Background: Natural gas (NG) is one of the world’s three primary energy sources. However, workers in the liquefied natural gas (LNG) industry are routinely exposed to various occupational hazards, including mechanical, physical, chemical, and psychosocial factors, as well as risks of fires and explosions. Objective(s): to assess some hematological and biochemical changes among workers exposed to Liquified Natural Gas in Egypt. Methods: A comparative cross-sectional study was performed on a sample of 181 workers in LNG industry, assigned into two groups: An exposed group including workers exposed to the different industrial processes, and a non-exposed group including workers engaged in administrative and clerical activities at the same LNG Company. Data were collected by a structured interviewing questionnaire and by performing a general clinical examination and some laboratory investigations, as complete blood count, fasting blood glucose, Liver enzymes, renal functions tests, tumor markers tests as Carcinoembryonic Antigen (CEA), Cancer Antigen 125 (CA-125), Carbohydrate Antigen 19-9 (CA 19-9), Cancer Antigen 15-3 (CA 15-3) and Prostate-Specific Antigen (PSA). Indoor air contaminants as Methanol, Methyl Ethyl Ketone, Ethylene Glycol, Hexane, Benzene, total Volatile Organic Compound, Nitrogen Dioxide, Hydrogen Sulfide and Carbon Dioxide were measured inside the LNG plant and the resultant measurement were presented as midrange and compared to the equivalent Threshold Limit Value according to Egyptian law. Results: The study revealed that there were statistically insignificant differences between exposed and non-exposed workers regarding all measured parameters except for some blood indices (HB, RBCs, Hematocrit and lymphocytic count) and some of the evaluated tumor markers, as Carcinoembryonic Antigen (CEA) and Cancer Antigen 125 (CA-125).. Regarding air levels of measured air contaminants all over the plant, they were lower than threshold limit values, except for Benzene which was coming from nearby industries. Conclusion: LNG exposure is safe, and no health effects are expected if its contaminants are kept below their threshold limit values. Benzene was the offending factor coming from nearby industries.

Background: Consumers' satisfaction is considered an attribute of quality of healthcare where its monitoring gives feedback on how appropriately as service is functioning. Positive consumer experience can be a key factor in the success of a mass vaccination program during a pandemic, with the goal of immunizing a significant proportion of the population.Objective(s): to assess Coronavirus disease 2019 vaccination consumers’ overall satisfaction with their experience and different process and organizational factors, as well as to find out suggestions for improvement.Methods: a cross-sectional design was used. The study was conducted in four randomly selected primary health care (PHC) COVID19 vaccination centers using a predesigned structured interview questionnaire to collect data from 400 consumers between July and October 2022.Results: The mean overall satisfaction score of the consumers with their vaccination experience was 7.8±1.58 out of 10. About 80% of consumers were willing to recommend the vaccine to others. Consumers were least satisfied with the presence of guiding signs about service steps (mean ± SD: 6.6±2.88), guidance of hotline team on the appropriate action to resolve problems related to vaccine (mean ± SD: 6.3±2.95), promptness of answer if you call hotline after any problem or side effect from the vaccine (mean ± SD: 6.2±2.47) and giving information about ministry of health hotline (mean ± SD: 3.2±3.72). The most common suggestion given by consumers was to improve the organization and decrease crowding (28.3%) followed by enhancing the hotline services (14.8%).Conclusion: Most of the COVID19 vaccination consumers were satisfied with their vaccination experience and were willing to advise others to take the vaccine. The competence of providers, information given by attending staff about the vaccine, convenience of working hours and accessibility to vaccination centers were the highest rated by the consumers; while hotline services in terms of promptness of answer and guidance to resolve any issue related to the vaccine and the presence of guiding signs inside the vaccination centers had the least satisfaction. Respondents’ most frequent recommendations were to improve the organization of PHC centers and decrease crowding followed by enhancing the hotline services.

