Efficacy and superiority of an innovative method (IM) of intravenous (IV) fluid drip drop rate calculation using IV set and its comparison with conventional methods (CM)

Background: Almost every indoor patient requires some form of intravenous (IV) fluids and its infusion rate should be proper as recommended for best treatment outcomes. To overcome the same, a simple, quick and easily applicable new method for drip drop rate calculation is proposed, which is user-friendly at bedside and doesn’t require mathematical skills or help.Methods: Author compared this novel innovative method (IM) of IV fluid drip drop rate method for both regular macro and micro drop infusion set against conventional mathematical calculation method (MC) of infusion in various IV fluid indoor orders and assessed for time-to-initiation of treatment (TI) required and its accuracy. Ten resident doctors and ten nursing staff participated to grade both conventional and novel methods by using pre-printed forms of various parameters like time consumption, comfort level, accuracy and applicability in ward and these both methods were scored on a scale of 1 to 10.Results: Conventional method (CM) required 14.23±1.10seconds, while novel method (IM) required average 3.63±0.73seconds for calculation of drop rate. Average grading for conventional method was 3.63±0.49 and for novel method was 7.84±0.6 out of 10.Conclusions: Novel method of IV fluid drip drop rate formula is easy, quick and superior in comparison to conventional method and it doesn’t require any additional instrumental help. It is good alternative to conventional formula for IV drip drop rate calculation in absence of infusion pump.

Impact of coronary artery disease on augmentation index as measured by estimated central blood pressure: A case control study in Asian Indians

Aims We compared various components of blood pressure and arterial stiffness of healthy control with those of coronary artery disease (CAD) patients using BP+ machine™. Methods In this prospective, case-control study, total 585 individuals of both the genders were enrolled. The study population consisted of 277 controls (healthy siblings of diseased subjects not having CAD – group A) and 308 CAD patients (group B). Age and sex adjusted regression and receiver operative curve (ROC) analysis was performed to assess the strength of association of these parameters. Results We found that mean systolic blood pressure (SBP) (137.14 ± 22.49 vs. 129.26 ± 19.86), central systolic blood pressure (CSBP) (130.78 ± 21.89 vs. 117.53 ± 17.98), augmentation index (AI) (108.55 ± 44.98 vs. 49.38 ± 21.03) and pulse rate variability (98.82 ± 231.09 vs. 82.86 ± 208.77) were significantly (p < 0.05) higher in CAD population as compared to healthy counterparts. Left ventricular contractibility as measured by dP/dt was significantly lower in CAD patients. All these parameters were significantly abnormal in CAD as compared to healthy control population irrespective of the gender of the patient except for SBP in females. Both – odds ratio (1.108; 95% CI: 1.081–1.135; p < 0.0001) and ROC analysis (AUC: 0.937; 95% CI: 0.919–0.956; p < 0.0001) showed AI as the strongest predictor of CAD, closely followed by CSBP. Conclusion Central aortic blood pressure parameters such as AI and CSBP measured noninvasively with BP+ machine could be the effective predictors of CAD in Asian Indians.

Occupational exposure to some environmental physical factors as related to productivity in the garment industry of Egypt

Background: garment industry in Egypt has been estimated in 2008 to be about 458 enterprises [employing 103,000 workers] representing 42.0% of the overall textile and garments industries, and 4.8% of the total private sector enterprises. Al-Mahalla Al-Kubra, which is the greatest city of El- Gharbia Governorate houses 263 [57.4%] of these enterprises [employing 12,209 workers]. The occupational exposure to physical hazards may adversely affect workers' comfort, health, performance and productivity

Objective[s]: this study was designed to assess the relation between work stresses imposed by exposure to physical hazards and productivity in Garment industry in that city

Methods: this was a cross-sectional study that was conducted in five garment enterprises in Al-Mahalla Al-Kobra city. The five enterprises included two public and three private sector units, representing 12% of the total number of garments' workers within the city. The collected data included data from records, workers' and employers' or managers' interview, and the results of the physical hazards' assessments. Since it was difficult to calculate the workers' productivities directly from enterprises' records, the productivities of the workers were computed as follows: % of productivity = Standard workers' productivity [100%] - % deficiency in his or her productivity from the standard

Results: the higher percent productivity reported in the Private sector enterprises [86.5%, 86.5% and 100% in C, D, and E enterprises respectively] than in the Public [71.5% and 54.7% in A and B enterprises respectively] may be attributed to the production payment regimen common in the former than in the latter. The workers in the Private-sector enterprises were keen to achieve the greatest production to get maximum payment. This may also interpret the considerably higher workers' attendance [less absenteeism] among Private-sector workers than in the Public-sector ones

