Assessment of needle stick injuries and related knowledge among health care workers participating in an infection control-training program at El Minia University Hospital

Needle stick injuries are an important and continuing cause of exposure to serious and fatal diseases among health care workers [HCWs] who suffer daily accidental occupational exposure to needle stick injuries during the course of their role of caring for patients to determine the burden of needle stick injuries, its causes and knowledge related to it among HCW participating in an infection control training program at Minia University Hospital [MUH]. A well-structured pre- and post-training questionnaires about general infection control knowledge was used and included also 10 basic knowledge questions and inquiries about incidents of needle sticks, its frequency and cause, and history of hepatitis B vaccination. A total of 278 physicians and 56 dentists participated in this study. Dentists were younger than physicians, and had a slightly higher knowledge score than physicians. We found that 63.2% of the participating physicians and dentists experienced at lease one needle stick during their practice. About 61% and 71.4% of the physicians and dentists experienced at lease one needle stick during their practice, respectively, suggesting that dentists were more likely to be exposed to needle stick injuries than physicians. The overall mean of needle stick injuries per year among the participants was 4.42 [ +/- 1.83]. However, the average numbers of sticks were 4.51 [ +/- 1.87] and 4.03 [ +/- 1.77] among the participating physicians and dentists, respectively. Self-inflicting injuries during bending or recapping of a used needle was the most frequent cause of needle sticks [41% for physicians and 59% for dentists]. Nearly 72% of the participants were categorized as excellent in basic knowledge regarding infection control. Also, knowledge of needle stick management significantly improved by 63.3% and 7.8% post-training among dentists and physicians, respectively. Importantly, as the knowledge score increases, the liability to be injured by needles decreased. On the other hand, physicians were three times more likely to be vaccinated against Hepatitis B virus [HBV] than dentists although the overall vaccination rate was very low [15.2% vs. 4.2% among physicians and dentists, respectively]. needle stick injuries are common among HCW of MUH and recapping and bending of needles are prevalent inappropriate practices that increase the likelihood of needle sticks. Ensuring that HCW are properly trained on safe use and disposal of sharps will make this practice safer

Comparing three clinical screening tools in identification of geriatric depression in a rural community setting

With the demographic transition, the elderly population is growing all over the world. Depression, currently considered as the 'disease of the century' ranks among the most significant health problems in older adults causing substantial morbidity, disability, functional decline, and mortality. Depression is reported in 13% of elderly community dwelling, and 24% of older medical outpatients, but there is a consensus that geriatric depression is underestimated. This is because older people in the community may not have contact with health services and because physicians may not screen for depression using the too lengthy tools leading to compounding of the depression problem. Efforts are needed to locate and identify those at risk and to provide care relevant to their needs. The Geriatric Depression Scale [GDS] is a screening instrument for depression in the elderly. Using a shortened GDS can greatly facilitate identification and assessment of depression in clinical and community settings. Determining the toll of depression among geriatric rural population in El Minia as well as to assess the value of application of the shorter version of geriatric depression scale and two-questions from PRIME-MD for screening of depression. The 15-item GDS, 5-items GDS and two-questions from PRIME-MD completed by all participants during community visit. 165 community dwellers aged 60 years and older were chosen randomly to be participated in the study and subjected to interview questionnaire administered to them at their household in Tehna Elgabal village, El Minia Governorate. ROC curve analyses showed .good agreement between 15-GDS, five-GDS and two-items PRIME-MD screener. Using GDS 15, it was found that nearly 30% of the participated geriatric rural populations in El Minia were moderately to severely depressed, while as 37.6% of them were categorized as so using GDS 5. Two items PRIME-MD screening categorized 24.2% as moderately- to- severely depressed. GDS was found to have a good specificity [0.85] in a representative sample of community-dwelling oldest old for the presence of major depression. This scale was developed as a basic screening measure for depression in older adults. 15-GDS is correlated to 5-GDS and Two items-PRIME-MD screener [r = 0.53, P < .000, r = 0.44, P =0.000] respectively.ROC curve analyses showed good agreement between 15-GDS and the 5-GDS as well as the Two-items PRIME-MD screener. It was found that 2 items [measuring depressed mood and anhedonia over the past month] demonstrated good sensitivity [88%] but only modest specificity [60%] compared with the 15-GDS. It was found that 5-GDS demonstrated excellent sensitivity [92%] but only fair specificity [50%] compared with the 15-GDS Interview Schedule. Nearly one fourth of community geriatric participated in the this study were found to be moderately to severely depressed using the 2-item PRIME-MD depression screening questionnaire which was found to be an efficient and effective way of separating patients with milder levels of depression from those with moderate to severe impairment. It was found that the short forms were adequate substitute for the long form and tends to be more suitable to be incorporated and widely used in primary care and community setting

