Impact of a culturally adapted behavioural family psychoeducational programme in patients with schizophrenia in Egypt

Objective: To study the effect of a culturally adapted, structured family intervention on symptom severity, medication attitudes and knowledge, social functioning and quality of life in patients with schizophrenia.

Methods: Thirty subjects with schizophrenia were selected to receive 14 sessions of a culturally adapted behavioural family psychoeducational programme (BFPEP). Another 30 subjects received standard treatment as usual (STU) for 6 months. Pre- and post-intervention outcomes were assessed using the Positive and Negative Syndrome Scale (PANSS), Drug Attitude Inventory 10-item scale (DAI-10), Quality of Life Scale (QLS) and Social Functioning Questionnaire (SFQ).

Results: There was a no significant difference between BFPEP and STU at baseline on all measures. There was a significant difference (p?<?.05) between pre- and post-treatment scores for BFPEP on all measures, a significant difference (p?<?.05) between pre- and post-treatment scores for STU on all measures (favouring pre-treatment scores) and a significant difference (p?<?.05) favouring BFPEP over STU on all measures post-treatment.

Conclusions: These results demonstrate the feasibility and effectiveness of implementing family therapy psychoeducational interventions in different cultural settings, with relatively minor modifications. This may have implications for mental health policy makers to make available such programmes for patients and mental health professionals.     

Study of the acidic deposition phenomenon over Alexandria city

Acid deposition commonly occurs due to conversion of primary acidic pollutants (SO2 & NO2) into secondary pollutants (H2SO4 & HNO3 and their salts). The main natural sources of acid deposition in Alexandria include lightening and microbial processes. Anthropogenic sources include traffic, industrial, fuel burning, and incineration activities. Acid deposition has ecological and economic effects in addition to health effects. The objective of this study is to assess acidity of dry and wet depositions in the atmosphere of Alexandria. Dry samples were collected as settled dust using plastic jar. Wet samples were collected as rain water using polyethylene bottle. All samples were analyzed for pH, sulfates, and nitrates. The relatively high pH values observed in depositions of Alexandria city (6.95+/-0.22) and (7.14+/-0.49) for settled dust and rain water respectively indicating the conversion of the formed acids (H2SO4 & HNO3) into their salts. This explanation was confirmed by the relatively high concentrations of sulfates and nitrates. The average values were (14.3+/-4.21 g/km2/month and 20.5+/-9.5mg/L for sulfates), and (22.6+/-10.6 g/km2/month and 0.5+/-0.32 mg/L for nitrates) for settled dust and rainwater samples respectively. It can be concluded that Alexandria is a lucky city regarding acidity of the atmosphere due to its geographic, topographic, and meteorological features. Building up acid deposition monitoring network that covers all Egyptian cities to be a nucleus for African network, using new technologies that reduce emission of acid deposition precursors and alternative sources of energy, implementing and enforcing regulations and standards for major pollutants, and increasing public awareness are recommended.     

Serum mannan-binding lectin in egyptian patients with chronic hepatitis C: its relation to disease progression and response to treatment

Background

Chronic hepatitis C virus (HCV) infection is a major worldwide public health problem. Egypt has the highest prevalence of adult HCV infection in the world, averaging 15%–25% in rural communities. Mannan-binding lectin (MBL) is a liver-derived pluripotent serum lectin that plays a role in the innate immune system of the host. It is an acute-phase protein that is involved in the activation of the classical complement pathway. MBL may play a defensive role in HCV infection.

Objectives

To investigate the relationship between MBL concentration and HCV infection in Egyptian patients suffering chronic hepatitis C.

Patients and Methods

Serum samples obtained from 35 Egyptian hepatitis C patients and 30 normal controls were assayed for MBL. MBL concentrations were correlated to disease characteristics and treatment response.

Results

Serum MBL was significantly higher in HCV patients than in controls, but no relationship was found between MBL concentration and disease progression in terms of hepatic fibrosis and inflammation. Responders to interferon (INF)-based therapy had significantly higher serum MBL than non-responders.

Conclusions

We found no association between serum MBL concentration and progression of HCV related liver disease. Responders to INF-based therapy had significantly higher serum MBL than non-responders.     

Subacute myopathy in a mature patient due to multiple acyl-coenzyme A dehydrogenase deficiency

Introduction: Multiple acyl‐coenzyme A dehydrogenase deficiency (MADD), also called glutaric aciduria type II, is an inherited metabolic disorder resulting from a deficiency in electron transfer flavoprotein (ETF) or of its ubiquinone oxidoreductase (ETF‐QO). It usually occurs in the neonatal period or in early infancy and, very rarely, in adolescents and young adult patients. Methods: We report the case of a 55‐year‐old woman who developed a painful subacute myopathy. Results: Lipid accumulation was found at biopsy. MADD was confirmed by plasma acylcarnitine profile and by assessment of ETF‐QO activity in muscle. Conclusions: This study demonstrates that metabolic myopathies usually found in infancy may be also diagnosed in older patients. MADD may be easily treated by riboflavin and coenzyme Q10 and therefore should be included in the differential diagnosis of adult‐onset painful myopathy. Muscle Nerve 43: 444–446, 2011     

A prediction model for the incidence patterns of female breast cancers in Alexandria, Egypt

Breast cancer is the most common cancer among women in the world. Female breast cancer incidence has historically increased all over the world during the past decades. The purpose of this study was to estimate the patterns of female breast cancer incidence in Alexandria, Egypt, from 1972 to 2001. An up-to-date perspective systematically collected data on the incidence of female breast cancers was used. Age categories-estimated incidence over the 30 years period were computed. Time series analysis showed that incidence of breast cancers is increasing significantly during the studied period. Linear trend model was best fitted, with the studied interval and the estimated cancer cases per year taken into account. Age-incidence correlation showed a high correlation between age group of 40-50 years old and incidence. Analysis of the patterns for cancer incidence indicates that the highest occurrence of female breast cancer is shown in the age category of 45-50 years followed respectively by the age categories of 40-45 years, 50-55 years, 35-40 years and then 55-60 years. These findings support the growing body of evidence from female breast cancer incidence suggesting that age is a well-known risk factor for breast cancer susceptibility.     

