Insight into hazard and control of transfusion-transmitted infections in Egypt: A narrative review.

Blood transfusion is a critical life-saving medical intervention, but it carries the risk of transfusion-transmitted infections (TTIs) that can lead to serious consequences. TTIs include viral, bacterial, parasitic, and prion infections, transmitted through asymptomatic donor blood, contamination of stored blood products, or transfusion-related immunosuppression. Recognized global agents posing challenges to blood safety include human immunodeficiency virus (HIV), hepatitis C virus (HCV), hepatitis B virus (HBV), Syphilis, etc. Emerging pathogens like SARS-CoV-2, hepatitis E, and others present additional risks. The residual risk of TTIs, representing the likelihood of infected donations passing screening tests, varies globally. High-income countries generally show lower prevalence rates than low-income countries. In Egypt, the estimated prevalence rates for HIV, HBV, HCV, and syphilis markers among the donors are 0.23 %, 0.76 %, 2.33 %, and 0.24 %, respectively. In Egypt, specific residual risk estimates are scarce, but prevalence rates for key infections highlight existing challenges. The World Health Organization promotes a global blood safety strategy, advocating for national blood systems, voluntary non-remunerated donors, and quality-assured testing. Despite these measures, the establishment of a haemovigilance system which is critical for monitoring and preventing adverse events, including TTIs, is reported as lacking in Egypt. This highlights the importance of comprehensive surveillance and safety measures in the blood donation process to ensure universal access to safe blood. Primary health care can play a pivotal role in preventing TTIs.

Cerebral Folate Transport Deficiency in 2 Cases with Intractable Myoclonic Epilepsy.

Cerebral folate transport deficiency due to folate receptor 1 gene (FOLR1) gene mutation results from impaired folate transport across the blood: choroidplexus: cerebrospinal fluid (CSF) barrier. This leads to low CSF 5-methyltetrahydrofolate, the active folate metabolite. We are reporting two children with this treatable cerebral folate transport deficiency. Eight years and 9-month-old female presented with delayed milestones followed by regression, seizures, and intention tremors. On examination child had microcephaly, generalized hypotonia, hyperreflexia, unsteady gait, and incoordination. Magnetic resonance imaging (MRI) of brain revealed dilated ventricular system and cerebellar atrophy. Computed tomography (CT) of brain showed brain calcifications. Whole exome sequencing was finally performed, revealing homozygous nonsense pathogenic variant in FOLR1 gene in exon 3 c.C382T p.R128W, confirming the diagnosis of cerebral folate deficiency. Twelve-year-old female child presented with global developmental delay since birth, myoclonic jerks and cognitive regression. Child had generalized hypotonia and hyperreflexia. Her coordination was markedly affected with intention tremors andunbalanced gait. CT brain showed bilateral basal ganglia and periventricular calcifications with brain atrophic changes. MRI brain showed a prominent cerebellar folia with mild brain atrophic changes. Genetic testing showed a homozygous pathogenic variant was identified in FOLR1 C.327_328 delinsAC, p.Cys109Ter. Both patients were started on intramuscular folinic acid injections with a decrease in seizure frequency. However, their seizures did not stop completely due to late initiation of therapy. In conclusion, cerebral folate transport deficiency should be suspected in every child with global developmental delay, intractable myoclonic epilepsy, ataxia with neuroimaging suggesting cerebellar atrophy and brain calcifications. Response to folinic acid supplementation is partial if diagnosed late and treatment initiation is delayed.

Work and Family Conflicts, Depression, and "Ikigai": A Mediation Analysis in a Cross-cultural Study Between Japanese and Egyptian Civil Workers.

