‫قل هل يستوي الذين‬
‫يعلمون والذين ال يعلمون‬
‫اللهم ال علم لي اال ما علمتني‬
‫‪1‬‬
‫االبحاث العلميه المقدمه من‬
‫الدكتور صبري سالم‬
‫للحصول على درجة البروفيسور‬
‫وهللا ولي التوفيق‬
‫‪2‬‬
Treatment Outcome Of Newly Diagnosed
Patients with Tuberculosis
In Benha Chest Hospital
By
• Sabry A. Salem*, Waheed, M. sayed
Ahmed **
*Department of community, Environment and
occupational medicine Benha faculty of
Medicine, Benha university.**Department of
chest diseases, Benha faculty of Medicine,
Benha University
Zagazig University Medical Journal
Jan, Feb (11) 2007
3
AIM OF THE WORK
(1) To study some epidemiological
features of newly diagnosed cases of
tuberculosis in Benha chest hospital
during the period of the study (20032006).
(2) To determine treatment outcome of
newly diagnosed cases of tuberculosis
during the same period.
4
PATIENTS AND METHODS
•
•
Retrospective study:
Data were collected from patient files and
registers. Suspected cases of tuberculosis
were investigated through the following
items:
Postero - anterior X- ray view of chest.
Sputum smear stained by Ziehl-Nelsen
stain.
5
• Tuberculin testing.
• Diagnosis of tuberculosis cases was
Preformed according to guidelines
of Egyptian National Tuberculosis
Control Program.
6
Follow up of treatment :A) For new TB cases with sputum smear
positive.
B) For previously treated cases with sputum
smear positive:
C) For new TB cases with sputum smear
negative .
D) For patients with sputum smear negative
(pulmonary, and extra- pulmonary TB).
7
OUTCOME OF TREATMENT
• Cured
• Completed treatment
• Treatment failure
• Defaulted
• Died
8
CONCLUSION
• Detection of newly diagnosed cases
of T.B. in general had decreased
(7.21% to 0.55%) and detection of
T.B cases with smear positive had
increased (40.23% to 55.05%).
9
• Cure rate among newly diagnosed
cases of T.B. had improved (34.48%
to 71.55%) and successful rate “cure
+ completed” had increased(49.42%
to 80.73%) but still lower than the
recommended (85%) .
10
• Treatment failure among newly
diagnosed
cases had
decreased and defaulted cases
are declined.
11
HOSPITAL BED UTILIZATION IN
BOTH BENHA UNIVERSITY HOSPITAL
AND BENHA EDUCATIONAL
HOSPITAL
By
Sabry A. Salem,* Salwa I. Mahmoud**
*Department of Community , Environmental and
Occupational Medicine Benha faculty of Medicine,
Benha University **Department of Nursing Service
Administration, Benha Faculty of Nursing,
Benha Medical Journal
May 2008
12
AIM OF THE WORK
To assess hospital bed utilization in
both Benha university hospital and
Benha educational hospital through
measuring some performance
indicators related to it.
13
MATERIALS AND METHODS
• Pre designed sheets were used to collect
required data which had been collected
monthly and included.
• Date of admission and discharge for every
patient.
• Total number of admitted and discharged
patients.
• Total number of in-patient service days.
14
• Number of deaths/month for each selected
department.
• Total number of beds for each selected
department. The period of hospital stay less
than one day was calculated as one day and
the day of admission and the day of
discharge are considered as one day.
15
• The indicators used to assess hospital
bed utilization were.
1-Average length of stay (ALOS)
2-Bed occupancy rate (B.O.R)
3-Turn over rate. (TOR)
• 4- Turn over interval (TOI)
16
CONCLUSION
Benha University hospital was relatively more
efficient in bed utilization than Benha
Educational hospital due to:
Short hospital stay
(4.02% days VS 5.03% days).
High bed occupancy rate
(70.16% VS 49.62%).
