Egyptian Community Medicine Association
The Egyptian Journal of Community Medicine
1110-1865
2090-2611
36
2
2018
04
01
Nutritional Status and Some Sociodemographic and Lifestyle Characteristics among A Group of Rural School Children in Fayoum Governorate, Egypt
1
11
EN
10.21608/ejcm.2018.11043
Background: In low and middle income countries, malnutrition especially among<br />children is an increasing health problem. According to Egyptian national surveys,<br />prevalence of malnutrition in school children is high, however, data is lacking at the<br />regional level. Objective: The current study aimed to assess the nutritional status, and<br />identify the socio-demographic and lifestyle factors affecting it among rural school<br />children. Methods: A school based cross sectional survey was conducted among rural<br />school children (6-17 years) in Manshit El Gamal village in Tamia district of Fayoum<br />Governorate, Egypt from October 2014 to April 2015. A sample of 736 students was<br />included in the study. Weight, height, and age were used to calculate z-scores of the three<br />different nutritional indicators. Sociodemographic, lifestyles and dietary habits were<br />collected using a pretested interview questionnaire. Results: Stunting (HAZ <-2SD),<br />underweight (WAZ<-2 SD), and wasting (WHZ <-2SD) were 34.2%, 3.4% and 0.8%<br />respectively, while over nutrition based on (WHO/NCHS) reference population BMI zscore<br />was 14.9%. Stunting was higher in females 36.2% than males 32.9% though not<br />significant. Whereas, obesity significantly decrease with age and was higher in males 17%<br />than females 12.1% with a significant different in the age group 10-13 years. Age, reduced<br />poultry consumption and escaping breakfast were risk factors for malnutrition, while daily<br />fruit consumption was a protective one. Conclusion: Malnutrition is highly prevalent in<br />rural school children of Fayoum governorate in line with the national prevalence and<br />significantly associated with children age, gender, mother’s education and regularity of<br />father’s work.
anthropometric measures,school children,Malnutrition,Obesity,Nutritional Status,Sociodemographic,Low and Middle income countries
https://ejcm.journals.ekb.eg/article_11043.html
https://ejcm.journals.ekb.eg/article_11043_ed13175fc432abe9d851fdfcff7410a6.pdf
Egyptian Community Medicine Association
The Egyptian Journal of Community Medicine
1110-1865
2090-2611
36
2
2018
04
01
Assessment of Nutritional Status in Chronic Hepatic Patients at Ain Shams University Hospital
13
22
EN
10.21608/ejcm.2018.11044
Background: Malnutrition is prevalent in all forms of liver disease. The presence of malnutrition is associated with increased number of complications and increased short and long term mortality. Objectives: to assess the nutritional status of patients with chronic liver disease & identify the relationship between hepatic disease severity and degree of malnutrition. Methods: A cross sectional study, on a sample of chronic hepatic patients in Gastroenterology and Hepatology Department at Ain Shams University hospital. An interview questionnaire including socio-demographics, medical, surgical history and gastrointestinal symptoms had been completed. Nutritional status was assessed by using scored patient-generated-subjective global assessment (PG-SGA), anthropometric, functional parameters and Laboratory tests. Liver disease severity was assessed using Child Pugh score. Results: Sample of 161 patients, 104 from outpatient clinic and 57 from inpatients. Their mean age was 51.3±12.5 years, 51.6% were males. They were 47%, 42% for class A,B and C in consequence as for Child classification of liver disease. Assessment of malnutrition using Global PG-SGA revealed 16.8% were severely malnourished (PG-SGA C), about half (50.9%) were moderately malnourished (PG-SGA B), one third (32.3%) were well nourished (PG-SGA A). About one quarter were moderately malnourished by either weight for age, MAC, TSF, MAMC or MAMA. There was a statistically significant difference between the three Child`s groups as regards PG-SGA total score and global rating and different anthropometric and functional methods. Conclusion & recommendation: There was a high prevalence of malnutrition among chronic hepatic patients in Ain Shams University hospital. The degree of malnutrition increases as the severity of liver disease increase. Accordingly, proper nutritional screening and assessment should be done routinely to all chronic hepatic patients.
