High Institute of Public Health, Alexandria UniversityJournal of High Institute of Public Health2357-060133420031001Compliance to Recommended Infection Control Measures at the Ministry of Health and Health Insurance Dental Clinic in Alexandria68570219216310.21608/jhiph.2003.192163ENKhalid M.MansourDental Research Center, Ministry of Health and Population, Alexandria, EgyptMostafa M.Nour El-DinHospital Administration Division, Health Administration and Behavioral Science Department, High Institute of Public Health, Alexandria University, EgyptJournal Article20210831Infection control forms an important part of practice for all health care professionals and remains one of the most cost-beneficial medical interventions available. The aim of the present study was to investigate dentists' and nurses' compliance to recommended infection control [IC] practices and to investigate the appropriateness of sterilizing common dental instruments at the Ministry of Health [MOH] and Health Insurance Organization [HIO] dental clinics in Alexandria. The study was conducted at 3 MOH and 3 HIO dental clinics in Alexandria. Dentists' and nurses' infection control practices and sterilization methods were observed using observation checklists. Results of the present study showed variations in dentists' and nurses' compliance to the recommended infection control practices at both the MOH and HIO dental clinics in Alexandria. Perfect compliance was observed for a few recommendations including the single use of needles and local anaesthetic cartridges on each patient, whereas other recommendations were never followed such as flushing waterlines after each patient. Steam autoclaves were not used at any of the HI0 dental clinics and were infrequently used at MOH dental clinics. Recommendations for improving compliance to infection control measures at MOH and HIO dental clinics are presented.High Institute of Public Health, Alexandria UniversityJournal of High Institute of Public Health2357-060133420031001Risk Management in the Main University Hospital in Alexandria70372619216910.21608/jhiph.2003.192169ENNagah AFM.AlyDepartment of Health Administration and Behavioral Science, High Institute of Public Health, Alexandria University, EgyptHoda Z.Abdul-KaderDepartment of Health Administration and Behavioral Science, High Institute of Public Health, Alexandria University, EgyptAbdella A.ShehataDepartment of Health Administration and Behavioral Science, High Institute of Public Health, Alexandria University, EgyptJournal Article20210831Risk management program has become a necessary activity in the administration of a hospital. The present study focused on assessment of some aspects of risk management in Main University Hospital in Alexandria [MUHA], including fire prevention and control measures, performance of hospital staff in providing some patient care activities and procedures which have the potential of risk of infection, knowledge of hospital staff regarding prevention of some occupational illnesses, training programs relevant to employees safety, and the role of relevant committees in implementation of risk management activities. The study was conducted in one male general medical ward and one surgical ward in Main University Hospital in Alexandria. Six checklists were designed to collect data about fire prevention and control measures and five patient care practices. Two questionnaires were prepared for interview with nurses, housekeepers and chairmen of safety-related hospital committees namely: occupational health and safety committee, infection control committee and environment committee. The study revealed shortcomings of risk management in the MUHA , in spite of the presence of occupational health and safety committee, infection control committee and environment committee. These shortcomings includes: missing of some fire prevention control measures that were either related to design [emergency exit and fire resistant doors] or measures that are considered as being of little importance such as fire blanket, color code oxygen cylinder or label indicating oxygen in use, omission of hospital staff of some infection control measures in hand washing, urinary catheterization, cleaning, decontamination and storing process of thermometers, cleaning, and sterilization process of dressing instruments, wound dressing and pre-operative care, omission of patient's right to be informed about surgical procedure or anesthesia or any instructions before operation , lack of training programs or instructions related to employees' safety and safe work practices, lack of written protocols for safe work practices and lack of incident reporting mechanism. The study recommended that the three safety related committees should have a definite active role identified, agreed upon and totally supported by hospital administrator, developing written protocols for safe work practices and infection control practices, establishing training programs related to hospital hazards and safety measures and considering the recommended safety principles of ward design in new building or in case of extension.High Institute of Public Health, Alexandria UniversityJournal of High Institute of Public Health2357-060133420031001Equity in Access to Health Services for People in Poor Urban Areas in Alexandria73776219217210.21608/jhiph.2003.192172ENHoda