eng
Egyptian Community Medicine Association
The Egyptian Journal of Community Medicine
1110-1865
2090-2611
2017-10-01
35
4
1
13
10.21608/ejcm.2017.5036
5036
Original Article
Elderly Falls Prevalence and Associated Factors in Sohag Governorate.
Population aging is a global challenge experienced by most developed and developing countries. There are diverse deleterious changes produced by aging process resulting in reduction of the effectiveness of various systems which can contribute to the occurrence of falls in the elderly. Elderly falls can have serious consequences and constitute a major cause of morbidity and mortality. Therefore, research is critically needed for establishing effective policies to reduce risk.Objective: This study was conducted to estimate the prevalence of elderly falls and identify associated factors in Sohag Governorate. Methods:A cross-sectional, population-based study conducted from December 2015 to April 2016 in a sample of non-institutionalized elderly people (60 years old or more), living in Sohag governorate.It included 1034participants. A questionnaire was designed to obtain data about history of falls in the previous 12 months and its associated factors.Results:Findings showed that 33.35% of the studied elderly populationin Sohag Governorate reported that they experienced falls in the previous year.Age, living alone, lighting, presence of stairs and carpets had a highly significant effect (P-value <0.001) on the incidence of falls among the studied population. Medication use, balance and mobility factors,most of the medical and psychological factors significantly affected the occurrence of falls among the studied population.Conclusion:The prevalence of falls in elderly is relatively high in Sohag Governorate. Identification of factors significantly affecting elderly falls can help in planning public health policies and programs for prevention of falls.
https://ejcm.journals.ekb.eg/article_5036_ecf17ece650d5c6be4064bcfc02e4330.pdf
Elderly
aged, accidental falls, falling, injuries, risk factor
eng
Egyptian Community Medicine Association
The Egyptian Journal of Community Medicine
1110-1865
2090-2611
2017-10-01
35
4
15
23
10.21608/ejcm.2017.5037
5037
Original Article
Factors Affecting Quality of Life in Patients with Pediatric Leukemia during Induction Chemotherapy.
Objectives: The aim of this study is to describe quality of life (QoL), identify predictors of worse QoL and examine QoL changes from diagnosis and the end of induction chemotherapy in acute leukemia pediatric patients. Methods: A prospective study was conducted, including 105 newly diagnosed leukemic patients aged from 2 to 17 years at pediatric department, National Cancer Institute, Cairo University. Parents were interviewed to complete QoL assessment questionnaire using the PedsQL 4.0 Acute Cancer Module. Older children (more than 13 years) were interviewed using the same questionnaire version. Results: Patients had an overall score of a median 39 (range 25–64) that changed by the end of induction (median 41.7, range 0–75). Pain and hurt reported a median score of 12 (range 0-100) at diagnosis and by the end of induction, median score was 75 (range 50-100). Both scores were statistically significant being improved by therapy. Both Cognitive Problems and Perceived Physical Appearance worsen by end of induction. Girls and older children had worse QoL. Conclusions: Girls and older children had worse QoL. Cognitive Problems and Perceived Physical Appearance deteriorate by therapy. Chemotherapy regimens for childhood leukemia are lengthy with medications administered over 2.5–3.5 years, and thus future efforts should focus on longitudinal studies that describe QoL over time within individual patients.
https://ejcm.journals.ekb.eg/article_5037_8e62796fb83d98437c600b8ce19fd130.pdf
Pediatric leukemia
quality of life
induction chemotherapy
eng
Egyptian Community Medicine Association
The Egyptian Journal of Community Medicine
1110-1865
2090-2611
2017-10-01
35
4
25
33
10.21608/ejcm.2017.5038
5038
Original Article
Adherence to Treatment of Rheumatoid Arthritis Patients at Zagazig University Hospitals
Background: Rheumatoid arthritis (RA) is a long-term disease that leads to inflammation of the joints and other organs. Adherence is essential to achieve the two main goals of RA treatment which are lowering disease activity and decreasing radiological progression. Objective: Our study aimed to measure rheumatoid arthritis patients’ adherence to treatment and factors affecting it. Methods: A cross sectional study was conducted on 159 rheumatoid arthritis patients attending rheumatology clinic at Zagazig university Hospitals using 8 items Morisky scale to assess their adherence to treatment and a structured questionnaire to assess barriers to their adherence. Results: There is a significant inverse correlation between adherence to treatment and both the age of rheumatoid patients and duration of disease and significant direct correlation with the educational level of patients. There is significant difference between the low and high adherence groups regarding loss of social support, medication cost, medication’s side effects, medication’s bad taste and long term therapy. Conclusion and recommendations: The existence of medication related factors as barriers to adherence necessitate more efforts from health care system to introduce low cost and more effective drugs with fewer side effects to increase patients’ adherence to treatment.
