ORIGINAL_ARTICLE
Effectiveness of An Educational Program on Knowledge and Practices Regarding Care of Central Venous Catheters among Dialysis Nurses
Background: Educational activities are the main pillar for prevention of central venous catheters (CVCs) related complications and a cornerstone in raising awareness among healthcare workers (HCWs). Objective: To assess knowledge and practice of nurses of Farwaniya hospital hemodialysis (HD) unit regarding care, maintenance and prevention of catheter related bloodstream infections (CRBSIs) of CVCs before and after application of an educational program. Method: An educational intervention pre-test/post-test study that was carried out over 7 months period among HD nurses of Farwaniya hospital. Knowledge and practice towards care, maintenance and prevention of CRBSIs were assessed using a questionnaire and observation checklists in the pre- and post-intervention phases. Lectures, demonstration sessions and bedside training were applied during the intervention phase. Results: The correct knowledge items regarding care and maintenance of CVCs and prevention of CRBSIs ranged from 31% to 100% and practice items ranged from 0% to 100% at the pre-intervention phase. Significant improvement in all aspects and the total mean scores of the knowledge (10.75+2.59 to 13.43+1.87, p < 0.001 ) and practice (23.72+1.62 to 26.28+1.40, p < 0.001) regarding care and maintenance of CVCs was observed among the participants in the post intervention phase after implementation of the educational program. Conclusion: The implemented educational intervention program improved nurses’ knowledge and practice about CVCs maintenance and care of dialysis patient. Provision of continuous and regular bed side training is a good alternative for those who cannot attend the prescheduled formal training.
https://ejcm.journals.ekb.eg/article_68615_e84c3963e5f45ab8d545fda09d4014a2.pdf
2020-01-01
1
11
10.21608/ejcm.2020.68615
Knowledge
Practice
dialysis
education
bedside training, patient safety
ORIGINAL_ARTICLE
Determining the Accuracy of Blood Pressure to Height Ratio as a Screening Tool for Hypertension among Egyptian Children
Background: Hypertension diagnosis in children is difficult because of the multiple sex, age, and height-specific thresholds to define elevated blood pressure (BP). Blood pressure-to-height ratio (BPHR) has been used to facilitate the identification of elevated BP in children. Methods: From January to June 2017, a cross-sectional study was conducted for 830 adolescents aged 12 to 15 years in Abu Kabir city, Sharkia governorate, Egypt. Blood pressure tables from the National High Blood Pressure Education Program (NHBPEP) Working Group on High Blood Pressure in Children and Adolescents were used as our standard of comparison. Sex-specific systolic and diastolic blood pressure-to-height ratios (SBPHR and DBPHR) were calculated. Receiver operating Characteristic (ROC) curve analyses were performed to assess the accuracy of BPHR for discriminating between hypertensive and non-hypertensive adolescents. Results: The prevalence of prehypertension and hypertension were 8.4% and 4.9% respectively. Optimal SBPHR and DBPHR thresholds for defining elevated BP were 0.741 and 0.475 in males, respectively, and 0.750 and 0.494 in females, respectively. The sensitivity of SBPHR and DBPHR in both sexes was all above 93%, and specificity in both sexes was above 94%. Positive predictive value for SBPHR and DBPHR was 76.4% for both in males; and 71.4% and 71.6% in females respectively; negative predictive values in both sexes were all above 98%. Conclusions: BPHR is a simple screening tool with high sensitivity and specificity for screening hypertension in adolescents.
https://ejcm.journals.ekb.eg/article_68616_ee1adbfae753dc0d12e63c7e23b3e07e.pdf
2020-01-01
12
21
10.21608/ejcm.2020.68616
Adolescents
Blood pressure to height ratio
Hypertension
Screening
ORIGINAL_ARTICLE
Awareness and Practice of Health Care Providers towards Communicable Disease Surveillance in Assuit University Hospitals - Egypt
Introduction: Communicable disease control is announced as one of the most important health issues internationally. Poor disease surveillance is a main cause for increased mortality and morbidity of communicable diseases.The main purpose of public health surveillance is to provide actionable health information to public health staff, governmental leaders and the public. Lack of knowledge, poor attitude and practice are identifiable causes of non-compliance to surveillance system requirements among health care providers. Objective: This study aims to assess the knowledge, attitude and practices of Assuit university health care providers regarding the reporting of communicable diseases. Method: Across sectional study was conducted on 347 physician and 73 head-nurses at Assuit University Hospitals. Interview questionnaire covering personal and work data, knowledge, attitude and practice was used. Results: only 40% of participants have knowledge about the presence of communicable disease surveillance system and unit. Regarding knowledge about the functions of the surveillance; the most known functions were: application of collected data for disease prevention and control and dissemination to allow action. Small percentage of participants didn’t know any function of the system. Conclusion: Less than a quarter of the participants have a good knowledge of the surveillance of communicable diseases. Most (three quarters) of the participants have a positive attitude about communicable diseases surveillance. Head nurses have slightly more adequate practice than physicians. The main reasons for non-reporting were: lack of knowledge about how or to whom to report or which diseases to report and time constraint.