BACKGROUND: Total work-family conflicts (TWFCs) could associate with mental health, and having ikigai (a purpose of life) may mediate this association. METHODS: In a cross-cultural study of 4,792 Japanese Aichi Workers' Cohort study participants and 3,109 Egyptian civil workers, the Midlife Development in the United States (MIDUS) questionnaire measured TWFCs and the Center for Epidemiological Studies Depression (CES-D) 11-item scale measured depression. We used logistic regression models to estimate odds ratios (ORs) of having depression and a high-ikigai across levels of TWFCs (low, moderate, and high), and the PROCESS macro of Hayes to test the mediation effect. RESULTS: The prevalence of high TWFCs, depression, and having a high ikigai were 17.9%, 39.4%, and 70.1% in Japanese women, 10.5%, 26.8%, and 70.1% in Japanese men, 23.7%, 58.2%, and 24.7% in Egyptian women, and 19.1%, 38.9%, and 36.9% in Egyptian men, respectively. Compared with participants with low TWFCs, the multivariable ORs of depression in Japanese women and men with high TWFCs were 4.11 (95% confidence interval [CI], 2.99-5.65) and 5.42 (95% CI, 4.18-7.02), and those in Egyptian women and men were 4.43 (95% CI, 3.30-5.95) and 4.79 (95% CI, 3.53-6.48), respectively. The respective ORs of having a high-ikigai were 0.46 (95% CI, 0.33-0.64) and 0.40 (95% CI, 0.31-0.52) in Japanese women and men and were 0.34 (95% CI, 0.24-0.48) and 0.28 (95% CI, 0.20-0.39) in Egyptian women and men. No interaction between TWFCs and country was observed for the associations with depression or ikigai. Ikigai mediated (up to 18%) the associations between the TWFCs and depression, especially in Egyptian civil workers. CONCLUSION: TWFCs were associated with depression, and having low ikigai mediated these associations in Japanese and Egyptian civil workers.

A comparative study of the work-family conflicts prevalence, their sociodemographic, family, and work attributes, and their relation to the self-reported health status in Japanese and Egyptian civil workers.

BACKGROUND: Cross-cultural studies studying work-family conflicts (W_F_Cs) are scarce. We compared the prevalence of W_F_Cs, factors correlated with them, and their association with self-rated health between Japan and Egypt. METHODS: Among 4862 Japanese and 3111 Egyptian civil workers recruited by a convenience sample in 2018/2019 and reported self-rated health status, we assessed the W_F_Cs by the Midlife Development in the US (MIDUS) and attributed them to sociodemographic, family, and work variables. We also evaluated the W_F_Cs' gender- and country-specific associations with self-rated health by logistic regression analyses. RESULTS: W_F_Cs were more prevalent in Egyptian than in Japanese women (23.7% vs. 18.2%) and men (19.1% vs. 10.5%), while poor self-rated health was more prevalent in Japanese than Egyptians (19.3% and 17.3% vs. 16.9% and 5.5%). Longer working hours, shift work, and overtime work were positively associated with stronger work-to-family conflict (WFC). Whereas being single was inversely associated with stronger family-to-work conflict (FWC). Living with children, fathers, or alone in Japan while education in Egypt was associated with these conflicts. The OR (95% CI) for poor self-reported health among those with the strong, in reference to weak total W_F_Cs, was 4.28 (2.91-6.30) and 6.01 (4.50-8.01) in Japanese women and men and was 2.46 (1.75-3.47) and 3.11 (1.67-5.80) in Egyptian women and men. CONCLUSIONS: Japanese and Egyptian civil workers have different prevalence and correlated factors of W_F_Cs and self-rated health. W_F_Cs were associated in a dose-response pattern with poor-self-rated health of civil workers in both countries.

Public Awareness and Perception of Family Medicine in Jeddah, Saudi Arabia.

Background Family medicine is a specialty that provides care for family members' physical, social, and psychological aspects regardless of age, gender, and health conditions. A family physician can manage a wide range of health conditions and prevent various diseases. However, there are scarce data on the awareness and perceptions of the Saudi population regarding family medicine; therefore, we aim to determine the awareness and perception of family medicine and family physicians in the population of Jeddah, Saudi Arabia. Methodology This cross-sectional study was conducted in Jeddah and randomly enrolled 519 participants aged 18 years and older through an online self-administered survey. Microsoft Excel and SPSS were employed for the data entry and analysis. Result The analysis indicated that 86.7% of the participants had heard about family physicians, 55.1% recognized the family physician's role, 61.7% had never visited one, and 57.2% were unfamiliar with the locations of family medicine clinics. Conclusion The results of this study demonstrated that the general population of Jeddah has moderate positive responses toward the role of a family physician as a vital element in the healthcare system. However, the majority of the participants had never previously visited a family physician and were unfamiliar with the locations of family medicine clinics.

