Association of vitamin D receptor gene polymorphisms with type 2 diabetes mellitus in Taif population: a case-control study

Abstract Several reasons may underlie the dramatic increase in type2 diabetes mellitus. One of these reasons is the genetic basis and variations. Vitamin D receptor polymorphisms are associated with different diseases such as rheumatoid arthritis and diabetes. The aim of this study is to investigate the possible association of two identified mutations ApaI (rs7975232) and TaqI (rs731236). Eighty-nine healthy individuals and Fifty-six Type 2 Diabetic (T2D) patients were investigated using RFLP technique for genotyping and haplotyping as well. The distribution of Apal genotypes was not statistically significant among the control (P=0.65) as well as for diabetic patients (P=0.58). For Taql allele frequencies of T allele was 0.61 where of G allele was 0.39. The frequency distribution of Taql genotypes was not statistically significant among the control (P=0.26) as well as diabetic patients (P=0.17). Relative risk of the allele T of Apa1 gene is 1.28 and the odds ratio of the same allele is 1.53, while both estimates were 1.0 of the allele G. Similarly, with the Taq1 gene the relative risk and the odds ratio values for the allele T are 1.09 and 1.27 respectively and both estimates of the allele C were 0.86 for the relative risk and 0.79 for the odds ratio. The pairwise linkage disequilibrium between the two SNPs Taq1/apa1 was statistically significant in control group (D = 0.218, D' = 0.925 and P value 0.001) and similar data in diabetic groups (D = 0.2, D' = 0.875 and P value 0.001). These data suggest that the T allele of both genes Apa1 and Taq1 is associated with the increased risk of type 2 diabetes. We think that we need a larger number of volunteers to reach a more accurate conclusion.

Resumo Várias razões podem estar subjacentes ao aumento dramático da diabetes mellitus tipo 2. Um desses motivos é a base genética e variações. Os polimorfismos do receptor da vitamina D estão associados a diferentes doenças, como artrite reumatoide e diabetes. O objetivo deste estudo é investigar a possível associação de duas mutações identificadas ApaI (rs7975232) e TaqI (rs731236). Oitenta e nove indivíduos saudáveis e 56 pacientes com diabetes tipo 2 (T2D) foram investigados usando a técnica RFLP para genotipagem e haplotipagem também. A distribuição dos genótipos Apal não foi estatisticamente significativa entre o controle (P = 0,65), bem como para os pacientes diabéticos (P = 0,58). Para as frequências do alelo Taql, o alelo T foi de 0,61, onde o alelo G foi de 0,39. A distribuição de frequência dos genótipos Taql não foi estatisticamente significativa entre o controle (P = 0,26), bem como os pacientes diabéticos (P = 0,17). O risco relativo do alelo T do gene Apa1 é 1,28 e a razão de chances do mesmo alelo é 1,53, enquanto ambas as estimativas foram 1,0 do alelo G. Da mesma forma, com o gene Taq1, os valores de risco relativo e razão de chances para o alelo T são 1,09 e 1,27, respectivamente, e ambas as estimativas do alelo C foram de 0,86 para o risco relativo e 0,79 para o odds ratio. O desequilíbrio de ligação par a par entre os dois SNPs Taq1 / apa1 foi estatisticamente significativo no grupo de controle (D = 0,218, D' = 0,925 e valor P 0,001) e dados semelhantes em grupos diabéticos (D = 0,2, D' = 0,875 e valor P 0,001). Esses dados sugerem que o alelo T de ambos os genes Apa1 e Taq1 está associado ao aumento do risco de diabetes tipo 2. Achamos que precisamos de um número maior de voluntários para chegar a uma conclusão mais precisa.

