validation study comparing the sensitivity and specificity of the new Dr. KSU H1N1 RT-PCR kit with reAl time RT-PCR for diagnosing influenza A [H1N1]

A new test [Dr. KSU H1N1 RT-PCR kit] was recently developed to provide a less expensive alternative to reAl time reverse transcriptase-polymerase chain reaction [RT-PCR]. We report the findings of a validation study designed to assess the diagnostic accuracy, including sensitivity and specificity, of the new kit, as compared to reAl time RT-PCR. Cross-sectional validation study conducted from 18-22 November 2009 at a primary care clinic for H1N1 at a tertiary care teaching hospital in Riyadh. Nasopharyngeal swab samples and data on socio-demographic characteristics and symptoms were collected from 186 patients. Swab samples were sent to the laboratory for testing with both reAl time RT-PCR and the new Dr. KSU H1N1 RT-PCR kit. We measured the sensitivity and specificity of the new test across the entire sample size and investigated how these values were affected by patient socio-demographic characteristics and symptoms. The outcomes of the two tests were highly correlated [kappa=0.85; P<.0001]. The sensitivity and specificity of the new test were 99.11% and 83.78%, respectively. The sensitivity of the new test was affected only minimally [96%-100%] by patient characteristics and number of symptoms. On the other hand, the specificity of the new test varied depending on how soon patients were tested after onset of symptoms [100% specificity when swabs were taken on the first day of the symptoms, decreasing to 75% when swabs were taken on or after the third day]. The specificity of the new test also increased with increasing body temperature. The new test seems to provide a cost-effective alternative to reAl time RT-PCR for diagnosing H1N1 influenza. However, further testing may be needed to verify the efficacy of the test in different settings and communities

[Effective strategies for empowerment of experts staff in health deputy of Shahrekord University of Medical Sciences, Iran, 2005]

The most valuable resource in every organization is its employees. Organization mobility depends on its staff empowerment. The aim of this study was to recognize and determine the priority of empowerment strategies in experts staff in health deputy in Shahrekord University of Medical Sciences in 2005. In a descriptive and analytical study, in 2005, all experts staff in provincial health center and health networks in 6 districts [approximately 210 persons] were introduced in this study. Need assessment questionnaires with 60 questions adjusted by Likrett indices were designed by surveyor. Data was collected and its suitability of factor analysis was confirmed by Bartlet test and Kaiser, Mayer, Olkin [KMO] test of sampling adequacy. Finally, 60 variables included 5 factors were selected and factor analysis was done by Varimax Yolling method. According to variables, factors and condition of each factor, 5 strategies were determined: 1-Liberty in job activities [42.25%], 2-Effective management of man power resources [5.99%], 3-Motivation [5.07%], 4-Self management [3.71%], 5-Development of organizational learning [2.84%]. There was a statistical relationship between expert's ideas about 5[th] strategy [development of organizational learning] and job location [P<0.01], between 2nd strategy [effective management of man power resources and age [P<0.01, r=0.19], between 5[th] strategy [development of organizational learning] and age [P<0.05, r=0.18]. The main strategies for health expert's empowerment are liberty in job activities and effective management of man power resources, motivation, self management and development of organizational learning. In point of view of older and more experts' staff development of organizational learning is more effective in organization development

Obesity among female school children in North West Riyadh in relation to affluent lifestyle

To estimate the prevalence of obesity among elementary school female students and to identify some obesity-associated risk factors. This cross-sectional study surveyed healthy female school students [grades 4-6] during 2006-2007. Four private schools in North West Riyadh, Kingdom of Saudi Arabia were selected where the majority of high income families enrolled their daughters. One thousand and two hundred students were included. A pre-designed validated questionnaire was used for data collection. Weights and heights were measured, and the body mass index [BMI] was calculated. Students were categorized into obese and non-obese according to BMI by age scale. A total of 1072 students participated in the study with a response rate of 89.3%. Obesity was prevalent among 14.9% of students. We observed that the proportion of obese students inversely increased by age and schooling grade [p<0.001]. Ninety-five percent of the students living in villas or big houses were obese. Approximately 89.2% admitted that they are performing some exercises; however, 13.8% of them were obese. Consuming fast food and soft drinks were common practiced among obese students. Watching television on daily basis was prevalent among 97.5% of obese students. The existence of obesity promoting factors, calls for integrating interventions at family and school level to match changes in social and cultural context. Awareness is needed to enhance healthy lifestyle

Case series of 111 Hirschsprung's disease among chronic constipated children referring to BooAli Sina hospital from 1997 to 2006

