Microbial profile of Egyptian currency

Background: Currency notes and coins are widely exchanged for goods and services in countries worldwide. Currency is handled by a large number of people, under a variety of personal and environmental conditions thus increase the possibility of acting as environmental vehicle for transmission of potential pathogenic microorganisms

Objectives: This study aimed to isolate microorganisms that may be carried by Egyptian currency [paper and coins], determine the antibiotic sensitivity of the isolated bacteria and detect unusual modes of transmission of certain common diseases

Methodology: Money samples of different denominations were collected from different places [120 samples: 60 paper money and 60 metal coins].Twenty samples were collected from each place. Paper money and coins were collected in sterile plastic bags using sterile gloves and the bags were labeled

Results: Nine bacterial species were isolated; Coagulase negative staphylococci [48.3%], Staphylococcus aureus [46.7%], Bacillus spp.[30%], E.coli [10.0%],Klebsiellapneumonia[9.2%],Pseudomonasauroginosa [8.3%],Acinetobacterbumannii [7.5%], Enterococcus fecalis [3.3%], Acid fast bacilli [1.7%].And 5 fungal species were isolated; Candidaalbicans [38.3%], Aspergillusniger [25%], Aspergillusfumigatus [21.7%], Cryptococcus [10.8% ]and Penicillium [5.8%].This study revealed the presence of antibiotic resistant strains of bacteria on Egyptian currency as[MRSA] [35.7%] and [VRSA] [25%] of the total isolated Staph.aureus, [MRSE ] [34.5%] and [VRSE] [17.2%] of the total isolated Staph.epidermidesand [VRE] [50%]of the total Enterococcus fecalis isolated

Conclusion: Egyptian paper currency and coins are highly contaminated and must be considered as an unusual mode of transmission of several bacteria and fungi

Vascular trauma and its management: one and a half years after the 25th January revolution

Vascular trauma is a common life-threatening injury leading to serious consequences if not timely and efficiently managed. Although they represent less than 3% of all injuries, they deserve special attention because of their severe complications. The aim of this study was to analyze the causes of injury, presentations, surgical [recent] approaches, outcomes, and complications of vascular trauma. This was a retrospective analysis performed over 1.5 years. From January 2011 to June 2012, 48 patients were included in the study and were operated upon for peripheral vascular injuries. Diagnosis was made by physical examination as well as with hand Doppler alone or in combination with Doppler scan/angiography. Primary vascular repair was carried out whenever possible; however, if it was not possible, an interposition vein graft was placed. In some patients, endovascular approaches were applied, whereas in other patients a combination of open surgical and endovascular approaches was used [hybrid technique]. Of the total 48 patients who sustained major vascular injuries during this period, 17 sustained injuries to the upper limb vessels, 26 had injuries of the lower limb vessels, two patients had injuries of the abdominal vessels, and three patients had injuries of the neck. A penetrating trauma was the cause in 45 cases and a blunt trauma was the cause in three cases. Of the 48 patients, 46 patients were successfully managed by vascular reconstruction without any residual disability. There were 46 male patients [95.83%] and two female patients [4.16%], and their ages ranged from 17-40 years [mean 28.5 years]. Patients who suffer vascular injuries should be transferred to vascular surgery centers as soon as possible. Decisive management of peripheral vascular trauma will maximize patient survival and limb salvage. Priorities must be established in the management of associated injuries, and delay must be avoided when ischemic changes are present

Effect of delclophenac phonophoresis versus low level laser therapy on osteoarthritis knee

Osteoarthritis of the knee is reported to be a major health problem worldwide. To compare between the declophenac phonophoresis and low level laser therapy in the treatment of knee osteoarthritis, thirty patients with knee osteoarthritis from both genders were selected, aged between 40-60 years. They were divided into two equal groups, fifteen patients in the first group received declophenac phonophoresis in addition to traditional exercise program in the form of stretching and strengthening exercises. Patients in the second group received laser therapy in addition to the same traditional exercise program. The program was done 3 times a week for 4 weeks. Pain level, range of motion of the knee joint and functional performance were measured before and after treatment, there were significant difference within the two groups before and after treatment and between the two groups after treatment in Pain, range of motion and functional disability. Declophenac phonophoresis was proved to be more beneficial in reducing knee pain, improving range of motion and reducing of functional disability in patients with knee osteoarthritis

Impact of educational and training program about chest physiotherapy for nurses working in emergency, intermediate and intensive care units at Assiut university children hospital

Chest physiotherapy plays an important role in management of several acute or chronic respiratory disorders of childhood [Ashwill and Droske, 2002]. So, the aim of this study is to design, implement and evaluate an educational and training program for nurses working in Emergency Unit, Intermediate and Intensive Care Units at Assiut University Children Hospital about chest physiotherapy. The methods of data collection were a structured interview questionnaire sheet and observational checklists. The present study revealed that total mean scores of nurses' knowledge and practice throughout intervention program phases were improved in the three studied units from a pre- program level of [3.18 +/- 3.74, 7.40 +/- 1.77, 7.44 +/- 2.28, respectively] for knowledge and [2.09 +/- 2.9, 2.33 +/- 3.48, and 2.72 +/- 2.11, respectively] for practice to an immediate post test of [19.18 +/- 3.66, 21.40 +/- 2.06, 20.39 +/- 2.72, respectively] for knowledge and [18.27 +/- 2.5, 21.13 +/- 1.99, 19.33 +/- 2.77, respectively] for practice. This improvement was statistically significant [P- value < 0.001]. However, the mean scores of total knowledge and practice have declined in the follow up phase [after 3 months], it is still statistically significant higher than the pre-program level. The study concluded that implementation of the program was associated with significant improvements of nurses' knowledge and practice. More experienced and aged nurses had better knowledge. The present study recommended that the developed program should be applied and repeated again every 2-3 months in the same study setting and organized according to the needs of nurses, with subsequent continuing evaluation to the progress and outcome of these programs. Pediatric nurses should update their knowledge and performances through continued nursing education and training and frequently attending seminars and conferences based on their needs assessment

