Effect of Implementing Central line Bundle on Minimizing Rate of Central Line-Associated Blood Stream Infection (CLA-BSI) among Intensive Care Patients

Central line-associated blood stream infection (CLA-BSI) are one  of the most common hospital acquired infections . This study aims assessment the effect of implementing central line bundle  on minimizing rate of  central line associated blood stream infection among intensive care patients. A quasi - experimental design were used in this study. The present study was conducted in Intensive Care Unit (ICU) at  Zagazig University Hospitals. The study subjects includes two groups Group I, consisted of all nurses provided direct nursing care for patient during insertion, caring and removal of central lines and group two, patients, 40 patients received routine nursing care for caring central line (control group )Group II, includes 40 patients received central line bundle based on guideline of center for disease control and prevention(study group). Tools of the study consist of three tools, the first tool was patient devolvement assessment form:- for assessment of central line associated blood stream infection  devolvement, the second tool  was a structured observational checklist while ,third tool was central line bundle. The study findings concluded, Implementation of central line bundle minimize rate of CLA-BSI compared to routine care of central line. The study recommended, empowering  nursing to enforce use of a central line bundle  to be sure all processes related to central line placement are executed for each line placement . Keywords: Central line bundle - Intensive care unit – patient

The Potential Protective Impact of Spirulina on Cisplatin Induced-Renal Toxicity in Adult Male Albino Rats: Histological, Immunohistochemical and Biochemical Study

Introduction: Cisplatin (CP) is regarded as a prevalent anticancer medication utilized against several cancer types. Spirulina (SP), a blue–green alga, has been utilized as a nutritional supplementation, in addition to other therapeutic enforcement. Spirulina includes lipids, proteins, carbohydrates, and vitamins including a pigmented protein and b-carotene besides some vital minerals.Objectives: The present study was carried out to verify the toxic impacts of cisplatin on kidney of the rat and the probable protective role of spirulina platensis supplementation.Material and methods: The twenty-four rats were randomly categorized into three equal groups (eight rats/each). Group I (Control Group): Eight rats were subdivided into two subgroups, four rats each: Group I-a: Four rats did not undergo any experiments and received only food and water for 8 days. Group I-b: Four rats received Spirulina (500 mg/kg) body weight orally by using a gastric tube for 8 days. Group II: The animals were administrated a single dose of cisplatin 6 mg/kg body weight intra-peritoneal. Group III: Each rat received Spirulina (500 mg/kg) body weight orally for 8 days and cisplatin 6 mg/kg body weight intraperitoneal on day 4. Results: cisplatin showed extensive tubular damage as wide vacuolations in tubular epithelium, pyknotic nuclei and distortion of renal corpuscles showing widening of Bowman’s space with adherence of glomerular capillary tuft to the parietal layer of Bowman’s capsule. Administration of spirulina showed regeneration of tubular epithelium and presence of tubular brush border and apparently normal lumen. Conclusion: Cisplatin resulted in histological as well as biochemical changes in the kidney of adult male rats. Administration of spirulina with cisplatin attenuated these negative impacts which can be attributed to the antioxidant activity

Effectiveness of Echinacea purpurea extract on immune deficiency induced by azathioprine in male albino rats

This study was performed to evaluate the effectiveness of Echinacea purpurea (E.P.) on azathioprine (AZA)-induced immune deficiency in albino rats. Thirty six male albino rats were divided into six equal groups. The first group served as normal control, the second and third groups were treated with two doses of AZA (3 and 5mg/kg/b.w/day IP), respectively for six weeks. The fourth group was treated with 50 mg kg/b.wt/day of Echinacea. The fifth and sixth groups were treated with3 and 5 mg AZAm respectively followed by50 mg E.P. administration. At the end of the experimental period, both doses of AZA revealed a significant reduction in total body and spleen weights, increase in tissue total protein with a significant increase in serum total protein and albumin, a marked decrease in the number of WBCS associated with a decrease in the number of lymphocytes, a significant decrease in serum total anti-oxidant capacity. Also,concentration of immunoglobulins (IgG and IgM) and interleukins (IL4 &IL6) showed a significant increase, while the level of IL10 decreased significantly in splenic tissue. The dose of AZA (5 mg /kg b.wt.) only resulted in a highly significant increase in serum level of T3 and T4. However, treatment with Echinacea purpurea extract had a significant influence on immune deficiency induced by azathioprine. These findings demonstrated that E.P. extract is a promising immunomodulatory agent with a potent therapeutic value in stimulating the immune response

