Effect of Designed Ureteral Stent Instructions on Patient Recovery

Context: Ureteral stent placement is performed in up to eighty percent of patients following ureteroscopy. It is associated with significant morbidity, resulting in a reduction in general health function in another eighty percent of patients.Aim: This study aimed to evaluate the effect of designed ureteral stent instructions on patient recovery.Methods: Quasi-experimental (pre/post-test) design was utilized in this study. The study was carried out at the urology department to be followed up through the urology outpatient clinic at Benha University Hospital from the beginning of February 2019 to February 2020 on a purposive sample of 134 patients. Four tools were used to collect the study data. These tools included a structured interview questionnaire to assess patients' knowledge regarding ureteral stents, a ureteral stent symptoms questionnaire, a ureteral stent discomfort test, and a patient's satisfaction assessment form. Results: Showed a mean study sample age of 43.42±6.47, 83.6% were males. The study also showed a statistically significant improvement of the study group’s knowledge in the post-operative and follow-up phases (p<0.017, <0.003), as well as a decrease in total mean score in ureteral stent symptoms and ureteral stent discomfort test (p<0.001), immediately and after designed instructions.Conclusion: Implementing designed instructions for patients with ureteral stents was effective in improving knowledge, a decrease of ureteral stent symptoms, and a decrease in patient discomfort. The study recommended manuals, information booklets, and self-instruction modules developed in areas of ureteral stent management

Effect of Enhanced Exercise Program on Pain and Physical Activity for Patients after Total Knee Arthroplasty

Context: Total knee arthroplasty (TKA) is considered the most effective orthopedic procedure for treating knee osteoarthritis. The need for knee replacement is predicted to increase six-fold between 2005 and 2030 to reflect an increasingly yet functionally demanding population.Aim: This study aimed to evaluate the effect of an enhanced exercise program on pain and physical activity after total knee arthroplasty. Methods: Quasi-experimental (pre/post-test) design was utilized in this study. The study was carried out in the orthopedic department, at Benha University Hospital, and followed the patients through the orthopedic outpatient clinic from the beginning of May 2020 till the beginning of May 2021. A purposive sample of 64 patients was recruited to achieve the aim of this study. Four tools were used to collect the study data. These are the structured interview questionnaire to assess patients' knowledge regarding total knee arthroplasty, Barthel ADL index scale, Lysholm knee scoring scale, and Numeric Pain Rating Scale to assess the effect of the enhanced exercise program. Results: Showed that nearly two-thirds of the study sample was ≤60 years old, females, and married. The study also showed a statistically significant difference between pre-and post- enhanced exercise program in terms of total knowledge mean score among the study sample, as well as an increase in the total mean score in Barthel ADL index, decrease in Lysholm knee scoring, and pain score after one month and after three months of enhanced program exercise implementation. Conclusion: Implementing an enhanced exercise program for patients with total knee arthroplasty effectively improved knowledge, increased physical activity (Barthel ADL index), and decreased Lysholm knee scoring, and pain score. The present study recommended including an enhanced exercise program in the treatment plan for patients with total knee arthroplasty to improve patients' knowledge and practices. Also, repeating the study on a larger probability sample to achieve generalization of the findings

Effects of Anesthetic Management on Inflammatory Markers in Patients After Major Abdominal Surgeries: A Double-Blind Controlled Study

Background: Surgical trauma induces systemic inflammatory responses. We aimed to evaluate the influence of different analgesic models on postoperative pain and inflammatory markers modulation after major abdominal surgeries. Materials and Methods: A total of 105 patients scheduled for elective abdominal colorectal surgeries were selected and randomly assigned to one of the three groups: Group-1 (GM) four micrograms/kg of IT morphine; Group-2 (GML) four microgram/kg of IT morphine plus 1.5 mg/kg intravenous Lidocaine loading dose and 2 mg/min saline infusion during the operation and the next 4 hours postoperative; Group-3 (G0, control group) no added drugs. Results: Pain scored statistically significant lower figures in GML than the other two groups; p<0.001. Tumor Necrosis Factor-alpha serum levels showed a statistically significant difference between the three groups; P <0.001; GML showed the lowest level, followed by group GM and Group 0 (10.3±4.4 vs. 20±4.4 vs. 26±7.5). Transforming Growth Factor beta-1 demonstrated the highest levels measured in GML, high levels in GM, and the lowest level in G0; p<0.001, where mean serum levels were 43.1±12.5, 26 ±4.2, and 18.9±7.7, respectively. Opioid consumption was significantly lower in GML than other two groups; P<0.001. Conclusion: Intraoperative and early postoperative intravenous Lidocaine infusion significantly improved the quality of postoperative analgesia. Optimizing analgesia in anesthetic management has a favorable effect on the pro and anti-inflammatory mediators. Keywords: Abdominal surgeries, Postoperative pain, TNF-alpha and TGF-bet

