Assessment of Behavioural Disorders in Children with Functional Constipation

BACKGROUND: Functional constipation (FC) is a common health problem in paediatrics that causes significant physical and emotional distress to patients and their families. AIM: In the current work, we assessed the presence of behavioural problems in children with functional constipation and their pattern and relation to various demographic and disease-associated factors. METHODS: A cross-sectional case-control study was conducted, including 55 consecutive children aged 4-16 years diagnosed with functional constipation and 55 healthy age and sex-matched controls. Psychological assessment was done using the Pediatric Symptom Checklist – 17 (PSC-17). RESULTS: Twenty-six (47.3%) patients with FC had positive total PSC-17 scores while none of the controls had positive scores (p-value < 0.001). Positive internalising and externalising behaviours scores and attention problems were found in 36 (65.5%), 15 (27.3%) and 12 (21.8%) of the patients respectively in contrary to controls where only 6 (10.9%) had positive scores in internalising behaviour, and non-showed externalising behaviour and 4 (7.3%) were inattentive. Older age, longer duration of illness, residency in rural areas and presence of encopresis were found to have a significant association with the presence of such problems. CONCLUSION: Children with FC have more behavioural disorders compared to healthy controls. Integration of psychosocial aspects and their management is recommended during dealing with patients with FC

Primary Science Teachers’ Perceptions towards STEM Education in Public Schools in Qatar

Understanding teachers' perceptions of STEM education is crucial to ensure the quality of teaching and learning provided for the students in the classrooms. This study aimed at investigating science teachers’ perceptions towards STEM education in primary public schools in the State of Qatar in terms of: teachers' knowledge, STEM teaching requirements, impact on students' outcomes. This study followed a sequential explanatory mixed-method approach. Quantitative data was collected by surveying (148) science teachers, while qualitative data was obtained using four focus groups. Results indicated that teachers have relatively high perceptions towards STEM education. However, the findings highlighted the need to increase teachers’ understanding and knowledge of STEM disciplines and their approaches to integration. Keywords: STEM education, perceptions, science teachers. DOI: 10.7176/JEP/13-24-04 Publication date:August 31st 202

Determination of dimenhydrinate and cinnarizine in combined dosage form in presence of cinnarizine impurity

Three accurate, sensitive and time saving spectrophotometric methods have been developed and validated for determination of mixture of dimenhydrinate (DMH) and cinnarizine (CIN) in presence of cinnarizine impurity (1-(diphenylmethyl)piperazine) (IMP). In method A; dimenhydrinate was determined by measuring 1D amplitudes at 292.0 nm while cinnarizine and its impurity were determined by 1DD method at 256.2 and 219.6 nm, respectively, using standard spectrum of 20 µg/mL of dimenhydrinate as a divisor. Method B depends on dividing spectrum of ternary mixture by standard spectrum of 20 µg/mL of dimenhydrinate and then cinnarizine and its impurity were determined in the obtained ratio spectrum by ratio difference method using the difference between 219.0 and 237.2 nm and between 230.0 and 264.0 nm, respectively. On the other hand dimenhydrinate could be determined by dividing spectrum of ternary mixture by standard spectrum of 20 µg/mL of cinnarizine and then it were determined at the obtained ratio spectrum by ratio difference method using the difference between 216.8 and 232.8 nm. Method C is the mean cantering of ratio spectra method (MCR) where the amplitudes at 234.8, 240.0 and 233.6 nm in the second mean centering ratio spectra were used for determination of dimenhydrinate, cinnarizine and its impurity, respectively. The developed methods were validated according to ICH guidelines regarding good accuracy and precision, and they were successfully applied to pharmaceutical formulation and laboratory prepared mixtures. The results were statistically compared with those obtained by reported method and no significant difference was found

Interferon therapy shifts natural killer subsets among Egyptian patients with chronic hepatitis C

