High Institute of Public Health, Alexandria University
Journal of High Institute of Public Health
2357-0601
2357-061X
35
4
2005
10
01
Effect of the Utilization of Nursing Practice Guidelines on Occurrence of Aspiration for Critically III Intubated Patients
739
762
EN
Nagwa
A.
Reda
Assistant Professor, Department of Critical Care Nursing, Faculty of Nursing, Alexandria University, Egypt
Youssreya
M.
Ibrahim
Assistant Professor, Department of Critical Care Nursing, Faculty of Nursing, Mansoura University, Egypt
10.21608/jhiph.2005.166667
Patients with artificial airways are considered at high risk for aspiration. An endotracheal tube [ETT] is the most commonly used artificial airway. Despite its benefit for providing airway management for critically ill patients, it may be associated with problems and complications that may be life threatening.
Objective: This study was conducted to determine the effect of utilization of nursing practice guidelines on occurrence of aspiration for critically ill intubated patients.
Design: A quasi-experimental design.
Sample: Forty critically ill intubated adult patients.
Method: An assessment of the nurses’ knowledge and skills to prevent occurrence of aspiration was initially performed. Observation was done first for nurses involved in providing direct patient care for the control group after 24 hours of intubation. Then implementation of the developed guidelines on the study group after instruction of these guidelines in the second day of intubation and followed up for seven consequent days. Assessment of the occurrence of aspiration among the control and study groups was done. Patients were followed up from the second day of intubation up to seven consequent days to detect aspiration’s manifestations and chest X-ray changes. Comparison between the control and study groups was done to determine the effect of the use of the nursing practice guidelines on occurrence of aspiration.
Results: Marked improvement in the nursing practices was found after instructions for the nursing guidelines. The results of the study revealed decrease in the percent of aspiration manifestations. Moreover, it was observed that there were some possible contributing factors for pulmonary aspiration such as age, Glasco coma scale, and the mode of ventilator.
Conclusion: The results of present study highlighted the importance of the nursing role in prevention of aspiration. The intubated patient requires meticulous care to ensure airways maintenance and prevent complications until he can maintain independent ventilation.
Nursing Practice Guidelines,Critically III Intubated Patients
https://jhiphalexu.journals.ekb.eg/article_166667.html
https://jhiphalexu.journals.ekb.eg/article_166667_d41d8cd98f00b204e9800998ecf8427e.pdf
High Institute of Public Health, Alexandria University
Journal of High Institute of Public Health
2357-0601
2357-061X
35
4
2005
10
01
Acute Pharyngitis as Challenge for Primary Prevention of Rheumatic Fever at a Rural Community in Gharbia Governorate
763
778
EN
Nadira
M.
Hassan
Public Health, Social, and Preventive Medicine Department, Egypt
Mostafa
M.
Awny
Pediatrics Department, Tanta Faculty of Medicine, Egypt
10.21608/jhiph.2005.166834
It is known that streptococcal infections of the pharynx are the precipitating cause of rheumatic fever.
The aim of the present study was to determine some preventable challenges in dealing with acute pharyngitis at a rural community in Gharbia Governorate. This study was conducted at Kafr Hegazy Village, during a period of four months from October 2004 up to the end of January 2005. All primary and preparatory schools of Kafr Hegazy Village were surveyed for children taking long acting penicillin as a preventive measure for rheumatic fever. Sociodemographic characteristics, history of attacks of acute pharyngitis, investigations performed for diagnosis, source of medical care, and type and duration of medications used for treatment were obtained from parents by direct interview using structured questionnaire sheet. All related investigations were reviewed.
The results revealed that: In all primary and preparatory schools of Kafr Hegazy Village, 173 children were taking long acting penicillin as a prophylactic measure for rheumatic fever. Of them, 95.4% had past history of acute pharyngitis and 61.9% of them had their first attacks below 6 years and suffered from more than 6 years and suffered from more than 6 attacks per year. There was no statistically significant difference between mother’s education [ꭓ<sup>2</sup>=7.194] and source of medical care [ꭓ<sup>2</sup>=5.838] on one hand and frequency of attacks of acute pharyngitis on the other. Governmental health services [53.3%], mainly school health insurance and primary health care unit were the main sources of medical care. The study showed that 58.2% of studied children were not asked for any investigations and only 1.2% of them were asked for throat culture. Also, the study revealed that the majority [84.2%] of rural mothers were seeking medical care for treating acute pharyngitis which was not significantly affected by their education [ꭓ<sup>2</sup>=1.309]. According to the finding of the study, oral antibiotic therapy was the commonly prescribed, [42.4%], but it was used for 3.9±1.6 days. On other hand, injection therapy [30.3%] was used commonly for 2.4±0.7 days. There was no statistically significant effect of mother’s education or source of medical care on duration of treatment.
