching in 2 cases 4%, and increasing sleepiness in 2 cases 4%. Carbamazepine is effective in treatment and in achievement of better asthma control with minimal side effect

Huge amoebic liver abscess presented with massive right empyema: a case report

Amoebic liver abscess is a complication of amoebiasis that needs early diagnosis and proper treatment before further complications occur. We report a-35 year old female presented by fever and dyspnea due to huge liver abscess complicated by massive right side empyema. The patient was effectively treated by percutaneous drainage for both the right lobe abscess and empyema together with pharmacologic agents

Perineural spread in Nasopharyngeal carcinoma: detection by CT and MRI

Nasopharyngeal carcinoma is mainly arising from the fossa of Rosenmuller frequently extends to the paranasopharyngeal space, which contains fibrofatty tissue and portions of the third division [V3] of the trigeminal nerve. The aims of this work are to describe the radiological findings of perineural spread in nasopharyngeal carcinoma and to compare the accuracy of MRI and CT in diagnosing perineural metastasis along the cranial nerves. A total of 52 patients diagnosed with nasopharyngeal carcinoma were included in this study. Both computed tomography and magnetic resonance imaging of the head and neck, including the nasopharynx, were performed for all patients. The extent of the trigeminal perineural tumor invasion was evaluated and correlated with neurologic symptoms. All 52 cases of nasopharyngeal carcinoma showed radiologic evidence of perineurai spread. However, clinical signs and symptoms of cranial nerve palsy were only seen in 36.5% [19 of 52] of the patients, leaving 63.5% [33 of 52] of the patients with no signs of nerve paralysis. The most common nerve to be infiltrated is the mandibular nerve in 30.7%. Maxillary nerve [V2], Ophthalmic division [VI] and vidian nerve were involved in 15.4%, 7.7%, 13.5% respectively. Maxillary and mandibular nerves were involved together in 32.7% of the patients. Perineural spread of the cranial nerves especially, trigeminal nerve is one of the most common and important routes in the intracranial extension of nasopharyngeal carcinoma.Clinical and radiologic findings reveal that nasopharyngeal carcinoma has a significant liability for perineural invasion. Neurologic symptoms usually present when the intracranial perineural spread has occurred. MR is the preferred imaging method for the evaluation of nasopharyngeal carcinoma perineural spread

Comparison of some heavy metal levels of round sardinella [Sardinella Aurita], dusky spinefoot [Siganus luridus] and Atlantic lizardfish [Synodus saurus] from Mex bay in Alexandria

Heavy metal [Cd, Cr, Cu, Cr, Pb, and Hg] concentrations in the muscle and liver of three fish species Round sardinella [Sardinella aurita], Dusky spinefoot [Siganus luridus] and Atlantic lizardfish [Synodus saurus] from Mex bay in Alexandria were measured and the relationships between fish size [length and weight] and metal concentrations in the tissues were investigated by linear regression analysis. Metal concentrations [as microg g-1 w. wt.] were highest in the liver and lowest in the muscle of all the fish species. Highest concentrations of Cd [0.36] and Cr [8.04] were measured in liver tissues of S. saurus and S. luridus, respectively. The liver of S. saurus showed strikingly high Cu concentrations [11.6]. Results of correlation coefficient showed that, except in a few cases, significant relationships between metal concentrations and fish size were negative. Highly significant [P<0.001] negative relationships were found between fish length and Cd concentrations in the liver of S. luridus and S. saurus, Cr concentrations in the muscles and liver of S. luridus and liver of S. saurus and Cu concentrations in the liver of S. saurus is and muscles of S. luridus. Cu and Hg concentrations in the liver of S. aurita also showed very significant [P<0.001] negative relationships. While, very significant [P<0.001] positive relationships found between Cd and Cr in the liver S. luridus and S. saurus, Hg and Pb in the liver of S saurus. The amount of metals consumed weekly calculated for each metal was compared with the provisional tolerable weekly intakes [PTWI]

Development of Egyptian barley with HMW-GS Dy10 gene of wheat

Transgenic barley plants with high-molecular-weight glutenin subunit [HMW-GS] gene from wheat were successfully generated. The HMW-GS Dy10 gene, known to be essential in bread industry, was introduced into the Egyptian barley cv. Giza 123 by biolistic bombardment. The transgenic plants, regenerated from immature embryo-derived callus cultures, were normal and fertile. Stable integration of Dy10 transgene was confirmed by molecular analysis and its expression was studied by protein analysis. Dy10 gene was co-transformed into barley with the plasmid pAHC25 harboring the bar gene for selection and the gus reporter gene. Production of Egyptian barley with wheat HMW-GS genes could be used to develop barley flour with the unique properties of wheat flour for use in bread industry