Detection of Equid Alphaherpesvirus 1 from Arabian Horses with different clinical presentations between 2016-2019 in Egypt.

Equid alphaherpesvirus 1 (EHV-1) is an important virus causing pathological disorders in horses. This highly contagious pathogen causes persistent outbreaks of upper respiratory tract infection, ocular affections, abortion, and neurological disorders with high mortality in Arabian horses in Egypt. The quick and accurate diagnosis is important to broaden our understanding about EHV-1 in the field, and to implicate stronger preventive, and control measures. Sixty-six Arabian horses from Cairo and Giza governorates were sampled from respiratory, abortigenic and neurological outbreaks over a period of 4 years. EHV-1 was diagnosed in these cases by immunohistochemistry using monoclonal antibody against EHV-1 glycoprotein B and molecular detection using gB, ORF33 specific real-time PCR. EHV-1 was detected in 25 cases, mostly from abortigenic outbreaks (14 abortions, 3 stillbirths, and two early neonatal deaths), in addition to 5 respiratory affections and single EHV-1 myeloencephalopathy. Molecular characterization revealed that the ORF33 sequences from this study were almost identical and closely related to the European EHV-1 strains. Furthermore, no difference in the amino acid sequences compared to previously published EHV-1 sequences from Egypt. The data in this study provides some insights about the prevalance of EHV-1 infection in Arabian horses, discusses EHV-1 diagnostic approaches, highlights the importance of accurate diagnosis and the importance of pregnant mare vaccination, and adds to the previous knowledge about EHV-1 in Egypt which may help in better controlling EHV-1 infections in the future.

The relationship between dietary intake and stunting among pre-school children in Upper Egypt.

OBJECTIVE: Linear growth is controlled by several factors, malnutrition is one of the leading causes of stunted child growth. The objective of this study was to determine the dietary intakes associated with stunting among pre-school children in rural Upper Egypt. DESIGN: Community-based cross-sectional study. SETTING: Data were collected by interviewing the children's caregivers in the rural household setting. PARTICIPANTS: The study included 497 pre-school children aged 2-5 years in rural Upper Egypt. Food intake data were estimated using 24-h recall method. Anthropometric measurements of children were taken and then converted to z-scores for weight-for-age Z-score, height-for-age Z-score and weight-for-height Z-score. RESULTS: The study included 497 children of which 19·1 % were stunted, 76·3 % did not meet recommended energetic intake and 13·7 % did not meet recommended protein intake and this was significantly higher than non-stunted children. Children who were stunted significantly consumed poultry, eggs and fruits less often than non-stunted children, by regression; male sex (adjusted odds ratio (aOR) = 1·91), mother's age (0·93), lower socio-economic status (SES); and not meeting recommended protein intake (aOR = 2·26) were found to be associated with stunting. CONCLUSION: Male sex, younger mothers, lower SES and not meeting recommended energy and protein were statistically associated with stunting. Nutrition education messages encouraging adequate and healthy eating are recommended.

Impact of household food insecurity on maternal mental health in Egypt.

BACKGROUND: Food insecurity leads to disturbed eating patterns, hunger or poor nutrition and is strongly correlated with poor mental health. AIMS: To determine the impact of household food insecurity on maternal mental health in a rural population in Egypt. METHODS: This community-based cross-sectional study was conducted in Qulubba Village in Minia Governorate. We interviewed 497 mothers with at least one child, using the Household Food Insecurity Access Scale and Hopkins Symptom Check List-25. RESULTS: Nearly 70% of women resided in food-insecure households. Symptoms of anxiety and depression were significantly more common among food-insecure mothers. By logistic regression analysis, household food insecurity, socioeconomic status, husband working abroad and number of children were significant predictors of maternal distress. Mothers with severe food insecurity were approximately 13 times more likely to experience mental distress than were food secure-mothers. CONCLUSIONS: Household food insecurity was associated with an increased likelihood of poor maternal mental health. The study highlights the need for policies to decrease poverty and programmes for screening and addressing food insecurity. Integrating mental health into programmes addressing food insecurity and providing counselling are recommended.

Psychological impacts of COVID-19 pandemic on the university students in Egypt.

