Effect of Self-Care Guidelines on Quality of Life for Patients with Hepatocellular Carcinoma Undergoing Radiofrequency Ablation

Context: Hepatocellular carcinoma (HCC) is considered one of the most challenging tumors with high incidence, prevalence, and mortality rates. Radiofrequency Ablation (RFA) is one of the emerging therapeutic modalities used for the minimally invasive treatment in the management of early-stage HCC.Aim: This study aimed to assess the effect of self-care guidelines on the quality of life for patients with Hepatocellular Carcinoma undergoing Radio Frequency Ablation. Methods: A quasi-experimental design was used to achieve the aim of this study. This study was conducted at the Interventional Radiology Unit, affiliated to Ain Shams University Hospital, on a purposive sample of 50 patients with hepatocellular carcinoma; 25 were randomly allocated to the study group, and 25 were allocated to the control group. A structured interview questionnaire for patients with hepatocellular carcinoma undergoing radiofrequency ablation was used to collect the study data. It comprises three parts: Sociodemographic characteristics, assessment of patients' medical health, and knowledge about HCC and RFA. The second tool was the quality of life of cancer survivors questionnaire (pre /post-test), and finally, a patient-reported self-care practices assessment checklist (pre /posttests). Results: There were statistically significant differences between the study and control groups regarding their total knowledge about hepatocellular carcinoma and radiofrequency ablation therapy pre and post-implementation of self-care guidelines. There were highly statistically significant differences between both groups regarding the total quality of life, pre and post-implementation of self-care guidelines. In addition, there were highly statistically significant differences regarding total self-care practice, pre, and post-implementation of self-care guidelines. A positive correlation was revealed between total knowledge with total self-care practice and total quality of life (pre/posttest). Also, a significant correlation was revealed between the total quality of life and self-care practices post-self-care guidelines implementation at (p<0.001). Conclusion: Implementation of self-care guidelines improved patients' knowledge, quality of life, and self-care practices for patients with hepatocellular carcinoma undergoing radiofrequency ablation. A simplified, illustrated, and comprehensive Arabic booklet including self-care guidelines should be available for patients with hepatocellular carcinoma undergoing radiofrequency ablation. Replication of the current study on a larger probability sample is recommended to achieve generalization of the results. Further studies are recommended to assess factors affecting the quality of life for patients with hepatocellular carcinoma undergoing radiofrequency ablation

High plasma levels of adrenomedullin in collagen diseases

Background: Adrenomedullin (ADM), a potent vasorelaxant/hypotensive peptide, was shown recently to be over-expressed in inflammatory rheumatic diseases. Objectives: The aim of this study was to investigate the value of ADM as a laboratory marker of disease activity in juvenile rheumatoid arthritis (JRA) and pediatric onset- systemic lupus erythematosus (SLE) and its relation to other markers of disease activity such as clinical scores, the ESR and tumor necrosis factor-α (TNF-α). Methods: The study included 24 patients with JRA, 17 with childhood onset- SLE, as well as, 19 with rheumatic arthritis and twenty clinically healthy age- and sex- matched subjects. Clinical evaluation for disease activity was performed using the clinical activity score index in JRA, and SLE-DAI in SLE. Subjects were investigated to verify the diagnosis and disease activity. Plasma ADM and serum of TNF-α levels were then assayed. Results: Serum TNF-α and plasma ADM levels were significantly higher in JRA and SLE patients than in rheumatic arthritis patients and healthy controls. Though serum TNF-α and plasma ADM levels were both higher in JRA (73.88 ± 11.6 pg/ml and 156.5 ± 22.4 pg/ml, respectively) compared to SLE (48.82 ± 7.5 pg/ml and 85.12 ± 15.7 pg/ml, respectively), the difference was of statistical significance only in ADM. Both serum TNF-α and plasma ADM levels were significantly higher in systemic onset-JRA (139.75 ± 18.5 and 260.25 &#177 28.6 pg/ml, respectively) compared to the pauciarticular-onset type (33.8 ± 3.04 and 93.4 ± 9.35 pg/ml, respectively), but comparable to the polyarticular onset cases (69.97 ± 8.45 and 149.87 ± 21.15 pg/ml, respectively). Positive correlations were noticed between plasma ADM and activity score index (r=0.72), ESR (r=0.59) and serum TNF-α (r=0.64) in JRA. The serum TNF- α was not influenced by the site of lupus activity unlike plasma ADM that was higher in subjects suffering from lupus arthritis or cardiovascular manifestations. The afore-mentioned markers correlated positively to the ESR in SLE but not to the SLE-DAI. With a cut-off value of TNF-α = 31 pg/ml and that for ADM = 80 pg/ml calculated from the results of the included rheumatic arthritis patients, ADM appeared to be a more sensitive marker of activity in JRA and SLE compared to TNF-α. Conclusion: Plasma ADM was over-expressed in JRA and SLE. It correlated with the clinical and biochemical activity markers in JRA suggesting that it can be used as an indicator of disease activity. In SLE, ADM levels correlated with ESR and TNF- α levels and it could be of value in identifying patients with arthritis and cardiac involvement.<br.Keywords: Adrenomedullin, JRA, SLE, TNF-α, arthritisEgypt J Pediatr Allergy Immunol 2004; 2(1): 28-3