Chelidonium majus leaves methanol extract and its chelidonine alkaloid ingredient reduce cadmium-induced nephrotoxicity in rats

The kidney is one of the critical target organs for chronic cadmium toxicity. Cadmium is a cumulative nephrotoxicant, and preferentially accumulates and persists in the kidneys. The natriuretic and antidiuretic effects of methyl alcohol extracts of Chelidonium majus L. (C. majus) leaves were evaluated in kidney of cadmium-intoxicated rats. Ninety-six male Sprague?CDawley Albino rats were divided into two major groups (toxicity and biochemical, 60 and 36 rats, respectively). There was a decrease in kidney weight and serum electrolytes, but an increase in urinary volume, excretion of electrolytes, serum urea and creatinine, after 9?weeks of cadmium chloride intoxication. Treatment of C. majus methyl alcohol extract for 10?weeks starting 1?week before cadmium administration shifted the above parameters towards the normal values. These results were supported by molecular and histological investigations. Treatment with C. majus methyl alcohol extract has natriuretic and antidiuretic effects against cadmium-induced nephrotoxicity in rats.     

A comparative study on the medical waste disposal in some hospitals in Alexandria

Though healthcare services aim to reduce the health problems and prevent the potential risks to the health of the community. These services create wastes which are considered as hazardous materials due to the higher potential of infection and injury possessed by these wastes than any other type of waste. Healthcare waste management is an integral part of healthcare services, and can create harm through inadequate waste management; thus reducing the overall benefits provided by healthcare centers. In the current study, a survey for medical waste disposal was performed in order to examine the current status of medical waste disposal in some hospitals in Alexandria and to properly assess management of this type of hazardous waste. A questionnaire was designed for hospitals to assess the quantity of medical waste, collection, sorting, storage, transportation and way of final disposal. From the total waste generated by healthcare activities, almost 80% are waste similar to domestic waste. The remaining approximate of 20% is considered as hazardous waste. As Alexandria has about 3911 healthcare facilities providing medical services for people, a huge amount of medical waste are generated daily with about 208 tons generated per month. The results revealed that the most common problems associated with healthcare wastes are the absence of waste management, lack of awareness about their health hazards, insufficient financial and human resources for proper management, and poor control of waste disposal. The current situation of medical waste disposal in Alexandria is depending on incinerators. Some of these incinerators are not working anymore. Incinerations as a system is not accepted at the time being in most developed countries due to the risks associated with it and suitable substitution management system for medical waste disposal is now taking its place.     

Nonalcoholic fatty liver disease is associated with hepatic and skeletal muscle insulin resistance in overweight adolescents

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) and insulin resistance are common in overweight adolescents. OBJECTIVE: The purpose of this study was to determine the relation between NAFLD and insulin sensitivity in liver and skeletal muscle by studying overweight adolescents with a normal or high intrahepatic triglyceride (IHTG) content, who were matched for age, sex, body mass index (BMI; in kg/m(2)), and Tanner stage. DESIGN: Stable-isotope-labeled tracer infusion and the hyperinsulinemic-euglycemic clamp procedure were used to assess skeletal muscle and hepatic insulin sensitivity, and magnetic resonance spectroscopy was used to assess the IHTG content in 10 overweight (BMI = 35.9 +/- 1.3) adolescents with NAFLD (IHTG = 28.4 +/- 3.4%) and 10 overweight (BMI = 36.6 +/- 1.5) adolescents with a normal IHTG content (3.3 +/- 0.5%). RESULTS: The baseline plasma glucose concentration and the rate of appearance of glucose in plasma were the same in subjects with a normal (87.1 +/- 1.2 mg/dL, 16.2 +/- 1.1 micromol . kg fat-free mass(-1) . min(-1)) or high (89.2 +/- 2.5 mg/dL, 16.3 +/- 1.2 micromol . kg fat-free mass(-1) . min(-1)) IHTG content. However, compared with subjects who had a normal IHTG content, subjects with NAFLD had a lower hepatic insulin sensitivity index, based on baseline glucose kinetics and insulin concentrations (4.0 +/- 0.5 compared with 2.4 +/- 0.4; P < 0.05) and an impaired increase in glucose uptake during insulin infusion (169 +/- 28.1% compared with 67 +/- 9.6% above baseline; P < 0.01). In addition, the plasma triglyceride concentration was greater and the plasma HDL-cholesterol concentration was lower in subjects with NAFLD than in those with a normal IHTG content. CONCLUSION: An elevated IHTG content in overweight adolescents is associated with dyslipidemia and with insulin-resistant glucose metabolism in both liver and skeletal muscle.