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

Evaluation of colour reproduction of CAD/CAM Lithuim-disilicate veneers of different thicknesses and translucency

Background: With the increasing patients’ demand for a perfect smile, the call for highly aesthetic and yet minimally invasive veneers has surmounted. Objective: The aim of this study was to evaluate the colour of CAD/CAM lithium disilicate veneers fabricated in different thicknesses and different translucencies of the lithium disilicate blocks. Materials and Methods: Forty discs of lithium disilicate glass-ceramic (IPS e.max CAD) of shade A1 of both high and low translucency (HT, LT) were tested for their colour reproduction. HT and low LT blocks were cut in the form of plates of dimensions (12 x 14 mm) and of different thicknesses (0.3 mm, 0.5 mm, 0.7 mm, and 0.9 mm). Twenty specimens of each translucency were classified into three sub-groups according to thickness (n=5). Colour reproduction (∆E) was determined using VITA Easyshade Advance against a foundation block and compared with A1 shade tab. Data was collected for statistical analysis. Analysis of Variance (ANOVA), and pair-wise comparison tests were used. Significance level was set to PResults: Two-way ANOVA test showed that the change in both thickness and translucency a well as the interaction between them had a significant effect over (∆E) values. One-way ANOVA and Bonferroni’s tests showed that the low translucency samples showed a statistically significant difference in (∆E) values between all thickness groups except between the 0.3 mm and 0.7 mm as well as between the 0.5 mm and 0.9 mm thickness specimens. High translucency specimens showed a significant difference between all thicknesses. Conclusions: The final colour of laminate veneers could be highly affected by both the thickness and translucency of the ceramic material used. LT specimens produced much better color reproduction with better masking ability than the HT specimens

Stunting and its Determinants among Governmental Primary School Children in Egypt: A School-based Cross-sectional Study

BACKGROUND: In developing countries, stunting among children is a major public health concern. It affects all aspects of children’s lives; its effects are not constrained to physical wellbeing but reach out to mental, social, and spiritual wellbeing. AIM: The aim of this study is to determine the prevalence of stunting in some of the Egyptian governmental primary school children and its nutritional and socioeconomic determinants. METHODS: A cross-sectional observational study was conducted on primary school children aged 6–12 years. General demographic, socioeconomic, and anthropometric data, as well as dietary pattern, were collected. RESULTS: Out of 1740 children, 7.8% were stunted. Not eating eggs and dairy products had the most profound effect on stunting in children (p < 0.001). Not having meals on time, skipping breakfast, and having <3 meals per day were predictors of stunting (p = 0.003, p = 0.00, and p = 0.008, respectively). Mother’s education (p = 0.005) followed by family income (p = 0.007) was the most affecting social factors. CONCLUSION: There are many nutritional factors associated with stunting as skipping breakfast, not having meals on time, and having <3 meals per day. Scarcity in nutritive foods as eggs and dairy products and increased soft drink intake can lead to stunting. There are many enabling social factors for stunting as mother’s education and family income. However, the effects of these factors can be modified by health awareness