Nutritional Status,Anthropometric assessment,hepatic patients,Malnutrition
https://ejcm.journals.ekb.eg/article_11044.html
https://ejcm.journals.ekb.eg/article_11044_c43ba6ea7c0afc939aba159613151116.pdf
Egyptian Community Medicine Association
The Egyptian Journal of Community Medicine
1110-1865
2090-2611
36
2
2018
04
01
Prevalence of Hypertension and Quality of Life among Hypertensive Patients in An Egyptian Village
23
35
EN
10.21608/ejcm.2018.11046
Background: Systemic Hypertension (SH) is a major cardiovascular risk factor with a<br />high prevalence in almost all countries and is one of the leading risk factors for global<br />mortality. It is estimated to have caused 7% of disease burden in 2010 and 9.4 million<br />deaths. Studies have been conducted to illustrate the negative effect of systemic<br />hypertension on health-related quality of life. Objective: To measure the prevalence of<br />hypertension and its risk factors among residents of a village in Menoufia governorate and<br />to describe the quality of life among the study population in the same village. Method:<br />The study was a cross sectional design with multistage random sampling. Six hundred<br />(600) people representing 10% of the population of Meet El Moze village in Menofia<br />governorate were included. The chosen households were visited where filling the<br />questionnaires and the clinical examination was carried out. Household residents 18 years<br />or older were recruited. Results: The results indicated that the prevalence of hypertension<br />was 38.2% in Meet El Moze village a rural area in Egypt. Overweight and obesity were<br />the most modifiable risk factors of hypertension. The quality of life was worsened among<br />hypertensive patients. Conclusion: It is concluded that hypertension is prominent in rural<br />areas and affects the quality of life of hypertensive patients
Hypertension,prevalence,quality of life,rural
https://ejcm.journals.ekb.eg/article_11046.html
https://ejcm.journals.ekb.eg/article_11046_f56232e3d004cc38fe78b7b616f2799e.pdf
Egyptian Community Medicine Association
The Egyptian Journal of Community Medicine
1110-1865
2090-2611
36
2
2018
04
01
Residents’ Physicians’ Awareness, Intention and Practice of Patient Rights at Ain Shams University hospitals
37
47
EN
10.21608/ejcm.2018.11048
During the past few years, Egypt has implemented several and diverse legal, political, and<br />administrative mechanisms to deal with health care ethical problems. Despite nurses and<br />physicians agreement that patients have rights and that they are committed to respecting these<br />rights, they are rarely able to do this. Objectives: To determine resident’s physicians’<br />knowledge, intention and practice of patient rights at Ain shams University Hospitals and to<br />find out factors that affect Physicians’ practice of patient's rights. Methods: A cross Sectional<br />study was conducted on a convenience sample of 400 resident physicians that were recruited<br />from different departments at Ain Shams University Hospital and agreed to participate in the<br />study. A Self-administered structured questionnaire was used to collect information about:<br />personal data, physicians’ awareness, intention and practice of patient rights. Results: All<br />(100.0%) of the participating physicians were aware about the statement of patients’ rights in<br />Egyptian health facilities; most of them obtain their knowledge from posters hanged on the<br />wall of the hospital, undergraduate and post graduate curriculum, and mass media, (99.8%)<br />had high intention score level towards practicing patient rights; while less than half of them<br />(45.5%) had high practice score level. There was no statistically significant correlation<br />between Residents’ physician knowledge, Intention and Practice scores towards patient rights<br />(p>0.05). In addition, there was a highly statistically significant difference between<br />physicians practice score levels regarding their specialty (p<0.01); where the majority<br />(77.0%) of participating physicians working in pediatric departments had got the highest<br />practice score level for the statement of patient rights Conclusion: The current study found a<br />gap between physicians’ awareness, intention toward practicing patient rights' and their actual<br />application of these rights. Recommendations: Hospital Management should develop preservice<br />(orientation period) and in-service training programs for resident physicians to update<br />their knowledge and practices in all patients’ rights aspects. Educating the patients about their<br />rights and actions that they could take if these rights were violated is an important mean for<br />improving patient satisfaction and improving the quality of care offered at health care<br />facilities.
