Screening for diabetes among tuberculosis patients: a nationwide population-based study in Egypt

Background: The prevalence of type 2 diabetes mellitus (DM) is increasing rapidly in Egypt and considered one of the major health problems in the Eastern Mediterranean region. Objectives: To measure the prevalence of diabetes and detect the undiagnosed cases of diabetes mellitus among patient with tuberculosis. Methods: Study Design: Nationwide population-based study. To diagnose DM among TB patients, we used a fasting blood sugar level of ≥ 126 mg/dl and a post-prandial blood glucose test result of ≥ 200 mg/dl. Results: Screening for DM among 1435 TB patients' with no history of DM detected 30 new cases of DM, with a case detection rate of 2.09%. The highest screening yields were among TB patients aged ≥ 40 years, females and those with pulmonary TB. The number needed to screen (NNS) TB patients for detecting one new case of DM was 48 while the lowest values were for older age (NNS=27) and females (NNS=29). Conclusion: Older age and being females and those with pulmonary type of TB were more prone to the double burden of TB and DM. Identifying cases with double burden of diseases will improve the proper management of both diseases and prevent complications.  Keywords: Screening test, diabetes mellitus, tuberculosis

SOLID LIPID NANOPARTICLES AND NANOSTRUCTURED LIPID CARRIERS OF TOLNAFTATE: DESIGN, OPTIMIZATION AND IN-VITRO EVALUATION

Objective: The target of our work is the preparation of tolnaftate (TOL) loaded solid lipid nanoparticles (SLNs) as well as nanostructured lipid carriers (NLCs).Methods: The high shear homogenization method was chosen for the preparation of nanoparticles. The nanoparticle dispersions were prepared using Compritol 888ATO, Tefose 63, Miglyol® 812, Poloxamer188, and Tween80. Particle size (PS), zeta potential (ZP), polydispersity index (PDI), drug entrapment efficiency (EE) and in vitro release study were determined. Differential Scanning Calorimetry (DSC) analysis and morphological transmission electron microscopy (TEM) examination were conducted. A stability study for 3 mo was performed.Results: The results revealed that NLC and SLN dispersions had spherical shapes with an average size between 41.10±1.92 nm and 98.85±1.01 nm. High entrapment efficiency was obtained with negatively charged zeta potential with PDI value ranging from 0.251±0.012 to 0.759±0.028. The release profiles of all formulations were characterized by a sustained release behavior over 24 h and the release rates increased as the amount of liquid lipid in lipid core increased. Tolnaftate loaded NLC showed more stability than its corresponding SLN.Conclusion: It can be fulfilled from this work that NLCs may represent a promising carrier for tolnaftate delivery offering both sustained release and stability.Â

Multicenter screening of diabetic patients for detecting new cases of tuberculosis: An approach to intensify the case detection rate of tuberculosis in developing countries with high prevalence of diabetes

Introduction: Tuberculosis (TB) is a major public health problem in most of developing countries. Meanwhile, the prevalence of type 2 diabetes mellitus (DM) is also increasing rapidly. Objectives: To describe the feasibility of implementing screening test for tuberculosis among diabetic patients and identifying factors associated with high detection rate. Methods: Study Design: Multi-center cross-sectional study. This study was implemented in the governmental healthcare settings. To diagnose TB among diabetics, we used a symptom-based questionnaire that included the symptoms of suspected TB according to the guidelines of National Tuberculosis Program in Egypt. Results: Among 4283 adult diabetics, 14 TB cases were diagnosed; 9 known TB cases and 5 newly detected cases. The number needed to detect one new case of TB was 855. Male diabetics and those suffered from liver disease experienced a significantly higher prevalence of TB and a higher detection rate of new active cases. Conclusions: Screening for TB among diabetics in routine governmental healthcare services was successfully implemented. Screening DM patients in countries with a high prevalence of DM will reveal a significant number of active TB cases, which will in turn improve the case detection rate of TB.

The Role of Physical Environment in Consumers’ Relationship with a Retail Outlet Offering a Regional Product

This paper reports the results of a quantitative study that examined the effect of a store’s physical environment on consumers’ relationship with a retail outlet. The results retained most of our research hypotheses. We found that a design with references to regional products positively influences consumer attachment to the point of sale. However, atmospherics have no significant impact on loyalty to the point of sale

Regional Product Assortment and Customer Loyalty to the Point Of Sale

This paper reports the results of a quantitative study of the effect of regional product assortment on loyalty to the point of sale. In this study, we found that availability of local regional products in an assortment positively influences commitment and loyalty to the point of sale. In addition, we found that commitment mediates the effect of an assortment containing a regional product on loyalty. Finally, we found that it is possible to think of a person attached to a brand without this latter showing an observed loyalty behavior

