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Biomedicine and Nursing
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Volume 6 - Issue 4 (Cumulated No. 23), December 25, 2020. (COVER)
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1. Review on Epidemiology and Economic Impact of Tsetse Transmitted Bovine Trypanasomosis in Ethiopia
Birhanu Eticha1 and Taddesse Yayeh2
1 Benishangul Gumuz Regional State Bureau of Agriculture and Natural Resource, P. O. BOX: 30, Asossa, Ethiopia, E-mail: brihanueticha12@gmail.com (DVM, MSc in Veterinary Epidemiology and Economics)
2 Bahir Dar University, College of Agriculture and Environmental Science, School of Animal Science and Veterinary Medicine (DVM, MSc, PhD, Associate Professor)

Abstract: Tsetse transmitted bovine trypanasomosis is widely distributed in tsetse infested parts of Ethiopia. Tsetse flies, in Ethiopia are confined to the southern and western regions between longitude 33o and 38o E and latitude 5 o and 12 o N and infested area extends from the southern part of the rift valley, around the south-western corner of the country and along the western lowlands and escarpments to the Blue Nile. Studies conducted in different parts of the country revealed that, tsetse transmitted bovine trypanasomosis is found widely distributed in Oromia, Amhara, South Nations Nationality people’s, Benishangul Gumuz and Gambella regions with a prevalence that ranges from 2.1 to 19.5%. Four species of tsetse flies namely G. pallidipes, G. m.submrsitans, G. fuscipes and G. tachnoides are widely distribution in the country. The most common tsetse transmitted trypanosome species responsible for the disease in Ethiopia are T. congolese, T. vivax and T. b. brucei. The severity of the disease in the country is the result of interactions between hosts, agents and the environment. Since tsetse transmitted bovine tryp anosomsis is a wasting disease, affected animals are unproductive in terms of milk, meat, manure and resulted in reduced birth rates, increased abortion rates and the mortality rate can be high and all of these affect the herd size and composition. Hence, participatory approach should be implemented so as to reduce vector density and prevalence of the disease to the level that they will not be major risk for cattle production.
[Birhanu Eticha and Taddesse Yayeh. Review on Epidemiology and Economic Impact of Tsetse Transmitted Bovine Trypanasomosis in Ethiopia. Biomedicine and Nursing 2020;6(4): 1-9]. ISSN 2379-8211 (print); ISSN 2379-8203 (online). http://www.nbmedicine.org. 1. doi:10.7537/marsbnj060420.01.
Keywords: Bovine, Ethiopia, Epidemiology, Risk Factor, Trypanosomosis, Tsetse Fly

2. Optical Coherence Tomography Angiography in Patients with Behcet Uveitis
Ahmed Eisa Abu Zaid, MSc, Amin E. Nawar, MD, FRCS (Glasg), Mohammad El Bradey, MD, Magdy Moussa, MD
Department of Ophthalmology, Faculty of Medicine, Tanta University, Egypt.
E-mail: ahmeabuzaid@gmail.com

Abstract: Purpose: to assess optical coherence tomography angiography (OCT-A) changes in patients with Behcet uveitis (BU). Method: This is a prospective, cross-sectional non-interventional study that was carried out on 30 eyes of 18 Behçet uveitis patients compared to 20 eyes of 10 normal subjects matched for age, sex and refraction. Swept source optical coherence tomography (SS OCT) was performed for all cases. OCT-A was also performed to assess areas of capillary non perfusion and to measure the foveal avascular zone (FAZ) in both superficial and deep capillary plexuses (SCP and DCP). Results: The BCVA was markedly reduced in patients with BU (,) p value <0.001. Macular edema, peripheral retinal vascular leakage and optic disc hyperfluorescence were the main angiographic findings in BU patients. Epiretinal membrane was the most common presentation in SS OCT followed by cystoid macular edema. Furthermore, FAZ was significantly enlarged in BU patients in both SCP and DCP (,) p value 0.005. BCVA was positively correlated with both SCP and DCP (,) p value 0.033. Conclusions:OCT-A is a new imaging modality that can assess foveal ischemia by measuring FAZ in SCP and DCP in BU patients.
[Ahmed Eisa Abu Zaid, Amin E. Nawar, Mohammad El Bradey, Magdy Moussa. Optical Coherence Tomography Angiography in Patients with Behcet Uveitis. Biomedicine and Nursing 2020;6(4): 10-15]. ISSN 2379-8211 (print); ISSN 2379-8203 (online). http://www.nbmedicine.org. 2. doi:10.7537/marsbnj060420.02.
Keywords: Behcet uveitis, Optical coherence tomography angiography, Foveal avascular zone, superficial capillary plexus, Deep capillary plexus

