Awareness and practice of patients' rights among hospitalized patients at Wad-Medani Teaching Hospital, Sudan

Patients' rights are a fundamental human right and an important part of modern health care practice. This is a cross-sectional descriptive analytic study, conducted amongst 263 patients at Wadi-Medani Teaching Hospital, Sudan, in March-April 2015. Most patients [95.2%] did not know about the Bill of Rights and most of them [92.8%] were not able to mention any of the patients' rights. The most practiced rights were: the right to be asked for permission before examination [88.1%], proper handling [87.8%], safety of the hospital [87%], presence of a third person when examining a female by a male doctor [85.6%], and admission file confidentiality [75.5%]. The awareness of Sudan FMOH Patients' Bill of Rights was very low among patients at Wad-Medani Teaching Hospital, yet they showed a high satisfaction rate probably due to their low socioeconomic status, educational level and expectations. Therefore, awareness of patients' rights must be increased

Risk factors of perinatal and neonatal mortality in Alexandria, Egypt

Background: Egypt has already achieved the goal of reducing the under-five mortality rate [U5MR] by two-thirds. However, one of the challenges that Egypt currently faces is how to reduce the perinatal and neonatal mortality [PM, NM]. This study aimed to identify the social and biomedical risk factors contributing toward PM and NM in Alexandria, Egypt

Participants and methods: A case-control design was used. Cases were 150 mothers whose index pregnancy terminated in perinatal [from the 28th week of pregnancy to less than 7 days after birth] and neonatal deaths [from the seventh day to less than the 28th day after birth]. They were selected from the antenatal clinic and neonatal care unit of ElShatby University hospital for Obstetrics and gynecology. Controls were 150 mothers with live births ranging in age from 28 days up to 2 months selected from the outpatient clinics of ElShatby University Hospital for Pediatrics

Results: Stepwise logistic regression analysis indicated a higher risk of PM/NM among very young or very old mothers [OR=4.1 and 6.46, respectively], those who had previous PM/NM [odds ratio [OR]=12.7; 95% confidence interval [CI]: 5.04-29.54], grand multiparous [OR=2.23; 95% CI: 1.50-5.42], those with infrequent antenatal visits [OR=3.88; 95% CI: 2.26-6.65], and mothers with complications during the index pregnancy [OR=9.21; 95% CI: 3.40-24.95]

Conclusion: This study confirms the evidence of a positive association between PM/NM and maternal age, obstetric history, and utilization of healthcare services. Appropriate age at marriage and pregnancy, spacing of and limiting the number of births, and improving antenatal, natal, and postnatal care are priority actions that can reduce PM/NM in Alexandria

Evaluation of some cucumber inbred lines and their hybrids for cucumber mosaic virus [CMV] resistance

The major objective of our cucumber breeding program involves breeding for CMV disease resistance to reduce losses in quality and yield. Seven half diallel cross hybrids resistant to CMV were developed at the Vegetables Breeding Dept., Hort. Res. Inst., Egypt during March, 2006. Sixteen genetically different pure inbred lines of Cucumis sativus were used to develop the hybrids obtained from different sources and selected for their CMV disease-resistance trait. The inbred lines and one commercial [Beit alpha] cultivar as a susceptible control were examined to CMV resistance using biological, serological and molecular methods. The CMV isolate identified by Plant Path. Res. Inst. Virus and Phytoplasma Res. Dept. [ARC] was used in mechanical inoculation of all cucumber genotypes used during this study. The seeds of the genotypes were incubated and the seedlings were cultivated in foam trays with peat soil and kept under greenhouse conditions. At the cotyledon stage, i.e. before the development of the first true leaf, the seedlings were mechanically inoculated by rubbing with virus inoculum. Disease severity was assessed visually 7- 10 days [on cotyledons] and 14-25 days [on true leaves] after inoculation with CMV. The results revealed that six out of sixteen cucumber inbred lines [Cus 260/1980, 6-5-23-2 Kaha, 1-180-309- 18-105 Dokky, 5-57-22-17 Kaha, Cus 38/1991, and 25-2-1-90 Kaha] were found to be without systemic symptoms of CMV infection and proved to be resistant to CMV when tested by DAS-ELISA and RT-PCR. The promising accessions as sources of resistance have been intercrossed with leading commercial type [Beit-alpha] in half diallel system. In order to determine the genetic polymorphism and discriminate between cucumber inbred lines, RAPD-PCR analyses were conducted on the DNA isolated from each line. Dendrograms representing genetic distances were performed on the studied genotypes using the UPGMA [Unweighted Pair Group Method with Arithmetic Average]. Twenty one cucumber hybrids obtained from the half diallel crossing between the six resistant genotypes and the local commercial cultivar [Beit-alpha] were subjected to CMV artificial inoculation in a separate greenhouse and symptoms were visually monitored for two months. Only seven cucumber hybrids showed high a level of resistance to CMV were screened in the greenhouse and evaluated for CMV resistance. The resistant hybrids obtained did not develop visual symptoms of CMV infection on cotyledons and true leaves. These resistant lines could serve as potential sources of resistance in breeding programs