Hirschsprung's disease [HD] as an organic cause of children constipation is only treated by surgical intervention. Regarding of variety of clinical manifestation of HD and lack of information about it in Sari, this study describes the prevalence of HD in constipated children referring to BooAli Hospital. This descriptive study was undertaken on children with protracted constipation and neonate suspicions for HD referring to BooAli Sina Hospital of Sari [1997-2006]. Clinical and pathological data of patients were collected from their records and analyzed using SPSS 13 software. 226 children were presented with constipation at a mean age of 30.6 +/- 34.8 months [range, 0.69-1.6 months]. Rectal biopsy performed in 187 cases. HD was diagnosed in 59.4% of biopsied patients. The mean age of patients diagnosed was 24.8 +/- 33.2 months. 27.1% patients with HD were diagnosed in the first month, 44.1% in 1-12, 18% in 12-48 and 10.8% in over 48 months. This study revealed 59.4% of protected chronically constipated children had HD, indicating usefulness of rectal biopsy in these patients

Perception of female students of king Saud university towards premarital screening

The aim of this study was to investigate the perception of King Saud University female students towards the implementation of premarital screening [PMS] in the Kingdom of Saudi Arabia [KSA]. Two consecutive surveys on knowledge, attitudes and practice [KAP] were conducted two and nine months after the compulsory implementation of PMS in KSA in 1/1/1425H. The female students of King Saud University were given health education lectures before the survey. The first survey was done with a designed close-ended questionnaire distributed at pre and post stages of the health education lecture. However, the second one explored the participants' perception of the same items in open-ended questions summarized as a [consensus statement]. In fulfillment of their demands, the signed statement was mailed to the legislative authorities. A total of 140 university female students attended the first lecture. The response rate for both pre and post lecture surveys were 132 [94.3%] and 128 [91.4%] respectively. A total of 112 out of 132 [84. 8%] students in the pre test and 111 out of 128 [86. 7%] in the post-test were single. Of the married students 7/20 [35.0%] and 7/17 [41.2%] in pre and post tests had previously had PMS screening. The attitude of the students towards PMS was generally positive. One hundred and eight [81.8%] in the pre test and 110 [85.9%] in the post test sa w the importance of PMS in controlling the commonest hereditary diseases. However, a smaller percentage of students [69.7% and 75.0%] in pre and post lecture respectively were in favor of the compulsory application of PMS in KSA In spite of the positive attitude of all the students in the pre and post tests, fears were expressed towards the confidentiality of PMS test results and it was felt that social and psychological problems would ensue from abnormal results. This, however, does not represent the feeling of the entire population in KSA since the participants of the study formed a select group. The second awareness lecture was attended by 319 students from the College of Education. They were subsequently requested to state their perceptions of PMS application with regard to its content, nature and method of application in KSA in their own words. The collected forms were summarized into a [consensus sta tement] and signed by all 319 students. They felt tha t the scope of PMS should be extended to investigate and screen for other diseases especially sexually transmitted diseases that would adversely affect the health of members of the family and the community as a whole. Their worry about the lack of screening for other diseases may be because a majority of the study group were single and would, therefore, re Rise to get married on account of the risks to their future offspring. In addition, it may reflect their knowledge of the effects ofglobalization on the transmission ofdiseases. Health education is an important means of improving the public's perception of newly-introduced health interventions. University students have a good perception of the compulsory implementation of PMS in KSA Pre-marital screening could be extended to include a broader spectrum of health/genetic disorders and will be useful for early identification and possible intervention as well as the prevention of complications

Plasma fibrinogen and its correlates in adult Saudi population

To determine plasma fibrinogen and its correlates in the adult Saudi population and to investigate hyperfibrinogenemia as a possible risk factor for cardiovascular diseases [CVD]. A cross-sectional survey was designed and carried out through multi-stage stratified cluster random sampling of every third house in 6 heterogeneously populated districts of Riyadh, Kingdom of Saudi Arabia, during the period 1999 to 2002. Demographic and clinical data of 2263 adult Saudi subjects, consisting of 1934 [85.5%] men and 329 [14.5%] women, was collected through a standard questionnaire. Body mass index [BMI], blood pressure [BP] and history of smoking were recorded. Plasma fibrinogen, total serum cholesterol, triglycerides, high density lipoproteins [HDL] and blood sugar were determined in fasting blood samples. The majority [84.6%] of the subjects were between 20-50 years of age. The mean plasma fibrinogen was 336 +/- 115 mg/dl, and was increasing with age both in men and women. The mean +/- SD fibrinogen in women [357 +/- 118 mg/dl] was significantly higher [p value of 0.03] than men [332 +/- 114 mg/dl]. Hyperfibrinogenemia [>400 mg/dl] was indicated in 554 [24.6%] of the total subjects. Among hyperfibrinogenemic Saudi adults, the prevalence of hypercholesterolemia was 14.3%, hypertriglyceridemia 24%, obesity 26.3%, systolic/diastolic hypertension 11.5% and 11% and hyperglycemia 26% [in women only]. A reciprocal relation was observed between HDL and plasm fibrinogen. Significant positive correlation was seen between fibrinogen and BMI, systolic and diastolic BP and total cholesterol. There was no significant difference in the distribution of plasma fibrinogen between smokers and non-smokers [p value of 0.864]. The difference in the magnitude of metabolic as well as modifiable CVD risk factors between smokers and non-smokers was not significant, except serum triglyceride which was significantly higher in smokers than non-smokers [p value of 0.020]. A significant positive correlation was observed between hyperfibrinogenemia and obesity, systolic/diastolic hypertension and hypercholesterolemia. Our results thus support the earlier reports that hyperfibrinogenemia is a potential CVD risk factor. Unlike other reports, we could not find any correlation between smoking and plasma fibrinogen in our studied subjects. The value of hyperfibrinogenemia as a definite risk factor for CVD has to be quantified in future case-control studies comparing its significance between CVD subjects and normal controls

