Impact of Nurses’ Work Patterns on Nurses and Patients in Critical Care and Toxicology Care Units of Alexandria University Hospitals

Background: Nowadays, there are difficulties in recruiting and retaining nursing staff with increasing pressures and demands on nurses working in critical care areas. The role of nursing care in patients' safety and healthcare outcomes has led to increased interest in measuring and reporting nurses’ work patterns and their consequences on nurses and patients. Objectives:  Describe nurses’ work patterns and their impacts on nurses and patient outcomes. Methods: Self-report forms were used to collect data regarding nurses’ time spent on direct and indirect nursing activities, non- nursing care and personal activities as well as care left undone. Questionnaires were used to measure stress, tension, conflict, nurses’ intent to leave, nurses' satisfaction and  patient satisfaction  Results: nurses spent their working time on direct nursing care (36.64 %); indirect nursing care (28.18 %), non-nursing care (30.64 %) and personal activities ( 4.7%). Profile of direct and indirect patient care and personal activities increased in night shifts, while the profile of non-nursing tasks increased in morning shifts.  There was a positive correlation between care left undone and three non-nursing tasks. Besides, there was a positive correlation between left care undone, non-nursing duties and four nursing job outcomes. There also was a negative correlation between care left undone, non-nursing tasks and nurses' and patients' satisfaction.  Conclusion:  the study focused on the importance of direct patient care on improving quality of care and patient safety. Reducing the performance of non-nursing duties by nurses and decreasing care left undone will most likely result in greater nurses’ and patients’  satisfaction, reduced stress, tension, and conflict and decreased numbers of  nurses’ leaving their jobs. Keywords: work, patterns, nurses, patients, outcome

Consensus evidence-based recommendations for treat-to-target management of immunoglobulin A vasculitis

IgA vasculitis (IgAV), formerly known as Henoch-Schönlein purpura, is the most common cause of systemic vasculitis in childhood. Given its potential life-threatening systemic complications, early and accurate diagnosis as well as management of IgAV represent a major challenge for health care professionals. This study was carried out to attain an evidence-based expert consensus on a treat-to-target management approach for IgAV using Delphi technique. The preliminary scientific committee identified a total of 16 key clinical questions according to the patient, intervention, comparison, and outcomes (PICO) approach. An evidence-based, systematic, literature review was conducted to compile evidence for the IgAV management. The core leadership team identified researchers and clinicians with expertise in IgAV management in Egypt upon which experts were gathered from different governorates and health centers across Egypt. Delphi process was implemented (two rounds) to reach a consensus. An online questionnaire was sent to expert panel (n = 26) who participated in the two rounds. After completing round 2, a total of 20 recommendation items, categorized into two sections were obtained. Agreement with the recommendations (rank 7–9) ranged from 91.7–100%. Consensus was reached (i.e. ⩾75% of respondents strongly agreed or agreed) on the wording of all the 20 clinical standards identified by the scientific committee. Algorithms for the diagnosis and management have been suggested. This was an expert, consensus recommendations for the diagnosis and treatment of IgAV and IgA vasculitic nephritis, based on best available evidence and expert opinion. The guideline presented a strategy of care with a pathway to achieve a state of remission as early as possible

In Vitro and In Silico Antioxidant Efficiency of Bio-Potent Secondary Metabolites From Different Taxa of Black Seed-Producing Plants and Their Derived Mycoendophytes

