Safe injection practice among health-care workers in Gharbiya Governorate, Egypt.

We assessed safe injection practices among 1100 health-care workers in 25 health-care facilities in Gharbiya Governorate. Questionnaires were used to collect information and 278 injections were observed using a standardized checklist. There was a lack of infection control policies in all the facilities and a lack of many supplies needed for safe injection. Proper needle manipulation before disposal was observed in only 41% of injections, safe needle disposal in 47.5% and safe syringe disposal in 0%. Reuse of used syringes and needles was reported by 13.2% of the health-care workers and 66.2% had experienced a needle-stick injury. Only 11.3% had received a full course of hepatitis B vaccination.

Safe injection practice among health-care workers in Gharbiya Governorate, Egypt

We assessed safe injection practices among 1100 health-care workers in 25 health-care facilities in Gharbiya Governorate. Questionnaires were used to collect information and 278 injections were observed using a standardized checklist. There was a lack of infection control policies in all the facilities and a lack of many supplies needed for safe injection. Proper needle manipulation before disposal was observed in only 41% of injections, safe needle disposal in 47.5% and safe syringe disposal in 0%. Reuse of used syringes and needles was reported by 13.2% of the health-care workers and 66.2% had experienced a needle-stick injury. Only 11.3% had received a full course of hepatitis B vaccination

Impact of life style on the nutritional status of medical students at Ain Shams University.

This cross sectional study was carried out to assess the nutritional status of medical students and to determine its relation to their life style. The study involved 317 students at, Am Shams University. Anthropometric measurements such as weight, height, mid-arm circumference, triceps skin fold thickness and body mass index were measured. The students completed a self-administered questionnaire including data about some life style factors and food-frequency consumption. The study revealed that 41.3% of the students were of normal weight while 9.5% of the sample were underweight, 36.9% were overweight and 12.5% were obese. The mean mid upper arm circumference (MUAC) and mid arm muscle circumference (MAMC) of males was significant higher than that of females, while the mean triceps skin fold (TSF) of females was significant higher than that of males. The food frequency questionnaire analysis showed that most of students consume all food groups items faire. There was no statistical significant difference between the body mass index (BMI) of students and different types of food consumption. About two thirds of the students used to practice exercise, 26.9% of the students practiced exercise for less than 2 hours per week, while 33.9% of them for more than 2 hours. There was no statistical significant difference between the BMI of students and different types of exercise. However, there was significant higher percentage of males play sports and practice running (44.7% and 19.4% respectively) compared to (11.7% and 8.1%) of females. Sixty four percent of the students usually have regular meals. About 87.2% of obese compared to 64.9% of normal weight students eat snacks between meals, the difference was statistically significant. Obese individuals eat more during watching television and during feeling of stress compared to non-obese and the difference was statistically significant. The duration of practicing exercise, sports and playing computer was significantly higher in males than females. However, the duration of watching television was significantly higher in females than males. Logistic regression analysis results showed that family history of obesity and some life style factors as duration of computer use, eating more during stress time and snacking between meals were important risk factors for obesity. We concluded that about half of medical students were overweight and obese. The most important life style factors responsible for obesity were longer time spent using computer, eating more during time of stress and snacking between meals. Also, genetic factors played an important role in development of obesity. It is recommended to develop nutritional education and physical activities programs to face the problem of increasing the rate of overweight and obesity among university students.

Pre-eclampsia: epidemiology and outcome of 995 cases.

OBJECTIVE: To study the epidemiology and pregnancy outcome of pre-eclampsia at Ain Shams University Hospital for Obstetrics and Gynecology. STUDY DESIGN: A case control study involved 995 cases of pre-eclampsia, 227 cases with chronic hypertension and 1375 cases with normal pregnancy delivered during the year 2000 at Ain Shams University Maternity Hospital. All these cases were critically analyzed regarding to some risk factors as age, parity, blood group, diabetes mellitus, Rhesus factor and multiple pregnancy. The outcomes of all these 3 groups were compared regarding to maternal and fetal morbidity and mortality. RESULTS: Pre-eclampsia was more common in elder age, blood group B, in Rhesus negative, during summer, multiple pregnancy and in patients with diabetes mellitus. The difference was statistically significant regarding all these risk factors (p < 0.01) when compared with cases of chronic hypertension and patients with normal pregnancies. CONCLUSIONS: In this work pre-eclampsia was found to be an important cause for maternal and fetal mortality. Also it was found to be an important cause for premature deliveries.

