Quality of death certificate completion by physicians in qualyopia, Benha

All physicians should be able to record the medical cause of death in a consequence order and issue death certificate according to the international form recommended by World Health Organization. In Egypt, most clinicians continue to list the cause of death as "cardiac arrest" or "cardiopulmonary arrest" on death certificate and the government organization accept them as causes of death. The forensic significance of death certificate may not become apparent until many weeks or months later. To evaluate the quality of death certificates issued in Qualyopia, Benha by determining whether any of the items missed or written wrongly or in a vague manner. Data of randomly chosen 200 death certificates issued within the year 2006 in Benha health offices was gathered to review the deceased personal data, medical cause of death, place, date and time of death, name and signature of the certifying physician. On reviewing a total of 200 issued death certificates, the full name, gender, age and residence of the deceased and the date of death were written in all certificates [100%], while the place of death were omitted in a small number of certificates [5%]. There was a vague indication of the medical cause of death in 12%, a correct cause of death with improper sequencing in 49%, and the mode presented as the cause of death in 24% and in 15%, the cause of death was absent The time of death was the commonest omission from death certificates [67%]. There is no place for the name and signature of the certifying physician in the certificates, only the name and signature of the certifying employees. The certifying physicians sign only in death declarations. Death certificates revealed serious deficiencies as regards cause and time of death; this can bring discredit on doctors, the profession as a whole and can also seriously prejudice the legal proceedings. As accurate issuing of death certificates should full within the capabilities of all doctors, aperiodic workshop about how to issue death certificate properly was recommended as well as establishment of quality control program before issuing death certificate

Benzene toxicity in shoemakers and role of vitamin A [as antioxidant]

The burden of liver disease in Egypt is exceptionally high. Unquestionably, additional factors contributing to liver disease burden remain to be elucidated. Human exposure to benzene in work environment is a gbbat occupational health problem; it may represent a risk factor for hepatotoxicity, liver cancer and hematotoxicity. The present study aimed to evaluate the hazardous effects of occupational exposure to benzene on liver and blood, as well as the protective role of the antioxidant [vitamin A] on hematotoxic and hepatotoxic effects among shoemakers who exposed to benzene. Twenty hundred and fifty workers were enrolled in this study after taking an informed consent; 140 occupationally exposed workers to benzene for more than 3 years [workers group; subdivided into non-treated and treated with vitamin A], and 110 workers never occupationally exposed to benzene [control group]. The benzene urine level, complete blood counts [CBC5], the liver enzymes, and the tumor marker, alphafetoprotein [AFP] were estimated. The benzene level in urine samples was significantly increased in shoemakers group. Benzene exposed non-treated workers showed significant increase in the liver enzymes and AFP, while the CBCs were significantly lower compared with both control group and benzene exposed treated group with vitamin A. Occupational exposure to benzene found to have hazardous effects, which were reflected on CBCs, liver enzymes, and AFP. Additionally, the vitamin A was observed to be effectively potent in ameliorating the haematotoxic and hepatotoxic effects in exposed workers. Periodic medical care and CBCs in combination with urinary benzene [UB] level were recommended in benzene workers