Nursing Students' Knowledge and Attitudes toward Danger Signs in Neonatal Illnesses.

Background and Objectives: Neonates can show subtle signs of illness that could be overlooked by their mothers and caregivers. Therefore, basic knowledge regarding neonatal health and early detection of neonatal diseases can help improve survival. We assessed nursing students' knowledge and attitudes toward the danger signs of neonatal illnesses. Materials and Methods: We performed a descriptive cross-sectional study using a structured online questionnaire based on danger signs categorized by the World Health Organization to assess knowledge of neonatal illness danger signs among nursing students. Results: We assessed 342 students, of which 67.0% (95% CI: 61.8-71.7) had good knowledge regarding neonatal illness danger signs, and 71.6% received information about neonatal care. About 33% of the participants had a basic knowledge of neonatal care, such as breastfeeding, immunization, routine postnatal care, and eye care. Students who received information on neonatal care were three times (AOR = 2.95, 95% CI: 11.59-5.47, p = 0.001) more likely to have good knowledge than those who did not. The students also showed a positive attitude towards the importance of knowledge regarding neonatal illness danger signs, teaching this subject in their college, participating in studies involving the practice and knowledge of mothers regarding neonatal illness danger signs, and the importance of knowledge in reducing neonatal mortality in the region. Conclusions: More training programs on neonatal care should be implemented to enhance knowledge and raise nursing students' awareness of the dangerous signs of neonatal illnesses.

Dynamics of parasite growth in genetically diverse Plasmodium falciparum isolates.

Multiple parasite lineages with different proliferation rates or fitness may coexist within a clinical malaria isolate, resulting in complex growth interactions and variations in phenotype. To elucidate the dynamics of parasite growth in multiclonal isolates, we measured growth rates (GRs) of three Plasmodium falciparum Cambodian isolates, including IPC_3445 (MRA-1236), IPC_5202 (MRA-1240), IPC_6403 (MRA-1285), and parasite lineages previously cloned from each of these isolates by limiting dilution. Following synchronization, in vitro cultures of each parasite line were maintained over four consecutive asexual cycles (192 h), with thin smears prepared at each 48-h cycle to estimate GR and fold change in parasitemia (FCP). Cell cycle time (CCT), the duration it takes for ring-stage parasites to develop into mature schizonts, was measured by monitoring the development of 0-3-h post-invasion rings for up to 52 h post-incubation. Laboratory lines 3D7 (MRA-102) and Dd2 (MRA-150) were used as controls. Significant differences in GR, FCP, and CCT were observed between parasite isolates and clonal lineages from each isolate. The parasite lines studied here have well-defined growth phenotypes and will facilitate basic malaria research and development of novel malaria interventions. These lines are available to malaria researchers through the MR4 collection of NIAID's BEI Resources Program.

Fabrication of a Novel CNT-COO-/Ag3PO4@AgIO4Composite with Enhanced Photocatalytic Activity under Natural Sunlight.

In this study, a carboxylated carbon nanotube-grafted Ag3PO4@AgIO4 (CNT-COO-/Ag3PO4@AgIO4) composite was synthesized through an in situ electrostatic deposition method. The synthesized composite was characterized by Fourier transform infrared (FT-IR) spectroscopy, X-ray diffraction (XRD), scanning electron microscopy (SEM), diffuse reflectance spectroscopy (DRS), and energy-dispersive X-ray spectroscopy (EDS). The electron transfer ability of the synthesized composite was studied using electrochemical impedance spectroscopy (EIS). The CNT-COO-/Ag3PO4@AgIO4 composite exhibited higher activity than CNT/Ag3PO4@AgIO4, Ag3PO4@AgIO4, and bare Ag3PO4. The material characterization and the detailed study of the various parameters thataffect the photocatalytic reaction revealed that the enhanced catalytic activity is related to the good interfacial interaction between CNT-COO and Ag3PO4. The energy band structure analysis is further considered as a reason for multi-electron reaction enhancement. The results and discussion in this study provide important information for the use of the functionalized CNT-COOH in the field of photocatalysis. Moreover, providinga new way to functionalize CNT viadifferent functional groups may lead to further development in the field of photocatalysis. This work could provide a new way to use natural sunlight to facilitate the practical application of photocatalysts toenvironmental issues.

