Admission delays' magnitude of traumatized patients in the emergency department of a hospital in Egypt: a cross-sectional study.

BACKGROUND: Injury is an escalating public health problem, representing about 9% of global mortality, which disproportionately impacts lower- and middle-income countries. There are approximately 12,000 annual fatalities from road traffic injuries in Egypt, but a little information about delays in seeking emergent care is available. OBJECTIVES: To measure the time interval between sustaining an injury and presentation to the emergency department of Ain Shams University Surgery Hospital and to identify possible causes of these delays. METHODS: We conducted a cross-sectional, facilitated survey of a convenience sample of trauma patients presenting to the emergency department of Ain Shams University Surgery Hospital from 1 February to 31 May 2014. Data obtained included: demographic information, trauma incident details, and injury assessment. RESULTS: The average reported transport time for patients from injury to hospital arrival was 3.8 h, while the mean ambulance response time was 45 min. Referral from other hospitals was revealed to be a significant cause of delay (P = 0.004), while ignorance of the local ambulance phone number could not be confirmed as a cause (P = 0.2). CONCLUSION: This study demonstrated that trauma patients at our hospital experience more than 3 h of delay until they reach the ED. It also identified the possible causes accounting for that delay. However, additional nationwide research is needed to establish the clear causation or association of these causes with the delay intervals.

Bulk liquid pertraction of NaCl from aqueous solution using carrier-mediated transport.

In the present work, removal of NaCl using the bulk liquid membrane (BLM) technique has been investigated, using a simple apparatus for conducting the experiments. Variables investigated were volume ratio of donor phase (DP) to receptor phase (RP), presence of sequestering agent (SA) in RP, type of organic liquid membrane (LM), quantity of mobile carrier (MC) in the LM. Stirring speed and volume of LM were kept constant at 100 rpm and 130 ml, respectively. The mass transfer of NaCl was analysed based on kinetic laws of two consecutive irreversible first-order reactions, and kinetic parameters (k1d, k2m, k2r, , tmax, , and ) for the transport of NaCl were investigated. The values obtained demonstrate that the process is diffusionally controlled. Results indicate that the membrane entrance and exit rate constants (k1, k2) increase with decreasing DP:RP ratio and with decrease in quantity of MC, and quantity of SA, and the presence of dichloroethane (DCE) is preferred to chloroform (CF) as LM.

Cyclin-dependent kinase-inhibitor 1 (CDKN1A) in the squamous epithelium of the oropharynx: possible implications of molecular biology and compartmentation.

The cdknlA gene encodes CDKN1A, a protein that regulates cell cycle progression, terminal differentiation, and apoptosis. Polymorphisms or loss of heterozygosity of this usually biallelically expressed gene have no major impact on carcinogenesis. The prevalence of somatic mutations in malignancies is low. Gene rearrangements involving cdknlA are scarce. CDKN1A is expressed in both premalignant and malignant lesions. While the prognostic value of nuclear CDKN1A expression is controversial, the prognostic value of its recently discovered cytoplasmic accumulation is simply unknown. CDKN1A translocates from the nucleus to the cytoplasm when cleaved by caspase-like activities during early apoptosis. The presence of cytoplasmic catabolites (e.g.: p14) might therefore indicate apoptosis. We found no correlation between nuclear and cytoplasmic anti-CDKN1A immunoreactivity in our samples of oropharyngeal squamous cell carcinoma. CDKN1A Cap20, CDKN1, CDKN1A, CDKNA1, Cip-1, Mda-6, P21, Pic1, Sdi-1, Waf-1.

Factors associated with fatigue in a family medicine clinic in the United Arab Emirates.

BACKGROUND: Fatigue is a common symptom in Family Medicine and it has many associated factors. The Arabian Gulf provides a unique setting for studying these factors, in particular the UAE where rapid development has been a prominent feature. OBJECTIVES: The aim of the study was to sample a group of GP attenders and examine the factors which were associated with fatigue in the UAE. METHODS: A fatigue scale, psychological questionnaire, detailed history, physical examination and laboratory testing were administered to a sample of attenders at a Family Medicine clinic. RESULTS: Fatigue was more prevalent than in western studies (males 34.0%, females 38. 2%). It was strongly associated with anxiety, especially in younger adults, and it has been recognized that rapid social change is felt most acutely in young adults and adolescents. Depression in females was also a factor. Lack of exercise, obesity and illiteracy played a minor role in the severity of fatigue. CONCLUSIONS: Fatigue appears to be a cultural 'idiom of distress', a way of expressing anxiety or depression in a rapidly changing society.