FORMULATION AND ASSESSMENT OF A HERBAL HAIR CREAM AGAINST CERTAIN DERMATOPHYTES

Objective: Developing an herbal antifungal formulation containing eruca and garlic oils against highly resistant dermatophytes (Malassezia fufur AUMC No. 5173, Microsporum canis bodin AUMC No. 5490 and Trichophyton mentagrophytes AUMC No. 5501. 5501) and assessment of garlic oil thiosulfonates during the ex vivo percutaneous permeation through albino rat skin.Methods: Assay of antifungal activity was performed by filter paper disc method and agar well diffusion method. The components of volatile constituents and fixed oil of eruca seeds were studied using GC/MS. Thiosulfinates in garlic oil were analyzed by HPLC/UV. Both oils were incorporated into hair cream using span 60 and brij 58 at three different concentrations (2, 4 and 6% w/w) and alliin, was ex vivo evaluated using albino rat skin mounted on Franz diffusion cells.Results: The two oils have a synergistic effect on the first and additive effect on the second and the third fungi. The main constituents in eruca are 4-(methyl thio) butyl isothiocyanate (82%) for volatile constituents and erucic acid (40%) for the fixed one. The highest flux for alliin (0.337±0.0015 mg/cm2/hr) was obtained at a 4% surfactant concentration.Conclusion: Combination of oils has a high activity on the selected dermatophytes. Formulation of an herbal hair cream using span 60 and Brij 58 with a concentration 4% gives the highest permeation rate for alliin in garlic oil.Keywords: Eruca, Garlic, Dermatophytes, Quantitative determination and Ex-vivo permeatio

Plasma miRNA expression profile in pediatric pineal pure germinomas

BackgroundPure germinomas account for 40% of pineal tumors and are characterized by the lack of appreciable tumor markers, thus requiring a tumor biopsy for diagnosis. MicroRNAs (miRNA) have emerged as potential non-invasive biomarkers for germ cell tumors and may facilitate the non-invasive diagnosis of pure pineal germinomas.Material and methodsA retrospective chart review was performed on all patients treated at the Children’s Cancer Hospital Egypt diagnosed with a pineal region tumor between June 2013 and March 2021 for whom a research blood sample was available. Plasma samples were profiled for miRNA expression, and DESeq2 was used to compare between pure germinoma and other tumor types. Differentially expressed miRNAs were identified. The area under the curve of the receive;r operating characteristic curve was constructed to evaluate diagnostic performance.ResultsSamples from 39 pediatric patients were available consisting of 12 pure germinomas and 27 pineal region tumors of other pathologies, including pineal origin tumors [n = 17; pineoblastoma (n = 13) and pineal parenchymal tumors of intermediate differentiation (n = 4)] and others [n = 10; low-grade glioma (n = 6) and atypical teratoid rhabdoid tumor (n = 4)]. Using an adjusted p-value <0.05, three miRNAs showed differential expression (miR-143-3p, miR-320c, miR-320d; adjusted p = 0.0058, p = 0.0478, and p = 0.0366, respectively) and good discriminatory power between the two groups (AUC 90.7%, p < 0.001) with a sensitivity of 25% and a specificity of 100%.ConclusionOur results suggest that a three-plasma miRNA signature has the potential to non-invasively identify pineal body pure germinomas which may allow selected patients to avoid the potential surgical complications

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation