Menofia University Research Articles

Rivaroxaban versus Low Molecular Weight Heparin in Treatment of Acute Deep Vein Thrombosis

Abstract Objectives The purpose of this study is to examine the use of low molecular weight heparin, warfarin, and rivaroxban in the treatment of acute deep vein thrombosis. Background A blood clot stops the passage of blood via vein, usually in the legs, causing deep vein thrombosis (DVT). Clots can detach and obstruct blood flow to the pulmonary, which can be deadly (pulmonary embolism (PE). Methodology This prospective study included 250 Patients with acute deep vein thrombosis 20 patients died (9 died due to Pulmonary embolism 1 died due to bleeding – 10 died due to myocardial infarction, stroke and cardiac aresst) during study, 30 patients lack of follow up. 100 Patients are subjected to low molecular weight heparin followed by warfarin and the other 100 subjected to rivaroxban. During the period of the study from Mars 2017 to July 2019 at emergency department in Menofia university. Results The total number of Patient selected for the tests was 200 Patient. The main age was 39 and the Minimum of age was 20 year and the maximum age are 55 year. the disruption of sex are not show any concentration in any groups, the mean BMI in Warfarin Group and Rivaroxban Group are the same with no significant, the age groups shows no statistically significant of data. Conclusion According to this study Warfarin need long term monitoring, Rivaroxaban does not require laboratory surveillance, which makes treatment easier, and there are no medication or dietary interactions with Rivaroxaban.

A study of the association between long non coding RNA (ULBP1 and MICA/B) expression and preeclampsia in Egypt

BackgroundPreeclampsia is associated with excessive inflammation and increased serum monokines. Although preeclampsia pathogenesis has been connected to uterine natural killer (NK) cells, natural killer group 2, member D (NKG2D) is thought to have a role in immune response mediation. NKG2D ligands (NKG2DLs) are significantly expressed in preeclampsia, and the heterogeneity of NKG2DL expression is unclear. Aim of the studyIn current study we aimed to study the expression levels of ULBP1 and MICA/B genes in women with preeclampsia. Patients & methodsThe Medical Biochemistry and Molecular Biology Department, as well as the Gynecological Department, at Menofia University's Faculty of Medicine, conducted this research. There were 120 female in all, with 80 of them having preeclampsia (40 mild and 40 severe preeclampsia). There were 40 healthy pregnant women as control group. All were chosen from the Menofia University Hospital's, Gynecological and Obstetric Departments between May 2020 and May 2021. After all subjects have given their informed permission, full history taking, clinical examination were performed on all participants and laboratory examinations include: measurement of liver function tests (AST&ALT), renal function tests (urea, creatinine, and uric acid), complete blood count, assessment of protein in urine and calculation of gene expression of ULPB1, MICA, and MICB in placental tissue by real time q PCR method. ResultsThere was significant increase in ULPB1, MICA and MICB genes expression in cases versus control and there was significant higher level of ULPB1, MICA, and MICB in severe cases compared to mild cases. ConclusionFrom this study, it could be concluded that expression of ULPB1, MICA and MICB levels might be used as biomarkers for diagnosis and detection of severity of preeclampsia.

Versatility Of The Superior Lateral Genicular Artery Perforator Flap For Coverage Of Soft Tissue Defects Around The Knee

