Physicochemical properties of some bottled water brands in Alexandria governorate, Egypt

Many people use bottled water instead of tap water for many reasons such as taste, ease of carrying, and thinking that it is safer than tap water. Irrespective of the reason, bottled water consumption has been steadily growing in the world for the past 30 years. In Egypt, this is still increasing to reach 3.8 l/person/day, despite its high price compared with tap water. The purpose of this study was to evaluate the physicochemical quality of some bottled water brands and to compare the quality with that reported on manufacture's labeling, Egyptian, and International standards. Fourteen bottled water brands were selected from the local markets of Alexandria city. Three bottles from each brand were randomly sampled, making a total sample size of 42 bottles. Sampling occurred between July 2012 and September 2012. Each bottle was analyzed for its physicochemical parameter and the average was calculated for each brand. The results obtained were compared with the Egyptian standard for bottled water, Food and Drug Administration [FDA], and with bottled water labels. In all bottles in the study, pH values ranged between 7.21 and 8.23, conductivity ranged between 195 and 675 micro s/cm, and total dissolved solids, sulfate, chloride, and fluoride were within the range specified by the FDA. Calcium concentrations ranged between 2.7373 and 29.2183 mg/l, magnesium concentrations ranged between 5.7886 and 17.6633 mg/l, sodium between 14.5 and 205.8 mg/l, and potassium between 6.5 and 29.8 mg/l. For heavy metals such as iron, zinc, copper, and manganese, all of them were in conformity with the Egyptian standards and FDA, but nickel concentration in 11 brands was higher than the Egyptian standards. Twelve brands were higher than the Egyptian standards in cadmium concentration, but on comparison with FDA there were only five brands exceeding limits. Lead concentrations were out of range for all brands. On comparison with the labeled values, the quality of bottled water was not complying with labeled values. Physicochemical parameters in all bottled water examined brands were consistent with the Egyptian Standard and FDA, except for total dissolved solids, nickel, cadmium, and lead. Statistical analysis showed that there was significant difference [P<0.05] in all parameters tested between different brands. Values on the bottled water labels were not in agreement with analytical results

Nurses Awareness Regarding Some Quality Healthcare Concepts at University Students' Hospital in Alexandria

Nurses constitute a major bulk of health service manpower. Additionally, nursing care is a major determinant of successful health care delivery worldwide and identifying nurses' opinion and perceptions toward quality care program is crucial for successful implementation of such program. The aim of this study is to assess the nurses' knowledge and perceptions regarding some concepts of health care quality at Alexandria University Students Hospital. Cross-sectional descriptive study design was conducted in which self-administrated questionnaire was introduced to all nurses available in all shifts [310 nurses] at the selected hospital to assess their knowledge about quality activities in the study hospital and their perceptions regarding certain quality aspects. Results indicated that 57.1% of nurses were aware about the presence of the quality department in their hospital and only 27.1% of them were knowledgeable about the presence of quality standards in the hospital. The majority of nurses responded positively to statements of the suggestions for quality improvement and barriers that hinder the implementation of quality in health services. In relation to nurses' awareness regarding certain quality aspects, there was statistically insignificant increase in the percent frequencies for nurses attending training courses concerning both [quality concepts] items [77.4%] and [suggestions for quality improvement] items [86.8%]. It was concluded that planning and implementation of continuous in-service quality training programs for nurses to improve their awareness and acceptance of quality of care are very critical for staff development. Also, designing organizational charts for quality department with name, authority and responsibilities is recommended together with, dissemination of mission, vision and objectives of quality department through the organization, so everyone become aware about them

Indications and findings of colonoscopy in patients presenting to the endoscopy unit at Soba University Hospital in Khartoum, Sudan

