Egyptian Community Medicine AssociationThe Egyptian Journal of Community Medicine1110-186538420201001Health Disorders among Professional Female Hairdressers in Menoufia Governorate, Egypt: A Cross-Sectional Study1611940810.21608/ejcm.2020.119408ENJournal Article20201018Background: Professional hairdressers are exposed to a variety of chemicals at their workplace. Objective: to assess health disorders among professional female hairdressers in Menoufia governorate, Egypt. Method: this cross sectional study was conducted on 115 female hairdressers in Menoufia governorate with a similar number of non-exposed controls. All participants were subjected to a predesigned questionnaire regarding respiratory, musculoskeletal, and reproductive manifestations followed by spirometry examinations. Data was collected and tabulated. Results: Lower respiratory manifestations including cough, wheezes, dyspnea, and asthma were more among hairdressers (p < 0.05) with highly significant reduction in spirometry measurements (p < 0.001). Musculoskeletal and Reproductive manifestations were significantly higher among hairdressers (p < 0.05) as well. Hairdressers working for more than 9 years were more prone for such disorders. Conclusion: Health and safety of professional hairdressers in Egypt has been inadequately provided as proved by development of respiratory, musculoskeletal and reproductive disorders, which mandates the high need for health education, diagnostic and therapeutic interventions to this work group.https://ejcm.journals.ekb.eg/article_119408_bc227eb5f074155e18f3c2ce778aedae.pdfEgyptian Community Medicine AssociationThe Egyptian Journal of Community Medicine1110-186538420201001Antibiotic Misuse among Medical Students in Sohag University71611940910.21608/ejcm.2020.119409ENJournal Article20201018Background: Antibiotics are commonly used for self-medication due to their rapid effect in alleviating symptoms resulting in serious adverse effects. Medical students are more prone to self-medicate by virtue of their study of medical subjects and because the information needed for self-diagnosis and treatment are easily accessible. Objective: The study was conducted to investigate the pattern of antibiotics misuse among medical students in Sohag university and associated factors. Method: A cross sectional study was conducted among medical students of Sohag University during the academic year 2016-2017. Faculties of Medicine, Pharmacy and Nursing were chosen to be involved in the present study with a sample of 373 students in the fourth year in the selected faculties. A questionnaire was designed to obtain data about sociodemographic variables and antibiotic misuse pattern among the studied medical students. Results: Findings showed that 65.95% of the participants used antibiotics without doctor’s prescription. About one third (32.5%) selected the antibiotics depending on their own experience. By asking about their opinion about using antibiotics for self-health care, 35.1% of the participants considered it acceptable and 5.9% considered it a good practice. None of the studied variables was significantly associated with antibiotics misuse among the participants. Conclusion: Among the medical students in Sohag University, 65.95% reported that they self-medicate with antibiotics. It is necessary to focus on increasing the awareness about the problem and its adverse effects, with implementing strict measures to prevent dispensing of drugs, especially antibiotics, without doctor’s prescription.https://ejcm.journals.ekb.eg/article_119409_9355c077553e9f36e6f4dc4d59df4439.pdfEgyptian Community Medicine AssociationThe Egyptian Journal of Community Medicine1110-186538420201001Eating Disorder Risk among Medical Students at Tanta University, Egypt172311941010.21608/ejcm.2020.119410ENJournal Article20201018Background: Eating disorders (EDs) are complex psychiatric syndromes that occur with increasing frequency among adolescents of all racial, ethnic, and socioeconomic groups. They are considered as the third most common chronic illness in adolescent females, with an incidence of up to 5%. Severe clinical complications can take place especially compromised nutritional status due to the delay in diagnosis or treatment. Objective: This study aimed to find out the prevalence of risk for eating disorders and its associated factors among medical students, Tanta University, Egypt. Method: A cross-sectional study was carried out through the first semester of the year 2018-2019 and included 615students.Data were collected using a pre-designed questionnaire which included personal and sociodemographic data, family and medical histories and a self-administered questionnaire