Otoplasty: Combined techniques

Protruding ears is the most common congenital deformity in the head and neck region. There are over 170 techniques described in the literatures. The surgeon should be able to select the best features of the most useful technique for correction of the deformity to provide excellent results. This work present combined techniques, which consists of skin excision of post auricular redundant skin, scoring of the anterior surface of the auricular cartilage, correction of antihelix by Mustarde's sutures, concha- mastoid sutures which correct the excessively deep concha and finally correction of prominent ear lobule. 29 patients with prominent ears were included in this study, [20 patients with bilateral prominent and 9 patients with unilateral prominent ears]. They were 20 males and 9 females. Their ages range from 3-18 years with an average of 7 years. Patients were followed up from 6 months to two years with an average 14 months. There were no infection, hematoma, skin necrosis one case of keloid formation at the site of post auricular incision. Adequate symmetry was achieved in all patients. Our procedure is simple, versatile and applicable to all age groups, as well as it is easy, safe and less time consuming with fewer complications

Persistence of anti - HBS antibodies in healthy Egyptian children and response to booster dose of hepatitis vaccine

Long-term protection against hepatitis B virus [HBV] is dependent on persistence of anti-HBs antibodies and/or strong immunological memory. In this study we evaluated the persistence of anti-HBs antibodies in healthy children aged 4-12 years after primary vaccination and the response to a booster dose using recombinant hepatitis B vaccine. Totally, 182 children who had received primary course of hepatitis B vaccine at 2, 4 and 6 months of age were included in this study. Anti-HBs levels were measured using enzyme-linked immunosorbent assay [ELISA] quantitative method to evaluate the immunogenecity of the vaccine. Children with anti-HBs levels < 10 m lU/ml were revaccinated with a pediatric dose of recombinant HB vaccine [0.5 ml: 10 microg] intramuscularly. After 4 weeks their anti-HBs levels were reevaluated to test the response. All children displayed an anamnestic antibody response when tested 4 weeks after the booster dose. The mean anti-HBs levels before and 4 weeks after injection were 2.8 and 108.7mlU/ml respectively. There was a significant negative correlation between age of the children and the prebooster antibody titre, while the age had no effect on the response of children to the booster vaccine. Other host related factors such as gender, BMI which could produce variability in immune response, showed no significant correlation with prebooster or anamnestic anti HBs response. In spite of declining levels of anti-HBs the subjects usually exhibit signs of well preserved B cell memory, they respond rapidly to a booster vaccination. Currently there is no reason to offer booster doses of hepatitis B vaccine within the first 12 years of age

"Biological study for evaluation of two types of soft denture lining materials"

Thirty completely edentulous male subjects, with no previous denture experience, participated in this study. The patients were divided into three groups. The maxillary dentures of group 1 [The control group] as well as the lower dentures of all groups, were constructed from conventional heat-cured acrylic resin. On the other hand, the maxillary dentures of groups II, III were lined with resilient lining inaterials super- soft for group II, and soft liner for group ill. Before denture Insertion, the palatal mucosa of all patients was sampled using the swab culture technique, to detect the presence of Candida albicans. One month, three months and six months after denture adjustment, the fitting surface of the maxillary dentures was similarly sampled using the same culture technique. The models were cultured at 37[degree]c for 48 hours after which the resulting colonies were counted and C. albicans was identified by Germ tube test and API 20C AUX Yeast Identification System. Each time the maxillary dentures were sampled, the clinical appearance. of the palatal denture bearing mucosa and the condition of the resilient denture liners were assessed. The results obtained from this study deduced that super- soft lining material has a less affinity to C. albicans colonization, the best color stability and the least frequency of inflammatory reactions of the underlying mucosa, compared to soft liner lining material. Conventional heat-cured acrylic resin has the least affinity to C. albicans colonization

Conclusion: from the results obtained in this study, the. Following conclusions could be drawn: 1- Both conventional and soft lined dentures have the potentiality to support Candida albicans growth. 2- The affinity of soft liner resilient denture liner for C. albicans colonization is significantly higher than that of super soft liner and relatively higher than that of conventional denture base resin

Evaluation of prosthodontic needs in an industrial community

A certain industrial community was chosen for this survey. Workers were examined thoroughly and a precise history was recorded. The study aimed at surveying prevalance of edentulous areas at various age groups, and its distribution, utilization rate of prosthetic appliances and possible causes of loss of teeth. Data obtained revealed that increase of prevalance of edentulous area increases with age distributed mostly in upper pre molar and molar areas and the main cause being caries. As for utilization rate of appliances in the partially edentulous this proved to be low. From this study it is clear that there is no coordination between the using dental needs and the dental facilities and services given. The survey has attracted our attention of the paramount importance of preventive dental care, education and motivation of workers as regards earlyprosthetic treatment and encouragement of further studies by Health Insurance Programmes as the health of our workers in general affects our industrial flourishment