The new endoscopy unit at Soba University Hospital in Khartoum, Sudan is an emerging unit, established in June 2003. In 2004 less than 200 colonoscopies were performed, the number rising to over 700 colonoscopies in 2009. The objectives of this study were to identify the common indications and findings in patients attending for colonoscopy and to study the correlation between patients' symptoms and significant endoscopic findings, mainly colonic polyps and colorectal cancer. All patients referred for colonoscopy were assessed prospectively by the study investigators and a questionnaire was filled with all relevant data including age, gender, indications for the procedure, clinical examination and endoscopic findings. A total of 123 patients were included in the study with a mean age of 46.7 years. Indications for colonoscopy included abdominal pain, altered bowel motions, rectal bleeding and iron deficiency anaemia. Polyps were found in 15% of cases and colorectal cancer in 11%. Male gender, iron deficiency anaemia and a rectal mass on digital examination were all significant risk factors in predicting a positive diagnostic yield on colonoscopy. Patients presenting with iron deficiency anaemia and a rectal mass on digital examination should have a priority over others in undergoing a colonoscopy. Despite the fact that flexible sigmoidoscopy is a useful initial investigation when a delay is anticipated in doing a colonoscopy, cases with proximal colonic polyps and cancers can be missed. Performing a full colonoscopy should be the investigation of choice in symptomatic patients

message from the past: splenectomy and devascularisation with salvage sclerotherapy in the treatment of bleeding schistosomal oesophageal varices

To study the short and long term results of splenectomy and esophagogastric devascularisation in the prevention of bleeding from esophageal varices secondary to schistosomal portal hypertension. This is a retrospective prospective study of patients, who underwent splenectomy and devascularisation for schistosomal bleeding varices during the period 1980 to 1990 at Soba university hospital. They had clinical, laboratory, and endoscopic evaluation. They were followed up for a period of 10 years [mean 4.5 years]. At follow up special emphasis was laid on recurrence of variceal hemorrhage and, or mortality. Patients with recurrent variceal bleeding received emergency treatment in the form of resuscitation, balloon tamponade when necessary, and flexible endoscopic sclerotherapy. Splenectomy and oesophagogastric devascularisation was performed in 185 patients, and devascularisation only in 5 patients. Early postoperative mortality occurred in 8 patients [4.2%]. Early recurrence of variceal bleeding occurred in 4 patients who responded to emergency treatment. Transient of treatable ascitis developed in 21% of patients, transient jaundice in 12.6%, and liver failure in 1.6%. Major postoperative septic complications occurred in 6.4%. The rate of recurrence of variceal bleeding was 18.1% within the first 5 years, and 23.6% by 10 years follow-up. Late mortality occurred in 8 patients [4.4%]. The overall mortality of the procedure was 8.4%. Splenectomy and oesophagogastric devascularisation for the treatment of schistosomal portal hypertension can be associated with a high rate of variceal rebleeding. However, when coupled with sclerotherapy for recurrence, it carries an acceptable mortality rate

Risk factors for bleeding in patients with asymptomatic oesophageal varices secondary to schistosomal portal hypertension: a longitudinal hospital based study

To determine the risk factors for bleeding from asymptomatic varices secondary to schistosomal portal hypertension. This is a retrospective, prospective, longitudinal, hospital, based study in a specialised portal hypertension clinic. Clinical, biochemical, haematological, endoscopic and sonographic evaluation were performed. Data was collected prospectively in a special portal hypertension folder designed for the purpose. 141 patients, 104 males and 37 females with an age range of 12 to 72 years [mean 33.7 +/- 13.7] were studied. They were followed-up for a minimum of 1 year and a maximum of 6 years [mean 27.6 months]. 21 patients [14.9%] bled from their varices. 11 patients [7.8%] bled within one year and 10 within the subsequent 6 years. The interval between presentation and bleeding ranged from 4 days to 78 months [mean 19.9 +/- 21.6]. Of the 21 who bled, 3 rebled [14.3%] within 1 year. The bleeders had significantly longer duration of schistosomiasis [p <0.05], more serum bilirubin above 2mg% [p<0.01], more thrombocytopenia [p <0.05], more grade III and IV varices [p <0.05] and more grade III periportal fibrosis [p <0.01]. It is suggested that patients with these risk factors should be considered for close follow-up and medical treatment

