Search

Purpose: Screening investigations are group of tests designed to the risks of subsequent disease or early detection of diseases in apparently healthy individuals. Seeking for screening tests is influenced by awareness of the individuals about its importance. The current study aimed at estimating the level of awareness about screening investigations among attendants of the primary health care centers. Methodology: Through a cross-sectional design, 389 attendants were randomly selected form four primary health care centers in Jeddah governorate, they responded to a predesigned questionnaire including items reflecting awareness of the respondents about the importance and types of screening investigations in the primary health care centers. Data entry and statistical analysis were done using Statistical Package for Social Science (SPSS) version (26). The awareness scores were tested for normality using Shapiro Wilk’s test, accordingly, for testing significance in difference between two subgroups. Independent sample t test was used, and ANOVA test was used for more than two groups. To detect significant factors predicting the level of awareness, linear logistic regression was used. Statistical significance was set at P-value

The study discussed the physiological changes of pregnancy in Sudanese pregnant women the study aimed to assess the effect of pregnancy in Red blood cell, Packed Cell Volume (PCV) and hemoglobin among Sudanese pregnant women, and to correlate the PCV as an indicator of hemodilution in different trimesters among Sudanese women using or not using iron and folic acid supplement. The researcher used across sectional study which applied on 300 pregnant women presented to Port-Sudan obstetrical Hospital for antenatal care from 2019 to 2020. The samples were collected with Chemically clean and sterile disposable needles, syringes and swab were used for all blood samples, 4.5 mL of blood was collected from each participant into a tube containing the anticoagulant Ethylene Diamine Tetraacetic Acid (EDTA), gently mixed the tube five to six times A full blood count was performed using Hematological analyzer (Sysmex XP 300). The study found out that 90 women in each trimester of pregnancy (first, second and third) the mean value of Hemoglobin (Hb) in pregnant women was 11.3±1.4 g/dl, 11.4 ±1.4 g/dl and 10.3±1.2 g/dl in 1st, 2nd and 3rd trimester respectively. The study also found out that the mean value of PCV was 33.35%. Moreover, Hb was lower during 3rd trimester compared with 1st (hemodilution). The cut off level for anemia in Sudanese non pregnant females could be even lower than 11g/dl as the normal level was found to be lower than the international one. Due to hemodilution anemia in pregnancy is considered if Hb less than 9g/dl. The study recommends that diagnosis of anemia should be revised during pregnancy as this study has shown Hb level less than 9g/dl (66%) can be the cut off level.

Background: Prostatectomy is a common procedure to remove the prostate gland, most often for prostate adenocarcinoma, although occasionally performed for benign prostatic hyperplasia. This study aimed to: Assess the pre and postoperative voiding habits among patients undergoing prostatectomy. Research design: Descriptive research design was utilized in carrying out this study. Setting: The study was conducted at Benha University Hospital in Urology Department. Subjects: The study was conducted on 105 patients undergoing prostatectomy. Study tools:Data were collected by using two toolsI:Structured interviewing assessment to assess, patients' socio-demographic characteristics, patients' clinical information, and life style changes characteristics. II:Pre and postoperative voiding habits questionnaire Results: 40.0%of the studied patients aged 50 years old and more. 66.7% of them had total healthy lifestyle score.There were highly statistically significant differences in all items related the studied patients' voiding habits between pre and postoperative. There were highly statistically significant positive correlations between the studied patients' voiding habits and their lifestyle characteristics. Conclusion: There were highly statistically significant differences in all items related the studied patients' voiding habits between pre and postoperative. There were highly statistically significant positive correlations between the studied patients' voiding habits and their lifestyle characteristics related to dietary habits, smoking habits, personal hygiene, stress, and sexual practices. While there were no statistically positive correlations between the studied patients' voiding habits and their activities as well as exercises, sleep and comfort. Recommendations: This study recommended conducting a study on the aspects of patients and knowledge, attitude, and practices towards prostate cancer. Establishing of an educational program to improve health related quality of life for prostate cancer patients. The same study should be replicated for a large sample size from different geographical areas to generalize the results.