Can metformin modulate the retinal degenerative changes in a rat model of retinitis pigmentosa?

Retinitis pigmentosa (RP) affects over a million people worldwide, characterized by photoreceptor cell death, progressive retinal degeneration, and visual loss. Metformin is demonstrated as a potential therapeutic approach for preventing light-induced retinal degeneration by decreasing apoptosis and oxidative stress. This work aimed to investigate the effect of metformin on the retina of the N-Ethyl-N-nitrosourea (ENU) induced rat model of RP. Eighteen adult male Wistar rats were divided into two groups. Group I: normal vehicle control (N = 6). Group II: ENU-induced photoreceptor degeneration (N = 12) received a single intraperitoneal injection of ENU at a 600 mg/kg dose. Rats in group II were equally divided into two subgroups: IIa: photoreceptor degeneration-induced group and IIb: metformin-treated group (200 mg/kg) for seven days. Specimens from the retina were processed for light and electron microscopy. In ENU treated group, the retina revealed vacuolations and morphological changes in the glia (Müller cells and microglia) and blood capillaries. Increasing caspase-3 (apoptotic marker), iNOS (oxidative stress marker), CD68 (macrophage marker) and glial fibrillary acidic protein (GFAP) expression were detected. In the metformin-treated group, the retinal vacuolations reduced with the morphological improvement in the glia and blood capillaries. Caspase-3, iNOS, CD68, and GFAP expression decreased. Metformin was found to have a neuroprotective effect on the retina in ENU induced rat model of RP.

Cobalt and lead concentrations in cosmetic products sold at local markets in Saudi Arabia.

Cosmetics are products that can be used on the human body for cleaning, beautification or enhancing perceived attractiveness. Cosmetics may contain a variety of heavy metals such as cobalt (Co) and lead (Pb), which at high concentrations may pose adverse effects on human health. This study focuses to measure the concentration of heavy metals (Co and Pb) in some cosmetic samples of four types (foundation, skin lighteners, kajal (kohl) and lawsone (henna)) available at local markets in Saudi Arabia. The total number of all cosmetic samples understudy was 41. The samples were analysed using atomic absorption spectroscopy to measure the content of Co and Pb. Quality control of the data was performed using Standard Reference Materials [IAEA-V-10] hay powder. For all cosmetic types and qualities combined, the Co concentration range was determined to be 21.14 ± 3.70-144.91 ± 2.27 µg/g and the Pb range 0.75 ± 0.00-10.60 ± 1.24 µg/g. The Co concentration in all cosmetic types understudy was higher than the recommended level. Pb concentration was within the range recommended by the United States Food and Drug Administration in all types of cosmetics except for kohl, for which 22 % of the samples contained concentrations higher than the permissible limit. The findings of this study call for immediate and ongoing testing to monitor the concentrations of toxic metals in cosmetic products used in Saudi Arabia to ensure that established limits are respected and thereby protect consumer health.

Metformin treatment confers protection of the optic nerve following photoreceptor degeneration.

Acquired or inherited or photoreceptor loss causes retinal ganglion cell loss and ultimately axonal transport alteration. Thus, therapies should be applied early during photoreceptors degeneration before the remodeling process reaches the inner retina. This study aimed to evaluate the protective effect of metformin on the rat optic nerve following photoreceptors loss induced by N-Ethyl-N-nitrosourea (ENU). Eighteen adults male Wistar rats were divided into two groups. Group I: normal vehicle control (n=6). Group II: ENU-induced photoreceptors degeneration (n=12) received a single intraperitoneal injection of ENU at a dose of 600 mg/kg. Rats in group II were equally divided into two subgroups: IIa: photoreceptor degeneration induced group and IIb: metformin treated group (200 mg/kg) for 7 days. Specimens from the optic nerve were processed for light and electron microscopy. In ENU treated group, the optic nerve revealed reduction in the diameter of the optic nerve fibers and thinning of myelin sheath with morphological changes in the glia (astrocytes, oligodendrocytes, and microglia). Caspase-3 (apoptotic marker), iNOS (oxidative stress marker) and CD68 (macrophage marker) expression increased. In metformin-treated group, the diameter of optic nerve fibers and myelin sheath thickness increased with improvement of the deterioration in the glia. Caspase-3, iNOS and CD68 expression decreased. Metformin ameliorates the histological changes of the rat optic nerve following photoreceptors loss induced by ENU.

