[Atrial septal defect in adult: usefulness of surgical closure]

The atrial septal defect [ASD] is one of the most common congenital heart diseases in adults. The objective of our study is to determine the value of the surgical closure of ASD in adults. Between January 1990 and December 2006, 87 adult patients underwent surgical closure of ASD. The mean age is 28 years; eighty one patients [93%] were in NYHA class I or II. All patients were operated on with extra corporeal circulation. There were 10% post operative complications, no early or late death. Surgical closure of ASD in adults given good results and in spite of percutaneous procedures progress surgery keeps some specific indications

Coping strategies of mothers of children with cardiac problems

Assessment of coping strategies is important in planning of health education programs to enhance coping. The aim of the present work was to assess the knowledge and attitude of mothers concerning cardiac problems, to assess the coping strategies of mothers of children with cardiac problems, and to identify some predictors of the coping strategies. A cross sectional study of 187 mothers of children with cardiac problems who attended the cardiology school health insurance clinic of Sporting Student's Hospital in Alexandria with their children within a period of one month was conducted. Every mother was subjected to the modified Jalowiec coping scale to assess the coping strategies. Knowledge and attitude of the mothers were assessed through a pre-designed interviewing questionnaire. The results showed marked variability in correct responses to various statements about cardiac problems. However, most of mothers showed poor knowledge [87.17%] and about half of them [46.0%] showed negative attitude. These figures were significantly higher among mothers of children with congenital heart defects [CHD] than among those whose children suffer from rheumatic heart disease [RHD]. The most commonly used coping method was [Pray; trust in god] [92.5%], followed by [Accept the situation as it is] [88.0%], and [Hope that things will be better] [73.5%]. More than half of the mothers [55.5%] reported that they always [Resign themselves to the situation because it is their fate] while 28.0% reported that they always [Worry]. The percent mean score of use of problem-oriented coping methods was nearly equal to that for affective-oriented coping methods. Duration of illness [p<0.01], previous hospitalization [p=0.01], and attitude of mothers to illness [p=0.05] were all significantly associated with coping strategies. However after adjustment for other variables, high percent mean total coping scores were more likely among mothers of children with longer disease duration and those whose mother showed negative attitude towards cardiac problems [p<0.05]. Health education programs are needed to enhance coping strategies, knowledge, and attitude of mothers of children with cardiac problems. However, high coping strategy scores are significantly associated with the longer duration of illness and the negative attitude of mothers, possibly due to prolonged exposure to stress and the feeling that their children are different. Support group for parents is a highly recommended strategy to help a family benefit from communication with others who share common concerns, interests, and goals

Street children in Alexandria: profile and psychological disorders

Today developed and developing countries are facing the problem posed by street children. The continuous and unrestrained exposure to the street and its associated lifestyles makes these children vulnerable to a range of health, social, and other problems. The aim of the present work was to assess the profile of street children and their living condition from different aspects, in addition to assessment of some psychological disorders among them. A cross-sectional study was conducted on 50 street boys present at El-Horreya institute for Children Community Development, which is a non-governmental organization in Alexandria. An equal control group of 50 school boys were selected at random from the first and second grades of one governmental boys preparatory school of the Middle District of Alexandria. Every child was subjected to an interviewing questionnaire. The Arabic version of Revised Ontario Child Health study scale, children Depression Inventory and the Cooper-Smith Self-Esteem Inventory, were used to identify children with conduct disorder, depression, and assess self-esteem, respectively. Anthropometric measurements including weight and height were measured for each street child and BMI was calculated. The present study revealed that more than half of street children [58.0%] came from large size families, about three-quarters [72.0%] reported insufficient income, most of them had low educated parents and unskilled fathers, 80.0% reported not living with both parents before coming to the institute, and 91.2% reported bad inter-parental relationship. Family history of drug abuse, alcohol intake, smoking, and imprison were significantly higher among street children compared to school children [p<0.001]. The present study showed that 74.0% of street children were smokers, 22.0% reported drug abuse, and 90.0% were dropped out of school. Family violence, beating, and beating without reason significantly increase the risk of being a street child [OR= 31.90, 2.0, and 44.58, respectively]. The risk of conduct disorder, depression, and low-self esteem were significantly more among street children compared to school children [OR= 44.59, 14.64, and 9.66, respectively]. The main cause of leaving home was beating, 80.0% lived in street after leaving home, 72.0% their main source of living was begging, and most of them faced problems in the street especially with the police. The results revealed that 92.0% were satisfied with the institute and 86.0% prefer to stay in the institute than returning to the street. Planning programs to prevent, protect, and rehabilitate street children are essential

Health-related lifestyles and risk behaviours among students living in Alexandria University hostels

