‫الجوهىرية اليونية‬

‫جاهعة حضرهىت‬
Republic of Yemen ‫كلية الطب والعلىم الصحية‬
Hadhramout University ‫قسن طب الوجتوع‬
College of Medicine and Health Sciences 2020 - 2018
Department of Community Medicine
2018-2020

AWARENESS OF DISC PROLAPSE AMONG

HADHRAMOUT UNIVERSITY STUDENTS IN
AL-MUKALLA DISTRICT 2018-2020

Group Five, Fourth Year

Supervisor: Dr. Khalid Ahmed Baeassa

Prepared by:
1. Abdullah Abdulkhaleq BinNuhaid 12. Mohee Al-deen Alzubidi
2. AbdurabhAbdulqwi Bin-Jathnan( 13. Mubarak Abdullah Sabba’a (Ch)
3. Ageel Mohsen Baras 14. Qamar Mohammed Shaya
4. Aisha Abdalwuhed Al-Jonaid 15. Reem Ahmed Bin-Swidan
5. Amal Aslam Mahmood 16. Safa Awad Aljaidi
6. Bushra Abubakr Alzubidi 17. Safa saeed Alakbri
7. Hussein Bin Al-Sheikh Abubkr (CoCh) 18. Sarah Khalid Bin-Lesud
8. Maha Salah Ba-wadi 19. Sumia Mahfoodh Baashan
9. Marwa Omer BinSaad 20. Tariq Abdulrraheem Al-Amoudi
10. Mohammed Hashem Bonemi 21. Jawaher Awadh Bin-lashram
11. Mohammed Saleh BaGhllab 22. Yousef Abdurrahman Wahoud
 Contents

Contents Pages
Introduction 1
Research questions 4
Research Objectives 5
Methodology 6
- Study design 6
- Study area 6
- Study population 6
- Sampling size estimation 7
- Sampling method 7-11
- Data collection 11
- Data analysis 11
- Ethical consideration 12
- Work plan 12
- Result 13-19
- Discussion 20-23
- Conclusion 23
- Recommendations 23
24-26
- References

Questionnaire ( English version )

Questionnaire ( Arabic version )

I
 Introduction

Disc Prolapse (DP) is a slipped or herniated disc, occurs when the gel-like, inner nucleus of

an intervertebral disc bulges or seeps through a weakened region in it is hard outer casing.[1]

Intervertebral discs are pads of fibrocartilage which lie between the vertebral bodies of the

spine.[2]

Disc-related diseases of the vertebral spine, such as lumbar and cervical disc herniation, are

common health problems and lead to work disability. In addition to establish risk factors such

as high-impact mechanical pressure due to manual materials handling, inflammatory and

atherosclerotic. Also, there are some risk factors association with unhealthy lifestyle-related

factors (for example, excess weight, smoking, and physical inactivity).[3] Men have roughly

twice the risk for lumbar herniated discs compared with women.[4] Jobs that require

heavy lifting and other physical labor have been linked to a greater risk of developing a lumbar

herniated disc. Pulling, pushing, and twisting actions can add to risk if they are done

repeatedly. Excess weight makes one more likely to experience a lumbar herniated disc and

12 times more likely to have the same disc herniate again, called a recurrent disc herniation,

after a micro discectomy surgery. Experts believe that carrying extra weight increase the stress

on the lumbar spine, making people who are obsess more prone to herniation.[5] Nicotine limits

blood flow to spinal discs, which speeds up disc degeneration and hampers healing.[6] A

degenerated disc is less pliable, making it more likely to tear or crack, which can lead to a

herniation.[7] The medical literature is mixed on whether people who smoke are at greater risk

for a new herniation following a discectomy.[8]Usually the symptoms of disc disease depending

on where the disc has herniated, and what nerve root it is pushing, these are some symptoms

1
 of disc disease; intermittent neck and back pain( sciatica). Pain that starts near the back and

buttocks and travels down the leg to the calf or into the foot, and spasm of the back muscle and

decreased reflexes may be noted.[9] In more advance cases these symptoms can convert into

complications such as Paresthesia, loss of sensation on lateral aspects of foot due to

impairment of nerve roots, decreased in ankle jerk reflex and decreased in planter flexion,

patient have difficulty in walking on the heel, loss of sensation in the lower back and urinary

retention due to compression of cauda equine nerves.[10]