Background: Coverage of soft tissue defects around the knee is a reconstructive challenge. The superior lateral genicular artery perforator (SLGAp) flap provides an excellent alternative to muscle and musclocutaneous flaps with less morbidity, for coverage of these defects, especially when the gastrocnemius muscle flap is not available. The vascular basis of this flap, SLGA perforators, have consistent and reliable anatomy.Aim of The Study: This study is a retrospective analysis of our clinical experience with the superior lateral genicular artery perforator flap for coverage of soft tissue defects of the kneePatients and methods: This study was done at The Department of Plastic and Reconstructive Surgery, Menofia University Hospitals, from January 2017 to November 2018, with follow up period of 12 months. It included 7 patients, 6 males, and 1 female, with their age ranged from 19 to 46 years. The around-knee defects were due to different etiologies, 1 patient due to shotgun, 1 patient with post-burn contracture of the lateral popliteal fossa, and 5 patients with traffic accidents. The defects were reconstructed by the superior lateral genicular artery perforator (SLGAp) flap.Results: all flaps survived, except in 2 cases, 1 case managed conservatively and healed well, and in the second, the necrotic part was debrided and skin grafted. The donor site was closed primarily in 2 cases and skin grafted in 5 cases. Skin graft take was perfect, except in 3 cases with minor patches of graft loss and healed spontaneously. Infection around the defect site occurred in 2 cases and managed conservatively. The flap provided stable and durable coverage with minimal donor site morbidity and no functional loss.Conclusion: The superior lateral genicular artery perforator flap is a versatile option for reconstruction of soft tissue defects around the knee or popliteal fossa. The anatomy of the flap perforators is consistent and reliable. The flap is thin, pliable and provides stable coverage with adequate match of the surroundings. Donor site morbidity is minimal with no functional loss.Key Words: Superior lateral genicular artery_ Knee defects_ perforator flap.

Impact of Educational Intervention on Nurses’ Knowledge, Practice and Attitude Related Prevention Measures of COVID 19

Background: The COVID-19 pandemic has not only caused highly significant challenges for health systems over the world, but also fueled a surge in misinformation. Nurses as the first member at health team must improve their performance about COVID-19 Research Aim: to assess impact of educational program on nurses’ knowledge, practice and attitude related prevention measures of COVID 19 Methodology: A Quasi-experimental research design was utilized from July 2020- November 2020 conducted at Shebin El Koum teaching Hospital and Menofia University Hospital for 50 nurses. A self-administered questionnaire containing four parts (characteristics, knowledge part, Attitude Rating Scale and nurses’ practice) Results: The present study showed mean age of studied nurses was 34.80±4.99 years and 52% of them providing care for COVID-19 patients. 70% of them had poor knowledge at pre intervention, while76% of them had good knowledge at post intervention and only 6% had poor knowledge. Mean score of studied nurses related total attitude at pre intervention was 13.70±3.45, while at post intervention was 25.18±3.66. Total practice, showed that 36% of nurses had competent practice while 90% of them had competent practice at post intervention with p value <0.01 Conclusions: To conclude, the present study reported that educational training program had positive effect on nurses’ knowledge, attitude and practice so hypothesis was accepted.

Effect of Application Bundle Skin Care on Nurses’ Performance and Orthopedic Patients’ Skin Outcome: Quasi-Experimental Study

Treating severe pressure ulcers may consume considerable manpower, time, and medical resources. Pressure ulcers can be avoided and effectively treated when nurses conduct proper skin assessment and care for wounds appropriately. Research hypothesis: There was positive impact of bundle skincare training on nurses' performance and orthopedic patients' skin outcome. quasi-experimental design was utilized at orthopedic units at Shebin El Koum teaching Hospital and Menofia University Hospital. Tools used for data collection were Pre-designed Questionnaire contained on nurses' characteristics, Attitude Rating Scale and Nurses' knowledge, also used Observational Checklist and BRADEN scale. The subject composed of 45 nurses and 90 orthopedic patients. Mean score of total knowledge pre-intervention was 6.83±3.1, while at the post was 9.95±2.1. Also, a mean score of total practice pre-intervention was 7.11±2.6, while at the post was 11.83±3.4, and, a mean score of total attitude pre-intervention was 5.02±2.8, while at the post was 7.82±1.9. Mean score of BRADEN scale at pre-intervention was 12.81±3.04, while at the post was 13.45±1.99. Application bundle skin care had a positive effect on nurses' knowledge, practice and attitude related skincare for orthopedic patients. So, there was an improvement at BRADEN score of patients post-application bundle skincare. Age, gender and previous hospitalization, BMI, and length had positive predictor effect on pressure sore risk. Skincare bundle for orthopedic patients is acceptable and has the potential to improve nursing care.

