Factors Predisposing to Organ (s) Dysfunction among Critically Ill Adult Patients at a Selected University Hospital in Egypt

Multiple organs dysfunction is one of the most challenging clinical problems in the intensive care units. It is one of the leading causes of morbidity and the main cause of mortality in critically ill patients. Therefore, requires efforts of of the health care team especially critical care nurses who are the healthcare providers and most closely involved in the daily care of critically ill patients. They have the opportunity to early detect and identify patients at risk for the development organs dysfunction. Aim of the study: to identify factors predisposing to organ(s) dysfunction among critically ill adult patients at a selected university hospital. Research questions: Q1-What is the frequency of organ dysfunction among critically ill adult patients at a selected university hospital, in Egypt? Q2-What are diffrent predisposing factors to organ dysfunction among critically ill adult patients at a selected university hospital, in Egypt?. Research design: A descriptive/exploratory research design was utilized. Sample: A sample of convince consisting of 110 adult male and female critically ill patients admitted to to different intensive care units over a period of six months was included. Tools of data collection: Four tools were utilized for data collection: Sociodemographic and Medical data Sheet; Predisposing Factors to Organ (s) Dysfunction Assessment Sheet; Physical Assessment Sheet; and The Sequential Organ Failure Assessment score (SOFA). Results: The current study revealed that: more than half (55.5%) of the studied sample had two organs dysfunction, of these (n=33/54.1%) were in age group from 58 - < 68, with no significant statistical relationship between the age and frequency of organs dysfunction (?2/P = 20.24/0.20). Infection, heart failure, hypertension, and diabetes were the common predisposing factors to organ(s) dysfunction in percentages of 63.6%, 30.2%, & 22% respectively. Mild degree of organs dysfunction were most frequently noticed on admission, after 24 and 96 hours of admission to the ICU with mean SOFA scores of 5.08 ± 1.601, 4.87± 1.86, & 5.00 ± 1.87 respectively. The mean total and subtotal SOFA scores didn’t differ significantly in different assessment times (F / P= 1.29/0.35, 3.63/0.10, 2.69/0.72). The fate of the studied sample differed significantly in relation to the total mean SOFA scores (?2= 54.96, p= 0.000). Conclusion: multi-organ(s) dysfunction was evident among critically ill patients. The most common predisposing factors were comorbidity diseases, infection on admission, after 48 and 96 hours of admission, having different types of shock, and trauma. So, identification and management of these predisposing factors may decrease the complication and improve patients' outcomes. Recommendations: Based on findings of the present study the following are recommended: strict application of universal precautions / infection control measures; prevention, and early detection of shock, sepsis, and so organ dysfunction; designing continuous practical educational programs about the application of the strict aseptic technique, the universal precautions and infection control for critical care nurses; Designing booklets and posters about early manifestation, predisposing factors, and importance of prevention of sepsis and organ dysfunction for critical care nurses; and utilization of SOFA scores in the management of patient with sepsis and organ dysfunction. Key words: Predisposing factors, Organ(s) Dysfunction, Critically Ill Patients, Sepsis, SOFA scores

Improvement in Production, Fruit Quality and Water Use Efficiency of Three Tomato Cultivars by Foliar Application of Tecamin Flower® Under Water Deficit Conditions

During drought, chemical elements in a fertilizer go into solution in the soil with difficulty and nutrients are less available to plants. Foliar fertilization with water soluble Tecamin flower®, a product containing chemicals needed by plants, compensates for nutrient deficiency by roots due to water deficit. The study was undertaken to evaluate impacts of foliar application of Tecamin flower® at 0 or 2.5 ml/l and deficit irrigation (50 or 100% of field capacity) in tomato (Solanum lycopersicum L.) cvs. Bobcat, Finenss and Hadeer. The results showed that ‘Bobcat’ cultivar produced the highest vitamin C content, fruit firmness and total yield. ‘Finenss’ had the highest total soluble solids and water use efficiency (WUE). ‘Hadeer’ had the highest titratable acidity and the lowest pH. Plants irrigated at a 50% rate produced the highest vitamin C content, total soluble solids, fruit firmness and the lowest pH. 100% irrigation resulted with the highest yield and WUE. The plant treated with 2.5 ml/l Tecamin flower® produced the highest vitamin C content, total soluble solids, titratable acidity, fruit firmness, total yield, WUE and the lowest pH. Foliar application of Tecamin flower®, regardless of cultivar, improved production, fruit quality and WUE of tomato under normal and water deficit conditions and played a role in alleviating the negative impact of water deficit

