association between serum thyroid-stimulating hormone concentration and development of differentiated thyroid cancers in nodular thyroid disease

To evaluate the relation between serum thyroid-stimulating hormone [TSH] and development of differentiated thyroid cancers in nodular thyroid disease [NTD] in Egyptians. One hundred patients were included in this study at Al-Azhar University Hospitals from 2010 to 2013; all patients with NTD, who were fi t for surgery, were selected for study. The preoperative TSH level was estimated and was compared with the final histopathological diagnosis for the presence of malignant thyroid lesions. A total of 100 patients were included in the study, with an average age of 46 years. The male to female ratio was 1: 4.7. Seventy-five patients had multinodular goiter, whereas 25 patients had a solitary thyroid nodule. Eighty-six patients underwent total thyroidectomy, whereas 14 patients underwent near- total thyroidectomy. The final histopathological data showed no evidence of malignancy in 83 patients, 83% [benign group], whereas malignant lesions were present in 17 patients, 17% [malignant group]. The preoperative mean TSH level in the benign group was 1.72 +/- 1.4 mIU/L, whereas the mean TSH concentration in the malignant group was 2.61 +/- 2.2 mIU/l. There is a definite relation between serum TSH and development of differentiated thyroid cancers in NTD as the risk of thyroid malignancy increases with increased serum TSH concentrations

Health disparities between Muslim and non-Muslim countries

We examined differences in health indicators and associated factors across countries according to the proportion of the population who are Muslim. Of 190 UN countries, 48 were classified as Muslim-majority countries [MMC] and 142 as non-MMC. Data on 41 potential determinants of health were obtained from 10 different data sources, and 4 primary outcome measures [male and female life expectancy, maternal mortality ratio and infant mortality rate] were analysed. Annual per capita expenditure on health in MMC was one-fifth that of non-MMC. Maternal mortality and infant mortality rates were twice as high in MMC as non-MMC. Adult literacy rate was significantly higher for non-MMC. Four significant predictors explained 52%-72% of the differences in health outcomes between the 2 groups: gross national income, literacy rate, access to clean water and level of corruption

Burden of fall injuries in Pakistan - analysis of the National Injury Survey of Pakistan

There are no reliable estimates of the burden of fall-related injuries in Pakistan. To assess this burden and develop an epidemiologic profile for these injuries data from the National Injury Survey of Pakistan, a cross-sectional population-based survey on injuries, were analysed to determine incidence and relative risks for fall injury. The annual incidence of fall-related injuries was 8.85 per 1000 population per year [95% Cl: 6.8-11,3]. The mean and median age of individuals injured by falls was 19 years and 10.5 years respectively. Children under the age of 15 years were at a substantially higher risk of fall injuries. Being a student and farmer/labourer/vendor were associated with a higher risk for falls compared with unemployed. Fall-related injuries are a health burden in Pakistan, especially in children under 15 years of age. This represents a significant loss of healthy life and requires policies to curb this burden in the population

Haematological abnormalities in malaria

This study was performed to observe the frequency of haematological abnormalities such as anaemia, thrombocytopaenia, and leucopaenia or disseminated intravascular coagulation [DIC] in patients suffering from malaria. The study was carried out at Bahawal Victoria Hospital, Bahawalpur from 01-07-2003 to 31-07-2004. A total of 50 consecutive patients of all ages and sex presenting with malaria in medical wards were studied. Detailed history was taken especially of fever, rigors, chills, headache, fits or bleeding from any site. The patients already taking antimalarial drugs were excluded. Baseline characteristics were recorded. In 50 patients studied, most of them were of young age with a peak occurrence between 21-35 years. More females [56%] were affected than males [44%]. In most of the patients [98%] fever was the presenting symptom associated with rigors [60%], chills [74%], headache [80%], fits [40%], unconsciousness [20%] and history of bleeding [4%]. The examination and investigations revealed anaemia [84%], jaundice [14%], spleenomegaly [72%], thrombocytopaenia [52%], leucopaenia [18%], haemoglobinuria [6%] and disseminated intravascular coagulation [2%]. In patients presenting with malaria the most common presentation is fever associated with headache, rigors and chills. The hematological abnormalities seen included anaemia and thrombocytopaenia in the patients suffering from malaria

impact of four wheel drives on road traffic disability and deaths compared to passenger cars