Impulsivity, Depression and Aggression among Psychiatric Patients

Aggression in inpatient facilities can generally be conceptualized as an interaction between an individual and the environment in which he or she finds themselves. The aim of this study was to assess impulsivity, depression and aggression among psychiatric patients. Descriptive correlational research design was used in this study. A convenient sample of 100 psychiatric patients from Beni-Ahmad psychiatric hospital in El-Minia, governorate, four tools were utilized to measure the study variables; Personal and clinical data Questionnaires, Barratt Impulsiveness Scale, Beck Depression Inventory and Aggression Questionnaire. Results of the study revealed that, 79% of the patients were in the age group from 20-35 years, 63% of the patients were males, and 52% of the patients were not working, 42% of the patients were schizophrenic, 56% of patients had moderate impulsivity, 58% of patients had extreme level of depression and 51% of the patients had severe level of aggression. In conclusion, more than half of psychiatric patients had moderate impulsivity level, extreme level of depression and severe level of aggression. There were positive correlations between impulsivity, depression and aggression. This study recommended developing and implementing psychosocial program to decrease impulsivity, depression and aggression among the psychiatric patients. Keywords: Impulsivity/ Depression /Aggression / psychiatric patients

Analysis of NPHS2 Gene Mutations in Egyptian Children with Nephrotic Syndrome

BACKGROUND: Mutations in the NPHS2 genes are the main aetiology of early-onset and familial steroid-resistant nephrotic syndrome (SRNS). The pathogenic NPHS2 mutation together with the p.R229Q variant has been less described among Egyptian children. AIM: This study aims to determine the mutation of NPHS2 in children with NS and discover the role of p.R229Q variant in SRNS METHODS: The study included 53 children with NS, and 53 healthy volunteers matched in age and sex controls. The median age at disease onset was 7.3 years. Among NS cases, 31 cases had steroid-sensitive nephrotic syndrome (SSNS) and 22 children with steroid-resistant nephrotic syndrome (SRNS). Polymerase chain reaction amplification of the whole coding region of NPHS2 gene was carried out for its mutational analysis. Restriction digestion testing was carried out after PCR to determine the presence of R229Q polymorphism. Randomly selected samples were re-genotyped by two independent technicians for assessment of Quality control RESULTS: NS patients showed a significant higher frequency of heterozygous genotype GA (89.5%) compared to control group (10.5%) with increased risk of NS (OR, 12.04; 95% CI, 2.61 to55.38; p < 0.0001). Moreover, SRNS showed a significant higher frequency of GA genotype (68.2%) than the SSNS group (6.5%). The GA genotype was associated with increased risk of SRNS (OR, 31.1; 95% CI, 5.73 to 168.48; P < 0.001) and the A allele was associated with increased risk of SRNS (OR, 15.52; 95% CI, 3.325 to 72.422; P < .001). CONCLUSION: R229Q polymorphisms are associated with SRNS, and any child with SRNS should be searched for mutations in the NPHS2 gene