Background: Coronary artery disease is a major cause of morbidity and mortality throughoutthe world. Health educational intervention can improve Physical function of CAD patients. Aim ofthis study was to evaluate effectiveness of educational intervention on physical function amongcoronary artery disease patients. Research Design: A quasi experimental research design wasutilized. Setting: This study was conducted in coronary care units and outpatient cardiac clinic atBenha University Hospitals. Sample: A purposive sample of 86 patients with coronary arterydisease was included in the study. Tools of data collection: Two tools were used to collect the data;1) interviewing questionnaire included patients` knowledge and physical function assessment. 2)Practical Checklist. Results: The highest percentage were male more than 50 years, 73.3% havingchronic disease mainly hypertension. There were statistically significant difference in patients’knowledge, physical function and patients’ practice (p

The aim of the current study is to review the molecular characteristics of Neisseria meningitidis (N. meningitidis) in Hamad Medical Corporation, which is the provider of secondary and tertiary care in the state of Qatar. A total of 39 isolates of N. meningitidis from the period of 2013 to 2018 were revived and identified by Vitek, and susceptibility on the basis of the E test was retrieved from the patient’s files. The revived isolates were subjected to multilocus sequence typing. The most common serogroup (19) of N. meningitidis was W135, of which 12 were isolated from blood and CSF. ST-11 was the most predominant ST clonal complex causing N. meningitidis cases (61.53%). Clonal complex ST-41/44 was the second most observed complex (3, 2 of which were related to serogroup B). The most frequent sequence type was 9596 (8 isolates). Determining the molecular pattern of N. meningitidis in Qatar is helpful for understanding the strains circulating in Qatar, and the study of the resistance trend of such strains may be very helpful for empirical treatment of future patients.

Background: Hepatitis C Virus (HCV) is an important public health problem in both developedand developing countries specifically Egypt which contains the highest prevalence of hepatitis C inthe world. The aim of this study was to assess acute hepatitis C patients’ performance regardingself-care management for complications prevention. Research design: A descriptive researchdesign was used. Setting: this study was conducted in hepatic department at Benha Fever Hospital.Sample: A purposive sample of 120 acute hepatitis C patients admitted in the previous mentionedsetting. Tool: Patients’ interviewing questionnaire that included the following parts; sociodemographic characteristics, knowledge and self-reported practice assessment regarding self-caremanagement. Results: More than half of studied subjects had unsatisfactory knowledge score andadequate practice score regarding self-care management. There was no statistically significantrelation between patients' knowledge and their demographic data. There were statisticallysignificant relations between patients’ practice and their demographic data; marital status,educational level and gender. While, there were no statistically significant relation betweenpatients’ practice and age, residence, occupation, monthly income P˃0.05. Conclusion: Nearly twothirds of the studied subjects had unsatisfactory knowledge score regarding HCV and self-caremanagement for complications prevention. However, more than half of them had adequate self-caremanagement practice. The study recommended that development of health education program forHCV patients and their families to teach them how to apply self-care management practices forcomplications prevention is very important.

Objective The challenge of employing evidence-based practice (EBP) is multifarious and varied. Nursing interventions supported by research evidence have been exposed to progress positive patient outcomes, while its implementation is faced with various obstacles. This study aimed to identify obstacles in employing EBP by nurses in their clinical settings. Methods This descriptive design study was conducted at Benha University Hospital with a convenient sample of 154 nurses. Two tools were utilized: (I) sociodemographic data sheet, which included sociodemographic characteristics of the participants, and (II) interview scale, which contained two parts: (1) obstacles scale, which contained obstacles that impede nurses from the utilization of EBP, and (2) questions to rank the three greatest obstacles in employing EBP by nurses. Results The greatest EBP obstacle ranked by nurses was the organizational limitations (90.9%), followed by research quality (86.9%) and research accessibility (51.0%), while individual characteristics (35.9%) were ranked as the least obstacle. There was a significant statistical correlation between organizational limitations, research quality as well accessibility-related obstacles and nurses’ age, level of education, as well their years of work experience (P Conclusions Findings of this study showed series of obstacles in employing EBP by nurses in their clinical settings, stressing the call for expansion of nurses’ capabilities related to EBP utilization in patients’ care.

