Menopause in Egypt: past and present perspectives.

The mean age of the menopause in Egypt is 46.7 years, which is low compared to many countries, but this age has been rising recently. The incidence of menopause-associated symptoms in Egyptian women is higher than in the West, probably because of the different 'sociocultural attitudes' towards the menopause in different communities. Bone mineral density charts have been constructed for Egyptian women and show that, in general, they have a lower bone mineral density compared to their Western counterparts. After the menopause, they suffer from osteoporosis, particularly at the femoral neck. Egyptian women do not know much about the menopause, except that the incidence of osteoporosis is increased. Their attitude towards the menopause is generally positive and about one-third of them regard the menopause as 'a normal physiological change'. Nevertheless, there exists a need for an awareness campaign in order to educate them about this important stage of their lives.

The effect of aflatoxin B1 on the utilization of serum calcium.

The mathematical analysis for plasma disappearance curve of aflatoxicosed animals, subsequently injected with 45Ca was determined. The analysis showed that the three main compartments of the calcium pool (plasma, bone and the labile calcium pool on the surface of bone and soft tissues) had been affected. Specifically, the fractional rate constant for migration of 45Ca from plasma pool to the labile pool had been diminished to its third value. This led to a corresponding reduction in the calcium content of the bone ash. The probable mechanism by which aflatoxin B1 affects calcium dynamics may be interpreted by the inhibitory effect of aflatoxin in the hydroxylation mechanism of vitamin D3 into an active intermediate. During aflatoxicosis (induction of 15 days) the animals entered a state of calcium deficiency, secondary to intestinal absorption inhibition. This was followed by bone resorption and disturbance of the fractional removal rate constant among different calcium compartments.

Arylsulfatases in bilharziasis.

Arylsulfatase A and B in urine have been estimated in 18 normal subjects and 50 bilharziasis patients. The bilharziasis patients were divided into two groups according to the type of infeciton. Those with bilharziasis haematobian type of infection and those with the bilharziasis mansoni type. Each group was further subdivided into subgroups according to the severity and progress of the disease. The activities of arylsulfatase A and B were significantly elevated in all the groups of patients studied and it is evident that there is a progressive increase with the progress of the disease in both types of bilharziasis infections (the haematobian and mansoni types). Liver dysfunction consequent of bilharzial infestation appears to take part in the mechanism of induction of the bilharzial bladder cancer.

Leucine aminopeptidase, Significance of serum elevation in bilharziasis.

Leucine aminopeptidase (LAP) activity and creatinine concentration was estimated in serum of twenty five normal adult subjects, twenty four cases with active urinary bilharziasis, eleven cases with active intestinal bilharziasis, ten cases with mixed bilharzial infection (urinary and intestinal), fourteen bilharzial cases with clinical hepato-splenomegaly of bilharzial etiology, thirteen bilharzial cases with clinical hepatosplenomegaly and ascites, and twelve cases with cancer bladder of bilharzial etiology. Significant elevation in the serum enzyme level was found in all bilharzial cases which generally ran parallel to the course of the disease, being more marked in hepatosplenomegalic cases than in cases which showed no clinical signs of liver or spleen involvement. However, it was observed that the enzyme level was lower ascitic than in nonascitic cases. For serum creatinine concentration, no significant variation from normal value was observed in the group of patients with active urinary, active intestinal, mixed infections of bilharziasis and bilharzial hepatosplenomegalic cases. However, a very highly significant decrease in serum creatinine concentration was observed in the group of patients with bilharzial hepatosplenomegaly and ascites. Serum LAP activity and creatinine concentration in the group of patients with cancer bladder of bilharzial etiology showed no statistical variation from normal values.

Urinary leucine aminopeptidase in bilharziasis.

Leucine aminopeptidase activity and total protein concentration was estimated in the fresh early morning sample of urine of twenty five normal adult subjects, twenty four cases with active urinary bilharziasis, eleven cases with active intestinal bilharziasis, ten cases with mixed bilharzial infection (urinary and intestinal), fourteen bilharzial cases with clinical hepatosplenomegaly of bilharzial etiology, thirteen bilharzial cases with clinical hepatosplenomegaly and ascites, and twelve cases with cancer bladder of bilharzial etiology. It was found that there is a significant increase in LAP activity in the urine of all groups of patients studied. Again this increase ran parallel to the course of the disease in bilharzial cases. Urine protein concentration was found to be increased significantly in all groups of bilharzial cases studied with the highest value in urine of patients with cancer bladder of bilharzial etiology. However no direct correlation was found between urinary LAP level and protein concentration either within the individual cases or within the different groups.