Quality of life among systemic lupus erythematosus female patients "an intervention study"

Systemic lupus erythematosus [SLE] is one of chronic disabling diseases that commonly affects women in their child-bearing years. [1] To assess the impact of SLE on quality of life of diseased females, [2] To identify the most affected dimensions of patients QOL, [3] To study the relation between some socio-demographic and disease characteristics and the level of patients QO and [4] To estimate the effect of training and educational health program on the most affected dimensions of QOL of the studied patients. This is an intervention study on a sample of 50 SLE female patients who where regularly attending Ain Shams University, Rheumatology Outpatient Clinic and were assessed throughout one month period, [March 2006]. The study sample included all who concurred a specific criteria; being females, 15-49 years, with established diagnosis since at least two years and they were receiving a stable treatment for at least 4 months. Data about socio-demographic and disease characteristics were collected by direct interview to fill in a pre-designed questionnaire. Data about QOL was collected using Arthritis Impact Measurement Scale 2. A specific training and health educational program for the most affected dimensions of QOL was applied on a sub sample of 23 patients for 8 weeks. Pre-post intervention assessment of QOL dimensions were compared. The study showed that 40% of the sample had bad and very bad QOL level. There were no statistically significant associations between most of socio-demographic and disease characteristics and the QOL level, except for presence of large family number >5 and those who took out prescribed medications, which were found higher among bad and very bad QOL group. The most affected dimensions of QOL were in sequence, social activity, tension, pain, walking and bending, mood, and household tasks. Post intervention assessment of QOL dimensions revealed highly statistically significant improvement not only among the program dimensions but also among the majority [5 out of 7 of the remaining dimensions. SLE disease has a great impact on most of the domains of patients QOL. Adopting different educational and training programs addressing the affected dimensions of health can greatly improve patients QOL

Pattern of pulmonary tuberculosis at Zagazig district after implantation of directly observed therapy, short course [DOTS] strategy

Considering tuberculosis as one of the resurgent disease, WHO started a directly observed therapy short course "DOTS" as a new strategy in Africa. Egypt began to adopt this strategy since 1996

Aim of the work: This study aimed to explore the pattern of pulmonary tuberculosis at Zagazig district [Sharkia Governorate] after DOTS implementation, as well as study some risk factors associated with the disease and those associated with uncure

Subjects and Methods: A follow-up study for all diagnosed pulmonary tuberculosis at Zagazig district [2003] was performed. Patients were followed up till completion of DOTS. Data was collected through questionnaires for patients and physicians, investigations and clinical examinations, as well as records review for the number of cases and their outcomes since 1990

Results: Prevalence of pulmonary tuberculosis showed a marked decline at the years 1996, 1997 and 1998 followed by a gradual rise at 1999 and 2000, then an unstable decline was noticed till the study year 2003. Cure rate showed a continuous rise since DOTS application [1996]. The majority of patients were of working age, males, urbans, married and of moderate socio-economic level. Smoking habit was found among 66.7% of them. Heavy Goza smokers represented 54.1% of Goza smokers. Nacrotics and diabetics were found among 20.8% and 25.0% of patients respectively. Vast majority of patients considered this disease as a stigma. A good percentage of patients >60% had a correct knowledge about the disease risk factors. DOTS succeeded in cure of 77.1% of patients while failed in 8.3% of them. The remaining percentage were defaulters [12.5%] and died [2.1%]. Patients conditions [general, local, chest, radiological and bacteriological] showed a significant improvement after DOTS, P < 0.00. Patients with high socio-economic level, diabetics and those who were categorized as relapsed and ttt failure, besides narcotics and high age patients were significantly found among the uncured group, [P<0.05]

Conclusions and Recommendation: DOTS is a successful strategy for TB control. Patients with high age> 40 years, relapsed and ttt failure, diabetics, narcotics and those of high socio-economic level should have a special program of monitoring throughout DOTS implementation

Risk factors affecting age at natural menopause in Zagazig district

As menopause is a natural phenomenon among all females that associated with risk of developing several long term diseases. Determinant factors associated with onset of that menopause need to be more explorated

Aim of work: studying different factors associated with age at menopause, focusing on factors associated with early onset of natural menopause

Subjects and Methods: a cross - Gectional study was conducted from May to September 2004, at Zagazig district. Nine hundreds and twelve fenlales [40 years and more] were interviewed after considering the needed sample size. The main sociodemographic, life style and biologic variables were inquired from them through a predesigned questionnaire. Score of physical activity as well as some anthropometric measurements were applied to them

Results: there were a significant association regarding history of chronic diseases[hypertension, diabetes..etc], insufficient income, marital status as [single, widow or divorced], and using an intrauterine contraceptive device [IUD] among menopaused females, [Odds Ratio: 5.41, 2.07, 1.9 and 1.74 respectively]. High kids number [4,+] late age at menarche [>15 years] as well as irregular and variable menses duration were significantly higher among menopaused females. Physical activity was not only significantly more affected among those group, but also much affected among those who developed early menopause [<45 years] [odds ratio: 4.83 and 3.56 respectively]. Early age at natural menopause was also significantly associated with non working status, insufficient income as well as [single, widow or divorced] and tilose with long and variable menses duration

Conclusion: among the significant factors, logistic regression analysis revealed that; menses duration [long/variable], non working status and marital status [single, widow or divorced] were the significant predictors for early onset of natural menopause. So, attention should be paid to those groups by regular health education and medical follow up for early prevention of the associated risks of multiple diseases