Nashwa Nabil Kamal

Background: Previous research suggests the role of social determinants of health (SDH) in the prevalence of hypertension. Objective: The study aimed to estimate the contribution of SDH to the prevalence of hypertension. Methods: We recruited 3072 Egyptian public servants who answered a self-administered ques-tionnaire, including hypertension history. We measured the participants’ blood pressure with standardized procedures. The logistic regression models were used to assess the associations be-tween SDH and hypertension Results: The prevalence of hypertension was 28.2% (34.2% in males and 22.5% in females). The prevalence of undiagnosed hypertension was 16.3% (23.9% and 9.2%, respectively); thus, 57.8% of the hypertensive subjects were unaware of their high blood pressure status. SDH were associat-ed with the odds of having hypertension in the unadjusted analyses. Higher education, being sin-gle, and having minor family members were associated with low odds of hypertension. On the other hand, non-professional occupations, job hours, household income, total family members, and work-family conflicts were associated with higher odds of hypertension. However, in the multivar-iable analyses, which included all SDH and adjusted for age, gender, smoking, physical activity, body mass index, medical history of chronic diseases, and family history of hypertension, only job hours were associated with the odds of having hypertension and undiagnosed hypertension: odds ratio (95% CI) = 1.07 (1.01-1.14) and 1.11 (1.02-1.20), respectively. Conclusion: SDH contributed minimally to the odds of having hypertension among public offi-cials in Minia, Egypt. Civil servants with long working hours should be tracked with regular blood pressure monitoring as a high-risk group for hypertension

Background: The effect of exam stress on serum cortisol, leptin, CRP, IL-6, and vitamins (C, E) levels among postgraduate students and their impact on academic performance was assayed. Methods: Fifty-two Minia University postgraduate nursing students were involved in this study. Stress was measured by the Kessler 10 Psychological Distress instrument (K10). Sera leptin, cortisol, Vitamins (C, E), CRP, TAC and Malondialdehyde (MDA) were assessed for each subject twice, the first time was one month before the exam date and the second time was one hour before the exam time. Results: The stress percentage increased from 51.9 % to 82.7% at the exam day. Exam stress caused an increase in cortisol, leptin and MDA levels and a decrease in vitamin C and TAC levels. Conclusion: The academic performance was better in mild and moderate stresses and the most contributing variables were leptin levels, TAC levels, and IL-6 levels. Exam stress caused an increase in leptin and cortisol levels and a decrease in vitamin C and TAC levels. Vitamin C by its correlation to cortisol may decrease stress response anxiety and improve academic performance. Key words: academic performance, stress, cortisol, leptin, Vitamins, postgraduate students, Minia

Background: Nocturnal enuresis is a common pediatric disorder. It can be defined as the involuntary passage of urine during sleep beyond the age of anticipated nighttime bladder control. Nocturnal enuresis can have a serious effect on the quality of life of children and their families. Objective: to estimate the frequency and types of treatment of nocturnal enuresis among children aged (6–12) years in Minia city, as well as to identify some risk factors associated with this problem. Methods: A cross-sectional, community based study was done among primary school children aged (6-12); they were selected from Minia city in Minia governorate, representing the urban and rural areas. Results: 16.5% of children were suffering from primary nocturnal enuresis. As the age of the child increases, the prevalence of enuresis is significantly decreased. Enuresis is significantly more common among children whose fathers’ occupation were clerical work, housewife mothers, and also more common among children of low socioeconomic status with no sex variation. Conclusion: Nocturnal enuresis is a pediatric public health problem; it is associated with younger age, low socioeconomic and low educational level of the parents, non-working mothers, and family history of enuresis. The most beneficial treatment measure was awaking the child to void and restricting fluid intake.

Background: There is growing body of evidence that use of computers can adversely affectthe visual health. Objective: To study the frequency and risk factors of computer visionsyndrome (CVS) among bank employees in Minia. Method: Community-based crosssectionalstudy of 218 bank employees who work on computer for at least one year precedingthe date of the study. Two hundred and eighteen (218) computer workers working in sevendifferent banks were selected randomly. Subjects were asked to fill a pre-tested structuredquestionnaire, and other relevant information was obtained by personal interview andinspection of workstation. Results: Among the 218 subjects studied, 85.2% suffer from ocularcomplaints. Headache (24.8%), eye strain (20.2%), diminution of vision (16.9%) were themost common ocular complaints and they have significant associations in subjects workingfor more than 4 hours, keeping a distance less than 20 inch from the computer, who do nottake breaks and do not adjust the brightness. Conclusions: Prevalence of CVS was noted tobe quite high among bank employee. Headache, eye strain, diminution of vision, blurredvision, double vision, itching and burning sensation were the factors independently associatedwith CVS.

Background: This study aimed to examine the relationship between mothers' knowledge related to treatment management of type 1 diabetes (T1D), with perceptions of coping with diabetes-related stress and to examine the relationship between children's metabolic control and maternal coping. A cross-sectional study was done among ninety-two mothers of T1D children. Methods: Data were collected using a structured questionnaire, Ways of coping questionnaire (WCQ), and Diabetes Knowledge questionnaire-24 (DKQ-24). Results: The most important predictors of the total knowledge scores among mothers were father education (P < 0.0001), followed by child age and sex (P < 0.0001), while the most important coping scales affected by total knowledge scores was accepting responsibility (P = 0.01). There were positive correlation between HBA1C and escape-avoidance and positive reappraisal coping scales (r = 0.24, P = 0.02 and r = 0.23, P = 0.02, respectively). Blood glucose level was the most important clinical characteristics affecting the use of seeking social support coping scale among mothers. Conclusions: Parents with more knowledge of diabetes and with better education were able to cope more effective and maintain a better glycemic control of their diabetic children.

