Sclerodactyly and Diabetic Complications among Egyptian Adolescent Type 1 Diabetic Patient

BACKGROUND: One of the common complications of diabetic patients is sclerodactyly which is considered as a part of limited joint mobility. AIM: To assess sclerodactyly in adolescent type 1 diabetics and to detect its relation to other diabetic complications. METHODS: Sixty-three diabetics and 60 controls were studied. Clinical, laboratory assessment, ultrasonography of the skin, carotid artery intima-media thickness (cIMT) & renal colour duplex were done for all participants. RESULTS: Sclerodactyly was positive in 12 (19%) of diabetics. Patients with sclerodactyly had a significantly thickened skin compared to patients without sclerodactyly and controls, P = 0.0001. Male diabetics had significantly thickened skin (p = 0.0001). Diabetic patients with sclerodactyly had significant higher systolic blood pressure (p = 0.03), cholesterol (p = 0.05) and triglyceride (p = 0.004) and lower HDL-c (p = 0.04). Skin thickness had a significant positive correlation with age of diabetic patients (p = 0.02), waist/height ratio (p = 0.04), glycosylated hemoglobin (p = 0.03), albumin/creatinine ratio (p = 0.03), and cIMT (p = 0.03). CONCLUSION: Ultrasound easily diagnoses sclerodactyly. Diabetic patients had a high prevalence of sclerodactyly with increased macrovascular and microvascular complications. Sclerodactyly may be a marker for diabetic vascular complications. Frequent follow up of diabetic patients for early detection of sclerodactyly in uncontrolled diabetic patients is recommended. It could be an alarming sign for microalbuminuria, hypertension, hyperlipidaemia and atherosclerosis

Extracellular Biofabrication, Characterization, and Antimicrobial Efficacy of Silver Nanoparticles Loaded on Cotton Fabrics Using Newly Isolated Streptomyces

Biological method for silver nanoparticles synthesis has been developed to obtain cost effective, clean, nontoxic, and ecofriendly size-controlled nanoparticles. The objective of this study is extracellular biosynthesis of antimicrobial AgNPs using cell-free supernatant of a local Streptomyces sp. strain SSHH-1E. Different medium composition and fermentation conditions were screened for maximal AgNPs biosynthesis using Plackett-Burman experimental design and the variables with statistically significant effects were selected to study their combined effects and to find out the optimum values using a Box-Behnken design. The synthesized AgNPs were characterized using UV-visible spectroscopy, transmission electron microscopy, Fourier transform infrared spectroscopy, and energy dispersive X-ray spectroscopy. Rapid biosynthesis of AgNPs was achieved by addition of 1 mM AgNO3 solution to the cell-free supernatant. The produced particles showed a single surface plasmon resonance peak at 400 nm by UV-Vis spectroscopy which confirmed the presence of AgNPs. Streptomyces sp. SSHH-1E was identified as Streptomyces narbonensis SSHH-1E. Transmission electron microscopy study indicated that the shape of AgNPs is spherical and the size is ranging from 20 to 40 nm. Fourier transform infrared spectroscopy analysis provides evidence for proteins as possible reducing and capping agents. Furthermore, the biosynthesized AgNPs significantly inhibited the growth of medically important pathogenic Gram-positive and Gram-negative bacteria and yeast. The maximum biosynthesis of AgNPs was achieved at initial pH of 8, peptone of 0.5 g, and inoculum age of 48 h. The statistical optimization resulted in a 4.5-fold increase in the production of AgNPs by Streptomyces narbonensis SSHH-1E

Emotional Intelligence among Baccalaureate Students at the Faculty of Nursing, Alexandria University, Egypt: A Cross-sectional Study

