Dehydrogenation of isobutane using a structured adsorptive reactor

Imperial Users onl

Nurses’ Knowledge and Practices about Administration of Medications via Nasogastric Tube among Critically Ill Patients

Administering medication via enteral tube is predominantly a nursing responsibility across countries. It is important to identify what nurses actually know and do when giving enteral medication for critically ill patients to ensure patient's safety and prevent complications. The aim of this study is to assess the nurses’ knowledge and practices about administration of medications via nasogastric tube (NGT) among critically ill patients at Cairo University Hospitals. Sample consists of sixty bedside male and female nurses who are working in the different Critical and Intensive Care Units. Descriptive/exploratory research design was utilized in the current study. This study was conducted at the different Critical and Intensive Care Units at El-Manial Specialty Hospitals affiliated to Cairo University. Three tools were utilized to collect data pertinent to the study; Nasogastric medication administration nurses' knowledge questionnaire schedule, Nurses' opinionaire sheet and Nasogastric medication administration observational checklist. The nurses were interviewed for answering the knowledge questionnaire schedule and opinionaire sheet then each nurse was observed during administration of medication via NGT for three different times using nurses' observational check list. The mean of the three observations was calculated. Findings of this study shows that the majority of the studied sample were females, married and having diploma qualification as well, more than two third of them their age ranged between 26 – 45 years. More than half of them had more than 10 years of experience. All of them were having an unsatisfactory level of knowledge and practices. Results of the present study indicated that there is a gap between nurses' knowledge and practices as compared to the standard guidelines about medication administration via nasogastric tube. The study recommended that enrichment of the Critical Care nurses at El-Manial Specialty Hospital knowledge and practices related to administration of medications via nasogastric tube according to the standard guidelines will be helpful to ensure patient safety and provide cost effective care. Also replication of this study on larger probability sample at the different geographical location at Egypt is highly recommended. Keywords: Nasogastric tube – administration of medication via nasogastric tube – critically ill patient – nurses' knowledge – nurses practices

The Poetic image of Existence and its aesthetic manifestations in the philosophy of Nietzsche

This research in the Poetic of Existence and its aesthetic manifestations in the philosophy of Nietzsche aims to clarify an essential idea which is that the existence.       we live in doesn’t have a single human facet or interpretation, but holds many. Therefore to explain this existence only by science or mind will be unfair to our lives, world, and existence. For science only represents one facet of humanity, and every vision represents its own particular perspective, so the picture will be complete only if we combine as much of these vision and perspectives as possible, we won’t say all but at least the minimum.Thus opening the horizon to a deeper view of humanity, its title is the art.Which will restore the social balance between science, mind, religion and morality, and will make man achieve humanity in his world and land. This achievement,which has not yet been complete due to the role of metaphysical concepts of all kinds, and their strong echoes through history, of making man lose his true values.  

Measuring the minimum biofilm eradication concentration for bacterial isolates from diabetic foot infections

Background: Diabetic foot infection (DFI) is considered the most common cause of diabetes-related hospitalization. Diabetic foot ulcers are subjected to bacterial colonization with biofilm forming organisms which are difficult to eradicate. The aim of this study was to identify the spectrum of bacteria associated with DFI and their ability to form biofilm, to evaluate differences in antibiotic susceptibility pattern between planktonic and biofilm phases, and to determine the antibiotics which are active on the organism in the biofilm phase. Methods: The study comprised 50 patients with DFI. A deep swab was collected from each patient and cultured. All isolates were identified and screened for biofilm formation. Biofilm forming isolates were further subjected to minimum biofilm eradication concentration (MBEC) assays to determine resistance to different antimicrobials while in the biofilm phase. Results: Seventy-one isolates were identified, (14.1%) were Gram positive cocci, (83.1%) were Gram negative bacilli, and (2.8%) were Candida species. The most frequently isolated organism was Klebsiella spp. (18/71, 25.4%), followed by Proteus spp. (14/71, 19.7%). The prevalence of biofilm forming isolates was 38%. All the studied isolates showed MBEC higher than the MIC for all tested antimicrobials. Conclusions: The substantial discrepancy between MIC and MBEC results observed in this study emphasizes the lack of reliability of the routine antimicrobial susceptibility testing in case of biofilm formation. Among all tested antimicrobials; cefoperazone/sulbactam, gentamicin, and vancomycin demonstrated activity against bacteria in the biofilm phase

