Contraception among women in two age groups: twenty five years or below and forty years or above, in Alexandria

This work was carried out to reveal some socioeconomic characteristics of contraceptive users in the reproductive ages /= 40 years, and reveal the pattern of previous and current contraceptive use among them. The descriptive epidemiological approach was used to carry out this study which was conducted in three Maternal and Child Health [MCH] centers and three specialized family planning [FP] centers in Alexandria. The studied women totaled 136, of them 82 aged /= 40 years [39.7%]. The results showed that about two thirds of studied young or old women were uneducated or had primary or preparatory educational levels [62.2% and 61.1% respectively]. Also, about a half of their husbands had the same low levels of education [54.9% and 51.8% respectively]. About two thirds of older women were working [64.8%]. Moreover, they were more significantly working than the younger ones [X[2] = 16.75]. Manual working was the highest prevalent occupation among the studied women's husbands. Intrauterine device [IUD] was the commonest method used either previously or currently by women in each age group. MCH centers were the commonest source of previous contraception followed by private physicians and pharmacies. Moreover, the commonest reasons behined their discontinuation were complications and desire for pregnancy. The differences between the two groups regarding examinations done before use of current contraceptives and counselling about them were all statistically insignificant. However, urine analysis and haemoglobin percentage were significantly more investigated in young women than in old ones [X[2]= 5.55]

conformity of physicians' performance with the national guidelines of the Egyptian family planning program

Data on adequacy of physicians' performance at family planning clinics in Alexandria is contained in this report. An observational check list was used for monitoring the daily performance of 35 physicians working in the 12 family planning clinics of Alexandria. Clients were intrauterine device users in their initial visits to the clinics. The whole care process was divided into five areas covering interpersonal communication and technical aspects. The percentage score [physicians' performance index] was calculated for total, area and sub-areas of care. The collective performance index combines indices of physicians in both types of facilities together. Fifty percent value of physician performance index was taken as the cut-off point between lower unacceptable performance and higher acceptable one. The collective total performance index was unacceptable [49.37 +/- 8.24] denoting considerable deviation from standards of adequate care. Areas of care related to examination and history taking tasks had the most deficient collective physician performance index [6.72 +/- 6.64 and 25.56 +/- 13.03 respectively]. Negligence of these two areas skips the two basic rationales for right choice of the contraceptive method. The collective performance index for communication was just above the acceptable value [51.20 +/- 13.37]. The two areas with highest performance index were infection control and intrauterine device insertion [63.36 +/- 10.79 and 65.66 +/- 12.08 respectively]. This is an indication of the technical orientation of physicians leaving the total program concepts like informed decision and continuation inadequately implemented. Performance index of physicians in specialized clinics was repeatedly found to be significantly higher than those of integrated clinics in all areas of care. In area of communication, the performance index in specialized clinics was acceptable in contrast to that in integrated ones. However, the performance index in the two types of clinics were found together in either the acceptable or the unacceptable range in all other areas. This may reflect the existence of a dominant atmosphere that enhances or weakens the performance in different areas of care and the priority of importance given to these areas

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

Pattern of growth and development of premature children at the age of two and three years in Alexandria, Egypt [Part I]

A case-control study was conducted in Alexandria on 68 premature children: 32 of them at the age of 2 and 36 at the age of three years. The aim was to depict the pattern of growth and development among them. Controls were full-term children, who were double the number of prematures and matched by age and sex. It was found that the growth pattern of full-term children aged two and three years was better than that of prematures. Moreover, prematures were significantly delayed in some developmental areas as language, fine motor-adaptive sectors and personal-social domains than their corresponding controls. The study suggests that the provision of quality medical care could eliminate the growth and developmental lag of premature children

Pattern of growth development of premature children at the age of two and three years in Alexandria, Egypt [Part II]

This is the second part of a paper on a study conducted in Alexandria on 68 premature children. Controls were full-term children, double the number of prematures, and matched by age and sex. The first part presented differences in growth and development in relation to prematurity. This part deals with risk factors for prematurity. The study revealed that low educational level of fathers and parental smoking were significant risk factors for prematurity. The mean age of both parents and mothers' gravidity were significantly higher for prematures. Other risk factors were identified. Mothers with diabetes and chronic nephritis were more likely to have a premature child

