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1. Physicians Concerns toward COVID-19 Vaccines

Author

Abdelraouf S, Ibrahem R, Aziza Saad El-Badry, and Marawan H

Subjects
Vaccination, medicine.medical_specialty, Isolation (health care), Coronavirus disease 2019 (COVID-19), business.industry, Family medicine, Health care, medicine, Residence, Odds ratio, Disease, business, Work experience
Abstract

Introduction: Vaccination is a successful method of controlling infectiousviral diseases, which may play a major role in virus spread limitation.Aimof Work: To assess the concerns of Egyptian physicians towards COVID-19vaccines and its associating factors. Materials and Methods: A crosssectionalstudy was conducted on 1026 Egyptian physicians; through a selfadministeredquestionnaire covering socio-demographic data and physicianconcerns toward COVID-19 vaccine was used. Results: Among 1026 studiedphysicians (their age ranged from 25 to 57 years, with a mean of 39.46±10.17),58.7% were male and 56.8% were from an urban residence. More than halfof physicians (56.9%) worked at a secondary care level and 21.7% of themworked at a tertiary care level, 48.8% of participants were specialists and19.3% were consultants. The mean duration of work experience was 12.94±7.54 and ranged from 2 – 25 years. Nearly half of the participants (49.8%)had COVID 19 disease before. Most of the studied physicians (74.9%) did notattend COVID-19 vaccine awareness campaigns. Binary logistic regressionanalysis showed that the significant independent predictors of high concernscore were working in a COVID-19 isolation unit, work experience more than10 years, history of COVID 19 infection, and attending vaccine awarenesscampaigns (odds ratio, 3.15, 2.0, 2.88 & 3.5 respectively). Conclusion:Healthcare workers’ concern score toward COVID-19 vaccine is of primeimportance as it drives them to accept or refuse to take the vaccine and HCWswere considered as a confident source of health information and advice to thepublic. The modifiable factor that improves vaccine concern was attendingCOVID-19 awareness campaigns about COVID-19 vaccine, so continuing andincreasing awareness campaigns about COVID 19 vaccine is warranted.

Published
2021

2. NECK AND UPPER LIMB PAIN AMONG GYNECOLOGISTS WORKING AT MENOUFIA GOVERNORATE IN EGYPT

Author

Marawan H, El-Badry A, and Allam H

Subjects
Working hours, medicine.medical_specialty, Medical treatment, business.industry, Upper limb pain, Human factors and ergonomics, Clinical Practice, medicine.anatomical_structure, Statistical analyses, Sick leave, Physical therapy, medicine, Upper limb, business
Abstract

Introduction: Little attention was paid to explore the prevalence of neck and upper limb pain among gynecologists particularly those who perform laparoscopic procedures.Aim of work: To assess the frequency of pain in the neck and upper limbs among gynecologists working at Menoufia governorate in Egypt and to explore common risk factors. Materials and methods: A pre-designed questionnaire was sent to 642 gynecologists who worked at Menoufia governorate in Egypt; 583 were returned (90.8%). Descriptive and analytical statistical analyses were performed to assess the frequency of pain in neck and upper limb and to detect their risk factors. Results: Among 583 gynecologists, 293 (50.3%) were male and 290 (49.7%) were females; age ranged from 27 to 60 years old, out of them 315 (54.03%) experienced neck and/or upper limb pain. Most of the affected participants experience pain 1-2 times/week (80.6%), received medical treatment for pain (92.7%), applied for sick leave 1-2 times/month (77.1%) and taught that attaining certain posture while operating is the main cause of their pain (73.3%). Age above 45 years (odd’s ratio 1.45), clinical practice over 15 years, laparoscopic procedures (odd’s ratio 1.88), more than ten operations per week (odd’s ratio 2.78) and operations took more than one hour (odd’s ratio 2.10) increase the risk for developing neck and/or upper limb pain. Conclusion: This study revealed that neck and/or upper limb pain is common among gynecologic laparoscopists. Adoption of ergonomic posture and decreasing working hours when performing laparoscopic procedures may help to minimize the risk of a work-related pain. Future research should explore the implementation of ergonomic guidelines and correlation with subsequent improvement of outcome.

Published
2018

4. Methyldopa versus nifedipine or no medication for treatment of chronic hypertension during pregnancy: A multicenter randomized clinical trial.