AbstractNatural killer cells can be divided into five subpopulations based on the relative expression of CD16 and CD56 markers. The majority of natural killer cells are CD56dim, which are considered to be the main cytotoxic effectors. A minority of the natural killer cells are CD56bright, and function as an important source of immune-regulatory cytokines. Shifts of these subsets have been reported in patients with chronic hepatitis C virus infection. We sought to investigate the shift of natural killer subsets among Egyptian patients with chronic HCV and to analyze the influence of interferon therapy on this shift. We applied a flow cytometric analysis of peripheral blood natural killer subsets for 12 interferon-untreated and 12 interferon-treated patients with chronic HCV, in comparison to 10 control subjects. Among interferon-untreated patients, there was a significant reduction of CD56-16+ (immature natural killer) cells. Among interferon-treated patients, the absolute count of natural killer cells was reduced, with expansion of the CD56bright subset and reduction of the CD56dim16+ subset. Natural killer subset counts were not significantly correlated to HCV viral load and were not significantly different among interferon responders and non-responders. In conclusion, HCV infection in Egyptian patients has been observed to be statistically and significantly associated with reduction of the CD56-16+NK subset, while a statistically significant expansion of CD56bright and reduction of CD56dim16+ subsets were observed after interferon therapy. Further studies are required to delineate the molecular basis of interferon-induced shift of natural killer subsets among patients with HCV

Genotypic detection of rifampicin and isoniazid resistant Mycobacterium tuberculosis strains by DNA sequencing: a randomized trial

Correction to Genotypic detection of rifampicin and isoniazid resistant Mycobacterium tuberculosis strains by DNA sequencing: a randomized trial Amina Abdelaal, Hassan Abd El-Ghaffar, Mohammad Hosam Eldeen Zaghloul, Noha El mashad, Ehab Badran, Amal Fathy Annals of Clinical Microbiology and Antimicrobials 2009, 8:4 (30 January 2009

Allergen-Vaccine Immunotherapy And Its Effect On Immunological Markers In Asthmatic Children

Abstract: Allergen immunotherapy is the administration of gradually increasing quantities of an allergen vaccine to an allergic subject, reaching a dose which is effective in ameliorating the symptoms associated with subsequent exposure to the causative allergen. So allergy vaccine immunotherapy is a treatment that can modify allergic disease. In the present study we evaluated a period of one and half year of house dust mite immunotherapy on the concentrations of two immunologic markers: Eosinophil cationic protein (ECR) and nitric oxide (NO). We also compared the effect on asthma symptoms, allergen specific bronchial challenge test and the skin prick test. The immunotherapy was performed on 36 mite allergic, asthmatic children (age range from 6-15 years) were included in our study. Twenty of the cases were treated with sublingual immunotherapy (55.5%) and 17 cases were controls as they refused to receive the medication. Efficacy was evaluated clinically on asthma symptoms and by measuring the serum NO and ECP, allergen specific bronchial challenge test and the skin prick test. Results: The sublingual immunotherapy (SLIT) group detected a significant improvement in asthma symptoms (P=0.001) and skin reactivity to dermatophagoides ptronyssinus (P=0.020) whereas the control group did not. The result of bronchial challenge to D pteronyssinus showed a similar pattern at baseline and after 2 years of treatment in both groups. The serum levels of NO and ECP were significantly reduced in the SLIT group (P=0.01 and P=0.018) compared to baseline, whereas the values remained the same in the control group. The result of bronchial challenge to D pteronyssinus showed similar results at baseline after 2 years of treatment in both groups. The tolerated allergen concentration increased in both groups (p<0.05). Lung function tests, total immunoglobulin (IgE) and specific IgE to D pteronyssinus and Dermatophagoides farinae did not change after 2 years of treatment in either group. Conclusion: The SLIT with D pteronyssinus improves the clinical parameters and the immunological parameters in mite allergic asthmatic children after one and half year of treatment. The skin prick test may be used as a marker of efficacy of therapy

Knowledge, attitude and practice of long acting reversible hormonal contraception (LARHC) among women in urban upper Egypt

