Shebin El Research Articles

Utilization and assessment of school healthcare services provided to schoolchildren by family physicians in Menoufia, Egypt

Objectives The aim of the study was to assess parents' satisfaction in as well as utilization of school healthcare services provided for their children. Background School healthcare services provide education and counseling in a variety of health and wellness topics and aid in controlling the spread of communicable diseases, serving as a medical resource in the development of policies and procedures in the school. Thus, improving school healthcare services will have a remarkable effect on children's health and on the community at large. Participants and methods This is a cross-sectional study involving 230 children older than 10 years chosen randomly from two grades from two schools, one from an urban area (Taha Hussein School in Shebin El Kom City, Menoufia Governorate) and the other from a rural area (Meet masoad primary school in Meet Masoad village, Menoufia Governorate), both schools having been chosen at random. This age group was selected so that the children were old enough to understand and help their parents fill up the questionnaire. The predesigned questionnaires were sent home with children to their parents and only 200 (86.95%) completed questionnaires were returned. The questionnaire include data on measurements of satisfaction in different services provided in the healthcare unit of the school, quality of school healthcare services, availability of school healthcare services, and degree of utilization of these services. The obtained data were tabulated and analyzed statistically. Results The study showed that there was no statistically significant difference between urban and rural areas with regard to the availability of school healthcare services. The study also showed that about 74% of parents in the rural area seek medical advice in primary healthcare, represented by the family health unit. Question No. 8 in our questionnaire asked about the type of medical care that was the participant's first choice (private clinic, hospital, or primary healthcare). Participants whose first choice was primary healthcare were classified as regular utilizers and the other participants were classified as nonregular utilizers. All 200 children were utilizers of school healthcare services. The study showed that differences in residence and parent satisfaction were highly significantly different between regular utilizers and nonregular utilizers (P The study showed that 35% of rural parents considered the services to be expensive compared with 11% of urban parents. Conclusion The quality of school healthcare services is poor, as evaluated through the responses in our questionnaire. We recommend regular measurement of satisfaction in services provided to children in order to improve quality as well as provide regular training programs for medical staff to update their knowledge and improve their performance.

Role of computed tomography in detection of complications of blunt chest trauma

Objective The aim of the study was to study the role of computed tomography (CT) in detection of complications of blunt chest trauma patients. Background Thoracic injuries are significant causes of morbidity and mortality in trauma patients. Injuries to the thorax are the third most common injuries in trauma patients, next to injuries to the head and extremities. Therefore, prompt diagnosis of blunt vascular injuries is imperative. Patients and methods This study included 100 patients, 66 male patients and 34 female patients with age distribution from 2 to 65 years. This study was conducted during the period from November 2012 to December 2013 at Menofyia University Hospitals and Shebin El Kom Educational Hospital. All patients subjected to blunt chest trauma presented to Menofyia Emergency Hospital and Shebin El Kom Educational Hospital during this given period were examined clinically. Those who had findings that suspect chest trauma on clinical examination underwent plain X-ray and CT examination. Finally, we compared between X-ray and CT in detection of complications of blunt chest trauma. Results CT has been shown to be useful for the evaluation of vascular, pulmonary, airway, skeletal, and diaphragmatic injuries as well. CT has overall greater sensitivity than radiography in the detection of pulmonary lacerations and pneumothoraces. In addition, it may be indicated in cases of suspected tracheobronchial injury . Conclusion Chest radiograph serves as the principle screening test for immediate assessment of the thorax after blunt chest trauma, whereas CT scanning, particularly with spiral capability, is highly sensitive than the supine chest X-ray at detecting intrathoracic injuries.

Liver transplantation for hepatocellular carcinoma: how far can the selection criteria be expanded?

