Evaluation of anatomical and functional results of overlapping anal sphincter repair with or without the injection of bone marrow aspirate concentrate: a case-control study.

AIM: Overlapping anal sphincter repair (OASR) is used for treatment of faecal incontinence due to an external anal sphincter (EAS) defect; however, it is not the optimal treatment as its functional results tend to deteriorate significantly with time. The present study aimed to evaluate the effect of local injection of bone marrow aspirate concentrate (BMAC) on the outcome of OASR. METHOD: We compared a prospective group of 20 patients with EAS defect who were managed with OASR and BMAC injection (group I) with a historical control group of an equal number of patients managed with OASR alone (group II). Patients were assessed preoperatively and during follow-up by the Wexner continence score and endoanal ultrasound. The primary end-points were the improvement of the continence level measured by the Wexner score and the residual EAS defect size measured by endoanal ultrasound. RESULTS: At the end of follow-up, group I had significantly lower mean postoperative Wexner score (5.4 ± 7.6 vs 10.6 ± 7.4; P = 0.03) and smaller EAS defect percentage (12.2 ± 17.5 vs 18.3 ± 18.9). These findings were statistically significant in patients with a small preoperative EAS defect equal to or less than one-third of the anal circumference. Patients with larger preoperative EAS did not show a significant improvement of the continence level after repair in either group. CONCLUSION: Augmenting OASR with local injection of BMAC in patients with faecal incontinence caused by an EAS defect, particularly a smaller defect, can improve both functional and anatomical outcomes of OASR.

The Effect of Organic Fertilizers and Flowering Plants on Sheet-Web and Wolf Spider Populations (Araneae: Lycosidae and Linyphiidae) and Its Importance for Pest Control.

The main goal of this study was to identify the treatment that increases the populations of spiders, which are effective predators in agroecosystems. In 2013 and 2014 the experimental eggplant (Solanum melongena L.) field was two different treatments, organic fertilizers and chemical fertilizer treatment, and in 2014 we surrounded organic fertilizer plots with the flowering plants mealy cup sage (Salvia farinacea Benth.), spearmint (Mentha spicata L.), and basil (Ocimum basilicum L.). Analysis using repeated measures ANOVA revealed significant influences of fertilizer type on the numbers of linyphiid spiders and Collembola in 2013. In 2014, the numbers of Collembola, thrips, and lycosid and linyphiid spider were higher in organic fertilizer with flowering plants treatment comparing with the chemical fertilizer treatment. Moreover, the numbers of Henosepilachna vigintioctopunctata (F.) were significantly lower in the organic fertilizer with flowering plants treatment than in chemical fertilizers treatment. Finally, we expect that Thysanoptera and Collembola were important alternative prey for linyphiid and lycosid spiders and the use of organic fertilizer and flowering plants enhanced the density of these spiders, and may increase their effectiveness in suppressing the populations of H. vigintioctopunctata (F.).

Feature selection in wind speed forecasting systems based on meta-heuristic optimization.

Technology for anticipating wind speed can improve the safety and stability of power networks with heavy wind penetration. Due to the unpredictability and instability of the wind, it is challenging to accurately forecast wind power and speed. Several approaches have been developed to improve this accuracy based on processing time series data. This work proposes a method for predicting wind speed with high accuracy based on a novel weighted ensemble model. The weight values in the proposed model are optimized using an adaptive dynamic grey wolf-dipper throated optimization (ADGWDTO) algorithm. The original GWO algorithm is redesigned to emulate the dynamic group-based cooperative to address the difficulty of establishing the balance between exploration and exploitation. Quick bowing movements and a white breast, which distinguish the dipper throated birds hunting method, are employed to improve the proposed algorithm exploration capability. The proposed ADGWDTO algorithm optimizes the hyperparameters of the multi-layer perceptron (MLP), K-nearest regressor (KNR), and Long Short-Term Memory (LSTM) regression models. A dataset from Kaggle entitled Global Energy Forecasting Competition 2012 is employed to assess the proposed algorithm. The findings confirm that the proposed ADGWDTO algorithm outperforms the literature's state-of-the-art wind speed forecasting algorithms. The proposed binary ADGWDTO algorithm achieved average fitness of 0.9209 with a standard deviation fitness of 0.7432 for feature selection, and the proposed weighted optimized ensemble model (Ensemble using ADGWDTO) achieved a root mean square error of 0.0035 compared to state-of-the-art algorithms. The proposed algorithm's stability and robustness are confirmed by statistical analysis of several tests, such as one-way analysis of variance (ANOVA) and Wilcoxon's rank-sum.

