Assessment of picture archiving and communication system [PACS] at three of ministry of health hospitals in Riyadh region - content analysis

Background: Picture archiving and communication system [PACS] are management information systems used for distributing, viewing and archiving digital images by integrating different types of modalities through communication networks. PACS have many advantages that can lead to improving health care quality. PACS has been widely used in hospitals in Saudi Arabia for the past 10 years. However, an extensive review of literature in the field of PACS, among physicians and radiologists in Saudi Arabia, showed lack of local studies of this costly and newly implemented technology. Therefore, this assessment is very important to provide an insightful study of PACS in Saudi Arabia to provide proper recommendations for the PACS projects implementation nationwide

Objectives: The objectives of this study are to, firstly, assess the perceived benefits of PACS among physicians and radiologists specifically in quality of care, secondly, assess the perceived challenges of PACS implementation and adoption inside and outside the radiology department, and thirdly, to compare between physicians' and radiologists' perceptions toward PACS

Methods: A cross-sectional descriptive study at three of Ministry of Health [MOH] Hospitals in the Riyadh region, Saudi Arabia. The researchers used two separate surveys questionnaires, for administration to the physicians and radiologists at the three hospitals. Apart from the questionnaire, included is feedback as responses to open-ended questions. Content analysis was used to analyze the feedback under two themes: benefits or challenges

Results: The response rate was 46% [84/183] physicians and 88% [15/17] radiologists have participated in this study. The result showed that 70% physicians' views affirms that PACS improved physicians' efficiency. On the other hand, all radiologists who responded affirmed that PACS improved efficiency. For questions on the ability to make decisions, 69% of views have affirmed that PACS improved physician's abilities to make decisions regarding patient care. Using PACS has led to a reduction in patients' length of stay in hospital [LOS] question, 79% of total views were positive. In contrast, only 18% of physicians talked about PACS positively in summary views and 82% talked about the challenges of PACS whereas 20% of radiologists talked about PACS positively

Conclusions: The results in the present study conclude that PACS was well perceived due to its numerous benefits among physicians and radiologists. However, radiologists showed more focus on the benefits of PACS than physicians. The main disadvantages are that PACS has resulted in difficulty in finding images, recurrent downtime and insufficient training

Portal hypertension treatment with candesartan plus propranolol for nine months restores normal portal circulation hemodynamic pattern

Post HCV liver cirrhosis is one of the most prominent etiologies behind the abnormal portal circulation hemodynamics. It occurs as a result of distorted balance between portal venous flow [PVF] and intrahepatic resistances [IHR]. PVF is partially controlled by using both specific and non-specific beta blockers [NSBBs] that have insignificant effects on IHR. Angiotensin receptor blockers [ARBs] inhibit the activated hepatic stellate cell [HSC] contraction and thought to reduce the dynamic portion of MR. The study aimed to slow down the venous blood flow and to reduce the IHR of portal vein vasculature to control sequelae of the enhanced post cirrhosis portal venous turbulence. We evaluated the effects of Candesartan plus propranolol compared to each of them individually in management of portal hypertension [PH]. Three groups of 25 patients each, presented with chronic HCV infection and grade II- III esophageal varices [OV], were randomly assigned to one of three treatment regimens: Propranolol or Candesartan or both. Subjects were screened every three month by Doppler Ultrasound for a total of nine months. Damping Index [DI], pulse Pulsatility index [PT], Portal Venous Flow [PVF] Volume, Portal Venous Peak Velocity [PVPV], and Portal Vein Diameter [PVD] were evaluated once every third month. Our study concluded that combined therapy [Propranolol + Candesartan] induced highly significant improvements that led to restoration of normal values of DI, PI, PVF volume and PVPV overtime compared to monotherapy regimens [P>0.001]. Data strongly recommended using Propranolol plus Candesartan in overtime management of portal hypertension

Evaluation of Balanites aegyptiaca oil as untraditional source of oil and its anti-inflammatory activity