https://ejcm.journals.ekb.eg/article_68617_7e5f8cef85b815f0a29089a7dd4a6572.pdf
2020-01-01
22
32
10.21608/ejcm.2020.68617
Awareness
Health
Provider
Communicable
surveillance
ORIGINAL_ARTICLE
Prevalence, Risk Factors and Impact of Voice Disorders among Primary School Teachers in Cairo, Egypt
Background: Teachers are at high risk to develop voice disorders (VDs) due to high vocal demands, which affect their professional life, their mental, physical and emotional state and their ability to communicate. Objective: the aim of the study was to estimate the prevalence rate of VDs among primary school teachers and to identify its risk factors and impact. Method: A cross-sectional study was conducted including 225 primary school teachers. Study tools included an interview questionnaire, Voice Handicap Index and voice ergonomic assessment. Noise levels were recorded. Results: Career prevalence of self-reported vocal problems was 56.4%, year prevalence was 55.1%, and point prevalence was 31.1%. Risk factors of VDs included female gender, high degree of voice loudness, lack of voice rest, use of anticoagulants, laryngeal disease, URTI, asthma and stress. More teachers with VDs had absenteeism, adjusted teaching method and changed overall job opinions. VDs also had negative impact on teachers' physical, functional and emotional state.
https://ejcm.journals.ekb.eg/article_68618_d26a4f9a09d6b063e407cc3bf08c67da.pdf
2020-01-01
33
41
10.21608/ejcm.2020.68618
Voice disorders
Dysphonia
teachers
Voice risk factors
Voice Handicap Index
ORIGINAL_ARTICLE
Susceptibility and Vaccination Coverage of Vaccine Preventable Diseases among Health Care Workers in a Paediatric Tertiary Hospital, Egypt
Health-care workers (HCWs) represent a high risk group for acquiring vaccine-preventable diseases (VPDs). Objective: to determine susceptibility and vaccination coverage rates against VPDs among a group of health care workers in a tertiary care paediatric hospital, Egypt. Method: A cross sectional study was conducted at the Paediatric hospital of the Faculty of Medicine, Ain Shams University from July 2017 to November 2017. A Structured self-administered questionnaire including Socio-demographic characteristics, exposure to occupational VPDs infections and vaccination coverage was used. Results: Out of the 110 HCWs enrolled, 50.0% were physicians, 34.5% were nurses and 15.5% were house keepers. The reported vaccination coverage rate was highest for Tuberculosis (95.5%) followed by Hepatitis B (86.4%) and lowest for chickenpox (9.1%). HCWs reporting no history of disease or vaccination were considered as “potentially susceptible HCWs”: 69.1% to rubella, 63.6 % to mumps, 58.2% to measles, 54.5% to chickenpox, 13.5% to hepatitis B and 1.8% to tuberculosis. The main reasons for non-immunization were lack of vaccine provision by the hospital (from 63.6% for influenza to 53.5% for hepatitis B), lack of knowledge of vaccine recommendation (from 89.5% MMR to 43.2%% for influenza), fear of vaccine side effects (from 33.3% for hepatitis B to 4.5% for influenza) and 10.2% reported that they don’t get influenza vaccine because they think that it is not a serious disease. Compared with nurses and housekeepers, physicians were more likely to have been vaccinated for hepatitis B, MMR and chickenpox (P < 0.01). Conclusion: The current study revealed that the vaccination coverage for most of the VPDs is generally below expectations. Raising awareness of the recommended vaccines in addition to providing them free of charge or at a reduced price by the hospital administration can improve the vaccination coverage among HCWs.