Terapia cognitivo-comportamental de grupo no tratamento da fobia social generalizada / Cognitive-behavioral group therapy in the treatment of generalized social phobia

Este estudo teve como objetivo verificar a efetividade da terapia cognitivo-comportamental de grupo em pacientes com fobia social generalizada. Vinte e nove pacientes com diagnóstico de fobia social generalizada foram randomicamente distribuídos em dois grupos de tratamento. Um grupo de terapia cognitivo-comportamental de grupo (TCCG) e outro grupo de controle placebo com credibilidade (CPC). Os pacientes preencheram 3 escalas de avaliaçã (Inventário de Fobia Social, Inventário de Ansiedade Beck e Escala de Impressão Clínica Global) na semana 1 de tratamento e na semana 12. Em todas as medidas de avaliações, ao final de 12 semanas, os pacientes que receberam TCCG apresentaram melhoras superioras ao grupo de CPC. Neste ensaio clínico randomizado, simples-cego, a TCCG foi superior ao CPC no tratamento da fobia social generalizada

The aim of this study is to assess the effectiveness of cognitive-behavioral group therapy in patientswith generalized social phobia. Twenty nine patients with diagnosis of generalized social phobiawere randomly allocated in two groups of treatments. One group of cognitive-behavioral grouptherapy (CBGT) and another group of credible placebo control (CPC). The patients completed 3evaluation scales (Social Phobia Inventory, Beck Anxiety Inventory and Clinical Global ImpressionScale) in the weeks 1 and 12. In all evaluation scales in the week 12 of treatment, the CBGTpatients were rated as more improved than CPC patients. In this randomized single-blind clinicaltrial, the CBGT was superior to a CPC in the treatment of generalized social phobia

Transgenic production using particle bombardment in Egyptian barley

A system for Egyptian barley [Hordeum vulgare L. cv Giza 123] transformation via biolistic bombardment has been established. Immature embryos 1.0-1.5 mm in length were aseptically isolated from barley plants cultivated in the open field. Embryos were then cultured on callus induction medium with scutellum side up. Scutellum derived calli were bombarded with the plasmid pAHC25, containing the marker gene uidA as a reporter gene and bar gene as a selectable marker gene. Bombarded tissues were transferred into callus induction medium containing bialaphos for selection. Calli grown on selection medium were transferred into regeneration medium supplemented with bialaphos. Putative transgenic callus events produced putative transgenic plants. Integration of transgenes was confirmed by molecular analysis. The expression of uidA genes was studied by histochemical staining while the expression of bar gene was studied by leaf paining assay technique

Integration and expression of the high-molecular-weight glutenin subunit Dy10 gene into Egyptian wheat

To investigate the possibility of manipulating gluten dough strength and elasticity by increasing the high molecular weight glutenin subunits [HMW-GS], bread wheat cv. Giza 164 was transformed with HMW-Dy10 subunit gene. Immature embryo-derived calli were co-transformed with a plasmid [pK-Dy10] harboring HMW-gene [Dy10] driven by its own promoter and pACH25 plasmid containing the scorable gus gene and the selectable bar gene. Integration of the three transgenes had been confirmed in the genome of transgenic T[0] plants by PCR analysis. Expression of gus gene was detected in transformed plants by histochemical staining and the expression of bar gene was detected using leaf painting assay. Grains of transgenic and non-transgenic [control] wheat plants were analyzed to estimate the level of glutenin protein using HPLC and it revealed higher levels of glutenin in transgenic grains comparing with control

use of cervical insulin-like growth factor-binding protein-1 assay for prediction of preterm labor in high risk women

The objective of this study was to determine the value of cervical insulin-like growth factor- binding protein-1 assay for the prediction of preterm labor in high-risk women. Thirty pregnant women at high risk for preterm labor were studied by serial cervical insulin-like growth factor - binding protein -1 assay between 26-36 weeks of gestation. The presence of cervical insulin-like growth factor-binding protein -1 in cervical secretions was compared to preterm labor. The preterm delivery rate was 40%. Cervical insulin-like growth factor- binding protein-1 was positive in 10/12 of women delivering preterm and in 7/18 of women delivering at term. As a prediction for preterm birth before 37 weeks, the presence of cervical insulin-like growth factor-binding protein- 1 showed a sensitivity of 83.3%, a specificity of 61.1%, a positive predictive value of 58.8% and a negative predictive value of 84.6%