Abdel-Hady El-Gilany

Violence Against Primary Health Care Workers in Al-Hassa, Saudi Arabia

This self-report questionnaire study was carried out in Al-Hassa, Saudi Arabia to highlight the magnitude, predictors, and circumstances of workplace violence against primary health care (PHC) workers. A total of 1,091 workers completed a self-administered questionnaire. About 28% were exposed to at least one violent event during the past year. Logistic regression analysis revealed that the most important predictors of violence are high education of workers (OR = 9.3), working in emergency clinics (OR = 6.8), and in Hegar (OR = 3.2). Emotional and physical violence accounted for 92.1% and 7.9% of violent events, respectively. Unmet needs of patients, overcrowding, and reaction to injury or illness were the leading contributing factors for violence. There is a need for violence prevention and control program in health care facilities.

Perceived stress among male medical students in Egypt and Saudi Arabia: effect of sociodemographic factors

BACKGROUND AND OBJECTIVES In Arab countries, epidemiological data about psychological morbidity among medical undergraduate students are scarce. This study sought to determine whether there was a difference in perceived stress levels of male medical students at Mansoura University, Egypt, compared with male medical students at King Faisal University, Saudi Arabia. METHODS The sample consisted of 304 male medical students in Egypt and and 284 male medical students in Saudi Arabia. The self-reported questionnaire covered four categories, including 15 items, on sources of stress (stressors). The perceived stress scale and hospital anxiety and depression scale were used to measure stress, anxiety and depression. RESULTS There was no significant difference between the two groups in number of stressors. However, Egyptian students were more likely to cite relationship, academic and environmental problems than Saudis. The prevalence of high stress was nearly equal in both groups. However, anxiety and depression were significantly higher among Egyptian than Saudi students. A logistic regression analysis of independent predictors of severe stress among both groups combined revealed that a satisfactory family income and university-graduated father were independent protective factors. The independent risk predictors were anxiety and number of stressors. CONCLUSIONS Stress, anxiety and depression are frequent among medical students. Counseling and preventive mental health services should be an integral part of the routine clinical facilities caring for medical students.

Factors associated with timely initiation of breastfeeding in Al-Hassa province, Saudi Arabia.

The World Health Organization recommends early initiation of breastfeeding (within 1 hour of giving birth). This study assessed the prevalence of timely initiation of breastfeeding by mothers of neonates in Al-Hassa province, Saudi Arabia. Mothers attending for birth registration at primary health care centres were interviewed and various sociodemographic, obstetric and health service related variables as well as breast problems were assessed for any influence on timely breastfeeding rates. While 91.9% of the 906 neonates studied were breastfed (8.1% were never breastfed), only 11.4% were given timely breastfeeding (within 1 hour after birth). Logistic regression revealed that the independent predictors of timely breastfeeding were: not giving prelacteal feed (OR 13.7), rural/hegar residence (OR 4.2), absence of breast problems (OR 3.4), parity 2 or 3 (OR 2.9) and parity 4+ (OR 2.4). Mothers at risk of delayed breastfeeding initiation should be the target of breastfeeding promotion during prenatal care.

Body mass index and obstetric outcomes in pregnant in Saudi Arabia: a prospective cohort study.

Background and Objectives: We examined the effect of body mass index in early pregnancy on pregnancy outcome since no study in Saudi Arabia has addressed this question. Methods: This prospective cohort study involved women registered for antenatal care during the first month of pregnancy at primary health care centers in Al-Hassa, Saudi Arabia. Data was collected from records and by direct interview. Results: The study included 787 women. Compared to normal weight women (n=307), overweight (n=187) and obese (n=226) women were at increased risk for pregnancy-induced hypertension (RR=4.9 [95% CI 1.6-11.1] and 6.1 [95% CI 2.1-17.8], respectively), gestational diabetes (RR=4.4 [95% CI 1.2-16.3] and 8.6 [95% CI 2.6-28.8]), preeclamptic toxemia (RR=3.8 [95% CI 1.1-14.6] and 5.9 [95% CI 1.7-20.4]), urinary tract infections (RR=1.4 [95% CI 0.5-3.9] and 3.7 [95% CI 1.7-6.2]), and cesarean delivery (RR=2.0 [95% CI 1.3-3.0] in obese women). Neonates born to obese women had an increased risk for postdate pregnancy (RR=3.7 [95% CI 1.2-11.6]), macrosomia (RR=6.8 [95% CI 1.5-30.7]), low 1-minute Apgar score (RR=1.9 [95% CI 1.1-3.6]), and admission to neonatal care units (RR=2.1 [95% CI 1.2-2.7]). On the other hand, low birth weight was less frequent among obese women (RR=0.5 [95% CI 0.3-0.9]) while the risk was high among underweight women (RR=2.3 [95% CI 1.4-3.8]). Conclusion: Even with adequate prenatal care, overweight and obesity can adversely affect pregnancy outcomes.

