Knowledge, Health Beliefs and Osteoporosis Preventive Behaviour Among Women of Reproductive Age in Egypt

@#Introduction: : Osteoporosis is an important, global public health issue that is expected to become an epidemic by 2050, and particularly affect an increasing number of elderly women worldwide. The current study was designed to measure the current osteoporosis knowledge level among a sample population of women, to assess osteoporosis health beliefs, and assess osteoporosis preventive measures and factors related to those taking preventive measures. Methods: A cross-sectional study was conducted, using multistage sampling. A total of 265 women were randomly selected among those attending outpatient clinics in primary health care units. The study used a questionnaire to assess knowledge, health beliefs, in addition to osteoporosis preventive behaviour. Results: About 59% of the participants showed inadequate knowledge and 70.7% had inadequate osteoporosis preventive behaviour. Inadequate knowledge levels were more common among the younger participants, and those with a lower educational level, absence of osteoporosis in first degree relatives and no history of fractures. Significant differences were observed in the mean score of overall health beliefs and all its sub-scales, except for perceived exercise benefits and perceived health motivation. Sub-optimal calcium intake levels were noted, but were significantly higher among those with adequate osteoporosis preventive behaviour than among those with inadequate osteoporosis preventive behaviour (907.2 ± 187.6 and 810.7 ± 123.3, respectively, p < 0.001). Conclusions: The sample of women under investigation showed unsatisfactory levels of knowledge regarding osteoporosis, substandard health beliefs and sub-optimal levels of calcium consumption. Community-based interventions should be conducted to overcome the barriers to adopting preventive behaviours.

Burnout among physicians and nursing staff working in the emergency hospital of Tanta University, Egypt

Little is known about professional burnout among health-care workers in Egypt. The current study aimed to reveal the extent of burnout among physicians and nursing staff working in the emergency hospital of Tanta University and to identify some of its determinants. A cross-sectional study was carried out on all physicians [n = 266] and a systematic random sample of nurses [n = 284]. Burnout was assessed using the Maslach Burnout Inventory and its subscales. Most of the participants [66.0%]had a moderate level of burnout and 24.9% of them had high burnout. Multivariate analysis of variables affecting burnout showed that age, sex, frequency of exposure to work-related violence, years of experience, work burden, supervision and work activities were significant predictors of burnout among the respondents. The authors recommend health education interventions during pre-employment training programmes for prevention of burnout syndrome and periodic screening for early detection and management of burnout

Occupational injuries prone to infectious risks amongst healthcare personnel in Kuwait: a retrospective study

The study aimed at determining the prevalence of incident occupational exposure to blood and other potentially infectious materials [OPIM] among healthcare personnel [HCP] during 2010 and at evaluating the factors associated with these incidents. Subjects and an epidemiological, retrospective, record-based study was conducted. All self-reported incidents of occupational exposure to blood and OPIM among HCP from all healthcare settings of the Kuwait Ministry of Health during 2010 were included. The total number of the exposed HCP was 249. The prevalence of incident exposure was 0.7% of the HCP at risk. Their mean age was 32.31 +/- 6.98 years. The majority were nurses: 166 [66.7%], followed by doctors: 35 [14.1%], technicians: 26 [10.4%] and housekeeping personnel: 22 [8.8%]. Needle stick injury was the most common type of exposure, in 189 [75.9%], followed by sharp-object injury, mucous-membrane exposure and contact with nonintact skin. The majority of needle stick exposures, i.e. 177 [93.7%], were caused by hollow-bore needles. Exposure to blood represented 96.8%, mostly during drawing blood and the insertion or removal of needles from patients [88 [35.4%]] and when performing surgical interventions [56 [22.6%]]. Easily preventable exposures such as injuries related to 2-handed recapping of needles [24 [9.6%]] and garbage collection [21 [8.4%]] were reported. Exposures mainly occurred in the inpatient wards [75 [30.1%]] and operating theaters [56 [22.6%]]. Among the exposed HCP, 130 [52.2%] had been fully vaccinated against hepatitis B virus [HBV]. Needle stick injuries are the most common exposure among HCP in Kuwait, and nurses are the most frequently involved HCP category. A good proportion of exposures could be easily prevented. HBV vaccination coverage is incomplete

Effect of prenatal organophosphate exposure on birth outcomes in rural areas in El Minia governorate