Highlights • Candida. auris can cause invasive infections, including bloodstream, urinary tract, skin and ssoft tissue and lower respiratory tract infections. • Identification of C. auris requires specialized laboratory methods. • C. auris is associated with high morbidity and mortality. • C. auris isolates were resistant to the common antifungal agents such as fluconazole and amphotericin B., Background and objectives So far there have been no studies on Candida auris in Qatar. This study aimed to describe the clinical spectrum and outcome of C. auris infection in patients admitted to a general hospital in Qatar. Methods We conducted this descriptive observational study in a general hospital in Qatar. We have involved all patients with C. auris infection and colonization admitted to a general hospital from December 2018 to August 2019. Results We identified 13 patients with confirmed C.auris infection/colonization, of which five cases represented an actual C. auris infection, while the remaining eight cases were considered as colonization. The mean age of the patients with infection was 76.6 ± 8.4 years, while the mean age of the patients with colonization was 66.4 ± 24.7 years. Among the individuals clinically infected with C. auris, two had urinary tract infections, one had candidemia, one acquired soft tissue infection, and one had a lower respiratory tract infection. All strains of C. auris were susceptible to echinocandins, flucytosine, and posaconazole while resistance to fluconazole and amphotericin B. Of the patients with C. auris infection who received systemic antifungal therapy, three (60%) died during antifungal therapy. Conclusion Our study showed that C. auris can cause a wide variety of invasive infections, including bloodstream infection, urinary tract infection, skin infection, and lower respiratory tract infections, especially in critically ill patients. In addition, our isolates showed resistance to the most common antifungal agents such as fluconazole and amphotericin B.

Objective Ileus usually occurs after abdominal surgery and is allied with complication and delays recovery. It is hypothesized that chewing gum reduces postoperative ileus by improving early recovery of gastrointestinal function. This study aimed to explore whether chewing gum after appendectomy accelerates the recovery of gastrointestinal function. Methods Randomized control trial was used in this study. This study was conducted in the General Surgery Department at Zagazig University Hospital. A total of 240 patients undergoing appendectomy were involved in this study; they were divided into the chewing sugar-free gum group (120) and the control group (120). Two tools were utilized in this study. Tool I: Structured Interviewing Schedule: part 1: assessment of personnel characteristics. Part 2: assessment of anthropometric measurements of the studied subjects as well as pre- and intraoperative indicators of them. Tool II: postoperative assessment sheet: assessed postoperative parameters of the intestinal function, occurrence of postoperative ileus, and related symptoms were assessed among studied participants. Results There were highly significant statistical differences in the time of resumption of gastrointestinal functions and postoperative ileus symptoms between the two groups (P <0.001), which was significantly shorter in the chewing gum group compared to the control group. Conclusions The use of chewing gum is a useful and cheap method that can be employed to cut down the time to recover and accelerate normalization of gastrointestinal function. Chewing sugar-free gum after abdominal surgery is recommended to be added to the protocol of nursing care in the surgery units as well as its involvement in the nursing curriculum.

