High Statistical Significant Difference Research Articles

Effect of Nursing Educational Program on knowledge Among Patients at Risk for Stroke

Background: Stroke is the third most common cause of death worldwide and the leading cause of adult disability. Aim of the study: was to assess the impact of a nursing education program on Knowledge among patients at risk for stroke. Subjects and Method: A quasi-experimental design was used in the current study. This study was carried out on a convenient sample of 133 patients at risk of stroke. This study was conductedin the outpatients clinics in governmental hospitals and the health insurance hospitals in Port-Said City. Three different tools were used for data collection, namely 1) -Structured interview questionnaire sheet , 2) - Stroke risk assessment screening tool and 3) - Patients' assessment knowledge about stroke. The educational program was designed based on an extensive revision of the related materials, recent medical surgical nursing textbooks, studies and literature. Results: The study results revealed that very high statistical significant difference in total and sub-items scores of studied patients' knowledge were found between before and immediately after program implementation and between before and 3months after program implementation, slightly decline was evident in total patient knowledge from post immediate and post 3 months after the program implementation(99.2% to 96.2%) respectively ,but it was still higher than before program implementation(6.0%).Conclusion: The study concluded that The knowledge was significantly improved after implementation of nursing educational program about stroke prevention. Recommendations: The study recommended thatregular continuouseducation programs should be conducted in the different outpatient clinics providing medical care for patients at risk for stroke to give information about stroke prevention for enhancing knowledge.

Role of MDCT in evaluation of epicardial fat volume as an independent risk factor for coronary atherosclerosis

ObjectiveThe aim of this study was to clarify the association between epicardial fat volume and coronary atherosclerosis. Materials and methodsA total of 90 patients with clinically suspected coronary artery disease underwent MDCT coronary angiography. The images were interpreted for Calcium score, quantification of epicardial adipose tissue (EAT) volume, and coronary artery disease (CAD) which was classified according to the number of affected vessels, location, extension, component of the lesion and degree of obstruction. EAT was correlated to CAD and Calcium score using 125 cm3 as a cutoff value for acceptable EAT volume. ResultsThe patients were classified into 3 groups: patients with 1-normal CCTA, 2-non-significant CAD and 3-significant CAD. A high statistical significant difference was found among the 3 groups regarding mean coronary calcium score (P value = 0.00) and mean EAT volume; Group 1 (125.14 ± 56.88 cm3), in group 2 (217.38 ± 56.88 cm3) and the largest EAT volume was seen in group 3 (327.94 ± 90.17 cm3), (P value: 0.00). ConclusionThe estimation of EAT volume could be considered as a screening test for any patients suspicious for CAD.

Role of computed tomography-guided percutaneous celiac plexus neurolysis in relieving pain caused by abdominal malignancy

Objective This study aims to assess the efficacy of computed tomography (CT)-guided celiac plexus neurolysis (CPN) to relieve pain caused by abdominal malignancy. Background The management of severe pain in patients with cancer is a challenging matter faced by medical care providers. CPN is an effective method that can alleviate pain caused by abdominal malignancies. It leads to marked decrease in the analgesics daily dose or even not needing it. Patient and methods CT-guided CPN was done for 20 (90%) adult patients experiencing abdominal cancer pain using ethanol as a neurolytic agent. To assess the degree of pain relief, the visual analog scale score was used to assess pain immediately, 1 week, 1 month, and 3 months after CPN. Results Marked decrease of the pain intensity in all the patients was noted. The visual analog scale score at baseline was 9.1 ± 0.85. One day after CPN, pain severity decreased to 1.3 ± 0.71; 1 week later, it was mostly maintained at the same level at 1.7 ± 0.89; 1 month after CPN, the pain severity was also maintained at the same level at 1.9 ± 0.79; and 3 months after CPN, pain severity still decreased significantly to 2.3 ± 1.02. The decline in pain severity at its average before and at different sequences after CPN recorded high significant statistical difference (P value less than 0.001). Conclusion CT-guided CPN is an effective and safe method for relieving severe pain owing to abdominal cancer.

