Nutritional status and serum leptin levels among a group of chronic liver disease Egyptian patients

Chronic liver disease [CLD] is one of the most prevalent morbidity problems in Egypt. A balanced diet can actually help the damaged liver to regenerate new liver cells. Early nutritional assessment and dietetic interventions are keys in helping to provide optimum success with these patients. Leptin is an adipose-derived hormone that plays an important role in regulating food intake and energy expenditure in mammals. Investigating the dietary characteristics as well as the overall nutritional status in relation to serum leptin levels in a group of Egyptian CLD patients. This was a descriptive exploratory study. It was conducted in the Tropical Medicine Department in one of the tertiary Care University Hospitals in Egypt. Commonly adopted last year dietary pattern was assessed in 59 males and 31 females with CLD. The body mass index [kg/m[2] was used to express the overall nutritional status. Serum leptin levels were determined by ELISA. Patients were categorized using the modified Child- Pugh criteria. Though most of the patients were diagnosed since more than a year ago, their food pattern was unbalanced. The most commonly and frequently food items included low cost cereals, fresh vegetables and fruits. Additionally, skimmed white cheese was the main source of high biological value proteins. Fats and oils were the least consumed especially by the Child C patients. In the advanced stages of liver disease, there was a significant decline in serum leptin levels if compared with the early stages. Significant positive correlations were found between serum leptin levels with the BMI in the overall patients and in both sexes specially females. Most of the studied patients did not follow balanced diet. Serum leptin levels tend to decline as liver function worsens. The physiologic correlations of serum leptin levels, sex and BMI were all preserved in CLD patients. Patients with CLD especially who live at the border line and mostly due to HCV, should be highlighted as one of the nutritionally at-risk groups. Serum leptin levels should be put into consideration while providing the timely appropriate nutritional guidance and counseling to the CLD patients

Implications of primary health care integration among a group of upper Egyptian women: a community based study

Integration of the fragmented vertical program is crucial for the efficiency and effectiveness of the primary health care [PHC] services. Therefore, identification of the strengths and challenges confronting the integration process through family medicine [FM] approach in some pilot projects will give insight to the potential to capitalize on the gains achieved. The study is an operations research, post intervention design. It used a test health facility [PHC unit implementing FM approach in rural Upper Egypt], and a comparative health facility in a demographically matched village [PHC unit operating according to the traditional PHC vertical programs]. Data sources were household survey, service statistics, and in depth interviews with the principal official stakeholders. The findings show that, the volume of services delivered in the test group showed initial increase. However, with no pronounced community satisfaction As well, the profile of utilization pattern did not show improvement specially for the women. The study recommended the gradual informed introduction of the concept of integration for all the concerned stakeholders including the served community.