Evaluation of Post-Thyroidectomy Complications in Autoimmune Thyroid Diseases versus Nodular Thyroid Diseases

Abstract Background: Thyroid surgery had been and was the most common endocrine surgical operations. An accurately per-formed operation on thyroid gland requires both experience and technical ability and is considered by many to be at the zenith of endocrine surgery. When thyroid operations are performed without sufficient interest, training, or experience the incidence of preventable complication is high. The mortality rate of thyroidectomy as reported in several large series approaches zero. The morbidity of thyroidectomy, however continues to be a matter of concern. Recent research suggests that surgeons may differ in their ability to perform this refined surgery with sufficient care. Aim of Study: The aim was to to evaluate of post-thyroidectomy complications in autoimmune thyroid diseases versus nodular thyroid diseases. Patients and Methods: The study was a prospective randomized study which was done over 100 patients suffering from thyroid disease into two groups, group (I) 50 patients presented with autoimmune thyroid diseases, group (II) 50 patients presented with nodular thyroid diseases. The patients was subjected to total thyroidectomy under general anesthesia which was performed in General Surgery Department of Faculty of Medicine, Menofia University in the period from April 2019 to May 2020. Operative time was reported from start of skin incision till closure of the wound. The two groups were followed-up for one month post-operative which is the end point of the study. Results: In cases of group (I); during operations there was difficulty dissection in 30 cases (30/50, 60%), excessive bleeding in 35 cases (35/50, 70%), nerve damage in 5 cases (5/50, 10%), tracheal damage in one case (1/50, 2%). While in group (II) difficulty dissection in 5 cases (5/50, 10%), excessive bleeding in 2 cases (2/50, 4%), nerve damage only in one case (1/50, 2%). And statistical analysis revealed the predominance of operative difficulties and complications in group (I) than in group (II) (p=0.01).In group (I), two cases needed to be reopened for hemos-tasis and bleeding control due to excessive bleeding (2/50, 4%) and two cases need the insertion of tracheostomy tube for either nerve damage or tracheal damage (2/50, 4%). While in group (II) only one case needed insertion of tracheostomy tube due to tracheomalacia with huge swelling (1/50, 2%). And the statistical analysis revealed a significant increase in early post-operative complications than in group (A) than in group (A) (p=0.024). Conclusion: From our study we can concluded that surgery in autoimmune thyroid swelling is more dangerous than in multinodular goiter this is because excessive fibrosis that leads to excessive and vigorous dissection that leads to bleeding and mare traumatic complications.

Adding MERGE Sequence to Routine MRI Examination of the Knee: Is it Valuable?

Abstract Background: Osteoarthritis is a leading cause of disability which has major implications in elderly and public health. Early detection is critical for understanding the disease pro-gression which can contribute in development of new treatment strategies to stop or slow its progression. MRI has excellent soft tissue contrast and advanced techniques have improved its ability to evaluate cartilage morphology and macromolecular changes. Aim of Study: To test the value of adding T2 MERGE sequence to the routine (MRI) protocol of the knee for early detection of cartilage changes around the knee. Patients and Methods: We retrospectively evaluated the images of 107 patients (64 male and 43 female) age ranged between 23-52 years (mean 43.52) who underwent MRI examination of the knee at Menofia University Hospital between June 2019 and February 2020. Results: Our study was a retrospective study done between June 2019 and Feb. 2020 on 107 patients. The patient's age ranged from 23 to 67 years with the mean age 45.6±12.7 years. The study included 64 males and 43 females. There was slight agreement between T2WI and surgical grading (k0/172, p < 0.001), while there was total agreement between 3D merge and surgical grading (k1.00, p < 0.001). 3D MERGE had 100% sensitivity, 100% PPV and 100% overall accuracy compared to Arthroscopic findings. Conclusion: Adding MERGE sequence to the routine protocol of knee MRI has improved sensitivity for detection of early cartilage lesions.

