Evaluation of Real Time PCR, ELISA and Direct Strip Tests for Detection of Helicobacter pylori Infection in Patients with Gastrointestinal Illnesses .

Helicobacter pylori (H. pylori) infection is very common worldwide. The infection causes chronic gastritis which significantly increases the risk of developing gastric or duodenal ulcer, gastric adenocarcinoma, and mucosa-associated lymphoid tissue (MALT) lymphoma. This study was undertaken for the detection of cagA gene in biopsy specimens from patients with gastrointestinal diseases by real time PCR test, in addition to serological detection of anti H. pylori IgG and IgM antibodies by ELISA and direct strip tests. A total of 50 antral biopsy and serum specimens were subjected to real time PCR test conducted together with ELISA test for serological diagnosis. Stomach cancer comprised the lowest frequency by admission diagnosis, 1(2%). PCR test was positive in 45 (90%) of study group. Specimens from patients with gastric ulcer, gastritis & dudenitis, stomach cancer, and multiple polyps recorded 100% positive PCR test. Out of total, ELISA-IgM was positive in 16 (32%) of study group, whereas IgG was positive in 23 (46%) of study group. Direct strip test was positive in 18 (36%) of study group. Our study suggested that stomach cancer is unusually rare in Iraq, despite the high prevalence rate of H. pylori infection in this developing country. ELISA-IgM and IgG and direct strip tests showed a low sensitivity and specificity for the diagnosis of H. pylori infection in a group of Iraqi patients. Polymerase chain reaction is highly specific and may be more sensitive than other biopsy-based diagnostic techniques. Although PCR is a time consuming and expensive procedure with need for highly trained staff performing it, our study demonstrated that using PCR methods for detection of H. pylori have a high diagnostic accuracy rate. Further research is needed to study virulence markers and genetic heterogeneity of H. pylori in patients with gastrointestinal illnesses.

Antimicrobial, anti-oxidant and hepatoprotective activities of Quinazolinone-4 derivatives on Paracetamol induced hepatotoxicity in Guinea pigs

In this study, two new compounds of quinazolinone-4 derivatives were synthesized and evaluated for some of their pharmacological activities that were predicted by computer program [PASS], and also testified for their yield obtained, by using some of strong polar aprotic solvents. The synthesis of new compounds in lab from 2-phenylbenzoxazinones-4 with some compound as [p-aminobenzenesulfonamides] in a medium of acid catalyst and strong polar aprotic solvents [DMSO and DMFA]. After purification and identification of the final synthesized products; known weight was dissolved in 1ml of DMSO. This solution was used to determine the antimicrobial activity, using diffusion method. Results showed that using of catalytic quantity of strong polar aprotic solvents increased the yield by 25% with DMSO and 12.5% with DMFA. A study of the in-vitro of compounds [A and B] shows no antibacterial activity. It is suggested that the activity will be shown clearly in experiments in vivo because these compounds will be metabolized into the corresponding sulfonamides. The synthesized compounds have been investigated for their toxicity and anti-oxidant activity [in vivo] by testing activity in inhibition of hepatotoxicity induced that the new compounds have low toxicity; since compound [A] gave class VI [harmless] and compound [B] gave class V [practically non toxic] according to Sidorov's classification. In the anti-oxidant study, the investigated compounds A and B showed high anti-oxidant activity, [29.08% and 48.2% respectively] higher than the compared standard. It is concluded that that the new synthesized quinazolinone-4 derivatives are preferably obtained with usage of strong polar aprotic solvents, especially DMSO. In addition, the pharmacological investigations have confirmed the prediction of PASS that testifies the high reliability of the obtained results.

