ORIGINAL_ARTICLE
Antibiotic Resistance Patterns of Uropathogens in Long Term Care Facilities
Background: Residence at a Long term care faci l i ty (LTCF) and older age are both recognized as signi ficant riskfactors for harboring mul tidrug resistant Gram-negative bacteria (MDRGNB)Aim: The objective of this descriptive study is to detect the commonest mul tidrug resistant bacteria and i tsantibiotic sensi tivi ty in urine of elderly residents at LTCF wi th urinary t ract infection (UTI ) .Methods: Eighty one LTCF elderly residents wi th UTI. Cul ture and sensi tivi ty was done for urine samplesdocumenting mul tidrug resistant organisms wi th antibiotic susceptibi l i ty to a range of di f ferent antibiotic groups.Demographic data was col lected and comorbidi ties were establ ished. Al l samples were processed as per standardtechniques and bacteria identi fied by standard biochemical tests. IBM SPSS statistics (version 24, IBM corp., USA,2016) was used for data analysis.Results: The age ranges f rom 60 to 90 years wi th mean 69.86 +/ - 9.68 years Males are 74.1% whi le females are25.9 %. The predominant resistant detected organism in these samples was Proteus (58.0%) then E col i (19.8 %),Klebsiela (18.5 %) then Pseudomonas (3.7 %). Proteus is found to be highly statistical ly signi ficant sensi tive toCefepime (CPM), Ciprofloxacin (CP), and Imipenam ( IMP) and to be highly statistical ly signi ficant resistant toCol istin (CT), Gentamycin (GM) , Tobramycin (Tobra. ), Ni trofurantoin (FD) , and Trimethoprim/Sul famethoxazole(TS). E Col i is found to be highly statistical ly signi ficant sensi tive to Col istin (CT), Trimethoprim/ Sul famethoxazole(TS), Gentamycin (GM), Tobramycin(Tobra. ) and Ni trofurantoin (FD) and resistant to Cefepime (CPM) . Furtherstudies are recommended on larger numbers of elderly patients to confi rm or not confi rm signi ficant findings in thisstudy, t ry to explain these findings, and make use of i t in cl inical practice.Conclusion: Proteus is the commonest mul ti resistant uropathogen in those under 70 years whi le psuedomonas isthe most prevalent one in elderly between71 -90 years of age
https://ejgg.journals.ekb.eg/article_5052_f46c02914b22a3f0091f307a610cc91f.pdf
2017-10-01
1
5
10.21608/ejgg.2017.5052
Antibiotic susceptibi l i ty
mul ti drug resistant bacteria
urine
UTI
long term care faci l i ty
Elderly
EL Bedewy
RMS
1
Geriatrics & Gerontology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
LEAD_AUTHOR
ORIGINAL_ARTICLE
Trace elements and septic shock in elderly patients
Background: Trace elements l ike copper and zinc have a signi ficant influence on the function of the immunesystem.Aim: To evaluate basel ine trace elements as s predictor of septic shock in Egyptian elderly patients wi thinintensive care set ting.Methods: A prospective study for al l patients admi t ted to Ain Shams Geriat rics intensive care uni t ( ICU) during a 6months period. Patients divided to: group who did not develop septic shock and those who developed septic shock.APACHE II score (Acute Physiology and Chronic Heal th Evalua tion I I) , systemic inflammatory response (SIR) andvi tal signs were veri fied. Routine laboratory tests, conscious level and length of stay were recorded. Traceelements (zinc (Zn) and copper (Cu)) were analysed.Results: The sample included 142 patients (49% females) . The mean age was 69.5±7.3. Septic shock wasobserved in 12% of them. There was a statistical ly signi f icant di fference between sept ic and non -septic shockpatients as regards basel ine serum zinc level (P ≤ 0.001) but no di f ference regarding serum copper level (p ≥0.05) .Conclusions: The study highl ighted that basel ine zinc deficiency may add to the risk of developing septic shock inelderly patients. However, further studies are needed to conf i rm such association
https://ejgg.journals.ekb.eg/article_5053_f386959830b7a69905aae81cb77696f2.pdf
2017-10-01
6
9
10.21608/ejgg.2017.5053
septic shock- elderly- zinc- copper
Hamza
SA
1
Geriatrics & Gerontology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
AUTHOR
Ali
SH
2
Geriatrics & Gerontology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
LEAD_AUTHOR
Abdul Kadir
KA
3
Cardiology Department; Faculty of Medicine, Ain shams university, Cairo, Egypt
AUTHOR
Shaat
MM
4
Geriatrics & Gerontology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
AUTHOR
ORIGINAL_ARTICLE
Social cognition profile in amnestic MCI
Background: For years, disturbance of social cogni tion was considered as an early feature of schizophrenia andautism. Recently, i t has been studied in many neurodegenerative diseases, and included as one of the six keydomains of cogni tive function defined by DSM- V. Mi ld cogni tive impai rment (MCI ) is a t ransi tional state betweennormal cogni tive aging and dementia, mainly of AD type. Few reports have addressed theory of mind (ToM)capaci ty in patients wi th MCIAim: To detect ToM impai rment among amnestic MCI patients and to characterize the neuropsychological andfunctional profi les of MCI cases according to thei r ToM capaci ty.Methods: 40 elderly diabetic patients wi th amnestic MCI were recrui ted. Each patient underwent cogni tive, andfunctional assessment. The secon d order false bel ief (John and Mer ry story) test was used to assess socialcogni tion.Results: There was no signi f icant di fference between cases wi th and wi thout impai red social cogni tion regardingage, ADL,or IADL, whi le MMSE scores were signi ficantly lower among cases wi th impai red second order bel ief .Stick design tests, and digi t span tests were signi ficantly af fected in the cases wi th impai red social cogni tion.Conclusions: Social cogni tion was impai red in about 17.5% of patients wi th MCI, which was n ot reflected uponfunctional status. MCI patients wi th impai red social cogni tion, performed worse in the stick design test and thedigi t span forward test.
