Search

Mikiyas Zike,1 Abdurahaman Mohammed Ahmed,2 Awraris Hailu,2 Bedru Hussien3 1Debre Berhan Town Health Facilities, MoH, Debre Berhan, Amhara National Regional State, Ethiopia; 2Department of Epidemiology, Debre Berhan University, Debre Berhan, Amhara National Regional State, Ethiopia; 3Department of Public Health, Madda Walabu University, Goba, Oromia National Regional State, EthiopiaCorrespondence: Bedru Hussien, Department of Public Health, Madda Walabu University, P.O. Box 302, Goba, Oromia National Regional State, Ethiopia, Tel +251911997287, Email bedru1964@gmail.comBackground: The majority of multidrug-resistant organisms found in immunocompromised patients are enterococci. The rise of vancomycin-resistant enterococci (VRE) poses a significant threat to public health. There is a scarcity of information regarding the prevalence of VRE in Ethiopia.Purpose: This study aims to determine the prevalence of VRE in fecal samples from Human Immunodeficiency Virus (HIV)-positive individuals, to identify associated factors, and to assess their susceptibility to selected commonly prescribed medications.Patients and Methods: A cross-sectional study was conducted from April 1 to July 15, 2023, on 170 HIV-positive clients at Debre Berhan Town. A pre-tested structured questionnaire was used to collect socio-demographic and clinical data. Stool sample was collected by trained health workers, and processed by standard microbiological techniques. Kirby-Bauer disk diffusion method was used for antimicrobial susceptibility testing. Data entry and analysis was carried out by SPSS Version 25. Bivariate and multivariate logistic regressions were used to assess the associated factors. Variables with a p-value of < 0.05 were considered to be significantly associated with the outcome variables and the results were displayed with tables.Results: From the total of 170 study participants, colonization of Enterococcus species was observed among 95 (55.9%). Vancomycin resistance was found in 13 (13.8%) of them with 95% confidence interval (CI) 7.4– 22.1. History of hospitalization Adjusted Odds Ratio (AOR): 11.9 (95% CI 1.11– 127.53); habit of eating uncooked food (AOR: 15.34 (95% CI 2.36– 99.63)) and invasive procedures (AOR: 23.07 (95% CI 3.54– 150)) were among the predictors of VRE. MDR (multidrug resistance) was observed in 83 (87.4%) of the isolates. The highest rate of resistance was observed for ampicillin with 72 (74.6%).Conclusion: Vancomycin and multidrug resistance of enterococci among HIV patients are significant in ART clinics of Debre Berhan Town. These warrant applicable infection prevention guidelines in the health facilities and health education on food hygiene.Keywords: Enterococci, vancomycin resistant, HIV patients, Ethiopia