The aim of this investigation was to study the physiochemical characteristics of Balanites aegyptiaca [BA] kernel oil. The influence of BA oil on liver and kidney functions in rat's serum was investigated. The anti-inflammatory activity of BA kernel oil using carrageenan-induced paw edema and arachidonic acid-induced ear edema in rats was also studied. The results revealed that the kernel had high contents of oil and protein. Linoleic acid was the major fatty acid. However, carbohydrates were the major constituents of the pulp. It was found that the supplementations of BA kernel oil had no significant effect on liver and kidney functions of rats. BA oil by 25, 50 and 100 mg/kg orally produced significant anti-inflammatory effect on both carrageenan and arachidonic acid models. The BA oil improved decreases in the activities of catalase [CAT], glutathione-S-transferase [GST] enzymes and increases nitric oxide [NO] and lipid peroxidation [LPO] contents resulting from edema induced by carrgeenan. Furthermore, the results demonstrated that the mRNA and protein expressions of tumor necrosis factor-alpha [TNF-alhpa] and interleukin-6 [IL-6] were decreased leading to the reduction of cyclooxygenase-2 [COX-2] and subsequently alleviated edema BA oil after BA oil treatment. These results indicated that BA oil could be exploited as a new source of oil. Also, it could be used as a source of dietary supplements to prevent inflammatory diseases

Immunopathological Changes in the Brain of Immunosuppressed Mice Experimentally Infected with Toxocara canis

Toxocariasis is a soil-transmitted helminthozoonosis due to infection of humans by larvae of Toxocara canis. The disease could produce cognitive and behavioral disturbances especially in children. Meanwhile, in our modern era, the incidence of immunosuppression has been progressively increasing due to increased incidence of malignancy as well as increased use of immunosuppressive agents. The present study aimed at comparing some of the pathological and immunological alterations in the brain of normal and immunosuppressed mice experimentally infected with T. canis. Therefore, 180 Swiss albino mice were divided into 4 groups including normal (control) group, immunocompetent T. canis-infected group, immunosuppressed group (control), and immunosuppressed infected group. Infected mice were subjected to larval counts in the brain, and the brains from all mice were assessed for histopathological changes, astrogliosis, and IL-5 mRNA expression levels in brain tissues. The results showed that under immunosuppression, there were significant increase in brain larval counts, significant enhancement of reactive gliosis, and significant reduction in IL-5 mRNA expression. All these changes were maximal in the chronic stage of infection. In conclusion, the immunopathological alterations in the brains of infected animals were progressive over time, and were exaggerated under the effect of immunosuppression as did the intensity of cerebral infection.

Immunopathological Changes in the Brain of Immunosuppressed Mice Experimentally Infected with Toxocara canis

Toxocariasis is a soil-transmitted helminthozoonosis due to infection of humans by larvae of Toxocara canis. The disease could produce cognitive and behavioral disturbances especially in children. Meanwhile, in our modern era, the incidence of immunosuppression has been progressively increasing due to increased incidence of malignancy as well as increased use of immunosuppressive agents. The present study aimed at comparing some of the pathological and immunological alterations in the brain of normal and immunosuppressed mice experimentally infected with T. canis. Therefore, 180 Swiss albino mice were divided into 4 groups including normal (control) group, immunocompetent T. canis-infected group, immunosuppressed group (control), and immunosuppressed infected group. Infected mice were subjected to larval counts in the brain, and the brains from all mice were assessed for histopathological changes, astrogliosis, and IL-5 mRNA expression levels in brain tissues. The results showed that under immunosuppression, there were significant increase in brain larval counts, significant enhancement of reactive gliosis, and significant reduction in IL-5 mRNA expression. All these changes were maximal in the chronic stage of infection. In conclusion, the immunopathological alterations in the brains of infected animals were progressive over time, and were exaggerated under the effect of immunosuppression as did the intensity of cerebral infection.