Inflammation and Diabetic Cardiomyopathy

Diabetes mellitus (DM) is a metabolic syndrome that manifests a low grade of systemic inflammation that contributes to the development of cardiovascular diseases (CVDs). DM is a predominant risk factor for CVDs inducing structural changes in the heart, infiltration of fibrosis, apoptosis, and cardiac remodeling, all leading to myocardial infarction (MI), heart failure (HF), and sudden cardiac death. Furthermore, more than 80% of diabetic patients usually die from heart diseases or diabetic cardiomyopathy (DCM). Currently, HF is one of the main causes of mortality in the world despite advances in drug treatments. According to literature, a strong association exists between chronic inflammation and the development of DCM. In order to have a better appreciation of the effect of diabetes and inflammation on the cardiovascular system (CVS), it is of paramount importance to have a better understanding of diabetes, the physiology of the CVS, and the pathophysiology of DM. Thus, the present review highlights the role of chronic inflammation in the complex interplay between the development of DM and DCM. Our understanding of the process is critical in the discovery of new targeted therapies for DCM and other forms of HF

Detection of HER-2/neu, c-myc amplification and p53 inactivation by FISH in Egyptian patients with breast cancer

Breast cancer is a leading cause of cancer-related deaths in women worldwide. The clinical course of this disease is highly variable and clinicians continuously search for prognostic parameters that can accurately predict prognosis, and indicate a suitable adjuvant therapy for each patient. Amplification of the two oncogenes HER-2/neu and c-myc and inactivation of the tumor suppressor gene p53 are frequently encountered in breast carcinomas. The purpose of this study was to use the fluorescence in situ hybridization (FISH) for the assessment of HER-2/neu and c-myc amplification and p53 inactivation and to relate these molecular markers with the commonly used clinical and pathological factors. The study was conducted on 34 tissue samples obtained from 33 females and 1 male with breast carcinomas and 17 samples obtained from 16 females and 1 male with benign breast lesions. Results revealed that the level of HER-2/neu, c-myc and p53 in the malignant group was significantly increased as compared to the benign group. On relating the level of the molecular markers to clinicopathological factors, p53 was significantly associated with increased patient’s age. The sensitivity of the investigated markers significantly increased with larger tumor size. Concerning tumor grade, HER-2/neu and p53 showed a significant increase in low-grade tumors whereas c-myc showed a highly significant increase in high-grade tumors. With regard to disease staging, HER-2/neu and c-myc were the only markers that showed significant increase at late stages of disease. p53 and HER-2/neu were significantly associated with positive lymph nodal status. A significant correlation was obtained between the levels of the three biomarkers to each other. Conclusively, the combination of HER-2/neu, c-myc and p53 can stratify patients into different risk groups

ACE gene polymorphism and serum ACE level with Progression of Nephropathy in Type 2 Diabetic Patients

Background. One of the most common complications of diabetes mellitus (DM) is diabetic nephropathy (DN).  Angiotensin- converting enzyme (ACE) gene was the first candidate gene of renin-angiotensin system (RAS) for predisposition to DN.Objective. Investigation whether the ACE insertion/deletion (I/D) polymorphism is associated with Egyptian type 2 diabetic patients (T2DM) with nephropathy. In addition, the study investigated the relationship between variants of ACE I/D gene polymorphism and serum ACE level and the progression of nephropathy in Egyptian T2DM patients.Methods.  A total of 85 T2DM patients (45 with nephropathy and 40 without nephropathy) besides 45 healthy (non-diabetic) age-matched subjects were recruited in this study for comparison. The (I/D) polymorphism of the ACE gene was investigated using PCR and serum ACE levels were determined using ELISA.Results. The frequency of ACE DD genotype and D allele was significantly higher in DN patients when compared to control healthy subjects and diabetic patients without nephropathy. In addition our results showed a significant association between DD genotype of ACE gene and elevated serum ACE level.Conclusion. The present study showing a strong association between the D allele and/or DD homozygous of ACE gene and diabetic patients developed nephropathy. In addition, individuals with D allele have higher levels of serum ACE compared to those having I allele. ACE gene polymorphism and serum ACE level may serve as a susceptibility biomarker for nephropathy in type 2 diabetic patients.Â

