Dalia G. Mahran

Knowledge, attitude and practice with respect to epilepsy among school teachers in Assiut city, Egypt

OBJECTIVE This study was designed to assess knowledge, attitude and practice with respect to epilepsy among secondary school teachers in Assiut city, Egypt. METHODS A cross sectional study was applied among secondary schools in Assiut city, Egypt. A 12-item questionnaire was self administered to 189 teachers, who selected randomly. RESULTS All teachers had heard about epilepsy. 54% of teachers deal with students with epilepsy as normal students. About one quarter (23.8%) of teachers accepted to give student with fit in the class first aid measures and 12.7% accepted to give the student, who was having a seizure in the class any form of prescribed treatment. Positive attitudes were common among females and single teachers. CONCLUSION The current study suggests that, a well directed health educational program about causes and management of epileptic seizures may improve the perception of epilepsy by teachers in Egypt. Teacher-targeted interventions aimed at reducing epilepsy-associated stigma and its sequel in Egyptian students.

Knowledge and attitude of epilepsy among secondary schools students (epileptic and non-epileptic) in Assiut city “Egypt”

THE PURPOSE OF THE RESEARCH This study was designed to assess knowledge and attitude with respect to epilepsy among secondary school students (epileptic and none) in Assiut city, Egypt. METHODS A cross sectional study was applied among secondary school students in Assiut city, Egypt. A 13-item questionnaire was self administered by 2226 students who selected randomly. THE PRINCIPAL RESULTS All students either epileptic or non-epileptic had been heard about epilepsy. Only 7.1% of epileptic students and 8.5% of non-epileptic students thought that the epilepsy is a brain disease. Out of 2198 non-epileptic students, 28.4% thought that person with epilepsy (PWE) should not marry and 92% of them refused to marry from PWE. The correct knowledge of epilepsy was significantly positive correlated with positive attitude towards PWE. MAJOR CONCLUSIONS However, students still feel persons with epilepsy are stigmatized and are different from others. Secondary school students in Egypt have a vague knowledge about the etiology of epilepsy. Misconceptions about and negative attitudes towards epilepsy are unexpectedly high among those students.

Hospitalized injuries and deaths in a trauma unit in upper Egypt.

Context: It is predicted that injuries will be among the top 20 leading causes of death worldwide by 2030. In Egypt, injuries burden is significant as it was the fifth leading cause of death in 2004. Also, its considered as a hidden epidemic due to under-reporting. Aims: To identify the patterns of hospitalized injury cases at Trauma Unit in Assiut University Hospitals and to provide an indication about who are at increased risk of hospitalization or death due to injury. Settings and Design: A descriptive retrospective study. Materials and Methods: Registered data of all hospitalized injuries from January 2002 to December 2009 at Trauma Unit of Assiut University Hospitals in Upper Egypt were included. Statistical Analysis: Advanced statistical package for social sciences (SPSS) program version 16 (IBM Corporation - http://www.spss.com) was used for data analysis. Descriptive statistics and tests of significance were used. P value was considered statistically significant when it was less than 0.05 and highly significant when it was less than 0.001. Results: Admitted cases of attended injuries were (31.8%). Most admissions were below the age of 30 years (58.4%). Male to female ratio was 3:1. Falls were the most common injuries (43.6%), followed by transport accidents (31.1%). More than half of deaths (56.4%) were due to transport accidents. Transport accidents, falls, interpersonal violence and gunshot injuries had an early ranking throughout the study period. Conclusion: Road traffic injuries, falls and violence are areas of priority in preventive strategies. Paying special attention for young adults is recommended.

