Impact of Interactive Digital-Based Hepatitis C Education on Self-Management and Quality of Life of Damanhour University Students Having Hepatitis C.

Background: Chronic hepatitis C virus (HCV) infection is a major public health crisis and currently is the most frequent cause of liver related morbidity and mortality which caused 1.34 million deaths in 2015 globally. Infected individuals experience a variety of physical and psychological symptoms, functional limitations and impaired quality of life as a result of having HCV. Aim of study: is to assess the impact of Interactive Digital-Based Hepatitis C Education on Self-Management and Quality of Life of Damanhour University Students Having Hepatitis C. Hypothesis: University students having Hepatitis C who engage in interactive digital-Based Hepatitis C education demonstrate greater improvement in Self-Management and quality of life than those who are not. Material and Methods: Quasi-experimental pre/post–test research design. Settings: The study was carried out in the medical health insurance clinic affiliated to Damanhour University. Subjects: the total sample was 36 students having Hepatitis C. Tools: Data was collected through using students’ knowledge about HCV Structured Questionnaire Sheet, Generic health-Related Quality Of Life Scale, Disease-Specific Health-Related Quality Of Life questionnaire, Hepatitis C Self-Management Profile Scale and Satisfaction with Interactive Digital-Based Hepatitis C educational program scale. Results: More than half of the intervention group (55.6%) aged more than 20 years with a mean age of 20.9±2.01 years, and more than one third of the control group (38.9%) with a mean age of 19.4±2.17 years. Above two thirds of the intervention and control groups, (66.7%, and 50.0% respectively) were males. Social networks and Websites, reported as the main source of information about hepatitis C by less than half of the intervention group (44.4%), and more than two thirds of the control group (66.7%). Only 11.1% of the intervention group had good knowledge level at pre program, with mean score of 7.08±3.01 compared to less than two thirds of them (61.1%) in post program. Significant differences was observed between intervention group at pre and 3 months post program implementation (t1=4.25, P=0.002). Interactive Digital-Based Education showed a significant impact on the intervention group's practices in different areas of Hepatitis C self-management. It is evident that, statistical significant correlation was found between intervention group's satisfaction with the program and total score of self-management practices and quality of life in post program. Conclusion and Recommendations: Interactive Digital-Based Education on Self- Management of Hepatitis C had positive impact on HCV outcomes including improvement in Hepatitis C knowledge, self-management practices and quality of life. In addition, it plays a significant role in improving Hepatitis C control, and motivates the students to adopt healthy lifestyle. The overall results revealed that, university students’ satisfaction with Interactive Digital-Based Hepatitis C educational program was high. Therefore, use interactive technology to disseminate hepatitis C education messages to young people, including WhatsApp, Web Based education, etc. Also, Develop University HCV Online platform for young people having Hepatitis C who need to receive age-appropriate Hepatitis C education. Keywords: Interactive Digital-Based education, Self-management, Hepatitis C, Health-Related Quality Of Life. DOI: 10.7176/JHMN/66-02 Publication date:September 30th 201

Diagnostic efficacy of monoclonal antibody based sandwich enzyme linked immunosorbent assay (ELISA) for detection of Fasciola gigantica excretory/secretory antigens in both serum and stool

<p>Abstract</p> <p>Background</p> <p>This research was carried out to develop a reliable monoclonal antibody (MoAb)-based sandwich enzyme linked immunosorbent assay (ELISA) for the diagnosis of active <it>Fasciola gigantica </it>infection in both serum and stool for comparative purposes.</p> <p>Methods</p> <p>From a panel of MoAbs raised against <it>F. gigantica </it>excretory/secretory antigens (ES Ags), a pair (12B/11D/3F and 10A/9D/10G) was chosen due to its high reactivity and strict specificity to <it>F. gigantica </it>antigen by indirect ELISA.</p> <p>Results</p> <p>The two MoAbs were of the IgG₁and IgG_2asubclasses, respectively. Using SDS-PAGE and EITB, the selected MoAbs recognized 83, 64, 45 and 26 kDa bands of ES Ags. The lower detection limit of ELISA assay was 3 ng/ml. In stool, the sensitivity, specificity and diagnostic efficacy of ELISA was 96%, 98.2 and 97.1%; while in serum they were 94%, 94.6% and 94.3%, respectively. Moreover, a positive correlation was found between ova count in stool of <it>F. gigantica </it>infected patients and the OD readings of ELISA in both stool and serum samples (<it>r </it>= 0.730, p < 0.01 and r = 0.608; p < 0.01, respectively).</p> <p>Conclusions</p> <p>These data showed that the use of MoAb-based sandwich ELISA for the detection of <it>F. gigantica </it>coproantigens in stool specimens was superior to serum samples; it provides a highly efficient, non-invasive technique for the diagnosis of active <it>F. gigantica </it>infection.</p

The extended latissimus dorsi flap option in autologous breast reconstruction: A report of 14 cases and review of the literature