association between nitrate contamination of drinking water and changes in methemoglobinemia and other hematological parameters in young and adult male rats

The objective of this investigation was to study the effect of prolonged exposure to nitrate polluted drinking water on blood methemoglobin [Met-Hb] level and other hematological parameters, as well as nitric oxide [NO] level in serum and urine [measured as indicator for nitrate toxicity] in male rats of two different ages, young [3 weeks-old] and adult [12 weeks-old]. Rats were administered sodium nitrate in drinking water at concentrations [100 mg/L = 8.7 mg/Kg, 250 mg/L=21.7 mg/Kg or 550 mg/L 47.7 mg/Kg] daily for four months. The obtained data showed a dose dependent reduction in the values of erythrocytes, leucocytes and platelets count, as well as jib content, Het%, MCV, NCH, MCHC and serum total iron in all nitrate exposed rats, with the marked decreases being occurred among the young animals. On contrary, nitrate exposure revealed a dose dependent increase in blood Met-Fib level, as well as NO production in serum and urine of all tested rats, however the young rats were more affected than the adult ones at different nitrate concentrations. This indicated that prolonged exposure to water nitrate pollution is a risk factor for developing increased Met-Hb level and the other hematological disorders in all the rats groups, particularly the when exposure started at young age which may contribute to the excess production of NO in response to nitrate exposure

prophylactic role of some edible wild plants against nitrosamine precursors experimentally-induced testicular toxicity in male albino rats

For a long time, nitrosamine compounds have been implicated in the pathogenesis of several clinical disorders, however, recent advances in biosciences support the hypothesis that diet improves various body functions and reduces the risk of some diseases. Therefore, the aim of the present study was to evaluate the ameliorative effect of two edible wild plants including purslane and chicory against the adverse biochemical action and testis injury induced by nitrosamine compounds resulting from the co-administration of sodium nitrite and chlorpromazine [CP] precursor in male rats. The results of the present study revealed that the concurrent administration of both sodium nitrite [0.05%] and chlorpromazine [1.7mg/Kg/day] for eight weeks caused a marked toxic effects on the testicular functions as indicated by the inhibition of serum testosterone and luteinizing hormone [LH] levels with concomitant increase in the activity of alkaline and acid phosphatase [ALP and ACP]. In addition, total protein content was decreased. Moreover, the testicular oxidative stress markers; lipid peroxidation and protein carbonyl group were significantly increased, while a marked decrease in the content of testis glutathione [GSH] as well as the activity of glutathione-S-transferase [GSH-S-T] and catalase was demonstrated. However, the occurred disturbances in the testicular functions and the above mentioned parameters were significantly improved as a consequence of feeding the sodium nitrite plus chlorpromazine treated rats on purslane [5% w/w] or chicory [10% w/w] for eight weeks indicating a protective role of purslane and chicory plants against the toxic effects of nitrosamine carcinogenic compounds resulting from interaction between sodium nitrite and chlorpromazine