Background:Candida auris is an invasive, multidrug-resistant pathogen that can cause outbreaks in hospitals. The mode of transmission is through contaminated hospital items such as fomites and staff interventions. The outbreak of Candida auris affecting 13 patients at the medical intensive care unit (MICU) and medical inpatient unit, either in the form of infection or colonization, is the first documented C. auris outbreak in the Qatar. Methods: The first case was identified in November 2018 in a patient colonized in the respiratory tract. Candida auris biweekly tests were conducted. The second to fourth cases were confirmed in the MICU admitted in the same room (room 2). The fifth case was identified incidentally and was not part of the screening in another ward (6 North Medical Inpatient Unit), and 4 weeks later, Candida auris was isolated from the urine and throat of a patient on this ward. The realization that case 5 was an index case changed the direction of the outbreak investigation, and expanded screening was started among the medical inpatients. When the IPC team identified cases 6–11 and 13, all had possible epidemiological links with case 5. Results: Our root-cause analysis suggests that the index case came from another general hospital. However, because no screening protocol has been established for Candida auris, interventions have not been in place to effectively prevent and control this organism. A strong collaborative outbreak team worked to end this outbreak using the following evidence-based IPC interventions: (1) patient screening and decolonization; (2) environmental screening; (3) enhanced environmental disinfection using peracetic acid wipes, 1% chlorine, and hydrogen peroxide vapor disinfection; (4) prophylactic contact precautions; (5) enhanced hand hygiene with bare below elbows protocol; and (6) a no white gown policy. Conclusions: The outbreak of Candida auris was declared to have nbeen terminated on August 22, 2019. Despite the long period involved in this outbreak, we succeeded in ending it through the concerted efforts of a multidisciplinary team utilizing the latest scientific evidence.Funding: NoneDisclosures: None

Background: So far, there have been no studies on Candida auris in Qatar. We describe the clinical spectrum and outcome of C. auris infection in patients admitted to a general hospital in Qatar. Methods: We conducted this descriptive observational study in a general hospital in Qatar. We have included all patients with C. auris infection and colonization admitted to a general hospital from December 2018 to August 2019. Results: We identified 13 patients with confirmed C. auris infection or colonization, of whom 5 cases represented an actual C. auris infection, while the remaining 8 cases were considered colonization. The mean age of the patients with infection was 76.6 years (SD, ±8.4), while the mean age of the patients with colonization was 66.4 years (SD, ±24.7). Among the individuals clinically infected with C. auris, 2 had urinary tract infections, 1 had candidemia, 1 acquired a soft-tissue infection, and 1 had a lower respiratory tract infection. All strains of C. auris were susceptible to echinocandins, flucytosine, and posaconazole while resistant to fluconazole and amphotericin B. Of the patients with C. auris infection who received systemic antifungal therapy, 3 (60%) died during antifungal therapy. Conclusions: Our study showed that C. auris can cause a wide variety of invasive infections, including bloodstream infection, urinary tract infection, skin infection, and lower respiratory tract infections, especially in critically ill patients. In addition, our isolates showed resistance to the most common antifungal agents such as fluconazole and amphotericin B.Funding: NoDisclosures: None

The objective of our study was to describe the molecular support of carbapenem resistance from randomly selected clinical isolates of multidrug-resistant (MDR) Acinetobacter baumannii as a pilot study from the Hamad Medical Corporation (HMC), Qatar. Results of our report will be used to study carbapenemases using molecular techniques in all isolated MDR A. baumannii. Forty-eight MDR A. baumannii were randomly selected from isolates preserved at HMC. Identification of all isolates was confirmed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Antibiotic resistance was tested phenotypically by Phoenix and confirmed by Etest. The molecular support of carbapenemases (blaOXA-23, blaOXA-24, blaOXA-58, blaNDM) was investigated by real-time PCR. The epidemiologic relatedness of the isolates was verified by phylogenetic analysis based on partial sequences of CsuE and blaOXA-51 genes. All 48 isolates were identified as A. baumannii and were confirmed to be resistant to most antibiotics, especially meropenem, imipenems, ciprofloxacin, levofloxacin, amikacin, gentamicin and most of the β-lactams; they were sensitive to colistin. All the isolates were positive for blaOXA-23 and negative for the other tested carbapenemase genes. Clonality analysis demonstrated that different lineages were actually circulating in Qatar; and we suggest that an outbreak occurred in the medical intensive care unit of HMC between 2011 and 2012. Here we report the emergence of MDR A. baumannii producing the carbapenemase OXA-23 in Qatar.

