Quality assessment of primary health care services provided for diabetes mellitus control in Alexandria

The present study was conducted aiming at: assessment of the quality of primary health care [PHC] services provided for the control of diabetes mellitus [DM] in Alexandria; and opportunistic screening of high risk individuals attending PHC facilities for DM. Accordingly, the availability of human and non-human resources for DM control in two r h and two urban PHC centers in Alexandria [one of them was sewing a desert area] was assessed by a pre-designed checklist 920 adult PHC attendants were screened for risk factors of DM. Individuals having more than one of the following risk factors: age above 50 years, overweight [body mass index >27 kg/m2], family history of DM in first degree relatives, history of hypertension, hypertension [systolic blood pressure >140 mm Hg and /or diastolic blood pressure >90 mm Hg], history of hyperlipidemia and history of gestational diabetes or birth of a large sized baby in females- were subjected to random capillary blood glucose [RCBG] testing. Cases were considered likely diabetic if RCBG was >200 mg/dl. The performance of all PHC physicians examining and managing 560 diabetic patients was observed over a period of two months. One fourth of the diabetic cases were checked for the level of glycaemic control by fasting capillary blood glucose testing

role of primary health care in patient education for diabetes control

The aim of the present work was to study the role of primary health care [PHC] in patient education for diabetes control in Alexandria. Accordingly, the knowledge and perception concerning diabetes and its management of all PHC physicians [88] and nurses [104] working in 2 rural health centers and 2 randomly chosen urban health centers of Alexandria Governorate were assessed by a pre-designed self-administered questionnaire. All diabetic patients [560] over 20 years of age attending the study health facilities over a period of 2 months were assessed for their knowledge and attitude concerning diabetes and self-management and asked about their degree of satisfaction with the provided PHC services by a pre-designed interview questionnaire. It may be concluded that there is a serious gap in the provision of basic education services to the majority of diabetic patients attending PHC facilities in Alexandria

Helicobacter pylori mitigates upper gastrointestinal haemorrhage: trick or truth?

Upper gastrointestinal haemorrhage [UGIH] constitutes a serious health problem arising mainly from bleeding oesophageal varices [OV] or peptic ulcer disease [PUD] in Egypt.Conflicting results concerning antagonism or synergism between Helicobacter pylori [H.pylori] and UGIH deserves paramount interest .In the present case-control study 300 patients [150 bleeders and 150 non bleeders crossly-matched for age, sex, residence and endoscopic findings] were examined clinically, endoscopically and investigated for H. pylori infection in an essay to identify the relationship of H. pylori to UGIH. OV [37.3%] followed by duodenal ulcers [DU] [26%], gastric erosions [GE] [24.7%] and gastroesophageal reflux [GOR][12%] were the causes of UGIH which yielded positive connection to each of nonsteroidal antiinflammatory drugs [NSAIDs] [33/150=22%], chronic liver disease [CLD] [86/150=57%], and HCV [39/150 =26%] [P<0.05]. Strikingly H. pylori showed only an eminent inverse association with UGIH due to PUD [Z = 2.09] and NSAIDs consumption [P<0.05]. After controlling for confounders-logistic regression analysis presented H. pylori, NSAIDs and HCV as powerful effective independent factors with significant negative impact of H. pylori on UGIH [OR = 0.4, Cl = 0.4-0.86] and a positive one of NSAIDs [OR = 2.1, Cl = 1.2-3.4] and HCV [OR = 1.6, Cl = 1.1-4.0]. In conclusion our study confirmed the principal role of OV followed by PUD in causation of UGIH in addition to the increased risk of UGIH associated with NSAIDs, HCV and CLD. On the contrary H. pylori behaved as if a protective weapon against UGIH arising only from PUD [DU and GE]. No relation was found between H. pylori and UGIH from OV. In the meanwhile ulcer-like dyspepsia [ULD] and dysmotility like dyspepsia [DLD] might be a striking clinical presentation of H.pylori infection

Cyclosporin A: a new promising and striking cercaricidal agent

The antischistosomal activity of cyclosporin A [CsA] was tested both in vitro and in vivo. All CsA-exposed cercariae died within less than 2.5 minutes. The number of dead cercariae showed direct association with the concentration of CsA [the higher the concentration, the more the cercaricidal activity]. In the same time, CsA was injected subcutaneously in male mice at a daily single dose of 50 mg/kg body weight/day for 3 [experiment I] and 2 [experiment II] successive days before infection with Schistosoma mansoni cercariae. Similarly, CsA exerted a remarkable protective lethal effect with mean efficacy of 100% and 98.7% in experiments I and II, respectively. Again, no significant differences in the weight and histopathology of either the liver or spleen between CsA-treated and control mice were noticed in either experiment. This was attributed to the unisexual cercarial infection with subsequent absence of Schistosoma eggs. In conclusion, CsA is emerging as an extremely valuable schistosomicidal agent

Candida associated diarrhoea in hospitalized children

Human candidosis is receiving considerable medical interest because of the widespread use of antibiotics, corticosteroids and immunosuppressive drugs. A total of 180 hospitalized children, who developed diarrhea after being medicated, were interviewed for inquiry about the characteristics of diarrhea and drugs prescribed to them. Candida positive diarrhea was detected in 114 cases [63.33%], 52.6 of them were caused by C. albicans. However, no significant variation by age, sex and drugs could be detected