Z.Abdul-KaderDepartment of Health Administration and Behavioral Sciences, High Institute of Public Health, Alexandria University, EgyptMona H A.HassanDepartment of Biotatistics, High Institute of Public Health, Alexandria University, EgyptJournal Article20210831This study was conducted to assess the prevalence and determinants associated with inequity in the utilization of outpatient or inpatient health services. Data was obtained from a cross-sectional study carried out in two poor urban areas in Alexandria, from March to May 2001, by interviewing 4154 individuals of all age groups. The Polytomous Logit Universal Models [PLUM] ordinal regression was used for multivariate analysis to extract the most significant determinants of the inequity of health services utilization and adjusted odds ratios with 95% confidence intervals were obtained. Dependent variables were the number of outpatient visits within 6 months and number of inpatient episodes within five years. Both dependent variables were categorized as no contact, 1-2 contacts and 3 or more contacts. Adiusted odds ratios showed that lower utilization rates are linked to younger age, male gender, working as clerical or skilled in contrast to manual work, lack of health insurance coverage, being the Ministry.of Health [MOH] a main site of care, absence of acute or chronic illnesses, living in separate house, high crowding index, and ownership of <6 electric instruments. Results suggest that despite the health system's universal coverage and free access, there is still some sort of inequity that could be overcome by extension of health insurance coverage, education and improvement of environmental conditions.High Institute of Public Health, Alexandria UniversityJournal of High Institute of Public Health2357-060133420031001Comparison between Wanted and Unwanted Pregnancy in Relation to some Aspects of Pregnancy and Labour76377419234810.21608/jhiph.2003.192348ENFatma A A.RomiaMaternity and Gynecological Nursing Department, Tanta University, EgyptAmina S.GoniedMaternity and Gynecological Nursing Department, Zagazig University, EgyptJournal Article20210901Each year women around the world experience 75 million unwanted pregnancies which can happen if the couple was not using contraceptions because of failed contraceptive methods or other individual reasons. The study was conducted from January to August 2002; A questionnaire sheet was developed to determine the impact of wanted and unwanted pregnancy on the nature of delivery and some aspects of pregnancy. Fifty percent of the studied sample was wanted and the other 50% of the studied sample was unwanted conceptions .Unwanted pregnancy for any women is considered a crucial problem , and it also causes future problems especially from the psychological and social aspects of her life. Further researches are required to explore women's knowledge as regards the presence of emergency contraception.High Institute of Public Health, Alexandria UniversityJournal of High Institute of Public Health2357-060133420031001A Study of Dental Caries and Treatment Needs among Drug Addicts in Alexandria77578619234910.21608/jhiph.2003.192349ENFayek El-KhwskyMedical Statistics Department, Medical Research Institute, Alexandria University, EgyptKaram A.El-HamidHigh Institute of Tourism, Hotels and Computer, El-Syouf, Alexandria, EgyptJournal Article20210901The purposes of this study were to assess dental caries and treatment needs and to investigate some risk factors associated with occurrence of dental caries among drug addicts. A random sample of 60 male subjects of drug addicts was chosen from all admissions to the ward of drug addicts in Maamoura Psychiatric Hospital in Alexandria. A questionnaire was designed and completed by interview with the patients to collect basic epidemiologic data. In addition, examination of dental caries was carried out with a mirror and probe, DMFT & OHI-S indices were measured. Most of drug addicts (78.33%) had decayed teeth. There was a big need for prosthetic appliances for many drug addicts. Out of eight variables entered in the model for multiple regression analysis, dental check up was the best predictor of DMF which means that irregular dental check up was associated with a higher DMF. A drug prevention program should be designed and implemented, offering the appropriate resources and/or assistance to drug addicts to improve safety and health.High Institute of Public Health, Alexandria UniversityJournal of High Institute of Public Health2357-060133420031001A Study of Periodontal Disease and Risk Factors in Pregnant Women78779819235010.21608/jhiph.2003.192350ENFayek El-KhwskyMedical Statistics Department, Medical Research Institute, Alexandria University, EgyptKaram A.El-HamidHigh Institute of Tourism, Hotels and Computer, El-Syouf, Alexandria, EgyptJournal Article20210901The purposes of this study are to assess the periodontal diseases & treatment needs and to investigate some risk factors associated with the occurrence of periodontal diseases in pregnant women attending MCH centers. A total sample of 200 women attending MCH centers in Alex were included in the study. A specially designed questionnaire was used for collection of data that serve the purposes of the study. The results of periodontal examination using a plane mirror & CPI probe and oral hygiene index [O.H.I] were