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1.
J Investig Allergol Clin Immunol ; 17 Suppl 1: 17-23, 2007.
Article in English | MEDLINE | ID: mdl-18050567

ABSTRACT

The olive tree is grown in many parts of the world. Its germplasm is very broad, with 250 varieties in Spain alone. Variations in the ability of pollen to germinate have been studied in detail and show conspicuous differences between varieties. However, commercial olive pollen from cultivars whose origin is unknown is the material that is commonly used for clinical and biological studies. We aim to assess the putative heterogeneity of olive cultivars with regard to the presence of several pollen allergens and to determine whether these differences have biological and clinical relevance. Previous studies show that most allergens isolated and characterized to date are highly polymorphic. Olive cultivars display wide differences in the expression levels of many allergens and in the number and molecular characteristics of the allergen isoforms expressed. These differences are maintained over the years, and are intrinsic to the genetics of each cultivar. Such broad polymorphism seems to be involved in the physiology of the olive reproductive system, which might include the adaptation of the plant to different environmental conditions, the establishment of the compatibility system, and pollen performance. The differences in allergen composition in cultivars, particularly in the Ole e 1 allergen, are responsible for the important differences in the allergenic potency of the extracts. These findings could have a number of implications for the diagnosis and therapy of olive pollen allergy. We discuss how cultivar differences affect extract quality, diagnostic and therapeutic efficacy and safety, and the development of new vaccines based on the use of recombinant allergens.


Subject(s)
Allergens/immunology , Olea/immunology , Pollen/immunology , Allergens/chemistry , Allergens/genetics , Humans , Olea/genetics , Olea/physiology , Pollen/cytology , Pollen/genetics , Pollen/physiology , Polymorphism, Genetic , Protein Isoforms , Rhinitis, Allergic, Seasonal/diagnosis , Rhinitis, Allergic, Seasonal/immunology , Rhinitis, Allergic, Seasonal/therapy , Spain
2.
J Egypt Soc Parasitol ; 31(2): 603-16, 2001 Aug.
Article in English | MEDLINE | ID: mdl-11478459

ABSTRACT

Water samples from household tanks in several districts of Alexandria, were examined for protozoa contamination and study to the effect of ozone and chlorine on their viability. The parasitic protozoa encountered were Giardia (56%), Cryptosporidia (50%), Blastocystis (12%), Cyclospora (9%) and Microsporidia (3%). Distilled water was treated by ozone or chlorine. Ozonated-water samples were prepared at a concentration of 1 ppm after contact times with ozone of three, five, seven and nine minutes. Chlorine concentrations were 4 and 8 ppm. Parasites were incubated overnight at room temperature with the treated distilled water. Viability of the parasites was assessed by examining intestinal sections of infected animals. The best results were obtained by using ozonated water after a contact time of nine minutes. Giardia, Cryptosporidia and Microsporidia were completely inactivated, while infectivity of Cyclospora and Blastocystis was markedly reduced. It is suggested that ozone at an appropriate concentration inactivate pathogenic protozoa in water.


Subject(s)
Eukaryota/drug effects , Fresh Water/parasitology , Ozone/pharmacology , Animals , Egypt
3.
J Egypt Soc Parasitol ; 31(3): 647-56 + 1p plate, 2001 Dec.
Article in English | MEDLINE | ID: mdl-11775092

ABSTRACT

A newly simplified culture method, the In-Pouch TV culture system, the wet mount (WM) examination and the acridine orange stain were compared with the Oxoid culture as a standard technique in the diagnosis of trichomoniasis. Out of 70 symptomatic cases enrolled in this study, 28 specimens were positive by all methods. Among these positive specimens, 21 were positive by the Oxoid culture (75%) and 24 (85.7%) with sensitivity of 85.7% by the In-Pouch system. Both wet mount preparation and acridine orange stain had less sensitivity than the In-Pouch system (61.9%) and detected 15 (53.6%) and 16 (57.1%) of the cases respectively. The In-Pouch system has been proved to be easier in the transport and culture technique than the ordinary culture method. It alleviates the need to enter the culture, thus prevents contamination. Its cost is comparable to the ordinary culture tube. Therefore, it is recommended to use the In-Pouch culture system as a method of diagnosing trichomoniasis.