Conclusions: the deleterious effects of workers' exposure to physical hazards; heat, noise and vibration, and improper illumination on their productivity are clearly demonstrated in the present study. Attention should be directed towards the control of these hazards and improving the work environment of the garment industry in Egypt, particularly in the Public sector enterprises

Quality of life in dialysis patients from the United Arab Emirates

The quality of life [QOL] has emerged as an important parameter for evaluating the quality of health-care for patients with renal failure. The literature suggests that many factors impact QOL. The QOL of dialysis patients in the United Arab Emirates [UAE] has not been studied before. This research examined the QOL of patients in the UAE on dialysis using two QOL tools. A descriptive comparative survey design was used to study 161 dialysis patients. The participants completed the 36-Item Short Form Health Survey [SF-36] and the QOL index dialysis version tool. Comparative analyses of the results for both tools were done using descriptive statistics. Multiple linear regression analysis determines the effect of the variables on the QOL scores. The questionnaires return rate was 93%. The overall QOL for dialysis patients was rated low when self-assessed using the SF-36 [58.9] compared to QOL index [77.2]. The multiple regression analysis revealed that having a chronic illness had the strongest impact on the total scores of both tools. The comparison between the statistically significant variables for both samples revealed contradictory results from the two tools used. This meant that the two tools measured QOL differently. The two QOL tools scores impacted very differently on most socio-demographic variables on the two samples. More studies are required to explore the concept of QOL in the Arab dialysis population

Study of anticardiolipin antibody in hepatitis C virus-positive patients

Several antibodies, including anticardiolipin antibodies (ACA), have been detected among chronically infected hepatitis C virus (HCV) patients. The present work aimed at ascertaining the clinical significance of ACA levels among HCV infection associated with two commonly encountered diseases, thrombocytopenia and arteriovenous-shunt malfunction. Six groups were studied, 11 HCV-positive thrombocytopenic patients (group I), 14 HCV-positive non-thrombocytopenic patients (group II) and 15 healthy controls (group III), 11 anti-HCV-positive hemodialysis patients with non-functioning shunt (group IV), 14 anti-HCV-positive hemodialysis patients with patent shunt (group V) (Bain Medical Equipment Co., China) and 15 healthy controls (group VI). Anticardiolipin antibody (ACA) assay was performed on all patients and controls whereas tumor necrosis factor α (TNF-α) assay was carried out on thrombocytopenic patients and controls. Thrombocytopenic groups presented an inverse correlation between IgG ACA levels and both thrombocytopenia and TNF-α levels. During the follow-up period, no other clinical manifestations related to ACA were developed. Hemodialysis groups showed a significant elevation in IgG ACA levels in groups IV and V compared to the controls, with statistically higher levels in group IV than group V. Three group IV patients were hypercholesterolemic. We can conclude that induction of proinflammatory cytokines such as TNF-α by persistent HCV infection may promote the generation of ACA. Complications of HCV, including thrombocytopenia and thrombosis in arteriovenous shunt, are more strongly correlated with IgG ACA than with IgM ACA.(AU)

biology of Egyptian woody perennials 4. dalbergia sissoo roxb. ex DC

The present article is the fourth in a series of review articles deal with the biology of Egyptian woody perennials. Available literatures dealt with the biology of the invasive tree Dalbergia sissoo Roxb. ex DC. in Nile Delta was reviewed. The area of natural distribution is the foothills of the Himalayas from eastern Afghanistan through Pakistan and India to Nepal. Dalbergia sissoo was introduced to Egypt by Ibrahim Basha in the age of Mohamed Ali [1805-1848] for ornamental and timber purposes. This review includes the nomenclature and taxonomy of the plant, its distribution, morphology, habitat and environment, phytomass production, control measures, propagation and management, pests and diseases, economic uses and ecological importance. Ecotypic variability among its local populations needs further studies, particularly the physiological and genetical adaptations along the prevailing environmental conditions

Letter a incision periareolar mastopexy with breast implant augmentation

20 females with mild to moderate drooping of breasts, undergone mastopexy and augmentation of breast at the same time, through letter A [upper half of areola] periareolar incision, after pointing the position of new areola towards the narrow part of letter A. We excised the excess skin, inserted the breast implant [silicon, saline filled] according to the size that the patients selected, closed the skin in layers. High satisfaction rate about 80% was achieved with very small post operative scars and few complications. The aim of this paper is to report our surgical experience in performing one-stage mastopexy with breast augmentation, with small periarolar scar, in 20 patients with mild to moderate drooping of the breasts