The status of epidermal growth factor receptor in borderline ovarian tumours

The majority of borderline ovarian tumours (BOTs) behave in a benign fashion, but some may show aggressive behavior. The reason behind this has not been elucidated. The epidermal growth factor receptor (EGFR) is known to contribute to cell survival signals as well as metastatic potential of some tumours. EGFR expression and gene status have not been thoroughly investigated in BOTs as it has in ovarian carcinomas. In this study we explore protein expression as well as gene mutations and amplifications of EGFR in BOTs in comparison to a subset of other epithelial ovarian tumours. We studied 85 tumours, including 61 BOTs, 10 low grade serous carcinomas (LGSCs), 9 high grade serous carcinomas (HGSCs) and 5 benign epithelial tumours. EGFR protein expression was studied using immunohistochemistry. Mutations were investigated by Sanger sequencing exons 18-21 of the tyrosine kinase domain of EGFR. Cases with comparatively higher protein expression were examined for gene amplification by chromogenic in situ hybridization. We also studied the tumours for KRAS and BRAF mutations. Immunohistochemistry results revealed both cytoplasmic and nuclear EGFR expression with variable degrees between tumours. The level of nuclear localization was relatively higher in BOTs and LGSCs as compared to HGSCs or benign tumours. The degree of nuclear expression of BOTs showed no significant difference from that in LGSCs (mean ranks 36.48, 33.05, respectively, p=0.625), but was significantly higher than in HGSCs (mean ranks: 38.88, 12.61 respectively, p<0.001) and benign tumours (mean ranks: 35.18, 13.00 respectively, p=0.010). Cytoplasmic expression level was higher in LGSCs. No EGFR gene mutations or amplification were identified, yet different polymorphisms were detected. Five different types of point mutations in the KRAS gene and the V600E BRAF mutation were detected exclusively in BOTs and LGSCs. Our study reports for the first time nuclear localization of EGFR in BOTs. The nuclear localization similarities between BOTs and LGSCs and not HGSCs support the hypothesis suggesting evolution of LGSCs from BOTs. We also confirm that EGFR mutations and amplifications are not molecular events in the pathogenesis of BOTs

Associations between Human Aldosterone Synthase (CYP11B2) and Angiotensin II type 1 Receptor (ATR1) Gene Polymorphisms with End Stage Renal Disease In hypertensive Egyptian Patients on Maintenance Hemodialysis

Many people with an advanced form of kidney disease do not know they have weak or failing kidneys, but early detection and treatment can help prevent the progression of kidney disease to kidney failure. The resulting costs of treatment of ESRD are enormous. ESRD is a complex phenotype, which results from the presence of underlying kidney disease, and superimposing inherited and environmental factors. Among the predisposing genetic factors, renin-angiotensin-aldosterone system (RAAS) disruption is clearly involved in ESRD development. The aim of this study is to evaluate the association between CYP11B2 C-344T and ATR1 A1166C gene polymorphisms with increased risk for ESRD in hypertensive Egyptian patients on maintenance hemodialysis.This study included 70 ESRD patients on maintenance hemodialysis (32 males and 28 females, mean age 54.5± 9.5 years, recruited from El Doaah and El Rayan hospitals, Cairo, Egypt. 70 healthy individuals, of matching age and sex (30 males and 40 females, mean age 50.2 ± 13.1 years), were also included in the study. All subjects were genotyped for both CYP11B2 C-344T and ATR1 A1166C gene polymorphisms. Serum aldosterone was also measured for all subjects. Concerning the CYP11B2 gene, HD patients showed increased frequency of the TT genotype (68.57%) as compared to controls (only 12.85%), with no significant differences in T allele distribution between the 2 groups. In contrast, HD patients had low frequency of the CC genotype (5.71%) as compared to controls (32.85%), with a significant difference in C allele distribution between the HD patients (28.56%) and controls (70.7%). Comparing serum aldosterone levels in various CYP11B2 genotypes in HD patients revealed that patients with TT genotype had statistically higher aldosterone levels (121.583 ± 43.311) than those with the TC (72.055 ± 11.709) or CC genotype (68.75 ± 13.145). On the other hand, for AT1R A1166C genotype frequency, HD patients showed significantly (p˂0.05) higher frequency of CC genotype (70%) than controls (7.1%), with lower AA genotype frequency (5.71%) compared to controls (57%). Moreover, there was significant differences in A allele distribution between the HD patients (27.13%) and controls (64.25%).  The same was true for the C allele, with a frequency of (59.28%) in HD patients compared to a frequency of (39.25%) in controls. On the other hand, studying ATR1 A1166C gene polymorphisms revealed that patients with the CC genotype had significantly higher aldosterone levels (121.25 ± 43.006) than those with AA (87.6 ± 25.4) genotype.

