A novel wide scale well-baby clinic mobile application: an Egyptian pilot study.

BACKGROUND: Utilization of under 5-year-old child healthcare services in Egypt is considered low, the highest proportion of well-baby visits is mainly for immunization in the first 2 years of age. Mobile health (mHealth) interventions have the potential to be a useful and low-cost way to disseminate information about proper nutrition, can be used to monitor children's growth using the official charts of World Health Organization, can also help in accessing vaccine-related information and schedules. OBJECTIVES: To assess needs and requirements for a new comprehensive well-baby clinic mobile application (app) covering well-baby clinic service components. Thereafter, to develop the app prototype and validate it. METHODS: This study was conducted in four phases: User requirements, development, validation and usage. In user requirement phase, the need for the new app was assessed by performing literature review, market app research and an online survey. In development phase, we developed the novel well-baby clinic app that constituted all well-baby clinic services for children's health monitoring relying on evidence-based information and honoring data safety. In validation phase, after a series of testing, the app was validated using Mobile app rating scale (MARS) by public health and pediatrics consultants to assess its quality. Finally, the app was launched and made available to the public on Android platform. RESULTS: Sehhat Tefly app was developed based on the demands and requirements of mothers of under 5-year-old children. The app constituted caregiver, child information and seven service elements: physical growth, developmental milestones, immunizations, nutrition, teething, safety & emergency measures and report. The app quality mean was rated 3.7 out of 5 by the panel of experts. The app was downloaded 1445 times in a 4 month period. CONCLUSIONS: Sehhat Tefly app can meet the need for a free, easy and accessible tool for caregivers to track the progress of children's development and wellbeing. It can also provide advice for referral to physician consultation in case of deviation from normal measures.

Prevalence, risk factors and quality of life impact of work-related musculoskeletal disorders among school teachers in Cairo, Egypt.

BACKGROUND: School teachers constitute an occupational group which reported a high prevalence of work-related musculoskeletal disorders (WRMSDs). Different individual, occupational and psychosocial factors have been identified to influence the complex process of WRMSDs. WRMSDs represent an important and costly occupational health problem being responsible for a poor quality of life (QOL) of teachers. This study aimed to determine the prevalence, the risk factors, and the impact of WRMSDs on the QOL of teachers. METHODS: 310 full-time teachers from 15 public schools were surveyed using an interview questionnaire about their sociodemographic and occupational characteristics, the Nordic Musculoskeletal Questionnaire and the SF-36 Health Survey (SF-36). RESULTS: Self-reported prevalence of WRMSDs at any body part over the past 12 months among teachers was 66.77%. Neck pain (56.1%) was the most prevalent WRMSD followed by shoulders (53.2%), low back (53.2%) and knees (50.6%) pain. Female gender, body mass index, the number of students per classroom, the number of classes per week, different adapted awkward postures and the lack of enough supervisor's psychological support at work were among the risk factors positively associated with WRMSDs. WRMSDs had a negative impact on the physical and mental QOL of teachers with WRMSDs as reflected by their lower scores on all scales of the SF-36 compared to their counterparts without WRMSDs (p ˂ 0.05). CONCLUSION: WRMSDs were a highly prevalent problem among teachers in Cairo, Egypt and negatively influencing their physical and mental QOL. Different individual, occupational and psychosocial factors had been shown to be significant predictors for the occurrence of WRMSDs reflecting their complex nature and multifactorial etiology.

Patient and visitor aggression de-escalation training for nurses in a teaching hospital in Cairo, Egypt.

BACKGROUND: Workplace violence (WPV) has been recognized as a major occupational hazard worldwide. Healthcare professions are particularly at a higher risk of WPV. Patients and their relatives are commonly the most common perpetrators for WPV against physicians. Trainings on the universal precautions of violence, how to effectively anticipate, recognize and manage potentially violent situation is recommended by OSHA as a part of a written, effective, comprehensive, and interactive WPV prevention program. OBJECTIVE: To implement and evaluate the effectiveness of a training session delivered to nurses. The training session aimed to increase nurses' ability to identify potentially violent situations and to effectively manage these situations in a teaching hospital in Egypt. METHODOLOGY: A total of 99 nurses attended the training sessions. Confidence in coping with aggressive patient scale, along with nurses' attitudes toward WPV, were used to assess the effectiveness of the training sessions. RESULTS: Nurses' perceived confidence to deal with aggression increased after attending the training sessions. Nurses' attitudes toward WPV positively changed after attending the training session. CONCLUSION AND RECOMMENDATIONS: Increasing awareness of the problem among healthcare professions as well as the public is warranted. Violence prevention program with a zero-tolerance policy is warranted.