The following was recommended: Special health education program for mothers to minimize throat infections and rheumatic fever and stress on the necessity of 10-day course of oral treatment, orientation and on job training courses for physicians especially those of the school health insurance, primary health care units, and private ones. Strategies for diagnosis and treatment of acute pharyngitis should be directed at identifying those patients who have group A ẞeta hemolytic streptococcal infections by using throat culture [especially for children under 6 years] and implementation of a single injection of benzathine penicillin G as recommended regimen for both treatment of acute pharyngitis and primary prevention of rheumatic fever.
acute pharyngitis,Rheumatic fever,Gharbia Governorate
https://jhiphalexu.journals.ekb.eg/article_166834.html
https://jhiphalexu.journals.ekb.eg/article_166834_d41d8cd98f00b204e9800998ecf8427e.pdf
High Institute of Public Health, Alexandria University
Journal of High Institute of Public Health
2357-0601
2357-061X
35
4
2005
10
01
Availability and Quality of Solid Waste Collection Service at Suburban Area in Alexandria City, Egypt
779
794
EN
Magda
Abd Elati
Environmental Health Department, High Institute of Public Health, Alexandria University, Egypt
Manal
Ahmed
Environmental Health Department, High Institute of Public Health, Alexandria University, Egypt
manalhassan_44@hotmail.com
10.21608/jhiph.2005.167033
Collection process is the main step in solid waste management program. If it was not done properly, it causes many environmental pollution and health risks. So, the aim of this study was to assess the solid waste collection services provided by Onyx in a suburban area in Alexandria Governorate. Khorshid suburban area was chosen, which is divided into two regions: north and south. The Northern part belongs to Montazah District while southern belongs to East District. Interview questionnaire sheets were filled by frequent visiting to this area. Collected data were analyzed statistically. Data revealed that the southern region of Khorshid was not serviced by Onyx at-all and the citizens disposed of their waste either onto the bank of the Mahmoudia Canal that leads to contamination of the water, in the streets, or is incinerated. On the other side, the north Khorshid which is serviced by Onyx Company suffered from many problems. The unavailability of adequate number of containers with respect to number of houses and the far distance between some houses and the place of waste containers led to accumulation of solid waste in the streets, spreading of bad odor, and overuse of insecticides. In addition, spreading of respiratory and diarrheal diseases was prevalent among children. Also, the results revealed the presence of indirect significant correlation [P<0.005] between the frequency of emptying containers by vehicle and prevalence of insects and consequently the overuse of insecticides and prevalence of allergic disease among children. There is a direct correlation between the diseases and spreading of insects and rats [P<0.05]. All resident said that the quality of collection services is worse and had worsened. The worst state from the public view was due to negligence from the company itself, inadequate number of workers, and there is no good supervision and follow up from the responsible supervisors. However, the Governorate enforces pay percentage of monthly electrical consumption. This system was unacceptable by nearly all residents because the charge was high whereas no service was provided. So, it is recommended that the solid waste collection by a private Company [Onyx] must be supervised strictly by Governorate itself to ensure the implementation of this service in remote areas as the same quality in urban areas. Follow up from the districts on services that are provided to customers to evaluate and improve it.
Solid Waste Collection Service,Suburban area,alexandria
https://jhiphalexu.journals.ekb.eg/article_167033.html
https://jhiphalexu.journals.ekb.eg/article_167033_d41d8cd98f00b204e9800998ecf8427e.pdf
High Institute of Public Health, Alexandria University
Journal of High Institute of Public Health
2357-0601
2357-061X
35
4
2005
10
01
Effect of a Training Program on Physicians’ Knowledge Regarding Family Medicine
795
818
EN
Ola
Akl
Primary Health Care Division, Tropical Health Department, High Institute of Public Health, Alexandria University, Egypt
Amr
A.
Sabra
Primary Health Care Division, Tropical Health Department, High Institute of Public Health, Alexandria University, Egypt
10.21608/jhiph.2005.167047
Egypt’s Health Sector Reform Program (HSRP) has envisioned a shift in Primary Health Care (PHC) provision approach to the concept of Family Medicine (FM). Within the reform strategies, the Ministry of Health and Population (MOHP) has performed continuous efforts in training General Practitioners (GPs) and medical graduates working in PHC facilities in FM either in Egyptian universities or abroad.
The aim of the present study was to assess the effectiveness of a training program on PHC physicians, by measuring their knowledge about (FM) aspects, before and after the training course. A 44 days’ training program was provided to 20 PHC physicians in San Stefano FM center, Alexandria Governorate.
The main objective of this course was to prepare the trainees for working in family practice. A self-administered questionnaire was designed to assess the physicians’ knowledge about different aspects of PHC and FM, both before and after the training.
The results of the present study revealed that 70% of the physicians were males, in the age group 40 to <50 years. None of them had post graduate degrees in PHC and/or FM, and 40% had no training courses at all. A minority received 3 months training courses in FM either in the United Kingdom or in Saudi Arabia. The effectiveness of the training program was proved by the significant improvement in the mean total knowledge score of the physicians, from 75.15 in the pre-test, to 94 in the post-test. Also, similar significant improvement occurred in the mean knowledge score of 7 out of 11 subscales. Moreover 85% of the physicians had good knowledge in the post-test in comparison to 25% in the pre-test and none of them had poor knowledge in the post-test in comparison to 10% in the pre-test.