Detection of cytogenetics abnormalities in chronic lymphocytic leukemia using FISH technique and their prognostic impact

Chronic lymphocytic leukemia [CLL] is a clonal lymphoproliferative disorder characterized by progressive accumulation of morphologically and immunophenotypically mature lymphocytes. Characterization of genomic aberrations may help to understand the pathogenesis of CLL and may give prognostic information independent from conventional clinical markers for a risk-adapted management of CLL patients. The aim of the present study is to determine the most common cytogenetics abnormalities between patients with CLL and its prognostic impact. The present study was carried out on 20 adult patients presented with chronic lymphocytic leukemia. The patients were diagnosed on the basis of standard clinical [lymph node involvement and/or hepatosplenomegaly], hematological and immunophenotypic criteria for diagnosis of B-CLL. All cases were studied at the time of their diagnosis. FISH technique was successfully performed on PB samples using CLL LSI probes for ATM [11q22] / GLI [12q13] and 13q14/ p53 [17pl3]. For comparative statistical studies, the patients were divided into group I [patients with favorable outcome] and group II [patients with unfavorable outcome]. All patients showed one or more cytogenetic abnormality with the prevalence of p53 in 16 patients out of 20 that perfectly correlated with the poor outcome of the patients. This is followed by deletion in the 13q14 and to a lesser extent deletion in ATM gene, but no one has exhibited amplification in the 12q13 locus. p53 deletion as a sole abnormality has a higher prognostic power than other cytogenetics abnormalities. The cytogenetics study using FISH panel for CLL patients in a complementary fashion to the other clinical and laboratory findings may overcome the pitfalls in the diagnosis and may also assess the assignment of therapeutic protocols for CLL patients according to the results of their cytogenetic analysis at the time of diagnosis

Effect of different traditional cooking styles on pesticides residues in fresh tilapia nilotica and clarias lazera fish in Garbia markets

Thirty fish samples were analyzed to determine the levels of organochlorine [OCP] and organophosphorous [OPP] pesticide residues in Tilapia nilotica [TN] and Clarias lazera [CL] [15 of each], collected from fish markers in Gharbia, Egypt, before and after different cooking techniques. The results showed that the mean values and the percentage of alpha HCH, gamma-HCH, Heptachlor, endosulfan and Endrin were 9.65 +/- 2.7 [20%], 10.60 [6.66%], 11.30 [6.66%], 20.49 [6.66%] and 21.74 +/- 6.72 [40%], respectively in [TN] samples, while for [CL] samples the mean values of alpha-HCH was 3.34 +/- 1.8 [26.66%] which significantly lower than that in [TN] [P<0.001], for gamma-HCH was 9.77 +/- 4.5 [26.66%] and for Endrin the mean value was 31.5 +/- 3.36 [26.66%] which significantly higher than that in [TN] [P<0.001]. The value of Primiphos methyle [OPP] in a [TN] fish was 2321.97 ng g [-1] [6.66%] which significantly decreased to 55.64% [97.65] and 0 [100%] by frying and grilling and in a [CL] fish which was 792.68 ng g[-1] [6.66%] was decreased to 32.34 [95.8%] by frying and to 0 [100%] by boiling while Prothiofos [OPP] evaluated in one [CL] samples by 74.96 [6.66%] and totally disappeared after frying and boiling. The levels of OC residues were significantly decreased in TN fish after frying by 85, 79 52and 100%, respectively. moreover, in [CL] samples the level decreased in percentage of 100, 54 and 83, respectively by frying and 100, 50 and 100, respectively by boiling. Cooking of raw fish contaminated with pesticides residues can therefore be expected to reduce the consumption exposure risk to human health

Combined viscocanalostomy-trabeculectomy for management of advanced Glaucoma- a comparative study of the contralateral eye: a pilot study

To compare combined viscocanalostomy-trabeculectomy [VISCO-TRAB] to trabeculectomy [TRAB] for the management of advanced glaucoma. The study cohort comprised of 18 subjects with bilateral advanced glaucoma who underwent VISCO-TRAB surgery [VISCO-TRAB group] in the right eye and TRAB [TRAB group] in the left eye. VISCO-TRAB constituted lamellar scleral flap, deep scleral flap dissection with deroofing of Schlemm's canal [SC], viscodilation of SC, penetrating trabeculectomy, peripheral iridectomy, and tight flap closure. All eyes received subconjunctival mitomycin. Success criteria included intraocular pressure [IOP] < 14 mmHg or > 30% lowering of IOP with no devastating complications. A P value less than 0.05 was considered statistically significant. Mean IOP was significantly lower after VISCO-TRAB compared to TRAB at 1 week and 3 months postoperatively [P<0.05]. No eyes lost more than two lines of Snellen acuity. There were more hypotony-related complications after TRAB than VISCO-TRAB surgery. Target IOP was achieved in 83.3% in the VISCO-TRAB group compared to 55.6% in the TRAB group. Combined VISCO-TRAB is effective in reducing IOP to the target level for advanced glaucoma with lower postoperative complications