Association of vitamin D receptor gene polymorphisms with type 2 diabetes mellitus in Taif population: a case-control study / Associação de polimorfismos do gene do receptor de vitamina D com diabetes mellitus tipo 2 na população Taif: um estudo de caso-controle

Abstract Several reasons may underlie the dramatic increase in type2 diabetes mellitus. One of these reasons is the genetic basis and variations. Vitamin D receptor polymorphisms are associated with different diseases such as rheumatoid arthritis and diabetes. The aim of this study is to investigate the possible association of two identified mutations ApaI (rs7975232) and TaqI (rs731236). Eighty-nine healthy individuals and Fifty-six Type 2 Diabetic (T2D) patients were investigated using RFLP technique for genotyping and haplotyping as well. The distribution of Apal genotypes was not statistically significant among the control (P=0.65) as well as for diabetic patients (P=0.58). For Taql allele frequencies of T allele was 0.61 where of G allele was 0.39. The frequency distribution of Taql genotypes was not statistically significant among the control (P=0.26) as well as diabetic patients (P=0.17). Relative risk of the allele T of Apa1 gene is 1.28 and the odds ratio of the same allele is 1.53, while both estimates were < 1.0 of the allele G. Similarly, with the Taq1 gene the relative risk and the odds ratio values for the allele T are 1.09 and 1.27 respectively and both estimates of the allele C were 0.86 for the relative risk and 0.79 for the odds ratio. The pairwise linkage disequilibrium between the two SNPs Taq1/apa1 was statistically significant in control group (D = 0.218, D' = 0.925 and P value < 0.001) and similar data in diabetic groups (D = 0.2, D' = 0.875 and P value < 0.001). These data suggest that the T allele of both genes Apa1 and Taq1 is associated with the increased risk of type 2 diabetes. We think that we need a larger number of volunteers to reach a more accurate conclusion.

Resumo Várias razões podem estar subjacentes ao aumento dramático da diabetes mellitus tipo 2. Um desses motivos é a base genética e variações. Os polimorfismos do receptor da vitamina D estão associados a diferentes doenças, como artrite reumatoide e diabetes. O objetivo deste estudo é investigar a possível associação de duas mutações identificadas ApaI (rs7975232) e TaqI (rs731236). Oitenta e nove indivíduos saudáveis ​​e 56 pacientes com diabetes tipo 2 (T2D) foram investigados usando a técnica RFLP para genotipagem e haplotipagem também. A distribuição dos genótipos Apal não foi estatisticamente significativa entre o controle (P = 0,65), bem como para os pacientes diabéticos (P = 0,58). Para as frequências do alelo Taql, o alelo T foi de 0,61, onde o alelo G foi de 0,39. A distribuição de frequência dos genótipos Taql não foi estatisticamente significativa entre o controle (P = 0,26), bem como os pacientes diabéticos (P = 0,17). O risco relativo do alelo T do gene Apa1 é 1,28 e a razão de chances do mesmo alelo é 1,53, enquanto ambas as estimativas foram < 1,0 do alelo G. Da mesma forma, com o gene Taq1, os valores de risco relativo e razão de chances para o alelo T são 1,09 e 1,27, respectivamente, e ambas as estimativas do alelo C foram de 0,86 para o risco relativo e 0,79 para o odds ratio. O desequilíbrio de ligação par a par entre os dois SNPs Taq1 / apa1 foi estatisticamente significativo no grupo de controle (D = 0,218, D' = 0,925 e valor P < 0,001) e dados semelhantes em grupos diabéticos (D = 0,2, D' = 0,875 e valor P < 0,001). Esses dados sugerem que o alelo T de ambos os genes Apa1 e Taq1 está associado ao aumento do risco de diabetes tipo 2. Achamos que precisamos de um número maior de voluntários para chegar a uma conclusão mais precisa.

Assessment of the Toxicity of Sub-chronic Low and High Doses of the Bio-insecticide Spinosad on the Liver, Kidney and the Cerebellum in Male Albino Mice

ABSTRACT Spinosad (SPD) is a highly selective insect control product. However, it was reported that SPD has toxicity toward other non-target organisms. This study was conducted to address the toxic effect of two sub-chronic low and high doses; 35 and 350 mg/kg SPD on some biochemical, histological and immunohistochemical parameters of the liver, kidney and cerebellum. Thirty-six male Swiss mice were divided into three groups of 12 mice each; first group (G1) served as a control, second group (G2) received a low sub-chronic dose of SPD that is equal to 35 mg/kg, and third group (G3) received a high sub-chronic dose of SPD that is equal to 350 mg/kg. The results showed that mice which were received 350 mg/kg SPD showed a significant decrease in the body weight and a significant increase in their relative kidney and spleen weights. They also showed a significant increase in alanine aminotransferase (ALT), triglycerides and urea levels. Histopathological examination showed cytoplasmic degeneration and cell necrosis in the liver and kidney. Immunohistochemical examination showed that cerebellum illustrated several neurodegenerative changes and a down-regulation of synaptophysin-Syp. In conclusion, exposure to a high dose of SPD that is equal to 350 mg/kg could cause a marked toxicity on the liver, kidney and cerebellum in male albino mice.