https://ejcm.journals.ekb.eg/article_5038_9a08bf0edcfdfbeaacf75f7a7c261efa.pdf
Rheumatoid Arthritis
adherence
Morisky
barriers
eng
Egyptian Community Medicine Association
The Egyptian Journal of Community Medicine
1110-1865
2090-2611
2017-10-01
35
4
35
46
10.21608/ejcm.2017.5040
5040
Original Article
Perception and Practices of Female Sex Workers towards Sexually Transmitted Infections in Greater Cairo, Egypt
Objective: to study the perception and practices of sexually transmitted infections among female sex workers in Greater Cairo. Methods: A cross sectional study including 431 of female sex workers. Results: 77.3% of participants knew about STIs. The majority (70.3%) claimed refusing sex in presence of STIs. However, unusual vaginal discharge last year was reported by 76.1% of participants, and genital ulcers by 15.5%. Only 40.1% informed their partners if having STIs and 63.1% claimed immediately starting treatment either from private or governmental facilities (45.9% and 33.6%, respectively). AIDS was known by 92.8% of participants while only 9.3% ever attended a raising awareness session. Correct methods of infection were known by 64.3% for breast milk, 78.4% from mother to her baby and 76.3% for sharing needles. Having one faithful partner, abstain from sex and proper use of condoms were the main preventive measures reported by participants (54.8%, 54.8% and 40.4%, respectively). Only 31.3% accepted taking care of an infected friend. Confidential counseling and testing for HIV was known by 57.1% but only 8.4% performed the test. Conclusion: The majorities of participants were knowledgeable about STIs and still had some misconceptions and a negative attitude towards people living with HIV. Key message: The paper addresses an issue for which limited information is available in our region due to illegal pattern of sex working. In many low prevalence countries the HIV epidemic is usually fueled by spread in most at risk population as sex workers before it turns to a generalized epidemic. The perception of HIV and STIs risk among sex workers is important to stimulate them to adopt harm reduction policies which can protect them and community from STIs including HIV infection.
https://ejcm.journals.ekb.eg/article_5040_f4269f689559b4bed06d1cc874ed49b6.pdf
Female sex workers
AIDS
Sexually transmitted infection
eng
Egyptian Community Medicine Association
The Egyptian Journal of Community Medicine
1110-1865
2090-2611
2017-10-01
35
4
47
56
10.21608/ejcm.2017.5041
5041
Original Article
Epidemiology of Ventilator Associated Pneumonia in Hospital Surgery Intensive Care Units of Ain Shams University Hospital
Background:Ventilator-associated pneumonia (VAP) is the most common intensive care unit acquired infection, and it is associated withincrease in hospitalization, health care cost and mortality. It classified into early onset or late onset. Objectives: measure the incidence rate and risk factors of VAP, measure the VAP impact on length of stay in ICUand duration ofmechanical ventilation and to measure adherence to IHI (institute of health improvement) ventilator bundle. Methods: A prospective study conducted at surgery hospital ICUs.All ventilated patients who didn't developed chest infections after 48h of mechanical ventilation are followed until discharge from ICU. Results: 56.2% of thestudy population wasmales; the mean age was 43.2+ 15.6. Incidence density was 38.3per 1000 ventilation day. Early onset VAP was 47.5% and late onset VAP was 52.5%. The independent risk factors of VAP infection are age ≥ 60 years, duration of mechanical ventilation, smoking, chest diseases, insertion of IV cannula and APACHE II score.Crudemortality rate was 42.1%. VAP infection has a significant impact on both the length of stay in ICU and duration of mechanical ventilation.VAP cases have lower adherence to all IHI ventilator bundle elements and the overall compliance was 71± 22.8 in VAP cases versus 80.7±16.0 in non VAP. Gram negative MDRs bacteria were isolated in 84.3% ofVAP cases.The commonest isolated bacteria wasAcintobacter(33.9%).Conclusion:VAP is a serious ICU acquired infection with significant impact and required effective preventive action.
https://ejcm.journals.ekb.eg/article_5041_1a41c1209de12ec1ba03f0e9cc2148ab.pdf
VAP
Incidence rate
impact
bundle adherence
eng
Egyptian Community Medicine Association
The Egyptian Journal of Community Medicine
1110-1865
2090-2611
2017-10-01
35
4
57
69
10.21608/ejcm.2017.5042
5042
Original Article
Effectiveness of health education intervention on foot self-care practice among diabetics at Zagazig university hospitals
Background: Diabetic patients are at risk for developing diabetic foot problems as infection, ulcer and gangrene which are the most common cause of hospitalization among diabetics. Proper foot care is very necessary for preventing these problems and improving quality of life of these patients. Aim the aim of this study was to assess the effectiveness of health education intervention on self-care knowledge and foot care practice among diabetic patients. Methods: an intervention field trial was conducted on 76 diabetic patients attending Zagazig University Hospital outpatient clinics using structured questionnaire for self-care knowledge assessment and structured questionnaire guided by American diabetesassociation guidelines for foot care practice assessment. The International Working Group on the Diabetic Foot (IWGDF) –Risk Classification System was used for risk classification of the studied diabetic patients. Results 31.5 % of studied patients had high risk for diabetic foot. There was significant improvement in the total knowledge score from 8.17±2.4 to16.16±2.3 after application of the intervention. Also there was significant improvement in the total practice score (p value <0.001). Recommendation: Targeted health education programs regarding foot care strategies for diabetic patients are needed to reduce diabetic foot complications and ultimately amputation.