Paediatric gastrointestinal endoscopy: experience in a Sudanese university hospital

We investigated the indications for and findings of gastrointestinal [GI] endoscopy in all children

Evaluation of four fixative-stain combinations for identification of intestinal protozoa in faecal sepcimens: a comparative study

Identification of some protozoa in faecal specimens using routine microscopy is sometimes difficult even for the experienced specialist. In order to reach a definite diagnosis, different stains have been routinely used. Most of the routinely used permanent stains require prior preservation of specimens in hazardous fixative. The objective of the present study is to evaluate four fixative-stain combinations for identification of intestinal protozoa in faecal specimens. Fresh stool specimens from 125 patients were divided into aliquots to which each of three different fixatives was added. Specimens were processed and stained with four different stains. A triple stain mixture [Chlorazol Black E, Fast Green and Jenner's stains] was used for specimens preserved in a Cobalt-Zinc based modified PVA fixative [Co-Zn-PVA]. Lacto-phenol cotton blue [LPCB] and modified iron Haematoxylin [MIHX] stains were used for staining of stool fixed in sodium acetate formaldehyde [SAF]. EcoStain was used for staining of EcoFix preserved stool. The first two stains were used as wet mount stains, while the later two were used for preparation of permanently stained slides. Regarding protozoan recovery, the significant figures were that of Entamoeba spp. when identified by LPCB and EcoStain. The stains identified Entamoeba spp. in 12% and 12.8% respectively of stool specimens which were significantly higher than those detected by each of the triple stain mixture and MIHX stains [8%] [p < 0.05]. Regarding the clarity of morphological details, both Triple stain and EcoStain worked better for flagellates, LPCB and EcoStain better identify trophozoites of Entamoeba spp., while both MIHX and triple stain worked better for cysts of Entamoeba spp. The stains which offered easy identification of protozoa from the contrasting background colours were EcoStain and Triple stain mixture. In addition, MIHX stain identified acid fast protozoa along with other intestinal protozoa in the same slide. There are more acceptable alternatives to the traditional methods of fixation and staining. The quality of staining partly depends on a properly matched fixative. According to the multi-attribute ranking of the four used fixative-staining techniques, EcoStain and EcoFix provided the best quality of staining

Mycotoxins in breast milk and its health hazards on breast fed infants in Sharkia, Egypt

In recent years, International Health Officials issued several warnings about the contamination of food with moulds and mycotoxins, as an emerging important health and economic problem. Mycotoxins are naturally occurring secondary metabolites of moulds that may be present in food products. Mycotoxicosis occur more frequently in developing countries, with hot and humid climate, favorable for the growth of moulds. The contamination of human breast milk with mycotoxins has been a matter of considerable concern. However, despite the recognition of the potential risk to humans, there are very few data in the literature regarding prevalence and impact of these toxic substances on infant health. The objective of this study was to identify if serum and breast milk of lactating mothers, are contaminated with mycotoxins [Aflatoxin and Ochratoxin], in Sharkia Governorate, and to study the effect of these toxins on kidney and liver functions of their exclusively breast fed infants. The results shows high total contamination rate of mothers' sera samples [82%], with aflatoxin, ochratoxin, and both, accounting for 10%, 34% and 38%, respectively. Breast milk samples were also highly contaminated [82%] with aflatoxin, ochratoxin, and both, in rates of 10%, 32% and 40%, respectively. Meanwhile, infants' sera accounted for 80% contamination rate with 10%, 32%, and 38%, respectively. Significant positive correlation between mothers' milk aflatoxin and ochratoxin on one side and that in infants' and mothers' sera on the other side was observed. Meanwhile, a significant negative correlation between infants' serum aflatoxin and infants' length/ age was reported. As markers of kidney function in study infants, both urinary microalbumin and beta 2 - microglobulin were significantly higher in infants positive for ochratoxin or ochratoxin and aflatoxin, than in those negative for this mycotoxin. In conclusion, subjects of Sharkia Governorate, Egypt, including the sample population of lactating mothers, are exposed to contamination by mycotoxins; lactating infants of mothers contaminated with mycotoxins, who were exposed to these mycotoxins prenatally, continue to be exposed, postnatally via breast milk. Finally, that mycotoxins may have adverse effects on the growth of infants, with the length/age as the most sensitive anthropometric measurement and that ochratoxin possibly have a nephrotoxic effect, in contaminated lactating infants. A wider scale study that includes different governorates is needed to facilitate the design and plan for a prevention and control program