Epidemiological study of congenital heart diseases among children attending outpatient clinics of Benha university hospital

Epidemiology of Congenital heart disease [CHD] up to date has not been fully determined nor it received the attention it warrants. Knowledge of epidemiology of CHD is the basis for planning of preventive and curative strategies. To estimate proportion of CHD among children attending pediatric clinics of Benha University Hospital and to identify risk factors that may predispose for its occurrence. The present is a cross - sectional study was conducted on children attending outpatient pediatric clinics of Benha University Hospital during the period from March 2009 to February 2010. Out of 6766 attendants, 426 cases are referred to echocardiography unit where 145 confirmed cases of CHD are identified to be compared with 320 cases of children not having CHD and were selected randomly. Questionnaire sheets were used in addition to Medical examination and laboratory investigations. The study revealed that the proportion of CHD among children attended pediatric clinic was 2.14%. Ventricular septal defect [29.65%], ASD 17.53% and PAD [12.41%] are the most common CHD detected. More than half of cases of CHD [62.76%] are detected at infancy and male predominance was found in VSD and AS. An association was found between family history [OR=1.83, 95% CI = 1.05 - 3.16], consanguinity [OR = 1.18, 95% CI = 0.66 - 2.13] and occurrence of CHD. Also an association was found between maternal risk factors such as of drug intake [OR = 2.5, 95% CI =1.6 - 3.94], exposure to febrile illness [OR = 1.8, 95% CI = 0.82 - 3.91] and exposure to radiation [X-ray] [OR = 1.4, 95% CI = 0.54 - 3.67] during pregnancy and CHD. CHD is a public health problem among infants and young children and there are many risk factors showed a significant effect on its occurrence such as positive family history, consanguinity and material risk factors during pregnancy such as drug intake, exposure to radiation and febrile illness during pregnancy. Integrated effects from all concerned authorities [medical, social] to be directed to the families especially pregnant women to raise awareness and health education to avoid risk factors that have a role in occurrence of the problem and raise attention of doctors for early detection of CHD for proper management

Patient satisfaction with primary health care services in Qassim province, Sandia Arabia

Studies of patient satisfaction towards health services constitute an important element in the extent to which health services received meet consumers expectations and needs. To evaluate the quality of primary health care services in Qassim province, Saudi Arabia from the view of the patients and to determine the relationship between some socio -demographic and medico - administrative factors and patient satisfaction scores of different aspects of care. The present study is a cross - sectional study which was conducted on 1360 [850 urbans and 510 rurals] patients attending PHC centers in Qassim province, Saudia Arabia. They were selected randomly using systematic random sample. Data was collected by well trained students of College of Medical Science, Qassim University by interview technique using a questionnaire sheet adapted from WHO model sheet [1995]. The type of rating scale used was the 4 point quality scale. The overall patient satisfaction to PHC services in Qassim province was relatively low in comparison to that recorded in other Arabian Gulf countries. The scores of satisfaction in urban health centers [76.9%] for most aspects of services were significantly higher than that recorded in rural health centers [70.65%]. In rural health centers, the elderly [98.23%], non Saudi[82.13%] and non employed patients[85 .11%] had recorded a significantly higher level of satisfaction while in urban health centers, illiterates [82.98%], single patients [76.33%] had recorded insignificant higher level of satisfaction and in both urban and rural health centers, patients of university level of education had recorded the lowest score of satisfaction [74.13%,77.33%repectively with significant difference, In both urban and rural health centers, with the increase of waiting time, satisfaction scores decrease while with the increase in consultation time, satisfaction scores increase with significant difference. Patients attending rural health centers reported a lower level of' satisfaction towards many aspects of care and socio demographic and medico administrative variables may have a role in determining the level of patient satisfaction . This study calls for further research to define and measure patient perceptions of health care quality and to remedy the areas that received low level of patient satisfaction through upgrading and development

