Egyptian Community Medicine AssociationThe Egyptian Journal of Community Medicine1110-186533120150101Prevalence of the most common Reproductive Tract Infections among women attending family Planning clinics in Montazah-Alexandria11471210.21608/ejcm.2015.712ENJournal Article20161109Background: The global burden of reproductive tract infections (RTIs) is enormous and of a major public health concern, particularly in developing countries where RTIs are endemic. RTIs constitute the second major cause of disease burden (after maternity related causes) in young adult women in developing countries. Aim of work: To measure the prevalence of Candida albicans, Trichomonas vaginalis and Bacterial vaginosis among married women and to identify some factors associated with them. Subject and methods: a cross sectional descriptive study was conducted in four health centers in El -Montazah health district-Alexandria. All women seeking family planning services at these clinics were included in the study till fulfilling the calculated sample size. An interview questionnaire, clinical examination and laboratory diagnosis were implemented on studied participants. Result: The study revealed that 484/615 (78.7%) studied women had at least one type of reproductive tract infections based on laboratory test. Candida albicans constituted (48.1%),<br />Bacterial Vaginosis constituted (28.9%), mixed Candidiasis and Bacterial Vaginosis constituted (15.4%) Trichomonas vaginalis constituted (4.1%) mixed Trichomonas and Candidiasis and / or Bacterial Vaginosis constituted (3.3%). Education and employment were found to be significantly associated with reproductive tract<br />infections however age and parity were not significantly associated with RTIs. Conclusion: RTIs are prevalent among women attending the family planning clinics. Both education and employment influence the presence of RTIs.Recommendation: As family planning is often a woman's primary, and sometimes sole contact with the health care system; it is recommended to integrate RTI saeening & management with family planning serviceshttps://ejcm.journals.ekb.eg/article_712_9067a3b7f6c2878972992aec1898d29d.pdfEgyptian Community Medicine AssociationThe Egyptian Journal of Community Medicine1110-186533120150101Barriers to The Utilization of Cardiovascular Risk Prediction Tools as Perceived by Primary Health Care and Family Physicians153271310.21608/ejcm.2015.713ENJournal Article20161109Background: Mortality from cardiovascular diseases was ranked the first cause of death in Egypt, accounting for 46% of total deaths. Although the use of cardiovascular risk prediction tools (CVRPT) to identify those at higher risk was proven to be a cost-effective strategy, these tools remain underutilized in clinical practice. Objective: To investigate the barriers to the utilization of CVRPT as perceived by primary health care and family physicians. Subjects and Methods: A cross sectional study was conducted in 25 primary health care and family medicine units in three Egyptian cities using an adapted questionnaire. Results: One hundred and seventy six (176) eligible physicians from a recruited sample of 230 (response rate=76%) participated in the study. About 81% of all physicians rarely or never use CVRPT. Most often stated barriers to use CVRPT are: distrust in stakeholders’ interest (88.7%), patients’ non-compliance due to inability to afford requested investigations (83%), and the imperfection of using single score in measuring patient’s global cardiovascular risk (82%). Among different questionnaire domains, the “distrust in CVRPT validity” was found to be the most important domain influencing the utilization of CVRPT (p=0.045), and among all questionnaire items, the “Distrust in stakeholders’ interest”, and “a single score doesn’t take into account the complex situation of the patient” were found to be the most important indicators influencing CVRPT utilization by logistic regression analysis. Forty seven percent (47%) reported that the health care system does not support the use of CVRPT due to economic reasons, and 36% reported the need for an easy and cost-effective tool. Conclusion: Distrust in the validity and comprehensiveness of CVRPT, distrust in stakeholders, lack of time, lack of physician knowledge and training, and economic reasons were the most important barriers against the utilization of CVRPT. Further studies are needed for examining the effect of global CVD calculation on actual patient outcomes. Communication among CVRPT stakeholders and health care policy makers in Egypt, adopting a simple, cost effective CVRPT, and physician training were suggested to promote the utilization of CVR scores in clinical practice.https://ejcm.journals.ekb.eg/article_713_2390ebe44b9c6cc747a8310d764c0621.pdfEgyptian Community Medicine AssociationThe Egyptian Journal of Community Medicine1110-186533120150101Hepatocellular Carcinoma in Relation to Occupational and Environmental Heavy metals Exposure334671410.21608/ejcm.2015.714ENJournal Article20161109Hepatitis C and B were considered the unique risk factors encountered for HCC. However epidemiological studies indicate that human liver is susceptible also to environmental carcinogens including heavy metals. In the current study lead and cadmium were examined to find the possible relation to either chronic hepatitis or hepatocellular carcinoma because those two heavy metals are widely distributed in the Egyptian community especially in rural community. Variety of pesticides, fertilizers in addition to drinking water contamination together with smoking were considered sources of different chemicals especially those two heavy metals. Objectives: To determine the possible relation between blood lead and cadmium and HCC and chronic hepatitis. Methodology: Three groups were included 50 HCC, 50 chronic hepatitis were compared to 50 matched control group. All subjects were asked to fill an interview questionnaire that covers detailed sociodemographic, occupational and environmental risk factors . Gas chromatography was used for measurement of blood heavy metals in whole blood sample. Results: blood cadmium level was higher among HCC group compared to chronic hepatitis group and controls (1.6+0.4, 1.2+0.3 and 1+0.4) respectively with a statistically significant difference (p0.01). No statistically significant difference has been the studied groups as regard blood lead level (14.8+5, 12.5+3.4 and 12+4.7 respectively p =0.21NS). ALT and AST were higher among HCC and chronic hepatitis group compared to controls (96+43, 76+55 and 23+5) and (78+40, 70+50.7 and 16.8+5 respectively p<0.001HS). Cadmium