Quality of Life and its associated factors among caregivers of patients with dementia – A crosssectional study in Kuching, Sarawak, Malaysia

@#Background: This study aimed to determine the quality of life and its associated factors among caregivers of patients with dementia in Kuching, Sarawak, Malaysia. Methods: This cross-sectional study was carried out among caregivers for dementia patients who visited three main hospitals in Kuching, Sarawak. Using a validated questionnaire, data was obtained based on socio-demographic profile, patient and caregiving characteristics, supports needs by caregivers, and quality of life (QoL) of caregivers modified from Zarit Burden Interview (ZBI), Hospital Anxiety and Depression Scale (HADS) and Evaluation’s Scale of the Caregiver’s QoL. Results: A total of 217 caregivers participated with response rate of 99.6%, with 67.3% female and 63.1% Chinese. Most respondent provide care for their parents (62.7%), and stay with patients (67.3%). Average duration of care was 4.2 years (SD±3.72). Resource referral (M=3.52, SD±1.334) and education support (M=3.67, SD±1.054) was highest need. Majority respondents experienced little to no burden (59%). Most respondents were not depressed (98.1%). The QoL of respondents was satisfactory (M=41.36, SD±25.840). Gender of caregivers, patients with behavioural and psychological symptoms of dementia, duration of caregiving, respite care need, caregiver disability or illness, belonging support need, education support need were significantly associated with QoL of caregivers (p<0.05). Conclusion: This study on QoL of caregivers of dementia patients in Sarawak, Malaysia shows that it can be influenced by many factors, both at the caregivers’ level as well as the patients themselves. Therefore, intervention should aim at patients and their caregivers, and within community and healthcare settings.

child with rotor syndrome and capillaria philippinensis: case report and review of literature

This paper reported Capillaria philippinensis in an Egyptian child based on clinical and laboratory diagnosis. The patient was successfullly treated with alben-dazole

plasma level of selenium and tumor necrosis factor-alpha and the activities of glutathione peroxidase lsoenzymes in colorectal cancer patients

Colorectal cancer represents a significant cause of morbidity and mortality worldwide. It is known that reactive oxygen species [ROS] are formed in excess in chronic diseases of the colon but the precise mechanisms of oxidative stress being induced in cancer cell and the role of ROS in colorectal cancer progression are still not exactly understood. The present study aimed to investigate the oxidative status of plasma as lipid peroxidation end products and the level of glutathione [GSH] in colorectal patients. The level of Selenium was also assessed by atomic absorption in association with the activities of GSH peroxidase isoenzymes [total, Se-dependent and non-Se-dependent]. Also the level of tumor necrosis factor-alpha [TNF-alpha] in plasma was assessed. The study was carried out on 30 colorectal cancer patients at different stages and grades and 10 healthy control subjects of matched age and sex. The results demonstrate that, colorectal cancer patients suffer from oxidative stress which is dependent on the grade and stage of the disease as indicated by elevated levels of lipid peroxidation end products, TNF-alpha and oxidized glutathione and by decreased levels of total and reduced GSH. Also, Se was significantly decreased in patients compared to control with the lowest level observed in grade III patients. This decrease in Se was associated with inhibited activities of total and Se-dependent GSH peroxidase while no change was observed in the activity of non-Se-dependent isoenzyme. Colorectal carcinogenesis is associated with serious oxidative stress and depletion of Selenium

status of antioxidant defences in glucose-6-phosphate dehydrogenase deficient patients. The role of antioxidants to ameliorate hemolytic crisis

In human, G6PD deficiency is the most common enzymopathy affecting over 400 million people throughout the world. It is associated with higher potential for oxidative damage due to chronic redox imbalance in red cells that often results in clinical manifcstation of mild to severe hemolysis. The NADPH product of G6PD is required for the reductive biosynthetic reactions as well as for the stability of catalase, and the preservation of the reduced form of glutathione [GSH]. The aim of this study was to clarify the role of G6PD in cellular antioxidant defense; the level of glutathione, catalase, NADPH and estimate the level of malondialdehyde which reflect the oxidative stress across the cell membrane. Also to study the effect of antioxidant treatment [vitamins C and E] to ameliorate high sensitivity of red cells to oxidative stress. This study was carried out on fifty G6PD-deficient children during the attack. The children were classified into two groups: Group 1: received blood transfusion only, and considered as an antioxidant-untreated group. Group 2: Received blood transfusion as group I in addition to antioxidant therapy [antioxidant-treated group], and healthy control subjects as control group, Our study proved that hemolytic attack in G6PD deficient patients is due to a concomitant impairment of the two main mechanisms of detoxification of H[2]O[2] in RBCs; GSH system and catalase. The most important finding in this study is the efficiency of treatment with a combination of vitamin E and vitamin C may improve antioxidant status in G6PD deficient patients and in reducing the symptoms of hemolytic crises

con A purified hydatid glycoprotein fraction effectively diagnoses human hydatidosis

