Influenza virus vaccination for adults and children as a part of protection of Hajj and Umrah persons from respiratory tract infections

Spread of respiratory tract infection starting by influenza attacks among Hajjs represents a real threat to this overcrowded, population in the context of SARS, Avian influenza and Multi Drug Resistant TB. The aim of this work was to: [1] test the protective effect of influenza virus vaccination and wearing of face mask as two components of the project to control respiratory tract infections during Hajj and Umrah seasons, [2] compare between the subunit and split virus influenza vaccines as regards the safety and protection, [3] test the effect and safety of subunit virus influenza vaccine in COPD and asthmatic patients. Five groups were enrolled in this prospective study: Three groups of high risk persons for recurrent chest infection; group I was vaccinated with subunit vaccine, group II was masked without vaccination, group Ill was neither vaccinated nor masked. The other two groups [groups lV and V] were care givers: group IV was vaccinated by split virus vaccine and was wearing masks [medical staff] while group V was vaccinated with split virus vaccine without face mask [paramedical]. All groups were followed up for one year. The selected internal Halls and Umrah persons [groups I, II, and Ill] were at high risk for recurrent respiratory tract infection. They included COPD, asthmatics that were not sensitive to egg protein, persons in irritant occupations, cases of recurrent pneumonia, bronchiectasis, D.M. or rheumatic heart diseases and elderly. The studied medical and paramedical staffs were vaccinated with split virus vaccine [516 females and 434 males sharing in internal Hajj and Umrah activities in El-Noor specialized Hospital [where most of Hajj and Umrah patient were referred]. The percent of protected persons in the studied groups was 98.5%, 59.0%, 21.0%, 984%and 40.9% in groups I, II, Ill, IV and V respectively. There was a significant difference between all groups regarding protection rate except between groups IV and I. Number of audible coughs/mm. in Mecca Haram was 90/mm during Dhu Alhejja compared to 1/mm. in Ragab, and 10 1mm. in Shaaban. Number of audible coughs/mm. in Madina Haram was 120/mm during Dhu Alhejja compared to one/mm. in Ragab. Most of respiratory tract infection attacks in Ragab Omrah started after Madina visits. The percentage of masked halls was 5% as counted between hajjs coming out from a Haram door. None of the vaccinated group with subunit virus vaccine was presented by lower respiratory tract infections. Only 1.5% of the vaccinated group with the sub-units vaccine were presented by uncomplicated flu, while 60% of the group who received split virus vaccine and unmasked was followed by bacterial phaiyngitis caused by haemophilus influenza in 42.8%, pneumococci in 34.2%, sterpt haemolyticus in 20% either A, C, D., and Klebsiella in 3%. One percent of cases were complicated by pneumonia Conclusions:-1] Influenza vaccination is effective to protect Halls and Umrah persons. 2] Subunit TIV is more effective and safer than split TIV. 3] Asthmatics, non-allergic to egg protein can be vaccinated by subunit TIV safely and can be benefited, 4] COPD patients are benefited from TIV 5] Face mask is partially protective for Hajjs and Umrah persons and may help in combination with TIV to control spread of respiratory tract infections among adults and children during Ha]] and Umrah season. Recommendations: 1-Broadening of TIV up to generalization to control influenza epidemic during Ha]]s and Umrah seasons 2-Co-vaccination with TIV and polyvalent pneumococcal to the risky group of Hajjs and Umrah patients vaccine should be furtherly investigated. 3-Combination of facemask wearing to vaccination with TIV can be recommended to promote control the spread of respiratory tract infections among all Hajjs and Umrah persons. 4-Holding a pan Islamic conference in Mecca and Madina for respiratory experts and Ministers of Health is recommended to discuss the control of respiratory infections during Hajj and Umrah seasons

Concepts of some reproductive health issues related to family formation among female adolescents, their parents and nursing students in greater Cairo

Egypt currently has its largest cohort of youth Family formation patterns adopted by this cohort will largely contribute to the demographic profile of Egypt 2000 2020 [NPC. 2004]. This study was conducted to address the perceptions about some reproductive health issues concerning future family formation among different generations aiming to modify their behavior. A purposive sample of 211 secondary school Students was chosen from the three governorates of Greater Cairo and interviewed. Self-administrative questionnaires were given to 21 students from Nursing Faculty of Cairo University and to parents of 165 Cairo secondary school students in a single school. Results showed that most of the study group participants refused early marriage and defined its age range as < 18 years. Its disadvantages were more perceived than advantages. Awareness about premarital examination was found in the majority of all groups and readiness to perform it was also dominant. Religious polite husbands with suitable socio-economic level were considered ideal. Homogeneity of answers among generations reflects success of mass media as an educational tool. However, parents' opposition could be a major obstacle to perform PME

effect of chronic lead exposure on the course of Schistosomiasis and the protective effect of the antioxidant preparation Antox

