The Journal of the Egyptian Public Health Association (J Egypt Publ Health Assoc )

Publisher: Egyptian Public Health Association


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Publications in this journal

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    ABSTRACT: Rice (Oryza sativa L.) is one of the leading food crops of the world, the staple food of over half the world's population. The bran, which is an important byproduct obtained during rice milling, constitutes about 1/10 of the weight of the rice grain. Rice bran is the outer brown layer including the rice germ that is removed during the milling process of brown grain. This milling byproduct is reported to be high in natural vitamins and minerals, particularly vitamin E. The present study was conducted to determine the chemical composition of bran and bran oil of 13 different rice varieties commonly produced in Egypt, to study the utilization of rice bran in bread production, and to assess the quality and acceptance of the rice bran edible oil produced. Rice bran was produced from 13 Egyptian varieties of recently harvested rice as well as from paddy rice stored for 1 year. The extracted bran was immediately stabilized then subjected to chemical analysis (such as moisture content, protein, fat, carbohydrates, fiber, and ash) as well as trace and heavy metals determination (P, K, Na, Ca, Fe, Zn, Cu, and Mg). Bread was produced by adding Giza172 rice bran at three different concentrations to wheat flour then subjected to chemical analysis, caloric content, and organoleptic examination. Bran oil was extracted from the different varieties of rice bran (recently harvested and stored) then subjected to chemical and organoleptic examinations as well as vitamin E and oryzanol determination. The percentage of rice bran of newly harvested Egyptian rice was 11.68% and was 10.97% in stored rice. The analysis showed mean values of 5.91 and 5.53% for moisture, 14.60 and 14.40% for crude protein, 14.83 and 15.20% for fat, 44.77 and 45.40% for carbohydrates, 6.55 and 7.06% for crude fiber, and 8.87 and 8.50% for ash for newly harvested and stored rice bran, respectively. Bread containing 15% rice bran showed the highest score percentages for organoleptic quality compared with the control (100% wheat flour). Rice bran oil showed higher scores of taste, smell, appearance, and texture than corn oil and sunflower oil. Rice bran contains high nutritional components as well as phytochemicals such as vitamin E (i.e. tocopherols and tocotrienols) and the γ-oryzanol fraction that have positive effects on human health. Storage of paddy rice before milling resulted in significant effect on all studied rice bran characters and rice bran oil characters under the present investigation except crude protein and carbohydrates characters. Substitution of wheat flour with rice bran by 15% in bread production to fortify the bread with vitamin E and to reduce the amount of imported flour is recommended.
    The Journal of the Egyptian Public Health Association 04/2014; 89(1):29-34.
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    ABSTRACT: The menopause marks a major biological transition in the lives of all women. Understanding the attitude of women about menopause facilitates the implementation of public health policies that focus on improving women's health. This study was designed to determine the attitude of a group of Iranian women toward menopause with respect to sociodemographic variables and menopausal status. A cross-sectional study was conducted at Primary Health Centers of Semnan during 2012. A total of 747 women aged 45-60 years were interviewed. Sociodemographic characteristics and attitude toward menopause were collected through a structured pretested questionnaire. The attitude scale consisted of 17 questions, each rated on a five-point Likert scale with a total score of 85 points. The mean (±SD) age of women was 51.3 (±4.5) years. Women were classified as premenopausal (38.4%), perimenopausal (16.9%), and postmenopausal (44.8%). The majority of respondents (63.5%) were illiterate or have had low level of education (<9 years), and 86.3% were unemployed. The mean (±SD) attitude score was 53.3 (±6.8). Most of the women (71%) had neutral attitude, 22.8% had positive, and only 6.3% had negative attitude toward menopause. Menopausal status, educational level, marital status, place of residency, and employment were not associated with women's attitude. In general, women's attitude toward menopause ranged from neutral to positive. The attitude did not differ significantly on the basis of menopausal status, educational level, marital status, place of residency, and employment.