PATTERN AND TREND OF INJURIES AMONG TRAUMA UNIT ATTENDANTS IN UPPER EGYPT

Background Injury is a growing public health problem worldwide. Deaths due to injuries account for 10% of the world’s mortality. More than 90% of the world’s injury deaths occur in low and middle income countries. In Egypt, injury is a hidden epidemic and its related deaths are misclassified due to lack of accurate national data. Furthermore, as a research problem it has also been largely ignored in developing countries. Objectives To determine the pattern and trend of injury from January 2002 to December 2009 among attendants at trauma unit in Assiut university hospital in Upper Egypt. Patients and Methods A descriptive retrospective study was conducted at the trauma unit in Assiut university hospital in Upper Egypt. All registered injuries during January 2002 to December 2009 were included in the study. Results During January 2002 to December 2009, 213835 injured cases were admitted to the trauma unit. The number of attendants increased every year from 9.3% from the total cases in all study period in 2002 up to 15.3% in 2009 with a statistically significant difference (P = 0.000). Young adults aged 20 - 29 years were the most common group affected by injuries (22.2%). Male to female ratio was 3:1. Falls represent one half of injuries (49.6%) from all attended cases, followed by exposure to inanimate mechanical forces (19.5%) and transport accidents (18.3%). Falls were ranked as the leading cause of injuries, while transport accidents were the second cause in 2007 - 2009. Conclusions Trauma in Upper Egypt is an under-recognized problem, which requires prioritized attention. Increasing the awareness of community, making policies and establishment of a trauma system are important to decrease the burden of injuries.

Egyptian students guardians knowledge, attitude and predictors of negative attitude of epilepsy in Assiut city

Background: Epilepsy is very prevalent in Egypt, approaching 6.98 per 1000 population. This study was designed to assess the knowledge and attitudes towards epilepsy among guardians of Egyptian high school students. Methods: A cross-sectional study was made among guardians (parents/guardians) of high school students in Assiut city, Egypt. A 15-item questionnaire was self-administered by 1257 students’ guardians who were randomly selected. Results: All recruited parents/guardians of high school students had heard about epilepsy. Families with a patient with epilepsy (PWE) had significantly better information about epilepsy and its aetiology than other families. The predictors of negative attitudes towards PWE were: age group ranging from 40 to 49 years, no work, skilled work, male sex and incorrect knowledge. Conclusion: Having a patient with epilepsy is a predictor to having greater knowledge and a better attitude towards epilepsy. However, people still have a concept that PWE are stigmatized and are different from others. Raising awareness about epilepsy and its aetiology will increase the knowledge and improve the attitudes towards PWE.

Epidemiology of bronchial asthma among preparatory school children in Assiut district

Background: The prevalence of asthma and allergies is increasing in both Western and developing countries. Few studies evaluated asthma prevalence in Egypt . Objectives: Determination of the prevalence and risk factors of asthma among preparatory school children in Assiut district, in Upper Egypt. Methods: A cross sectional study was conducted among preparatory school students in Assiut city and two rural areas in Assiut district in Upper Egypt. Twelve schools were selected randomly from different regions in Assiut city and two rural areas one to the North and the other to the South of Assiut city. The total coverage of the students included was 1048 (482 boys and 566 girls). Data were collected by self-administered questionnaire (in Arabic Language) which was filled by the participants. Results: Of the 1048 positively responding subjects, 65 fitted the diagnosis of asthma with over all prevalence of 6.2%. No significant difference was found between urban and rural areas (P = 0.075). Using logistic regression analysis: a positive family history of allergy and the presence of other one or more allergic diseases were significantly associated risk factors for asthma. Exposure to dust, cigarette smoke, playing and physical activity, common cold attacks, and special food or drinks were the most common triggering factors for asthma exacerbations . Conclusion: Bronchial asthma is a significant health problem among children and adolescents in Assiut district and needs special medical care. Wider scale multi-center studies in upper Egypt and other localities of Egypt are needed to outline the profile of bronchial asthma among children and adolescents in the whole country. Keywords: prevalence of asthma, preparatory school children, Assiut district Egypt J Pediatr Allergy Immunol 2012;10(2):109-117

Hypovitaminosis D Among Patients Admitted With Hip Fracture to a Level-1 Trauma Center in the Sunny Upper Egypt Prevalence and Associated Correlates

