Effect of Counteracting Lifestyle Barriers through Health Education in Egyptian Type 2 Diabetic Patients

BACKGROUND: Egypt is among the world top 10 countries in diabetes prevalence. It is the first country among the MENA region. Healthy lifestyle education and support help people with diabetes to improve health outcomes. Many physical and psychological barriers can hinder patients from following a healthy lifestyle. AIM: This study aimed to examine the effect of lifestyle modification educational sessions in helping Egyptian patients to overcome main barriers of diabetes self-management through improving nutritional behaviours, physical activity, medication compliance, and blood glucose monitoring. METHODS: A cohort study included 205 patients with type 2 diabetes. Baseline assessment of patients' lifestyle behaviours and barriers using personal diabetes questionnaire of Louisville University, with both anthropometric and blood glucose assessment. Interventional lifestyle health education was provided weekly through multiple integrated techniques, followed by a post-intervention assessment to evaluate the effect of the health education sessions. Statistical analysis was done to identify any statistically significant difference before and after the health education intervention. RESULTS: There was a significant improvement of the post-education mean scores of the studied behaviours when compared with the pre-education scores of the participants’ behaviours (p < 0.001). There was also a significant reduction in the barriers facing patients to diabetes self-management including nutritional barriers (P < 0.001), medication compliance barriers (P < 0.001) with a percent change (43%), physical activity barriers (p < 0.001), and blood glucose monitoring (p < 0.001) with a percent change (44%).There was a statistically significant positive correlation between improvement of medication compliance (P = 0.027), blood glucose monitoring(P = 0.045), and glycated haemoglobin of the study participants CONCLUSION: lifestyle modification education of type 2 diabetic patients can overcome the main barriers of following a healthy lifestyle and improve their anthropometric measures and blood glucose level

Dietary seasonal variations in the Medieval Nubian population of Kulubnarti as indicated by the stable isotope composition of hair

Objectives The island of Kulubnarti is located in Sudanese Nubia and contains two cemeteries, named R and S, which are dated to AD 550–800. In order to provide more detailed dietary information for this population and examine seasonality of diet, we analyzed the carbon isotope composition of hair samples from both cemeteries. Materials and methods Forty seven separate hair samples from 8 adults, 29 adolescents, 7 infants and 3 individuals with unknown age were analyzed. Long hair samples were cut transversely and divided into 2 cm longitudinal segments, to examine temporal variations in the dietary carbon sources. Results The average carbon isotope value for the whole population was −17.95‰ (SD = 1.8). A significant difference between the two cemeteries was found with variances in the amount of C4 dietary carbon sources consumed. Discussion The results of hair isotope compositions concur with previous soft tissue investigations of Kulubnarti population which suggested that the dietary regimen contains a mix of C3 and C4 plant-based sources. A seasonal variation in diet can be inferred from the sequential hair segments of Kulubnarti individuals. These suggest a dietary transition between dominant C3 plant-based sources in winter to dominant C4 ones in summer with a small contribution of the non-harvested, alternative, crop

Cut-Off Values of Anthropometric Indices for the Prediction of Hypertension in a Sample of Egyptian Adults

Background: Obesity, particularly abdominal adiposity, is closely associated with premature atherosclerosis and many metabolic modifications including insulin resistance dyslipidemia hypertension and diabetes. Cut-off values for abdominal obesity predicting future cardiovascular disease are known to be population specific.Objective: To identify cut-off points of some anthropometric measurements (BMI, WC, WHR and WHtR) that associated with hypertension in a sample of Egyptian adults.Subjects and Methods: This is a cross-sectional analysis. The blood pressure of 5550 Egyptian adults was measured (2670 females – 2880 males).The subjects represented different geographic localities and different social classes. Anthropometric measurements including height, weight, waist circumferences, and hip circumferences were also measured by practitioners.Results: The cut-off values to detect hypertension in females were 30.08 for BMI, 87.75 for WC , 0.81 for WHR and 0.65 for WHtR, and the corresponding sensitivity and specificity were 69.1; 60.7- 80.9; 48.6 -65.3; 53.4 and 61.4; 58.9, respectively. The cut-off values to detect hypertension in males were 27.98 for BMI, 95.75 for WC, 0.92 for WHR, and 0.57 for WHtR and the corresponding sensitivity and specificity were 62.8; 59.9 -71.9; 51.9 -64.6; 55.8 and 59.7; 55.8, respectively.Conclusion: The BMI, Waist circumference, WHR and WHtR values can predict the presence of hypertension risk in adult Egyptians