Combined Effects of Yellow Mealworm (Tenebrio molitor) and Saccharomyces cerevisiae on the Growth Performance, Feed Utilization Intestinal Health, and Blood Biomarkers of Nile Tilapia (Oreochromis niloticus) Fed Fish Meal-Free Diets.

Aquafeed quality is the most critical factor for aquaculture sustainability. However, limitations of traditional feed ingredients such as fishmeal (FM) need alternative strategies to ensure the nutritional requirements for aquatic animals. In this trial, four test diets were formulated (2 × 2 factorial design), where FM was incorporated in two diets at 10% with or without Saccharomyces cerevisiae (SC) at 1 g/kg. At the same time, FM was replaced with yellow mealworm (Tenebrio molitor) meal (TM) with or without SC at 1 g/kg. The growth performance indices (final weight, weight gain, and SGR), and the feed utilization indices (FCR and PER) were markedly affected by the protein source (FM or TM) and dietary SC (P < 0.05). The protein source (FM or TM) significantly (P < 0.05) affected the whole-body protein and lipid contents, while the moisture and ash contents were unaffected (P > 0.05) by TM or SC. The growth of the intestinal villi showed a marked increase in both height and branching in the treated groups with SC along the whole length of the intestine. Furthermore, the immune cell infiltration was prominent near the intestinal crypts of the middle intestinal segments in the supplemented groups by SC. Dietary TM and SC revealed improved hepatic parenchyma in the liver tissue better than other groups. The hematological indices, including hemoglobulin, hematocrit, red blood cells, and white blood cells, were markedly affected by dietary SC (P < 0.05). The lysozyme activity and phagocytic index were markedly affected by dietary SC, while phagocytic activity was affected by dietary TM (P < 0.05). The catalase, glutathione peroxidase, and malondialdehyde were markedly affected by the interaction between dietary protein source and SC, while superoxide dismutase was affected by dietary SC (P < 0.05). In conclusion, adding SC could enhance the utilization of TM by Nile tilapia with positive effects on the intestinal and liver histological features and the immune and antioxidative responses.

Effect of Mutagens on Yield and its Components of Two Varieties of Faba Bean (Vicia faba L.).

<b>Background and Objective:</b> It is known that any genetic improvement depends on the presence of many genetic variations so that the plant breeder can choose the desired traits such as the trait of the crop or resistance to some diseases. Different or it can be used for selection, whether for yield, early maturity or other characteristics. This study aimed to use gamma irradiation and the chemical mutagen Dimethyl sulfoxide for the induction of genetic variation in two types of beans. <b>Materials and Methods:</b> The Giza 429 and Misr 1 genotypes were treated with three different concentrations of dimethyl sulfur oxide (1000, 2000 and 3000 ppm) and gamma radiation doses (10, 15 and 20 kr) to perform mutagenesis treatments. <b>Results:</b> In the first and second seasons of the study, all the mutations resulting from the radiological and chemical mutagenic treatments of the two Egyptian bean cultivars, Giza 429 and Misr 1, were highly significant for all treatments in the following traits: Number of branches/plant, plant height, number of pods/plant with the weight of 100 seeds (g) and seed yield/plant (g). <b>Conclusion:</b> The benefit of this research was obtained from plants that outperformed the two cultivars Giza 429 and Misr 1 and are considered among the promising plants that can be used in mixed breeding programs or direct selection for high productivity.

