Anti-Obesity Effect of Methanolic Extracts of Local Punica granatum in High-Fat Diet-Induced Obese Rats

@#Introduction: Obesity has been linked to coronary artery disease, type II diabetes, metabolic syndrome, stroke, and cancer. Pomegranate (Punica granatum; PG) has been used extensively in folk medicine for several therapeutic purposes. The goal of this study is to investigate the anti-obesity effect of PG peel and pulp methanolic extracts in highfat diet (HFD)-induced Sprague-Dawley rats. Methods: The animals were separated into 7 groups namely Normal control group (normal diet); HFD-induced only as negative control group, and positive control group (HFD-induced + orlistat); treatment group included HFD-induced + peel 125 mg/kg, HFD-induced +peel 250 mg/kg, HFD-induced + pulp 125 mg/kg and HFD-induced + pulp 250 mg/kg. Results: It was observed that methanolic extract of peel and pulp PG 250 mg/kg showed low increment of body weight with a reduction in weight of liver, visceral fat, and subcutaneous fat. Compared to the negative control group, total cholesterol, triglyceride, and low-density lipoprotein levels were shown to be lowered for PG peel and pulp groups also showed higher values in high-density lipoprotein. Conclusion: PG reduced obesity-related markers in blood, liver, and adipose tissue and inhibited obesity caused by a high-fat diet probably because of its antioxidant properties.

Preparedness of Healthcare Facilities of Manipur in the Management of Noncommunicable Diseases: A Cross-Sectional Study

Background: India is experiencing a rapid health transition with a rising burden of noncommunicable diseases (NCDs), causing significant morbidity and mortality. Cost?effective interventions for comprehensive NCD management can only be designed after assessing the readiness of various health facilities. Objectives: This study aimed to assess the preparedness of healthcare facilities of Manipur in the management of NCDs and to assess the knowledge of doctors regarding NCDs. Methods: A cross?sectional study was conducted in 21 public healthcare facilities in seven districts of Manipur during October 2021. Readiness of these facilities was assessed through observation and interview of doctors and nurses using a checklist adapted from the WHO Package of Essential NCDs. Knowledge of 153 doctors was also assessed using a self?administered, structured questionnaire. Data were entered in SPSS?26 and expressed using descriptive statistics. Results: General readiness index of primary health centers(PHCs), community health centers(CHCs), district hospitals(DHs), and tertiary care centers(TCCs) was 47%, 66.3%, 73.2%, and 70%, respectively. CHCs were ready in the domains of patient care services (80%), human resources (75%), and advocacy (91.7%). DHs and TCCs were ready in terms of patient care services, human resources, record maintenance, referral system, and advocacy. PHCs were not ready in any of the nine domains. Majority of the doctors (88%) had inadequate knowledge regarding NCDs. Conclusion: PHCs and CHCs were not adequately prepared, but DHs and TCCs were ready to manage NCDs. More than four?fifth of the doctors had inadequate knowledge. Strengthening PHCs and CHCs and training of healthcare workers are needed for integrated NCD management.

Comparative Study between Spinal Anesthesia and Lumbar Plexus Block for Intraoperative Anesthesia and Postoperative Analgesia in Fracture Femur Surgery