Ab externo 240-degree trabeculotomy versus trabeculotomy–trabeculectomy in primary congenital glaucoma

This prospective study aimed to compare the surgical outcomes of ab externo 240-degree trabeculotomy and trabeculotomy-trabeculectomy in managing primary congenital glaucoma (PCG). The study included 30 eyes of 30 patients aged less than 3 years who were diagnosed with PCG and was conducted in Menofia University Hospital between November 2018 and January 2020. The studied eyes were divided into two equal groups. Ab externo 240-degree trabeculotomy and combined trabeculotomy with trabeculectomy with MMC were performed for groups I and II, respectively. Post-operative measurements included intraocular pressure (IOP), optic disc changes, alteration in corneal clarity and transverse corneal diameter, as they are needed for antiglaucoma therapy. Post-operative complications were followed up for 1-year. There was significant reduction in IOP in both groups during the follow-up period. The reduction was higher in group I, where mean preoperative IOP was 28.20 ± 1.74 mmHg. The IOP in the group II was 28.07 ± 3.51 mmHg. The mean IOP decreased to 13.93 ± 1.8 mmHg and 14.60 ± 1.24 mmHg in groups I and II, respectively, after 1 year (P < 0.001); however, the difference between the two groups was not significant. Regarding post-operative complications, post-operative hypotony was more common in group I. Other complications such as shallow anterior chamber, choroidal detachment and blebitis occurred more frequently in group II. However, post-operative hyphema was more common in group I. Corneal clarity improved significantly in both groups, but more so in group I, where an improvement was seen in 13 cases (86.6%), compared to 11 cases in group II (73.3%). Ab externo 240° trabeculotomy and trabeculotomy-trabeculectomy are effective techniques in primary congenital glaucoma with more reduction in IOP in Ab Externo 240° trabeculotomy. Ab externo 240° trabeculotomy provided more better surgical outcome with limited complications, especially those related to bleb formation.

Tenon Capsule Grafting versus Autologous Scleral Graft in Ahmed Glaucoma Valve Surgery.

Objective To compare between the surgical outcomes of Tenon capsule grafting and autologous scleral graft in Ahmed glaucoma valve (AGV) surgery in the management of refractory glaucoma and prevention of tube exposure. Patients and Methods. This prospective randomised study included 30 eyes of 30 patients with refractory glaucoma, who were aged between 46 and 58 years and diagnosed with refractory glaucoma. This study was conducted in Menofia University Hospital between July 2018 and December 2019. Informed patient consent was obtained. The studied eyes were divided into two groups: the first group included 15 eyes for which AGV with Tenon capsule grafting was performed, while the second group included 15 eyes for which AGV with autologous scleral graft was performed. All patients were followed up for one year after the surgery. The outcomes were evaluated according to intraocular pressure (IOP) and the number of postoperative glaucoma medications. Visual acuity, visual field, number of postoperative glaucoma medications, and postoperative complications were followed throughout the 1-year follow-up period. Results There was a significant reduction in IOP in both groups, with more reduction in the Tenon graft group where the mean IOP after one year was 11.66 ± 0.89 mmHg, whereas in the scleral graft group, the mean IOP was 14.20 ± 4.0 mmHg (p value < 0.001). However, the difference between the 2 groups in lowering IOP was insignificant. Regarding postoperative complications, tube exposure was observed in one case in the scleral graft group with associated scleral melting and hypotony, postoperative hypotony was more in the scleral graft group with 3 cases (20%), and in the Tenon graft group, hypotony occurred only in 1 case (6.67%). In addition, less vascular blebs were seen in most cases in the Tenon graft group, while most blebs seen in the scleral graft group were vascular blebs. In addition, both groups showed stability in terms of visual acuity and visual field. Conclusion Tenon capsule grafting and autologous scleral grafting might be effective and safe techniques when applied with AGV in the management of refractory glaucoma. Tenon capsule resection with grafting showed relatively low incidence of tube exposure and hypertensive phase.