Biodegradation of Organophosphorus Pesticide (Malathion) by Bacillus sp. FYM31 Isolated from Agriculture Drainage Water

Organophosphorus pesticides (OP) are used extensively in many arenas including agriculture and industry leading to humans and agroecosystems disorders. Malathion is one of the OP that are used in agriculture to control pest and protect crops. Also, they harm non-target organisms and affect cruelly water sources, air, and soil quality. The present study aimed to isolate and identify a potent bacterial isolate capable of degrading malathion. Bacterial strain that isolated from Al Fayoum governorate, Egypt exhibited high efficiency for malathion biodegradation. Biodegradation process using minimal salt medium (MSM) supplemented with different malathion concentrations indicated that the bacterium was able to degrade and use malathion as a sole carbon source up to 700 mg/l at 37°C.The potent strain that exhibited biodegradation potential was identified as Bacillus sp. FYM31 and deposited into GenBank with the accession number OK325597. HPLC proved the effectiveness of malathion removal by Bacillus sp. FYM31 after 12 days of incubation to the level of 70.1% malathion (700 mg/l) degradation. Organophosphorus hydrolase (opd) gene was detected in the potent Bacillus sp. FYM31 strain. Due to the widespread usage of malathion in Egypt's agricultural areas, Bacillus sp. FYM31 can help bio-remediate the polluted areas

Functional Low-fat Set Yogurt Enhanced with Microbial Exo-polysaccharides-mediated Anticancer Activity

Exopolysaccharides (EPSs) are novel functional additives for low-fat yogurt. Pharmaceutical, medical, and food industries are using more LAB-based EPSs. In this study, Leuconostoc spp. was used to produce ninth bacterial EPSs in a modified molasses medium. Production of EPSs was concentration-dependent on all stains and the highest yield was obtained from the S3 strain (55.23 g/l), followed by S6 (49.95 g/l), S8 (45.68 g/l), and S7 (44.23), respectively. HPLC and FTIR analysis showed that all purified EPSs from Leuconostoc citreum (S3) and Leuconstoc holzaapfelii (S8) were related to exopolysaccharide glucan. Anticancer activity of all EPSs samples (EPSs1-9) against Caco-2 cells and normal MCR-5 cells were investigated using MTT assay. The results revealed that Caco-2 cells were more sensitive than the normal MCR-5 cells. The highest anticancer activity against Caco-2 cancer cells was recorded for EPS8 (IC50 = 22.94 µg/ml, SI=3.73), followed by EPS3 (IC50 = 36.15 µg/ml, SI=8.72), EPS1 (IC50 = 50.01 µg/ml, SI=3.73), and EPS4 (IC50 = 94.90 µg/ml, SI=3.26), respectively. The lowest cytotoxicity was recorded for EPS5 (IC50 = 130.5 µg/ml). The most active EPSs (EPS3 and EPS8) were used as fat replacements and stabilizers in low-fat set yogurt at non-toxic concentrations (0.4, 0.8, and 1.2%). EPS3 and EPS8 improved the low-fat yogurt’s organoleptic and rheological properties. EPS8 had the highest water holding capacity (77.26%), viscosity (3660 CP), and lowest syneresis (22.95%) and whey off (0.6 ml). Low-fat set yogurt enhanced with EPS3 and EPS8 recorded the highest sensory evaluation values with overall acceptability, especially EPS3b, EPS3c, EPS8c, and EPS8b; the total score point of 97.50, 97.43, 96.51, and 96.36, respectively in fresh age compared to control yogurt (92.64). In conclusion, Leuconostoc EPSs, especially EPS8, can be explored for anti-cancer effects on Caco-2 colorectal cancer cells. It could also improve the rheological and organoleptic qualities of low-fat set yogurt