Influence of Effective Microorganisms on Some Biological and Biochemical Aspects of Spodoptera littoralis (Boisduval) (Lepidoptera: Noctuidae).

The cotton leafworm, Spodoptera littoralis (Bosid.), is a major pest in African and Asian nations that attacks a wide variety of host plants. This study was conducted to assess the effectiveness of effective microorganisms (EMs) on the biological and physiological features of S. littoralis larvae. Five concentrations (100, 200, 300, 400, and 500 ppm) of EMs were tested. Antifeedant activity, food consumption index, the efficiency of converting digested food, the efficiency of converting ingested food, relative growth rate, and approximate body tissue of the fourth larval instar of S. littoralis were determined. Moreover, carbohydrate enzyme activities (amylase, trehalose, and invertase), total protein, and total lipids of S. littoralis larvae were measured to elucidate the mode of action of the tested agent in the S. littoralis's larval stage. The EMs at 500 ppm had a substantial impact on antifeedant activity, nutritional indices, egg deposit reduction, and hatchability in S. littoralis during the five days. All concentrations interrupted S. littoralis's life cycle and developmental phases. Furthermore, all concentrations were quite useful in lengthening the developmental stages of S. littoralis. In addition, Ems affected the biochemical activities of larvae, leading to disturbances in carbohydrate, lipid, and protein levels. From this study, EMs can be used as a bioinsecticide alternative to traditional insecticides against S. littoralis and may be compatible with integrated pest management approaches.

Effect of Sodium Azide on Yield and its Components in Bread Wheat (Triticum aestivum L.).

<b>Background and Objective:</b> The wheat crop is considered one of the most important crops globally, especially in Egypt. It has great nutritional importance, so it was necessary to increase productivity and any genetic improvement depends on the presence of many genetic differences so that breeders can achieve this. This study aimed to use chemical mutagenic (sodium azide) to obtain the desired genetic differences in two wheat cultivars. <b>Materials and Methods:</b> Two types of bread Sids 12 and Giza 164 were treated with different concentrations of sodium azide (NaN₃) (1000, 2000, 3000, 4000, 5000 and 6000 ppm). <b>Results:</b> The highest grain/plant 78.91 g was obtained from Sis12 and 62.96 g from Giza 164 compared to the control 42.57 and 40.24 g for Sids 12 and Giza 164, respectively. Also from the results obtained, the relationship of yield was positive and significant with both grain/spike, spikelet's no./spike spikes no./plant and height/plant. On the contrary, it was negative and significant with a 1000-grain weight (-0.433). <b>Conclusion:</b> The two treatments (1000 and 2000 ppm) were the best in the Sids 12, while (1000 and 5000 ppm) were the best treatments in the Giza 164.

Gamma Radiation: An Eco-Friendly Control Method for the Rice Weevil, Sitophilus oryzae (L.) (Coleoptera: Curculionidae).

The rice weevil, Sitophilus oryzae (L.), is the most destructive insect pest of stored cereals worldwide. The current study was conducted to determine the lethal, reproductive, and histological effects of gamma irradiation on S. oryzae adults. In addition, the impact on germination, chlorophyll, and proline content in wheat seedlings from treated grains was determined. Wheat grains were infested with rice weevil adults and then irradiated by gamma rays. Gamma radiation was applied at a dosage of 0.10, 0.25, 0.50, and 1.00 kGy. Mortality percentage and LD50 were recorded after 48, 72, 96, and 120 h of treatment. The dosage of 1.00 kGy caused 100% mortality after 96 h of irradiation. The required dosage of gamma radiation to kill 50% (LD50) of adults after 48 h was 1.51 kGy. All tested doses caused complete sterility to 24 h old adults. A histological alteration was noticed at a dosage of 1.00 kGy, which showed cytoplasmic vacuolization, tissues exhibiting signs of putrefaction, and necrosis of cells; furthermore, gamma irradiation affected chlorophyll a and b. The highest amounts were detected in wheat seedlings from grains irradiated at 0.10 kGy. There was a significant increase in plant proline content at the higher doses (0.50 and 1.00 kGy) compared with seedlings from nonirradiated grains. It could be concluded that gamma radiation can be used as an eco-friendly trend to control stored-product pests without any residual effects.

