The relation between interstitial lung disease and chronic HCV infection

Background and study aim: Interstitial lung disease (ILD) includes a variety group of about 200 conditions that insult the lung parenchyma with different patterns of inflammation and fibrosis. Hepatitis C virus (HCV)is Flavivirus with diverse hepatic and extrahepatic diseases. Its direct and indirect pathogenic association with many pulmonary manifestations-including interstitial lung disease-has been suggested yet needs more elucidation.Patients and Methods: A case control study was conducted with a total of 50 chronic hepatic patients. They were equally divided into two groups, HCV positive group (group 1= 25 patients) and HCV negative group (group 2= 25 patients). Group 1 was subdivided into two subgroups, without-idiopathic interstitial pneumonias patients (without IIPs subgroup A= 13 patients) and with idiopathic interstitial pneumonias patients (IIPs subgroup B = 12 patients). Both groups were subjected to thorough history taking, clinical examination, and routine investigations. The diagnosis of HCV was confirmed by viral markers including HCV antibodies and PCR. Other chronic hepatic liver diseases were confirmed by abdominal ultrasound and ultrasound- guided liver biopsy. Arterial blood gases, auto antibodies, Computerized pulmonary function tests and radiological studies including plain X ray chest and heart and HRCT scanning were also done. All patients with idiopathic pulmonary fibrosis (IPF) had fulfilled the ATS/ ERS diagnostic guidelines. Both groups were matched according to age, sex and body mass index.Results: The HCV positive group was found to have a significantly higher frequency of ILD than the HCV negative group with also more restrictive pattern hypoxemia and higher scores of IPF (by computed tomography).Conclusion: ILD is more frequent in patients with chronic HCV infection with higher grades of fibrosis and hypoxemia.HCV infection may be predisposing factor for IPF

Assessment of follicular-fluid neurotrophin levels as predictor for ovarian reserve in women undergoing assisted reproductive technology for different etiologies of infertility

Background: brain-derived neurotrophic factor [BDNF] is a27-kDa polypeptide that belongs to the neurotrophin family binding with high-affinity protein kinase receptors [Trk] and the unselective p75NGFR receptor. The BDNF gene has a complex structure with multiple regulatory elements and four promoters that are differentially expressed in the central or peripheral tissue

Aim of the Work: this study aimed to detect affection of follicular fluid neurotrophin level in different types of infirtility and its using as peredictor for ovarian reserve

Patients and Methods: this crosssectional study was carried out in Ain Shams University, Maternity Hospitals Assisted Reproductive Technology Unit [ART unit] in the period from Septemper2016 to June 2017

Results: the present study showed a cut-off value of BDNF for the patients who underwent this study was 2.7 pg/ml with sensitivity of 74.2%, specificity 95.5%, PPV 85.2% and NPV 91.4%

Conclusion: FF-BDNF measurement on the d-OPU in women with different types of infertility underwent COH for IVF-ET, had positive correlation with ovarian reserve and positive predictor of pregnancy which occurred in 25.8% of cases

Recommendations: BDNF has positive correlation with ovarian reserve and positive correlation with pregnancy outcome so we recommend to measure serum BDNF before starting IVF cycle as predictive factore and cost effective

Comparison of the effectiveness of three groin compression methods following cardiac catheterization

Cardiac catheterization is an extremely valuable procedure in diagnosis and treatment. However, few changes have occurred in the techniques used for percutaneous arterial cannulation, and for attaining hemeostasis after cardiac interventions. Studies about femoral puncture site dressing bandage are limited. Few investigations have examined pain, distress, and patient satisfaction associated with compression of the femoral artery. This study was aimed at comparing the effectiveness of three groin compression methods [manual, manual with bandage, and compressor] on patient vascular complications, distress, pain, and satisfaction following cardiac catheterization. A randomized clinical trial was conducted in cardiac catheterization unit at Ain Shams University Hospital and Dar El Fouad Hospital. It included a sample of 150 patients admitted for performing cardiac catheterization via femoral artery randomly assigned to 3 equal groups: manual compression, manual compression with bandage, and compressor. The tools used for data collection included Patient assessment sheet for demographic and procedure data, Patient observation sheet for vascular complications, pain intensity numeric scale, procedure distress scale, and patient satisfaction procedure scale. The study maneuvers were applied according to the group. Groin sites were inspected immediately after sheath removal, and after 10 minutes, 12 hours and after 24 hours. The incidence of hematoma and ecchymosis was statistically significantly higher in the compressor group at the 12 and 24 hours. The lowest rates were in the manual+ bandage group, but they had the highest rates of leg pain [24.0%], back pain [24.0%], and difficult micturition [8.0%]. The time of compression in the manual+bandage group was much longer [144.9 +/- 50.5 minutes], compared to 22.4 +/- 6.2 and 15.1 +/- 2.7 minutes, in the manual and compressor groups, respectively. The manual group had the lowest duration of bed rest [4.8 +/- 1.3 hours], and hospital stay [13.4 +/- 9.0 hours], p<0.001. Patients in the manual group had the lowest scores of distress and pain at all three assessment times [1, 2 and 10 minutes], p<0.001 The highest percentage of patient satisfaction was in the manual group, while it was lowest in the compressor group. It is concluded that manual compression method after sheath removal in cardiac catheterization patients is associated with lower time of compression, hemeostasis, ACT, bed rest, and hospital stay, as well as lower incidence of complications, less pain and distress, and higher levels of patient satisfaction. Therefore. it is recommended to use this method, which does not need any special equipment, and is comfortable to the patient