This highlights the importance of Continuing Medical Education (CME) as well as training course in increasing physicians’ competency and ability to cope with new vision for delivering good quality health care.
family medicine,Training program,Physicians’ Knowledge
https://jhiphalexu.journals.ekb.eg/article_167047.html
https://jhiphalexu.journals.ekb.eg/article_167047_d41d8cd98f00b204e9800998ecf8427e.pdf
High Institute of Public Health, Alexandria University
Journal of High Institute of Public Health
2357-0601
2357-061X
35
4
2005
10
01
Using of Particle Counter as a Monitoring Tool for Giardia and Cryptosporidium in a Water Purification Plant
819
840
EN
Manal
A.
Mohamed
Environmental Health Department, High Institute of Public Health, Alexandria University, Egypt
10.21608/jhiph.2005.168744
Drinking water plays a major role in the spread of intestinal protozoa pathogenic for human, namely <em>Giardia</em> <em>lamblia</em> and <em>Cryptosporidium </em>parvum. Surface water is contaminated with <em>Giardia </em>or<em> Cryptosporidium </em>in two major ways: wastewater treatment plants may discharge effluent with cysts or by fecal pollution by various animals that live on the watersheds. So, they are of great concern to the water treatment industry because they are known to have caused a number of waterborne outbreaks of disease. Since, the identifying of <em>Giardia </em>cysts and <em>Cryptosporidium </em>oocysts require. special technique and lab personnel specially trained in microbiology. Particle counting is another physical technique for enumeration of <em>Giardia </em>cysts and <em>Cryptosporidium </em>oocysts by instrument depending on their size distribution.
This study aims at evaluating the use of particle counter as a monitoring tool for particle removal in a conventional pilot water treatment plant.
The results revealed that coagulation, sedimentation, and filtration removed the most percentage of the both parasites. The average removals of both parasites by coagulation and sedimentation were 76% and 71%, while filtration process only removed about ≥99.5%.On the other hand, the average removal of turbidity was 90.7% by coagulation and sedimentation and 95.2% by filtration. The average over-all removals of turbidity, <em>Giardia,</em> and <em>Cryptosporidium </em>were 99.53%, 99.95%, and 99.89%, respectively. While, the average log removal of parasites and turbidity were 3.3 log for <em>Giardia, </em>3.02 log for <em>Cryptosporidium, </em>and 2.38 log for turbidity. A significant strong correlation was found between total particle removal and cyst and oocyst sizes removals, while a significant correlation between turbidity and parasites removal were observed. So, particle counter and turbidimeter can be used as surrogate indicator of <em>Giardia</em> and <em>Cryptosporidium </em>removal.
The study recommended reducing the risk of raw water infection by <em>Giardia</em> and <em>Cryptosporidium </em>through the multiple barrier approach to treatment, including watershed protection, optimization of chemical pretreatment, filtration, disinfection, and a properly operated and maintained distribution system. It should be installed on-line instruments – particle counting and turbiditimeter monitoring – at various stages of the water treatment process to evaluate water purification plant performance for <em>Giardia</em> and <em>Cryptosporidium </em>removal and enable the operator to develop optimal operations conditions to achieve maximum particulates removal.
Giardia,Cryptosporidium,Particle Counter,Water Purification Plant
https://jhiphalexu.journals.ekb.eg/article_168744.html
https://jhiphalexu.journals.ekb.eg/article_168744_d41d8cd98f00b204e9800998ecf8427e.pdf
High Institute of Public Health, Alexandria University
Journal of High Institute of Public Health
2357-0601
2357-061X
35
4
2005
10
01
Prothrombin G20210A Mutation in Women with Preeclampsia in Alexandria
841
852
EN
Amina
R.
El Gezeery
Human Genetics Department, Medical Research Institute, Alexandria University, Egypt
Mohamed
M.
Mokhtar
Human Genetics Department, Medical Research Institute, Alexandria University, Egypt
Samia
M.
Kotb
Human Genetics Department, Medical Research Institute, Alexandria University, Egypt
Maged
Zien-Eldien
Human Genetics Department, Medical Research Institute, Alexandria University, Egypt
10.21608/jhiph.2005.168779
The etiology and pathogenesis of preeclampsia remain unknown but it has been proposed that genetic predisposition to coagulation abnormalities contributes to the development of preeclampsia by increasing the thrombotic tendency. This study was conducted to estimate one of the thrombosis variant, prothrombin G20210A Mutation, as a risk factor for preeclampsia. One hundred and seventeen preeclamptic women and 102 normal control group were included in this study, both groups were in the 3<sup>rd</sup> trimester of pregnancy. A positive association was fond between maternal age over 35 years [OR = 8; CI: 1.54-44.23], previous preeclampsia [OR = 6.34; CI: 2.16-19.96], positive family history of hypertension [OR = 3.44; CI: 1.28-9.60], diabetes mellitus [OR = 10.14; CI: 1.24-221.18], history of recurrent abortion [OR = 24.05; CI: 1.39-416.94], intrauterine fetal death [OR = 19.5; CI: 1.11-342.65], and fetal anomalies [OR = 8.42; CI: 1.06-180.0] and preeclampsia. The frequency of heterozygous carriers of the prothrombin G20210A mutation in preeclamptic women [6.8%] was higher than that in controls [2.9%], but the difference was statistically non-significant. However, the frequency of prothrombin mutation was statistically higher in severe preeclamptic women [14.7%] compared to women with mild preeclampsia [3.6%] [P<0.05]. This indicated that prothrombin mutation is associated with severe preeclampsia and worsens the prognosis of the disease.
