Time trend mortality of egyptian major non-communicable diseases to age, vegetables and fruits intake

Background: The relation between fruit and vegetables and mortality with implications for health policy has been stuidied to assessthe protective effect of vegetables and fruits on major non-communicable diseases [NCDs] such as cardio- vascular, respiratory gastrointestinal and cancer

Aims: To study the relationship between vegetables and fruits intake, NCDs, age group [0-18] years and gender

Methodology: It is a cross-sectional descriptive secondary data study obtained from Central Agency for Public Mobilization and Statistics, and Egyptian Ministry og Agriculture along the years 2009 to 2015 StatisticalAnalysis was done by Epi Inf 7,CDC 2016

Results: Results indicated that the amount of vegetables and fruits consumption per each year showed statistically significant relation effects on prevention of the major non-communicable the major NCDs leading cause of mortality amon Egyptians are; CVDs, digestive diseases,respiratory diseases, and cancer [66.3%, 14.16%, and 8.52%, respectively]. Multiple regression analysis for the studied predictor is in this model, beta= -3.901[P=0.007] for fruit intake in Kgm/year

Recommendation: It is to encourage public more consumption of fresh fruits for prevention of those major non-communicable diseases

Time Trend Mortality og Egyptian Major Non-Communicable Diseasesin relation to Age, Garlic and Onion Consumption

Background: The relationship between garlic and onion consumption and mortality with effect on health policy has been studied to assess the protective effect of garlic and onion consumption on major Non-communicable diseases [NCDs] such as cardio- vascular, respiratory, gastrointestinal diseases and cancer

Objective: To study the effect of garclic and onion consumption on NCDs in relation to age group [0- 18 years] and gender

Methodology: It is a cross- sectional descriptive secondary data study obtained from central agency for public mobilization and statistic, and Egyptian ministry of agriculture along the years from 2009 to 2015. statistical analysis was done by EoiInf 7, CDC 2016

Results: Results indicated that the amounts of garlic and onion consumtion per year showed significant relation effects on the prevention of the major non-communicable diseases. the leading cause of mortality among Egyptians are: 66.37%, 14.16%, and 8.52% of the major NCDs [CVDs, digestive diseases, respiratory diseases, and cancer], respectively. multiple regression analysis for the studied predictors garlic intake and onion [kgm/ year and gm/ days] show multiple R= 0.467 for CVDs [P= 0.014] the most important predictor is in this model, beta= -0.467 [P= 0.014] for garlic and onion intake in Kgm/year

Conclusion: Thee consumption of gralic and onion has role for prevention of these major non-communicable diseases

Recommendation: It is recommended to encourage increased consumption of gralic and onion for prevention of these major non-communicable diseases

Trend of main psychiatric health problems among children and adolescent at different districts in Egypt

Background: Mental disorders and suicide can result from the interaction of mental disorders and other factors were the second leading cause of death among children aged [12-17] ys in 2010 at United States

Objective: To study the prevalence of main psychiatric health problems in Egyptian children and adolescents for early intervention to help raising the new generations in an appropriate way assuring building up healthy society

Methodology: First phase; a meta- analysis study data derived from Egyptian psychiatric informatics in children [EPIC], which were conducted from 1980 to 2005, including 57.802 subjects, studying the trend of mam psychiatric health problems among children and adolescent at different governorates. Second Phase; Attention deficit hyperactivity disorders [ADHD] data are added to the data of EPIC regarding ADHD to study the prevalence of disease at different governorates

Results: The first phase includes 57.802 subjects from different governorates in Egypt. Among this group there are 38.731 subjects [67.0%], without psychiatric health problems and 19.071 subjects [33.0%], with psychiatric health problems, the trend of psychiatric health problems among children and adolescence at different periods. In general there was increase in psychiatric health problems prevalence among this age group and this difference statistically highly significant [P=0.0 001]. Also, the prevalence of main psychiatric health problems increase among those who lose their parent [81.5%] and [43.6%] on the other group and this difference was statistically highly saignificant [P=0.0 001]. Second phase, prevalence of ADHD at different governorates showed non- significant difference between all studied governorates [P=0.999]