level was inversely correlated with albumin level (r=-0.30 and p=0.02). Cadmium is positively correlated versus age r=0.32 and p=0.02S. On the other hand no statistically significant correlation could be detected between cadmium with. Lead was positively correlated versus age (r=-0.29 and p=0.04S). On the other hand no statistically significant correlation could be detected between lead and other variables (p>0.05). No statistically significant difference between males and females as regard lead and cadmium. Conclusion: This study reinforces that blood cadmium may play a role in HCC but direct effect couldn’t be confirmed. Smoking represents the main environmental source of cadmium among HCC patients. Further studies are needed to clarify direct effects of environmental risk factors in the pathogenesis and progression of liver cancer.https://ejcm.journals.ekb.eg/article_714_af7160fcf372aba90b76b0a407ae6143.pdfEgyptian Community Medicine AssociationThe Egyptian Journal of Community Medicine1110-186533120150101Management of stress among primary school teachers in Ismailia city. An intervention study476071510.21608/ejcm.2015.715ENJournal Article20161109Teacher stress is a multifactorial phenomenon that spread globally irrespective to the level of development of country. Aim of study: The aim of this study was to measure the efficacy of a stress management program in lowering the level of stress among schools’ teachers who suffers work-related stress. Subjects and Methods: A quasi-experimental design was used to test the effect of application of stress management program among primary school teachers living in Ismailia city. Cluster sampling technique was used to choose the primary schools included in the study. A sample size of 170 school teachers was selected randomly from the chosen schools. A self administered questionnaire was used as a tool for the study before and after the intervention. Intervention program was composed of small lectures and watching videos with coping maneuvers to be followed in case of any stress situation. Results: 64.7% and 22.4% of surveyed school teachers were having moderate and severe stress respectively. Bad behavior of students, long working hours and not enough salary were the common reported factors to cause a lot to severe stress among the sample. After introducing the stress management program, the percentage of teachers who have no stress increased from 12.9% to 32.9% and the percentage of those who have severe stress decreased from 22.4% to 5.9%. In conclusion, the study revealed that one fifth of primary school teachers in Ismailia city perceived teaching as a severely stressful job. This study can be considered as a pilot study and further research need to be conducted to determine the most suitable stress management activities that suit our culture and local circumstances.https://ejcm.journals.ekb.eg/article_715_ab2534371b41ff98d01a4d23d57a6a77.pdfEgyptian Community Medicine AssociationThe Egyptian Journal of Community Medicine1110-186533120150101Knowledge &Practices of Exclusive Breast Feeding in Fayoum, Egypt617771610.21608/ejcm.2015.716ENJournal Article20161109Background Breastfeeding is an important public health strategy for improving infant and child morbidity and mortality, The WHO recommends that for the first six months of life, infants should be exclusively breastfed. This study aimed at assessing exclusive breastfeeding EBF knowledge, and practice among lactating mothers attending Benisaleh Family Health Unit having infant aged from 2-6 moths. Methods: A cross-sectional study using structured questionnaire was conducted among mothers having infant aged from 2-6 months attending Bensaleh FHU for immunization practices through period from July to September 2013. Results: Out of 400 mothers interviewed; exclusive breast feeding was reported among 50 (12.5 %). The mean total knowledge score of participants was 10.22±2.9& ranged from 4 to 22 out of 27 knowledge questions. The mean<br />knowledge score was significantly higher in mothers, with higher education, working mothers and those who received knowledge from media & combined source than those with lower education, not working and who received knowledge from PHC workers. The significant predictors for exclusive breastfeeding practice among participants were; male sex, early breastfeeding initiation after delivery, and good knowledge with odds ratios of 3.02, 13.2 and 7.9 respectively. Conclusion and Recommendation: There was a lack of knowledge and correct feeding practice regarding EBF. Urban and educated mothers have good knowledge. Counseling<br />for mothers on EBF needs to be improved and health care workers need to be better trained to provide counseling services during antenatal care visits.https://ejcm.journals.ekb.eg/article_716_f87328c293393b4b2c89e9801d7c4e26.pdfEgyptian Community Medicine AssociationThe Egyptian Journal of Community Medicine1110-186533120150101Prevalence and predictors of emotional and behavioral problems among rural school Egyptian adolescents799271710.21608/ejcm.2015.717ENJournal Article20161109BACKGROUND: Emotional and behavioral problems among adolescents are common<br />problems in developing and developed countries with a great impact on their health and<br />wellbeing. The OBJECTIVE is to determine prevalence, predictors and impact of emotional<br />and behavioral problems among rural adolescents’ school children.<br />METHODS: A cross sectional study with multistage random sample was taken from Giza<br />governorate rural school students aged 13 to 17 years during the academic year 2012-2013. A<br />sample of 476 students was selected. Psychological assessment was conducted using selfreported<br />strengths and difficulties questionnaire (SDQ).<br />RESULTS: The study showed that 18.5% of students had behavioral problems with the highest<br />proportion in emotional problems followed by conduct problems, hyperactive problems and<br />lastly peer relations. Abnormal impact score was found in 13.7% of studied students. Students<br />from private school, at secondary educational grade, with separated or dead parent and<br />frequently punished at school were significant predictors of behavioral problems.<br />CONCLUSIONS: Students from private schools, secondary education, with separated or dead<br />parent, and frequently punished were at higher risk to have behavioral abnormalities than others.<br />School teachers need proper training on how to communicate properly with their adolescent<br />students aiming to avoid frequent punishments.https://ejcm.journals.ekb.eg/article_717_ca2d71d8ce0982f063561140d67c1b66.pdf