In Pakistan of the determined locations L5/S1 was the commonest (34.6%) followed by

L4/L5 (33.4%). 24.2%of the patients had prolapsed disks at 2 levels (L3/L4, L4/L5 andL4/L5,

L5/S1). Prolapsed disc was commonest in the 31–49 year age group. Male were mostly

affected with male to female ratio of 2.02%. The most common surgery performed was

discectomy with fenestration (60.64% of total surgeries performed) and most common

postoperative complication being mechanical backache (4.8%).[10] A study in Taif city, Saudi

Arabia reported that the prevalence and risk factors of low back pain among nurses (48.41%)
[11 ]
were complained of low back pain and significantly more than male. Other study reported

that: A total of 477 patients with chronic low backache were included in the study out of which

274 (57.4%) were males. Age of the patients ranged from 19 to 75 (39.92±12.31) years. Out of

477 patients 38 (7.9%) had significant radiological evidence of disc prolapse at lumbar vertebral

levels.[12]

In Taif city, Saudi Arabia the sample distributed to 716 (69.2%) male and 318 (30.8) female

with common age group 18-28 years by percentage (52.8%), most of participant were Saudi 972

(94.0%) and universal and education level(60.2%). Most of sample haven't complaining of disc

prolapse with percentage (81.4%) and (53.8%) of participant have no family history, (66.5%)of

2
participant heard about disc prolapse and most of them have an information about the risk

factors of disc prolapse with highest percentage (81.6%) regard diagnosis of disc prolapse most

of participant answer MRI is the best modality for diagnosis of disc prolapse by percentage

(61.5%).Also, statistical significant difference between participants complaining of disc

prolapse, risk factors and demographic data P:≤0.05.[13]

There is no previous researches done in Al-Mukalla district, that aware people at the age of

18-27, which including the university students. And because of the this category, which also

have a higher risk to be affected by disc prolapse due to the asymptomatic character of it in early

stages. It is necessary for the students to acquire awareness, and integrate the necessary

precaution into their life style in order to avoid disc prolapse, and ensure early diagnosis.

Therefore, the present study will be conducted and aimed to investigate the awareness of disc

prolapse among Hadhramout University students (aged 18 – 27 years) in Al-Mukalla district.

3
 Research Questions

1. What is the level of student's awareness about the risk factors of disc prolapse among

Hadhramout University students (aged 18-27 years) in Al-Mukalla district?

2. What is the knowledge of the students about the diagnosis of disc prolapse among

Hadhramout University students (aged 18-27 years) in Al-Mukalla district?

3. What is the knowledge of the students about the prevention from disc prolapse among

Hadhramout University students (aged 18-27 years) in Al- Mukalla district?

4
 Research Objectives

General Objective:
To investigate the awareness of disc prolapse among Hadhramout University students

(aged 18-27 years) in Al-Mukalla district.

Specific Objectives:

I. To evaluate the level of student's awareness about the risk factors of disc prolapse among

Hadhramout University students (aged 18-27 years) in Al- Mukalla district.

II. To determine the student's awareness about diagnosis of disc prolapse among

Hadhramout University students (aged 18-27 years) in Al-Mukalla district.

III. To evaluate the student's knowledge about the prevention from disc prolapse among

Hadhramout University students (aged 18-27 years) in Al-Mukalla district.

5
 Methodology

 Study design:

A descriptive cross section study will be conducted by group (5) of fourth year medical students

of College of Medicine and Health sciences in Hadhramout University to investigate the

awareness of disc prolapse (DP) among Hadhramout University students in Al-Mukalla district

during 2019-2020.

 Study area:

The study will be conducted among all Colleges of Hadhramout University in Al-Mukalla district

during 2019-2020.

 Study population:

The study will be conducted among students of all colleges of Hadhramout University in Al-

Mukalla district during 2019-2020.

6
 Sample size estimation:

The sample size will be calculated by using the following formula:

(𝑧2) 𝑝𝑞
Sample size (n) =
𝑑2

Where n= the desired sample size.

z = certainty (for 95% use 1.96).

p= proportion of the characteristics in the population. (p=53%)

q= 1-p (1-0.53= 0.47)

d= precision or error allowable (using 0.05).

