Medical errors in neonatal intensive care unit at Benha University Hospital, Egypt

This study was conducted in the neonatal intensive care unit of Benha University Hospital, Egypt from 1 August 2012 to the 31 January 2013 to identify medical errors and to determine the risk factors and consequences of these errors. Errors were detected by follow-up of neonates and review of reports including nursing follow-up sheets, resident progression notes and investigation reports. We detected 3819 errors that affected 97% of neonates. Types of errors included 403 medication errors [10.55% of total errors], 652 errors in daily routine procedures [17.07%], 1042 errors in invasive procedures [27.28%], 68 errors in nutrition [1.78%], 63 equipment errors [1.64%], 260 administration errors [6.8%], 656 staffing errors [17.18%], 107 environmental errors [2.8%], 448 infection control errors [11.73%] and 120 nosocomial infection errors [3.14%]. Medical errors were high in low birth weight, low gestational age neonates and increased with duration of admission

Genetic polymorphism of Toxoplasma gondii from recently infected aborted Egyptian women

Toxoplasmosis caused by Toxoplasma gondii is one of the most prevalent parasitic diseases in human beings. Human toxoplasmosis can be associated with serious clinical manifestations, particularly in developing fetus. The aim of the current study was to identify the possible lineage type of Toxoplasma gondii, molecularly detected in placental samples of women whose pregnancies were spontaneously terminated in the first trimester. Preliminary detection of Toxoplasma genomic materials was done by a SYBR green qPCR technology. Subsequent identification of Toxoplasma strain was done for the positive samples using PCR- restriction fragment length polymorphism [RFLP] at the SAG2 loci of T. gondii using restriction enzymes HhaI and Sau3AI. Out of 72 tested samples, Toxoplasma B1 gene was detected in 9 cases. Toxoplasma genotypes I and II in addition to unknown type were identified in 4, 3 and 2 cases respectively, while type III was not detected in our samples, hence excluded as a leading cause of abortion in humans in our preliminary study. Nevertheless, it remains uncertain to what extent the genotype of the parasite directly contributes to the clinical severity of human toxoplasmosis. Certainly, advanced molecular techniques targeting different Toxoplasma strains are crucial for better understanding of human toxoplasmosis. For more elucidation, additional studies are recommended intended for genetic characterization of such serious parasitic infection using larger number of samples

Mosquito identification and molecular xenomonitoring of lymphatic filariasis in selected endemic areas in Giza and Qualioubiya governorates, Egypt

Lymphatic filariasis is a vector-borne health problem that has been focally endemic in Egypt for centuries. The chief vectors of transmission are Culicinae species. Control measures in the form of mass drug administration of DEC citrate treatment have been implemented in Nile delta for almost a decade. This study aimed to identify the prevalent mosquito species in endemic areas in Giza and Qualioubiya governorates and to monitor Wuchereria bancrofti infection by detecting the parasite DNA in collected mosquitoes. Adult mosquitoes were collected using light traps hung indoors. Microscopic examination was performed to identify and examine the morphologic characters of mosquitoes. Female Culex mosquitoes were subjected to semi-nested PCR to detect filarial DNA targeting repetitive DNA sequences [pWb12 repetitive region] specific for W.bancrofti

The results revealed 3 species of mosquitoes Culex pipiens, Culex pusillus and Culex quinquefasciatus with the predominance of Culex pipiens [85.7%]. Wuchereria bancrofti DNA was not detected in any of the collected mosquito pools. With the progress of elimination programme in Nile Delta, follow up studies with larger sample size are recommended as the predominance of Culex pipiens the main lymphatic filariasis vector remains a risk of transmission in such areas

Therapeutic effect of lauric acid, a medium chain saturated fatty acid on giardia lamblia in experimentally infected hamsters

