2024-03-28T20:02:30Z
https://ejcm.journals.ekb.eg/?_action=export&rf=summon&issue=8296
The Egyptian Journal of Community Medicine
The Egypt. J. of Community Medicine
1110-1865
1110-1865
2019
37
4
The Relation between Delay in Diagnosis and Management of Tuberculosis and Treatment Failure
Background: Tuberculosis (TB) remains a public health problem in middle and low-income countries. Delay in tuberculosis diagnosis may also lead to a more advanced disease and complications that may result in poor treatment outcomes. Objective: to identify the importance of early diagnosis and management of TB by assessing its relation with treatment failure. Method: The study was conducted on 2 phases. First phase was cross-sectional study to estimate the proportion and duration of delay in diagnosis and management of TB. Cut off point using median value of delay was used to classify patients into either delayed or non-delayed patients. The second phase was a cohort study. The two groups of patients were followed for 6 months to assess treatment failure. The study included 189 TB patients who were registered in directly observed treatment of short course program (DOTs) from January 2017 to January of 2018. Data was collected by an interview questionnaire. Results: Near half of patients (49.20%) had unacceptable total TB delay with a median value of 65 days (range: 6–244 days). Regarding treatment outcome; 101 (55.2%) of patients were cured, while 12 (6.6%) of patients reported treatment failure which is defined by WHO as A TB patient whose sputum smears or culture is positive at month 5 or later during treatment. Among 90 patients who had delay in diagnosis and management of TB, eight (8.8%) of them developed treatment failure but this was not statistically significant (p value =0.21). Conclusions: Delay in diagnosis and management of TB was not a predictor of treatment failure though 8.8% of patients who had delay in diagnosis and management of TB, developed treatment failure.
tuberculosis
Delay
treatment outcome
Treatment Failure
2019
10
01
1
6
https://ejcm.journals.ekb.eg/article_54285_47c9dc54233042f94bf303be850550ac.pdf
The Egyptian Journal of Community Medicine
The Egypt. J. of Community Medicine
1110-1865
1110-1865
2019
37
4
Relationship of Biological Family Characteristics to The Pattern of Growth and Development of Children in Alexandria, Egypt
Background: Children during early years of age go through rapid growth and development that is greatly influenced by various factors of which biological family characteristics are of prime importance. Objective: This study aimed to portray the current profile of biological family characteristics in relation to the pattern of growth and development of children at two years of age in Alexandria, 2017 and to compare the results with previous comparable study. Method: The study included 128 children; 16 children from each district. Data were collected by interview questionnaire and anthropometric measurements and Denver II Developmental Screening test. Results: Significant negative correlation was found between weight of studied children and both family size and birth order. Large family size, older or younger maternal age, short or prolonged inter-birth intervals and high birth order were significantly associated with delayed development. Conclusion: Large family size, older or younger maternal age, short or prolonged inter-birth intervals and high birth order were significantly associated with delayed development. Marked effort is needed to achieve the desired success waited in the Egyptian Family Planning Program.
Child growth and development
biological family characteristics
DENVER II
2019
10
01
7
16
https://ejcm.journals.ekb.eg/article_54286_d524eba5a381795efb920706ee0c3f51.pdf
The Egyptian Journal of Community Medicine
The Egypt. J. of Community Medicine
1110-1865
1110-1865
2019
37
4
Age at Weaning between WHO Recommendations and Malpractice in Sharkia Governorate
Background: The introduction of complementary food during the first 6 months of infant’s age known as early weaning. Early weaning occurs due to many factors. Determining these factors could help to overcome this faulty habit. Objectives: To assess the frequency of early weaning and to determine associated factors among mothers in Sharkia governorate - Egypt.Method: A cross-sectional study was conducted on 331 infants. Three healthcare facilities were selected to represent rural and urban areas. Participants’ data regarding socio-demographic characteristics, the timing and causes of early weaning, non-nutritive sucking habits and the timing of first teeth eruption were collected via semi-structured questionnaire.Results: The study revealed that the highest percentage (47%) of age at weaning for infants’ in Sharkia governorate was 3-5 months. Two hundreds and thirteen mothers (64.4%) in the sample had weaned their babies before the age of 6 months, (17.2%) of them weaned their babies before the age of 3 months. Multivariate logistic regression analysis revealed that infants had a time of 1st tooth eruption before 6 months, their mothers did not receive follow up postnatal care from the affiliated health unit, their mothers work for more than 6 hours per day or for more than 5 days per week, had birth weight < 3500 g, were breastfed and had non-nutritive sucking habits were more likely to be weaned before the age of 6 months. Conclusion: There is a large gap between WHO’s recommendations and infants’ feeding practice in Sharkia governorate. So further public health interventions are required to overcome this gap.