Interplay of Biochemical, Genetic, and Immunohistochemical Factors in the Etio-Pathogenesis of Gastric Ulcer in Rats: A Comparative Study of the Effect of Pomegranate Loaded Nanoparticles Versus Pomegranate Peel Extract.

BACKGROUND: Few data are available about the role of herbal extract loaded nanoparticles as an alternative safe medicine for the management of a gastric ulcer. AIM: This work is targeted at exploring the physiological effects of pomegranate loaded nanoparticles (PLN) against an indomethacin IND-induced gastric ulcer and comparing the results with traditional pomegranate peel extract (PPE). METHODS: Twenty-four rats were equally distributed into four groups: control, IND-treated, PLN-treated, and PPE-treated groups. Gross examination of gastric mucosa, and the calculation of ulcer and inhibition indices were done. Serum malondialdehyde (MDA), total antioxidant capacity (TAC), interleukin 2 (IL-2), IL-6, IL-10, gastric homogenate prostaglandin E2 (PGE2), and nitric oxide (NO) were estimated. Mucosal endothelial nitric oxide synthase (eNOS mRNA) expression was identified by qPCR. Histological and immuno-histochemical staining of Tumor necrosis factor-α (TNF-α) and eNOS of stomach mucosa were performed. RESULTS: In comparison with the control group, IND-treated rats showed visible multiple ulcers with ulcer index, serum MDA, IL-2 and IL-6 were elevated while IL-10, PGE2, NO, and eNOS mRNA expression were significantly reduced. Damaged surface epithelium with disrupted glandular architecture and heavy leucocyte infiltration of lamina propria was noticed. Immunohistochemical staining of stomach mucosa revealed marked increased TNF-α and reduced eNOS. Oral administration of PLN and PPE succeeded in improving the gross mucosal picture, and all biochemical, histological, and immunohistochemical alterations. CONCLUSION: Both PLN and PPE potently alleviated IND-induced gastric ulceration via increasing TAC, PGE2, NO, eNOS mRNA, and protein expression. However, the healing effect of PLN was obviously greater than PPE-treated rats.

Dissection of haplotype-specific drug response phenotypes in multiclonal malaria isolates.

Natural infections of Plasmodium falciparum, the parasite responsible for the deadliest form of human malaria, often comprise multiple parasite lineages (haplotypes). Multiclonal parasite isolates may exhibit variable phenotypes including different drug susceptibility profiles over time due to the presence of multiple haplotypes. To test this hypothesis, three P. falciparum Cambodian isolates IPC_3445 (MRA-1236), IPC_5202 (MRA-1240) and IPC_6403 (MRA-1285) suspected to be multiclonal were cloned by limiting dilution, and the resulting clones genotyped at 24 highly polymorphic single nucleotide polymorphisms (SNPs). Isolates harbored up to three constituent haplotypes, and exhibited significant variability (p < 0.05) in susceptibility to chloroquine, mefloquine, artemisinin and piperaquine as measured by half maximal drug inhibitory concentration (IC50) assays and parasite survival assays, which measure viability following exposure to pharmacologically relevant concentrations of antimalarial drugs. The IC50 of the most abundant haplotype frequently reflected that of the uncloned parental isolate, suggesting that a single haplotype dominates the antimalarial susceptibility profile and masks the effect of minor frequency haplotypes. These results indicate that phenotypic variability in parasite isolates is often due to the presence of multiple haplotypes. Depending on intended end-use, clinical isolates should be cloned to yield single parasite lineages with well-defined phenotypes and genotypes. The availability of such standardized clonal parasite lineages through NIAID's BEI Resources program will aid research directed towards the development of diagnostics and interventions including drugs against malaria.

Glucagon-like peptide-1 analog improves neuronal and behavioral impairment and promotes neuroprotection in a rat model of aluminum-induced dementia.