تحسين جودة الحياة الوظيفية لأعضاء هيئة التدريس بجامعة المنوفية باستخدام مدخل التمکين

هدف هدف البحث الحالي إلى تحسين جودة الحياة الوظيفية لأعضاء هيئة التدريس بجامعة المنوفية باستخدام مدخل التمکين، وذلک من خلال التعرف على الإطار المفاهيمي لجودة الحياة الوظيفية ومداخل تحسينها، والإطار المفاهيمي لتمکين أعضاء هيئة التدريس وأهميته في المؤسسات الجامعية، وقد استخدمت الباحثة المنهج الوصفي لمناسبته لموضوع البحث وطبيعته، وقد تکونت عينة البحث من عدد (244) عضوا من أعضاء هيئة التدريس بجامعة المنوفية، ولتحقيق هدف البحث قامت الباحثة بتصميم استبانة کأداة للتعرف على واقع جودة الحياة الوظيفية لأعضاء هيئة التدريس بجامعة المنوفية، وکذلک التعرف على درجة موافقتهم على آليات تحسينها باستخدام مدخل التمکين وفقا لآراء أعضاء هيئة التدريس بجامعة المنوفية، وتم استخدام التکرارات، والنسب المئوية، والمتوسطات الحسابية، والانحرافات المعيارية، والترتيب، اختبار (ت) T-Test، واختبار تحليل التباين أحادى الاتجاه ANOVA one way، اختبار LSD، واستخدام معامل الارتباط لبيرسون، ومعامل ألفا کرونباخ. وقد أسفر البحث عن مجموعة من النتائج أهمها: إن واقع جودة الحياة الوظيفية لأعضاء هيئة التدريس بجامعة المنوفية جاء بدرجة متوسطة، اتفاق أعضاء هيئة التدريس بجامعة المنوفية بدرجة کبيرة على آليات تحسين جودة الحياة الوظيفية لديهم باستخدام مدخل التمکين نظرا لما يوفره من آليات هامة لتحسين جودة الحياة الوظيفية لديهم، واقع جودة الحياة الوظيفية لأعضاء هيئة التدريس بجامعة المنوفية يختلف باختلاف الدرجة الوظيفية لصالح (الأستاذ)، وسنوات الخبرة لصالح (الأکثر من 20عاما). The aim of the current research is to improve the quality of the career life of faculty members at Menofia University by using the empowerment approach, by identifying the conceptual framework for the quality of career life and the approaches to improving it, and the conceptual framework for empowering faculty members and its importance in university institutions, and the researcher has used the descriptive approach to its relevance to the subject and nature of the research The research sample consisted of (244) members from the faculty members at Menofia University, and to achieve the goal of the research, the researcher designed a questionnaire as a tool to identify the reality of the quality of the career life of faculty members at Menofia University, as well as to identify p To the extent of their approval of the mechanisms to improve them using the empowerment entrance, according to the opinions of the faculty members at Menofia University, iterations, percentages, arithmetic mean, standard deviations, ranking, T-Test, and ANOVA one way, test were used. LSD, use of the Pearson correlation coefficient, and the Alpha Cronbach coefficient. The research resulted in a set of results, the most important of which are: The reality of the quality of the career life for faculty members at Menofia University came at a moderate degree, the agreement of faculty members at Menofia University to a large degree on the mechanisms to improve the quality of their career life using the entrance to empowerment due to the important mechanisms it provides to improve the quality of life The job they have, the reality of the quality of the career life of the faculty members at Menofia University varies according to the job grade in favor of (Professor), and years of experience in favor of (more than 20 year).

Dietary Rehabilitation Effectiveness On Coronary Artery Diseases Patient's Outcomes

Background: Heart disease (Coronary artery disease) is a major health problem and is behind so many other causes of death throughout the world. Cardiac rehabilitation is designed to optimize an early intervention for heart disease. It was reported that participation in cardiac rehabilitation is associated with about 20% lower cardiovascular mortality and morbidity. Aim of this study was to determine the impact of dietary modification teaching program on the compliance and recovery outcomes of patients with coronary artery diseases. Methods: The study was conducted at the cardiac care unit and the cardiac outpatients.Clinics at Menofia University and Shebien El- koom teaching hospitals. A deliberately chosen sample of 60 adult patients with coronary artery dysfunction was divided into two equal groups. All patients in both groups were assessed to collect the baseline data using the designed tools. Patients in the study group received a dietary modification teaching program including oral instructions supported with booklet and demonstration. Three sessions were given to each patient; each for at least 45 minutes. Patients in the control group follow the routine hospital care without any interference from researchers. Patients in both groups were reevaluated after two- and three-months post-discharge for nutritional status, cardiac manifestation, and compliance. Results: The consumption of total calories, fats, cholesterol and sodium were significantly lowered among study than the control group. The cardiac, respiratory, integument, gastrointestinal and neurological manifestations significantly improved in the study group more than in the control group. Conclusion: The recovery outcomes were improved among coronary artery disease's patients who received the dietary modification teaching program than those who exposed only to routine hospital care. Recommendation: Supervised dietary modification teaching program should be carried out for patient's in the outpatients clinics to improve their dietary compliance and recovery outcomes.