Repellent and Toxicant Effects of Eight Essential Oils against the Red Flour Beetle, Tribolium castaneum Herbst (Coleoptera: Tenebrionidae).

This study was conducted to compare the repellent effect and contact toxicity of eight essential oils (EOs), including Syzygium aromaticum, Allium sativum, Eucalyptus camaldulensis, Lavandula officinalis, Simmondsia chinensis, Matricaria chamomilla, Citrus limon, and Prunus dulcis, against adults of Tribolium castaneum Herbst. Four concentrations (1, 5, 10, and 15% in acetone solvent) of each EO were tested. The 5, 10, and 15% concentrations of S. aromaticum EO had a high repellency effect against T. castaneum compared with A. sativum, E. camaldulensis, L. officinalis, S. chinensis, M. chamomilla, C. limon, and P. dulcis after 30 min of exposure. The repellency test of the S. aromaticum, E. camaldulensis, L. officinalis, M. chamomilla, C. limon, and P. dulcis EOs on T. castaneum has shown that the mortality percentages enhanced with the increase in the EOs concentration and also with the exposure time. The 15% concentration of P. dulcis and M. chamomilla EOs have a significant impact on the mortality rate of T. castaneum compared with S. aromaticum, A. sativum, E. camaldulensis, L. officinalis, and S. chinensis after the 24 h of contact test. Moreover, the 15% concentration of the C. limon EO caused a greater mortality percentage compared with S. aromaticum, A. sativum, E. camaldulensis, and L. officinalis. It could be concluded that using the S. aromaticum EO as a repellent oil and using P. dulcis, M. chamomilla, and C. limon for contact toxicity to treat the flour infested by T. castaneum can play an important role in protecting stored grains and their products.

The impact of cold storage durations on Trichogramma evanescens (Westwood) (Hymenoptera: Trichogrammatidae) during their pupal stage.

This experimental study was done at the Biological Control Laboratory, Sakha Agricultural Research Station, Sakha, Kafrelsheikh, Egypt. We aimed to estimate the impact of different cold (10 °C) storage durations [0 (non-cold-stored parasitized eggs), 3, 6, 9, 12, 15, 18, 21, 24, 27, and 30 days], on Trichogramma evanescens (Westwood) (Hymenoptera: Trichogrammatidae) during the pupal stage using the eggs of Sitotroga cerealella after exposing to T. evanescens. The emergence percentage of non-cold-stored eggs of S. cerealella was higher than all cold-stored durations. Also, the female's percentages of T. evanescens in the cold storage durations were lower than the non-cold storage one, and they were influenced by extended cold storage durations. There were non-significant differences in the female's longevity of T. evanescens obtained from 0, 3, and 6 days cold-stored parasitized eggs of S. cerealella at 10 °C, but it began to decrease from those produced after 9 days of cold-stored eggs. In addition, the emergence percentage in F1 progeny of T. evanescens was greater than 50% until 21 days of cold storage. It could be concluded that cold storage reduced the % emergence, % females, female's longevity, and emergence percentage in F1 progeny of T. evanescens. For a successful biological control program, the decrease of T. evanescens performance after cold storage durations should be considered in mass production, and the release percentage should be increased by the equivalent of a lack of % emergence. Also, the economic importance of using cold storage periods in commercial mass rearing should be assessed in the biological control program.

Advanced Meta-Heuristics, Convolutional Neural Networks, and Feature Selectors for Efficient COVID-19 X-Ray Chest Image Classification.