Study of the acidic deposition phenomenon over Alexandria city

Acid deposition commonly occurs due to conversion of primary acidic pollutants [SO[2] and NO[2]] into secondary pollutants [H[2]SO[4] and HNO[3] and their salts]. The main natural sources of acid deposition in Alexandria include lightening and microbial processes. Anthropogenic sources include traffic, industrial, fuel burning, and incineration activities. Acid deposition has ecological and economic effects in addition to health effects. The objective of this study is to assess acidity of dry and wet depositions in the atmosphere of Alexandria. Dry samples were collected as settled dust using plastic jar. Wet samples were collected as rain water using polyethylene bottle. All samples were analyzed for pH, sulfates, and nitrates. The relatively high pH values observed in depositions of Alexandria city [6.95 +/- 0.22] and [7.14 +/- 0.49] for settled dust and rain water respectively indicating the conversion of the formed acids [H[2]SO[4] and HNO[3]] into their salts. This explanation was confirmed by the relatively high concentrations of sulfates and nitrates. The average values were [14.3 +/- 4.21 g/km[2]/month and 20.5 +/- 9.5mg/L for sulfates], and [22.6 +/- 10.6 g/km[2]/month and 0.5 +/- 0.32 mg/L for nitrates] for settled dust and rainwater samples respectively. It can be concluded that Alexandria is a lucky city regarding acidity of the atmosphere due to its geographic, topographic, and meteorological features. Building up acid deposition monitoring network that covers all Egyptian cities to be a nucleus for African network, using new technologies that reduce emission of acid deposition precursors and alternative sources of energy, implementing and enforcing regulations and standards for major pollutants, and increasing public awareness are recommended

Treatment of chronic lymphedema of the legs by suction with low morbidity rate

A 20-year old male complaining of severe swelling [chronic lymphedema] of both legs, thighs, with very huge mass more than 10 cm in diameter since birth, increasing in the size gradually up to 30 cm, visited our hospital, with interference in function and movement The patient was un-married. He had undergone multiple sessions of suctions of abnormal tissues by liposuction cannula at few weeks interval. We measured the size of the lesion before each session and recorded the regression of the lesion with very low morbidity rate. The patients followed up for 2 years with no recurrences

steroid benefit in treating complicated hemangiomas

The aim of this paper is to report beneficial effect of treating haemangioma with steroids. Thirty patients with complicated hemangiomas [ulceration, bleeding, obstruction of anatomical orifice, and interfere with function or movement] of different age groups collected by simple random sampling in out patient, cases were treated with local injection of diluted triamcinolone 4mg with 5m1 normal saline in multiple sessions with 2 weeks apart. After treatment 60% of cutaneous heamangioma regress in age group between 1-<2 years old, from 2-4 years old regress in about 40%, and >6 years old is about 25%

Ventriculo-Peritoneal Shunt Infections in Infants and Children

Objective: To determine the rate and the type of ventriculoperitoneal (VP) shunt infections in infants and children admitted to King Fahad Hofuf hospital of Al-Ahsaa area at the Eastern Province of Saudi Arabia. Methods: From mid 2003 to end of 2006; VP shunt infection episodes were reviewed. Once infection was suspected; a cerebro- spinal fluid (CSF) sample was taken and empirical antibiotics were recommended. Once infection was confirmed; VP shunt was removed and external ventricular drainage (EVD) was inserted until CSF became sterile after which a new shunt was inserted. Results : 25.9 of patients with VP shunts had infections which represents 29.3of the procedures. 40 of infected patients had recurrent episodes. 59.1 of infections occurred throughout the first two months following insertion. Single pathogen was isolated in each episode. Pseudomonas auerginosa represented 50 of isolated pathogens compared with 18.2 with Staphylococcus epidermidis. Conclusions There is a high incidence of VP shunt infections in King Fahad Hofuf hospital when compared with other international centres. Gram negative organisms are the most common cause of the infection

Traumatic Brain Injury in Pediatric Age Group: Predictors of Outcome in Pediatric Intensive Care Unit