complementary feeding
early weaning
infants
Sharkia governorate
2019
10
01
18
26
https://ejcm.journals.ekb.eg/article_54287_b71a00ab2bc5055ac56fb1218d349a93.pdf
The Egyptian Journal of Community Medicine
The Egypt. J. of Community Medicine
1110-1865
1110-1865
2019
37
4
Clinical and Metabolic Effects of Ramadan Fasting among A Sample of Diabetic Patients Attending Qualubeya Governorate Hospitals
Background: During Ramadan month Muslims neither eat or drink from down to sunset. Islam exempts some Muslims from fasting including diabetic patients. However, many diabetic patients insist on fasting without proper medical advice. Objectives: To determine the clinical effects of Ramadan fasting on diabetic patients, to identify the underlying factors of these effects and to outline recommendations for safe fasting. Method: This follow up study recruited 284 Muslim diabetic patients from two hospitals in Qualubeya Governorate, of these; only 200 patients completed the study. The patients were assessed by a structured questionnaire sheet, diabetes symptom checklist, anthropometric measurement and blood samples were collected to measure fasting blood glucose, cholesterol, triglyceride, High Density Lipoprotein, Low Density Lipoprotein and glycated hemoglobin (HbA1C). Results: There was a statistically significant increase in five DM symptom domain scores at the end of Ramadan than before; neuropathic pain, psychological fatigue, cardiovascular, psychological cognitive function and hyperglycemia P<0.05 for all). Anthropometric measurements (weight, BMI, waist-hip ratio), lipid profile and HbA1C were significantly (P<0.05) decreased at the end of Ramadan. Complicated DM during Ramadan fasting was related to physical inactivity, previous DM complications during Ramadan fasting, decreased food intake, increased fluid and sugar intake. Conclusion: Ramadan fasting is associated with DM complications in diabetic patients. So, management plans are recommended to minimize these complications.
Diabetes mellitus
DM
Ramadan fasting
Complications
risk factors
2019
10
01
27
38
https://ejcm.journals.ekb.eg/article_54288_c51edf47882af6deafa8476d12463dfc.pdf
The Egyptian Journal of Community Medicine
The Egypt. J. of Community Medicine
1110-1865
1110-1865
2019
37
4
Cost Effectiveness Analysis of Bundle versus No Bundle Strategy during Central Venous Catheter Insertion on Reduction of Central Line-Associated Bloodstream Infections in Abu El Reesh Hospital, Egypt.
Background: Central line-associated bloodstream infections (CLABSI) are frequent, costly to payers and patients, and potentially fatal. This paper aims to appraise the cost-effectiveness of implementing "Bundle precautions" during Central Venous Catheter (CVC) insertion, focusing on reducing CLABSI infections from the hospital perspective.Objective: To determine cost-effectiveness of using bundle versus non-bundle application in term of nosocomial infection rate. Method: Economic evaluation sub-study, parallel to a non- randomized controlled trail comparing "Bundle precautions" to non- Bundle precautions applied to patients with CVC insertion. The study was conducted in intensive care units, teaching pediatric hospital. Pediatric patients in 2 months to age of 18 years age interval, requiring CVC insertion were recruited following ICU admission and classified into 2 groups with one group receiving bundle precautions and one not. Economic costs of "Bundle precautions" versus "No Bundle precautions" of central line-associated bloodstream infections were estimated from the perspective of the hospital in 2015 Egyptian pounds. Primary main outcome measure is Central line-associated bloodstream infections prevented. Cost-effectiveness ratios were estimated. One way sensitivity analysis was performed. Results: Weighed against the current practice, the "Bundle precautions" is strongly dominant; approx. 482.95 LE were saved, and about 9.8 episodes of CLABSI/1000 CVL were avoided. In One-way sensitivity analysis, Bundle precautions continued to be a dominant strategy. Conclusions: Use of "Bundle precautions" during CVC insertion lowers medical costs and decreases the incidence of Central line-associated bloodstream infections. Cost savings were found over a range of clinical and economic assumptions, suggesting that "Bundle precautions" should be routinely used during CVCs insertion at Abu-El Reesh Hospital' Pediatric Intensive Care Unit.