Background:Fracture femur is common in elderly. Spinal anesthesia (SA) in elderly patients can be associated with major hemodynamic changes whereas lumbar plexus block (LPB) can provide ideal perioperativeanalgesia as there is no hemodynamic instability or depression of pulmonary functions. The purpose of this study is to compare the efficacy of SA versus LPB for intraoperative anesthesia and postoperative analgesia in fracture femur surgery.Materials andMethods: This prospective randomized controlled study was carried out 70 patients of either sex with age >20 years, ASA physical status I -III scheduled for fracture femur surgery. Patients were randomly classified into two equal groups (n = 35); group I(SA) received SA by heavy bupivacaine HCL 0.5% 2.5-3.5 ml and group II (LBP) received posterior LPB by 30-35 ml bupivacaine 0.5% Results:The time for performing the block was significantly longer in group LPB than group SA. The onset of sensory and motor block was significantly increased in group LPB than group SA. The intraoperative HR was significantly increased, and intraoperative MAP was significantly decreased in group SA compared to group LPB at 5, 10, 15, 20, 25 and 30 minutes. Postoperative HR and MAP was significantly increased in group SA compared to group LPB at 1 and 6 h. Postoperative VAS was significantly increased in group SA than group LPB at 1 and 6 h. The duration of sensory and motor block was significantly increased in group LPB than group SA. The time of postoperative first analgesic requirement was significantly longer and the total pethidine consumption in the 1st24 h was significantly lower in group LPB than group SA. SA was associated with significant increase in hypotension, nausea, vomiting and headache.Conclusion:LPB is an effective alternative to SA as an anesthetic technique for femur fracture surgeries. LBP offers a more stable intraoperative hemodynamics and provides longer duration of analgesia postoperatively with less side effects. However, SA has shorter time for performing the block with earlier onset of sensory and motor block

Prevalence of Carbapenem-Resistance among Enterobacteriaceae Isolated from Patients Attending Uduth Sokoto, North West Nigeria

Themajorproblemthreateningthecontinuedsuccessofantimicrobialdrugsisthedevelopmentofresistantorganisms.Thisstudywasdesignedtodeterminetheoccurrenceandprevalenceofcarbapenemresistanceamongenterobacteriaceaeisolatedfromin-patientsattendingUsmanuDanfodiyoUniversityTeachingHospital(UDUTH)Sokoto,andalsotodeterminetheantimicrobialsusceptibilitypatternsoftheorganismsisolated.TheMethodologyinvolvestheuseoftrypticasesoybrothcontaining10μgofcarbapenem(imipenem)forprimaryisolation.ThesecondaryisolationinvolvestheuseofMacConkeyagarandbiochemical(SimmoncitrateAgar)foridentification,andthenantimicrobialsusceptibilitytestingbythediskdiffusionmethod.Atotalof191stoolsamplesfrommaleandfemalein-patientswithintherangeof2-60yearswerescreenedforthe gastrointestinalcolonizationofCarbapenemResistanceEnterobacteriacea(CRE).DatawereanalysedusingStatisticalPackageforSocialSciences(SPSS)windowsversion21.Theoverallprevalencewas15.7%Theprevalenceratewasfoundexclusivelyinmales.Thehighestprevalencewasfoundwithintheagegroupof30-40years.Escherichiacoli,Klebsiellaspecies,Pseudomonasspeciesandsalmonellaspecieswerethebacteriaisolated.ThemostpredominantbacteriaisolatedwereEscherichiacoli,accountingfor85(9.4%)resistantstrains,Klebsiellaspeciesaccountingfor50(8%)resistantstrain,Pseudomonasaeruginosa21%andSalmonellaspeciesaccountingfor42(0%)noresistantstrainisolated.Themisuseofantibioticsisamajorfactorresponsibleforthehighrateofbacterialresistance.Improvementonthemanagementandpersonalhygiene,aswellastheappropriateuseofantibioticswouldreducetheprevalenceofNosocomialCarbapenemResistance(NCR)especiallyamongprolongedhospitalizedpatients

A comparative study on hematological parameters among the social and problem drinkers admitted in a tertiary care rehabilitation centre