Predictors of disability among elderly population in Rural Minia

A key measure of functional independence in elderly is the ability to do activities of daily living [ADL] without the assistance of another person. 506 rural population in El Minia, aged 60-80 yrs were subjected to interview questionnaire, where daily living [ADL] and self-rated health were assessed. Katz's ADL items of disability [bathing, dressing, transfer, toileting, and eating] were used to construct a three-level five-item ADL scale: not disabled [no disabilities], moderately disabled [1-2 disabilities], severely disabled [3-5 disabilities]. household based cross sectional study using an interview questionnaire.To assess the functional capacity and self-rated health of rural aging. Nearly 10% of the participants can be categorized as being disable with variable levels of severity. Either moderate or severe disability was found to be more prevalent among females where nearly 67% and 54% of those who classified as moderately or severely disable respectively were females. Female elders were more likely to report poor health status than males. The results of this study revealed that the most common causes of disability were DM [22%], Osteoarthritis and fracture [20%] followed by COPD [16%], eye problems [8%] and CVDs [6%]. Osteoarthritis and diabetes mellitus were significantly contributing to the occurrence of disability. About 68% of the participants had a positive history of health problems, 30% were bed ridden and about 24% were hospitalized for various reasons at some time during the last year. Almost 7% and 48% were self-rated their health as poor and fair respectively. Mean number of days staying at bed or admitted to hospital as inpatients during the last year were significantly more among elders with disability than their counterparts without disability [142 and 14.5 days vs. 22.2 days and 14.3 days] respectively. Rural Elderly population experiencing disabilities were significantly belonging to lower socioeconomic class. Unmarried status was found to be significantly related to both occurrence of disability and poor health status, where nearly up to 54% of either moderately or severely disabled were unmarried and about 66% rated their health as poor. Disability in ADL and poor health were prevalent among nearly 10% and 7% of elderly population in rural Minia respectively. Diabetes and Osteoarthritis were more prevalent among disable and were contributing significantly to it. Disability was also associated with age, low income, female gender, and single status. develop adequate responses to the problem of disability

Perception of violence against women by El Minia University female students

Violence against women [VAW] represents a staggering public health problem which refers to many types of harmful behavior directed at women and girls because of their sex in forms ranging from verbal abuse to homicide throughout the life cycle and derives essentially from some cultural patterns that perpetuate the lower status accorded to women in the family, the workplace, the community and society. Obviously, VAW is considered a profound health problem which may cause a range of bad outcomes as adverse mental health conditions, such as depression, anxiety, and low self-esteem, poor physical health consequences, such as gynecological complications, Physical injuries, chronic headaches, sleep disturbances, nausea, behavioral problems that further damage their health or risk their lives, such as substance abuse, alcoholism, and increased risk of suicide attempts and increased use of health services up to homicide. In Arab and Islamic countries, domestic violence has an increasing frequency and serious consequences. Surveys in Egypt, Palestine, and Tunisia show that at least one out of three women is beaten by her husband. Knowledge about VAW causes, consequences, and protective measures are needed to be studied. To examine awareness of University female students about violence, and to explore their knowledge and attitude towards VAW. A cross sectional study of a total of 152 students from education and nursing faculties completed a self administered questionnaire including Sociodemoraphic characteristics of respondents; parents, knowledge perception, attitudes of causes of violence, history of self experience to violence; friends and/or relatives exposure to a violence. Their believes about what causes violence and their opinions regarding methods to prevent it. Out of 152, 68.4% of the students agreed that cirumcision is a type of violence and 80% of them reported that it causes physical, psychic and sexual harm. Almost 85% of the sample considered early marriage, as a form of violence, and about 88% stated that low education is another form of violence against women. The majority of the respondants 94.7% and 98% agreed that physical abuse and rape respectively are forms of violence. About half of these students are exposed to some sort of violence [53.7%]. More than half of these females beileved that the most common reason for violence is low socioeconomic level [62%]. Nearly half of the female students [52.%] believed that VAW is on the rise [upward trend] than before. About 39.5% of study sample believed that female work, low socioeconomic status, weak religious belief, TV drama and addiction, altogether, are the causes of this increase. The police were informed about violence experienced by others by only 19.8% of the sample. Nearly all these students [95.4%] believed that protection from VAW can effecetively be done through religious institutions and increase female education [90.8%]. Most female university students in El-Minia University are aware about most types of VAW. About half of these students are exposed to some sort of violence [53.7%]. Women work, low socioeconomic level, weak religious belief, different media and addiction are the causes of increased VAW. Educating girls to their fullest potential, victims of violence need reliable counseling and support programmes, women should be educated about their human rights and empowered to protect their own safety