Conclusion: About 33% of the studied group had main psychiatric health problems that showed increase by the time. A plan must be designed to overcome this problem which may lead to high morbidity and mortality among this important age group

Management of acute bacterial meningitis- a prospective study

Background: Meningitis is defined as an inflammation of the membranes and cerebrospinal fluid that cover completely and bathes the brain and spinal cord. It is a serious disease and may result in permanent complications if not diagnosed and treated early. The initial treatment approach to the patient with suspected acute bacterial meningitis depends on early recognition of the meningitis syndrome, rapid diagnostic evaluation, and emergent antimicrobial and adjunctive therapy

Objectives: To compare the short course antimicrobial treatment of acute bacterial meningitis versus long course; wheather the organism identified or not in Abbassia Fever Hospital

Methodology: Prospective study; in Abbassia Fever Hospital from June 2013 till December 2014

Results: N. meninigitidis were only three cases [three from 84cases]; mean 14.33 and SD +/- 6.03. All these cases received R, V as line of treatment while other organisms as enterococci most of them received the same line [i. e. R, V] 45.8% and only two cases [2.8%] received R, U, and E. The patients whom fully recovered most of them used the treatment plan R, V [38, 63.3%] followed by R, V, E [9, 15%] and to a lesser extent R, U [7, 11.7%]. There was statistical highly significance between the treatment plan chose and the outcomes of the patients and the p value was 0.010. R, V is the most common treatment plan used [44 cases] followed by R, V, E [17 cases] and the least common plan used was R, U, E [2 cases]. The absence of hydrocephalus or shunt operation was the most prevalent [81 cases] where the mean was 11.63 and SD +/- 3.93

Conclusions: The most commonly used treatment plan was ceftriaxone and vancomydn. Only 10 patients received short duration of therapy. Recommendations: Further studies should be conducted on more national level to discuss the importance of short course therapy and which cases can receive it

Epidemiological study of school performance and asthma medications among asthmatic Egyptian school children

Childhood asthma is a major health problem in Egypt and worldwide. Barriers to reducing the burden of asthma include symptom-based rather than disease-based approaches, tendency of care to be [acute] rather than [regular] and cultural attitudes towards drugs and drug delivery systems. To measure the disease effect on school performance and to map asthma medications with respect to types, routes and course of use. This cross sectional study involved 206 Cairene asthmatic school children, enrolled from the school students' health insurance facility of El-Matareya Teaching Hospital and the pediatric outpatient clinic of Saint Mark Charity Hospital representing different social classes and residential locations. Their ages ranged between 5 and 15 years and they comprised 100 males and 106 females. They were assessed clinically and by peak expiratory flowmetry. Parents or caregivers were interviewed about disease symptoms, school achievement and attendance and medications used including relievers and controllers, route and course of use, whether continuously, intermittently and/or during attacks. Asthma had a strong impact on school achievement and school absence; 77.3% of study population reported school absence due to asthma and 41.3% reported weak to average school achievement. School performance was associated with asthma severity; the majority of moderate asthmatics [64.6%] had average and weak school performance. Number of days of school absence demonstrated highly significant relation with asthma seventy; 43.6% of moderate asthmatics had 5-6 absent days/month and 33.4% had 3-4 absent days/month. Combined beta 2-agonists andxanthines was the most commonly used [54.8%] reliever therapy followed by beta 2-agonists alone [44.2%] while corticosteroids were the most common controllers used [97.6%]. Therapy was taken mainly by oral than inhalation route. Other medications like cromolyns, anti-histamines, anti-leukotrienes and anti-cholinergics were rarely used. Both rectal and injection routes were rarely used also. Asthma has a social burden on asthmatic children as it affects both school achievement and school attendance. Medical management of asthma in Egyptian children still lags behind available medical knowledge. Patients' and health care givers' education is a cornerstone in improving the current status of asthma management in Egypt