Background: Alcoholism is a broad form for problems with alcohol and is generally used to mean compulsive and uncontrolled consumption of alcoholic beverages, usually to the determinant of drinker’s health, personal relationships and social standing. It is medically considered a disease, specifically an addictive illness. Alcohol has numerous adverse effects on the various types of blood cells and their functions. This study aimed to evaluate the hematological changes in alcoholic patients admitted in tertiary care hospital.Methods: The blood samples were collected from alcoholics admitted in a psychiatric and rehabilitation centre and the samples were processed in hematology laboratory in a tertiary care hospital. The hematological parameters (CBC) except ESR, were performed by using fully automated blood cell counters. The change in alcoholics was studied under two categories-social drinkers and problem drinkers. The results of these parameters were compared with age and sex matched normal population.Results: Total 200 cases included in which 110 were abstainers and 90 were alcoholics. Among alcoholics 67% were problem drinkers and 33% were social drinkers. The mean values of Hb, RBC and MCV in social drinkers were 11.1 g/dl, 3.1 million cells /μl and 100.5 fl, in problem drinkers were 9.8 g/dl, 2.89 million cells /μl and 105.5 fl, and in control population were 14.8 g/dl, 4.8 million cells / μl and 93 fl respectively.Conclusions: The study shown that parameters were changed in both social drinkers and problem drinkers. But predominant changes were observed in problem drinkers. The presence of elevated MCV and decreased RBC and Hb are suggestive of megaloblastic changes.

A comparative study on efficacy of metoprolol and ivabradine in acute ST elevation myocardial infarction patients

Background: The ST-elevation myocardial infarction (STEMI), a fatal disease, is rapidly extending in patients, worldwide. Therefore, proper and timely diagnosis followed by appropriate management becomes necessary. The study aimed to compare the effectiveness of metoprolol and ivabradine in acute STEMI patients.Methods: This was an observational, comparative, in-hospital study carried out in patients admitted in the in-patient cardiac department, intensive cardiac care unit of a tertiary care centre in India. Total 60 patients diagnosed with acute ST-elevation MI were included in the study and were equally divided into two groups. Group 1 involved patients who were given metoprolol for treatment and group 2 involved patients who were given ivabradine. The patients were assessed in terms of heart rate, NYHA class, and ejection fraction. Follow-up of 30 days was taken in all patients.Results: Ivabradine reduced mean heart rate from 85.57 bpm at baseline to 78.23 bpm. Heart rate in the metoprolol group was reduced from 81.93 bpm to 76.47 bpm over the same time period. Metoprolol and ivabradine showed significant improvement in the ejection fraction volume during the in-hospitalization stay. Ivabradine showed a better improvement in ejection fraction when compared to metoprolol but the difference was not found to be statistically significant. Higher mortality was assessed in ivabradine group compared to metoprolol.Conclusions: The study gives the gold standard efficacy and mortality benefit of metoprolol, although ivabradine on the other hand gave better responses in heart rate reduction and improvements in ejection fraction.

Pattern of drug use in psoriasis inpatients in the department of dermatology at a tertiary care teaching hospital.

Background: The pattern of drug use in people hospitalized with a primary diagnosis of psoriasis has never been studied previously in India. The aim of the study was to characterize the prescription pattern of people admitted to hospital with psoriasis so that rational prescribing could be promoted among dermatologists. Methods: Case files belonging to 32 patients, admitted in the Department of Dermatology with psoriasis, of a tertiary care teaching hospital in Kerala, over a period of 1-year were retrieved with the assistance of the medical records department. The data thus obtained was analyzed using descriptive statistics. Results: The average age of patients who were admitted with psoriasis was 49.9 years, and their average duration of hospital stay was 7.96 days. A total of 296 formulations were prescribed to 32 patients. Out of 296 formulations, only 10 (3.37%) were generic and rest 286 (96.62%) branded. Fixed dose combinations consisted of 32.43% (96/296) of the prescribed formulations. Psoriasis vulgaris (56.25%) was the most common cause for admission. Of all the prescribed medications, 4 (1.35%) did not contain clear instructions for the route of administration. Strength was clearly mentioned in only 89 (30%) of the preparations. In 98% of the prescriptions, the exact dose was missing. Conclusions: The study reveals various deficiencies which exist in the prescribing pattern of drugs for management of psoriasis. Educational interventions among the doctors as well as students should be carried out to promote rational drug use.

