Quantitative analysis of naturally-occurring regulatory t cells in pediatric patients with systemic lupus erythematosus

Background: There is clear evidence that CD4+CD25[hl] naturally-occurring regulatory T cells [nTregs] are important component of the immune system in controlling tiutoimmunity. These cells exhibit powerful suppressive properties. Objectives: This study was conducted to determine [i] the percentage of CD4CD25[hl] nTregs in pediatric patients with systemic lupus erythematosus [SLE] before and after corticosieroid treatment, and [ii] the correlation between the percentage of nTregs and SLE disease activity index [SLEDAI]. Subjects and Methods: Thirty children with new-onset SLE were enrolled in this study. Patients were divided into 2 groups according to their disease activity. Further 24 children were included as a control group. Flow cytometric analysis was used for evaluation of the percentage of CD4+CD25[hl] nTregs in the peripheral blood of SLE patients, and control subjects

Results: A significant lower percentage ofCD4+CD25[hl] nTreg was detected in children with active SLE compared to those with inactive disease [0.59 +/- 0.27% versus 1.28 +/- 0.35%; p = 0.0001], and control subjects [0.59 +/- 0.27% versus 2.29 +/- 0.39%; p'= 0.0001]. A significant increase in the percentage of CD4+CD25[hl] nTregs was detected after corticosteroid therapy [p = 0.0001], but with no significant difference between patients with active and inactive disease [p >0.05]. Intriguingly, the percentage of nTregs was inversely correlated with SLEDAI [T = -0.6, p 0.001]. Conclusion: These results suggest that the quantitative defect of nTregs in pediatric patients with SLE may play a role in the patho genesis of this autoimmune disorder?

effect of nurses knowledge and beliefs on their practices while haning cytotoxix drugs

The handling of cytotoxic drugs [CDs] is currently considered to be an occupationally hazardous. Therefore, safety measures must be followed to protect health care personnel, especially nurses, who are always exposed to these drugs in the hospital setting. Of this study was to evaluate the effect of nurses' knowledge and beliefs concerning occupational exposure about their practice while handling CDs. The study was carried out at the Oncology Care Unit at the Main University Hospital of Alexandria University. The sample of this study consisted of all nurses [No=40] who are responsible for preparation and administration of CDs in Oncology Care Unit. Two tools were used to collect the necessary data. Tool I: A questionnaire to assess nurses' knowledge and beliefs was developed, in addition to a list of symptoms and reasons for not following preventive measures guidelines. Tool II: Consists of an observation checklist to assess nurses' practice of safety measure during preparation and administration of CDs. A gap was found between the nurses' knowledge and beliefs on one hand and their practice of safety measures during handling CDs on other. The study findings support the need to promote primary prevention by providing a safe environment for nurses by means of education, training with regards to safety measures, unit policy, written rules, and guidelines

Effect of nutritional regimen for moderate burn patients on graft take

Early and individually estimated nutritional care plan is considered to be an important component of therapy for burn healing and graft take. This study aimed to determine the effect of nutritional regimen for moderate burn patients on graft take. It was carried out at the Burns Units of the Main University Hospital in Alexandria. Fifty recent moderate burned patients within 12 hours post burn were included. Included patients were divided sequentially into a control [n=30] and an experimental [n=20] groups and they were uncomplicated with any condition or disease that recommends special dietary regimen. Four tools were developed and used for data collection. A nutritional assessment sheet, food intake record, graft checklist, and dietary plans were done individually for the experimental group. Weekly modifications were done as required. Calculations of caloric requirements were based on Curreri formula [25 Kcal x weight [Kg]] + [40 Kcal x% TBSA]. Adequate level of caloric intake was attained by all patients of the experimental group versus only 20% of patients of the control group. Half of the control group reached the satisfactory level, however the intake of the rest percentage [30%] was unsatisfactory. The majority of both control and experimental groups [90% and 100%] respectively reached the adequate level of fat intake. Unsatisfactory level of fat intake was recorded by only 10% of the patients of control group. Adequate level of food intake-especially calories and proteins, showed significant relationship with graft take among burned patients despite the deterioration which was noticed in the nutritional indicators as anthropometric measurements and laboratory investigations

use of continuous quality improvement methodology to improve nurses' infection control practices at a general hospital in Alexandria

