@article { author = {Wahdan, Iman and Madkour, Marwa and El-Nimr, Nessrin}, title = {Prevalence and Determinants of Glucose Abnormalities among Patients with Chronic Liver Disease in Alexandria, Egypt}, journal = {Journal of High Institute of Public Health}, volume = {44}, number = {1}, pages = {1-7}, year = {2014}, publisher = {High Institute of Public Health, Alexandria University}, issn = {2357-0601}, eissn = {2357-061X}, doi = {10.21608/jhiph.2014.20335}, abstract = {Background: The term Chronic liver disease (CLD) encompasses a large number of conditions existing on acontinuum between hepatitis infection and cirrhosis. Chronic hepatitis C infection was found to be associated withdiabetes mellitus (DM) with a significantly higher prevalence than the prevalence in the general population.Objectives: The aim of the present study was to assess the prevalence and determinants of glucose abnormalitiesamong patients with CLD in Alexandria, Egypt.Methods: Over a period of two years, 264 consecutive patients with CLD referred to the Hepatology andGastroenterology Unit, Medical Research Institute, Alexandria University were enrolled in the study. Personal,demographic and medical histories were obtained by interviewing each patient and reviewing his/her records. Clinicalexamination for each patient was also performed. Complete blood picture, fasting blood glucose level and lipidprofile, liver profile and imaging were recorded. Serological and/or immunological markers identifying the etiology ofCLD were also recorded.Results: The prevalence of glucose abnormalities among hepatitis C positive patients was higher than that amongpatients with other CLD (39.2% versus 21.7% respectively), with a statistically significant difference. Threeindependent risk factors were found to be significantly affecting the prevalence of glucose abnormalities among CLDpatients; namely etiology of liver disease, presence of fatty liver and total cholesterol level.Conclusion: The present study indicates a high prevalence of DM in patients with CLD in Alexandria. It is thereforeimperative that patients with CLD especially chronic hepatitis C patients be screened periodically for glucoseintolerance.}, keywords = {Chronic liver disease,Diabetes mellitus,impaired fasting glucose,hepatitis C}, url = {https://jhiphalexu.journals.ekb.eg/article_20335.html}, eprint = {https://jhiphalexu.journals.ekb.eg/article_20335_0de2424879e9231bad60e387cd8ce593.pdf} } @article { author = {Salama, Basem and Elgaml, Ahmed and Alwakil, Ismail and Elsayed, Mohamed and Elsheref, Saad}, title = {Ventilator Associated Pneumonia: Incidence and Risk Factors in a University Hospital}, journal = {Journal of High Institute of Public Health}, volume = {44}, number = {1}, pages = {8-12}, year = {2014}, publisher = {High Institute of Public Health, Alexandria University}, issn = {2357-0601}, eissn = {2357-061X}, doi = {10.21608/jhiph.2014.20336}, abstract = {Background: Ventilator associated pneumonia (VAP) is a type of nosocomial pneumonia associatedwith increased morbidity and mortality. Awareness about the risk factors can be used to implementsimple and effective preventive measures.Objectives: To determine the factors associated with development of VAP and its microbial profileamong patients admitted to ICUs.Methods: A nested case-cohort study was conducted at Al-Hussein university hospital in Cairo city,Egypt for a period of 6 months from the 1st of March 2013 to the end of August 2013. Patients whowere on mechanical ventilation (MV) for more than 48 hours were monitored at frequent intervals fordevelopment of VAP. Samples obtained by endotracheal aspiration were ccultured on Blood agar -Chocolate agar - MacConkey agar, plates of which were incubated at 37c for 24 hours. The isolatedorganism was identified by morphological and biochemical identification.Results: Of the 73 samples which were taken from endotracheal tubes of the patients, 42 cases werediagnosed as VAP with an incidence rate of 57.5%. Early onset VAP occurred in 36 (85.7%), whilelate onset VAP was observed in the remaining 6 patients(14.3%). Escherichia coli (40.5%) followedby Klebsiella pneumoniae (23.8%) were the most commonly isolated pathogens. Univariate analysisshowed that the duration of MV and ICU stay, re-intubation, supine head position, impairedconsciousness, steroids use and H2 blocker use were the risk factors associated with VAP (p < 0.05).Logistic regression revealed duration of MV as an independent risk factor for VAP.Conclusion: The incidence of ventilator pneumonia is high in our study. VAP was significantlyrelated to duration of MV and ICU stay, re-intubation, supine head position, impaired consciousness,steroids use and H2 blocker use.