Influence of non-alcoholic malt beverages on urinary excretions of calcium and uric acid

Background and objective: Malt beverage without alcohol [Barbican] is an energy beverage which is regularly consumed by Muslim countries and substantial quantities are exported to the Gulf States and Middle East countries. Barbican is used widely by people whom alcohol is forbidden either on medical grounds or on religious aspects. The aim of this study was to assess the effect of short-term drinking of Barbican on urinary excretion of calcium and uric acid in normal young males in Erbil city

Methods: Thirty healthy male volunteer subjects of 21-23 years age consumed 330 ml of Barbican® beverage per day for two successive days after cross design. The urinary calcium and urinary uric acid were evaluated before and after consumption

Results: There was no statistically significant increase in urinary uric acid before and after consumption of Barbican beverage [P = 0.071]. Urinary calcium significantly decreased after consumption of Barbican drink [P = 0.037]

Conclusion: Although many extrinsic and intrinsic factors influence formation of kidney stones and bone resorption, this study suggests that drinking of Barbican beverage may be helpful to prevent bone resorption and also to reduce risk of stone formation

Lobar pneumonia in hospitalized children and response to empirical antibiotic treatment

Background: It is an inflammatory disease of lungs with consolidation of one or more lobes caused mostly by Streptocccus pneumoniae bacteria. It is a worldwide disease with high mortality among children less than 5 years old

Objective: To determine the proper empirical antibiotic treatment for lobar pneumonia in hospitalized children and the correlation between the blood culture result and response to treatment

Patients and Methods: A Cross sectional study was performed between January 2013 through December 2013 to 69 patient admitted to Central Teaching Hospital Of Pediatrics in Baghdad, aged more than two months to ten years, all of them met the WHO case definition of pneumonia, data was collected from the mothers for [age, sex, previous health and vaccination status]. Blood sample was collected for blood culture and sensitivity for all patients

Results: The study showed that of 69 patients hospitalized with lobar pneumonia 69.5% were males, and 30.5% were females, 82.6% of patients were in an age group less than one year. The study found that 69.6% of patients were not vaccinated and they were mostly less than 1 year. The response to treatment range from 88.8%-94% and Blood culture was negative in 95.6% of samples. Mortality rate was 4.3%

Conclusion: Treatment with Ceftriaxone [3rd generation Cephalosporine] alone is effective as an empirical treatment for lobar pneumonia in hospitalized patients, so no need for combination therapy of Ceftriaxone and Vancomycin and the Blood culture was negative for Streptococcus pneumoniae in all cases so the results of Blood Culture had no correlation with response to treatment

Prescription audit of corticosteroid usage in the department of dermatology at a tertiary care teaching hospital.

Background: Corticosteroids are a group of commonly used drugs in dermatology practice whose non judicious use frequently results in undesirable and unwanted effects. Prescribing them rationally with care allows us to derive the maximum benefit out of them with minimal side effects. Methods: Retrospective analysis of 112 case files belonging to patients admitted in the department of dermatology over a period of one year was undertaken to ascertain the usage pattern of corticosteroids in relation to their potency, strength, frequency, duration, route, quantity to be applied. The data thus collected was expressed in terms of averages, ratios and proportions. Results: The total number of formulations prescribed were 929 out of which 10.8% were corticosteroids. The average number of formulations prescribed per patient was 8.29. About 78(70%) patients admitted in dermatology received corticosteroids. Topical steroids were prescribed in 50 patients (44.7 %) out of whom 36 (72%) received only topical, the remaining 14(28%) were prescribed both systemic and topical corticosteroids. Brand names were used in all cases. Highly potent corticosteroids like clobetasol, halobetasol and mometasone were prescribed to 39(50%) of all cases who received topical corticosteroids. Conclusion: The study reveals the deficiencies which exist in the present prescribing pattern of corticosteroids. Educational interventions among the doctors as well as students should be carried out to in order to promote rational drug use.