Clinical significance of hTERC and C-Myc genes amplification in a group of egyptian patients with cancer cervix

Cervical cancer is the second most common cancer in women worldwide after breast cancer. Cervical cancer is a preventable disease. The implementation of cervical cancer screening programs has greatly decreased the morbidity and mortality, as precancerous lesions and early invasive cervical cancer could be detected and treated effectively. The detection of hTERC gene amplification was suggested as a possible diagnostic marker for use in routine cytological screening. The present study was designed to detect genomic gains of the hTERC and C-MYC genes using FISH technique and to investigate the relationship between genes amplification and the clinical data of the patients. The current study was carried out on twelve cases with cervical cancer at different grades [three cases were grade I, six cases were grade II and three cases were grade III]. Interphase FISH analysis using LSI probe, Cervical Cancer probe hTERC [3q26] and C-MYC [8q24], was successfully performed on 12 patients with cancer cervix. Interphase FISH analysis revealed positive hTERC gene amplification in all cases of cancer cervix [100%]. However C-MYC gene amplification was detected in four cases only [33.3%]. Statistical analysis of the data revealed significant correlation between hTERC amplification and grating. Also, there was significant correlation between C-MYC amplification and grading and highly significant correlation between C-MYC amplification and hTERC amplification. On the other hand hTERC and C-MYC genes amplification showed an inverse correlation with the ages of the patients. The present study highlights the importance of using hTERC and C-MYC genes FISH probes for cases with cancer cervix or pre-malignant lesions as a sensitive technique. This method provides an easy and effective applicable approach which helps in the diagnosis and prognosis, as an increased copy number is associated with a more advanced grade that could be detected in the early stages of the disease

Molecular detection of circulating thyroid specific transcripts [TSHR/Tg-mRNAs] in thyroid cancer patients: their diagnostic significance

Thyroid cancer is the most prevalent endocrine malignancy. The preoperative diagnosis of differentiated thyroid cancer [DTC] that relies solely on fine-needle aspiration [FNAC] biopsy, sometimes possesses conflicting results. New molecular markers for thyroid cancer have been investigated with most of them based on the detection in thyroid nodules or tumor tissue specimens. Recently, it was possible to detect thyroid cancer cells in the circulation by measuring the mRNA of thyroid specific genes. Among these, thyroglobulin and more recently thyroid stimulating hormone receptor mRNAs, TSHR/Tg-mRNAs in peripheral blood might serve as cancer-specific markers. These have become promising new circulating markers for thyroid cancer. The purpose of this study is to assess TSHR/Tg-mRNAs as diagnostic molecular markers for thyroid cancer and if they can be used preoperatively in synergy with FNAC. This study was performed on 60 subjects; 20 healthy volunteers and 40 patients; including 16 patients with benign thyroid diseases, 24 patients with thyroid cancer; 18 patients with newly diagnosed [DTC] and 6 patients with recurrent thyroid cancer. Diagnosis of cancer was based on FNAC and histopathology of surgical specimens. All subjects had TSHR/Tg-mRNAs in peripheral blood measured by reverse transcriptase [RT]-PCR. Based on cytology/pathology; 18 patients had newly diagnosed DTC and 11 had benign thyroid disease. Preoperative FNAC was performed on 29 of 40 patients; FNAC was diagnostic in 11/18 of malignant lesions [61.1%], in 8/11 of benign lesions [72.7%], while 10/29 [34.5%] were indeterminate. TSHR/Tg-mRNAs correctly diagnosed DTC in 20/24 and 19/24 [sensitivity 83.3% and 79.1%] and benign disease in 14/16 and 13/16 [specificity 87.5% and 81.3%], respectively. With indeterminate FNA, TSHR/Tg-mRNAs correctly diagnosed DTC [follicular type] in 5/7 and benign disease in 2/3 [combined sensitivity 71.4%; specificity 66.7%]. There was high concordance between RT-PCR results for TSHR-mRNA and Tg-mRNA. Of the controls 19/20 [95%] and 16/20 [80%] were negative for both TSHR- and Tg-mRNAs. With the use of a carefully selected primer pair and qualitative RT-PCR; our results indicate that TSHR/Tg-mRNAs in peripheral blood are both equally sensitive and specific markers for detection of thyroid cancer cells. Combining TSHR/Tg-mRNAs and FNAC and ultrasound enhances the preoperative detection of cancer in patients with thyroid nodules, reducing unnecessary surgeries and correctly classified most follicular cancers and could have spared surgery in patients with benign disease