Awareness,Practice,Patient Rights,Resident Physicians,Ain Shams University Hospitals
https://ejcm.journals.ekb.eg/article_11048.html
https://ejcm.journals.ekb.eg/article_11048_a16734edb1b5626d5296f21eb13fb430.pdf
Egyptian Community Medicine Association
The Egyptian Journal of Community Medicine
1110-1865
2090-2611
36
2
2018
04
01
Clinical Profile, Associated Co-morbidities and Risk Factors of Cerebral Palsy in Children in Sohag, Egypt
49
56
EN
10.21608/ejcm.2018.11049
Background: Cerebral palsy (CP) is a group of permanent disorders of movement and<br />posture resulting from a non-progressive lesion to an immature brain. Objective: is to<br />identify the prevalent subtypes, associated co-morbidity and risk factors of CP among<br />children less than 12 years in Sohag, Egypt. Method: a case control study was conducted<br />where 122 cases of CP attending the neuropediatric clinic of Sohag University Hospital<br />were compared to age and sex matched control group (280 normal children) as regard<br />history of prenatal, perinatal and postnatal risk factors of CP. Data related to the subtype<br />and associated co-morbidity were also collected from the studied cases of CP. Results:<br />Among the studied cases of CP, 45% had quadriplegia, 9.8% and 6.5% had hemiplegia<br />and paraplegia respectively. 77.8% had spastic CP and 65% had hypertonia. 65% of cases<br />had intellectual sub-normality, 29.5% of cases had epilepsy, 25% and 15% of cases had<br />visual and hearing impairment respectively and 23.3% of the cases suffered from<br />contracture. History of perinatal asphyxia and post natal encephalitis were the only<br />detected significant risk factors for CP. Conclusion: The most common type of CP<br />detected in our locality was severe spastic (hypertonic) quadriplegia level IV, these<br />findings were attributed to the most common risk factors of CP in our locality which were<br />hypoxic–ischemic encephalopathy and CNS infections. Appropriate screening and<br />management of co-morbidities especially vision, hearing and seizures, improve the overall<br />prognosis in cases of CP.
Cerebral palsy,risk factors,Neuropediatric
https://ejcm.journals.ekb.eg/article_11049.html
https://ejcm.journals.ekb.eg/article_11049_941247e6dd9d0a20ecb5c3b6b364d5d2.pdf
Egyptian Community Medicine Association
The Egyptian Journal of Community Medicine
1110-1865
2090-2611
36
2
2018
04
01
Correlates of Married Men's Attitude towards Gender Based Violence, Secondary Analysis of Survey of Young People In Egypt (SYPE) Data,2014.
57
67
EN
10.21608/ejcm.2018.11051
Background: Nowadays, One of the Main public health problems is intimate partner violence<br />(IPV). Men's Attitude has been verified as one of the important predictors of IPV.<br />Objectives: To Identify attitude and its correlates towards gender-based violence (GBV)<br />among ever married males. Methods: Secondary analysis using Survey of Young People in<br />Egypt (SYPE) data, 2014. Dependent variable: men's attitude towards gender-based violence.<br />Independent variables: socio-demographic variables, attitude toward gender equity, parent's<br />response to mistakes, mental health and some marital issues. Results: Among ever married<br />males, 77.1% accepted GBV, 82.2% whom wives age at marriage was less than 18 years,<br />81.8% from rural residence, 88.4% whom parents were not giving any response to mistakes,<br />83.9% of those with positive attitude toward divorcing their wives accepted GBV with<br />statistically significant difference. Logistic regression analysis revealed that the significant<br />predictors for accepting GBV were: rural residence, attitude that makes husbands divorce<br />their wives and parents' response to mistakes. Conclusion: The significant correlates of<br />married men's acceptance of GBV were rural residence, respondents with an attitude toward<br />divorcing their wives and inappropriate parents' response to mistakes. Recommendations:<br />Development of intervention programs aiming to change social and cultural gender norms<br />related to gender inequality and GBV especially in rural areas is highly recommended.
