ISSN 2379-8203

BIOMEDICINE & NURSING

Biomedicine and Nursing
Quarterly
Volume 6 - Issue 3 (Cumulated No. 22), September 25, 2020. (COVER)   

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1. Nurses Knowledge and Attitude about Covid-19 among Elderly Patients at Intensive Care Units: Suggested Education 

Marwa M. Abdelbacky1, Aml Ali Mohamed1 and Eman Fadl Abd El khalik2
1 Department of Medical Surgical Nursing, (Critical Care Nursing), Faculty of Nursing, Minia University, Egypt
2 Department of Medical Surgical Nursing, Faculty of Nursing, Minia University, Egypt
Email: marwa.radwan1@mu.edu.eg

Abstract: Covid-19is health emergency causing fatal acute respiratory distress syndrome in elderly patients. Knowledge of nurses working with elderly infected had an impact on the attitude and care provided. Aim: assess nurses’ knowledge and attitude about Covid-19 among elderly patients at intensive care units. Design: descriptive research. Sample: purposive sample of 78 nurses (male, female) selected conveniently included nurses working at isolation ICUs at Cardiothoracic, Health Insurance, and Malawi Isolation Hospital in Minia city, Egypt. Results: (62.8%) of the sample were female, (48.1%) of them had bachelor degree, and (47.4%) institute. (29.5 %) had a satisfactory knowledge (25.6%) had `positive attitude. Mean ± S.D of knowledge (9.50±0.68) for satisfactory group and (6.48±0.68) for unsatisfactory. (21.5±1.10) had positive attitude and (10.7±3.53) were negative. A high statistical significant difference between both domains presented by P value (0.000**).Conclusion: nurses had lower knowledge level about caring of elderly patients with COVID-19which reflected on their attitude. 
[Marwa M. Abdelbacky, Aml Ali Mohamed and Eman Fadl Abd El khalik. Nurses Knowledge and Attitude about Covid-19 among Elderly Patients at Intensive Care Units: Suggested Education. Biomedicine and Nursing 2020;6(3): 1-10]. ISSN 2379-8211 (print); ISSN 2379-8203 (online). http://www.nbmedicine.org. 1. doi:10.7537/marsbnj060320.01.
Key words: Nurses knowledge, Attitude, Covid-19, elderly, Intensive Care units, education


2. Assessment of Subclinical Endometritis in Unexplained Primary Infertility
Dr. Abdelsamie Abdelmonaiem Abdelsamie1, Mohammed Sobhy Bakry1, Dr. Sameh Samy Abou-Beih2, Medhat Abdelrahman Abdelhalim Ibrahim1
1Obstetrics and Gynecology Department, Faculty of Medicine, Fayoum University, Egypt
2Pathology Department, Faculty of Medicine, Fayoum University, Egypt
Email: dr_dido5@yahoo.com


Abstract: Introduction: One of the most common conditions in a fertility clinic is unexplained infertility. Only recently, chronic endometritis (CE) has been linked to embryonic transplantation failure and infertility. Aim of the work: The purpose of the study was to assess subclinical chronic endometritis in cases of primary infertility and also assess the benefits of hysteroscopic procedures in the diagnosis of latent CE as a supplement to current theories. Materials and methods: The present study was conducted on 50 female patients under age of 40 years attending the infertility clinic at Mataria teaching hospital complaining of unexplained primary infertility during the period from May 2018 to April 2019. Patients were divided randomly into two equal groups; (Group A & Group B) each of 25 patients. In group A, patients underwent office hysteroscopy for obtaining a visualized endometrial biopsy. In group B, patients were subjected to a blind endometrial biopsy by a Pipelle de Cornier. Results: In this study, we found that 30 patients (60 %) had chronic endometritis. Twenty one (42%) cases were diagnosed by biopsies taken by the hysteroscopy while 9 (18%) patients were diagnosed by biopsies taken by the Pipelle. The diagnostic accuracy of hysteroscopy in diagnosis of CE in our study was 52%. The hysteroscopy sensitivity was 48%, the specificity was 75%, the positive predictive was 91%, and the negative predictive was 21%. Conclusions: Chronic endometritis should be considered in the workup of unexplained primary infertility. Hysteroscopy is a useful, simple, cost effective procedure with a high diagnostic accuracy in chronic endometritis screening in asymptomatic infertile women; however endometrial biopsy should be complemented for the CE diagnosis. 
[Abdelsamie Abdelmonaiem Abdelsamie, Mohammed Sobhy Bakry, Sameh Samy Abou-Beih, Medhat Abdelrahman Abdelhalim Ibrahim. Assessment of Subclinical Endometritis in Unexplained Primary Infertility. Biomedicine and Nursing 2020;6(3): 11-19]. ISSN 2379-8211 (print); ISSN 2379-8203 (online). http://www.nbmedicine.org. 2. doi:10.7537/marsbnj060320.02.
Keywords: Assessment; Subclinical; Endometritis; Unexplained Primary Infertility