2 ×0.53× 0.47
n = (1.96) = 3.842 × 0.2491 = 0.95694256 = 382.8
(0.05)2 0.0025 0.0025

The sample size required was 383 university students.

We added 10% (38) as a drop out to the sample size to avoid any missing among university

students during data collection, so the sample size was increased to 421 university students.

 Sample method:

The sample will be selected by three stages sampling method as the following:

 First stage:

 At first will determined the number of colleges in Al-Mukalla district. There

are twelve colleges in Al Mukalla district.

7
  Secondly we selected randomly four colleges which are Arts, Administrative

sciences, Computers and information technology, Environmental sciences and

Marine biology.

 Thirdly we determined the total number of students in each college.

The sample size is 421 will be distributed proportionally among the chosen four

colleges according to the total number of students in each college.

Sample size required in each colleges:

𝑁𝑢𝑚𝑏𝑒𝑟𝑜𝑓𝑠𝑡𝑢𝑑𝑒𝑛𝑡𝑠 𝑖𝑛 each𝑐𝑜𝑙𝑙𝑒𝑔𝑒
× 421
𝑁𝑢𝑚𝑏𝑒𝑟𝑜𝑓𝑠𝑡𝑢𝑑𝑒𝑛𝑡𝑠 𝑖𝑛 f𝑜𝑢𝑟 colleges

College Number of students Sample size required

in each college

Arts 1413 148

Administrative sciences 1958 205

Computers and information technology 273 29

Environmental sciences and Marine Biology 377 39

Total 4021 421

8
  Second stage:

 Firstly we selected two departments from each college of the four colleges

randomly ,which are department of English language, Arabic language,

Accounting ,Business administration, Information technology, computer sciences,

Environmental sciences, and Marine Biology respectively

 Secondly we determined the total number of students in each department.

Sample size required in each department:

𝑁𝑢𝑚𝑏𝑒𝑟𝑜𝑓𝑠𝑡𝑢𝑑𝑒𝑛𝑡𝑠 𝑖𝑛 𝑒𝑎ch 𝑑𝑒𝑝𝑎𝑟𝑡𝑚𝑒𝑛𝑡

×𝑆𝑎𝑚𝑝𝑙𝑒 𝑠𝑖𝑧𝑒 𝑟𝑒𝑞𝑢𝑖r𝑒𝑑 𝑖𝑛 𝑒𝑎ch 𝑐𝑜𝑙𝑙𝑒𝑔𝑒
𝑁𝑢𝑚𝑏𝑒𝑟𝑜𝑓𝑠𝑡𝑢𝑑𝑒𝑛𝑡𝑠 𝑖𝑛 two 𝑑𝑒𝑝𝑎𝑟𝑡𝑚𝑒𝑛𝑡𝑠

College Department Number of students Sample size required

in each department
Arts English language 313 89

Arabic language 205 59

Administrative Accounting 737 113
sciences
Business 602 92
administration
Computers and Computer science 76 8
information
technology Information 197 21
technology
Environmental Environmental 182 26
sciences and Marine sciences
Biology Marine Biology 86 13
Total 2398 421

9
  Third stage:

 Firstly we selected all levels of each department.

 Secondly we determined the total number of students in each level.

Sample size required in each level:

𝑁𝑢𝑚𝑏𝑒𝑟 𝑜f 𝑠𝑡𝑢𝑑𝑒𝑛𝑡 𝑖𝑛 𝑒𝑎ch 𝑙𝑒𝑣𝑒𝑙 ×s𝑎𝑚ple 𝑠𝑖𝑧𝑒 𝑒𝑞𝑢𝑖𝑟𝑒𝑑 𝑖𝑛 𝑒𝑎ch 𝑑𝑒𝑝𝑎𝑟𝑡𝑚𝑒𝑛𝑡

𝑁𝑢𝑚𝑏𝑒𝑟𝑜𝑓𝑠𝑡𝑢𝑑𝑒𝑛𝑡 𝑖𝑛 𝑓𝑜𝑢𝑟𝑙𝑒𝑣𝑒𝑙𝑠

Department Level Number of student Sample size required in

each level
English language First 100 28
Second 85 24
Third 70 20
Fourth 58 17
Arabic language First 65 19
Second 55 16
Third 45 13
Fourth 40 11
Accounting First 206 33
Second 190 29
Third 179 27
Fourth 162 24
Business administration First 180 28
Second 160 24
Third 140 21
Fourth 122 19
Computer science First 24 3
Second 19 2
Third 17 2
Fourth 16 1
Information technology First 60 6
Second 50 5
Third 45 5
Fourth 42 5
Environmental First 60 9
Second 50 7