Subject(s)
Trichomonas Vaginitis/diagnosis , Trichomonas vaginalis/isolation & purification , Acridine Orange , Adolescent , Adult , Animals , Diagnostic Techniques, Obstetrical and Gynecological , Female , Humans , Microscopy, Fluorescence , Middle Aged , Sensitivity and Specificity , Vagina/parasitology
4.
J Egypt Soc Parasitol ; 31(3): 799-814, 2001 Dec.
Article in English | MEDLINE | ID: mdl-11775106

ABSTRACT

The present work was to clarify whether C. parvum oocysts have different strains in human patients by using different staining, electron microscopical and genetical techniques. A trial to induce a vaccine against Cryptosporidial infection in mice was carried out using killed autoclaved Cryptosporidial oocysts. The results obtained were satisfactory. Two genotypes of C. parvum, viz: human and zoonotic genotypes were detected and described. The killed vaccine used orally gave a promising results.


Subject(s)
Cryptosporidiosis/prevention & control , Cryptosporidium parvum/immunology , Protozoan Vaccines , Animals , Cryptosporidiosis/epidemiology , Cryptosporidiosis/parasitology , Cryptosporidium parvum/genetics , Cryptosporidium parvum/ultrastructure , Egypt/epidemiology , Humans , Mice , Microscopy, Electron, Scanning , Prevalence
5.
J Egypt Soc Parasitol ; 30(3): 709-16, 2000 Dec.
Article in English | MEDLINE | ID: mdl-11198368

ABSTRACT

Identification of Microsporidia detected in diarrhoeic stool of human and from press preparation of crabs, and bivalves muscles was done by staining with Giemsa, modified trichrome and H & E stains respectively. Positive samples were isolated & used for infection of 3 groups of mice viz group A human isolate, group B crab & group C bivalve isolates. Parasitological and histopathological studies using light and transmission electron microscopy (TEM) were done for samples from each group. The results clarified that human, crab & bivalve Microsporidia isolates showed common features. They were found in the supranuclear region of enterocytes. The stages observed were meronts, sporonts and free spores. Each spore was 1-2 um in length containing a single nucleus, a vacuole and a polar filament. Further genetical and biochemical studies will be undertaken to confirm the similarity or differences between these isolates.


Subject(s)
Crustacea/parasitology , Microsporidia/isolation & purification , Animals , Diarrhea/parasitology , Feces/parasitology , Humans , Mice , Microscopy, Electron , Microsporidia/ultrastructure
6.
East Mediterr Health J ; 6(5-6): 898-907, 2000.
Article in English | MEDLINE | ID: mdl-12197347

ABSTRACT

Confirmation of the presence of Cryptosporidium in environmental samples is laborious, costly and often difficult. We report here a simple and economic slide agglutination test (co-agglutination test) for detecting cryptosporidial antigen in stool, serum and water. The results show that as a screening method co-agglutination is clearly superior to enzyme-linked immunosorbent assay (ELISA) and modified Ziehl-Neelsen staining, although ELISA is more accurate. The co-agglutination test is recommended for application as a new tool for detecting cryptosporidial antigen in large-scale epidemiological surveys.


Subject(s)
Agglutination Tests/methods , Antigens, Protozoan/analysis , Cryptosporidiosis/diagnosis , Cryptosporidium parvum/immunology , Enzyme-Linked Immunosorbent Assay/methods , Acute Disease , Agglutination Tests/standards , Animals , Antigens, Protozoan/blood , Antigens, Protozoan/immunology , Blood/parasitology , Case-Control Studies , Child , Child, Preschool , Chronic Disease , Cryptosporidiosis/blood , Cryptosporidiosis/complications , Cryptosporidiosis/immunology , Cryptosporidiosis/parasitology , Diarrhea/parasitology , Disease Models, Animal , Egypt , Enzyme-Linked Immunosorbent Assay/standards , Feces/parasitology , Humans , Mass Screening/methods , Mass Screening/standards , Mice , Sensitivity and Specificity , Water/parasitology
7.
East Mediterr Health J ; 6(5-6): 908-18, 2000.
Article in English | MEDLINE | ID: mdl-12197348

ABSTRACT

Cryptosporidiosis and toxoplasmosis are diseases caused by opportunistic coccidial parasites that can lead to life-threatening infection in immunocompromised patients. We evaluated dehydroepiandrosterone as prophylaxis and therapy in immunosuppressed mice infected with Cryptosporidium parvum and avirulent Toxoplasma gondii. Mice were infected with either Cryptosporidium oocysts or Toxoplasma cysts. Assessment was by mortality rates, parasitic counts and electron microscopic studies. Mortality rates were significantly reduced in all treated groups. A significant reduction in the cryptosporidial oocyst count in stool and intestinal villi and in Toxoplasma cysts in the brains of infected mice was observed in all the groups. The effect of the drug was greater when given prior to infection.


