Quality of care of Egyptian asthmatic children: Clinicians adherence to asthma guidelines

<p>Abstract</p> <p>Background</p> <p>Despite the development and dissemination of guidelines for the diagnosis and management of asthma, a gap remains between current recommendations and actual practice.</p> <p>Objectives</p> <p>To assess the physicians attitude towards asthma guidelines and their adherence to its recommendations.</p> <p>Methods</p> <p>Three hundred and fifty two clinicians (101 General practitioners, 131 pediatric specialists, 35 pediatric consultants and 85 doctors did not report the qualification) engaged in direct childhood asthma care in Cairo, Egypt were subjected to a self-administered questionnaire with 35 questions of which most were multiple choices, aiming at assessment of three important aspects about the involved physicians; physician's knowledge, practice and attitude. 165 of the clinicians were working in governmental hospitals, 68 clinicians work in private clinics and 119 clinicians work in both.</p> <p>Results</p> <p>Agreement with asthma guidelines was present in 76.2% of the studied physicians, however those who not in agreement with the guidelines claimed that this was mainly due to patient factors, firstly the poor socioeconomic standard of the patient (18.1%) and secondly due to poor patient compliance (16%). Poor knowledge was found in 28.5%, poor practice was found in 43.6% and poor attitude was found in 14.4% of the studied physicians. There was positive highly significant correlation between qualification and knowledge, (p < 0.01), positive highly significant correlation between qualification and practice, (p < 0.01), and positive highly significant correlation between qualification and attitude, (p < 0.01).</p> <p>Conclusion</p> <p>The attitude of the studied physicians revealed agreement of their majority with the guidelines, while the disagreement was mainly explained by the poor socioeconomic standard of the patients. The degree of poor practice is more marked than that of poor knowledge or poor attitude reflecting resources limitations and applications obstacles in the physician's practice.</p

Prediction of Length of Postoperative Ventilation in CDH Survivors; Preoperative and Operative Variables

Background/Purpose: The period taken for complete weaning from ventilation in cases of repaired congenital diaphragmatic hernia (CDH) varies greatly. We tried to relate the endo-tracheal tube removal time (ETTRT) in these cases with the different variables; both preoperative and operative. Materials &amp; Methods: This is a retrospective study of cases of CDH survivors managed by the authors over the period from January 2003 till February 2010. The preoperative variables included gestational age, gender, birth weight, Apgar score, the time of intubation, the ventilation strategy, the presence of a significant PDA in the ECHO study and the time-lapse till surgery. The operative variables (all by laparotomy approach) included the side of the hernia, the herniated contents, the presence of a sac, the insertion of a chest tube and the degree of abdominal wall stretch required. The successful weaning from ventilation and ETTRT were classified into two groups; &le;7 days and &gt; 7 days postoperatively. Results: During the study period, 26 cases were included (21 Males and 5 females). The ETTRT ranged from 2 to 23 days (mean=7.7 &plusmn;7.15). Among the variables studied; the statistically significant ones (P value &lt; 0.05) were Apgar score at 1 minute (preoperatively) and the need for "vigorous" abdominal wall stretch (operatively). Conclusion: Apgar score of less than 8 at 1 minute; preoperatively, and the need for "vigorous" abdominal wall stretch; operatively, were associated with delayed weaning from ventilation in CDH survivors. This could have a predictive value in the management of these cases.Index Word: Congenital diaphragmatic hernia, Mechanical ventilation weaning, Endo-tracheal tube removal

N,N-Diphenylanilino-heterocyclic aldehyde-based chemosensors for UV-vis/NIR and fluorescence Cu(II) detection