10
Sciences Third 42 6
Fourth 30 4
Marine Biology First 30 5
Second 20 3
Third 19 3
Fourth 17 2

 Data collection:

The data was collect by self-administered questionnaire based up on review of literature and

evaluation from special doctors. It includes four parts:

I- First part: Socio-demographic data: (age, gender, address, marital

status,college,department, and college level).

II-Second parts: Knowledge and awareness about risk factors of disc prolapse .

III- Third part: Knowledge of participant about diagnosis of disc prolapse.

IV- Fourth parts: knowledge of participants about protection from disc prolapse.

 Data analysis:

Data will be summarized and collected by the statistical package for social science (SPSS)

program and analyzed and produced as frequencies and percentages. Data will be presented in

tables and graphs by using computer application of the Microsoft Offices.

11
  Ethical Consideration:

An approval of the project will be obtained from Hadhramout University College of Medicine

(HUCOM) and department of community medicine, and will take a letter to the mangers of

colleges which include Arts, Administrative sciences, Computers and information technology,

Environmental sciences and Marine Biology, to facilitate our work and data collection.

We will provide information about our research and its objectives to the participants and we will

ensure that their information will be used only for the benefits of society and for scientific

purposes.

Work Plan :

Tasks 2018 2019 2020

1 2 3 4 5 6 7 8 9 10 11 12 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3

Prepare the

proposal

Data

Collection

Data

Analysis

Final

Report

Presentation

12
  The result:-

Table 1: socio-demographic characteristics of study sample (N = 421).

Variable No %
Gender
Male 240 57%
Female 181 43%
Total 421 100%
Age group
18 – 20 years 116 27.6%
21 – 23 years 253 60.1%
24 – 27 years 52 12.4%
Total 421 100%
Mean and SD 21.65 ± 1.539
Marital state
Single 397 94.3%
Married 21 5.0%
Divorced 3 0.7%
Total 421 100%
Address
Alsahel 387 91.9%
Alwadi 28 6.7%
Almahrah 5 1.2%
Sugotra 1 0.2%
Total 421 100%
College
Administrative sciences 205 48.7%
Arts 148 35.2%
Environmental sciences and 39 9.3%
Marine Biology
Computers and information 29 6.9%
technology
Total 421 100%
Department
Accounting 113 26.8%
Business administration 92 21.9%
English language 89 21.1%
Arabic language 59 14.0%
Environmental sciences 26 6.2%
Information technology 21 3.1%
Marine Biology 13 1.9%
Computer science 8
Total 421 100%
College level
Level 1 131 31.1%
Level 2 110 26.1%
13
Level3 97 23.0%
Level4 83 19.7%
Total 421 100%
*Table (1): This table represent that most of participant were male , age group ranged from (18-27years)
with mean± DS21.65 ± 1.539.single, from alsahl, Administrative sciences college, Accounting
Department ,level1,( 94.3%,91.9%,48.7%,26.8% and 31.1%,respectively ).

Graph (1) : Heard of participant about disc prolapse (N = 421)

12.35%

87.65%

yes no

Graph (1):- This graph Shows that most of sample have heard about disc prolapse 369(87.65%)
and 52(12.35%) do not heard.