of the Eating Attitudes Test-26 (EAT-26). Results: About one third (33.0%) of the studied students were at risk for eating disorder. EDs Risk was more common among students in the clinical stage compared to the pre-clinical stage. Also, unmarried, those with higher BMI and those practicing regular physical activity were at more risk (p < 0.05). Conclusions: A considerable proportion of medical students are at greater risk of eating disorders. Special programs are needed for managing this potential problem for the sake of future physicians and their patients.https://ejcm.journals.ekb.eg/article_119410_aaab204d172e4dea63e097a100bf4788.pdfEgyptian Community Medicine AssociationThe Egyptian Journal of Community Medicine1110-186538420201001To What Extent Assisted Reproductive Technology Is Risky?243411941210.21608/ejcm.2020.119412ENJournal Article20201018Background: The number of infants born after assisted reproductive technology (ART) is increasing worldwide. Concerns are rising regarding its safety with inconsistent results. Objective: to explore maternal and child health outcomes following ART. Method: The current case-control study was conducted in Alexandria from January to December 2018. Target population was all children that attended El-Shatby Pediatric University Hospital during the period of study. Interviewing questionnaire, clinical examination, and radiological investigation were the tools of data collection. Results: The present study involved 113 singleton children born after ART and a similar number of naturally conceived controls. It showed that among ART group; subfertility was primary in 90.3% and mostly due to male factor (64.6%). The study revealed that ART mothers were more likely to have hypertension in pregnancy (OR=4.8), preeclampsia (OR= 4.3), gestational diabetes (OR=3.4) placenta previa (OR=2.8), premature rupture of membrane (OR=2.7) and Caesarean section (OR= 2.3) versus naturally conceived (NC) women. ART children were more prone to low birth weight (OR=3.2), admission to neonatal intensive care unit (OR=4.9) or hospital (OR=2.4) with longer stay (p=0.001) versus naturally conceived children. Odds of Autism spectrum disorders (OR= 5.4) and global developmental delay (OR= 4.4) were higher among children born after ART than among controls. Major and multiple congenital anomalies were more likely to be observed among ART (OR=4.5 and OR= 2.1 respectively) versus NC children. Anomalies of the cardio vascular and central nervous systems (4.4% each) were the most frequent. Adversely affected ART children (100%) were well accepted within their families and all primary subfertile mothers (90.3%) were welling to have more. Conclusion and recommendations: Our study confirmed an increased risk of adverse maternal and child outcome after ART. Pre-implantation genetic screening, careful neonatal examination, long term follow up of ART children, and prospective studies to assess early and delayed ART outcomes and their determinants are recommended.https://ejcm.journals.ekb.eg/article_119412_ff2be3eb85c1d605c5bfd4a9ff2a597a.pdfEgyptian Community Medicine AssociationThe Egyptian Journal of Community Medicine1110-186538420201001Evaluation of Patient Rights Practice among Doctors in Gynaecology and Obstetrics Department in Zagazig General Hospital354211941310.21608/ejcm.2020.119413ENJournal Article20201018Background: The key competency of health professionals is their ability to protect the health of individuals. The recent developments of the healthcare systems lead to increased hazards in medical practice which raise the importance of knowing and practicing the patient rights. Objective: To evaluate the effect of a training program to improve awareness and knowledge of doctors about patient rights in Zagazig general hospital. Method: The current study is an interventional study that was conducted in Zagazig general hospital. A total of 70 physicians were evaluated regarding patient rights then a training program was conducted and evaluated three months later. The collected data were analyzed by SPSS program version 20 considering statistical significance when P value<0.05. Results: Only 51.4 % of the studied physicians were aware about patients’ rights. There was poor attention to patients’ rights’ practice as more than half of the study population rarely or never paid attention to patients’ rights during practice. About 50 % of participants perceived that patients’ rights have influence on medical practice. In general, there was poor satisfaction from the surveyed physicians about the organizational climate which would explain the poor compliance with the patients’ rights. Implementation of training program