Amal Sedrak

BACKGROUND: Increasing knowledge and awareness of cancer screening significantly influence health promotion behavior which could markedly reduce incidence rates. In many countries, health care providers are the principal source of information concerning cancer screening. This study was carried out to assess the level of knowledge concerning cancer screening among medical students, house officers and residents and to explore their attitude towards cancer screening practices.

MATERIALS AND METHODS: This cross-sectional study was conducted in Kasr Al Ainy Medical School at Cairo University in Egypt, with 300 undergraduate medical students and 150 postgraduates (interns and residents) enrolled. A pre-tested self-administered questionnaire was used to collect data from the study participants regarding personal and education-related information, knowledge about cancer screening and its sources, and attitude towards cancer screening.

RESULTS: More than 64% of participants had knowledge scores of ≤ 10 points (out of 24). The total knowledge score (out of 6 points) for breast cancer screening increased from 1.9±1.0 to 2.3±1.2 and 2.4±1.1 for 4th, 5th and 6th year respectively, interns showed the highest score of 2.6 ±1.1, P= 0.001. Year of enrollment at medical school was a significant positive predictor of acquiring knowledge about cancer screening (post graduate vs. undergraduate students) (OR= 1.30, C.I =1.01-1.63), lack of or none receiving of orientation/training about cancer screening was the sole negative significant predictor for proper knowledge about cancer screening (OR=0.50, C.I=0.31-0.82). Over 92% of students agreed that they had insufficient knowledge about cancer screening, 88.2% appraised the need to have enough knowledge in order to direct/advice patients, relatives and friends, and 93.7% required that the faculty should emphasize the importance of cancer screening in the delivered curricula at medical school.

CONCLUSIONS: A relatively low to moderate level of knowledge about cancer screening was detected among the selected medical students regardless of their year of enrollment at medical school or their graduation status, which may implicate a negative impact on early cancer detection especially in a low resource country like Egypt.

BACKGROUND: Early identification of septic patients at risk of mortality is important in their prognosis.

OBJECTIVE: Identification of septic patients at risk of mortality in Pediatric Intensive Care Units (PICUs) at Cairo University Hospitals, through measuring the levels of certain immunological parameters.

METHODS: A hospital-based prospective cohort study was conducted in two PICUs at Cairo University Hospitals; all patients with diagnosis of severe sepsis or septic shock on admission were included. A total of 57 patients were prospectively followed at the selected PICUs and their demographic and clinical data were recorded. Microbiological and immunological workup (at days 1 and 7) was conducted for all patients to detect the causative organism of sepsis and to measure the levels of immunoglobulins (IgG, IgM and IgA), complement factors (C3 and C4), mature lymphocyte subpopulations (CD3+) and natural killer (NK) cells (CD3-CD16+CD56+), respectively.

RESULTS: Mortality rate was 24.6%; the most frequent causes of death were multi-organ dysfunction and refractory shock. PELOD and PRISM III scores were significantly higher among non-survivors. At day 1, non-survivors had significantly higher levels of IgG, C4 and NK cells than survivors. However, from day 1 to day 7, survivors had a progressive increase in most of the immunological parameters (IgG, IgM, C4and CD3+ T lymphocytes). Survival curve analysis revealed the significant predictive ability of NK cells to detect early mortality.

CONCLUSION: Monitoring the levels of cellular and humoral immunological parameters together with assessing PELOD and PRISM III scores can significantly affect prognosis and survival of septic children.