Emotional intelligence (EI) is seen as a necessity in health care practices, especially the nursing practice. Assessing levels of EI and ascertaining its progression among nursing students is essential for ensuring effective nursing education and competent professional nursing skills before graduation. This study aimed at assessing the level of emotional intelligence among baccalaureate students at the Faculty of Nursing, Alexandria University, and determining its development over the academic semesters. The study followed a cross-sectional descriptive design. It was conducted at the Faculty of Nursing, Alexandria University, on 450 randomly selected students who registered in four semesters. A Socio-demographic and Academic Data Questionnaire, and Emotional Intelligence Scale, were used to collect data. The results indicated that the majority of the studied students in the four semesters had moderate levels of EI. The mean score of EI of the eighth semester's students was slightly increased by the end of the same semester. It was recommended that the student’s level of EI should be considered prior to entrance into the Faculty of Nursing, and EI concept should be incorporated into the nursing curriculum. Keywords: Emotional intelligence, Nursing students, Nursing education

Comparison of tolterodine and Solifancine in treatment of female with overactive bladder

Background: OAB (overactive bladder) is primarily a neuromuscular problem in which the detrusor muscle contracts inappropriately during bladder filling (i.e., storage phase). These contractions often occur regardless of the amount of urine in the bladder. The aim of this work is to study the effect of Solifenacin in comparison to Tolterodine in treatment of females with idiopathic over active bladder.Methods: This study included 50 patients who presented between March 2020 and February2021 to the outpatients clinic at El-Shatby maternity Hospital, Alexandria university. The patients were complaining of urinary urgency usually with urinary frequency, nocturia with or without urge incontinence. All cases were divided in two groups one of them receive Solifenacin5mg twice daily and the otherreceiveTolterodine2mg twice daily.Results: Both groups showed significant decrease in frequency number per day with p value <0.001ingroup I with Solifenacin which mean statistically significant difference between two groups. When the percentage of symptoms severity were compared between both groups, group 1 showed 53% reduction in symptoms severity while group II showed 6.67% reduction which cleared significant difference statistically in group I (p=0.001). The percentage of reduction of severity of symptoms was compared between the two groups, it showed about 60%reduction in symptoms severity in group 1while in group II only 9.7% reduction. This was statistically significant with (p<0.001) in group I with Solifenacin.Conclusions: This study suggests that Solifenacin10mg/day is more effective than Tolterodine4mg/day in reducing OAB incontinence episodes

Comparison between different methods of sonographic cervical length assessment during pregnancy

Background: Preterm birth is the presence of uterine contraction of sufficient frequency and intensity to effect progressive effacement and dilatation of cervix prior to term gestation (between 20 and 37 weeks). The objective of this study was to compare between the different methods of assessment of cervical length (Trans abdominal, trans vaginal, and transperineal) during pregnancy as a possible screening of preterm birth.Methods: Prospective cohort study was performed on 200 cases who attended at Elshat by hospital. At gestational age from 20 to 26 weeks, there was no significant difference regarding demographic data as (maternal age, parity). The route of examination was started according to urinary bladder fullness at admission. Accordingly, the patient was not instructed to void if she had full bladder, rather we started by transabdominal route. If she had empty bladder at the time she presented we started by transperineal then transvaginal route. The four measurements were compared to each other and the difference between them calculated. The selected sample size was found to be 200 pregnant women.Results: Transvaginal route gave the longest cervical measurements followed by transperineal route then abdominal route (full bladder) and finally tans abdominal route (semi-full bladder). Our results indicate that there is a significant positive correlation among the four methods of measuring cervical length in that gestational age.Conclusions: Tran-abdominal assessment could be used initially for cervical length screening, considering the maternal and fetal condition. Then, if the need arises, transvaginal sonography could be used. This step by step approach may be more convenient and useful to both patients and physicians for cervical length screening

Copeptin as a Biomarker of Atherosclerosis in Type 1 Diabetic Patients

AIM: To evaluate copeptin as an early marker of atherosclerosis in adolescent type 1 diabetics. METHODS: Sixty-two type 1 diabetic patients and 50 healthy volunteers were enrolled in the study. Serum copeptin, glycosylated haemoglobin (HbA1c), lipid profile, oxidised low-density lipoprotein (OxLDL), urinary albumin/creatinine ratio, carotid intimal medial thickness (cIMT), aortic intimal medial thickness (aIMT) and resistivity index were assessed for all participant in the study. RESULTS: HbA1, albumin/creatinine ratio, lipid profile, OxlDL, copeptin, cIMT and aIMT were significantly higher in diabetic patients. Copeptin was higher in patients with positive cIMT and aIMT. Copeptin correlated with cIMT and aIMT. Stepwise multiple regression analysis found that copeptin correlated with aIMT. ROC curve showed that copeptin had 100 % specificity with aIMT and cIMT and 95.2 and 60,7 sensitivity with aIMT and cIMT respectively. CONCLUSION: Copeptin can be used as a marker for early detection of atherosclerosis of type 1 diabetic patients