Cost-effectiveness
Bundle precautions
Central Line-Associated Bloodstream Infections
2019
10
01
39
50
https://ejcm.journals.ekb.eg/article_54289_3e6424d6862751b0264f81c928956791.pdf
The Egyptian Journal of Community Medicine
The Egypt. J. of Community Medicine
1110-1865
1110-1865
2019
37
4
Work-Related Musculoskeletal Disorders among Nursing Staff of Tanta University Hospitals: Pattern, Risk Factors, and Coping Strategies
Background: Work-related musculoskeletal disorders (WMSDs) represent a considerable occupational problem amongst nurses. Objectives: To determine the pattern, the associated job risk factors for the development of WMSDs and to identify the coping strategies for reducing the risk of WMSDs among Tanta University Hospitals` nursing staff. Method: A cross-sectional survey was conducted among the nurses at Tanta University Hospitals using a stratified random sampling method via a self-administered structured questionnaire. Results: Most of the studied nurses (92.3%) had WRMSDs in the past 12 months. The most frequently reported complaint was low back pain (56.6%), followed by neck pain in 51.5% and knee pain in 50.4% of them. The most frequently reported job risk factors were working in the same positions for long periods (90.8%), continuing to work while injured or hurt (90.7%), and bending or twisting your back in an awkward way (85.2%). Getting help in handling heavy patients (91.0%), modifying patient’s/nurse position (79.6%), and inadequate formal training on injury prevention (80.6%) were the top three coping strategies. Conclusion: Most of Tanta University Hospitals` nurses reported WMSDs at different body sites, where the low back being harmed most frequently. Training programmes on injury prevention are recommended to lower the rate of WMSDs and to encourage efficiency in patient care.
work-related musculoskeletal disorders (WMSDs)
Nurses
Tanta
Coping strategies
risk factors
2019
10
01
51
61
https://ejcm.journals.ekb.eg/article_54290_c4723c2f40903051b61d4933a387d141.pdf
The Egyptian Journal of Community Medicine
The Egypt. J. of Community Medicine
1110-1865
1110-1865
2019
37
4
Maternal and Perinatal Outcome of Hypertensive Disorders of Pregnancy: A Prospective Study, Al-Hasaa, KSA.
Background: Hypertension in pregnancy is a major health problem responsible for significant maternal and perinatal morbidity and mortality. Early detection and appropriate monitoring may improve outcome. Objective: To determine outcome of hypertensive disorders of pregnancy (HDP) and the associated factors. Method: A prospective study was conducted during June 2015 to March 2016. Target population was Saudi hypertensive and normotensive gravidas attending the Maternity and Children Hospital, Al-Hasaa, Saudi Arabia. Data were collected through a scheduled questionnaire, clinical examination, laboratory investigations, sonographic examinations as well record reviewing. Results: The study included 132 hypertensive and similar normotensive pregnant women matched by age. Pre-eclampsia was the most prevailing subtype (47.7%). HDP increased the risk of maternal (17.4%, RR=5.4) and perinatal (52.3%, RR=4.7) complications. Hypertensive women were more prone to, preterm labour (RR=5.5), Cesarean section (RR=5), labour induction (RR=5), and pregnancy termination (RR=2). Fetal complications included small for gestational age (RR=15.9), intrauterine growth restriction (RR=15.2), prematurity (RR=4.8), and fetal distress (RR=2.2). Neonates were at risk of admission to neonatal intensive care unit (RR=14.2) and low Apgar score at one (RR=14.4) and five minutes (RR=2.2). No deaths were recorded in the study. Pre-eclampsia was the most risky. Incidence of post HDP chronic hypertension was 18.5%. Conclusion: HDP carry a risk for both mothers and babies. Adverse outcome of HDP could be predicted by absent antenatal care, lower maternal age, elevated serum bilirubin, preterm delivery, poor education, uncontrolled blood pressure and primigravida. Proper follow up and timely management may HELLP reduction of unfavourable outcome.