Immediate Relief TMJ Clicking Following Low Level Laser Therapy After Orthodontic Treatment :- A Case Report.

Introduction: To determine efficacy of low level laser therapy for clicking temporomandibular joint (TMJ) with a diode laser following orthodontic treatment. Methods: Performance of LLLT with a diode laser for temporomandibular clicking and postoperative findings were evaluated in a case of an orthodontic patient following the termination of treatment. Patient had a history of severe clicking before initiation of treatment protocol. Low level diode laser ((λ= 905 nm, power = 0.7 watt, mode = continuous, Time = 60 seconds)), applied for the purpose of relieving the signs.Results: During the process of intervention and establishing the proper dental occlusion sign of temporomandibular joint dysfunction i.e. clicking reduced significantly (p<0.05) but remained at the lowest level from the perspective of frequency and severity index. Patient had no sign and symptom at the end of treatment. Clicking was reemerged in the retention period, i.e. after six months. Clinical signs disappeared immediately after the application of laser once (p<0.05) with no recurrence after four months follow up.Conclusion: Low level laser therapy serves as an adjuvant to orthodontic treatment while establishing the proper occlusion of stomatognathic system has pivotal role in function and stability of outcome.

Adult sickle cell disease a five-year experience of intensive care management in a university hospital in Oman

Sickle cell disease [SCD] is an inherited disease caused by an abnormal type of haemoglobin. It is one of the most common genetic blood disorders in the Gulf area, including Oman. It may be associated with complications requiring intensive care unit [ICU] admission. This study investigated the causes of ICU admission for SCD patients. This was a retrospective analysis of all adult patients >/= 12 years old with SCD admitted to Sultan Qaboos University Hospital [SQUH] ICU between 1st January 2005 and 31st December 2009. A total number of 49 sickle cell patients were admitted 56 times to ICU. The reasons for admission were acute chest syndrome [69.6%], painful crises [16.1%], multi-organ failure [7.1%] and others [7.2%]. The mortality for SCD patients in our ICU was 16.1%. The haemoglobin [Hb] and Hb S levels at time of ICU admission were studied as predictors of mortality and neither showed statistical significance by Student's t-test. The odds ratio, with 95% confidence intervals, was used to study other six organ supportive measures as predictors of mortality. The need for inotropic support and mechanical ventilation was a good predictor of mortality. While the need for non-invasive ventilation, haemofiltration, blood transfusions and exchange transfusions were not significant predictors of mortality. Acute chest syndrome is the main cause of ICU admission in SCD patient. Unlike other supportive measures, the use of inotropic support and/or mechanical ventilation is an indicator of high mortality rate SCD patient

Knowledge, attitude and practice of nurses toward peak expiratory flow meter in primary health care centers in Kuwait

Peak expiratory flow meter [PEFM] is an easy to use, relatively cheap device that can be used for guiding management of bronchial asthma by the patients at home according to a preset plan by health care workers. The aim of the study is to reveal the extent of knowledge and perception of nurses about PEFM and factors affecting their knowledge. Out of the total primary health care centers in Kuwait, 50% were randomly selected. Out of 699 nurses currently working in the selected centers, 516 nurses were interviewed for this study with an overall response rate of 73.8%. The results of this study showed that nurses had a relatively low total knowledge score percent of 64.7 +/- 7.3%. The lowest individual mean percent score was that of procedures and steps of measuring peak expiratory flow rate [39.0 +/- 24.1%]. The highest percent knowledge score was that of benefits of use and content instructions for teaching patients [78.3 +/- 19.5% and 78.1 +/- 12.0%, respectively]. Sociodemographic factors did not affect the total knowledge score. Receiving training, availability of PRFM in the health center and being responsible about taking the measurements for patients proved to significantly affect the level of knowledge of nurses. Training nurses about use of PEFM and providing primary health care centers with the devices would plan an important role to improve knowledge of nurses and hence improve domestic health care of patients with obstructive lung diseases

