The aims of this cross-sectional study were to investigate the prevalence and circumstances of needlestick injury (NSI) among heath care workers at University of Alexandria teaching hospitals and to assess the effectiveness of the existing control measures and standard precautions. Data were obtained by anonymous, self-reporting questionnaire from 645 nurses, physicians and ancillary staff in 2007. Around two-thirds of workers (67.9%) had suffered at least 1 NSI in the last 12 months. High-risk patients (with history of HIV, hepatitis B virus or , hepatitis C virus infection or injecting drug use) were involved in 8.2% of injuries. On evaluating the effectiveness of existing control measures, significant protective factors against NSI were: using devices with safety features (OR 0.41), adherence to infection control guidelines (OR 0.42), training in injection safety (OR 0.14), comfortable room temperature (OR 0.32) and availability of a written protocol for prompt reporting (OR 0.37). ‫شوقي‬‫منى‬ ‫قاسم،‬ ‫رشيف‬ ‫حممد‬ ، ‫حميي‬ ‫عايدة‬ ‫حنفي،‬ ‫منال‬ ‫املستشفيات‬ ‫يف‬ ‫الصحية‬ ‫الرعاية‬ ‫يف‬ ‫العاملني‬ ‫لدى‬ ‫اإلبر‬ ‫بوخز‬ ‫اإلصابات‬ ‫وظروف‬ ‫انتشار‬ ‫معدل‬ ‫الستقصاء‬ ‫املستعرضة‬ ‫الدراسة‬ ‫هذه‬ ‫هتدف‬ ‫اخلالصـة:‬ ‫خالل‬ ‫من‬ ‫املعطيات‬ ‫عىل‬ ‫الباحثون‬ ‫حصل‬ ‫وقد‬ ‫للوقاية.‬ ‫املعيارية‬ ‫واالحتياطات‬ ‫احلالية‬ ‫املكافحة‬ ‫إجراءات‬ ‫فعالية‬ ‫لتقيـيم‬ ‫اإلسكندرية،‬ ‫جلامعة‬ ‫التعليمية‬ )%67.9( ‫العاملني‬ ‫ثلثي‬ ‫من‬ ‫يقرب‬ ‫ما‬ ‫أن‬ ‫نَّ‬ ‫وتبني‬ .2007 ‫عام‬ ‫يف‬ ً ‫مساعدا‬ ً ‫طبيا‬ ً ‫وعامال‬ ً ‫وطبيبا‬ ‫ممرضة‬ 645 ‫استوفاه‬ ‫األسامء،‬ ‫ذكر‬ ‫دون‬ ً ‫ذاتيا‬ ‫ىَ‬ ‫ستوف‬ ُ ‫ي‬ ‫استبيان‬ ‫اخلطورة‬ ‫مرتفعي‬ ‫بمرىض‬ ‫العناية‬ ‫أثناء‬ ‫احلاالت‬ ‫من‬ %8.2 ‫يف‬ ‫اإلصابات‬ ‫كانت‬ ‫وقد‬ ‫السابقة.‬ ‫عرش‬ ‫االثني‬ ‫األشهر‬ ‫يف‬ ‫األقل‬ ‫عىل‬ ‫إبرة‬ ‫وخزة‬ ‫من‬ ‫عانى‬ ‫قد‬ ‫فعالية‬ ‫تقيـيم‬ ‫من‬ ‫نَّ‬ ‫وتبني‬ ‫باحلقن).‬ ‫املخدرات‬ ‫يتعاطون‬ ‫نَّن‬ ‫مم‬ ‫أو‬ ‫«يس»‬ ‫أو‬ ‫«يب»‬ ‫الكبدي‬ ‫االلتهاب‬ ‫بفريوس‬ ‫أو‬ ‫اإليدز‬ ‫بفريوس‬ ‫اإلصابة‬ ‫سوابق‬ ‫(لدهيم‬ ‫األرجحية‬ ‫(معدل‬ ‫السالمة‬ ‫ها‬ ُ ‫ر‬ ِ ‫ظاه‬ ‫أدوات‬ ‫استخدام‬ ‫هي:‬ ‫اإلبر‬ ‫بوخز‬ ‫اإلصابة‬ ‫من‬ ‫هبا‬ ‫ىَدُّ‬ ‫ت‬ ْ ‫ع‬ ُ ‫ي‬ ‫التي‬ ‫الوقائية‬ ‫العوامل‬ ‫أن‬ ً ‫حاليا‬ ‫القائمة‬ ‫املكافحة‬ ‫إجراءات‬ ‫درجة‬ ‫وكون‬ )0.14 ‫األرجحية‬ ‫(معدل‬ ‫احلقن‬ ‫سالمة‬ ‫عىل‬ ‫والتدريب‬ ،)0.42 ‫األرجحية‬ ‫(معدل‬ ‫العدوى‬ ‫ملكافحة‬ ‫اإلرشادية‬ ‫بالدالئل‬ ‫وااللتزام‬ ،)0.41 .)0.37 ‫األرجحية‬ ‫(معدل‬ ‫الفوري‬ ‫لإلبالغ‬ ‫مكتوب‬ ‫بروتوكول‬ ‫وتوافر‬ ،)0.32 ‫األرجحية‬ ‫(معدل‬ ‫رحية‬ ُ ‫م‬ ‫الغرفة‬ ‫حرارة‬ Blessures par piqûre d'aiguille chez les agents de soins de santé des hôpitaux universitaires d'Alexandrie RéSUmé Les objectifs de la présente étude transversale étaient d'étudier la prévalence et les circonstances des blessures par piqûre d'aiguille chez les agents de soins de santé des hôpitaux universitaires d'Alexandrie et d'évaluer l'efficacité des mesures de lutte existantes et les précautions standard. Les données ont été obtenues au moyen d'un questionnaire anonyme direct rempli par 645 infirmières, médecins et personnels auxiliaires en 2007. Environ deux-tiers de ces personnels (67,9 ...

