Knowledge and practice of folic acid supplementation and impact of income level on awareness among women of child-bearing age in Saudi Arabia

Purpose: To investigate the knowledge of Saudi women (pregnant and non-pregnant) about the significance of folic acid (FA) supplementation and to determine how income levels affects this knowledge and its implementation. Methods: The study was conducted among women of child-bearing age attending Al-Hada Armed Forces Hospital and Khaliss General Hospital (both in Riyadh, Saudi Arabia) for pregnant women and Omm Al-Qura University in Makkah Governorate (Saudi Arabia) for non-pregnant women. A structured questionnaire was used to collect socio-demographic data and to analyze levels of FA knowledge, including general awareness, proper timing of its use, information source, FA benefits, and the perils of FA deficiency. A chi-square test was performed to test the differences between variables. Results: Analysis of the survey data revealed that 81.1 % of non–pregnant and 91.1 % of pregnant women were aware of the term, FA (p < 0.05). Moreover, 71.1 % of the pregnant compared to 35.6% of non-pregnant women knew that this supplement must be taken before becoming pregnant and this difference was statistically significant (p < 0.05). For pregnant women, doctors and previous pregnancies were the main sources of FA knowledge, while mass media was the most frequently reported source for non-pregnant women (p < 0.05). Income level was not associated with FA knowledge in either group. Conclusions: This study illustrates a deficiency in the knowledge and consumption of this important micronutrient in women of childbearing age, the population most in need of this information. Nutrition education should be provided to increase the understanding and practice of FA supplementation periconceptionally and during pregnancy

Effect of Physical Exercise on Bone Density and Remodeling in Egyptian Type 1 Diabetic Osteopenic Adolescents

<p>Abstract</p> <p>Background</p> <p>The study was planned to assess effect of physical exercise on bone remodeling in type I diabetics with osteopenia.</p> <p>Methods</p> <p>Twenty-four type I diabetes mellitus (DM1) with osteopenia (10 females and 14 males) were compared to thirty-eight age- and sex-matched healthy control individuals (20 females and 18 males) for biochemical and radiologic parameters of bone mass. Laboratory investigations included serum and urinary calcium, inorganic phosphorus, alkaline phosphatase, and serum "procollagen type 1 N-terminal propeptide (P1NP). Bone densitometry was assessed at neck femur using Dual Energy X-ray Absorptiometry (DEXA). Serum P1NP and DEXA were reevaluated after a planned exercise program.</p> <p>Results</p> <p>Patients and controls were comparable with respect to serum as well as urinary biochemical parameters of bone mass namely; calcium, phosphorus and total serum alkaline phosphatase. Osteopenic DM1 patients displayed lower mean serum P1NP than control group (20.11 ± 6.72 ugdL versus 64.96 ± 34.89 ugdL; p < 0.05). A significant correlation was observed between BMD and degree of glycemic control reflected by serum glycated hemoglobin (r = -0.44, p, 0.030). Bone densitometry correlated with serum P1NP (r = -0.508, p, 0.011). After a planned regular exercise for 3 months, serum P1NP and BMD levels increased with percentage change of 40.88 ± 31.73 and 3.36 ± 2.94, respectively. Five patients resumed normal densitometry and they were all males.</p> <p>Conclusion</p> <p>Diabetic osteopenic patients displayed lower serum levels of procollagen type 1 N-terminal propeptide which reflects poor bone formation. A 3-months planned exercise program was associated with improvement of bone densitometry and significant increment of serum P1NP.</p

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Latex Hypersensitivity among Allergic Egyptian Children: Relation to Parental/Self Reports

Background. Latex allergy is one of the major health concerns and allergic reactions to latex may be serious and fatal. Purpose. In this study, we sought to determine the frequency of latex hypersensitivity in a group of allergic Egyptian infants and children and its relation to the history provided by the patients or caregivers. Methods. We consecutively enrolled 400 patients with physician diagnosed allergic diseases. The study measurements included clinical evaluation for the site and duration of allergy, history suggestive of latex allergy, family history of allergy, and skin prick testing (SPT) using a commercial latex extract. Results. The study revealed that 16/400 (4%) patients had positive SPT; 11 of them only had positive history of sensitivity to latex. Positive latex SPT was reported in 3.4% (11/326) of patients with bronchial asthma, 5.9% (7/118) of patients with skin allergy, and 4.5% (2/44) of patients with allergic rhinitis. SPT was positive in 7.4% (4/54) of patients with concomitant respiratory and skin allergy. Latex SPT was more specific than sensitive (97.69% and 77.77%, resp.) with a negative predictive value of 99.47%. Conclusion. Although underrecognized, latex is an important allergen in the pediatric age group with a sensitization frequency of 4% among allergic children. It was observed to be especially associated with multiple allergic diseases coexisting in the same patient. Pediatric allergologists should educate their patients on latex allergy and encourage the use of latex-free products