1599P - The relation between the symptom burden of hospitalized patients with incurable cancer and the quality-of-life of their family caregivers

BackgroundFamily caregivers (FCs) play important roles in the care provided to patients with incurable cancer. These patients experience a wide range of distressing symptoms. This symptom burden may add to the burden of FCs and consequently may have a negative impact on their quality of life (QoL). This study was conducted to determine the relationship between the symptom burden in a cohort of patients with incurable cancer and the QoL of their FCs. MethodsThe study included 94 dyads of hospitalized incurable cancer patients and one of their FCs. The symptom burden among patients was assessed using the revised Edmonton Symptom Assessment System (ESAS-r) and the QoL of their FCs was measured using the Medical Outcomes Study 36-Item Short-Form (MOS SF-36) questionnaire. ResultsNausea was the most common symptom to associate with poorer QoL scores. There was a significant negative correlation between nausea and the following MOS SF-36 scales: physical functioning (r=-0.219, p=0.034), role limitations due to physical health (r =-0.0228, p=0.027), pain (r=-0.404, p<0.001), general health (r =-0.222, p=0.031) and health change (r=-0.317, p=0.002). Other symptoms that correlated significantly with at least one of the MOS SF-36 scales were weakness, drowsiness, lack of appetite, shortness of breath, depression and wellbeing. The total ESAS-r score correlated significantly with poorer scores on the pain (r=-0.248, p=0.016) and health change (r=-0.311, p=0.002) scales of MOS SF-36. In addition; older FCs age, hours of care per day, total period of care, FCs employment and inadequate income correlated significantly with poorer scores of at least one of the MOS SF-36 scales. ConclusionsThe high symptom burden experienced by patients with incurable cancer may have a negative impact on the QoL of their FCs, especially the physical aspect. Legal entity responsible for the studyClinical Oncology Department, Menofia University. FundingHas not received any funding. DisclosureAll authors have declared no conflicts of interest.

Safety measures between reality and intentions among nursing students regarding needle stick injuries

Objective: The purpose of this study was to describe safety measures between reality and intentions among nursing students regarding needle stick injuries.Methods: Research Design: descriptive study cross sectional design. Setting: The study was carried out at three setting as the following: Faculty of Nursing, Institute of Nursing, School of Nursing at Menofia University, Menofia Governorate, Egypt. Subjects: 150 student nurses were included in the study. Tools for data collection: Interviewing questionnaire comprised of two sections: Demographic information, questionnaire regarding; mechanism of a needle stick injury the nursing students if present, at which stage needle injury occurs and reasons for not reporting that injury from student’s point of view, and safety injection checklist for assessing injection practices among injection providers.Results: Majority of studied sample were female mostly injured at outpatient clinic, medical department. Injury occurred mainly during IV injection, followed by IM injection and recapping needle. The majority of studied subject perceived that the reason of injury of needle stick injury were excitement and fear of Punishment and low grade during evaluation was the most common cause for non- reporting injury of needle stick injuries. Safety Injection Checklist for assessing injection practices among injection providers; showed 18% of study group were unsatisfied practiced while 100% of 3rd group showed satisfied practice.Conclusions: Increasing the awareness about the importance of reporting needle stick injuries is cardinal intervention to take adequate preventive measures for safety and continuous training and awareness program on injection safety to all the student nurses is a necessity for reducing the unsafe practices.