Development of weight gain charts for healthy Egyptian pregnant women.

A prospective study was conducted to develop weight gain charts for healthy Egyptian pregnant women and to determine the relationship between different anthropometric indicators and favorable birth weight. A total of 830 pregnant women were enrolled in the study. The mean total weight gain was 9.3 kg. The velocity growth chart that were developed for weight gain showed that the increment of weight was about one kg up to the 4th gestational month, then, a steady increase of 0.37 kg per week till the end of pregnancy. The mean total gain in mid upper arm circumference (MUAC) was 0.8 cm and in triceps skin fold was 1.9 mm. There was a highly positive correlation between all anthropometric indicators studied and the birth weight. However only total weight gain and weight of the mother at first trimester showed significant relation with birth weight after using multi regression analysis. It is recommended to use the developed weight gain charts for monitoring the nutritional status of pregnant women and the MUAC and triceps skin folds are to be used for screening women at risk for malnutrition.

Magnesium deficiency and other risk factors for diabetic retinopathy.

A case control study was carried out to detect the relation between magnesium deficiency and diabetic retinopathy and to study other risk factors for diabetic retinopathy. The study involved 30 cases with diabetic retinopathy, 30 diabetics and 30 non-diabetics with normal retina as controls. Serum magnesium was significantly lower in the diabetic control group than both other groups. Significant association between diabetic retinopathy and hypertension, poor control of blood sugar, irregularity in drug treatment, lack of routine fundus examination, high gravidity and low socioeconomic status were found. Multiple regression analysis was used to adjust for all variables mentioned. Magnesium deficiency was found to be statistically significantly associated with diabetic retinopathy after considering the effects of other variables.

The prevalence of antibodies to hepatitis C virus in Hail region, Saudi Arabia.

The prevalence of subjects positive for anti-HCV antibodies was studied at Hail region Kingdom of Saudi Arabia (KSA). The study involved 8862 subjects tested for anti-HCV antibodies at King Khalid General Hospital during the years 1994-Using Elisa, a total prevalence of 5.09% positive subjects was found. The disease is shown to be mainly acquired at school age and adulthood. Unlike hepatitis B virus, vertical transmission among preschool children does not seem to have an important role in transmission of HCV virus. Egyptians had a high prevalence of 26% as compared to other expatriates. Blood donors had a prevalence of 4.3% which is higher than that reported from other regions in Saudi Arabia. Medical staff had a prevalence rate of 2.2% indicating a relatively low risk of infection. Dialysis patients had a prevalence of 6.9% which is lower than that reported from other regions in Saudi Arabia. The higher prevalence of HCV infection in Hail (which has a lower socioeconomic status) compared to those in Riyadh and Eastern province suggests the possibility of other modes of transmission.

Prevalence of diabetes mellitus and hypertension in relation to chemical composition of drinking water: Does magnesium protect against diabetes mellitus?

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PATTERN OF HBsAg POSITIVITY IN SELECTED GROUPS AT KING KHALID GENERAL HOSPITAL - HAIL REGION, KINGDOM OF SAUDI ARABIA.

BACKGROUND: Hepatitis B virus (HBV) is endemic in the Kingdom of Saudi Arabia. The acquisition of infection occurs early in life. The availability of safe and efficacious vaccines has led to the feasibility of an effective control of HBV infection. This study compares the pattern of HBsAg positivity among selected groups of patients with similar groups in other regions in the Kingdom of Saudi Arabia. OBJECTIVES: This study is conducted to determine the prevalence of HBsAg positive subjects among selected groups of patients attending the main general hospital in the Hail region. SUBJECTS AND METHODS: This retrospective study included 14029 subjects that were tested for HBsAg at King Khalid General Hospital, during the period from April 1994 to April 1996. RESULTS AND DISCUSSION: The overall prevalence of HBsAg positive subjects was 3.5%. The prevalence for Saudis was about 3.2% for Saudis. Pakistanis had the highest prevalence of 11.8%. The prevalence was 3.02% for blood donors, and 2.1 % among pregnant women. No significant difference was found among different age groups. Hail region had a lower prevalence of HBsAg positive cases compared to that estimated by previous studies in the Kingdom, suggesting success in efforts applied by the Ministry of Health (110H) for prevention of Hepatitis B viral infection. CONCLUSION: We can conclude that the prevalence of HBsAg positive subjects is declining in the Hail region, Kingdom of Saudi Arabia (KSA). This decline suggests the success of preventive efforts such as vaccination of newborns with the HBsAg vaccine. However, screening of pregnant women for HBsAg scents to be necessary.