Determinants of Exclusive Breastfeeding in a Sample of Egyptian Infants

BACKGROUND: Breastfeeding is an optimum, healthy, and economical mode of feeding an infant. However, many preventable obstacles hinder exclusive breastfeeding in the first six months of life. AIM: We aimed to assess the social-, maternal- and infant-related factors disturbing exclusive breastfeeding in the first six months of life. METHODS: It is a retrospective study included 827 dyads of mothers and infants older than 6 months (411 exclusively breastfed, 311 artificially-fed and 105 mixed feds). Mothers were interviewed to obtain sociodemographic information, maternal medical history and perinatal history and a detailed history of infant feeding. RSULTS: Many factors were found to support the decision for artificial feeding rather than exclusive breastfeeding, including maternal age < 25 years (OR = 2.252), child birth order > 3rd (OR = 2.436), being a primi-para (OR = 1.878), single marital status (OR = 2.762), preterm infant (OR = 3.287) and complicated labor (OR = 1.841). Factors in favor of mixed feeding included cesarean section (OR = 2.004) and admission to the Neonatal Intensive Care Unit (OR = 1.925). CONCLUSIONS: Although it isn’t a community-based study and its results can’t be generalised, plans to improve health and development of children are preferable to include the following: health education and awareness programs about the importance of exclusive breastfeeding should be directed for young and first-time mothers. Improved antenatal care to reduce perinatal and neonatal problems; and training, monitoring, and supervising community health care workers to recognise labour complications and provide support and knowledge to lactating mothers

Potential Risk Factors of Developmental Cognitive Delay in the First Two Years of Life

BACKGROUND: The first two years of life constitute a critical period of rapid change. The events during this phase prepare the child for subsequent developmental competency.AIM: To determine the potential risk factors that affect an infant’s cognitive development in the first two years of life in a sample of Egyptian infantsSUBJECTS AND METHODS: A cross-sectional comparative study included 655 male and female infants. Their age ranged from 3 – 24 months. Bayley Scales of Infant and Toddler Development (Bayley III) were used for cognitive assessment. Perinatal and nutritional data were recorded. Levels of serum Zinc, Copper, Iron, vitamin B12 and complete blood count (CBC) were assessed in a subsample of 193 infants.RESULTS: Infants having below the average cognitive composite score (CCS) represented 38.47% of the whole sample. The risk of having a low average (CCS) was determined by multiple factors. Poor maternal education and low family income were the most significant social risk factors (OR = 2.19, p = 0.0003; OR = 1.64, p = 0.002 respectively). Prematurity and complicated labor represented significant perinatal risks (OR = 1.22, p = 0.005; OR = 2.39, p =0.001respectively). Bottle feeding versus breastfeeding in the first six months of life was the most significant nutritional predictor of low average (CCS) (OR = 1.79, p = 0.001). Infants with low average (CCS) had significantly lower levels of serum zinc and vitamin B12 than those with average scores. CONCLUSION: Multiple factors appear to interact affecting the early cognitive development of Egyptian infants. Prematurity, complicated labour, poor maternal education, low family income and micronutrient deficiency are the main risk factors. Studying these factors is of great value in directing governmental intervention efforts

The Interaction of Social, Physical and Nutritive Factors in Triggering Early Developmental Language Delay in a Sample of Egyptian Children