Diagnosis and quantification of Echinococcus granulosus in-fection in man and animal hosts are centralized to feasible con-trol this study included 93 serum sample, 25 sure positive hydatid cases confirmed surgically, 7 suspected cases diagnosed by indirect haemagglutination IHA and 41 cases other parasitic infection [15 S. mansoni, 8 fasciola, 7 Ascaris, 5 H. nana and 6 Ancylostoma] diagnosed by microscopic examination and were negative by ELISA and/or IHA for anti-hydatid antibody. Twen-ty negative serum samples served as healthy controls. Six types of hydatid fluid antigens [crude, host-free and Con-A purified] of human and camel origin were subjected to electrophoretic separ-ation [SDS-PAGE] and immunoblotting [EITB]. The anti-hydat-id IgG was detected in sera of the different groups for evalua-tion of sensitivity, specificity and diagnostic efficacy each type of antigens. Detection of circulating hydatid antigen [CAg] was performed using anti rabbit hyperimmune sera raised again-st Con-A purified either human or camel hydatid antigen. SDS-PGE revealed several bands ranging from 55-185- kDa with 10kD band shared by all antigens. The specific bands revealed by EITB for Con-A purified camel and human antigens were at 80, 110, 55, 110 kDa respectively. ELISA highest sensitivity [96.9%] was by using host-free Con-A purified glycoprotein fraction of human hydatied antigen. Highest specificity [98.4%] was reco-rded upon use of either Con-A purified camel or human antigen with 94.5% and 97.7 and diagnostic efficacy respectively. Detection of circulating antigen by polyclonal antibodies against Con-A purified human hydatid antigen revealed 91.8%specificity.

retrospective hospital study of human cystic echinococcosis in Egypt

We performed a retrospective study to determine annual clinical incidence of human cystic echinococcosis [CE] in 14 Egyptian hospitals between January 1997 and December 1999. From 492 353 records examined, 133 [0.027%] new human CE cases were recorded. Of these, 50 [37.6%] were from Alexandria and Matrouh hospitals, 33 [24.8%] from Giza Chest Hospital and 50 from other regions. Matrouh governorate had the highest annual clinical incidence [1.34-2.60 per 100 000] followed by Giza governorate [0.80-1.16 per 100 000]. About a third of those affected were aged

Improved purification and yield of antitetanic antiserum with the aid of caprylic acid

The aim of this study was to obtain highly purified antitetanic globulin by optimizing the conditions of extraction and purification. This was achieved through adjustment of the concentration of pepsin, the time of digestion, the value of pH and the concentration of caprylic acid. Our results indicate that the best conditions to obtain antitetanic antiserum are 0.5% caprylic acid, pH 3.3, 3.5 gm/l pepsin and 90 min for digestion

Appendicitis; appendectomy and the value of endemic parasitic infestation

Schistosomiasis, enterobiasis and amebiasis are endemic parasitic infestations in Egypt, that were condemned by many authors as having a role in the pathogenesis of appendicitis. In the present work 127 appendices removed from patients suffering from symptoms and signs of appendicitis in the emergency surgical unit in Theodore Bilharz Research Institute [TBRI], Egypt, during the period of time from 6/96 to 6/99. Cross and microscopic histopathological examinations were done for all cases in the pathology department [TBRI]. Females were found to be more affected than males with most of patients were at the second decade of life. Parasites were detected in 14.8% of removed appendices. Enterobios vermicularis worms were detected in 10% of cases having no or mild histopathological changes, in 5.3% of cases with histopathological picture of acute appendicitis and in 14.3% of cases with histopathological features of chronic appendicitis. Schistosomiasis infestation was detected in 6.3% of removed appendectomy specimens and in 28.6% cases with histopathological features of chronic appendicitis. Ainebiasis was not detected in any of the examined appendices. We concluded that infestations of the appendix by schistosomiasis and enterobiasis are important factors in the pathogenesis of appendicitis in Egypt, thus early and proper diagnosis as well as treatment of these infestations is indicated to avoid the development of appendicitis with subsequent appendectomy

Field evaluation of a rapid-format kit for the diagnosis of bancroftian filariasis in Egypt