High turn over rate
(59.25 turn/bed VS 36.32 turn/bed).
17
EPIDEMIOLOGICAL STUDY OF NOCTURNAL
ENURESIS AMONG SCHOOL
CHILDREN ATTENDING OUT PATIENT
CLINICS OF BENHA UNIVERSITY HOSPITAL
By
*Sabry A. Salem, **Ashrf M. Shaheen
*Department of Community, Environmental And
Occupational Medicine, ** Department of Pediatrics
Benha Faculty of Medicine, Benha University.
Zagazig University Medical Journal
January 2008
18
AIM OF THE WORK
• Estimation the proportion
of
nocturnal enuresis among
school
children attending out patient clinics
of Benha university hospital.
• Identification for some risk factors
that may predispose to enuresis
among this age group.
19
SUBJECTS AND METHODS
Cross sectional study:
Out of 2749 attendants, 218 enuretic cases
were defined to be compared with well
matched 705 non enuretic attended school
children who were selected randomly to
make the over all sample population 923
attendants of school children.
•Questionnaire sheets were used and
included the following items.
20
1-Socio demographic data e.g
age, sex, residence, social class.
2-Personal characteristics: e.g
birth
order,
lactation,
development
e.g
speech,
walking, toilet training.
21
• 3-Familial characteristics e.g. family
history, consanguinity stressful life
events (e.g death of one parents,
divorce, family troubles, accidents,
birth of one sibling.
• 4-Sleep pattern (deep or light) as
reported by their parents.
22
• 5-Presence of school academic problems e.g
failure, fear of examinations, change to a
new school, punishment from the teacher,
unsatisfactory relations with fellows.
• 6-Past history of any organic or pathological
conditions e.g D.M, allergy, accidents,
hospitalization.
23
•7-Family
attitude
“parents:
towards their enuretic children.
“punitive,
un punitive or not
aware”
•8-Type of nocturnal enuresis
primary or secondary.
24
• All included cases in the study were
subjected to medical examination in
the form of clinical, urological,
neurological
and
psychological
examination,
routine laboratory
investigations
(urine
and
stool
analysis) X-ray on urinary tract and
urine culture if needed.
25
CONCLUSION
•Proportion of N.E. among school children
attending University hospital was 7.93 %
•Significant association between N.E. and the
following factors ;
1- significant decline in the percent of
enuresis with the increase of the age
2- with the delayed development of
milestones ,the percent of enuresis increased.
26
3- presence of school academic
problems and enuresis
4- educational level of mothers and
enuresis .With the decrease of level of
education ,percent of enuresis
increases
5- With the increase the percent of
urinary tract infections, the percent of
enuresis increases
27
• Mothers of enuretic children
were significantly more users to
the punitive approach towards
children with primary type than
those with secondary type of
enuresis.
28
IMPACT OF BREAST FEEDING ON GROWTH AND
MORBIDITY AMONG INFANTS ATTENDING
MCH CENTERS IN BENHA CITY
By
Soad D. El-Gendy, Abdel Moiem A. Dawah, Eman
A.Al-Bitar, Abdallah M. Al-Mosallemany,
Sabry A. Salem, Rasha S. Ali
Community Medicine Department, Faculty of
Medicine, Benha University
Zagaizg University Medical Journal
October 2006
29
AIM OF THE WORK
This study aimed at studying the
impact of breastfeeding on growth,
some morbidities affecting infants
and detecting some possible causes
beyond failure of initiation or
maintenance
of
exclusive
breastfeeding.
30
MATERIALS AND
METHODS
A structured questionnaire sheet was
designed to collect data, it included:
Data about the parents of the
studied infants such as demographic
and socioeconomic data.
31
- Socio-behavioral data about feeding of
infants which included type of infant feeding
during the first 6 months of life (exclusive
breast feeding, non exclusive or artificial
feeding), practice of rooming in, time of
starting feeding.
