Chemotherapy Health Hazards among Oncology Nurses and Its Possible Relation to Malpractice and Workplace Environment

Context: Chemotherapeutic drugs are chemical substances used for cancer treatment and are known to be carcinogenic, teratogenic, and mutagenic to humans. Occupational exposure to chemotherapeutic drugs has led to higher health hazards among nurses who handle them. Aim: Assess chemotherapy health hazards among oncology nurses and their possible relation to malpractice and the workplace environment. Method: A descriptive and exploratory research design was used in the present study. All available nurses from both sexes working in the chemotherapy department comprised 50 nurses with one year of experience. The study was conducted at Oncology Center in Minia City, Egypt, in the outpatient and inpatient chemotherapy department. Three tools were used to collect the study data. An interview structured questionnaire for nurses was designed to assess the studied nurses' socio-demographic characteristics and medical history. The second tool is nursing practice observation checklists to assess safe practice in chemotherapy handling. The third tool was environmental safety checklists to assess workplace environmental safety. Results: The main results of this study clarified that about half of the study sample (48%) complained of health hazards presented as skin irritation/allergy, chest allergy, and inflammation of eyes (45.8%, 16.7%, 37.5%, respectively). Maternal hazards presented mainly as irregular menstrual bleeding (50%), menorrhagia, and abortion (33.3%). Decrease environmental safety presented mainly as absence of biological safety cabinet, specific personal protective equipment (PPE), safe handling chemotherapy guidelines. Along with certain nurses' malpractice as most of the study sample (74%) has poor practice scores in handling chemotherapy. Conclusion: This study indicated the presence of general and maternal health hazards among nurses handling chemotherapy in the form of general and maternal health hazards. The study also clarified nurses' malpractice among about three-fourths of nurses and provided evidence of an unsafe environment. The results strengthened the increased need to improve nurses' knowledge and practice regarding chemotherapy handling and the provision of needed equipment/supplies to underpin safe and effective practice in this area

Effect of Nursing Exercise Protocol on Hemodynamics and Functional Capacity among Patients after Cardiac Surgery

Context: Exercise interventions are the cornerstone of cardiac rehabilitation. The exercise program consists of respiratory physiotherapy, neck and shoulder exercises, walking, and cycling. The purpose is to prevent respiratory complications, neck and shoulder pain and increase the physical functional level.Aim: This study evaluates the effect of applying nursing exercise protocol on hemodynamics and functional capacity among post-cardiac surgery patients. Methods: Quasi-experimental research design utilized in the current study. A purposive sample, including 60 male and female patients, was classified equally into two equal groups; study group (n= 30) and control group (n= 30), collected through 14 months. This study was carried out in the inpatient cardiac surgery department and the outpatient cardiac clinic of Cardiothoracic Surgery Hospital in New Minia City. Four tools were utilized in collecting data; named Health Assessment Record; Six Minute Walk Distance Test; Modified Medical Research Council Scale (MMRC) for measuring dyspnea; and Nursing Educational Protocol Checklist. Results: Current study findings displayed an improvement of total distance walked among study groups compared to the control group. It also showed highly statistically significant differences between the groups related to total distance walked after 12th-week post-discharge documented by p-value (0.000).Conclusion: The current study findings concluded that the nursing educational protocol in the form of deep breathing, incentive spirometer; coughing, and early ambulation induces a significant improvement in hemodynamic variables and six-minute walk distance, recommending that hospitals should implement the nursing educational protocol as a routine hospital policy among all cardiac surgical patients in all age groups

Effect of Prophylactic Physical Activities on Reducing Lymphedema among Women Post Mastectomy