The AMRAD-ICT Filariasis Test [ICT-Fil] is a new, rapid-format card test for the detection of bancroftian antigenaemia in human blood. We evaluated the performance of the test under field conditions in Egypt by comparing 1813 endemic and 102 nonendemic participants. Endemic participants were tested for microfilaraemia [thick smear and membrane filtration] and serum antigenaemia [ELISA]. The infection rates detected were 2.8% by thick smear, 3.5% by membrane filtration, 8.8% by ELISA and 9.0% by ICT-Fil. The card test detected antigenaemia in 98.0% and 95.3% of microfilaraemia carriers testing positive by thick smear and blood filtration respectively. Nonendemic participants were ICT-Fil negative. Identical results were obtained for 173 out of 184 [94%] endemic participants tested by the serum and whole blood ICT-Fil versions

Degenerative joint disease: a new cartilage marker

The aim of the present study was to quantity COMP level in serum of patients with newly developed and late OA in attempt to the prognostic value of its serum measurement as a new cartilage marker. The study was carried out on thirty patients with OA diagnosed according to ARA criteria subdivided into 2 groups [IA and IB] representing early and late OA, and twenty healthy normal individuals as controls [II]. group IA, IB and II were subject to clinical evaluation, routine investigations and determination of serum Ca, phosphorus. uric acid, RF, and X-ray of the affected joints. COMP level estimation in serum was done to all patients and controls Serum concentration of COMP ranged from 1.53-2.1 microg/ml, 2.18-2.65 microg/ml, and -2.65 3.02 microg/ml in the control group, group IA and IB respectively. COMP serum levels is significantly increased in GIA and IB than control [p < 0001]. Also, the comparison is significant between IA and IB patients [p < 0.001] For uric acid, Ca, and phosphorus no difference could be demonstrated between IA and IB. Serum level of COMP is significantly higher in late OA, than early cases, yet both groups are higher than control. The determination of serum COMP may be tried as indicative of therapy in OA cases especially when using chondroprotective therapeutic agents

Molecular weight determination of fasciola antigens specific for diagnosis of acute fascioliasis

Acute human fascioliasis depends on its diagnosis on detecting specific antibodies in the sera of patients. It was observed that both somatic fraction I and crude E/S products of adult Fasciola gigantica worm gave sensitive and specific results. Using IgM ELISA, the cut off OD was 0.6 and 0.3 nm and the accuracy was 93% and 98% for the two antigens, respectively. Determination of the molecular weight of these two antigens was undertaken by SDS-PAGE. The molecular weight of the somatic fraction I ranged from 17.5 to 43.9 kD, that of the crude E/S products ranged from 12.5 to 14.7 kD. These results were compared with those of previous works performed on antigens of F. hepatica

Clinical study for the use of torps and porps in ossicular chain recon struction

Plasti-pore ossicular replacement prosthesis are widely used now. This paper is presented to evaluate the results of 190 cases in whom either plasti-pore TORP or PORP had been used. Patients, were divided into groups depending on whether total or partial replacement prosthesis was used and also whether open or closed technique was done during surgery. Follow up carried out for a period of minimum of one year and a maximum of three years. Our results were evaluated both anatomically and functionally. Anatomically, the rate of extrusion of TORPs was 20%, while that for PORPs was 52.1%. PORPS were not applied when wide access was used, so the percentage of extrusion of PORPs in cases associated with cholesteatoma where posterior tympanotomy was done was 66.6%, this high rate of extrusion was attributed to the eustachian tube dysfunction which is usually prisentin in these cases. The rate of rejection of TORPs in wide access tympanoplasty was almost 0%, although functional results were not gratifying. For central perforations the rate of extrusion of both PORPs and TORPs was 50%, Hearing was improved only in 50% of the non-rejected cases. This paper is presented in order to evaluate the results of this widely used material in relation to the technique of surgery

Ossicular reconstruction after open technique tympanoplasty

16 cases of chronic suppurative otitis media with cholesteatoma were treated by open technique tympanoplasty. Ossicular reconstruction was done using tragal cartilage and perichondrium presenting a new technique for its fashioning and application. This was done either as one stage or two stages procedure. Follow up was done for 15 months both clinically and audiologically. Results were assessed both anatomically and functionally. Good anatomical results i. e. grajr take was obtained in 81.25% of cases. As for functional results; post-operative air bone gap equal or less than 20 dB was obtained in 37.5% of cases, while air bone gap equal or less than 25 dB was obtained in 75% of cases. This method is presented as an alternative to autograft ossicles whenever they can not be used