Perception and Practice of Road Safety among Medical Students, Mansoura, Egypt

OBJECTIVES: To assess the knowledge and attitude of medical students towards road safety and to determine their driving behavior and its relation to different related factors. METHODS: This cross-sectional study involved 480 medical students at Mansoura University, Egypt. A self-administered questionnaire was used to collect student personal data, knowledge about road safety, attitude towards road safety, and driving practices. RESULTS: More than 40% of students experienced an injury in the previous year, mainly as a pedestrian (56%), and 15.2% practiced driving, although only 9.6% had a driving licence. Most of the students had correct road safety knowledge except for awareness that the safe time to read maps is when your vehicle is parked (44%), one should drive in the left lane (29.6%), and one should overtake from the right-hand lane only (25.8%). The majority of the students reported that road traffic injuries can be prevented (89.2%). The mean score of the driving practices of the students ranged from 0.66±1.04 to 2.44±6.28 and rural residents showed significantly higher score regarding errors and lapses. CONCLUSION: Good road safety knowledge and a favorable, low risk attitude, did not translate into improved road traffic behavior and this highlights the importance of stricter implementation of the existing rules and including road safety in medical education programs.

Work profile and associated health hazards among nursing students at Mansoura University, Egypt

Nursing students are increasingly undertaking paid term-time employment to finance their living expenses and studies. The objectives of this study are to estimate its prevalence, factors associated, and possible health hazards. A cross-sectional study was conducted of nursing students using a questionnaire that included sociodemographic and employment data, reasons for working, possible health hazards in the workplace, and perceived effects on academic performance. The prevalence of student paid employment was found to be 23.3%. Being male and belonging to a low social class were independently associated with the likelihood of working while studying. Financial support was the main reason for student employment. Workplace hazards included noise, temperature extremes and psychosocial stressors. Sleep disorders were the most frequent health effects followed by musculoskeletal complaints. Nursing students are at risk from many deleterious health effects which are not covered by occupational health and safety programmes

Amniotic Fluid-Derived Mesenchymal Stem Cells Cut Short the Acuteness of Cisplatin-Induced Nephrotoxicity in Sprague-Dawley Rats

BACKGROUND AND OBJECTIVES: Cisplatin is a nephrotoxic chemotherapeutic agent. So, preventive measures worth to be evaluated. Human amniotic fluid stem cells (hAFSCs) in prevention or amelioration of cisplatin-induced acute kidney injury (AKI) in Sprague-Dawley rates have been tested. METHODS: 80 Sprague-Dawley rats (250~300 g) were used and divided into 4 major groups, 20 rats each. Group I: Saline-injected group. Group II: Cisplatin-injected group (5 mg/kg I.P). Group III: Cisplatin-injected and hAFSCs-treated group (5×106 hAFSCs I.V. one day after cisplatin administration). Group IV: Cisplatin-injected and culture media-treated group. Each major group was further divided into 4 equal subgroups according to the timing of sacrifice; 4, 7, 11 and 30 days post-cisplatin injection. Renal function tests were done. Kidney tissue homogenate oxidative stress parameters malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione (GSH) were determined. Histopathological scoring systems for active injury, regenerative and chronic changes were analyzed separately. RESULTS: hAFSCs characterization and differentiation was proved. Cisplatin injection resulted in a significant increase in serum creatinine and MDA and decrease in SOD, GSH and creatinine clearance. These changes were attenuated early by day 4 with the use of hAFSCs. Cisplatin injection induced tubular necrosis, atrophy, inflammatory cells infiltration and fibrosis. The use of hAFSCs was associated with significantly lowered injury score at day 4, 7, 11 and 30 with marked regenerative changes starting from day 4. CONCLUSION: hAFSCs have both a protective and regenerative activities largely through an antioxidant activity. This activity cut short the acuteness of cisplatin nephrotoxicity.