- Fertility data e.g. gravidity, parity, last inter
pregnancy space and type of last delivery.
32
- Antenatal data as practicing antenatal care or
not, time of start, place and pattern of visits,
medical problems.
- Data about the studied infant as age, sex,
order of birth, some morbidities affecting
infants such as ARI, vomiting, diarrhea,
malnutrition and other.
- Growth assessment was done for each
infant using anthropometric measurement.
33
Conclusion
• Exclusive breast feeding has a better effect
on infant growth and decreasing morbidity
e.g. A.R.I and G.E.
• Majority of exclusively breast fed infants
were born to mothers ;
–aged 20- 30 years
–rurals ,non working mothers
–from middle and low social classes
–multipara .
–pregnancy spacing 3 years or more
34
• Most of highly educated mothers (70.1
% ) were mothers to artificially fed
infants
• Majority of exclusively breast fed infants
had
– normal weight gain
– ARI and G.E. among them were
lower than that recorded among
artificially fed infants
35
• Failure of initiation or maintenance
of exclusive breast feeding was
due to ;
– Maternal causes ;e.g. mothers
work ,mode of delivery, failure of
secretion of milk
–Infant causes e g. refuse of
breast feeding, twin, multiple
pregnancy
36
PREMENSTRUAL DYSPHORIC
DISORDERS IN BENHA UNIVERSITY
FEMALE STUDENTS
By
Mona H. El Mahdy Sabry A. Salem
Alid . Alla . M. El Mouslemany Hanaa S. Alid El
Rahman
Dpartment of community, Environment and
occptional medicine, Benha Faculty of medicine
Benha university
Zagazig university Medical Journal,
Mars 2007
37
AIM OF THE WORK
1- To determine the magnitude of t he
problem of premenstrual dysphoric
disorder (PMDD) among students of
Benha University.
2- To identify some risk factors that
predispose to the occurrence of
premenstral dysphoric disorder.
38
SUBJECTS AND METHODS
• The data was collected from female
students of Benha University by the
help
of
self
administrated
questionnaire as well as personal
interview .
• 1-Personal data
• 2- Menstrual characters.
39
• 3- Data for evaluation of :
a)Academic performance.
b) Social performance.
• 4- Physical activity.
• 5- History of physical and psychiatric
disorders.
• B- Anthropometric measurement.
• C- Physical examination.
40
CONCLUSION
•Prevalence of Premenstrual Dysphoric
Disorder( PDD) was 51.47 % among the
studied group.
•More than half (61.27 % ) of female
students were from urban areas.
•Majority of female students with PDD
had:
-Regular menstruation.
-Duration 6 days or less.
-with dysmenorrheal
41
• More than half (52.06 % ) of
students with PDD recorded
significantly monthly absenteism of
one or more days because of
Premenstrual symptoms
• One third (36.83 % ) of students
with PDD were overweight and
obese.
42
• Majority of students with PDD
(94.29% ) had practiced mild
physical activity
• Majority of students with PDD
(88.25 % ) were circumcised.
43
EPIDEMIOLOGICAL FEATURES OF CHILD
ABUSE AMONG A SAMPLE OF
PREPARATORY SCHOOL
CHILDREN IN BENHA CITY
By
Mahmoud A. Saleh, Mona H. El Mahdy
Sabry A. Salem, Abdalla M., Al Muslemani
Department of Community, Environmental
And occupational Medicine,
Benha Faculty of Medicine
Benha Medical Journal
January 2009
44
AIM OF THE WORK
To identify some epidemiological
features of child abuse among a
sample of preparatory school
children in Benha city).
45
SUBJECTS AND
METHODS
The data was collected from
students of Benha preparatory
schools by use of semi-structured,
self administrated questionnaire
guided by researcher's instructions.
46
• The questionnaire included the
following items:
1-Socio-demographic characteristics.
