Effect of Psycho-educational Intervention on Burden and Quality of Life Among Family Caregivers of Schizophrenic Patients

Introduction: Schizophrenia is a disturbing and stressful disorder for both the patient and his caregiver. Psycho-educational intervention is believed to efficiently meet the informational needs of families to improve their quality of life when caring for a family member with schizophrenia, thereby reducing the patient’s relapse from the disorder. Aim: The study aimed to determine the effect of the psycho- educational intervention on burden and quality of life among caregivers of schizophrenic patients. Methods: A quasi-experimental research design [pretest -posttest] was used in the current study,  The subjects consisted of  50 caregivers of hospitalized schizophrenic patients, who were selected according to the inclusion criteria. The study was carried out at the in-patient psychiatric department of the Mansoura University Hospital. The instruments used for data collection were, Socio-demographic and Clinical Data Structured Interview Schedule, The Zarit Burden Interview and Quality of life scale. Results: There was a statistically significant difference in mean scores of the burden and quality of life between pre and post the intervention. Conclusion: Burden and quality of life of caregivers of patients with schizophrenia improved significantly after the psycho-educational intervention. Recommendation: Caregivers of schizophrenic patients should be counseled and encouraged to participate in psycho-educational programs to understand unnecessary behavioral changes and to to improve their burden and quality of life. Keywords: schizophrenia, caregivers, burden, quality of life, psycho-educational intervention DOI: 10.7176/JHMN/63-09 Publication date:June 30th 201

Blood Pressure and Blood Pressure Deficits as Predictors of Acute Kidney Injury in Vasopressor Dependent Patients Post Cardiovascular Surgery

BACKGROUND: Acute kidney injury (AKI) is a common and serious post-operative complication following cardiovascular surgery. AIM: The aim of the study was to evaluate the value of blood pressure and blood pressure deficits as predictors of AKI in post cardiovascular surgery vasopressors’ dependent patients. METHODS: A prospective observational, single center study, conducted on 100 patients requiring vasopressor support for more than 4 h after cardiovascular surgery. All included patients were subjected to the measurements of three or more systolic arterial pressure (SAP), diastolic arterial pressure (DAP), and mean arterial pressure (MAP) readings from the ward charts before surgery and the mean of these measures was calculated, was recorded and pre-operative systolic perfusion pressure (SPP), diastolic perfusion pressure (DPP), and mean perfusion pressure (MPP) were calculated. A vasopressor-associated average values for hemodynamic pressure-related parameters (SAP, DAP, MAP, CVP, SPP, DPP, and MPP) were calculated on the 1st 24 h after admission. The percent deficit in post-operative average parameters in relation to pre-operative parameters was determined as % parameter deficit. RESULTS: The pre-operative SAP, DAP, MAP, SPP, DPP, and MPP were significantly higher in the non-AKI compared to AKI patients while pre-operative central venous pressure (CVP) was significantly higher in AKI patients. The post-operative DAP, MAP, DPP, and MPP were also higher in non-AKI and the post-operative CVP was lower in non-AKI compared to AKI patients. CONCLUSIONS: This study concluded that the relative decrease in the perfusion pressures could be significant predictors of AKI after cardiovascular surgery in vasopressor dependent patients. The higher pre- or post-operative CVP or its relative decrease after cardiac surgery was seen also to be associated with higher incidence of AKI

Self -Compassion and Self-Efficacy Among Academic Nursing Staff: Relationship Approach

Self-compassion may help academic staff experience the relationship benefits associated with high self- efficacy. Hence, relationship self-efficacy is positively associated with changes in relationship satisfaction.  Aim of the study: This study aimed to assess the relationship between self-efficacy, and self-compassion and socio demographic data among academic nursing staff in Mansoura University, Egypt. Research Design: A descriptive design. Tools of data collection: three tools were used to collect data; 1- Data interview questionnaire .2-Neff self -compassion scale, 2011 3- General self- efficacy scale by (Schwarzer and Jerusalem, 1995). Results: The total mean score of self- compassion was 37.3±7.2. It is also observed that mindfulness subscales obtained a higher mean score X±SD =8.3±6.5, followed by Common-humanity subscale X±SD =6.7±1.6, Self- kindness had a mean score of X±SD = 6.6±1.2.General self -efficacy scale, total mean score was 30.3±4.4. There were significant positive correlation between self- kindness subscale and general self -efficacy P=.000. Also there is statistical significant negative correlation regarding Self- judgment, and general self –efficacy= 0.000. Conclusion: Self -compassion was moderate among academic nursing staff while Self- efficacy was higher among them. Self -efficacy significantly correlated with self- kindness and negatively with self -judgment. Key words: Academic nursing staff, self -compassion, self -efficacy. DOI: 10.7176/JHMN/62-05 Publication date:May 31st 201