Primary lens extraction for glaucoma management: a review article

Recently, primary lens extraction alone gained more acceptance as an alternative surgical approach for glaucoma management. This view was supported by the advances in phacoemulsification and intraocular lenses with greater safety and visual recovery, in addition to a substantial reduction of intraocular pressure and deepening of the anterior chamber and filtration angle. The decrease in IOP after cataract surgery in primary open-angle glaucoma [POAG] is mild, less predictable, related to baseline levels, and may return to presurgical values after an initial period of reduction. Therefore, the IOP-lowering effect of primary cataract extraction in POAG may be insufficient to achieve adequate IOP control. The IOP reduction after lens extraction is consistently greater in eyes with primary angle closure glaucoma [PACG] than in eyes with POAG. Primary lens extraction in acute PACG eliminates, or at least, reduces the risk of recurrence of acute attacks and deepens the anterior chamber and widens the angle which reduces the risk of progression of peripheral anterior synechiae and development of chronic PACG. Primary lens extraction may be more preferable to glaucoma incisional surgery in mild to moderate PACG eyes with appositional angle closure. The decision to do lens extraction as a primary treatment for glaucoma should be individualized based upon several factors other than the effect on IOP. These factors include patients' characteristics, surgeons' skills and preferences, status of glaucoma control, type of cataract and intraocular lens implanted, and potential harm of laser treatment for late capsular opacification and fibrosis

Screening for diabetes in Kuwait and evaluation of risk scores

This study aimed to develop a simple risk score to identify individuals at high risk for undiagnosed diabetes in the Kuwaiti adult population and to assess the performance of previously published diabetes risk scores. A cross-sectional survey with a sample of 562 Kuwaiti public sector employees was carried out in 2007. Data were collected through a self-administered questionnaire and a blood glucose test. The overall prevalence of diabetes using American Diabetes Association 2003 criteria was 21.4% [4.1% newly detected]. The proposed score had 87% sensitivity and 64% specificity in predicting undetected diabetes using only 4 questions [age, waist circumference, use of blood pressure medication and diabetes in a sibling]. Most previously published risk scores were not applicable to this population

Role of multidetector CT [MDCT] in preoperative resectability assessment of central cholangiocarcinoma

CT is an excellent imaging technique for evaluating the soft-tissue extent of hilar cholangiocarcinoma and the relation between the tumor and the hepatic vasculature. To assess the role of multidetector CT [MDCT] in preoperative resectability assessment of hilar cholangiocarcinoma. The study included 20 patients presenting with hilar cholangiocarcinoma. Informed consent signed by the patients. All patients subjected to proper history taking, clinical examination as well as routine laboratory investigations. Triphasic abdominal MDCT. Post-processing techniques including multi-planner reformation [MPR], maximum intensity projection [MIP] and minimum intensity projection [MinIP]. 11 patients with portal vein invasion, 10 patients with hepatic artery invasion. Four patients had type I obstruction; four patients, type II obstruction; two patients, type IIIa obstruction; four patients, type IIIb obstruction; and six patients, type IV obstruction. The tumors were considered resectable in 12 patients in the preoperative assessment. Multidetector CT provides important information on the preoperative assessment of central cholangiocarcinoma resectability and the extent of surgery

role of Thrombomodulin, IL-12, transforming growth factor-beta2 in early onset preeclamsia: a potential biomarker for disease severity

