Could the employment-based targeting approach serve Egypt in moving towards a social health insurance model?

The current health insurance system in Egypt targets the productive population through an employment-based scheme bounded by a cost ceiling and focusing on curative care. Egypt Social Contract Survey data from 2005 were used to evaluate the impact of the employment-based scheme on health system accessibility and financing. Only 22.8% of the population in the productive age range [19-59 years] benefited from any health insurance scheme. The employment-based scheme covered 39.3% of the working population and was skewed towards urban areas, older people, females and the wealthier. It did not increase service utilization, but reduced out-of-pocket expenditure. Egypt should blend all health insurance schemes and adopt an innovative approach to reach universal coverage

Primary health care in the Eastern Mediterranean Region: from Alma-Ata to Doha

The celebration in Doha of the 30th anniversary of the Alma-Ata Declaration at the International Conference on Primary Health Care renewed the commitment of the Eastern Mediterranean Region to primary health care as the tool for better health. The principles agreed at Alma-Ata in 1978 apply as much now as they did before. The event provided an opportunity for the Eastern Mediterranean countries to define future directions to steer the health systems to integrate primary health carg and harness the intersectoral approach

Formulation and evaluation of sustained release tablets containing antioxidants

Deficiency in nutrients especially antioxidants play an important role in the pathogenesis of acquired immuno-deficiency syndrome [AIDS,]. Antioxidants; vitamin A, vitamin C, vitamin E, zinc and selenium are available in market as capsules. The release rate is very fast followed by fast elimination. It is necessary to prolong the residence time of antioxidants. Sustained release tablet formulation was designed and evaluated on small scale and on large scale preparations. Low attention has been discuss the use of sustained release formula in treatment of AIDS. Sustained release tablet formulation was designed and evaluated on small scale and on large scale preparations. The formulated tablets contained beta-carotene, vitamin C, tocopherol acetate, selenium, yeast and zinc pidolate. Vitamin C was chosen as tracer for detection and evaluation of tablet dosage form. Vitamin C was found to be stable in 0.1 N HCl [pH 1.2] along 8 hrs at 37°C. The formulated tablets passed the pharmacopeial requirements for all tablet tests. The formulated tablets showed sustained release characteristics of vitamin C as a tracer, within 8 hrs

Depleted uranium: an overview of its properties and health effects

There has been much debate about the use of depleted uranium in the Gulf War and its health effects on United States and European war veterans. However, studies on the impact of this radioactive substance on the residents of the surrounding Gulf region are far from adequate. Depleted uranium introduces large quantities of radioactive material that is hazardous to biological organisms, continues to decay for millennia and is able to travel tens of kilometres in air. If depleted uranium were used in the Gulf War, its impact on the health of people in the area would have been considerable. This review of depleted uranium-its origin, properties, uses and effects on the human environment and health-aims to trigger further research on this subject

Infant mortality in Arab countries: sociodemographic, perinatal and economic factors

The infant mortality rates for 1978 and 1998 of 16 Arab countries in the Eastern Mediterranean region were studied. The data were extracted from World Health Organization and United Nations Children's Fund sources. The impact of demographic, social, perinatal care and economic indicators on infant mortality rates in 1998 was studied using Spearman rank coefficient to detect significant correlations. All countries, except Iraq, showed a sharp decline in rates from 1978 to 1998. Infant mortality rates were directly related to population size, annual total births, low birth weight and maternal mortality ratios. Also, infant mortality rates were inversely related to literacy status of both sexes, annual gross national product per capita and access to safe drinking-water and adequate sanitation facilities

Early teenage marriage and subsequent pregnancy outcome

The relationship between marriage before 16 years and pregnancy outcome throughout the childbearing period was examined. Participants included all married women attending six randomly selected primary health care units in Jeddah with at least one infant and complete medical files. Early teenage marriage was found for 27.2% of women. Most of these were illiterate [57.1%], housewives [92.4%] and grand multiparae [66.7%]. They were at twice the risk of spontaneous abortion, four times the risk of combined fetal death and infant mortality, and twice the risk of losing pregnancies any time during their childbearing years. They remained at high risk of poor pregnancy outcome throughout their reproductive lives. Despite tradition, marriage should be discouraged before 16 years

treatment of infected non union of the tibia by compression distraction techniques using Ilizarov external fixator

The application of ilizarov techniques to diaphyseal infected non unions is very encouraging. It may prove to be an excellent technique for future management of resistant diaphyseal infections of bone. Circular external fixation using the Ilizarov apparatus combined with compression-distraction techniques were used to treat eleven patients with infected non union of the tibia. There were 8 males and 3 females with an average age of 27 years [range 17-51 years]. The average number of previous failed surgical attempts at union was two per patients [range one to four]. of the eleven patients there were 8 with chronic tibial defects; one with normal extremity length; 5 with shortening associated with bone fragment contact and two With bone loss in excess of the amount of shortening. There were three infected non union without shortening treated with complete resection of the non union site and conversion of the diaphysis into a segmental defect. In eleven patients, the infected extremities healed without the addition of a cancellous graft, microvascularfibular or soft tissue grafting. The average length of regenerate gain was 3.7 cm [range 1.5 to 4.9 cm]. Postoperative antibiotics were administered in. 3 out of the eleven patients for 10 days after en block resection of the diaphyseal sequestrae. Functional results were excellent in 5, [45.45%] good in 3, [2 7.2 7%] fair in 2 [18.18%] and poor in only one patient [9.10%] There were no additional bone grafting procedures, microvascular bone transplants, or other grafting techniques used in any patient

Evaluation of the results of reconstruction of chronic anterior Cruciate Ligament insufficiency using a bone - patellar tendon-bone autograft

Reconstruction the Anterior Cruciate Ligament using one-third of the patellar tendon, as a graft has been a popular procedure. Today, the central third of the tendon used as a free graft with a bony plug at each end, is Considered the best procedure Nineteen male patients with a mean age at the time of injury of 24 years [range 18-32 years] were followed up for average of 20 months after operative reconstruction of Chronic cruciate injuries with a minimal arthrotomy using a bone-patellar- tendon-bone autograft. The average duration between the initial injury and the surgery ranged from 1 to 30 months [mean= 13 months]. Initially, 12 patients [63.20%] were classified as competitive and 7 [36.8%] as recreational athletes. At follow-up, 12 patients [63.20%] were satisfied subjectively and .13 [68.4%] were classified objectively as excellent or good on Lysholm's score. Anterior stability was good in 18 knees [94.7%]. The Lachman test showed that 10 cases [52.6%] were completely stable. The test was strongly positive in one patient. The pivot shift test was negative in 14 patients [73.7%] and markedly positive in one [5.3%] and wasting of the thigh was more prominent in 5 patients. So reconstruction of ACL insufficiency with a bone-patellar ligament-bone graft using a miniarthrotomy leads to good stability and good function and most patients will be able to return to their sport activity