Tumor necrosis factor alpha as a parameter used in assessing patients with acute myocardial infarction with and without acute left sided heart failure

To clarify the use of tumor necrosis factor alpha in the course and prognosis of acute myocardial infarction and its relation to development of left sided heart failure following myocardial infarction. This case-control study was conducted on 30 persons, 20 of them were newly diagnosed as acute myocardial infarction [AMI] [group A] and 10 healthy age and sex-matched served as controls [group B]. All subjects [patients and controls] were subjected to full medical history and family history of coronary heart disease, thorough clinical examination, chest X-ray post- anterior [PA] and lateral, electrocardiography [ECG], measurement of cardiac enzymes [CPK, SGOT, LDH, CBC, CRP and ESR], estimation of plasma TNF alpha for both patients and controls by ELISA. AMI patients [group A] had a highly significant increase of serum TNF alpha level on admission, especially with those with signs of heart failure, significant increase of its level at 24 hours and insignificant increase of its level at 48 hours compared to healthy control [group B]. There was a significant positive correlation between TNF alpha and CPK level on admission in AM1 patients. There was a significant negative correlation between them at 24 and 48 hours

Assessment of some MCH activities in Maghagha District, El Minia during the year 1997

The aim of this work was to assess some MCH activities using antenatal care, maternal health status and outcome of pregnancy as indicators and to discover the shortcomings in performances, process and outcome in some MCH services and suggest a plan for improvement to be applied on the light of this evaluation study. This study examined the data collected from 12 randomly selected out of 23 rural units and the two urban maternal and child health centers in Maghagha District, El-Minia Governorate from July 1997 to December 1997. Monthly reports of different MCH activities during this period were collected, revised, summarized and computarized for processing and analysis. A total of 416 and 1589 pregnant women were registered in urban and rural units, respectively, during the six-month study period

Perception of current smokers towards smoking and its health hazards in Bany Ghany village El-Minia governorate

The seriousness of health problems caused by tobacco warrents serious attention. The extent to which smokers know the health implications and addictive nature of cigarettes is critical in control of tobacco use thereby, assessment of people's understanding to the health risks of smoking can estimate public awareness which is necessary for tobacco control. This household cross-sectional study was conducted in Bany Ghany village which is 20 km south of El- Minia City with 20 000 inhabitants in September, 2000. The aim of this study was lo describe the knowledge profile of current smokers regarding smoking and its health consequences, and to measure the health toll of smoking on heavy smokers. A household survey was undertaken and the initial screening indicated that 3440 villagers are currently smoking in Bany Ghany with a total prevalence of 17.2 percent. About 20 percent of current smokers [698] were randomly selected from the total smokers to be interviewed. An interview questionnaire was used which include demographic data and smoking history, amount and duration and questions regarding knowledge and encompass most of the possible health risks posed by smoking. Of all smokers interviewed, two hundred heavy smokers [25 or more cigarettes per day] were further subjected to explicit clinical examination. About 52.3 percent of the current smokers were illiterate. 87.8 percent were married and 7 percent were unemployed. Nearly 70 percent initiated smoking as a response to peer pressure and influence of friends. Out of 698 smokers interviewed, 96 percent had the knowledge that smoking is hazardous to health which is risk taking behavior. Almost 30.8 percent were heavy smokers. 40.2 percent were moderate smokers and 29 percent were mild smokers. Nearly two-third of the sample smoke cigarettes alone, 16. 7 percent smoke in addition shisha or Goza, and only 7.9 percent smoke shisha or goza alone. Mean numbers of cigarettes smoked per day was 17.7 +/- 11 25. Mean age of the study sample was 42.1 +/- 132, the mean age of smoking initiation was 20.1 +/- 9.1, and the mean cost of smoking per month was LE 53 +/- 75.5. Mean monthly income was 150.8 +/- 106.3. Mean numbers of quitting trials was 3.2 +/- 3.1. Among the causes of failure of previous trials of quitting were lack of inner drive in 66.7 percent, peer pressure represented 15.7 percent, being not serious in 12.9 percent and lastly not convinced was reported by 4.7 percent of the smokers. Reasons behind resorting to quitting trials was found to be related to occurrence of health problems in 35.2 percent of the cases, economic strain in 20.8 percent of cases and 40. 8 percent of cases were due to the knowledge that smoking can pose health risk, and social conflicts were found to be responsible for quitting trials in 3.2 percent of cases. Mean duration of smoking was found to be significantly longer among those who denied any relation between smoking and cancer or heart disease. On interviewing and examining heavy cigarette smokers, cardiopulmonary manifestations was diagnosed in the form of chronic cough, hypertension and corpulmonale in 55 percent, 8 percent and 15 percent of the total heavy smokers respectively. Community intervention trial for smoking cessation is recommended to change smoking behavior, achieve and maintain cessation