Infection with H. pylori is declining among healthy individuals of Al Madinah, Saudi Arabia. Infection is acquired at an early age and reaches up to 36.9% as age advances. The risk of H. pylori seropositivity was related to socioeconomic, lifestyle, and environmental factors. A nationwide epidemiological study is warranted to determine the seroprevalence of H. pylori in Saudi Arabia.

Background: Needle stick injury has been recognized as one of the occupational hazards which results in transmission of blood borne pathogens. As there was limited data on the national level about these injuries determinants of such injuries are important to investigate and to design effective prevention programs. Objective: The purpose of this study was to investigate the prevalence and circumstances of needle stick injuries among heath care personnel working at Alexandria University hospitals. Effectiveness of the existing control measures and practice of standard precautions were also assessed. Methods: A cross-sectional survey was carried out among 913 health care workers (HCW) in different clinical departments of the three teaching hospitals from January to December 2007. Data were obtained by an anonymous, self-reporting questionnaire. Health Belief Model (HBM) was used to explain standard precautions practice. Multiple linear regression was performed to predict factors associated with the practice of standard precautions. Results: Of the recruited participants, 70.6% (645/913) had completed the questionnaires. Nurses had the highest response rate (92.5%). More than two thirds (68.0%, n=438) of participating HCWs had sustained at least one needle stick injury in the last 12 months. Risk of (Needle Stick Injuries (NSIs) was significantly associated with younger age of the participants and fewer years of work experience. More specifically, of all occupational groups, nurses have the highest risk to experience needle stick injuries (62.3%). Disposable syringes accounted for 38.4% of injuries. Most needle stick injuries (36.5%) occurred at the patient's ward. Evaluating the kind of activity under which the needle stick injury occurred, on average 36.0% of injuries occurred during recapping of a needle especially if this practice was handily done. High risk patients (one with a history of infection with HIV, hepatitis B, hepatitis C, or injection drug use) were involved in 8.2% of injuries. The majority of NSIs (73.1%) occurred at end of the shift. Most health care workers (77.4%) were mentally distressed during their injury. Factors increase possibility of infection transmission were the procedure involving a needle placed directly in patient's vein or artery, exposure to a source patient who had evidence of blood borne infection, low immune status of the HCW (i.e., no vaccination with HBV), deep injury, and lack use of personal protective equipment. A total of 327 respondents (74.7%) did not report the injury to an employee health service. Lack knowledge of appropriate procedure after injury was the most common cited reason for not reporting the injury. The survey revealed that use of preventive measures was inadequate. Only 10.0% of all participant workers knew new needless safety devices. The significant protective factors that decreased the frequency of needle stick injuries were using devices with safety features (OR=0.41), satisfactory adherence of a health care worker to infection control guidelines (OR=...