Self-reported depression and anxiety by students at an Egyptian medical school

To explore the anxiety and depression experienced by medical students in Mansoura medical school and to identify its associated risk factors. Cross- sectional study. The study was conducted at Mansoura University, Mansoura, Egypt in 2009 and 2010. a self-administered questionnaire, including questions on sociodemographic characteristics and five instruments determining level of anxiety and depressive symptoms, perceived stress, physical wellbeing factors, and some personality traits were given to students who were selected by stratified cluster sampling. A total of 311 students were enrolled in the study. Prevalence of depression and anxiety were 28.3% and 21.2%, respectively. Logistic regression analysis revealed that the independent predictors of depression were sex, level of perceived stress, level of satisfaction with early relation with mother. On the hand, the independent predictors of anxiety were level of perceived stress, level of satisfaction with early relation with mother. On the hand, the independent predictors of anxiety were level of perceived stress, neuroticism and residence. The mean depression and anxiety scores were 8.1 +/- 3.3 and 9.9 +/- 3.1, respectively. Linear regression revealed that anxiety score, number stressors, chronic health problem score, and score of early relation with mother are independently correlated with depression score. Whereas, perceived stress, early relationship with mother and neuroticism scores were independently correlated with anxiety score

Body mass index and obstetric outcomes in Saudi Arabia: a prospective cohort study

We examined the effect of body mass index in early pregnancy on pregnancy outcome since no study in Saudi Arabia has addressed this question. This prospective cohort study involved women registered for antenatal care during the first month of pregnancy at primary health care centers in Al Hassa, Saudi Arabia. Data was collected from records and by direct interview. The study included 787 women. Compared to normal weight women [n=307], overweight [n=187] and obese [n=226] women were at increased risk for pregnancy-induced hypertension [RR=4.9 [95% CI 1.6-11.1] and 6.1 [95% CI 2.1-17.8], respectively], gestational diabetes [RR=4.4 [95% CI 1.2-16.3] and 8.6 [95% CI 2.6-28.8]], preeclamptic toxemia [RR=3.8 [95% CI 1.1-14.6] and 5.9 [95% CI 1.7-20.4]], urinary tract infections [RR=1.4 [95% CI 0.5-3.9] and 3.7 [95% CI 1.7-6.2]], and cesarean delivery [RR=2.0 [95% CI 1.3-3.0] in obese women]. Neonates born to obese women had an increased risk for postdate pregnancy [RR=3.7 [95% CI 1.2-11.6]], macrosomia [RR=6.8 [95% CI 1.5-30.7]], low 1-minute Apgar score [RR=1.9 [95% CI 1.1-3.6]], and admission to neonatal care units [RR=2.1 [95% CI 1.2-2.7]]. On the other hand, low birth weight was less frequent among obese women [RR=0.5 [95% CI 0.3-0.9]] while the risk was high among underweight women [RR=2.3 [95% CI 1.4-3.8]]. Even with adequate prenatal care, overweight and obesity can adversely affect pregnancy outcomes

Spontaneous bacterial peritonitis: clinico-epidemiological and microbiological study