Subject(s)
Adjuvants, Immunologic/therapeutic use , Cryptosporidiosis/drug therapy , Cryptosporidiosis/prevention & control , Cryptosporidium parvum , Dehydroepiandrosterone/therapeutic use , Disease Models, Animal , Immunocompromised Host , Toxoplasmosis, Animal/drug therapy , Toxoplasmosis, Animal/prevention & control , Animals , Biopsy , Cryptosporidiosis/diagnosis , Cryptosporidiosis/immunology , Cyclophosphamide , Dehydroepiandrosterone/immunology , Drug Evaluation, Preclinical , Feces/parasitology , Immunosuppressive Agents , Mice , Toxoplasmosis, Animal/diagnosis , Toxoplasmosis, Animal/immunology
8.
(East. Mediterr. health j).
in English | WHO IRIS | ID: who-118945

ABSTRACT

Cryptosporidiosis and toxoplasmosis are diseases caused by opportunistic coccidial parasites that can lead to life-threatening infection in immunocompromised patients. We evaluated dehydroepiandrosterone as prophylaxis and therapy in immunosuppressed mice infected with Cryptosporidium parvum and avirulent Toxoplasma gondii. Mice were infected with either Cryptosporidium oocysts or Toxoplasma cysts. Assessment was by mortality rates, parasitic counts and electron microscopic studies. Mortality rates were significantly reduced in all treated groups. A significant reduction in the cryptosporidial oocyst count in stool and intestinal villi and in Toxoplasma cysts in the brains of infected mice was observed in all the groups. The effect of the drug was greater when given prior to infection


Subject(s)
Dehydroepiandrosterone , Cryptosporidiosis , Toxoplasmosis , Cryptosporidium parvum , Immunocompromised Host , Mice , Toxoplasma , Coccidiosis
9.
(East. Mediterr. health j).
in English | WHO IRIS | ID: who-118944

ABSTRACT

Confirmation of the presence of Cryptosporidium in environmental samples is laborious, costly and often difficult. We report here a simple and economic slide agglutination test [co-agglutination test] for detecting cryptosporidial antigen in stool, serum and water. The results show that as a screening method co-agglutination is clearly superior to enzyme-linked immunosorbent assay [ELISA] and modified Ziehl-Neelsen staining, although ELISA is more accurate. The co-agglutination test is recommended for application as a new tool for detecting cryptosporidial antigen in large-scale epidemiological surveys


Subject(s)
Agglutination Tests , Enzyme-Linked Immunosorbent Assay , Mice , Water , Cryptosporidium parvum
10.
J Egypt Soc Parasitol ; 29(1): 157-65, 1999.
Article in English | MEDLINE | ID: mdl-12561895

ABSTRACT

One hundred and fifty stool samples were collected from diarrheic patients of different ages, and examined for Blastocystis hominis by direct smears and concentrated by Sheather's sugar flotation. Staining was done by: Giemsa, two modifications of trichrome stain, modified Ziehl-Neelsen, safranin-methylene blue and two-auramine stains. Out of the 150 cases nine were positive for blastocystosis. The best stains were safranin-methylene blue and modified Ziehl-Neelsen stains. They had the advantage of staining cysts and amoeboid forms besides being rapid and easy to perform. The modified trichrome stains identified 8 ie, less specific and were time consuming. The auramine dyes stained the cyst, both the wall and internal body fluoresced brightly. Giemsa stain was not an efficient stain. Scanning and transmission electron microscopy (SEM, TEM) were performed to study the fine ultrastructure.