Author

Salama M, Rezk M, Gaber W, Hamza H, Marawan H, Gamal A, and Abdallah S

Subjects
Administration, Oral, Adult, Antihypertensive Agents administration & dosage, Egypt, Female, Humans, Infant, Newborn, Methyldopa administration & dosage, Nifedipine administration & dosage, Pregnancy, Prenatal Diagnosis, Treatment Outcome, Young Adult, Antihypertensive Agents therapeutic use, Hypertension drug therapy, Hypertension, Pregnancy-Induced drug therapy, Methyldopa therapeutic use, Nifedipine therapeutic use, Pregnancy Complications, Cardiovascular drug therapy
Abstract

Objective: To assess the maternal and fetal outcome in women with mild to moderate chronic hypertension on antihypertensive drug (methyldopa or nifedipine) therapy compared to no medication., Methods: This multicenter randomized clinical trial was conducted at Menoufia University hospital, Shibin El-kom Teaching hospital and 11 Central hospitals at Menoufia governorate, Egypt.490 pregnant women with mild to moderate chronic hypertension were randomized into three groups; methyldopa group (n = 166), nifedipine group (n = 160) and control or no medication group (n = 164) who were followed from the beginning of pregnancy till the end of puerperium to record maternal and fetal outcome., Results: Mothers in the control (no medication) group were more prone for the development of severe hypertension, preeclampsia, renal impairment, ECG changes, placental abruption and repeated hospital admissions (p < 0.001) when compared to mothers in both treatment groups (methyldopa and nifedipine). Neonates in the control (no medication) group were more prone for prematurity and admission to neonatal ICU (p < 0.001)., Conclusion: Antihypertensive drug therapy is advisable in mild to moderate chronic hypertension during pregnancy to decrease maternal and fetal morbidity. When considering which agents to use for treatment, oral methyldopa and nifedipine are valid options., (Copyright © 2019 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.)

Published
2019
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5. Effects of a levonorgestrel intrauterine system versus a copper intrauterine device on menstrual changes and uterine artery Doppler.

Author

Rezk M, Elshamy E, Shaheen AE, Shawky M, and Marawan H

Subjects
Adult, Contraceptive Agents, Female, Egypt, Female, Humans, Ultrasonography, Doppler, Uterine Artery diagnostic imaging, Young Adult, Intrauterine Devices, Copper, Intrauterine Devices, Medicated, Levonorgestrel administration & dosage, Menorrhagia drug therapy, Uterine Artery drug effects
Abstract

Objective: To compare the effects of a levonorgestrel-releasing intrauterine system (LNG-IUS) and a copper intrauterine device (Cu-IUD) on menstrual changes and uterine artery Doppler indices., Methods: A randomized clinical trial was conducted at Menoufia University Hospital, Egypt, between December 2016 and August 2017. 306 multiparous women desiring intrauterine contraception were randomly assigned to LNG-IUS (n=152) or Cu-IUD (n=154). Uterine artery pulsatility index (PI) and resistant index (RI) were measured before use, and 3 and 6 months after insertion, and associations with abnormal bleeding were evaluated., Results: Irregular bleeding was initially reported by 31 (74%) of 42 women in the LNG-IUS group, and heavy menstrual bleeding by 53 (67%) of 79 women in the Cu-IUD group. Incidence of abnormal bleeding decreased over the 6-month study period. Uterine artery PI was significantly correlated with abnormal bleeding at a cutoff of 1.35 with area under the curve (AUC) 0.93, sensitivity 88%, and specificity 100%, whereas uterine artery RI was significantly correlated with abnormal bleeding at a cutoff of 0.62 with AUC 0.1, sensitivity 96%, and specificity 100%., Conclusion: LNG-IUS-related abnormal bleeding was associated with changes in uterine artery blood flow that were not evident among Cu-IUD users. Pan African Clinical Trials Registry: PACTR201701001900640., (© 2019 International Federation of Gynecology and Obstetrics.)

Published
2019
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6. Lactoferrin versus ferrous sulphate for the treatment of iron deficiency anemia during pregnancy: a randomized clinical trial.

Author

Rezk M, Dawood R, Abo-Elnasr M, Al Halaby A, and Marawan H

Subjects
Adult, Female, Humans, Pregnancy, Young Adult, Anemia, Iron-Deficiency drug therapy, Ferrous Compounds therapeutic use, Hematinics therapeutic use, Lactoferrin therapeutic use, Pregnancy Complications, Hematologic drug therapy
Abstract

Objective: This study was conducted to evaluate the efficacy and safety of lactoferrin in comparison to ferrous sulphate for the treatment of iron deficiency anemia (IDA) during pregnancy., Materials and Methods: This prospective, randomized, parallel-group, single-center study was conducted in the Department of Obstetrics and Gynecology at Menoufia University Hospital, Egypt and included a total of 200 pregnant women in the second trimester with IDA who were enrolled and randomly assigned either to receive 150 mg of dried ferrous sulphate capsules or lactoferrin 250 mg capsules once daily for eight consecutive weeks. The primary efficacy parameter was the amount of increase in hemoglobin concentration by 4 and 8 weeks, the adverse effects related to iron therapy and the patient compliance to the treatment., Results: Total increase in Hb after 2 months with lactoferrin was higher (2.26 ± 0.51 g/dL) compared to ferrous sulfate (1.11 ± 0.22 g/dL) (p < 0.001). Gastrointestinal adverse events occurred more frequently with ferrous sulphate than the lactoferrin group (p < 0.001). The number of women requesting change the drug was higher in the ferrous sulphate group (p < 0.001)., Conclusion: Lactoferrin was more effective than ferrous sulfate over a two-month period in pregnant women with IDA, with fewer gastrointestinal adverse events and better treatment acceptability.

Published
2016
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