Epidemiological study of risk factors in pediatric asthma

Childhood asthma is a major public health problem in Egypt and worldwide. Epidemiologic, physiologic, and social factors appear to be associated with an increased risk of asthma. The aim of the study was to determine the most frequent risk factors of childhood asthma exacerbation and severity in our community. This cross sectional study involved 206 asthmatic children. 5 to 15 years old. They were enrolled from the School Students Health Insurance facility of El-Matareya Teaching Hospital and from the Pediatric Outpatient Clinic of Saint Mark Charity Hospital representing several social and residential classes. They were assessed clinically and by peak expiratory flow rate [PEFR]. Parents of children were interviewed for symptoms and some demographic, social, environmental, housing and familial data as well as asthma triggers through a comprehensive detailed questionnaire. Residential distribution and social status were significantly associated with asthma .severity as most moderate persistent asthmatics lived in semi-urban areas [70.8%] and belonged to the low-level segment of social classification [47. 9%]. In the majority of the study population [69.9%], a family member or more had a positive history of bronchial asthma, and this was especially evident in moderate persistent cases [70.8%]. Passive smoking and dust triggered exacerbations in 48.6% and 65% of the studied sample respectively and in most moderate persistent asthmatics [83.4% and 93.7%]. Most houses of moderate asthmatics were infested with cockroaches [91.7%] and domestic animals were present in 56.2%. Recurrent chest infections and cold/flu attacks were strongly associated with asthma exacerbation and severity [93.8% and 93.7% of moderate persistent cases respectively]. Most moderate persistent asthmatics [91. 7%] reported exercise-induced asthma while 64.6% stated that emotional stress triggered their symptoms. Indoor pollutants such as insecticides, household chemicals and odors were strongly associated with asthma severity and exacerbation especially in moderate persistent cases [triggered symptoms in 66.7%, 52.1% and 58.3% of cases respectively]. Smoking, emotional stress and dust were the most significant triggers of asthma exacerbation and severity in our series. Identification and avoidance of risk factors for persistent asthma, combined with early institution of pharmacologic and other intervention strategies, may lead to a better outcome

Morbidity and mortality patterns of infection among under five year's children and the effect of intervention by vit. A.

This study aimed to explore the relationship between vitamin A status and frequency of infection among infants and preschool children and evaluate the effect of intervention by vitamin A supplementation and its efficacy in reduction of infant morbidity in preschool children. Seventy children suffering from recurrent infection [46 males and 24 females], their ages ranged between 6 and 60 months, supplemented with an oral daily dose of vitamin A of 30 ug RE/kg/day for eight weeks then followed up for 10 months after supplementation. Results showed that 34 patients out of 70 [48.6%] who suffered from high frequency of infection/year [>12 time/y] significantly declined to 6 [8.5%] after intervention. Highly infected children [with CRP> 24 mg/L] were significantly dropped from 38 [54.3%] to 6 children [8.6%] after intervention. Mean values of plasma retinol was significantly increased after intervention [29.6 +/- 3.7 and 4.1 ug/dl, P<0.001]. Plasma retionol by multiple regression analysis, was the most contributing factor affecting frequency of infection in young preschool children [P<0.01]. So, it could be concluded that severity as well as frequency of infection is proportionate with serum retinol level. Supplementation by vitamin A or its food fortification must be done in less than five years children

Database by meta-analysis: health behavior and health services for cardiovascular diseases in Egypt

Cardiovascular diseases [CVDs] represent major public health problem in many countries including Egypt. There are limited national data about morbidity and mortality of CVDs in Egypt. Purpose: was to evaluate the health behavior changes and health services regarding risk factors of CVDs for all age groups in Egypt through data base by Meta-analysis [Type 3]

Methods: data were collected from the available electronic national data base from available theses, medical and nursing reports, and published research relevant to CVDs from allover Egypt

