Impact of Nutritional Health Education on Knowledge and Practices of Mothers of Anemic Children in El Othmanyia Village – Egypt

BACKGROUND: In Egypt, more than one in four children suffers from some degree of anemia. AIM: This study was carried out to assess and improve the nutritional knowledge and risky nutritional habits of the mothers of anemic children aged 2–12 years old in El Othmanyia village. MATERIALS AND METHODS: An interventional study was conducted among anemic children aged 2–12 years old and their mothers in El Othmanyia village, Egypt. The study passed through three stages over 1 and ½ years; pre-interventional assessment of awareness (n = 350), educational interventions targeting anemic children and their mothers, and post-interventional evaluation of change in awareness and practice. RESULTS: The mean knowledge % score of mothers increased significantly after the intervention (82.2 ± 14.2 vs. 6.3 ± 5.8, respectively). Furthermore, the mean hemoglobin of the studied children increased significantly after the intervention (11.1 ± 0.7 vs. 10.5 ± 0.7). The percent of children with anemia decreased significantly from 100% to 40.3% after the intervention (p < 0.001). CONCLUSION: The knowledge and practices of mothers are moving in a desirable direction after the health education intervention. Hence, nutrition education is an appropriate, effective, and sustainable approach to combat iron deficiency anemia. Recommendations: A multiple interventional strategies between different ministries to set policies and guidelines that support the healthy nutritional behavior among children are recommended. &nbsp

Neurological Alterations in Type 1 Diabetes Mellitus Among Adolescents

BACKGROUND: Diabetes mellitus (DM) is a group of chronic disorders of metabolism characterised by high blood glucose levels. There is an increased prevalence of Type 1 DM in children and adolescents with its adverse complications especially microvascular ones (retinopathy, nephropathy and neuropathy) that might cause multiple organ damage. AIM: To study the relation between DM and neurological affection. METHODS: Fifty-nine children with type I DM, divided randomly into 2 groups, aged 8-18 years old of both sexes were enrolled in this cross-sectional study. All children were subjected to full history taking, physical, neurological and systemic examination. RESULTS: There was an affection of motor power in both upper limbs as well as lower limbs. Also, we found that there was an affection of the superficial peripheral sensation affecting both upper and lower limbs. CONCLUSION: Neurological assessment of children with diabetes mellitus type I should be a routine to early discover these manifestations which can have a deteriorating effect on the child’s health

Is Neck Circumference an Indicator for Metabolic Complication of Childhood Obesity?

BACKGROUND: The possible role of neck circumference (NC) for screening childhood obesity and its complication is not well characterized.AIM: To assess NC and to explore its increase as risk factor with metabolic syndrome (MS) variables. METHODS: Cross sectional case-control study included 50 obese children (BMI ≥95th percentile) and 50 healthy (BMI 15th-‹85th percentile). All were subjected to clinical examination, measuring blood pressure (BP), body weight, height, NC, waist (WC) and hip (HC)., fasting blood glucose, insulin and lipid profile.  RESULTS: MS was detected among 52% of obese participants, but not among controls (0%). Clinical parameters and most of the laboratory values were higher in subjects with MS than in non-metabolic subjects, with statistical significance only in blood pressure and triglycerides. Among obese without MS, NC showed significantly positive correlations with age, weight, height, WC, HC and negative with LDL. While among Obese with MS, NC showed significantly positive correlations with age, weight, height, BMI-SDS, WC, HC and DBP.CONCLUSION: NC can be considered as a good indicator and predictor for obesity, especially central obesity. However, NC has no relation with lipid profile or fasting blood sugar

Neck Circumference as a Predictor of Adiposity among Healthy and Obese Children

BACKGROUND: Obesity, particularly in the upper part of body, is a major health problem. Because body mass index (BMI) does not adequately describe regional adiposity, other indices of body fatness are being explored.OBJECTIVES: To determine if neck circumference is a valid measure of adiposity (fat distribution) among group of Egyptian children.SUBJECTS AND METHODS: This is a cross sectional study, included 50 obese subjects, aged 7 - 12 years recruited from Endocrine, obesity and Metabolism Pediatric Unit at Children Hospital, Cairo University and 50 healthy children, age and sex matched. All children were subjected to blood pressure assessment (systolic SBP and diastolic DBP), and anthropometric assessment (body weight, height, neck circumference (NC), waist (WC) and hip (HC) circumferences, and skin fold thicknesses at three sites: biceps, triceps and sub scapular. BMI [weight (kg)/height (m2)] was calculated.RESULTS: In healthy females, significant associations were detected between NC and SBP, DBP and all anthropometric measurements. However, in healthy males NC was not significantly associated with BMI, SBP and DBP. In the obese group; both sexes; insignificant association was found between NC and SBP, DBP, BMI and skinfold thickness. CONCLUSION: NC is related to fat distribution among normal healthy female children. However, this relation disappears with increasing adiposity. The results do not support the use of NC as a useful screening tool for childhood obesity

Influence of Interleukin-6 (174G/C) Gene Polymorphism on Obesity in Egyptian Children