Table2: A concept about disc prolapse among Hadhramout university students(2019) (N = 421)
Variable
what is the concept of dis prolapse? (N=369) No. (%)
Tearing of discs between vertebrae . 168 (45.5%)
Inflammatory process occurring in nerve . 10 (2.7%)
Muscle spasm of back. 16 (4.3%)
Tearing in ligaments associated with vertebral column . 91 (24.7%)
I don't know. 84 (22.8%)
Total 369 (100%)
What is the most common symptom? No. (%)
Back pain 294 (79.7%)
Numbness of one or both arms 2 (0.5%)
Neck pain 7 (1.9%)
Weakness involving one or both arms or legs 23 (6.2%)
I don't know. 43 (11.7%)
Total 369 (100%)

14
 *Table (2):This table Show highest percent regard the concept of the disc prolapse is tearing of discs
between vertebrae . lowest percent Inflammatory process occurring in nerve ( 45.5% and 2.7%
,respectively) and most common symptom, highest percent back pain, lowest percent numbness of one or
both arms ( 79.7%and 0.5%,respectively)

Graph (2):- Source of information about disc prolapse

prolapse
35.00% prolapse
prolapse 142
30.00% 134 28.90%
120
27.30%
24.40%
25.00%

20.00%

15.00%
40
10.00% 23 8.10%
22
3 7 4.70% 4.50%
5.00%
0.60% 1.40%
0.00%
TV Radio Internet Press Medical University School Other
awareness
campaign

*Graph(2):- show that ,most of participant get their information about disc prolapse from Internet and TV
(28.9%and 27.3%,respectively) , lowest percent Radio 0.6%.

Table(3): Awareness of participant about risk factors of disc prolapse (N = 421).

Variable Yes No I don't know
N/% N/% N/%

People who are used to carrying heavy objects throughout 313 17 91

their life increase their chance of developing disc prolapse 74.4% 4.0% 21.6%
more than others ?
Increasing age have a chance of disc prolapse ? 179 88 154
42.5% 20.9% 36.6%

Smoking increases the chance of disc prolapse? 24 169 228

5.7% 40.1% 54.2%

People who suffer from obesity or excessive weight gain 174 51 196
have a chance of disc prolapse ? 41.3% 12.1% 46.6%

15
 Sitting for long periods with same position increase the 269 22 130
incidence of disc prolapse ? 63.9% 5.2% 30.9%

Malnutrition have a role in disc prolapse? 92 120 209

21.9% 28.5% 49.6%

*Table (3):This table show that most of participant haven't information about the risk factors of disc prolapse,
highest percent regard the People who are used to carrying heavy objects throughout their life increase their
chance of developing disc prolapse more than others , lowest percent Smoking increases the chance of disc
prolapse (74.4%and 5.7%,respectively).

Table(4): Awareness of participant about prevention from disc prolapse (N = 421).

Variable Yes No I don't know
N/% N/% N/%
Maintaining a healthy weight and keeping away from 283 24 114
obesity is a prevention against disc prolapse? 67.2% 5.7% 27.1%
Avoid smoking prevents from disc prolapse ? 53 115 253
12.6% 27.3% 60.1%
Exercise morning as yoga and others for at least 30 minutes 321 8 92
is considered a prevention against disc prolapse ? 76.2% 1.9% 21.9%
The speed of pain treatment considered as a preventing 316 12 93
factor from the disc prolapse ? 75.1% 2.8% 22.1%
Changing the position of sitting , especially in long trips 277 20 124
every 15 to 39 minutes is considered as a prevention against 65.8% 4.8% 29.4%
disc prolapse ?
Caution or awareness of people accustomed to carry heavy 336 9 76
things with the risk of disc prolapse is considered as 79.8% 2.1% 18.1%
preventing factor?
Protection of the back when sitting on the chair and put a 260 21 140
small pillow between the back and the chair, is considered 61.8% 5% 33.2%
as prevention against the risk of injury?
Lying on one side during sleep, so that contributes to reduce 146 46 229
pressure on the back, is a preventing factor? 34.7% 10.9% 54.9%
Taking into account the correct ways to sit , stand and walk 308 15 98
is considered as prevention against the risk of disc 73.1% 3.6 23.3%
prolapse?
*Table (4): This table illustrate that knowledge of participant about prevention fromdisc prolapse ,most of
participant have knowledge regard Caution or awareness of people accustomed to carry heavy things with the risk
of disc prolapse is considered a preventing factor, Exercise morning as yoga and others for at least 30 minutes is
considered as prevention against disc prolapse. The speed of pain treatment considered as a preventing factor
from the disc prolapse, and Taking into account the correct ways to sit , stand and walk is considered a prevention
against the risk of disc prolapse, (79.8%,76.2%,75.1%,and 73.1%,respectively ).