BACKGROUND: Language acquisition and child development during the early years of life depend on multiple interacting factors. AIM: To explore potential factors that can impact language development in 2 groups of Egyptian children, one with normal language development and the second with delayed development. Also, to explore to what extent can the involvement of impaired motor development potentiate the risk of developmental language delay. METHODS: This cross-sectional case-control study involved Egyptian children belonging to the middle socioeconomic class between 18 and 36 months of age. Children were classified according to their performance on language domain of Bayley Scales of Infant and Toddler Development (Bayley-III) into two groups, infants with the average or above score (control group) and those having below-average scores (cases). Motor development was assessed on the same scale. Factors affecting language development were tested, including socio-demographic, obstetric, and maternal medical factors in addition to Infant Feeding Practices. RESULTS: The independent factors lowering the language scores were early introduction of complementary food, low family income, history of delivery problems, pregnancy-related diseases of the mother, and maternal education. Impaired motor development appears as a further highly significant risk factor to the previously mentioned factors CONCLUSION: In Egyptian children, delayed language development is severely affected by the interaction of medical, social and nutritional factors. Providing adequate maternal health care during pregnancy and childbirth, regular developmental monitoring at each child visit, and screening for such risk factors, can reduce size of the problem and promote child’s social and psychological development

Histopathological evaluation of insulin-DMSO formula designed for direct nose-to-brain delivery

The combination of insulin and DMSO is a patented (Publication No US8987199B2), noninvasive, pharmaceutically strategized preparation for direct noseto-brain delivery (DN2BD) suggested for the treatment of Alzheimer’s disease (AD). Although its main ingredients have been individually researched, no histopathological investigations have been conducted to address this combination effect on the CNS and nasal tissues in animals. The present work was, therefore, designed to investigate the potential histopathological changes induced by this new pharmaceutical combination using a newly developed refractory staining method. The findings presented herein showed no signs of treatment-related lesions or behavioral changes in Sprague Dawley rats following a three-month successive treatment with two strengths of the formula

Prevalence of Pre-hypertension and Hypertension in a sample of Egyptian Adults and its Relation to Obesity

Abstract: Objective: to study the prevalence of prehypertension and hypertension in Egyptian adults and its relation to obesity. Subjects and Methods: The blood pressure of 5534 Egyptian subjects was measured (2663 females -2871 males) aged 20 to 75 years old. They represented different geographic localities and different social classes. Anthropometric measurements including height, weight, waist circumferences, and hip circumferences were also measured. Waist to hip ratio and body mass index (BMI) were calculated. Fasting blood sugar was tested. Results: The prevalence of prehypertension and hypertension was 49.22 % (54.4 and 43.1 for males and females) and 16.84 %( 18.5% and 15.1% for males and females) respectively. There was a tendency to increase of both prehypertension and hypertension in males as compared to females. The percentages of the hypertensive individuals were increased with age and degree of obesity. Prehypertension was higher in the cases having glucose intolerance, while hypertension was increased mainly in those suffering from diabetes mellitus. Conclusion: High rates of prehypertension and hypertension were observed in the studied Egyptian adults. Overweight/obesity and diabetes are important risk factors for hypertension. Strategies that can enhance public awareness of hypertension and increase access to affordable medications are urgently needed

Early Life Predictors of Socio-Emotional Development in a Sample of Egyptian Infants.

INTRODUCTION:Emotional problems are amongst the most critical concerns to be intentionally handled to enhance the wellbeing and development of children. OBJECTIVE:To determine the predictors of socio-emotional development of Egyptian infants related to infant feeding practices, aspects of infant and maternal health and socioeconomic status. SUBJECTS AND METHODS:A cross-sectional comparative study included 322 breast fed, 240 bottle fed and 93 mixed fed infants, from 6-24 months of age, who were enrolled in the Well-Baby Clinic of the National Research Centre and from pediatric outpatient facilities in urban Cairo. Assessment of socio-emotional development was performed using Bayley Scales of Infant and Toddler Development (Bayley III). Detailed maternal and infant history was recorded. Levels of serum zinc, copper, iron, vitamin B12 and complete blood count (CBC) were assessed in a subsample of 193 infants. RESULTS:The risk of having below average socio-emotional composite score was nearly two and half times among formula-fed infants than among breast-fed infants. By binary logistical regression analysis, predictors of below average socio-emotional score were a lower serum zinc value, being formula fed during the first half-year and introduction of complementary food before the age of six months (p< 0.05). CONCLUSION:Exclusive breastfeeding and to a lesser extent mixed feeding during the first half year is correlated with above average socio-emotional development. Maternal education and zinc status were also determinants of better infant mental health. Our endeavors ought to be directed towards integrated interventions addressing multiple risks to children's development