assessed. The majority of pregnant women [98%] had periodontal diseases in comparison to [64%] among non pregnant women, out of six variables entered in the multiple regression analysis, vomiting during pregnancy was the best one variable predictor of increased mean number of sextants with pockets i.e vomiting during pregnancy was associated with a higher mean number of gingival pockets. There was a big need to periodontal treatment for almost all pregnant in the study sample. Preventive oral hygiene programs should be designed and implemented for maintaining healthy gingiva during pregnancy.High Institute of Public Health, Alexandria UniversityJournal of High Institute of Public Health2357-060133420031001Effectiveness of Clinical Instructors’ Teaching Behaviors as rated by First Year Nursing Students79981019236010.21608/jhiph.2003.192360ENThoraya Abdel WahabAdult Nursing Department, Faculty of Nursing, Alexandria University, EgyptJournal Article20210901<span class="s1">Clinical instructor evaluation by students is recognized as a valid source of data which facilitate changes in clinical teaching and improve quality of teaching. The aim of this study is to investigate the effectiveness of clinical instructor's teaching behaviors as rated by first vear nursing students after conducting clinical rotation at hospitals. The study was conducted at hospitals used for students training were Moassat, Medical Research Institute, and Alexandria Main University Hospitals. The sample included 60 students and 6 clinical instructors, in both clinical rotation of second semester. A designed questionnaire and routine evaluation student sheet were used. The results showed that there were some effective clinical teaching behaviors used [</span><span style="text-decoration: underline;"><span class="s2"><</span></span><span class="s1">80%], and other behavior were considered ineffective. In addition, it was found that more than 60 % of students gained excellent and very good score, 30 % gained good score and only 8.33 % gained satisfactory score.</span>High Institute of Public Health, Alexandria UniversityJournal of High Institute of Public Health2357-060133420031001Effect of Improving Knowledge and Performance of Caregivers Concerning 5 Child Maltreatment81183019298510.21608/jhiph.2003.192985ENRahma S.BahgatAssistant Professor of Pediatric Nursing Lecturer of Community Health Nursing, Faculty of Nursing, Tanta University, EgyptLatifa M.FoudaAssistant Professor of Pediatric Nursing Lecturer of Community Health Nursing, Faculty of Nursing, Tanta University, EgyptJournal Article20210905Child maltreatment is a common serious and under reported medical concern which hes become an increasingly important concern for community workers worldwide. They constitute major psychosocial and health problem all over the world. The aim of this study was to study the effect of improving knowledge and performance by educating the caregivers concerning child maltreatment. The total sample included 70 caregivers. They were divided into two groups, group A [40 care givers] working in governmental nursery school. Group B [30 care givers] working in private nursery schools.Questionnaire and observation check lists were designed to fulfill the aim of the study. Health education program was developed and implemented based on assessment of caregiver to improve knowledge and performance concerning child maltreatment. Caregiver's knowledge and perception took an average score. The present study revealed that there was significance difference between the mean scores of knowledge and perception regarding child maltreatment before and after the program. The reaction of governmental caregivers to different situation of child maltreatment. Significant difference was found in all situations except for abuse or neglect and leave disability, while the reaction of caregivers working in the privet school there was significa difference regarding all items in relation before and after implementation of the program except abuse or neglect, leave disability and ride the public transportation. Prevention of child maltreatment requires collaboration of all community workers including all the primary health activities on face with the problem through well established plan highlighting the goal.High Institute of Public Health, Alexandria UniversityJournal of High Institute of Public Health2357-060133420031001Effect of Irrigation with Chromium Enriched Brackish Water on Growth Parameters of Sugar Beet Crop83185219298710.21608/jhiph.2003.192987ENEl-Sebaie OEnvironment Health Department, High Institute of Public Health, Alexandria University, EgyptHussien AEnvironment Health Department, High Institute of Public Health, Alexandria University, EgyptAmer MAgriculture Institute Research Center, Alexandria, EgyptAhmed MEnvironment Health Department, High Institute of Public Health, Alexandria University, EgyptAbdul-Aziz MAgriculture Institute Research Center, Alexandria, EgyptJournal Article20210905The enhancement of industrial activities led to an increase of heavy metals in the AbSament, which affected badly soil properties, plant, groundwater, and human health. In envien the accumulation of salts within the soil produced harmful effects on plants by adeesing the osmotic potential of the soil solution. On the other hand, the needs to save igation water and the