Early onset Preeclampsia is a pregnancy specific heterogeneous syndrome with genetic predisposition ranging from hypertension, proteinuria and edema to severe preeclampsia with complications. A defective implantation and placentation, circulating factors including proinflammatory molecules, cytokines and adhesion molecules have been implicated in the pathogenesis of preeclampsia. Was to assess the clinical value of assaying maternal serum concentration of thrombomodulin [TM] interleukin-12 [IL-12] and transforming growth factor beta-2 [TGF-beta 2], in normotensive, mild and severe preeclamptic pregnant women, and to evaluate the correlation between these factors and the blood pressure, uric acid and creatinine. The second objective was to look for differences between mild and severe early onset preeclampsia, compared with a healthy pregnant and non pregnant cross sectional investigated groups. Serum TM, IL-12 and TGF-beta 2 were measured using enzyme linked immunoassay [ELISA] and enzyme immunoassay respectively in 45 women with preeclampsia divided into 24 mild and 21 severe preeclamptic patients and compared with 21 pregnant normotensive and 20 non pregnant controls. Serum uric acid and creatinine were measured as well. Severe preeclamptic women had significantly increased levels of TM [p<0.01], IL-12 [p<0.01] and TGF-beta 2 p<0.01] compared with women with normal pregnancy and non pregnant women. Serum creatinine and uric acid co1Icentrations were significantly higher in severe preeclamptic patients [1.35 +/- 0.17mg/dL, 7.43 +/- 0.74mg/dL, respectively, mean +/- SD] and did not change significantly in mild preeclamptic women compared with those of healthy normotensive pregnant women. Significant positive correlations existed between serum TGF-beta 2 concentrations and mean arterial blood pressure, TM. serum creatinine and uric acid concentrations in severe pre peclamptic patients. Conclusion: Increase concentration of thrombomodulin, II-12 and TGF-beta 2, in severe preeclamptic patient might explain the shallow placentation, endothelial cell dysfunction and renal involvement described in severe preeclampsia. Measurement of maternal plasma of TM, IL-l2, TGF-beta 2 levels in preeclampsia can be useful biomarker for the assessment of the severity of the disease

Outcome of intravitreal bevacizumab [avastin] followed by aqueous shunting tube surgery for management of intractable neovascular glaucoma

To study safety and efficacy of intravitreal Bevacizumab [IVB] injection followed by aqueous shunting tube surgery [ASTS] for management of neovascular glaucoma [NVG] with intractable high IOP. Twenty-five eyes of 25 patients with NVG and high IOP not responsive to maximally tolerated antiglaucoma medications were treated with ASTS [Ahmad valve]. Patients were classified into two groups; Group 1 [14 eyes] received IVB [1.25 mg/ 0.05ml] before ASTS. These eyes had severe retinopathy, florid NVI, dense cataract, or corneal edema that prevented proper panretinal photocoagulation [PRP] before glaucoma surgery. Group 2 [11 eyes] was treated by PRP followed by ASTS without IVB injection. Outcome measures included IOP reduction and operative complications. Mean preoperative IOP was 56.3 mmHg in group 1 and 53.3 mmHg in group 2 [p=0.8]. After IVB injection, NVI regressed markedly with media clarity and mild reduction of IOP [44.2 mmHg]. Average duration between IVB injection and ASTS was 12 days. IOP at last follow-up was 19.5 mmHg in group 1 and 17.6 mmHg in group 2 [p=0.5], with 5 eyes in group 1 and 4 eyes in group 2 on antiglaucoma drops. Post-ASTS complications were comparable between both groups. One eye in each group had one surgical intervention to treat postoperative complications. One eye in group 2 required additional glaucoma surgery. Intravitreal Bevacizumab is a useful preparatory step to safely and effectively implant an aqueous shunting tube in eyes with severe NVG and intractable IOP which cannot be treated preoperatively by PRP

Seroprevalence study of Toxocara canis in selected Egyptian patients

This study was conducted in order to reveal the seroprevalence of T. canis infection in selected 150 Egyptian patients with presumptive clinical syndromes. They were children [128] with respiratory symptoms or pyrexia of unknown origin [PUO] and adults [22] with PUO. Anti-Toxocara antibodies [IgG] were detected in sera by ELISA. The results showed 6.2% positivity in children. The frequency increased in male gender, those in rural residence and in 6-12 years group versus 1-6 years, and 4% and 13.3% positivity in those with respiratory symptoms and PUO respectively. Adults positivity was 18%. So, male gender and residence in rural regions could be considered as risk factors for transmission of toxocariasis in children