Effect of dietary supplementation with tigernut tubers on streptozotocin-induced diabetic rats

This work has been carried out to detect the effect of tigernut tubers as an antidiabetic plant on some biochemical parameters in streptozotocin [STZ]-induced diabetic rats. Diabetes mellitus was induced by a single intraperitoneal injection of 45 mg STZ /kg body weight. The present results indicated an increase in both serum glucose level and liver glucose-6-phosphatase [G6P] activity in STZ-diabetic rats. In addition, a significant decrease in serum insulin level and liver glycogen content was recorded in the same rats. Moreover, serum total lipids, total cholesterol, triglycerides and LDL-cholesterol levels revealed a significant increase, while a decrease in the level of HDL-cholesterol was observed in STZ-diabetic rats. The activity of serum aspartate aminotransferase [AST], alanine aminotransferase [ALT] and alkaline phosphatase [ALP] showed marked increase in STZ-diabetic rats. On the other hand, tigernut-supplemented diet [25% w/w] for two or four weeks recorded a significant improvement in all the above biochemical parameters affected by STZ injection especially after four weeks of treatment. Therefore, it was concluded that tigernut tubers had appreciable hypoglycemic and hypolipidemic effects on STZ-diabetic rats

Cytokines, lipid peroxide and nitric oxide in Egyptian hepatocellular carcinoma on top of HCV and HBV infection

Many studies have shown the relative roles of hepatitis B and C viruses in hepato-carcinogenesis. The aim of this study is to define the independent and interactive roles of some cytokines namely, TNF alpha , IL-6, IL-1 beta together with NO and TEARS in the genesis of HCC following the infection with such viruses. Blood samples were taken from 58 patients with hepatocellular carcinoma and were divided into four groups: a] 28 patients with HCV, b] 10 patients with HBV, c] 11 patients with B+C, d] 9 patients without viral infection. In addition, 20 healthy subjects served as control group for each, TNF alpha , IL-6, and IL-1 beta were measured using ELISA technique, in addition to NO and TBARs using chemical methods. Patients with coinfection B-C viral infection showed the highest levels in studied parameters. Patients with HCV and HBV separately showed more or less similar results. However, patients without viral infection showed the least higher levels comparing to the control group. Cytokines in addition to NO and TEARS have a definite role in hepatic carcinogenesis. Coinfection with the two viruses carries a synergistic risk factor of hepatocellular carcinoma development. Depending on the results of the studied parameters HCV did not show predominancy on HBV. Further studies are needed to clarify the exact mechanism of carcinogenesis especially in HCV patients

The possible protective role of bees honey against hazard effects of some synthetic food additives on the kidney functions of male rats

Recently the use of synthetic food additives was increased and the levels of human exposure to such agents are very broad, thus feeding over long periods may continually possess potential hazards to the human health. Also, protection against the adverse biological action of these widely used preservatives deserves a great attention. Therefore the aim of this work was to evaluate the protective role of bees honey against the kidney dysfunctions induced by food additives [sodium nitrite as a food preservative and sunset yellow as a food colorants] in male albino rats. The results of this study revealed that the oral administration of both sodium nitrite [10 mg/Kg body weight] and sunset yellow [0.6% w/w in diet] for 4 weeks induced renal dysfunction as reflected by a significant elevation in serum levels of uric acid, urea and creatinine, which was accompanied with a significant reduction in their urinary levels as well as in creatinine clearance. This results is apparently linked to the presently observed increase in potassium and decrease in sodium and calcium levels in both serum and urine. The study also showed a significant decrease in total protein and albumin levels as well as an increase in renal protein carbonyl content in rats administered both sodium nitrite and sunset yellow. Furthermore, enzymes activity represented in alkaline phosphatase [ALP], gamma-glutamyl transferase [gamma GT] and Na[+]/K[+] ATPase showed marked increase in both ALP and gamma GT and decrease in Na[+]/K[+] ATPase activity, while the number of the nephrons was non-significantly changed after the administration of these food additives. On the other hand, the daily intake of natural bees honey at a dose of 2.5g/Kg body weight resulted in sufficient amelioration against the hazard effects of food additives as indicated by the observed improvement in all tested biochemical parameters of kidney functions. Virtually, strict regulations have been set for the use of synthetic food additives to avoid introducing materials injurious to health