Epidemiological features of child abuse among a sample of preparatory school-children in Benha city

Child abuse is a world wide phenomenon and had become a major concern in many countries throughout the world. The problem was found to be serious for many children due to its toxic outcomes for children and society. To identify the prevalence rate of child abuse and its epidemiological features among a sample of preparatory school children in Benha city. This is a cross-sectional study was carried out at preparatory schools of Benha city during the academic year 2006-2007. Three hundred thirty students were selected by systematic random method from the chosen schools. Data was collected by using self administrated questionnaire that included socio-demographic characteristics and child traumatic questionnaire. The study revealed that 75.8% of the studied group had exposed to child abuse and 28.6% of females were not exposed to abuse versus 19.4% among male students. Combined form of abuse [28.4%], emotional [24%] and physical abuse [20.4%] were the more prevailing types. Only 10.1% of students belonging to low social class had not exposed to child abuse and students belonging to married parents had recorded the higher percentage [28.5%] of absence of abuse among them. Students belonging to below secondary school graduated fathers had exposed to combined form of abuse [24.3%], emotional abuse [21.8%] and physical abuse [16.3%] with frequencies higher than that recorded among students belonging to university graduated fathers. More than half of abused children [51.6%] had exposed to abuse at homes followed by those at schools [27.2%]. it could be concluded that child abuse and neglect is a big problem among prep school children because the prevalence rate in the study sample is 75.8% and there are many risk factors had shared in its Prevailing. National program is needed to prevent all forms of child abuse for all children and to control the problem through intervention strategies directed to parents, children, health care professionals, school staff and governmental and non governmental organizations to show how to prevent, diagnose and cope with the problem

Informally raw milk and kareish cheese investigation on the occurrence of toxigenic escherich1a coli in Qena city, Egypt with emphasis on molecular characterization

The informally raw milk and Kareish cheese sold in ftena city [Upper Egypt] were analyzed to determine the presence of toxigenic E.coli. The isolates were screened for the presence of verotoxigenic E.coli [VTEC] and enterotoxigenic E.coli [ETEG] by Polymerase Chain Reaction [PCR]. Bio-resistance to antimicrobial agents was evaluated by the disk diffusion method. E.coli were recovered from 38 [76%] of raw milk and 11 [47.8%] of Kareish cheese samples. Three [6.1%] of the E.coli isolates were VTEG and none of them hat eaeA gene encoded a pathogenicity island typical of E.coli 0157:H7 [EHEC]. PCR of enterotoxins showed that only one isolate carried LT enterotoxins of ETEC. Bio-resistance was frequently observed to nalidixic acid [42.9%], ampicillin [32.7%], tetracycline [22.4%], trimethoprim-sulfamethoxazol [14.3%], ciprofloxacin [4.1%] and cefoxtin [2.0%]. Results suggested a possibility of potential public health threat of E.coli originating from raw milk sources

impact of splenectomy on the patient's susceptability to infection

Splenectomy, is a procedure that has significantly decreased in frequency as the understanding of its complications increase. Susceptibility to infection is the best-defined and most widely understood complication of splenectomy. The aim was to study the impact of splenectomy on the patients susceptibility to infections, and its effect on morbidity and mortality statistics of patients admitted to fever hospitals. The study included 506 patients admitted to fever hospital and they divided according to history of splenectomy into group 1 of 432 patients with no history of splenectomy and group II of 74 patients with history of splenectomy. The cause and duration of splenectomy, hospital stay, the type and duration of antibiotic prescribed in hospital the diagnosis and the outcome at discharge were the main history items. Chronic liver disease [CLD] was the main cause of splenectomy followed by trauma and Thalassemia 67%, 20% and 12% respectively. No significant difference in blood culture between the 2 group but capsulated organism were more in group II. Respiratory tract infection was the main cause of admission in both groups with a high incidence of respiratory, urinary tract infection, meningitis and pyrexia of unknown origin in group II. Quinolones, Penicillin and Cephalosporins were the commonly used groups of antibiotics with statistical difference in group 2 than group 1. Prolonged hospital stay in group II with high statistical difference than group I [14.07 +/- 8.68 versus 4.57 +/- 3.29] [P<0.001]. The improved outcome were significantly higher in group 1 than group 2 and the not improved outcome [frequent admission, escape from hospital and university hospital referral] were higher in group 2 than group 1 and it correlate with duration of splenectomy