Predictability of conversion from laparoscopic to open cholecystectomy: retrospective analysis of risk factors

Laparoscopic Cholecystectomy [LC] is the gold standard operation for cholelithiasis; however, conversion to [Open Cholecystectomy [OC]] is still required in some patients. Is to assess the predictability of conversion by recognition of probable risk factors, a fact that would be beneficial for patient selection and planning of laparoscopic procedures. Retrospective analysis of data concerning 1350 cases of LC in the last 8 years from 2001 to 2008. A total of 28 patients required conversion [overall conversion rate of 2.1%]. Preoperative clinical, laboratory and radiological data were evaluated with regard to conversion. Six factors; male gender, age above 45 years, presentation as acute cholecystitis[ACs], history of repeated attacks of ACs, ultrsonographic gall bladder wall thickness of more than 3 mm. and previous history of upper abdominal operation; showed a statistically significant effect on conversion. Three other factors; raised white Blood Cell [WBC] count, Common Bile Duct [CBD] stone[s] and experience of the surgeon; failed to reach significance. On the basis of Univariate analysis results, all significant predictors were allocated a score, which indicate risk score for conversion. Increasing score was associated with a significantly increased probability of conversion. The optimal cutoff score was 2 with a conversion rate of 3.05%. Conversion rate was 20% with a score of 8. Risk of conversion is predictable on basis of this scoring. Patients predicted to have high risk of conversion may be informed and scheduled appropriately

Incidence and potential risk factors of low birth weight among full term deliveries

Low birth weight [less than 2500 grams] [LBW] is a reliable indicator in monitoring and evaluating the success of maternal and child health programs. Giving birth to a LBW infant is influenced by several factors. The aim of the study was to determine the incidence of LBW among live born full term deliveries in Al-Adan governmental hospital and to study the possible determinants of its occurrence. The first phase of the study was a descriptive one including all live born full term deliveries of women attended the hospital within the first 2 months of pregnancy and followed up till delivery. In the second phase LBW women [cases] were compared with a double number of women who gave birth to normal birth weight infants. Among 939 women eligible for the study, the incidence of LBW was 7.8%. Reproductive age lower than 25 years, gestational age lower than 40 weeks, history of previous abortion, primiparity, maternal underweight and anemia were detected as independent risk factors for LBW. On the other hand, obesity was a protective factor. Low birth weight occurs frequently in Kuwait, although its incidence is much lower than in many countries in the region. Prenatal management of modifiable factors and adequate antenatal care and screening for susceptible women should be a target for all obstetricians for reducing the incidence of LBW

Current prevalence and predictors of protein-energy malnutrition among schoolchildren in rural Peninsular Malaysia.

A cross-sectional study was carried out to determine the current prevalence of protein-energy malnutrition (PEM) among Orang Asli schoolchildren and to investigate the potential predictors of malnutrition. A total of 241 (120 males and 121 females) Orang Asli schoolchildren age 7-12 years living in remote areas of Pos Betau, Pahang participated voluntarily in this study. Anthropometric and socioeconomic data were collected and the children were screened for intestinal parasitic infections. The overall prevalences of mild and significant underweight conditions were 52.3% and 37.3%, respectively, and the prevalences of mild stunting and wasting were 43.6% and 43.1%, respectively, while the prevalences of significant stunting and wasting were 43.6% and 5.6%, respectively. There was a significant association between gender (male) and malnutrition (p = 0.029). The results also showed a higher prevalence of stunting among children age < or = 10 years than in older children (p = 0.001). Other independent variables, including socioeconomic status and intestinal parasitic infections, had no significant associations with malnutrition indices. PEM is prevalent among schoolchildren in rural Malaysia and therefore of public health concern since PEM diminishes immune function and impairs cognitive function and educational performance. School-based programs of prevention through health education and interventions should be considered as an essential part of measures to improve the quality of life of schoolchildren in rural Malaysia.