Nitric Oxide Gene Polymorphism is a Risk Factor for Diabetic Nephropathy and Atherosclerosis in Type 1 Diabetic Patients

AIM: To assess the risk factor for diabetic atherosclerosis nephropathy and diabetic nephropathy in type 1 diabetic patients. PATIENTS AND METHODS: Thirty healthy volunteers age and sex-matched and Sixty-five type 1 diabetic patient were in rolled in the study. The mean age of patients was 17.99 ± 2.59 years, mean age of onset of diabetes was 7.00 ± 3.28 years, mean duration of diabetes was 10.91 ± 3.54 years. Glycosylated sex-matched (HbA1c) was assessed in blood samples, serum lipid profile was determined, and serum level of oxidised low-density lipoprotein (OxLDL), and nitric oxide was evaluated by enzyme-linked immunosorbent assay (ELISA) technique. Nitric oxide 894G &gt; T genotype was analysed by (PCR-RFLP) method and confirmed by Sequencing. Assessment of the albumin / creatinine ratio was done in urine samples. Renal Doppler and Carotid intima-media thickness (cIMT) via ultrasound was also performed. RESULTS: OxLDL, lipid profile, albumin/creatinine ratio, cIMT and resistivity index were significantly higher in diabetic patients while nitric oxide was significantly lower. Nitric oxide genotype shows no significant difference between diabetic’s patients and controls. Diabetic patients with homozygous NO had a significantly lower serum level of Nitric oxide, a significantly higher OxLDL, albumin / creatinine ratio and lipid profile. CONCLUSION: diabetic patients are liable for the occurrence of early diabetic nephropathy and atherosclerosis as a result of the presence of low level of nitric oxide. Nitric oxide gene polymorphism 894G &gt; T in diabetic patients is a risk factor for diabetic nephropathy and atherosclerosis

Osteopontin for Early Detection of Microvascular and Macrovascular Type 1 Diabetic Complication

AIM: To evaluate the relationship between osteopontin and diabetes complication in type 1 diabetic patient. PATIENTS AND METHODS: Seventy types 1 diabetic and 60 healthy volunteers were studied. Full history, examination, laboratory tests of glycosylated haemoglobin (HbA1c), serum lipids {cholesterol, triglyceride (Tg), high-density lipoprotein-cholesterol (HDL-c), low-density lipoprotein – cholesterol (LDL-c)}, oxidised low-density lipoprotein (OxLDL), Osteopontin and urinary microalbuminuria (albumin/creatinine ratio) were done. Image study in the form of a carotid intimal medial thickness (cIMT) and aortic intimal medial thickness (aIMT), renal doppler for resistivity index was also done for all participant included in the study. RESULTS: Urinary albumin/creatinine ratio, lipid profile, osteopontin, cIMT and aIMT were higher in people with diabetes. Osteopontin was higher in people with diabetes with positive microalbuminuria and cIMT. Systolic blood pressure, microalbuminuria and cIMT had a positive correlation with osteopontin in people with diabetes. Stepwise multiple regression analysis showed that osteopontin had a significant correlation with cIMT. Receiver operating characteristic (ROC) curve showed that the cut off value of Osteopontin for detection of cIMT was &gt; 60 with a specificity of 100% and sensitivity 80.5%, while that of albumin/creatinine ratio was &gt; 64 with a specificity of 66.7 and sensitivity of 92.3. CONCLUSION: Osteopontin is higher in type 1 diabetics and is useful for early detection of diabetic microvascular and macrovascular complication