Spontaneous bacterial peritonitis [SBP] is a frequent severe and potentially life-threatening complication of cirrhotic patients with ascites. The clinical presentation of SBP depends on the stage at which the infection is diagnosed. In early stages, most patients are asymptomatic or present with insidious, non specific symptoms. As the disease progresses, patients show signs and symptoms of peritoneal infection. To determine the prevalent pathogens responsible for SBP in our locality and their sensitivity pattern, to test the efficiency of different culture techniques in microbial isolation, and to study the diagnostic predictors of such cases. Two hundred fifteen adults with cirrhotic ascites consecutively admitted to Tropical Medicine Unit Mansoura University Hospital were screened for SBP. One hundred eight SBP episodes from 92 adult patients were compared to 88 cirrhotic ascites patients cross-matched with age and sex without SBP. Diagnosis of cirrhosis was based on clinical biochemical radiological and/or histo-pathological data. Ascitic fluid was subjected to cytological biochemical examination and culture on both conventional and blood culture bottles at the bedside for bacterial identification and antimicrobial susceptibility testing. Diagnosis of SBP and its variants were made depending on ascitic fluid poly-morphnuclear count >/= 250 cell/ mm[3] and/or monomicrobial growth in ascitic fluid culture without evidence of an infra-abdominal surgically treatable source of infection, and no recent use of antibiotics. A total of 432 diagnostic paracentesis were performed in 215 cirrhotic patients with ascites. The prevalence of SBP was 25.02%. History of previous episode of SBP or history of paracentesis were significantly more frequent in SBP patients [P=0.000 and P=0.001] respectively also, Abdominal wall edema and redness [cellulitis], presence of ascetic fluid with numerous fine internal hyper-echoic particulates by ultrasonography and the aspiration of slightly turbid ascites were significantly more frequent in SBP patients [P= 0.01, P=0.031 and P=0.035] respectively. Ascitic fluid protein levels and serum albumin levels were significantly lower and serum creatinine levels were significantly higher in SBP patients. [P=0.009, P=0.03, and P= 0.003] respectively. Applying the model of logistic regression analysis between SBP and Non SBP clinical and laboratory data revealed that; previous SBP episode, low ascitic fluid protein levels, high serum creatinine and low serum albumin levels were significant predictors of SBP [P-0.000]. Fourty-nine [45.37%] episodes of SBP were detected by the conventional culture compared to 79 [73.15%] by modified technique with a significant P value <0.001. Gram-negative bacteria were the cause of SBP in 46 [58.23%] culture positive episodes while Gram-positive bacteria were the isolated organisms in 33 cases [41.77%]. Escherichia coli and Staphylococcus aureus were the most commonly detected organisms in 40 [50.63%] and 26 [32.91%] cases respectively. In this study, 31.65% of cultures were highly sensitive to Levofloxacin, 29.11% were sensitive to Cefotaxime, 20.25% were sensitive to Amoxicillin-Clavulanic acid, 18.99% were sensitive to Meropenem, 17.72% were sensitive to Ciprofloxacin and 15.19% were sensitive to Ceftazidime. On the other hand, antibiotic resistant rates to Ciprofloxacin were 25.32%, 24.05% to Ceftazidime and 21.52% to Cefotaxime. Previous SBP episode, low ascetic fluid protein levels, high serum creatinine, and low serum albumin levels, all had a significant prediction of SBP. Beside cytological and biochemical examination, culture of ascitic fluid in blood culture bottles at bedside increases the sensitivity of SBP detection and must be a routine in every hospitalized patient with cirrhotic ascites. Gram-negative organisms still, the prevalent microorganisms causing SBP but there is a significant recent increase in Gram-posittue pathogen with emergence of maltidrug resistance especially for Ciprofloxacin, Ceftazidime and Cefotaxime. These recent changes may have an impact on guidelines for management and treatment of SBP in oar locality

Perceived stress among male medical students in Egypt and Saudi Arabia: a cross-culture comparison

In recent years there has been a growing appreciation of the issues of stresses among medical students as this may affect their learning and academic performance. However, such studies are scarce in Arab countries, to determine if there is a difference in the perceived stress levels of male medical students in Mansoura University, Egypt and King Faisal University, Saudi Arabia. The sample consisted of 304 and 284 male medical students in Egypt and Saudi Arabia, respectively. Study tool is a self-reported questionnaire covering sociodemographics and four categories, including 15 items, of sources of stress [stressors]. Perceived stress scale [PSS] and Hospital anxiety and depression [HAD] scale were used to measure stress, anxiety and depression there is no significant difference between the two groups regarding number of stressors. However, Egyptian students were more likely to cite relationship, academic and environmental problems than Saudis. Prevalence of high stress level was nearly equal in both groups. However, anxiety and depression are significantly higher among Egyptian than Saudi students. Logistic regression analysis of independent predictors of severe degree of stress among both groups combined revealed that satisfactory family income and highly educated father are independent protective factors. The independent risky predictors are anxiety and number of stressors. stress, anxiety and depression are frequent among medical students, especially the Egyptian. Counseling and preventive mental health services should be an integral part of the routine clinical services caring for medical students

Perceived stress among male medical students in Egypt and Saudi Arabia: effect of sociodemographic factors