Background: Health related quality of life (HRQOL) is an important measure of the health status of preschool children. The TAPQOL questionnaire was designed to measure HRQOL in preschool children aged 2 to 48 months and contains 43 questions distributed in 4 domains and 12 subdomains (scales). TAPQOL was developed originally in Dutch language and was translated in different languages including English, French, German, Brazilian Portuguese, Spanish, Chinese, Korean and Malay language. Till now there is no Arabic version of the TAPQOL questionnaire. Objective(s): This study aims to translate the English version of the TAPQOL questionnaire into Arabic language and qualitatively validate this Arabic translation to obtain an Arabic version of the TAPQOL Questionnaire that would be both semantically and culturally equivalent to the original. Methods: This study was conducted through 2 phases; translation and qualitative validation. Regarding translation phase, after evaluating the potential conceptual equivalence by the first and the second authors, the English TAPQOL questionnaire was translated into Arabic by independent forward-translation by three bilingual translators (the first author and 2 professional English-Arabic translators) and reconciliation (by the second author). Concerning qualitative validation, it was conducted in 2 stages: validation by a committee of 8 independent bilingual experts (face and content validity) then validation by cognitive debriefing (real-life face validity). The cognitive debriefing was carried out on 7 preschool children aged 2-48 months, through conducting a face-to-face interview with their mothers (the main caregiver) whose mother-tongue is the Egyptian Arabic language. Results: After the independent forward-translation by several translators, the reconciliator made the final decisions about the instrument translation, confirmed equivalence of the translated instrument with the originals, and selected the most appropriate wording for the final Arabic version to better reflect the Egyptian cultural meaning. However, the findings of the first stage of qualitative validation clearly indicated that the Arabic version of the TAPQOL was not suitable for use after the initial translation. The committee of experts asked for some modifications which consolidated the translated version of the questionnaire by means of equivalence in several areas: linguistic/semantical; idiomatic; cultural; conceptual; and experiential equivalence. After implementing those modifications, the cognitive debriefing yielded that there was no need to carry-out more modifications than those required by the validating experts. Conclusion: This Egyptian Arabic version of the TAPQOL has proven to be acceptable and culturally equivalent to its English version as its face and content validity was qualitatively confirmed. Future studies should complete the validation by extensive quantitative investigation of the psychometric properties of the Arabic version of TAPQOL questionnaire and compare them with those of the original version.

Background: Physician retention in primary healthcare centers is essential for ensuring continuity, accessibility, and quality of care.Objective(s): The aim of present study was to assess the levels of job satisfaction, organizational commitment, and turnover intention among primary healthcare physicians in Kuwait and to identify key sociodemographic and organizational predictors of turnover intention.Results: Among participants, 55.0% were satisfied with their job, while 66.2% demonstrated low organizational commitment, and 38.7% of participants were likely to leave current employer organization. Turnover intention was significantly higher among older physicians, those with postgraduate qualifications, divorced/widowed individuals, physicians with higher income levels, and those reporting poor or fair health (all p < 0.05). Family medicine physicians exhibited higher turnover intention compared to those in emergency care. Organizational commitment showed a moderate negative correlation with turnover intention (r = -0.354, p < 0.001). Multiple regression analysis identified postgraduate qualifications (MSc: B = 0.66, p = 0.004; MD/PhD: B = 1.22, p < 0.001) as predictors of higher turnover intention, while organizational commitment significantly reduced the likelihood of leaving (B = -0.162, p < 0.001).Conclusion: Primary healthcare physicians in Kuwait exhibit moderate job satisfaction, low organizational commitment, and notable turnover intention. Strengthening organizational commitment and addressing professional dissatisfaction, especially among highly qualified physicians, should be prioritized in workforce retention strategies.

Pediatric feeding disorders (PFDs) can have significant impacts on a child's physical, social, emotional, and cognitive development, as well as increase caregiver stress and financial burden. Early identification and treatment of PFDs are critical to the long-term health and well-being of affected children. Optimal care requires a multidisciplinary approach, involving healthcare professionals from various disciplines to address the complex nature of feeding disorders. Interdisciplinary interventions can lead to increased oral intake, improved eating behaviors, and reduced parental stress. The Sequential Oral Sensory (SOS) approach to feeding is one of several strategies available for addressing feeding difficulties. It employs systematic desensitization techniques and oral motor training to help children tolerate, engage with, smell, touch, taste, and eat a diverse range of foods. This method is playful and intervention-based, aiming to expand both the variety and quantity of foods a child consumes. The SOS approach to feeding represents a promising method for managing PFDs, but further research is needed to address existing gaps in the literature, particularly regarding long-term outcomes. Implementing tailored, ethical, and evidence-based interventions can significantly improve the quality of life for children with PFDs and their families.

Background: Premarital health services aim at promoting the health of couples as well as prevention of health hazards for both future parents and their offspring, thereby improving population health by reducing morbidity and mortality related to genetic and hereditary disorders. Objective(s): The study aimed to assess the resources and process of premarital care in Family Health Facilities (FHFs) as well as assessment of the satisfaction of attendees regarding the received premarital services in Alexandria Governorate, Egypt. Methods: A cross-sectional study was conducted in all FHFs providing premarital services in Alexandria by using predesigned observational checklists to assess the availability of resources and the performance of all family physicians (FPs) providing premarital services. In addition, a total of 400 attendees for premarital services in the studied FHFs were interviewed for assessing their satisfaction regarding the received services using a predesigned structured questionnaire. Results: Around 90% of the needed non-human resources were available in the studied FHFs. The monthly physician/ attendees ratio varied between the FHFs, the lowest was 1:189 and the highest was 1:25. About one third (34.2%) of FPs were trained on premarital services in the studied FHFs. All observed FPs showed a good level of performance. Most of the participating attendees (96%) were highly satisfied with the services they received. Conclusion: In general, the provided premarital services in the studied FHFs were satisfactory and most of the study participants were highly satisfied with the received services.

Background: Caesarean section (CS) rates have been steadily increasing worldwide over the last few decades, exceeding levels that are not medically necessary. Objective(s): To identify the prevalence and determinants of CS deliveries in Kafr-El Zayat General Hospital and the health outcomes of CS deliveries for mothers and neonates within 30 days after delivery. Methods: A cross-sectional and prospective study was carried out. The study included 500 women aged 17-50 years, who delivered during this period in the gynecology and obstetrics department at Kafr-El Zayat General Hospital. Results: Among the studied women, 65% delivered by CS. Higher percentages of CS were observed among highly educated women, those from urban areas, and those employed in government sectors. The most frequent obstetric indications for CS were previous CS (30.4%), malpresentation (18.5%), poor outcomes (18%), and failure to progress (7.6%). Non-clinical indications included maternal request (12.9%) and physician’s preference (36.9%). Vaginal delivery was associated with better outcomes for both mothers and newborns compared to CS. Significant predictors of the type of delivery included advanced maternal age, higher education levels, passive smoking, previous CS delivery, and presenting in labor upon admission. Conclusion: The frequency of CS deliveries in Kafr-El Zayat General Hospital, Gharbia Governorate, is highly prevalent and represents a multifaceted challenge.