BACKGROUND: Obesity is a multi-factorial chronic disorder. A considerable number of studies have been performed to figure out whether there is an association between obesity and polymorphisms of gene IL-6 (174G/C), but the results are equivocal.AIM: This study aimed to find out whether the IL-6 (174G/C) gene was associated with the risk of developing obesity in Egyptian children.SUBJECTS AND METHODS: The study included 149 children and adolescents with age ranged between 9.5 – 18 years. Eighty-five of them were obese which BMIZ-score is > 2, and sixty-four children with BMIZ-score ≤ 2 served as control group. Serum level of IL-6 and genetic analysis for IL-6 (174G/C) gene polymorphism were done.RESULTS: Obese children had significantly higher serum levels of IL-6 as compared to those of control children (P = 0.003). A high percentage of IL-6 polymorphism GC was found in obese subjects (93.7%), while the control group had a higher percentage of IL-6 polymorphism GG (70.6 %).CONCLUSION: Our study showed that carriers of the C allele for the IL-6 (174G/C) polymorphism have higher BMI. As the G174C polymorphism is likely to affect IL-6 expression and its physiological regulation; consequently this polymorphism may affect adiposity

Role of Culex and Anopheles mosquito species as potential vectors of rift valley fever virus in Sudan outbreak, 2007

<p>Abstract</p> <p>Background</p> <p>Rift Valley fever (RVF) is an acute febrile arthropod-borne viral disease of man and animals caused by a member of the <it>Phlebovirus </it>genus, one of the five genera in the family <it>Bunyaviridae</it>. RVF virus (RVFV) is transmitted between animals and human by mosquitoes, particularly those belonging to the <it>Culex, Anopheles </it>and <it>Aedes </it>genera.</p> <p>Methods</p> <p>Experiments were designed during RVF outbreak, 2007 in Sudan to provide an answer about many raised questions about the estimated role of vector in RVFV epidemiology. During this study, adult and immature mosquito species were collected from Khartoum and White Nile states, identified and species abundance was calculated. All samples were frozen individually for further virus detection. Total RNA was extracted from individual insects and RVF virus was detected from <it>Culex, Anopheles </it>and <it>Aedes </it>species using RT-PCR. In addition, data were collected about human cases up to November 24^th, 2007 to asses the situation of the disease in affected states. Furthermore, a historical background of the RVF outbreaks was discussed in relation to global climatic anomalies and incriminated vector species.</p> <p>Results</p> <p>A total of 978 mosquitoes, belonging to 3 genera and 7 species, were collected during Sudan outbreak, 2007. <it>Anopheles gambiae arabiensis </it>was the most frequent species (80.7%) in White Nile state. Meanwhile, <it>Cx. pipiens </it>complex was the most abundant species (91.2%) in Khartoum state. RT-PCR was used and successfully amplified 551 bp within the M segment of the tripartite negative-sense single stranded RNA genome of RVFV. The virus was detected in female, male and larval stages of <it>Culex </it>and <it>Anopheles </it>species. The most affected human age interval was 15-29 years old followed by ≥ 45 years old, 30-44 years old, and then 5-14 years old. Regarding to the profession, housewives followed by farmers, students, shepherd, workers and the free were more vulnerable to the infection. Furthermore, connection between human and entomological studies results in important human case-vulnerability relatedness findings.</p> <p>Conclusion</p> <p>Model performance, integrated with epidemiologic and environmental surveillance systems should be assessed systematically for RVF and other mosquito-borne diseases using historical epidemiologic and satellite monitoring data. Case management related interventions; health education and vector control efforts are extremely effective in preparedness for viral hemorrhagic fever and other seasonal outbreaks.</p

Urinary bisphenol A concentrations in girls from rural and urban Egypt: a pilot study

Abstract Background Exposure to endocrine active compounds, including bisphenol A (BPA), remains poorly characterized in developing countries despite the fact that behavioral practices related to westernization have the potential to influence exposure. BPA is a high production volume chemical that has been associated with metabolic dysfunction as well as behavioral and developmental effects in people, including children. In this pilot study, we evaluate BPA exposure and assess likely pathways of exposure among girls from urban and rural Egypt. Methods We measured urinary concentrations of total (free plus conjugated) species of BPA in spot samples in urban (N = 30) and rural (N = 30) Egyptian girls, and compared these concentrations to preexisting data from age-matched American girls (N = 47) from the U.S. National Health and Nutrition Examination Survey (NHANES). We also collected anthropometric and questionnaire data regarding food storage behaviors to assess potential routes of exposure. Results Urban and rural Egyptian girls exhibited similar concentrations of urinary total BPA, with median unadjusted values of 1.00 and 0.60 ng/mL, respectively. Concentrations of urinary BPA in this group of Egyptian girls (median unadjusted: 0.70 ng/mL) were significantly lower compared to age-matched American girls (median unadjusted: 2.60 ng/mL) according to NHANES 2009-2010 data. Reported storage of food in plastic containers was a significant predictor of increasing concentrations of urinary BPA. Conclusions Despite the relatively low urinary BPA concentrations within this Egyptian cohort, the significant association between food storage behaviors and increasing urinary BPA concentration highlights the need to understand food and consumer product patterns that may be closing the gap between urban and rural lifestyles.http://deepblue.lib.umich.edu/bitstream/2027.42/112495/1/12940_2011_Article_523.pd

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p&lt;0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p&lt;0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised