Evaluation of stool and urine parameters correlation to CRP and D-dimer in COVID-19 infected adults and their contact children

Aim: Aim is to depict suggestive urine and stool parameters in asymptomatic suspected contact children living with COVID-19 infected adults. These parameters will facilitate identifying  children who deserve the confirmatory diagnosis of COVID-19 by PCR test.  Methods: Study was conducted in the National Hepatology and Tropical Medicine Research institute (NHTMRI) Cairo, Egypt. It included 66 mild COVID-19 adult patients (group1) and their 82 asymptomatic contact children (group 2). Results:  In group 1, both C reactive protein (CRP) and D-dimer levels were significantly high. C reactive protein was significantly positively correlated with urinary microalbumin> 30, albumin/ creatinine ratio and urine pus >10 cells / HPF and significantly negatively correlated with vitamin C. D-dimer was significantly negatively correlated with vitamin C. In group 2, CRP and D-dimer were significantly negatively correlated with urine specific gravity (SG), urinary vitamin C. CRP was significantly negatively correlated with stool pus > 10 cells/ HPF, while D-dimer was significantly positively correlated with stool occult blood.   Receiver Operating Curve (ROC) analysis revealed that urine SG showed the highest area under the curve (AUC); 0.859, 0.96, sensitivity of 100%, 100% and specificity of 71.8%, 77.8% with reference to D-dimer and CRP; respectively. Conclusions: In contact children of adult COVID-19 proved infection, urine SG, stool occult blood and stool pus > 10 cells/ HPF can be feasible tool for suspected COVID-19 infection, based on its results COVID-19 PCR request can be an imperative option to confirm the diagnosis; particularly in developing countries where detection of COVID -19 by PCR is not readily feasible.COVID19; urine; stool; childre

EFFECT OF EDUCATIONAL GUIDELINES ABOUT PHYSICAL RESTRAINT ON NURSES PRACTICES AT PSYCHIATRIC HOSPITAL.

Background: In psychiatric hospitals, aggressive and threats of aggressive constitute serious emergencies that may be difficult to control by nursing staff, the physical restraints are the best solution to protect patient and other. Study design: The one-group pretest-posttest pre-experimental design was practiced. Aim: This study aimed to evaluate the effectiveness of the educational guidelines about physical restrain on nurses? practices at psychiatric hospital.. Setting: This study was conducted at the two settings: Psychiatric department in the ZagazigUniversity Hospital and Al-Dar Hospital of Psychiatry and Addiction at Zagazig city- at El Sharkia- Egypt. Subjects: A convenience sample of 50 psychiatric nurses involved. Tools of the study:Physical restraint questionnaire was used which contains two parts; Part one: The Nurses\' Practices Regarding the Use of Physical Restraint and part two: Socio-demographic and clinical characteristics. The results: The results demonstrates that about two third of studied nurses have an inadequate practice in applying physical restraints before the educational sessions, while, most of the nurses have an adequate practice in applying physical restrain after implementation of educational sessions and there is a positive significant difference in nursing performance of physical restraint before and after educational sessions Conclusions:It can be concluded that the majority of the studied nurses\' level of practices improved after implementation of educational sessions about guidelines to applying physical restraint, with a highly positive significant statistical differencebetween nurses\' level of practices in performing and applying physical restraint before and after educational sessions. Recommendations: Apply the educational sessions about guidelines of applying physical restraint to improve nursing performance in all psychiatric settings and increase awareness of the mental health team about the importance of the policy of applying physical restrain

Population structure of the European anchovy, Engraulis encrasicolus (Linnaeus, 1758) in Lake Manzala, Egypt