3. Effectiveness of Rehabilitation Nursing Protocol on Phantom Pain and Lifestyle Modification Among Patients with Lower Limb Amputation
Assist Prof. Hanan R. Attalla (1) and Dr. Hanaa E. El- Sayad (2)
Medical Surgical Nursing Department, Faculty of Nursing, Menoufia University, Egypt (1-2)

Email: hanan.ataaallah@nursing.menofia.edu.eg; Phone; 0201010183631


Abstract: Background: Phantom Limb Pain affects a significant percentage of patients with amputation. Nurses are in unexclusive position to care these patients during hospitalization and follow up after discharge to have good quality of life (1). This study aimed to evaluate effectiveness of rehabilitation nursing protocol on phantom pain and lifestyle modification among patients with lower limb amputation. Methods; Research Design: Quasi Experimental design was utilized for this study. Setting: study was carried out at vascular outpatient clinic and in an inpatient rehabilitation unit At Menoufia University Hospital, Egypt. Subjects: A purposive sample of 100 patients suffering from phantom pain due to lower limb amputation Tools for data collection: four tools were applied; Socio demographic characteristics tool, Defense and veterans pain rating scale, RAND 36 item health surveys related to quality of life scale, and Barthel Index Scale. Results;76% of study group and 64% of control group were male with mean grades of pain 2.76±2.65 and 6.40±2.11 of study and control groups respectively at post-intervention. There were statistically significant improvements related to mean emotional wellness, social functioning and general health at post-intervention as p- value <0.001. The means total scores of Barthel Index scale were 77.0±17.26 and 33.80±17.88 for study and control groups respectively. Conclusion: nursing rehabilitation protocol after lower limb amputation was effective in reducing phantom pain, improving performance of activities of daily living and enhancing better lifestyle. Recommendation: Offering a planned continuous standard rehabilitation programs regularly to improve phantom pain and lifestyle for patients with lower limb amputation at outpatient vascular clinic.
[Assist Prof. Hanan R. Attalla (1) and Dr. Hanaa E. El- Sayad (2). Effectiveness of Rehabilitation Nursing Protocol on Phantom Pain and Lifestyle Modification Among Patients with Lower Limb Amputation. Biomedicine and Nursing 2020;6(3): 20-34]. ISSN 2379-8211 (print); ISSN 2379-8203 (online). http://www.nbmedicine.org. 3. doi:10.7537/marsbnj060320.03.
Key words; Phantom Pain; Amputation; Rehabilitation


4. Visual and Tear Film Alterations in Patients of Meibomean Gland Dysfunction
Mohamed Sh. Ghazy (MSC), Mohamed A. El-Desouky (MD), Osama Shalaby (MD), Amr M. Awara (MD)
Ophthalmology Department, Faculty of Medicine, Tanta University, Egypt
mohamed.sharaf.ghazy6336@gmail.com


