Determinants of birth spacing among Saudi women

High fertility levels are of major concern to planners and policy makers in most countries in the developing world. In Saudi Arabia, the rale of population growth is the third highest of the countries of the Eastern Mediterranean Region. This study aimed at identifying determinants of birth spacing and attitudes toward family planning among Saudi women, A cross sectional survey of all women who lutve been married before, aged 15 -49 years attending A I Hada armed forces hospital [primary health care and antenatal care clinics], was conducted between 1[st] February 2005 and 31[st] January 2006. Data was collected on sociodemographic biological characteristics, beliefs, attitudes, and utilization of family planning services, pregnancy intervals and medical history. For the 786 women included in the study, the mean duration of interbirth interval was 2.38 +/- 1.24 years. The multivariate Cox regression revealed thai a woman's education, work status, husband's work status, a woman's history of chronic diseases, and husband's encouragement of inierbirth spacing were the only significant predictors of longer interbirth intervals. Shorter interbirth intervals were independently predicted by lower family income, and presence of female offspring only or equal number of male and female offspring as opposed to presence of more males. The great majority of participating women [98%] had a positive opinion of the effect of birth spacing on the family. This study showed that certain factors were significant predictors of interbirth spacing for the Saudi women. This should lead to the encouragement of longer intervals between births. However futher studies are needed to ascertain a cause-effect association

Depression and body image disturbances among females seeking treatment for obesity in Saudi Arabia

Obesity is an increasingly prevalent disease around the world and is becoming one of the main public health problems in developed countries. The relationship between obesity and psychological distress continued to be debated by researchers and clinicians alike. This study aimed at assessing depression and body image disturbances in obese patients seeking treatment for obesity. A case-control design was adopted in the study. A total of [236] obese women, selt-referred to a residential weight-loss facility for weight control, were invited to participate in this study. Obese women were compared with [296] of a control group [of the same age range, but with normal weight]. All participants completed the Beck Depression Inventory for depressive symptoms, Multidimensional Body-Self Relations Questionnaire for body-image satisfaction and The Body Image Avoidance Questionnaire. Results revealed that obesity was more common among older than younger females, among married than single females, and among those with lower level of education than those with higher level. Obese women as compared with non-obese reported significantly more symptoms of depression and signiticantly more negative body image

Conclusions: The present results indicate a high frequency of depressive symptoms, and concern with body image among obese patients. Therefore, obese women who seek treatment should be screened for depression and body image dissatisfaction

Association of maternal work with adverse perinatal outcome

Little information exists about the effect of work during pregnancy and adverse perinatal outcome in our country, Egypt, as a developing one. In order to investigate such relationship, 2419 women were interviewed shortly after delivery in the three main public and Health Insurance hospitals in Alexandria, Egypt during a period of 4 months. There were 730 [30.2%] working and 1689 [69.8%] non-working parturients. Detailed description of working status was analysed, along with risk profile which was compared between both groups. There was no significant association between different work characteristics and perinatal outcomes. There was an excess rate of small-for-gestational-age [SGA] and perinatal death among the non-working group, while preterm delivery was significantly increased among those who worked throughout the whole pregnancy. After adjusting for confounders, the risk of preterm delivery was no more significant [OR = 1.2 and 95% CI = 0.96 - 1.71. On the other hand, working status had a beneficial effect on SGA and perinatal death [OR = 0.41, 0.26 and 95% CI = 0.26-0.64 and 0.14-0.48, respectively]. These results cast doubt on the hazardous element of work and adverse pregnancy outcome and work per se doesn't constitute a health risk factor but may even have a positive social impact on pregnancy

Nosocomial blood stream infection in the neonatal ICU in Abha general Hospital, KSA: incidence and determinants

To determine the incidence and micro-organisms responsible for neonatal nosocomial infection and to identify the most relevant risk factors for sepsis. All neonates admitted to the Intensive care unit [ICU] during the period of one year study, between April 2002 and March 2003, were included in the study. They were followed up until discharge or death. Only infections developing after 48 hours from admission to the unit were recorded. Logistic regression analysis was performed to identify which factors were independently associated with blood stream infections. The incidence of nosocomial bloodstream infections [NBSI] was 9.1%. The major organisms were Enterobacter [39.3%] coagulase-ve staphylococci [CONS] [32.1%], while Klebseilla and E. coli constituted 17.9% and 10.7% respectively. The associated mortality from infection represented 25.8% of all deaths. The following factors were associated with sepsis: prematurity, prolonged stay in the unit, presence of intravascular catheter, and mechanical ventilation. The recognition of risk factors for nosocomial infections and responsible organisms is an important tool for identification and development of intervention to minimize the risks in NICU

prognostic value of congestion index in patients with portal hypertension due to schistosomal hepatic fibrosis with and without chronic hepatitis C: a clinico-pathological and hemodynamic study