3. Verification of the reliability of anterior segment OCT in measuring limbus-insertion distance in horizontal recti muscles
Dr. Ali Hammouda Ghoraba, Prof. Dr. Heba Mohamed Shafik, Prof. Dr. El Sayed Samir Arafa, Prof. Dr Ahmed Lotfi Ali
Ophthalmology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
Email: Ali.h.g1993@gmail.com

Abstract: Background: Measuring limbus-insertion distance of horizontal recti muscles can have many benefits in observing muscle changes postoperatively and in finding correlation between the degree and type of ocular misalignment and limbus-insertion distance, many modalities were introduced to image extraocular muscles (1)(2) but anterior segment OCT remains the most recent modality introduced for such purpose. Patients and Methods: Prospective observational case series study was carried out in 40 eyes in 20 patients with manifest strabismus who were planned for surgical correction, all patients were subjected to complete ophthalmological examination and to preoperative and intraoperative measurement of limbus-insertion distance by anterior segment OCT and surgical caliber respectively. Results: When comparing the measurements via the two methods a statistically significant correlation was evident with tendency of anterior segment OCT to overestimate the limbus-insertion distance. Conclusion: Anterior segment OCT is a reliable method in determining limbus-insertion distance in eyes undergoing primary squint surgery. Aim of the work: Assessing the reliability of Anterior Segment OCT in measuring limbus-insertion distance of horizontal recti muscles. [Ali Hammouda Ghoraba, Heba Mohamed Shafik, El Sayed Samir Arafa, Ahmed Lotfi Ali. Verification of the reliability of anterior segment OCT in measuring limbus-insertion distance in horizontal recti muscles. Biomedicine and Nursing 2020;6(4): 16-22]. ISSN 2379-8211 (print); ISSN 2379-8203 (online). http://www.nbmedicine.org. 3. doi:10.7537/marsbnj060420.03.

Keywords: Limbus-insertion distance, Anterior segment OCT, strabismus.

4. African Animal Trypanosomosis and Its Control: A review
Birhanu Eticha
Benishangul Gumuz Region Bureau of Agriculture and Natural Resource, P.O. Box 30, Assosa, Ethiopia
e-mail: brihanueticha12@gmail.com

Summary: Trypanosomes are protozoan parasites that cause debilitating diseases called trypanosomosis in animals, sleeping sickness in humans and have great socio-economic impact adversely affecting food production and economic growth in many parts of Africa, particularly in Sub-Saharan Africa. The disease caused by these extracellular hemoflagellates in domestic animals is called “Nagana” or African animal trypanosomosis. Trypanosomosis in animal is transmitted cyclically by the genus Glossina, but it can also be transmitted mechanically by other biting flies among which Tabanus and Stomoxys are presumed to be the most important. The distribution of the disease coincides with the habitat of the tsetse fly vector and is called the tsetse fly “belt”. Trypanosomosis is controlled either by controlling the vector or the parasites or by controlling both and for many years, a large number of vector control tools have been developed and implemented. However, control of animal trypanosomosis in poor rural community has mainly been relied on the use of trypanocidal drugs. But only a small group of chemo prophylactic and chemo therapeutic trypanocidal compounds are currently in use and new compounds are unlikely to become fabricated The inevitable outcome of continued use of the same compounds for decades has resulted in drug resistance that has been largely responsible for frequently observed chemo therapeutic failures. Hence, strategic control of trpanosomosis focusing on the vector should be implemented to mitigate the problem.
[Birhanu Eticha. African Animal Trypanosomosis and Its Control: A review. Biomedicine and Nursing 2020;6(4): 23-35].ISSN 2379-8211 (print); ISSN 2379-8203 (online). http://www.nbmedicine.org. 4. doi:10.7537/marsbnj060420.04.
Keywords: Animal, Glossina, Trypanosomosis