Abstract: Background: Meibomean gland dysfunction is a sight threatening condition worldwide particularly among the working-age population and it may be the first presentation of serious systemic disease. Etiologically, posterior uveitis may be the result of infectious, non-infectious or ‘masquerade’ causes as described by the international uveitis study group (IUSG). Noninfectious uveitis with no associated systemic disease or other precipitant is termed ‘idiopathic’. Involvement of posterior segment structures as described by the standardization of uveitis nomenclature (SUN) may be focal, multifocal, or diffuse. Due to a wide variety of phenotypic features, the diagnostic approach is not that simple including careful history taking, comprehensive review of systems, précised ocular examination, targeted laboratory workup, and tailored ocular imaging. Retinal & choroid imaging is very important in diagnosing pathologies and monitoring inflammatory process and treatment of posterior uveitis. Fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) are the most commonly used imaging techniques. Aim of the study: This controlled, selective, cross-sectional study aimed to evaluate chorioretinal changes in eyes with newly diagnosed posterior uveitis using swept source optical coherence tomography (SS-OCT). Patients and Methods: The study was performed on 44 eyes of 30 patients with freshly diagnosed acute posterior uveitis (in 14 patients, the disease was bilateral) and 30 eyes of 15 normal age/sex/refraction-matched individuals as control group. Results: The mean age of the patients was 32 years (range 12 to 56 years) and of the controls was 33 years (range 15 to 53 years). This study was conducted on 13 male and 17 female patients with 6 male and 9 female controls. In the study, 40.91% of cases showed posterior uveitis with spillover anterior uveitis. Best corrected visual acuity (BCVA) was measured in all participants using decimal notation and the mean (0.149 ± 0.141) was markedly decreased. A complete fundus examination, fundus photography and FFA were done to all patients and we documented a variable degree of vitritis in all eyes, retinitis in 11 eyes of 10 patients, choroiditis in 12 eyes of 6 patients, and chorioretinitis in 21 eyes of 14 patients. Retinal vasculitis was found in 15 eyes and 20 eyes had optic neuritis. Non-infectious uveitis was clinically diagnosed, with or without a definite entity classification, in 26 cases and 4 cases had infectious etiology (clinically and laboratory diagnosed). SS-OCT was done for all participants and we found that in acute posterior uveitis the structural changes were macular edema (ME) in all eyes (cystoid ME in 11 eyes and spongy ME in 33 eyes), neurosensory detachment (NSD) in 16 eyes, thickened choroid in all patients and interrupted photoreceptor layers in 19 eyes. Changes in the choroidal architecture were documented in 18 eyes and focal hyper-reflective thickening of the retinal pigment epithelium (RPE)/choriocapillaris complex was found in 13 eyes. Two SS-OCT parameters were measured in all participants retinal thickness (RT) using early treatment diabetes retinopathy study (ETDRS) map {in the form of central subfield (CSF), mean inner macular (MIM) and mean outer macular (MOM) thickness} and subfovealchoroidal thickening (SFCT). Our results revealed that both parameters were significantly greater in diseased than in control eyes. Interestingly, we detected significant topographical changes in the macula of our patients using ETDRS map, the thickest macular region was the parafoveal area (inner ring) followed by the perifoveal area (outer ring) and the CSF was least affected. Significant negative correlation was found between RT {CSF, MIM and MOM thickness}and BCVA and cystoid macular edema (CME) was associated with more reduction in BCVA than spongy ME. Also, NSD had negative significant relation with BCVA. Moreover, SFCT had a significant negative correlation with BCVA and a statically significant relation with NSD. A positive weak correlation between RT and SFCT was found but the result was statically insignificant. Conclusion: SS-OCT yields reasonable amount of data regarding morphological changes of the vitreoretinal interface, retina, and choroid in acute posterior uveitis.
[Mohamed Sh. Ghazy, Mohamed A. El-Desouky, Osama Shalaby, Amr M. Awara. Visual and Tear Film Alterations in Patients of Meibomean Gland Dysfunction. Biomedicine and Nursing 2020;6(3): 35-41]. ISSN 2379-8211 (print); ISSN 2379-8203 (online). http://www.nbmedicine.org. 4. doi:10.7537/marsbnj060320.04.