Results: The total number of persons included in this project was 4110 cases from 104 medical, and 14 nursing studies, hospital and population based. The cardiovascular cases included 2906 males and 1204 females. These studies extended from 1995-2002. Most of studies were at Ain Shams, Cairo and Alexandria University hospitals, and the Ministry of Health and Population hospitals. The studies revealed that, CVDs were higher in the year 1997, among age group 40-60 years and in male group. Also, the study indicated a significant correlation between adverse life-style [increase serum lipids, hypertension, smoking, obesity and inactivity] and occurrence of CVDs. Although more than half of cases attended to the university hospitals for obtaining health services, two thirds of the cases did not receive follow-up services

Conclusion: According to this preliminary study concerning Egyptian data, CVDs are still a presentable problem. There is relative increase of prevalence of CVDs in the exception of the last two years

Recommendations: The study revealed 1] the importance of utilizing the available data from theses and other sources of data related to CVDs to build up an electronic database for these diseases and this procedure can be used similarly in other medical and nursing areas, 2] Governmental commitment is urgently required for the establishment of a national program for prevention and control of CVDs

Midazolam co-induction in the elderly

In elderly patients I have compared the effects of midazolam co induction and propofol predosing on the induction dose requirements of propofol. In a randomized, double blind controlled trial, I have enrolled 150 patients over 65 years of age scheduled for urological endoscopic surgery and randomly assigned them into 3 groups 50 in each group to receive either midazolam 0.05 mg/kg, propofol 0.2 mg/kg, or normal saline [placebo] 2 min. before induction of anesthesia with propofol 1% infusion at 5 ml/min, the dose of propofol was calculated from the start of infusion till the loss of verbal contact with the patient and the ability to smoothly insert an oropharybgeal airway. Cardiovascular parameters were recorded at 1 min interval until induction was complete. the primary outcome of this study is the reduction of the induction dose of propofol by 20% and a secondary outcome was the reduction of the induction time, the relative risk of the primary outcome was found 0.89 [at confidence interval 95%], the absolute risk reduction 0.82. The midazolam group showed a significant reduction in the propofol dose requirements for induction [p=0.05] compared to the placebo group. The propofol group did not show significant dose reduction compared to the placebo group. Cardiovascular parameters were not significantly different in the 3 groups in terms of stability. I conclude that midazolam co-induction reduces the induction dose of propofol in elderly patients

Factors affecting initiation and continuation of breast feeding in a rural area in El-Minia Governorate

A cross sectional study was performed on 243 infants living in a rural area at [Towa village] in El-Minia Governorate during Autumn 1996, to examine breast feeding pattern, during the first two years of life a questionnaire including demographic, antenatal, natal and post natal factors was designed and used. Among the interviewed mothers 78.1%were found to have breast fed their infants till 2 years of age. Most of lactating mothers [80.4%] begin breast feeding within l hour after delivery. Only 53.2% of breast fed mothers had antenatal care. History of successful breast feeding was found in 86.5% of lactating mothers these differences were statistically significant p=0.0001. By multiple regression analysis the most affecting factors were onest of initiation of breast feeding and time of introduction of supplements [weaning]. In conclusion most of mothers in rural area in El-Minia are still early initiating and maintaing breast feeding

Airway management under general anesthesia; comparison between esophageal-tracheal combitube and laryngeal mask airway LMA

The incidence of unanticipated difficult intubations ranges from 1-3% when the patient can not be intubated by direct laryngoscope. This study was designed to compare between the laryngeal mask and the combitube in providing adequate oxygenation and adequate ventilation as well as to compare the pressor response and the complications associated with the insertion of each device. Forty patients ASA physical status I and II, aged between 20 and 40 years, were scheduled to undergo elective surgical procedures. These surgical procedures were requiring the supine position, not involving penetration of a serrous cavity or the use of muscle relaxant and expected to be less than two hours in duration. The 40 patients were randomly divided into 2 groups, each containing 20 patients. The patients were assessed for the hemodynamic changes, oxygen saturation and end tidal carbon dioxide. This study concluded that the insertion of the combitube was associated with a high incidence of sore throat and upper airway trauma. One patient of LA group develop laryngeal spasm, while non the ECT group develop this spasm. No one in both groups had nausea nor vomiting after the removal of the LMA or the combitube

