Background: To our knowledge, there is no national screening program for prostate cancer in Egypt. The Uro-surgery department in Alexandria University established a screening program for prostate cancer among men aged 55 years or more in January 2012. Objective: To determine a valid Prostatic Specific Antigen (PSA) cutoff point for performing Transrectal Ultrasonography (TRUS) guided biopsy among asymptomatic elderly men. Methods: A screening cross sectional study was conducted on a convenient sample of 1207 men aged ≥55 years who were attending urology department, Alexandria University for non-prostatic symptoms during years 2013 and 2014. Digital Rectal Examination (DRE) and PSA level measurement were performed for all included subjects. TRUS guided biopsy was done for those who found to have PSA ˃ 4ng/ ml and or suspicious DRE. Results: Among subjects who had PSA level of 4.1-10, the Positive Predictive Value (PPV) for cancer prostate was 54% among those with suspicious DRE findings as compared to 0 among those with nonsuspicious DRE. For PSA level of 10.1-20 and >20 with suspicious DRE, PPV was (77% and100% respectively). The mean serum total PSA was 77 and 0.6 ng/ ml for patients with and without prostatic cancer respectively (p= 0.0001). The yield of cancer prostate among all screened men was 103/1207= 8% and 103/157= 66% among those with PSA˃ 4 ng/ ml and or having suspicious DRE and were biopsied. Considering all men who had biopsy, ROC curve could derive a cutoff value of 10.05 ng/ml with a sensitivity of 92% and a specificity of 92.6%. Inability to perform biopsy for men with PSA ≤4 ng/ml was the main limitation. Conclusion: In a country of relatively low prevalence of prostate cancer like Egypt, a cutoff point of PSA in combination with DRE for doing TRUS biopsy could be 10.05 ng/ ml among asymptomatic men ≥55 years of age with a likelihood ratio of 12.43.
Cases of measles among 165 vaccinated and unvaccinated children were studied and the level of measles antibody in 230 previously vaccinated children was determined. Associations between demographic factors and immunological response to vaccination were also investigated. Approximately 80% of the children with measles had been vaccinated;their cases had significantly lower rates of complication. Rural areas accounted for significantly higher numbers of unvaccinated cases. Vaccination status did not correspond to place of exposure, duration of prodrome or accuracy of preliminary diagnosis. The seropositivity rate among vaccinated children was 86.1% with no significant variation with age. We recommend a second dose of measles vaccine and maintaining high vaccine coverage
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