resulted in significant improvement in physicians’ knowledge and awareness about patients’ rights. Conclusion There was poor knowledge about patients’ rights. This is related to the organizational climate performance and application of educational program resulted in improved knowledge about patients’ rightshttps://ejcm.journals.ekb.eg/article_119413_bdceaf6b25b4394fa25d0576e99e2eb7.pdfEgyptian Community Medicine AssociationThe Egyptian Journal of Community Medicine1110-186538420201001Knowledge, Attitude and Practice of Resident Physicians towards Evidence Based Medicine in Mansoura, Egypt435111941610.21608/ejcm.2020.119416ENJournal Article20201018Background: Application of Evidence Based Medicine (EBM) is widely growing as a tool for the best available evidence in decision making in the health care. Objective: This study aims to assess knowledge, attitude and practice of resident physician towards EBM and to compare theses aspects between residents in a Teaching and a General Hospital in the same city and to determine their educational needs for greater use of EBM in health care. Method: This cross-sectional study included 522 residents from two hospitals. Data was collected using a self-administered questionnaire addressing knowledge, attitudes & practices about EBM and to define the barriers to practice it. Results: In most aspects, the knowledge, attitude and practice of Mansoura University Hospital residents about EBM was significantly higher than that for Mansoura General Hospital Conclusions: Although there is a high positive attitude among physicians towards EBM, the knowledge and the practice of EBM is still defective.https://ejcm.journals.ekb.eg/article_119416_7a590fd20c018abcd33e98c42a751a5a.pdfEgyptian Community Medicine AssociationThe Egyptian Journal of Community Medicine1110-186538420201001Socio-Demographic Factors Associated with Exclusive Breastfeeding from Birth to Six Months in An Urban Public Health Center, Egypt526111941810.21608/ejcm.2020.119418ENJournal Article20201018Background: Breastfeeding is the best first source of infant nutrition. Breastfeeding provides health benefits to both the baby and the mother. Babies ought to be exclusively breastfed for the first 6 months. Numerous factors are associated with the exclusivity of breastfeeding and one of the important ones is the socio-demographic factors. Objectives: To estimate the proportion of infants who are breastfed exclusively during the first 6 months. To identify maternal socio-demographic factors and barriers affecting the practice/duration of exclusive breastfeeding (EBF) among them. Method: Cross-sectional study was conducted among 334 mothers at 1st Settlement health care center; a standardized interview questionnaire was used to gather information about socio-demographic characteristics, health service utilization, the outcome of pregnancy, Family support in childcare and maternal knowledge, attitude and practice concerning EBF. Results: 51.1% of studied mothers practice EBF. The age, education, and occupation didn’t affect the practice of EBF. Also, no difference was found regarding the utilization of antenatal care, the outcome of pregnancy and family support in childcare. The number of living children, using stimulant drinks, knowledge scores, attitude towards breastfeeding concerning exclusive breastfeeding in 1st 6 months and its stoppage during the illness of mother or child were the key indicators for exclusive breastfeeding. practice differs between two groups in the form of time of beginning breastfeeding, lactation frequency and frequency of breastfeeding/day. Conclusion: Providing adequate knowledge to raise awareness of EBF and increase the involvement of health care providers in enhancing knowledge through antenatal care will be the best approaches to increase EBF practice.https://ejcm.journals.ekb.eg/article_119418_b0312cd6b0ae254d8a7f936ad00c5db9.pdfEgyptian Community Medicine AssociationThe Egyptian Journal of Community Medicine1110-186538420201001Knowledge, Attitude and Practice towards Vitamin D Importance and Supplementation among Mothers of under Five Children in a Primary Health Care Center in Cairo627511941910.21608/ejcm.2020.119419ENJournal Article20201018Background: Vitamin D deficiency is a pandemic especially in women in childbearing age mainly due to lack of awareness about the importance of vitamin D and prevention of its deficiency. Objective: To assess the knowledge, attitude and practice of mothers attending primary health care center in Cairo towards vitamin D, its supplementation & sun light exposure. Methods: A cross sectional study was conducted on 195 mothers attending a primary health care center in El-Sherouk