Epidemiology of school injuries in Alexandria

This study was conducted to reveal the magnitude of school injuries in Alexandria, their epidemiological patterns and outcomes. All pupils attending the casualty department of Alexandria Students' Hospital during the scholastic year 1996-1997 with school injuries were included in this study. An interview questionnaire and a transfer sheet were used to collect relevant information. Data were analyzed and the 5% level was taken to judge the significance of the obtained results. During the study period, 3422 pupils sustained school injuries yielding a rate of 4.25 per 1000. This rate was significantly higher among boys [6.43 per 1000] as well as in secondary schools [8.11 per 1000]. Most of these injuries occurred inside the school [72.0%]. In relation to school activity, injuries occurred more frequently during breaks [28.1%], school trips [27.8%] and teaching sessions [25.6%]. Falls were responsible for 52.3% of the injuries followed by struck by or against [25.2%], while 11.9% were due to road traffic accidents. The most commonly affected sites were the upper [46.2%] and lower [32.1%] limbs as well as the head and neck [16.6%]. High proportions of the resulting injuries were minor, however, severe injuries namely, fractures [23.2%] and brain concussions [2.8%] were encountered. Significant differences were observed in this respect in relation to the pupils' gender and educational stage. Only 12.5% of the cases were hospitalized. All recovered completely except four cases of leg amputation and no deaths were recorded. School injuries appear to be a priority area for primary preventive activities. School personnel should receive safety rounds to recognize the potential environmental hazards. Stringent supervision is required in areas and during activities with high frequency of injuries. Moreover, safety education should be incorporated in the curriculum and activities involving school children

Effect of different modalities of treatment on the quality of life of breast cancer patients in Egypt

The impact of breast cancer therapy on the quality of life [QL] of Egyptian women was studied. Patients were divided into four groups: 1: mastectomy alone; 2: surgery plus radiotherapy; 3: surgery plus chemotherapy; and 4: triple modality. The results revealed that all the four domains of QL of women having adjuvant therapy [groups 2, 3, or 4] were significantly altered compared to those who underwent mastectomy alone. Triple modality adversely affected global QL the most compared to radiotherapy or chemotherapy; radiotherapy had significantly less effect on QL compared to chemotherapy. Triple modality predicted the worst QL. QL measures should be incorporated with the traditional end points for evaluation of treatment and patients given health education on the effects of each therapy

Poliomyelitis, measles and neonatal tetanus: a hospital based epidemiological study

Vaccine-preventable diseases constitute a major health problem contributing to the morbidity and mortality in many developing countries including Egypt. WHO adopted resolutions to eradicate poliomyelitis by the year 2000, eliminate neonatal tetanus by the year 1995, and reduce measles mortality by 95% and morbidity by 90%, compared to the pre-immunization levels by 1995. Evaluation of preventive programs for these diseases necessitates availability of up to date information on their occurrence. The present study was undertaken to determine the current epidemiological features of poliomyelitis, neonatal tetanus and measles, to identify the trends of these diseases as well as to determine their outcomes and hospital loads. Data about the admitted cases of poliomyelitis, neonatal tetanus and measles were collected from the hospital register of Alexandria fever hospital for five successive years [1992-96]. Available information on age, sex, residence, diagnosis, outcome of treatment, dates of admission and discharge were collected. The total number of cases of the three diseases admitted to the hospital during the period 1992-96 were 1406, measles represented 85.4%, neonatal tetanus 13.9% and poliomyelitis 0.7%. The results revealed that in the year 1994 only one case of poliomyelitis was admitted and since then no other cases were reported. The number of measles cases increased gradually in the latter years and about 78% of them were older than five years of age. A significant increase in the age of measles occurrence was observed. A gradual decline in the number of neonatal tetanus cases was observed. These cases were more apt to occur among early neonates but still clustered in certain geographical areas. The results of the study pinpoint the long term impact of the well run program aiming at eradicating poliomyelitis in Alexandria. However, for elimination of neonatal tetanus and controlling measles morbidity, further activities are required including strengthening the surveillance activities for detection of the high risk geographical areas and the high risk factors

Evaluation of an educational training programme for the development of trainers in child mental health in Alexandria

A six-day workshop was conducted to develop trainers in mental health by providing physicians participating in the programme with the necessary educational knowledge and skills. A significant improvement was observed in the participants' knowledge and skills after the workshop. A significant correlation was found between the increase in knowledge and that of performance. The increase was affected neither by the years of work experience nor by the postgraduate degree held. This observed benefit and the satisfaction expressed by participants encourage the replication of such a programme in order to develop qualified health personnel capable of expanding mental health services for children

Determinants of the duration of lactional amenorrhea among mothers in Alexandria

A total of 300 women nursing a child aged 6 to 24 months were interviewed to determine their sociodemographic and biological characteristics, the antenatal care received, health problems encountered during pregnancy and the postpartum period, breast-feeding practices, child nutrition, and the duration of postpartum amenorrhoea. Multivariate Cox regression analysis revealed that seeking antenatal care, the time of initiation of breast-feeding, and the infant's age at the time of supplement introduction were the only significant independent determinants of the duration of the lactational amenorrhoea. To prolong the duration of lactational amenorrhoea, health education regarding good breast-feeding practices is of crucial value