}, keywords = {Ventilator-Associated Pneumonia (VAP),Intensive Care Unit,Incidence,risk factors}, url = {https://jhiphalexu.journals.ekb.eg/article_20336.html}, eprint = {https://jhiphalexu.journals.ekb.eg/article_20336_312a77d248773c3138bf633b075d033b.pdf} } @article { author = {Zenhom, Samaa and Saleh, Noha and Elaraby, Amira}, title = {Impact of Accreditation on the Information Management System in Primary Health Care Units in El-Behera Governorate, Egypt}, journal = {Journal of High Institute of Public Health}, volume = {44}, number = {1}, pages = {13-20}, year = {2014}, publisher = {High Institute of Public Health, Alexandria University}, issn = {2357-0601}, eissn = {2357-061X}, doi = {10.21608/jhiph.2014.20337}, abstract = {Background: Accreditation is one of increasingly employed method for promoting quality at theprimary health care units (PHC). It is a self-assessment and external peer reviewed process used byhealthcare organizations to assess their level of performance accurately in relation to the establishedstandards and to implement ways to improve the healthcare system continuously.Objectives: The aim of this study is to assess the impact of accreditation on compliance withinformation management system standards in El-Behera PHC units.Methods: A cross-sectional study was carried out in primary health care facilities in El-BeheraGovernorate. The study population included PHC units participating in accreditation and PHC unitsnot participating in accreditation selected via a two stage stratified random sampling technique. Thedata were collected using a checklist developed in concordance with the Egyptian accreditationstandards for primary health care facilities 2005 for areas related to the information managementsystem. Accreditation standards were scored on a scale of 0-3 (score 3 given for fully met, 2 foracceptable partially met, 1 for unacceptable partially met and 0 for not met). An average percentagescore was calculated (standards average percentage score = total facility score/ Target score X 100).Results: The overall average score percentage for standard is significantly (p< 0.05) higher inaccredited units than non-accredited ones (64.5 ± 17.9 versus 39.3 ± 13.6 respectively). The lowestmean score percent in accredited PHC units was demonstrated in almost two standards namelyaccuracy of medical records and verification of implementation (57.8±9.9 and 55.6±12.5 respectively).Conclusion: There was a significant impact of primary health units' accreditation on the healthinformation management system. However, those accredited units still not reach the desired level instandards regarding accuracy of medical records and verification of implementation.}, keywords = {Accreditation Egyptian standards,Health information management,primary health care}, url = {https://jhiphalexu.journals.ekb.eg/article_20337.html}, eprint = {https://jhiphalexu.journals.ekb.eg/article_20337_c7be2eac5a3ed78cfbf670fcdeea9a00.pdf} } @article { author = {Taher, Engy and Swelam, Manal and Mansy, Amr and Elgammal, Marwa}, title = {Methotrexate and Misoprostol against Misoprostol Alone for Early Medical Abortion: Comparative Study}, journal = {Journal of High Institute of Public Health}, volume = {44}, number = {1}, pages = {21-24}, year = {2014}, publisher = {High Institute of Public Health, Alexandria University}, issn = {2357-0601}, eissn = {2357-061X}, doi = {10.21608/jhiph.2014.20338}, abstract = {Background: Vaginal mifepristone oral misoprostol have proven to be highly effective medicalabortion methods and are used widely in in modern countries.Objectives: The objective of this study is to compare the efficacy for two medical abortion regimensused in one clinic setting misoprostol alone, intramuscular methotrexate and vaginal misoprostol.Methods: An intervention study was conducted on a total of 100 randomly selected women