The chest X-ray is considered a significant clinical utility for basic examination and diagnosis. The human lung area can be affected by various infections, such as bacteria and viruses, leading to pneumonia. Efficient and reliable classification method facilities the diagnosis of such infections. Deep transfer learning has been introduced for pneumonia detection from chest X-rays in different models. However, there is still a need for further improvements in the feature extraction and advanced classification stages. This paper proposes a classification method with two stages to classify different cases from the chest X-ray images based on a proposed Advanced Squirrel Search Optimization Algorithm (ASSOA). The first stage is the feature learning and extraction processes based on a Convolutional Neural Network (CNN) model named ResNet-50 with image augmentation and dropout processes. The ASSOA algorithm is then applied to the extracted features for the feature selection process. Finally, the Multi-layer Perceptron (MLP) Neural Network's connection weights are optimized by the proposed ASSOA algorithm (using the selected features) to classify input cases. A Kaggle chest X-ray images (Pneumonia) dataset consists of 5,863 X-rays is employed in the experiments. The proposed ASSOA algorithm is compared with the basic Squirrel Search (SS) optimization algorithm, Grey Wolf Optimizer (GWO), and Genetic Algorithm (GA) for feature selection to validate its efficiency. The proposed (ASSOA + MLP) is also compared with other classifiers, based on (SS + MLP), (GWO + MLP), and (GA + MLP), in performance metrics. The proposed (ASSOA + MLP) algorithm achieved a classification mean accuracy of (99.26%). The ASSOA + MLP algorithm also achieved a classification mean accuracy of (99.7%) for a chest X-ray COVID-19 dataset tested from GitHub. The results and statistical tests demonstrate the high effectiveness of the proposed method in determining the infected cases.

Interferon gamma gene polymorphism as a biochemical marker in Egyptian atopic patients.

OBJECTIVES: The aim of this study was to clarify the role of interferon (IFN) gamma in the diagnosis and follow-up of atopic patients. We genotyped the IFN-gamma polymorphism at position +874 to examine the relationship between serum levels of IFN-gamma and disease severity and the role of IFN-gamma as a biochemical and immunologic marker. METHODS: The study population comprised 75 patients suffering from atopic asthma, atopic dermatitis, and allergic rhinitis (25 each), and 25 control participants. Total immunoglobulin (Ig) E and serum IFN-gamma were measured by enzyme-linked immunosorbent assay, the IFN-gamma polymorphism at position +874 was determined by amplification refractory mutation system-polymerase chain reaction, and eosinophil counts were recorded. RESULTS: There was a significant association between genotype and the frequency of the A allele of the +874T/A polymorphism in atopic patients when compared with controls (P < .001). In all 3 groups, there was a significant increase in total IgE levels and eosinophil counts, and a decrease in serum IFN-gamma levels towards the presence of homozygous AA compared with homozygous TT. CONCLUSIONS: The IFN-gamma gene polymorphism at position +874 contributes to susceptibility to atopic diseases by decreasing the amount of IFN-gamma. Identification of variants of IFN-gamma gene signalling and its role in the development of atopic diseases provides a focus for the development of novel diagnostic and therapeutic strategies for these diseases.

Potential Role for a Panel of Immunohistochemical Markers in the Management of Endometrial Carcinoma.

BACKGROUND: In order to improve the efficacy of endometrial carcinoma (EC) treatment, identifying prognostic factors for high risk patients is a high research priority. This study aimed to assess the relationships among the expression of estrogen receptors (ER), progesterone receptors (PR), human epidermal growth factor receptor 2 (HER2), Ki-67, and the different histopathological prognostic parameters in EC and to assess the value of these in the management of EC. METHODS: We examined 109 cases of EC. Immunohistochemistry for ER, PR, HER2, and Ki-67 were evaluated in relation to age, tumor size, International Federation of Gynecology and Obstetrics (FIGO) stage and grade, depth of infiltration, cervical and ovarian involvement, lymphovascular space invasion (LVSI), and lymph node (LN) metastasis. RESULTS: The mean age of patients in this study was 59.8 ± 8.2 years. Low ER and PR expression scores and high Ki-67 expression showed highly significant associations with non-endometrioid histology (p = .007, p < .001, and p < .001, respectively) and poor differentiation (p = .007, p < .001, and p <. 001, respectively). Low PR score showed a significant association with advanced stage (p = .009). Low ER score was highly associated with LVSI (p = .006), and low PR scores were associated significantly with LN metastasis (p = .026). HER2 expression was significantly related to advanced stages (p = .04), increased depth of infiltration (p = .02), LVSI (p = .017), ovarian involvement (p = .038), and LN metastasis (p = .038). There was a close relationship between HER2 expression and uterine cervical involvement (p = .009). Higher Ki-67 values were associated with LN involvement (p = .012). CONCLUSIONS: The over-expression of HER2 and Ki-67 and low expression of ER and PR indicate a more malignant EC behavior. An immunohistochemical panel for the identification of high risk tumors can contribute significantly to prognostic assessments.