Upright versus recumbent position during first stage of labor among primipara women on labor outcomes

Objective: The aim of this study was to assess the effect of upright versus recumbent position during the active phase of first stage of labor among primipara women on labor outcomes in term of progress, duration of labor, method of delivery, neonatal outcome and maternal satisfaction with assumed position.Methods: Quasi experimental design was used. The study was conducted in the labor unit in obstetric department at Benha University Hospital. A purposive sample of 100 parturient women in 1st stage of labor were recruited in the study, they divided into two groups; upright group (50) and recumbent group (50). Data were collected through four main tools: Structured Interviewing questionnaire sheet, Structured Observational Checklist include (Partograph and Apgar score), Visual analogue pain intensity scale and maternal satisfaction with assumed position questionnaire.Results: It revealed that high statistical significant difference between the upright and recumbent groups in term of decreases interval and increases duration, frequency and intensity of uterine contraction, cervical dilatation and fetal head descent/fifth among the upright group. While the recumbent group showed less progress. Moreover, the recumbent group expressed more pain score, consume longer duration of 1st, 2nd, 3rd stage of labor than the upright group and statistical significant difference in Apgar score of the neonate during both first and fifth minute. In addition, the upright group had higher satisfaction scores compared to those assumed recumbent positions (p < .001).Conclusions: Upright position had positive effect on progress of labor, decreased duration of the three stages of labor, better neonatal outcomes and improving parturient women's satisfaction with assumed position. The study recommended that all parturient women in low-risk labor should be informed about the benefits of assuming upright positions during first stage of labor, and be encouraged and supported to use them.

Elderly Home Health Care Challenges among Health Care Provider in Riyadh at Nursing College Princess Nourah Bint Abdelrhman University

Home health care is a kind of health care provided in the home which is provided by licensed caregiver’s professionals who provide medical treatment needs. So the current study aimed to identify the challenges faced by health care provider for home health care among elderly in Riyadh City, Kingdom of Saudi Arabia. Descriptive design was used for this study among 100 home health care provider. A self-administered questionnaire was used after testing reliability and validity. The result revealed that 77% of the study sample was nurses and 68% was female. Majority of the respondents agree that Saudi community needs home health care. Support from Government agencies and insurance companies for home health care provider considered to be the most challenging. The study found that there was a high statistical significant difference in attitudes between the two groups of health care providers (Gender and Marital status) (with P value 0.10, 0.00 respectively). Home health care in Saudi Arabia is a significant need that merits support and attention.

Clinical Evaluation of Nano-Hydroxyapatite as Dentin Desensitizer

Objectives: This clinical study was conducted to evaluate the efficiency of nano-hydroxyapatite (n-HAp) in reducing dentin hypersensitivity individually or combined with fluoride. Materials and methods: Forty hypersensitive teeth from 10 patients with hypersensitive symptoms were treated using hydroxyapatite nanoparticles (nHAp) gel at different concentrations/ sodium fluoride (NaF) containing according to four treatment groups: Group 1; 15% nHAp + 1% NaF, Group 2; 15% nHAp, Group 3;25% nHAp+ 1% NaF, Group 4; 25% nHAp. The initial sensitivity levels were recorded using a verbal rating scale (VRS) and visual analogue scale (VAS) at the baseline visit. The responses were evaluated at 0, 1 day, 1, 2 and 4 weeks respectively for all groups. Results: There was a high statistical significant differences between pain scores before and after treatment for all treated groups. There was statistically significantly high difference between 25% nHAp and the other groups, as they need 4 applications for complete relief while 25% nHAp needs only 3 applications. Conclusion: Nano-hydroxyapatite with 25% concentration was the most effective in alleviating the hypersensitivity symptoms.

Effect of implementing guideline instruction on awareness of newly married women regarding family planning methods

Background: Family planning (F.P) is an important strategy in promoting maternal and child health. Contraceptive use is a key factor in preventing unwanted pregnancies, reducing maternal and child mortality, and improving the lives of women and their families. A recent study estimated that contraceptive use could avert more than two-fifths of maternal deaths. Aim of this study: was to assess the effect of implementing guideline instruction on awareness of newly married women regarding family planning methods Research question: what is the effect of implementing guideline instruction on awareness of newly married women regarding family planning methods?. Research design: A Descriptive cross sectional research design has been utilized in the present study. (Subjects and methods) Sample: Three hundred participants were included in this study. Tools: a structured interviewing questionnaire sheet developed by the researcher. Pretest was done to evaluate participant's knowledge regarding contraceptives then the guideline and health education for participants, Post evaluation was done to test improvement of their awareness after 3 months of intervention. Results: showed that level of knowledge regarding contraceptives among newly married women was poor in the pre test while after implementing the guideline and health education a great improvement in their level of knowledge was observed with high statistical significant difference (P≤ 0.001). Conclusion: health education and implemented guideline were effective in increasing the knowledge of women regarding family planning. Recommendations: Efforts should be made to strengthen the media for providing accurate knowledge about F.P programs, premarital family planning counseling for male and females, and increase quality of F.P services staff through training program and updating information.