Body fat distribution, serum leptin, and insulin resistance in obese subjects with obstructive sleep Apnoea

Obstructive sleep apnoea [OSA] is strongly associated with obesity and is characterized by endocrine and metabolic changes. The aim of the present study is to clarify whether there is interrelationship between body fat, serum leptin, glucose-insulin metabolism and OSA

Subjects and measurements: We studied 23 obese subjects with OSA [13 males,and 10 females; age mean 36 +/- 4.4 years; BMI: 31.7 +/- 3.6 kg/m2; WHR: 1.2 +/- .25 in males and 0.81+.5 in females ;Apnoea Index "AI"[ 9.2 +/- 6.1] event/hour of sleep by means of overnight polysomnography; fasting glucose[109.8 +/- 21.4 mg/dL] ; fasting insulin[18.6 +/- 7.1 uU/L ]; IR[6.7 +/- 2.8]; fasting leptin[577.69 +/- 201.6 ng/ml]. Results were compared with those of 10 healthy normal weight subjects[6 males,4 females; age mean 36.8 +/- 4.4 years; BMI: 25 +/- 0.24 kg/m2; WHR: 0.86 +/- 0.01; AI: 2.1 +/- 1.1 event/hour; fasting glucose[71.7 +/- 2.8 mg /dL ]; fasting insulin[15.3 +/- . 48 uU/L ]; IR[4.6 +/- . 17]; fasting leptin [42.4 +/- 11.5 ng/ml]

Results: Anthropometric measurements of OSA subjects were highly significantly greater than controls; body weight [P<0.003]; BMI [P<0.00]; waist [P<0.000]; and WHR [P<0.000]. Fasting glucose levels; fasting plasma insulin; IR and leptin levels were significantly higher in OSA subjects than controls [P<0.000, 0.03, 0.002; and 0.000] respectively. Overnight polysomnography revealed significant difference between OSA subjects and controls as regards AI [P<0.001]. The major dependent outcome variable was the apnoea index [AI], "the average number of apnoeas per hour of sleep determined by overnight polysomnography". OSA was defined as AI >/= 5. Highly significant correlation between AI and WHR [P<0.00]; Fasting insulin [P<0.04]; IR [P<001] and Leptin [P<0.000] were detected. Also leptin concentrations correlated with fasting insulin [P<0.02]; IR [P<0.00] and WHR [P<0.000] besides the AI

In Conclusion: There is strong bidirectional, feed-forward pernicious correlation detected between OSA in one side and each of visceral obesity, leptin, and IR; also between leptin, obesity, and IR. This association may contribute to the pathological manifestations and somatic sequale of this condition. Leptin could have major role linking OSA with various metabolic abnormalities detected in obese subjects. High circulating leptin found in this study, suggests that both obesity and OSA may be caused by a leptin resistant state. Among obese subjects, it is visceral fat [WHR], rather than generalized obesity [BMI] that predisposes to OSA

Women's perception and experience of menopause: a community-based study in Alexandria, Egypt

To determine symptoms, perceptions and practices after natural menopause by women aged 50-59 years, we conducted a cross-sectional study of 450 women from Alexandria. The most frequently recalled symptoms were tiredness [96.0%], headache [95.1%], hot flushes [90.7%], skin wrinkles [90.7%] and decreased sexual desire [89.1%]. About 91% of women had never heard about hormone replacement therapy; 42.7% would expose their body to the sun; 12.4% were moderately active the year before menopause. Multiple regression analysis indicated that women's knowledge about menopause was related to marital status, education and employment status; practices were related to pattern of menopause, age of menopause and income

use of ginger [zingiber officinale] powder to modulate the carbon tetrachloride- induced oxidative stress in rat brain