The present study is to identify the population and stock characteristics of Engraulis encrasicolus in the Mediterranean lagoon “Lake Manzala” of Egypt. A total of 1536 specimens were collected seasonally by a local trammel net (El-Balla), from 2019 to 2021. The length ranged from 4.2 to 12.1 cm, where the dominance was of medium sizes. Two age groups were observed with a short longevity (tmax = 3.16 y). Parameters of Von Bertalanffy, L?, and K, were estimated as 12.52 cm and 0.95 y-1, respectively. The growth performance index (Ø) was estimated as 2.17, expressing liner growth and environmental suitability. The calculated length at first maturity (Lm) = 8.1 cm, compared to 6.9 cm of length at first capture (Lc), expressing high fishing effort. Mortality indices include: total mortality (Z) = 3.71 y-1, and natural mortality (M) = 1.46 y-1. According to biological reference points, Fopt = 0.73 y-1 and Flimit = 0.97 y-1, the fishing mortality (F = 2.25 y-1) indicated overfishing of the anchovy stock in Lake Manzala. The current exploitation rate, E = 0.61 expressed the occurrence of overexploitation. Based on the results, reducing fishing efforts is vital to maintaining stock stability

Assessment the Accuracy of Risk Adjustment in Congenital Heart Surgery Score in Congenital Cardiac Centers at Dakahlya Government

Background: There has been massive progress in congenital cardiac surgery outcomes analysis in the last two decades. The RACHS-1 score was developed to adjust for the huge difference in congenital cardiac pathologies when comparing the operative mortality for children undergoing paediatric congenital heart surgery. Methods: This prospective observational study was conducted on all patients undergoing cardiac surgery in all congenital heart surgery centers in Dakahlya Governorate, where we assessed the operative mortality post-surgery and compared it to the RACHS-1 expected mortality to assess the accuracy of using the RACHS-1 to predict mortality in our society. Results: This study included 559 patients in two years period, VSD was the most frequent diagnosis (13.6%), followed by Single ventricle (11.3%), then TOF (10.4%). VSD closure was the most frequent procedure (11.3%), followed by mB-T shunt (8.9%), then TOF repair (8.1%). Day-30 outcome among the studied cases Mortality was uncommon (7.9%), the main cause was heart in aetiology (43.2%). Mortality was significantly highest in HLHS, and then followed by TAPVD. The overall mortality according to each category was 1.2%, 3%, 8.57%, 17.39%, 0% and 57.1% for category 1, 2, 3, 4, 5 and 6. Conclusion: RACHS-1 is an accurate method to predict mortality early post operatively. Ventricular septal defect (VSD) was the most frequent diagnosis. VSD closure was the most frequent procedure, followed by mB-T shunt, then TOF repair, most of them were elective. The most common category of RACHS-1 was 3. HLHS, RACHS≥3, Palliation operation were significant independent factors increase the day-30 mortality

Heart Rate Variability as A Predictor of Hypotension Following Spinal Anesthesia for Elective Caesarian Section in Preeclamptic Parturients: A Descriptive Observational Study

AIM: In this study we aimed to find out the heart rate variability measuring using electrical cardiometry is not reliable as a predictor for hypotension following spinal anesthesia in preeclamptic parturients undergoing elective cesarean section. METHODS: Electrical Cardiometry system was used to measure Heart rate variability (HRV) at five different time points before fluid loading (T0, baseline), after fluid loading (T1), 5 min after spinal anaesthesia (T2), 15 min after spinal anaesthesia (T3) and 30 min after spinal anaesthesia (T4). Traditional HRV measurement was determined using time-domain analysis. This Observational descriptive cohort study was conducted in Kasr Al-Ainy Hospital, Faculty of Medicine, Cairo University from February 2018 till June 2019, after approval of the Ethical Committee and written patients consent. RESULTS: The main finding of the current study is that heart rate variability measuring using electrical cardiometry is not reliable as a predictor for hypotension following spinal anaesthesia in preeclamptic parturients undergoing elective cesarean section. CONCLUSION: Heart rate variability cannot be used as a predictor for hypotension following spinal anaesthesia in preeclamptic patients undergoing elective caesarean section using electrical cardiometry

Neonatal Auditory Screening is a Necessity in The Neonatal Intensive Care Unit: Single Center Study