Effect of Teaching Guidelines on self-efficacy for Patients with End Stage Renal Disease Undergoing Hemodialysis

Background: End stage renal disease (ESRD) could be developed with or without the risk factors. However, the more risk factors presented the greater likelihood of developing ESRD. The aim of the present study was to evaluate the effect of teaching guidelines on self-efficacy for patients with end stage renal disease. Research design used was Quasi experimental research design utilized in this study. The study was carried out at Urology and Nephrology Center of Mansoura University. A purposive sample including 80 Egyptian patients with ESRD on Hemodialysis therapy. Two tools were used in data collection; Tool I a structured Questionnaire tool, Tool II Chronic Kidney Disease- Self Efficacy (CKD- SE) Scale. The Result of the study reveals that there were high statistical significant differences in study subjects’ Mean Scores of four domains of CKD-SE scale between Pre and Post implementation of the teaching guidelines. Conclusion: It can be concluded that patients with ESRD treated with Hemodialysis tended to have higher scores (better SE) post implementation of teaching guidelines. Recommendations: Replication and expanded studies are needed for hemodialysis patients. Future studies should try to incorporate prospective data collection, long term follow-up and validated disease specific SE instruments

Overexpression of the giant FAT1 cadherin gene and its prognostic significance in de novo acute leukaemia patients

FAT1 is a type 1 transmembrane protein belonging to the cadherin superfamily. Many reports showed either overexpression of FAT1 gene or its loss in solid cancers. Limited studies evaluated its importance in leukemogenesis. Real-time quantitative reverse transcriptase polymerase chain reaction (RTQ-PCR) was used to examine the levels of FAT1 mRNA expression in 50 paediatric acute lymphoblastic leukaemia (ALL) and 50 adult cytogenetically normal acute myeloid leukaemia (CN-AML). Each group was compared with 20 age- and gender-matched healthy controls. Peripheral blood (PB) samples were collected at time of diagnosis from all patients and controls. FAT1 mRNA was detected in 66% of the paediatric ALL cases, 50% of the adult CN-AML cases, while not expressed in the PB of the control groups. T cell ALL (T-ALL) cases showed high statistical significant difference in the expression levels of FAT1 when compared to B cell precursor (BCP)-ALL (P = 0.001). Paediatric FAT1high ALL expressors showed poor response to induction therapy than FAT1low ALL (P = 0.001) as well as FAT1pos expressors in adult CN-AML when compared to FAT1neg (P = 0.01). FAT1 plays an important role in leukemogenesis; its expression levels may be used as an independent prognostic indicator in paediatric ALL and may help in distinguishing an important risk group in adult CN-AML.

Effect of applying play therapy on children with attention deficit hyperactivity disorder

