Yemeni experience with phacoemulsification

To evaluate the first experience of phacoemulsification in Yemen from 2000-2007 regarding the visual results, and complications. Two hundred and fifty-eight eyes of 182 adult patients with significant cataract were included during the last 96 months. All eyes underwent phacoemulsification with implantation of intraocular lenses. The results were recorded and statistically analyzed. The male:female ratio was 1:1, with an average age of 52 years. Phacoemulsification was carried out by scleral approach in 14 eyes, and by clear corneal approach in 244 eyes. A visual acuity of >/= 6/18 was achieved in 85.3%, and the most common serious complication was intraoperative posterior capsule rupture, which was reported in approximately 10.1%. The results of phacoemulsification are very impressive, and the most common intraoperative complication was ruptured posterior capsule

Impact of percutaneous balloon mitral valvuloplasty on right and left ventricular functions assessed by tissue Doppler imaging

Pure mitral stenosis affect left ventricular performance as a result of myocardial and mechanical factors. It has been found that, with increase in pulmonary artery pressure, the right ventricle may hypertrophy and dilate, and right ventricular ejection fraction decreases. Pulsed TDI has been used for the evaluation of impaired systolic or diastolic function. Percutaneous mitral valvotomy has proven to be effective technique for the relief of obstruction in patients with mitral stenosis. However, the results of the studies about the effect of percutaneous mitral balloon valvuloplasty [PMBV] on ventricular functions are controversial. Of this study was to assess right and left ventricular functions using Doppler tissue imaging [DTI] before and after percutaneous mitral valvuloplasty two days after and at 3 months follow up. We studied 30 selected thirty patients with symptomatic mitral stenosis of rheumatic etiology, who were admitted for percutaneous mitral valvuloplasty and another twenty normal disease free subjects, as proved by electrocardiography ECG and Doppler-echocardiography, thirteen were females and seven were males. All patients were subjected to history analysis, clinical examination, ECG analysis, transthoracic echo Doppler study to asses mitral valve area and trans mitral diastolic gradient, transoesophageal echo study to exclude left atrial cavity or appendage thrombi and lastly pulsed TDI to asses right and left ventricular functions one day before and two days after percutaneous mitral valvuloplasty and then repeat at 3 months follow up. Significant increase in mitral valve area, drop of transmitral pressure gradient and increase of left and right venticular ejection fraction two days and 3 months after the procedure [p <0.05]. By TDI all the myocardial velocities significantly increased after PMV but still below the normal values of the control group [p < 0.05]. PMV results in significant improvement of systolic myocardial velocities of right and left ventricles two after and at follow up, but these velocities are still below the normal values

Insulin resistance as a predictor of restenosis in patients with type II diabetes mellitus undergoing coronary angioplasty and stent implantation

Hyperinsulinaemia is an independent risk factor for ischemic heart disease and induces greater vascular smooth muscle cell proliferation in experimental models. Restenosis after coronary stenting is neointimal tissue proliferation. The rationale of this study is to asses the predictive value of insulin resistance for in-stent restenosis in patients with type II diabetes mellitus. The study population included forty patients [20 diabetic and 20 non diabetic] undergoing percutaneous coronary intervention PCI with stenting and all patients were followed up for 6 months and Homeostasis model assessment insulin resistance [HOMA-IR] were done for assessment of insulin resistance. All clinical, angiographic, procedural, Doppler echocardiographic and laboratory variables were analyzed for all patients in multivariate analysis. Angiographic in-stent restenosis occurred in 14/20 [70%] diabetic patients with no significant difference compared to 13/20 [65%] non-diabetic patients. Multivariate regression analysis showed that HOMA-IR were an independent predictor for restenosis after coronary stenting [HOMA IR p=0.001 for non-diabetic and p=0.025 for diabetics]. HOMA-IR and fasting insulin can be used as a predictor for in stent restenosis in both diabetic and non-diabetic patients

Role of plasma vascular cell adhesion molecule-1, human angiogenin and caspase-3 activity in breast cancer metastasis

To assess the role of sVCAM-1 [soluble vascular cell adhesion molecule - 1], human ANG [angiogenin] and active caspase-3 in the process of development of metastasis in female breast cancer patients and to find out the interrelations among them. Subjects and 25 female patients with early stages breast cancer [GI], 25 female patients with the late stages breast cancer [GII] and 25 apparently healthy volunteers [GIII] were studied. Plasma VCAM-1 and ANG were estimated by ELISA while PMNL [polymorphnuclear leucocyte] caspase-3 activity was estimated by colorimetric method. Plasma VCAM- 1 level was significantly increased in GI than Gill as well as between GII and GIII. As regard plasma ANG level, there was a statistically significant increase in GI than GIII as well as between GII and GIII and between GI and GII. There was a significant increase in PMNL caspase-3 activity in GII than GIII as well as in GII than GI. VCAM-1 plays an important role in breast cancer development and metastasis. ANG could be used as a tumour marker for the assessment of prognosis in breast cancer. There is an immune defects among patients with breast cancer and neutrophil apoptosis could be a feature of neoplasia and identifies a potential new target for apoptosis used therapy in breast cancer

Relation of angiotensin converting enzyme activity and gene polymorphism to restenosis after percutaneous transluminal coronary angioplasty

