Background: Hernia is a very common surgical condition affecting all ages and both sexes. To describe and find the possible differences in the spectrum of abdominal hernias and document trends in their management, we carried out a descriptive study of all patients with abdominal hernias admitted to a single tertiary institution during a five years period. Methods: A descriptive study of all abdominal wall hernia repairs from Jan. 2002 to Jan. 2007. Data collection was done using patients’ medical records that were included in the hospital archives. Variables included age, sex, final diagnosis and type of repair. Results: 2516 hernia repairs were done. Inguinal hernias were the most common (56%), followed by adult umbilical hernia (22.7%), incisional hernia (10.3%), and epigastric hernia (7.4%). There is an increasing trend towards the use of synthetic mesh repair in different hernia varieties. Mesh repair in adult umbilical and incisional hernias has increased from 32 and 34.6% in 2002 to 63.8% and 90.7% in 2006 respectively. Conclusion: We have a higher relative frequency of adult umbilical and epigastric hernia in Upper Egypt. There is a change in the pattern of hernia repairs with increasing trend towards mesh repair in different varieties.

Background: Congenital anomalies (CA) are significant causes of infant morbidity, mortality and disability. Objective(s): To assess the knowledge and attitude regarding congenital anomalies and their associated factors among married adults. Methods: A community based cross sectional study was conducted on 633 currently married inhabitants in a rural village, Assiut. An interview was used for data collection via a semi-structured questionnaire. Results: Most participants (96.7%) had ever heard about CA, 20.1% of participants had good knowledge, whereas 73.0% of them had positive attitude. Factors significantly affecting knowledge were family history of CA, educational level, and gender. The same factors were also significantly affecting the attitude towards CA in addition to age. Conclusion: Only one fifth of participants had good knowledge about CA. Family history of CA, educational level, and gender are significant factors affecting both knowledge and attitude. Recommendation: To increase the awareness about CA among the public in general and increase the role of health care providers in raising awareness and counseling about CA.

Background: Congenital anomalies (CA) are significant causes of infant morbidity, mortality and disability. Objective(s): To assess the knowledge and attitude regarding congenital anomalies and their associated factors among married adults. Methods: A community based cross sectional study was conducted on 633 currently married inhabitants in a rural village, Assiut. An interview was used for data collection via a semi-structured questionnaire. Results: Most participants (96.7%) had ever heard about CA, 20.1% of participants had good knowledge, whereas 73.0% of them had positive attitude. Factors significantly affecting knowledge were family history of CA, educational level, and gender. The same factors were also significantly affecting the attitude towards CA in addition to age. Conclusion: Only one fifth of participants had good knowledge about CA. Family history of CA, educational level, and gender are significant factors affecting both knowledge and attitude. Recommendation: To increase the awareness about CA among the public in general and increase the role of health care providers in raising awareness and counseling about CA.

Bronchial asthma is a chronic, inflammatory lung disease with exacerbations. Patients with asthma have higher risks of coronary heart disease, diabetes mellitus, and hypertension, although the impact of asthma on other vital organs is not yet verified. Chronic kidney disease (CKD) is a major global problem. In addition to well-known risk factors of CKD, there might be other previously underestimated or unrecognized risk factors that are not yet discovered. Aim The aim of this study was to determine the frequency and factors associated with CKD among asthmatic patients. Patients and methods An analytical, cross-sectional study was conducted on 118 patients known to have bronchial asthma and 118 healthy individuals; all of them were subjected to spirometry. Glomerular filtration rate (GFR) was estimated using the Modification of Diet in Renal Disease study group equation. Results Development of CKD was significantly higher among asthmatic patients than in healthy individuals (17.4 vs. 0.8%, respectively). GFR was higher in the wellcontrolled asthmatic group than in the uncontrolled group (96.3±18.1 vs. 90.1 ±20.3), but this difference was statistically insignificant. Occurrence of CKD was significantly higher among those with asthma for 20 years or longer than those with asthma for less than 20 years (45.5 vs. 2.4%, respectively). GFR was negatively correlated to age, BMI, and disease duration with high statistical significance, and was positively correlated with all parameters of pulmonary function test (FVC%, FEV1%, FEV1/FVC, and PEFR%) and partial O2 pressure with high statistical significance. Significant predictors for the development of CKD among asthmatic patients were longer disease duration and higher BMI. However, high partial O2 pressure was protective for the development of CKD. Conclusion Bronchial asthma can be associated with CKD. Prolonged disease duration and higher BMI were the most common predictors for the development of CKD. Keywords: bronchial asthma, chronic kidney diseases, GFR