    The Journal of the Egyptian Public Health Association 04/2014; 89(1):42-5.
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    ABSTRACT: Healthcare-associated infection is a prominent problem among patients in pediatric intensive care units (PICU) as it could result in significant morbidity, prolonged hospitalization, and increase in medical care costs. The role of nurses is extremely important in preventing hazards and sequela of healthcare-associated infections. The aim of this study was to assess the effect of a health education program regarding infection-control measures on nurses' knowledge and attitude in PICUs at Cairo University hospitals. This was a pre-post test interventional study in which a convenient sample of 125 nurses was taken from the nursing staff in different PICUs at Cairo University hospitals. The study took place in three phases. In the first phase, the nursing staff's knowledge, attitude and practice concerning infection-control measures were tested using a self-administered pretested questionnaire and an observation checklist. The second phase included health education sessions in the form of powerpoint and video presentations; and in the third phase the nurses' knowledge and attitude on infection-control measures were reassessed. A significantly higher level of knowledge was revealed in the postintervention phase as compared with the preintervention phase with regards to the types of nosocomial infections (94.4 vs. 76.8%, P<0.001), the at-risk groups for acquiring infection (95.2 vs. 86.4%, P=0.035) and the measures applied to control nosocomial infections (89.6 vs. 68%, P<0.001). Nurses in the postintervention phase had significantly more knowledge about the types of hand washing (99.2 vs. 91.2%, P=0.006). A significantly higher percent of nurses in the postintervention phase knew the importance of avoiding recapping syringes (72.8 vs. 34.4%, P<0.001) and believed that infection-control measures could protect them completely from acquiring infection (79.2 vs. 65.6%, P=0.033). Statistically significant higher total knowledge and attitude scores were revealed in the postintervention phase as compared with the preintervention one (P<0.001). The percentage practice score of observed units was the highest among nurses in the neonatal intensive care unit at the Japanese Hospital (88%), whereas it was the lowest in the emergency pediatric unit (65%). There is scope for improvement in knowledge and attitude after educational program was offered to the nursing staff. Educational training programs should be multidisciplinary interventions in the era of quality control to help healthcare workers realize the importance of basic infection-control measures in reducing pediatric morbidity and mortality and improving the quality of care.
    The Journal of the Egyptian Public Health Association 04/2014; 89(1):22-8.
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    ABSTRACT: Childhood attention deficit hyperactivity disorder (ADHD) is a chronic disorder that carries an immense amount of suffering for its victims, their families, and communities. The efficacy of behavioral parent training in the treatment of ADHD has been supported in several studies. To evaluate the efficacy of a predesigned culturally sensitive psychosocial intervention program for parents of ADHD children in Alexandria, Egypt. A pretest-post-test intervention study was carried out at the Child Mental Health Clinic for School Students affiliated to the Health Insurance Organization, Alexandria. The intervention aimed at improving parents' knowledge of ADHD, building their skills in effective parenting, stress management and problem-solving, as well as providing social support. All the participants (50 parents) were assigned to groups, each of five to eight parents. They received a total of eight sessions on a weekly basis. The program was evaluated immediately after completion and 2 months later using the Arabic Version of Conners' Rating Scale to identify ADHD and to assess its severity, Home Situations Questionnaire, Parenting Scale, the Arabic Version of Depression Anxiety Stress Scales (DASS), and parental ADHD-related knowledge questionnaire were used. There was a statistically significant decrease in the mean total scores recorded by parents on Conners' Rating Scale (P<0.001), Home Situations Questionnaire (P<0.05), Parenting Scale (P<0.001), and DASS (P<0.001) immediately after program completion and 2 months later compared with that reported before program initiation. The total scores of participants on the ADHD-related knowledge questionnaire increased significantly after attending the program (P<0.001). Provision of a psychosocial intervention program for parents of ADHD children proved to be effective in reducing perceived severity of the symptoms and problem situations, as well as improving parents' knowledge, discipline practices, and psychological well-being.