Prothrombin G20210A,Women,preeclampsia,alexandria
https://jhiphalexu.journals.ekb.eg/article_168779.html
https://jhiphalexu.journals.ekb.eg/article_168779_d41d8cd98f00b204e9800998ecf8427e.pdf
High Institute of Public Health, Alexandria University
Journal of High Institute of Public Health
2357-0601
2357-061X
35
4
2005
10
01
Effect of Practice Guidelines on Management of Emergency Conditions in a General Hospital in Alexandria
853
884
EN
Samma
Z.
Ibrahim
Department of Health Administration and Behavioral Sciences, High Institute of Public Health, University of Alexandria, Egypt
Nailia
H.
Amer
Department of Health Administration and Behavioral Sciences, High Institute of Public Health, University of Alexandria, Egypt
Wafaa
W.
Guirguis
Department of Health Administration and Behavioral Sciences, High Institute of Public Health, University of Alexandria, Egypt
Nagwa
Y.
Abo El-Enein
Department of Health Administration and Behavioral Sciences, High Institute of Public Health, University of Alexandria, Egypt
Tayseer
M.
Zeitoun
Department of Critical Care, Faculty of Medicine, University of Alexandria, Egypt
10.21608/jhiph.2005.169263
Quality of medical care should be the highest priority with every department in every hospital, and this is especially true for the emergency department [ED], Guidelines should be seen as only one strategy that can help improve the quality of care that patients receive. This study conducted to determine the effect of development and dissemination of practice guidelines on the quality of care provided to patients presenting with three selected complaints, namely: dyspnea, abdominal pain, and chest pain at ED of Abou Kir General Hospital. The study was carried out at ED of Abou Kir General Hospital in Alexandria, a 180-bed hospital affiliated to Ministry of Health and Population. The study was a quasiexpermental, before and after approach and consisted of three phases. Comparison of process of care before and after intervention was done. The intervention was educational. Observation check lists were used for assessment of adherence to certain elements of process of care based on the developed and validated clinical practice guidelines of dyspnea, abdominal pain, and chest pain during pre- and post-intervention phase. The guidelines were presented to emergency physicians during the three-week interval between the pre- and post-intervention phases and after conduction of workshop. All physicians [18 physicians] working in ED were included in the study. All [258] patients presenting at ED with the three selected complaints: dyspnea, abdominal pain, or chest pain, were included in the study. The study concluded that development and implementation of guidelines for patients presenting at ED with acute dyspnea, acute chest pain, and acute abdominal pain improved compliance of physicians with these guidelines and improve the process of care. The lowest compliance weighted mean score percent concerning the three selected conditions was for history items during both pre-intervention phase [ranging between 4.7% and 28.4%] and post-intervention phase [ranging between 19.7% and 48.9%]. With respect to physical examination area, there was statistically significant improvement in weighted mean score percent for the three selected conditions with highest improvement for abdominal pain [from 30.7% to 50.4%]. As regards management area, there was no statistically significant improvement in weighted mean score percent for the three selected conditions. With highest improvement for dyspnea [from 88.7% to 99.0%]. Based on this study it is recommended to target improvement of the overall knowledge and skills of Emergency Department physicians, as most physicians are not emergency medicine specialists. More time must be allocated to training in the accident and emergency departments than at present; this should be supported by making available more detailed and comprehensive clinical guidelines. Also greater use of complementary educational methods such as practical skill training, case presentation, and clinical audit are very important.
Practice Guidelines,Emergency conditions,General Hospital in Alexandria
https://jhiphalexu.journals.ekb.eg/article_169263.html
https://jhiphalexu.journals.ekb.eg/article_169263_d41d8cd98f00b204e9800998ecf8427e.pdf
High Institute of Public Health, Alexandria University
Journal of High Institute of Public Health
2357-0601
2357-061X
35
4
2005
10
01
Evaluation of the Role of D-Dimer in the Diagnosis of Suspected Pulmonary Embolism
885
896
EN
Sourour
M.
S
Department of Chest, Faculty of Medicine, Alexandria University, Egypt
Atta
M.
S
Department of Chest, Faculty of Medicine, Alexandria University, Egypt
Shaheen
M.
M
Department of Chest, Faculty of Medicine, Alexandria University, Egypt
Deghady
A.