Background: Attention Deficit Hyperactivity Disorder (ADHD) is a serious public health problem affecting a large number of children that often lasts into adulthood, and it is characterized by persistence of inattention, hyperactivity and impulsivity that interferes with functioning or development. Children with ADHD are managed with appropriate pharmacological and non-pharmacological intervention such as educational, psychological, behavioral support and play therapy. Whereas, play therapy is a technique during which the child would be given an opportunity to experience development under the most ideal circumstances. Aim: Evaluate the effect of applying play therapy on children with ADHD.Methods: Study Design: A quasi experimental. Setting: The study was conducted in Badghish care & Rehabilitation center at Jeddah in Kingdom of Saudi Arabia. Subjects: Purposive sample composed of 40 preschool & school age children with ADHD with their parents and teachers. Study Tools: Data were collected through using a self-administered questionnaire for the parents to assess the socio-demographic characteristics of the studied children and their families, Conner’s Abbreviated Parents and Teachers Rating scale, it was used to assess and evaluate the problematic behaviors of children with ADHD for their responses and progress monitoring through play therapy, Children's Symptom Inventory (CSI-4)-Parents and Teachers Form Scale, it was used to assess the children for ADHD symptoms including; inattention, hyperactivity and impulsivity through their parents and teachers and Vanderbilt ADHD Parent and Teacher Rating Scale, it was used to assess children's anxiety symptoms through their parents and teachers.Results: The mean age of children was 6.282 ± 1.52 years. Also, 67.5% of children were boys and 32.5% were girls. Meanwhile, there were high statistical significant differences (p-value at .00) regarding children inattention, hyperactivity and impulsivity as reported by their parents and teachers pre and post applying play therapy.Conclusions: The current study concluded that applying play therapy had a positive effect on paying attention, decreasing hyperactivity and controlling impulsive behavior of children with ADHD. Also, there were statistical significant differences in children's emotional and behavioral disturbances pre and post applying play therapy sessions. Recommendations: Encourage parents to cooperate actively when play therapy sessions are held for persistency of treatment effects and further studies should be carried out on the effectiveness of play therapy and use of other different kinds of therapies for children with ADHD are beneficial.

Effect of Platelet-Rich Fibrin on The Regeneration Capacity of Bone Marrow Aspirate In Alveolar Cleft Grafting (Clinical and Radiographic Study)

The present study aimed to evaluate the enhancing effect of platelet-rich fibrin (PRF) on autogenous bone marrow aspirate (BMA) using in a resorbable matrix for repair of alveolar cleft defects. It was conducted on 12 patients (7 males and 5 females) with unilateral alveolar cleft and oronasal leakage. They divided into two random equal groups (group I and II). In group I, alveolar cleft defect packed with a mixture of PRF, β-Tricalcium phosphate, and BMA, and the same mixture without PRF for group II. Our clinical results revealed that, all patients had uneventful wound healing except some cases in group II. While, densitometric analysis showed a high statistical significant difference between two groups (p=0.011737) at 6 months interval but, at 12 months interval difference was not statistically significant (p=0.142480). Also, volumetric measurements of new bone showed that, there was highly statistical significant difference (p=0.037997) between group I and II at 12 month interval. The present study concluded that PRF may enhance the regeneration capacity of the stem cells when it added to BMA. Thereby, they may accelerate bone regeneration in alveolar cleft defects. Moreover, it may be used as membrane to cover grafted alveolar defect.

Nursing Guidelines and Its Effects on Nurses’ Knowledge and Patient Safety Regarding Nosocomial Infection Control Measures in Burn Unit

Background:Infection prevention and control is critical component of patient safety, as hospital acquired infection are the most common complication affecting hospitalized patients. The aim of this study was to evaluate effect of implementing nursing guidelines on nurse's knowledge and patient's safety regarding nosocomial infection control measures in burn unit. Methods: A quasi-experimental design was used to conduct the study on 35 nurses working in the burn units at Public Fayoum, in addition to 40 patients were randomly assigned from these units previous. A structured questionnaire to collect data related to socio-demographic data for nurses, nosocomial infection nurses’ knowledge questionnaires, observational checklist and patient assessment sheet that include scio-demographic data related to patients, and observational for sign and symptoms sheet. Results: The present study revealed that: (a) The mean total knowledge scores of nurses were increased immediately after implementation of nursing guidelines with statistical significant difference compared to pre implementation. (b) There were a positive correlation between nurses’ knowledge and practice with a high statistical significant difference. (d) There were positive safety burn patients as evidence by fewer incidences of signs and symptoms of infection among study group after received intervention than pre received intervention. Conclusion: This study revealed that nursing staffs’ knowledge and practice about nosocomial control measures could be improved. Participants in the study reported that they could use the nursing guidelines effectively and easily in the prevention of nosocomial infection among their burn patients, which decreases the occurrence of signs and symptoms of infection and as well as improved patient outcome and promote patient safety. Recommendations: The present study recommended that continues education program for the nursing staff, which is necessary for the continuously advancing care for patients in this area. Keyword:Nosocomial infection, nursing guideline, patient safety, burn injury

Assistant lecture of medical surgical nursing, Medical-Surgical Nursing, Faculty of Nursing , Assiut University, Egypt.