An integrated mediating and moderating model to improve service quality through job involvement, job satisfaction, and organizational commitment

Employees’ perception of their job and organization is believed to influence service quality (SQ). Hence, this study aims to integrate a mediating and moderating model to improve SQ through job involvement (JI), job satisfaction (JS), and organizational commitment (OC), and investigate how that model incorporating JI, JS, and OC can improve SQ in higher education contexts in developing countries. This study applied a conceptual integration between employees who provide the service and customer-perceived service quality. Data collection from the respondents was performed using a two-sample research design and two sets of questionnaires. The academic staff (296 responses) and their students (1480 responses) formed the study’s sample size. Structural Equation Modelling (SEM) was used to analyze the collected data. The data analysis showed a significant impact of JS on OC and SQ (i.e., the quality of lectures they received in the classroom that shaped their learning experiences). OC significantly affected SQ and partially mediated the effect of JS and SQ. JI plays a moderator role in the JS-OC and SQ relationship. This study contributes to the literature by linking employees’ JI, JS, and OC to SQ. Employee JI, JS, and OC are crucial in promoting service quality. Practical implications for students, employees, institutions, and society were provided

Tecamin flower® foliar application to alleviate water deficit effects on growth, yield and water use efficiency of tomato

During drought chemical elements in a dry fertilizer go into solution in the soil with difficulty and the nutrients are less available to the plant. Foliar fertilization with Tecamin flower®, could compensate for nutrient deficiency due to water deficit. This study was designed to observe the effects of different application rates of foliar application of Tecamin flower® on growth, yield and field water use efficiency (CWUE) of tomato under water deficit. The field experiment was conducted from March till July 2016 at the teaching and research farm of Diyala University, Iraq. Performance of tomato genotype 'Bobcat', 'Finenss' and 'Hadeer' was assessed by foliar application of Tecamin flower® at (0 and 2.5 mL L-1) and two irrigation levels (50 and 100% based on field capacity). The results showed that chlorophyll content, fruit weight, yield per plant, total yield and CWUE were significantly affected by genotype and irrigations levels and application of Tecamin flower®. 'Bobcat' genotype has the highest value of plant yield (3.39 kg) and total yield (90.19 t ha-1). 'Finenss' has the highest values for number fruit per plant (40.75), CWUE (75.37 kg m-3) and the minimum leaf proline content (2.584 mg g-1). Plant irrigated at 100% had the highest value of number fruit (35.27 fruit), most yield per plant (3.53 kg), total yield (94.02 t ha-1) and minimum leaf proline content (2.557 mg g-1). The highest CWUE (84.50 kg m-3) were at 50% level. Plant treated at 2.5 mL L-1 Tecamin flower® had most fruit/plant (37.61) yield per plant (3.73 kg), total yield (99.16 t ha-1), CWUE (85.22 kg m-3) and minimum leaf proline content (2.437 mg g-1)

Improvement of cyclodextrin glycosyltransferase gene expression in Escherichia coli by insertion of regulatory sequences involved in the promotion of RNA transcription

Regulation of RNA transcription in controlling the expression of genes at promoter and terminator regions is crucial as the interaction of RNA polymerase occurred at both sites. Gene encoding cyclodextrin glycosyltransferase (CGTase) from Bacillus sp. NR5 UPM isolated in the previous study was used for further construction of pTZCGT-SS, pTZCGT-BS and pTZCGT-BT expression systems for enhancement of CGTase production. The putative promoter regions, −35 and −10 sequences were found in the upstream of the mature gene start codon. Whereas, long inverted repeats sequences which can form a stable stem and loop structure was found downstream of the open reading frame (ORF) of Bacillus sp. NR5 UPM CGTase. The construction of E. coli strain harbouring pTZCGT-BS showed increment of 3.2-fold in CGTase activity compared to the wild type producer. However, insertion of terminator downstream of CGTase gene in E. coli strain harbouring pTZCGT-BT only resulted in 4.42 % increment of CGTase production compared to E. coli strain containing pTZCGT-BS, perhaps due to low intrinsic termination efficiency. Thus, it is suggested that the insertion of the putative promoter regions upstream of the coding sequence for the construction of CGTase expression system will further enhance in the recombinant enzyme production

Performance analysis of a pv/fc hybrid system for generating electricity in Iraq's remote areas

