A study of pattern of gastrointestinal malignant neoplasms in the last decade (1987-1996) in Alexandria.

The present study was conducted to reveal the pattern of different gastrointestinal malignant neoplasms in Alexandria in the last decade (1987-1996). All registered cases of GIT cancers in Alexandria. Main University Hospital in the last decade were included in the study. The results revealed that the total number of cases was 2184, 58.6% were males and 41.4% were females. The mean age of registered cases was significantly older among males than females (t = 2.43). The highest percentage (47.2%) of cases were in the age group (40- < 60 years). Less than quarters (73.3%) of the total cases have had malignant neoplasms of digestive organs and 26.7% have had malignant neoplasms of lips, oral cavity and pharynx. Of the latter category cancer pharynx came first in both sexes (49.9%) with the youngest mean age (45.65 +/- 15.79 years), followed by cancer tongue (24.9%) with the oldest mean age (58.56 +/- 12.4). Among cases of malignant neoplasms of digestive organs, cancer colon came first in both sexes (26.9%) with the youngest mean age (44.11 +/- 14.08 years). Cancer gall bladder came last (1.2%) with the oldest mean age (55.80 +/- 10.20 years). Over the last decade trend of malignant neoplasms of colon, rectum, liver and pancreas were increasing while the reverse was observed for cancer oesophagus and stomach. So it is necessary to plan for GIT cancer control programme.

Quality assessment of medical care in chest dispensaries in Alexandria.

Eight million new cases of tuberculosis are merging annually, worldwide, of which an estimated three million are dying. The quality of medical care rendered by chest clinics (dispensaries) to tuberculous patients is crucial. The present study was conducted in order to assess quality of medical care rendered to tuberculous patients in all chest clinics in Alexandria (n=7). To achieve this aim, three checklists were developed in relation to the three dimensions of medical care, namely, structure, process of care and outcome. They were validated and rated by ten medical experts working in the field of tuberculosis and chest diseases. Accordingly for the process of care, each item was scored using weighted scores for physicians' performance. Unit weighted scoring was also used for physicians, nurses, as well as social workers. Direct observation was conducted for assessment of structure and process of care rendered by physicians, nurses and social workers. On the other hand, outcome was measured by cure or treatment completion rate, treatment failure rate, defaulter rate, as well as death rate. The results revealed that percentage of recommended structure items ranged between 77.8% and 94.4%. Regarding process of care, it was found that the overall weighted physicians' performance index (PPI) expressed in percentage was 36.97+/-13.65%, while the mean unit weighted PPI was 35.26+/-13.5%. For the different areas of care, the mean weighted and unit weighted PPI, respectively, were 27.86+/-20.83% and 28.6+/-21.7% in history taking, 54.65+/-11.92% and 42.83+/-13.83% for examination, 31.64+/-19.61% and 37.10+/-19.40% for educating patients, while it was 36.36+/-16.0% and 37.90+/-16.20% for measures applied to contacts. Moreover, assessment of nurses and social workers' performance revealed that they had carried out 91.86% and 86.60% of their recommended activities, respectively. Outcome indices among the different clinics showed that cure or treatment completion rate ranged from 47.48% to 81.51%, while treatment failure rate ranged between 1.71% and 11.54%. On the other hand, the defaulter rate showed a minimum of 13.70% and a maximum of 44.86%. From the present study it could be recommended that quality of medical care in chest clinics should be emphasized specially as regards process of care given by physicians.

A study of nosocomial infection in a general hospital.

The present study was conducted in Hail General Hospital, in Kingdom of Saudi Arabia, over six months period starting from December 1994. All notified cases of nosocomial infections were taken into consideration. Cases who satisfied the definition and criteria of nosocomial infection were included in the study (n = 105). Data were abstracted from the special routine monthly resorts to the General Directorate of Health Affairs. The results of the present study revealed that invasive procedures were conducted for the majority of cases (81.9%). The most common site of infection was urinary tract (36.6%), followed by respiratory and wound infection (23.8% and 22.8% respectively), while other sites accounted for the remaining part of the sample (16.8%). Out of the culture positive cases (n = 101) gram negative bacteria represented 85.15% of cases where the most common ones were Klebsiella pneumonia and pseudomonas. Bivariate analysis revealed a significant linear association between invasive procedures and age (Mantel Hanszel test = 17.37). Moreover, invasive procedures were found to be significantly related to the occurrence of gram negative infection (chi2 = 4.77). Multiple regression analysis, for factors affecting length of hospital stay, showed that age and presence of host factors lowering host resistance had significant effect in prolonging the duration of stay among cases.

Risk factors related to deaf-mutism among pupils attending the Alexandria governmental deaf-mute schools.

Childhood deafness interferes with the cognitive development of the child, so it is considered a major handicap. The present work was carried out to reveal possible risk factors of deaf-mutism and the magnitude of each. The case control design was chosen as a research methodology. A 50% sample of deaf-mute pupils at the primary level were selected at random from each of the two governmental schools for the deaf-mutes in Alexandria (boys=96, & girls=76). A control group chosen at random from a main stream governmental school and matched by age and sex of the pupils as well as with education and occupation of the father. Matching was carried out at the sampling phase, pairing each case to its control. Data were collected by interviewing the mothers using an interviewing schedule. Matched analysis was carried out where pairing of cases and controls was retained. The likelihood estimate of Odds ratio conditional on the number of discordant pairs was estimated using McNemer's test. The 5% level was chosen as the level of significance. The study revealed 172 deaf-mute pupils. Their mean age was 9.48+/-1.981 years. Boys outnumbered girls (55.8% and 44.2% respectively). In 59.4% parents were cousins. Deafness was first noticed at 6 to 60 months of age with a mean of 14.70+/-10.2 months. Most fathers and mothers were illiterate (48.84% and 61.63%). Heredity was a risk factor, where 84.82% of cases had a positive family history compared to none of the controls. Moreover, in case of consanguinity the Odds ratio=5.60. Acquired deafness constituted the second important group of all causes of deafness. Meningitis featured as the most important cause of acquired deafness with an estimated relative risk of 18.5, followed by fever (Odds ratio=4.67), then repeated attacks of acute tonsillitis and ear disease where the case control percent difference was 8.72% and 4.65% respectively.