Introduction: Despite abundant sunshine, hypovitaminosis D is common in the Middle East. The aim of this study was to determine the prevalence of hypovitaminosis D and related correlates among patients with hip fracture in Assiut University Hospitals in Upper Egypt. Materials and Methods: A cross-sectional study was carried out in 133 patients with hip fracture, aged 50 years and older, admitted to Trauma Unit of Assiut University Hospitals, from January through December 2014. Patients were selected by systematic random sampling. Serum 25-hydroxy vitamin D level was measured by enzyme-linked immunosorbent assay; bone mineral density (BMD) by dual-energy X-ray absorptiometry. Weight and height measurements were used for body mass index (BMI) calculation. Results: Patients’ median age was 70 years (range: 50-99); 51.9% were females. Osteoporosis (femoral neck T score: <−2.5 standard deviation) prevalence was 72.2%. Of all patients, 60.9% had vitamin D deficiency (<20 ng/mL); 15.8% reported vitamin D inadequacy (from 20 to 29 ng/mL) and vitamin D levels were normal in 23.3% (>30 ng/mL). According to univariate analysis, vitamin D deficiency was significantly associated with obesity (P = .012) and low T scores of the femoral neck (P = .001), L2 (P = .021), L3 (P = .031), L4 (P = .012), and the greater trochanter (P < .001). In a multivariable logistic regression model, high BMI and low BMD of the femoral neck and greater trochanter were associated with hypovitaminosis D. Conclusion: Prevalence of hypovitaminosis D is high among patients with hip fracture and associated with low BMD and high BMI. Increasing awareness about prevention as well as detection and treatment of vitamin D deficiency is recommended.

Bone mineral density in women of a low socioeconomic level using DMPA for contraception in rural Upper Egypt

To evaluate the effect of long‐term use of depot medroxyprogesterone acetate (DMPA) on bone mineral density (BMD).

Delays associated with maternal near-miss cases admitted in Women's Health Hospital, Assiut University

Introduction Pregnancy and childbirth remain serious life‐threatening events. Over 1000 women still die from pregnancy‐related complications everyday around the world and the vast majority of these deaths occur in developing countries [1]. Maternal health policies need to be concerned not only with averting the loss of life but also with ameliorating care of severe maternal complications at all levels, including primary care [2].

Multicenter Assessment of Health-Related Quality of Life (HRQOL) Among Stroke Survivor

Background: Stoke is a long-term condition. Estimation of stroke outcomes is lacking. Stroke is known as the most common cause of disability among adults. The measurement of Health-Related Quality of Life (HRQOL) is important to understand the actual status of the patients. Aim: The aim of this study was to assess HRQOL among stroke patients and analyze clinical and functional factors that influence it. Material and method: A cross-sectional study was applied to 65 strokes outpatients, 33 from Assiut University hospital, Assiut, Egypt and 32 from, King Abdulaziz University, Jeddah, Saudi Arabia. A questionnaire was used to complete related data and assessment of HRQOL was done by the use of Barthel index, SF36, and SSQOL by personal interview. Result: No significant differences were detected between two studied groups in all characteristics. For all study sample, our patients had low mean scores in all SF36 domains, the lowest was for RE with 3.46 ± 9.1 and GH was the best mean (51.7 ± 12.99). As regards SSQOL, patients had low mean scores on the lowest subscale in productivity (6.72 ± 3.21), whereas the language was the least affected (15.86 ± 6.26). There was a significant difference between the means of PCS and SSQOL in post-stroke duration which was significantly higher in >24 months (37.21 ± 8.59 and p = 0.007and 141.57 ± 36.12 and p = 0.052 respectively) than in the shorter durations. The independent patients had significantly higher PCS and SSQOL mean scores than who need assistance and immobile ones (26.79 ± 5.09 and p< 0.0001 and 101.93 ± 22.16 and p< 0.0001 respectively). Age and mobility were significantly negative correlated with PCS, SSQOL, and Barthel scores while there was a significant positive correlation between ULVC and LLVC testing grades and PCS, MCS, SSQOL and Barthel index scores. In the linear regression model, duration, mobility and voluntary control of lower limbs were predictors for PCS of SF-36 (p = 0.045, 0.000 and 0.036 respectively). There were no significant predictors on MCS. On the other hand Mobility and voluntary control of lower limbs were significant predictors for SSQOL (p = 0.001 and 0.051 respectively). Conclusion: Stroke patient had poor QOL. A need for post-stroke care programs for improving the physical, mental and social quality of life for those patients is mandatory.