University students are at elevated risk for mental health problems. The COVID-19 pandemic and subsequent public health measures taken to combat it burdened the students' life with additional dramatic psychological impacts. The aim of this study was to investigate the psychological impacts that affected the university students in Egypt during the COVID-19 pandemic. An online survey was sent to the Egyptian university students via all means of online communication during the first week of May 2020 by using a non-probability snowball sampling. A survey included a short version Depression Anxiety Stress Scale-21 (DASS-21) and socio-demographic data. Overall, 70.5, 53.6 and 47.8% of Egyptian students had depression, anxiety and stress, respectively. Being a female, having a relative or acquaintance infected with COVID-19, having a preexisting chronic disease and lacking of psychological support from families, community and universities increase the risk of depression, anxiety and stress among Egyptian students. Being a medical student is associated with depression while, spending more time to follow news of COVID-19 pandemic is associated with increased anxiety. Egyptian students experience varying levels of psychological disturbance during COVID-19 pandemic. This study suggests that mental health of the university students should be carefully, monitored during the crisis and the universities should provide psychological-oriented services, adapted to these circumstances to mitigate its emotional impact on the students.

Determinants of caregiver burden of persons with disabilities in a rural district in Egypt.

BACKGROUND: Family caregivers are critical partners in the plan of care of people with disabilities. The study aims to demonstrate the factor structure and internal consistency of the Caregiver Burden Inventory (CBI) among the studied caregivers of disabled persons and to determine the effects of patients' and caregivers' characteristics on the burden and its dimensions. METHODS: A cross-sectional study among 260 family caregivers of disabled patients was carried out in a randomly chosen rural area, Minia, Egypt, 2019. Exploratory factor analysis (EFA) was conducted to determine the factorial validity of the CBI. Multiple linear regression was used to identify the significant factors affecting the burden. RESULTS: Factor analysis resulted in a five-factor solution using 20 items (four for each dimension) accounting for 72.7% of the total variance. The CBI and its dimensions showed high internal consistency (Cronbach's alpha value > 0.70). Education of caregiver, family income, mental impairments, and mixed disabilities were significant predictors of total CBI burden. CONCLUSIONS: CBI is an effective multidimensional measure of the caregiver burden of disabled subjects. Caregivers experienced a distinct level of burden that is determined by caregiver and care recipient characteristics. Therefore, support and individualized counseling services should be optimized.

Female genital mutilation: current awareness, believes and future intention in rural Egypt.

BACKGROUND: Female genital cutting, also termed female genital mutilation (FGM), is a damaging practice with no health benefits for girls or women, and is considered to be a violation of children's rights. METHODS: A cross-sectional, community-based study using interview administered questionnaire to explore knowledge and attitude of people living in a rural area in Minia. Systematic random sampling was used to interview 618 males and females above the age of 18 in the period from September to November 2016. RESULTS: FGM was performed on 76.6% of females, complications occurred in 35.6% of them. Females demonstrated a higher level of knowledge than males. Nearly 56% of respondents believed that this practice should continue. Females were more supportive of the continuation of FGM than men (60.3% vs. 47.9%). The attitude that FGM is a good practice, knowledge level, women's status and religion were significantly associated with women's willingness to subject their daughters to FGM in the future. Attitude was the only significant predictor associated with men's willingness to subject their daughters to FGM. CONCLUSION: The strong correlation between social pressure and intentions to carry out FGM means that FGM practice will continue to be embraced among future generations unless policies are put in place to eradicate this practice through empowering females by education and reasonable income.

Does Uterine Fibroid Adversely Affect Obstetric Outcome of Pregnancy?