BACKGROUND: Alzheimer's disease (AD) is a worldwide severe medical and social burden. Liraglutide (LIR) has neuroprotective effects in preclinical animal models. AIM: To explore the probable neuroprotective impact of Glucagon-like peptide-1 (GLP-1) on rats' behavior and to elucidate its underlying mechanisms. METHODS: A total of 24 male albino rats were assigned to control, LIR (300 µg/kg subcutaneously (s.c.)), AD only (100 mg/kg aluminum chloride (AlCl3 ) orally) and LIR + AD treated groups. Eight radial arm maze was performed. Serum blood glucose, proinflammatory cytokines, oxidative stress markers were measured and hippocampal tissue homogenate neurotransmitters were evaluated. Histopathological and immunofluorescent examinations were performed. RESULTS: LIR prevents the impairment of learning and improves both working memory and reference memory through significant reduction of serum tumor necrosis factor (TNF-α), interleukin 6 (IL-6) and interferon-γ (INF-γ) and malondialdehyde (MDA) and through the increase of superoxide dismutase (SOD), dopamine, adrenaline, and noradrenaline. LIR also improves hippocampal histological features of ALCL3 administrated rats and decreases the percentage of neuronal loss. CONCLUSION: LIR normalizes ALCL3 -induced dementia. It improves cognitive dysfunction and ameliorates cerebral damage.

Etching Patterns of Sodium Hypochlorite Pretreated Hypocalcified Amelogenesis Imperfecta Primary Molars: SEM Study.

Aim: To investigate the etching patterns of hypocalcified amelogenesis imperfecta (AI) in primary molars pretreated with 5.25% NaOCl prior to phosphoric acid application using scanning electron microscopy (SEM). Study design: Ten hypocalcified AI primary molars were collected, sectioned longitudinally into 2 parts and allocated into two groups of ten specimens each. The enamel surface in the first group (control group) was etched using 37% phosphoric acid gel for 15 seconds; while in the second group (study group), it was pretreated using 5.25 sodium hypochlorite(NaOCl) for 60 seconds prior to acid etching. Each specimen was examined at 16 different sites, and evaluated for the etching pattern (types I, II, and III) distribution using SEM. A total of 320 microphotographs at 1,500 magnification were obtained using Auto-Cad 2007 software. Results: The etching pattern with phosphoric acid was not uniform with predominance of type III etching (65.63%), while the pretreated enamel surfaces showed a significant increase in type I and II(82.5%) etching patterns (P<0.001). Conclusion: Treatment of primary teeth affected by hypocalcified AI using 5.25% NaOCl prior to phosphoric acid etching significantly improves the etching pattern which is required for good resin bonding.

Minocycline modulates microglia polarization in ischemia-reperfusion model of retinal degeneration and induces neuroprotection.

Retinal ischemia-reperfusion (IR) injury causes irreversible loss of neurons and ultimately leads to permanent visual impairment and blindness. The cellular response under this pathological retinal condition is less clear. Using genetically modified mice, we systematically examined the behavior of microglia/macrophages after injury. We show that IR leads to activation of microglia/macrophages indicated by migration and proliferation of resident microglia and recruitment of circulating monocytes. IR-induced microglia/macrophages associate with apoptotic retinal neurons. Very interestingly, neuron loss can be mitigated by minocycline treatment. Minocycline induces Il4 expression and M2 polarization of microglia/macrophages. IL4 neutralization dampens minocycline-induced M2 polarization and neuroprotection. Given a well-established safety profile as an antibiotic, our results provide a rationale for using minocycline as a therapeutic agent for treating ischemic retinal degeneration.

Mycetoma laboratory diagnosis: Review article.

Mycetoma is a unique neglected tropical disease caused by a substantial number of microorganisms of fungal or bacterial origins. Identification of the causative organism and the disease extension are the first steps in the management of the affected patients and predicting disease treatment outcome and prognosis. Different laboratory-based diagnostic tools and techniques were developed over the years to determine and identify the causative agents. These include direct microscopy and cytological, histopathological, and immunohistochemical techniques in addition to the classical grain culture. More recently, various molecular-based techniques have joined the mycetoma diagnostic armamentarium. The available mycetoma diagnostic techniques are of various specificity and sensitivity rates. Most are invasive, time consuming, and operator dependent, and a combination of them is required to reach a diagnosis. In addition, they need a well-equipped laboratory and are therefore not field friendly. This review aims to provide an update on the laboratory investigations used in the diagnosis of mycetoma. It further aims to assist practising health professionals dealing with mycetoma by outlining the guidelines developed by the Mycetoma Research Centre, University of Khartoum, WHO collaborating centre on mycetoma following a cumulative experience of managing more than 7,700 mycetoma patients.