Syed Irfan Karim,1,2 Farhana Irfan,2 Shazia Haris,3 Nassr Al-Maflehi,4 Abdullah MA Ahmed,2 Gominda Ponnamperuma,5 Shuaa Al Sayyari,6 Eiad Al Faris1,2 1Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 2King Saud University Chair for Medical Education Research and Development, Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 3Ministry of Health, Riyadh, Saudi Arabia; 4College of Dentistry, King Saud University, Riyadh, Saudi Arabia; 5Department of Medical Education, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka; 6College of Medicine, King Saud University, Riyadh, Saudi ArabiaCorrespondence: Syed Irfan Karim, Department of Family and Community Medicine, College of Medicine, King Saud University, PO Box 2925, Riyadh, 11461, Saudi Arabia, Tel +966114679253, Fax +966114671967, Email irfankarim1969@gmail.comPurpose: The increasing prevalence of distress among students is of global concern. Several factors such as school and family environment and ineffective study skills could influence mental health. The study explored the rate of distress symptoms among school students’ and its relationship with their study skills, stressors and demographic factors.Methods: In this cross-sectional analytical study, a sample of 215 students from a community school participated in the study. Three questionnaires, demographic questionnaire, Study Skills Inventory and the Kessler Psychological Distress Scale, were used for data collection. Data were analyzed using Student’s t-test, ANOVA, Pearson’s correlation coefficient and stepwise linear regression.Results: Response rate was 70% (n = 150). A high proportion of respondents (75%) was distressed (mean 27.28 ± 8.77). Correlation analysis showed that distress (K10 score) was negatively related to study skills (SSI total score) (r = − 0.247, p = 0.002). The rate of distress symptoms was higher among female students (79%) compared to their male counterparts (72%). The factors associated with distress included negative association of teachers’ level of help to develop competencies (p = 0.000, β = − 0.278, R2 = 0.249), unfavorable school environment (p = 0.000, β = 0.285, R2 = 0.123), inability to cope with studies (p = 0.005, β = 0.205, R2 = 0.038), family problems (p = 0.014, β = 0.184, R2 = 0.173) and lower study skills (p = 0.031, β = − 0.164, R2 = 0.270). The overall regression analysis explained 33.6% of the variance (corrected R2 = 0.336).Conclusion: Higher than expected levels of distress (75%) was found in immigrant school students. Poor study skills have a significant relationship with distress. Learning environment and related stress factors were associated with distress among students. Based on the findings, it is recommended that stakeholders in education address the hidden curriculum, as it is usually unacknowledged and might affect students’ wellbeing, and move from student centered to an interpersonal relation-centered education.Keywords: school students, distress, study skills, stressors

Heba Mohamed Abd Elgalil, Asmaa Abdelghany Elsheikh, Doaa Sadek Ahmed, Amal M Ahmed, Soso Shawky Mohamed Community and Occupational Medicine Department, Faculty of Medicine, Al-Azhar University, Cairo, EgyptCorrespondence: Heba Mohamed Abd Elgalil, Community and Occupational Medicine Department. Faculty of Medicine, Al -Azhar University, Cairo, Egypt, Tel +20- 01153411236, Email Hebamohamed.medg@azhar.edu.egBackground: There are still many concerns related to various types of COVID-19 vaccines, which may result in individuals’ hesitancy presenting a problem for public health authorities to achieve coverage for population immunity. As trustworthy health-care workers, medical and nursing students’ perception towards COVID-19 vaccines may greatly influence the future population’s uptake of vaccines; however, studies related to the vaccine acceptance rates among them are limited.Objective: To identify the perception of medical and nursing students toward COVID-19 vaccines and the factors acting either as motivators or barriers to be vaccinated.Methods: A cross-sectional comparative study was conducted on 500 undergraduate students aged ≥ 18 years from medical and nursing faculties. Data were collected via a semi-structured self-administered questionnaire that consisted of questions on general characteristics of the participants and source of information about the vaccine. Also, it includes items assessing the perception and acceptance of COVID-19 vaccines. Descriptive statistics, chi-squared, t-test and multiple logistic regressions were performed using SPSS version 22.Results: Positive perception was detected among more than half of overall students. Although medical students had significant higher positive perception toward COVID-19 vaccines than nursing students (54.9% vs. 41.1%, p < 0.05), they were more hesitant to get vaccinated than nursing students (25.7% vs. 19.6%, p > 0.05). While, medical students had a higher intention to encourage family members or friends to get vaccinated than did nursing students (47.7% vs .43.8%, respectively) (p > 0:05). Furthermore, participants were more likely to accept vaccination if they reported higher levels of positive perception especially for vaccine safety and increasing recovery rate.Conclusion: Academic medical and nursing leaders should consider female students’ vaccine concerns, and future efforts are needed to reduce their hesitancy and raise awareness about vaccinations that may eventually improve perception and acceptance of COVID-19 vaccines.Keywords: COVID-19, medical students, vaccine acceptance, nursing students, Egypt