BACKGROUND: Fibroid is the most common benign tumor of the uterus and if associated with pregnancy may adversely affect the outcome of pregnancy. Objective of the present study was to assess the obstetric outcome (maternal and fetal) in pregnancy with fibroid. METHODS: A prospective observational study was performed over a period from May 2015 to August 2017 at Obstetrics and Gynecology Department in Zagazig University Hospitals, Egypt. 64 pregnant patients with >2 cm fibroid were taken in the study. Routine fundamental investigations were done for all. They were followed during antenatal period clinically and scanned by ultrasonogram which was done at booking visit and during subsequent visits to assess the change in the size of the fibroid and other obstetric complications. Maternal age, parity, size of fibroid, complications during pregnancy, and mode of delivery were noted. RESULTS: 64 pregnant patients with uterine fibroids were recruited; 47 of them completed the study to the end. The average age was 31.80 ± 3.27 years, body mass index (BMI) [calculated as weight in kilograms divided by the square of height in meters] was 24.67 ± 2.46, primigravida was 23.4%, multigravida was 76.6%, duration of menstrual cycle/day was 29.68 ± 3.10, and duration of menstrual period/day was 6.46 ± 1.12. The percentage of spontaneous conception was 59.57% and 40.43% for using assisted reproductive technology. The results of obstetric outcome were spontaneous abortion in 2%, premature delivery in 27.7%, and delivery at 37-41 weeks of pregnancy in 70.2%. The mode of delivery was vaginal delivery in 15% and cesarean sections in 85%. Also, 34% had threatened miscarriage, 21% had preterm labor, 2% had antepartum bleeding in the form of placenta previa, 4% had abdominal pain needing admission, one of them underwent laparotomy and was diagnosed as red degeneration, 2 (4%) had postpartum hemorrhage, and only one needed blood transfusion. Cesarean sections were done in 85%. Neonatal outcome was acceptable with no perinatal mortality. There were no significant differences between patients with single or multiple fibroids as regards the obstetric outcome or type of fibroid either intramural or subserosal. The obstetric outcomes were not significantly affected by the number, size, or type of fibroids. CONCLUSIONS: Even most of fibroids in pregnancy are asymptomatic but may be associated with some complications affecting the course of pregnancy and labor. So, pregnancy has to be cautiously screened in the antenatal period, through regular follow-up, to detect any adverse obstetric complications and so improve the outcome.

Effects of Mothers' Knowledge and Coping Strategies on the Glycemic Control of Their Diabetic Children in Egypt.

BACKGROUND: This study aimed to examine the relationship between mothers' knowledge related to treatment management of type 1 diabetes (T1D), with perceptions of coping with diabetes-related stress and to examine the relationship between children's metabolic control and maternal coping. A cross-sectional study was done among ninety-two mothers of T1D children. METHODS: Data were collected using a structured questionnaire, Ways of coping questionnaire (WCQ), and Diabetes Knowledge questionnaire-24 (DKQ-24). RESULTS: The most important predictors of the total knowledge scores among mothers were father education (P < 0.0001), followed by child age and sex (P < 0.0001), while the most important coping scales affected by total knowledge scores was accepting responsibility (P = 0.01). There were positive correlation between HBA1C and escape-avoidance and positive reappraisal coping scales (r = 0.24, P = 0.02 and r = 0.23, P = 0.02, respectively). Blood glucose level was the most important clinical characteristics affecting the use of seeking social support coping scale among mothers. CONCLUSIONS: Parents with more knowledge of diabetes and with better education were able to cope more effective and maintain a better glycemic control of their diabetic children.

Dietary Factors Associated with Pancreatic Cancer Risk in Minia, Egypt: Principal Component Analysis

Background: Pancreatic cancer (PC) is a serious and rapidly progressing malignancy. Identifying risk factors including dietary elements is important to develop preventive strategies. This study focused on possible links between diet and PC. Methods: We conducted a case-control study including all PC patients diagnosed at Minia Cancer Center and controls from general population from June 2014 to December 2015. Dietary data were collected directly through personal interviews. Principal component analysis (PCA) was performed to identify dietary groups. The data were analyzed using crude odds ratios (ORs) and multivariable logistic regression with adjusted ORs and 95% confidence intervals (CIs). Results: A total of 75 cases and 149 controls were included in the study. PCA identified six dietary groups, labeled as cereals and grains, vegetables, proteins, dairy products, fruits, and sugars. Bivariate analysis showed that consumption of vegetables, fruits, sugars, and total energy intake were associated with change in PC risk. In multivariable-adjusted models comparing highest versus lowest levels of intake, we observed significant lower odds of PC in association with vegetable intake (OR 0.24; 95% CI, 0.07-0.85, P=0.012) and a higher likelihood with the total energy intake (OR 9.88; 95% CI, 2.56-38.09, P<0.0001). There was also a suggested link between high fruit consumption and reduced odds of PC. Conclusions: The study supports the association between dietary factors and the odds of PC development in Egypt. It was found that higher energy intake is associated with an increase in likelihood of PC, while increased vegetable consumption is associated with a lower odds ratio.