Subject(s)
Blastocystis Infections/diagnosis , Blastocystis hominis/isolation & purification , Staining and Labeling/methods , Animals , Blastocystis Infections/parasitology , Blastocystis hominis/growth & development , Blastocystis hominis/ultrastructure , Feces/parasitology , Humans , Methylene Blue , Microscopy, Electron , Microscopy, Electron, Scanning , Phenazines
11.
J Egypt Soc Parasitol ; 28(2): 487-96, 1998 Aug.
Article in English | MEDLINE | ID: mdl-9707677

ABSTRACT

Cryptosporidium paruum has become one of the most important contaminant found in drinking water and is associated with high risk of waterborne diseases particularly for the immunocompromised. In the present study, Cryptosporidium was found in uncovered water tanks, nearby the shore in El Noubareya and El Mahmoudeya canals and in one swimming pool. Direct flourescence monoclonal antibody was more sensitive in detecting the organism. Ziehl-Neelsen although less sensitive, yet it has the advantage that it could recognize other protozoa causing diarrhoea as G. lamblia, B hominis and Cyclospora sp.


Subject(s)
Antibodies, Monoclonal , Cryptosporidium parvum/isolation & purification , Staining and Labeling/methods , Water Supply , Water/parasitology , Animals , Antibodies, Protozoan , Cryptosporidium parvum/immunology , Egypt , Fluorescent Antibody Technique, Direct , Sensitivity and Specificity
12.
J Egypt Soc Parasitol ; 28(3): 797-805, 1998 Dec.
Article in English | MEDLINE | ID: mdl-9914702

ABSTRACT

The prevalence of epilepsy in developing countries is much higher than in developed ones. Some of the highest prevalence rates in developing countries have been reported from tropical Africa where parasitic infections are endemic. This work was carried out to assess the effect of different parasitic antigens on the activity of cerebral cortex in rats. Nine crude antigens were used: Adult Fasciola, adult S. mansoni, hydatid cyst, T. spiralis, E. histolytica, Acanthamoeba spp. G. lamblia, Cryptosporidium spp. and crude antigen of T. gondii. All the parasitic antigens induced electroencephalographic changes compared with baseline tracings.


Subject(s)
Antigens, Helminth/adverse effects , Antigens, Protozoan/adverse effects , Cerebral Cortex/physiopathology , Epilepsy/etiology , Parasitic Diseases/complications , Animals , Cerebral Cortex/parasitology , Electroencephalography , Epilepsy/epidemiology , Male , Prevalence , Rats , Rats, Sprague-Dawley
13.
J Egypt Soc Parasitol ; 25(1): 53-61, 1995 Apr.
Article in English | MEDLINE | ID: mdl-7602172

ABSTRACT

Giardia lamblia infection may be asymptomatic or may produce diarrhea with or without malabsorption. Many drugs were used for treatment of giardiasis, but none proved to be ideal since all have potential troublesome side effects as they are absorbed from the intestine. In this study, a locally acting drug aminosidine-sulphate (gabbroral) has been tried in treatment of experimental giardiasis in a rat model under different conditions of gastric acidity which is one of the main local factors affecting the pathogenicity of the organism. The best results were obtained in the group with hyperacidity which was induced by indomethacin (indocid) with significant improvement in the pathological picture and parasitic count. While in experimental animals with normal acidity there was only partial eradication of the parasite. However, in the group with hypoacidity induced by cimetidine (cimetex), the drug showed no beneficial effects since most organisms invaded the deeper layers of the intestine escaping the local action of the drug.


Subject(s)
Giardia lamblia/drug effects , Giardiasis/drug therapy , Paromomycin/therapeutic use , Animals , Antiprotozoal Agents/therapeutic use , Cimetidine/pharmacology , Gastric Acid/metabolism , Giardia lamblia/growth & development , Giardiasis/parasitology , Giardiasis/pathology , Indomethacin/pharmacology , Intestine, Small/parasitology , Intestine, Small/pathology , Parasite Egg Count , Rats
14.
J Egypt Soc Parasitol ; 24(2): 239-46, 1994 Aug.
Article in English | MEDLINE | ID: mdl-8077744

ABSTRACT

The present study aimed at investigating the efficiency of a recent antibiotic Aminosidine sulphate (Gabbroral) in experimental cryptosporidiosis. The course of infection was studied when the drug was given early before the infection, and late during the infection both parasitologically and histopathologically. When the drug was given early, the results were satisfactory, with a significant reduction of size, number and pathological changes of the parasites in the stool and in ileal sections of infected mice. However, the drug had no effect when given late during the infection.