The anterior cruciate ligament (ACL) is important ligaments of the knee. The Aim of the study is to assessknowledge and practice of patients undergoing arthroscopy for anterior cruciate ligament injury , to evaluate theeffect of applying nursing teaching program on knowledge and practice of patients undergoing arthroscopy foranterior cruciate ligament injury. Quasi experimental research design was utilized in this study . First tool interviewquestionnaire sehedule consists of biosocial characteristics of patients , second tool to assess patients knowledgeand practice. Results concluded that high statistical significant difference between the study and the control groupregarding their knowledge and practice with P value (0.001). Conclusion : it can be concluded that, patients`knowledge and practice regarding ACL surgery for orthopaedic patient of Assiut University Hospitals are improvedafter teaching program . Recommendation : providing written guidelines for patients was much more effective thanthose patients in the control group who received resident's oral instructions

Stem Cell Factor and Interleukin-31 Expression: Association with IgE among Egyptian Patients with Atopic and Nonatopic Bronchial Asthma

ABSTRACTBronchial asthma is a chronic inflammatory disorder which remains a significant cause of morbidity. Recently, it has been reported that the stem cell factor (SCF) and interleukin-31 (IL-31) may play a major role in bronchial asthma. The aim of the current study was to study the association of the stem cell factor and interleukin-31 expression with serum immunoglobulin E among Egyptian patients with atopic and nonatopic bronchial asthma. After measuring serum IgE using total enzyme linked immunosorbent assay (ELISA), Ribonucleic acid (RNA) was isolated to determine gene expression of SCF and IL-31 by real-time polymerase chain reaction (PCR). The levels of SCF mRNAs in atopic asthmatic patients’ PBMCs were significantly higher than those in controls (p = 0.0001**) and nonatopic asthmatics (p = 0.0001**). There was a high statistical significant difference also with regard to IL-31 between atopic asthmatics and controls (p = 0.0001**) and between them and nonatopic patients (p = 0.014*). There was a strong significant direct correlation between SCF, IL-31 (r = 0.827 and p = 0.0001**) and between both of them and IgE in asthmatics (r = 0.543 and p = 0.0001**) (r = 0.443 and p = 0.0001**), respectively. A direct correlation between SCF, IL-31 and FEV-1/ FVC %, CRP and wheezing existed. These findings suggest that both SCF and IL-31 play an important role in mediating inflammation and enhancing severity of atopic asthma. Augmented inhaled glucocorticoid therapy was associated with significant reductions in SCF and IL-31 mRNA expression as well as improvements in lung function, symptom scores and bronchial hyperresponsiveness to methacholine (PD20) in atopic and nonatopic asthmatics.

Study of epidemiological features of hepatitis D virus infection in HBsAg-positive chronic hemodialysis patients

Objective Study the prevalence, clinical, and laboratory features of hepatitis D virus (HDV) infection in hepatitis B surface antigen positive chronic hemodialysis (HD) patients. Background Delta virus or HDV is a small RNA-containing virus requiring the concomitant presence of hepatitis B virus (HBV) for its survival and pathogenicity. Worldwide, 20 million of chronic HBV patients are thought to be infected with HDV. It is important to know that HDV infection is present in a HD patient with HBV infection, because it allows a more accurate determination of prognosis, and the response of HDV patients to antiviral therapy and needed dosage therapeutic regimens are different from those with chronic hepatitis B alone. Materials and methods The study included 50 chronic HBV-infected renal patients and 25 chronic HBV nonrenal patients collected from Shebin El-Kom Fever Hospital and Menoufiya University Hospital, Menoufiya, Egypt. The study was conducted from January 2013 to May 2014. Enzyme-linked immunosorbent an assay was used to detect hepatitis B surface antigen and HDV antibodies (total antibody). Results HDV antibody (total) was positive in 58% of the HBV renal patients and in 24% of the HBV nonrenal patients, with high significant statistical difference. Laboratory data showed significant statistical differences between the two groups regarding platelet concentration (higher in HBV renal patients), albumin and prothrombin (higher in HBV nonrenal patients), bilirubin levels, and renal functions (higher in HBV renal patients). Furthermore, the infection with hepatitis delta is more common in HBV renal patients in the HD group IA (72%) than HBV renal patients on conservative treatment group IB (44%), with significant statistical differences of laboratory data between the two groups regarding hemoglobin (higher in group IB) and platelet concentration (higher in group IA), albumin and prothrombin (higher in group IA), bilirubin levels (higher in group IB), and renal functions (higher in group IA). Conclusion It is concluded that HD may have a major role in widening the prevalence of delta infection among the studied HBV renal patients (72%).