Oxidative stress is involved in the pathophysiology of multiple health complications, and it has become a major focus in targeted research fields. As known, black seeds are rich sources of bio-active compounds and widely used to promote human health due to their excellent medicinal and pharmaceutical properties. The present study investigated the antioxidant potency of various black seeds from plants and their derived mycoendophytes, and determined the total phenolic and flavonoid contents in different extracts, followed by characterization of major constituents by HPLC analysis. Finally, in silico docking determined their binding affinities to target myeloperoxidase enzymes. Ten dominant mycoendophytes were isolated from different black seed plants. Three isolates were then selected based on high antiradical potency and further identified by ITS ribosomal gene sequencing. Those isolated were Aspergillus niger TU 62, Chaetomium madrasense AUMC14830, and Rhizopus oryzae AUMC14823. Nigella sativa seeds and their corresponding endophyte A. niger had the highest content of phenolics in their n-butanol extracts (28.50 and 24.43 mg/g), flavonoids (15.02 and 11.45 mg/g), and antioxidant activities (90.48 and 81.48%), respectively, followed by Dodonaea viscosa and Portulaca oleracea along with their mycoendophytic R. oryzae and C. madrasense. Significant positive correlations were found between total phenolics, flavonoids, and the antioxidant activities of different tested extracts. The n-butanol extracts of both black seeds and their derived mycoendophytes showed reasonable IC50 values (0.81–1.44 mg/ml) compared to the control with significant correlations among their phytochemical contents. Overall, seventeen standard phenolics and flavonoids were used, and the compounds were detected in different degrees of existence and concentration in the examined extracts through HPLC analysis. Moreover, the investigation of the molecular simulation results of detected compounds against the myeloperoxidase enzyme revealed that, as a targeted antioxidant, rutin possessed a high affinity (−15.3184 kcal/mol) as an inhibitor. Taken together, the black seeds and their derived mycoendophytes are promising bio-prospects for the broad industrial sector of antioxidants with several valuable potential pharmaceutical and nutritional applications

Chemical constituents, anti-inflammatory, and antioxidant activities of Anisotes trisulcus

Anisotes trisulcus (Forssk.) Nees. (family Acanthaceae) aerial part is used in folk medicine in the Arabian peninsula for treatment of hepatic conditions. It showed different activities such as antibacterial, hepatoprotective, and cytotoxicity. It is a rich source of alkaloids and is used as an antidiabetic, bronchodilator, hypotensive, and local anesthetic. To the best of our knowledge, there is no report on the phenolic constituents of A. trisulcus. Therefore, this study aims to identify the constituents and establish antioxidant and anti-inflammatory activities of the total methanolic extract and different fractions. One new benzoyl flavonol: 7,8,3′-trihydroxy-5-methoxy-4′-benzoyl flavonol (5), along with eight known compounds: α-amyrin (1), β-sitosterol (2), stigmasterol (3), (2S,3S,4R)-2[(2′R)-2′-hydroxytetracosanoyl amino]-octadecane-1,3,4-triol (4), allopateuletin (6), veratric acid (7), vanillic acid (8), and β-sitosterol-3-O-β-d-glucopyranoside (9) were isolated from A. trisulcus aerial parts. Their structures were established by physical, chemical, and spectral data (UV, IR, MS, and 1D NMR), as well as comparison with authentic samples. The anti-inflammatory activity of the total methanolic extract and different fractions was evaluated using carrageenan-induced paw edema method at a dose of 400 mg/kg. Also, the antioxidant activity was determined using DPPH assay at concentrations 0.25, 0.5, and 1 mg/mL. The total MeOH extract and EtOAc fraction showed high antioxidant activity 75% and 68% (Conc. 1 mg/mL), respectively while, the n-hexane and EtOAc fractions exhibited significant anti-inflammatory effects

New secoiridoid ester of swertiamarin and secoxyloganic acid with hepatoprotective activity from Centaurium spicatum L.

Context: Centaurium spicatum (L.) Fritsch (Gentianaceae) is an annual herb occurring in Southern Europe and Northern Africa where it is used in traditional medicine for treatment of numerous illness. Aims: To isolate compounds from C. spicatum having hepatoprotective activity. Methods: Structure elucidation of the new compound was established on the basis of 1D and 2D NMR analyses including 1H-, 13C- NMR, DEPT-135 NMR, HMQC, HMBC and H- H HOHAHA experiments in addition to FAB+ and HRFAB+ Mass spectrometry. In vivo transaminases inhibition activity was carried out. Results: A new ester of swertiamarin and secoxyloganic acid (1) was isolated from C. spicatum in addition to its known components secoiridoids swertiamarin (2) and secoxyloganic acid (3). All tested secoiridoids have transaminases inhibition activity with different values for each compound 1, 2, 3 (86, 83, 81%) for SGOT and (96, 93, 91%) for SGPT, respectively. Conclusions: The new ester compound from C. spicatum has hepatoprotective activity over than its components

Hepatoprotection and Antioxidant Activity of Gazania Longiscapa and G. Rigens with the Isolation and Quantitative Analysis of Bioactive Metabolites