Exclusive breastfeeding in Al-Hassa, Saudi Arabia.

BACKGROUND The World Health Organization recommends exclusive breastfeeding in the first 6 months of life. The objective of this study was to assess the exclusive breastfeeding rate among infants and its predictors in Al-Hassa, Saudi Arabia. SUBJECTS AND METHODS Mothers attending for vaccinating their infants at the age of 6 months at primary healthcare centers were interviewed. Various sociodemographic variables, obstetric and infant factors, and breastfeeding practices were assessed for any influence on exclusive breastfeeding. RESULTS Only 24.4% of infants were exclusively breastfed at the age of 6 months. Logistic regression revealed that the independent predictors of exclusive breastfeeding were (in order) being a housewife mother (adjusted odds ratio [AOR]= 4.7), infant on-demand feeding (odds ratio =3.4), not giving prelacteal feed (AOR= 3.1), rural/hegar residence (AOR= 2.2), timely breastfeeding initiation (AOR= 2.0), average-weight infants (AOR= 1.8), and spontaneous vaginal delivery (AOR =1.6). CONCLUSIONS Mothers at risk of not breastfeeding exclusively should be the target of breastfeeding promotion during prenatal care. Working mothers should continue breastfeeding after returning to work.

Physical activity profile of students in Mansoura University, Egypt.

A cross-sectional study was carried out on 1708 students from Mansoura University, Egypt, to describe the pattern of physical activity, predictors of physical inactivity and perceived barriers to and benefits of physical activity. The International Physical Activity Questionnaire (IPAQ) was used to measure physical activity. Data were analysed according to the guidelines for data processing and analysis of the IPAQ. Perceived barriers to and potential benefits of physical activity were asked for. More than 11% of students were physically inactive. On logistic regression analysis, the independent predictors of physical inactivity were high socioeconomic standard of the family (OR 2.1), female sex (OR 1.8), medical education (OR 1.8) and non-membership in sports clubs OR 1.6). The most frequent barriers to physical activity were time limitation and lack of accessible and suitable sporting places. More than 70% of the participants stated that physical activity promotes and maintains health.

Nosocomial infection surveillance in an Egyptian neonatal intensive care unit.

BACKGROUND Nosocomial infections (NIs) have become a matter of major concern and an important cause of morbidity and mortality in neonatal intensive care units (NICUs). AIM The objective of this study was to determine the incidence, anatomical sites and causative organisms of NI in an Egyptian NICU, and to assess the impact of NI on length of stay and mortality. METHODS This was a descriptive hospital-based study carried out for 12 months in the NICU of the Mansoura University Childrens Hospital. NI rates were calculated using different denominators (overall nosocomial infection rate, nosocomial infection incidence density, device-specific infection rates and device-days infection rates). FINDINGS Of the 238 neonates evaluated, 49 developed 51 nosocomial infective episodes, equating to an incidence rate of 21.4% or 13.8 infections per 1000 bed-days. Pneumonia was the most frequently occurring infection (11.3%) followed by bloodstream infection (8.8%). The most frequently isolated organisms were Klebsiella spp. (33.3%) followed by Escherichia coli (21.6%). NIs were associated with prolonged hospital stay. CONCLUSION NI is a significant problem in the Mansoura University Childrens Hospital NICU. Gram-negative bacteria, especially Klebsiella spp., were the predominant causes of neonatal NI, as has been described in other studies from developing countries.