Subject(s)
Cryptosporidiosis/drug therapy , Paromomycin/therapeutic use , Animals , Animals, Newborn , Cryptosporidiosis/pathology , Feces/parasitology , Mice , Mice, Inbred Strains , Parasite Egg Count , Paromomycin/administration & dosage , Time Factors
15.
J Egypt Soc Parasitol ; 22(3): 667-74, 1992 Dec.
Article in English | MEDLINE | ID: mdl-1431285

ABSTRACT

Cryptosporidium oocysts were isolated from stools of infected patients diagnosed as cryptosporidiosis. Suckling Swiss albino mice were infected orally by these oocysts in a dose of 10(6) oocysts/mouse. Mice were divided into 9 groups according to the duration of infection 2, 3, 4, 5, 6, 7, 10, 10, 15, 21 days postinfection, corresponding non infected control groups were included. Stools of infected mice were examined twice daily to determine; infection rate, prepatent period and intensity of infection. Mice were sacrificed according to the schedule and the whole intestine was isolated and processed for histopathological examination by H & E and modified Ziehl Nielsen stain, and histochemical examination for acid and alkaline phosphatase activity. The results revealed that the infection rate was 90% and prepatent period 3-5 days and the course of infection was 21 days. The maximum pathological changes were in the ileum. These changes were reversible.


Subject(s)
Cryptosporidiosis/pathology , Cryptosporidium/isolation & purification , Intestines/pathology , Animals , Animals, Suckling , Cryptosporidiosis/parasitology , Feces/parasitology , Histocytochemistry , Intestines/parasitology , Mice
16.
Article in English | MEDLINE | ID: mdl-2986095

ABSTRACT

In patients on maintenance haemodialysis the number of lymphocyte beta 2-adrenoceptors (determined by (+/-)-125 iodocyanopindolol binding) was not different from that in healthy controls; lymphocyte cyclic AMP responses to (-)-isoprenaline (10(-8)-10(-4) M) or NaF (10 and 50 mM), however, were significantly reduced. Dynamic exercise on a bicycle (80% of maximum heart rate) for 15 minutes caused in 10 healthy volunteers a fourfold increase in plasma catecholamines; concomitantly lymphocyte beta 2-adrenoceptor number increased by about 55 per cent. In contrast, in patients on maintenance haemodialysis exercise induced only a twofold increase in plasma catecholamines and did not affect beta 2-adrenoceptor number. It is concluded that in chronic uraemia regulation and responsiveness of beta-adrenoceptors is impaired.


Subject(s)
Receptors, Adrenergic, beta/metabolism , Renal Dialysis/adverse effects , Adult , Aged , Catecholamines/blood , Cyclic AMP/blood , Female , Humans , Isoproterenol/pharmacology , Lymphocytes/metabolism , Male , Middle Aged , Physical Exertion
17.
J Cardiovasc Pharmacol ; 7 Suppl 6: S162-7, 1985.
Article in English | MEDLINE | ID: mdl-2414581

ABSTRACT

The properties of platelet alpha 2-adrenoceptors and of lymphocyte beta 2-adrenoceptors were determined in 40 male patients with established essential hypertension and compared with those in 40 male normotensives. The densities of platelet alpha 2-adrenoceptors (assessed by 3H-yohimbine binding) and of lymphocyte beta 2-adrenoceptors [determined by (+/-)-125iodocyanopindolol binding] were in patients with essential hypertension significantly higher than in controls; there were significant positive correlations between the mean arterial blood pressure of the subjects and alpha 2- and beta 2-adrenoceptor density, respectively. Concomitantly with receptor densities, functional responses to adrenergic stimulation were exaggerated in essential hypertension: in platelets, the aggregatory response to (-)-adrenaline (via alpha 2-adrenoceptor stimulation) was enhanced; in lymphocytes, the cyclic AMP response to (-)-isoprenaline (via beta 2-adrenoceptor stimulation) was elevated. It is concluded that the increased adrenoceptor density and responsiveness in circulating blood cells of patients with essential hypertension may reflect increased sympathetic activity, which might contribute to the elevation of blood pressure.