Comparative "Omics" of the Fusarium fujikuroi Species Complex Highlights Differences in Genetic Potential and Metabolite Synthesis.

Species of the Fusarium fujikuroi species complex (FFC) cause a wide spectrum of often devastating diseases on diverse agricultural crops, including coffee, fig, mango, maize, rice, and sugarcane. Although species within the FFC are difficult to distinguish by morphology, and their genes often share 90% sequence similarity, they can differ in host plant specificity and life style. FFC species can also produce structurally diverse secondary metabolites (SMs), including the mycotoxins fumonisins, fusarins, fusaric acid, and beauvericin, and the phytohormones gibberellins, auxins, and cytokinins. The spectrum of SMs produced can differ among closely related species, suggesting that SMs might be determinants of host specificity. To date, genomes of only a limited number of FFC species have been sequenced. Here, we provide draft genome sequences of three more members of the FFC: a single isolate of F. mangiferae, the cause of mango malformation, and two isolates of F. proliferatum, one a pathogen of maize and the other an orchid endophyte. We compared these genomes to publicly available genome sequences of three other FFC species. The comparisons revealed species-specific and isolate-specific differences in the composition and expression (in vitro and in planta) of genes involved in SM production including those for phytohormome biosynthesis. Such differences have the potential to impact host specificity and, as in the case of F. proliferatum, the pathogenic versus endophytic life style.

Mesoionic xanthine analogues: phosphodiesterase inhibitory and hypotensive activity.

Several mesoionic thiazolo[3,2-alphapyrimidines and mesoionic 1,3,4-thiadiazol[3,2-alpha-pyrimidines were evaluated as inhibitors of cyclic-AMP phosphodiesterase. While small alkyl substituents at the 6 position have no significant effect on activity, phenyl and benzyl substituents enhance activity. Mesoionic structures such as 1 (R2 = H; R8 = Et) possess 20 to 40 times the activity of theophylline when the R6 substituent is phenyl or 4-chlorobenzyl. methyl and ethyl substitution at the 2 position essentially abolishes activity. Although plagued by solubility problems, several of the mesoionic derivatives were found to display weak hypotensive effects in vivo.

Correlation between the in vivo and in vitro antimicrobial properties of commercially available mouthwash preparations.

The effectiveness of six commercially available mouthwashes against common buccal organisms was studied. The minimum inhibitory concentrations (MIC) for two of the studied mouthwashes (Corsodyl and Oraldene) against buccal organisms were determined in Todd Hewitt medium with or without 5% serum. The concentration of the active substance in these two mouthwashes was in excess of the corresponding MIC. When the medium was supplemented with serum, lower MIC values were observed. Kill-time determinations, used at half the concentration of the normal preparation, revealed a rapid lethal effect for all tested mouthwashes. The slowest lethal effect was observed with Fluocaril mouthwash. When mouthwashes were tested in volunteers, an immediate significant fall in salivary bacterial counts was produced by all except Fluocaril. With the latter mouthwash the decrease was significant 2-30 minutes after rinsing. The bacterial levels returned to pre-rinse levels after 30 minutes for Listerine, after 90 minutes for both Oraldene and Mint and after 180 minutes for Corsodyl, Fluocaril and Sansilla mouthwashes. The results indicate that there is a good correlation between in vivo efficacy and in vitro determination of all mouthwash preparations.

Macrolides induced suppression of virulence factors produced by Staphylococcus aureus.