Attitudes,correlates, Men,Gender based violence
https://ejcm.journals.ekb.eg/article_11051.html
https://ejcm.journals.ekb.eg/article_11051_01a62865ade60f2313b08465c343be0e.pdf
Egyptian Community Medicine Association
The Egyptian Journal of Community Medicine
1110-1865
2090-2611
36
2
2018
04
01
Respiratory Distress and Its Outcome among Neonates Admitted to Neonatal Intensive Care Unit of Assiut University Children Hospital, Egypt
69
78
EN
10.21608/ejcm.2018.11052
Objective: To identify proportion and etiology of respiratory distress (RD), its mortalities and<br />associated risk factors among neonates admitted to Neonatal Intensive Care Unit (NICU) of<br />Assiut University Children Hospital. Methods: A cross-sectional study design was carried<br />out. All RD neonates admitted to NICU of Assiut University Children Hospital during the<br />study period were included. Results: Respiratory distress neonates constituted 52.9% of total<br />admission. Hyaline membrane disease represented 45.8% of RD cases. The majority of<br />hyaline membrane disease cases (RDS) were preterm and low birth weight (96.2% & 93.7%<br />% respectively). The majority of hyaline membrane diseased neonates who were treated by<br />surfactant or Continuous Positive Airway Pressure (CPAP) recovered (75.8%& 66.7%<br />respectively) with significant statistically difference. The most fatal of respiratory distress<br />diseases were persistent pulmonary hypertension (91.2%). Significant independent factors<br />associated with neonatal mortalities due to respiratory distress were residence, causes of RD,<br />birth weight and place of delivery. Conclusion: Hyaline membrane disease, pneumonia,<br />transient tachypnea of the newborn (TTN), meconium aspiration syndrome (MAS) were<br />important causes of neonatal respiratory distress. Residence, causes of RD, birth weight and<br />place of delivery were significantly associated with respiratory distress mortalities.<br />Recommendation: Development of strategies aiming to reduction of RD among neonates is<br />highly recommended. Moreover, surveillance programs for neonatal mortality should be<br />coupled with preventive measures and interventions for better natal care and postnatal<br />outcome.<br />Key words:
respiratory distress,Neonate,Neonatal Care Unit,Outcome,Assiut University Children Hospital
https://ejcm.journals.ekb.eg/article_11052.html
https://ejcm.journals.ekb.eg/article_11052_ce3369dd920d7890d66782082ab17677.pdf
Egyptian Community Medicine Association
The Egyptian Journal of Community Medicine
1110-1865
2090-2611
36
2
2018
04
01
Risk Factors and Presentations of Acute Otitis Media in the Emergency Department of A Specialized Pediatric Hospital
79
86
EN
10.21608/ejcm.2018.11053
Background: Acute otitis media (AOM) diagnosis in children had always been a dilemma to<br />diagnose, as children presentations usually are a combination of non-specific symptoms rather<br />than an earache. Objectives: to identify the risk factors predisposing to AOM and the<br />commonest presentations. Methods: Children presented with AOM to our hospital<br />emergency department of age less than five were included. A thorough literature review was<br />done to identify the risk and predisposing factors to AOM, data were collected using a data<br />collection sheet which included the demographic data and the factors gathered from the<br />literature over six months period between June and December 2015 all of the patients were<br />presented in our hospital emergency department. Results: 112 children were diagnosed with<br />AOM. The most frequently encountered risk factors for development of AOM was common<br />cold (75%, n= 84), followed by crowding (63.1% n=70) and male sex (61.6%, n=69).<br />Systemic symptoms were noted in the majority patients, fever appears as the commonest<br />clinical presentation (80.4%, n=90) while convulsion is the least (15.2%, n=17), clear ear<br />symptoms were not a constant presentation of our patients. It was found that an earache was<br />statically related to older ages 4-5 years, while fever, irritability, feeding difficulties, and<br />diarrhea were related to young ages of less than 1 year. Conclusions: the most frequently<br />encountered risk factors for the development of AOM were a common cold, followed by<br />crowding, and male sex. The most common clinical presentation among the children have<br />AOM was fever, while clear ear symptoms were not constant presentations among our<br />patients.
Otitis media,Presentation,risk factors
https://ejcm.journals.ekb.eg/article_11053.html
https://ejcm.journals.ekb.eg/article_11053_a5bc3ef6876b156e986f846932397e22.pdf
Egyptian Community Medicine Association
The Egyptian Journal of Community Medicine
1110-1865
2090-2611
36
2
2018
04
01
Risk Factors of Diabetic Foot in Type 2 Diabetic Patients, Menoufia University Hospital, Egypt.