Olfactory functioning in children with attention deficit hyperactivity disorder

Introduction: Attention deficit hyperactivity disorder (ADHD) is characterized by a persistent pattern of behavior, present in two or more settings that can negatively impact on social, academic or occupational functioning. Children with ADHD tend to have one or more sensory processing problems. Very few studies have investigated olfactory impairment in children with ADHD and results are not consistent. Objective: The aim of this study is to examine the olfactory functioning in group of children with ADHD compared with healthy children matched for age, gender and school achievement. Method: We have analyzed a group of 24 children with diagnosis of ADHD according to DSM-V, aged 7-14 years, as well as 26 healthy control subjects with no data of any behavioral or psychological problem. Assessment of the olfactory identification and discrimination was performed using the Sniffin' Stick test of nasal chemosensory performance. Results: There were no significant differences among two groups of participants in terms of age, gender and school achievement. The mean (SD) age of patients and healthy children was 11, 57 (2, 32) and 11, 95 (1, 77) respectively. Significant differences between the two groups were evident in the both domains of olfactory function. According to odor discrimination we found statistically significant difference between the ADHD and control group (p<0.05) and according to odor identification we found high statistical significant difference (p<0.001). Conclusion: Olfactory function in children with ADHD has been a topic of increasing interest. The results of our study suggest olfactory impairment in two different domains of olfactory functioning. We believe that dopaminergic dysregulation is one of underlying mechanism of this phenomenon. Future studies with large sample size could include all three domain of olfactory functions as well as other sensory processing problems in children with ADHD.

Correlation of Notch1/Hes1 Genes Expression Levels in Egyptian Paediatric Patients with Newly Diagnosed and Persistent Primary Immune(Idiopathic) Thrombocytopenic Purpura.

Notch signalling is involved in the development of several autoimmune diseases, one of such diseases is ITP. The aim of this study was to investigate and compare the expression levels of Notch1 receptor and its target Hes1 gene in Egyptian paediatric ITP patients. Real-time quantitative reverse transcriptase polymerase chain reaction was used to analyse the expression levels of Notch1 and Hes1 in 42 children with primary ITP (22 newly diagnosed and 20 persistent) cases. Twenty age and sex matched non-ITP controls were included. The expression levels of Notch1 were higher in newly diagnosed and persistent cases than controls with high statistical significant difference (P value <0.001, P<0.001) respectively, similarly as regards the expression levels of HES1 (P value <0.001, P<0.007) respectively. A significant positive correlation was found between Notch1 and Hes1 expression levels in newly diagnosed cases (r=0.587, P value=0.004). There was an association between levels of both genes in most of ITP patients but Hes1 was markedly elevated than Notch1 in few cases. High expression levels of Notch1/Hes1 indicated the important role of Notch signalling in both newly diagnosed and persistent ITP. High expression levels of Hes1 than Notch1 may shed light on its value as a therapeutic target for future research in ITP.

Propofol dexmedetomidine versus propofol ketamine for anesthesia of endoscopic retrograde cholangiopancreatography (ERCP) (A randomized comparative study)

