Knowledge and practice of students of Ain Shams university in measles and rubella [MR] catch up campaign

The ministry of health in Egypt implemented Measles Rubella [MR] campaign in 2008 based on the recommendation of the WHO for supplementary immunization activities to eliminate measles by 2010. The targeted age was 10 to 20 years. Egypt had an epidemic of rubella in spring of 2007. This campaign is unique in Egypt as it is the first national vaccination campaign targeting university students. This study aimed at reporting the practice of vaccination among medical and non medical students in the MR vaccination campaign, to assess the knowledge about the vaccination, side effects and contraindications. Also to explore the compliance to vaccination and causes of refusal of vaccine uptake. The study was done in two stages, first stage during the vaccination sessions. Medical and non medical students were given a questionnaire to assess their knowledge about the campaign and the vaccine. The second stage was done after the end of the campaign to assess the compliance of medical students to vaccination. Vaccination posters inside the university were the main source of knowledge about the campaign as reported by 73.3% of students followed by friends 56% and TV ads 40.7%. Lack of knowledge about adverse effects, and contraindication was high [80.5% and 68.8% respectively]. The mean knowledge score percent of students was 26.5% and was higher among medical than non medical. Overall compliance with vaccination among medical students was [64.8%] which was significantly higher among females compared to males [81.5% versus 52.1% respectively]. Non compliant students had a significant higher mean age. Almost half of non compliant students reported refusal of vaccination due to insufficient information about the vaccine [43.3%]. A successful vaccination campaign was conducted at Am Shams University yet there were insufficient health education messages to support it

Guided liver biopsy of hepatic focal lesions in chronic liver disease patients: when and why?

Hepatocelluar carcinoma [HCC] is one of the most common malignant neoplasms in the world. To assess the value of the ultrasound or CT guided biopsy of hepatic focal lesion [s] with normal or mild elevation of serum alpha fetoprotein [below 200ng/mL] in the diagnosis of hepatocellular carcinoma. One-hundred twenty one chronic liver disease patients with hepatic focal lesion[s] and serum alpha fetoprotein below 200ng/ml were included in the present study. All patients were subjected to careful history taking and full clinical examinations, laboratory investigations [CBC, liver profile, hepatitis markers and serum AFP level], abdominal ultrasound, abdominal triphasic spiral computed tomography [CT] and biopsy of the hepatic focal lesion[s] guided by ultrasound for histopathological examination. According to the histopathological diagnosis of the lesion, patients were divided into non-HCC group [Group I] and HCC group [Group II] which included dysplastic nodules as well. Group I included a total of 29 patients -20 males [68.9%] and 9 females [31.1%] - aged between 30 and 68 [mean 51.7 +/- 9.3] years. Pathological examination of their liver biopsies revealed 14 cases as chronic hepatitis, 5 cases as liver cirrhosis, 5 cases as adenocarcinoma, 1 case as squamous cell carcinoma 2 cases as hemangioma and 1 case as cholangiocarcinoma and one case of lymphoma. Group II included a total of 92 patients -75 males [81.5%] and 17 females [18.5%] - aged between 36 and 74 [mean 55.0 +/- 8.8] years. Pathological examination of their liver biopsies revealed 88 cases as HCC and 4 cases as hepatic dysplastic nodules. The sensitivity and specificity of triphasic abdominal spiral CT in the diagnosis of HCC were 91.3% and 69.0% respectively, while, the positive and negative predictive values were 90.3% and 72.5% respectively. Guided liver biopsy of hepatic focal lesions in chronic liver disease patients has a valuable diagnostic role in cases with low alpha fetoprotein below 200ng/ml in whom the non-HCC nature is suspected and cases with negative or atypical HCC criteria in spiral abdominal CT