    The Journal of the Egyptian Public Health Association 04/2014; 89(1):9-15.
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    ABSTRACT: The adequacy and timing of complementary feeding of the breastfed child are critical for optimal child growth and development.Considerable efforts have been made to improve complementary feeding in the first 2 years of life. One of them was the WHO complementary feeding counseling course (CFC). To evaluate the effectiveness of the WHO CFC on knowledge and counseling abilities of primary healthcare physicians; on caretaker's knowledge and adherence to physicians' recommendations and their feeding practices; and on children's growth. A single-blinded randomized-controlled study was carried out in 40 primary healthcare centers divided into matched pairs according to their location, either in rural or urban areas, and training of the selected physicians on integrated management of childhood illness. One center from each pair was selected randomly for its physician to receive CFC training in nutrition counseling and the matched center was selected as a control. Forty primary healthcare center physicians and 480 mother-child (6-18 months) pairs were included in the study. The mother-child pairs recruited were visited at home within 2 weeks, 90, and 180 days after the initial consultation with trained health workers. Special questionnaires were used to collect information on healthcare providers' knowledge of nutrition counseling and practice (counseling skills); maternal knowledge of basic nutrition-counseling recommendations, maternal compliance with the recommended feeding practice; child dietary intake; and gains in weight and length. CFC-trained physicians were more likely to engage in nutrition counseling and to deliver more appropriate advice. This was reflected in improvements in maternal recall of complementary feeding messages, which were higher in the intervention group compared with the control group. Six months after the consultation, children in the intervention group had significantly greater weight gains compared with the control group (0.96 vs. 0.78 kg; P=0.038). Children in the intervention group, who were 12-18 months of age at the time of recruitment, had significantly less faltering in length gain compared with the control group (height/age Z-score; 0.23 vs. 0.04; P=0.004). Nutrition counseling training improved counseling abilities of primary healthcare physicians and led to improvements in mothers' knowledge and practices of complementary feeding. In turn, this led to improved growth of children. We recommend wide and regular utilization of the CFC course to improve the knowledge and skills of health workers who provide counseling to mothers for complementary feeding.
    The Journal of the Egyptian Public Health Association 04/2014; 89(1):1-8.
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    ABSTRACT: Deficiencies of protein, energy, and micronutrients are highly prevalent in developing countries and have major effects on pregnancy outcome. Low dietary intake is the most common reason for zinc deficiency. The present research is part of a larger double-blind randomized-controlled trial to evaluate the effect of zinc supplementation on the pregnancy outcome. The aim of the present study was to assess the zinc status and dietary intake of zinc and other macronutrients and micronutrients among pregnant women in Alexandria, Egypt. Participants were pregnant women attending two antenatal care centers that serve low-income and middle-income pregnant populations. A total of 1055 healthy pregnant women aged 20-45 years were assessed for eligibility. Of these, only 675 had serum zinc level below the median for the gestational age. They were assigned randomly to one of three parallel groups. Zinc supplements were provided from 16 weeks until delivery. A subsample of 100 women was assessed for their dietary intake. A questionnaire interview was used to collect basic socioeconomic and data on current pregnancy and labor. Dietary data were collected using the 24-h recall method and a food frequency questionnaire. The nutritive value of the daily diet was computed using the Egyptian food composition tables. The blood hemoglobin level, serum zinc level, and fasting blood sugar were determined. Zinc deficiency was detected among 53.5% of the sample. Dietary intake of zinc was low, representing 59.4, 59.4, and 62% of the recommended dietary allowance (RDA) for the zinc group, zinc plus multivitamins, and the placebo group, respectively. The iron intake was below 50% of the RDA. Protein intake was less than 70% of the RDA. The mean intakes of fat were 191.97, 211.8, and 196.3 g/day for the three groups. The mean energy intake represented 51.1, 53.5, and 49.8% of the RDA. Except for carbohydrate intake, the dietary intake of all macronutrients and micronutrients was low. The lowest intake was of iron (below 50% of the RDA). Zinc and protein intake represented less than 70% of the RDA. The overall energy intake was around 50% of the RDA. Nutritional health education should be used as a preventive approach to allow the large sector of the low-income population to maximize the use of the limited resources in the best way. In women at high risk of zinc deficiency, zinc supplementation should be added to the routine supplements.
    The Journal of the Egyptian Public Health Association 04/2014; 89(1):35-41.
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    ABSTRACT: Smoking addiction is influenced by cultural and environmental factors and personality traits. We assessed the associations between neuroticism and depression and smoking behavior and motives among Egyptian adult men in rural Qalyubia Governorate. Using a cross-sectional design, we administered questionnaires to randomly selected 201, 278, and 120 adult men aged 18 years or above who were never, current, and former smokers, respectively. We used Center for Epidemiologic Studies Short Depression (CES-D) scale, Eysenck Personality Inventory (EPI), Fagerström Test for Nicotine Dependence (FTND), and Wisconsin Inventory of Smoking Dependence Motives scales to assess the associations between neuroticism, depression, and smoking risk. The mean CES-D and EPI scores were significantly higher among current smokers as compared with never smokers (P=0.02 and 0.006, respectively). The greatest risk for ever smoking was observed among those with both neuroticism and depression [adjusted odds ratio (95% confidence interval) were 1.98 (1.23-3.19); 2.56 (1.34-4.88); and 1.82 (1.10-3.03) for ever, former, and current smokers, respectively]. Both CES-D and EPI scores were associated with a variety of smoking motives and with the level of severity or intensity of nicotine dependence on FTND. Neuroticism and depression were associated with smoking behavior and motives among Egyptians, and thus attention should be given to individual needs in designing and implementing smoking cessation interventions.
    The Journal of the Egyptian Public Health Association 04/2014; 89(1):16-21.
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    ABSTRACT: Combating poverty and illiteracy represents the cornerstone for promoting health among Egyptian children; yet, drop out from the elementary education is a major problem facing stakeholders in Egyptian governorates. To tackle this problem, many projects were implemented such as reading and writing classes, and Girls Education Initiatives (GEIs). The aim of the study was to construct a clinical and laboratory database for students attending the Girls Education Initiative schools in Upper Egypt. This cross-sectional study was carried out by involving schoolchildren in three Egyptian Governorates implementing the Girls Education Initiative (GEI) project in 197 schools in these governorates. For each student, a questionnaire investigated the possible predictors for intestinal parasitic infections, a stool sample was examined using the Kato-Katz technique, the hemoglobin concentration was measured, and anthropometric assessments measuring weight and height were carried out. Out of 2695 students, 898 (33.3%) students were infected by parasites; 92% of these students were infected by Enterobius vermicularis worms. The mean weight of the girls was 29.4±10.6 kg and that of the boys was 29.1±8.6 kg. The mean height of the girls was 132.5±16.9 cm and that of the boys was 132.9±16.3 cm. BMI was 16.6±6.8 and 16.7±9.5 for girls and boys, respectively. The mean hemoglobin levels were 10.6±1.37 and 10.7±1.4 mg for girls and boys, respectively. More than two-thirds of the studied group had poor hygiene habits, such as contact with canal water, not washing their hands before and after eating food, not washing their hands after bathroom visits, and not washing vegetables and fruits. The students studied had chronic nutritional deficiencies, mainly anemia. Poor hygiene habits, poor household sanitation, and lack of parents' education in rural areas were predictors for intestinal infections. It is recommended that health education campaigns be conducted to increase students' and mothers' awareness and encourage proper sanitation and hygiene habits at home and in their environment.
    The Journal of the Egyptian Public Health Association 12/2013; 88(3):153-9.