Impact of smoking on the physiological and pulmonary functional status in patients with chronic obstructive pulmonary diseases [COPD]

Smoking tobacco dramatically increases the risk developing many diseases. It is responsible for a substantial majority of cases of COPD. COPD takes years to develop and progress. The symptoms usually progress quickly in patients who continue to smoke and who have higher life time tobacco exposure. A study reported that the physiological effect of smoking would limit ability to improve their functional status. This study aimed at identifing the effects of smoking on the pulmonary function testes [PFTs] and pulmonary functional status [PFS] in patients with Chronic Obstructive Pulmonary Diseases [COPD]. It was carried out at the Chest Diseases Hospital of Abu Seta, Tripoli, Algmaheria Arabia of Libya. It included 40 patients [20 patients who smoke and 20 patients who non-smoke]. Great percentages of them were found suffering from both bronchial asthma and chronic bronchitis. All the studied sample included in the present study were males. The majority of the sample were <50 years of age who ranged from 25>40 years. This study excluded patients who were less than 25 years because their years of smoking affected the physical and functional status. Three tools were used in the study. COPD patients' Assessment Sheet, part I comprised patients personal characteristics [the patient's age, sex, marital status, level of education, socioeconomic, occupation, diagnosis, and smoking patterns]. This part involved closed ended questions related to patients' characteristics. Part II included Pulmonary Functions Tests [PFTs] record. This part aimed at estimating the pulmonary functions tests, once before inhalation of bronchodilators by Metered Dose Inhaler and once after drug was administered within 15-20 minutes. This was to evaluate the lung functioning changes and improvement in how responsive to bronchodilator for patients who smoke compared with those who non-smoke, e.g., Forced exoiratory volume [FEV1] in one second, forced vital capacity [FVC] and FVC/FEV1, [FEV1 %]. The pulmonary functional Status scale was designed to assess the functional status and psychological be havior according to Weaver and Narsavage. 10 it includes 56 items scale and addresses the nine sub-constructions that contribute to functional status, namely: self-care, mobility, household tasks, grocery shopping, meal preparation, daily act'vities, relationship, as well as dyspnea, and psychological behavior, including, anxiety state, and depression. This instrument was designed to subscale scores of the functional status, dyspnea and psychological status. The Calibrated Computerized Spirometry was used to measure the forced vital capacity [FVC], Forced expiratory volume in one second [FEV1], FVC/FEV, and [FEV1 %]. This study revealed significant effects of bronchodilator on the FEV1 and FVC amongst smokers and non-smokers. But significant better effects were among non-smokers group more than smokers group. This may perhaps be to years of smoking and numbers of cigarette smoking as seen in this study which stated that number of cigarette smoken affects the FEV1 significantly. As regarding the pulmonary functional status, the present study revealed that high significant differences between smokers and non-smokers were found in the area of mobility, daily activity, and dyspnea as well as anxiety. The present study also revealed that mild grocery shopping of functional status was affected by FVC and differed significantly between smokers and non-smokers. Similarly, a statistically significant difference emerged also in FVC for both smokers and non-smokers who were in mild, married and moderate dyspnea, respectively. Concerning FEV1, according to the functional status In smokers and non-smokers there was found a significant difference among them in mild daily activity mild single relationship, and highly significant relation in areas of mild grocery shopping, mild married relationship, moderate dyspnea, moderate anxiety, and depression. it also revealed that FVC/FEV1 [FEV1 %] in relation to the functional status, a highly significant relation was observed between smokers and non-smokers in moderate self-care, mild mobility, mild daily activity, mild married relation, and single relation as well as moderate and mild depression. The present findings have put in evidence that a well planned smoking cessation program has been helpful in COPD patients to resume their normal condition as possible