Background: Hearing impairment early in life interferes with normal healthy psychosocial, linguistic and educational development. Neonatal morbidities might be complicated by increased hearing impairment. Aim of the Work: To study the frequency of hearing loss among neonates with morbidities necessitating admission to neonatal intensive care units. Materials and Methods: This cross-sectional study involved screening of 250 neonate on day of discharge from Neonatal Intensive Care Unit (NICU), Children Hospital, Cairo University Hospitals, Egypt during 2020 using evoked otoacoustic emission (EOAE). Automated auditory brain stem response (AABR) was used as a confirmatory test for those who failed EOAE. Results: among the 250 neonates, 70 (28%) failed the screening by EOAE, and hearing loss was confirmed by AABR among 35(14%). Morbidity risk factors that contributed to hearing impairment was prematurity (p = 0.001), low birth weight (p = 0.003), low APGAR score at 1 and 5 minutes (p = 0.004), long NICU stay duration (p = 0.001), complications of pregnancy and delivery (p = 0.001 and p = 0.006 respectively), hypoxic ischemic encephalopathy (p = 0.001), intracranial hemorrhage (p = 0.001), meningitis (p = 0.003), mechanical ventilation for more than 5 days (p = 0.005), ototoxic drug use (p = 0.007) and hyperbilirubinemia at level of exchange transfusion (p = 0.001). Conclusion: EOAE and confirmatory AABR non- invasively and objectively detected 14% hearing loss among neonates admitted to NICU. Implementation of screening for hearing impairment among those with morbidity risk factors is a necessity to allow prompt diagnosis and early management of hearing loss

European Association of Cardiothoracic Anesthesiology and Intensive Care (EACTAIC) Fellowship Curriculum: Second Edition.

International audienceThis document represents the first update of the Cardiothoracic and Vascular Anaesthesia Fellowship Curriculum of the European Association of Cardiothoracic Anaesthesiology and Intensive Care. After obtaining feedback from exit interviews with fellows in training, graduate fellows, and program directors, 2 modified online Delphi procedures with questionnaires were conducted. A consensus was reached when two-thirds of responding committee members gave green or yellow ratings on a traffic light system, and >70% indicated strong agreement or agreement on a 5-point Likert scale. The new regulations include the following: (1) more flexibility in the fellows` rotation, as long as the total number of days, rotations, and cases are completed during the training year; (2) recommendation for strict compliance with national working-time guidelines; (3) no extension of fellowship training to compensate for annual and/or sick leave, unless the required minimum number of cases and rotations are not reached; (4) interruption of fellowship training for >12 months is allowed for personal or medical reasons; (5) introduction of a checklist for quantitative assessment of standard clinical skills; (6) recommendations for a uniform structure of exit interviews; (7) possibility of a 1-month training rotation in a postanesthesia care unit instead of an intensive care unit; and (8) provided all other requirements have been met, the allowance of progression from the basic training year to the advanced fellowship training year without first passing the transesophageal echocardiography examination

E-learning as a tool for organizational learning and knowledge management in international hotel companies

E-learning is still an emerging phenomenon in international hotel companies about which very few previous academic studies have been carried out. This had created a need for this research. This study is an endeavor to bridge the gap in knowledge regarding the use of e-learning in international hotel companies. More specifically it focuses on exploring how international hotel companies can optimize the benefits that they get from using the e-learning tools (e-learning portal). This research is novel in the area of hospitality management and more specifically in the literature focusing on international hotel companies. This is the first study, to the author's knowledge, that has examined e-learning in international hotel companies from the perspectives of organizational learning and knowledge management. This study uncovered the practices in using e-learning of the three studied international hotel companies. This thesis highlights the importance of building a close (integral) relationship between e-learning, organizational learning and knowledge management. E-learning is viewed as a complex adaptive system. This study is organized into eleven chapters. The first six chapters focus on the literature review that supported the achievement of the main aims of this research. Chapter seven is the methodology. In order to attain the aims of this research, data were collected from multiple sources, for example interviews, data published in the public domain (internet sources) and documents collected from the three studied companies. Chapters eight, nine and ten are the case studies of the three studied companies. Each of these chapters in divided into two phases of analysis. Chapter eleven is the conclusion, recommendations and contributions of this research.EThOS - Electronic Theses Online ServiceGBUnited Kingdo