Background: Lymphedema is the build-up of lymph fluid in the tissues just under the skin. Lymphedema following mastectomy as a treatment for breast cancer is a major concern for most women who experience it. Physical activities are very helpful for lymphede­ma control. Aim: To evaluate the effect of prophylactic physical activities on reducing lymphedema among women post-mastectomy. Subjects & Method: Design: A Quasi-experimental design was utilized. Setting: This study was carried out in Minia oncology center- outpatient and inpatient surgical department. Affiliated by Secretariat of Specialized Medical Centres, at Minia Governorate, Egypt. Subjects: Included a total of 200 women have had a mastectomy. Tools: Five tools were used. 1) structured questionnaire; 2) scale for pitting edema measurement; 3) scale for lymphedema stage assessment; 4) international physical activity Questionnaire; 5) observational checklist for Physical Activities performance. Results: The mean age of the sample was 58.9 years old and 52.5% of them were elderly women. During the first assessment, more than eighty percent of the sample complained from a stage1 lymphedema. However, there was a significant reduction in this percentage among the study group during post-test. Likewise, there was a statistically significant difference between the groups regarding the lymphedema time and stage of development during the first assessment, after 6 weeks and 16 weeks (P<0.001*). Moreover, 49.0% of the study group compared to 29.0% of the control group had a moderate level of physical activity during the post-test. This indicated an increase in the level of a total pattern of physical activity between the two groups during the post-test. Conclusion: Prophylactic physical activities can reduce lymphedema associated symptoms. Also, the study group had a better level of physical activities than the control group. Recommendations: Early detection and nursing interventions have been gradually advocated to prevent lymphedema progression. So, the prophylactic physical activities are essential measures post-mastectomy to reduce lymphedema. Keywords: Lymphedema, Prophylactic, Physical activities, Mastectomy. DOI: 10.7176/JHMN/61-10 Publication date: April 30th 201

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

Characterization of greater middle eastern genetic variation for enhanced disease gene discovery

The Greater Middle East (GME) has been a central hub of human migration and population admixture. The tradition of consanguinity, variably practiced in the Persian Gulf region, North Africa, and Central Asia1-3, has resulted in an elevated burden of recessive disease4. Here we generated a whole-exome GME variome from 1,111 unrelated subjects. We detected substantial diversity and admixture in continental and subregional populations, corresponding to several ancient founder populations with little evidence of bottlenecks. Measured consanguinity rates were an order of magnitude above those in other sampled populations, and the GME population exhibited an increased burden of runs of homozygosity (ROHs) but showed no evidence for reduced burden of deleterious variation due to classically theorized ‘genetic purging’. Applying this database to unsolved recessive conditions in the GME population reduced the number of potential disease-causing variants by four- to sevenfold. These results show variegated genetic architecture in GME populations and support future human genetic discoveries in Mendelian and population genetics

The role of ultrasound guided peri-tendinous injection in the treatment of non-calcific tendinopathy

Purpose: To evaluate the effectiveness of the percutaneous ultrasound guided peri-tendinous injection in improving or treating non-calcific tendinopathy. Patients and methods: Between January 2012 and March 2014, 25 patients with non calcific tendinosis were treated by ultrasound guided corticosteroid injection. All patients underwent pre-treatment diagnostic ultrasound, as well as assessment of the pain and disability of the affected area through a self-answered questionnaire. Reevaluation of the ultrasound changes and clinical response as regard the pain and disability score on regular follow up visits, were done at the 1st, 3rd and 6th month posttreatment. Results: According to the results of this study, there was statistically marked reduction in patients pain and disability score, with reduction of the mean pain score from maximum 3 points pre-treatment to 0.5 post-treatment, and mean disability score form 1.5 point pre-treatment to 0 point at the 6th month follow up visit. The clinical success rate was 87%, with a technical success rate of 100%. Conclusion: Ultrasound is a non invasive imaging technique that allows real time guidance for interventional therapy of non-calcific tendinopathy improving the result of peri-tendinous corticosteroid injection

Quantitative Analysis of Abamectin, Albendazole, Levamisole HCl and Closantel in Q-DRENCH Oral Suspension Using a Stability-Indicating HPLC-DAD Method

Combination therapy of many anthelmintic drugs has been used to achieve fast animal curing. Q-DRENCH is an oral suspension, containing four different active drugs against GIT worms in sheep, commonly used in Australia and New Zeeland. The anti-parasitic drugs are Albendazole (ALB), Levamisole HCl (LEV), Abamectin (ABA), and Closantel (CLO). The main purpose of this study is to present a new simultaneous stability-indicting HPLC-DAD method for the analysis of the four drugs. The recommended liquid system was 1 mL of Triethylamine/L water, adjusting the pH to 3.5 by glacial acetic acid: acetonitrile solvent (20:80, v/v). Isocratic elusion achieved the desired results of separation at a 2 mL/min flow rate using Zorbax C-18 as a stationary phase. Detection was performed at 210 nm. The linearity ranges were 15.15 to 93.75 μg/mL for ALB, 25 to 150 μg/mL for LEV, 30 to 150 μg/mL for ABA, and 11.7 to 140.63 μg/mL for CLO. Moreover, the final greenness score was 0.62 using the AGREE tool, which reflects the eco-friendly nature. Moreover, the four drugs were determined successfully in the presence of their stressful degradation products. This work presents the first chromatographic method for simultaneous analysis for Q-DRENCH oral suspension drugs in the presence of their stressful degradation products