@article { author = {}, title = {Risk Factors of Colorectal Cancer; A Case-Control Study}, journal = {The Egyptian Journal of Community Medicine}, volume = {34}, number = {1}, pages = {1-15}, year = {2016}, publisher = {Egyptian Community Medicine Association}, issn = {1110-1865}, eissn = {2090-2611}, doi = {10.21608/ejcm.2016.643}, abstract = {Background: Colorectal cancer is one of the commonest malignant tumors worldwide. Life style factors may contribute to the etiology of colorectal cancer as they are modifiable. A better understanding of the associations between lifestyle related factors and colorectal cancer risk may be of importance in order to develop novel strategies for prevention of the disease. This study aimed at identifying some risk factors of developing colorectal cancer and assessing the validity of carcinoembryonic antigen as a screening test for colorectal cancer. Subject and methods: Case-control study, hospital-based study, 25 cases and 100 controls investigated by colonoscopy and confirmed histologically between October 2011 and March 2013. Results: All cases were adenocarcinoma among them 18 (72%) cases were well to moderately differentiated carcinoma. The majority of the cases were diagnosed as pT1 (80%); whereas the minority were pT3 (12%). There was a significant association between history of diabetes mellitus, high BMI (>30), smoking and dietary habits (p < 0.05),while age, sex of participant and family history of colorectal cancer, physical activity and NSAID intake were not significantly associated with colorectal cancer (p > 0.05). The best combined sensitivity and specificity of CEA was at cutoff 5.5 mcg/dl. Conclusion: Exposure to personal and environmental risk factors play an important role in the development of colorectal cancer}, keywords = {colorectal cancer,Physical activity,smoking and dietary habits}, url = {https://ejcm.journals.ekb.eg/article_643.html}, eprint = {https://ejcm.journals.ekb.eg/article_643_897205c575850d751a9e057e5ada121b.pdf} } @article { author = {}, title = {Patient - Service Provider Communication is a Key for Patients' Satisfaction in Emergency Department -Cairo University Hospitals - Egypt}, journal = {The Egyptian Journal of Community Medicine}, volume = {34}, number = {1}, pages = {17-33}, year = {2016}, publisher = {Egyptian Community Medicine Association}, issn = {1110-1865}, eissn = {2090-2611}, doi = {10.21608/ejcm.2016.644}, abstract = {The satisfaction profile of emergency care patients guides strategies for improving quality of pre-hospital and in-hospital care. Aim: Display resources and hospital bed utilization pattern 2009-2013 in Cairo University Hospital –Emergency Department, tracking pre-hospital events and delineate the perspectives of patients towards hospital services.Methods: Setting: the study was conducted in. Design Cairo University Hospital –Emergency Department sampling: cross-sectional study that recruited 208 patients discharged from CUH-ED in year 2013. Data sources: the accessible service statistics of CUH-ED 2009 - 2013, and structured interview guide for recoding patient's data. Data analysis tested the association of pre-hospital and in-hospital care with overall patient satisfaction at time of discharge from CUH-ED.Results:In CUH-ED 2013,nurse: bed ratio was 1: 7.6 per shift; bed occupancy rate 84% and average length of hospital stay was 4 days and in-hospital mortality 1.2%. There were insignificant difference between satisfied and unsatisfied patients by socio-demographic background, and configuration of pre-hospital events and condition at discharge (improved/deteriorated). Satisfaction from physician performance was detected in 76.3% of patients, while satisfaction from nurse performance was elicited in 51.8%. About 69.7% of patients expressed their satisfaction from patient-provider communication (p> 0.001 OR =205 CI= 27 – 1560).Conclusion: Patient-provider communication in CUH-ED is appreciated by patients to be a key for quality services for in-hospital emergency care.}, keywords = {patient satisfaction,configuration of pre-hospital events,patient-provider communication}, url = {https://ejcm.journals.ekb.eg/article_644.html}, eprint = {https://ejcm.journals.ekb.eg/article_644_73f412334701db0ee5e27b1680ed032a.pdf} } @article { author = {}, title = {Patient safety Culture among Physicians in a Public Medium Size Hospital in Cairo}, journal = {The Egyptian Journal of Community Medicine}, volume = {34}, number = {1}, pages = {35-43}, year = {2016}, publisher = {Egyptian Community Medicine Association}, issn = {1110-1865}, eissn = {2090-2611}, doi = {10.21608/ejcm.2016.645}, abstract = {AbstractGood clinical practice means providing care that is safe and effective without doing harm. This requires proper identification and acceptance of errors through sound safety culture. This study aims to measure patient safety culture among physicians and identify factors affecting it. Methods:The study was carried out in a medium sized public hospital in Cairo. Study tool is an Arabic version of the hospital survey on patient safety culture developed by the Agency for Healthcare Research and Quality (AHRQ). It measures 12 dimensions of safety culture in addition to two outcome variables. Results: A total of 78 physicians answered the questionnaire, analysis of data showed that only 42.3% of participants scored ≥50% total safety culture. All dimensions scored < 75 while 8 out of the 12 dimensions scored below 50%. Certification was barely significant as a factor affecting total score safety culture while other studied factors were not significant. Conclusion and Recommendations: Perception of Patient safety culture among physicians of Al Qahira Al Fatimya hospital w as negative. It is recommended that the hospital adopt a more open and non-punitive culture as well as training of physicians for a better safety culture.