Giardia lamblia is a common cause of diarrheal disease in humans, particularly among children causing nutritional disorders. Metronidazole and other nitroimidazoles are commonly used as the mainstay of therapy for giardiasis. The present work was carried out to evaluate the effect of lauric acid, a natural product extracted from coconut oil, against G. lamblia in experimentally infected hamsters [Mesocricetus auratus]. Sixty five laboratory bred hamsters were used in the current experimental study. Ten served as normal non infected non treated control group [A]. Fifteen uninfected hamsters served as drug control group [B]: five received metronidazole group [B1]; five received lauric acid group [B2] and five received combined treatment [metronidazole and lauric acid] at a half doses of each drug [B3]. The remaining forty hamsters were orally infected by 10,000 G. lamblia cysts/hamster [group C], and were divided into 4 groups of 10 hamsters each: infected control [C1]; metronidazole treated [C2]; lauric acid treated [C3]; combined treatment at a half dose of each drug [C4]. Two weeks after treatment, compared with infected non treated controls, the highest percentages of reduction in the number of Giardia cysts and trophozoites were in the group that received combined treatment [98.83%, 96.95%, respectively]. Lower percentages of reduction were recorded for the metronidazole treated group [93.77%, 95.50%, respectively] and the lauric acid treated group [82.03%, 78.76%, respectively]. Histopathological examination and electron microscopic examination revealed complete healing of intestinal mucosa after the combined treatment, while partial healing of the lining epithelium of the intestine was noticed after metronidazole or lauric acid treatment alone. Lauric acid improved the therapeutic effect against giardiasis when combined with metronidazole

Assessment of osteoporosis in psoriasis with and without arthritis: correlation with disease severity

To assess osteoporosis in psoriatic and psoriatic arthritis [PsA] patients, by dual energy x ray absorptiometry [DEXA], and measuring serum osteoprotegrin [OPG] level, and to correlate findings with the extent of both skin and joint manifestations. Fifty psoriatic patients [16 of them had arthritis] were assessed by psoriasis area and severity index [PASI]. Total joint score was used to assess joint manifestations in PsA patients. DEXA were done for all patients and 20 healthy controls. Laboratory assessment of erythrocyte sedimentation rate, serum calcium, rheumatoid factor, and OPG was done. Fifty OPG level was significantly increased in both psoriatic and PsA patients in comparison to controls. However, PsA patients had more significant osteoporosis in neck of femur and wrist as detected by DEXA. In PsA patients, total joint score was positively correlated with disease duration and extent of skin involvement [area score of PASI] and negatively correlated with Z score of femur. Psoriatic patients with or without arthritis could suffer from osteoporosis as evidenced by significantly increased OPG. Prolonged and extensive cutaneous disease is an important risk factor for the development and severity of PsA

Protective effects of amlodipine, coenzyme Q10 and their combination on myocardial ischemia/reperfusion injury in rats

Ischemia/reperfusion [I/R] injury is of major clinical relevance during ischemic heart diseases, percutaneous transluminal angioplasty, coronary artery bypass and heart transplantation. Amlodipine, a calcium channel blocker, exhibits antioxidant and antiproliferative activities as well as eNOS activation that could help in cardioprotection following I/R insult. Coenzyme Q10 [CoQ], a mitochondrial coenzyme involved in oxidative phosphorylation, possesses strong antioxidant and lipid peroxyl neutralizing functions. The current study demonstrated the possible cardioprotection of amlodipine [15 mg/kg/day] and CoQ [200 mg/kg/day] alone or in combination against myocardial I/R-induced functional, metabolic and cellular changes. Drugs were administered orally for one week. Rats were then subjected to myocardial I/R [35min/10min]. Heart rates and incidence of ventricular arrhythmias were recorded during l/R progress. At the end of reperfusion, blood samples were collected for estimation of plasma creatine kinase [CK] activity. The left ventricle homogenates were used for determination of lactate, ATP, thiobarbituric acid reactive substances [TBARS], reduced glutathione [GSH] and total nitrate/nitrite [NOx] contents as well as myeloperoxidase [MPO] activity. Finally, histological examination was performed to visualize the possible cellular effects of the drugs. Amlodipine, CoQ and their combination significantly protected against reperfusion-induced tachycardia and decreased the incidence and severity of arrhythmias. Amlodipine afforded a significant degree of protection against plasma CK elevation and myocardial GSH depletion, while it completely protected against myocardial MPO, lactate and TBARS elevation. On the other hand, it failed to defend against ATP depletion and NOx elevation. CoQ provided a significant degree of protection against plasma CK, myocardial MPO, NOx elevation and ATP depletion. It completely protected against GSH depletion, lactate and TBARS elevation. Combination therapy provided significant increase in myocardial ATP and GSH contents and significant decrease in plasma CK activity in comparison with amlodipine monotherapy. It could be concluded that adding CoQ to amlodipine therapy offered remarkable improvement in the cardioprotective effect of amlodipine

