Postoperative wound infections after minor surgery: incidence and some associated risk factors

To determine the incidence of and some associated risk factors for surgical wound infections after minor surgery. Prospective cohort study included patients presenting for minor surgery at surgical clinics and offices, surgery departments at Al-Hussein and Bab El-Shaarria hospitals, Al-Azhar University, Cairo, Egypt. The study included 428 eligible patients. Relevant data were collected from participated patients using a pre-designed questionnaire. The included patients were assessed for post-operative wound infection. Overall incidence of postoperative wound infection is calculated with its 95% confidence interval. Multivariate logistic regression analyses were done to calculate the risk of postoperative wound infection with the various studied factors. The overall incidence of wound infection was occurred in 37 of the studied 428 patients [8.6%; 95% CI, 3.5%-13.8%]. Excisions from thigh [Relative risk [RR] = 2.2; 95% confidence interval [CI] = 1.3-3.6], excision of lipoma [RR= 2.2; 95% CI= 1.3-3.4] or biopsy of squamous cell carcinoma [1.8; 95% CI= 1.2-2.6], and diabetes [RR= 1.8; 95% 1.4-2.2] were independent risk factors for wound infection following minor surgery carried out in surgical clinics and offices. No risk difference was observed regarding the method of wound management. Our results indicate the high-risk groups for wound infection following minor surgery, such as people with diabetes and those undergoing excision of a non-melanocytic skin cancer or excision from a lower limb. Recognition of these groups could encourage more judicial use of prophylactic antibiotics and use of other interventions, including operating in the theatre, aimed at reducing infection rates

Peripheral neuropathy in type-II diabetic patients attending diabetic clinics in Al Azhar University Hospitals, Egypt

Peripheral neuropathy [PN] is a common neurological complication in patients with diabetes mellitus [DM] which affects their quality of life. To determine the frequency of PN and the risk factors associated with its occurrence in the studied diabetic patients. A cross sectional study was conducted in Al-Azhar University Hospitals, Cairo, Egypt. The study recruited 300 patients with type-II DM who attending the outpatient diabetic clinics in the studied hospitals, from October 1st 2005 through January 2006. A clinical neurological examination was conducted for all patients using the Michigan Neuropathy Diabetic Scoring [MNDS] criteria for diagnosis of PN. Subsequently, we considered patients with PN as study cases, and those without PN as controls to assess the risk factors associated with PN. Statistical analysis including multivariate logistic regression analysis was done. The frequency of PN among the studied subjects was 29.7%. Related risk factors were: older age above 60 years [odds ratio [OR] = 73.0; 95% confidence interval [CI] = 14.2-377.2], associated moderate to severe hypertension [OR =10.2; 95% CI = 2.8-38.0] and associated ischemic heart disease [IHD] [OR = 3.80; 95% CI = 1.50-9.80], poor control of DM [OR = 9.1; 95% CI = 2.6-32.1], and duration of DM. The risk of PN, however, was significantly reduced among married patients and those reported high educational and family income levels. Diabetic PN is a considerable complication of DM. The related risk factors were old age, prolonged and poorly controlled DM and associated medical disorders

Port-site non-tuberculous mycobacterial infection after laparoscopic cholecystectomy: a case series study

Port-site infection by mycobacterial organism is an unusual complication. This article aims to report the occurrence of port-site mycobacterial infection after laparoscopic cholecystectomy and to describe the diagnostic and therapeutic tools of this unusual complication. This case series study included 7 cases presented by port-site unhealed sinuses after laparoscopic cholecystectomy in Al-Azhar University hospital, Cairo, Egypt. Two methods were used to confirm the diagnosis; the bacteriological diagnosis by culture of pus collected from the port-site and histopathological examination of specimens after resection of port-site unhealed sinuses. Bacteriological and histopathological examinations showed the presence of mycobacterial infection in 4 cases [57,1%]. There was a special characteristic picture on sinogram and during surgical excision of the sinuses. All cases cured by meticulous surgery followed by anti-mycobacterial medications. Mycobacterial infection may be one of the causes of port-site delayed wound healing and the treatment should mainly depend on good meticulous surgical excision

Some sociodemographic and lifestyle factors associated with primary arterial hypertension: a hospital-based case control study