Subject(s)
Blood Platelets/physiology , Hypertension/physiopathology , Lymphocytes/physiology , Receptors, Adrenergic, alpha/physiology , Receptors, Adrenergic, beta/physiology , Adult , Aged , Catecholamines/pharmacology , Cyclic AMP/biosynthesis , Humans , Male , Middle Aged , Platelet Aggregation/drug effects , Sympathomimetics/pharmacology
19.
Dirasat Sukkaniyah ; 10(65): 3-40, [23-7], 1983.
Article in English | MEDLINE | ID: mdl-12279683

ABSTRACT

PIP: Egypt's Second Rural Fertility Survey was conducted in 1982 and covered 122 villages. In each of these villages a number of households were interviewed, and individual questionnaires were used for the wife, husband, and widowed/ divorced between the ages of 15-49. The objective of this paper is to use the preliminary findings obtained from the wife's questionnaire to assess the performance of the Population and Development (PDP) program. The paper's 3 sections focus on general observations, the preliminary analysis of the PDP impact, and program exposure. The present survey demonstrates that highly traditional sex role attitudes are characteristic of the female, that knowledge of contraception is rather superficial, that women give little thought to the number of children they should have, and that considerable opposition or indifference to family planning still exists. A total of 3845 eligible ever married women were successfully interviewed. The analysis is carried out separately for Upper and Lower Egypt because of the demographic and socioeconomic differences between the areas. In Upper Egypt, women married younger (39.3% married before the legal age of 16 compared to 33.4% in Lower Egypt). Women's participation in the labor force was relatively higher in Lower Egypt. Differences in children ever born were not statistically different in Lower Egypt between PDP villages (4.47) and non-PDP villages (4.32). The differences were also not statistically significant in Lower Egypt. Although ever users of contraception were slightly higher in the PDP villages of Lower Egypt, the percentage of current users seemed unaffected. The proportion currently using modern contraceptive methods was approximately 23% in both PDP and non-PDP villages. The PDP significantly affected increasing contraceptive use in Upper Egypt. Both ever and current user were found in higher proportions in PDP villages: 21.2% and 9.2% respectively, in contrast to 16.1% and 5.2% in non-PDP villages. In both Upper and Lower Egypt there were statistically significant differences between PDP and non-PDP villages regarding knowledge of oral contraceptives (OCs) and the IUD. Program impact was clearest in the case of Upper Egypt, where PDP areas were characterized by slightly lower fertility and child mortality, higher contraceptive prevalence, superior knowledge of contraceptives, and more favorable attitudes toward family planning. While all villages generally showed an increase in contraceptive practice, villages in which the PDP had been working for 3 or more years showed the greatest increases. The evidence suggests that efforts should be intensified to take advantage of the public's general awareness of family planning and favorable attitudes toward it.^ieng


Subject(s)
Attitude , Birth Rate , Contraception Behavior , Evaluation Studies as Topic , Family Characteristics , Health Knowledge, Attitudes, Practice , Health Planning , Knowledge , Population Characteristics , Program Evaluation , Africa , Africa, Northern , Age Factors , Behavior , Contraception , Data Collection , Demography , Developing Countries , Educational Status , Egypt , Employment , Family Planning Services , Fertility , Infant Mortality , Information Services , Marriage , Middle East , Mortality , Organization and Administration , Parity , Population , Population Dynamics , Psychology , Research , Sampling Studies
20.
Stud Fam Plann ; 13(12 Pt 1): 365-72, 384, 1982 Dec.
Article in English | MEDLINE | ID: mdl-6965187

ABSTRACT

Egypt's Population and Development Program (PDP) is an effort to combine family planning and development approaches at the grass roots level. Introduced as a pilot project in the late 1970s, it is now active in nearly three quarters of Egypt's villages. A 1980 Contraceptive Prevalence Survey of over 5,000 rural women stratified 124 villages according to their exposure to the program (from zero to two or more years). Comparison of women living in villages of varying exposure revealed no differences in fertility; but modest differences in knowledge, attitudes, and contraceptive practice were apparent, especially in Upper Egypt. A multivariate analysis with socioeconomic and demographic controls did not weaken these relationships. Moreover, program effects were most marked among those most in need of services--noncontracepting fecund women who were illiterate.


Subject(s)
Contraception Behavior , Developing Countries , Family Planning Services/trends , Adolescent , Adult , Egypt , Female , Health Knowledge, Attitudes, Practice , Humans , Middle Aged , Pregnancy
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