Vulnerability and Weaknesses of Eating Habits of Overweight School Children as an Entry Risk for COVID-19

BACKGROUND: In developing countries, overweight among children becomes an alarming problem and a health concern. Obesity is a factor in disease severity of coronavirus disease (COVID-19) having the greatest impact on patients. AIM: The aim of this study was to determine the prevalence of overweight in some of the Egyptian governmental primary school children, its nutritional and socioeconomic determinants. Special focus was directed to identify the current dietary practices including risky nutritional habits of overweight children as a weak point leading to increasing their vulnerability to catching COVID-19 infection. METHODS: A cross-sectional observational study was conducted on primary school children aged 6–12 years. General demographic data, socioeconomic data, dietary pattern, intake of a diversity of nutrient-rich food versus calorie-dense food, and anthropometrical data were collected. RESULTS: Of 1600 child, there were 8% overweight who are considered at risk of COVID-19 infection. Considering the weekly share of the stomach, only one-third of the food consumed by overweight children is nutrient-rich, with high consumption of French fries and Candies (once per day among 95% and 78 % of overweight children, respectively). Moreover, 90% of them consume sugar-sweetened beverages (SSB) more than once per day. The majority of overweight children belonged to small, middle- income families, and had illiterate or read and write mothers. CONCLUSION: Overweight children eat narrow diversity of nutrient-rich food that includes vegetables, fruits, protein, and dairy products. They eat more calorie-dense foods, every day. The increase of family income increased the likelihood of having overweight children with a high intake of SSB, candies, and chips; consumption of snacks between meals and before sleep. Protective predictors against overweight were highly educated mothers, taking breakfast before school, having dinner, and taking meals on time. RECOMMENDATION: Nutritional behavioral education aiming at choosing nutritious and varied options of food that is effective for improving children’s nutritional status is the key to decreasing vulnerability toward COVID 19

Determinants of Exclusive Breastfeeding in a Sample of Egyptian Infants

BACKGROUND: Breastfeeding is an optimum, healthy, and economical mode of feeding an infant. However, many preventable obstacles hinder exclusive breastfeeding in the first six months of life. AIM: We aimed to assess the social-, maternal- and infant-related factors disturbing exclusive breastfeeding in the first six months of life. METHODS: It is a retrospective study included 827 dyads of mothers and infants older than 6 months (411 exclusively breastfed, 311 artificially-fed and 105 mixed feds). Mothers were interviewed to obtain sociodemographic information, maternal medical history and perinatal history and a detailed history of infant feeding. RSULTS: Many factors were found to support the decision for artificial feeding rather than exclusive breastfeeding, including maternal age &lt; 25 years (OR = 2.252), child birth order &gt; 3rd (OR = 2.436), being a primi-para (OR = 1.878), single marital status (OR = 2.762), preterm infant (OR = 3.287) and complicated labor (OR = 1.841). Factors in favor of mixed feeding included cesarean section (OR = 2.004) and admission to the Neonatal Intensive Care Unit (OR = 1.925). CONCLUSIONS: Although it isn’t a community-based study and its results can’t be generalised, plans to improve health and development of children are preferable to include the following: health education and awareness programs about the importance of exclusive breastfeeding should be directed for young and first-time mothers. Improved antenatal care to reduce perinatal and neonatal problems; and training, monitoring, and supervising community health care workers to recognise labour complications and provide support and knowledge to lactating mothers

Pituitary models

pre-printPituitary tumor animal models provide researchers a microenvironment that simulates the clinical situation; however, in comparison with astrocytoma and meningioma tumor research where intracranial xenograft transplantations are increasingly being used to test various therapeutic modalities, in vivo therapeutic research on pituitary animal models focuses on direct drug therapy to the tumor because of the lack of established intracranial pituitary tumor models. The rat subcutaneous prolactin-secreting pituitary model allows investigators to noninvasively measure tumor size and the effect of direct tumor-guided therapy in a serial manner and is considered biologically relevant because it has proven to be histologically, immunocytochemically, and ultrastructurally consistent with human pituitary tumors