16
Table(5): Awareness of participant about diagnosis of disc prolapse (N = 421).
Variable Yes N% No N%
Do you know the diagnosis of the disc prolapse 115 (27.3%) 306 (72.7%)

If yes, what is it? No. %

MRI 58 50.4%
CT 31 27.0%
X-ray 26 22.6%
Total 115 100%
*Table (5): This table showed that most of participant 72.7%% answer no regard diagnosis of disc
prolapse, 50.4%from participant answer yes regard MRI is best modality for diagnosis disc prolapse.

Table(6): Total awareness of participant about risk factors of disc prolapse (N = 421).
Variable No. %
Good awareness 110 26.1%
Poor awareness 311 73.9%
Total 421 100%
*Table (6): This table showed that most of participants have poor awareness about risk factors (73.9%).

Table(7): Total awareness of participant about protection of disc prolapse (N = 421).

Variable No. %
Good awareness 277 65.8%
Poor awareness 144 34.2%
Total 421 100%
*Table (7): This table showed that most of participants had good awareness about protection of disc
prolapse (65.8%).

Table(8): Association between awareness of disc prolapse and demographic data (N = 421).
Variable Awareness of disc prolapse X2 P.
Aware Unawareness
Age group
18-20 101 ( 27.4%) 15 (28.8%) 0.663 0.718
21-23 224 (60.7%) 29 (55.8%) NS
24-27 44 (11.9%) 8 (15.4%)
Total 369 (100%) 52 (100%)
Gender
Male 213 (57.7%) 27 (51.9%) 0.626 0.429
Female 156 (42.3%) 25 (48.1%) NS
Total 369 (100%) 52 (100%)
Marital state
Single 348 (94.3%) 49 (94.2%) 0.495 0.781
Married 18 (4.9%) 3 (5.8%) NS
Divorced 3 (0.8%) 0 (0.0%)
Total 369 (100%) 52 (100%)

17
Address
Alsahel 339 (91.9%) 48 (92.3%)
Alwadi 25 (6.8%) 3 (5.8%) 7.871 0.049
Almahrah 5 (1.4%) 0 (0.0%) S
Sugotra 0 (0.0%) 1 (1.9%)
Total 369 (100%) 52 (100%)
College
Administrative sciences 175 (47.4%) 30 (57.7%)
Arts 132 (35.8%) 16 (30.8%) 3.246 0.355
Environmental sciences and Marine 37 (10.0%) 2 (3.8%) NS
Biology 25 (6.8%) 4 (7.7%)
Computers and information technology
Total 369 (100%) 52 (100%)
Department
Accounting 93 (25.2%) 20 (38.5%)
Business administration 82 (22.2%) 10 (19.2%)
English language 77 (20.9%) 12 (23.1%)
Arabic language 55 (14.9%) 4 (7.7%) 7.395 0.389
Environmental sciences 24 (6.5%) 2 (3.8%) NS
Information technology 18 (4.9%) 3 (5.8%)
Marine Biology 13 (3.1%) 0 (0.0%)
Computer science 7 (1.9%) 1 (1.9%)
Total 369 (100%) 52 (100%)
College level
Level 1 113 (30.6%) 18 (34.6%)
Level 2 94 (25.5%) 16 (30.8%) 1.660 0.646
Level 3 87 (19.7%) 10 (19.2) NS
Level 4 75 (20.3%) 8 (15.4%)
Total 369 (100%) 52 (100%)
*Table (8): This table showed no statistical significant difference between participants awareness of disc
prolapse and demographic data(age, gender ,marital status ,College, department and College level) P:
>0.05.and statistical significant difference between participants awareness of disc prolapse and address
P:≤0.05

Table(9): Association between participant awareness about risk factors and demographic data (N = 421).
Variable Total risk factors X2 P.
Good Poor
awareness awareness
Age group
18-20 35(31.8%) 81 (26.0%) 2.290 0.318
21-23 65(59.1%) 188 (60.5%) NS
24-27 10 (9.1%) 42 (13.5%)
Total 110 (100%) 311 (100%)

