Complementary and alternative medicine use among children in Ismailia-Egypt: community based study

This study aimed to determine the prevalence of the use of complementary medicine, the types most frequently used, and the conditions it is used for among children in rural community-El Mahsma village-Ismailia-Egypt. This cross-sectional community-based study was conducted in a rural community in Ismailia. A structured interview was conducted by trained interviewers with the study population [368 participants in the age group of less than 18 years] in three hamlets representing the catchment area. The data were coded and entered into the computer. The appropriate statistical tests were used to identify significant difference. The present study showed that, the overall use of complementary/alternative medicine among rural children was 44% at some time in the past in their life. Herbs/home remedies were the most frequently used [99.4%] as CAM therapy, followed by Honey [16.3%]. In contrast, other therapies including acupuncture [1.9%] and Hujama [0.6%] were uncommon. It was evident that, CAM showed significant association with age and education as CAM was more common among children younger than 1 year [8 5%] and before primary school [56.6%] [P<0.05]. Children who are living within the family are not exception in exposure to the CAM Practices in rural community such as El Mahsma village. The study showed high use of CAM therapies among the children. The results of the present study paid attention towards the need of training of health care providers in the era of CAM. More emphasis on training of those providing health care in rural community; who are in touch with folklore and other alternative interventions in their daily practice. The responsibility of the health care provider regarding CAM use, side effects, and benefits must be acknowledged for such vulnerable group. Setting strategies for discussing CAM with children and parents with routinely screening of CAM use particularly herbal therapy is crucial

Comprehensive evaluation of right ventricular function in acute myocardial infarction by tissue doppler echocardiography. Does ventricular interdependence exist?

The involvement of the right ventricle in acute myocardial infarction [AMI] has been shown to be associated with an increased risk of life-threatening arrhythmias and sudden cardiac death. The study aimed at investigating the right ventricular function in AMI and the interaction between left and right ventricles using Doppler tissue imaging [DTI]. The study included 125 patients admitted to coronary care units and diagnosed as AMI at all sites [anterior and inferior] [100 males and 25 females] with age ranging from 36 to 82 years. They were classified according to clinical, ECG and angiographic data into: group I included 52 patients with RV myocardial infarction [RVMI], group II: included 73 AMI patients without RVMI. They were compared to 25 age and sex matched healthy individuals as a control group. Conventional Doppler mitral and tricuspid inflow velocities and tricuspid annulus systolic excursion using 2D echocardiography were used to evaluate LV and RV functions. Also, Peak systolic and peak early and late diastolic velocities [S,E,A, E/A], contraction time [CT], pre-contraction [PCT], acceleration [AT] and deceleration time [DT] of S velocity were acquired from the apical four-chamber view at the lateral side of tricuspid annulus[ta], the septal, lateral, anterior and inferior sides of the mitral annulus [ma] using DTI. RV function using DTI; S[ta] PCT[ta] IRT[ta] were significantly impaired in group I compared to group II and control [9.2 +/- 1.4 vs 12.3 +/- 1.96 vs 14.6 +/- 2.2], [103.5 +/- 16.5, vs 84.6 +/- 24.3 vs 78.4 +/- 16] and [110.6 +/- 18.7 vs 84.9 +/- 30.2 vs 56 +/- 18.9] respectively. [P< 0.001]. Similarly, TASE was significantly lower in group I vs II and group II vs control [7.2 +/- 2.6 vs 12.4 +/- 4.9 vs 15.7 +/- 5.3 respectively [P<0.001]. LV functions S[ma], PCT[ma], CT[ma], E[ma], E[ma]/A[ma], were significantly decreased in group I and II compared to control [P< 0.001] but no significant difference of LV functions between patients with or without RV infarction. Almost all DTI parameters used in evaluation of systolic and diastolic RV functions showed strong direct correlation to the corresponding LV parameters [P<0.001]. RV end diastolic pressure was passively correlated to S[ta] but not E/E[ta] of the RV in all AMI patients. The interaction between the two ventricles can be identified using DTI which now plays a relevant role in clinical scenarios. In AMI, despite the proved increased risk of morbidity and mortality in RVMI, LV dysfunction adversely affects RV function even in absence of RV infarction

Patient education and weight control of non-insulin dependent diabetic patients

Non insulin dependent diabetes mellitus is a growing problem in developing countries. The majority of patients are obese and characterized by increased deposition in the trunk [central obesity]. Voluntary weight reduction initiated by patients early in the course of the disease was found to delay morbidity and mortality that accompany the disease. The aim of this study was: to achieve weight reduction and reduction in the waist/hip ratio through educating the patient to follow a special dietary regimen that supply approximately 1500 kcal/day and to practice active walking for half to one hour per day through a period of 6 months. Also to show the effect of this dietary regimen and exercise on the blood glucose level. The study included 190 patients aged from 37 up to 69 years old [47 males and 143 females] recruited from those attending the [Diabetic Care Unit] In El Menshawy General Hospital, Tanta, Egypt. Those patients were subjected to monthly health education sessions for a period of 6 months. Through these sessions the patients were advised to follow a moderately restricted caloric diet and to practice active walking for half to one hour daily. The results of the study showed that 84.73% of them were over weight and obese and 93.68% showed central deposition of fat. At the end of the study the patients showed significant reduction in their weight as shown by the reduction in body mass index from 32.48 +/- 4.73 to 30.55 +/- 4.89 in male patients and from 31.30 +/- 4.58 to 29.95 +/- 5.07 in female patients. The waist/hip ratio has been also reduced from 1.07 +/- 0.13 to 0.98 +/- 0.09 in male patients and from 1.05 +/- 0.13 to 0.96+0.09 in female patients. Also the study showed significant reduction in both fasting and postprandial blood glucose level. The restriction in B.M.I was not statistically significant among those who did not follow a regular dietary restriction. Both B.M.I and waist/hip ratio showed non-significant reduction among patients suffering from the disease more than 10 years. These findings show the importance of early dietary intervention for controlling the disease and the importance of team approach in health care of patients with chronic diseases including diabetes mellitus