Effect of physicians' smoking status on their knowledge, attitude, opinions and practices of smoking cessation in a University Hospital, in Egypt.

BACKGROUND: The tobacco epidemic is one of the biggest public health threats. Smoking prevalence and smoking cessation intentions among physicians vary from a country/community to another. Recently, a global reduction in the rates of smoking among healthcare providers is observed. AIM: This study aims to describe the effect of physicians' smoking status on their knowledge, attitude, opinions, and practices of smoking cessation in patients in a Tertiary Healthcare University Hospital in Cairo, Egypt. MATERIALS AND METHODS: A cross-sectional study was carried out at four specialized hospitals in a Tertiary Healthcare University Hospital in Cairo. Anonymous questionnaires included sociodemographic, occupational data, history of smoking, smoking-related knowledge, attitude, and practices of smoking cessation counselling. RESULTS: The study included 521 physicians, 26.5% of physicians have never received training on smoking-cessation approaches. The prevalence of current smoking among the studied physicians was 21.5%. Only 45.5% of smoking physicians have never smoked in front of a patient and 27.7% have no compliance to the smoke-free policy in nonsmoking areas. Smoking physicians were significantly less likely than nonsmokers to identify the effect of passive smoking on the heart, lungs, and on neonates (67.9, 58.9, and 53.6% compared with 83.6, 77, 60, and 56.7%, respectively). A lower percentage of smoking physicians (34.8%) agreed that smoking physicians are less likely to convince patients to quit smoking compared with about 60% of nonsmoking physicians. The practices related to smoking cessation as reported by both smokers and nonsmokers were inadequate. CONCLUSION: Smoking status significantly affects the knowledge, attitude, and some practices of physicians related to smoking cessation counselling. Training on smoking cessation should be enforced during undergraduate and postgraduate studies of physicians.

Comparison of Pregnancy Outcome between Ultrasound- Guided Tubal Recanalization and Office-Based Microhysteroscopic Ostial Dilatation in Patients with Proximal Blocked Tubes.

BACKGROUND: The current research to the best of my knowledge is the first to compare the pregnancy outcome between ultrasound-guided tubal recanalization (UGTR) using a special fallopian tubal catheter, and office-based micrhysteroscopic ostial dilatation (MHOD) using the same tubal catherter in infertile women with previously diagnosed bilateral proximal tubal obstruction (PTO). MATERIALS AND METHODS: This prospective study reported the pregnancy outcomes for 200 women in private infertility care center in Arafa hospital in Fayoum and in El Minya University Hospital in the period between January 2010 and October 2013 treated as outpatients for their bilateral PTO after the routine hysterosalpingography (HSG). A Cook's catheter, special fallopian tubal catheter, were used to recanalize the blocked tubes in 100 women (group A) under UGTR, and the same Cook's tubal catheter was used through 2mm microhysteroscope to cannulate both ostia using MHOD in another 100 women (group B). Pregnancy outcome was determined after the procedures for a 12-month period follow-up. RESULTS: The number of the recanalization of PTO was not significantly different between two groups. As of the 200 blocked fallopian tubes in group A, 140 tubes (70%) were successfully recanalized by passing the ultrasound-guided special cannula, while 150 tubes (75%) were successfully recanalized in group B, using the same tubal catheter through a 2mm microhysteroscope. The cumulative pregnancy rate after the two procedures was not statistically different between two groups. It was 25.9% in group A, while it was 26.3% in group B, after a 12-month period follow-up. CONCLUSION: UGTR is highly recommended as the first step to manage infertile women due to PTO, as it is easier procedure; however, there is possible to obtain nearly similar results after MHOD.

Pregnancy Outcome after Office Microhysteroscopy in Women with Unexplained Infertility.