We intended to assess the value of congestion index of portal vein [Cl PV] [derived from the ratio between the cross-sectional area of the portal vein and the mean velocity of portal flow] in assessing the severity of portal hypertension and its correlation with North Italian Endoscopic Club [NIEC] index and risk of bleeding in patients with schistosomal hepatic fibrosis with and without chronic hepatitis C. We studied 64 patients with portal hypertension who were categorized into three groups based on histological diagnosis: group I [19 with pure schistosomal hepatic fibrosis], group II [22 patients with combined schistosomal hepatic fibrosis and chronic hepatitis C] and group III [23 patients with combined schistosomal hepatic fibrosis and chronic hepatitis C with cirrhosis]. All patients were of the Child class A.They were subjected to; clinical examination, stool and serological examinations for schistosoma infection, serum transaminases and alkaline phosphatase, serum albumin, prothrombin activity and virological markers. Upper endoscopy, abdominal Ultrasonography with duplex as well as liver biopsies were performed to all patients. The results showed that the mean value of Cl PV was found to be higher in groups II [0.155 +/- 0.05] and III [0.179 +/- 0.04] than in group I [0.134 +/- 0.04], which reached a significant level only between groups III and I [P<0.05]. The mean values of NIEC index and NIEC risk of bleeding were found to be significantly higher in group III [28.5 +/- 4, 18.3 +/- 6.3] respectively than in groups I [23.6 +/- 5, 10.6 +/- 7.8] and II [23.5+4, 11+6.5] [P<0.05] with no significant difference between groups I and II. The Cl PV was found to have a significant positive correlation with the degree of fibrosis as assessed by both the sonographic and the histopathologic examinations. It was also significantly correlated with NIEC risk of bleeding. We concluded that the congestion index of portal vein is a valuable non invasive parameter in assessing the severity of portal hypertension and in predicting bleeding in schistosomal patients with and without chronic hepatitis C

Helicobacter pylori mitigates upper gastrointestinal haemorrhage: trick or truth?

Upper gastrointestinal haemorrhage [UGIH] constitutes a serious health problem arising mainly from bleeding oesophageal varices [OV] or peptic ulcer disease [PUD] in Egypt.Conflicting results concerning antagonism or synergism between Helicobacter pylori [H.pylori] and UGIH deserves paramount interest .In the present case-control study 300 patients [150 bleeders and 150 non bleeders crossly-matched for age, sex, residence and endoscopic findings] were examined clinically, endoscopically and investigated for H. pylori infection in an essay to identify the relationship of H. pylori to UGIH. OV [37.3%] followed by duodenal ulcers [DU] [26%], gastric erosions [GE] [24.7%] and gastroesophageal reflux [GOR][12%] were the causes of UGIH which yielded positive connection to each of nonsteroidal antiinflammatory drugs [NSAIDs] [33/150=22%], chronic liver disease [CLD] [86/150=57%], and HCV [39/150 =26%] [P<0.05]. Strikingly H. pylori showed only an eminent inverse association with UGIH due to PUD [Z = 2.09] and NSAIDs consumption [P<0.05]. After controlling for confounders-logistic regression analysis presented H. pylori, NSAIDs and HCV as powerful effective independent factors with significant negative impact of H. pylori on UGIH [OR = 0.4, Cl = 0.4-0.86] and a positive one of NSAIDs [OR = 2.1, Cl = 1.2-3.4] and HCV [OR = 1.6, Cl = 1.1-4.0]. In conclusion our study confirmed the principal role of OV followed by PUD in causation of UGIH in addition to the increased risk of UGIH associated with NSAIDs, HCV and CLD. On the contrary H. pylori behaved as if a protective weapon against UGIH arising only from PUD [DU and GE]. No relation was found between H. pylori and UGIH from OV. In the meanwhile ulcer-like dyspepsia [ULD] and dysmotility like dyspepsia [DLD] might be a striking clinical presentation of H.pylori infection