Effectiveness of Structured Nursing Teaching Program on Outcomes of Chronic Low Back Pain Patients Undergoing Radiofrequency Ablation

Background: Chronic low back pain is a full disorder that considers an important health problem. Aim: To evaluate the effectiveness of structured teaching program on outcomes of chronic low back pain patients undergoing radiofrequency ablation. Methods: A quasi-experimental research design has been utilized. Setting: Anesthesia and pain management department at the main Assiut University Hospital. Sample: Sixty low back pain patients undergoing radiofrequency ablation. They were randomly assigned in two groups of 30 patients each. Tools: three tools were utilized: Tool I: Structured interview patients' questionnaire. Tool II: Visual analogue pain scale and Tool III: "Modified Oswestry low back pain disability questionnaire" in addition, structured nursing teaching program. Results: More than half (53.3%) of the case group their age was from 18 to < 55 years, and the rest of them (46.7%) were older adults aged 55 years and more. 80% of the case group had good knowledge post implementation of the program. (100%) of the case group had worst pain intensity level which decrease to (46.7%) post program. 40% of case group had sever disability, which decreased to 30% post implementation of the program. there were significant relation between pain analogue scale and Oswestry low back pain disability scale in pre and post structured nursing teaching program regarding to occupation Conclusion: Structured nursing teaching program had an effective strategy to improve the patients’ outcomes through increasing patients' knowledge, and decreasing both pain intensity and physical disability in the case group versus the control group. Recommendation: Supervised structured teaching program should be carried out for all patients undergoing radiofrequency ablation about pre-and post-procedure instructions and helpful hints for a healthy back when standing, walking, sitting, sleeping, and lifting. Keywords: Chronic low back pain, Radiofrequency ablation, structured nursing teaching program. DOI: 10.7176/JHMN/65-08 Publication date: August 31st 201

In vitro cytotoxicity of Withania somnifera (L.) roots and fruits on oral squamous cell carcinoma cell lines: a study supported by flow cytometry, spectral, and computational investigations

Oral cancer is a severe health problem that accounts for an alarmingly high number of fatalities worldwide. Withania somnifera (L.) Dunal has been extensively studied against various tumor cell lines from different body organs, rarely from the oral cavity. We thus investigated the cytotoxicity of W. somnifera fruits (W-F) and roots (W-R) hydromethanolic extracts and their chromatographic fractions against oral squamous cell carcinoma (OSCC) cell lines [Ca9-22 (derived from gingiva), HSC-2, HSC-3, and HSC-4 (derived from tongue)] and three normal oral mesenchymal cells [human gingival fibroblast (HGF), human periodontal ligament fibroblast (HPLF), and human pulp cells (HPC)] in comparison to standard drugs. The root polar ethyl acetate (W-R EtOAc) and butanol (W-R BuOH) fractions exhibited the strongest cytotoxicity against the Ca9-22 cell line (CC50 = 51.8 and 40.1 μg/mL, respectively), which is relatively the same effect as 5-FU at CC50 = 69.4 μM and melphalan at CC50 = 36.3 μM on the same cancer cell line. Flow cytometric analysis revealed changes in morphology as well as in the cell cycle profile of the W-R EtOAc and W-R BuOH-treated oral cancer Ca9-22 cells compared to the untreated control. The W-R EtOAc (125 μg/mL) exerted morphological changes and induced subG1 accumulation, suggesting apoptotic cell death. A UHPLC MS/MS analysis of the extract enabled the identification of 26 compounds, mainly alkaloids, withanolides, withanosides, and flavonoids. Pharmacophore-based inverse virtual screening proposed that BRD3 and CDK2 are the cancer-relevant targets for the annotated withanolides D (18) and O (12), and the flavonoid kaempferol (11). Molecular modeling studies highlighted the BRD3 and CDK2 as the most probable oncogenic targets of anticancer activity of these molecules. These findings highlight W. somnifera’s potential as an affordable source of therapeutic agents for a range of oral malignancies