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    ABSTRACT: Evidence-based medical practice has gained worldwide attention and is an emerging must-know topic for today's physicians. Yet, it continues to puzzle physicians either in its understanding or in its practice, and gaps continue to exist between research-based evidence and clinical practice. This study aimed to evaluate the self perceived EBM competency of the clinicians and staff of Zagazig University Hospital. A cross-sectional study was carried out on a sample of 184 clinicians during the period of March-July 2012 at five randomly chosen special medicine departments (tropical medicine, rheumatology, neurology, dermatology, and hematology-oncology) using a self-administered, specifically tailored questionnaire. Sampled clinicians were dichotomized according to their self-reported frequency of evidence-based practice into evidence-based medicine (EBM) nonusers (62.5%) and EBM users (37.5%). There was no significant difference between users and nonusers in total mean scores (21.37±1.86 vs. 21.34±2.2, P=0.119). Users had significantly higher mean score for self-perceived EBM competency compared with nonusers (P=0.000), although both users and nonusers had unsatisfactory mean score for EBM competency (38.33±2.87 vs. 32.96±3.026, respectively) (median, 39 vs. 33, respectively). Users of EBM had a significantly higher score in competencies related to the use of a bibliographic database, understanding of methodological terminology, confidence in their skills in EBM steps, and consequently in cumulative EBM competency (P=0.000). Our findings support some important facts: first, there is discrepancy between clinicians' perceptions and their competency, as they considered themselves practicing EBM although they were not; second, strategies to promote a change in clinical practice are more likely to be successful if they are based on an analysis of problems. All findings in this study highlighted the importance of training in EBM.
    The Journal of the Egyptian Public Health Association 12/2013; 88(3):121-9.
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    ABSTRACT: Thyroid dysfunction is a known complication of transfusion-dependent β-thalassemia. However, information on its frequency and risk factors among Egyptian Children is still unclear. We aimed to determine the frequency of functional thyroid abnormalities among young patients with β-thalassemia and compare the thyroid function status among patients with β-thalassemia major (TM) and β-thalassemia intermedia (TI). This was a cross-sectional study that included 52 β-thalassemia children [27 boys and 25 girls; 34 (65.4%) with TM and 18 (34.6%) with TI]. Their mean age was 16.0±1.91 (range: 12-18) years. Thyroid function and iron load status were assessed by measurement of free tetraiodothyronine, free triiodothyronine, thyroid stimulating hormone (TSH), and serum ferritin concentrations. Serum TSH of the studied cases ranged from 0.28 to 25 μIU/ml with a mean of 4.5±4.8 μIU/ml. None of the studied cases had overt primary hypothyroidism and the frequency of subclinical hypothyroidism was 19.2%. No risk factors for thyroid dysfunction could be identified among our cases. The thyroid profile was comparable in TM and TI patients (P>0.05) and the frequency of subclinical hypothyroidism among TM cases was 20.6% and it was comparable to the 16.7% found among TI patients (P>0.05). No correlations were found between TSH, serum ferritin, chelation therapy, and frequency of blood transfusion. Both TM and TI patients are at risk for subclinical thyroid failure regardless of their iron overload status. Early evaluation of thyroid function in β-thalassemia children and thyroid replacement therapy for subclinical hypothyroidism should be introduced in the treatment protocols.
    The Journal of the Egyptian Public Health Association 12/2013; 88(3):148-52.