Herein, three N,N-diphenylanilino-heterocyclic aldehyde probes (5, 6 and 7) are synthesized, characterized and their sensing behaviour against metal cations tested. Acetonitrile solutions of the three probes show an intramolecular charge-transfer band in the 360-420 nm range due to the presence of an electron donor N,N-diphenylanilino group and an electron acceptor aldehyde moiety. Besides, all three probes are moderately emissive with bands in the 540-580 nm range in acetronitrile. The chromo-fluorogenic behaviour of the three probes in acetonitrile in the presence of selected metal cations is assessed. Of all the metal cations tested only Cu(ii) induces marked colour and emission changes. In this respect, addition of Cu(ii) cations to solutions of the probes induces the appearance of NIR absorptions at 756 nm for 5, at 852 nm for 6 and at 527, 625 and 1072 nm for 7. Besides, Cu(ii) induces a marked quenching of the emission of the three probes. The observed spectral changes are ascribed to the formation of 1:1 probe-Cu(ii) complexes in which the metal cation interacts with the acceptor part of the chemosensors. In addition, the limits of detection determined using UV-visible and fluorescence titrations are in the 0.21-5.12 M range, which are values lower than the minimum concentration prescribed by the World Health Organization (WHO) guideline for drinking water for copper (30 mM). Besides, probe 7 is used for the detection of Cu(ii) in aqueous environments using SDS anionic surfactant.We thank the Spanish Government (MAT2015-64139-C4-1-R) and Generalitat Valenciana (PROMETEO2018/024). H. E. O. thanks Generalitat Valenciana for his Grisolia fellowship. Thanks are due to Fundação para a Ciência e Tecnologia (FCT) for a PhD grant to R. C. M. Ferreira (SFRH/BD/86408/2012), and FEDER (European Fund for Regional Development)-COMPETE-QREN-EU for financial support through the Chemistry Research Centre of the University of Minho (Ref. PEst-C/QUI/UI0686/2016 and PEst-C/QUI/UI0686/2018). The NMR spectrometer Bruker Avance III 400 is part of the National NMR Network and was purchased within the framework of the National Program for Scientific Re-equipment, contract REDE/1517/RMN/2005 with funds from POCI 2010 (FEDER) and FCT

A simple and easy-to-prepare imidazole-based probe for the selective chromo-fluorogenic recognition of biothiols and Cu(II) in aqueous environments

A new simple and easy-to-prepare imidazole-based probe 1 was synthesized and used to detect Cu(II) and biothiols (Cys, Hcy and GSH) in aqueous environments. Addition of increasing amounts of Cu(II) to water (pH 7.4)-acetonitrile 90:10 v/v solutions of probe 1 induced the apperance of a red-shifted absorption together with a marked colour change from colorless to deep blue. In addition, probe 1 was fluorescent and a marked emission quenching in the presence of Cu(II) was observed. The optical response is selective and other cations tested do not induce significant chromo-fluorogenic modulations. Limits of detection for Cu(II) of 0.7 and 3.2 μM using UV–visible and fluorescence data were determined. On the other hand, addition of Cys, Hcy and GSH to the deep-blue water (pH 7.4)-acetonitrile 90:10 v/v solutions of the 1-Cu(II) complex reulted in a marked bleaching together with the appearance of a highly emissive band centred at 475 nm. Other amino acids tested induced negligible response. The limits of detection for Cys, Hcy and GSH using 1-Cu(II) and emission data are 6.5, 5.0 and 10.2 μM, respectively. These optical changes were ascribed to a biothiol-induced demetallation process of the 1-Cu(II) complex that released the free probe. Besides, probe 1 is non-toxic and can be used for Cu(II) detection in HeLa cells.FCT - Generalitat Valenciana(PROMETEOII/2014/047); Spanish Government (projects MAT2015-64139-C4-1-R and AGL2015-70235-C2-2-R) and the Generalitat Valenciana (project PROMETEOII/2014/047). Thanks are also due to Fundação para a Ciência e a Tecnologia for financial support to the Portuguese NMR network (PTNMR, Bruker Avance III 400-Univ. Minho), FCT and FEDER (European Fund for Regional Development)-COMPETEQREN-EU for financial support to the research centre CQ/UM (Ref. UID/QUI/00686/2013 and UID/QUI/0686/2016), and a PhD grant to R. C. M. Ferreira (SFRH/BD/86408/2012)info:eu-repo/semantics/publishedVersio

Immunological and genotoxic effects of occupational exposure to α-cypermethrin pesticide