withgestations of first-trimester pregnancy, who sought a missed abortion. Study population was assignedas two groups, the first was subjected to vaginal administration of Misoprostol and the second wassubjected to IM injection of methotrexate and self-administration of vaginal misoprostol After 72h.All patients were followed up for recording any side effects of the drugs, progress of abortion & ifthere was any need for surgical interference [manual vacuum aspiration (MVA) or dilatation andcurettageResults: Success rate of the methotrexate regimen was 80% and did not differ significantly from themisoprostol regimen that had success rate of 84%.Conclusions: In this real-use setting, the use of misoprostol in combination with methotrexate oralone for the missed abortion termination are both safe and effective methods without serious sideeffects.}, keywords = {Methotrexate,misoprostol,Pregnancy,Abortion}, url = {https://jhiphalexu.journals.ekb.eg/article_20338.html}, eprint = {https://jhiphalexu.journals.ekb.eg/article_20338_93d0814fd20be39f3fb7a16eb0448590.pdf} } @article { author = {El Dalatony, Mervat and Salem, Eman and Diab, Hanan}, title = {Prevalence and Risk Factors for Musculoskeletal Complaints among Dental Practitioners in Alexandria, Egypt}, journal = {Journal of High Institute of Public Health}, volume = {44}, number = {1}, pages = {25-32}, year = {2014}, publisher = {High Institute of Public Health, Alexandria University}, issn = {2357-0601}, eissn = {2357-061X}, doi = {10.21608/jhiph.2014.20354}, abstract = {Background: Musculoskeletal complaints represent a significant occupational health issue indentistry. In Egypt, data about the prevalence and risk factors of this problem are scarce so far.Objectives: To investigate the prevalence of musculoskeletal complaints among dental practitionersand assess the risk factors of these complaints among dentists.Methods: Cross-sectional was used for implementation of the study. Data were collected using Nordicstandard questionnaire and demographics questionnaire which were filled out by 200 dentalpractitioners in their offices in public dental centers in Alexandria, Egypt.Results: A large percent of dentists (72.0%) reported musculoskeletal symptoms in at least one siteduring the past 12 months. The most commonly affected sites were low back (52.0%), upper back(44.0%), ankles and feet (30.0%) and knees (29.5%). A significant difference was observed betweendental specialists regarding neck pain only as it was more prevalent among periodontics (40.9%)followed by prosthodontics (36.4%).A significant association was found between MusculoskeletalDisorders (MSDs) and duration of work ≤ 10 years (P=0.005). In addition, non-prolonged sitting wassignificantly associated with MSDs (P=0.026). Sick leaves from 1-7 days due to MSDs were reportedby more than half (54.0%) of the practitioners who complained of MSD in the last twelve months.Conclusions: A high prevalence of MSD symptoms exists among dental practitioners in Alexandria,Egypt, which affects the daily practice of nearly half of them. Lower and upper back pain symptomswere particularly common. Therefore, it is recommended that an appropriate training program beimplemented to improve dentists’ awareness regarding musculoskeletal symptoms and theirprevention.}, keywords = {Dental practitioners,Musculoskeletal disorders,risk factors,Nordic standardized questionnaire,Egypt}, url = {https://jhiphalexu.journals.ekb.eg/article_20354.html}, eprint = {https://jhiphalexu.journals.ekb.eg/article_20354_37e7d29041241e2e13d29f3f25b609c1.pdf} } @article { author = {EL-Deeb, Mona and EL Malwany, Hatem and Khalil, Yehia and Mourad, Saher}, title = {Interferon Gamma Release Assays (IGRA) in the Diagnosis of Active Pulmonary Tuberculosis}, journal = {Journal of High Institute of Public Health}, volume = {44}, number = {1}, pages = {33-40}, year = {2014}, publisher = {High Institute of Public Health, Alexandria University}, issn = {2357-0601}, eissn = {2357-061X}, doi = {10.21608/jhiph.2014.20355}, abstract = {Background: Tuberculosis is one of the deadliest diseases over the world. Diagnosis of pulmonary TBdepends on combination various parameters. IGRA measure T cell release of IFN-γ in response to M.TBantigen. WHO policy statement as on IGRA use in low