Keywords: Chorioretinal Changes, Posterior Uveitis, Optical Coherence Tomography


5. Role of magnetic resonance cholangiopancreatography in evaluation of asymptomatic and symptomatic patients with unexplained biliary radicals' dilatation using the ultrasound
Youssef AT, Abbas A, Magdy A.
Diagnostic Radiology Department, Faculty of Medicine, Fayoum University, Egypt
abdoomagdy36@gmail.com


Abstract: Introduction: The common bile duct (CBD) dilatation is a common finding during ultrasound and CT examination that usually recommends further assessment to evaluate its significance, cause and outcome, many disorders can cause common bile duct dilatation. A diameter of more than 7 mm (except post cholecystectomy or post ERCP) is regarded as abnormal dilatation and is a sign of cholestasis, multiple reasons causes CBD dilatation ascholedocholithiasis, pancreatic head masses. ERCP has been the gold standard investigation for evaluation of the biliary system for a long duration yet it is relatively invasive with reported complications, so Magnetic resonance cholangiopancreatography (MRCP) become a major diagnostic modality is diagnosis not only of the biliary diseases but also is pancreatic disorders. Aim of the work: The purpose of this study was conducted to determine the yield of magnetic resonance cholangiopancreatography (MRCP) in asymptomatic & symptomatic patients with a finding of common biliary duct dilatation, more focusing on the asymptomatic category and the group of symptomatic patients with no obvious cause detected by US scan. Patients and methods: Fifty cases were obtained, Some of these cases were complaining of jaundice, epigastric pain or low grade fever, other was not complaining and CBD dilatation was discovered incidentally by US, all cases had CBD dilatation on US > 7 mm. All were subjected to MRCP assessment. Results: In our study ultrasound MRCP successfully diagnosed 27 cases of CBD stones, 15 cases of pancreatic head masses as well as 4 causes of benign biliary stricture while US successfully diagnosed 20 cases of CBD stones, 10 cases of pancreatic head masses as well as one cause of benign biliary stricture out of 50 patients, so we found that MRCP has more accuracy than dedicated US is diagnosis of biliary tract pathologies especially distal CBD stones, also MRCP is more accurate than US in detecting pancreatic pathologies. Conclusion: MRCP could diagnose almost all causes of biliary tract dilation, also it plays a major role in detecting pancreatic causes of distal biliary radicles obstruction, so we recommend that MRCP is the best tool for diagnosis of biliary radicles obstruction especially when the obstruction was involving the distal CBD and was cause by pancreatic pathology.
[Youssef AT, Abbas A, Magdy A. Role of magnetic resonance cholangiopancreatography in evaluation of asymptomatic and symptomatic patients with unexplained biliary radicals' dilatation using the ultrasound. Biomedicine and Nursing 2020;6(3): 42-48]. ISSN 2379-8211 (print); ISSN 2379-8203 (online). http://www.nbmedicine.org. 5. doi:10.7537/marsbnj060320.05.
Keywords: Magnetic resonance cholangiopancreatography. Dilated biliary radicles. Benign biliary radicles stricture. Pancreatic head masses. Asymptomatic biliary radicles dilation.


6. Nurses knowledge and Attitude about Covid-19among elderly patients at Intensive Care Units: suggested education 
Marwa M. Abdelbacky, Aml Ali Mohamed & Eman Fadl Abd El khalik
Lecturer in Medical Surgical Nursing Department, (Critical Care Nursing), Faculty of Nursing, Minia University, Egypt

Lecturer in Medical Surgical Nursing Department, (Geriatric Nursing), Faculty of Nursing, Minia University, Egypt
Lecturer in Medical Surgical Nursing Department, Faculty of Nursing, Minia University, Egypt
Email: marwa.radwan1@mu.edu.eg