The Impact of Breathing Buildings Envelopes on Architecture in Terms ‎of Achieving Sustainability and Visual Formation ‎ أثر تصميم أغلفة المباني المتنفسة على العمارة من حيث تحقيق الاستدامة والتشكيل البصري

يناقش البحث إمكانية تطبيق أغلفة المباني المتنفسة لتحسين البيئة الداخلية للفراغات بالمباني والوصول إلى الراحة الداخلية المطلوبة للشاغلين.بالاضافة الي دورها الفني التشكيلي لتحسين الصورة البصريه الخارجيه للمباني ، فبالرغم من أهمية دور الغلاف في رفع كفاءة المبنى البيئية، الا ان هناك مفهوم شائع عند الكثير وهو أن وظيفة الغلاف تقتصر على الدور التشكيلي البصري بالاضافه الي العزل والفصل التام بين المبنى والبيئة الخارجية، مع تجاهل إمكانية الاستفادة من الظروف المناخية الخارجية؛ مما يترتب عليه تقييد الاستفادة من عمليات التخزين والنقل الطبيعي للحرارة والطاقة الشمسية والهواء والرطوبة والضوء والاعتماد على أنظمة ميكانيكية تزيد من استهلاك الطاقة بالمبنى بغرض الوصول لمناخ داخلي مناسب لشاغلي المبنى.لذلك تهدف هذه الدراسة إلى توضيح دور الغلاف في الدمج بين الدور الفني التشكيلي والصورة البصرية للمبني مع رفع الكفاءة البيئية للمبنى والوصول الى بيئة داخلية مناسبة متكيفة مع التغيرات البيئية الخارجية، وذلك للاستفادة منها مع تجنب ظروفها القاسية، من خلال عرض مفهوم غلاف المبنى والعوامل المؤثرة عليه ووظائفه بشكل عام فنيا ووظيفيا، ودراسة مفهوم الأغلفة المتنفسة على وجه الخصوص وذكر خصائصها ودورها في تحقيق الراحة الحرارية وجودة الهواء الداخلي. مع تحليل بعض التطبيقات لمباني قائمة ذات أغلفة متنفسة لاستنباط سماتها وكيفية عملها ومدى كفاءتها

Impact of a Designed Nursing Intervention Protocol about Preoperative Liver transplantation Care on Patients’ Outcomes at A University Hospital in Egypt

Background: Literature review cited that, Liver transplantation is now considered as the gold standard for treatment of patients with end-stage liver diseases and early liver tumors in cirrhotic livers. Patient education is vital to the safety and success of a transplant. Aim: the aim is to assess the impact of a designed nursing intervention protocol about preoperative liver transplantation care on patient’s outcomes as indicated by: patients` knowledge & practice mean scores, and complications developed. To fulfill the aim of this study, the following hypothesis was formulated: patients undergoing liver transplantation who will be exposed to the designed nursing intervention protocol about preoperative liver transplantation care will show better outcomes. Material and Methods: A convenient sample of 14 adult male and female patients admitted to Liver Transplant Unit at El Manial University Hospital were included, three of them were died with an attrition rate of 21.4%. Four tools were formulated to collect data pertinent to the study. 1- Sociodemographic and medical data sheet; 2- Pre/Post knowledge assessment questionnaire sheet, 3- Observational checklists, & 4- Complications assessment sheet. Structured interview, reviewing medical records, direct observation and physical examination were utilized for data collection. Results: a  significant statistical difference was found in relation to the total and subtotal mean knowledge and practice scores during different assessment periods  with P values (0.00 for both); as well, 45.5 %  of patients developed respiratory complications (pleural effusion) compared to 53.8 % of their correspondence who developed respiratory complications (pleural effusion, chest infection, and others), in addition, 9.1% of the studied subjects developed  rejection, and ascites as compared to (1.9 %, 5.7%) of their correspondence over the last consecutive three years respectively. Conclusion: Liver transplantation patients showed a positive improvement in their knowledge and practice in relation to breathing, coughing, & using respirometer exercises and range of motion. Replication of this study on a larger sample selected from different geographical areas is highly recommended. Key wards: liver transplantation, designed nursing intervention protocol, preoperative liver transplantation care, knowledge, complications, and patient`s outcome