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.

A matched case control study has been conducted in the children's hospitals in Alexandria, Egypt, during 2 years-period, aiming at investigating the risk factors for the occurrence of congenital heart diseases. Our results showed that the significant risk factors for developing any type of congenital heart disease and ventricular septal defects were: older paternal age at birth, positive consanguinity, positive family history, female sex hormones, irradiation, hazardous maternal occupation, diabetes mellitus and suburban or rural residence. However, some environmental/teratogenic factors were not implicated in the etiology of atrial septal defects or pulmonary stenosis. These findings strongly suggest that environmental factors vary according to the specific type of congenital heart disease. This study emphasizes on the need to instruct the public about the importance of pre-marital counseling and the deleterious effects of various teratogens in the environment.

The role of constitutional and environmental factors on the risk of non-melanomatous skin cancer was evaluated in a case-control study conducted in 1992 in Alexandria, Egypt, on 136 incident histologically confirmed (99 basal-cell and 37 squamous-cell) cases of non-melanomatous skin cancer (NMSC) and 145 controls in hospital for a broad spectrum of acute non-sun-related dermatological conditions. In relation to skin colour, compared with brown-skinned subjects, the multivariate relative risks (RR) were 2.3 for olive-skinned subjects and 3.8 for fair/medium-skinned subjects. Three cases and 29 controls were black (RR = 0.2). The trend in risk with skin colour was significant. Likewise, compared with subjects with brown or hazel eyes, those with green or blue eyes had a RR of 3.1. In relation to acute sun reaction, compared with subjects reporting easy tanning, the RRs were 2.5 for subjects reporting moderate tanning and 4.7 for those reporting easy burning. The risk of NMSC was higher for subjects reporting an outdoor occupation than for those reporting an indoor occupation (RR = 7.7). A significant trend in risk was observed with degree of sun exposure: compared with subjects reporting light sun exposure, the RR was 3.0 for those reporting moderate exposure, and 6.1 for those reporting heavy sun exposure. There was an indication of a relationship between clothing pattern and skin-cancer risk: compared with subjects reporting frequent use of traditional Egyptian clothes, the RR for dressing in short clothes was 1.8. The presence of signs of photodamage was also associated with NMSC (RR = 3.7). Exposure to arsenic was reported by 10 cases and 1 control (RR = 9.5). A positive interaction between sun exposure and skin colour was observed, and the RR rose to 14.2 for medium- or fair-skinned subjects with heavy exposure compared with brown- or black-skinned subjects with light or moderate sun exposure. In this Egyptian population, over 60% of NMSC could be attributed to sun exposure and approximately 45% to skin colour.

Background Obesity has emerged as a public health crisis in many populations including Egypt. Adipose tissue produces a number of adipokines, one of them is adiponectin which has attracted much attention because of its antidiabetic and antiatherogenic effects. Objective To determine the effect of a weight loss program on serum adiponectin level and insulin resistance among overweight and obese adult premenopausal females. Study design A pre-postintervention study was carried out among 95 premenopausal overweight and obese females (body mass index ≥ 25 kg/m2) aged 20 to 40 years at the integrated health clinic affiliated to the High Institute of Public Health, Alexandria, Egypt, from February 2016 to February 2017. All participants underwent a weight loss program based on a reduced calorie balanced diet and advised to increase their physical activity. Dietary instructions and follow-up were done weekly throughout 16 weeks. Blood samples were collected to investigate serum adiponectin level and insulin resistance at the beginning and the end of the intervention. Results After 16 weeks, a significant decrease in body weight by 9.7% was associated with a significant increase in serum adiponectin from 13.3 ± 4.9 μg/ml to 18.5 ± 5.6 μg/ml. Both fasting insulin and insulin resistance had decreased significantly by 13.6% and 13.7%, respectively. Conclusion A weight reduction program depending on a reduced calorie diet for 16 weeks was associated with a significant increase in total adiponectin level and reduction in insulin resistance. An emphasis on the importance of keeping normal weight through nutritional education and the promotion of healthy diets is recommended to reduce the risk of occurrence of insulin resistance, type 2 diabetes, and cardiovascular diseases.

Background: Detecting Breast Cancer (BC) at earlier stages comes with a better prognosis, while diagnosis at late stages has poor outcomes and escalating mortality rates from the disease. The study aims to understand the factors associated with the latestage diagnosis of BC in Egypt. Design and Methods: A sample of 400 women with a pathologically confirmed BC were enrolled from one of the main tertiary cancer hospitals in Egypt. A cross-sectional study design was conducted. The collected data included: clinical characteristics of the tumor, socio-demographic characteristics of the studied women, reproductive and medical history, screening practices, and the time from symptom onset to definite diagnosis as suspected predictors to the stage of BC at diagnosis. Data was analyzed by crude odds ratios (95% confidence interval) and multivariate logistic regression analysis. Results: The study revealed that 47.5% were diagnosed at late stages (40% at stage III/ 7.5% at stage IV), while (52.5%) were diagnosed at early stages (6.5% at stage I/46% at stage II). A binary logistic regression model showed that unmarried females (p=0.012), had non-luminal molecular subtype of BC including HER2 enriched and triple-negative tumors (p<0.001), presentation with breast changes and a non-palpable lump (p=0.024) or nonbreast symptoms (P=0.002), a delay longer than 3 months to the first presentation by patients (p<0.001), and a delay to definite diagnosis longer than 1 month by providers (p<0.001) were significant risk factors of late-stage diagnosis of BC. Conclusions: Late-stage diagnosis of BC in Egypt is associated with the aggressiveness of some molecular subtypes and other important modifiable factors that should be addressed.