Comparison of vitamin D deficiency in Saudi married couples.

BACKGROUND/OBJECTIVE: Vitamin D deficiency is highly prevalent in Saudi Arabia. The study objective was to compare vitamin D deficiency in Saudi married couples. SUBJECTS/METHODS: This cross-sectional study was carried out in the Royal Guard primary health care center in Riyadh, Saudi Arabia on a consecutive sample of 50 Saudi married couples attending the center without complaints related to vitamin D deficiency. Data were collected through an interview questionnaire addressing the risk factors and dietary habits. Quantitative determination of total 25-hydroxy vitamin D in blood was done by Electro-Chemical Luminescence assay. Fieldwork was carried out from December 2010 to January 2011. RESULTS: Men had higher sun exposure (P = 0.001), more use of light clothes at home (P = 0.002) and more intake of milk (P = 0.023) and soft drinks (P = 0.001). Vitamin D was higher in men with mean difference about 9 nmol/l (P < 0.001). The prevalence of vitamin D deficiency (<25 nmol/l) was 70% in women, compared with 40% in men (P = 0.001). Multivariate analysis identified male gender, physical activity and the intake of milk as statistically significant positive independent predictors of vitamin D level, adjusted for factors as age, sun exposure, clothing, skin color, BMI, soft drinks and animal protein intake. CONCLUSION: Vitamin D deficiency is very high among Saudi married couples, especially wives. Female gender is an independent predictor of lower vitamin D level, in addition to sedentary lifestyle and low milk consumption. There is a need to revise the levels set for the diagnosis of vitamin D deficiency or insufficiency in the study region.

Epidermal growth factor receptor in colorectal carcinoma: correlation with clinico-pathological prognostic factors.

OBJECTIVE: This study was undertaken to determine the relationship between epidermal growth factor receptor (EGFR) status in primary colorectal cancer (CRC) to different clinico-pathological prognostic factors. METHOD: Seventy-nine primary CRC were studied using four scoring systems: 1- EGFR pharmDx score, 2- score modified from the Hercept test [J Histo cytochem, 52 (2004) 893], 3- two additive scores with different cutoff points [Mod Pathol, 11 (1998) 155], 4- two multiplicative scores with different cutoff points [Ann Oncol, 16 (2005) 102]. RESULTS: More than 10% membranous EGFR reactivity was identified in 46.8% (37/79) of the tumours. The intensity was classified as mild, moderate and strong representing 8.9%, 20.3% and 17.7% respectively. Strong correlation was found between the EGFR pharmDx and the proposed scores, at different cutoff points (P < 0.01). A strong correlation was found between EGFR expression, advanced clinical stage (P < 0.01), nodal involvement (P < 0.01) and lympho-vascular invasion (LV) (P < 0.05) in category I factors, poorly differentiated tumours in IIA (P < 0.05), infiltrative border configuration in IIB (P < 0.01), perineural invasion (PN) in III (P < 0.01), and larger tumours in IV (P < 0.01). Heterogenous staining was present in 46.3% of tumours and was associated with an increased score, LV and PN invasion and advanced clinical stage (P < 0.05). CONCLUSION: Using a cut-off point of 10%, similar results with different scoring systems were obtained, representing standardization for EGFR interpretation. EGFR expression is correlated with conventional clinico-pathological prognostic factors.

Worksite and personal factors associated with carpal tunnel syndrome in an Egyptian electronics assembly factory.

The study objective was to identify personal and work-related risk factors associated with carpal tunnel syndrome (CTS) in electronics assembly, operators relative to clerical workers in the same factory. Of 422 workers in a television assembly factory located in Ismailia, Suez Canal Area, Egypt, 198 (46.9%) participated. The electronics assembly workers were more likely to report CTS (odds ratio = 11.41, 95% CI = 3.6 -40.26) than were the clerical workers. The significant risk factors were longer work years (odds ratio = 1.11, 95% CI = 1.03-1.20) and precision-type hand grip (odds ratio = 6.5, 95% CI = 1.08-39.23). The results suggest an association between electronics assembly and CTS. Work years and precision grip are possible risk factors for CTS and should be studied more thoroughly. Tools to reduce the need for precision grip may help reduce CTS.

The epidemiology of schistosomiasis in Egypt: Ismailia governorate.

