Detection of helicobacter pylori infection and upper gastrointestinal disorders among Zagazig university hospitals waste collectors: a comparative cross- sectional study

Hospital work, involving direct patient contact and poor sanitary conditions, constitutes a major risk factor for acquisition of H. pylori infection. 1] determining the prevalence and occupational risk of, pylori infection among hospital waste collectors, 2] identifying some of its associated risk factors, 3] investigating the validity of some non-invasive tests for the diagnosis of H. pylori infection in comparison with the gold-standard invasive test, esophagogastroduodenoscopy with biopsy, 4] comparing the diagnostic performance of salivary H. pylori IgG with that of serum H. pylori IgG, and 5] determining the percentages of upper gastrointestinal [GIT] symptoms and the endoscopic findings among hospital waste collectors and assessing their relation to H. pylori infection. This comparative cross-sectional study was conducted on 78 hospital waste collectors and 78 security and administrative workers from Zagazig University Hospitals as a control group. All participants filled pre-constructed questionnaires and were subjected to H. pylori stool antigen and serum and salivary anti-H. pylori IgG tests; while only 110 workers underwent esophagogastroduodenoscopy with biopsy and rapid urease test. The results revealed absence of significant occupational risk of H. pylori infection acquisition among hospital waste collectors compared to the controls. Moreover, Male sex, smoking habit, low socioeconomic status, poor personal hygiene, and family history of upper GIT complaints were the risk factors significantly associated with active H. pylori infection. Fecal antigen test had the highest sensitivity, specificity, positive, and negative predictive values for the diagnosis of H, pylori infection compared to the other non-invasive tests. Moreover, there was a fair degree of agreement between salivary and serum H. pylori IgG tests regarding their diagnostic performance [0.34]. Also, absence of statistical significant differences between both studied groups regarding the percentages of upper gastrointestinal symptoms and different endoscopic findings was revealed. Finally, current H. pylori infection was found to be significantly associated with different types of gastritis; however, normal mucosa by endoscopy didn't exclude the presence of H, pylori infection. So, improving the overall standard of living in our country, environmental sanitation, introducing effective anti-infective sanitary regulations at work, mass screening through either stool antigen or serum IgG or salivary IgG tests to detect infected persons, and proper treatment of infected persons are mandatory

De quervain's tenosynovitis and occupation: an epidemiological study

A cross - sectional study was carried out in five different occupational settings in City to determine the prevalence of de Quervain's tenosynovitis among workers performing repetitive hand and thumb movements and to identify the potential associated risk factors. Washer women, brick layers, nurses and computer keyboard operators were selected randomly as the exposed group and compared with a group of randomly selected non-exposed workers. A total number of one-hundred and fifty six workers were interviewed using a preconstructed questionnaire. Those workers who were diagnosed as de Quervain's tenosynovitis by clinical manifestations and positive Finklestein's test were subjected to magnetic resonance imaging [MRI] of the wrist. The results revealed that the highest prevalence of de Quervain's tenosynovitis was among washer women [36.4%] and brick layers [30.8%] followed by nurses [17.6%] then computer keyboard operators [15.3%] and the least was 1.3% among the non-exposed group. De Quervain's tenosynovitis symptoms were more frequently reported among exposed workers [59%] compared to the non-exposed [7.7%]. Among those complaining of symptoms suggestive of de Quervain's tenosynovitis, 12.8% were diagnosed as de Quervain's disease by Finklestein's test. MR imaging revealed that increased tendon thickness and thickening and edema of the synovial sheath were the most reliable findings. Multivariate logistic regression analysis revealed that the type of current occupation, actual hours worked per day, older age and female gender were likely to be associated with de Quervain's tenosynovitis. In conclusion, exposure to heavy manual work load in occupations that need repetitive hand motions alone or with forceful squeezing, forceful gripping and/or forceful grasping and turning were associaled with high prevalence of de Quervain's tenosynovitis. This condition was also related more to age, sex and actual hours worked per day. So, administrative regulations and surveillance for de Quervain's tenosynovitis in the work place may be of great benefit for early referral of cases for treatment and to reduce the occurrence of the condition