87
98
EN
10.21608/ejcm.2018.11054
Background: Diabetic foot is a serious disabling complication of type 2 diabetes mellitus as<br />it may lead to unhealed injuries in lower limb and impending amputation. Identifying its risk<br />factors is an important step for prevention. Objective: To identify the risk factors of diabetic<br />foot among type 2 diabetic patients. Method: This is a case control study of random sample<br />of 60 diabetic foot patients (cases) and 420 diabetic patients without foot lesion (control),<br />selected from patients attending Family medicine, Internal medicine, Endocrinology and<br />Diabetic foot outpatient clinics; Menoufia University hospitals. The patients were interviewed<br />using predesigned questionnaire inquired about personal and present history items. Fasting,<br />two hours postprandial blood glucose and HbA1c were done as a part of routine diabetic<br />investigations. Results: Independent risk factors by logistic regression were age more than 50<br />(OR=4.04; 95% CI 2.41 – 8.17; p<0.001), urban residence which was protective (OR=0.09;<br />95% CI 0.028 – 0.285; p<0.001), low socioeconomic standard (OR=2.22; 95% CI 1.074 –<br />4.595; p=0.031), hyperlipidmia (OR=4.72 ; 95% CI 1.597 – 7.285; p=0.005), obese patients<br />(OR=2.26; 95% CI 1.09 – 4.73; p=0.029), hypertension (OR=7.21; 95% CI 2.29 –<br />14.63; p=0.001) and absence of neuropathy (OR= 0.02; 95% CI 0.008 – 0.076 ; p<0.001).<br />Conclusion: Age more than 50; rural residence, low socioeconomic standard, hyperlipdemia,<br />obesity, hypertension and neuropathy were identified as risk factors for diabetic foot in the<br />studied type 2 diabetes patients. Determining these risk factors for individual patients is an<br />important step for prevention of disability and reduction of the cost of hospitalization..
risk factors,Diabetic foot,Type 2 diabetes mellitus
https://ejcm.journals.ekb.eg/article_11054.html
https://ejcm.journals.ekb.eg/article_11054_b469564cb93e3a38a502979927bc7527.pdf
Egyptian Community Medicine Association
The Egyptian Journal of Community Medicine
1110-1865
2090-2611
36
2
2018
04
01
Prevalence and outcome of Preterm Premature Rupture of Membranes (PPROM) among pregnant women attending Ain Shams maternity hospital
99
107
EN
10.21608/ejcm.2018.11055
Background: Preterm premature rupture of membranes (PPROM) is one of the leading<br />identifiable causes of premature birth and it accounts for high rates of perinatal deaths in<br />developed and developing countries. Objectives: The study was conducted to measure the<br />prevalence of PPROM among pregnant women attending Ain Shams maternity hospital,<br />and to identify the fetal/neonatal outcome among pregnant women presented with PPROM<br />and potential factors associated with poor fetal/neonatal outcome. Method: A cross<br />sectional study was conducted on two phases using data retrieved from computerized<br />hospital information system (HIS), Ain Shams Maternity Hospital. Data about all<br />deliveries from 2011-2015 was revised from Hospital Information System to calculate the<br />frequency of PPROM during these years. A sample of 300 medical files of pregnant<br />women who were diagnosed with PPROM before 37 weeks and admitted to the hospital in<br />the year 2015 were then extracted from the hospital archive and revised using a checklist<br />developed by the investigators. Relevant data was obtained from these medical files.<br />Results: Prevalence of PPROM ranged from 2.4% in 2011 to 4.7% in 2015 with the<br />highest rate during 2013 (5.3%). Only 4.3% of women presented with PPROM developed<br />chorio-amnionitis. Regarding fetal outcome, 61.3% of infants developed a poor fetal<br />outcome including; (fetal death and ICU admission), while 38.7% of infants had good<br />fetal outcome (alive & well). By multivariate analysis women employment (OR 1.9 CI 1.2<br />– 3.5), gush type of PPROM (OR 1.9 CI 1.4 – 3.6), history of chorioamnionitis (OR 14.5<br />CI 12.4 – 132.1), delivery by CS (OR 2.5 CI 2.01 – 4.5) and later gestational age at<br />PPROM (OR 0.8 CI 0.2 – 0.9) were significant independent predictors of poor fetal<br />outcome. Conclusion & Recommendations: Prevalence PPROM at Ain Shams maternity<br />hospital is increasing during study duration with fetal/neonatal complications that<br />necessitate proper antenatal care and proper management.
PPROM,Fetal outcome,Ain Shams,maternity hospital
https://ejcm.journals.ekb.eg/article_11055.html
https://ejcm.journals.ekb.eg/article_11055_05364bc13786db7e93c502c1211cc8f6.pdf
Egyptian Community Medicine Association
The Egyptian Journal of Community Medicine
1110-1865
2090-2611
36
2
2018
04
01
Obituary Professor Adel Abdel Fattah Mahmoud (1942-2018)
109
111
EN
10.21608/ejcm.2018.11056
https://ejcm.journals.ekb.eg/article_11056.html
https://ejcm.journals.ekb.eg/article_11056_c6d8543aceab654b9f141e0e69b6eff1.pdf