ABSTRACT Background: tuberculosis (TB) represents a global health issue. In Egypt all efforts are directed to early detection and proper management of TB cases. Objectives: to highlight the pattern of the reported TB cases during the study period. Methods: The study was conducted in Al-Azhar university hospitals (Al-Hussein & Bab-Alshaaria), Cairo, Egypt. All patients registered with TB from January 2009 to December 2013 were included in the study. All data were coded and statistically analyzed to gain insight into the pattern of TB cases over the period. Results: we found 654 cases reported during 5 years period. The mean age of patients infected with tuberculosis was 36.3±15. 4 years, there was equal number of male and female. In both genders, the highest number of tuberculosis patient was found in productive age groups. During the 5-year study period, the highest percentage of cases was newly diagnosed and the highest frequency of cases was during year 2013 and lowest frequency was during year 2012. Most of PTB cases (82.5 %) were smear positive. the most common site for EPTB were lymph node, pleura and bone& joint. Conclusions: there is decline in total number of TB cases across the studied years except slight rise in 2013 and most studied cases were newly diagnosed,pulmonary smear positive cases. In all age groups, PTB was more common than EPTB except in age group 5-15 year. Efforts should be directed towards TB prevention and control highlighted by the changes in the pattern of cases through early detection and management of both PTB& EPTB.

ABSTRACT Background: tuberculosis (TB) represents a global health issue. In Egypt all efforts are directed to early detection and proper management of TB cases. Objectives: to highlight the pattern of the reported TB cases during the study period. Methods: The study was conducted in Al-Azhar university hospitals (Al-Hussein & Bab-Alshaaria), Cairo, Egypt. All patients registered with TB from January 2009 to December 2013 were included in the study. All data were coded and statistically analyzed to gain insight into the pattern of TB cases over the period. Results: we found 654 cases reported during 5 years period. The mean age of patients infected with tuberculosis was 36.3±15. 4 years, there was equal number of male and female. In both genders, the highest number of tuberculosis patient was found in productive age groups. During the 5-year study period, the highest percentage of cases was newly diagnosed and the highest frequency of cases was during year 2013 and lowest frequency was during year 2012. Most of PTB cases (82.5 %) were smear positive. the most common site for EPTB were lymph node, pleura and bone& joint. Conclusions: there is decline in total number of TB cases across the studied years except slight rise in 2013 and most studied cases were newly diagnosed,pulmonary smear positive cases. In all age groups, PTB was more common than EPTB except in age group 5-15 year. Efforts should be directed towards TB prevention and control highlighted by the changes in the pattern of cases through early detection and management of both PTB& EPTB.

In Egypt, bladder cancer is one of the most popular cancer, accounting for 31% of all cancer cases. It ranks first in males about 16.2% of male cancer. The incidence in rural areas among males is near 32 per 100,000. The exact etiology of bladder cancer is still unknown; K-ras gene is known as a critical DNA target for chemical carcinogens as a pesticide. Some occupational hazard exposure is thought to be directly genotoxic, while others might enhance the mutagenicity and carcinogenicity of directly acting genotoxic agents. Analysis of the relationship between pesticide exposure and mutation in the K-ras gene in human bladder cancer. One hundred patients were diagnosed with bladder cancer and one hundred controls attended the outpatient clinic; after taking consent and filling a questionnaire for age, sex, occupation and pesticide exposure, surgically resected specimens were collected and the samples were used to determine the k-ras mutation. Blood samples were taken to analyze the level of acetylcholinesterase enzyme and level of P53. The present study indicated that pesticide exposure may play a great role in malignant transformation of the bladder cells through mutation in the K-ras gene; there was a significant correlation between the acetylcholinesterase enzyme level and k-ras mutation (p 0.001). The results revealed that the level of P53 was significantly high in comparison with the control group (p 0.001). These findings give an alarm to decrease the amount of pesticides used in our area; also, p53 may be used as an indicator to bladder cancer.

