ABSTRACT
Child abuse and its long-term consequences in adulthood have been recently gaining increased attention in the Arab world. This study is an extension of a similar study in Saudi Arabia, and aims to explore some epidemiological characteristics of the problem in Egypt. To study the prevalence of child abuse and associated psychological problems in adulthood, as presented in a sample of university students in Egypt. 963 students, from three different colleges of Zagazig University [Medicine, Education and Arts and Literature] answered multi-questionnaires including: General health Questionnaire [GHQ], Child Traumatic Questionnaire [CTQ] and Psychological Problem Scale [PPS]. Students reported having suffered Emotional neglect [19%], Emotional abuse [8.9%], Physical neglect [44%] and Physical abuse [6%] and Sexual abuse [13%]. Moderate to severe childhood abuse was correlated with various combinations of psychological problems [Low Self-Esteem, Dissociation, Self Harm, Impulsivity and Aggression] in adulthood. Gender and situational stresses, as indicated by GHQ, did not seem to influence the results as much as low income and large family size. In a large proportion of our sample reported both child abuse and several long-term pathological consequences of abuse in adulthood. The problem seems to be serious in this middle class sample and it remains possible that these problems could be worse in lower social classes
ABSTRACT
Epidemiological data have long demonstrated a correlation between diabetes and cardiovascular disease which accounts for up to 80% of deaths in patients with diabetes [1]. To elucidate the cardiac structure and function in normotensive patients with type 2 diabetes and impaired glucose tolerant patients in order to assess the effect of diabetes mellitus itself on cardiac function. In addition, to show the relation between the insulin level and sensitivity, and the presence of associated peripheral vascular disease. 15 healthy control subjects; 15 patients with type 2 DM on oral hypoglycemic drugs, and 15 patients with impaired glucose tolerance were randomized from outpatient clinics of Cairo University Hospitals. They were subjected to the following: Thorough clinical examination. Serum samples for measurements of: Fasting and two hours postprandial blood glucose, fasting serum insulin, glycated hemoglobin [HbA1c], serum creatinine, urea, cholesterol, triglycerides, LDL and HDL cholesterol. Calculation of insulin sensitivity and resistance, electrocardiogram [ECG], resting echocardiography, carotid duplex and ankle brachial indices were performed. There were echocardiographic abnormalities in patients with type 2 DM. These include: a- Systolic and diastolic left ventricular function abnormalities, b- Abnormal dimensions of left ventricular mass, aortic root and left atrium. Echocardiographic abnormalities in patients with impaired glucose tolerance include: a- Diastolic left ventricular function abnormalities, b- Abnormal dimensions of left ventricular mass, aortic root and left atrium. In type 2 diabetic patients there was a negative correlation between insulin sensitivity measured by HOMA-B and LVDD and IVSD. On the other hand, there was positive correlation between HOMA-R and IVSD and E/A ratio. In patients with impaired glucose tolerance there was a negative correlation between LVDS and insulin sensitivity by HOMA-B method. Insulin resistance is positively correlated with diastolic and systolic left ventricular function abnormalities even in the prediabetic stage. This may represent the first stage of diabetic cardiomyophathy and may contribute to the increased rate of cardiovascular events that has been associated with the cardiovascular metabolic syndrome