https://ejgg.journals.ekb.eg/article_5054_1a85dea32dba129d926001c22b86a04c.pdf
2017-10-01
10
14
10.21608/ejgg.2017.5054
Theory of Mind
social cogni tion
second order false bel ief
Amer
M S
1
1Geriatrics & Gerontology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt. 2Ain Shams Ageing Research Center.
AUTHOR
Adly
N N
2
1Geriatrics & Gerontology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt. 2Ain Shams Ageing Research Center.
AUTHOR
Rasheedy
D
3
1Geriatrics & Gerontology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt. 2Ain Shams Ageing Research Center.
AUTHOR
Mahdy
R
4
1Geriatrics & Gerontology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt. 2Ain Shams Ageing Research Center.
AUTHOR
ORIGINAL_ARTICLE
Food System as a Crucial Factor Defining Nutritional Status of Nursing Home Female Residents
Background: Malnut ri tion in insti tutional ized elderly is of individual and publ ic concern and should be evaluatedAim: To assess the nut ri tional status and discuss the relation between malnutri tion and food system amongfemale residents of elderly homes in Cai ro, Egypt .Methods: From seven elderly homes in Cai ro, two hundred female residents were randomly selected. Medical datawas col lected. The MNA was used to assess thei r nut ri tional status then a questionnai re assessing the feedingsystem in the elderly homes was appl ied to nursing home personnel .Results: Among the 200 par t icipants, 28(14%) of them were malnourished, 94 (47%) were at risk of malnut ri tionand 78 (39%) were wel l nour ished . The nursing home characters decreasing the risk of malnut ri tion were thepresence of dining room, food variabi l i ty, avai labi l i ty of al ternate food and the presence of dietician. Regardingfood habi ts; nasogast ric feeding, water cups <5.0 per day, non-f ried food, presence of diet regimens, absence ofsnacks and absence of external food were associated wi th malnut ri tion.Conclusions: Elderly homes play a crucial role in provision of a heal thy envi ronment for residents. To achievebet ter nut ri tional status, adjusting food system is needed. Pr esence of a dietician among the staff in elderly homeshas a paramount role in residents' nut ri tional status.
https://ejgg.journals.ekb.eg/article_5055_cc0cbb08cdb911925a8889f93813d364.pdf
2017-10-01
15
19
10.21608/ejgg.2017.5055
Malnutri tion
Elder ly females
Nursing homes
Egypt
Sweed
HS
1
1Geriatrics & Gerontology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt. 2Clinical Pathology department, Faculty of Medicine, Ain Shams University. Cairo, Egypt.
AUTHOR
Mabrouk
RR
2
Clinical Pathology department, Faculty of Medicine, Ain Shams University. Cairo, Egypt.
AUTHOR
Ali
SH
3
Geriatrics & Gerontology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
LEAD_AUTHOR
Abd el mawla
NM
4
Geriatrics & Gerontology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
AUTHOR
ORIGINAL_ARTICLE
Prevalence of Depression among Caregivers of Dementia Patients
Background: Depression is a common problem af fecting caregivers of dementia pat ients . Factors such asc ar egi v e rs ’ ag e, g en de r, ed ucational level , mari tal status and financial status may play a role in care givingrelated depressive disorder.Aim: to detect the prevalence of depression among caregivers .Methods: The study included 96 caregivers for demented elderly patients. Depression among caregivers was assessed using PHQ-9 scaleResults: T he c a r egi v e rs ’ m ea n ag e was (4 2. 94 ) ± 1 3.1 7 y e a rs . (69.7%) of the care givers were women. More than hal f of them (52%) were mar ried. (38.5%) of caregivers had moderate to severe depression, (43.7%) had mi ld to moderate depression and (17.7%) were wi th minimal depressive symptoms .Conclusions: Caregivers of patients wi th dementia are prone to depression and physical ai lments. Caregiverfactors predicting l iabi l i ty to caregiver burden are c a re gi v e r ’ s fi n anc i al s t at us , c a re gi v e r’ s ed uc a ti o n l ev el am on gother socio-demographic variables.
https://ejgg.journals.ekb.eg/article_5056_fd2285e2a7d319740b2025074922d512.pdf
2017-10-01
20
22
10.21608/ejgg.2017.5056
Caregiver Burden
Dementia
depression
Female caregivers
socio -demographic status and burden
Hamza
SA
1
1Geriatrics& Gerontology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt. 2Ain Shams Ageing Research Center.
