Traditional medicine: perceptions and experience of medical students from Egypt and Saudi Arabia, a comparative study

In view of the increasing popularity of traditional medicine [TM], it is imperative that medical students, the health professionals of tomorrow, possess adequate knowledge on the topic. The incorporation of TM into medical curricula is handled quite differently by different institutions and countries. To assess the knowledge, attitudes and experience of Alexandria and Saudi medical students about TM and compare between them, and to identify their perceptions and opinions about applicability and the importance of its integration into the medical curriculum. This is a comparative descriptive study. A questionnaire-based cross-sectional survey was done on 489 fourth year medical students selected randomly from Alexandria medical college and 85 fourth year students selected from Tiabah medical college [Saudi Arabia]. Comparison between the two groups and different variables were tested using the x2-and Mann-Whitney tests of significance, Taibah students were more aware of and believed that some of the TM modalities are useful. The two groups of students lacked knowledge about their safety and efficacy. Taibah students were significantly more experienced in TM than Alexandria students. Most of the students in the two groups believed that TM should be used in conjunction with conventional medicine and that, if given adequate training, they would incorporate it in their future medical practice. Most students in the two disciplines favored incorporation of TM into the medical curriculum and the difference was not significant. Despite being aware of the usefulness of TM, only a few medical students had pursued further knowledge. Therefore consideration for incorporation of TM in medical curriculum may be helpful and necessary

Risk factors of childhood acute lymphoblastic leukaemia: a case-control study

The Alexandria Cancer Registry in 1992 reported that Acute Lymphoblastic Leukaemia [ALL] constituted 24.7% of childhood malignancies among male children and 19.2% among female children. This relative high magnitude of ALL in Egypt needs to be studied in depth. The aim is to reveal the different risk factors related to development of the childhood ALL and provide essential data for planning preventive programs. A hospital based case control study was carried out in two hospitals: Alexandria University Children Hospital and School Students Hospital. Data collection was carried using a structured interview schedule. All newly diagnosed cases of ALL during the period from March, 2003 - 31[st] December, 2004 were included in the case series [90 cases]. For each case, two controls were randomly recruited [180] of matched age and sex with ALL cases. The mean age of cases was 4.58 +/- 2.35 years. The ratio of boys to girls was 2.1:1. The final model of multiple logistic regression analysis revealed that first born or only born child and birth weight >/= 3500 gm, consanguinity, fathers' smoking before conception, child exposure to hydrocarbons/benzene, electromagnetic field sources, family history of blood cancers, maternal history of prior fetal losses, some infections, allergies, exposure to radiation or intake of medications during pregnancy, also different childhood diseases all were significant contributing factors that increased risk of ALL, whereas exclusive breast-feeding and early day-care attendance were associated significantly with decreased risk of ALL. The consistency of results of current work with several other research works can support the identification of specific possible risk factors. The research points to specific environmental, social, health and biological factors that need to be addressed. Further research is needed. The data presented in this work can be used to formulate hypotheses

Motivational readiness of Alexandria overweight and obese medical students to weight loss behavior