Pre- operative intrathecal morphine for postoperative pain relief after laparoscopic surgery

This study assessed the lumbar intrathecal administration of small dose of morphine [100 ug] preoperatively combined with 2.5 mg hyperbaric bupivacaine. This work studied 30 patients [ASA I and II] randomly assigned to two groups [each of 15 patients] to receive lumbar intrathecal morphine and bupivacaine [spinal group] and the other group [control group], which did not receive intrathecal morphine and bupivacaine and proceeded to general anesthesia directly. Intraoperative minimal alveolar concentration [MAC] of isoflurance was measured in the two groups together with intra and postoperative morphine requirements. Hemodynamic changes during insufflation were recorded. Postoperative pain score was assessed by the visual analog scale and morphine-related side effects. Postoperative pain score was significantly lower in the spinal group [24 mm vs 45 mm in the control group] as well as total morphine requirements which was 8 +/- 1.1 mg in the spinal group vs 11 +/- 0.6 mg there was no significant difference in postoperative side effects in both groups

Anesthesia for extracorporeal shock wave lithotripsy: General anesthesia versus total intravenous anesthesia

This study compared propofol-based total intravenous anesthesia [T1VA] and sevoflurane-based general anesthesia [GA] for outpatients of ESWI. After receiving midazolam 2 mg i.v., 60 subjects were randomly assigned to one of two groups. In the TIVA group propofol 50-100 ug/kg/min. i.v. was titrated to maintain an observer's assessment of alertness/sedation score [OAA/S] of 2-3 [five awake to one asleep]. Fentanyl 0.1 ug/kg/min. supplemented with 0 5 ug/kg boluses i.v. was administered for pain control. In the GA group anesthesia was induced with propofol 1.5 mg/kg i.v. and fentanyl 1 mug/kg i.v. and maintained with sevoflurane titrated according to clinical signs and nitrous oxide 60%. In the GA group metoclopramide was administered as a prophylactic anti-emetic. Recovery times and postoperative side effects were assessed up to 12 hours after the procedure. The use of sevoflurane reduced the opioid requirements and episodes of desaturation and decreased disruptive movements during the procedure in addition to hemodynamic stability. Discharge times were similar in both groups

Smoking cessation through intervention by health education program

Health education program was designed in order to increase the awareness of the workers about the health hazards of smoking and helping smokers to quit smoking. The subjects of the study were taken from permanent male workers of El- Minya Nile Cotton Ginning Company. The study was done in three stages. The first stage was screening all the workers to identify the smokers; the second stage was health education of the smokers and the third stage was evaluation of the health education program. The study found significant relation between the type of work and smoking habit of the workers, also there was significant difference between the level of education of the workers and their smoking habit. Among those who received the health education program 8.8 percent quit smoking, while 45.6 percent of them reduced the number of cigarettes they previously used to smoke per day. The majority of those who quit or reduced smoking did so because they believed in our program. The study had found a significant increase in the mean score of knowledge and attitude of the workers about the health hazards of smoking after our educational program. These differences were more noticed among those who quit or reduced smoking. The study found that the most effective variable in quitting or reduction of smoking was the level of education then came the number of cigarettes smoked per day and the duration of smoking in years

Epidemiology of breast cancer: descriptive and analytical review

The descriptive portion of this review explores briefly the historical literature for breast cancer. Also, it discusses occurrence, morbidity, mortality, personal risk factors, geographical distribution, effects of time and the latent period of breast cancer. The analytical portion of this review describes the role of genetics, viral and bacterial agents, glandular secretion and diet on the pathogenesis of breast cancer. In conclusion a variety of interrelated genetic, environmental and endocrine factors appear to be associated with increased risk of breast cancer, but no single factor or combination of variables presently known is sufficient to explain the etiology of this malignancy