AUTHOR
Raafat
V
2
1Geriatrics& Gerontology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt. 2Ain Shams Ageing Research Center.
AUTHOR
Fawzy
H
3
1Geriatrics& Gerontology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt. 2Ain Shams Ageing Research Center.
AUTHOR
Abbass
A
4
1Geriatrics& Gerontology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt. 2Ain Shams Ageing Research Center.
AUTHOR
ORIGINAL_ARTICLE
Role of Platelets Rich Plasma Intra-Articular Injections in the Treatment of Knee Osteoarthritis among Elderly
Background: Knee OA is a major publ ic heal th problem among elderly. I t is a debi l i tating condi tion associatedwi th increased morbidi ty and disabi l i ty . Thus, the development of therapeutic interventions could enhance thequal i ty of l i fe for the elderlyAim: To evaluate the cl inical effi cacy of platelets rich plasma int ra articular injections in t reatment of KneeOsteoarthri tis among Elderly.Methods: one arm cl inical t rial on 44 elderly par ticipants al l of them received a single session of intraarticularPRP injection, they were subjected to physical function and mobi l i ty assessment using Western Ontario andMcMaster Universi ties Ar thri tis Index (WOMAC) questionnai re and pain assessment by the numeric pain ratingscale (NRS-11) at 6 and 12 months post injection.Results: study reported a statistical ly signi ficant improvement in al l functional WOMAC assessment scores andNRS after 6 months and 12 months post injection fol low up wi th the tendency for gradual decl ine of cl inicalimprovement ti l l the end of fol low up after 1 y ear.Conclusions: Intraar ticular PRP injections are safe, effective and rel iable t reatment option providing functionalimprovement and pain cont rol for elderly patients wi th knee OA
https://ejgg.journals.ekb.eg/article_5057_af6f7d4aabe2320ecf9d3d1ba83a4063.pdf
2017-10-01
23
27
10.21608/ejgg.2017.5057
osteoarthri tis
Western Ontario and McMaster Universi ties Arthr i tis Index (WOMAC)
platelets rich plasma (PRP)
Elderly
Sweed
HS
1
1Geriatric Medicine& Gerontology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt. 2 Ain Shams Ageing Research Center
AUTHOR
Emara
KM
2
Orthopedic Surgery Department, Faculty of Medicine - Ain Shams University, Cairo, Egypt
AUTHOR
El-Helw
MR
3
Physical medicine, Rheumatology and Rehabilitation Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
AUTHOR
Munier
MM
4
Geriatric Medicine& Gerontology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
AUTHOR
Zakaria
MA
5
Physical medicine, Rheumatology and Rehabilitation Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
AUTHOR
Taha
RM
6
Geriatric Medicine& Gerontology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
AUTHOR
ORIGINAL_ARTICLE
A Case of a Rare Skin Manifestation of Celiac Disease
Case description: A 67 years old man presented to the cl inic complaining of an i tchy bl istering skin rash overelbows, knees and but tocks for the past 2 months that is not responding to antihistamines. Itching has no diurnalvariation. Patient has no chronic comorbidi ties a nd is not on regular medications. On examination, symmet ricalvesicular lesions wi th erythema, crusting and i tch marks are seen over both elbows, knees and back wi th -veNi c ol s k y ’ s s i gn . G en e ral ex a mi na ti on rev eal s p al l o r, p ati ent B MI 1 7.5 , ab do mi nal di s te ntion, and peripheralneuropathy. Investigations showed microcytic hypochromic anemia wi th HGB 9.8 mg/dl , MCV 68, HCT 29.8, WBCsand platelets are normal . K 3.1mg/dl , Na 135 meq/dl , Ca 8.5mg/dl , albumin 3g/dl . Skin biopsy and di rectimmunofluorescence of the skin around the lesions was taken that was diagnosed as dermati tis herpeti formis.Endoscopy was done and i t confi rmed the diagnosis of cel iac disease.Treatment: Patient was advised to fol low agluten f ree diet plan and dapsone was started at a dose of 1 00 mg/day. Patient rash resolved gradual ly over aperiod of 3 weeks.
https://ejgg.journals.ekb.eg/article_5058_9ae531b4896005ef50ce8cff98cfed26.pdf
2017-10-01
28
29
10.21608/ejgg.2017.5058
Dermati tis Herpeti formis
atypical presentation
Cel iac Disease
Gluten Enteropathy
Abdul-Rahman
SA
1
Geriatrics & Gerontology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
AUTHOR