Gazania longiscapa and G. rigens are two species belonging to family Asteraceae. The present study aimed the isolation of the main active constituents from the methanol extracts using different chromatographic methods and their identification using different spectroscopic techniques, beside the quantitation of some biologically important active constituent as rutin using HPLC technique, together with estimation of total polyphenolic content calculated as gallic acid and estimation of total flavonoid content calculated as rutin using UV technique. Concomitantly the determination of the antioxidant and hepatoprotective activity of the total methanol extracts of the aerial parts of G. longiscapa and G. rigens. This work resulted in the isolation of 4 flavonoids (Apigenin, Luteolin, Luteolin 7-O-β-D-glucopyranosid, Apigenin 7-O-β-Dglucopyranosid), 3 phenolic acids (Caffeic acid, Chlorogenic acid and 3,5- di- O-caffeoylquinic acid) from G. longiscapa for the first time; these 3 phenolic acids were also isolated from G. rigens, together with one flavonoid (rutin), The quantitative determination of the methanol extracts showed that G. longiscapa is a richer source of phenolic acids than G. rigens and both Gazania species are valuable sources of rutin beside having hepatoprotective and antioxidant activity

Nutritional, Antioxidant, Antimicrobial, and Anticholinesterase Properties of <i>Phyllanthus emblica</i>: A Study Supported by Spectroscopic and Computational Investigations

Dietary fruits and vegetables play a vital role as food and drugs and are the main sources of antioxidant defences against degenerative diseases, such as brain dysfunctions, cardiovascular diseases, immune system deteriorations, and cancers, brought on by oxidative damage. Phyllanthus emblica is a significant herbal remedy used in conventional medicine to recover lost strength and power. In this research, the potential value of Phyllanthus emblica as a food and drug is researched. The total phenolic, total flavonoid, and total tannin contents as well as the nutritional value, vitamin C, vitamin E, and mineral contents of different organs of P. emblica were evaluated. The antioxidant and antimicrobial activities of extracts and fractions of different organs of P. emblica were determined. A total of eleven flavonoids, simple phenolic, tannin-related phenolic, and tannin molecules were isolated from a hydroalcoholic extract of the leaves and fruits. The structures were identified by spectroscopic data and comparison with the literature values as gallic acid (1), naringenin 7-O-(6″-O-galloyl)-β-D-glucopyranoside (2), 3,3′-di-O-methyl ellagic acid-4′-O-β-d-glucopyranoside (3), 1-O-galloyl glycerol (4), 1,6-di-O-galloyl-β-d-glucopyranoside (5), flavogallonic acid bislactone (6), corilagin (7), ethyl gallate (8), urolithin M5 (9), (E)-p-coumaroyl-1-O-β-d-glucopyranoside (10), and 1,2,4,6-tetra-O-galloyl-β-d-glucopyranoside (11). Among them, compounds 3 and 10 are first isolated from the plant. Molecular docking was performed to investigate the comparative interactions between positive controls (galantamine and donepezil) and selected compounds utilizing acetylcholinesterase (4EY7) as a target receptor. Results exhibited the potency of these compounds against the target receptor. In summary, P. emblica has a wealth of minerals, vitamins C and E, and polyphenolic phytochemicals that may work together to treat infectious disease, prevent and/or treat oxidative-damage-related illnesses including Alzheimer’s disease

Determination of Morphine and Its Metabolites in Human Urine by Capillary Electrophoresis with Laser Induced Fluorescence Detection Employing On-Column Labeling with a New Boronic Acid Functionalized Squarylium Cyanine Dye

A novel method for the labeling and rapid separation of morphine, morphine-3-beta-d-glucuronide (M3G) and morphine-6-beta-d-glucuronide (M6G) in human urine employing a new boronic acid functionalized squarylium dye (SQ-BA3) and capillary electrophoresis with laser induced fluorescence detection (CE-LIF) is described. The spectrochemical properties, solution stability, pH range, and mechanisms for interactions with morphine and its metabolites were first established for SQ-BA3, followed by optimization of an on-column labeling procedure and CE-LIF method. SQ-BA3 itself was shown to be unstable and weakly fluorescent in aqueous buffers due to aggregate formation. However, SQ-BA3 showed a relative stability and dramatic increase in fluorescence intensity upon the addition of morphine, M3G, and M6G. Because of the low background fluorescence of this dye, on-column labeling was feasible, leading to a simple and rapid analytical method with the potential for clinical applications