Quality of care provided to children with cerebral palsy, Alexandria, Egypt

Background: Assessing the quality of care has become increasingly important to health care providers, regulators and purchasers of care.

Aims: This study assessed the quality of care provided to children with cerebral palsy attending Alexandria University Children's Hospital, Egypt.

Methods: Paediatric neurology residents [n = 15] who provided care to children with cerebral palsy at the hospital completed a structured checklist assessing their compliance with generic care standards. The medical records of 84 children with cerebral palsy who received care at the hospital were reviewed using the same checklist. Another checklist was completed by the head of the paediatric neurology unit, medical director of the hospital, head of physical medicine and head nurse to assess adherence to process and service improvement standards. Face-to-face interviews were conducted with the caregivers/parents of the children using a client satisfaction questionnaire.

Results: Based on what was reported by health care providers, most did not adhere to the recommended practices in the care of children with cerebral palsy. Review of the medical records also showed a lack of compliance with standards. The mean total satisfaction percentage score of parents/caregivers was 55.43% [SD 18.16]. Satisfaction was particularly low for waiting time, waiting area and availability of required facilities for their child's care.

Conclusions: There is a wide gap between the actual care provided to children with cerebral palsy and the recommended standards. Moreover, the documentation system in the hospital is poor. A quality improvement plan is needed for the provision of care to children with cerebral palsy

Brown-vialetto-Van Laere syndrome: Egyptian case report

We report an Egyptian case with Brown-Vialetto-Van Laere syndrome. A five-year-oldgirl with progressive hearing loss was documented by brainstem auditory evoked potentials [BAEP] as sensorineural deafness, bilateral facial palsy and bilateral partial vocal cord paralysis in the paramedian position. There was no evidence of involvement of the upper motor neurons or spinalmotor nerves. There is no similar case in the family

role of modified and chelated cellulose for removal of copper from aqueous solution

This work describes preparation of new chelating materials derived from cellulose for adsorption of Cu+"ion from aqueous solutions. The first part involved treatment of cellulose with NaOH, NH4OH, citric acid, oxalic acid and ferric chloride and chelation processes. The products of the above treatments were subjected to elemental analysis, infrared spectra and X- ray powder diffraction. The second part consists of evaluating the adsorption capacity of the none- modified and modified materials for Cu[+] ions from aqueous solutions. Plence, influences of contact time. pH, and initial concentration of Cu[+], on the adsorption process were determined. Maximum adsorption capacities of the modified materials for Cu+2 ions ranged from 46.73 to 188.68, whereas for non-modified cellulose presented 14.33 mg g. The optimum pH value was found to be 6 and the reaction balance was reached after 75 min. Pseudo first and second order kinetic models were fitted to the obtained data indicating different mechanisms for Cu[+] bio-sorption. Among different models used to describe sorption and kinetics of the experimental data, the Langmuir and Freundlich isotherm models are found to better fit the results. We conclude that the chemically modified cellulose materials can be efficiently used to remove Cu[+] from aqueous solutions

role of modified and chelated cellulose for removal of copper from aqueous solution

This work describes preparation of new chelating materials derived from cellulose for adsorption of Cu[+] ion from aqueous solutions. The first part involved treatment of cellulose with NaOH, NH4OH, citric acid, oxalic acid and ferric chloride and chelation processes. The products of the above treatments were subjected to elemental analysis, infrared spectra and X- ray powder diffraction. The second part consists of evaluating the adsorption capacity of the none- modified and modified materials for Cu[+] ions from aqueous solutions. Hence, influences of contact time, pH, and initial concentration of Cu[+] , on the adsorption process were determined. Maximum adsorption capacities of the modified materials for Cu[+] ions ranged from 46.73 to 188.68, whereas for non-modified cellulose presented 14.33 mg g. The optimum pH value was found to be 6 and the reaction balance was reached after 75 min. Pseudo first and second order kinetic models were fitted to the obtained data indicating different mechanisms for Cu[+] bio-sorption. Among different models used to describe sorption and kinetics of the experimental data, the Langmuir and Freundlich isotherm models are found to better fit the results. We conclude that the chemically modified cellulose materials can be efficiently used to remove Cu[+] from aqueous solutions