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    ABSTRACT: Schistosomiasis is one of the most important public health problems in Yemen. The prevalence of urinary schistosomiasis varies considerably across different parts of Yemen and was estimated to be 10% among schoolchildren in Sana'a. Praziquantel (PZQ) is highly effective against all five major human species of schistosomes. The aim of the present work was to estimate the prevalence of urinary schistosomiasis, describe the risk factors associated with its endemicity, and implement and assess a chemotherapeutic intervention using PZQ in a village in Yemen. The sample included 696 schoolchildren from a village in Abyan Governorate. During the baseline school survey, personal, sociodemographic, and environmental data, and data on practices in relation to water contact were collected from each study participant using a predesigned structured questionnaire. Urine samples from each participant were examined for macrohematuria and the presence of Schistosoma haematobium eggs. The chemotherapeutic intervention was assessed 3 and 6 months after the treatment and certain indicators were calculated. The prevalence of S. haematobium was 18.1%. The main significant risk factors were male sex; proximity of houses to water ponds; and using pond water for swimming, agricultural activities, and for bathing in houses. PZQ treatment reduced the prevalence of infection and decreased the prevalence of high-intensity infection. Survival analysis showed that the probability of residual infection also dropped after the treatment intervention. Male sex and using pond water for various activities were the main significant risk factors associated with urinary schistosomiasis. PZQ is still a cornerstone drug in reducing or eliminating morbidity associated with schistosomiasis infection. Health education programs tailored for the community are required for the control and prevention of urinary schistosomiasis. To address schoolchildren, school curricula should include lessons about urinary schistosomiasis.
    The Journal of the Egyptian Public Health Association 12/2013; 88(3):130-6.
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    ABSTRACT: Type 1 diabetes mellitus (T1DM) can be associated with an increased prevalence of Helicobacter pylori infection, which could contribute to the pathogenesis of autoimmune thyroiditis observed in this disease. The aim of this study was to assess the relationship between H. pylori infection and T1DM and to identify of the interconnection between H. pylori infection and autoimmune thyroiditis in patients with T1DM. A case-control design was used. The study group included 60 children and adolescents with T1DM who were selected from the pediatric outpatient clinic of Suez Canal University Hospital by a systematic random sampling method. The control group included 60 healthy children and adolescents matched for age and sex and selected from among relatives (brothers or cousins) of the patients with T1DM. The study participants were subjected to several investigations including estimation of levels of HbA1c, thyroid stimulating hormone (TSH), T3, T4, anti-thyroglobulin (anti-Tg), and anti-thyroid peroxidase (anti-TPO). The mean age of the patients with T1DM was 12.53±2.35 years, whereas that of the control group was 12.30±1.98 years, with no statistically significant difference between the two groups. The patients with diabetes had significantly higher levels of H. pylori IgG, TSH, anti-TPO, and anti-Tg (20.43±14.84 μ/ml, 4.03±1.53 mIu/l, 14.98 ±5.04 Iu/ml, and 5.66±3.37 Iu/ml, respectively) and significantly lower levels of T3 and T4 (120±15.86 μg/dl and 4.93±0.93 μg/dl, respectively) compared with the control group. In addition, the seroprevalence rate of H. pylori, anti-Tg, and anti-TPO was significantly higher in diabetic patients, and the duration of diabetes was significantly longer in H. pylori-positive patients with higher levels of HbA1c, insulin requirement, TSH, anti-TPO, and anti-Tg. The association between H. pylori infection and autoimmune thyroiditis in patients with T1DM was revealed in this study. Hence, screening and treatment of H. pylori infection in T1DM patients is recommended.
    The Journal of the Egyptian Public Health Association 12/2013; 88(3):143-7.
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    ABSTRACT: Neonatal bacterial sepsis is a challenging disease that needs to be detected early. As it is a life-threatening condition, the use of an approach that could be more rapid than standard culture and identification techniques for detection of neonatal sepsis would be highly desirable. The aim of this work was to assess the effectiveness of the PCR technique compared with blood culture for the early detection of bacterial sepsis. This study included 50 neonates with suspected sepsis. A blood sample was collected and divided into two parts: one part was subjected to broad-range 16S rDNA detection by PCR (runtime 6 h) and the other part was inoculated onto blood culture bottles (monitored for 6 days). In addition, some risk factors associated with clinical sepsis were explored. Twenty-four neonates (48%) were positive for bacterial DNA by PCR and 17 cases (34%) had a positive blood culture. Seventeen neonates were positive for both blood culture and bacterial DNA. There was no statistical significance between both methods and the risk factors studied, except for sex and blood culture. The results of PCR in the detection of bacterial sepsis when compared with blood culture showed 100% sensitivity, 78.79% specificity, 70.83% positive predictive value, and 100% negative predictive value. An excellent agreement was found between the two methods (κ=0.716, P<0.001). The PCR detected a higher rate of sepsis in neonates than blood culture. Therefore, PCR is useful for the rapid and accurate diagnosis of bacterial infection, with a significant impact on the current inappropriate and unnecessary use of antibiotics in the treatment of newborns. We recommend using broad-range PCR to rapidly diagnose infants with sepsis.