Chlorpyrifos [CPF] is a form of organophosphate [OP] insecticide that is widely used in both agricultural and home settings. This study was conducted in Minia University Hospital in collaboration with the Department of Forensic Medicine and Toxicology, Faculty of Medicine, El-Minia University to evaluate the effects of the prenatal exposure to OP on birth outcomes and the levels of maternal blood OP and umbilical cord blood OP in OP exposed areas in comparison with non exposed areas. Seventy pregnant women were recruited for the study during the period from June 2009 to June 2010. The pregnant women were divided into two groups, group I [study group] were selected from areas where exposure is to organophosphates compounds in the villages of Saft Al labn and AlByrjaiah and group 11 [control group] were selected from areas non exposed to organophosphates compounds, each included 35 pregnant women. They were subjected to history taking, general and obstetric examination, ultrasound evaluation, fetal biophysical profile [BPP] scoring, and doppler flow velocity waveform analysis. Chlorpyrifos [CPF] was determined in maternal and umbilical cord blood collected at parturition, in cases with exposed and non exposed babies to evaluate the fetal growth and different perinatal outcome variables.The difference between the two groups in clinical characteristics was statistically insignificant. There were statistical significant differences between the two groups as regards maternal blood CPF, and umbilical cord blood CPF levels [p<0.00l] suggesting a higher risk of CPF exposure in the study group. There were statistically significant differences in all perinatal outcome variables between the two groups [p<0.00l]. In the study group, There was positive correlation [r = 0.53, p0.0l] between maternal and umbilical cord blood CPF levels confirmed the transfer of CPF from mother to the fetus. There was a week but significant correlation between UC blood CPF levels and neonatal birth weight, head circumference and fetal length [r = - 0.22, p < 0.01], [r = - 0.25, p < 0.01], [r = - 0.14, p < 0.01] respectively. Maternal CPF exposure is associated with increased adverse perinatal outcome. For those interested in environmental health to take all the ways that reduce exposure to Chlorpyrifos and also the need to apply continuous bio-monitoring program to assess the impact of environmental pollutants on the health of women and children

Nailfold capilloroscopy in systemic lupus erythematosus

Nailfold capillaroscopy is a non-invasive technique to recognize peripheral microangiopathy, which is an important feature in SLE. To study the prevalence of nailfold capillaroscopy [NFC] changes in patients with systemic lupus erythematosus [SLE], find out the patterns of these changes and to correlate these findings with different clinical and laboratory parameters. Forty patients with SLE, all fulfilling the 1997 revised criteria for the classification of SLE were included. All patients included in this study were subjected to full history taking, clinical examination, laboratory investigations as well as nailfold capillaroscopy [NFC] examination. The prevalence of nailfold capilloroscopic [NFC] changes in SLE patients was 75%. Nailfold capillaroscopic abnormalities were significantly more frequent in SLE patients than in controls [P < 0.05]. Different abnormal NFC changes were seen with the meandering pattern more frequently seen. The afferent and efferent capillary loops diameters were significantly increased in the SLE patients than in the control group [P < 0.05]. Some of the NFC abnormalities showed statistical significant correlations with different clinical and laboratory parameters. Capillary loop afferent and efferent diameters were significantly correlated with disease duration [P < 0.05] as well as the occurrence of digital gangrene [P < 0.05]. Also the capillary loop afferent diameter was found to be correlated with the intake of cyclophosphamide [P < 0.05]. Significant microcirculatory changes occur in systemic lupus erythematosus [SLE] patients as proved by the high prevalence of capillary abnormalities in lupus patients compared to controls by means of nailfold capillaroscopy. Some nailfold capillaroscopy changes e.g. meandering capillaries may complete picture of SLE diagnosis. Duration of SLE disease may have an impact on microcirculation of these patients. The presence of some nailfold capillaroscopy changes in SLE patients may be an alarming sign to fatal ischemia of the digits

Assessment of patient satisfaction towards primary health care facilities - a survey study in Sharkia Governorate

Patient satisfaction is an important tool that measure performance of health care providers. To assess patient satisfaction towards Primary Care in Sharkia Governorate in 2009, and to detect causes of patient dissatisfaction. This study was carried out on 893 patients from 18 Primary Health Care Facilities in Sharkia. Data were collected through interview sheet including seven domains of patient satisfaction: reception service, doctors' and nurses' performance, accessibility in time and place, health environment and patients' rights. Responses were put in Likert Scale from excellent to poor, then satisfaction level was classified into: unsatisfied, partially satisfied and strongly satisfied. Pareto analysis for causes of dissatisfaction was done. The majority of patients were satisfied with accessibility of facilities in time 96.98% and place [98.54%], short waiting time [97.98%]. 73.46% of patients were satisfied with doctors' performance and 60.36% with nurses' performance. 33.26% of patients reported drugs unavailability, 25.87% were dissatisfied with the inadequacy of laboratory capabilities. Pareto analysis revealed that causes of dissatisfaction were deficiency in: information given to patients, bio-psychosocial approach, co-ordination between drugs, shared management, examination, follow-up, health education, referral, drugs, cleanliness, nurses' skills, and investigations. Most of patients were satisfied with accessibility of PHC facilities in time and place, short waiting time, cost of tickets, preventive services and staff performance. Most of patient dissatisfaction [80%] resulted from only 8 of studied causes regarding doctors' performance and only 7 of studied causes of nurses' performance, and health care environment

