Adenotonsillectomy Operation in Children is Effective to Improve Otitis Media with Effusion

Background: OME usually present because of the associated hearing impairment, defective speech and sometimes with a preceding history of fever and otalgia consequent on an episode of acute otitis media. Objective: The aim of the study was to evaluate adenotonsillectomy operation in children is effective to improve otitis media with effusion.Material & Methods:This was a clinical study done in the otolaryngology department of medical college for women and hospital, Uttara, Dhaka from January 2003 to December 2005 for three years. Children with 4 to 15 years of age admitted with chronic tonsillitis and enlarged adenoid having otitis media with effusion were included in the study. Statistical analysis of the results was obtained by using window-based computer software devised with Statistical Packages for Social Sciences (SPSS-22).Results:All of these patients underwent adenotonsillectomy operation and were followed up for up to six months. The overall success rate of resolution of middle ear effusion was 81% at six months post operatively.Conclusions:Our findings demonstrated that adenotonsillectomy operation is effective for the treatment of persistent otitis media with effusion due to chronic tonsillitis with enlarged adenoid.

Knowledge, attitudes and practice with regard to the articles of the framework convention on tobacco control among Egyptian adults

Egypt signed the Framework Convention on Tobacco Control [FCTC] in 2003, and it was ratified by the Egyptian Parliament in February 2005. Although most of the articles of the FCTC are reflected in Egyptian law and regulations, enforcement is rare for many reasons. The aim of the study was to evaluate knowledge, attitudes and practice toward the FCTC among Egyptian adults. Cross-sectional survey with an interview questionnaire about knowledge, attitudes and practice as regards the FCTC among 2941 people from them 1584 smokers [97% men, 3% women] in two governorates of Egypt. The prevalence of smoking varied, being higher among men [97%] than women [3%] and was higher among adults under the age of 55 years. Most smokers [74%] knew that smoking by children and adolescents was not allowed, and that tobacco contains tar and nicotine, which are hazardous to health. Half of the smokers were unaware of the presence of warning signs on boxes. Most smokers knew that advertising of cigarettes is not allowed [66.8%], the media do not advocate for smoking prevention [67.8%], not enough information is given about its hazards [64.3%], and there is no media campaign against smoking [83.9%].Most smokers [62.2%] considered that there is no active strategy against smoking, and 77.3% said that there was no Government policy against smoking. Half the smokers [50.4%] thought that people in the community were not interested in smoking prevention, and medical personnel should help; 70.7% concluded that little was being done to prevent smoking. The data from this study could be used as a baseline for future evaluations of tobacco control programmes implemented by the Ministry of Health of Egypt

Fibroscan of chronic HCV patients coinfected with schistosomiasis

Both hepatitis C virus [HCV] and schistosomiasis are highly endemic in Egypt and coinfection is frequently encountered. Such coinfection is responsible for leading to a more severe liver disease. Hence, the aim of the study was to assess the fibroscan in chronic HCV patients coinfected with Schistosoma. This study included 231 chronic HCV patients. Routine pre-treatment work-up was done including anti-schistosomal antibodies. Liver stiffness measurements using fibroscan and reference needle-liver biopsy were done. Patients were categorised into two groups: HCV patients with positive schistosomal serology and HCV patients with negative schistosomal serology. Anti-schistosomal antibody was positive in 29% of the studied population. Positive schistosomal serology status was significantly associated with the disagreement between the results of liver biopsy [Metavir] and the fibroscan results [p value = 0.02], which was more obvious in F2 and F3 fibrosis stages. The sensitivity of fibroscan for the detection of the F2 stage decreased from 64% among negative schistosomal serology patients to 30.8% among positive schistosomal serology patients, and for the F3 stage it decreased from 43.8% to 21.4%, respectively. Multivariate logistic regression showed that fibrosis stages [FO-F1 and F4] were the most independent factors that were associated with the agreement between fibroscan and liver biopsy [odds ratio [OR] 3.4, 7.12 and p value <0.001, <0.001, respectively]. Although the sensitivity of fibroscan for the detection of fibrosis stages [F2 and F3] was impaired in patients with positive schistosomal serology, fibrosis stages [FO-F1 and F4] were the most independent factors associated with the agreement between fibroscan and liver biopsy