Antioxidant status in minimal change nephrotic syndrome

Minimal change nephrotic syndrome [MCNS] accounts for about 75% of causes of NS in children. A still growing body of evidence has accumulated indicating that a disturbance of balance between oxidative stress and antioxidant defence mechanisms plays a major role in the pathomechanism of glomerular diseases. This study was carried out to evaluate the role of oxidant-antioxidant imbalance in the pathogenesis of MCNS. The serum levels of some antioxidants [alpha -tocopherol, superoxide dismutase "SOD", selenium, zinc and copper] were estimated in 50 children, of ages ranging from 2 to 12 years, diagnosed as MCNS, and compared with that of 20 healthy age and sex- matched control children. Oxidant stress was evaluated as well in all subjected by estimating levels of serum and urinary malondialdhyde [MDA]. Levels of antioxidants, but vitamin E were significantly decreased in children suffering MCNS compared to control children. Meanwhile oxidative stress, measured by serum and urinary MDA was significantly increased in patients group. In addition, a significant positive correlation between SOD and both copper and zinc was reported. It was concluded that an oxidative stress, in. the face of defective antioxidant defence, does exist and may play a role in the pathogenesis of idiopathic nephrotic syndrome. So it is recommended that nutritional antioxidants, especially vitamin E, selenium, zinc, and copper should be added in the diet of children and all risky groups

Bed utilization pattern in the neonatology unit of zagazig University Hospitals in the year 1999

The objective of this study was to assess case mix and its effects on the average length of hospital stay, average bed turnover and their outcome over the year 1999. Among 1169 admitted cases, there were significant relationship between the cause of admission and sex, mean age at admission, birth order, place of admission and outcome. On other h and, the outcome of the admitted cases was not affected by the mode of delivery and sex but affected by the weight of infant at admission. Hyperbilirubinemia was the most common cause of admission [29.43%] with the best outcome [89.83% improved] and the lowest average length of stay [4.7 days], while preterms constituted a third cause of admission [20.19%] with the worst outcome [62.71% dead] and the highest average length of stay [12.5 days]. The average length of stay for beds and incubators were 5.6 and 10.7 days respectively, and the bed occupancy rate for beds and incubators were 94.84% and 90.48% respectively. The average bed turnover for beds and incubators were 61.33 and 30.92 turn/year respectively. It is concluded that preventive aspects are important in order to decrease the neonatal morbidity and mortality

Carotene sesquiterpenes from ferula sinaica boiss growing in Egypt

Phytochemical investigation of the air-dried roots of Ferula sinaica Boiss resulted in the isolation and identification of ten known carotane sesquiterpenes. Of these, 7 compounds were isolated for the first time from this species and characterized as: 1-alpha- angeloyloxy-5-alpha-p-methoxybenzoyloxy-10-beta-hydroxydauc-2-ene, lancerodiol p-methoxybenzoate, p-methoxybenzoate of epoxyjaesckeanadiol, p-hydroxybenzoate of epoxyjaesckeanadiol, isolancerotriol-5-p-methoxybenzoate, 1 alpha-beta-hydroxy-5 alpha-p- methoxybenzoyloxy-10-beta-hydroxydauc-2-ene and 1-alpha- hydroxy-5-alpha-p-methoxybenzoyloxy-10-beta-hydroxydauc-2-ene, in addition to beta-sitosterol. Identification of the isolated compounds was established using physical and spectroscopic methods