In Egypt, bladder cancer is one of the most popular cancer, accounting for 31% of all cancer cases. It ranks first in males about 16.2% of male cancer. The incidence in rural areas among males is near 32 per 100,000. The exact etiology of bladder cancer is still unknown; K-ras gene is known as a critical DNA target for chemical carcinogens as a pesticide. Some occupational hazard exposure is thought to be directly genotoxic, while others might enhance the mutagenicity and carcinogenicity of directly acting genotoxic agents. Analysis of the relationship between pesticide exposure and mutation in the K-ras gene in human bladder cancer. One hundred patients were diagnosed with bladder cancer and one hundred controls attended the outpatient clinic; after taking consent and filling a questionnaire for age, sex, occupation and pesticide exposure, surgically resected specimens were collected and the samples were used to determine the k-ras mutation. Blood samples were taken to analyze the level of acetylcholinesterase enzyme and level of P53. The present study indicated that pesticide exposure may play a great role in malignant transformation of the bladder cells through mutation in the K-ras gene; there was a significant correlation between the acetylcholinesterase enzyme level and k-ras mutation (p 0.001). The results revealed that the level of P53 was significantly high in comparison with the control group (p 0.001). These findings give an alarm to decrease the amount of pesticides used in our area; also, p53 may be used as an indicator to bladder cancer.

In Egypt, bladder cancer is one of the most popular cancer, accounting for 31% of all cancer cases. It ranks first in males about 16.2% of male cancer. The incidence in rural areas among males is near 32 per 100,000. The exact etiology of bladder cancer is still unknown; K-ras gene is known as a critical DNA target for chemical carcinogens as a pesticide. Some occupational hazard exposure is thought to be directly genotoxic, while others might enhance the mutagenicity and carcinogenicity of directly acting genotoxic agents. Analysis of the relationship between pesticide exposure and mutation in the K-ras gene in human bladder cancer. One hundred patients were diagnosed with bladder cancer and one hundred controls attended the outpatient clinic; after taking consent and filling a questionnaire for age, sex, occupation and pesticide exposure, surgically resected specimens were collected and the samples were used to determine the k-ras mutation. Blood samples were taken to analyze the level of acetylcholinesterase enzyme and level of P53. The present study indicated that pesticide exposure may play a great role in malignant transformation of the bladder cells through mutation in the K-ras gene; there was a significant correlation between the acetylcholinesterase enzyme level and k-ras mutation (p 0.001). The results revealed that the level of P53 was significantly high in comparison with the control group (p 0.001). These findings give an alarm to decrease the amount of pesticides used in our area; also, p53 may be used as an indicator to bladder cancer.

In Egypt, bladder cancer is one of the most popular cancer, accounting for 31% of all cancer cases. It ranks first in males about 16.2% of male cancer. The incidence in rural areas among males is near 32 per 100,000. The exact etiology of bladder cancer is still unknown; K-ras gene is known as a critical DNA target for chemical carcinogens as a pesticide. Some occupational hazard exposure is thought to be directly genotoxic, while others might enhance the mutagenicity and carcinogenicity of directly acting genotoxic agents. Analysis of the relationship between pesticide exposure and mutation in the K-ras gene in human bladder cancer. One hundred patients were diagnosed with bladder cancer and one hundred controls attended the outpatient clinic; after taking consent and filling a questionnaire for age, sex, occupation and pesticide exposure, surgically resected specimens were collected and the samples were used to determine the k-ras mutation. Blood samples were taken to analyze the level of acetylcholinesterase enzyme and level of P53. The present study indicated that pesticide exposure may play a great role in malignant transformation of the bladder cells through mutation in the K-ras gene; there was a significant correlation between the acetylcholinesterase enzyme level and k-ras mutation (p 0.001). The results revealed that the level of P53 was significantly high in comparison with the control group (p 0.001). These findings give an alarm to decrease the amount of pesticides used in our area; also, p53 may be used as an indicator to bladder cancer.