2- Child Traumatic Questionnaire
(CTQ): The questionnaire inquires
about 4 types of abuse (maltreat
ment): physical, emotional sexual and
neglect.
47
• The score of physical abuse
ranged from
0 to 6. three
or more indicate abuse .
• The score of emotional abuse
ranged form 0 to 10. Five or
more indicate abuses.
48
• The score of neglect ranged
form o to 10. Five or more
indicate abuse.
• The score of sexual abuse
ranged form 0 to 6. three or
more indicate abuse.
49
CONCLUSION
•More than half (75.8%) of the studied
group of students had exposed to child
abuse .Combined form of abuse ( 28.4
% ),emotional abuse ( 24 % ) and
physical abuse ( 20.4% ) were the
more prevailing types
50
• Female students were the more
prevailing ( 28 6 % )regarding
absence of abuse among them
more than male students (
19.4 % ).
51
• Absence of abuse was
significantly found with higher
frequencies among students
belonging to ;
–high social class ( 43 .5 % )
–married parents ( 28.5 % )
–university graduated fathers (
43.3 % )
–unemployed mothers ( 42.3 % )
52
• Physical abuse was more prevailing
among male students (22.6 %
),emotional abuse among students
of low social class (37% ) while
sexual abuse was more prevailing
among student belonging to
divorced parents ( 26.6%)
53
• More than half of abused children
( 51,6 % ) had exposed to abuse at
homes followed by at schools
( 27.2 %).
54
OVERWEIGHT AND OBESITY : SOME CAUSES
AND HEALTH HAZARDS AMONG FEMALE
STUDENTS OF SECONDARY SCHOOLS
By
Abd alla M.El-moslemani , Sami B. Al-ashgar ,Sabri A.
salem and Rania H.Shaker Mona, A El ayady
.Departments of community Medicine and Appl.Med.
sciences. Universities of Benha ( Egypt) and Al-Baha
(KSA).
55
AIM OF THE WORK
Identification some causes and
health disorders related to
overweight and obesity among
female students of secondary
schools.
56
MATERIAL AND
METHODS
The data was collected from female
students with the help of self
administered
questionnaire
that
included:
a-Sociodemographic data.
b-Dietary habits.
57
c-Activities.
1- Participating in exercise or
not.
2-Means of trans portation to
school.
3- Indoor environment e.g hours
of sitting in front of T. V., reading
58
• d-Academic performance:
• 1- Academic success that
included four groups
•
50-64.9%
65 - 74.9%
•
75 - 84.9 % and
85%
or more
• 2- Previous failures.
59
• e-Personal behavior:
with brothers and peer
• II-Anthropometric measurements
• III-Physical examination :
• IV-Assessment of depression by special
psychometric test using beck depression
inventory scale
60
CONCLUSION
•No significant difference between over
weight &obese students and normal
weight students regarding residence
,level of education of their parents and
working of their mothers.
61
• There was a significant difference
between overweight & obese students
and normal weight students regarding ;
–excess sweet intake and dietary
habits ( excellent dietary habits are
more among normal weight students)
–participating physical exercise ( obese
are less participating ).
62
–setting hours in front of T.V. and
computer ( more setting hours
for obese students )
–playing with their brothers
• academic performance ( 85 % or
more academic success was more
among normal weight students ).
63
• Health hazards and its association with
obesity
–significant difference regarding
depression , easy fatigability (more
among obese students )
–insignificant difference regarding joint
pain and other psychological
disorders.
64
• Estimation of depression showed
significant difference regarding
degree of depression. Mild and
moderate degrees of depression
were more among obese students.