Domestic violence, unwanted pregnancy and pregnancy termination among urban women of Bangladesh

This paper explores the relationship between domestic violence against women inflicted by husbands, unwanted pregnancy and pregnancy termination of Bangladeshi urban women. The study used the nationally representative 2007 Bangladesh Demographic and Health Survey [BDHS] data. The BDHS covered a representative sample of 10,996 ever married women from rural and urban areas. The BDHS used a separate module to collect information from women regarding domestic violence. The survey gathered information of domestic violence from 1,013 urban women which are the basis of the study. Simple cross tabulation, bivariate and multivariate statistical analyses were performed to analyzing data. Overall, the lifetime prevalence of domestic violence was 47.5%. Of the most recent pregnancies, 15.6% were unwanted and 16.0% of the women terminated pregnancy in their marital life. The multivariate binary logistic regression analyses yielded quantitatively important and reliable estimate of unwanted pregnancy and pregnancy termination. The regression analyses yielded significantly [p<0.05] increased risk of unwanted pregnancy only for physical violence [OR=2.35, 95% CI=1.28-4.32] and for both physical and sexual violence [OR=2.27, 95% CI=1.02-5.28], and higher risk of pregnancy termination for only physical violence [OR=1.41, 95% CI=0.95-2.10] and for both physical and sexual violence [OR=1.81, 95% CI=1.07-3.04] than women who were never abused. Current age, higher parity and early marriage are also important determinants of unwanted pregnancy and pregnancy termination. Violence against women inflicted by husbands is commonplace in Bangladesh. Any strategy to reduce the burden of unwanted pregnancy and induced abortion should include prevention of violence against women and strengthening women's sexual and reproductive health

Socioeconomic correlates of contraceptive use among the ethnic tribal women of Bangladesh: does sex preference matter?

To examine the relationship between socioeconomic factors affecting contraceptive use among tribal women of Bangladesh with focusing on son preference over daughter. The study used data gathered through a cross sectional survey on four tribal communities resided in the Rangamati Hill District of the Chittagong Hill Tracts, Bangladesh. A multistage random sampling procedure was applied to collect data from 865 currently married women of whom 806 women were currently married, non-pregnant and had at least one living child, which are the basis of this study. The information was recorded in a pre-structured questionnaire. Simple cross tabulation, chi-square tests and logistic regression analyses were performed to analyzing data. The contraceptive prevalence rate among the study tribal women was 73%. The multivariate analyses yielded quantitatively important and reliable estimates of likelihood of contraceptive use. Findings revealed that after controlling for other variables, the likelihood of contraceptive use was found not to be significant among women with at least one son than those who had only daughters, indicating no preference of son over daughter. Multivariate logistic regression analysis suggests that home visitations by family planning workers, tribal identity, place of residence, husband's education, and type of family, television ownership, electricity connection in the household and number of times married are important determinants of any contraceptive method use among the tribal women. The contraceptive use rate among the disadvantaged tribal women was more than that of the national level. Door-step delivery services of modern methods should be reached and available targeting the poor and remote zones

Socio-economic Determinants of Severe and Moderate Stunting among Under-Five Children of Rural Bangladesh

Introduction: Malnutrition among under-five children is a chronic problem in developing countries. This study explores the socio-economic determinants of severe and moderate stunting among under-five children of rural Bangladesh. Methods: The study used data from the 2007 Bangladesh Demographic and Health Survey. Cross-sectional and multinomial logistic regression analyses were used to assess the effect of the socio-demographic variables on moderate and severe stunting over normal among the children. Results: Findings revealed that over two-fifths of the children were stunted, of which 26.3% were moderately stunted and 15.1% were severely stunted. The multivariate multinomial logistic regression analysis yielded significantly increased risk of severe stunting (OR=2.53, 95% CI=1.34-4.79) and moderate stunting (OR=2.37, 95% CI=1.47-3.83) over normal among children with a thinner mother. Region, father’s education, toilet facilities, child’s age, birth order of children and wealth index were also important determinants of children’s nutritional status. Conclusion: Development and poverty alleviation programmes should focus on the disadvantaged rural segments of people to improve their nutritional status.

