Egyptian Community Medicine AssociationThe Egyptian Journal of Community Medicine1110-186535320170701The Effect of Induction Chemotherapy and Socioeconomic Status on The Prevelance of Malnutrition among Pediatric Leukemia Patients.110408810.21608/ejcm.2017.4088ENJournal Article20171022<strong>Objectives:</strong> The aim of this study is to identify malnutrition status among pediatric patients newly diagnosed with leukemia and assess nutritional deterioration during induction therapy and to determine its relation with the socioeconomic status. <strong>Methods: </strong>A prospective study was conducted, including 105 leukemic patients aged from 2 to 17 years at pediatric department, National Cancer Institute (NCI), Cairo University. Anthropometric parameters, such as body weight and height were measured. Albumin level was measured as the biochemical marker for malnutrition. Malnutrition definition of every single parameter was done based on the American Society for Parenteral and Enteral Nutrition (ASPEN). An overall malnutrition definition was based on St. Jude Children’s Research Hospital risk criteria. Socioeconomic status was determined by Al Shakhs familial socioeconomic status scale (SES) for hospitalized patients. <strong>Results:</strong> The presence of malnutrition at diagnosis differs depending upon the measurement used. It was 25.7% among children ≤10<sup>th</sup> weight percentile and 30.6% among those ≤10<sup>th</sup> height percentile. Hypo-albuminemia was found in 9.4% of children. At diagnosis, according to St. Jude Children’s Research Hospital risk criteria, about 26.7% were severely depleted. By the end of induction 35.2% had severe malnutrition at the final examination. There was no correlation between socioeconomic status and nutritional measurement parameters (p>0.05). Weak correlation between SES and albumin (r=0.29, p=0.039) was found. <strong>Conclusion</strong>: Malnutrition is not infrequent in pediatric leukemia patients at diagnosis and the percentage of severely depleted children increased by the end of induction therapy. SES is not correlated to malnutrition status during induction therapy.
<strong> </strong>Egyptian Community Medicine AssociationThe Egyptian Journal of Community Medicine1110-186535320170701Assessment of Patient Safety Culture among Health Care Workers in Beni-Suef University Hospital, Egypt1119408910.21608/ejcm.2017.4089ENJournal Article20171022<strong>Background:</strong> Patient safety is an essential component in the quality of patient care. It remains a challenge for developing countries. Assessment of patient safety culture in healthcare organizations is becoming an integral component to improve patients' safety. <strong>Aim:</strong> To assess the perceptions of patient safety culture attitude among health-care workers in Beni-Suef University hospital. <strong>Participants and</strong><strong>Methods:</strong>A cross sectional study was conducted from January till December 2015 using the Hospital Survey on Patient Safety Culture (HSOPSC) self-administered questionnaire which includes 12 dimensions on 500 university hospital staff members in Beni-Suef University hospital with a response rate of 84.6% (423/500). <strong>Results:</strong>The overall mean positive response rate for patient safety in Beni-Suef University Hospital was 39.3%. Healthcare workers had lower perceptions about patient safety culture. Only two dimensions showed positivity above 50%. The highest positive mean score dimension was “Teamwork within units” (57.4%) while the lowest positive mean score dimension was “Frequency of events reporting” (23.2%). Patient safety grade in relation to the staff position showed significant difference between the studied groups (p=0.009). <strong>Conclusion</strong><strong> and Recommendations</strong><strong>:</strong>Healthcare workers appear to have a lower perception of patient safety culture. Training of healthcare workers on patient safety and broad based research are highly recommended in order to improve patient safety culture. Patient safety needs to be incorporated into the education of health professionals across the spectrum of healthcare. There should be a blame-free system for identifying threats to patient safety, sharing information and learning from events. <br /> <strong> </strong>Egyptian Community Medicine AssociationThe Egyptian Journal of Community Medicine1110-186535320170701Evaluation of neonatal sepsis and assessment of its severity by Red Cell Distribution Width indicator2132409010.21608/ejcm.2017.4090ENJournal Article20171022<strong>Background:</strong> Neonatal sepsis remains a challenge for neonatal care providers.<strong> Aim: </strong>to measure red cell distribution width percent (RDW %) as a marker for neonatal sepsis severity and to correlate the determined severity with other indicators.<strong> Methods: </strong>This case control studywascarried out at neonatal intensive care unit at Assiut Al Azhar University Hospital from June to December 2015. Ethical Research Committee Approval and written consents were obtained from parents of the neonates 50 neonatal sepsis cases and 30 normal controls. Inclusion criteria: age from 1-28 days and had findings of sepsis either clinical or laboratory. Neonates were subjected to: History taking, clinical examination for manifestations of sepsis. Complete blood count- C- reactive protein, Blood culture and sensitivity and determination of RDW % were done to all neonates. <strong>Results:</strong> Mean RDW % was higher among cases than controls (18.35± 1.79 & 12.95± 2.23 respectively) (P < 0.001), meanwhile hemoglobin (HB) was lower in cases than controls P=0.094. WBCs were higher among cases compared to control (P =0.030). CRP was normal in all controls, and was higher in all cases. RDW % was higher in severe sepsis than mild (19.4 ± 1.8 % & 17.2± 0.58% respectively) (P < 0.0001), while HB and WBCs showed insignificant relation with severity of sepsis (p =0.299 and 0.129 respectively). CRP showed significant relationship with severity of sepsis p<0.01<strong>. Conclusion: </strong>RDW % can serve as a marker and prognostic indicator in assessing severity evaluation and risk stratification of neonatal sepsis.