65
NEUROPSYCHOLOGICAL FUNCTIONING
AND HEALTH OF DENTISTS EXPOSED
TO MERCURY
By
Ahmed H. Abdel Karim MD, Abdelbary F. Abdelbary MD*,
Eman A. Al-Bitar MD*, Sabry A. Salem MD*, and
Lamiaa A. Al-Basiony MD**
Department of Occupational Medicine, National research Centr;
*Department of Community, Environmental and Occupational
Medicine, Benha Faculty of medicine, Benha University;
** Department of Community, Environmental and occupational
Medicine, Monofia Faculty of Medicine, Monofia University, Egypt.
Benha Medical Journal
Sept. 2005
66
AIM OF THE WORK
To determine if there is an effect of
mercury on an exposed population.
67
MATERIALS AND METHODS
•The Questionnaire included information
about amalgam preparation, mercury
storage, and mercury spillages.
• Also questions relating to other possible
influences on psychomotor response.
• The Questionnaire also covered some
personal habits.
68
Biological measurements:
•A sample of urine on the day of the
visit to the surgery for analysis of
mercury concentration.
•Hair and nail mercury analysis
subjects were asked for samples of
head hair, finger nails, and toe nails.
69
•Environmental
mercury
concentrations. The concentrations of
mercury vapor in the dental surgeries
were measured.
•Psychomotor
performance
psychomotor
performance
was
measured with a package of eight
tests.
70
CONCLUSION
•Dentists were significantly more likely to
have kidney disorders and memory
disturbance (6.6% ,25.6 % ) more than
controls ( 1.1% , 8.8 % ) while controls
were significantly more likely to have loss
of appetite more than dentists ( 13.3%
,6.6% )
71
• Highly significant difference between
urinary mercury concentration of
dentists and controls (mean urinary
mercury concentration for dentists 2.58
mmol while for controls 0.67mmol).
72
• Hair and nails of the dentist group had
higher mercury concentration than that
of the control group with insignificant
difference.
• Environmental mercury measurements
showed concentrations of mercury above
that of the occupational exposure
standards in one or more separate
areas.
73
• Significant difference in the
scores of dentists and controls
for number vigilance .
74
• No significant association between
concentration of mercury in hair an
finger nails and any of psychomotor
tests.
• Finally ; exposure to mercury at levels
experienced by the dentists in the
study does not have a detrimental
effect on psychomotor performance .
75
RISK FACTORS OF OTITIS MEDIA
AMONG CHILDREN OF SHARKIA
GOVERNORATE
BY
Sami S. Ashgar, Abd Alla Almslmani, Sabri A.
Salem, Rania H. Shaker and Ahmed A. Soliman
Departments of Community Medicine and Otolaryngology,
Faculties of Medicine and App. Med. Sciences , Al Baha
(KSA) , Benha and Zagazig Universities.
Zagazig university Medical Journal
January 2008
76
AIM OF THE WORK
To identify the risk factors of
otitis media in children and to
plan for prevention and control.
77
MATERIAL AND METHODS
•This study included 600 children with OM,
selected from Otolaryngology clinic of Zagazig
University Hospital and aged between 3
months to 12 years in the period from January,
2007 to February, 2007.
•Another 600 children of the same age and sex
were selected from Ophthalmology and
Dermatology clinics as control group.
78
• Both case and control groups were
submitted to questionnaire comprising a
full history about any health disorders
related to nose, ear, throat or
respiratory tract.
• Also, all children were subjected to local
clinical examination, tympanometry (for
children >7months) 6 and audiometry
(for children >3years) 7.
79
• The collected data were presented
and analyzed statistically by using
X2 and Odd Ratio.
80
CONCLUSION
• Otitis media was more common among
children from rural areas , artificial and mixed
feeding and with low socioeconomic level with
significant difference between them and
controls.
• Significant difference between children with
O.M. and controls regarding allergic rhinitis
,chronic tonsillitis and repeated attacks of
common cold.
81
• Significant association between O.M
and previous past history of O.M
,introduction of foreign bodies to ear
and misuse of antibiotics.
• A.O.M was more frequent among
infants and preschool children while
S.O.M. was more prevailing among
school children.
82