Distribution of T4 TSH values in children - the Shifa experience

To evaluate the distribution of Thyroxin [T4] and Thyroid Stimulating Hormone [TSH] values in children of various age groups attending our hospital. Subject and We have retrospectively reviewed the T4, TSH levels recorded at our hospital in children from birth to 5 years and evaluated the reference intervals for T4 TSH amongst different ages. Non parametric methods were used to establish a 97.5th, 95th, 50th, 5th and 2.5th centiles. In T4 [n=1148] and TSH [n=1142] samples reviewed a TSH surge following delivery showed a sharp decline in the first 4 days of life. This was followed by a more gradual downward trend. Data on T4 estimations showed a similar but more gradual downward trend in advancing age groups. The 5th - 95th centile reference range for TSH showed values between 1.7--22.5 [0--4days; n=992], 0.6--13.3 [5--7days; n=36], 0.9--14.0 [1week--1 month; n=38], 0.5--13.6 [1month-1 year; n=38] and 0.4--12.8 [1--5 years; n=38] microIU/mL. The 5th - 95th centile reference range for T4 showed values between 10.7-25.0 [0-4days; n=995], 6.5--20.4 [5--7 days; n=35], 8.0-18.1 [1week--1month; n=38], 6.0--16.1 [1month--1year; n=41], 6.9-15.3 [1--5 years; n=39] micro gm/dl. We recommend using separate T4 and TSH reference values for children in different age groups. Further large-scale studies should be done in Pakistan to establish these reference values within age groups. A national center for neonatal thyroid screening is highly recommended

Vascular injuries of the neck a prospective study of 36 patients

To evaluate the proper role of clinical examination alone in the diagnosis of vascular injury of the neck in a less equipped hospital. Design: Thirty six patients with vascular injuries to the neck, admitted during 1982-96 were prospectively studied. Setting: Diseases Department of Cardiovascular Surgery, the National Institute Cardiovascular [NICVD], Dhaka, Bangladesh. Patients: Thirty six patients admitted with vascular injury to the neck were studied. Main outcome measures: Incidence of vascular injury to the neck, patients undergoing neck exploration on the basis of clinical evaluation alone. Stab wounds constituted more than 66% of vascular injuries in the neck. Out of total 36 patients 16 had carotid artery and 20 had external or internal jugular vein injuries. Lateral suture repair of 20 vessels and end to end anastomosis of 12 vessels were performed without perioperative neurologic deficit. Four cases of common carotid artery [CCA] pseudoaneurysms undergone aneurysmectomy and end to end anastomosis or vein patch repair while on one patient with A-V fistula between CCA and internal jugular vein, ligation and excision of the fistula and Dacron patch repair of the arterial wall defect was performed. Conclusions; The correct decision of neck exploration for suspected vascular injuries can be taken on clinical findings alone while advanced diagnostic facilities are either lacking or absent. Based on our findings routine use of angiagrophy in penetrating neck injuries is probably not justified

Molluscicidal activity of damsisa ambrosia maritima field trial in Assiut governorate

The effect of damsissa "ambrosia maritima" on bulinus truncates snails was studied. In a segment of Sahel Saleem canal Damsissa whole plant was appliced. An upstream segment of the same canal [without using Damsissa] was taken as a control. Each segment was divided in 10 stations snail surveys at each station were done 5 times before and 5 times after the application of damsissa. The experimental part of the canal showed a significant decline of the number of bulinus truncatus snails in the period after Damsissa application. No significant change in the same period was found in the control part of the canal. Data points to the significant effect of Damsissa in the control for bulinus truncatus snails