In the present study, 80 adult male hamsters were used; 20 of them were divided equally into non-infected non-treated control group and chronic lead exposed group, that was given lead acetate intraperitoneally dissolved in distilled water, 2 mg/kg/day for 7 weeks. Then, two experiments were carried out on the remaining animals. Each experiment [included 30 animals] was divided equally into three groups. Experiment A was carried out on the following groups: Schistosoma mansoni infected group, Schistosoma mansoni infected and chronic lead exposed group and Schistosoma mansoni infected, chronic lead exposed and Antox-treated group. Experiment B was done following the previous design, except that infection was carried out by Schistosoma haematobium cercaria. The study revealed significant reduction in oxidative stress parameters as well as blood and hepatic lead levels and in hepatic 8-oxodeoxyguanosine phosphate level after giving the antioxidant Antox to the Schistosoma infected and chronic lead exposed groups. However, the administration of the antioxidant Antox to Schistosoma infected and chronic lead exposed groups has insignificantly increased all the parasitological parameters

Patient education and weight control of non-insulin dependent diabetic patients

Non insulin dependent diabetes mellitus is a growing problem in developing countries. The majority of patients are obese and characterized by increased deposition in the trunk [central obesity]. Voluntary weight reduction initiated by patients early in the course of the disease was found to delay morbidity and mortality that accompany the disease. The aim of this study was: to achieve weight reduction and reduction in the waist/hip ratio through educating the patient to follow a special dietary regimen that supply approximately 1500 kcal/day and to practice active walking for half to one hour per day through a period of 6 months. Also to show the effect of this dietary regimen and exercise on the blood glucose level. The study included 190 patients aged from 37 up to 69 years old [47 males and 143 females] recruited from those attending the [Diabetic Care Unit] In El Menshawy General Hospital, Tanta, Egypt. Those patients were subjected to monthly health education sessions for a period of 6 months. Through these sessions the patients were advised to follow a moderately restricted caloric diet and to practice active walking for half to one hour daily. The results of the study showed that 84.73% of them were over weight and obese and 93.68% showed central deposition of fat. At the end of the study the patients showed significant reduction in their weight as shown by the reduction in body mass index from 32.48 +/- 4.73 to 30.55 +/- 4.89 in male patients and from 31.30 +/- 4.58 to 29.95 +/- 5.07 in female patients. The waist/hip ratio has been also reduced from 1.07 +/- 0.13 to 0.98 +/- 0.09 in male patients and from 1.05 +/- 0.13 to 0.96+0.09 in female patients. Also the study showed significant reduction in both fasting and postprandial blood glucose level. The restriction in B.M.I was not statistically significant among those who did not follow a regular dietary restriction. Both B.M.I and waist/hip ratio showed non-significant reduction among patients suffering from the disease more than 10 years. These findings show the importance of early dietary intervention for controlling the disease and the importance of team approach in health care of patients with chronic diseases including diabetes mellitus

Relationship between iron status in pregnant women and their newborn babies

To evaluate the effect of maternal iron deficiency anemia on the iron status of the fetus at term gestation with special reference to iron stores. Also, to study the impact of maternal infection on maternal and neonatal iron status. Design: A prospective clinical and laboratory study. Setting: Department of Obstetrics and Gynecology, Menoufiya University Hospital. Patients and The study included 40 full-term pregnant patients admitted for delivery. Twenty-five of the participants were anemic [Hb <11 gm/dl] and fifteen were healthy normal controls [Hb >11 gm/dl], among the anemic group, 12 cases were infected. Hemoglobin, serum iron TIBC and serum ferritin were measured both in mothers and their neonates of both groups. In addition, maternal serum albumin was measured as an indicator of the nutritional status. Maternal hemoglobin, albumin, serum iron and serum ferritin were significantly lower in the anemic group compared to the control [p - 0.05] while TIBC was significantly higher in the anemic group [p = 0.02]. On the other hand, only serum ferritin was reduced in newborns of anemic mothers [p = 0.02] despite a significant reduction in the neonatal hemoglobin [p < 0.0001]. Iron deficiency predisposes to infection and is not a sequelae since patients with infection showed significant decrease in serum iron [p = 0.006] and serum ferritin [p = 0.01] and significant increase in TIBC [p = 0.004] compared to noninfected cases

Correlations between ventilatory function tests, arterid blood gases and blood levels of some radioactive isotopes in asymptomatic and symptomatic cigarette smokers

In this work, three groups of subjects were studied. The first was control group [8 cases], the second was asymptomatic cigarette smokers [30 cases] and the third was symptomatic cigarette smokers [36 cases] that was in turn divided into three equal subgroups: asthma, COPD and cancer lung. All groups were examined for ventilatory function tests [FVC, FEV1 -FEV1% and FEF 25-75%], arterial blood gases, [Pa O2 and PaCO2, pH] and blood levels of lead 212, lead214, and Cesium 137. There was a significant decrease in all ventilalory function tests, PaO 2and increase PaCO2 in symptomatic group in relation to control and asymptomatic groups. The pH of blood showed no change. The study showed a significant increase in the levels of lead 212, lead214 and cesium137 in both smokers groups in relation to control. FEV1 and FEF 25-75%, lead212, lead 214 and cesium 137 showed significant differences between the three studied groups. Also there was a significant negative correlation between the blood lead 212 and the FEV1% in the symptomatic cigarette smokers group. These changes were related to the toxic contents of cigarette leaves and wrappings including the high content of the previously estimated radioisotopes