Tyrosinemia type 1: clinical and biochemical analysis of cases with poor treatment outcome

Tyrosinemia Type I [TT1] is a metabolic disorder with impaired activity of fumarylacetoacetate hydrolase enzyme. The causes of death are liver failure, pseudo porphyric crisis and hepatocarcinoma. The treatment is based on diet restriction, liver transplantation and the NTBC. Aim: To review the clinical presentation, biochemical analysis and expose the causes of failure of treatment in 3 patients with TT1. By studying the clinical and biochemical data of 3 dead patients with TT1 [part of the total 15 patients with the same diagnosis], during [October 2001 to October 2009].The diagnosis was established by high tyrosin in the blood and succinylacetone in the urine. Monitoring was based on the combination of liver imaging, and alpha feto protein as tumor marker. Two patients were treated by NTBC and diet restriction [patients 1 and 2] while the 3rd patient was treated by diet restriction only. Overall survival rate was 80% [85.7% in those treated by NTBC]. The age at onset was respectively 8, 5 and 1.5 months .The age at diagnosis was 40, 6 and 6 months. All three patients were presented with severe liver failure. [PT ranged from 21% to 24%], patient 1 was treated with NTBC for 4 months and died after 2 months of stopping NTBC. The second patient did not respond to NTBC and died after 5 months of treatment. The third patient died after 2 months of treatment. A. Poor prognosis in patient 1 and 2 could be explained by [1] The dose was less than 2mg/kg/d [2] Late diagnosis in patient 1. [3] Difficulty of management and monitoring. B. Poor prognosis in patient 3 was on diet restriction as in the literature. C. Slow decrease of alpha feto protein can explain the possibility of hepatocarcinoma in patient 1 and 2 but the duration of the treatment was short to conclude, the increase in patient 3 is well known as a part of hepatocarcinoma mechanism. [1] Early diagnosis and starting NTBC with diet restriction give good prognosis. [2] Starting neonatal metabolic screening

[Identification and evaluation of suicidal risk in general practice]

Suicide is a major public health problem in many countries. In morocco, and in the absence of official statistics, some indicators suggest that our country is not immune to this phenomenon. In current medical practice, any physician may be confronted with this problem, and therefore, must know how to detect and assess patients at risk. The presence of psychiatric disorders, especially depression, a history of suicide, impulsive behavior, severe somatic pathologies, and a context of solitude are proven vulnerabilities. The assessment of suicide risk requires well-conducted interview, to determine the risk, the urgency of the threat and the danger of suicide scenario, this assessment is preferably based on standardized tools, as the Mini International Neuropsychiatric Interview, which was translated and validated in Moroccan dialect. However, the problem of specificity and sensitivity of this evaluation still persists

Assessing the nursing knowledge and practices in premature feeding in premature units

A descriptive study has been conducted in the premature baby unit in Al-Khansaa and Al-Batool hospitals for maternity and children in Mosul city to assess knowledge and practice of the nursing staff in the caring of premature infants. A descriptive study has been conducted in the premature baby unit in Al-Khansaa' and Al-Batool hospitals for maternity and children in Mosul city to assess knowledge and practice of the nursing staff in the caring of premature infants. the data were collected by using knowledge assessment and practice measurement tool. the results of the study show that high percentages [about 40%] of the staff who work in the premature baby units are of the young age group. It has also been found that the ratio of 2/1 of female workers is higher than male workers in such units. Highly significant differences have been found by measuring the average of knowledge and practice in general with regard to theoretical Mean. The study shows that there are significant differences [<0.001 at P- value] in knowledge, practice and the variables of the educational level, training courses and the real period of working in the baby units. There are also significant differences regarding baby feeding [<0.001 at P-value] through feeding bottle and the variables of educational level since the study shows that the nurses have shortcomings in this field. There are no significant differences between knowledge and practice scores of nursing staff with regard to their sex. age and social status