https://ejcm.journals.ekb.eg/article_68619_96e8cece03825e113ae5fa859dbec1be.pdf
2020-01-01
42
50
10.21608/ejcm.2020.68619
Health Care Workers
Vaccination coverage
Vaccine Preventable Diseases
Vaccine Preventable Diseases susceptibility
ORIGINAL_ARTICLE
Prevalence of Malnutrition Detected by Anthropometric Assessment among Children Under Five Years of Age in Selected Rural Areas in Lower Egypt
Background: Malnourished children have a weakened immune system with a greater risk of developing preventable illnesses like pneumonia and diarrhea. Under nutrition is responsible directly or indirectly for 60% of the 10.9 million deaths occurring annually among children under five worldwide. On the other side, over nutrition (overweight and obesity), is a major contributor to the increased prevalence of non-communicable diseases in adulthood with its debilitating effects and increased cost of care between the elder population. Objective: To determine the prevalence of malnutrition detected by basic anthropometric assessment (weight and height) in children 0-60 month of age in selected rural areas of two districts in the governorates of Qalyubia and Gharbia and to explore the possible underlying factors of malnutrition in these areas. Method: A nutritional survey on 3871 children less than 5 years was conducted in rural health units in Kafr Shokr and Samanoud. Data was collected using an interviewed questionnaire with the mothers and anthropometric measurement sheet. Results: The study revealed that overweight and stunting were the most common forms of malnutrition prevalent within the study population at 15.2%, and 11.3% respectively and that some socio-demographic characteristics related to the children and their mothers were found to have their impact on the children's nutritional status. Conclusion: Nutritional status among Egyptian children needs due concern. Health education on promoting dietary pattern and importance of breast feeding will aid in promoting their health.
https://ejcm.journals.ekb.eg/article_68620_f8cb6b8f1931fd158f398d96b375bb54.pdf
2020-01-01
51
63
10.21608/ejcm.2020.68620
Malnutrition – Under five years – Rural lower Egypt
ORIGINAL_ARTICLE
Diabetes Assessment Scales, and the Impact of Health Education on Diabetic Patient Knowledge
Objectives: To assess the diabetic patient condition using different diabetic scales and its relation to the blood glucose level and to assess the impact of health education message on their knowledge and to evaluate the possibility to create computational models for assessing diabetic patient condition automatically. Method: An interventional study was carried out on diabetic patients attending the diabetic clinic of Mansoura General Hospital, during the period of May to September 2015. Results: Random blood sugar showed significant positive correlation with Diabetes duration, BMI, depression and significant negative correlation with self-efficacy, empowerment, and social support, stage of change for diet and stage of change for exercise. However, diabetes activity showed significant positive correlation with different scales (Diabetes duration, BMI, social support, self-efficacy, empowerment, stage of change for diet and stage of change for exercise) except with random blood glucose and depression which showed significant negative correlation. Linear regression analysis showed that stage of change for exercise, social support, empowerment and BMI are common predictors for both random blood glucose and diabetes activity. Based on this study, two computational models could be concluded for predicting diabetes activity and random glucose level from different diabetes scales using artificial neural networks (ANNs). Improvement in the knowledge was observed after the health education setting as detected by the increase in the mean knowledge score. Conclusion: Computational models for diabetes condition assessment could be concluded where different variables under study were found related to the outcome of diabetes either management adherence or blood glucose level.
https://ejcm.journals.ekb.eg/article_68621_11a1b757f5d188c53a0bf288fd793f6c.pdf
2020-01-01
64
74
10.21608/ejcm.2020.68621
Diabetes Scales
Diabetes Control
health education
Statistical Analysis
Artificial Neural Networks (ANNs)
ORIGINAL_ARTICLE
Assessment of Quality of Care Provided to Hypertensive Patients in Primary Health Care Units in Ismailia City
Background: Several studies examined the link between care processes and controlled hypertension (HTN). However, these studies may not serve as the best preface to the current state of quality of care in primary health care (PHC). Previous analyses often comprised regional rather than national data, probably restrict the generalizability of the results. Furthermore, no such researches were accomplished in Egypt. Objective: to assess the quality of care provided to hypertensive patients at PHC units in Ismailia city. Method: Seventy-two hypertensive patients regularly follow-up at PHC for >6 months were recruited into the study. Data was collected from (1) Care Performance measures, (2) Quality of Care indicators, (3) Patients’ Satisfaction (patient’s perspective about quality of care) by Arabic version of Client Perception of Coordination Questionnaire (CPCQ), and (4) Patients’ characteristics. Results: The frequency of inadequate care performance was 56.9%. Only 5.6% of our patients were under health insurance coverage. The most common deficient indicator for quality of care was performing lifestyle modification (5.6%). Approximately 60% of the patients had uncontrolled HTN and 59.7% of the cases had positive perception about the care. The most common problems facing the patients were waiting too long till receiving the services (83.3%) and 23.6% of the studied patients didn’t have any caregiver. Significant factors affecting care performance were health insurance coverage, degree of caregiver involvement and quality of care adequacy. Conclusion: Quality of care provided to hypertensive patients at the PHC in Ismailia City was inadequate.