Effect of lower limb compression bandaging on preventing signs and symptoms of first seating induced postural hypotension after major surgery: a controlled clinical trial

Post-operative hypotension is most often due to hypovolemia secondary to surgical blood loss, third-space losses, or vasodilatation due to anesthetic agents. The nurse should put into consideration the nursing measures to minimizing it. To evaluate the preventive role of lower limb compression bandaging on postural hypotension and the associated manifestations in post-operative patients with major surgery when first seated from lying position. The research was conducted in the surgery departments at El-Demerdash Hospital, using a controlled clinical trial research design. A sample of 60 patients undergoing major surgery was recruited and randomly divided into two equal groups: a study group who had a bandage applied in their lower limbs, and a control group with no bandage. A patient assessment sheet was designed by the researchers to record patient data. It consisted of parts for demographic data, medical history, and physical assessment. At the fifth minute, the mean systolic and diastolic blood pressure were statistically significantly higher in the study group, p=0.01 and p=0.04 respectively, compared to the control group. Also, heart rate, and the severity of palpitations and dizziness, were statistically significantly lower in the study group, at the first, third, and fifth minutes of the sitting position, p<0.001. The mean oxygen saturation was statistically significantly higher in the study group, compared to the control group at all sitting times, p<0.001. Postural hypotension was less in the study group at the fifth minute, p=0.02. Light-headedness, visual disturbances, and pallor were statistically significantly higher among patients in the control group, p<0.001. Postural hypotension and its consequences may be prevented by prior leg bandaging. Use of elastic bandages is advisable when seating patients post-operatively, especially with major surgery and long bed recumbence

clinical evaluation tool for medical-surgical nursing students at Banha University

Assessment of student nurse's clinical skills is an important issue in nurse education. However, suitable instruments are difficult to design. The development of reliable measurements of student performance with predictive validity of role is a gold standard yet to be achieved. Two aspects of reliability have been well researched inter-rater and inter-case [candidate]. Inter-rater measures the consistency of rating of performance by different evaluators. The use of multiple evaluators across cases improves reliability. So the aim of this study is to test content validity and inter-rater reliability of the evaluation tool for medical surgical nursing students at Banha University. The study was carried out in the Faculty of Nursing at Banha University. The inter-rater reliability was established by having the investigators and another qualified clinical instructor [who had more than three years experience as an instructor in the Medical-Surgical Nursing Department] evaluating the students during their practice in the four clinical areas: CCU, Orthopedics, Urology, and Neurosurgery simultaneously and independently, rating the same student. Both raters were not aware of each other scores to the entire students. It can be conclude that this tool after testing the content validity was highly reliable between faculty members. It is recommended that Faculty of Nursing needs to establish clinical evaluation standards for all selected variables within its clinical area. These standards should include what to be observed and how observations should be documented

Database by meta-analysis: health behavior and health services for cardiovascular diseases in Egypt

Cardiovascular diseases [CVDs] represent major public health problem in many countries including Egypt. There are limited national data about morbidity and mortality of CVDs in Egypt. Purpose: was to evaluate the health behavior changes and health services regarding risk factors of CVDs for all age groups in Egypt through data base by Meta-analysis [Type 3]

Methods: data were collected from the available electronic national data base from available theses, medical and nursing reports, and published research relevant to CVDs from allover Egypt

Results: The total number of persons included in this project was 4110 cases from 104 medical, and 14 nursing studies, hospital and population based. The cardiovascular cases included 2906 males and 1204 females. These studies extended from 1995-2002. Most of studies were at Ain Shams, Cairo and Alexandria University hospitals, and the Ministry of Health and Population hospitals. The studies revealed that, CVDs were higher in the year 1997, among age group 40-60 years and in male group. Also, the study indicated a significant correlation between adverse life-style [increase serum lipids, hypertension, smoking, obesity and inactivity] and occurrence of CVDs. Although more than half of cases attended to the university hospitals for obtaining health services, two thirds of the cases did not receive follow-up services

Conclusion: According to this preliminary study concerning Egyptian data, CVDs are still a presentable problem. There is relative increase of prevalence of CVDs in the exception of the last two years

Recommendations: The study revealed 1] the importance of utilizing the available data from theses and other sources of data related to CVDs to build up an electronic database for these diseases and this procedure can be used similarly in other medical and nursing areas, 2] Governmental commitment is urgently required for the establishment of a national program for prevention and control of CVDs