A
Clinical Pathology, Faculty of Medicine, Alexandria University, Egypt
Assar
A.
M
Department of Chest, Faculty of Medicine, Alexandria University, Egypt
10.21608/jhiph.2005.169657
Objective: The purpose of this study was to evaluate the role of D-dimer in the diagnosis of suspected pulmonary embolism [PE].
Patients and Methods: This study entailed 40 subjects representing group I; 15 patients clinically suspected as PE and have positive V/Q scan, group II; 15 patients clinically suspected as PE and have negative V/Q scan, and group III; 10 normal volunteers. All participants were subjected to history taking, clinical examination, radiological examination, V/Q scan, and assessment of D-dimer level using an agglutination immunological assay.
Results: The sensitivity of D-dimer as a diagnostic marker of pulmonary embolism was 93.3%, specificity 60%, positive predictive value 70%, negative predictive value 90%, and accuracy 76.7%. The sensitivity of D-dimer as a diagnostic marker of pulmonary embolism and/or DVT was 94.4%, specificity 75%, positive predictive value 85%, negative predictive value 90%, and accuracy 86.7%. The results of D-dimer in control group was negative in all subjects.
Conclusion: D-dimer had a definite place in the diagnostic procedure for suspected acute pulmonary embolism; when the concentration is below 500μg/L, the diagnosis can be ruled out. D-dimer had a better specificity in the diagnosis of pulmonary embolism when there are no co-morbid conditions as thrombosed piles or recent surgery.
D-Dimer,pulmonary embolism diagnosis,PE laboratory diagnosis
https://jhiphalexu.journals.ekb.eg/article_169657.html
https://jhiphalexu.journals.ekb.eg/article_169657_d41d8cd98f00b204e9800998ecf8427e.pdf
High Institute of Public Health, Alexandria University
Journal of High Institute of Public Health
2357-0601
2357-061X
35
4
2005
10
01
Assessment of the Value of Review of Pathology Material by a Second Pathologist
897
902
EN
Ahmed
M R.
Shalaby
Oncologic Pathology Department, Damanhour National Medicine Institute, Egypt
10.21608/jhiph.2005.169665
In many pathology departments, some cases are reviewed routinely by a second pathologist within the same department before sign-out. The value of this practice is not known. This study reviewed and compared the disagreement and amendment rates for cases reviewed by 1 or more pathologists based on the results of blind review. A total of 4,181 cases underwent blind review, and of these, 543 [13.0%] were reviewed by more than 1 pathologist before sign-out. The disagreement rate for cases reviewed by more than 1 pathologist was 4.8% and this was significantly lower than for cases reviewed by only 1 pathologist which was 6.9% [P=0.004]. The amendment rate was 0.0% and 0.5%, respectively, but this difference was not statistically significant [P=0.12]. Review of material by a second pathologist before sign-out is associated with a lower disagreement rate. These results suggest that second review of surgical pathology is of value, but the best selection of cases to be reviewed remains to be defined.
Pathology,Diagnosis,Slide Revision
https://jhiphalexu.journals.ekb.eg/article_169665.html
https://jhiphalexu.journals.ekb.eg/article_169665_d41d8cd98f00b204e9800998ecf8427e.pdf
High Institute of Public Health, Alexandria University
Journal of High Institute of Public Health
2357-0601
2357-061X
35
4
2005
10
01
Morbidity Profile of Elderly Attended/Admitted in Jeddah Health Facilities, Saudi Arabia
903
918
EN
Ibrahim
N.
K
Department of Family and Community Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
Ghabrah
T.
M
Department of Family and Community Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
Quadi
M
Department of Family and Community Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
10.21608/jhiph.2005.169671
A cross-sectional study was conducted to determine morbidity profile and predictors of increased number of morbidities among 2264 elderly attended/admitted in Jeddah health facilities. About one-fourth of elderly reported poor self-perceived health, 37.3% were dependent on others in their activities and 32.1% utilized >3 drugs/ day. Diminished vision was the commonest complaint while the most prevalent diseases were diabetes mellitus, arthritis and hypertension. The number of morbidities ranged from 1-6 with a mean of 2.11±1.16. In multivariate analysis, the predictors of increased morbidities were obesity [OR=1.83; 95% CI=1.37-2.44], feeling depressed [OR=1.64; 95% CI=1.26-2.13], advanced age, stop working, and female gender. It is recommended that there is a great need for increasing elderly medical and social care.