We assessed health - related lifestyles and their determinants among 600 Alexandria students living in university hostels. Data were collected by questionnaires, and anthropometric University and blood pressure measurements were taken. Most students were not satisfied with their situation in terms of accommodation, health and support. About 86% ate unhealthy diets, 33.8% were physically inactive, 25.3% were overweight or at risk of becoming overweight, 17.5% of male students were smokers and 32.2% had poor sleep behaviours. About 28% of the students adopted 3 or more current risk behaviours. About 23% reported low perceived health status and 80.3% felt they had low to moderate social support. There were significant sex differences regarding some behaviours

Assessment of health related quality of life among school children with cancer in Alexandria

In recent years, the necessity of measuring health related quality of life [HRQOL] among children with cancer has been stressed. The aim of the present work was to assess the HRQOL in terms of physical, emotional and social functioning, to identify some predictors of QOL and to describe the scholastic achievement and nutritional status among schooI children with cancer in Alexandria. A cross-sectionaI study of 215 students with cancer who attended the oncology school health insurance clinic of Sporting Student's Hospital in Alexandria governorate within a period of one month [June 20051 was conducted. Every child was subjected to the Pediatric Oncology Quality Of Life scale to assess the quality of life with cancer. Anthropometric measurements including weight and height were measured for each child and BMI was calculated. Review of records of each child was done to take the Iast hearnoglobin level. Lymphoma was the most common tumour [34.9%], followed by leukemia [24.2%], brain tumour [13.0%], osteosarcoma [7.9%], and Wilmfs tumour [7%]. About one third of the sample [36.7%] reported poor QOL which was more evident in the physical domain [54.4%], as compared to 34.4% in emotional domain and 26% in the social domain. Sex [p<0.05], age [p<0.05], complications [p<0.01], place of treatment [p<0.05], place of diagnosis [p<0.05] and treatment [p<0.05] were all significantly associated with QOL. However after adjustment for other variables, poor QOL was more likely among students of younger age, students with cornplications, and students whose diagnosis was done at the student hospital. About two thirds of the sample [68.5%] reported poor scholastic achievement, 25.1% were underweight and 87.4% were anemic. HRQOL measurement should be done as a routine for all children with cancer in order to identify specific therapies that require modifications in uldnagrrnent. More efforts are needed to improve the health care in the studentfs hospital, especially for young children with cancer

Nutritional factors affecting the menarcheal state of adolescent school girls in Alexandria

The nutritional status of adolescents plays a dominant role in determining the maturation status. The aim of the present work was to assess the mean age of menarche and the main nutritional factors affecting it. A cross-sectional study of 1606 girls was conducted in primary and preparatory schools in Alexandria. Every girl was subjected to anthropometric assessment including weight, height, mid upper arm circumference [MUAC], waist circumference, hip circumference and triceps skin-fold thickness. BMI and body fat percentage were calculated. A 24 hours diet recall method was used to assess the dietary intake. The mean age of menarche was 11.98 +/- 0.96years. The mean MUAC, triceps skin-fold thickness, waist circumference and hip circumference were significantly higher among menstruating girls as compared to non-menstruating. [p<0.01]. Only 7.5% of the females less than the 5th percentile of BMI [thinness] were menstruating, while the corresponding figure for those at or more than 85th percentile [overweight] was 65.6% and this was statistically significant [=102.8, P<0.001]. Girls who attained menstruation demonstrated a higher significant mean percent of body fat [43.40 +/- 10.0] as compared to non menstruating ones [35.41 +/- 7.87], [t=17.09, P<0.001]. The oldest age at menarche was noted when the protein, iron and caloric intake was less than 80% of the RDAs. However after adjustment of other variables direct relation was detected between age of girls and their age of menarche and those in private school had earlier age of menarche than those in governmental one. The nutritional status of the adolescents had a significant association with the onset of menstruation and the age at menarche

[PSA doubling time: methods of calculation and importance]

PSA doubling time is a mathematical tool which gives a dynamic value to PSA [prostatic specific antigen]. The diversity of methods applied for its calculation constitutes a real problem for urologists. We reviewed the literature and selected two simple methods used to calculate the PSA doubling time. We also evaluated the importance of PSA doubling time in contemporary urological practice