Awareness about Breast Cancer and Its Screening among Rural Egyptian Women, Minia District: a Population-Based Study

Background: Recent global cancer statistics indicate rising global incidence of breast cancer and the increase is occurring at a faster rate in developing countries. Training women how to carry out breast self-examination (BSE) can help them to be alert to any abnormalities in their breasts to speedily seek medical consultation. Health behavior may be influenced by level of awareness about breast cancer. Methods: A cross-sectional community- based study aimed to assess the level of knowledge about breast cancer risk factors, early warning signs, screening approaches and related predictors. Also, to determine the extent of practice of breast self- examination (BSE) among rural women, Minia in the period from February to May 2016. A total of 600 women were randomly included in the study. A questionnaire included socio-demographic characteristics and information related to their knowledge about breast cancer. Data analysis was carried out using SPSS version 19. Results: Moderate and high knowledge scores were presented by 46.9 %. Nearly 40% of participants had the knowledge that smoking increased the likelihood of cancer breast and almost 30% of them affirmed that being obese or having a positive family history of cancer breast made them vulnerable to cancer breast. It was found that 28.7% and 18.2% of them knew that aging and nulliparity increased the likelihood of breast cancer. Participants with better knowledge score were 4.8 times more likely to practice BSE. Conclusion: This study revealed poor knowledge among rural women regarding cancer breast. BSE and clinical breast examination were not well practiced. It is recommended to create awareness programs about breast cancer and regular patterns of BSE.

Effect of Honey and Royal Jelly against Cisplatin-Induced Nephrotoxicity in Patients with Cancer.

OBJECTIVES: Cisplatin constitutes one of the most potent antineoplastic drugs; however, nephrotoxicity limited its eligibility for optimal clinical use. This study was designed to evaluate the role of honey and royal jelly with antioxidant properties in the protection of cisplatin-induced acute kidney injury in patients with cancer. METHODS: Patients with cancer assigned for cisplatin chemotherapy were randomly divided into bee honey and royal jelly groups pretreated before the initiation and during cisplatin chemotherapeutic regimen and control group on cisplatin only. Serum creatinine and urea levels were measured before and after the chemotherapeutic cycle and over 2 cycles. RESULTS: Patients on crude bee honey and royal jelly capsules showed lower serum levels of renal injury products (creatinine and urea) compared to those in the control group. The changes in kidney parameters were significantly (p < 0.05) lower when compared within the bee honey group before and after cisplatin treatment. Royal jelly was found to be effective; however, the difference in creatinine and urea levels before and after chemotherapy was not statistically significant. CONCLUSIONS: The use of bee honey and royal jelly as natural compounds is effective in reducing cisplatin nephrotoxicity and may offer a promising chance for clinically meaningful prevention. This study has potentially important implications for the treatment of cisplatin kidney side effects and is considered to be the first to investigate this effect of honey and royal jelly in human subjects. However, due to its small sample size, we recommend further investigation using a larger sample size.

Characterization of buffalo interleukin 8 (IL-8) and its expression in endometritis.

River buffalo (Bubalus bubalis bubalis) with a population over 135 million heads is an important livestock. Interleukin 8 (IL-8) is a member of the chemokine family and is an important chemoattractant for neutrophils associated with a wide variety of inflammatory diseases such as endometritis. Tissue samples from the mammary gland, uterus and ovary were obtained from river buffalo (Mediterranean type) with and without endometritis. Bacteriological examination showed the presence of both gram positive and negative in all buffalo with endometritis. RNA extraction and complementary DNA (cDNA) synthesis were conducted from all tissues. Specific primer for IL8 full coding regions was designed using known cDNA sequences of Bubalus bubalis, Genbank accession number AY952930.1. IL-8 gene expression was investigated in buffalo tissues. Expression of IL-8 in buffalo with endometritis was found to increase significantly over buffalo without endometritis only in the uterus (P = 0.0159). PCR products from uterus tissues (target organs) of buffalo with and without endometritis, were purified and sequenced. No polymorphic sites were detected in the investigated samples. IL-8 cDNA nucleotide sequences of buffalo with and without endometritis were 100% identical (accession number JX413057). Buffalo IL8 cDNAs were compared with corresponding sequences of member of subfamily Bovinae (buffalo and cattle) and subfamily Caprinae (sheep and goat). IL-8 species specific differences were identified.