Background: Intestinal parasitic infections (IPIs) are major health problems in developing countries. Globally, over 568 million school-age children live in intestinal helminth prevalent areas. Diagnosis is an important part of parasitic control programs, but till now there is no gold standard method for diagnosing IPIs. Objective(s): The present work aimed to evaluate the performance of Mini-FLOTAC by comparing it with Kato-Katz and formol ether concentration techniques (FECT) and to validate its diagnostic effectiveness in detecting intestinal parasites in a population with low infection intensities. Methods: The study was carried out in a primary school, in Banger El-Sokkar vilage, Borg El-Arab area, Alexandria Governorate, Egypt. Fecal samples were collected from 250 schoolchildren and examined using Mini-FLOTAC, FECT and Kato-Katz techniques. Results: Pooled data from the three techniques was used as gold standard reference. The results revealed that out of 250 schoolchildren examined, 36.4% were positive for IPIs. Protozoan rate was 34.8% while helminths rate was 1.6%. The most prevalent protozoan was Entamoeba histolytica (18.8%) followed by B. hominis (11.2%) and Giardia lamblia (10.8%). Ascaris lumbricoides was the only helminth found (1.6%). Mini-FLOTAC showed a higher sensitivity and a higher diagnostic accuracy in detecting IPIs than FECT (97.8% and 99.2% versus 69.23% and 88.8% respectively). Moreover, an almost perfect agreement was revealed between the gold standard and the Mini-FLOTAC while an only substantial agreement was detected with FECT. Kato-katz technique failed to diagnose any helminths. Conclusion: Mini-FLOTAC is a good alternative for IPIs diagnosis especially in low intensity settings and in limited resources settings.

Background: Recognizing environmental risk factors that trigger Colorectal cancer (CRC) occurrence and progression is essential to apply more effective prevention and risk reduction measures. Objective(s): The main objectives of this study were to compare the plasma levels of lead and copper between CRC patients and healthy subjects and to estimate the relationship between exposure to some environmental risk factors and CRC. Methods: A case-control study was performed at the Alexandria Main University Hospital. The study sample consisted of 25 CRC patients and 25 healthy controls who matched the cases based on age and sex. An interview questionnaire collected data about possible environmental risk factors. Lead and copper Levels were measured by graphite furnace atomic absorption spectrometry. Results: Higher significant levels of lead and copper were detected in CRC patients compared to healthy subjects (p < 0.05). The multivariate stepwise logistic regression model revealed that four factors had a significant association with CRC: living near solid waste collection sites, environmental tobacco smoke (ETS) exposure, plasma lead level (>0.164 mg/L), and living in a house with old oily painting (OR=83.25, 95% CI=1.28-5419.13; OR=32.20, 95% CI=1.53-678.07; OR=31.06, 95% CI=1.55-622.59; OR=9.35, 95% CI=1.02-85.79, respectively). Conclusion: There were significant differences in lead and copper plasma levels between CRC patients and healthy subjects. Other notable risk factors included ETS exposure, old oily paint in homes, and living near solid waste sites. These findings suggested a link between chronic exposure to these pollutants and CRC, but further research is needed to solidify the connection between heavy metals and cancer.

This study is aimed at assessing the effect of glycosylated hemoglobin [HbA1c) level on the pregnancy outcome in diabetic women. A follow-up study was carried out which included 169 diabetic women attending the maternity hospital and one diabetic clinic in Kuwait. An age matched control group of 80 non-diabetic pregnant women were also studied. The World Health Organization diagnostic criteria were used for ascertainment of diabetes. A standardized form was used to collect data, and all relevant investigations were carried out for diabetic and control groups. Fourteen diabetics and 4 non-diabetics were excluded due to failure to regularly attend for antenatal return visits. Eighty four [54.2%] had preconception diabetes [PCD] and 71[45.8%] had gestational diabetes [GD]. Spontaneous premature labor was recorded in 35.8% and 11.3% in PCD and GD groups respectively, compared to 10% in the control group. The rate of spontaneous abortion among PCD [9.5%] was higher than the control group [1.3%]. There was significant correlation between HbAc levels and fasting and postprandial serum blood glucose levels. Skinfold thickness of neonates were significantly higher in diabetics than controls. In conclusions HbAic levels are not particularly useful in diagnosis of diabetes, but are valuable in monitoring diabetic control and establishing the relationship of glucose control to abnormalities of diabetic status. Improvement of the perinatal outcome of diabetic patients will require a form of management that leads to reduced incidence of fetal congenital anomalies. Routine sonographic examinations of diabetic pregnancies, however, will identify a significant proportion of fetuses with major congenital anomalies, while first trimester biochemical evaluation of HbAc will identify mothers at risk of delivering anomalies infants.