The problems and impacts of orofacial pain among a group of Malaysian aborigines

Background: The high prevalence and impacts of orofacial pain (OFP) have caused major sufferings to individuals and society. The purpose of the study was to investigate the problems and impacts of OFP among a group of Malaysian aborigines. The objectives were to determine (i) the prevalence, aetiology, duration, severity, types and persistence of OFP during the past 3 months preceding the study; (ii) its associated impact on daily performance; and (iii) the measures taken for pain relief. Methods: This is a cross sectional study carried out in Kuala Lipis, Pahang involving 6 villages of Orang Asli Bateq and Semai. Study sample was chosen using convenient sampling including adults aged 16 years and above. Participants were invited for an interview using structured questionnaire followed by clinical examination. Data analysis was carried out using SPSS ver12. Results: Response rate was low at 20% (n = 140). Over one-quarter (26.4%) of the sample experienced OFP in the previous 3 months. Toothache was found to be the main aetiology (83.3%) followed by gingival pain (18.9%), temporomandibular joint (10.8%) and facial pain (8.1%). Mean duration of pain was 9.8 days for toothache, 162.4 days for gingival pain, 7.3 days for TMJ and 5.7 days for facial pain. Of those who had OFP, over half rated the pain as moderate (37.8%) and severe (29.7%) and most of the pain was ‘intermittent’ in nature (81.1%). Over half (62.2%) admitted the pain had disappeared during the interview. In terms of pain relief, 56.8% of the sample used traditional medicine. The pain had impacted on the chewing ability (70.3%, p=0.01), ability to sleep at night (73.0%, p<0.001), levels of anxiety (70.3%), ability to perform daily chores (33.3%) and social life (35.1%) of the Orang Asli sample. Conclusion: This study suggests the prevalence of OFP was high among the Orang Asli sample, which imposed considerable physical and psychological impacts on daily life.

Margin width, internal line angle and labial emergence profiles of maxillary metalloceramic crowns

The purpose of this study were to compare the emergence profiles of crowns with their contralateral tooth, in vitro, and to determine if there is any association between the design of tooth preparations and the resultant emergence profile. 50 working models used for single crown construction were examined. Measurements of the faciolingual width of the crowns and contralateral teeth were taken using digital calipers. Internal line angles and the margin width of dies and the emergence profile of the corresponding crowns were measured from longitudinally sectioned polyvinylsiloxane indices mounted on a flat-bed scanner using image analysis software. Using Students t tests, no statistically significant differences (p>0.05) were found for shoulder width (mean 0.94 ± 0.23mm), internal line angle (mean 105.83 ± 13.57°) or emergence profiles (28.56 ± 12.95°) in the different (anterior, premolar or molar) preparations or crowns. The mean emergence profiles for all crowns was statistically significantly greater (p<0.001) than the contralateral tooth (mean 15.33 ± 7.77°). Using linear regression, there was a weak statistical relationship between emergence profile and margin width (Emergence profile° = 31.352 – 2.973 x margin width (mm)). There was no statistical association between the internal line angle and the resultant emergence profile. In conclusion, the emergence profiles of crowns were higher than the contralateral teeth. Maxillary metalloceramic crown preparations had shoulder widths that did not conform to recommendations in standard texts but line angles were within a satisfactory range. The margin width exerts a weak effect upon the emergence profile of the crown.

Factors influencing nursing students career preferences

Study of 100 nursing student who are in third and fourth classes, to determine their choices of future specialties and the factors influenced their choices. We used a modified questionnaire derived from the graduation questionnaire of the Association of American Medical College. Sixty percentage choose adult nursing as a result of presence of excillent consultant and they possess necessary skills in their clinical performance. 13% choose community health nursing as they interested to work with specific groups of population through primary health care services. 12, 5, 4 and 2% choose paediatric nursing, obstetric nursing, fundamental nursing and psychiatric nursing respectively, Avoidance of male student to obstetric and gynaecological nursing appear clearly. 4% choose learning specialties in nursing college to continue their learning in post graduate in responses to economic factors and career prestige. Understanding factors that influence the nursing student choices of specialties is an important issue in nursing education