Epidemiology of streptococcal infections and its sequalaes in a rural area in the age group [5-25 years]

In this study, the burden of streptococcal infections and the most prevalent sequelae in the community was studied in a rural area in the period from 9/9/1999 to 16/9/1999. Descriptive study with house to house visits were undertaken to pick up those subject [age 5-25 years] of both sexes having subjective sore throat for referral for further examination and investigation. Two hundreds patients complaining of sore throat presented to the health center during one week study period were interviewed and filled a questionnaire including sociodemographic and medical history. Clinical examination, echocardiography, abdominal sonography, ECG and complete urine analysis were done to all patients. Males represented 55%, the mean age was 12.7 +/- 6.4, 18.5% were married, 43.5% were students and 13.5%were smokers. Out of 200 examined, 171 had shown to have sore throat and 29 were free. Post history of repeated sore throat was found to be 44% of whom 30.5% received treatment. Recurrent attack of fleeting arthritis were15.5%. Fainting attacks were complained by 18% of the total sample. Renal problems was found in 19.5% of the total. Heart examination using echocardiography revealed that 4.5% of the total had abnormal findings of whom, 3% had mitral stenosis and 1.5% had combined mitral stenosis and mitral regurgitation

Risk factor patterns in a sample of adult population in El Minia, Egypt

A descriptive study was conducted to assess the risk factors for chronic diseases among adult population in El-Menia. This was achieved by recruiting three groups of individuals; medical students, university employees and Demsheer villagers. Demsheer is a village located nearby El-Menia city which was randomly selected and their inhabitants were visited house-to-house and invited to participate in this study. Four hundred participants completed the questionnaire which included questions about personal behaviors regarding smoking and dietary habits as well as the levels and types of activity. Food items were selected to include the most important nutrient contributors in the diet. It also included history familial occurrence of chronic diseases [hypertension, diabetes, heart diseases, cancer and obesity]. Out of 400 responders, 91 were faculty students, 107 were university employees and 202 were villagers [Demsheer, El-Menia]. The mean age was 32.7 +/- 11.4, males constituted 53.8% of the total sample. The mean consumption of milk was found to be less than one cup per day [0.8 +/- 0.9] and the mean consumption of fruits is [101 +/- 0.9] serving. One out of seven females eats four or more serving of fruits, while one out of eight males do so. Almost 50.7% of males, 46.5% of females add extra salts and 24.2% of males and 11.9% of females eat too much fat. Of the 400 participants in the study, 27% were ranked to be sedentary according to their self reporting. Walking is the most popular type of activity reported [49.5%]. Out of 185 respondents females, 68.6% were ranked to be sedentary in comparison to 50.3% out of 215 males

Value of abdominal sonography in rapid assessment of acute abdominal pain in a peripheral health care facility in a village in El Minia Governorate

The aim of this study was to assess the role of portable sonar in improving the health outcome of acute abdominal pain patients through early diagnosis in a peripheral health care facility. All patients with the main complaint of acute abdominal pain and presented to the health center of a village in El Minia from January to March 2000 were interviewed for history taking about accompanying symptoms and were subjected to abdominal examination, blood pressure measurement and abdominal sonography, laboratory investigation [Renal function tests, liver function tests, blood glucose] as well as ECG. Patients with chronic abdominal pain were excluded from the study. It was recommended to supply some of the key peripheral health care facilities with such a screening package including portable sonar and to train primary health care providers to use it as indicated as to minimize the complications resulted from delayed diagnosis and referral. It will be useful to design a standard checklist for the common conditions to be used for the management of patients in peripheral health care facilities