Environmental contamination with the various toxins including carbon tetrachioride is a problem of national region as well as global importance. Carbon tetrachloride [CCI[4]] is a neurotoxin capable of altering membrane structure and function. Therefore, the present study was designed to investigate the biochemical alteration and oxidative stress induced in the brain of male rats by CCI[4] In addition, the possible role of ginger in modulating these adverse effects was evaluated. Adult male rats were given a single dose of CCI[4] [4 ml/Kg b. wt of 50% v/v CCI[4] in olive oil, subcutaneous] followed by ginger supplemented diet [1%] for 4 weeks. The administration of CCI[4] produced a significant increase in thiobarbituric acid reactive substances [TBARS] indicating increased lipid peroxidation [LPO] and a significant decreased in brain glutathione content In addition, the activity of superoxide disamutase [SOD], acetylcholine esterase [AChE], and Na,K-ATPase enzymes as well as phospholipids concentration were significantly decreased, whereas the activity of lactic dehydrogenase [LDH] enzyme was significantly increased in CCI[4]-intoxicated rats. However, administration of ginger to CCI[4]-intoxicated rats exerted an improving effect on brain biochemical abnormalities and oxidative stress recorded with CCI[4] intoxication, suggesting that ginger can alleviate the neurotoxin effects of CCI[4]

Canonical correlation analysis of the determinants of menopausal symptoms

To describe the intensity and determinants of symptoms commonly attributed to the menopause among a random sample of women aged 50 to 59 years, selected from the total population of a geographically defined area. Data were collected based on a cross-sectional design using structured questionnaire and face-to-face interview survey. Households. Four hundred and fifty women, aged 50 to 59 years, randomly selected from Alexandria residents by the method of cluster sampling. Self-reported symptoms, factor scores for menopausal symptoms extracted by factor analysis, and an index for the number of experienced symptoms.77.5% of currently married women and 800.3% of unmarried women reported moderate-to-severe symptoms with significant differences between the two groups in intensity of vasomotor [more intense among married], psychological, and miscellaneous [more intense among unmarried]. Canonical correlation revealed seven significant roots among married women explaining 82.2% of variance in menopausal symptoms and four among the unmarried explaining 57.5% of variance. Among married women, the prominent factors in relation to menopausal symptoms are duration of hormone use, obesity, knowledge and attitude concerning menopause, pattern of menopause, and physical activity. Among the unmarried, there were also correlations of menopausal symptoms with same factors in addition to work, education, and time since last menses. Though menopause is a natural biological process, it has been shaped by social, economic, medical, and reproductive factors. Putting these factors in mind of health care workers can help women to go through this passage of life with no or minimal discomfort

intervention programme for improving the nutritional status of children aged 2-5 years in Alexandria

We assessed the effect of a selected intervention on the nutritional status of 2-5-year-old children in day care centres. Using a longitudinal prospective pretest/post-test intervention design, 974 children from 3 day care centres in Alexandria were followed for 1 year. Anthropometric measurements and 3-day 24-hour recall data were gathered at base line and dietary intake was calculated and compared with recommended daily allowances. An intervention programme was implemented through the establishment of kitchens in the 3 centres, provision of 2 meals/day, nutrition education for parents and training of supervisors. Baseline data revealed deficient intake of most nutrients especially calcium, calories, vitamin C and iron. Post-intervention test revealed improvement in mothers' nutrition knowledge and the percentage of anaemic children decreased from 47.3% to 14.2%. A decrease in the percentage of underweight, stunted and wasted was also observed. The cost of the programme per child per year was US$ 20.5

Role of some inflammatory mediators in asthmatic children below 5 years of age

This study was carried on 38 children [24 boys and 14 girls] between 2 and 4 years of age suffering from wheezy chest. In addition, 15 age matched apparently normal children were included in the study serving as normal control group. Eosinophilic cationic protein [ECP], sICAM-1 and E-selectin were measured during both acute exacerbation and stable condition. The results showed that ECP concentration was significantly higher in children with acute wheezy exacerbation than either in stable condition or in control group. Total blood eosinophilic count showed nonsignificant increase in children with acute wheezy exacerbation than either children in stable condition or in control group. Serum sICAM-1 was significantly higher during acute exacerbation of asthmatic children than those in stable condition or control group. The results of E-selectin showed a significant increase during acute exacerbation of asthmatic children than either in stable condition or in control group. E-selectin level in children in stable condition also showed significant difference when compared to control group. These results suggested that these parameters play an important role in the pathogenesis of asthmatic children below 5 years of age