use of low water quality for irrigation were of high concern. So, the aim of this work is to investigate the effect of salinity and chromium in irrigation water and the interaction between them on the growth parameters of sugar beet. The sandy soil was collected from El-Sadat City, a newely reclaimed area, and analyzed chemically and physically, e.g., pH, EC. soluble cations, and anions. A completely randomized block design experiment was carried out which contained three concentrations of brackish water having EC 0.5, 4, and 8 dS/m and five concentrations of chromium were 0,5,10,20 and 40 ppm. The different saline water was enriched with the chromium concentrations to show the effect of chromium on the growth parameters of sugar beet. The EC of 0.5 represents the control of treatment. After 4 and 6 months, plants were collected and analyzed for chromium concentration, and their growth parameters were measured.From the obtained results, it can be concluded that the EC of irrigation water had not significantly affected the growth parameters except at EC 8 dS/m due to tolerance of sugar beet to salinity up to 4 dS/m. While the irrigation with Cr-enriched brackish water (Cr concentration ranged from 5 ppm to 40 ppm) reduced significantly the growth parameters of sugar beet. Both parameters of the two stages of growth showed significant correlation with the chromium. The reduction in fresh weight reached 85.7% and in dry weight was 89%, while in root size it reached 96%. Also, the data indicates that in spite of the insignificance effect of EC on crop productivity, yet the phytotoxic effect of Cr even at low concentration (5 ppm) was clear enough. In addition, the capacity of the roots to accumulate Cr increased with the increase of both Cr and EC in irrigation water. That is, a high portion of the total amount of Cr taken up by the plant was retained in the roots, where only a small amount was translocated to the shoots. So, this study recommended that sugar beet can be cultivated in reclaimed land with poor quality of water (i.e, water with high salinity up to 4 dS/m). But, the irrigation water must have low level of Cr content less than 5 ppm due to its toxicity and damaging effects on growth parameters of sugar beet and health hazards on human being. Also, the Egyptian Food Authority should establish maximum allowable limits for Cr concentration for irrigation water and for vegetables, fruits, and field crops to avoid its harmful health effects.High Institute of Public Health, Alexandria UniversityJournal of High Institute of Public Health2357-060133420031001Statistical Study of Adult Mortality in Alexandria: Times Series Analysis and Life Expectancy85387619326710.21608/jhiph.2003.193267ENNehad H.MahdyBiostatistics Department, High Institute of Public Health, Alexandria University, EgyptJournal Article20210906Mortality statistics for adult is important for understanding the health consequences of social inequality, human behavior, biological factors, and various other forces in human populations. The present study aimed to determine the trend and pattern of adult mortality from 1996-2002, to study the mortality statistics for the leading causes of death and to estimate the life expectancy for adult. A retrospective study was conducted in health information center in Alexandria to collect data about adult mortality aged 15-59 years from the year1996 to 2002. The present study revealed that the crude death rate increased from 3.22/1000 in 1996 to 3.88/1000 in 2002. A significant increasing trend in age adjusted death rates for both males and females [F =10.01, 8.49, P <0.05],the lowest age specific death rate [ASDR] was for adult females in all age groups, while the highest one was for male population. There was a variability in ranking cause of death by years but diseases of the heart and malignancy were the first and second leading cause of death in almost all the studied years among adult aged <45 and 45 years or more, by the year 2002, the proportionate mortality rate for heart diseases was [18.1% and 22.82%] of adult deaths respectively for the both age groups, and [14.4 % &15.35%] for malignancy. The following leading causes were accident, injuries and septicemia for those aged <45 years, and cerebrovascular and chronic liver diseases for those aged 45 years or more. The proportionate mortality rate from accidents demonstrated a steady increase among young adult [from0.50% in 1996 to 15 % in 2002] Death rate from heart diseases and accidents was significantky higher among males than females. A sharp increase in the death rate from all causes was noticed among adult aged 45 years or more, from 983.37/100,000 in 1996 to 1244.5/100,000 in 2002 .There was a significant decreasing trend of life expectancy 00and this was more pronounced among male population. Better focus of the specific disease burden for adult. Health education, screening measures, are different approaches to these problems for health improvement.High Institute of Public Health, Alexandria UniversityJournal of High Institute of Public Health2357-060133420031001Heavy Metal Uptake by some Plants Grown on Sludge-Treated Soil87789419327410.21608/jhiph.2003.193274ENEl- Sebaie OHigh Institute of Public Health, Alexandria University, EgyptAbd El-Monem MAgricultural Institute Research Center, Alexandria, EgyptAhmed MHigh Institute