Application of Transtheoretical Model of Change on Foot Care Management among Diabetic Patients: Prevention Better than Cure

Diabetic foot ulcer is one of the most common consequences of uncontrolled blood glucose level which takes place in 15% of people with diabetes, and precedes 84% of all diabetes-related lower-leg amputations that have the adverse effect on the diabetic patients causing physical, psychosocial, and financial burden as well as an economic burden on health care system. The aim of the study is to improve foot care management among diabetic patients by applying the Transtheoretical Model of Change. Design: A quasi-experimental design was conducted with a systematic random sample. Study sample: 154 patients who were selected from the registration system were divided equally into (77 study group) and (77 control group). Setting: the study was conducted at the outpatient diabetic clinic affiliated to Tanta University Hospital and Segar primary health care center affiliated to ministry of health, Tanat Governorate, Egypt. Tools: three tools were used for the purpose of data collection (I) Bio-socio-demographic characteristics questionnaire;(II)Trans-theoretical Model scale and (III) Diabetes Management Self-Efficacy Scale (DMSES). A survey was conducted by using Arabic version of self-reporting questionnaire to assess the stages of change and self efficacy among the studied groups as a baseline and during the implementation of foot care intervention program. Results revealed that, there was a statistical significant difference in the stages of change of the Transtheoretical Model for diabetic foot care management of the study group compared to the control group at 2, 4, and 6 months after implementation of intervention program. In addition, there was a statistical significant difference in Diabetes Management Self-Efficacy Levels between study group who received program intervention compared to control group 6 months after intervention. Recommendation: encouraging nurses who are dealing with diabetic patients to use the Transtheoretical Model of change or other health promotion models to enhance diabetic patient for foot care management, and adoption of healthy behavior.Keywords: Transtheoretical model of change, diabetic foot care management

Minimally invasive, no hardware subtalar arthrodesis with autogenous posterior iliac bone graft

Sixteen patients underwent minimally invasive subtalar arthrodesis through a mini-invasive approach with posterior iliac graft between 2004 and 2006. No hardware was used to transfix the arthrodesis and partial weight bearing was allowed immediately. The primary indication for surgery was the squeal of fracture os calcis in terms of subtalar joint arthritis, loss of heel height, malalignment of the hindfoot, and pain with weight bearing. There were 12 male and 4 female patients with a mean age of 30 (range 17–52). Patients were followed up for a period of 40.8 months (range 36–48 months). The mean interval from injury to fusion was 2 (+0.6) years ranging from 6 months to 6 years post fracture. The average clinical rating scale based on the American Orthopaedic Foot and Ankle Society (AOFAS) improved from 36 preoperatively to 78 at the latest follow-up (P < 0.05). Union rate was 94%. Radiographic evaluation revealed a mean increase in calcaneal inclination of 6.25 + 8.3° (P < 0.07) and a mean increase in the lateral talocalcaneal angle of 7.42 + 10.2° (P < 0.08). Complications were graft nonunion in 1 patient and transient tendoachilles tendinitis in another. This technique can be used to decrease the morbidity associated with the late complications of os calcis fractures by aligning the hindfoot, restoring the heel height and correcting calcaneal and talar inclination. It offers the advantage of early weight bearing while avoiding hardware complications

Kristalna struktura i optička svojstva sustava Bi-Sb-Te-Se

The quaternary systems of Bi-Sb-Te-Se were synthesized by direct fusion technique. Thin films of these compounds were prepared by thermal evaporation under vacuum of 10−4 Pa. The structural properties of these compounds in powder and thin film forms were investigated by X-ray diffraction. The optical constants (absorption coefficient and band gap) of the thin films were determined by measurements of IR absorbance in the region 2.5 – 10 µm. Analysis of the optical absorption spectra revealed the existence of two direct energy gaps.Sintetizirali smo sustave Bi-Sb-Te-Se sa četiri sastavnice izravnom metodom staljivanja. Tanke slojeve tih spojeva pripremali smo isparavanjem u vakuumu (na 10−4 Pa). Primjenom rendgenske difrakcije odredili smo strukturna svojstva praha i tankih slojeva tih spojeva. Optičke konstante tankih slojeva (koeficijent apsorpcije i procijep med–u vrpcama) odredili smo mjerenjem apsorpcije u području 2.5 – 10 µm. Analiza optičkih apsorpcijskih spektara pokazuje dva izravna procijepa