Serum troponin in neonates of pre-eclamptic mothers

Cardiac troponin I, the biochemical marker of myocardial injury is characterized by high sensitivity and specificity in comparison with other markers used in the past. The aim of this study was to evaluate serum levels of troponin in neonates of pre-eclamptic mothers compared with levels in age and sex matched controls, and to correlate the levels of troponin I with Cardiac Creatine Kinase [CK-MB] and other markers of myocardial injury. Forty neonates of pre-eclamptic mothers were included in the study [group A]. Also, 30 age and sex matched healthy neonates were included as controls [group B]. All neonates were subjected to full clinical assessment and routine laboratory investigations. Echocardiographic study was done stressing on myocardial contractility, and calculating the E/A ratio where E= Mitral peak velocity of early diastole in centimeters per second, and A Peak velocity of the atrial contraction in centimeters per second. Cardiac troponin [was measured in serum by ELIZA. CK-MB was measured in serum by chemical analysis. The results showed that troponin I, CK-MB, and E/A levels were significantly higher in group A compared with group B [p=0.003, p=0.03, and p=0.01 respectively]. There were significant positive correlations between troponin I with CK-MB, C-reactive protein and the mean E/A value in group A [r=0.86; p=0.02, r=0.50; p=0.01, and r=0.75; p=0.05 respectively]. Troponin I had a sensitivity of 83.3% and a sensitivity of 86.6% in diagnosing myocardial injury while CK-MB had a sensitivity of 75% and a specificity of 76% in diagnosing myocardial injury. From the present study we conclude that cardiac Troponin I is a more specific and more sensitive marker for myocardial injury than the standard biochemical markers such as CK-MB and it can detect minor myocardial damage not diagnosed early by echo cardio graphic study. Also we conclude that preterm neonates of preeclamptic mothers are more susceptible to myocardial injury than full-term neonates. Troponin I may have prognostic significance because, if present, it identifies the neonates of pre-eclamptic mothers who are at risk of cardiac injury

Psychosocial characteristics of diabetic students at Sporting Students Hospital in Alexandria

Type 1 diabetes mellitus is a chronic disease that may have an impact on children's psychosocial adjustment. The aim of the present work was to study the psychosocial characteristics of diabetic students and to determine predictors of diabetes control. A cross-sectional study of 150 diabetic students who attended the diabetic school health insurance clinic of Sporting Student's Hospital in Alexandria governorate within a period of one month was conducted. A pre-designed interviewing questionnaire was used to collect - from the child and / or his / her parents - personal data, data about the child social relationships and school and disease characteristics. School adjustment index and stress symptom index were used to assess the school performance and the stress symptoms respectively. The result revealed that 34% of the diabetic students were maladjusted to school and 31.3% were symptomatic based on the stress index. Generally speaking, diabetic children reported good relationship to peers [65.3%], parents [57.3%] and siblings [51.3%], most of them have good friendship [82%] and those involved in one or more kind of hobby were about three fourth of all. Both age [P<0.05], sex [P<0.05], social class [P<0.05], disease duration [P<0.05] and stress symptoms [P<0.05] were all significantly associated with the disease control. However after adjustment for other variables, students of low social class families [OR=5.1, p<0.01] and those of longer disease duration [6-10 years] [OR=7.9, p<0.05] were significant predictors of diabetes control. In conclusion diabetes-per se might have no significant association with academic performance or social relationship. Students with large diabetic duration-especially those of low social class families- are at increased risk of suboptimal glycaemic control and should be targeted for interventional strategies

Predictors of personality disorders among Alexandria University students

Personality disorders [PDs] represent a common and serious public health problem. The aim of the present work was to determine the prevalence of different PDs among first grade students of Alexandria University and to investigate some ecological factors of the problem. A cross-sectional study was carried out and included 1086 students. The Arabic Version of Personality Diagnostic Questionnaire-4+ [PDQ-4+] was applied. Results revealed that more than one quarter of the studied sample had at least one PD [26.1%]. Cluster C was the most frequently occurring [24.9%]. The commonest subtypes recorded were avoidant PD [20.4%] and obsessive-compulsive PD [20.2%] followed by paranoid PD [15.0%]. Significant predictors of PD delineated on the logistic regression analysis were mainly psychosocial factors including parental inconsistent discipline, intrafamilial conflicts, parental rejection and control, decreased familial and friends social support, and sexual abuse. A positive history of conduct disorder, chronic medical illness or psychiatric problem also significantly predicted the occurrence of PD. Lack of freedom in college selection and smoking emerged as recent events that predicted the PD status of students

Improving students' knowledge, attitude and practice towards cancer prevention through a health education program. Part II

A health education program for cancer risk reduction was conducted among 649 students out of 896 for whom Knowledge, Attitude and Practice [KAP] had been obtained at the initial study. Three hundred and sixteen students acted as the intervented group and three hundred and thirty three were the control group. There was a great improvement in the percentage of correct knowledge answers in the majority of the questions from pre to post tests especially for the questions about the effect of excessive use of fatty foods [76.3%] and excessive use of salty foods [68.0%] on the occurrence of cancer. After the program, at least 87% or more of the students recognized the hazards of risky food, 86.1% knew that mothers who do not breast feed their infants have a greater chance of getting cancer breast, 51.3% responded correctly to the question about the effect of oral contraceptive pills after 40 years. More than 86% recognized the serious effect of prolonged exposure to the sun. A significant shift toward positive attitude was found especially with the item "I am very afraid to know that I have cancer, so I avoid going to the physician" [76.9%]. It was found that 94% of the students agreed that there is a relation between the type of food and cancer. The students showed significant increases in median practice scores from pre to post tests and the larger gain associated with participants in the program [9.97%]. The majority of the students reported increases in their daily consumption of fruits, cereals, leafy vegetables and salad. These significant changes in KAP scores from pre to post tests were noticed for both sexes, different social classes and different educational grades