Detection of Cancer Stem Cells in Colorectal Cancer: Histopathological and Immunohistochemical Study

BACKGROUND: Growing evidence supports the notion that the onset of tumorigenesis could occur through cancer stem cells (CSCs). These tumour cells show low proliferative rates, high self-renewal capacity, propensity to differentiate into active proliferating tumour cells & resistance to chemoradiotherapy thus, possibly causing local recurrences & metastasis formation. CD44 has been used as a marker to isolate CSCs from colorectal carcinoma (CRC).AIM: To investigate the immunohistochemical expression of cancer stem cells marker (CD44) in CRC and correlate its expression with the clinicopathological aspects, TNM staging and modified Dukes’ classification.MATERIALS AND METHODS: Tumour biopsies from colectomy specimens of 60 patients with CRC were stained with hematoxylin-eosin for histological evaluation then immunostained with monoclonal antibodies against CD44 which was detected in term of negative or positive expression.RESULTS: CD44 was demonstrated in 58.3% (35/60) of cases and showed statistically significant correlation with tumour site and histological type (p-value < 0.05). However, CD44 showed statistically insignificant inverse correlation with tumour invasiveness (T), lymph node status (N), grade, TNM stage grouping and modified Dukes’ classification, while it was directly correlated with distant metastasis (M) (p-value > 0.05). Chi-square /Fisher exact test proportion independence and the p-value are set significant at 0.05 level.CONCLUSION: the CD44 rate of expression is higher in the colon than rectum and in adenocarcinoma than mucinous and undifferentiated carcinoma. CD44 showed statistically insignificant relation with T, N, M, grade, TNM stage grouping and modified Dukes’ classification

The impact of global climatic changes on the aquatic environment

AbstractGlobal climatic change, as defined by the U.S. Global Change Research Act of 1990 (GCRA), “means changes in the global environment (including alterations in climate, land productivity, oceans or other water resources, atmospheric chemistry, and ecological systems) that may alter the capacity of the Earth to sustain life”. Climatic changes are the most drastic variables interacting with all live aspects of the world's development equation. Global warming, melting glaciers, sea level rise with increased coastal erosions, increased rate of lake evaporation, green house effects, increased ocean acidity, increased rates of biological invasions and deteriorated biodiversity are the interacting variables. There is a very clear fact that climatic change is not a country made product, however, it is a trans-continental issue. The abrupt surge in the catastrophic consequences of climatic changes was primarily derived from the hydrologic changes in global water that gradually moved forward toward the land. This fact puts the aquatic species on the top list of the most impacted creatures. As an ideal example for the regional impacts of global climatic changes, the coastal zones of the Levantine Mediterranean Sea at the basins of countries like Egypt, Israel and Lebanon are on an ongoing process of continuous coastal land erosions with subsequent fisheries recession due to critical damage of the breeding habitats of the native fishes at such pristine areas of the world. Further, the historical opening of Suez Canal in 1869 was a triggering force behind the development of many ecological changes in the Levantine Mediterranean as well as the Egyptian territories from the Red Sea basin. Such climatic changes have favoured the move of some invasive species like Rabbit fish and Erythrean mytilid mussel from the Red Sea to the Mediterranean Sea with their consequent huge negative impacts on the native biodiversity of the southeast Mediterranean. Other detrimental factors that will ultimately lead to great impact on the aquatic biodiversity are the inland aquaculture, eutrophication; aquatic habitat destruction and fragmentation. Thus, without a real creative international initiative to save the world's ecosystem from the colossal destructive effects of climatic changes, there will be possible endangering effects on all living creatures on planet earth