A reliable electrical energy supply is a prerequisite for improving the standard economic and quality of life levels in a country. As is the case in many countries, Iraq is home to a collection of remote villages. Since it is uneconomical to connect these villages to the existing grid, the installation of standalone electrical power generators has become common practice. As a result, diesel stand-alone power generators see widespread use in these remote locales, which, whilst fit for their intended purpose, unfortunately suffer from several drawbacks, including instability in regards to everyday oil prices and a number of environmental issues. The implementation of a PV/FC hybrid power system could be one potential alternative to help solve these problems. Therefore, this paper will present PV/FC system control strategies alongside information relating to the performance of such system components, based on a case study that was conducted in Al-Gowair, Iraq. This study is especially important in terms of envisioning the future energy supply needs of Iraq. The HOMER simulation results showed that by using the proposed control strategies and suggested components of a PV/FC system, it was able to produce a satisfactory outcome

Effects of polyvinylpyrrolidone on structural and optical properties of willemite semiconductor nanoparticles by polymer thermal treatment method

Willemite is an inorganic semiconductor material used for optoelectronic applications. The present study purposes a new polymer thermal treatment method involving calcination temperature to fabricate the willemite nanoparticles. The effects of polyvinylpyrrolidone (PVP) on the structural and optical properties of the material were thoroughly investigated. Thermogravimetric and its derivative confirmed the decomposition behavior of PVP. The minimum calcination temperature to decompose PVP was appraised at 740 °C. The FTIR and the Raman analyses confirmed the presence of organic source before the calcination process and the formation of the crystalline structure of the willemite nanoparticles after the heat treatment. The optimum PVP concentration in this study based on the FTIR results was found to be 40 g L−1. This is the minimum concentration at which the willemite nanoparticles remained pure with homogenous distribution. X-ray diffraction analysis of the PVP samples before calcination was confirmed to be amorphous, and upon calcination between 800 and 1000 °C, an α-willemite phase was obtained. The morphology and the average particle size were determined with FESEM and HR-TEM analysis. The average particle size is between 23.8 and 36.7 nm. The optical energy band was found to be increasing from 5.24 to 5.32 eV with the corresponding increase in PVP concentration from 20 to 50 g L−1. The findings in this study provides a new pathway to understand the effects of PVP concentrations on the structural and optical properties of willemite semiconductor nanoparticles as it may have key potential applications for future optoelectronic devices

Clinico-pathology and hemato-biochemistry responses in buffaloes infected with Pasteurella multocida type B:2 immunogen outer membrane protein

The aim of this study was to investigate the clinico-pathology and haemato-biochemistry alterations in buffaloes inoculated with Pasteurella multocida type B:2 immunogen outer membrane protein via subcutaneous and oral routes. Nine buffalo heifers were divided equally into 3 treatment groups. Group 1 was inoculated orally with 10 mL of phosphate buffer saline (PBS); Group 2 and 3 were inoculated with 10 mL of outer membrane protein broth subcutaneously and orally respectively. Group 2 buffaloes showed typical haemorrhagic septicaemia clinical signs and were only able to survive for 72 h of the experiment. However, Group 3 buffaloes were able to survive throughout the stipulated time of 21 days of experiment. There were significant differences (p 0.05) in edema between groups except for the lung. This study was a proof that oral route infection of Pasteurella multocida type B:2 immunogen outer membrane protein can be used to stimulate host cell

The management of myocardial injury related to SARS-CoV-2 pneumonia

The global evolution of the SARS-CoV-2 virus is known to all. The diagnosis of SARS-CoV-2 pneumonia is expected to worsen, and mortality will be higher when combined with myocardial injury (MI). The combination of novel coronavirus infections in patients with MI can cause confusion in diagnosis and assessment, with each condition exacerbating the other, and increasing the complexity and difficulty of treatment. It would be a formidable challenge for clinical practice to deal with this situation. Therefore, this review aims to gather literature on the progress in managing MI related to SARS-CoV-2 pneumonia. This article reviews the definition, pathogenesis, clinical evaluation, management, and treatment plan for MI related to SARS-CoV-2 pneumonia based on the most recent literature, diagnosis, and treatment trial reports. Many studies have shown that early diagnosis and implementation of targeted treatment measures according to the different stages of disease can reduce the mortality rate among patients with MI related to SARS-CoV-2 pneumonia. The reviewed studies show that multiple strategies have been adopted for the management of MI related to COVID-19. Clinicians should closely monitor SARS-CoV-2 pneumonia patients with MI, as their condition can rapidly deteriorate and progress to heart failure, acute myocardial infarction, and/or cardiogenic shock. In addition, appropriate measures need to be implemented in the diagnosis and treatment to provide reasonable care to the patient