18
Gender
Male 67(60.9%) 173(55.6%) 0.925 0.336
Female 43(39.1%) 138(44.4%) NS
Total 110 (100%) 311 (100%)
Marital state
Single 105 (95.9%) 292 (93.9%)
Married 2(1.8%) 19 (6.1%) 11.503 0.003
Divorced 3(2.7%) 0 (0.0%) S
Total 110 (100%) 311 (100%)
Address
Alsahel 102 (92.7%) 285 (91.6%)
Alwadi 7 (6.4%) 21 (6.8%) 0.480 0.923
Almahrah 1 (0.9%) 4 (1.3%) NS
Sugotra 0 (0.0%) 1 (0.3%)
Total 110 (100%) 311 (100%)
College
Administrative sciences 50 (45.5%) 155 (49.8%)
Arts 41 (37.3%) 107 (34.4%) 1.748 0.626
Environmental sciences and Marine 9 (8.2%) 30 (9.6%) NS
Biology 10 (9.1%) 19 (8.2%)
Computers and information technology
Total 110 (100%) 311 (100%)
Department
Accounting 26 (23.6%) 87 (28.0%)
Business administration 24 (21.8%) 68 (21.9%)
English language 21 (19.1%) 68 (21.9%)
Arabic language 20 (18.2%) 39 (12.5%) 5.326 0.620
Environmental sciences 6 (5.5%) 20 (6.4%) NS
Information technology 6 (5.5%) 15 (4.8%)
Marine Biology 3 (2.7%) 10 (3.2%)
Computer science 4 (3.6%) 4 (1.3%)
Total 110 (100%) 311 (100%)
College level
Level 1 37 (33.6%) 94 (30.2%)
Level 2 27 (24.5%) 83 (26.7%) 1.672 0.643
Level 3 28 (25.5%) 69 (22.2%) NS
Level 4 18 (16.4%) 65 (20.9%)
Total 110 (100%) 311 (100%)
*Table 9:This table shows that no statistical significant difference between participant awareness about
risk factors of disc prolapse and age, gender , Address, College, department College level P: >0.05and
statistical significant difference between marital status regard risk factors P:≤0.05.

19
 Discussion:

Disc Prolapse( DP )is a major cause of disability in developing countries, so the present study aimed to

investigate the awareness of disc prolapse among Hadhramout university students in Al-Mukalla city

,Yemen .This study represents 87% of participants have heard about disc prolapse due to all of them are

educated which they are university students. Most of participants get their information about disc prolapse

from Internet and T.V (28.9% and 27% respectively ) as a result of developing technology and easy to get

information from these sources. Regarding the concept of disc prolapse, most of participants decided to

choose 'Tearing of discs between vertebrae with percentage 45.5% , and it is definitely the correct one as

reported in Adim's A.M(2012)(1). (79.7%) percentage of participants answered that back pain as the most

common symptom of disc prolapse and it is truly agree with American Academy of orthopedic surgeons

(AAOS)(15),which demonstrate that in most cases, back pain is the first symptom and common of a

herniated disk. This pain may last for a few days, then improve. Other symptoms may include

weakness, numbness of one or both arms and legs.

Founding from our study represents that poor awareness about the risk factors of disc prolapse with

percentage (73.9%), most of the participants they don’t think smoking increases the chance of disc

prolapse with percentage 169(40.1%).However, most of the them they think Sitting for long periods with

same position and carrying heavy objects will increase the risk factor of the disc prolapse with percentage

269(63.9%) and 313(74.4%) respectively. They think older people which getting dryness in gelatin

between cartilage disc, malnutrition and obesity increases the chance of disc prolapse with percentage

179(42.5%), 92 (21.9%) and 174 (41.3%) respectively. Our study is inconsistent with the study that is

coined on the in Taif,Sauid Arabia(13), which demonstrated that most of the participants had a poor

knowledge of risk factors of disc prolapse, unlike what was proven by the study in Taif, where they had a

good knowledge about risk factors. Previous studies which demonstrate that major risks include
20
occupational risk factors type of work and position of the body assumed at work, in developing countries

many people spend their day in unsuitable working positions. For this later categories, education on work
(16 , 17)
posture modification and provision of appropriate furniture may be worthwhile .

