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

Possible new role for angiotensin-converting enzyme inhibitors in treating glomerulonephritis

Serum transforming growth factor-beta [TGF-beta1] production was estimated for 10 patients with essential hypertension, 12 patients with glomerulonephritis [5 hypertensive and 7 normotensive] and 10 healthy controls. The glomerulonephritis group received angiotensin-converting enzyme inhibitor captopril 25-75 mg/day for 4 weeks. Blood urea, serum creatinine, 24-hour urinary protein and serum TGF-beta1 were then re-estimated. Urea and creatinine were significantly higher in the hypertension and glomerulonephritis groups than in the controls and also higher in the glomerulonephritis group than the hypertension group. TGF-beta1 was significantly higher in the glomerulonephritis groups than in the control and hypertension groups. TGF-beta1 and 24-hour urinary protein were significantly reduced in the glomerulonephritis group

Growth hormone and insulin like growth factor-1 in patients with heart failure due to dilated cardiomyopathy

The aim of this study was to evaluate the level of growth hormone [GH] and insulin like growth factor-1 [IGF-1] in patients with heart failure due to idiopathic dilated cardiomyopathy to find out if the development or progression of heart failure is associated with a derangement of GH and IGF-1. The study was conducted on 30 patients with congestive heart failure due to dilated cardiomyopathy and 7 normal healthy subjects as a control group. The results revealed a significant increase in the serum levels of GH and a significant low serum IGF-1 and albumin in the patients as compared with the control group. Then, the patients were classified according to the NYHA functional classes into four classes [I, II, III and IV]. Sixteen patients were found in functional class IV. There were no differences in the results of this class and the whole patients group, suggesting that class IV represented the whole patient group studied. The study concluded that the serum levels of GH were increased and the serum levels of IGF-1 were diminished in patients with heart failure due to dilated cardiomyopathy. These abnormalities in GH and IGF-1 may have many etiological factors. Abnormalities of GH/IGF-1 axis might have a role either in the development or the progression of heart failure in dilated cardiomyopathy

Preparation and evaluation of the protective efficacyof pseudomonas aeruginosa irradiated vaccine in chickens

A total of 75 P. aeruginosa isolates were secured out of 280 samples from diseased chickens suffering from different respiratory manifestations. The isolates were characterized and serotyped. The most prevalent serotypes were O3 and O4. An inactivated bivalent P. aeruginosa vaccine was prepared from these serotypes. The inactivation was achieved through irradiation with Cobalt 60. The quality control analysis of the prepared irradiated vaccine indicated that it was safe and its use was not associated with any clinical distress. Application of ELISA for evaluation of humoral immune response developed against P. aeruginosa in the vaccinated chicken groups showed significant increase in antibody titers, which was influenced by the route of immunization. The protection rates post challenge reached 100%, 96% and 90% among the intramuscularly, subcutaneously and orally vaccinated chicken groups, respectively. Also, vaccination of egg laying hens with the prepared vaccine stimulated formation and concentration of P. aeruginosa. specific IgY in the egg yolk

Evaluation of sensitivity and specificity of bovine Gamma-Interferon In-Vitro Assay for Diagnosis of tuberculosis in buffaloes

The sensitivity and specificity of the Bovine Gamma Interferon [IFN-lambda] in-vitro assay [BOVI-GAM] in the diagnosis of bovine tuberculousis in buffaloes as compared to the single intradermal cervical tuberculin test [SICT] and cultural isolation of Mycobacterium bovis were investigated. Thirty buffaloes from a dairy farm, in which tuberculin positive animals had been previously diagnosed, were tested. In the SICT test examined buffaloes 36.7% were positive and 23.3% were doubtful as compared with 53.3% positive and 16.7% doubtful results using the IFN- lambda assay. Two animals were positive to avian tuberculin in the IFN- lambda assay. The prevalence rate reached 60% and 70% using the SICT test and the IFN- lambda assay respectively. The sensitivity of the SICT and the IFN- lambda assay as compared with the cultural isolation of M. bovis were 75% and 95%, respectively, while the specificity were 70% and 80%, respectively. M. bovis was isolated from five buffaloes that were negative to SICT and one buffalo that was negative to the IFN- lambda assay. In conclusion, the present study demonstrated that the IFN- lambda assay is a practical, more sensitive and specific in-vitro diagnostic test than the conventional tuberculin test for detection of bovine tuberculosis in buffaloes

Kinetic analysis of drainage time and volume in patients on intermittent peritoneal dialysis