Benzene toxicity in shoemakers and role of vitamin A [as antioxidant]

The burden of liver disease in Egypt is exceptionally high. Unquestionably, additional factors contributing to liver disease burden remain to be elucidated. Human exposure to benzene in work environment is a gbbat occupational health problem; it may represent a risk factor for hepatotoxicity, liver cancer and hematotoxicity. The present study aimed to evaluate the hazardous effects of occupational exposure to benzene on liver and blood, as well as the protective role of the antioxidant [vitamin A] on hematotoxic and hepatotoxic effects among shoemakers who exposed to benzene. Twenty hundred and fifty workers were enrolled in this study after taking an informed consent; 140 occupationally exposed workers to benzene for more than 3 years [workers group; subdivided into non-treated and treated with vitamin A], and 110 workers never occupationally exposed to benzene [control group]. The benzene urine level, complete blood counts [CBC5], the liver enzymes, and the tumor marker, alphafetoprotein [AFP] were estimated. The benzene level in urine samples was significantly increased in shoemakers group. Benzene exposed non-treated workers showed significant increase in the liver enzymes and AFP, while the CBCs were significantly lower compared with both control group and benzene exposed treated group with vitamin A. Occupational exposure to benzene found to have hazardous effects, which were reflected on CBCs, liver enzymes, and AFP. Additionally, the vitamin A was observed to be effectively potent in ameliorating the haematotoxic and hepatotoxic effects in exposed workers. Periodic medical care and CBCs in combination with urinary benzene [UB] level were recommended in benzene workers

An unceasing problem: soil-transmitted helminthiases in rural Malaysian communities.

Despite great development in socioeconomic status throughout 50 years of independence, Malaysia is still plagued with soil-transmitted helminthiases (STH). STH continue to have a significant impact on public health particularly in rural communities. In order to determine the prevalence of STH among rural Orang Asli children and to investigate the possible risk factors affecting the pattern of this prevalence, fecal samples were collected from 292 Orang Asli primary schoolchildren (145 males and 147 females) age 7-12 years, from Pos Betau, Kuala Lipis, Pahang. The samples were examined by Kato-Katz and Harada Mori techniques. Socioeconomic data were collected using pre-tested questionnaires. The overall prevalence of ascariasis, trichuriasis, and hookworm infections were 67.8, 95.5 and 13.4%, respectively. Twenty-nine point eight percent of the children had heavy trichuriasis, while 22.3% had heavy ascariasis. Sixty-seven point seven percent of the children had mixed infections. Age > 10 years (p = 0.016), no toilet in the house (p = 0.012), working mother (p = 0.040), low household income (p = 0.033), and large family size (p = 0.028) were identified as risk factors for ascariasis. Logistic regression confirmed low income, no toilet in the house and working mother as significant risk factors for ascariasis. The prevalence of STH is still very high in rural Malaysian communities. STH may also contribute to other health problems such as micronutrient deficiencies, protein-energy malnutrition and poor educational achievement. Public health personnel need to reassess current control measures and identify innovative and integrated ways in order to reduce STH significantly in rural communities.

Usefulness of molecular techniques to identify ongoing tuberculosis transmission in Saudi Arabia

This study represents the first time that molecular tracing techniques have been used to identify patterns of tuberculosis TB infection in Saudi Arabia. The 2 strains were isolated from a socio-economically advantaged family who share a number of common facilities including a car and a driver. There are several factors that may play vital roles in on-going transmission of TB in Saudi Arabia including a high number of expatriates, the Hajj pilgrimage, and the social habits of Saudi citizens. Our sibling case series is believed to be a frequent pattern of disease transmission in this country. Control measures such as health education, active case finding, and prompt and supervised medical treatment are needed. More studies using molecular techniques are recommended to find the incidence of cross infection in Saudi Arabia. In addition, molecular techniques have to be established in all reference laboratories to help the detection of ongoing active transmission, molecular epidemiology and detect sources of infection