Ihab Abdel Aziz,1 Mohamed Fawzy Alsoda,2 Tarek Mohamed Elmenofy,1 Mohamed Medhat Sakhsoukh,1 Noha Mohamed Abd el Azim,1 Amr Mahmoud Ahmed,1 Sohaila Ali Abd El-Halim,3 Sherine Salaheldin Hassan Baris,3 Yousef Ahmed Fouad,4 Ayman Mohyieldin Elghonemy,1 Heba Metwally,1 Wael Mohamed El Gendy,1 Raghdaa Ali,2 Yehia Mahmoud Basha,5 Eman Abo ElMaaty Mohamed,6 Wafaa Mohamed Amin,6 Maged Adly Naguib,1 Hazem Abdallah Elnashar1 1Department of Ophthalmology, The Memorial Institute for Ophthalmic Research, Giza, Egypt; 2Department of Pediatrics and Neonatology, Ahmed Maher Teaching Hospital, Cairo, Egypt; 3Department of Pediatrics and Neonatology, Mataria Teaching Hospital, Cairo, Egypt; 4Department of Ophthalmology, Ain Shams University Hospitals, Cairo, Egypt; 5Department of Pediatrics and Neonatology, Damanhour Teaching Hospital, Beheira, Egypt; 6Department of Pediatrics and Neonatology, El-Galaa Teaching Hospital, Cairo, EgyptCorrespondence: Hazem Abdallah Elnashar, Department of Ophthalmology, The Memorial Institute for Ophthalmic Research, Giza, 23314, Egypt, Tel +201227011043, Email Dr.hazemelnashar@gmail.comBackground: Retinopathy of prematurity (ROP) is increasing in incidence in developing nations, including Egypt. Secondary prevention requires timely detection through the development of regional screening guidelines, which should be preceded by large-scale studies to characterize the population at risk.Methods: A prospective, multicentric exploratory study that included five large tertiary institutions in an urban Egyptian setting. All infants born with gestational age (GA) < 37 weeks and/or birth weight (BW) ≤ 2000 grams were screened. More mature and heavier infants with unstable clinical course were also included. The primary outcome measure was the rate of ROP and high-risk disease occurrence in relation to underlying risk factors.Results: Of the 768 eyes (384 screened infants), 347 eyes (45.2%) had stage 1 or higher disease, and 43 eyes (5.6%) had high-risk disease. Eyes with stage 1 or higher ROP and treatment-requiring ROP had a mean (± SD) GA of 33.4 (± 2.6) weeks and 32.8 (± 3.2) weeks, and BW of 1842.3 (± 570.1) grams and 1747.6 ± (676.2) grams, respectively. Treatment-requiring eyes belonged to infants that had significantly lower GA and significantly higher prevalence of co-morbidities than non-treatment-requiring eyes.Conclusion: The incidence of ROP and high-risk disease in an urban Egyptian setting are similar to those in comparable settings elsewhere and locally. This exploratory study supports tailoring local screening criteria for ROP, and may aid the future development of national guidelines.Keywords: retinopathy of prematurity, ROP, screening, plus disease, preterm

Ahmed Salah Abdelgalil, Ahmed Mansour Ahmed, Reham M Gamal, Mamdouh Mahmoud Elshal, Ahmed Hussein Bakeer, Ehab Hanafy Shaker Anesthesia, Intensive Care and Pain Management, National Cancer Institute, Cairo University, Cairo, EgyptCorrespondence: Ahmed Salah Abdelgalil, Anesthesia, Intensive Care and Pain Management, National Cancer Institute, Cairo University, Cairo, 11796, Egypt, Email ahmed.salah@nci.cu.edu.egBackground: It is critical to manage acute postoperative pain for patient satisfaction and better outcome. Erector spinae plane block (ESPB) can produce sensory blocking on both visceral and somatic levels. This study aimed to evaluate the ESPB efficacy in controlling acute postoperative pain in open nephrectomy for renal malignancies.Methods: This prospective randomized, controlled, open-label trial included 60 cases scheduled for open nephrectomy for renal malignancy under general anesthesia. Cases were assigned randomly into two equal groups. Group E administered continuous preoperative unilateral ESPB (20mL bupivacaine 0.25% bolus then 6 mL/h 0.1% for 48 hours). Group C administered intravenous (IV) patient-controlled analgesia (PCA) morphine (0.01 mg/kg/h). Postoperative analgesia was managed by morphine (3 mg IV in group E or 0.01 mg/kg bolus with a 15-min lockout in group C) to keep the visual analog scale (VAS) scores < 4.Results: Intraoperative fentanyl consumption and total morphine consumption in 1st 48 hours postoperatively were significantly lower in group E than group C (P= 0.001 and < 0.001, respectively). The time to first analgesic request was significantly longer in group E than group C (P < 0.001). VAS scores at movement and rest were significantly lower in group E than group C (P < 0.001).Conclusion: In renal malignancies, ESPB provided better analgesia with prolonged time and lower pain scores at both rest and movement compared to IV PCA following open nephrectomy.Keywords: erector spinae plane block, PCA, analgesia, nephrectomy, renal malignancy

