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.

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.

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.

Compliance to diabetes self-management in rural El-Mina, Egypt.

BACKGROUND: Diabetes is a serious public health problem that threatens the quality of life of patiens with diabetes, the success of long-term maintenance therapy for diabetes depends largely on the patients' compliance with a therapeutic plan. AIM OF THIS STUDY: To assess compliance of diabetic patients to diabetes self-Management in rural El Minia, and to determine the associated factors related to it. SUBJECTS AND METHOD: Cross sectional analytic study. Rural adults identified as having previously diagnosed diabetes were recruited to participate in this study. A total of 206 rural community diabetics were randomly chosen and subjected to interview questionnaire on history of diabetes, type of medication, self-management of diabetes as glucose examination, dietary modification, and eye examination. RESULTS: Mean age of participants was 54 +/- 6.3 years and mean duration of diabetes was 12 +/- 8 years. Nearly one third of the patients used insulin and more than half used oral hypoglycemic. The results of this study revealed that good adherence to diabetes self-management was reported among 41.7% of adult diabetic patients who show good adherence to diet instructions, but only 21.4% to blood glucose test. There was no gender difference regarding self care of diabetes. Younger age group had more glycemic control than older age; longer duration of diabetes was significantly associated with poor glycemic control. CONCLUSION: Compliance to self-management of diabetes is suboptimal among rural adult community diabetic.

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.

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.