In Arab countries, epidemiological data about psychological morbidity among medical undergraduate students are scarce. This study sought to determine whether there was a difference in perceived stress levels of male medical students at Mansoura University, Egypt, compared with male medical students at King Faisal University, Saudi Arabia. The sample consisted of 304 male medical students in Egypt and 284 male medical students in Saudi Arabia. The self-reported questionnaire covered four categories, including 15 items, on sources of stress [stressors]. The perceived stress scale and hospital anxiety and depression scale were used to measure stress, anxiety and depression. There was no significant difference between the two groups in number of stressors. However, Egyptian students were more likely to cite relationship, academic and environmental problems than Saudis. The prevalence of high stress was nearly equal in both groups. However, anxiety and depression were significantly higher among Egyptian than Saudi students. A logistic regression analysis of independent predictors of severe stress among both groups combined revealed that a satisfactory family income and university-graduated father were independent protective factors. The independent risk predictors were anxiety and number of stressors. Stress, anxiety and depression are frequent among medical students. Counseling and preventive mental health services should be an integral part of the routine clinical facilities caring for medical students

Maternal work and infant health in Al-Hassa, Saudi Arabia

This comparative study aimed to examine the effects of maternal work on infant health in Al-Hassa, Saudi Arabia. Many aspects of infant health were compared between two groups, one of working and the other of non-working mothers. Data were collected from family records kept at primary health care centers as well as by direct interview with 128 working and 512 non-working mothers with children who had completed their first year of life. Results showed that working mothers spent significantly less time on infant care than non-working mothers. Infants of working mothers were more likely to be of heavier weight, with a larger mid-arm circumference, and more likely to show above normal growth than infants of non-working mothers. None of the working mothers exclusively breast-fed their babies during the first four months of age. These mothers were more likely to give their babies bottle feeds, start weaning earlier and introduce solid foods earlier. Infants of working mothers are more likely to suffer from diarrhea and acute respiratory infections and make more visits to health centers because of illness. Also, they are more likely to be hospitalized than infants of non-working mothers. Vaccination coverage did not differ between the two groups of infants. Maternal work adversely affects some aspects of infants' health, especially breast-feeding and morbidities. This could be mitigated by prolonged paid maternal leave or providing flexible working conditions so as not to interfere with breast-feeding

study of stress in medical students at Mansoura University

This is a cross sectional study on 311 medical students selected from students of Mansoura Medical College to highlight the prevalence of different stressors and factors associated with perceived stress. Data was collected through an anonymous self-administered questionnaire covering the socio-demographic data, stressors, perceived stress scale, assessment of physical wellbeing, hospital anxiety and depression scale as well as neuroticism and extraversion subscales of Eysenck personality questionnaire. Only 5.5% of students reported no stressors. On average each student reported a mean of 3.4 stressors. The most common stressor is relationship problems with teachers. Multivariate logistic regression revealed that the independent predictors of high stress level were presence of more than five stressors, anxiety, depression as well as global sickness index and extroversion and neuroticism sub-scales. Decreasing stressors and ameliorating their stressful effect will minimize the prevalence of perceived stress among medical students. This study calls for the necessity for planning and introduction of psychiatric and social facilities into health services of Mansoura University

Violence against primary health care workers in Al Hassa, Saudi Arabia

This study was carried out in AI-Hassa, Saudi Arabia to highlight the magnitude, predictors and circumstances of workplace violence against primary health care workers. A total of 1091 workers completed a self-administered questionnaire modified from the questionnaire developed by World Health Organization and used in country case studies. About 28% were exposed to at least one violent event during the last year. Logistic regression analysis revealed that the most predictors of violence are high education of workers, [OR=9.3], working in emergency clinics [OR=6.8] and working in Hegar [far areas in the desert] [OR=3.2]. A total 913 violent events were analyzed. Emotional and physical violence accounted for 92.1% and 7.9% of violent events, respectively. Unmet needs of patients, overcrowding and reaction to injury, accident or illness were the leading contributing factors for violence. Perpetrators were mostly Saudi, males, of age less than 40 years and patients' relatives. Violent events affected the victims adversely. Suggestions made by victims should be considered during planning and implementation of violence prevention and control program in health care facilities. A further large-scale study of violence in health care sector, including different types of health facilities is warranted