Ahmed M Ahmed,1 Omar F Khabour,1,2 Akram H Awadalla,3 Hisham A Waggiallah4 1Department of Clinical Laboratory Sciences, Faculty of Applied Medical Sciences, Taibah University, Medina, Saudi Arabia; 2Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan; 3Department of Clinical Chemistry, College of Medical Laboratory Sciences, Kordofan University, Alobayid, Sudan; 4Department of Medical Laboratory Sciences, Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia Background: Diabetes mellitus is associated with imbalance in body trace elements. The aim of the current investigation was to compare the levels of trace elements (Zn, Mg, Mn, Cu, Na, K, Fe, Ca, Cr, and Se) in insulin dependent (IDDM) and non-insulin dependent (NIDDM) diabetes. Methods: A total of 100 patients with diabetes (40 IDDM and 60 NIDDM) and 50 healthy subjects were recruited in the study from both genders. Biochemical measures include glucose, lipids, and HbA1C. Results: The results showed that Zn, Mg, Cu and Cr were significant lower in patients with diabetes compared to the control group (P0.05). Conclusion: Disturbance in trace element profile among IDDM and NIDDM is similar. Keywords: trace elements, diabetes mellitus, IDDM, NIDDM

Solomon Hailemeskel,1 Osman Yimer Mohammed,1 Abdurahman Mohammed Ahmed2 1Department of Midwifery, 2Department of Nursing, College of Health Sciences, Institute of Medicine and Health Science, Debre Berhan University, Debre Berhan, Ethiopia Background: One of the specific targets of Directly Observed Treatment, Short-course detailed in the updated Global Plan (2011–2015) was to achieve a treatment success rate of 87% by 2015. This strategy was introduced to Ethiopia in 1995 to reach full coverage in 2005; however, by 2009, treatment had not been as successful as expected.Objective: This study was conducted to determine treatment success rate and identify risk factors for tuberculosis (TB) treatment outcomes in North Shoa Administrative Zone, Amhara Regional State, Ethiopia.Methods: A retrospective cohort study was conducted on all TB patients (739) who registered for TB treatment from September 1, 2012 to August 31, 2014 at public hospitals in North Shoa Administrative Zone, Ethiopia. Data were gathered by using a pretested structured medical record checklist. Four data collectors and two supervisors were involved in gathering the data. The data were analyzed using descriptive statistics and logistic regression and were entered into Epi Info and analyzed by using the SPSS software package version 20.Results: This study revealed that the TB treatment success rate was 86.1% (169 [22.9%] cured and 467 [63.2%] completed). In addition, 22 (3%) of the study participants defaulted their treatment of which 19 (86.4%) withdrew during the intensive phase. The multiple logistic regression model revealed that the study year of treatment, sputum smear positivity at the second-month follow-up, history of treatment default, and subsequent hospitalization were significantly associated with the TB treatment outcome.Conclusion: The TB treatment success rate in the study area was low compared to that estimated by World Health Organization to achieve by 2015. Therefore, Federal Ministry of Health and Regional and Zonal Health Office have to strengthen the interventions on minimizing anti-TB treatment default rate through well-organized documentation, follow-up on TB patients, and awareness-creation programs. Keywords: TB, treatment outcomes, risk factors, governmental hospitals, North Shoa, Ethiopia