Cone Photoreceptor Irregularity on Adaptive Optics Scanning Laser Ophthalmoscopy Correlates With Severity of Diabetic Retinopathy and Macular Edema.

Purpose: To determine whether cone density, spacing, or regularity in eyes with and without diabetes (DM) as assessed by high-resolution adaptive optics scanning laser ophthalmoscopy (AOSLO) correlates with presence of diabetes, diabetic retinopathy (DR) severity, or presence of diabetic macular edema (DME). Methods: Participants with type 1 or 2 DM and healthy controls underwent AOSLO imaging of four macular regions. Cone assessment was performed by independent graders for cone density, packing factor (PF), nearest neighbor distance (NND), and Voronoi tile area (VTA). Regularity indices (mean/SD) of NND (RI-NND) and VTA (RI-VTA) were calculated. Results: Fifty-three eyes (53 subjects) were assessed. Mean ± SD age was 44 ± 12 years; 81% had DM (duration: 22 ± 13 years; glycated hemoglobin [HbA1c]: 8.0 ± 1.7%; DM type 1: 72%). No significant relationship was found between DM, HbA1c, or DR severity and cone density or spacing parameters. However, decreased regularity of cone arrangement in the macular quadrants was correlated with presence of DM (RI-NND: P = 0.04; RI-VTA: P = 0.04), increasing DR severity (RI-NND: P = 0.04), and presence of DME (RI-VTA: P = 0.04). Eyes with DME were associated with decreased density (P = 0.04), PF (P = 0.03), and RI-VTA (0.04). Conclusions: Although absolute cone density and spacing don't appear to change substantially in DM, decreased regularity of the cone arrangement is consistently associated with the presence of DM, increasing DR severity, and DME. Future AOSLO evaluation of cone regularity is warranted to determine whether these changes are correlated with, or predict, anatomic or functional deficits in patients with DM.

As good as it gets? Retention in care of people newly diagnosed with HIV at the Sydney Sexual Health Centre.

A retrospective review of all new HIV positive patients attending the Sydney Sexual Health Centre in 2012 and 2013 was performed to ascertain the retention in care rates, proportion that achieved viral suppression, number of SMS reminders sent and counselling uptake. Ninety-six patients had a retention rate of 66%. Thirty-three patients (34%) were not retained in care, 16 (17%) were knowingly attending another healthcare service with 17 (18%) categorised as lost to follow up. Counselling referrals had a 74% (71/96) uptake (95%CI: 5.08-69.69, P<0.001), with SMS reminders sent in 97% (93/96) of cases (95%CI: not possible with zero count cells, P=0.038). Overall, the clinic performed well compared with international standards but the lost to follow-up rate remains a concern.

Arabic-speaking students' primary care experiences in Scotland.

Internationalisation of the higher education sector has resulted in greater ethnic and cultural diversity within the student population throughout the UK and European Union. There is limited knowledge about the burden of poor health and health care utilisation among minority ethnic groups in higher education. Scottish health policy is directed toward proactive care delivered within primary care settings. The community of one university in Scotland was chosen to explore the perceptions of accessibility and acceptability of primary care among one minority group, namely Arabic speakers. The research methodology was of an exploratory descriptive design, with a convenience sample of Arabic speakers studying at one university. Quantitative and qualitative data were provided by 20 respondents. A questionnaire elicited demographic data and information about any primary care services used, while semi-structured interviews gathered more in-depth data. Participants were generally satisfied with primary health services. The majority were satisfied with the availability of a healthcare professional of their preferred gender, and their communication with and attitudes of healthcare professionals, as well as the health information provided. Recommendations include greater availability of written information in Arabic, and further research concerning cultural competence for healthcare professionals.

Clinical evaluation of Papacarie in primary teeth.