Health Hazards Assessment and Geochemistry of ElSibai-Abu ElTiyur Granites, Central Eastern Desert, Egypt

In this paper, a thorough radio- and chem-ecological evaluation of ElSibai-Abu ElTiyur granites located within Egypt&rsquo;s crystalline basement rocks was conducted for risk and dose assessments. Twenty granitic samples from the study area&rsquo;s various lithological units were analyzed using high-resolution &gamma;-ray spectrometry to determine the natural radioisotopes (U-238, Th-232, and K-40) concentrations. The average concentrations of U-238, Th-232, and K-40 were 38.72, 38.23, and 860.71 Bq/kg, respectively, exceeding the GAV (global average value) documented by UNSCEAR (Scientific Committee on the Effects of Atomic Radiation, Vienna, Austria). The radiological parameters and indices judging the usage of ElSibai-Abu ElTiyur granites in homes were computed. The obtained results showed that ElSibai-Abu ElTiyur granites are safe to be used by inhabitants as superficial building materials, as per the globally accepted values and the recommended safety limits approved by UNSEAR, WHO (World Health Organization, Geneva, Switzerland), ICRP (International Commission on Radiological Protection, Ottawa, ON, Canada), and EC (European Commission, Luxembourg). Further, the samples were subjected to ICP-MS (inductively coupled plasma mass spectrometry) analysis for quantifying radionuclide variations with chemical composition. Geochemically based on the ICP-MS results, the studied granites proved to be highly evolved A-type granites. They span the metaluminous to peralkaline fields. The REE patterns are characterized by the enrichment of the light rare earths (LREE) over the heavy ones (HREE) where (La/Yb)n = 5.2, (Gd/Yb)n = 1.63 with pronounced negative Eu-anomalies (Eu/Eu*)n = 0.49. The albite granite exhibits the highest concentrations of Ga, Nb, Ta, U, and Y, and REE (Gd, Dy, Ho, Yb) than the Na-metasomatic granites. Finally, the obtained data serve as a valuable future database for finding out the compatibility of the geochemical data with the natural radioactivity levels of granites

Health Hazards Assessment and Geochemistry of ElSibai-Abu ElTiyur Granites, Central Eastern Desert, Egypt

In this paper, a thorough radio- and chem-ecological evaluation of ElSibai-Abu ElTiyur granites located within Egypt’s crystalline basement rocks was conducted for risk and dose assessments. Twenty granitic samples from the study area’s various lithological units were analyzed using high-resolution γ-ray spectrometry to determine the natural radioisotopes (U-238, Th-232, and K-40) concentrations. The average concentrations of U-238, Th-232, and K-40 were 38.72, 38.23, and 860.71 Bq/kg, respectively, exceeding the GAV (global average value) documented by UNSCEAR (Scientific Committee on the Effects of Atomic Radiation, Vienna, Austria). The radiological parameters and indices judging the usage of ElSibai-Abu ElTiyur granites in homes were computed. The obtained results showed that ElSibai-Abu ElTiyur granites are safe to be used by inhabitants as superficial building materials, as per the globally accepted values and the recommended safety limits approved by UNSEAR, WHO (World Health Organization, Geneva, Switzerland), ICRP (International Commission on Radiological Protection, Ottawa, ON, Canada), and EC (European Commission, Luxembourg). Further, the samples were subjected to ICP-MS (inductively coupled plasma mass spectrometry) analysis for quantifying radionuclide variations with chemical composition. Geochemically based on the ICP-MS results, the studied granites proved to be highly evolved A-type granites. They span the metaluminous to peralkaline fields. The REE patterns are characterized by the enrichment of the light rare earths (LREE) over the heavy ones (HREE) where (La/Yb)n = 5.2, (Gd/Yb)n = 1.63 with pronounced negative Eu-anomalies (Eu/Eu*)n = 0.49. The albite granite exhibits the highest concentrations of Ga, Nb, Ta, U, and Y, and REE (Gd, Dy, Ho, Yb) than the Na-metasomatic granites. Finally, the obtained data serve as a valuable future database for finding out the compatibility of the geochemical data with the natural radioactivity levels of granites