city in Cairo using structured questionnaire including socio-demographic data, mother’s knowledge, attitude and practice towards the importance of Vitamin D, its supplementation and sun light exposure for herself and her child and a scoring system was designed. Results: Less than one quarter of the mothers (22.6%) had a good knowledge (total knowledge score percentage > 50%). Thirty six percent (36%) of mothers had a positive attitude (total attitude score percentage ≥75%) & forty-six (46%) percent of mothers had a good practice (total practice score percentage ≥75%). About 53.5% of mothers were exposed to the sun from 10 am to 3 pm, and 91.1% were exposed to the sun more than one hour per week. Only 48.7% of the mothers gave their children vitamin D supplementation. Conclusion & recommendation: Less than one quarter of the mothers had a good knowledge while about three fifths of the mothers had a positive attitude & less than half of them had a good practice towards vitamin D and its supplementation. Awareness campaigns may help in improving awareness about vitamin D importance.https://ejcm.journals.ekb.eg/article_119419_1645e8a7486a5e19044bc7f6acf8b924.pdfEgyptian Community Medicine AssociationThe Egyptian Journal of Community Medicine1110-186538420201001Prevalence, Risk Factors, Control and Treatment Adherence of Hypertension: A Community-Based Study In An Egyptian Village768611942110.21608/ejcm.2020.119421ENJournal Article20201018Background: Hypertension is common in developing countries and most of its risk factors are preventable. Objective: This study aims to estimate the prevalence and risk factors of hypertension among rural adults in an Egyptian village. Method: a nested case-control study was carried out in Meet El-Amel village, Aga District, Dakahlia Governorate it was targeting adult subjects aged from 18 years and more, pregnant and lactating women were excluded. The mean age of participants was 44.6±15.9 years. Results: the overall prevalence of hypertension was 31.9%. Multivariate logistic regression model has identified that being a woman (AOR= 46.5), being adherent to drug therapy (AOR= 40.3) and secondary or higher education levels (AOR= 14.8) as the only predictors for controlled hypertension among self-reported hypertensive. Excess salt (AOR= 17.5), smokers (AOR=5.8), obesity (AOR=5.1), high cholesterol (AOR=4.8), those belonging to 40-59 age group (AOR=3.5), low HDL (3.2), positive family history of hypertension (AOR= 3.1), physical inactivity (AOR= 2.9), those ≥ 60 years old (AOR=2.8) and men gender (AOR=2.3) are predictors of newly discovered hypertension. Conclusion: primary prevention of modifiable risk factors of hypertension is crucial.https://ejcm.journals.ekb.eg/article_119421_194b7c7f086575a57269158b27380eac.pdfEgyptian Community Medicine AssociationThe Egyptian Journal of Community Medicine1110-186538420201001Cost Minimization of Pre-Enrolment Investigations in Treating HCV Infected Patients879911942310.21608/ejcm.2020.119423ENJournal Article20201018Background: A screening program was launched in Egypt in 2018, targeting adult population for HCV and hypertension, diabetes, and obesity. Objective: To assess the financial impact of reducing cost of pre-enrolment investigations before treatment allocation. Method: 6771 adult patients, recently diagnosed with anti-HCV antibody positive during screening campaigns were included. Scenario-1: patients were categorized into 2 groups; Difficult and Easy to treat. Scenario-2: Patients were categorized by Fib-4 score into 2 groups with score ≤3.25 and score >3.25. Costs of pre-enrolment data obtained from National Committee for Control of Viral Hepatitis (NCCVH) administrative records. Cost minimization (CM) analysis compared the 2 scenarios with incremental analysis in Egyptian pounds. Results: Direct medical costs of both scenarios, pre-enrolment costs, direct treatment costs in scenarios 1 and 2 were 2528 and 3866 L.E respectively. Total costs in scenario-1 is 18,536,706 L.E. Comparing the 2 scenarios, 502 patients would have discordant results of both scenarios. Based on 89% SVR response expected from chronic HCV patients in previous literatures, supposing 11% treatment failure in patients with discordant results, 55 patients would need retreatment with Direct antivirus agents (DAAs) with 24 weeks duration. Total cost of scenario 2 is 18,087,772 L.E. Incremental cost minimization analysis per patient is 66 Egyptian pounds (LE). Conclusion: In limited resources countries with high prevalence of HCV as in Egypt, cost minimization in pre-enrolment setting would be preferable.https://ejcm.journals.ekb.eg/article_119423_98ee759f27075fd81c76b49a801dcaa2.pdf