Street children in Alexandria: profile and psychological disorders

Today developed and developing countries are facing the problem posed by street children. The continuous and unrestrained exposure to the street and its associated lifestyles makes these children vulnerable to a range of health, social, and other problems. The aim of the present work was to assess the profile of street children and their living condition from different aspects, in addition to assessment of some psychological disorders among them. A cross-sectional study was conducted on 50 street boys present at El-Horreya institute for Children Community Development, which is a non-governmental organization in Alexandria. An equal control group of 50 school boys were selected at random from the first and second grades of one governmental boys preparatory school of the Middle District of Alexandria. Every child was subjected to an interviewing questionnaire. The Arabic version of Revised Ontario Child Health study scale, children Depression Inventory and the Cooper-Smith Self-Esteem Inventory, were used to identify children with conduct disorder, depression, and assess self-esteem, respectively. Anthropometric measurements including weight and height were measured for each street child and BMI was calculated. The present study revealed that more than half of street children [58.0%] came from large size families, about three-quarters [72.0%] reported insufficient income, most of them had low educated parents and unskilled fathers, 80.0% reported not living with both parents before coming to the institute, and 91.2% reported bad inter-parental relationship. Family history of drug abuse, alcohol intake, smoking, and imprison were significantly higher among street children compared to school children [p<0.001]. The present study showed that 74.0% of street children were smokers, 22.0% reported drug abuse, and 90.0% were dropped out of school. Family violence, beating, and beating without reason significantly increase the risk of being a street child [OR= 31.90, 2.0, and 44.58, respectively]. The risk of conduct disorder, depression, and low-self esteem were significantly more among street children compared to school children [OR= 44.59, 14.64, and 9.66, respectively]. The main cause of leaving home was beating, 80.0% lived in street after leaving home, 72.0% their main source of living was begging, and most of them faced problems in the street especially with the police. The results revealed that 92.0% were satisfied with the institute and 86.0% prefer to stay in the institute than returning to the street. Planning programs to prevent, protect, and rehabilitate street children are essential

Randomized controlled trial to enhance psychosocial adjustment of asthmatic childern

The aim of the present study was to evaluate the effect of a psychosocial patient education program on the psychological adjustment of asthmatic children between 11 and 18 years old. One hundred children attending the outpatient health insurance clinic were randomly selected and randomized to experimental and control groups. Children's asthma knowledge, self-esteem, asthma severity and psychological adjustment were assessed for both groups before and after the intervention. An intervention program was developed and introduced to the experimental group. The program consisted of sixteen sessions of Information giving and cognitive-behavioral strategies for the children. The results revealed significant differences in the mean percentage change of the intervention and control groups regarding self-esteem, knowledge and asthma severity [Z=2.83, Z=4.75 and Z=2.24 respectively, P< 0.05]. Statistical significant differences were found between the mean percentage change of the intervention and control groups regarding, dependency, hostility, productivity and withdrawal domains as well as the total PARS Ill score. In conclusion, the study demonstrated positive effect of the intervention in promoting the adjustment of asthmatic children. It is suggested that similar interventions can be directed to children with any chronic illness and can be implemented in a variety of pediatric settings

Anxiety among school age children suffering from asthma

This study was conducted on 146 asthmatic preparatory school students. A matching control of 223 non-asthmatic students from the preparatory school was also included in the study. The study was carried out through a cross-sectional approach. A structured self-administered questionnaire was used to collect data about the general characteristics of the sample, interpersonal and inter-parental relationships, school performance and the attitude and behavior of mothers towards their asthmatic children. The Arabic version of state-trait anxiety inventory [STAI] was used to identify children with anxiety state. The present result revealed that 24.7% of the asthmatic students were anxious with a higher preponderance among boys than girls. Bad interpersonal and inter-parental relationships had increased the risk of the occurrence of anxiety state among asthmatic children. Also, poor scholastic achievement was more encountered among asthmatics who had anxiety. The development of asthma education programs to increase parents', children's and teachers' awareness of asthma symptoms and asthma trigger events was recommended

Relationship of adolescent self-esteem to sociodemographic factors, and scholastic achievement