Pedicled perforator flaps for leg reconstruction

Objective The objective of this study was to assess the efficacy of perforator flaps for the reconstruction of an injured leg. Background Defects of the lower limb remain a health problem. Application of perforator flaps for reconstruction of these defects represents a very good option giving good coverage. Patients and methods This was a prospective study. It was performed at Menofia University Hospital and Shebin El-Kom Teaching Hospital during a period of 14 months from February 2017 to March 2018. The study was carried out on 20 patients with leg defects; six types of perforator flaps were used; seven patients were treated by posterior tibial artery perforator flap, seven patients by reversed sural perforator flap, two by peroneal artery perforator flap, two by lateral supramalleolar flap, one by anterior tibial artery perforator flap and one by medial sural artery perforator flap. Results The mean ± SD age of the patients was 36.85 ± 16.60 years. Of 20 patients, 15 (75%) were male individuals and five (25%) were female individuals. The mean ± SD area size of the defect was 43.90 ± 33.47 cm. Of 20 flaps, 14 (70%) flaps had no complications, four (20%) flaps were complicated by distal-end congestion, 18 (90%) flaps passed successfully, and two (10%) flaps were complicated by necrosis and failed to survive. Conclusion Perforator flaps represent an effective method for reconstruction of leg defects, giving good satisfactory, functional and aesthetic results, as leg defects were successfully covered and healed by using perforator flaps, giving normal function and shape of the leg.

A study of Some Medico-Legal Aspects of Fatal Burn Cases Admitted to Menofia University Hospital over Five Years "A Retrospective Study"

A study of Some Medico-Legal Aspects of Fatal Burn Cases Admitted to Menofia University Hospital over Five Years "A Retrospective Study"

Short Term Follow up for Diabetic Patients Presented with Acute STEMI Undergoing Preventive Versus Culprit Lesion in Primary Percutaneous Coronary Intervention

Objectives: This study aimed to evaluate the short term follow up for diabetic patients presented with acute STEMI underwent preventive percutaneous coronary intervention. Background: preventive PCI appears to be safe as culprit artery PCI with effective reduction of refractory angina and repeated revascularization in selected patients but no benefit on mortality or recurrent MI. Methods: Our study was a prospective, observational study conducted at multicenter hospitals included 120 diabetic patients admitted with acute STEMI and multivessels CAD at National Heart Institute, Menofia university hospital, police academy center and some private hospitals patients from June 2017 to august 2018, group (A) Consisted of 70 diabetic patients with acute STEMI undergone preventive PCI in whom PCI will be done for culprit & non culprit lesions, group (B) Consisted of 50 diabetic patients with acute STEMI undergone PCI for culprit lesion only. Results: The total revascularization group were significantly less suffering from refractory angina 5 (7.1%) vs 15 (30.0%), p= <0.001 and less re-hospitalized for cardiac causes 14 (20.0%) vs 22 (44.0%), p= 0.005, cardiac mortality was 2 patients 0 (0.0%) vs 2 (4%) p= 0.092. Conclusion: The preventive PCI appears to be safe as culprit artery PCI with effective reduction of refractory angina and repeated revascularization but no benefit on mortality or recurrent MI in selected hemodynamically stable STEMI diabetic patients with multivessel disease.

Comparison the efficacy and safety between Insulin and Metformin in gestational diabetes mellitus management

Objective The objective of this study was to evaluate the efficacy and safety between insulin and metformin in the management of gestational diabetes mellitus (GDM). Background GDM is a common complication of pregnancy. Blood glucose control improves perinatal outcomes. Medical nutrition therapy is the milestone management. Patients and methods In a prospective randomized comparative study, 240 antenatal women whose pregnancies had been complicated by GDM and did not respond to diet alone were recruited from antenatal clinics at the Obstetrics Department in Menofia University Hospitals and Shebin El-Kom Teaching Hospital from November 2016 to March 2018. They were divided randomly into two groups; 120 patients in each group were subjected to either insulin or metformin medications. Outcomes were comparing the effects of medications on maternal glycemic control, maternal complications and neonatal outcome. Results There was no significant difference in controlling high blood sugar in GDM with the use of insulin or metformin. Maternal complications in both groups had no significant difference, and fetal outcomes were as well similar. Conclusion Glycemic control in GDM can be achieved by using metformin orally without increasing the risk for maternal complications with a satisfying neonatal outcome.