This hospital-based case control study was conducted in Al-Azhar University hospitals, Cairo, Egypt, to examine the association of some sociodemographic and lifestyle factors with primary arterial hypertension. The sociodemographic and lifestyle data were collected from cases and controls by interview questionnaire. Risk estimates were generated by applying logistic regression methods to 193 cases and 200 controls aged 41-63 years. The analysis revealed the risk of primary hypertension to increase with increased age, male gender and moderate family income. Furthermore, adjusted risk of primary hypertension was significantly increased among smokers [OR = 1.75; 95% CI = 1.01-2.97], particularly among heavy smokers who reported more than 20 pack years of smoking [OR- 1.90; 95% Cl = 1.00-3.77], sedentary life subjects [OR = 1.90; 95% CI = 1.15-3.02], and among those drinking more than 3 glasses of black tea/day. Additionally, stratified analysis revealed more effect of smoking pack years and consumption of black tea on the risk of stage II hypertension. These results suggest that increased age, male gender and moderate level family income, smoking, sedentary life and black tea drinking are risk factors of primary hypertension in Egyptian population. However, these findings need to be verified in larger confirmatory population-based studies

Rule of schistosomiasis infection in chronic hepatitis C

The prevalence of antibodies against hepatitis C virus [HCV] among Egyptians is 10-20%. Schistosomiasis is another hepatotropic infection with a major burden on Egyptian patient population particularly in rural societies. The aim of the present study is to describe and compare the clinical, laboratory, virology, ultrasonographic and histopathological features of HCV patients and HCV patients co-infected with Schistomiasis. is there a relationship between severity of HCV infection and Schistosomiasis. The medical files of 74 HCV patients attending tropical medicine department, Tanta University, Tanta, Egypt, were reviewed. The studied patients were classified into two groups: group A: patients with HCV co infected with Schistosomiasis [n = 38]; and group B: patients with HCV only [n = 36]. From the patients' medical files, clinical, laboratory, virology [HCV RNA titer by RT/PCR], abdominal ultrasonographic and histopathological data were extracted, reviewed and analyzed by using statistical analysis software package [SAS]. The results of this study found no significant differences with regard to mean age, sex distribution and clinical presentation between patients in the two studied groups. The majority of HCV patients co infected with Schistosomiasis [79%] was rural residence. Significant differences were observed regarding the hemoglobin percent, total leucocytic count, serum albumin and prothrombin concentration with the lower levels were among patients with Concomitant HCV and Schistosomiasis infection [group A]. In the same group, the higher levels of viremia were also observed. Liver fibrosis and cirrhosis were found to be relatively higher in group A [38%] compared to group B [17%], but with statistically significant difference [p < 0.05]. Patients with concomitant HCV and Schistosomiasis infection were characterized by more advanced liver disease as indicated by cirrhosis and laboratory findings

Mid-year test score achievement and absenteeism days

This study aimed to assess the relation between mid year test score achievement of the 4th grade medical students [fifth group] followed practical course of public health and community medicine and their recorded absenteeism days during the first session of the study year 2005-2006. The fifth group of the 4th grade medical students [78 students], Al-Azhar faculty of medicine for boys, Cairo, who followed practical course of public health and community medicine during the first session of the study year 2005-2006 are the subjects of this study. Using a self reported questionnaire, data were collected from only 47 students agreed to participate in this study. The data collected include information about students' residence, some lifestyle factors, and their attitudes towards the teaching methods and performance, and benefit from the lectures. The absenteeism days and test score records of the students were then linked to the collected data. The average mid year test score [score points = 30] and absenteeism days [attendance days = 17] for all students [n=78] were 20.5 +/- 4.2 and 5.5 +/- 4.1 respectively. For the participated students [n=47], the average test score and absenteeism days were 20.9 +/- 4.6 and 4.2 +/- 3.5 respectively. A negative and significant correlation between test score and absenteeism days was observed among the participated students [correlation coefficient = - 0.60] as well as among all students [correlation coefficient = - 0.47]. For the participated students, the univariate and multivariate regression analysis showed also significant negative association [regression coefficient = - 0.78]. This coefficient indicates an average decrease in the test score by 0.78 for each absenteeism day. The average predicted test score for students with no absenteeism days was 24.2 score points in the univariate model and 26.8 score points in the adjusted model. Analysis by test score grades [failed, pass and good, very good and excellent], the study found significant differences between test score grades and absenteeism days, residence, and student benefit from attending the lectures. This study found a negative association between test score achievement and absenteeism days. Other studies with large number of students are needed to confirm these results and to investigate the causes of absenteeism