Morbidity Profile of Elderly,Attended/Admitted,Jeddah Health Facilities,Saudi Arabia
https://jhiphalexu.journals.ekb.eg/article_169671.html
https://jhiphalexu.journals.ekb.eg/article_169671_d41d8cd98f00b204e9800998ecf8427e.pdf
High Institute of Public Health, Alexandria University
Journal of High Institute of Public Health
2357-0601
2357-061X
35
4
2005
10
01
Predictors of Clinical Outcome among Adolescents with First Episode Schizophrenia in Alexandria
919
944
EN
Amira
Seif El-Din
Community Medicine Department, Faculty of Medicine, Alexandria University, Egypt
Aida
Mohey
Community Medicine Department, Faculty of Medicine, Alexandria University, Egypt
Nagwa
Shokair
Community Medicine Department, Faculty of Medicine, Alexandria University, Egypt
Salwa
Tayel
Community Medicine Department, Faculty of Medicine, Alexandria University, Egypt
salwatayel123@gmail.com
10.21608/jhiph.2005.170344
Evidence was emerging that the early phase following the onset of a first psychotic illness could be conceived of as a critical period, influencing the long-term course of the illness. Effective intervention at this stage might alter the subsequent course of the illness. Psychosis may be developed as the action of social or psychological stressors acting on the vulnerable individuals. The present study aimed at providing data about potential sociodemographic and family risk factors related to development of first episode schizophrenia [FES], identifying clinical profile of FES among adolescents, providing baseline assessment of patients with FES as well as changes in assessment domains during five months follow up period, and finally identifying significant contribution factors related to clinical outcome of FES among adolescents. A clinic-based case control study was carried out. Cases were recruited from Psychiatric Consultation Clinic for school children in Alexandria. The trained investigators themselves collected the data using precoded structured questionnaire. A structured clinical interview format was used for assessing five domains. The majority of cases [88.7%] claimed that illness was precipitated by stressful life events. Source of referral was the physician in 66.2% of instances. The most commonly cited reason for referral was aggression and violence [39.4%]. More than one-fifth of cases [21.1%] visited faith healer before referral and 19.7% did not seek any medical care. Just less than two-thirds of family members [60.6%] had negative attitude towards the illness. Nearly three-quarter of cases [73.2%] reported progressive course of illness. Significant risk factors for FES in logistic regression model were: positive family history of mental disorders [Adjusted OR=6.47, 95% CI=1.29-9.61], unskilled fathers’ occupation [Adjusted OR=1.34, 95% CI=1.22-3.03], low mothers’ educational level [Adjusted OR=4.92, 95% CI=2.42-9.71], and negative parental rearing style [Adjusted OR=2.51, 95% CI=1.67-4.47]. The estimated remission rate following the follow up period was 86.3%. Positive symptoms improved in 87.3% of cases while negative symptoms improved in 83.1% of cases. Moreover, 73.2% of cases experienced improvement in psychopathological symptoms. Social functioning had improved in 76.1% of cases. Compliance to medication and family support were the only significant predictors for clinical improvement in patients with FES [Adjusted OR=3.15, 95% CI=2.64-6.83, P<0.001, and 2.63, 95% CI=1.89-5.72, P=0.008].The present work concluded that the best strategy is to early diagnose and treat patients suffering from first episode psychosis. This includes appropriate medical diagnosis, neurocognitive and psychological assessment, and appropriate medication. The support and necessary education were needed for family members to be helpful.
Clinical Outcome,Adolescents,First Episode Schizophrenia,alexandria
https://jhiphalexu.journals.ekb.eg/article_170344.html
https://jhiphalexu.journals.ekb.eg/article_170344_d41d8cd98f00b204e9800998ecf8427e.pdf
High Institute of Public Health, Alexandria University
Journal of High Institute of Public Health
2357-0601
2357-061X
35
4
2005
10
01
Needle Stick Injuries and Post-Exposure Practices among Omani Nurses
945
958
EN
Mona
E.
Shama
Department of Health Education & Behavioral Sciences, High Institute of Public Health, Alexandria University, Egypt
Amr
M.
Taman
Department of Public Health, Faculty of Medicine, Tanta University, Egypt
10.21608/jhiph.2005.170349
Nurses are at high risk for exposure to blood-borne pathogens via sharp injuries such as needle stich injuries.
This study aimed at studying the occurrence of needle stick injuries among Omani nurses and measures followed by nurses after exposure. To fulfill this aim, a total of 489 nurses involved in the direct day-to-day management of patients answered a questionnaire inquiring about occurrence of needle stick injuries and measures taken by the nurse after exposure.
The results revealed that 31.1% of the sample experienced at least one needle stick injury during the period of one year prior to the study. No significant relationship was found between the occurrence of needle stick injury and any of the nurses’ characteristic. Nurses working in welayat hospitals experienced significantly higher percentage of needle stick injuries than those working in regional hospitals [40.3% compared to 27.6%]. Nurses working in obstetric and gynecology departments experienced the highest percentage of needle stick injuries [46.3%] followed by those working in internal medicine wards [40.4%], whereas the lowest occurrence was among nurses working in renal dialysis units and surgical wards [12.5% and 12.0%, respectively]. Only 63.2% of needle stick injuries were notified and only 55.3% were reported.
It was concluded that needle stick injury represents an important hazard for Omani nurses. Effective educational programs for prevention of injuries and enhancing post-exposure preventive measures should be considered.
needle stick injuries,Omani Nurses
https://jhiphalexu.journals.ekb.eg/article_170349.html
https://jhiphalexu.journals.ekb.eg/article_170349_d41d8cd98f00b204e9800998ecf8427e.pdf
High Institute of Public Health, Alexandria University
Journal of High Institute of Public Health
2357-0601
2357-061X
35
4
2005
10
01
Evaluation of the Antischistosomal Activity of the Molluscicidal Plant, Euphorbia Schimperiana
959
982
EN
Najia
A.