and middle income countries is not establishedyet. Objective: The present study aimed to compare between tuberculin skin test (TST) and interferongamma release assay (IGRA) in the diagnosis of active tuberculosis infection and study the effect of 3months of first line anti-TB therapy on the positivity of the IGRA test.Methods: 40 Egyptian patients were included in the study, and assigned as two groups; Group Icomprised 20 patients with negative sputum for AFB by Ziehl-Neelsen stains with positive sputumculture for M.TB and Group II included 20 patients with positive sputum and Ziehl-Neelsen for AFBbefore and after 3 months of first line of anti-TB therapy. All patients were subjected to full historytaking, clinical examination, X- ray chest, lab investigations, ESR measurements, microbiological testsand ELISA measurement of Quantiferon-TB Gold.Results: Lower significant values were found in group II after treatment than before treatment regardingclinical parameters and 1st and 2nd hours ESR. IGRA test and TST showed sensitivity (91.18%, 76.4%),specificity (83.33%, 66.67%), positive predictive value (96.88%, 92.86%), negative predictive value(62.5%, 33.3%) and accuracy of (90%, 75%) respectively. IGRA results had no statistical significantdifferences between the studied groups with poor agreement with TST ((κ) = 0.025).Conclusion: IGRAS test had high sensitivity and specificity in diagnosis of active TB. More studies areneeded to evaluate the effect of anti-TB therapy on IGRA level.}, keywords = {Interferon gamma release assays (IGRA),tuberculosis (TB),tuberculin skin test (TST)}, url = {https://jhiphalexu.journals.ekb.eg/article_20355.html}, eprint = {https://jhiphalexu.journals.ekb.eg/article_20355_c472ddfa349676321d4696c49ed7d328.pdf} } @article { author = {Khattab Abd El-Rahman, Samia}, title = {Impact of Balance Disorders on the Health Outcomes of Elderly People in Damanhur- Egypt}, journal = {Journal of High Institute of Public Health}, volume = {44}, number = {1}, pages = {41-47}, year = {2014}, publisher = {High Institute of Public Health, Alexandria University}, issn = {2357-0601}, eissn = {2357-061X}, doi = {10.21608/jhiph.2014.20356}, abstract = {Background: Balance disorders are a major cause of falls and the most common geriatric syndromesthreatening the independence and affecting the health outcome of elderly people and it reduced levelof function.Objective: The study aimed to assess the effects of balance disorders on health outcomes of elderlypeople. A cross-sectional study was conducted and comprised 114 elderly (60 years and above) fromthe elderly home, Damanhur. Their demographic characteristics, balance measurements and healthoutcomes have been evaluated. Data was collected according to the Arabic version of 12-item shortform of health outcomes. The Berg Balance Scale (BBS) was used to evaluate balance. The TimedUp and Go (TUG) test was used to measure basic functional mobility. Flexibility was assessed by asit and reach test, to determine the level of fear of falling in daily life by the visual analogue scale(VAS) was used.Results: One-third of the participants (33.3%) had a history of falls once or more. The most reportedmorbidities were hypertension and diabetes mellitus (43.9% and 26.3%, respectively).The BBSscores were significantly associated with physical and social health domains, (r = 0.625,p=0.042, andr =0.19, p =0.048).While it was negatively correlated with the psychological health domain (r = -0.16,p =0.087). A positive correlation was observed between the health outcome (SF-12 scores) andBBS, flexibility (r =0.016, 0.082, and 0.119).Whereas, fear of falling was negatively associated withall measured parameters except the flexibility (r = 0.063). The majority of the participants, (80.7%)had moderate health-related quality of life.Conclusion: The assessment of falling risks and body balance of the elderly in elderly homes willguide the implementation of suitable intervention programs to improve body balance, reduce fallingand its consequences among elderly.