Abstract: Covid-19is health emergency causing fatal acute respiratory distress syndrome in elderly patients. knowledge of nurses working with elderly infected had an impact on the attitude and care provided. Aim: assess nurses’ knowledge and attitude about Covid-19 among elderly patients at intensive care units. Design: descriptive research. Sample: purposive sample of 78 nurses (male, female) selected conveniently included nurses working at isolation ICUs at Cardiothoracic, Health Insurance, and Malawi Isolation Hospital in Minia city, Egypt. Results: (62.8%) of the sample were female, (48.1%) of them had bachelor degree, and (47.4%) institute. (29.5 %) had a satisfactory knowledge (25.6%) had `positive attitude. Mean ± S.D of knowledge (9.50±0.68) for satisfactory group and (6.48±0.68) for unsatisfactory. (21.5±1.10) had positive attitude and (10.7±3.53) were negative. A high statistical significant difference between both domains presented by P value (0.000**).Conclusion: nurses had lower knowledge level about caring of elderly patients with COVID-19which reflected on their attitude. 

[Marwa M. Abdelbacky, Aml Ali Mohamed & Eman Fadl Abd El khalik. Nurses knowledge and Attitude about Covid-19among elderly patients at Intensive Care Units: suggested education. Biomedicine and Nursing 2020;6(3): 49-58]. ISSN 2379-8211 (print); ISSN 2379-8203 (online). http://www.nbmedicine.org. 6. doi:10.7537/marsbnj060320.06.

Key words: Nurses knowledge, Attitude, Covid-19, elderly, Intensive Care units, education


7. Study on the prevalence and associated risk factors of bovine mastitis in and around dessie town, south wollo, northeastern Ethiopia
Mulunesh Yenew, Habtamu Addis
Department of veterinary medicine in Wollo university Desie Ethiopia, P.O. BOX 145
Email: muluneshyenewu@gmail.com


Abstract: Mastitis is a disease of major economic importance in dairy industry worldwide, particularly in developing countries. Even though mastitis is reported from different parts of Ethiopia, information concerning this disease in and around Dessie town is limited. Hence, this cross- sectional study was conducted from November 2016 to April 2017 in and around Dessie town, Ethiopia, to estimate the prevalence and risk factors, and isolate the major bacterial pathogens of bovine mastitis at cow level. Out of the total 180 lactating dairy cows clinically examined and tested by CMT, the overall prevalence of mastitis was 27.2%; where 3.3 % and 23.9 % cows were found with clinical and sub clinical mastitis, respectively. Generally, except study area (p- value > 0.05) almost all other risk factors such as farm, breed, age, parity, lactation stage and hygienic condition considered in this study were significantly associated (p- value < 0.05) with the overall prevalence of mastitis and bacterial isolates. Of 49 milk samples collected from 6 clinical and 43 sub clinical mastitic cows, and cultured for bacteriological examination, 85.7% (n=42) yielded bacteria. The isolation rate of Escherichia coli, Staphylococcus aureus and coagulase negative staphylococcus from mastitis milk samples in this study were 77.6 %, 61.2% and 16.3 %, respectively. All risk factors considered in this study such as farm, areas, breed, age, parity, lactation stage and hygienic condition were not significantly associated (p- value > 0.05) with the isolation rate of Escherichia coli, Staphylococcus aureus and coagulase negative staphylococcus from mastitic milk samples. All bacterial isolates were tested for their antimicrobial susceptibility patterns and showed varied responses. The majority of Escherichia coli isolates were resistance against Cloxacillin and Erythromycin but susceptible to Streptomycin, Ampicillin and Sulfamethoxazole-Trimethoprim. All Staphylococcus auerus isolates were susceptible for kanamycin but showed intermediate resistance for Enrofloxacin, Ciprofloxacin, Chloramphinicol and Streptomycin. All coagulase negative staphylococcus isolates were resistant for Bacitracin, Penicillin G and tetracycline but susceptible for Kanamycin and Gentamycine. In general, the presence of mastitis and emergence of multidrug resistant bacteria in the study area could indicate their potential risks on dairy production and public health. Based on the results obtained, recommendations are forwarded for further studies, and prevention and control of mastitis in the study area.
[Mulunesh Yenew, Habtamu Addis. Study on the prevalence and associated risk factors of bovine mastitis in and around dessie town, south wollo, northeastern Ethiopia. Biomedicine and Nursing 2020;6(3): 59-76]. ISSN 2379-8211 (print); ISSN 2379-8203 (online). http://www.nbmedicine.org. 7. doi:10.7537/marsbnj060320.07.
Key words: Coagulase Negative Staphylococcus, Escherichia coli, Mastitis, Staphylococcus aure


