Pharmacoepidemiological study of self-medication in adults attending pharmacies in Alexandria, Egypt

A cross-sectional study was conducted to determine the extent and pattern of selfmedication among adults, to identify their knowledge and practice concerning the purchased drugs and to calculate prescribing and purchaser care indicators. Following WHO methods, 35 pharmacies were randomly selected from districts in Alexandria city, Egypt. Of 1294 clients interviewed at these pharmacies, 1050 [81.1%] purchased self-medication; the commonest reason given was a belief that the condition was minor. The most frequently dispensed drugs were those for the respiratory system. The mean number of drugs per encounter was 1.10, mean cost LE 7.29 and mean dispensing time 2.53 minutes. Purchasers' knowledge and practice regarding the purchased drugs were poor

Device-related nosocomial infection in intensive care units of Alexandria University Students Hospital

We studied the magnitude and determinants of device-related nosocomial infections in intensive care units [ICU] and identified the predominant microorganisms involved. Sputum, urine, blood cultures and chest X-ray were taken from each patient on admission and on appearance of any sign/symptom of infection. Out of 400 patients admitted to 3 units during the study, 45 [11.3%] developed nosocomial infections. The most important determinants of infection were previous admission to an ICU, whether in the same or another hospital, and duration of stay. Overall, 38 patients developed 43 device-related nosocomial infections [1.13 episodes per patient]. The main infectied association with invasive procedures were ventilator-associated pneumonia followed by catheter-related urinary tract infection and bloodstream infections

Epidermal growth factor in human breast milk

The present study compared the level of EGF in different human milk samples obtained from Egyptian mothers delivered at full and preterm. Human milk samples were collected from two groups of lactating mothers, the first group comprised 45 mothers who delivered at fullterm and the second group were 45 mothers who delivered at preterm. The concentration of EGF in human milk samples was measured by ELISA. Milk samples were collected from 3 to 10 days after delivery. Breast milk from the mothers in the first group had a significantly lower EFG concentration compared to that from mothers in the second group. EGF in human breast milk negatively correlated with the gestational age of the neonates in the two studied groups with r = - 0.783 and for the first group and r= -0.913 and for the second group. EGF concentrations negatively correlated with the day of milk sample collection in the two studied groups with r = -0.943 and for the first group and r= -0.960 for the second group

Expression of some apoptosis-controlling proteins in pediatric lymphoproliferative malignancies

The aim of this study was to determine the expression [levels] of some apoptosis-controlling proteins [Bcl-2 and soluble Fas] in children with lymphoproliferative malignancies and to find out the relation between their expression and the clinico-laboratory parameters as well as the outcome of the disease. The study included 39 children with lymphoproliferative malignancies [14 with non-Hodgkin lymphoma [NHL], 5 with Hodgkin lymphoma [HD] and 20 with acute lymphoblastic leukemia [ALL]]. Their age ranged from 0.5-14 years, they were 28 males and 11 females. Twelve apparently healthy children were included as a control group. Cases and controls were subjected to full history taking, thorough clinical examination and certain investigations [serum levels of Bcl-2 and soluble Fas proteins and complete blood picture]. For cases only, bone marrow examination, CSF examination, immunophenotyping and radiological evaluation were done. One-year follow-up of cases was performed for the evaluation of the prognosis and the outcome of the disease. The study concluded that increased serum expression of Bcl-2 and soluble Fas can be demonstrated in children with lymphoproliferative malignancies. High serum levels of such apoptotic controlling proteins were correlated with poor prognosis in patients with HL and NHL, while no correlation was found with the prognosis in patients with ALL