This study was conducted through a cross sectional approach to assess the relationship of adolescent self-esteem to sociodemographic factors and scholastic achievement among preparatory school pupils in Alexandria. The study included 707 pupils selected by using a multistage stratified random sample of pupils enrolled in the preparatory schools in Alexandria Governorate. The results of the study revealed that 14.85% of the adolescents had low self-esteem. Girls were at higher risk to develop low-self esteem [OR=1.9]. Low socioeconomic level was the only significant predictor for the development of low self-esteem

Violence among schoolchildren in Alexandria

Violent behaviour among school students and its predictors were investigated. Selected children [2170] were requested to complete a self-administered questionnaire. Initiating violent assaults in the 18 months prior to the study was reported by 51.0% of boys and 20.9% of girls. Multivariate logistic regression analysis pointed to 16 predictive variables for violent behaviour; few were related to family background whereas the majority were related to the children themselves. Violent assaults were more likely to be initiated by boys and those who were dangerously daring and risk-takers, often fought verbally, threatened to attack others, were cruel to animals, disrupted class discipline, were truant from school or ran away from home and were disciplined by corporal punishment by their parents and their teachers. School-based prevention and intervention programmes addressing modifiable predictors should be considered

HIV Seropositivity and KAP towards AIDS among drug addicts in Alexandria

HIV/AIDS has become the leading public health problem worldwide; the EMR is no exception from this pandemic. Intravenous drug abuse is an important route for indigenous transmission of HIV in their region. This work aimed at testing HIV seroprevalence and KAP concerning AIDS among a group of drug addicts admitted for treatment at the Alexandria Psychiatric Hospital. All 100 addicts chosen for the study were interviewed using a specially designed questionnaire, subjected to ELISA testing for HIV as well as urine testing for 5 groups of psychoactive drugs; namely, amphetamine, cannabis, benzodiazepines, opiates and barbiturates. None of the addicts were found seropositive for HIV. The mean age of addicts was 35.75 +/- 11.45 years, half of whom were of primary education or could just read and write. Most addicts acknowledged AIDS causation [86%], its inevitable fatality [80%], absence of a vaccine [84%] and prevention by safe sexual behaviors [92%]. Half of them used two or more drugs [especially opiates] for more than 10 years, through IV route [alone or in combination]. However, most addicts [85%] denied needle sharing and only 29% acknowledged its possible transmission through needle- sharing. Stratifying by route of drug administration, only 22% of IV drug users [IDU] and 37% of non-IV users [NIDU] stated that it could be transmitted through needle sharing. 32% acknowledged extramarital sexual relationships. About 11% of IDU and 8.7% of NIDU suffered from an STD [mainly gonorrhea]. It is recommended that routine HIV testing be performed for all diagnosed drug addicts. Integration of health education concerning HIV/AIDS in rehabilitation programs targeted at this group is needed to further emphasize the additional dangers of drug abuse, through possible HIV infection

Effect of melatonin with vitamin E or verapamil on kainate-induced lipid peroxidation in rat brain

This work aimed to study the in vivo protective effect of melatonin [Mel] alone or in combination with either vitamin E [Vit E] or verapamil [Ver] against lipid peroxidation that induced by kainic acid [KA] in rat brain. KA was given in a single dose of either 5 mg/kg [LoKA] or 10 mg/kg [HiKA]. Mel [10 mg/kg] was injected three times every eight hours before KA administration. Vit E [200 mg/kg] or Ver [10 mg/kg] was injected once daily for seven days before KA. The protective effect of their combination with Mel was tested. The whole brain malondialdehyde [MDA] was assessed as an index of lipid peroxidation as well as the antioxidants; namely, glutathione peroxidase activity [GProx] and reduced glutathione [GSH]. It was shown that KA increased brain MDA content and GProx activity, while GSH level was decreased, and these effects were more pronounced with HiKA

Infection: a problem among patients undergoing cardiac surgery: an evaluative study

The study aimed to examine the effect of preoperative colonization on postoperative recovery and to propose measures to control the sources of infection. Swabs were taken from nose, throat and rectum pre and postoperative as well as from dressing, medication, endotracheal tube ect. The highest rate of infection was in wound 60%, followed by respiratory infection 26.67%, chest tube 23.33%, followed by 6.67% urinary infection. The main implications of this study is to provide nurses with measures to control the sources of infection with regard to the impact of recovery and this will minimize hospital stay as well as the cost