The aim of the present study was to assess the effectiveness of continuous quality improvement [CQI] methodology in improving selected nurses' infection control practices at a general hospital in Alexandria. The study population consisted of important infection control practices performed by nurses. Important practices were defined as high-volume, high-risk, high-cost, and problem-prone activities. Based on these criteria, three practices were selected: [1] handwashing, [2] surgical site dressing, and [3] peripheral intravenous catheterization. The present study used pre-test post-test design to examine nurses' practices before and after implementation of CQI project. It consisted of the following three distinct phases: [1] observation of nurses' practices before intervention, [2] implementation of a quality improvement project, and [3] observation of nurses' practices following implementation of the project. After implementation of CQI interventions, the percentage of times in which indicated handwashing/alcohol hand rubbing was performed increased from 1.7% to 2.8%, and the percentage of times nurses complied with recommended handwashing practices increased for 5 of actual 7 steps. Nurses' practices of surgical site dressing technique showed statistically significant improvement in all 12 steps after implementation of CQI interventions. The proportion of occasions in which nurses complied with recommended procedure for peripheral intravenous catheterization significantly improved after implementation of CQI intervention in 9 of 12 steps

Effects of heparin protamine and heparin-protamine complex on cardiovascular system

The cardiovascular effects of heparin and protamine sulphate were studied in the in vitro isolated perfused heart and aortic spiral strips of rabbits and in the in vitro arterial blood pressure and ECG of anesthetized cats. Heparin and protamine sulphate, in therapeutic doses, induced a dose dependent cardioinhibitory effect which was reversible and might be through a direct myocardial depressant action. Combined administration of both drugs showed an effect lesser than the summation effect of each drug separately. Protamine [32-256 ug/ml] and only high concentration of heparin [25.6 units/ml] reduced the response of aortic strip to noradrenaline. The combined effect of both drugs together was lesser than expected. In vivo, I.V. injection of heparin did not produce any change in the arterial blood pressure or ECG of anesthetized cats. But rapid I.V. injection of protamine in periods less than 30 seconds, revealed dose dependent reductions of heart rates and decreased the blood pressure suddenly and transient in only 25% of the cases studied. This drop of blood pressure and negative chromotropic effect occurred even after preheparinization of the cats. These data demonstrate that cardiovascular effects, previously attributed to heparin-protamine complex, are due to heparin and protamine themselves separately and circulating heparin does not aggravate these effects of protamine alone

Effect of addition of oil and a dietary fibre preparation to a popular Egyptian meal on blood glucose and plasma insulin in NIDD patients

Cooked beans is a popular meal for most of the Egyptians. We aimed to study blood glucose and insulin response to a beans meal and the effect of adding oil and excess fibre. We studied 21 non-insulin dependent diabetic patients [in 2 groups], and 10 controls. An oral carbohydrate tolerance curve was performed for all patients and controls using 480 gm of cooked beans [equivalent to 75 gm carbohydrates]. On the next day the curve was repeated after addition of 3 table spoonfuls of corn oil [58 gm] in group I [11 patients] and in controls or 2.84 gm of dietary fibre in group II [10 patients]. Beans were eaten with 160 gm whole meal bread. Compared to the values before the addition of oil, the mean percent increment rise of glucose and insulin after addition of oil, was not significant in diabetics [group, I] or controls [except at 120 and 180 minutes in controls]. In group II diabetics there was significant reduction in the values of percent increment rise of blood glucose and insulin at 60 and 90 minutes after the addition of the fibre diet if compared to the respective values without the fibre diet. In conclusion, corn oil is not harmful to diabetics and adding fibres to complex carbohydrate meals improves metabolic control