Community participation in health survey in rural areas in gharbia Governorate, Egypt

This study was a pilot done through the activities of a health caravan of the Faculty of Medicine, Tanta University in three villages away from Tanta City by about 3-5 Km. in Gharbia Governorate. The study included 24 of the community leaders in the three villages and 30 from the university students named as young helpers. The community leaders and the young helpers were exposed to health education sessions regarding the common health problems in their communities and the young helpers were prepared to disseminate the learned information to their villagers. The study also recorded 1188 patients from those who attended the health caravan seeking medical treatment and/or advice [30.23% of them were males and 67.75% were females]. The main illnesses recorded among them were as follows: gastrointestinal [25.9%] orthopedic [18.9%], skin [8.8%], ophthalmic [8.3%], E.N.T [7.7%], chest [4.5%] and cardiac diseases [4.3%]. Systolic hypertension was recorded among 10.41% of those above 10 years old, diastolic hypertension was recorded among 14.62% and both systolic and diastolic hypertension were diagnosed among 9.82% of them. Community participation was found to be important in facilitating the work of the health team and increasing the efficiency of the services presented. Also, continuous monitoring of the health status of the population and the underlying changeable socioeconomic conditions are important for health promotion of the rural communities

Street children Gharbia governorate: a public health problem

The phenomena of street children is a growing one all over the world. The aim of this work was to throw light on the problem of street children in Gharbia Governorate, Egypt. A total of 377 children aged from 8 up to 17 years were included in the study, 191 of them [50.66%] were collected from different workshops in the slums of the large cities [Tanta, El Mehala El Kobra and Kafr El Zyat], 106 [28.12%] were practicing petty jobs and 80 children [22.88] were begging in the street corners and traffic stations in the three cities. The causes that enforced these children to be street children were poverty [22.02], maltreatment either at home or at school [210.40], broken families [19.36] and absence of the father [19.28]. More than one cause were present among 104 children [28.12%]. The social factors behind this phenomena recorded in this study were low educational level, unstable and unskilled work with unfixed salaries beside broken families due to either death of one or both parents or their divorce or the travel of the father abroad. The children usually spent their earned salaries to support their family income, for getting their personal and school needs and for entertainment.Regarding the school attendance, the study showed that only 92 children [24.4%] still attended the school regularly and 173 of them [45.89%] never attended schools, while 112 children [29.71%] have dropped out of schools due to either poverty, failure at school, maltreatment, poor control over the children and peer pressure. Abnormal behaviors recorded among the studied children were begging and stealing among 40.05% and 27.56% respectively. Aggressive behaviors against others were reported among 28.12% of them. 313 [83.02%] were smokers, addiction and drug abuse were a problem among nearly about one fifth of them [22.12%].Regarding the health status of those children, 60.73% of them were suffering from underweight and malnutrition. Signs of physical maltreatment were recorded among 24.61% of the examined children. In conclusion, the problem of street children is a growing problem that need more attention and more medical and social care should be made available for this vulnerable group in the community

Serum lipoprotein [a] and risk of coronary heart disease: its relation to degree of coronary artery occlusion

To study the relationship between the serum lipoprotein [a] levels and the degree of coronary artery occlusion, 40 patients [32 males and 8 females] with a previous attack of acute myocardial infarction were included in this study. The age of pateints was ranged from 36 to 60 years [mean age = 47.13 +/- 5.5 years]. Patients were evaluated clinically and by laboratory means and underwent coronary angiography. They were classified into 3 groups according to coronary atherosclerosis score [CAS]; Group I comprised 20 patients with CAS /= 8. Results showed that the plasma levels of total cholesterol, triglycerides, LDL and HDL were not significantly differed among the different groups of the patients, while the plasma Lp[a] level was significantly increased from 20.27 +/- 7.25 mg/dl in group I to 32.00 +/- 8.70 mg/dl in group Il and to 52.71 +/- 14.5 mg/dl in group Ill, p <0.001. Correlation between the degree of coronary artery narrowing [as measured by CAS] and the plasma lipids revealed significant positive correlation only with Lp[a], r = 0.77, p <0.001. Regression model consists of Lp[a], cholesterol, triglycerides, LDLand HDL showed that Lp[a] is the most important risk factor associated with coronary artery occlusion, r[2] = 0.60, p <0.001. Thus Lp [a] is a major plasma lipid risk factor [or coronary heart disease and its level can predict the extent of the coronary artery narrowing