A cross-sectional study was carried out to explore the effect of the Ramadan fast on daily practices (life events, diet and smoking), health and performance of 265 university students. Analysis showed that more people got involved in stress reducing (watching TV, listening to the radio and visiting) and spiritual activities (prayers and reading Kotan) during this month. They drank less caffeine-containing beverages and smoked less. Food intake appeared to improve during Ramadan with higher proportions eating foods from all food groups. The amount of foods did not differ significantly except in the case of foods from the cereal, meat and vegetable groups. Even though less, cereal consumption was still in the adequate range. Change in weight was variable. Weight loss was significantly more among the sick. A large proportion of the latter improved during the month especially those with irritable bowel syndrome and constipation. Reduced activity, study desire and concentration ability were reported by more than 50% of subjects.

Background Faulty dietary habits and overnutrition are prevalent among Egyptian patients with multiple sclerosis (MS) who do not receive nutrition care as part of treatment. Thus, this study was conducted to identify the effect of nutrition counseling on the nutritional status of patients with MS. This endeavor might provide evidence for the value of counseling in such a setting and advance the integration of nutrition counseling into the routine management of patients with MS. Methods A single-blinded, parallel-randomized controlled clinical trial was conducted at Kasr Alainy MS Unit on 120 eligible patients with MS from September 2019 to February 2020. Patients were randomly allocated to either the nutrition counseling intervention group (IG) or the control group (CG). Allocation concealment was performed by using sequentially numbered opaque sealed envelopes. All patients were assessed initially and complied with the Kasr Alainy MS Unit standard management protocol for the study period. Only patients in the IG underwent initial nutrition counseling sessions followed by a monthly evaluation. All patients were assessed at the end of the 3-month follow-up period. Sociodemographic data were gathered through a structured interview. Nutritional status was assessed anthropometrically and via 24-h recall. The 2 groups were compared initially and at the end of the follow-up. Both intention-to-treat and per-protocol analyses were conducted. Results At baseline assessment, the prevalence of overweight and obesity was 31.7% and 32.5%, respectively, and the mean body mass index was 27.7 ± 5.7 kg/m2. Mean waist circumference was 93.5 ± 11.9 and 99.2 ± 13.1 cm for males and females, respectively. Approximately 27.3% of males and 83.9% of females showed abdominal obesity. After 3 months of counseling, weight, body mass index, waist circumference, nutrient intake and adequacy significantly improved in the IG (p < 0.05). Conclusion Nutrition counseling significantly improved anthropometric measurements, dietary habits, nutrient intake and adequacy. Trial registration The study was registered on ClinicalTrial.gov and was given a code (NCT04217564).

A study was carried out to identify the microbial contaminants of weaning foods in an Egyptian village and the sources of contamination. All 300 households containing infants (< 24 months) were visited. Information regarding food preparation and household sanitation was gathered. Samples of weaning foods (270) were collected and analysed for the presence of Escherichia coli, Bacillus cereus, Shigella and parasites. The first two pathogens were detected in 43.7 per cent and 21.4 per cent of samples respectively. The others were not detected in any sample. The risk of contamination by E. coli and B. cereus was significantly associated with the presence of dung and/or refuse in the house, lack of indoor latrine, non-use of latrine by children, weaning foods not freshly prepared, uncovered storage of foods, and the presence of a case of diarrhoea in the house.