Assessment of the Effect of Granisetron on the Gastric Cross-Sectional Area By Ultrasound on Patients Undergoing Elective Cesarean Section: A Randomized Double-Blind Study

Background: Gastric ultrasound is considered a valuable tool for the assessment of gastric volume preoperatively. Materials and Methods: The goal of this study was to assess the effect of granisetron on the gastric cross-sectional area by ultrasound estimation of its cross-sectional area for elective Cesarean Section. Sixty patients were assigned randomly into one of 2 groups; Granisetron group (n=30): received 1 mg granisetron diluted in 10 mL normal saline 0.9%. Control (n=30): received 10 mL of normal saline 0.9%. Cross-sectional area and volume of stomach contents were measured using ultrasound immediately before administration of the study drug and one hour later. Results: No statistical difference was detected in post-treatment antral CSA nor gastric residual volume between the two groups (4.8±1.4 vs 4.6±2.1, P: 0.8) and (50±19 vs 57±27, P: 0.3) for antral CSA and gastric volume comparison between both groups. However, a significant statistical difference was found in antral CSA pre and post-granisetron administration (4.8±1.4 vs 4 ±1.2; P<0.001). The Granesitron group had a statistically significantly lower rate of nausea and vomiting than the control group. Conclusion: Based on ultrasonographic measurement granesitron could effectively reduce the gastric cross-sectional area when administered preoperatively to parturients undergoing elective CS

أزمة الفكر الفلسفي العربي وانعكاساتها على الواقع

تعود أزمة الفكر الفلسفي العربي اليوم إلى مجموعة من الأسباب التي جعلت ملامِحه ترتَسِم ضمن صورةٍ تتّسم بالغموض في توجّهاته، فتارةً نجده أسير الحضارة العربية الماضية التي مثّلت أوج ازدهار الفكر والفلسفة العربية، وتارةً يحاول اللحاق بما آل إليه الفكر العالمي المعاصر، وما يتم طرحه من موضوعات تؤثر وبشكل مباشر في الواقع وتزيد من فعاليّة المشروع الفكري. لذلك فإن هذا المقال يهدف إلى توضيح بعض ملامح تلك الأَزمة، وتبيان أنه لا بدّ للفكر العربي اليوم من حركة قويّة تتخطّى الانتكاسة التي يمرّ بها وتستعيد البوصلة الفكرية إلى ما كانت عليه وفق منهج واضح محدد المعالم

A randomized trial of brief treatment of earlystage Hodgkin lymphoma: Is it effective?

BACKGROUND AND OBJECTIVESWhether it is possible to reduce the intensity of treatment in early (stage I or II) Hodgkin lymphoma with a favorable prognosis remains unclear. Therefore, we conducted this randomized trial, comparing two treatment groups consisting of a combination chemotherapy regimen of two different intensities followed by involved-field radiation therapy at two different dose levels.DESIGN AND SETTINGProspective, randomized, in patients referred to the Department of Clinical Oncology and Nuclear Medicine.PATIENTS AND METHODSNinety-eight patients with histologically proven early-stage Hodgkin lymphoma with a favorable prognosis were enrolled in this study between January 2008 and June 2010. They were randomly assigned in one of two treatment arms: arm I received four cycles of ABVD (Adriamycin, belomycin, vinblastine, dacarbazine) followed by 30Gy of involved-field radiation therapy; arm II received two cycles of ABVD followed by 20Gy of involved-field radiation therapy.RESULTSDuring the follow-up period, the 2-year relapse free survival rates were 96% and 95% in arm I and arm II, respectively(P=.8), while the 2-year overall survival rates were 98% and 95% in arm I and arm II, respectively (P=.16). Acute toxicity affected 54% of patients treated with four cycles of ABVD, who had grade III or IV toxicity, as compared with 30% of those receiving two cycles (P<.02). The rates of acute toxicity (grade III or IV) were also higher among patients treated with 30Gy of involved-field radiation therapy than among those receiving 20Gy (16% vs. 2.5%, P<.03).CONCLUSIONIn patients with early-stage Hodgkin lymphoma and a favorable prognosis, treatment with two cycles of ABVD followed by 20Gy of involved-field radiation therapy was as effective as, and less toxic than, four cycles of ABVD followed by 30Gy of involved-field radiation therapy