Reproductive tract infections among married women in Upper Egypt

In a house-to-house survey using cluster sampling, 1344 married women from urban and rural areas of Upper Egypt [Minia, Assiut and Sohag] were interviewed and examined to study the magnitude and determinants of reproductive tract infections. Overall prevalence was found to be 52.8%, with the most prevalent forms being Candida albicans [28.0%], Trichomonas vaginalis [8.7%], Aspergillus species [7.4%], streptococci [4.6%] and Chlamydia trachomatis [4.2%]. Multivariate analysis identified certain groups of women at high risk of developing reproductive tract infections [those currently using an intrauterine device, those who regularly practised internal vaginal washing]. Discriminant analysis showed that symptoms were of low discriminating value. There is a great need to increase community and women's understanding of reproductive tract infections

Reproductive health of married adolescent women in squatter areas in Alexandria, Egypt

Through a house-to-house survey, 455 married adolescent women [< 20 years] and 455 married women aged 20-45 years from squatter areas in Alexandria were interviewed. Determinants of early marriage were consanguinity, illiteracy and unawareness of reproductive health. Of the currently pregnant adolescents, 22% were receiving antenatal care compared with 40% of the older women. Family planning methods were currently being used by 39% of the adolescents and 63% of the older wives. Determinants of non-use were: adolescence, illiteracy and previous miscarriage/stillbirth. There is a need to increase public awareness of reproductive health and change the behaviour of both groups of women in this under-privileged sector

Plasma fibronectin in bacterial meningitis

Twenty-two cases of bacterial meningitis with age ranged between 1-12 years were examined and 20 healthy children matched for age and sex served as controls. All cases and controls were investigated for plasma fibronectin, total leucocytic count [WBC] and erythrocytic sedimentation rate [ESR]. Cerebrospinal fluid [CSF] glucose and protein had returned to normal levels in all cases after treatment, while CSF cell count remained abnormally high in 32% of cases. Plasma fibronectin, WBC and ESR did not significantly differ regarding the bacterial isolates from CSF

Surveillance of acute respiratory infections in El-Mina University Hospital within one year [clinico-epidemiological study]

Seven thous and s and fourteen children less than five years old with acute respiratory infections [ARI] were surveyed over a period of one year [1993]. ARI occurred in all seasons of the year and the seasonal incidence was 25.5% in winter, 15.4% in spring, 10.8% in summer and 17.8% in autumn. The relative frequency of each diagnosis among the total ARI cases was no pneumonia [cough or cold] 54.80%, pneumonia [not severe] 22.12%, severe pneumonia 3.76%, very severe illness 0.52%, acute otitis media 3.35%, suspected acute streptococcal sore throat 8.55% and bronchial asthma 6.9%

Growth in children with chronic renal failure and after transplantation

The aim of this work was to study the relation between height expressed as st and ard deviation scores [HtSDS] for chronological age, glomerular filtration rate [GFR] and hormonal alteration in children with chronic renal failure [CRF] on regular hemodialysis [HD] and the possible role of normal graft function after kidney transplantation in this respect. The study comprised 18 children with a mean age of 10.56 +/- 3.08 year and 16 children with normal graft function [mean age 11.06 + 3.19]. The mean duration on HD was 14.72 +/- 7.73 month for CRF group and the mean interval after transplantation was 1.97 +/- 0.9 year for the group of functioning grafts. Ten normal healthy children of matched age and sex served as controls. All patients were subjected to careful history taking, full clinical examination, assessment of growth parameters, laboratory investigation including serum growth hormone [hGH] and serum parathormone [PTH] measured by radioimmunoassay. Growth performance was evaluated twice at the beginning of the study and after a period of one year

Clinicopathological study of children with idiopathic steroid insensitive nephrotic syndrome