https://ejcm.journals.ekb.eg/article_68623_c84fe1ade39c9c4a77d2e2fbe8e1200d.pdf
2020-01-01
75
90
10.21608/ejcm.2020.68623
Care performance
patients’ satisfaction
client perception
ORIGINAL_ARTICLE
Evaluation of the Role of Serum Level of YKL-40 Protein as a Diagnostic Test in Asthmatic Children Patients in El-Minia Governorate
Background: The global prevalence of asthma ranges from from1% to 18% of the population with significant differences among countries (about 300 million affected persons globally). YKL-40 (chitinase 3-like protein 1) is a glycopeptide produced and secreted from different cells including epithelial and smooth muscle cells of airways. It has been involved in inflammation and tissue remodeling, and increased expression of YKL-40 in diseases with T-helper-2 inflammation e.g. asthma. Objective: To evaluate the serum levels of YKL-40 in a group of Egyptian asthmatic children (both stable and acute) and compare them to a matched healthy control group. Method: This case-control study was conducted at Minia university hospitals, it was held from January 2017 to May 2017, sixty patients were included as cases which were divided into 2 subgroups: 30 acute asthmatics and 30 stable asthmatics in addition to 30 healthy age-matched children were included as controls. They were recruited from the follow-up clinics of the hospital after consent from their caregivers. Detailed history and complete physical examination were done to all children. A complete blood count was performed and estimation of serum YKL-40 level was performed using a commercial enzyme-linked immune sorbent assay (ELISA) kit. Results: YKL-40 Serum levels are significantly higher in children with bronchial asthma compared to healthy controls. Acute asthmatic children serum levels of YKL-40 are significantly higher in comparison to stable asthmatics. Conclusion: The study concludes that YKL-40 might have a role in pediatric asthma pathogenesis; however, further research on a larger scale is warranted.
https://ejcm.journals.ekb.eg/article_68624_4ce3bf7ba82f182658622d904ed71f50.pdf
2020-01-01
91
102
10.21608/ejcm.2020.68624
Asthma
children
YKL-40
biomarker
Minia
ORIGINAL_ARTICLE
Screening for Depression and Anxiety Symptoms among a Sample of Working Syrian Refugees in Egypt
Background: Since the Arab spring, a large number of Syrian refugees arrived to Egypt. The majority of these refugees faced numerous traumatic events both in their country of origin and while moving from it. This raised the prevalence rates of depression and anxiety disorders among refugees than other populations. There are very few studies regarding the mental health of these vulnerable populations in Egypt. Objective: This study aims to screen for depressive and anxiety symptoms among a sample of working Syrian refugees in Cairo, Egypt and to estimate their socio-demographic and employment correlates. Method: A cross sectional study with convenient method of sampling was carried out. The sample was recruited from a primary healthcare center. Socio-demographic data were identified using designed questionnaires. Depressive and anxiety symptoms were evaluated using Beck Depression inventory (BDI) and Taylor anxiety scales respectively. Results: Ninety-four Syrian worker refugees participated in the current study. Depressive symptoms were prevalent among 63 % of the studied sample and anxiety symptoms were found among 89 % of them. The refugee’s duration of being away from his/her country represents a statistical significant factor that was associated with higher rates of depressive symptoms. None of other socio-demographic & employment factors were found to be associated with the rates of depressive or anxiety symptoms among the study sample. Conclusion: Syrian refugees are at high risk of developing depressive and anxiety symptoms. Increased attention from primary and mental health care services to adequately support Syrian refugees’ mental health needs are urgently needed.
https://ejcm.journals.ekb.eg/article_68625_957583da8e4a45c54f29edcde56003b1.pdf
2020-01-01
103
111
10.21608/ejcm.2020.68625
depression
anxiety
Syrian refugees
Egypt
ORIGINAL_ARTICLE
Message from the new editor in chief of EJCM
https://ejcm.journals.ekb.eg/article_68903_630ca1bd69481c951b9eb0a8e9fb8e8a.pdf
2020-01-01
112
113
10.21608/ejcm.2020.68903