Objectives The aim of this work has been to find out the occupational oxidative stress, immunological and genotoxic health hazards among α-cypermethrin (CYP) pesticide-exposed workers. Material and Methods A cross-sectional study was performed including 200 workers divided into 3 groups according to the level of exposure: highly exposed group (50 workers), moderately exposed group (50 workers) and unexposed group (100 workers). All workers were subjected to detailed laboratory investigation for gene P53 mutations, immunological parameters as a cluster of differentiation into 3 percentage (CD3%), CD4% and CD8% in addition to peripheral blood total leukocytic and platelet counts that were measured. Spectrophotometer technique was used for detection of superoxide dismutase (SOD), catalase (CAT), glutathione (GSH) and glutathione peroxidase (GPx). Air samples were collected with a High Volume Small Surface Sampler for measurement of α-cypermethrin level. Results A highly exposed group to the α-cypermethrin had lower CD4/CD8 as compared to an unexposed group with statistically significant difference. As regards gene mutation, exons 5a and 6 were more frequent among the highly exposed group as compared to no mutation among moderately exposed and unexposed groups with significant difference. As regards antioxidants; SOD, CAT, GSH and GPx were higher among the unexposed group as compared to the highly and moderately exposed group with statistically significant difference. Significant negative correlation was found between working years and antioxidant parameters. Conclusions Repeated exposure to α-CYP may lead to gene mutations, immunological disturbances and oxidative stress. Strict safety precautions are required not only for workers but also for public users. Int J Occup Med Environ Health 2017;30(4):603–61

Switching to instant black coffee modulates sodium selenite-induced cataract in rats

The influence of daily consumption of some common beverages on the development of cataract in rats was investigated. Total phenol content was determined in the beverages and an oral standardized dose of total phenols from each beverage was given to the treated rats. Weaned male albino rats were used and divided into five groups (n=7). Rats were fed Ain 93G and administered the standardized dose of instant coffee, black tea and hibiscus beverages for 30 days. On day 14 all rats were injected with a single dose of sodium selenite (NaSeO) bodyweight, except the control groups NC (negative control, did not receive NaSeO) and PC (positive control, was already injected on day 1 of the study). The rats were continued on Ain 93G and the standardized dose for another 16 days. Positive control rats were used. Total phenols were 210, 40, and 44 mg/g dry weight gallic acid equivalent in black coffee, black tea, and hibiscus, respectively. Decreased levels (statistically significant P<0.05) of malondialdehyde, total nitric oxide, Ca-Ae, tumor necrosis factor-α, interleukin-1β, superoxide dismutase, and conversely, increased levels (statistically significant P<0.05) of total protein, reduced glutathione, catalase were found in the lenses of the coffee group compared to PC. There are co-phenol substances in the instant black coffee that promoted coffee to be the most effective beverage

Potent Antiviral Activity of Vitamin B12 against Severe Acute Respiratory Syndrome Coronavirus 2, Middle East Respiratory Syndrome Coronavirus, and Human Coronavirus 229E

Repurposing vitamins as antiviral supporting agents is a rapid approach used to control emerging viral infections. Although there is considerable evidence supporting the use of vitamin supplementation in viral infections, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the specific role of each vitamin in defending against coronaviruses remains unclear. Antiviral activities of available vitamins on the infectivity and replication of human coronaviruses, namely, SARS-CoV-2, Middle East respiratory syndrome coronavirus (MERS-CoV), and human coronavirus 229E (HCoV-229E), were investigated using in silico and in vitro studies. We identified potential broad-spectrum inhibitor effects of Hydroxocobalamin and Methylcobalamin against the three tested CoVs. Cyanocobalamin could selectively affect SARS-CoV-2 but not MERS-CoV and HCoV-229E. Methylcobalamin showed significantly higher inhibition values on SARS-CoV-2 compared with Hydroxocobalamin and Cyanocobalamin, while Hydroxocobalamin showed the highest potent antiviral activity against MERS-CoV and Cyanocobalamin against HCoV-229E. Furthermore, in silico studies were performed for these promising vitamins to investigate their interaction with SARS-CoV-2, MERS-CoV, and HCoV-229E viral-specific cell receptors (ACE2, DPP4, and hAPN protein, respectively) and viral proteins (S-RBD, 3CL pro, RdRp), suggesting that Hydroxocobalamin, Methylcobalamin, and Cyanocobalamin may have significant binding affinity to these proteins. These results show that Methylcobalamin may have potential benefits for coronavirus-infected patients