Evening primrose seeds [Oenothera biennis L.] as a rich source of natural antioxidants and anti-inflammatory oil

Chemical composition of evening primrose seeds and physiochemical properties of its oil were determined. Antioxidant activity of evening primrose meal extracts, methanol 80% [MeOH], ethanol 80% [EtOH] and ethyl acetate [E.A.], at different concentrations was investigated using diphenylpicrylhydrazyl [DPPH*] radical scavenging assay, hydrogen peroxide scavenging assay and lipid peroxidation in mitochondrja assay. Also, the anti-inflammatory activity of evening primrose seeds oil at three dosages [90, 180, 360 mg/Kg b.w.] on carrageenan-induced paw oedema in rats was investigated. Results revealed that, the oil was distinguished by its high content of gamma-linolenic acid and beta-sitosterol and has a dose-dependent anti-inflarnn.iatory activity. Also, the antioxidant activity of all extracts displayed a concentrationdependent scavenging of H2O2 and DPPH*. One hundred micrograms of MeOH and EtOH extracts displayed a 100% scavenging of H2O2 and DPPH*. In addition, all extracts have inhibitory effect against lipid peroxidation in mitochondria The results demonstrated that evening primrose meal extracts [EPR] have antioxidant activity and its oil has anti-inflammatory activity

Assessment of plasma carnitine and acylcarnitine levels in preeclampsia

Objective: carnitine plays a crucial role in fatty acids oxidation. The aim of the study is to assess plasma carnitine and acylcarnitines levels in preeclamptic womedas a measure of abnormal fatty acid oxidation

Methods: the study included 40 women with preeclampsia and 30 normotensive control women in the third trimester of pregnancy. Women with multiple pregnancy, chronic hypertension, diabetes mellitus and renal diseases were excluded. Plasma levels of free carnitine and acylcarnitines were measured with high performance liquid chromatography [HPLC]

results: total and free carnitines and acylcamitines were significantly increased in preeclamptic cases in comparison to the control group. A positive correlation was found between acylcarnitines and diastolic blood pressure [r=0.382, p= 0.018]

Conclusion: the significantly high plasma carnitine concentrations found in this study supports the hypothesis of abnormal fatty acid metabolism in the pathophysiology of preeclampsia. This may contribute to the endothelial cell dysfunction of preeclarnpsia

Delegation: a key to management productivity

Delegation is at the heart of management-it is getting work done and meeting goals through others. It is about developing trust and empowering employees. Effective delegation increases productivity as well as production capacity [Burns, 2001]. Delegation cannot be viewed as an abstract technique; it depends on individuals and individual needs [Blair, 2003]. In this context, a non-experimental ex post facto or correlation design study was used to investigate how delegation was being performed by nurse managers [head nurses] at two different settings [Elshohada Hospital and Quesna Hospital in Al Minufiyah Governorate of Egypt]. A second purpose of the study was to identify the effect that delegation had on head nurses' productivity. A convincing sample of 35 head nurses working in different units in the two hospitals was included in the study. Data were collected by two tools. The first tool was a two-part questionnaire. Part I included demographic characteristics of the sample size, such as age, education, and years of experience. Part II consisted of 18 statements, translated into Arabic, aimed at assessing the degree of work delegation by respondents. The second tool measured professional productivity by means of efficacy, effectiveness, and efficiency categories [Curtin, 1984]. The study concluded that the majority of respondents understood and correctly used delegation. In addition, there was statistically significant correlation between delegation and nurse managers' productivity. Recommendations were made in light of these findings

rational approach to the management of deformities

In Collin's dictionary deform means to mar, alter the form of, to make misshapen, to disfigure; deformation is the art of altering for the worse; deformity is the state of being disfigured, a malformation of character, a moral defect. In Thorndike-Barnhart dictionary deform means that the part is not properly formed, or ugliness of mind or body