Fetal cardiac dysfunction in pre-eclampsia [combined doppler ultrasonography and biochemical study]

The purpose of this study was to correlate Doppler ultrasonographic parameters of fetal haemodynamic compromise with neonatal umbilical artery cardiacTroponin T [cTnT] level as a biochemical marker of fetal cardiac dysfunction in pregnancies complicated by preeclampsia [PE]].This study comprised 50 pregnant women, recruited within two years duration, from the antenatal care clinic and the high-risk pregnancy unit of Alnoor specialist hospital, Holy Makkah, KSA. Their gestational ages were ranging between 32-38 weeks and they were divided into: control group [20 women] with normal pregnancies [G] and study group [30 women], out of them 20 with PE without any ultrasonic Doppler detection of transmitted atrial pulsations to the intra-abdominal portion of fetal umbilical vein [GII] and 10 women with PE with ultrasonic Doppler detection of transmitted atrial pulsations, to the intra-abdominal portion of fetal umbilical vein [GIII]. For all cases routine ultrasound scanning, Doppler velocimetry [S/D ratio] for umbilical artery [UA] and for the intra abdominal portion of umbilical vein were done. Maternal cubital vein and neonatal UA serum troponin- T levels was measured. Cardiac troponin T concentrations showed high significant increase [P <0.01] in neonates who had transmitted atrial pulsations in fetal intra-abdominal part of umbilical vein, suggesting fetal myocardial cell damage, with the higher levels in fetuses with severe placental insufficiency, showing absent end-diastolic or reversed flow in UA. Maternal troponin T concentrations were within normal levels, even in cases in which neonatal troponin T levels were increased, which demonstrate that the umbilical artery troponin T measured in neonates was not of maternal origin.Doppler detectable transmitted atrial pulsations in the intraabdominal part of the umbilical vein is an ominous Doppler sign for fetal outcome in cases of PE associated with placental insufficiency, indicating fetal myocardial damage and mandates prompt delivery in hospital with well-equipped neonatal intensive care unit. The optimal timing of delivery in such cases should be before the appearance of this bad prognostic sign, depending on other Doppler parameters of fetal circulation

Triple H syndrome: a novel auto-immune endocrinaopathy characterized by dysfunction of the hippocampas, hair follicle and hypothalamic pituitary - adrenal axis a replication study

In this study, we described two, unrelated adult, female and male patients. They developed sever fatigue, weakness, anxiety postural hypotension and hypoglycemia. Progressive alopecia areata with impairment of antrograde memory were also present. Marked hypocortisolemia, Anti bodies to some endocrinal cells. Associated with radiological abnormalities in the hippocampus were detected. The similarity between these two cases and the uncommon nature of the component abnormalities suggest the involvement of a molecular target for autoimmunity shared among hippocampus, hair follicle and the hypothalamus and/or corticotrophin, it is the cause of its name "Triple H. Syndrome". A German female 41 years old presented to the endocrine department of AI- Aahraa university Hospital in September 2002 with total loss of body hair. In year 2000 the patient noticed progressive constipation, loss of appitite and sleeping tendency. This was associated with loss of memory specially for recent events. Laboratory investigation in the form of free T[3], free T[4], TSH and thyroid AB were done [Table 1], and the patient was diagnosed as having hypothyroidism. She received medical treatment in the form of EI-Troxin 75 Mic. gm/d. and the condition gradually improved. After 7 months of treatment the patient became pregnant, after delivery she started to lose scalp hair gradually, followed tow months later by loss of eye brows, axially and pubic hair. Subsequently she complained of fatigue, memory loss especially for recent events along with symptoms of hypertension and repeated hypoglycemic attacks

