Evaluation of the newborn screening program for congenital hypothyroidism in Alexandria 2000-2003

The Newborn Screening Program for Congenital Hypothyroidism started in Alexandria in October 2000. The aim of this study was to evaluate the program in terms of coverage, performance of providers, effectiveness of detecting cases and knowledge of mothers about newborn screening. The computer data base in Alexandria Health Directorate were reviewed from October 2000 to December 2003.A structured interview questionnaire with mothers [during their infants' BCG vaccination] to test their orientation and knowledge about newborn screening. An observation checklist was used to assess nurses' performance during sample collection. Records of the pediatric clinic [where positive cases were treated] were reviewed for screening results Focus group discussions were conducted with health care providers. The mean percentage of coverage was 63.58% with 268747 live births and 170881 screened infants. The total positive cases were 70 with 43 true. positive cases. The positive predictive value in the 3 years was 61.4%, and the incidence of primary [CH] among screened infants was 1:3974. False positive rate among screened infants was 0.016%. 40.5% of mothers had good knowledge about newborn screening. The Knowledge of primary health care physicians about the screening program was good but most of them felt that they were not involved in the program. The knowledge of nurses about [CH] was not satisfactory; their attitude towards infection control measures was not good. The screening program of [CH] in Alexandria has been established and became a routine part of primary health care activities, the screening of other diseases rather than [CH] should follow. Efforts are needed to improve different aspects of the program

Cesarean section deliveries in one health insurance hospital in Alexandria

Cesarean section [CS] rates have been increasing world wide, raising the question of the appropriateness of the selection of cases for the procedure. The World Health Organization [WHO] states that no region in the world is justified in having a cesarean rate greater than 10 to 15 percent. The aim of the work was to determine the trend of cesarean section deliveries in Gamal Abdel Naser Hospital which is affiliated to the Health Insurance Organization [HIO]. The study was conducted through a descriptive retrospective approach. The study sample included the a] recorded deliveries between 1998-2005 [n=15917] for estimating the trend of cesarean section deliveries, and b] the medical records of CS deliveries at 2002 in the hospital [n=837] for identifying the indications of CS and their adequacy as a source of information for evaluation of CS deliveries. The study revealed that; cesarean section rate was high and increasing during the period from 1998 - 2005.The highest percent was in the year 2004 [57.9%]. The trend of increase was significant [c for linear trend = 162.717, p = 0.000].Thursdays accounted for the highest percent of both admissions and deliveries, while Fridays accounted for the lowest percent. More than one half of deliveries occurred between 2 pm to before 8 pm. More than three quarters of the study sample [77.9%] did not have trial labour. Only 12.8% of the total study sample had induction and the outcome of induction was dystocia in 85%.The main indication of cesarean section was previous CS [41.2%], fetal distress [17.6%], failed trial and failure to progress [11.4%], cephalo-pelvic disproportion [10.3%], abnormal presentation [5.6%] and ante-partum hemorrhage [3.2%]. Patient's records lack most of the essential information so it was not possible to verify recorded indication to justify caesarean section

Palatal rugae area: a landmark for analysis of pre- and post-orthodontically treated adult Egyptian patients

We aimed to evaluate the stability of the palatal rugae area before and after orthodontic treatment in adult Egyptian patients, and to suggest whether it could be used in superimposition in order to analyse orthodontic treatment change. Fifty pre- and post-dental casts of orthodontically treated adult Egyptian patients were collected from the clinic of the Orthodontic Department the University of Cairo. All patients were indicated to have symmetrical extraction of first premolars. The casts were scanned and analysed. The most reliable points were found to be the lateral third rugae points, which could be used as reference points for cast super-imposition