Tobacco smoking in Egypt: a scoping literature review of its epidemiology and control measures

Background: According to World Health Organization [WHO] reports, the prevalence of smoking is increasing in many developing countries, including Egypt. The aim of this study is to summarize the published data in the literature about tobacco smoking in Egypt. Methods: A computerized literature search of PubMed and relevant Egyptian journals was conducted using the relevant keywords. The findings of retrieved studies were extracted and discussed in a narrative approach. Results: Our search retrieved 44 relevant studies. The most updated prevalence of tobacco smoking in Egypt is 22% in 2010 and is increasing. Highly significant odds ratios were reported for sibling, parent, and peer smoking as risk factors for smoking. Cardiovascular disorders, malignant tumors, and erectile dysfunction are common complications of smoking in the Egyptian population. Efforts to control tobacco smoking are available, but inadequate. Conclusions: Tobacco smoking is a prevalent health problem in Egypt, associated with cardiovascular disorders and malignant tumors. Health education programmes should be delivered through mass media and school-based programmes to reach a large section of the Egyptian population

Effect of metformin on maternal and neonatal outcomes in pregnant obese non-diabetic women: a meta-analysis

Background: metformin reduces maternal and neonatal weight gain in gestational diabetes mellitus; however, this effect is poorly investigated in non-diabetic women

Objective: we performed this meta-analysis to investigate the effect of metformin intake during pregnancy on maternal and neonatal outcomes in obese non-diabetic women

Materials and Methods: we searched Medline, EMBASE, and Cochrane CENTRAL for eligible randomized controlled trials addressing the efficacy of metformin in pregnant obese non-diabetic women. Data were extracted and analyzed using RevMan software [Version 5.3]. Neonatal birth weight was the key outcome. Secondary outcomes included maternal weight gain, the incidence of preeclampsia, and neonatal adverse effects [miscarriage, stillbirth and congenital anomalies]

Results: pooled data from two RCTs [n=843] showed that metformin caused a significant reduction in maternal gestational weight gain [MD-1.35, 95% CI: [2.08, -0.630]], compared to placebo. The summary effect-estimate did not favor either of the two groups in terms of reduction of neonatal birth weight Z score [MD-0.09, 95% CI: [0.23, 0.06]]. Metformin was associated with 41% reduction in the risk of preeclampsia; however, this reduction was not statistically significant [RR 0.59, 95% CI: [0.03, 11.46]]. None of the neonatal adverse events including stillbirth [RR 1.14, 95% CI: 0.42, 3.10]] and congenital anomalies [RR= 1.36, 95% CI: [0.58, 3.21]] differed significantly between the two groups

Conclusion: for obese pregnant women, metformin could decrease gestational weight gain with no significant reduction in neonatal birth weight. In light of the current evidence, metformin should not be used to prevent poor pregnancy outcomes in obese non-diabetic women