    The Journal of the Egyptian Public Health Association 12/2013; 88(3):160-4.
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    ABSTRACT: Systematic reviews of the studies published in the major medical data bases have not shown solid support for the use of ozone therapy. Unpublished or grey literature, including postgraduate theses, may solve this controversy. To review the postgraduate theses published in Egypt in order to assess the clinical safety and effectiveness of ozone therapy in specific medical conditions. The databases of the Egyptian Universities' Library Consortium and the databases of each university were searched for postgraduate theses that evaluated ozone therapy as an intervention for any disease or condition in any age group, compared with any or no other intervention and published before September 2010. A total of 28 quasi trials were included. The theses did not report any safety issues in terms of ozone therapy. With respect to its effectiveness, the studies suggested some benefits of ozone in the treatment of dental infection and recovery, musculoskeletal disorders, diabetes mellitus, chronic diseases, and obstetrics and gynaecology. However, the number of studies included was small and they were of limited quality. There is insufficient evidence to recommend the use of ozone in the treatment of dental infections, in facilitating faster dental recovery after extraction or implantation, in diabetes mellitus, musculoskeletal disorders, or obstetrics and gynaecology.
    The Journal of the Egyptian Public Health Association 08/2013; 88(2):57-66.
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    ABSTRACT: The prevalence of gestational diabetes mellitus (GDM) has increased worldwide, with a subsequent increase in the associated adverse pregnancy outcomes. The objective of this study was to determine the prevalence of GDM and to compare the maternal and neonatal outcomes of women with GDM with nondiabetic women. This is a retrospective cohort study investigating the maternal and the neonatal outcomes of women with GDM who delivered in King Khalid University Hospital as compared with the outcomes of nondiabetic women who delivered during the same period. The data were collected from the 1st of January to the 31st of December 2010 from the labor ward registry. The pregnancy outcomes of the women with GDM were compared with the outcomes of nondiabetic women who delivered during the same study period. Out of 3041 women who delivered during the study period, 569 (18.7%) had GDM and 2472 (81.3%) were not diabetic. Compared with the nondiabetic women, women with GDM were more likely to be delivered by emergency cesarean section (CS), odds ratio (OR) 1.30, 95% confidence intervals (CI) (1.02-1.66), or elective CS (OR 1.72, 95% CI 1.22-2.44, P<0.001). The neonates of the mothers with GDM were significantly heavier and more frequently macrosomic (OR 1.75, 95% CI 1.14-2.71, P<0.001). There was no significant difference between the two groups in the frequency of APGAR scores less than 7 in 5 min, preterm delivery at less than 37 weeks of gestation, or in the frequency of intrauterine fetal death. The prevalence of GDM in King Khalid University Hospital is among the highest in the world. GDM is associated with an increased risk for CS delivery and macrosomia.
    The Journal of the Egyptian Public Health Association 08/2013; 88(2):104-8.