BACKGROUND: Hysteroscopy offers diagnostic accuracy and the ability to treat uterine pathology. The current study aimed to review the findings and feasibility of the proposed office-based diagnostic and operative microhysteroscopy in previously diagnosed wom- en with unexplained infertility and to evaluate the post-microhysteroscopic pregnancy outcome in a-year follow-up period. MATERIALS AND METHODS: This prospective controlled study was conducted between 2006 and 2013. Two hundreds women with unexplained infertility were randomized into two groups: A. study group including 100 women recruited for office micohysteroscopic session and B. control group including 100 without the proposed microhysteroscopic intervention. A malleable fiberoptic 2-mm, 0 and 30 degrees angled hysteroscopy along with an operative channel for grasping forceps, scissors, or coaxial bipolar electrode were used for both diagnostic and operative indications. The findings, complications, and patient tolerance were recorded. A-year follow-up of pregnancy outcome for both groups was also performed. RESULTS: Seventy cases (70%) of patients had a normal uterine cavity. Twenty wom- en (20%) had endometrial polyps. Other pathology included submucous myomas in 3 cases (3%), intrauterine adhesions in 3 cases (3%), polypoid endometrium in 3 cases (3%), and bicornuate uterus in one case (1%). The pathological findings were treated in all patients without complication. Also a-year follow-up of the to- tal developing cumulative pregnancy rate (CPR) was evaluated in groups A and B (control). Group A revealed the total CPR of 28.5%, among which 25% in women without pathology, 40% in women with endometrial polyps, 23% in women with adhesions, 33% in women with polypoid endometrium, and 21% in those with bi- cornuate uterus. However, A-year follow-up of spontaneous pregnancy outcome in group B showed a total CPR of 15%. CONCLUSION: Women tolerance, safety, and feasibility of simultaneous operative correc- tion make the proposed office microhysteroscopy an ideal and routine procedure in order to diagnose and to treat missed intrauterine abnormalities, especially in cases with un- explained infertility, with additional improvement of the pregnancy outcome after the procedure.

Frequent transient hepatitis C viremia without seroconversion among healthcare workers in Cairo, Egypt.

BACKGROUNDS: With 10% of the general population aged 15-59 years chronically infected with hepatitis C virus (HCV), Egypt is the country with the highest HCV prevalence worldwide. Healthcare workers (HCWs) are therefore at particularly high risk of HCV infection. Our aim was to study HCV infection risk after occupational blood exposure among HCWs in Cairo. METHODOLOGY/PRINCIPAL FINDINGS: The study was conducted in 2008-2010 at Ain Shams University Hospital, Cairo. HCWs reporting an occupational blood exposure at screening, having neither anti-HCV antibodies (anti-HCV) nor HCV RNA, and exposed to a HCV RNA positive patient, were enrolled in a 6-month prospective cohort with follow-up visits at weeks 2, 4, 8, 12 and 24. During follow-up, anti-HCV, HCV RNA and ALT were tested. Among 597 HCWs who reported a blood exposure, anti-HCV prevalence at screening was 7.2%, not different from that of the general population of Cairo after age-standardization (11.6% and 10.4% respectively, p = 0.62). The proportion of HCV viremia among index patients was 37%. Of 73 HCWs exposed to HCV RNA from index patients, nine (12.3%; 95%CI, 5.8-22.1%) presented transient viremia, the majority of which occurred within the first two weeks after exposure. None of the workers presented seroconversion or elevation of ALT. CONCLUSIONS/SIGNIFICANCE: HCWs of a general University hospital in Cairo were exposed to a highly viremic patient population. They experienced frequent occupational blood exposures, particularly in early stages of training. These exposures resulted in transient viremic episodes without established infection. These findings call for further investigation of potential immune protection against HCV persistence in this high risk group.

Semen parameters in men with spinal cord injury: changes and aetiology.

AIM: To assess the changes in semen parameters in men with spinal cord injury (SCI) and the possible causes of these changes. METHODS: The study included 45 subjects with SCI. Semen retrieval was done by masturbation (2), vigorous prostatic massage (n = 13), penile vibratory stimulation (n = 13) or electroejaculation (n = 17). RESULTS: The semen of men with SCI showed normal volume (2.3 +/- 1.9 mL) and sperm count (85.0 X 10(6) +/- 83.8 X 10(6)/mL) with decreased motility (11.6% +/- 0.1%), vitality (18.5% +/- 5.2%) and normal forms (17.5% +/- 3.4%), and pus cells has been increased (6.0 X 10(6) +/- 8.2 X 10(6)/mL). Total (13.4 +/- 9.9 vs. 7.1 +/- 6.8) and progressive (4.4 +/- 3.9 vs.2.2 +/- 2.1) motility were significantly higher in subjects with lower scrotal temperatures. There was no statistical significant difference between electroejaculation and penile vibratory stimulation groups as regards any of the semen parameters. Subjects'age, infrequent ejaculation, injury duration and hormonal profile showed no significant effect on semen parameters. CONCLUSION: The defining characteristics of the seminogram in men with SCI are normal volume and count with decreased sperm motility, vitality and normal forms, and the increased number of pus cells. The most acceptable cause of the deterioration of semen is elevated scrotal temperature.