Potential Risk Factors of Developmental Cognitive Delay in the First Two Years of Life

BACKGROUND: The first two years of life constitute a critical period of rapid change. The events during this phase prepare the child for subsequent developmental competency.AIM: To determine the potential risk factors that affect an infant’s cognitive development in the first two years of life in a sample of Egyptian infantsSUBJECTS AND METHODS: A cross-sectional comparative study included 655 male and female infants. Their age ranged from 3 – 24 months. Bayley Scales of Infant and Toddler Development (Bayley III) were used for cognitive assessment. Perinatal and nutritional data were recorded. Levels of serum Zinc, Copper, Iron, vitamin B12 and complete blood count (CBC) were assessed in a subsample of 193 infants.RESULTS: Infants having below the average cognitive composite score (CCS) represented 38.47% of the whole sample. The risk of having a low average (CCS) was determined by multiple factors. Poor maternal education and low family income were the most significant social risk factors (OR = 2.19, p = 0.0003; OR = 1.64, p = 0.002 respectively). Prematurity and complicated labor represented significant perinatal risks (OR = 1.22, p = 0.005; OR = 2.39, p =0.001respectively). Bottle feeding versus breastfeeding in the first six months of life was the most significant nutritional predictor of low average (CCS) (OR = 1.79, p = 0.001). Infants with low average (CCS) had significantly lower levels of serum zinc and vitamin B12 than those with average scores. CONCLUSION: Multiple factors appear to interact affecting the early cognitive development of Egyptian infants. Prematurity, complicated labour, poor maternal education, low family income and micronutrient deficiency are the main risk factors. Studying these factors is of great value in directing governmental intervention efforts

Antiprogestin mifepristone inhibits the growth of cancer cells of reproductive and non-reproductive origin regardless of progesterone receptor expression

<p>Abstract</p> <p>Background</p> <p>Mifepristone (MF) has been largely used in reproductive medicine due to its capacity to modulate the progesterone receptor (PR). The study of MF has been expanded to the field of oncology; yet it remains unclear whether the expression of PR is required for MF to act as an anti-cancer agent. Our laboratory has shown that MF is a potent inhibitor of ovarian cancer cell growth. In this study we questioned whether the growth inhibitory properties of MF observed in ovarian cancer cells would translate to other cancers of reproductive and non-reproductive origin and, importantly, whether its efficacy is related to the expression of cognate PR.</p> <p>Methods</p> <p>Dose-response experiments were conducted with cancer cell lines of the nervous system, breast, prostate, ovary, and bone. Cultures were exposed to vehicle or increasing concentrations of MF for 72 h and analysed for cell number and cell cycle traverse, and hypodiploid DNA content characteristic of apoptotic cell death. For all cell lines, expression of steroid hormone receptors upon treatment with vehicle or cytostatic doses of MF for 24 h was studied by Western blot, whereas the activity of the G1/S regulatory protein Cdk2 in both treatment groups was monitored <it>in vitro </it>by the capacity of Cdk2 to phosphorylate histone H1.</p> <p>Results</p> <p>MF growth inhibited all cancer cell lines regardless of tissue of origin and hormone responsiveness, and reduced the activity of Cdk2. Cancer cells in which MF induced G1 growth arrest were less susceptible to lethality in the presence of high concentrations of MF, when compared to cancer cells that did not accumulate in G1. While all cancer cell lines were growth inhibited by MF, only the breast cancer MCF-7 cells expressed cognate PR.</p> <p>Conclusions</p> <p>Antiprogestin MF inhibits the growth of different cancer cell lines with a cytostatic effect at lower concentrations in association with a decline in the activity of the cell cycle regulatory protein Cdk2, and apoptotic lethality at higher doses in association with increased hypodiploid DNA content. Contrary to common opinion, growth inhibition of cancer cells by antiprogestin MF is not dependent upon expression of classical, nuclear PR.</p