The effect of sub-MICs of azithromycin, clarithromycin and roxithromycin, as compared to erythromycin, on the production of coagulase, beta-hemolysin, lecithinase and deoxyribonuclease by Staphylococcus aureus was studied. All new macrolides completely inhibited coagulase and beta-hemolysin production and partially inhibited lecithinase and deoxyribonuclease. Such inhibition is not related either to growth inhibition or to inhibition of enzyme activity. Erythromycin, on the other hand, had no effect on coagulase or beta-hemolysin production but slightly suppressed the production of lecithinase and deoxyribonuclease. This inhibitory effect might have clinical significance if it was found to occur in vivo.

Teenage pregnancy: are teenagers a high risk group?

OBJECTIVES: To study health profile of pregnant teenagers and their pattern of utilization of primary health care services in comparison with pregnant women aged 20-35 years in Abha, Saudi Arabia. STUDY DESIGN: A cohort of 1938 Saudi pregnant women (214 teenagers less than 20 years and 1724 aged 20-35 years) was selected by stratified random sampling technique. They were screened for anemia and hypertension using WHO criteria and followed until delivery to observe the method of delivery. RESULTS: The prevalence of anemia (9.6% and 12.0%, respectively) and hypertension (1.1% and 3.5%, respectively) was not significantly different among primigravida of both age groups. The same trend was observed among multigravida. Follow-up showed that the rate of abnormal deliveries among primigravida of both groups was not significantly different, and even lower among multigravida teenagers. Pregnant women in both groups had similar average prenatal visits (6.6 +/- 1.1 and 6.7 +/- 1.2 respectively, P < 0.05) and the majority contacted the primary health care center early in pregnancy (87.4% and 88.9%, respectively, P < 0.05). CONCLUSION: These results indicate that pregnant teenagers are not a high risk group if good prenatal care is provided.

PIP: Teenage pregnancy has been shown to be associated with an increase in obstetric complications. In particular, gestation associated hypertension and anemia were found more frequently among these young women. The authors screened 1938 pregnant Saudi women for anemia and hypertension using WHO criteria and followed them until delivery to observe the method of delivery in the study of whether or not pregnant women younger than 20 years old are at greater risk of obstetric complications than pregnant women aged 20-35 years. The women were selected by stratified random sampling technique from Abha, Saudi Arabia. 214 were younger than 20 years old, while the rest were aged 20-35. Among primigravida pregnant women younger than 20 years old, 9.6% were anemic and 1.1% suffered hypertension. Among primigravida pregnant women aged 20-35 years old, 12.0% were anemic and 3.5% suffered hypertension. These differences in rates between age groups are not significant. The same trend was observed for multigravida women. Furthermore, the rate of abnormal deliveries among primigravida of both groups was not significantly different, and even lower among multigravida teens. Pregnant women in both age groups made, on average, 6.6-6.8 prenatal visits, while 87.4% and 88.9%, respectively, contacted the primary health care center early in pregnancy. It may be concluded from these findings that pregnant teens do not constitute a high-risk group if good prenatal care is provided.

Altitude and socio-biological determinants of pregnancy-associated hypertension.

OBJECTIVES: To study the prevalence of gestation-associated hypertension and to determine the effect of altitude and related socio-biological factors. METHODS: A stratified random sample of 3988 pregnant women living at high altitude and 2744 at sea level in the Asir region, Saudi Arabia was interviewed for socio-biological conditions and examined for blood pressure, proteinuria and body mass. RESULTS: An overall prevalence of 2.4% was found. Certain groups of pregnant women are at high risk of developing hypertension. They include women who are over 40 years, high multipara, having short inter-pregnancy spacing, are overweight, are illiterate and those living at high altitude. Multivariate analysis showed that high altitude is a strong risk factor (adjusted odds ratio (OR), 1.879; 95% confidence interval (CI), 1.123-2.819) and cannot be masked when other variables are controlled. CONCLUSIONS: Special health education and more frequent screening programs at primary health care level should be given to pregnant women living at high altitude.