Assessment of Self-Care Practice of Patients on Maintenance Hemodialysis at Cairo University Hospitals

Modalities of renal replacement therapy (RRT), hemodialysis, peritoneal dialysis and kidney transplantation, mean an important challenge for the patient's own disease management. By focusing on regaining and promoting self-care, patients with ESRD are encouraged to use their potential for personal development and to increase their responsibility for their health and well-being. Aim: the current study was carried out to assess self care practice of patients on maintenance hemodialysis at teaching hospital. Research questions: Q. How do patients on maintenance hemodialysis care of themselves? Design: A descriptive correlational research design was utilized to achieve the aim of the study. Sample: 56 adult male and female patients on maintenance hemodialysis for more than one year were study subjects. Setting: The study was conducted at King Fahd Unit, university hospital; Cairo. Tools: For the purpose of this study, an interviewing questionnaire of assessing self care practices of patients on maintenance hemodialysis was utilized. Results: The subjects' mean age (40.83±14.17) years; More than half of the subjects were females (51.8%). (53.6%) were married, 2/3 (66.1%) need  help, the duration of being treated with hemodialysis (37.5%) was between 3->6 years, (64.3%) having co-morbid diseases and other health problems such as hypertension, diabetes and systemic lupus; (73.2%) have the shunt in left arm, (92.9%) are scheduled for three times a week, (91.1%) practice and achieve their activities independently, almost all of the subjects provide care for shunt site most of the days , and (94.6 %) drinking more than the allowed amount of fluid/ day. Keywords: self care practice, assessment, and hemodialysi

Effects of Poly-MVA on the rheological properties of blood after in-vivo exposure to gamma radiation

AbstractThis study aims to examine the radio-prophylactic effects of poly-MVA against exposure to acute dose of gamma radiation. Adult male rats, weighing 200 gm, were exposed to 6 Gy gamma radiation from Cs-137 source. The animals received daily oral administration of 2 ml/kg body weight of poly-MVA for different time intervals. The prophylactic effect was examined by two modes of administration: two weeks before irradiation and another group which received continuous administration for two weeks before and two other weeks after irradiation (total time of administration 28 days). Different parameters were performed, which include determination of cellular antioxidant enzymes (Glutathione (GSH), catalase and superoxide dismutase) in hepatic cells, the rheological properties of blood, osmotic fragility and scanning electron microscope photography of red blood cells. Exposure to radiation resulted in a significant decrease in cellular antioxidant enzymes (GSH, Catalase and SOD) and decrease in Bingham viscosity, yield stress and aggregation index of blood. Furthermore it induced slightly increase in average osmotic fragility of red blood cells accompanied by decrease in osmotic dispersion and remarkable modification of red blood cell morphology. Administration of Poly-MVA showed markedly elevation in GSH, Catalase and SOD content in liver cells in all treated groups. It also showed improvement in all observed parameters. The obtained results showed that oral uptake of poly MVA posses a radio-prophylactic effect that might be used in planned radiation exposure in diagnosis and radiotherapy

Radio-mitigation effect of poly-MVA after exposure to an acute dose of gamma radiation

AbstractAdult male rats were exposed to a 6Gy single dose from a Cs-137 source. The radio-mitigation effect of poly-MVA was evaluated by daily administration of 2ml/kg of body weight immediately after irradiation for two weeks. The morphological changes in the red blood cells were studied. The osmotic fragility and rheological properties of blood, the alteration in the contents of antioxidant enzymes (glutathione, catalase and superoxide dismutase) and lipid peroxidation in hepatic cells were determined. The results showed that exposure to radiation resulted in significant changes in cellular antioxidant enzymes (GSH, catalase and SOD) and a decrease in the blood Bingham viscosity, yield stress and aggregation index. Furthermore, it induced a slight increase in the average osmotic fragility of red blood cells accompanied by a decrease in osmotic dispersion, as well as a modification of red blood cell morphology. It also caused a significant increase (75%) in the lipid peroxidation 1 day after exposure to radiation, which persisted until the 14th day recorded after irradiation. Oral administration of poly-MVA after irradiation reduced the radiation-induced damage, as seen in the non-significant change in lipid peroxidation compared to the control. It also resulted in improvement in the observed parameters

Reforming Fiscal Institutions in Resource-Rich Arab Economies: Policy Proposals

This paper traces the evolution of fiscal institutions of Resource Rich Arab Economies (RRAEs) over time since their pre-oil days, through the discovery of oil to their build-up of oil exports. It then identifies challenges faced by RRAEs and variations in their severity among the different countries over time. Finally, it articulates specific policy reforms, which, if implemented successfully, could help to overcome these challenges. In some cases, however, these policy proposals may give rise to important trade-offs that will have to be evaluated carefully in individual cases

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

International development : ideas, experience and prospects; chapter 44

This chapter reviews the development experience of Arab countries since World War II, arguing that extractive economic and political institutions are the primary cause of underdevelopment in the region. While macroeconomic mismanagement and oil abundance are important determinants of performance, these factors are shaped primarily by prevailing political institutions, which predate the discovery of oil. In the oil-poor Arab countries, limited progress is attributed to an authoritarian bargain in which the rulers offer economic benefits to the poor and the middle class in exchange for political acquiescence

Are international food price spikes the source of Egypt’s high inflation?

Sherine Al-Shawarby; Hoda Seli

Study of the added value of transthoracic ultrasound in staging of lung cancer

Introduction: Lung cancer is one of the leading causes of cancer-related deaths in the world and early detection and proper staging are highly important for planning of treatment strategy. Aim of the work: To study the possible added value of transthoracic ultrasound (TUS) in staging of lung cancer. Patients and methods: The study was carried out at Chest Department, Kasr El-Aini hospital in the period from April 2012 to December 2012. TUS was carried out on 50 cases with primary lung cancer after revision of CT chest images. Results: TUS was only able to detect pulmonary masses in 31 cases (they had an ultrasound (US) window to reach the tumor mass). The study found that TUS was more able to detect more cases with chest wall invasion than CT chest and it was able to differentiate between visceral and parietal pleural invasion. It was also not only more able to detect the presence of pleural fluid encystation than CT scan detection but also was more able to further characterize its type. Diaphragmatic mobility was also assessed by TUS. There was also a statistical significant difference between TUS and CT chest in detecting consolidation and/or collapse. Conclusion: TUS is complementary and adding a value to both clinical and computerized tomographic diagnoses of lung cancer. It can help in staging of lung cancer and aid chest physicians in determining the modality of treatment in each patient depending on his/her stage