8. The effects of smoking cigarette on health in case of Mettu teachers teaching college 2nd year 
Getasew Abebaw
Faculty of Natural and Computational Science, Department of Sport Science, Woldia University, Ethiopia, P.O. Box. 400
geteshabebaw@gmail.com


Abstract: The objective of this study was focused effects of smoking cigarette on health in the case of Mettu College of teachers teaching 2nd year natural science department of biology class male students. Method; To gather the effective data the researcher used purpose sampling technique and the numbers of respondents of this study was 13 male students. Result: The researches have been made the following conclusion.46.15 of respondents knew the effects of smoking on health smokers starting by the reason of refreshment, work pressure load anger. Among total respondents 6(46.15 of respondents were have interest to stop cigarette used for future by used different method such as separated from smoker , participating, recreation, by advice of health profession.

[Getasew Abebaw. The effects of smoking cigarette on health in case of Mettu teachers teaching college 2nd year. Biomedicine and Nursing 2020;6(3): 77-82]. ISSN 2379-8211 (print); ISSN 2379-8203 (online). http://www.nbmedicine.org. 8. doi:10.7537/marsbnj060320.08.
Keywords: Cigarettes, Chronic Diseases, Physical Exercise


9. Development and Validation of HPLC assay of Lycopene in Different Matrices
M. Amjad *, S. Hussain
Department of Chemistry, Lahore Garrison University, Lahore, Pakistan

*Corresponding author: Muhammad Amjad 
*Corresponding Author’s E-mail: amjadqcm@gmail.com
Email address: dr.shabbirhussain@lgu.edu.pk (Dr. Shabbir Hussain) 


Abstract: Lycopene is the red pigment richly found in many red -colored fruits and vegetables such as tomatoes, papaya, pink grapefruit, pink guava, and watermelon. It is an antioxidant that has various beneficent effects and protects against oxidative damage to lipids, protein, and DNA. It is a potent quencher of oxygen and most effective against cancer, cardiovascular diseases, osteoporosis, hypertension, male infertility, and neurodegenerative disease. Lycopene is synthesized by plants and microorganisms but not animals and humans. The main objective of this study is to develop and validate an HPLC assay method for the determination of lycopene in tomato, watermelon, and human blood. A simple assay method is an economical assay method, suitable for the determination of lycopene from plant and biological sources. A new accurate, specific, precise, high performance liquid chromatographic (HPLC) method has been developed and validated for the determination of lycopene in tomatoes, watermelon and blood sample according to the International Council for Harmonization (ICH) guidelines. Acetonitrile, Methanol, Water (65%, 20%, and 15%) was used as the mobile phase at a flow rate of 0.7ml/min. using a symmetry C18 column. The effluent was spectrophotometrically monitored at 484nm. The calibration curve was linear with a correlation coefficient of 0.9994. The average recovery was found to be 102.0%. The proposed HPLC method was successfully applied to quantify the amount of lycopene in different matrices.
[M. Amjad, S. Hussain. Development and Validation of HPLC assay of Lycopene in Different Matrices. Biomedicine and Nursing 2020;6(3): 83-91]. ISSN 2379-8211 (print); ISSN 2379-8203 (online). http://www.nbmedicine.org. 9. doi:10.7537/marsbnj060320.09.
Keywords: HPLC; Lycopene; C18, Correlation Coefficient; Validation


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