Background: Patient safety is a critical component of healthcare quality. This study aimed at assessing the perceptions of primary healthcare staff members about patient safety culture and explores the areas of deficiency and opportunities for improvement concerning this issue. Methods: This descriptive cross sectional study surveyed 328 staff members in 28 primary healthcare facilities in Alexandria using an anonymous direct structured interview format of a modified “Hospital Survey on Patient Safety Culture” adopted questionnaire. The total number of respondents was 250 participants (response rate = 76.2%). The main outcome measures include patient safety culture score including sub scores on 12 dimensions and 42 items; patient safety grade, number of events reported and factors contributing to the adverse events. Results: The overall median% score for perception of patient safety culture at the facility level was 68.6%. After controlling of the confounders; being female respondent, being physicians or nurses or midwives, having long experience in PHC service and receiving education and training about safety issues were positively associated with positive response on patient safety culture scale. The domains with the highest positive score and are thus considered areas of strength were teamwork within units (80.0%), management support for patient safety (80.0%), supervisor expectations and actions promoting patient safety (75.0%) and handoffs and transitions (75.0%). Dimensions scoring the lowest and as such can be considered areas requiring improvement were overall perceptions of patient safety, frequency of events reported and staffing (60% give positive response for each). More than two-fifths (43.6%) did not report any events in the 12 months preceding the survey. The difference between professions regarding the most common procedure that causes adverse event is statistically significant. Patients' related factors such as ignorance and socio cultural acceptance were reported to be the most common factors contributing to the adverse events (92.4% of the studied participants reported that). Conclusions: Improving patient safety culture should be a priority among health center administrators. Healthcare staff should be encouraged to report errors

Background: Ultrasonography is widely utilized by emergency physicians and radiologists to diagnose various orthopaedic diseases, including fractures. We aim to derive a definitive estimate of the diagnostic accuracy of ultrasonography in clinically suspected scaphoid fractures. Methods: We undertook a systematic review and meta-analysis of included diagnostic cohort studies that discussed the use of ultrasonography in the diagnosis of occult scaphoid fractures. We searched the National Institute for Health and Care Excellence database using the Healthcare Databases Advanced Search tool. In addition, we utilized the PubMed database to search the Medical Literature Analysis and Retrieval System Online, Excerpta Medica database, Cumulative Index of Nursing and Allied Health and Allied and Complimentary Medicine databases. Studies were included if they discuss the role of ultrasound imaging in the diagnosis of scaphoid fractures based on cortical interruption, radio-carpal effusion and scapho-trapezium-trapezoid effusion. Quality assessment was performed using the methodological index for non-randomized studies scoring system. Results: 6 non-randomized control studies met the inclusion criteria. Collectively, these included 236 patients with a mean age ranging from 18 to 41.2 years. The quality of these articles ranged between moderate and high based on the methodological index for non-randomized studies score. The mean sensitivity was 88.95% (standard deviation 10.03) and mean specificity was 89.50% (standard deviation 12.21). Conclusion: The current literature reveals high sensitivity and specificity in the use of ultrasonography in scaphoid fracture diagnosis. However, multiple factors including technical differences in ultrasound machines and probes, small sample sizes and variability of subsequent confirmatory tests have created a challenge in determining the ultimate reliability of ultrasonography in the diagnosis of occult scaphoid fractures. Considering these factors and limitations, large-sample and high-quality clinical trials are needed to adequately assess its reliability for this purpose. One stop clinics, in the authors’ opinion, would be an ideal setting for its introduction as well as for future trials.