Objective: To determine predictors for outcomes of traumatic brain injury (TBI) in infants and children younger than twelve years admitted to our pediatric intensive care units (PICU).Methods: This is a retrospective cohort study from 2004-5; done at the PICU of King Fahad Hofuf Hospital; Eastern Province; Saudi Arabia. One hundred and six patients with TBI; 65 boys and 41 girls ages 12 or under; with a mean age of 5.7 years; were included. Of them; 11.3died (Deaths group); 11survived with neurological deficits (ND-group); and 77survived with no neurological deficits (NND-group). The potential predictors for death or neurological deficits were examined.Results: 83of deaths had initial Glascow coma scale (GCS) of = 4/15; 50of ND had initial GCS = 8 and 27of NND had GCS 12. The initial brain CT was abnormal in 92of deaths and ND groups; but in only 37of NND. Combined brain pathologies were found in 92of deaths; 63of ND and only in 5of NND. Hypotension was seen in 67of deaths; 17ND and only in 1of NND. Mechanical ventilation was required in all deaths and more than half of ND. Liver enzymes were high in 50of deaths and 66of ND but in only 20of NND. Serum albumin was low in 33of deaths; 42of ND and only 1NND.Conclusion: Glasgow coma score; brain CT findings; combined brain pathologies; hypotension; high liver enzymes and low serum albumin predict outcome after TBI in pediatric age group

Evaluation of occupational hazards in foundries

The working environment of foundries is hazardous and characterized by multiple simultaneous chemical, physical and mechanical hazards exposure, which would lead to injuries of foundry workers. The aim of the present work is to evaluate occupational hazards in four foundries, two in Alexandria: El Nasr and Ramsis, and two in Behira: Misr Spinning and Weaving and Misr Rayon companies. Levels of total and respirable dust, free silica% in total dust and lead concentration in total and respirable dust; NO 2, SO 2 and CO concentrations; noise and heat stress levels have been determined in the present work. Occupational injuries data were analyzed in a three years period from 1998 to 2000. The results of the present work revealed; 1. The levels of total dust and respirable dust exceeded the threshold limit values at knockout and cleaning operations at El Nasr Company. 2. Free silica percentage exceeded permissible levels in all operations except pouring in El Nasr Company. 3. CO levels in Misr Spinning and Weaving Company were higher than threshold levels. 4. Noise levels in knockout and cleaning operations at the four companies were exceeding the threshold limit values. 5. Heat stress levels in melting and pouring operations in El Nasr and in pouring operation in Ramsis Company were higher than the maximum permissible levels. 6. The age group 31-40 years has recorded the highest average incidence rate of injuries of age groups [P<0.01]. 7. Lower extremities and higher extremities have recorded the highest average incidence rate in the four companies [P<0.001-P<0.01 respectively]. 8. Transportation and lifting was the main cause of injury in the four companies [P<0.05]. 9. Faulty action and striking against was the main mean of injury in the four companies [P<0.01]. 10. Ramsis Company has the highest average incidence rate in almost all injuries parameters and indices [frequency rate and severity rate] [P<0.05-P<0.001]. The present work is a massive survey, which highlights the occupational hazards in Egyptian foundries

Estimation of tissue hypothyroidism in patients with overt and subclinical hypothoidism

The clinical score, and tests that reflect tissue hypothyroidism [ankle reflex relaxation time, serum cholesterol level] were reevaluated in the high of the modern laboratory tests of thyroid function. We analyzed 95 female subjects: 40 overt hypothyroid patients, 25 sub clinical hypothyroidism [SCH], and 30 euthyroid control subjects. The clinical score was defined as the sum of the 2 best discriminating signs and symptom. Beside TSH and thyroid hormones, we measured parameters known to reflect tissue manifestations of hypothyroidism, such as ankle reflex relaxation time and total serum cholesterol. So Classical signs and symptoms of hypothyroidism were present only in patients with sever overt hypothyroidism with low T3, It has been found that the clinical score, showed an excellent correlation with ankle reflex relaxation time p < 0.01 and serum cholesterol level p < 0.001, and CK p < 0.01 but not correlated with serum TSH in patient group with overt hypothyroidism. While in subclinical hypothyrodism the clinical score correlate significantly with ankle reflex relaxation time p < 0.01 with fT4 p < 0.01 with serum TSH p < 0.01 but not correlated other parameters It could be concluded That Scoring of symptoms and signs of hypothyroidism with the new clinical score and measurement of ankle reflex relaxation time in addition to routine thyroid function tests is very useful for the individual assessment of thyroid failure and monitoring of treatment