Hospital bed utilization in both Benha university hospital and Benha educational hospital

Hospital bed utilization is one of influences that affect largely on performance of the hospital and can be assessed through many indices that can be used to evaluate hospital in patient care. To compare some performance indictors related to hospital bed utilization in both Benha university hospital and Benha educational hospital. Five departments from each hospital were selected to be included in the study. Average length of hospital stay, Bed occupancy rate, turn over rate and turn over interval are indices used in comparison for the total hospital and for the five departments separately through the year of the study. The over all admission rate in Benha university hospital [16.40%] was nearly twice that recorded in educational hospital [9.28%]. Average length of hospital stay in Benha university hospital was lower [4.02 days] than that recorded in educational hospital [5.03 days] and orthopedic department in both hospitals had recorded the highest average length of hospital stay. Bed occupancy rate for university hospital [70.16%] was higher than that recorded for the total educational hospital [49.62%] and emergency department and intensive care unit in both hospitals had recorded the highest B.O.R Bed turn over rate in university hospital [54.2 turn /bed] was higher than that recorded for educational hospital [36.32 turn/bed] and emergency department in both university hospital and educational hospital had the highest T.O.R. Turn over interval for the total university hospital [1.78 days] was relatively higher than that recorded for educational hospital [1.62 days] and emergency department and intensive care unit in both hospitals had recorded the lowest turn over interval. Benha university hospital during the year of the study was relatively more efficient in bed utilization than Benha educational hospital due to shorter hospital stay, higher bed occupancy rate, higher turn over rate in comparison to that recorded for Benha educational hospital. Some recommendations are put to maximize bed utilization in both hospitals

Paraoxonase 1 activity and genotyping in systemic lupus erythematosus and their relationships with cardiovascular complications

Systemic lupus erythematosus [SLE] is characterized by an enhanced risk of atherosclerosis and cardiovascular diseases [CVD]. Human serum paraoxonase 1 [PON1], an antioxidant enzyme closely associated with high density lipoprotein [HDL], has been implicated in the prevention of low density lipoprotein [LDL] oxidation, and these may provide HDL-associated protection against atherosclerosis. Our objective was to evaluate PON1 activity and genotypes in SLE patients and their relationships to cardiovascular complications and some other risk factors of cardiovascular diseases in those patients. Thirty SLE patients, subdivided into patients with CVD and without CVD, and fifteen matched healthy control subjects were studied. Laboratory investigations included lipid profile, lupus anticoagulants [LA], anticardiolipin antibodies [aCL]. PON1 activity was determined by paraoxon substrate. PON1 genotyping was conducted by PCR amplification, followed by polymorphism-specific restriction enzyme digestion and gel electrophoresis. Our study revealed that PON1 activity was significantly decreased in SLE patients groups compared to controls and in SLE patients with CVD compared to those without CVD [p<0.001]. PON1 activity was significantly negatively correlated with total cholesterol, LDL-C and LDL-C/HDL-C ratio, positively correlated with HDL-C but not significantly correlated with triglycerides, disease activity, LA or a CL antibodies. As regard PON1 192 gene polymorphism, there was significant increase in B allele frequency in SLE patients with CVD compared to those without CVD and control groups, while no significant difference was found between SLE patients without CVD and control group. As regard PON1 55 gene polymorphism, there was no significant difference in genotype distribution or allele frequency between the three groups. The Odds ratio of development of CVD in SLE patients who carry PON1 192B allele was 6 [95% CI 1.2-30.7, p<0.05]. PON1 activity determined by paraoxon substrate was significantly higher in BB and LL, intermediates in AB and LM, and lower in AA and MM genotypes