Unintended pregnancy in Dakahisa governorate, Egypt

This study covered 805 married women to measure the frequency and predictors of unintended pregnancy and couple agreement among pregnant women attending for antenatal care at governmental primary health care facilities in Dakahlia Governorate, Egypt. There is a strong agreement [92.3%] between couples regarding pregnancy intention status. Unintended pregnancies, as reported by mothers, accounted for 29.6% [95% CI =26.5-32.8], These unintended pregnancies includes 19.5% mistimed and 10.1% unwanted. Contraceptive failure accounted for 17.6%, 27.6% and 20.9% of mistimed, unwanted and total unintended pregnancies among family planning users, respectively. logistic regression analysis indicated factors that independently raised the likelihood of unintended pregnancy these are having children of both or either sex, family planning method failure, working mothers and large family size. High gravidity and low family income were associated with higher risk of unwanted pregnancy. In contrast variables that significantly lowered the probability include urban residence. On the other hand, longer pregnancy spacing decreased the risk of unwanted pregnancy. Family planning program should identify women at risk of unintended pregnancy and help them to achieve either adequate pregnancy spacing or fertility termination. To prevent unintended pregnancy, programs must understand and account for the characteristics of the couples at risk. Causes of method failure should be identified to choose the most effective method for each couple

Student labor in Mansoura, Egypt

This study was carried out on 1293 students enrolled in governmental secondary schools in Mansoura, Egypt. The aims were to highlight the prevalence of student labor, its underlying factors, work hazards and injuries. its health, educational and social impacts, as well as work circumstances and student rights at work. The study revealed that 8.6% and 27.5% of students reported year round and summer work in the year prior to the study. Logistic regression analysis revealed that lower social classes of the family, technical education, male sex. Large family size and rural residence were the most significant predictors of student labor. Concerning the health of the students, present complaints, smoking and substance abuse were significantly more reported by working than non-working students. On the other hand, student work does not affect their anthropometric measurements. Hazards at work place, work injuries as well as corporal punishments by work owners were prevalent among working students. Student labor adversely affected their education and social life. The majority of working students work for six hours or more per day. Contribution to family income was the main cause for student labor. More than 51% of year-round and 26% of summer working students reported work satisfaction, respectively. Few working students have a written contract with work owner. have medical checkup or paid sick leaves. There is a need for effective enforcement of child labor legislation and formulation of legislation for student labor, so as not to affect their health. Education andsocial lives. School health team should consider the potential occupational hazards when examining a sick working student. Through schools we can reach a sizeable segment of working children and adolescents

KAP of adolescent schoolgirls about menstruation in Mansoura, Egypt

This is a cross sectional study carried out on schoolgirls in Mansoura to study their knowledge, attitude, and practices about menstruation and the impact of education on their knowledge. Also incidence of menstrual disorders was described. A total of 664 female students were selected by cluster sampling techniques from public general, technical, and nursing secondary schools of urban and rural areas. Data were collected through an anonymous self-administered questionnaire during the class time. Twenty-two [3.3%] of students never menstruated. The mean age of menarche was 12.9 years. Menarche occurred at significantly younger age among girls of general secondary schools, girls of urban residence, and those belonging to high social class. The onset of menarche was shameful and embarrassing and leaves bad impression in more than 50% of girls. Furthermore, 80.1% believe that menstrual blood is unclean, unnecessary and/or harmful to the body. 32.1% reported no knowledge about menstruation before menarche. Mothers were the commonest source of knowledge whether before or after menarche. Menstruation was irregular in 33.2% of girls. The mean cycle length and mean duration of bleeding were 30.6 and 2.5 days, respectively. Bleeding was heavy in 17.3% of girls. 66.9% of girls use sanitary pads for protection during menstrual bleeding and 80.2% of them dispose off the material used with domestic refuse. Lack of privacy during hygienic care was reported by 24.5% of girls. During menstruation, religious practices were avoided by 99.5% of girls, 78.3% avoids sports and excess movement, and 43.9% avoid special foods. Reasons cited for such behavior were, religious teaching, habit and imitation of others as well as advice from others. 12.5%, 32.7%, and 17.1% of girls reported correct knowledge about cause of bleeding, relation of ovulation to bleeding, and origin of menstrual blood. The correct knowledge was significantly higher among nursing students, urban girls, and those of high social class. 64% of girls need more knowledge about menstruation. Dysmenorrhea and premenstrual syndrome were the most frequently reported menstrual disorders, 74.6% and 62.2%, respectively. Conclusion: Menarche occurs at younger age in girls from the well-to-do social status. Girls were not adequately informed about menstruation and its hygiene. Menstrual abnormalities were frequent among studied girls. Many girls avoid specific behavior and foods due to a variety of reasons. The situation is expected to be worst among out-of schoolgirls. There is a need for health education program for this sector of girls. School health should cover counseling and management of menstrual abnormalities