Self-efficacy for dietary behaviour concerning heart disease among Alexandria school pupils

A study of 1134 preparatory-school pupils was conducted to measure children's self-efficacy for selecting healthy food for the heart, to examine the relationship between self-efficacy and self-reported usual food consumption and to estimate test-retest reliability. Results revealed an acceptable estimate of internal consistency of dietary self-efficacy [Cronbach alpha = 0.76]. Over half the students exhibited a moderate level of self-efficacy and 42% a high level. Test-retest reliability of the scale was good [r = 0.65, Cronbach alpha = 0.79]. Usual food choice was the first best predictor of dietary self-efficacy [r = 0.44], followed by sex [boys had higher self-efficacy than girls] and then knowledge [r = 0.37].The three factors contributed to explain 25% of the variance

Carcinogenesis of mouse submandibular salivary gland using DMBA implant

Carcinogenesis of 35 ddy male mice subtmandibular salivary glands were attempted; using implants of a 1 mg [2 mm] prepared pellets of the potent chemical carcinogen 9, 10-dimethyl-1, 2-benzanthracene [DMBA] dry powder without a vehicle or carrier. This method appeared to be easy, fast and effective. Within a period ranging from 7-14 weeks; twenty animals developed epidermoid carcinoma [two of them developed squamous cell carcinoma of covering skin as well], and two animals developed mixed tumors [pleomorphic adenoma like tumor] but neither adenocytic carcinoma nor sarcoma were found, the results were adequacy discussed

effect of different etching times on subsequent depths of ground primary enamel A scanning electron microscopic study

Labial surfaces of 30 caries free recently exfoliated primary teeth were used in this study. Outer, middle and inner enamel layers were ground on the same labial surface of each tooth. All teeth were etched 37% phosphoric acid gel for 20, 30, 60, 90 and 120 seconds. The results are given in details

Uses of magnetic resonance imaging [MRI] in presurgical evaluation of internal derangement of temporomandibular joint [TMJ]

Nine cases of unilateral internal derangement of TMJ indicated for surgical intervention were selected for this study. The affected joints were imaged by MRI presurgically. The non-affected joints were also imaged as controls MRI findings were correlated with intraoperative surgical findings. The results were absolutely accurate as regards degenerative joint pathosis and capsular rupture, and with high degree of accuracy [85.7 percent] in detection of disc displacement. Two cases of disc perforation were not detected by MRI. The results were promising and encouraging the use of this non-invasive Imaging technique as presurgical aid in TMJ disorders

Cephalosporins prophylaxis of patients undergoing oral surgical procedures

The present study aims to assess the value of cephalosporins prophylaxis for patients undergoing oral surgery procedures specially removal of both impacted lower third molars. The study was carried out on total of thirty patients, presented with impacted bilateral lower third molars, all cases included in the study were bilateral deeply impacted lower third molar [position B and C]. All patients were clinically free from any systemic diseases. The patients were randomly divided into two groups, the first group divided into two subgroups

Blood pressure patterns among primary school children in Alexandria

The present study was conducted to illustrate the patterns of blood pressure among primary school children in Alexandria and to study some biological and socioeconomic factors determining these normal levels. Using the proportional allocation method, a total sample of 605 students was selected to represent the 6 zones of Alexandria. A purposive sample of 100 pupils was also selected to represent non governmental students of high socioeconomic level. For each child, two blood pressure readings, taken 5 minutes apart, were recorded and the means were calculated. The percentile distribution of blood pressure values was determined. The results revealed that there was a gradual increase in the mean systolic and diastolic blood pressure with increasing age, with a statistically significant difference between the youngest and eldest age groups. No significant difference was detected for both systolic and diastolic blood pressure in both sexes. A variety of socioeconomic and biological factors was involved in the determination of the normal levels of blood pressure. Stepwise multiple regression analysis revealed that the most important were salt consumption, positive family history of hypertension, age, and physical exercise. It is recommended that blood pressure should be measured as a routine in the comprehensive medical examination of school children and plotted on the percentile charts in order to determine whether the child is tracking in a favorable direction or not

Augmentation of the atrophic mandibular alveolar ridge with silastic

Five adult healthy patients were chosen for this work having severe atrophicmandibular ridges. Augmentation of mandibular ridges was done with medicalgrade silicone rubber [solid type] using degloving surgical techniques withmarked success of the technique in three out of five patients