}, keywords = {}, url = {https://ejcm.journals.ekb.eg/article_645.html}, eprint = {https://ejcm.journals.ekb.eg/article_645_094574b994eecbef50de69dd93059b43.pdf} } @article { author = {}, title = {Improving Health System in Egypt: Perspectives of Physicians}, journal = {The Egyptian Journal of Community Medicine}, volume = {34}, number = {1}, pages = {45-58}, year = {2016}, publisher = {Egyptian Community Medicine Association}, issn = {1110-1865}, eissn = {2090-2611}, doi = {10.21608/ejcm.2016.646}, abstract = {Introduction: There are well-identified shortcomings in the health system at the policy level. However, there is no adequate information at the implementation level, especially at the level of health services providers. Objectives: The goal of the study is to improve the health system in Egypt through utilizing information derived from the perspectives of the health service providers towards the health system. Methodology: a health system research exploratory study was conducted in Cairo governorate. A convenient sample of 225 physicians, working in MOH and private facilities, were included. Results: More than half of physicians agree that there are shortages in the health system resources: (70.6%), (53.7%) and (25%) in private, secondary health care (SHC) and primary health care (PHC), respectively, P=0.04. (71.2%) and (49.7%) say there is bias in human recruitment and no clear job description, respectively, with no significant difference by place of work. Moreover, about (66.2%) and (57.6%) of all participants physicians, respectively, say that there is neither supervision for their performance nor records with performance indicators. Subsequently, (58.9%) of the physicians see that the health status of the Egyptian is:”unaccepted”. Conclusion and recommendations: The health care system still faces multiple challenges in improving health status of all Egyptians. There are shortages in health care resources, at different levels of care. Physicians see that organizational structure and management of the system still need reform. The distribution and quality of human resources need to be improved, equally. Physicians were aware of system problems’. For that, their opinions should guide the policy makers for setting effective strategies to improve the health system}, keywords = {Health system,Physicians,Management}, url = {https://ejcm.journals.ekb.eg/article_646.html}, eprint = {https://ejcm.journals.ekb.eg/article_646_2f00220c734333c1f587644a7ba95525.pdf} } @article { author = {}, title = {Assessment of infection control measures in primary health care units in Assiut Governorate}, journal = {The Egyptian Journal of Community Medicine}, volume = {34}, number = {1}, pages = {59-64}, year = {2016}, publisher = {Egyptian Community Medicine Association}, issn = {1110-1865}, eissn = {2090-2611}, doi = {10.21608/ejcm.2016.647}, abstract = {Background: Thousands of people die every day around the world from infections acquired while receiving health care. Infection control encompasses the processes and activities that identify and reduce the risks of acquiring and transmitting endemic or epidemic infections among individuals. Aim of the study: The aim is assessment of infection control measures at the primary health care units in Assiut Governorate. Materials and Methods: The present study is a cross-sectional study that had been conducted in three districts out of the eleven districts composing Assiut Governorate. The three districts had been randomly selected and they are Assiut District (include urban and rural areas), Al-fat-h District and Sedfa District. The study covered all the primary health care units located in these three districts during the period from August 2013 to January 2014. Data were analyzed using SPSS version 16. Results: This study totally covered the 79 primary health care units and it was found that 94.9% of the units their physicians were trained on infection control program, while all nurses were trained on infection control. As a total, Rural Assiut had the highest mean percentage (53.52 ± 5.33). The highest mean percentage in administrative measures was found in West Assiut Neighborhood Administration (64.98 ± 6.09). Conclusion and Recommendations: There are statistically significant differences among the studied areas in all aspects of infection control as general, rural Assiut had the highest mean percentage. Continuous supervision and take an action against any person does not follow these procedures will help in rise the level of infection control in primary health care units in Assiut Governorate.}, keywords = {Assessment,measures,Infection control,primary health care units}, url = {https://ejcm.journals.ekb.eg/article_647.html}, eprint = {https://ejcm.journals.ekb.eg/article_647_75b6456f2d93f940d3ade433c640d83b.pdf} } @article { author = {}, title = {Assessment of emergency room cycle time in a tertiary hospital in Egypt}, journal = {The Egyptian Journal of Community Medicine}, volume = {34}, number = {1}, pages = {65-76}, year = {2016}, publisher = {Egyptian Community Medicine Association}, issn = {1110-1865}, eissn = {2090-2611}, doi = {10.21608/ejcm.2016.648}, abstract = {Timeliness of care is a critical element in the emergency room (ER) care process. The purpose of this study is to evaluate the timeliness of the emergency room cycle time which is measured from patient registration till patient disposition in a tertiary hospital in Egypt. Method: The ER cycle time was tracked by direct observation and by using a data collection sheet. Results: The results showed that the longest phase was the initial physician assessment with a median of 16 minutes and interquartile range of 47 minutes. While the shortest phase was the registration phase with a median of 2 minutes and interquartile range of 2 minutes. The total ER cycle time had a median of 37 minutes and interquartile range of 60 minutes. The time to physician assessment in different categories of patient severity by Canadian Triage and Acuity Scale (CTAS) was noted to meet target duration for each category of the CTAS. Also 30.6% of patients experienced nursing assessment in less than 2 minutes, 28.6% of patients experienced physician assessment in less than 4 minutes, 35.5% of patient experienced their disposition in less than 2 minutes and 26.8% of patients experienced their total ER cycle time between 38-80 minutes.}, keywords = {Emergency Room,Cycle Time,Hospital Setting,Egypt}, url = {https://ejcm.journals.ekb.eg/article_648.html}, eprint = {https://ejcm.journals.ekb.eg/article_648_0da28787995d3caea42234593148bc79.pdf} }