https://ejcm.journals.ekb.eg/article_5042_1fff5ffeba6c42819d183388eb0b234d.pdf
diabetics
foot practice
Self-Care
Knowledge
health education
eng
Egyptian Community Medicine Association
The Egyptian Journal of Community Medicine
1110-1865
2090-2611
2017-10-01
35
4
70
81
10.21608/ejcm.2017.5043
5043
Original Article
Violence Attitude and Its Relation to Health-Related Habits in Medical Students’ at Faculty of Medicine, Ain Shams University.
Background: Youth violence is a global public health problem. It includes a range of acts from bullying and physical fighting, to more severe sexual and physical assault to homicide. Worldwide an estimated 200 000 homicides occur among youth 10–29 years of age each year, making it the fourth leading cause of death for people in this age group. Youth homicide rates vary dramatically between and within countries, being more common in developing countries than more developed ones. Researchers and prevention specialists are trying to identify the factors that increase young people attitude toward violence in order to plan for successful interventions and to design more effective prevention programs. Objectives: to measure medical students’ attitude toward violence at Ain Shams university hospital and to find out the relations between medical students’ scores on the attitudes toward violence, demographic variables, and health-related habits. Methods: A Descriptive cross-sectional study was carried out at Faculty of Medicine, Ain Shams University; 1257 Medical Students were included in the study. Data was collected using a structured interviewed questionnaire adopted from National centre for injury prevention and control of the centre for disease control and prevention. Results: The total attitude score toward violence was 53.02 ± 11.74, (48.0%) of the studied medical students show moderate attitude toward violence. There was a highly statistically significant relationship between violence attitude level and Smoking status, Taking Anxiolytics, Analgesics and Alcohol. Ordinal logistic regression analysis shows that Students’ gender, grade, smoking status and analgesic intake are independent predictors of total attitude score toward violence (P<0.05). Conclusion: An increase in attitude score towards violence among medical students is well observed. Male gender, older student ages, smoking and analgesics intake are important influencing factors that require special attention while designing intervention programs aiming at reducing violence rates among youth.
https://ejcm.journals.ekb.eg/article_5043_080f6fb0891a5b88fc822b62e611a14e.pdf
Attitude towards Violence – Health-related habits –Medical students
eng
Egyptian Community Medicine Association
The Egyptian Journal of Community Medicine
1110-1865
2090-2611
2017-10-01
35
4
83
93
10.21608/ejcm.2017.5044
5044
Original Article
Impact of Obesity on Male Subfertility and Semen Quality: A Cross- Sectional Study
Background: Relationship between obesity and male subfertility is a matter of controversial. Objective: To clarify relationship between obesity and male subfertility as well as confirm the relationship between BMI and quality of semen parameters. Methods: Study is observational cross-sectional, conducted in Department of Dermatology, Venereology and Andrology, Assiut University Hospital, between May and September 2015. Two hundred twenty males met our inclusion criteria were enrolled. Semen analysis was done to volunteers for follow up of their reproductive health after getting their consent. History taking, general and local genital examinations were done: participants were divided into 3 groups, group (I) normal weight (42) , (II) overweight (104) , (III) obese (94). Results: Mean BMI was 29.5 ± 6.2, semen volume was decreased from 3.3 ± 1.2 in normal weight to 2.9 ± 1.45 & 2.56 ± 1.4 in overweight and obese (P= 0.02). Similar findings were reported in sperm concentration and count, while abnormal forms increased from 87.7 ±7.4 in normal to 90.9 ±6.6 & 91.6 ±8.1 in overweight and obese (P= 0.04. Motility decreased from 14.3 ± 4 .2 in normal to 13.3 ± 3.45 & 11.8 ± 5.4 in overweight and obese (P= 0.007), teratozoospermia index increased from 1.28 ± 0 .18 in normal to 2.38 ± 0.17 and 3.29 ± 0.22 in overweight and obese (P= 0.009), the same findings was observed in sperm deformity index. Conclusion: Obesity may play a negative role in sperm parameters and male subfertility.
https://ejcm.journals.ekb.eg/article_5044_e267ac6aed3e2656f18d20e1b4e726db.pdf
Obesity
Infertility
BMI
Semen. Quality
male