Cardiac Parameters and Interleukin-6 Differences between Adolescents with Hepatitis B Infection versus those Complicated with Hepatocelluar Carcinoma

Background and study aim: Hepatitis B virus (HBV) is a major risk factor of hepatocellular carcinoma (HCC) in all age groups. There is a need to differentiate between them in the adolescence age by laboratory and physical examination for assessment of different outcomes of both diseases. Subjects and Methods: Cross sectional study that included Session [UserIDID] adolescents with HBV, another Session [UserIDID] with HCC with age ranging from 12 and up to 17 years. They were selected from those admitted to Tropical Medicine Department, Menofia University and Tropical Medicine Department, Zagazig University. All patient underwent laboratory assessment of interleukin6 (IL6) and were further examined at the Cardiology Unit in Pediatric department of Ain Shams University hospitals for complete echo-cardiographic and anthropometric evaluation. Results: Twenty four patients have HCC were examined with mean age (14.15± 3.01) years and another Session [UserIDID] are having HBV (14.64±3.13) years. Differences were found between both groups as regards IL6 as mean values were (13.29 pg/ml) in HBV and (77.63 pg/ml) in HCC group while no differences were detected as regards cardiac and anthropometric evaluations. Conclusion: IL6 seems to be a useful marker to compare between HBV and HCC in adolescent patients instead of depending on clinical cardiac evaluation or growth parameters that showed no differences.

A randomized control trial: Effects of teach back method on self-efficacy among mothers of children with congenital heart defects

Background/Objective: Congenital Heart Defects (CHD) remain a major health concern all over the world particularly Egypt where the prevalence of CHD is 1.0 per 1,000. Nurses are instrumental in supplying information. The teach-back method is a technique used for improving patient understanding and outcomes. This study aimed to evaluate the effect of teach back method on self-efficacy and satisfaction among mothers of children with congenital heart defects.Methods: The design of this study was randomized control trail. A sample of 60 children with congenital heart defects and their mothers participated in this study. It conducted at Menofia University hospital. Tools of this study included Self Efficacy Scale; Teach back Discharge Education Audit and Satisfaction Assessment.Results: The current study revealed that the majority of nurses were unfamiliar with teach-back method and there was significant difference between mothers in the experimental and control groups regarding their self-efficacy.Conclusions: This study concluded that mothers who received discharge instructions through teach back method had increased self-efficacy and high level of satisfaction. Therefore, pediatric nurses should integrate teach back method as a routine nursing intervention in the discharge plan for children with congenital heart defects.

Organizational change readiness and manager' behavior in managing change

Background and objective: Organizational readiness refers to organizational members’ change commitment and change efficacy to implement organizational change and confidence in their accumulative abilities to do so. The aim of the study was to assess the nurse managers’ behavior in managing change, and the level of the organizational change readiness at selected hospitals at Menofia Governorate.Methods: Design: A descriptive cross-sectional design was used. Setting: The study was conducted at two hospitals, namely University Hospital and Shebin El-Kom Teaching Hospital, in Menofia Governorate, Egypt. Subjects: It consisted of two groups, Group 1: A convenience sample of 136 staff nurses (67 staff nurses from Menofia University Hospital, and 69 from Shebin El-Kom Teaching Hospital), Group 2: All nurse manager available on the time of the study (31 from Menofia University Hospitals, and 30 from Shebin El-Kom Teaching Hospital). Tools: a) Tool one: Change management process Questionnaire, b) Tool two: Change Readiness Assessment Scale.Results: More than half of the nurse managers reported that they have a good behavior in managing change in the organization, while the staff nurses reported that their managers had a bad behavior during the change process. Organizational readiness level was higher in University hospitals than in Teaching hospital as perceived by the study subjects.Conclusions: The nurse managers and staff nurses reported that the organization had a bad readiness level to change. Additionally there was a positive correlation between organizational readiness and manager behavior in managing change. Recommendations: Organization should have a readiness for change to support the change process by possessing the right resources and conditions, a clear insights and goals for the intended change and have the inventiveness, behavior to participate with the change and develop work. Also, agents of change chiefs and management must need to drive a strong reaction for change from the stakeholders that leads to highest performance improvement.