Hepatocellular carcinoma (HCC) is the fifth most common malignancy in the world and is associated with the third highest number of cancer-related deaths [1]. Surgical curative treatments for HCC include complete tumor resection and liver transplantation (LT). The LT offers the potential advantage of removing both the tumor and the organ at risk for developing future malignancies [2]. However, although LT is a widely accepted treatment for HCC, the basis for transplant selection can still be controversial. The famous Milan criteria described in the landmark paper by Mazzaferro et al. [3] demonstrated that in patients with cirrhosis and a single tumor up to 5 cm, or up to 3 lesions none larger than 3 cm, and with no evidence of extrahepatic spread or macrovascular invasion, the 4-year actuarial and recurrence-free survival rates were 75 and 83%, respectively. Milan criteria were rapidly established as the standard for transplantation and were introduced to clinical practice. Despite being validated by many studies, some believed that the Milan criteria were too restrictive and excluded a subset of patients with HCC who could have excellent outcomes if they were transplanted [4]. Yao et al. [5] further expanded the selection criteria and proposed the University of California at San Francisco (UCSF) criteria (a single tumor nodule with a diameter of up to 6.5 cm or 3 or fewer tumors, the largest of which has a diameter of 4.5 cm with the sum of the tumor diameters not more than 8 cm, and without extrahepatic metastasis) on the basis of preoperative imaging findings with survival rates of 90% at 1 year and 75.2% at 5 years. Currently, however, there is no international consensus regarding these approaches in clinical practice. Following the thought-provoking findings of UCSF’s study, other groups have also ventured into pushing the limits set by the Milan criteria without compromising overall patient survival and HCC recurrence rate. Mazzaferro et al. [6] suggested the replacement of their strict Milan criteria with the use of the ‘‘up-to-seven’’ criteria, where the seven refers to the sum of the largest tumor in centimeters and the number of tumor nodules. In their retrospective survey of over 1,000 patients, the authors showed that a group of patients who had survival rates similar to those transplanted within the Milan criteria could be identified by the use of this ‘‘upto-seven’’ rule. It is unlikely that the size and number of tumors reflect more than a marker for tumor biology and it is widely accepted that they are poor surrogates for the likelihood of the transplant ‘‘curing’’ the patient, but serological, molecular, or histological biomarkers are not yet sufficiently established to form a robust basis for treatment decisions [7]. Hence the challenge is to decide which histopathologic features, other than size and number, may better assess the biological behavior of HCC in these transplant recipients and add to the prognostic value. Microvascular invasion, defined as microscopic tumor invasion in smaller intrahepatic vessels, was stressed as a poor prognostic factor of liver resection (LR) and LT in several studies [8–10]; however, this was not clear in other reports [5, 11]. It would be useful to clarify the significance of microvascular invasion for lesions within the ‘‘up-to-7 criteria.’’ The study by Chan et al., reported in this issue of Hepatology International, investigated how significant microvascular invasion is compromising the long-term survival of LT recipients, regardless of whether a deceased donor graft or a living donor graft was used and also N. Allam (&) Department of Hepatology and Liver Transplantation, National Liver Institute, Shebin El kom, Egypt e-mail: naglaaallam@yahoo.com

Hepatitis B vaccined children at five years of age in need of a booster dose: Mohamed A El Guindi, Liver Institute, Cairo Egypt; Aleef A Alam, Ahmed A Raouf, Liver Institute, Shebin El Kom Egypt

Hepatitis B vaccined children at five years of age in need of a booster dose: Mohamed A El Guindi, Liver Institute, Cairo Egypt; Aleef A Alam, Ahmed A Raouf, Liver Institute, Shebin El Kom Egypt

Developing a Self Care Training Program for Visually Impaired School in Shebin El Kom

Developing a Self Care Training Program for Visually Impaired School in Shebin El Kom

A Comparison of the Environment of Thiol Groups in Bovine and Human γ Crystallins Using Raman Spectroscopy

To evaluate the levels of ischemia-modified albumin (IMA) in relation to oxidant–antioxidant profiles in the serum, aqueous, and lens in cataract patients.Department of Ophthalmology, Menoufia University, Shebin El Kom, Menoufia, Egypt.Prospective case series.Patients were divided into 2 groups. The cataract (study) group comprised patients with senile cataract and the control group, age- and sex-matched healthy persons. Patients with systemic disease or cataract formation secondary to identifiable causes were excluded. In all cases, a complete history was taken and a clinical examination was performed. In the cataract group, the lens was examined, and the cataract type and severity were graded. Blood levels of catalase, malondialdehyde (MDA), superoxide dismutase (SOD), and IMA were measured in all participants and in the aqueous and lens lysate of cataract patients.Each group comprised 30 participants. Cataract patients had significant higher levels of serum MDA and IMA than the control group but had lower levels of serum catalase and SOD. Patients with cortical cataracts had higher level of serum IMA, aqueous catalase, and SOD levels patients with nuclear cataracts but had a lower level of lens SOD. There was a significant positive correlation between serum MDA and the patient's age and serum catalase levels.Patients with cortical cataract had increased local oxidative stress and diminished antioxidant activity compared with systemic oxidative activity, which was not the same in patients with nuclear cataract.