Hypertensive disorders
Pregnancy
Outcome
Hassa
2019
10
01
62
74
https://ejcm.journals.ekb.eg/article_54691_96882d0c4053a7f9fcf14276819de008.pdf
The Egyptian Journal of Community Medicine
The Egypt. J. of Community Medicine
1110-1865
1110-1865
2019
37
4
Occupational Exposures and Health Profile among Workers in an Egyptian Printing Press
Background: Printing workers are at risk of several occupational exposures due to their job nature and their awareness of these hazards is important so that they can protect themselves. Objective: The current study aimed at comparing the health status of the printing workers with that of administrative department employees and to describe the knowledge of printing press workers about different exposures. Method: 171 printing workers and 175 administrative staff were recruited from an Egyptian press company in Cairo. An interview questionnaire was used including data on socioeconomic, occupational characteristics of the study population; questions about their awareness of different exposures; assessment of the worker's health through asking about various symptoms of different systems were also included. Results: The percentage of workers perceiving their working environment as dangerous was significantly higher than that of the administrative group. Most of the workers reported exposure to chemicals affecting the respiratory system (50.9%) followed by exposure to chemicals affecting the skin (33.3%). On the other hand, administrative workers reported spending long time working in one position (47.4%). The percentage of workers was significantly higher than that of administrative staff reporting eye irritation, hearing impairment, tinnitus, tremors, backache, numbness, dyspnea, chronic cough and skin inflammatory symptoms. Percent of administrative staff reporting neck pain was of higher than printing workers but without statistical significance. Conclusion & Recommendation: Printing press workers are exposed to various occupational hazards in their work environment which adversely affect their health status. Workers in printing industry need to be targeted by awareness programs to help them understand the types of occupational exposures they may experience and how to protect themselves from such exposures.
Printing Press
Egypt
Printing workers
health status
Occupational Exposures
2019
10
01
75
83
https://ejcm.journals.ekb.eg/article_54693_653067edbeb13f95f00a1e19f45ca80e.pdf
The Egyptian Journal of Community Medicine
The Egypt. J. of Community Medicine
1110-1865
1110-1865
2019
37
4
Compliance with Anti–Hypertension Regimen: Prevalence, Predictors and Health Belief Model, Their Effect on Managing Hypertension in Mansoura. A Hospital-Based Study.
Background: Hypertension (HTN) is an important health problem with great complications that can be prevented through proper management which depends mainly on patient compliance. Method: A cross-sectional study was conducted on attendants of the outpatient's clinic of Mansoura International Hospital (MIH) for HTN management during the period from January 2014 to June 2015. Results: The study included 350 patients; 170 (48.6%) of them were compliant with the medication regimen and 141 (59.7%) compliant to lifestyle modification. Compliance to medication regimen was mainly affected by gender, residence, work status and educational level, internal factors (personal factors), health care provider and cues to action. While gender, the perception of a barrier to compliance and internal factors (personal factors) were the predictors' for compliance to lifestyle modification. A proved relationship between compliance with medical regimen and lowering blood pressure level of the participants and also their BMI was detected. Conclusion: as compliance with medical regimen affect managing hypertension; so measures to increase patient's awareness about nature of HTN and its complication providing them with clear and direct messages. Continuous follow-up for the non-compliant patients to improve their behavior, involve them in the drug choice or decisions about treatment strategies. Incorporate family members to ensure medication compliance.
Hypertension
health belief model
compliance with medication
compliance to lifestyle
Mansoura
Egypt
2019
10
01
84
94
https://ejcm.journals.ekb.eg/article_54694_ad7c26ac4a8c328dad3896768534351b.pdf
The Egyptian Journal of Community Medicine
The Egypt. J. of Community Medicine
1110-1865
1110-1865
2019
37
4
Personal & Environmental Risk Factors of Missed Miscarriage among Women Attending Ain -Shams University Maternity Hospital, Cairo, Egypt
Background: In recent years, the incidence of missed miscarriage tended to increase; its prevalence becomes more than 3% of all pregnancies. Although chromosomal abnormalities are implicated in approximately 50% of all spontaneous miscarriages, the remaining 50% may be preventable and related to environmental factors. Objectives: To determine the risk factors for missed miscarriage among women attending the emergency room and outpatient clinic at Ain-Shams University Maternity hospital. Method: A Case control study was carried out among 130 women with normal pregnancies and 130 cases of missed miscarriage. Data were collected using a structured interviewed questionnaire. Anthropometric measurements were performed, and Ultrasonography was done to all participants to confirm the diagnosis of missed abortion. Results: Age, Hypercoagulation of blood, DM, PCO, Practicing physical exercise, using mobile phone for long time and fast food are independent significant predictors for missed miscarriage in the studied pregnant women. Conclusion: Missed Abortion is linked to many modifiable risk factors which could be easily prevented and hence decrease maternal morbidity & mortality; the researchers recommend further work to confirm these findings in other study populations.
Missed miscarriage – Risk factors – Environmental – Lifestyle – Cairo
Egypt
2019
10
01
95
106
https://ejcm.journals.ekb.eg/article_54697_57c7708f8f6a19fbbfcc8eac8a4ea694.pdf