5. Pentacam Significant Topographical Characteristics and Indices in Keratoconus
Ghady Saleh Farag Al-Shobak; Mohamed E Lsaadany Ghoraba, Prof. Dr. Ahmed Mohamed Ghoneim, Dr. Hazem Ahmed Elbedewy
Department of Ophthalmology, Faculty of Medicine, Tanta University, Tanta, Egypt

Abstract: Background: The pentacam system is a relatively new diagnostic imaging tool. It is a special imaging system that seems to be able to reliably measure both the anterior and posterior corneal surfaces, both pre- and post-operatively, using a rotating Scheimpflug camera. The pentacam helps the ophthalmologist to better quantify normal postoperative cornea and better diagnose ectatic disorders. Aim: To study the common topographical characteristics of Scheimpflug system (Oculus Pentacam) of patients with a confirmed diagnosis of keratoconus in private centers at Tanta city. Patients and Methods: This comparative, retrospective research was conducted in 100 eyes of 50 patients with keratoconus (32 male, 18 female with were included in this study. The mean age was 26.07±4.98 years. The Control Group included hundred eyes of 50 individuals with average normal corneal parameter (non keratoconic) (30 male, 20 female). Results: It has been concluded, the interpretation and investigation of the show is intuitive: if the progression of the corneal thickness indicates an average index greater than 1.1, the rise in the progression of the thickness is clinically relevant and the red curve is not parallel to the black broken lines but steeper. It is also clinically relevant if a red center is seen in the difference map between the BFS and the improved BFS elevation map. Conclusion: The aim of our study is to help the refractive surgeon identify patients who may be at risk of post-surgical ectasia and/or to help identify early or subclinical keratoconus.
[Ghady Saleh Farag Al-Shobak; Mohamed E Lsaadany Ghoraba, Ahmed Mohamed Ghoneim, Hazem Ahmed Elbedewy. Pentacam Significant Topographical Characteristics and Indices in Keratoconus. Biomedicine and Nursing 2020;6(4): 36-41]. ISSN 2379-8211 (print); ISSN 2379-8203 (online). http://www.nbmedicine.org. 5. doi:10.7537/marsbnj060420.05.
Key words: Pentacam, topography, Keratoconus, scheimpflug

6. Albuterol as an Adjuvant Therapy in Acute Anticholinesterase Pesticides Poisoning: A Randomized Clinical Trial
Al-Shaimma Mahmoud Mohamed El-Mansy, Arwa Ahmed Abo-Elfadl, Ahmad Abdelsattar El-Ebiary, Anas Mohammad El-Bassiony Abo Samak and Ahmed Abd Alraouf Hashem.

Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Tanta University, Tanta, Egypt

Abstract: Background: Acute anticholinesterase pesticides poisoning is a major problem in developing countries. Although atropine and oximes are known antidotes, novel therapeutic regimens are needed to improve patients’ outcome. Albuterol is a selective bet 2 adrenergic agonist that can improve oxygenation. Objective: The aim of this study was to evaluate safety and efficacy of aerosolized albuterol as an adjuvant in the management of patients with acute anticholinesterase pesticide poisoning. Methods: This was a randomized, controlled, parallel-group study performed between May 2017 and August 2018 on 60 patients with acute anticholinesterase poisoning who were admitted to the Tanta University Emergency Hospital Poison Control Center. The patients were randomized into 3 equal groups (20 patients each). Group I participants received the standard treatment. In addition, each participant in groups II and III received a single dose (2.5 mg and 5 mg) of aerosolized albuterol respectively. Oxygenation, mortality, total dose of atropine administered, hospital stay period and the need for ICU admission and/or mechanical ventilation were the outcome measures included. Results: There were a total of 89 patients examined and 60 patients randomized. We found no statistically substantial differences in patient demographics among the groups studied, exposure characteristics, clinical manifestations or routine laboratory investigations on admission. The duration of hospital stay in patients treated with albuterol was substantially lower. However, the use of aerosolized albuterol as an added treatment could not improve oxygenation. Conclusion: Aerosolized albuterol was seemingly safe, and in patients with acute anticholinesterase pesticide poisoning, hospital stays were decreased.
[Al-Shaimma Mahmoud Mohamed El-Mansy, Arwa Ahmed Abo-Elfadl, Ahmad Abdelsattar El-Ebiary, Anas Mohammad El-Bassiony Abo Samak and Ahmed Abd Alraouf Hashem.