This study was carried out on 100 children with idiopathic steroid insensitive nephrotic syndrome aged 3 to 16 years. They were 61 males and 39 females. Cases with the secondary forms of nephrotic syndrome and those who were steroid sensitive were excluded from the study. After a thorough history and clinical examination, all cases were subjected to laboratory investigations including complete urine analysis, 24 hr urinary protein estimation, serum creatinine. Plasma proteins, serum albumin, total serum cholesterol, C3, C4, and ultrasound - guided renal biopsy where kidney tissues were examined using light and immunofluorescence microscopy. Our results showed the presence of the minimal change nephrotic syndrome in 62 percent of cases [36 patients with nil disease and 26 patients with other minimal change variants], focal segmental glomerulosclerosis [FSGS] in 25 percent, diffuse mesangial proliferation in 5 percent, membranous nephropathy in 4 percent and membranoproliferative glomerulonephritis in 4 percent of cases. Patients with MCNS had significantly younger age of onset, less frequent hypertension, and lower level of serum creatinine compared to those with other renal histopathology [P < 0.01, < 0.05 and < 0.01, respectively]. Steroid resistance was significantly more frequent than steroid dependence among children with renal histopathology other than MCNS. Patients with steroid resistant nephrotic syndrome had significantly older age of onset, significantly higher frequency of hypertension, significantly higher serum creatinine, and significantly more frequent heavy proteinuria when compared with those having frequently relapsing steroid dependent nephrotic syndrome [P < 0.05, < 0.01, < 0.01, and < 0.05, respectively]

Granulocytopoiesis in children with acute lymphoblastic leukemia

Numbers, proliferative potential, and differentiative capacity of bone marrow granulocyte-macrophage precursor cells were studied in 130 children with acute lymphoblastic leukemia [ALL], including 77 children in an acute phase of the disease and 53 in remission. Bone marrow samples from 65 children without hematopoietic abnormalities were used as controls. The numbers of clonogenic precursors were found to be below normal in all phases of ALL, particularly during the acute period when the bone marrow was heavily infiltrated with leukemic cells. It is shown that the decreases in the numbers and proliferative potential of the precursor cells during the acute phases were associated with the effects of leukemic blast cells, but that in remission the observed reduction in the precursor cell pool was due to the cytostatic effect of therapy. The differentiative capacity of clonogenic granulocyte and macrophage precursors was not altered in children with ALL

Epidemiology of gonorrhea among married females presenting with leucorrhoea

Gonococcal infection among females presenting with leucorrhoea was studied in Alexandria during the year 1979. The number of cases was 200 and their age ranged between 15 and 50 years old. Nine percent were positive for gonococci. The gonocccal infection was more among those of middle socio-economic class [21.21%], divorced [66.86%] and infertile [10.52%]. T.vaginalis and C.albicans were also isolated [42.5% and 29.5%]. The most common complaint was menstrual abnormality [26.6%]. The uterine cervix was the site of highest yield [77.7%] for gonococci

study of mortality in Alexandria

The causes of death in relation to various epidemiologic parameters, among a sample of mortalities from health offices chosen randomly to represent the different socio economic levels in Alexandria, were studied. The main leading causes of death were circulatory system diseases symptoms, signs and illdefined conditions, infectious and parasitic diseases, endocrine, nutritional and metabolic disorders. They varied with age, sex, marital status, occupation and social class

Viral hepatitis in Alexandria

This study was carried out on 1919 clinically diagnosed hepatitis patients admitted to the Alexandria Communicable Diseases Hospital during the period from August 1974 -July 1975. With the aim of investigating the personal, social and environmental background of cases, to determine the proportion of HBsAg positive cases among a sample of the patients and to study the outcome of the disease. The attack rate was found to be 9.4 per 10,000 population and was considered to be a minimum attack rate. It varied by district in Alexandria, and was highest for the age group 15 - 24 years. The male to female ratio was 2: 1. Technical and manual work was the most frequent occupation reported by the patients. Hepatitis cases were prevalent all the year round with an increase in late summer. A large proportion of the cases was living at high levels of crowding with a rather low level of sanitary standard of the homes. The mean duration of hospitalization was 14.12 days. The sera of 175 patients subjected to R. I. A. testing detected 53.7% positive cases for HBsAg. Relapse occured in 13.24% of the cases. The calculated fatality rate for hepatitis was 1.62% being higher for patients aged 45 years and more than other age groups