}, keywords = {Balance impairments,health outputs,(BBS) Berg Balance Scale,elderly home,Egypt}, url = {https://jhiphalexu.journals.ekb.eg/article_20356.html}, eprint = {https://jhiphalexu.journals.ekb.eg/article_20356_f58db39ded331defdecc3e06e91b260c.pdf} } @article { author = {Khalifa, Emadeldin and Al Samrah, Mohamed and Mahmoud, Tamer and Abdeen, Noha}, title = {Chromohystroscopy after Failed Intracytoplasmic Sperm Injection (ICSI)}, journal = {Journal of High Institute of Public Health}, volume = {44}, number = {1}, pages = {48-52}, year = {2014}, publisher = {High Institute of Public Health, Alexandria University}, issn = {2357-0601}, eissn = {2357-061X}, doi = {10.21608/jhiph.2014.20358}, abstract = {Background: Intra cytoplasmic sperm injection (ICSI), is a procedure adoptedworldwide as the ultimate micro-assisted fertilization approach due to its clinicalsuccess.Objectives: The objective of this study was to assess the value of using Chromohystroscopy modality ininfertility workup after failed ICSI procedures in evaluating uterine receptivity and detect any signs of chronicendometritis by a less invasive method.Methods: prospective cohort study. A total of 50infertile patients recruited from the infertility clinic in El-ShatbyUniversity Hospital, Faculty of Medicine, Alexandria University. Cases were allocated into two groups. The firstgroup includes cases that had a failed trial of intracytoplasmic sperm injection. The second group includes controlcases from patients seeking for fertility treatment with no previous history of intracytoplasmic sperm injectionand with no history of anatomic uterine abnormalities. The selected sample size was found to be 50 women, andwere randomly selected and allocated in two groups each group was 25 women after fulfilling the inclusioncriteria.Results: There was a statically significant increase in the incidence of endometritis among the study group 68%in comparison to 16% in the control group.Conclusions: In this study.Endometrial dyeing with methylene blue at hysteroscopy improves the detection ofchronic endometritis.}, keywords = {Chromohystroscopy,Intra cytoplasmic sperm injection (ICSI)}, url = {https://jhiphalexu.journals.ekb.eg/article_20358.html}, eprint = {https://jhiphalexu.journals.ekb.eg/article_20358_589a53944fc84fe365fa98b6c7b2e37d.pdf} } @article { author = {Shaaban, Fouada and Zahran, Safaa and Mohamed, Mona}, title = {Decision Making Performance Process among Head Nurses}, journal = {Journal of High Institute of Public Health}, volume = {44}, number = {1}, pages = {53-60}, year = {2014}, publisher = {High Institute of Public Health, Alexandria University}, issn = {2357-0601}, eissn = {2357-061X}, doi = {10.21608/jhiph.2014.20359}, abstract = {Background: Decisions play important roles as they determine both organizational and managerial activities. It is the key part of head nurses' activities. Decisions are made at every level of nursing management to ensure that the nursing department goals are achieved. Objectives: The study aimed to assess the decision making performance process among head nurses. Methods: The study was conducted at El-Menshawi and El-Mahala General Hospitals which are affiliated to the Ministry of Health and Population. Study subject included all (95) head nurses working at the assigned hospitals. Decision Making Analysis of Areas and Activities Questionnaire and Decision Making Rating Scale for head nurses were used as tools for data collection. Results: More than one third of head nurses propose the budget of nursing department imposed on them and make decision in concerning the needed qualifications of nursing personnel on each unit in conjunction with the chief. Seventy percentages of head nurses at El-Mahala General Hospital had high levels in the decision making process. More than half at El-Mahala hospital had moderate levels in the strategy of decision making performance process. Conclusion: head nurses fulfilled the areas and activities of decision making process but a lot of decisions making is done with the chief either with or without subordinating opinions. Establishing training programs is recommended to help head nurses and subordinate staff in making effective decision, developing the budget of nursing unit and improving standard of care activities.}, keywords = {Decision Making,head nurse,performance,decision making process}, url = {https://jhiphalexu.journals.ekb.eg/article_20359.html}, eprint = {https://jhiphalexu.journals.ekb.eg/article_20359_e5d45c0dcfc9a452affdaf51bcadb4f1.pdf} }