Predictors of Delay in Seeking Health Care among Myocardial Infarction Patients, Minia District, Egypt.

Objectives. To determine the barriers that hinder early seeking of medical care among Minia's myocardial infarction patients. Methods. The study was based on individual interviews with 207 men and women with a first confirmed myocardial infarction (MI), admitted to the coronary care units of hospitals in Minia city in the period from April 1 to August 30, 2014. Data was collected via structured questionnaire and patient medical charts. The delay was evaluated by assisting patients to triangulate time of symptom onset and time of professional health care by placing both times in context of daily activities that participants could easily remember. Results. The median (25th, 75th percentiles) delay time was 4 (2, 10) h. Only 32.8% of patients arrived within 2 hours of symptoms onset. Variables that significantly predicted prehospital delay time were patient's misinterpretation of nature of pain with OR 8.98 (95% CI) (3.97-20.32), illiteracy 7.98 (2.77-22.95), age (>65) 5.07 (1.57-16.29), and pain resistance behavior 4.61 (2.04-10.41). Conclusions. Interventions to decrease prehospital delay must focus on improving public awareness of acute myocardial infarction symptoms and increasing their knowledge on early treatment benefits.

Child labor in a rural Egyptian community: an epidemiological study.

OBJECTIVES: Estimating the burden of child labor in a rural community of El-Minia governorate, Egypt and exploring its determinants and health impact. METHODS: One hundred and ninety nine children randomly participated from a randomly selected village; 147 (73.9%) males and 52 (26.1%) females, whose ages ranged from 6 to 17 years (mean age 12.1 ± 2.9). All children were subjected to interview questionnaire, and medical examination. RESULTS: Ninety (45.2%) of the children reported that they are engaged in a work. The working children belonged to 65.6 and 85.6% of illiterate fathers and mothers, respectively. The majority of the working children were engaged in jobs at quarries (58.9%), followed by farming (21.1%), then small proportions of children were working in other jobs. Poverty, big families and insufficient family's income were the most frequently reported reasons for starting to work (80%). There was a significant higher prevalence of the reported health complaints among working children. CONCLUSIONS: Working children are at high risk of many health problems. Poverty, parents' illiteracy, large family size and fathers' absence are the driving force for child labor in the rural community of Eastern Minia.

The role of dietary and lifestyle factors in the development of colorectal cancer: case control study in Minia, Egypt.

BACKGROUND: Colorectal cancer (CRC) is the third most common cancer worldwide, after lung and breast cancer, and is associated with the population dietary and lifestyle factors. AIM: To determine the relation between dietary and lifestyle factors and development of CRC in patients attending Minia oncology centre and compare them with their control. METHODS: Study included 150 CRC patients attending Minia oncology centre and 300 control subjects matched by age and sex. Subjects participating in the study filled in a questionnaire including questions about socio-demographic data, medical data concerning CRC and its treatment as well as dietary and lifestyle factors. RESULTS: The most significant dietary and lifestyle CRC risk factors were higher consumption of red meat (OR = 57.1), preserved food (OR = 39.4), artificial sweeteners (OR = 20.8), fast foods (OR = 12.8), soft drinks (OR = 4.6), spicy foods (OR = 4.2), processed meat (OR = 2.4), and smoking (OR = 8.8). The most significant protective factors were physical activity (OR = 0.001), calcium rich diet (OR = 0.08), higher consumption of fruits and vegetable (OR = 0.02), cruciferous vegetables (broccoli OR = 0.11, cauliflower OR = 0.30 and cabbage OR = 0.30), high fiber bread (OR = 0.15), fruit juice (OR = 0.18), and sea foods (tuna OR = 0.28 and fish OR = 0.38). CONCLUSION: Sedentary lifestyle and unhealthy dietary choices were prevalent among CRC cases. This study provides strong evidence that lifestyle and dietary modification are important factors in the prevention of colorectal cancer.