Al-Zanbagi
Biological Science Department, Girls Section, Science College, King Abdul-Aziz University
Nabeel
Z.
Zahid
Biological Science Department, Girls Section, Science College, King Abdul-Aziz University
Dalia
A.
Abuljadayel
Biological Science Department, Girls Section, Science College, King Abdul-Aziz University
10.21608/jhiph.2005.170371
Intestinal schistosomiasis is one of the most wide spread parasitic disease which is caused by digenetic trematodes of the parasite <em>schistosoma mansoni</em>. Chemotherapy with orally administered antischistosomal drugs remains the best method to care for people infected by the parasites. However, this approach is rather expensive, an alternative method is to destroy the intermediate host with molluscicidal agents. The molluscicidal activity of <em>Euphorbia schimperiana </em>[Euphorbiaceae] had been determined. Many experiments were done to investigate the characterization of <em>Euphorbia schimperiana </em>extract as antischistosomal drug and morphological changes of the treated worms were noted and compared with the normal ones. Reduction in worm burden, oogram changes, and reduction of eggs in tissues were the three criteria considered for the assessment of antischistosomal activity.
Intestinal schistosomiasis,Schistosoma mansoni,antischistosomal drugs,molluscicidal activity,Euphorbia schimperiana,Morphological changes
https://jhiphalexu.journals.ekb.eg/article_170371.html
https://jhiphalexu.journals.ekb.eg/article_170371_d41d8cd98f00b204e9800998ecf8427e.pdf
High Institute of Public Health, Alexandria University
Journal of High Institute of Public Health
2357-0601
2357-061X
35
4
2005
10
01
Role of Angiotensin Converting Enzyme Inhibitor on the Functional Changes in Irradiated Rates
983
994
EN
Samia
M.
Elewa
Department of Physioloy, Medical Research Institute, Alexandria University, Egypt
Amel
L.
El-Sawaf
Department of Physioloy, Medical Research Institute, Alexandria University, Egypt
Yossriya
El-Sayed
Department of Physioloy, Medical Research Institute, Alexandria University, Egypt
Abd El-Aziz
M.
Belal
Radiotherapy Unit, Faculty of Medicine, Alexandria University, Egypt
10.21608/jhiph.2005.170453
Background: Kidney irradiation clearly leads to a progressive reduction in function associated with concomitant glomerulosclerosis and/or tubulointerstitial fibrosis. Administration of Angiotensin-converting enzyme [ACE] inhibitor markedly abrogates the severity of radiation nephropathy and can prevent the functional changes that occur after irradiation.
Objective: The present study was designed to test the efficacy of converting enzyme inhibition [enalapril] and its possible mechanistic basis in preventing functional changes in irradiated rates.
Method: Prior to irradiation, rats were randomized to groups receiving enalapril or no treatment, in addition to a control group of non-irradiated, non-treated rates. Enalapril was administered intraperitoneally [0.1 mg/kg body weight/day], 4 weeks before and 12 weeks after irradiation. Both groups were exposed to a single dose of 7Gy gamma radiation.
Results: Irradiation induced significant elevations in the levels of blood urea nitrogen, serum creatinine, and serum activities of lactate dehydrogenase [LDH]; creatine kinase [CK]; alanine amino transferase [ALT]; and aspartate amino transferase [AST] compare to control values, indicative of renal, cardiac, and hepatic injury. Also there was an increase in the serum levels of triglycerides, total cholesterol, and LDL-cholesterol. On the contrary, HDL-cholesterol level was decrease. The heart, kidney and liver antioxidant enzymes including total glutathione peroxidase [total-GPX], glutathione reductase [GR], and superoxide dismutase [SOD] activities were inhibited, while malondialdehyde [MDA] level in these organs was elevated, indicative of increased lipid peroxidation. These data confirm the role of oxidative stress in radiation injury.
It can be concluded that enalapril treatment of rats prior to irradiation was able to diminish the functional changes that occur after irradiation as evidenced by a beneficial decrease in all parameters determined in the sera of these rats, with an increase in the level of HDL-cholesterol and an amelioration of inhibition of antioxidant enzymes activities in the organs of these rats.
Angiotensin converting enzyme,Irradiated Rates
https://jhiphalexu.journals.ekb.eg/article_170453.html
https://jhiphalexu.journals.ekb.eg/article_170453_d41d8cd98f00b204e9800998ecf8427e.pdf
High Institute of Public Health, Alexandria University
Journal of High Institute of Public Health
2357-0601
2357-061X
35
4
2005
10
01
Alteration of some Brain Neurotransmitters and Superoxide Dismutase Induced by Extremely Low Frequency Magnetic Field [3 mT, 50 Hz]: Effect of the Antioxidant CoQ10
995
1008
EN
Hoda
Hamdy
Applied Medical Chemistry
Thanaa
I.