The prevalence of obesity has reached epidemic proportions among Alexandria medical students. Physical inactivity and unhealthy eating habits are major risk behaviors for obesity. Each behavioral risk factor has its own set of knowledge, attitudes, intentions, decisional balance, self-efficacy, and barriers to overcome. Understanding the stage of readiness to control weight and its correlates may be particularly important to tailor interventions to an individual's level of motivational readiness to change behavior. was to determine the stages of motivational readiness to change to weight loss behavior among overweight and obese medical students in Alexandria and to identify factors related to readiness stages. A cross sectional survey was carried out from 1[st] April to 31[st] July 2005. A total of 310 medical students, who were identified as being overweight or obese in a previous anthropometric survey, represented the target population. Data was collected both qualitatively and quantitatively. Students' motivational readiness to change to several weight-related behaviors was assessed using the Prochaska's stage of change conceptual framework. Bivariate analyses were performed to describe factors associated with stages of readiness to change. Ordinal logistic regression was also conducted to determine predictors of being in advanced stages of readiness to change. Regarding intention of medical students to control weight, precontemplators constituted more than a fourth of the sample [26.77]. More than a tenth [12.26%] was in the contemplation stage. The highest proportion of students [50.65%] was in the preparation stage of change. However, the least [10.32%] were in the action stage. Statistical significant associations were observed between age of the students, their academic level, monthly income, BMI and stage of motivational readiness to weight loss behavior [P = 0.001, 0.001, 0.032, and 0.001 respectively]. No statistical significant differences were observed between students in different stages of readiness to change as regards previous attempts to lose weight [X[2][12] = 7.124, P = 0.850], mean recent weight gain [P = 0.521] ml mean doctor's visits in the last year [F = 1.284, P = 0.741]. However, students in the preparation and action stages reported recent weight change more significantly than those of early stages [P-0.014]. A statistical significant association was observed between expected weight loss and stage of motivational readiness to change [P = 0.018]. The four questions assessing attitude towards food, dieting and exercise were significantly associated with stages of readiness to change [P = 0.006, 0.040, 0.001, and 0.006 respectively]. Also, all of the questions regarding perception of what others think about weight were significantly associated to students' stage of motivational readiness to change. Statistical significant associations were observed between students' self-rated wight, body weight satisfaction and stage of motivational readiness to change [P = 0.008, and 0.001]. Moreover, each of the five Pros [perceived benefits] scale questions was significantly associated with stage of change to weight loss behavior. Students in the preparation and action stages were significantly more interested to discuss weight related behaviors with health care professionals, than those in precontemplation and contemplation stage. Lack of self-efficiency [confidence in ability to successfully make changes], unavailability of facilities and equipment for physical activity, and lots of stresses were the cited barriers that were significantly associated with the stage of motivational readiness to weight loss behavior. BMI [OR = 1.09], expectation of ideal body figure [OR = 2.03], attitude scale score [OR = 2.63], body weight satisfaction [OR = 1.93], perceived risks [OR = 1.94], Prosscale score [OR-3.64], and interest scale score [OR-1.72] were identified as significant predictors associated with stage of motivational readiness to change in the logistic regression model. The stage of change model is a promising approach for designing more appropriate interventions. It is particularly encouraging that in the present study, most students were in the ready stage for weight loss, dietary practice, physical activity change and willingness to communicate with health care professionals regarding these lifestyle changes. Students in the ready stage are the most amenable to University health interventions. Emphasizing the Pros for weight loss behaviors, decreasing the Cons for exercising and dietary practices, and increasing confidence in making change are strategies that can be used to help students become more ready to change behaviors for weight control

Risk factors of congenital pediatric surgical birth defects: a case control study

Birth defect is a global health problem. Serious birth defects are life threatening or have the potential to result in disability. In Egypt the prevalence of birth defects is increasing, it reached 3.2% of all births [1998]. The present study was earned out to identify different potential risk factors for birth defects and estimate the magnitude of risk for each factor Identified. A case control study was carried out in the Pediatric Surgical Department of El Shatby University Hospital in Alexandria. A structured interview schedule was used to collect data. Gastrointestinal tract [GIT] is the most commonly encountered system for birth defect [53.0%]. Only 11.0% of cases were diagnosed during pregnancy. Boys were more encountered than girls. The final model of multiple logistic regression analysis revealed that high maternal education, unplanned pregnancy, medical problems prior to pregnancy and eating contaminated raw food were significant contributing factors that increased risk of birth defects. No significant associations were found between cases and controls as regards consanguinity parental age, housing and working conditions, family and reproductive history. A pre- pregnancy visit was recommended to identify risk factors and allow for appropriate testing and guide for better changes to improve chances of having a healthy baby

Predictors of clinical outcome among adolescents with first episode schizophrenia in Alexandria.

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 contributing 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% Cl=1.29-9.61], unskilled fathers' occupation [Adjusted OR=1.34, 95% Cl=1.22-3.03], low mothers' educational level [Adjusted OR=4.92, 95% Cl=2.42-9.71], and negative parental rearing style [Adjusted OR=2.51, 95% Cl=1.67-4.471. 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% Cl=2.64-6.83, P<0.001, and 2.63, 95% Cl=1.89-5.72, P=0.0081. 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