Background: The current study aims to assess the knowledge, attitude and practice of long acting reversible hormonal contraception (LARHC) among women in urban upper Egypt.Methods: A cross sectional study which included 902 married women, in the reproductive age, attending the outpatient clinics (Gynecology and family planning) of: 1-Assiut University Maternity Hospital, 2- Sohag University Hospital, and 3-Gehina General Hospital (MOH hospital) with current or previous use of any method of LARHC methods. A Questionnaire file was designed to assay knowledge attitude and practice of clients towards contraceptive methods. All data collected from clients reviewed separately to assess knowledge, attitude and practice of women towards contraceptive methods.Results: The most popular contraceptive method is COCs followed by IUD then DMPA. 99% of studied sample heard with good description about different types of LARHC. 54.9% of studied sample most popular/famous LARHC DMPA, most sources of information on LARHC were, Hospital, Relative/friends and health workers. 94.24% of the studied sample were in favor to use of LARHC, 94.2% of them agree to take a space between births, about 55.4% of them were health child and 61% comfortable lifestyle benefit from birth spacing, 33% of studied sample were maternal health, 68% of them were think/prefer to use implants, 64.5% of them didn’t pregnant while breastfeeding. 11% of sample women never used any contraception before and most reasons for not using contraception are fear of side effects, desire for more children, irregular sexual relationship, and husband opposition. Only 16.6 % of studied sample used LARHC before and most of them used DMPA, however 3 women who used DMPA get pregnant while using it.Conclusions: There is a good level of knowledge between upper Egypt women about LARHC methods

Glycated albumin and glycated albumin/ glycated haemoglobin ratio decrease with increasing BMI compared to Glycated haemoglobin in Type 2 diabetes patients

Abstract: Background: Obese T2DM patients are more prone to develop accelerated complications which burdens the global health systems with undue expenditure. Glycated haemoglobin (A1c) had been settled as a gold standard glycemic indicator though it's levels must be prudently interpreted in some patients. Glycatedalbumin (GA) as an alternative, intermediate glycemic indicator is gaining much attention. Aim: assessing the correlation of each of glycated albumin and glycated haemoglobin to body mass index (BMI) in T2DM patients Hypothesis: negative correlation existsbetween BMI & glycated albumin. Subjects and methods: Cross sectional study into which 62 participants-aged 25-60 years -who are T2DM on insulin were recruited at Suez Canal University hospital.None of them was smoker or known to be CLD or DKD patient, none was on regular statins, aspirin or metformin. All had normal CBC and albumin indices, they underwent thorough history taking & examination. anthropometric measurements namely body mass index (BMI) were taken.They were grouped into a non-obese group with BMI <25 Kg/m 2 & obese group whose BMI ≥25 Kg/m 2 , each with a sample size of 31 participants. FPG,PPPG, HbA1c, CBC, serum albumin, serum insulin and GA were analyzed.insulin resistance was measured by HOMA-IR. Results: GA was insignificantly lower in obese T2DM compared to non-obese (579.3 µmol/L vs 600.0 µmol/L,p-value = 0.631), while GA/HbA1c ratio was significantly low among obese compared to non-obese. (61.1 vs 66.8, p-value= 0.040). Also GA was insignificantly lower in obese with insulin resistance (615.0 ±177.5 µmol/L) than obese with no insulin resistance (550.0±148.2 µmol/L) and also lower than non-obese with insulin resistance (637.4±153.0 µmol/L).Similarly GA/HbA1c ratio was lower in obese with &without insulin resistance (mean 57.6 ±SD 12.8 & mean 64.1 ±SD 9.0 respectively) compared to GA/HbA1c ratio in non-obese with & without insulin resistance (mean 66.9 ±SD 11.0 & mean 66.7 ±SD 9.1 respectively). Conclusion: This study showed that care to be paid while interpreting GA levels in obese T2DM as GA and GA/HbA1c ratio are lower in this population. [Iman El -Sherif, Mohamed I. Shoeir, Mohamed M. Mohey El Din Awad, Amal Fathy and Seham Ahmed. Glycated albumin and glycated albumin/ glycated haemoglobin ratio decrease with increasing BMI compared to Glycated haemoglobin in Type 2 diabetes patients

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London