In our study represents that the most of the participants have good awareness about prevention from disc

prolapse with percentage 65.8% ,most of them have knowledge regard Caution or awareness of people

accustomed to carry heavy things with the risk of disc prolapse and exercise morning as yoga and others

for at least 30 minutes are considered a prevention against disc prolapse which agree with Moussa

etal,(2013)(18)Most of the patients were aware by the fact that lack of physical exercise is an impotent

causes of musculoskeletal pain 88.9% . The speed of pain treatment through early diagnosis, and taking into

account the correct ways to sit , stand and walk are considered a prevention against the risk of disc

prolapse, (79.8%,76.2%,75.1% , and 73.1%,respectively ).However , 27.3% of participants answered that

( 14 )
avoid smoking does not protect from disc prolapse which disagree with Shady E study(2015) ,

suggested with smoke cessation provided significant improvements in disc health .keeping away from

obesity and changing the position of sitting especially in long trips every 15-39 minutes are considered as

a prevention against disc prolapse( 62.2% and 65.8% respectively).

The most of participants they don’t know diagnosis and modalities used of the disc prolapse with

percentage 306(72.7%) ,but 115(27.3%) have knowledge about diagnosis,58(50.4%) answer MRI is best

modalities for diagnosis disc prolapse as in .Raghavendraetal.,(2014)(19),reported that MRI is

recommended as an appropriate, noninvasive test to confirm the presence of disc herniation, and

26(22.6% ) of participant answer x-ray used for diagnosis of disc prolapse . However, the evidence for

diagnostic accuracy of diagnostic imaging for disc herniation is still unclear(20).

21
According to association between awareness of disc prolapse and demographic data reveal that the male

and female they have awareness about disc prolapse with higher percentage in the males 213 (57.7%)

than females 156 (42.3%) . All age groups aware of disc prolapse with higher percentage in age group 21-

23 yrs ( 60.7% ) followed by age group 18 -20 yrs ( 27.4% ) . All marital status of participants they have

awareness about disc prolapse with higher percentage in single status 348 (94.3%) followed by married

status 18 ( 4.9% ) . Regard address there is statistical significant difference between participants

awareness of disc prolapse and address P:≤0.05 , Address participants aware of disc prolapse with high

percentage in Alashel 339 (91.9%) followed by Alwadi 25 ( 6.8% ), due to most of them from Alashel by

387(91.9%) . All collage participants aware of disc prolapse with high percentage in Administrative

sciences 175 ( 47.4% ) followed by Arts 132 (35.8%) . All Department participants aware of disc prolapse

with high percentage in Accounting 93 (25.2%) followed by Business administration 82 (22.2%) . All

collage level participants aware of disc prolapse with high percentage in Level [1] 113 (30.6%) followed

by Level [2] 94 (25.5%) . No statistical significant difference between participants awareness of disc

prolapse and demographic data (age , gender , marital status , College , department and College level) P:

>0.05.

According to association between participant awareness about risk factor and demographic data reveal

that the male and female have poor awareness about risk factors with high percentage in the male

173(55.6%) than female 138(44.4%) . All age groups have poor awareness of risk factor with higher

percentage in age group 21-23 years 188(60.%), followed by 18-20 years 81(25%).Regard marital status

there is statistical significant difference between participants awareness of risk factors and marital status

with high percentage in in single 292(93.9%) . This due to most of the sample were single by percentage

397(94.3%),followed married and divorced by percentage 21(5%) and 3(0.7%) respectively. Regard

address, most of participants have poor awareness with high percentage in Alashel followed Alwadi by

22
 (91.6%) and (21.6.8%) respectively. All collage participants have poor awareness of risk factors with

high percentage in Accounting 87(28%) followed by Business administration and English language with

same percentage 68(21.9%).All collage level participants have poor aware of risk factor with high

percentage in first level 94(30.2%) followed second level by 83(26.7%).No statistical significant

difference between participant awareness about risk factor of disc prolapse and (age , gender , Address ,

Collage , Department and collage level)P:> 0.05 .

 Conclusion :

The majority of participants have been heard about disc prolapse with good awareness of prevention.

However, most of them have poor awareness of risks and methods of diagnosis.

 Recommendations:-

More education about risk factors, methods of diagnosis of disc prolapse must be implemented in

Hadhramout University students in Al-Mukalla district.

23
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