Leptin, insulin and thyroid hormones in a cohort of Egyptian obese Down syndrome children: a comparative study

BackgroundObesity is a major worldwide health problem. It is commonly observed in Down syndrome individuals than in the general population. The reason for increased risk of obesity in DS is unclear.The current study was designed to clarify differences in some obesity- related hormones in a group of prepubertal Down syndrome children.MethodsThirty six Egyptian children with Down syndrome were enrolled in this study, divided according to their body mass index (BMI) into 23 obese and13 non obese. Another group of 43 non Down children were recruited, they were divided according to their BMI into 20 patients having simple obesity and 23 non obese, as control groups. Fasting blood samples were collected for estimation of fasting blood glucose (FBG), insulin, leptin, free thyroxin (FT4), thyroid stimulating hormones (TSH) and creatine kinase (CK). Insulin resistance was assessed by Homeostasis Model Assessment method (HOMA-IR). The ratio of leptin to BMI (LEP/BMI) was used as an index of leptin resistance.ResultsMedian values of FBG, insulin, and HOMA-IR were significantly higher in Down versus non Down groups, while median values of leptin and leptin resistance were non-significantly different among Down versus non Down groups. Median TSH values were non- significantly different between obese Down and obese non Down. Although the median values of TSH and FT4 were within normal range in Down groups, four cases of subclinical hypothyroidism were encountered. Leptin levels were correlated with insulin and IR but not with TSH in Down groups.ConclusionIncreased circulating leptin, a marker of leptin resistance in obese children with Down syndrome seems to be similar to that in children with simple obesity. Elevated FBG and insulin in obese Down children highlights the presence of early IR. Associated myopathy evidenced by mildly elevated CK levels could be an added factor for obesity in such group of patients.

Newborn First Feed and Prelacteal Feeds in Mansoura, Egypt

Background. Prelacteal feed (feeding any other substance before first breastfeeding) appears to be common despite its harmful effects. By definition a child provided with prelacteal feed (PLF) is not exclusively breastfed and PLF has many implications for the success and early initiation of breastfeeding. Objectives. To describe the prevalence of, nature of, and reasons for and factors associated with PLF. Methods. 647 mother-infant dyads were studied. Data was collected about the sociodemographic features of the family and baby, maternity care, the type of first feed before suckling, and causes of PLF. Maternal weight and height were measured and body mass index was calculated. Results. About 58% of newborns received prelacteal feeds. The commonest PLF was sugar/glucose water (39.6%). The most frequent reasons for giving PLF are tradition (61.0%) and mothers/mother in laws advice (58.3%). The logistic regression revealed that the independent predictors of PLF are urban residence; maternal education; fathers education; low, middle, and high social class; maternal obesity; receiving antenatal care at private clinics and no antenatal care; Caesarean section; female babies; low birth weight; and admission to neonatal intensive care. Conclusion. Indiscriminate use of PLF should be discouraged in medical education and in antenatal maternal health education.

Musculoskeletal disorders among municipal solid waste collectors in Mansoura, Egypt: a cross-sectional study

Objective To assess the percentage of musculoskeletal complaints and their possible risk factors among municipal solid waste (MSW) collectors. Design A descriptive cross-sectional study with a comparison group. Setting Primary level of care, at the Western Municipality of Mansoura City, Egypt. Participants A total of 160 male MSW collectors fulfilled the eligibility criteria and 120 of them participated in the study (response rate of 75%). The inclusion criteria were permanent or temporary solid waste collectors employed for 1 year or more. A comparison group of 110 male service workers at the Faculty of Medicine, Mansoura University, comparable to MSW collectors in most of the variables. Outcome The percentage of musculoskeletal disorders (MSDs) among collectors, their risk factors (socio-demographic, psychosocial, physical), and the independent risk factors for having the disorders. Results The percentage of musculoskeletal complaints during the past 12 months was higher among MSW collectors (60.8%) than the comparison group (43.6%). Low back was the most frequently affected body region among MSW collectors. The differences in the distribution of musculoskeletal complaints between the two groups were statistically significant for the neck and hip/thigh regions. Logistic regression analysis revealed that the independent risk factors for musculoskeletal symptoms among MSW collectors were the longer duration of employment (OR=0.4, 95% CI=0.1 to 0.9); low decision latitude (OR=0.3, 95% CI=0.1 to 0.7); lifting, pulling; pushing/carrying loads >20 kg (OR=5.5, 95% CI=1.8 to 17.0) and walking for long periods of time (OR=2.6, 95% CI=1.1 to 6.6). Conclusions Musculoskeletal complaints are highly prevalent among MSW collectors which require engineering, medical and legislative measures. We suggest further research in the interventions that could reduce the high percentage among collectors.