Indoor air quality of schools in Alexandria city

Poor air quality in schools can affect children's desire and ability to concentrate and learn and may lead to increased rate of absenteeism. This study was carried out with the aim of characterizing and measuring indoor air quality in school buildings, measuring ventilation status and studying the impact of design and environmental parameters on some measured pollutant levels. The study was carried out in some primary schools of Alexandria City. All ventilation rate levels exceeded the ASHRAE standard of 15 cfm/pupil except for a few cases. Badly located and small window area led to air stagnation and low ventilation rates. Levels of TSP greatly exceeded a suggested daily guideline of 150 mug/m3. The highest average levels of TSP were found inside classrooms surrounded by unpaved playground and located near semi rural, commercial and heavy traffic areas, while lowest levels were in classrooms located next to residential areas. The average total bacteria were highest in winter. There was also a slight increase in respiratory symptoms and signs in winter. There was a significant positive correlation between average total, pathogenic and non-pathogenic bacteria with average TSP Levels, indoor CO2 levels and relative humidity; while a significant negative correlation was observed with ventilation rate and class volume occupied. The average attack rate of respiratory conditions was 1.96 episode per child. Running nose was the highest frequent symptom. Students of first grade had an incidence rate higher than that among fifth grade students

Cardiovascular and haematological changes among workers chronically exposed to heat

This study was conducted in a copper and aluminium company in Alexandria. Levels of exposure were ranked according to compliance with threshold limit value [TLV] of the ACGIH into high, i.e. above TLV, moderate i.e. within TLV, and low heat stress. Heat stress measurements exceeded the TLV in 50% of the measured areas. Heat strain indices in terms of recovery oral temperature, and recovery pulse rate as well as systolic blood pressure were significantly higher among the high versus the low exposure groups, but within average physiologic limits. Increased T wave amplitude was observed in ECGs of high exposure group. Hematological examination revealed non-specific findings in terms of mild degree of anemia, decreased clotting time, and increased bleeding time among the high exposure group

Development of a modified method for the simultaneous determination of vinyl chloride monomer and ethylene dichloride in the air

A commercial grade activated carbon has been used as an adsorbent medium. It has been loaded via a simple device with different mixtures of vinyl chloride and ethylene dichloride each administered separately. About 3 g of loaded active carbon is put in a vacutainer tube while 10 ml of technical grade CS2 as adsorbent is added. The tube is stoppered and stored at 4C. After 24 hours, 1 ml aliquot is injected through a closed loop to a precalibrated infrared gas analyzer to assess the percentage recovery of vinyl chloride and ethylene dichloride. The spent activated carbon is washed thoroughly with water and is dried in two stages [at 50C for 8 hours and at 120C for 16 hours] to be used again. The procedure is accurate, precise, simple and economic. It gave percentage recoveries of 85% for VCM and 100% for EDC. It depends on the available resources, making it a suitable methodology to be applied in a developing country

follow-up study of workers' exposure to mercury vapour in a fluorescent tube manufacturing plant in Alexandria, Egypt

The present study was conducted after 10 years of a previous one in order to check the effect of the technical manifestations excuted in a fluorescent tubes manufacturing plant on work environment and workers' health. The environmental condition have worsened indicating deficient modifications and/or environmental deteriorations. Medical and laboratory investigations of 81 workers and 50 controls indicated that complaints related to mercurialism prevailed in high proportion of the workers. Their blood and urinary mercury were correlated with the environmental exposure, but not with the toxic manifestations. Renal impairment was demonstrated among the workers as a significant higher mean serum creatinine level than that of the controls

Study of the role of airborne lead in food chain of crops grown around a main highway in Egypt

The present study was conducted to clarify the fate of airborne lead derived from petrol and its role in the food chain of tomato cultivated in lead - contaminated -soil. Settled dust was sampled at 4 stations at 7, 75, 150 and 500 meters from Alexandria/Cairo highway, and analysed for lead, sulfate and nitrate. Tomato fruits -and plants - were harvested at the sampling sites and analysed for lead. Settled dust and lead content steadily decreased by distance from the highway, indicating that traffic derived lead aggregates with other pollutants in particles and settle at distance of a few hundred meters. The lead tends to be evenly distributed in aggregates of different particle sizes, while the sulfate and nitrate tend to concentrate in medium-sized aggregates. The lead in plants of different stages of growth correlated with that in the dust, and was the highest in fruit and roots. Lead contamination of the plant had an impact on tomato crop reduction. The levels of lead in tomato fruits were 17.7 ppm in the samples collected at 7 - 500 meters from the highway, while the legal limit for lead in food is 1 ppm