Study of drug dependence among industrial workers in one of the factories in Alexandria

The aim of the study was to estimate the prevalence of drug dependence among industrial workers in one of the factories in Alexandria and to identify the type of drug used among them. A total sample of 200 industrial workers from one of oil and soap factories were chosen by a multistage sampling procedure. The data needed was collected by using an interviewing questionnaire. Also a fresh urine sample was collected from every worker included in the study for screening of psychoactive drugs [amphetamines, benzodiazipines, barbiturates and opiates]. The main results showed that the prevalence rate of drug dependence among industrial male workers was [4%] and for females was [0%]. The most common psychoactive drug used was barbiturates [87.5%]. The drug dependent was significantly more encountered among unskilled workers [100%] and in those of large families [87.5%]. Moreover, a significant relation was found among drug dependent industrial workers who gave history of psychological problems [87.5%] or history of absenteeism

Study of physical environment of schools for mentally handicapped children in Alexandria

The aim of the study was to develop simple criteria for assessment of physical facilities in the schools for mentally handicapped as well as assessment of existing facilities in these schools based on the developed criteria. The study was carried out on the three governmental schools for mentally handicapped children in Alexandria. Criteria for physical facilities were developed and a total sore ranged from 0-54. it was divided into 4 categories namely v. poor, poor, good and v. good according to the obtained score. The main results demonstrated that 2 schools scored v. poor and poor regarding their architecture as they constitute [12.5% and 37.5% respectively]. On the other hand one school scored v. poor as regards environment and furniture [0%] while the other 2 schools scored just good [50% and 50% respectively]

Effect of mazindol administration in lithium carbonate-treated rats on certain brain transmitters and metabolic aspects

Possible effects due to interaction between mazinodl and lithium carbonate have been studied on intact rats. Lithium carbonate [1 mmol/kg/day] was given orally for 13 successive days. Mazindol [2 mg/kg] either alone or in combination with lithium carbonate [1 mmol/kg/day] was given orally either at a single dose once ordaily for 3 successive days. Deception of rats has been carried out 3 hours after the single dose treatments and 24 hours after the repeated administration of drugs. Effects on some brain transmitters [norepinephrine, dopamine and 5-hydroxytrypatamine] as well as on serum glucose, insulin and corticosterone has been studied. Revealed that mazindol did not changes the effect of lithium carbonate on brain transmitters. However, mazindol, 3 hours, after its aministration, antagonized the effect of lithium carbonate on serum glucose and insulin. On the other hand mazindol potentiated the effect of lithium carbonate on serum glucose, insulin and corticosterone, when given for 3 successive days. This effect might be attributed to increased serum lithium carbonate level after repeated mazindol administration. It could be concluded that mazindol does not interfere with the effect of lithium carbonate on brain transmitters although it potentiated lithium carbonate effect on metabolic aspects studied

Some immunological studies in cases of idiopathic facial palsy [Bell's palsy]

A prospective clinical and immunological study was performed on 20 consecutive Bell's palsy patients in addition to 10 normal controls of matched age and sex, to study some immunological changes that might occur in the blood and sera of the patients. They were subjected to thorough clinical neurological and medical examinations, complete blood picture, Erythrocyte sedimentation rate, glucose tolerance curve and immunological investigations that include estimation of-T-and-B lymphocytes percentage of the peripheral blood. Estimation of serum levels of immunoglobulins [IgG, IgA and IgM] and complement C[3] and C[4]. The immunological investigations were done during the acute phase of the disease [1-7 days] and after 4 weeks from the first investigations and at least 2 weeks after stopping treatment. The study revealed a significant decrease in the peripheral blood -T- lymphocyte percentage as well as an increase in -B-lymphocyte percentage [P < 0.001] in cases of Bell's palsy patients during the acute phase of the illness with a slow return to normal values which began after 4 weeks from the onset. A highly significant positive correlation was found between the increase in-B-lymphocyte percentage and the levels of immunoglobulin IgM during the acute phase of the disease. The clinical and immunological data of Bell's palsy show a similar pattern to those of several demyelinating disease such as in acute exacerbations of multiple sclerosis and the acute stage of Guillian-Barre syndrome and also similar to those found during the clinical course of many viral infections suggesting that Bell's palsy may be an autoimmune demyelinating neuropathy of the facial nerve which may be caused by a preceding viral infection