The aim of this study was to examine the pattern of injuries resulting from road traffic crashes involving four wheel drives [4WD] vehicles and passenger cars in the United Arab Emirates [UAE]. Descriptive study. Al-Ain and Tawam Hospital, UAE, during a period from 1st January to 31st December 2000. A questionnaire was created and filled out concerning: sociodemographic information; data about driving behavior and attitude which included driving experience, adherence to traffic laws [including speed limits and wearing seat belt], driving habits, and assessment of sustained injury was performed according to the Abbreviated Injury Score [AIS]. A total of 1157 motor vehicle crashes related casualty patients were hospitalized during the year 2000. Of these total patients, 495 victims [42.8%] were involved with 4WDs road traffic crashes related injuries and 72.9% of them required hospitalization. Of these, 76.8% were males, 60.7% were non-UAE nationals. The head injury was more common in those who had crashes from 4WD vehicles [45.6%] than those who had crashes from small cars [37.3%]. Abbreviated injury scare showed that four wheelers caused more severe [9.1%], serious [10.3%], critical [8.3%] and moderate injuries [13.9%]. A significant higher risk was observed for speed violations [OR=2.06; 95% CI=1.55-2.76, p<0.001]; property damage [OR=1.54; 95% CI=1.07-2.22, p<0.014] and pedestrian accident [OR=2.09; 95% CI=1.46-2.99, p<0.001]. The present study findings indicated that nearly half of the road traffic crashes were involved with 4WD vehicles and that most of the injured individuals were pedestrian and younger drivers. Reduction in motor vehicle injuries and deaths represents a major public health success

Carotid endarterectomy at Punjab institute of cardiology, Lahore: Mid term postoperative results

This study was designed to review postoperative results of the carotid endarterectomy [CABG/CEA] performed at the Punjab Institute of Cardiology, Lahore. Cconsecutive 10 patients with coexisting severe ischemic cardiac and carotid artery disease were operated on during 1-year period ending December 2003 at Punjab Institute of Cardiology, Lahore. The mean age of the study population was 60.20 +/- 7.56 years, among theses 9 were male and 1 female patient. Four [40%] patients with carotid artery stenosis were asymptomatic. Previous stroke occurred in 2 [20%] patients: two [20%] patients presented with a history of blackouts and two [20%] with a transient ischemic attack. The mid term results with regard to 30-day postoperative mortality, stroke and major postoperative complications were significantly low in terms of post operative infection as only one [10%] patient had chest infection and there was no in-hospital mortality. Combined interventions of CE and CABG can be performed with an acceptable morbidity and mortality when severe carotid stenosis is associated with advanced, symptomatic ischemic heart disease. The introduction of routine preoperative carotid duplex scanning resulted in higher diagnostic rate for asymptomatic carotid artery disease among the patients scheduled for combined CABG/CE procedure

Hepatitis C virus associated glomerulopathy in Egyptian children

Hepatitis C virus [HCV] infection causes both acute and chronic liver disease and is also associated with renal disease in adults. Whether HCV is associated with renal disease in children, as hepatitis B virus is not known. The study described the clinical and virologic features of 46 children with nephrotic syndrome who were followed up in the Pediatric Vapour Nephrology Clinic, Ain-Shams University. Most of the patients had normal kidney and liver functions. Anti-HCV was detected in 6 patients and it was negative in all children in the control group. Patients with anti-HCV were furtherly studied for HCV-RNA, C3 and cryoglobulins. Two patients had HCV-RNA detected in their serum, 2 had hypocomplementemia and cryoglobulins were not detected in all the patients. It is concluded that HCV infection is more common in Egyptian nephrotic children in comparison to healthy children. The exact role of this infection in the etiology or perpetuation of the renal disease is not known. HCV associated glomerulopathy differ in prognosis and management from primary glomerulopathy