ENHANCED ENZYMATIC ACTIVITY OF STREPTOMYCES GRISEOPLANUS L-ASPARGINASE VIA ITS INCORPORATION IN AN OIL-BASED NANOCARRIER

Objective: L-asparaginase (L-asp) is a vital enzyme used as a therapeutic agent in combination with other drugs in the treatment of acute lymphoma, melanosarcoma and lymphocytic leukemia. Immobilization of enzymes through loading on nanoemulsion (NE) results in some advantages such as enhancing their stability and increasing their resistance to proteases. Aim of the present study is to formulate L-asp loaded nanoemulsion to enhance its efficiency and thermal stability. Methods: Nanoemulsion loaded with L-asp crude extract (specific activity 13.23U/mg protein) was prepared employing oleic acid as oil, tween 20/tween 80 as surfactants and propylene glycol (PG) as co-surfactant. L-asp loaded NE underwent several thermodynamic stability studies and the optimized formulae were further examined for their biochemical properties and thermal stability. Results The developed formulations were spherical in shape and their sizes were in the nanometric dimensions with negatively charged zeta potential values. Upon comparing the enzyme activity of L-asp loaded NE employing tween 20 (F1) or tween80 (F4) at different concentrations, the results revealed that F4 NE showed higher enzymatic activity [323 U/ml] compared to F1 NE [197 U/ml] at the same concentration. The nanosized immobilized L-asp was more stable in the pH range from 8 to 8.5 as compared to free L-asp. The immobilized enzyme preserved about 59.11% of its residual activity at 50 °C; while free L-asp preserved about 33.84%. Conclusion: In the view of these results, NE composed of oleic acid, tween 80 and PG represents a promising dosage form for enhancing the activity and stability of Streptomyces griseoplanus L-asp

Mental Health Problems and Sociodemographic Correlates in Elderly Medical Inpatients in a University Hospital in Egypt

Background. Depression and cognitive impairment are two common mental and public health problems especially among elderly. In this study, we determined the prevalence of these problems and their associations with sociodemographic factors among hospitalized elderly in Egypt. To achieve this, 200 elderly medical inpatients were included in this cross-sectional study. Methods. Comprehensive geriatric assessment was done for every participant. Sociodemographic variables were assessed by interviews with patients and their family members. Depressive symptoms were screened for by the 15-item Geriatric Depression Scale (GDS), and the presence of depressive symptoms was defined as a GDS score of ≥6. Cognitive impairment was assessed by the Mini-Mental State Examination (MMSE) Scale, and cognitive impairment was defined as a MMSE score of ≤23 out of a total score of 30. Results. The prevalence of both depressive symptoms and cognitive impairment was 72% and 30%, respectively. Significant associations were noticed between each of depressive symptoms and cognitive impairment, and low income and advancing age (), respectively. Other associations were insignificant. Conclusions. The findings of this study may be an alarm for health authorities and staffs involved in elderly care to increase their awareness of social and mental health problems among the elderly

Usefulness of Sunlight and Artificial UV Radiation Versus Chlorine for the Inactivation of Cryptosporidium Oocysts: An in Vivo Animal Study

BACKGROUND: Cryptosporidium is an important waterborne protozoan.AIM: The aim of this study was to investigate the effect of sunlight being the natural source of UV and artificial UV irradiation on Cryptosporidium oocysts versus the effect of chlorination, being the traditional method of water disinfection and to provide an insight into the viability and degree of infectivity of Cryptosporidium oocysts, using an animal model.METHODS: An experimental study including 300 neonatal mice was carried out to investigate the effect of artificial ultraviolet (UV) irradiation and sunlight being the natural source of UV irradiation versus chlorine, the traditionally used water disinfectant on the infectivity of Cryptosporidium oocysts present in water. For each item, nine different exposure times were investigated. Parasitological assessment (Modified Ziehl Neelsen stained stool smears) and histopathological assessment of the excised segments of the small intestine (stained by both Haematoxylin & Eosin and ZN stain) of mice were used to verify the inactivation of oocysts.RESULTS: Cryptosporidium oocysts failed to induce any noticeable infection after 4 hours of artificial UV exposure that provided a UV dose of 10mJ/cm2 and after an 8 hours exposure to sunlight, whereas they showed resistance to disinfection by chlorine.CONCLUSION: The results of the study demonstrate the important role of an 8 hours sunlight exposure of potable water in plastic bottles in achieving complete inactivation of any contaminating Cryptosporidium oocysts, thus offering an applicable, economical and convenient method for the control of cryptosporidiosis especially in developing countries

The Role of Religion on Suicidal Behavior, Attitudes and Psychological Distress in University Students: A Multinational Study

The purpose of this study was to determine the association of religion to suicidal behavior, attitudes and psychological distress in 5572 students from 12 countries by means of a selfreport questionnaire. Our results showed that an affiliation with Islam was associated with reduced risk for suicide ideation, however affiliating with Orthodox Christianity and no religion was related to increased risk for suicide ideation. While affiliating with Buddhism, Catholic religion and no religion associated with lowered risk for attempting suicide, affiliation with Islam was related to heightened risk for attempting suicide. Affiliation with Hinduism, Orthodox Christianity, Protestantism, Catholicism, other religions and with no religion was associated with decreased risk for psychological distress but those reported affiliating with Islam evinced greater risk for psychological distress. The associations of the strength of religious belief to suicidal ideation and attempts were in the expected direction for most but it had a positive relation in respondents affiliating with Catholicism and other religions. Students reporting affiliation with Islam, Orthodox religion and Buddhism were the least accepting of suicide but they displayed a more confronting interpersonal style to an imagined peer with a suicidal decision. It was concluded that the protective function of religion in educated segments of populations (university students) and in university students residing in Muslim countries where freedom from religion is restricted or religion is normative and/or compulsory is likely to be limited. Our findings suggest that public policies supporting religious freedom may augment the protective function of religion against suicide and psychological distress