Objectives We sought to describe the epidemiological and clinical features of typhoid fever in Qatar. Methods We conducted a retrospective study of adult patients treated for typhoid fever at Hamad General Hospital and Alkhor Hospital between 2005 and 2012. Results The mean age of the 354 patients enrolled in the study was 28.4±9.3 years; 296 (83.6%) were males. There were 42, 48, 39, 44, 46, 47, 52, and 36 cases of adults with typhoid fever in 2005, 2006, 2007, 2008, 2009, 2010, 2011, and 2012, respectively. Overall, 343 (96.9%) patients had a history of travel to endemic areas. Among them, 93.0% acquired typhoid fever in the Indian subcontinent. Fever was observed in all cases, and the other predominant symptoms were abdominal pain (38.1%), diarrhea (35.6%), and headache (33.1%). Salmonella typhi, showed high resistance to ciprofloxacin (n = 163; 46.0%), and low resistance to ceftriaxone (n = 2; 0.6%). Four patients developed intestinal perforation, which was surgically repaired in two cases. Two patients (0.6%) died. Conclusions Typhoid fever was frequent among immigrants to endemic areas. Travelers returning from endemic areas with suspected typhoid fever should be treated empirically with third-generation cephalosporin after obtaining appropriate cultures. Moreover, preventive measurements such as education on food and water hygiene, and effective vaccination of travelers should be practiced widely among travelers to endemic areas to reduce morbidity and mortality.

Hand Hygiene is the cheapest and simplest way to prevent the spread of infection, however international compliance is below than 40% (WHO, 2009). In the experience of Al Wakra Hospital, the improvement in hand hygiene compliance highlighted not just interventions towards training and education but also behavioral motivation and physical allocations of hand hygiene appliances and equipment. Through motivating the behavioral, emotional, physical and intellectual dimensions of the different healthcare worker professions, hand hygiene compliance has increased from 60.78% in 2011 to 94.14% by the end of December 2015. It took 25 months of continuous and collaborative work with different healthcare workers to reach the 90% hand hygiene target. "Together, we have reached our goals and together we fight against infections! Because we always strive for excellence in everything we do - that is our vision here in Al Wakra Hospital."

Background There are limited data describing carbapenem-resistant Enterobacteriaceae (CRE) from the Arabian Gulf region. Our aims were to describe the clinical, microbiological and molecular characteristics of CRE infections and to characterize the gene displaying resistance to carbapenem. Methods Retrospective and prospective review of clinical, microbiological and molecular characteristics of CRE isolated between April 2015 and November 2017 at 7 tertiary hospitals in Qatar. Susceptibility testing was performed and interpreted according to Clinical Laboratory Standards Institute methodology and breakpoints. Carbapenemase genes were identified using PCR. Whole-genome sequencing followed by bioinformatics analysis was performed on a subset of samples for accurate detection of resistant genes. SPSS V.21.0 was used for all statistical analyses. Results A total of 144 nonrepeating CRE strains were recovered from 137 individuals over the study period, of which 35 (24.3%) represented colonization. Klebsiella spp. (98, 68.1%) and E. coli (38, 26.4%) were the most predominant. The most prevalent carbapenemases were NDM (69, 47.9%), OXA-48 (36, 25.0%), and KPC (15, 10.4%). Sixteen (11.1%) strains possessed multiple carbapenemase genes but none were detected in 37 (25.7%) strains. Genomic analysis also detected the presence of NDM-7, NDM-5, NDM1, VIM4, and OXA48-like carbapenemase genes among 34 clinical samples. The majority of the strains were susceptible to tigecycline (124, 86.1%), fosfomycin (122, 84.7%) and amikacin (102, 70.8%). There were 109 CRE infections involving the urinary tract (40, 36.7%), bloodstream (31, 28.4%), and respiratory tract (17, 15.6%). Fifty-seven (52.3%) were males and the median age was 57 years (range 3–97). Baseline comorbidities included diabetes (57, 52.3%), chronic kidney disease (27, 24.8%), and cancer (27, 24.8%) (Table 1). Within the 30 days preceding CRE infection, 38 (34.9%) had received carbapenem therapy, 65 (59.6%) had undergone invasive procedures and 33 (30.3%) had had surgery. All-cause 30-day mortality was 29.4%. The only variable independently associated with mortality was baseline SAPS Score (Table 2). Conclusion NDM and OXA-48 are the predominant carbapenemases in Qatar. CRE infections are associated with high overall mortality. Disclosures All authors: No reported disclosures.