Evaluation of subcutaneous fat and muscle layers by chest radiography in malnourished children

The soft tissue of the chest wall is a mirror of nutritional state in children. Of the two components that constitute this soft tissue, the fat element is depleted more rapidly with the onset of protein calorie malnutrition. The subcutaneous fat layer was not significantly reduced in kwashiorkor but highly significantly reduced in marasmus and marasmickwashiorkor groups to the extent that it was immeasurable in most cases. The muscle layer is similarly wasted but not to the same extent. Such soft tissue radiography can be used to differentiate between different groups of malnutrition still between those and controls. Furthermore, we suggest to use those parameters for follow up after recovery

Antihistaminics and congenital limb-reduction defects

This paper included 6 cases examined in our Genetics Unit because of their limb malformations. We used a detailed structured questionaire to be sure that the mothers were healthy during the 40 weeks of gestation and have never been exposed to any drug except antihistamine especially in the first trimester. For the 6 patients; careful clinical examination, pedigree analysis, radiological examination, chromosomal study, and metabolic studies were done. The karyotypes and metabolic investigations were normal. Clinical and radiological studies showed a specific defect which is congenital limb- reduction deformity. This indicates a possible teratogenic effect of antihistamines. Thus we recommend to stop using antihistamines during pregnancy especially in the first trimester

Dermatoglyphics in glucose6- phosphate dehydrogenase deficiency

The palmar and plantar dermatoglyphics were studied in 30 male children affected with G6PD deficiency, their mothers who were taken as obligate carriers and their 17 unaffected male sibs. The results were compared with those of 420 normal persons as control group. Certain significant dermatogiyphic features were detected both in the patients and their mothers but not in their unaffected male sibs. These features may be due to the association or linkage between the mutant X-linked gene of G6PD and one or more of the genes controlling the development of dermal ridge patterns However, the similarity of the findings of the patients and carriers led us to suggest taking these features to identify the carriers in a family having a patient with G6PD deficiency

Defective antibody production in Down's syndrome

The work included 62 patients with trisomy 21 and 24 normmal children of matched age and sex. They were divided into two groups: [1] the first group comprised 29 patients and 12 controls. They were vaccinated with Measles vaccine, [2] the second group comprised 33 patients and 12 controls and were vaccinated with TAB vaccine. Serum samples were taken before and after vaccination. Determinations of antibody titres against measles in the first group and O, TH, AH, and BH antigens were done. It is evident that antibody response against both measles and TAB and the increase in levels of antibodies is significantly defective in trisomy 21 compared to normals. We conclude that there is some defect in the mechanism by which specific antibodies are either elaborated or released into the circulation in response to antigenic stimulation

presumptive new presentation of Norrie's disease

The present work is on an Egyptian family with ten males in three generations affected by Norre's disease. Only 34 affected families have been reported in different localities. The 35th reported here, is the first detected in Africa. The disease segregates as an X-linked recessive pleiotropic trait. The patients are ten affected males in three generations. Their ages varying from 3[1/2] to 46 years. They have the classical presentations of the disease which are: [1] Congenital blindness in 100% of cases. [2] Progressive sensorineural hearing loss. [3] Mental deficiency. Moreover additional findings are found: [1] Progressive deafness was found to start at age 10 years in every body. [2] Microcephaly in all cases, [3] Short thumbs in all cases, [4] Total impotence after age 30, with normal testicular biopsy, testosterone level and seminal analysis. This may be due to late degeneration in the center of erection. We conclude that the genetical relationship between this new variant and the classical form of the disease could result from the following situations: [1] Two different alleles for the two forms; [2] Different loci on the X chromosome; [3] They result from the action of a modifier on the Nome's disease gene