Background Nutrition was claimed to be a factor in MS causation, course, complications, and management. Several studies were conducted to assess the nutritional status of MS patients; however, few studies were conducted to assess this problem in Egypt. Therefore, the purpose of the current study was to assess the nutritional status of a sample of MS patients. Methods The researchers conducted an exploratory cross-sectional study among 76 relapsing-remitting MS (RRMS) patients attending Kasr Alainy Multiple Sclerosis Unit (KAMSU) from October 2018 to January 2019 to assess the nutritional status of a sample of MS patients. Data were collected using a structured interview questionnaire including an inquiry about the socioeconomic status, and nutritional status using anthropometric measurements, patient-generated subjective global assessment (PG-SGA), semi-quantitative food frequency questionnaires (SQFFQ), and hemoglobin level measurement. Assessment of fatigue was done using the Modified Fatigue Impact Scale 5-items version. Results The mean age of the study participants was 30 ± 6 years. The disease duration ranged from 2 to 264 months. Malnutrition was prevalent among 67.1% (27.6 % overweight, 36.8% obese, and 2.6% underweight). Half of the investigated patients were anemic. According to the PG-SGA, more than half of the studied patients (53.9%) were classified as moderately or suspected malnourished. The unhealthy dietary habits such as taking only a few meals, junk food intake and skipping breakfast were observed in considerable proportions of the group. The SQFFQ revealed overconsumption of energy and fat, and less than acceptable consumption of dietary fibers by most of the studied patients. Conclusions Overweight, obesity, anemia, and unhealthy dietary habits were prevalent among the RRMS patients attending the KAMSU. Nutrition care service is extremely needed for this group of patients.

It is difficult nowadays to open a popular science magazine, or a leading science journal, without reading about complexity, the approach to science that is expected to "define the scientific agenda for the 21st century." But this has had little influence on the theory and practice of epidemiology. Complexity is the study of complex adaptive systems, and they key concepts are: self-organisation, adaptation, upheavals at the edge of chaos, the unpredictability of the effects of small changes in the initial conditions, and the existence of simplicity at some levels while chaos exists at others. There are very few examples of the use of complexity theory in epidemiologydthe main ones to date involve communicable diseased but there are many examples of epidemiological problems for which complexity theory is relevant. In particular, a focus on the population level, and the socio-cultural context, does not necessitate the use of complexity theory, but it does make its value and potential more relevant. However, complexity theory doesn't fit with standard approaches to epidemiology. If we are not to be "prisoners of the proximate" then it will be necessary to develop new epidemiologic methods that are more appropriate for addressing the complexity of population health. These new methods will look less like a randomised controlled trial, and more like complex observational research such as evolutionary biology and cosmology. If we are going to address the major public health problems of the 21st century, then complexity theory is likely to play an important role.

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Adolescent abuse was studied in 555 school students [mean age 15.6 +/- 1.5 years] selected by multistage random sampling in Beni Suef in 1998. Each student received a general physical examination and a pre-coded questionnaire to identify determinants of abuse. Prevalence of abuse was 36.6%. Emotional, physical, sexual and combined abuse prevalence was 12.3%, 7.6%, 7.0% and 9.7% respectively. Significant predictors of sexual abuse were hyperactive child, disabled child, disinterested mother, low birth order child or wasted child. For physical abuse, significant predictors were maternal disinterest, maternal education and injuries. Significant predictors of emotional abuse were overcrowding, disease and mistreatment by a teacher. Violent behaviour was reported for more than 20% of the emotionally and the sexually abused

Introduction The mortality rate Indonesian Hajj Pilgrims is higher than Indonesian population mortality. The mortality rate of Indonesian hajj pilgrims fluctuated ranging from 2 to 3.8 per 1000 hajj. Methods and Materials This research conducted to the 149 537 ordinary hajj pilgrims. Design of the study was cross-sectional ecological studies. Analysis was done using multilevel logistic regression. Results Factors that contribute to mortality of Indonesian hajj pilgrims are age, sex, educational level, length of stay and preexisting diseases. The factors with the highest contributions to mortality were age 60e69 years (36.4%), age >79 years (30.0%). male (27.6%) and low education (29.0%). Pre-existing disease contributed <6% to the death rate. Adjusted real per capita expenditure, no access to health facilities adult literacy, populations with health problems and populations self medicating contributed to mortality of Indonesian hajj pilgrims after controlling for other variables. Conclusions It appears safer for Moslems to go to Mecca before age 50 years. We would suggest paying increased attention to the Hajj pilgrims >50 years old, males, those that are thin, those who have lung diseases, metabolic problems or cardio-cerebrovascular and those who flight in the second turn. Further research is needed about the cause of death of Hajj pilgrims in order to assess the effects of environment conditions in Saudi Arabia on Indonesian Hajj pilgrims.