Early restenosis in up to 30% of cases limits the benefits of percutaneous transluminal coronary angioplasty [PTCA]. The mechanisms that underlie restenosis are uncertain, although experimental evidence suggests that the renin-angiotensin system is involved in the vascular response to angioplasty. The ACE gene is one of the major genes of the renin-angiotensin and kallikrein-kinin systems and is a candidate gene for several cardiovascular diseases for which a genetic predisposition has been established. The ACE gene contains a common insertion deletion polymorphism termed I and D, respectively. The three possible genotypes are DD, ID and II, and the plasma level of ACE is highest with the DD genotype. This work aimed to investigate whether ACE gene polymorphism influences the risk of restenosis after PTCA to explore a relation between the total ACE level and restenosis and to compare the ACE genotypes of the patients of the study with those of a control group of healthy subjects. This study included 53 patients with CAD, 48 males and 5 females, their age ranged from 36 to 63 years. All patients were compared to 46 control subjects with age and sex matched. The patients were divided into two groups: group [A][40 patients with no restenosis] and group [B][13 patients with restenosis]. All patients were subjected to: full history and clinical examination, laboratory investigations which include estimation of serum angiotensin converting enzyme levels and detection of genotypes of the ACE gene I/D polymorphism, 12-lead electrocardiogram, treadmill exercise stress testing, coronary angiography and PTCA. The distribution of ACE genotype [DD] was not significantly different in-group B patients with restenosis compared with group A patients with no restenosis [8 out of 13, versus 15 out of 40 respectively, P> 0.05]. Plasma ACE levels did not differ between patients and control subjects [P value > 0.05]. Although plasma ACE levels were significantly higher in relation to ACE genotypes [P value < 0.05], plasma ACE levels were insignificant in relation to restenosis [P value > 0.05]. Since there was no evidence that variation at the ACE gene defined by the I/D polymorphism influences the extent of restenosis, it could be concluded that determination of ACE I/D genotypes is unlikely to be useful in identifying patients at higher risk of restenosis after PTCA and continued studies with clinically different subsets of patients is warranted

Triclabendazole in the treatment of human fascioliasis: a community-based study

The efficacy of triclabendazole in the treatment of chronic Fasciola infection was assessed. A total of 134 asymptomatic cases of established Fasciola infection were treated: 68 individuals received a single dose of 10 mg/kg and 66 individuals received 2 doses of 10 mg/kg on 2 consecutive days. Cure was assessed 5 weeks after treatment and 79.4% of the first group and 93.9% of the second group were cured. The drug was well tolerated; no serious side-effects were noted. One patient developed biochemical cholestasis the third day after treatment, but her enzyme profiles returned to normal after 2 months. We conclude triclabendazole is a safe and potent fasciolicidic drug

Effects of two types of composite resin on oral bacterial plaque In vitro qualitative and quantitative study

160 specimens of composite [80 chemical and 80 light cured] were prepared in teflon mold 4 mmx 2.5mm in dimension. Plaque samples were collected using absorbent paper points from 20 normal persons and 20 persons with cervical carious teeth. The samples were inoculated in TSB containing both types of composites. Duplicate cultures were done for aerobic and anaerobic incubations at 37°C. There was no effect of both types of composite on the quality of the isolated organisms from normal group or patient group. Chemical and light cured composite increased significantly the count of aerobic bacterial plaque from normal group. While they decreased the count of aerobic bacterial plaque from patient group and also the anaerobic bacterial plaque from both normal and patient group

study of accidental injuries among nurses as potential hazards for transmission of hepatitis B infection

The aim of this study was to assess the rate of accidental injuries among nurses who are more likely to be in contact with the patients for the transmission of hepatitis B, and to determine risk practices which causes the nurses more liable to accidental injuries. The target population of the study were 100 nurses working at Medical, Surgical Departments, Hemodialysis Unit and Burn Unit in Liver Institute and Shebin El-Koum Teaching Hospital. Questionnaire sheet was used to assess the rate of accidental injuries and determine risk practices which let the nurses liable to accidental injuries, the sheet was designed by the investigators. An observation sheet also was used, it included the main items of infection control in dealing with patient having I.V. or I.M injection. A blood sample was collected from each nurse among sample to route out or to confirm hepatitis infection and to identify the carriers. Results of the study revealed that 77.5% of the sample had hepatitis B virus due to needle stick injuries, 68.6% among sample who are working at the Liver Institute were vaccinated against HBV compared to only 2% of the sample who are working at the Teaching Hospital. Majority of nurses did not follow the principles of asepsis. It was recommended that an inservice training program should be provided to those high risk group, also guidelines should be followed when dealing with hepatitis patient

Faculty development prognosis in the high institutes of nursing in Egypt

The aim of this study was to investigate the need for staff development among Nursing Faculty members and their associates, in the 8 High Institutes of Nursing available in Egypt. The questionnaire was distributed to available staff and their associates [instructors and assistant lecturers] at the different institutes through a special visit arranged for that purpose for each institute. It is concluded that staff development is a high priority needed among all categories of Nursing Faculty and their associates. Accordingly, it is recommended that nurse education administrators should start assessment of this need and plan development programs. Based on the study findings, planning should consider educational content and skill training, as well as research policies and regulation. Periodic training and retraining is also recommended on a continuous basis as expected by faculty to maintain their productivity

Analytical study of stones and juice of the gall bladder

Twenty patients with gall bladder stone, admitted to Alexandria University Main Hospital, full clinical and laboratory examination and radiological examination were done. Cholecystectomy was done for each patient, bile juice and stone were analysed for chemical composition, cholesterol, phospholipids and bile salts, for the twenty patients [14 cases with mixed stones, 4 cases with cholesterol stones and two cases with pigment stones]