Albuterol as an Adjuvant Therapy in Acute Anticholinesterase Pesticides Poisoning: A Randomized Clinical Trial. Biomedicine and Nursing 2020;6(4): 42-49]. ISSN 2379-8211 (print); ISSN 2379-8203 (online). http://www.nbmedicine.org. 6. doi:10.7537/marsbnj060420.06.
Keywords: albuterol; anticholinesterase pesticide poisoning; safety; oxygenation.

7. Evaluation of multi-focal electroretinogram and optical coherence tomography angiography findings in diabetic maculopathy
Moataz Ayman Elshiekh (MSCh), Amin E Nawar (MD, FRCS), Yasser Ragab Serag (MD), Hamdy Abd El- Azim El- Koumy (MD)
Ophthalmology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
Moataz.elshiekh93@yahoo.com

Abstract: Background: Diabetic maculopathy refers to two distinct eye diseases; diabetic macular oedema (DME) and diabetic ischaemic maculopathy. The two types of maculopathy are often comorbid, Ischaemic maculopathy occurs in conjunction with macular oedema and may occur even when macular oedema is mild. Diabetic macular oedema is one of the most important causes of blindness in developed countries under 70 years of age. Some studies have reported impaired function in the middle and inner layers of the retina in diabetic patients before vascular complications have been identified. Therefore, there is a need for an objective test for early detection and diagnosis of patients with abnormal retinal function due to diabetic retinopathy (DR) and DME. Multifocal electroretinography (mfERG) is important objective test identifying functional changes of the retina in early phases of DR Optical Coherence Tomography angiography (OCTA) can image vascular changes of diabetic maculopathy such as neovascularization and non-perfused areas (ischemic maculopathy). Aim of the study: is to evaluate the functional changes by multifocal electroretinography and the vascular changes by optical coherence tomography angiography in cases of diabetic maculopathy. Patients and Methods: A prospective randomized cross-sectional controlled study was done on (30 eyes) of (20 consecutive patients) with diabetic maculopathy and control group of (10 eyes) of (8 patients) with diabetic changes without macular affection and (10 eyes) of (10 participants) without ocular or systemic disease of the same age group. Results:The participants of the study are classified into 4 group, the 1st group included patients with non-central involving macular edema by OCT, 2nd group included patients with central involving macular edema by OCT, the 3rd group included patients with diabetic retinopathy without evident maculopathy neither by OCT nor FFA and the 4th group includes normal participants without ocular or systemic disease. The results showed statistically significant difference between the mean vascular density index (VDI) of the superficial capillary plexus (SCP) of each group (1stnon-center involving ME,2ndcenter involving ME & 3rddiabetic without evident maculopathy by OCT group) and the normal (4th) group with higher difference is between the 2nd(center involving ME) group and the normal. Also showed statistically significant difference between VDI of the deep capillary plexus (DCP) of each group (1st non-center involving ME, 2nd center involving ME & 3rd diabetic without evident maculopathy by OCT group) and the normal (4th) group with higher difference is between the 2nd (center involving ME) group and the normal. The results of analysis of the average of the five rings of mfERG showed statistically significant difference between the mean of P1 amplitude of each of the 3 groups and the normal group with the highest difference between the 2nd (center involving ME) group and the normal group. Also, showed statistically significant difference between the mean of P1 latency of 1st and 2nd group and between 2nd and 3rd groups with the highest difference between the 2nd (center involving ME) group and the normal group with statistically significant difference between the mean retinal response density of each of the 3 groups and the normal group with the highest difference between the 2nd (center involving ME) group and the normal group. Conclusion: Both OCTA and mfERG could detect early vascular and functional impairment in cases of early diabetic maculopathy despite normal clinical examination and OCT scans.
[Moataz Ayman Elshiekh, Amin E Nawar, Yasser Ragab Serag, Hamdy Abd El-Azim El-Koumy. Evaluation of multi-focal electroretinogram and optical coherence tomography angiography findings in diabetic maculopathy. Biomedicine and Nursing 2020;6(4): 50-55]. ISSN 2379-8211 (print); ISSN 2379-8203 (online). http://www.nbmedicine.org. 7. doi:10.7537/marsbnj060420.07.
Keywords: Early diabetic maculopathy, Multifocal electroretinography, Optical Coherence Tomography angiography.