Effect of zinc supplementation on growth Hormone Insulin growth factor axis in short Egyptian children with zinc deficiency

BACKGROUND: The relationship between zinc (Zn) and growth hormone-insulin growth factor (GH-IGF) system and how Zn therapy stimulates growth in children has not been clearly defined in humans. Thus, we aimed to assess GH-IGF axis in short children with Zn deficiency and to investigate the effect of Zn supplementation on these parameters. METHODS: Fifty pre-pubertal Egyptian children with short stature and Zn deficiency were compared to 50 age-, sex-, and pubertal stage- matched controls. All subjects were subjected to history, auxological assessment and measurement of serum Zn, IGF-1, insulin growth factor binding protein-3 (IGFBP-3); and basal and stimulated GH before and 3 months after Zn supplementation (50 mg/day). RESULTS: After 3 months of Zn supplementation in Zn-deficient patients, there were significant increases in height standard deviation score (SDS, P = 0.033), serum Zn (P < 0.001), IGF-1 (P < 0.01), IGF-1 standard deviation score (SDS,P < 0.01) and IGFBP-3 (P = 0.042). Zn rose in all patients but reached normal ranges in 64 %, IGF-1 levels rose in 60 % but reached normal ranges in 40 % and IGFBP-3 levels rose in 40 % but reached reference ranges in 22 %. Growth velocity (GV) SDS did not differ between cases and controls (p = 0.15) but was higher in GH-deficient patients than non-deficient ones, both having Zn deficiency (p = 0.03). CONCLUSION: Serum IGF-1 and IGFBP-3 levels were low in short children with Zn deficiency, and increased after Zn supplementation for 3 months but their levels were still lower than the normal reference ranges in most children; therefore, Zn supplementation may be necessary for longer periods

Schistosomiasis and Bladder Cancer in Egypt: Truths and Myths

BACKGROUND: The gathered archeopathological evidence has confirmed that Schistosomiasis has been endemic in Ancient Egypt for over 500 decades. The association between Schistosoma hematobium and increase bladder cancer risk is also well acknowledged. However, over the years, there is a proved changing pattern of bladder cancer that needs to be investigated. AIM: We aim to discuss the truths and myths about bladder cancer and its association with Schistosomiasis in Egypt. METHODS: A cross-sectional, case-control study was performed to collect recent data on the topic. RESULTS: Of the reported cancer cases, 79.3% were transitional cell carcinoma (TCC), an additional 6% showed associated squamous features. Squamous cell carcinoma (SCC) constituted only 13.8% of cancer cases. Schistosomiasis was histologically confirmed in 19 cancer cases, only one was SCC. The relative frequency of TCC is increasing, while SCC is decreasing. There is no evidence that this pattern is related to smoking or environmental factors, as the incidence of lung cancer, is not proportionately increasing. CONCLUSION: The old concept that Schistosomiasis is associated with SCC should be revaluated as most cases are associated with TCC. Relying on the histopathology for confirmation of Schistosomiasis in our research studies appears to be non-accurate and leads to irrelevant results

Fetal adrenal biometry, cervical assessment and inflammatory cytokine for prediction of preterm labor: Comparative study

Background: Preterm birth is a multifactorial problem with a confounding management. Latent interval (Time to delivery) always shows wide variation and presence of a valid, reliable and applicable predictor is a controversial issue.Objectives: to evaluate the role of fetal adrenal biometry (corrected-total gland volume c-TGV and fetal zone enlargement FZE), cervical length and IL17 serum level (maternal inflammatory biomarker) in prediction of preterm that could help in proper management and decreased morbidities.Patient and Methods: Observational comparative study for 100 case (28 to 36 weeks gestation) showing clinical signs of threatened preterm labor. Corrected fetal adrenal gland volume, fetal zone enlargement, cervical length and IL17 serum level were measured then all candidates were followed up till delivery to classify the results into two groups according to the (latent interval). Diagnostic performance for all variables was done to detect the best cutoff value that can predict impending preterm delivery within 7 days using univariate analysis and receiver operating characteristic (ROC) curve.Results: The studied predictors were showing best cutoff, sensitivity%, specificity% and accuracy% as follow: c-TGV (≥400 mm3/kg, 80, 75, 85), FZE(≥ 50%, 90, 80, 92), cervical length (≤16 mm, 70, 67, 65), IL17 serum level (8 pg/ml, 80, 95, 83) respectively.Conclusion Utility of corrected fetal adrenal gland volume, fetal zone enlargement in addition to the IL17 (inflammatory marker) as a non-invasive predictors for impending preterm birth can guide a proper decision