<strong> </strong>Egyptian Community Medicine AssociationThe Egyptian Journal of Community Medicine1110-186535320170701Stunting among Children Attending a Pediatrics Outpatient Clinic in Cairo, Egypt3342409110.21608/ejcm.2017.4091ENJournal Article20171022<strong>Background:</strong> Stunting is a considerable problem in developing countries, contributing to increasing under-five mortality, while children of stunted mothers have a higher risk of stunting. <strong>Objective:</strong> to determine the prevalence and risk factors of stunting among children aged 1-12 years attending the outpatient Paediatrics clinic of Al-Azhar University Hospital (Al-Hussein), Cairo. <strong>Participants and methods:</strong> the anthropometric measurements of 800 children aged 1-12 years with no history of chronic diseases attending the paediatrics outpatient clinic of Al-Hussein Hospital were recruited and a short questionnaire was administered. <strong>Results:</strong> the prevalence of stunting was 15.8% with no sex variation. Stunting was found to be associated with parental consanguinity, mother’s employment status, and a family history of short stature. <strong>Conclusion:</strong> there is considerable stunting prevalence rate among this study group. The public should be educated about the importance of avoiding consanguineous marriage. It is important to reduce stunting, especially among girls, to prevent their children from in turn being stunted.Egyptian Community Medicine AssociationThe Egyptian Journal of Community Medicine1110-186535320170701Foot Care Knowledge Assessment among Type 2 Diabetic Patients attending Three Family Medicine Centers in Cairo4353409810.21608/ejcm.2017.4098ENJournal Article20171022<strong>Background:</strong> Diabetic complications are strongly attributed to poor foot care knowledge and practice. Knowledge about diabetes enables patients to play an active role in effective diabetes self-management. Proper daily foot care is an effective part of diabetic foot ulcer (DFU) prevention and enables diabetic patients to early detect foot abnormalities and injuries, thus reduce or even prevent the risk of foot ulceration. <strong>Objectives</strong>:to measure foot care knowledge and to identify possible associated factors among Egyptian diabetic patients attending three Family Medicine centers in Cairo <strong>Methods</strong>: A cross-sectional study was carried out in three Family Medicine centers on140 diabetic who met the inclusion criteria<strong>. </strong>Data on foot care knowledge was collected using a structured interview questionnaire.<strong> Results:</strong> More than half (62.1%) of the participants had poor foot care knowledge, 24.3% had satisfactory level and only13.6% have good knowledge. The mean of knowledge score was as follow in the three centers; El Sadis (7.18±2.697) El Darrasa (6.92±3.168) and in Saraya was (5.96±3.037) and no statistical difference in foot care knowledge score or grade was found between the three centers. A strong and significant relation was found between income and knowledge grade. Also Longer disease duration and history of foot ulcer were associated with good foot care knowledge. <strong>Conclusion:</strong> Poor foot care knowledge was evident among the study participants in the three Family Medicine Centers and hence interactive health educational programs targeting type 2 diabetic patients are strongly recommended. Egyptian Community Medicine AssociationThe Egyptian Journal of Community Medicine1110-186535320170701Women with Fibromyalgia: Association of Body Mass Index with Socioeconomic Status, Disease Severity, Functional Disability and Quality of Life5568409910.21608/ejcm.2017.4099ENJournal Article20171022Fibromyalgia syndrome (FMS) may cause functional disability, severe pain and fatigue and affect quality of life (QoL)which interfere with daily activities of patients. Aim: To determine the association between body mass index (BMI) and symptom severity, QoL and functional capacity in patients with fibromyalgia. Participants and Methods: Fifty women (50) with fibromyalgia and thirty (30) age matched healthy women control group were assessed for BMI, socio-economic (SES) status assessment and clinical signs of fibromyalgia by FMS-related measurements, visual analogue scale (VAS), number of tender points (NTP) Fibromyalgia Impact Questionnaire (FIQ) and Myalgia score. The short form health survey - 36, Functional capacity was conducted by six minute walk test. Results: The majority of patients were obese (74%): 48% class 1, 20% class 2, and 6 % class 3. Greater fibromyalgia-related symptoms and functional impairment were found in the higher BMI group with statistically significant differences regarding SES total score; education and culture total domain, NTP and myalgic score, 6 minutes’ walk test, some domains of SF36 and leptin concentration. Severe FM showed higher VAS, NTP, Myalgic score, disease duration, BMI and leptin concentration but lower age and SES than other grades with statistically significant differences regarding disease duration VAS, myalgic score, leptin concentration and all SF36 domains except general health perception. Conclusion and Recommendation: The findings support that excess weight is negatively related to QOL, functional capacity , SES but positively related to disease severity (clinical and lab) in women with FMS. A fibromyalgia treatment program needs to incorporate medical and behavioral weight loss programs for obese patients Egyptian Community Medicine AssociationThe Egyptian Journal of Community Medicine1110-186535320170701Effect of Health Education Intervention on Knowledge, and attitude regarding Menopausal Period among Premenopausal Female Employees6981410010.21608/ejcm.2017.4100ENJournal Article20171022<strong>Background: </strong>The menopausal transition is a critical period in women’s life; many physiological changes occur and cause morbidity to women at this stage. Women generally know very little about menopause, therefore, they should have knowledge about menopause. <strong>Objectives:</strong> to evaluate the effect of a health education program addressing the general health of menopausal women.<strong> Participants and method:</strong> An interventional study was carried out on 80 premenopausal female employees aged from 40 to 45 years at 10<sup>th</sup> of Ramadan city schools by comparing pre-intervention with post-intervention questionnaire after a health education program which included questions to assess knowledge and attitude about menopause. <strong>Results:</strong> there were statistically significant improvement of knowledge and attitude after the interventional program that corrected knowledge: being 51.3% among studied participants before the educational program and improved to 88.8% after the program and a positive attitude that changes from 6.3% before the program to 90% after the program. <strong>Conclusion and recommendation</strong>: This study concluded that health education about menopause improved knowledge and attitude of the studied women, so health education programs directed to menopause women need to be integrated within health care system.Egyptian Community Medicine AssociationThe Egyptian Journal of Community Medicine1110-186535320170701Frequency of Hypertension Associated with Pregnancy among The Pregnant Women Attending Maternal and Child Care Centers in Belbeis City.8391410110.21608/ejcm.2017.4101ENJournal Article20171022<strong>Background: </strong>Hypertensive disorders of pregnancy are a major cause of maternal and fetal mortality and morbidity, and affect approximately 8% of all pregnancies.<strong> Objective:</strong> To identity frequency of hypertension among pregnant women attending (MCH) centers in Belbeis city and to identify probable factors associated with hypertension.<strong> Method:</strong> A cross–sectional study included 554 pregnant women after 20 weeks of gestation enrolled from 2 rural primary heath care centers in Belbeis City (Sharkia governorate) during the period from the first of September 2014, to end of April 2015.<strong> Results:</strong> The study revealed that, the percentage of hypertension among pregnant women was 4.5% and there were no cases of preeclampsia. The significant risk factors predisposing to development of hypertension during pregnancy were age of mother, smoking, family size, obesity, presence of diabetes mellitus, renal diseases and history of hypertension in previous pregnancy. By logistic regression only age of mother was independent predictor of hypertension in pregnant mother. <strong>Recommendation: </strong>The health care physicians in the (MCH) Centers should increase their efforts to provide the high risk pregnant women as early as possible with proper antenatal care and management of hypertension during pregnancy.