Shalaby
Biophysics Department, Medical Research Institute
Azza
M.
Baraka
pharmacology Department, Faculty of Medicine, Alexandria University, Egypt
azzabarakamnh@gmail.com
10.21608/jhiph.2005.170515
The aim of this study was to provide a possible laboratory support to health risk evaluation associated with exposure to low frequency static and alternating magnetic fields [MFs] at flux density of 3 mT, and the possible protective effect of the antioxidant drug, CoQ10.
In this study, thirty male mice were exposed to a combination of static and alternating magnetic fields at flux density of 3 mT. Antioxidant drug [CoQ10] was administered at the beginning of MFs exposure. Superoxide dismutase [SOD] activity [U/mg protein] serotonin, and dopamine concentrations [μg/g brain] were determined in brain homogenates.
The results indicated significant elevation in SOD activity and concentrations of serotonin and dopamine, after MFs exposure. Such alterations could not be reported after administration of the antioxidant, CoQ10.
In conclusion: antioxidant drug has a beneficial effect on brain tissues against MF exposure.
Antioxidant CoQ10,Brain Neurotransmitters,Low Frequency Magnetic
https://jhiphalexu.journals.ekb.eg/article_170515.html
https://jhiphalexu.journals.ekb.eg/article_170515_d41d8cd98f00b204e9800998ecf8427e.pdf
High Institute of Public Health, Alexandria University
Journal of High Institute of Public Health
2357-0601
2357-061X
35
4
2005
10
01
Organochlorine Contamination in Fish from Red Sea, Egypt
1009
1022
EN
Nadia
Abou-El-Ela
Tropical Health Department, University of Alexandria, High Institute of public Health, Egypt
Aly
M A.
Abdallah
National Institute of Oceanography and Fisheries, Alexandria, Egypt
10.21608/jhiph.2005.170541
Organochlorine compounds were analyzed in three species of fish [Bouri, Moza, and Mousa], from three Egyptian areas [Suez, Hurghada and Marsa Alam]. Although all fish studied are bottom or near-bttom feeders, remarkable variations in concentrations between studied species were noticed. The MPI values recorded at the studied cities were in descending order: Bouri > Moza > Mousa. The highest concentration of pesticides was recorded in Suez Governorate fish [113.9 ng/g of dry weight] and the p,p’-DDE dominated over the other p,p’-isomers in all studied fish, while aldrin was the dominated in the studied cyclodiene compounds. However, hexachlorobenzene [HCB] was present in all the studied fish. Toxaphene was detected in all fish collected from Suez to Marsa Alam areas. Chlordane was not detected in fish from Marsa Alam. The level of organochlorine pesticides contamination in fish from the studied areas is relatively low and should not pose a health risk to consumers.
Egypt,Red Sea,organochlorine pesticides,Bouri,Moza,Mousa
https://jhiphalexu.journals.ekb.eg/article_170541.html
https://jhiphalexu.journals.ekb.eg/article_170541_d41d8cd98f00b204e9800998ecf8427e.pdf
High Institute of Public Health, Alexandria University
Journal of High Institute of Public Health
2357-0601
2357-061X
35
4
2005
10
01
A Clinical Evaluation Tool for Medical-Surgical Nursing Students at Banha University
1023
1038
EN
Nabila
A A.
Bedier
Adult Care Nursing Department, Alexandria University, Egypt
Hanan
G.
Mohammed
Medical-Surgical Department, Banha University, Egypt
10.21608/jhiph.2005.170552
Assessment of student nurse’s clinical skills is an important issue in nurse education. However, suitable instruments are difficult to design. The development of reliable measurements of student performance with predictive validity of role is a gold standard yet to be achieved. Two aspects of reliability have been well researched inter-rater and inter-case [candidate]. Inter-rater measures the consistency of rating of performance by different evaluators. The use of multiple evaluators across cases improves reliability.
So the aim of this study is to test content validity and inter-rater reliability of the evaluation tool for medical surgical nursing students at Banha University. The study was carried out in the Faculty of Nursing at Banha University. The inter-rater reliability was established by having the investigators and another qualified clinical instructors [who had more than three years experience as an instructor in the Medical-Surgical Nursing Department] evaluating the students during their practice in the four clinical areas: CCU, Orthopedics, Urology, and Neurosurgery simultaneously and independently, rating the same student. Both raters were not aware of each other scores to the entire students.
It can be conclude that this tool after testing the content validity was highly reliable between faculty members. It is recommended that Faculty of Nursing needs to establish clinical evaluation standards for all selected variables within its clinical area. These standards should include what to be observations should be documented.
A Clinical Evaluation Tool,Medical-Surgical Nursing Students,Banha University
https://jhiphalexu.journals.ekb.eg/article_170552.html
https://jhiphalexu.journals.ekb.eg/article_170552_d41d8cd98f00b204e9800998ecf8427e.pdf