KAP of PHC nurses about breast cancer screening

This is a descriptive study carried out in Dakahlia Governorate, Egypt to explore KAP of PHC nurses about breast cancer screening. A total of 178 nurses completed an anonymous self-administered questionnaire concerning KAP about breast cancer and its screening. Despite the finding that 84.3% of nurses agreed that breast cancer can be diagnosed early, knowledge about effectiveness of breast self-examination [BSE], clinical breast examination [CBE] and mammography in early detection of breast cancer is low with a negative attitude towards mammographic screening. About 44% of nurses never Screened by any method. Only 53.9% ever did BSE, 16.3% ever had a CBE and 2.2% ever had a mammogram. CBE and mammogram were mostly done on doctors' advice due to presence of breast problems. Value and methods of breast cancer screening should be an integral part of nursing school curriculum. Also in service training will be of great value. Despite controversies about efficacy of BSE, it remains the most suitable screening method in our community due to economic and cultural reasons

Prevalence of skin diseases among handicapped students in Mansoura, Egypt.

This study aimed to estimate the prevalence of skin diseases among handicapped children in Mansoura, Egypt. A total of 636 handicapped students [76 blinds, 446 deaf-mutes and 114 mentally retarded] and 720 sex and age matched normal students [control] were subjected to thorough dermatological examination. 89.5% of blinds, 99.3% of deaf- mutes and all mentally retarded students had one or more skin diseases in comparison with 24.2% of the controls. Skin diseases, either the infectious or the noninfectious, were significantly higher among handicapped cases compared with the controls. Strict hygienic measures, periodic skin examination and health education to personnel caring for those handicapped were recommended

Brucellosis in a Saudi Community

To assess the magnitude of the problem of brucellosis in the North region of Saudi Arabia and to study the important risk factors associated with exposure to infection. Method: 1092 Saudi subjects of all age groups were recruited through a systemic random sample of 182 households. A questionnaire was filled out and physical examination was done. Blood samples were taken and screened for brucella antibodies by microplate agglutination test. All positive sera were confirmed by tube agglutination test. Active disease was diagnosed with a titer of 1:160 with the presence of clinical manifestations compatible with brucellosis. Prevalence of infection was found to be 20.4%, while active brucellosis was found to be 1.9% of the study population. Prevalence of infection is higher in rural than urban areas, among males, in old age groups and in low socioeconomic classes. Various risk factors that predispose to infection in this community were discussed. Fever-end rheumatologic symptoms were the commonest clinical manifestations of active brucellosis. In conclusion, the prevalence of brucella infection in North region of Saudi Arabia is unacceptably higher than the national level. There is an urgent need to strengthen the ongoing control measures

Epidemiology of glucose intolerance among adults in the north region of Saudi Arabia

This study was performed on a total of 1843 Saudi subjects to determine the prevalence of glucose intolerance and its associated risk factors among the adult population in the North Region of Saudi Arabia. Relevant socioeconomic, demographic and clinical data were collected. Body mass index was calculated for each subject. Blood glucose was estimated immediately in the fasting state as well as two hours post glucose load. The diagnosis of diabetes mellitus and impaired glucose tolerance was based on WHO criteria. The results showed an overall prevalence of glucose intolerance of 14.9% for DM and 6.5% for IGT