This study was done to examine features of drainage flow and to determine whether the drainage period could be safely reduced in intermittent peritoneal dialysis patients [IPD]. Eight patients were examined in an open nonrandomized prospective study. Drainage flow pattern was measured using 2-L dialysate. The drainage period was reduced from 30 minutes [mean] to 10 minutes throughout the dialysis sitting. Ultrafiltration volume, body weight and peritoneal clearance of urea, creatinine and phosphate as well as the protein loss were measured. A kinetic analysis of the drainage period and volume indicated a positive linear correlation with two different slopes: one for rapid drainage for the first 7 minutes and one for subsequent slow drainage. The effluent exceeded 90 percent in the first 10 minutes. Ultrafiltration volume and body weight showed no change due to the reduction. Most of the patients were satisfied with the reduction and desired its continuation. We can conclude that ten minutes is a sufficient drainage period for most IPD patients with a 2-L dialysate volume. This may possibly allow an increase in effective peritoneal membrane dialysate contact period

Chronic high dose glucocorticoids accelerates renal disease in patients with idiopathic nephrotic syndrome

Fifteen young nephrotic patients in incomplete remission who were on two different chronic prednisone treatment regimens, were studied. Group 1 included 6 patients who were on high dose prednisone and group 2 included 9 patients who were on low dose prednisone and azathioprine. The two groups were followed for two months as regards their weight, blood pressure, extent of edema, serum creatinine and 24 hours proteinuria. Renal biopsy was done at the end of the study period. There was a significant drop in the extent of proteinuria in both groups at the study [P<0.05]. Renal biopsy showed a higher incidence in group 1 than group 2 of tubular atrophy, interstitial inflammatory cell infiltration and fibrosis, hypertrophic changes in arterioles and focal and segmental obsolescence and hyalinosis of the glomeruli. It is concluded that chronic administration of high dose steroids to patients with compromised renal pathology can be associated with acceleration of glomerular injury

Skin manifestations in insulin dependent diabetes mellitus [IDDM]

This study included one hundred children with IDDM, 51 females and 49 males with mean age 9.15 years +/- 2.25. They were subjected to full history taking, thorough clinical examination and investigations including random urine sugar and acetone, random blood sugar, glycosylated hemoglobin level, and clinical examination of skin lesions. Bacteriological and mycological examinations were done when needed. No significant relation was detected between the occurrence of skin manifestations and either the blood glucose level or the presence of ketoacidosis. The pyogenic and fungal infections increased significantly in children with poor glycemic control as proved by measuring the glycosylated hemoglobin level [HBA1C] which raises the need for proper geycemic control in IDDM. In conclusion the diabetic children should be regularly followed up and examincd dermatologieally for early detection and treatment of any skin disorder associating IDDM

Dithiocarbamate esters Part III: Synthesis and spectra of tetrahydroquinoline Dithiocarbamate and xanthate Esters

Reaction of sodium tetrahydroquinoline dithiocarbamate [2] with different halides, afforded the corresponding esters [3], while reaction of [2] with diiodomethane yielded the bis-dithiocarbamate esters [4]. Xanthate esters [7] were prepared from the reaction of the appropriate potassium xanthates [6] with the appropriate halide. Xanthic dithiocarbamate esters [8] were also prepared by the reaction of [6] and sodium dithiocarbamate in the presence of diiodomethane. The assigned structures of the new compounds were affirmed by micro analyses and spectral examination

Glycemic index of some common Egyptian diets in NIDDM

It is well known that different carbohydrate foods elicit a wide spectrum of plasma glucose responses when eaten without other foods [Garpo et al., 1980]. The choice of carbohydrate diet should not be based on its chemical composition but on the glycemic index it produces [Garpo et al, 1981]. The aim of this work is to study the glycemic response of some.commonly used Egyptian foods in their individual and mixed forms to determine their effects on blood glucose response and hence, the possibility of incorporating them into diets of non-insulin dependent diabetics. Sixty adult NIDDM patients were studied. They were divided into six groups studied for foods each containing an equivalent amount of carbohydrate to 100 gm of glucose. The glycemic responses were calculated according to the formula of Jenkins [1981]. It has been found that the tested diets gave blood glucose responses much lower than those of equivalent amounts of glucose in a liquid formula. Leguminous diets [beans and lentils] gave lower glycemic indices then cereals [bread], with the glycemic index of lentils being lower than that of beans. Regarding mixed diets, bread and tamia had higher index than other tested foods. On previous studies [Khater 1986A and 1986B] we found the same difference in glycemic response to the tested foods in normals. This finding is different from Collier et al [1986], who found different glycemic response to the same diet between normals and diabetic individuals