UNLABELLED: The change in the concepts of cavity preparation and the development of reliable adhesive materials lead to the development of alternative methods of caries removal. Chemo-mechanical caries removal (CMCR) involves the chemical softening of carious dentin, followed by its removal with gentle excavation. OBJECTIVE: The present study was conducted to evaluate clinically the efficiency of caries removal using a new chemo-mechanical agent (Papacarie) compared to the conventional drilling method including the need for local anesthesia, the need for drill, duration of the treatment and the pain reaction. STUDY DESIGN: This study was split mouth design. The study was performed on thirty seven bilateral open carious lesions. They were divided into two equal groups according to method of caries removal. In Group I, caries was removed using the Papacarie system and in Group II, caries was removed with the conventional drill. RESULTS: The results showed that the Papacarie was as efficient as the drill in caries removal from open carious lesions with no significant difference in the operating time. The new CMCR agent also reduced significantly the need for local anesthesia and the use of drill. In addition, Papacarie was also more comfortable than the traditional rotatory instruments. CONCLUSIONS: It was concluded that Papacarie could be an effective caries removal method to treat children, particularly those who present with early childhood caries or management problems.

Study of selected trace elements in cancerous and non-cancerous human breast tissues from Sudanese subjects using instrumental neutron activation analysis.

This study was performed to investigate the influence of cancer on selected trace elements among Sudanese patients with confirmed breast cancer. Instrumental neutron activation analysis was used to estimate contents of Se, Zn, Fe, Cr, Rb, Cs, Co and Sc in 40 subjects. Wilcoxon signed ranks test was used to examine if there was any difference in the concentrations of elements from normal and malignant tissues. It was found that Se, Zn and Cr elements from the malignant tissues are significantly elevated (P < 0.05) compared to the normal tissue. The results obtained have shown consistency with results obtained by some previous studies.

Overview of biomedical waste management in selected Governorates in Egypt: a pilot study.

Inadequate management of biomedical waste can be associated with risks to healthcare workers, patients, communities and their environment. This study was conducted to assess the handling and treatment of biomedical waste in different healthcare settings in Egypt. Five hospitals and ten primary healthcare settings were surveyed using a modified survey questionnaire for waste management. This questionnaire was obtained from the World Health Organization (WHO), with the aim of assessing the processing systems for biomedical waste disposal. Researchers found that biomedical waste is inadequately processed in hospitals and primary healthcare settings due to the absence of written policies and protocols. Accordingly, healthcare staff, patients, the community and the environment may be negatively affected by exposure to the hazards of biomedical waste. The development of waste management policies, plans, and protocols are strongly recommended, in addition to establishing training programs on proper waste management for all healthcare workers.

Assessment of the nutritional status of end-stage renal disease patients on maintenance hemodialysis.

We assessed the nutritional status of 50 patients on maintenance hemodialysis by performing anthropometric measurement (pre and post dialytic weight, height, mid-upper arm circumference (MUAC) and related biochemical analysis. The malnutrition score was calculated from the body mass index (BMI), MUAC, hemoglobin, clinical signs of nutritional deficiencies and gastrointestinal manifestations. Stepwise multiple logistic regression analysis was carried out with malnutrition as a dependent variable. There was equal number of men and women in the study with a mean age of 39.5+/-12.1 years. The main cause of renal failure was arterial hypetension (30%), followed by glomerulonephritis (22%). The mean period of hemodialysis was 1.2 +/- 0.9 years. The mean total knowledge score about avoidable food was 2.86+/-1.59 (Total=6) and only 14% have a satisfactory knowledge score. A significant difference between men and women was found in the mean predialytic (52.1+/-9.6 kg) and post dialytic weight (50.0+/-9.7 kg) P< 0.05, while there was insignificant difference in the mean MUAC (22.6+/-3.3 centimeters) and BMI (20.3+/-2.9 kg/meter 2 ). The malnutrition score showed 70% of moderately malnourished patients and 20% severely malnourished. Abnormal biochemical parameters were encountered in the majority of patients. Old age (>/=50 years) was significantly associated with malnutrition. All the patients received only six hours of dialysis a week, which was inadequate dose and had the major impact on the patient's nutritional status. We conclude that poor nutritional status was detected among a significant number of patients with poor dietary knowledge and practices. Increased risk of malnutrition was significantly associated with older age (>/=50 years) and inadequate dialysis dose.