SELF-EFFICACY AND DRUG ADHERENCE AMONG DIABETIC UNIVERSITY STUDENTS

<p><strong>Abstract </strong></p><p><strong>Background</strong>: Nurses play vital role to incorporate the self-efficacy concept in assisting university students to develop their own strategies for long-term disease medication adherence.<strong> Aim of the study:</strong> To assess self-efficacy and medication adherence among diabetic university students. <strong>Subjects and methods</strong>: descriptive design was applied in Assiut university student's hospital on (80) university<strong> </strong>students. <strong>Tools:</strong> (I): The Diabetes Management Self-Efficacy Scale (DMSES) which contained demographic and medical and Diabetes Management Self-Efficacy Scale (DMSES). (II): Morisky Medication Adherence Scale ( MMAS – 8).<strong> Results</strong>: Majority of the studied university students were males, from rural areas, their mean SD of ages was 15.6±1.9 years old. The diabetic duration was 6.7 ±3.2 years, with glucose level 276.0 ± 71.7 mg/dl and HbA1c was 8.6 ± 1.8%.<strong> </strong>There was a statistically significant difference between medication adherence and their gender but there was no statistical difference between Self-efficacy for diabetes and their gender.<strong> Conclusion:</strong> development of chronic complications. The present study found the majority of the studied patients had a low self-efficacy score and medication adherence. There was a positive correlation between perceived self-efficacy and medication. <strong>Recommendations: </strong>Provision of integrated better application of guidelines intervention for diabetic University students to improve health efficacy and medication adherence.</p&gt

Effects of Nursing Guidance About Venipuncture Versus Ordinary Syringe, A Comparative Study On Rates of Phlebotomy Hematoma

Objective: To assess the effects of nursing guidance about Venipuncture versus ordinary syringe, a Comparative Study on Rates of phlebotomy hematoma. Background: In order to reducing the incidence of phlebotomy hematoma, nurses should receive comprehensive training regarding appropriate blood sampling  Study design and methods: Pre-posttest, comparative study design using a quasi-experimental design for both groups. Setting: The surgery departments at Assiut University Hospital. Subjects: There were 40 nurses in total coverage, and 100 randomly selected patients underwent blood sample. The nurses and patients were split into two equal groups. Tools: (I): Patients' assessment (personnel and clinical data), (II): Easy hematoma degree classification and (III) Nurses' awareness questionnaire (demographic characteristics, knowledge, and observation checklist). Results: A statistically significant difference the venipuncture and ordinary syringe groups regarding the rates of phlebotomy hematoma (wound quality of life and wound healing) with a significant correlation between them. Moreover, a statistically significant difference between nurses' knowledge and practice of applying the nursing guidance pre- and post-test.  Conclusion: The nursing guidance had a beneficial impact on nurses' knowledge and practice, and it improved the rates of phlebotomy hematoma occurrence among patients who underwent venipuncture compared to the other group using an ordinary syringe Implications for research, policy, and practice: Enhance nurses' knowledge and practice, offer ongoing education and in-service training program to the surgery departments. Apply venipuncture to blood sampling to reduce the risk of phlebotomy hematomas. &nbsp

The role of miRNA-29b1, MMP-2, MMP-9 mRNAs, and proteins in early diagnosis of HCC

Abstract Background Hepatocellular carcinoma (HCC) is a common, serious malignancy with a dismal prognosis. As HCC is frequently missed in its early stages, non-invasive early detection is urgently needed. The purpose of this study was to evaluate the possible utility of circulating miRNA-29b1, matrix metalloproteinases (MMPs)-2 and -9 mRNAs, and proteins as diagnostic and predictive biomarkers for HCC. Subjects and methods This study included 92 subjects, including 52 patients with HCC at various stages and grades and 40 healthy subjects as controls. RT-PCR was used to detect circulating miRNA-29b1, MMPs-2, and 9 mRNAs, while ELISA was used to detect AFP, MMPs-2, and 9 proteins in the participants’ blood. Results When HCC patients were compared to controls, there were significant increases in the levels of MMPs-2, 9 mRNAs, and proteins, and a significant drop in the levels of miRNA-29b1. There were no significant variations in the levels of miRNA-29b1, mRNAs, and MMP-2 and -9 proteins in advanced HCC. There were negative associations between miRNA-29b1 and MMPs-2, 9 mRNAs, and proteins, implying overlapping molecular microRNA-mediated mechanisms that control MMPs that should be investigated further in the future. The levels of miRNA-29b1, MMPs-2, 9 mRNAs, and proteins indicated significant sensitivity and specificity in the early identification of HCC. Conclusion MMP-2, 9 mRNAs, and proteins may be employed as diagnostic but not prognostic biomarkers in HCC. miRNA-29b1 may play a protective role in HCC. An overlapping molecular microRNA-29b1-mediated pathway that may control MMPs-2 and 9 requires further experimental investigation in the future