Neurophysiologic and psychometric changes in patients with liver cirrhosis

Because of its prognostic and socioeconomic relevance, interest has focused on SHE, which describes a poorly defined syndrome found in the grey zone between normality and manifest HE. the aim was to study the neurophysiologic and nero psychologic changes in chronic liver diseases to diagnoses subclinical heptic encephalopathy [SHE]. Sixty patients with chronic liver disease 30 had cirrhosis due to chronic HCV [group 1], and 30 patients had liver fibrosis due to Schistosomiasis [alone or with hepatitis] [group2]. and 20 healthy subjects as control [group 3], all were subjected to, clinical examination, assessment of liver function, routine tab., investigations, Abd, US. and EEG and psychometric assessment by [NCT] and symbol [SDT]. NCT abnormal score was found in 46.7% group2. ranging from 42.3% to 75% in Child-Pugh grade A, B respectively, however the control group had normal NCT score. Positive EEG changes were in [60%]and [50%] ranging from [47.05% to 76.92%] and from [46.15% to 75.0%], in group 1 and group 2 in Child-Pugh grade A and B, respectively, while in group 3 EEG was normal in [90%] and non specific changes found in[10%]. EEC changes and psychometric defects were detected in considerable percentage of cirrhotic patients and were related to the severity of liver cirrhosis, so psychometric tests and EEG may be suitable tools for diagnosis of SHE

Mesh plug repair for umbilical and paraumbilical hernias

The use of a mesh plug in hernia repair is not a new concept This study describes and evaluates the application of a prolene mesh plug in the repair of umbilical and para-umbilical hernias. Thirty-two patients with umbilical and paraumbilical hernias were subjected for operative intervention using mesh plug technique under spinal general or local anaesthesia. After dissection of hernial sacs and reduction of contents, a prolene mesh plug was inserted in to the defect and fixed with 2/0 prolene sutures in four quadrants. Operative time, complications, length of hospital stay, anaesthetic used, analgesia required, duration of drain, patient's return to activity and satisfaction were recorded. Mean operative time was 36 +/- 7 min and mean hospital stay was 20 +/- 4.5 hours. The patients regained their normal activities after 9 to 16 days. Seven patients [21.9%] received non-narcotic analgesics [Di-clofenac], all of them were of general anaesthesia group, no haematoma formation, no wound dehiscence. Seromas formed after removal of drains in 2 patients [6.3%] and aspirated once. Twenty-five patients [78.1%] were satisfied and 7 patients [21.9%] were dissatisfied because of pain [2[6.25%]], infection [1 [3.125%]] and recurrence [2 [6.25%]].Mesh plug repair of umbilical and PUH is a simple, easy and satisfactory technique with short convalescence, less recurrence and good patients satisfaction

Contamination of some babies' food with heavy metals

Twenty samples of milk powder from two brands [10 samples each] and milk-based infant formula [10 samples] were randomly collected from different localities in Alexandria Governorate and investigated for the levels of lead, cadmium, and copper using atomic absorption spectrophotometer. The mean lead levels in the examined samples were 0.49 + 0.08, 0.6 + 0.11, and 0.29 + 0.03 ppm, respectively. The mean cadmium levels in the examined samples were 0.08 + 0.02, 0.15 + 0.09, and 0.06 + 0.01 ppm, respectively, While the mean copper levels were 0.21 + 0.02, 0.24 + 0.06, and 0.29 + 0.04 ppm, respectively. Suggestive measures to protect children from excessive intake of lead, cadmium, and copper are given

Usefulness of bronchoscopy in children

Seventy-three fiberoptic bronchoscopes, using flexible bronchoscope under general anesthesia, were carried out. Bronchoscopic diagnosis was established in 63 cases, while in the remaining 10 cases, the airways appeared normal. Its efficacy, as a diagnostic tool, was 100% in cases presented with stridor and in cases of suspected foreign body aspiration. As a therapeutic tool, the rigid bronchoscope [Doesel- Huzly] was used to remove foreign bodies from the airways of children successfully, but the flexible type failed to inflate the collapsed lung segments not due to foreign body inhalation. Minimal and trivial complications had occurred during and after bronchoscopy. The high diagnostic and therapeutic benefits, with low rate of complications, strongly support the use of bronchoscopes in children and infants who have a variety of pulmonary problems

Lead exposure and sociodemographic parameters affecting the cognitive function of a sample of children in Qalyoubia governorate