Effect of extract of Aloe vera, Querous infectoria and Catha edulis on the isolated rabbit duodenum

The aim of this study is to detect the pharmacological effect of aloe [fresh plant and dried Aloe socotrana], gall and the extract of khat leaves [Catha edulis Forsk] on the isolated rabbit duodenum. Extracts of aloe, gall and khat leaves were assayed using isolated rabbit duodenum technique. Mechanical activity of the tissue was registered with a frontal ink isotonic lever on a kymograph drum under continuous oxygen bubbling. The aqueous extract of gall showed a contraction, which was persistent after incubating the tissue with atropine. Fresh extract from the plant aloe as well as aqueous extract of the dried aloe reduced the tone of the mechanical activity of the isolated rabbit tissue. Incubating the tissue with propranolol did not change this response. Ethyl acetate extract of khat leaves from Aldhalae and Yafae provinces did not modify the tone of the tissue, but Yafae khat extract changed the motility. The findings suggest that the gall induced contraction was not based on cholinergic activity, while relaxation, produced by aloe, seemed not to be associated with adrenergic agonism. Yafae khat leaves disturbed the mechanical activity of the tissue

Urinary tract infection and adverse outcome of pregnancy

Urinary tract infections [UTIs] during pregnancy are among the commonest health problems world wide, specially in developing countries, including Egypt. It has several adverse outcomes not only on the mother but also on the fetus as well.. The aim of this study is to determine the incidence of UTIs during pregnancy, study the main risk factors associated with such infections and find the impact of these infections on some pregnancy outcomes namely the gestational age and birth weight. A follow-up study on 249 pregnant women attending the ante natal care clinic at Zagazig university hospital. They were recruited over a period from 1st of September to 30th of or November, 2005. The outcome could be recorded for 201 of them. Data were collected through a pretested questionnaire, repeated urine analyses and recording of outcome of pregnancy. The study revealed that the incidence of UTIs during pregnancy was 31.3%. The commonest organisms were Klebsiella and E-coli. Several socio-demographic characteristics were found significantly associated with UTIs, age being 30 years and more, illiterates and low educational level, low socio-economic level and those with unsatisfactory personal hygiene and those using underwear clothes other than cotton. Significant associations with UTIs were also found in multigravidae 4th and more, those having more than one child and those who previously suffered UTIs. The only predicting variable with UTIs was low socio-economic level. The study revealed that the probability of delivering premature infants and low birth weights was significantly higher among those who experienced UTIs during pregnancy. Multivariate analysis revealed that UTI was one of the main contributors to pre-mature deliveries. Conclusion and Recommendations: Urinary tract infections with pregnancy still constitute a big problem with high incidence. It has a great impact on pregnancy outcome mainly pre-mature labor. So, the study recommends health education about personal hygiene, repeated urine cultures early in pregnancy and during the third trimesters, specially for low socio-economic pregnant women. Specific antibiotics should be prescribed to avoid adverse pregnancy outcome

Morphological identification of scorpion species from Jazan and Al-Medina Al-Munawara regions, Saudi Arabia

The present work is a complementary contribution to the comprehensive study of the scorpion sting syndrome in Saudi Arabia. It deals with the identification and determination of medically important scorpions and the other ones, which were collected from two regions (Jazan and Al-Medina Al-Munawara), based on their morphology (the molecular phylogeny and venom characteristics will appear in subsequent publications). The specimens collected from those two regions were brought to the Research Center laboratories in several batches. Morphological identification of the collected specimens was done employing identification keys. There were 646 specimens collected from Jazan Region. A single species, Nebo hierichonticus (Family Diplocentridae), and five genera with four identified species, Parabuthus liosoma, Hottentotta jayakari (salei?), Compsobuthus werneri, Leiurus quinquestriatus (Vachoniolus globimanus?), Vachoniolus spp. (other species) and Orthochirus innesi (Family Buthidae), were classified as extant scorpions in the region. Three hundred and ninety-six specimens from Al-Medina Al-Munawara Region were categorized into eight groups; four of them were identified. Three buthids, Leiurus quinquestriatus, Androctonus crassicauda, Orthochirus innesi and one scorpion specimen, Scorpio maurus, were identified and classified as extant scorpions in this region. The other four species are still not completely identified. They are Vachoniolus (Buthacus minipectinibus?) globimanus? (Unidentified-1), Compsobuthus spp (arabicus?) (Unidentified-2), Compsobuthus spp (werneri?) (Unidentified-3) and a single specimen of Androctonus spp (australis?) (Unidentified-4), all of which belong to the family Buthidae.