8. Ureteral Stenting after Ureteroscopy for Stone Treatment, Prospective Study on Indications and Outcomes
Ahmed Mahmoud Fouad Abdelaziz, Ahmed Fayez Ghaith, Maged Mostafa Ragab, Ayman Ahmed Hassan
Department of Urology, Faculty of Medicine, Tanta University, Tanta, Egypt
Ahmedmfaziz1992@icloud.com

Abstract: Ureteroscopy (URS), is an appropriate option for the management of ureteral stones. Advances in working instruments and lithotripsy devices have enabled urologists to perform successful URS rendering the patient stone-free without complications. The need to place a DJ after URS is controversially discussed in literature and depends on the subjective discretion of the treating urologist. However, the majority of studies suffer from retrospective design and low patient number. Aims: The aim of this work is to analyse the postoperative ureteral stenting strategy in clinical practice after URS for stone treatment looking at the indications, outcome, types of stents used and the duration of stenting after ureteroscopy for stone treatment. Place and duration of the study: This study was carried out at the Department of Urology, the University of Tanta, Egypt, between March 2019 and February 2020. Methodology: This was an observational study that was carried out on 600 consecutives candidates for ureteroscopy to evaluate indications, outcomes of post-operative stenting. Results: In our department we followed the AUA guide lines for placement of double-J stent post URS as we placed it for the following reasons dilation of the ureteric orifice either by balloon (89.8%) or UAS (4.9%), intraoperative complications as following traumatic injury of the mucosa (15.3%), migrated stones in (4.3%) and perforation in (3.1%). Other reasons included; edema at the site of stone impaction (8.98%) stricture ureter (4.92%) solitary kidney (3.7%) impaired renal function (9.8%) large fragment that left for spontaneous passage (5.5%), surgeon’s ’s preference at the end of procedure (4.9%) and long operative time in (12.5%). In our series we found that (53%) of the presented patients didn’t require stenting post ureteroscopy. It was also noted that balloon dilation was the main reason for post-ureteroscopy stenting. Conclusion: From this study we suggested that the use of post uretroscopic stenting is justified only in complicated cases, impaired renal function, single kidney, or a need for additional intervention as mentioned by the AUA guidelines. The use of post ureteroscopy double JJ stents should be judicious, because most of the candidates are at the working age and the indiscriminate routine use of stents would not only affect the quality of life, add cost, but would also affect the career of the patient.
[Ahmed Mahmoud Fouad Abdelaziz, Ahmed Fayez Ghaith, Maged Mostafa Ragab, Ayman Ahmed Hassan. Ureteral Stenting after Ureteroscopy for Stone Treatment, Prospective Study on Indications and Outcomes. Biomedicine and Nursing 2020;6(4): 56-64]. ISSN 2379-8211 (print); ISSN 2379-8203 (online). http://www.nbmedicine.org. 8. doi:10.7537/marsbnj060420.08.
Keywords: Ureteric stones, ureteroscopy (URS), Double J (JJ) stents, Ureteicballon dilation, and ureteric edema