This cross-sectional, short term study is conducted in Benha city at randomly selected primary school. The target group is 100- randomly chosen- children of the 4th and 5th grades. They were subjected to a structured questionnaire for personal and familial data. IQ - is assessed using Stanford Beneit test. Blood samples were drawn to determine haemoglubin level as well as blood lead level. Scholastic achievement of the target group was measured using the mean of the last 3 months marks. Analysing data of the study reveals that 64% of children included in the study were urban residents while the remaining 36% were rural inhabitants. Urban inhabitants show statistically significant higher percentage for normal IQ. The present study reveals that Hb.%, blood lead level, mother's smoking as well as residence significantly affect the IQ. of children. Regarding scholastic achievement as an indicator for cognitive function it was found that Hb.%, blood lead level as well as I.Q. are the best predictors. Monitoring [Both environmental and Biological] is required to assess lead level in the environment as well as blood lead level. Environmental sources of lead and its hazards are required to be highlighted. Mass screening of school children for anaemia is required and subsequently proper treatment for anaemia and anaemia predisposing conditions. Finally hazards of smoking, especially by mothers, is required to be highlighted

epidemiological study of female circumcision in Benha city, Kalyoubia governorate

This cross-sectional study was conducted on 350 target females having at least one female child daughter between 5 and 15 years old, who attended MCH center in Benha city, Kalyobia Governorate during the period from July to September 2000. The study aimed at determining the magnitude of the female circumcision problem in Kalyoubia Governorate and to highlight some factors that influence the attitude of mothers towards its practice. Results revealed that the circumcised mothers were 84.6% and 73.4% of their daughters were circumcised, 63.4% were performed at age 5-9 years, 67.7% of them were carried-out by non medical personnel, 73.2% were performed without anesthesia and 30.7% of them had complications. Also, the study illustrated that significant associations exist between some sociodemographic characters of mothers and their attitude and practice of female circumcision. Mothers aged 30 years and above, rural mothers, those married at age less than 20 years, the illiterate and read and write, those with illiterate husband, housewives and mothers who belonged to low social class were more significantly agreed with performance of female circumcision. The study revealed the dire necessity to an integrated educational program to be delivered through primary health care services to change the attitude of population towards the practice of female circumcision

Hand needle stick injuries among nurses in Kalyoubia governorate

This prospective study was designed to throw some light on frequency of occurrence and complications resulting from needle stick injuries in nurses working in health care units of Kalyoubia Governorate. A total of 200 nurses were interviewed to answer a structured questionnaire. The target group was followed up using hepatitis B and C markers. Analysis of data shows that the mean age of the studied group was 42.22 +/- 7.35. Forty nine percent of the studied nurses were urban inhabitants, while 51% were rural inhabitants. Thirty eight percent of the studied nurses were employed for less than 10 years, 33.33% were employed for more than 20 years. About seventy one percent of nurses working in immunization show injuries in fingers. About 85% of nurses working in non-immunization units show injuries in the palm and dorsum. Health care seeking differs among individuals. The majority [86.67%] of nurses working in immunization don't seek treatment, 9.52% treated with antiseptic. However the perception of seriousness of illness were more obvious among nurses working in non-immunization tasks as the majority of them [64%] seek treatment in the form of local antiseptics [37.89%], medical treatment [10.5%] and surgical treatment [15.79%]. Only 1.9% of nurses working at immunization units had positive past history for hepatitis. On follow-up of these nurses by hepatitis B and C markers 6 months later, it was found that 11.43% of nurses working in immunization unites show positive HBs Ag compared to 3.16% + ve HBs Ag of nurses working in non-immunization units. However, nurses working in immunization unites show the presence of anti-HCV antibody in a percentage of 29.52%. Nurses working in non-immunization unites show statistically significant correlation higher percentage for being negative for anti HCV antibodies. Needle stick injury show negative statistically significant correlation with the duration of employment and nurses age. However, needle stick injury is correlated positively with presence of HBs Ag as well as Anti HCV antibodies. That calls for intensive pre-service and in-service training programs for nurses to follow safty rules to avoid needle stick injuries. Hepatitis B vaccine should be compulsory for all health care providers

Correlation between serum and gastric levels of tumor necrosis factor - alpha and interleukin - 8 in patients with Helicobacter Pylori infection