Light microscopic study of the effect of flubendazole, praziquantel and combination of both drugs on adult schistosoma mansoni [with 14 figures]

It is considered that combination of chemotherapy with other control measures can reduce transmission and morbidity of schistosomiasis. This study was done using 60 albino mice infected with cercariae of Schistosoma mansoni. Mice were divided into 4 groups [control, flubendazole treated, praziquantel treated and combination of both drugs]. The effect of treatment was evaluated on male and female worms after [1, 2 and 3 Week Post Treatment]. Worms were collected by perfusion of portal vein and mesenteric veins separately, stained with acetic acid alum carmine and examined by light microscope

Scanning electron microscopy of adult schistosoma mansoni after treatment with praziquantel, flubendazol and combination of both [with 4 plates]

Many antischistosomal drugs are known to cause changes in the ultrastructure of adult worms. This study was done using 60 albino mice infected with cercariae of Schistosoma mansoni. Mice were divided into 4 groups [Control, Flubendazole-treated, Praziquantel-treated and the last group treated by combination of both drugs]. The effect of treatment was evaluated on male and female worms after one and three weeks post treatment. Worms were collected by perfusion of portal vein and mesenteric vein separately then examined by scanning electron microscopy

Pharmacological characterization of rat paw edema induced by Cerastes gasperettii (cerastes) venom

Inflammatory response induced by the venom of the Arabian sand viper Cerastes gasperettii was studied by measuring rat hind-paw edema. Cerastes gasperettii venom (CgV, 3.75-240 µg/paw), heated for 30s at 97°C, caused a marked dose and time-dependent edema in rat paw. Response was maximal 2h after venom administration and ceased within 24h. Heated CgV was routinely used in our experiments at the dose of 120 µg/paw. Among all the drugs and antivenoms tested, cyproheptadine and 5-nitroindazole were the most effective in inhibiting edema formation. Aprotinin, mepyramine, dexamethasone, diclofenac, dipyridamole, Nomega-nitro-L-arginine, quinacrine, and nordihydroguaiaretic acid showed statistically (p 0.001) significant inhibitory effect, but with variations in their inhibition degree. Equine polyspecific and rabbit monospecific antivenoms significantly (p 0.001) reduced edema when locally administered (subplantar) but were ineffective when intravenously injected. We can conclude that the principal inflammatory mediators were serotonin, histamine, adenosine transport factors, phosphodiesterase (PDE), cyclooxygenase, lipoxygenase and phospholipase A2 (PLA2), in addition to other prostaglandins and cytokines.

Upper gastro-intestinal hemorrhage in Upper Egypt [El-Minia] an endoscopic survey of 142 cases

One hundred and forty two [142] consecutive patients with upper gastrointestinal haemorrhage [UGIH], admitted to Menia University Hospital over the 3-year period 1989-91, were studied prospectively. The mean age was 41 years, the male: female ratio was 3:1, causes of bleeding were most common oesophageal varices causing 43% [61 cases], followed by bleeding duodenal peptic ulcers 21.1% [30 cases], and 8.5% [12 cases] from gastric ulcer, drug induced bleeding lesions forming 7.1% [10 cases]; [9 cases] had erosive mucosal gastritis 6.3%, and [20 cases] 14% had additional causes. Forty three patients [30%] had operations with an overall mortality of [14%] 6 cases, while 22 cases [22%] of the unoperated patients died. The prognosis of the oesophageal varices depends on liver function, with mortality 19%. While the overall mortality in the peptic ulcer group is low [7%], the presence of stigmata of recent haemorrhage is associated with a high risk of rebleeding

Factors inducing stress for immobilized patients

Immobilization reduces the ability of the patient to interact with his environment in a healthy way. This study was carried out to determine factors inducing stress experienced by 85 immobilized patients at El-Hadara Orthopaedic Hospital. An interview-questionnaire was filled on the fifth day, after admission. Results, showed that social factors were the most important stressing factors for both sexes, with different age groups, education and occupations. Hospitalization was second in importance for both sexes