ObjectivesThe aim of this study was to compare the effects of propofol/dexmedetomidine and propofol/ketamine combinations for anesthesia in patients undergoing ERCP regarding hemodynamic changes, propofol requirements and the recovery criteria.Patient and methodsSixty patients aged 20–50 years ASA II or III scheduled for ERCP were enrolled in this study. Patients were randomly allocated into two equal groups: dexmedetomidine/propofol (DP) group and ketamine/propofol (KP) group. DP patients received a loading dose of iv dexmedetomidine 1 μg/kg over 15 min then maintained by a 0.5 μg/kg/h. Group KP patients received a loading dose of iv ketamine 1 mg/kg over15 min then maintained by 0.5 mg/kg/h. Induction of anesthesia was achieved with propofol 2 mg/kg, atracurium 0.5 mg/kg to facilitate endotracheal intubation. Anesthesia was maintained by propofol infusion 5 mg/kg/h, intermittent iv propofol boluses (0.5 mg/kg) were administered if needed. MAP and HR were recorded before loading of study drugs (baseline) and recorded every 5 min after beginning of loading throughout the procedure and just after intubation, then every 15 min for one hour post-operative. Total propofol consumption, recovery time, VAS and postoperative complications (PONV, cognitive dysfunction, and respiratory complications) were recorded.ResultsThe intra-procedural HR and MAP showed high statistical significant differences between both groups throughout the procedure with lower values in DP group (p < 0.01 or <0.001). During the post-procedural period, the HR and MAP were significantly lower in DP group. Propofol consumption was comparable in both groups (268.0 ± 122.3 mg) in DP group versus (304.7 ± 142.0 mg) in KP group. Postprocedural recovery time was significantly shorter in DP group (5.7 ± 1.7 min) compared with (22.2 ± 8.2 min) KP group (p < 0.01). VAS was comparable in the two groups. PONV was 46.67% of KP group, while it was absent in DP group. Post-operative cognitive disorders showed a high statistical significant difference between both groups (p < 0.001) with no cases was reported in DP group. No respiratory complications in both groups.ConclusionDexmedetomidine–propofol combination as TIVA during ERCP showed better intra-and post-procedural hemodynamic stability, less PONV, less postoperative cognitive dysfunctions and shorter recovery time when compared with ketamine–propofol combination.

Detection of Integrons in Gram Positive and Non Fermentative Gram Negative Isolates from Intensive Care Unit of Zagazig University Hospitals

Background: Integrons are mobile genetic elements considered to play a role in transmission of antibiotic resistance genes with limited studies concerning this issue. Objectives of this study: were first to detect the prevalence of integrons in Gram positive and non fermentative Gram negative isolates from Intensive Care Unit of Zagazig University Hospitals and to investigate the association between integrons carriage and antimicrobial susceptibility of bacterial isolates. Methodology: Culture, API identification and antibiotic susceptibility testing were done to all isolates. PCR using primers for integrons Class I, II and III followed by RFLP using RsaI enzyme was applied to all Gram-positive and non-fermentative Gram-negative isolates. Results: Out of '83 clinical samples: 40 non fermentative Gram negative and 33 Gram positive bacteria were detected. The most predominant isolates of both groups were Pseudomonas aeruginosa (62.5%) and Staph aureus (69.7%) respectively. A high statistical significant difference regarding association between amikacin, spectinomycin and ciprofloxacin resistance, and integron existence was found in P.aeruginosa. Meanwhile, ceftazidime, aztreonam, cefotaxime, tetracycline, piperacillin and Sulphamethoxazole-trimethoprim resistance were high significantly associated with integron existance in isolated A. baumannii. Conclusion: A high statistically significant difference exists between integrons carriage and multidrug resistant pathogens

In vitro Evaluation of the Accuracy of Seating Cast Metal Fixed Partial Denture on the Abutment Teeth with Varying Degree of Convergence Angle.

The prime goal of a diligent prosthodontist is to obtain adequate marginal fit while restoring lost tooth structure. The marginal fit of the restoration, in turn depends upon the geometrical morphology of the tooth preparation. To determine the effect of varying degree of convergence angle on the marginal seating of the single crown, three-unit fixed partial denture and multiple-unit fixed partial denture with pier abutment. Three dies, of same convergence angle, were placed in an arch form on a base. In this way, four arch forms were prepared for four different convergence angles i.e. 0°, 6°, 12°, and 20°. Five castings each were made for single crown, 3-unit fixed partial denture and multiple-unit fixed partial denture (FPD) with pier abutment for each convergence angle. The castings were seated on their respective dies and vertical marginal discrepancy was measured at four points for each casting with the help of an optical microscope. The results showed that 200 convergence angle showed better marginal seating of the single crown, 3-unit FPD as well as for the multiple unit FPD. There was a possibility that the retention and resistance may be compromised with 200 taper. Hence 120 taper is suggested for crowns and fixed partial denture retainers as the marginal discrepancy is reasonable and retention and resistance is optimum. There was a high statistical significant difference in the values obtained for the different convergence angles.