This study was carried out to determine the rate of H. pylori infection among dyspeptic patients and to investigate if there is a correlation between the inflammatory cytokines, TNF-a and IL-8 and the mucosal damage observed in H. pylori infected patients by comparing the mucosal levels of these two cytokines with their serum levels and the endoscopic diagnosis. Two prepyloric antral biopsy specimens, serum samples and gastric juice were collected from 60 dyspeptic patients, 50 with gastr oduedenal lesion [20 with gastritis, 9 with duodenitis, 9 with gastric ulcer and 12 with duodenal ulcer] and 10 with normal endoscopic findings [control group]. It was found that, out of 60 dyspeptic patients, 32 were found positive for H.pylori [53.3%], out of these 32 cases, 30 [93.75%] were symptomatic and had different gastroduodenal lesions, and 2 cases [6.25%] were asymptomatic and diagnosed as functional dyspepsia. The rate of infection is significant only in the patient group with gastroduodenal lesion compared to the control group. [p < 0.05] .The prevalence of H. pylori infection among patients with non-ulcer dyspepsia is [45%] while its prevalenc among patients with gastric or duodenal ulcer is [81%]. The difference in prevalence is statistically highly significant [P< 0.01]. It was found that the rate of H.pylori infection is higher in males [78.12%] than females [21.87%] and in patients more than 40 years old [68.75%] than those less than 40 years old [31.25%]. The levels of TNF-a and IL8 in gastric juice of patients with gastroduodenal lesion were significantly higher than those of controls [p < 0.001] Also, the levels of IL8 in serum of patients with gastroduedenal lesions were significantly higher than those of controls. However, the serum levels of TNF-a in these patients did not differ significantly from those of controls [P > 0.05] The levels of TNF and IL8 in both the gastric juice and serum of patients with ulcer dyspepsia [gastric and duodenal ulcer] were significantly higher than those of patients with non-ulcer dyspepsia Also, the levels of TNF-a and IL8 in gastric juice samples of H. pylori-positive patients with gastroduodenal lesions were significantly higher than those of H. pylori-negativc ones. To the contrary serum levels of TNF-a and IL8 of H. pylori-positive patient did not show a statistically significant difference from those of H. pylori-negative cases. Moreover, a statistically significant positive correlation was found between the levels of TNF-a and IL8 in gastric juice of patient positive for H. pylori. This study concluded that the increased gastric production of IL8 and TN F-a may be implicated in the pathogenesis of H. pylori associated gastroduodenal diseases, and understanding the potential role of these two cytokines in inflammation may provide a new basis for the design of anti-inflammatory agents used in treatment

Dialyzer reuse and hepatitis C virus in hemodialysis population in Egypt

In this work, we have evaluated the potential risk ofdialyzer reuse in transmission of hepatitis C virus [HCV] among hemodialysis [HD] patients. Two groups of regular HD patients from 7 dialysis units in Cairo, matched for risk factors of HCV, were tested for anti HCV antibodies at start of the work and 6 months later. Group A [Non-reuse group] [170 patients] with single use dialyzers and Group B [Reuse group] [165 patients] with reused dialyzers. Results indicate a prevalence of anti-HCV of 76.1% in nanreuse group and 67.3% in reuse group with no significant difference between both groups. Both reuse and non reuse grops show a similar correlation between prevalence of anti-HCV and all studied risk factors for HCV transmission. Duration of dialysis stands as the main risk factor for increased HCV prevalence. Sero conversion rate of anti HCV positivity was similar in the non reuse [21.6%] and reuse group [20.8%]. We emphasize the high prevelence of HCV and high frequency of detected sero conversions among HD patients whether on reuse or non-reuse dialyzers. There appears to be other risk factors that play a role in increasing HCV in both reuse and non-reuse patients

Role of ultrasonography in dagnosis of acute intussusception in children

Intussusception represents the most common abdominal emergency in early childhood. To assess the diagnostic value of ultrasonography in clinically suspected acute intussusception, we compared U.S and barium enema studies in 24 infants and young children. Ninteen cases were diagnosed as intussusception by the presence of the characteristic, sonographic appearance [doughnut and pseudo kidney sign]. All cases were examined with barium enema under fluoroscopic guidance for confirmation of the diagnosis and as a trial for hydrostatic reduction [partial or complete] of the positive cases. The sensitivity of U.S was 100%in detection of the intestinal mass. Complete barium reduction was successful in 14 out of the 19 cases of intussusception. Ultrasound and barium enema compare favourable to each other for the diagnosis of intussusception. However, US is easier and less time consuming