Five-year survival study of acute myocardial infarction patients in Alexandria [a follow-up study between 1986-1992]

Survival studies are important as measures of prognosis severity of the disease, treatment outcome and for comparison purposes. Many studies showed an improving trends overtime in short-term survival for coronary heart disease patients discharged from hospital. Information regarding coronary heart disease prognosis in Egypt were lacking. Thus, this study was carried out to measure case fatality rates and 5-year survival of 160 myocardial infarction patients who were hospitalized in Alexandria Insurance Hospitals in the year 1986 and followed up till 1992. 5-year survival rate was 52.77% and case fatality rate after one year of follow up was 20.19%, reached 47.23% at the end of the study. The influence of some prognostic factors on survival of patients was also studied. The older the patient, the lower percentage of survivors [t = 3.88]. In females, risk of death [X2 = 8.14] significantly increased; the relative risk of dying among females was nearly twice that for men [1.93]. A significantly poorer in-hospital survival for myocardial infarction patients with prior diabetes was noted [X2 = 12.16] with excess risk of death among diabetics of 1.86 times that of non diabetics. Also, the presence of type A behavior in patients indicated worse prognosis [X2 = 6.72] and they were 1.58 times as likely to die as type B patients

Study of knowledge of nurses working in university and Ministry of Health Hospital in Alexandria in relation to Acquired Immunodeficiency Syndrome

AIDS is the severe late stage of infection with human immunodeficiency virus which destroy body's immune system. Nurses have a major role in the education of HIV infected individuals, their families and the community. The aim of the study is to assess nurses knowledge about AIDS who are working in Alexandria University and Ministry of Health Hospitals. Ten percent of nurses working in these hospitals were randomly selected proportionately among different hospitals and departments. The results revealed that about half of the sample [n=258] considered AIDS as a significant health problem in Egypt. 73.64% of them knew that causative agent is a virus and 81.01% of them were aware of presence of carrier state. As regards mode of transmission more than 90% of nurses identified the proved modes of transmission of AIDS [sexual and parental]. However, large proportion of them [more than 56%] had misconceptions about mode of transmission. Only 41.47% of nurses could recognize the risk groups and only 42.64% were aware of the methods for prevention of AIDS. The main source of information for nurses was T.V. [in 63.57% of sample]

Incidence of coronary heart disease among health insured workers in Alexandria, longitudinal study for five years

Longitudinal studies, allow the measurement of disease incidence among a group of people more accurately and enable the study of its natural history. Those studies can also point to risk factors, markers and quantify the associated risk. The present work aimed at studying morbidity pattern of a cohort of 214 adult working men between 1986-1991. Initially, they were free from coronary heart disease, hypertension and diabetes. At the end of 5 year period of follow-up, 4.67% developed coronary-heart disease, 9.34% developed non-insulin dependent diabetes mellitus and 19.16% developed hypertension with an average annual incidence rates of 0.90%, 1.87% and 3.83%, respectively. Significantly higher proportions of those who developed coronary heart disease were smokers [X=4.14], diabetics [X[2]=2.44] and hypertensives [X[2]=11.30] than non-coronary heart disease subjects. Also, they were significantly older [t=2.25] and having higher waist-to-hip ratio [t=2.20]. Concerning measurement of risk, the results of this work indicated that old age [> 50 years], smoking and diabetes were the factors having the highest population attributable risks precent for development of coronary heart disease [61.70%, 61.70 and 44.68%, respectively]

comparison of anthropometric measurements of institutionalized and primary school children in Alexandria

The aim of this work is to compare the anthropometric measurements of instituted children to those of primary school children enjoying normal family life. To accomplish this aim, institutionalized children [n=175] age 6-12 years enrolled in five social institutions in Alexandria during the year 1984 were interviewed. The control group were randomly selected after matching age and sex [from nearest primary school at each institution]. The study revealed that institutionalized children have higher means of weight, height, triceps skin fold and Quetlet index than their control. Lower measurements of the chest circumferences were recorded for institutionalized children [6-9 years old] than their control while the reverse is obtained at 9-12 years of age

study of causes of mortality among patients of a teaching hospital

Deaths oocuring in Alexandria University Principal Hospital during year 1968 were studied. There were 1305 deaths of which 861 were modes and 444 were females. Various factors at fecting these deaths were analysed and discussed