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    ABSTRACT: Salmonella is a significant microbial hazard in seafood. Salmonella-contaminated seafood usually looks and smells normal; it is therefore essential that every effort is made toward the rapid detection of Salmonella as an important criterion in quality control of seafood. This study aims to determine the percentage of Salmonella in some Egyptian seafood sold in Alexandria markets and to study the validity of Chromagar Salmonella Plus (CASP) agar versus xylose lysine desoxycholate and Salmonella-Shigella agar for the isolation and identification of Salmonella in seafood. Two hundred and twenty-five samples of three seafood types, shrimp, gandofli, and river mussel (om-elkhloul) were studied. Samples were selectively enriched in Rappaport-Vassiliadis and tetrathionate broth, and then plated onto the aforementioned plating media for the detection of Salmonella. In total, Salmonella was detected in 9.8% of the samples. The sensitivity and specificity of the media used varied according to the media and enrichment broth combinations used. The CASP and Rappaport-Vassiliadis combination yielded the best sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 95.45, 100, 100, 99.5, and 99.5%, respectively. CASP was more accurate than xylose lysine desoxycholate and Salmonella-Shigella in the detection of Salmonella from seafood samples. We recommend that CASP medium should be tested against more Salmonella-positive samples before it is used as a screening plating medium for Salmonella in seafood.
    The Journal of the Egyptian Public Health Association 08/2013; 88(2):115-20.
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    ABSTRACT: Sick building syndrome (SBS) is a group of symptoms relatively common among office workers; such symptoms could have an impact on the workers' productivity. The aim of this study is to measure the prevalence of SBS symptoms among office workers in the Faculty of Medicine, Ain Shams University, Cairo, Egypt, and to determine the possible risk factors. A cross-sectional study was carried out at the Ain Shams Faculty of Medicine including 826 workers. Data were collected through a self-administered questionnaire that included sociodemographic and occupational histories, work environment, and symptoms related to SBS. Fatigue and headache were the most prevalent symptoms (76.9 and 74.7%, respectively). Using univariate analysis, poor lighting, poor ventilation, lack of sunlight, absence of air currents, high noise, temperature, humidity, environmental tobacco smoke, use of photocopiers, and inadequate office cleaning were associated statistically with SBS symptoms (P<0.05). High work load and poor job satisfaction were also associated significantly with SBS symptoms (P<0.05). Logistic regression analysis showed that poor ventilation, poor lighting, environmental tobacco smoke, high temperature, poor job satisfaction, and inadequate office cleaning were the risk factors of SBS. SBS was highly prevalent among office workers and was influenced by physical and psychosocial working conditions. Good ventilation, reducing room temperature, effective cleaning routines, providing proper lighting, restricting smoking in the workplace, and improving psychosocial working conditions are important ways to reduce SBS symptoms.
    The Journal of the Egyptian Public Health Association 08/2013; 88(2):109-14.
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    ABSTRACT: High-quality patient care depends on a nursing workforce that is empowered to provide care according to professional nursing standards. Numerous studies have established positive relationships between empowerment and important nursing outcomes such as work effectiveness, job satisfaction, and organizational commitment. A cross-sectional study design was used to assess the relationships between structural and psychological empowerment and their effects on hospital nurses' organizational commitment at the Main University Hospital in Alexandria governorate. The total number of nurses who participated in the study was 150 nurses, and four interview questionnaires were used to measure the study variables. The mean score percentage was higher for overall psychological empowerment (68.75%) than for overall structural empowerment (46.25%). There was a significant direct intermediate correlation between nurses' perceptions of overall structural and psychological work empowerment and their overall organizational commitment. There was no significant relationship between structural and psychological empowerment, organizational commitment and sociodemographic characteristics of nurses except for the overall organizational commitment with age (r=0.260), overall structural empowerment in the working department (P=0.031), and overall organizational commitment with nursing experience (significance=0.025). Overall psychological empowerment achieved a higher mean score percentage compared with overall structural empowerment. Changing workplace structures is within the mandate of nurses' managers in their roles as advocates for and facilitators of high-quality care. The most significant opportunity for improvement is in the area of formal power, including flexibility, adaptability, creativity associated with discretionary decision-making, visibility, and centrality to organizational purpose and goals.
    The Journal of the Egyptian Public Health Association 08/2013; 88(2):90-6.

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