of Public Health, Alexandria University, EgyptAhmed AAgricultural Institute Research Center, Alexandria, EgyptJournal Article20210906Agricultural use of sludge has been increased as a mean of disposal and beneficial reuse. However, elevated concentrations of heavy metals on land receiving sludge pose publiC concern. The amount of metals uptake by the plants depends on the content of the soil metal, plant species, and soil parameters particularly pH. The aim of this study was to investigate the effect of lime in reducing heavy metals uptake by corn grown in the sludge-treated sandy soil. In addition, the residual effect of lime on heavy metals uptake by fababean grown in rotation with corn was studied. The plants were sampled at the harvesting time beside the grains and pods hull and all samples were examined for heavy metals content [µg/g] and uptake [µg/plant]. The results revealed that lime application to sludge-treated sandy soil decreased Zinc and Nickel in the grains of corn. However, the residual effect of lime in sandy soil decreased Zinc, Nickel, and Cadmium contents of fababean grains and Copper in the fababean pods hull below the recommended toxic levels of these metals. So, it is recommended to apply lime to sludge-treated sandy soil to minimize the uptake of heavy metals by corn and fababean and to reduce the public health effects of these heavy metals.High Institute of Public Health, Alexandria UniversityJournal of High Institute of Public Health2357-060133420031001Prevalence of Obesity in Egypt89592619352610.21608/jhiph.2003.193526ENTawfik A.AAssistant Consultant, Child Health, National Nutrition Institute, Cairo, EgyptHathout M.HHead of Field Studies and Researches Department, National Nutrition Institute, Cairo, EgyptShaheen M.FEx-Dean of National Nutrition Institute, Cairo, EgyptJournal Article20210907The prevalence of obesity is rising steadily all over the world, in developed as well as in many developing countries. The scientific community supported by WHO urged governments in different countries of the world to set strategies to prevent and control the giobal epidemic of obesity. To develop such strategies, a thorough assessment should be preceding at the national level to define the extent and magnitude of the problem. Hence, the Importance of this national survey. This study aimed, generally, at assessing the prevalence and types of obesity among Egyptians, as well as to obtain Egyptian norms of weight and height in each gender, in different age groups, and geographical areas. The survey also helps to build up a database for future surveillance on obesity in Egypt. Sampling of this survey was designed to be nationally representative of total sample including 31798000 individuals of different age groups from both sexes. Governorates of Egypt were stratified into six strata. From each stratum, one governorate was subjectively selected for the study and the following geographic areas were chosen; Cairo [the capital], Coastal represented by Beheira, Suez Canal represented by Suez, Lower Egypt represented by Gharbia, Upper Egypt represented by Quena and Beni-suef, and Frontier governorates represented by El-Wadi El-Gadid and Matrouh .In Cairo, three districts were randomly selected from contrasting socio-economic standards. In urban/rural governorates, the capital city was included in the sample with probability equal to one. A rural area [village] affiliated to the capital city was selected with probability proportionate to size. Sample design and size allow estimates to be obtained both on the national and regional levels. A sample size of 350 households/city or village allow estimation of the prevalence with a precision of 3%, error of 5%, and power of 80%.These estimates were obtained for rural and urban areas, males and females, and for the three social classes. For propose of date analysis, different strata according to age groups was done; preschool age [2-6y], age group [6-12y], age group [12-19y], and adults [20-80y]. The sample individuals were interviewed to collect some sample characteristics; they were also subjected to anthropometric measurements [weight, and height]. Indicators used for these anthropometric measurements are based on WHO, 1995 and WHO, 2000. Results of the national survey on obesity in Egypt concluded that overweight and obesity prevalence is reaching an alarming rate. The problem appears to be increasing rapidly in adults, adolescents, as well as in children. The prevalence of obesity is higher in urban than in rural population. It is apparent from the study that women have higher rates of obesity than men, while men have higher rates of overweight. The study revealed that the prevalence of overweight and obesity increased with age, as prevalence of overweight among men and prevalence of obesity among women started to increase at age 20y-<30y to reach the peak at 50 years. After that, overweight and obesity decreased slightly among men and overweight remained higher among women. The study recommends a spectrum of four key strategies for obesity management: prevention of weight gain; promotion of weight maintenance; management of obesity co-morbidities; and promotion of weight loss. Harmonizing national food and nutrition policies and public health policies should integrate obesity with non-communicable diseases [NCD] control program.