A multi-stage stratified sample of 12,515 individuals from 1,941 households in 42 villages in the Ismailia governorate of Egypt were surveyed for schistosomal infection. A subset of 2,390 subjects were surveyed for morbidity by physical and ultrasonographic examination. The prevalence of Schistosoma mansoni infection in rural Ismailia was 42.9% and the geometric mean egg count (GMEC) was 93.3 eggs/gram of stool, with considerable variability between communities. Prevalence and intensity peaked in the 20-30-year-old age group and was higher in males than in females. Prevalence and intensity of S. haematobium was very low: 1.8% and 3.5 ova/10 ml of urine GMEC, respectively. Canal water exposure risk factors for S. mansoni infection were males bathing (odds ratio [OR] = 2.2), females washing clothes (OR = 1.9), and children playing or swimming (OR = 2.3). Presence of in-house piped water supply and latrine lowered infection rates (P < 0.001 and P = 0.002, respectively). Histories of S. mansoni infection (OR = 1.6) or treatment (OR = 1.5) and blood in feces (OR = 3.5) were associated with infection. Hepatomegaly (16.0%) was more frequently detected than splenomegaly (3.6%) by physical examination, with both being more frequent in older age groups. Splenomegaly, but not hepatomegaly, was associated with presence of S. mansoni ova in stools (OR = 1.4) and the community burden of infection (P = 0.02). Ultrasonographically detected hepatomegaly, splenomegaly, and periportal fibrosis (PPF) were detected in 43.0%, 17.4%, and 39.7% of the subjects, respectively. The higher grades of PPF were rare. Ultrasonographically detected splenomegaly, not hepatomegaly, was associated with S. mansoni infection, community burden of infection, and PPF. Risk factors for PPF were the same as for S. mansoni infection. There was a marginal association of PPF with infection and none (P = 0.33) with the intensity of infection in individuals or in the community. We conclude that in rural Ismailia, S. haematobium infection is rare but the prevalence and intensity of infection with S. mansoni is high. The risk of infection is associated with environmentally detected factors and behaviors. Hepatosplenic morbidity attributable to S. mansoni infection is low, presumably because of the favorable effect of wide application of praziquantel therapy.

Cancer in the Eastern Region of Saudi Arabia: A population-based study (1987-1988).

This study presents the findings of the first population-based tumor registry in the Eastern region (ER). Data on all cancer sites, in 1987 and 1988, were captured from all health facilities in the ER. A regional population census was obtained from regional health authorities. Cancer deaths were obtained from death registries. Age-specific rate, crude incidence rate (CIR), age-standardized incidence rate (ASR) and relative age-standardized incidence rate (%ASR) were compared with available population-based data from 137 tumor registries. 1559 primary cancer cases were captured. The CIR and ASR/100,000/year for cancer among Saudi males were respectively 59.8 and 125.7. The corresponding rates among Saudi females were 43.6 and 95.5. These rates rank very low on the international scale. Cancer sites with the highest %ASR among Saudi males were lung, lymphomas, leukemias, urinary bladder and tumors of uncertain primary. For Saudi females, these sites were breast, leukemias, tumors of brain and nervous system, thyroid and tumors of uncertain primary. Lung cancer was the leading cause of death from cancer among Saudi males. The first regional population-based cancer registry in Saudi Arabia was established in 1987. The overall cancer ASR in the ER is low. The leading cancer sites with the highest %ASR are lung in Saudi males and breast in Saudi females.

Leukemia in the eastern region of Saudi Arabia: A population-based study (1987-1988).

This is the first population-based data in Saudi Arabia on the incidence of leukemias in the Eastern Region, as conducted by its regional tumor registry. Data on cancer were captured from all health facilities in the region in 1987-1988. Population census was derived from a survey. Data on cancer deaths were obtained from all death registries. Crude, age-specific, age-standardized, and relative age-standardized incidence rates were used as indicators for the incidence of leukemia. There were 124 cases of leukemias registered. The yearly average crude incidence rate was 5.2 and 3.6 per 100,000 for Saudi males and females, respectively. The age-standardized incidence rate was 7.3 and 6.1 per 100,000 per year in Saudi males and females respectively. The relative age-standardized incidence of leukemias in Saudi males and females ranked, respectively, third and second highest on the international scale. Death from leukemia among Saudis was responsible for 8.9% of the total deaths from cancer. Statistical indicators point to a high incidence rate of leukemias in the Eastern Region of Saudi Arabia among Saudis. Leukemia was the third leading cause of death from cancer. The relative age-standardized rate of leukemias among Saudis of either gender rank very high on the international scale.