Right mini-thoracotomy versus median sternotomy for mitral valve replacement

Background: The advantages of minimally invasive mitral valve surgery over the conventional approach is still debated. This study aimed to evaluate early outcomes after mitral valve replacement (MVR) using the right mini-thoracotomy (RMT) versus median sternotomy (MS). Methods: We prospectively included 60 patients who had MVR from May 2015 to June 2017. We classified patients into two groups; Group A (n= 30) had RMT, and Group B (n= 30) had MS. Postoperative pain score, wound satisfaction, and clinical and echocardiographic outcomes were compared between both groups. Results: The mean age was 39.90 ± 12.34 years in Group A and 45.75 ± 13.10 years in Group B (p= 0.08). Preoperative and echocardiographic data showed no statistical significance difference between the groups. Group A had longer aortic cross-clamp (118.85 ± 40.56 vs. 70.75 ± 24.81 minutes, p<0.001) and cardiopulmonary bypass times (186.70 ± 67.44 vs. 104.65 ± 42.60 minutes, p<0.001).  Group B had more blood loss (565 ± 344.3 vs. 241.5 ±89.16 ml/24 hours, p<0.001). The median pain score was 1 (range: 1- 3) in Group A and 4 (2- 8) in Group B (p<0.001), and the median wound satisfaction was 1.5 (1- 4) in Group A and 4 (1- 7) in Group B (p<0.001).  Wound infection occurred in 1 (3.3%) patient in Group A and 6 (20%) patients in Group B (p=0.04). Conclusion: Mitral valve replacement through the right mini-thoracotomy could be a safe alternative to median sternotomy. The right mini-thoracotomy was associated with longer operative times but better pain and wound satisfaction scores and lower wound infection

Neuro-Symbolic AI: A Probabilistic Perspective

The last decade has witnessed an explosion of interest in Artificial Intelligence, not only among researchers, but also in the public eye. This has led to machine learning (ML) systems being increasingly deployed in domains with high personal and societal impact. Consequently, there’s a growing need to reason about the behavior of these machine learning systems, with the ultimate goal of mitigating unwanted behaviors, ensuring reliable outputs, and fostering trustworthy interactions with the end user. This dissertation lays the foundations for reasoning about the behavior of such systems, especially when we have access to domain knowledge—sets of rules, or constraints, that characterize the set of valid predictions given the problem at hand. In particular, a core contribution of this dissertation is viewing ML systems as inducing probability distributions over output spaces. To reason about the behavior of these systems, one must then reason about the behavior of the underlying probability distributions. Building upon that perspective, the dissertation begins by developing methods that minimize the probability of ML systems producing invalid outputs, even when the constraints and distributions are theoretically intractable. It then goes further, developing methods that provide guarantees on the outputs of these ML systems, developing probabilistically-sound approaches to gradient estimation when the constraints are embedded within the architecture. The developed methods make use of tractable circuits whose structure differs from that of typical ML architectures. This dissertation, therefore, develops frameworks for expressing constraints as Python functions that can then be efficiently computed on GPUs. Lastly, this dissertation showcases the scalability and efficacy of the developed methods on real-word applications

l-Methioninase from some Streptomyces isolates I: Isolation, identification of best producers and some properties of the crude enzyme produced

Among 60 isolates of Streptomyces tested; only 40 isolates were capable to utilize l-methionine as the only source of nitrogen in medium. In addition, 24 of these isolates could grow in medium amended with l-methionine as a source of nitrogen and carbon. Qualitative rapid plate assay test shows the ability of 18 of these isolates to grow with a pink color surrounding their colonial growth, while 6 of these isolates could grow and utilize l-methionine without any pink color around their colonial growth. Quantitative assay test shows the rate of l-methioninase production by all isolates tested. Permeabilization treatment including chemical and physical methods proved that l-methioninase was found to be extracellularly produced. The results also indicate that l-methioninase production was not correlated with growth rate or l-methionine consumption in medium. On the other hand, quantitative assay test shows that these six isolates were l-methioninase negative and failed to produce any amount of l-methioninase. In addition, results also show that isolates No. 4 and No. 60 were the most suitable for l-methioninase production, these two isolates were characterized and identified as Streptomyces sp. DMMMH 4 and Streptomyces sp. MDMMH 60 using 16S rRNA with accession No. in gene bank. Furthermore, optimal conditions for enzyme activity produced by the two isolates were established in relation to temperature, pH, reaction time and type of buffer used and its molarities

Tips and tricks in surgical management of maxillary sinus tumors

Background: 3% of head and neck carcinomas are sinonasal malignancy. Aim of study: Epidemiological evaluation of cancer maxilla in National Cancer Institute, Cairo University with emphasis on surgical strategy and intraoperative assessment of tumor extension that augment the oncologic, functional and esthetic results after resection of tumors of the maxilla. Patients and methods: 30 patients diagnosed as malignant maxillary tumor in the surgical department, National Cancer Institute, Cairo University in the period from October 2012 to May 2016. Results: In this study the most commonly recorded pathological diagnosis was squamous cell carcinoma 14 patients (46.7%). Most of the patients were presented with delayed presentation, in this study stage IVa was the most frequent stage (detected in 15 patients accounting for 50%). The overall survival of the studied cases was estimated using Kaplan-Meier survival estimate. It was of mean 22 months. The 2 year survival rate for the overall studied cases was 40% During the follow up period, local recurrence was recorded in 12 patients in this study (40%). Distant metastases were detected during follow up in two patients in this study (6.6%). Conclusion: Fine intraoperative surgical maneuvers can obtain secured resection margin (with special attention to adenoid cystic carcinoma); avoid postoperative functional complications like trismus, nasal regurgitation of food, epiphora or double vision finally enhance esthetic result