Detection of cotinine in neonate meconium as a marker for nicotine exposure in utero

Neonate meconium cotinine level was evaluated as a marker of prenatal exposure to nicotine from tobacco smoking by mothers. Mothers admitted to a maternity hospital in Alexandria, Egypt, were divided into 3 groups: 10 active smokers, 10 passive smokers and 10 with no tobacco exposure during pregnancy. Urine and saliva samples were collected from mothers and first-day meconium samples from their neonates. Mean maternal urinary cotinine levels, measured using radioimmunoassay, differed significantly between the 3 groups, as did mean salivary cotinine and mean cotinine levels in meconium.There was a significant positive correlation between cotinine levels in meconium and both maternal urinary and salivary cotinine levels. Meconium is an ideal biological marker for testing direct fetal exposure to tobacco smoke in the neonatal period

Prevalence of rheumatic heart diseases among school students in Sharkia governorate, Egypt

The prevalence of rheumatic heart diseases [RHD] in school students in Sharkia Gorernorate [about 500.000 students] was studied in contribution with the current screening program of school Health Insurance System in Sharkia Governorate. Target population [6- I 5 years, old] was followed during the period from January 1994 to November 1996. Students were medically examined in collaboration with school physicians, positive screened cases were further submitted to investigations by serial echocardiography and Doppler ultrasongoraphy and other diagnostic tools at Health Insurance Hospital at Zagazig City. The prevalence of RHD among school student was 5.2%. The highest prevalence rate of RHD was observed among females aged 15 years or more. Double mitral valve disease was the commonest lesion while combined mitral and tricuspid valve diseases were the least one. The use of echocardiography during this work removed any bias and attached more accuracy to our data. Authors recommended comprehensive field studies for early detection of cases, also more efforts must be paid for the prevention and control of rheumatic fever and RHD especially among adolescent females

Evaluation of the health service performance in outpatient clinics in Zagazig University

Many illnessess now can be treated on an ambulatory base [outpatient care] due to the shortage of hospital beds and escalation in operating expenses for inpatient care. The objective of this study is to evaluate the health service performance in Outpatient Clinics in Zagazig, University Hospitals for the sake of promotion of health services in these clinics. This work was done at the Pediatric and Gynecologic Outpatient Clinics, Zagazig University Hospitals. The health care - providers [physician number 37] and a random sample of 800 consumers of both studied clinics, were included in the present study The performance of the health service was evaluated by assessment of structure, care process, and outcome of care of the studied clinics.The work conditions of the studied outpatient clinics were satisfactory in general, but that for site, area and artificial ventilation of the Gynecologic clinic were inadequate. Lavatones and booklets were not adequate in both clinics while posters were not available in Gynecologic clinic The required medical equipments were available in Pediatric [35%] and Gynecologic clinics [73.9%], while non medical ones represented 62.5% and 68.7% of the required items respectively. Drugs availability was not satisfactory [at both studied clinics] according to both providors and consumers oponion. One record was present at each clinic in which recorded data were inaccurate and incomplete. Functional analysis of physicians showed that their performance was generally satisfactory except for completing ticket data and supervising subordinates. About case management, there was deficiency in communication skills [e.g. welcoming of the patient] versus manual skills [e, g.local examination] Consumer study revealed that rural residence and lower levels of education were significantly associated with higher degree of satisfaction. But consumers of both studied clinics were generally satisfied with service offered except for waiting time at Pediatric clinic. Institution of a quality assurance program to monitor the health service performance at the outpatient clinics on a regular basis is highly recommended