T lymphocyte subpopulation and function in children with shigellosis

This study was carried on sixty-two children aged from 12 to 60 months, attending TABARAK pediatric hospital with acute dysentery [visible blood in the stool and the presence or absence of fever]. Of the 62 children enrolled in this study, 43 had shigella dysentery 1 [S, dysentery] infection and 19 children matched for age and without any infection as control group, [NI; n= 19]. Children with S. dysentery were divided into 3 groups: those who had HUS or leukomoid reactions [complicated shigellosis, CS; n=25], those who developed complications following enrollment [subsequently complicated shigeliosis, SCS; n=6], and those who had no complication [uncomplicated shigellosis, US; n=12]. T lymphocyte subpopulation and function was evaluated for these children

RESULTS showed that children with SCS differed from other groups in as follows: [i] the number of CD3 and CD4 was lower compared to NI children [P<0.05]. [ii] CD4/CD8 ratio was lower compared to US children [PO.05] and NI children [PO.05]. [iii] The level of DTH response was lower than this in children with US [PO.05]. Three to five days after enrollment, the number of CD4 cells increased in children with SCS, The results showed that T lymphocyte phenotypes and function were altered prior to development ofcomplication in children with shigellosis, and once complications develop, the pattern of alteration changes. Whether these alterations have a role in predicting complications or whether they reflect events underlying the development of complications remains to be elucidated

Sickle cell infections among Saudi children

In this study, a total of 350 pediatric patients with sickle cell anemia was admitted to the Pediatric Ward of Military Hospital of Sharourah in the Southern Region of Saudi Arabia. Thirty-three patients had a major infection [septicemia, meningitis or osteomyelitis] with an incidence of 9.4%. During the same period of the study, a total of 3400 non-sickle children was admitted and 35 of them had a major infection with an incidence of 1%. Three patients died in the sickle cell group with a case fatality rate of 9.1%, while one patient in the control group died with a case fatality rate of 2.9%. Salmonella species were responsible for 11 cases of septicemia and 3 episodes of osteomyelitis and Streptococcus pneumoniae was the source in 7 cases of septicemia and one case of meningitis in sickle cell disease cases. Meningitis was caused by different organisms, such as Streptococcus pneumoniae, Salmonellae and Meningococci

Utilization of survival analysis to predict age of natural menopause for working women in Alexandria University

A stratified random sample of 527 women aged 40-65 years was selected in two stages. In the first stage, five colleges were selected randomly from a list of all collages; in the second stage, stratification was made according to job and the sample was allocated proportionally over strata. Two methods of survival analysis were used: The Kaplan-Meier method was used to estimate the median age at the natural menopause and Cox-regression analysis was used to study the correlates of age at the natural menopause. The mean current age of the study group was 47.23 +/- 5.06 years, 26.8% were staff, 59.0% employees and 14.2% workers. Cox-regression revealed that women with higher hazard of menopause at a given age are characteristically of low job category, consumers of red meat > once/week, with a small amount of menstrual bleeding, not practicing sporting, with chronic illness, with > 24 years age at first full-term pregnancy and with late age at menarche. Monitoring of the timing of age at the natural menopause may be a useful instrument to assess the impact of intervention strategies aimed at changing practices related to family planning and contraception

Nutritional status of adolescent girls in secondary school for nurses

This study was carried out on adolescent girls in a secondary school for nurses which offers two meals to students during the day [breakfast and lunch] to explore the effect of school dietary program on the nutritional status. Adolescents [100 girls] consumed on the average 91%, 71% and 103% of the recommended dietary allowances for iron, vitamin A and vitamin C, respectively, from the school meals. These school meals provide more than 200% of the recommended dietary allowances for protein to adolescents and more than 75% of RDA of energy. No significant difference in mean blood indexes of anemia was noticed between girls who consumed more or less than 30% of RDA of energy from home meal. The data available proved that school meals as supplement to home food had the desired effect, but some modifications were required to achieve their goals