Summary The relationship between history of schistosomiasis and bladder cancer risk was investigated using data from a case-control study conducted between January 1994 and July 1996 in Alexandria, Egypt. Cases were 190 subjects with incident, histologically confirmed invasive cancer of the bladder, and controls were 187 subjects admitted to hospital for acute, non-neoplastic, non-urinary tract conditions. Eighty-six cases (45%) vs 69 controls (37%) reported a history of urinary schistosomiasis. The corresponding multivariate odds ratio (OR) of bladder cancer -after allowance for age, sex, education, smoking, other urinary infections and high-risk occupations -was 1.72 (95% confidence interval (Cl) 1.0-2.9). The ORs were 0.22 (95% Cl 0.1-0.4) for intestinal schistosomiasis and 0.32 (95% Cl 0.1-1.9) for schistosomiasis of other types. The OR for urinary schistosomiasis was higher in subjects who were younger at first diagnosis (OR of 3.3 for <15 years) and in those with a long time since first diagnosis (OR of 3.0 for . 35 years). The ORs were 15.8 for male ever-smokers with a history of urinary schistosomiasis, compared with never-smokers without such a history, and 3.2 for men ever-infected with urinary Schistosoma haematobium and ever-employed in high-risk occupations, compared with those never-infected and with no high-risk occupational history. This study confirms that clinical history of urinary schistosomiasis is significantly, but modestly, associated with increased bladder cancer risk, explaining some 16% of bladder cancer cases in this Egyptian population.Keywords: bladder cancer; epidemiology; schistosomiasis; tobacco Bladder cancer rates in Egypt are the highest in the world, with overall age-standardized (world standard) death certification rates of 10.8 per 100 000 in men and 2.3 per 100 000 in women . In Alexandria, where incidence rates have been available since 1972, bladder cancer incidence was 19.2 per 100 000 in men and 3.6 per 100 000 in women. Bladder cancer was the commonest of all cancers in men (17.5%), and more than twice as common as lung cancer (Bedwani et al, 1993).This substantial excess has been generally attributed to a high prevalence of Schistosoma haematobium infection (urinary schistosomiasis). An association between bladder cancer, particularly squamous cell cancer (Lucas, 1982), and infection with S. haematobium has long been suggested by clinical observations as well as by analytical and descriptive epidemiology. The relation has been explained through chronic irritation of the urothelium, altered metabolism with elevated urinary levels of carcinogenic metabolites and N-nitroso compounds and/or elevated urinary levels of Pglucuronidase (Matanoski and Elliott, 1981; WHO, 1994; Badawi et al, 1995).It has been estimated that the prevalence of schistosomal infection was over 20% for women and over 40% for men during the

The present study confirms that a considerable proportion of people with T2DM have microvascular complications and/or PAD at the time of, and possibly years before diagnosis. Having shown that, it is strongly recommended to apply appropriate screening strategies for subjects with diabetes at the time of diagnosis. Finally, these results should be considered as a call for action for the health care planners and providers in our region to plan for early screening for diabetes and its complications to reduce the disease burden in our community.

No abstract

A study was undertaken to determine the prevalence and relative frequencies of congenital heart diseases diagnosed by echocardiography among school children in Alexandria, Egypt. The study was conducted during a 1-year period (1 May 1995-1 May 1996) at the Students' Health Insurance Hospital, which is a referral center for all health insurance units, providing an echocardiography service. The prevalence of congenital heart diseases (CHD) among school children accounted for 1.01/1,000. There was a male predominance in cases of pulmonary stenosis and single ventricle, while in cases of patent ductus arteriosus, mitral valve prolapse, and partial atrioventricular canal there was a female predominance. The commonest cardiac defects were ventricular septal defects, pulmonary stenosis, and atrial septal defects. Pulmonary stenosis ranked the second commonest defect and is a peculiar finding in our Egyptian population. The mere presence of these cardiac defects in school children is an indicator of the poor quality of care provided to this growing childhood population.

No abstract

Summaryobjective The Kato-Katz technique misses a proportion of low-intensity schistosomiasis cases. We set out to estimate the rate of false negative results after Kato-Katz. conclusion The Percoll technique seems to be the technique of choice for diagnosis of S. mansoni in low intensity areas and after treatment.

CAM use is notably prevalent among T2DM patients in Alexandria, Egypt, with significant impact on compliance to conventional therapies and the associated complications. Hence, there is increasing importance for raising patient awareness and continuing medical education for physicians.

Traumatic brain injury is a major problem worldwide. Our objective is to synthesize available evidence in the literature concerning the effectiveness of neuroprotective drugs (cerebrolysin, citicoline, and piracetam) on Glasgow outcome score (GOS), cognitive performance, and survival in traumatic brain injury patients. Comprehensive search of electronic databases, search engines, and conferences proceedings; hand search journals; searching reference lists of relevant articles, theses, and local publications; and contact of authors for incomplete data were performed. Studies included patients in all age groups regardless of severity of trauma. There was no publication date restriction. Two reviewers independently extracted data from each study. Fixed effect or random effects model selection depends on results of statistical tests for heterogeneity. The literature search yielded 13 studies. Patients treated with cerebrolysin (n = 112) had favorable GOS three times more than controls (OR 3.019; 95 % CI 1.76 to 5.16; p = 0.003*). The odds of cognition improvement in the treatment group was 3.4 times more than controls (OR 3.4; 95 % CI 1.82 to 5.21; p < 0.001*). Survival of cerebrolysin-treated patients did not differ from controls (103 patients; OR = 2.81; 95 % CI 0.905 to 8.76). Citicoline did not improve GOS (1355 patients; OR 0.96; 95 % CI 0.830 to 1.129; p = 0.676), cognitive performance (4 studies; 1291 patients; OR 1.35; 95 % CI 0.58 to 3.16; p = 0.478), and survival (1037 patients; OR = 1.38; 95 % CI 0.855 to 2.239). One study showed a positive effect of piracetam on cognition. Further research with high validity is needed to reach a solid conclusion about the use of neuroprotective drugs in cases of brain injury.