Background: Autologous breast reconstruction using the extended latissimus dorsi flap has been infrequently reported. In the current study, the authors are reporting their own clinical experience with this method. A review of the literature is also discussed. Materials and Methods: Over a three year period, 14 patients underwent breast reconstruction using the extended latissimus dorsi (LD) flap. Patients with small to medium sized breasts were selected. The age of the patients ranged from 29 to 42 years with a follow-up period ranging from six to 18 months. The indications, flap-related complications and donor site morbidity and aesthetic results were evaluated. Results: The main indication to use the flap was dorsal donor site preference by patients. The remaining patients were either not suitable for a flap from the abdomen or wished to get pregnant and were offered the dorsal donor site. Neither total nor partial flap loss was recorded but donor site morbidity was mainly due to seroma, which was treated conservatively in all patients, except for one who required surgery. Another two patients suffered from wound breakdown and distal necrosis of the back flaps. Mild contour deformity was also noted on the back of all patients but caused no major concern. Indeed, the overall patient satisfaction was very high. Conclusion: The extended LD flap proved to be a good option for autologous breast reconstruction in selected patients. Patients should be warned of the potential for seroma and mild contour back deformity

MONOCYTE ADHESION MOLECULES EXPRESSION IN PATIENTS WITH CHRONIC HEPATITIS C AND LIVER CIRRHOSIS

Abstract: Introduction: Chronic viral hepatitis is histologically characterized by predominantly periportal infiltration of mononuclear cells, including monocytes/macrophages. Intralobular infiltration of these inflammatory cells is an ominous sign of deterioration and a criterion for disease activity. We aimed to study the expression of monocytes adhesion molecules and their endothelial ligands in patients with chronic hepatitis C (CHC) and liver cirrhosis (LC). The influence of cytokines and chemokine on monocyte adhesion was also taken into account. Material and Methods: The current study included 30 cases of CHC, 30 cases of LC and 15 normal healthy controls. Flow cytometric quantification of CD11a, CD11b and CD49d monocyte surface antigen expression was performed. Circulating sE-selectin, sICAM-1, sVCAM-1, TNF-α, IL-1 and MCP-1 were measured by ELISA kits. Results: The expression of CD11b, CD49d, and the serum level of sICAM-1, sVCAM-1, TNF-α showed progressive increase from non-cirrhotic to cirrhotic patients. correlation was found between monocyte adhesion molecules CD11a, CD11b and CD49d and each of sICAM-1 and sVCAM-1 Conclusions: These findings suggest that the modulation of monocyte-subset recruitment into the liver via adhesion molecules or cytokines/cytokine receptors may represent promising approaches for therapeutic interventions in human liver fibrosis. Measurement of serum soluble adhesion molecules may be useful for monitoring progression of liver inflammation and fibrosis during CHC

Free Anterolateral Thigh Flap for Reconstruction of Major Craniofacial Defects

ABSTRACT Free-tissue transfer has revolutionized skull-base surgery by expanding the ability to perform cranial base resection and by improving the quality of reconstruction. The anterolateral thigh flap has come recently into use in the field of head and neck reconstruction. Its role in craniofacial and midface reconstruction has not been specifically defined. This study involved a total of 18 patients who were treated over a 5-year period from 1998 to 2003. Seventeen patients had locally advanced head and neck cancer, requiring craniofacial resection, and one patient had a complicated gun shot wound of the forehead. Thirteen patients were treated at the National Cancer Institute, Cairo University, Egypt, and five patients at the University of Miami, Florida. The patients presented with defects of the anterior skull base (5), lateral skull base (3), scalp and calvarium (3), and the midface (7). The anterolateral thigh flap was used as a myocutaneous flap in 11 cases and as a perforator fasciocutaneous flap in seven cases. Musculocutaneous perforators supplied the majority of flaps (17/18). Total flap survival occurred in 17 cases; one patient developed complete flap necrosis. The most commonly used reciepient vessels were the facial vessels and the external jugular vein. Major complications included one case with meningitis; the patient died after failure of treatment. Another patient died 6 weeks postoperatively from pulmonary embolism. One patient developed CSF leak that stopped spontaneously. In addition, two patients developed minor wound dehiscence that healed spontaneously. The donor-site wound healed without problems except in two cases. One patient had an incomplete take of the skin graft; the other developed wound infection and superficial sloughing. Both wounds healed spontaneously. In addition to the feasibility of simultaneous flap harvesting with tumor resection, the flap's advantage in skull base reconstruction is its reliable blood supply, which can provide adequate dural cover and protection of the brain. Its size and moderate thickness are suitable for reconstruction of scalp and calvarial defects. The abundance of reliably vascularized fat in the flap may be an advantage in long-term maintenance of the volume of the flap in midface reconstruction. Similar to other soft tissue flaps, additional skeletal reconstruction may still be required to achieve an optimal functional and aesthetic result