Objective: The geographical incidence of type 1 diabetes mellitus (T1DM) varies widely worldwide. Both genetic and environmental factors have been implicated, although environmental factors are still speculative and elusive. More epidemiological studies are needed to uncover such factors. To date, there are no reported studies on the epidemiology of childhood T1DM in Nile Delta, Egypt. We aimed to define the incidence, prevalence and demographic characteristics of T1DM in children (0-18 years) living in the Nile Delta region, one of the most densely populated areas in Egypt.Methods: The study included all T1DM patients aged 0-18 years who lived in the Nile Delta region of Egypt and who were either diagnosed at or referred to Mansoura University Children’s Hospital (MUCH) between 1 January 1994 and 31 December 2011. The hospital files of the patients were reviewed. General population data on the 0-18 year age group in the Nile Delta governorates were also presented.Results: From a total of 1600 T1DM patients, 891 (55.7%) were females (p=0.000) and 935 (58.4%) were from rural areas (p=0.000). Calculated age-adjusted incidence of T1DM in 1996, 2006 and 2011 were 0.7, 2.0 and 3.1/105/year, respectively, while calculated age-adjusted prevalence of T1DM in the same years were 1.9, 15.5 and 26.8/105/year, respectively. Patients presented most frequently in the 5-10 year age group (p<0.000) and in winter months (p=0.009).Conclusion: In this first childhood T1DM epidemiology study in the Nile Delta region of Egypt, T1DM incidence and prevalence were found to show an increase over the past 18 years (1994-2011). Incidence and prevalence were higher in females and more cases were found to originate from rural areas.
Cryptogenic epilepsy is a group of epilepsy syndromes where aetiology is unknown but an underlying brain disease is suspected. Increased seropositivity for Toxocara and Toxoplasma gondii have been observed in epileptic patients with sparse data about their seropositivity in cryptogenic epileptic patients. Therefore, we investigated the probable relationship between seropositivity against T. gondii and Toxocara with cryptogenic epilepsy. We examined patients who had cryptogenic epilepsy and healthy non epileptic controls for seropositivity for Toxocara and T. gondii antibodies by ELISA. Out of 132 cryptogenic epileptic patients, 80 (60.6 %) and 64 (48.5%) were seropositive for T. gondii and Toxocara immunoglobulin G (IgG) antibodies respectively. The seropositivity in the control group was 26 (43.3%) and 28 (46.7%) for T. gondii and Toxocara IgG respectively. We found a significant association between chronic T. gondii infection and cryptogenic epilepsy while the association between Toxocara infection and cryptogenic epilepsy was insignificant. Our findings indicate that toxoplasmosis may be a cause of cryptogenic epilepsy. We recommended both promoting health education to prevent such infection and screening children for toxoplasmosis which would help early treatment and so decreasing the incidence of epilepsy.
Fasting during Ramadan is feasible and is associated with significant improvement in fructosamine level in children with T1DM using different insulin regimens. Mandatory consideration to the quality and quantity of food offered to patients with T1DM during Ramadan to guard against adverse changes in lipid profile.
We emphasize the inter- and intra-familial genetic heterogeneity among Egyptian patients with overlapping features of SLC29A3 disorders. This suggests the presence of other factors like regulatory genes or epigenetic factors that may explain variable disease manifestations and severity.
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