Luce and Smith discuss death certification reforms,12 which will also improve other aspects of healthcare quality. Mortality is the most important performance indicator for healthcare organisations. Local programmes of mortality review—including establishing whether the death was avoidable and what lessons can be learned to reduce …

Background: Breast cancer is a global health emergency and it is the principal reason of cancer related deaths in Developing Countries owing to the prevailing cultural beliefs and lack of awareness among women. This study aimed to evaluate the effect of health belief model-based education about breast cancer on nursing students' knowledge, health beliefs and breast self-examination practice.Subjects and Methods: A quasi-experimental design was utilized. Setting: The study was conducted at the Faculty of Nursing, Benha University, Benha city. A purposive sample of 104 nursing students were included in the study and divided into a study group (52) and control group (52). Three tools were used for data collection; first tool: self-administrated questionnaire to collect data about the subjects' socio-demographic characteristics, and knowledge regarding breast cancer. Second tool: the health belief model scale. Third tool: an observation checklist to assess the nursing students' practice of breast self-examination.Results: A statistically significant differences were observed between the study and control groups regarding knowledge about breast cancer after educational intervention based on health belief model (t test = 19.53, P=0.000). The mean scores of perceived susceptibility, severity, benefits, cues for action, self-efficacy and total heath belief model were significantly higher in the study group compared to control group (P = 0.000). Moreover a statistically significant difference was observed between both groups regarding breast self-examination practice after educational intervention (t test = 31.266, P= 0.000).Conclusion and recommendation: The health belief model based education is an effective and efficient manner in enhancing girls’ breast self-examination practice and improving their knowledge level and health beliefs about breast cancer. Thus the current study recommends implementing health belief model based educational intervention about breast cancer at different stages of life and settings to reach all targeted women to fight the disease.

Background: Coronary artery disease is a major cause of morbidity and mortality throughout the world. Modification of life style can be achieved by patients' education to improve their health status. Aim: To evaluate effect of lifestyle modification intervention on health status of coronary artery disease patients. Design: Randomized control trial used to achieve the aim of this study. Setting: The current study conducted at the coronary care unit and cardiology out-patient clinics of Benha University Hospital, Benha City. Subjects: Purposive sample of 92 coronary artery disease patients (study and control) were included in the study. Tools: Two tools used in this study 1) Interview questionnaire. 2) Health status questionnaire. Results: Significant percentage of the study participants from both groups were adhered to unhealthy life-style practices as smoking, eating salty and fatty foods, drinking tea and coffee as well as they didn't practice exercises and recreational activities. After lifestyle modification intervention, there were significant statistical differences between the two groups favoring the study group regarding all aspects of health status; physical function, bodily pain, social function, role limitation due to physical or emotional problems and mental health (P

Susceptibility testing using the EUCAST-AFST method against 39 clinical Fusarium strains consecutively collected from local and invasive infections during the last 10years assessed the in vitro activities of amphotericin B (AmB) and triazole antifungal agents. In addition, the susceptibility pattern of 12 reference strains from the CBS-KNAW Fungal Biodiversity Centre (CBS) was evaluated. In particular Fusarium petroliphilum and F. solani sensu lato were involved in disseminated infections and known for treatment failure. AmB displayed the lowest MICs followed by voriconazole VRC, posaconazole (POC). Itraconazole (ITC) showed high MIC values, displaying in vitro resistance. Clinical isolates were significantly (P