Risk factors of childhood acute lymphoblastic leukaemia: a case-control study

The Alexandria Cancer Registry in 1992 reported that Acute Lymphoblastic Leukaemia [ALL] constituted 24.7% of childhood malignancies among male children and 19.2% among female children. This relative high magnitude of ALL in Egypt needs to be studied in depth. The aim is to reveal the different risk factors related to development of the childhood ALL and provide essential data for planning preventive programs. A hospital based case control study was carried out in two hospitals: Alexandria University Children Hospital and School Students Hospital. Data collection was carried using a structured interview schedule. All newly diagnosed cases of ALL during the period from March, 2003 - 31[st] December, 2004 were included in the case series [90 cases]. For each case, two controls were randomly recruited [180] of matched age and sex with ALL cases. The mean age of cases was 4.58 +/- 2.35 years. The ratio of boys to girls was 2.1:1. The final model of multiple logistic regression analysis revealed that first born or only born child and birth weight >/= 3500 gm, consanguinity, fathers' smoking before conception, child exposure to hydrocarbons/benzene, electromagnetic field sources, family history of blood cancers, maternal history of prior fetal losses, some infections, allergies, exposure to radiation or intake of medications during pregnancy, also different childhood diseases all were significant contributing factors that increased risk of ALL, whereas exclusive breast-feeding and early day-care attendance were associated significantly with decreased risk of ALL. The consistency of results of current work with several other research works can support the identification of specific possible risk factors. The research points to specific environmental, social, health and biological factors that need to be addressed. Further research is needed. The data presented in this work can be used to formulate hypotheses

Risk factors of congenital pediatric surgical birth defects: a case control study

Birth defect is a global health problem. Serious birth defects are life threatening or have the potential to result in disability. In Egypt the prevalence of birth defects is increasing, it reached 3.2% of all births [1998]. The present study was earned out to identify different potential risk factors for birth defects and estimate the magnitude of risk for each factor Identified. A case control study was carried out in the Pediatric Surgical Department of El Shatby University Hospital in Alexandria. A structured interview schedule was used to collect data. Gastrointestinal tract [GIT] is the most commonly encountered system for birth defect [53.0%]. Only 11.0% of cases were diagnosed during pregnancy. Boys were more encountered than girls. The final model of multiple logistic regression analysis revealed that high maternal education, unplanned pregnancy, medical problems prior to pregnancy and eating contaminated raw food were significant contributing factors that increased risk of birth defects. No significant associations were found between cases and controls as regards consanguinity parental age, housing and working conditions, family and reproductive history. A pre- pregnancy visit was recommended to identify risk factors and allow for appropriate testing and guide for better changes to improve chances of having a healthy baby

Study of risk-taking behaviors among adolescents in Alexandria

Adolescence is a dynamic period in human development. It is a time of risk-taking as a normal part of the process of growing up. It was found that much of the adverse health consequences experienced by adolescents are to a large extent, the result of risk behaviors. However, 70% of premature deaths among adults are largely due to behaviors initiated during adolescents. In Egypt, a limited number of studies had been conducted in this area. The present study was carried out to identify the prevalence of risk-taking behaviors [RTB] among adolescents and clarify the related factors. A school-based cross sectional survey was selected. The multistage stratified random sampling technique was used to obtain a representative sample of students attending the first grade secondary, general and technical schools in Alexandria. The sample size was estimated to be 1070 students. A self administered anonymous questionnaire was used to collect data. Results showed that RTB such as physical violence, illicit sexual relation, smoking, and substance abuse are prevalent among adolescents. Factors which are significantly associated with these behaviors were: gender, family structure, satisfaction of adult adolescent relationship, educational zones, scholastic achievement, peers adoption of RTB, asking for advice, and practicing of unplanned activities. Early preventive intervention programs are recommended to help students to adopt life skills techniques through collaboration with parents, school, and the community so as to help manage daily faced stressors and reduce the adoption of RTB

Predictors of clinical outcome among adolescents with first episode schizophrenia in Alexandria.

Evidence was emerging that the early phase following the onset of a first psychotic illness could be conceived of as a critical period, influencing the long-term course of the illness. Effective intervention at this stage might alter the subsequent course of the illness. Psychosis may be developed as the action of social or psychological stressors acting on the vulnerable individuals. The present study aimed at providing data about potential sociodemographic and family risk factors related to development of first episode schizophrenia [FES], identifying clinical profile of FES among adolescents, providing baseline assessment of patients with FES as well as changes in assessment domains during five months follow up period, and finally identifying significant contributing factors related to clinical outcome of FES among adolescents. A clinic-based case control study was carried out. Cases were recruited from Psychiatric Consultation Clinic for school children in Alexandria. The trained investigators themselves collected the data using precoded structured questionnaire. A structured clinical interview format was used for assessing five domains. The majority of cases [88.7%] claimed that illness was precipitated by stressful life events. Source of referral was the physician in 66.2% of instances. The most commonly cited reason for referral was aggression and violence [39.4%]. More than one-fifth of cases [21.1%] visited faith healer before referral and 19.7% did not seek any medical care. Just less than two-thirds of family members [60.6%] had negative attitude towards the illness. Nearly three-quarter of cases [73.2%] reported progressive course of illness. Significant risk factors for FES in logistic regression model were: positive family history of mental disorders [Adjusted OR=6.47, 95% Cl=1.29-9.61], unskilled fathers' occupation [Adjusted OR=1.34, 95% Cl=1.22-3.03], low mothers' educational level [Adjusted OR=4.92, 95% Cl=2.42-9.71], and negative parental rearing style [Adjusted OR=2.51, 95% Cl=1.67-4.471. The estimated remission rate following the follow up period was 86.3%. Positive symptoms improved in 87.3% of cases while negative symptoms improved in 83.1% of cases. Moreover, 73.2% of cases experienced improvement in psychopathological symptoms. Social functioning had improved in 76.1% of cases. Compliance to medication and family support were the only significant predictors for clinical improvement in patients with FES [Adjusted OR=3.15, 95% Cl=2.64-6.83, P<0.001, and 2.63, 95% Cl=1.89-5.72, P=0.0081. The present work concluded that the best strategy is to early diagnose and treat patients suffering from first episode psychosis. This includes appropriate medical diagnosis, neurocognitive and psychological assessment, and appropriate medication. The support and necessary education were needed for family members to be helpful