Background: To determine the association between problematic Internet use (PIU) and disordered eating attitudes (DEAs) and to detect the potential risk factors for PIU among University students in Minia, Egypt. Methods: A cross-sectional study was carried out among a random sample (n = 2365) of Minia University students. PIU was assessed using The Problematic Internet Use Scale (PIUS), and the DEAs were assessed using eating attitudes test-26 questionnaire. Results: Of the 2365 students, 424 (17.9%) had DEAs, and it was more in females than males (22.3% and 14.5%, respectively). The mean of the PIUS score also was significantly higher in males than females (120.3 ± 30.5, and 117.5 ± 30.6, respectively). A positive moderate correlation (r = 0.48, P < 0.05) was detected between PIU and DEAs. Conclusions: The results of this study indicate that PIU is significantly correlated with DEAs among University students in Minia, Egypt, and further studies are needed to identify the association between DEAs and PIU.

Diabetes is considered an independent risk factor for cognitive impairments. Objectives: The aim of this study was to evaluate the cognitive disorder of elderly outpatients with and without type 2 diabetes (T2DM) in releationto oxidative stress markers and some inflammatory markers Methodology: Two hundred and twelve participants were classified into four groups according to their fasting blood glucose level, glycosylated hemoglobin (HbA1c) and mini-mental state examination (MMSE) score. Control subjects were 118 subjects, diabetic group without dementia was 54 subjects, diabetic group with dementia was 26 subjects and 14 subjects of dementia without diabetes. Body mass index and waist/hip ratio were measured. Blood glucose, HbA1c, plasma malondialdehyde (MDA), total antioxidant activity (TAC), and some inflammatory markers: C-reactive protein (CRP) and tumor necrosis factor-α (TNF-α) were measured. Results: Diabetic patients have significant increases in FBG, HbA1c, MDA with a significant decrease in TAC compared to control group. In all groups of patients, the levels of CRP, and TNF-α were significantly higher as compared to control group. The highest level of inflammatory markers was detected in diabetic group with dementia. MMSE score was negatively correlated with HbA1c levels and TNF-α and HbA1c levels were positively correlated with all inflammatory markers. In multivariate logistic regression analysis, MDA,CRP, Hb1c, TNF-a, and FBG were the most predictive risk factors for dementia Conclusions: These results suggest that a decrease in anti-oxidant levels and an increase in anti-inflammatory and oxidative stress markers might be involved in the pathophysiology of cognitive disorder associated with T2DM.

Background: Emergency department (ED) physicians provide care to patients with a wide range of prognoses, and must develop care plans that anticipate patient's survival. However, the tools available to guide care planning had limited data to support their use. There is a new concern to understand if palliative care (PC) should be offered in the ED and the Palliative Performance Scale (PPS), a screening tool used in other settings in PC, has been little used in the ED. Aim: The aim of this study is to assess the prognostic value of the PPS in predicting 1, 3 and 6 months survival in patients admitted through the ED. Design: This was a prospective, cohort study. Subjects and Methods: We evaluated 147 patients at the age of 35 years and more admitted through the ED of Minia University hospital from May 1, 2016 to June 31, 2016. Each patient's PPS score was evaluated initially in the ED, with follow-up assessments of survival at 1, 3, and 6 months. Results: Baseline PPS for the 147 patients was 50. The PPS score was a strong predictor of survival (Log-rank test of Kaplan–Meir P < 0.0001). Patients with an initial PPS score of 40 or less were less likely to survive at 6 months. Conclusion: The PPS score may predict survival in patients admitted to the hospital through the ED. The ease of use holds promise that the use of the PPS in the ED may help ED physicians predict survival and plan for a better decision.

Problematic Internet Use (PIU) is a growing problem in Egyptian adolescents. This study was designed to assess the prevalence of PIU among high school students in El-Minia Governorate and to determine the personal, clinical, and social characteristics of them. A cross-sectional study was applied among a random sample of high school students in El-Minia Governorate. PIU was assessed by the 20-item Young Internet Addiction Test (YIAT). Information was also collected on demographics, dietary, and health-related factors. Statistical analysis used: Statistical Package for Social Sciences (SPSS-16) software was used. Chi-square test (X2), Fisher's Exact Test, and one-way analysis of variance (ANOVA) were used whenever, applicable. Multinomial logistic regression analyses were also applied in order to calculate the odds ratios (OR). Of the 605 students, 16 (2.6%) were Problematic Internet Users (PIUs), 110 (18.2%) were Potential (PIUs). Adolescents with PIU were associated with male gender, poor friends’ relations, bad family relations, irregular bedtime, and bad personal hygiene. PIUs were more likely to suffer from physical symptoms; weight gain, joint stiffness, lack of physical energy, and emotional symptoms. The prevalence of PIU reported in this study is low, however, the Potential PIUs was high and preventative measures are recommended.