Kristalna struktura i optička svojstva sustava Bi-Sb-Te-Se

The quaternary systems of Bi-Sb-Te-Se were synthesized by direct fusion technique. Thin films of these compounds were prepared by thermal evaporation under vacuum of 10−4 Pa. The structural properties of these compounds in powder and thin film forms were investigated by X-ray diffraction. The optical constants (absorption coefficient and band gap) of the thin films were determined by measurements of IR absorbance in the region 2.5 – 10 µm. Analysis of the optical absorption spectra revealed the existence of two direct energy gaps.Sintetizirali smo sustave Bi-Sb-Te-Se sa četiri sastavnice izravnom metodom staljivanja. Tanke slojeve tih spojeva pripremali smo isparavanjem u vakuumu (na 10−4 Pa). Primjenom rendgenske difrakcije odredili smo strukturna svojstva praha i tankih slojeva tih spojeva. Optičke konstante tankih slojeva (koeficijent apsorpcije i procijep med–u vrpcama) odredili smo mjerenjem apsorpcije u području 2.5 – 10 µm. Analiza optičkih apsorpcijskih spektara pokazuje dva izravna procijepa

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p&lt;0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p&lt;0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Improving Iris Localization Performance Using Image Processing Tools: Multi-Input Databases

Abstract The interface of computer technologies and biology is having a huge impact on society. Human recognition research projects promises new life to many security-consulting. Iris recognition is considered to be the most reliable biometric authentication system. Image quality plays a crucial role in any pattern matching system. Three different iris databases have been employed for comparison of performance of proposed iris detection and isolation technique based on morphological features. CASIA, UPOL, and UBIRIS databases were processed as different types of noise like iris obstruction by eyelids, eyelashes, lighting reflections, and poor focused images. To process the iris patterns in an efficient and effective way against existing methods, many simple and effective image processing methods have been presented in image selection, iris preprocessing, iris segmentation, iris localization, and isolation. Experimental results show that our method achieves an accuracy of 100% for select best iris data, and 99% for isolate iris region

Prevalence of low back pain in working nurses in Zagazig University Hospitals: an epidemiological study

Background Nursing is one of the occupations with a high risk for back injuries. The etiology of low back pain (LBP) among nurses is usually multifactorial, probably because job demands in nursing is a mixture of physically demanding and mentally demanding tasks. Objective The aim of this study was to identify the prevalence of and risk factors for chronic LBP in nursing personnel working in Zagazig University Hospitals. Materials and methods This study is a quantitative, retrospective, analytical, cross-sectional one. It included 150 female nurses who are currently working in Zagazig University Hospitals. All participants completed a self-administered Oswestry Low Back Disability Questionnaire. Data for risk factors of LBP (age, height, weight, BMI, marital state, parity) and working conditions (duration of employment in the current work, average working hours per week, work demands, duration of absence from work in the last year) were collected. Results LBP prevailed in 79.3% of the studied group of working nurses. The highest percentage was found among nurses working in the ICU (95.0%) and the least among those working in the outpatient clinics (64.0%). There was a highly significant association between LBP and body mass index (BMI) (P < 0.001). A higher incidence of LBP was associated with lifting heavy loads, followed by twisting, prolonged standing, prolonged sitting, walking for long distances, and bending forward. Conclusion Prevalence of LBP is high among nurses, resulting in significant medical and socioprofessional consequences. Risk factors necessitate multidisciplinary involvement to reduce the incidence of LBP and related costs

Hypoglycemic Effect of Selected Herbal Extracts on Streptozotocin Induced Diabetic Rats

Abstract: This study was carried out to investigate the most effective compounds extracted from approved selected antidiabetic plants on control blood glucose, serum insulin, lipid profile level and protective effect against oxidative stress in streptozotocin induced diabetic rats. Method: 70 albino rats were divided into 7 groups 10 rats each. Group ² normal control, group Ï diabetic control, group Ø received essential onion oil (100mg/kg b.w. orally), group ²V received alkaloids of lupin (100mg/kg b.w. orally), group V, group V² received anthocyanins of cinnamon and mulberry respectively (16 mg/kg b.w. orally) and group VÏ received their combination together (58 mg/kg b.w. orally) for 21 days. At the end of experiment Blood glucose, insulin levels, triglycerides, total cholesterol, HDL-cholesterol, LDL-cholesterol were estimated. Oxidative stress biomarkers represented in the amount of thiobarbituric acid reactive substances (TBARS) and nitric oxide were determined. Liver and kidney removed for histopathological examination. Results: All isolated compound improved diabetes status but the most potent antidiabetic effect was observed in combination of all compounds. W hile onion essential oil had both antioxdiabetic and antioxidant effect. Conculsion: These results suggest that administration of the combined drug and essential onion oil used as antidiabetic agent and improved diabetic status