9. Knowledge, Attitude and Practice of Emergency 115 system's Operating Personnel in Triage System and Its Effective Factors
Mahmood Ebrahimi1, Mehdi Zahabi2, Mojtaba Khaledi3
1MD, MPH, Ministry of Health - Curative Affairs, Iran.
2MSc, Nursing Department, Ministry of Health - Curative Affairs, Iran.
3BSc, Nursing Department, Ministry of Health - Curative Affairs, Iran.
E-mail: mahmoodebrahimi454@yahoo.com

Abstract: Triage system is necessary and critical for facilitating urgent distinguishing critically injured and ill patients from patients who have chronic and non-emergent complaints. Thus knowledge and attitude of operating personnel of triage system both can improve their performance and increase the system's effectiveness and efficiency. Therefore, the major aim of this study is investigating knowledge, attitude, and practice of emergency 115 system's operating personnel in triage system and identifying effective factors. Findings show that most personnel fully believe in effectiveness of triage in 115 emergency system, however, the major information of personnel about triage and its implementation is experimental. In addition, findings show that 50% of the individuals had formal triage certificate, while none had optimal academic preparation. In other words, not only formal triage education is seriously pursued for 115 system personnel, but content retraining in triage is not desirable and acceptable.
[Ebrahimi Mahmood, Zahabi Mehdi, Khaledi Mojtaba. Knowledge, Attitude and Practice of Emergency 115 system's Operating Personnel in Triage System and Its Effective Factors. Biomedicine and Nursing 2020;6(4): 65-68]. ISSN 2379-8211 (print); ISSN 2379-8203 (online). http://www.nbmedicine.org. 9. doi:10.7537/marsbnj060420.09.
Keywords: Knowledge, Attitudes, Operational Personnel, Triage Systems

10. Organizational Cynicism and its effect on Staff Nurses Job Embeddedness and Organizational Citizenship Behaviors
Ebtsam Ahmed Mohamed1, Rasha Mohamed Nagib Ali2
1Lecturer of Nursing Administration, Faculty of Nursing. Minia University, Egypt
2Lecturer of Nursing Administration, Faculty of Nursing. Minia University, Egypt
Telephone: 20.1099348644; E-mail: tamem.ali23@yahoo.com

Abstract: Background: Health care organizations cannot succeed without productive nursing staff. Improving the productivity and performance of health care workers in order to enhance efficiency in health interventions, is a major challenge. Objectives: This study determined whether there were an effect of organizational cynicism on job embeddedness and organizational citizenship behaviors among staff nurses. Methods: A descriptive correlation research design was conducted to achieve the aim of the current study. Setting: The study was conducted at Minia General Hospital. Subject: convenience sample of staff nurses who were working at Minia General Hospital (n=331). Fourth tools was used for collecting data for this study, 1st: Personal data questionnaire 2nd: Organizational Cynicism Scale (OCS),3rd: Job Embeddedness Scale, and 4th: Organizational Citizenship Behaviors Questionnaire. Result: The findings of the present study revealed that the majority percent of Minia general hospital staff nurses exhibited “high “responses toward organizational cynicism dimensions. On the contrary, the highly percent of the nurses were responses to “low” for total job embeddedness and nurses exhibited “low” responses toward organizational citizenship behavior dimensions. Conclusion: From this study it can be concluded that there were a negative correlation between organizational cynicism and job embeddedness and organizational citizenship behavior. In addition, there were a positive correlation between job embeddedness and organizational citizenship behavior. Recommendation: it is suggested that every manager in organizations need to play a more active and vital role in preventing cynicism, and managers need to be more understanding about the causes of cynicism and how to dealing with all employees.
[Ebtsam Ahmed Mohamed, Rasha Mohamed Nagib Ali. Organizational Cynicism and its effect on Staff Nurses Job Embeddedness and Organizational Citizenship Behaviors. Biomedicine and Nursing 2020;6(4): 69-81]. ISSN 2379-8211 (print); ISSN 2379-8203 (online). http://www.nbmedicine.org. 10. doi:10.7537/marsbnj060420.10.
Keywords: organizational cynicism, job embeddedness, organizational citizenship behavior and staff nurses

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