Scorpion sting syndrome: epidemiology, clinical presentation and management of 2240 cases

All cases of scorpion stings [2240] that attended all primary health care centres and hospitals in Hail region, Saudi Arabia, from 1 June 1994 to 31 August 1995 were recorded and analysed. The incidence of scorpion stings and treatment by antivenom were studied. A total incidence of 1.87% was found for the 15-month period. The severity of symptoms and signs were marked among infants. Guidelines for the management of scorpion stings are suggested and the importance of local treatment of stings affecting infants and preschool children is emphasized

Impact of training of primary health care staff on maternity and child health services.

INTRODUCTION: Training of primary health care (PHC) staff, at Hail region, is conducted as a part of a national program for training all PHC staff all over the Kingdom of Saudi Arabia. The program started in Hail region during the year 1412H. The objective of the program was to train all PHC staff, or at least a doctor and a nurse or a midwife in every health center, on Maternity and Child Health (MCH) services. This objective was achieved at Hail region by the end of the year 1414H. OBJECTIVES: The objective of this study is to evaluate the impact of training of PHC staff on maternal and child health services in Hail region. MATERIALS AND METHODS: Collection of data about MCH services was done by using structured forms, pre-tested and distributed at the end of each year studied to all Primary Health Care Centres (PHCCs). These forms were collected, data were encoded into the computer and analyzed by using SPSS for Windows statistical package. RESULTS: Evaluation of the program, at the end of the year 1415H, showed improvement in utilization of MCH services, and improved quality of care provided for mothers and children. This improvement was manifested by reduction of percentage of home deliveries without medical supervision, and increased numbers of risk factors discovered among pregnant mothers and children. However, the percentage of deliveries conducted at PHCCs were not increased, and pregnancy outcome showed slight reduction of S.B. rate. DISCUSSION: Improvement in the knowledge of the trainees was marked. Also intellectual skills e.g., using growth charts were markedly improved. However, because of the short duration of the courses, manual skills were not improved significantly. So increased frequencies of risk factors discovered among registered pregnant mothers and children was evident, however, deliveries at PHCCs were not increased. CONCLUSION: Training of PHC staff had a positive impact on maternal health services at Hail region. However, more time must be allowed to the practical part of training at the hospitals.

Evaluation of BCG vaccination: an intervention study in Rail Region, Saudi Arabia.

Inspection of 300 infants attending a primary health care (PHC) center at Hail region showed that 18.8% of children failed to develop BCG reations. This directed attention to inspect the process of vaccination at hospitals in which 80% of deliveries and BCG vaccination took place. Defects in the process of vaccination and cold chain system were noticed. Reorganization of the process of vaccination in addition to training the staff responsible for vaccination were done. A survey was followed to evaluate failure of BCG vaccination before and after the intervention. We checked 4145 infants two to twelve months of age, for any reaction at the site of BCG vaccination. After intervention vaccination failure dropped from 20.4% to 4.9% for infants vaccinated in hospitals (p = 0.00001), and from 7.9% to 3.2% for those vaccinated in health centers (p = 0.01). Moreover, before intervention success of BCG vaccination was significantly higher in PHC centers (92.1%) than in hospitals (79.6%). This difference became insignificant after intervention because success of BCG vaccination in hospitals has increased up to 95.1% compared to 96.8% in health centers. Inspection of all infants for BCG reaction is continued as a part of routine work at PHC centers, and re-vaccination of those who failed to develop reation to BCG is conducted without any reported complications.