Socio-economic Correlates of Malnutrition among Married Women in Bangladesh

This paper examines the prevalence and socio-economic correlates of malnutrition among ever married non-pregnant women of reproductive age of Bangladesh using a nationally representative weighted sample of 10,145. Body mass index was used to measure nutritional status. Both bivariate and multivariate statistical analyses were employed to assess the relationship between socio-economic characteristics and women’s nutritional status. Overall, 28.5% of the women were found to be underweight. The fixed effect multivariate binary logistic regression analysis yielded significantly increased risk of underweight for the young, currently working, non-Muslim, rural residents, widowed, divorced or separated women. Significant wide variations of malnourishment prevailed in the administrative regions of the country. Wealth index and women’s education were the most important determinants of underweight. The multivariate logistic regression analysis revealed that the risk of being underweight was almost seven times higher (OR=6.76, 95% CI=5.20-8.80) among women with no formal education as compared to those with higher education and the likelihood of underweight was significantly (p<0.001) 5.2 times (OR=5.23, 95% CI=4.51-6.07) in the poorest as compared to their richest counterparts. Poverty alleviation programmes should be strengthened targeting the poor. Effective policies, information and health education programmes for women are required to ensure adequate access to health services and for them to understand the components of a healthy diet.

Effects of Wealth on Nutritional Status of Pre-school Children in Bangladesh

This paper explores the relationship between household wealth and nutritional status of pre-school children in Bangladesh using the nationally representative 2007 Bangladesh Demographic and Health Survey data. Chronic malnutrition was measured by z-score of height-for-age and the effect of household wealth on adverse childhood growth rate was assessed by multivariate logistic regression analyses. Overall, 43% of the children were stunted. The multivariate binary logistic regression analysis yielded significantly increased risk of stunting among the poorest (OR=2.26, 95% CI=1.77-2.89) as compared to the richest. The multivariate multinomial logistic regression produced elevated risk of moderate stunting (OR=1.98, 95% CI=1.50-2.61) and severe stunting (OR=2.88, 95% CI=2.00-4.14) of children in the poorest category compared to their richest counterparts. Children’s age, duration of breastfeeding, mother’s education, body mass index, mother’s working status and place of region were also identified as important determinants of children’s nutritional status. The findings suggest that apart from poverty reduction, maternal education, and strengthening of child and maternal health care services are important to improve health and nutritional status of the children.

Surveillance system for HCV infection: testing a model based on blood banks

Developing a National surveillance system for hepatitis C virus infection could provide a reasonable tool for reflecting changes in the trend of the disease in the Egyptian community. The aim of the study is to develop a national sentinel surveillance system, based on blood banks, by measuring the prevalence of hepatitis C virus antibody in the sera of blood donors. The results were compared with that of the National community-based survey [NS] of the year 1997 from the areas surrounding the blood banks by age-standardized methods. Data were collected retrospectively from 3 blood banks in Cairo. The study population included 2845 consecutive blood donors from the years 1999 and 2000: 1265 [998 males and 267 females] from Mansheyat Elbakry blood bank, 986[840 males and 146 females] from El Galaa blood bank, and 594 [531 males and 63 females] from Ahmed Maher blood bank. Data collected from sheet includes personal data, blood banks serology results of HCV through testing with third generation ELISA. The over all prevalence of HCV among blood donors aged from 18-59 years was 7.6% [males 7.8%, females 6.9%] [NS=15.2%, males 15.5%, females 15.0% for the same age group]. Among different age groups the total prevalence of HCV was; 4.2% in the 18-29 years age group [NS=5.3%], 9.1% in the 30-39 age group [NS=17.9%], 19.0% in the 40-49 age group [NS=19.0%] and 20% in the 50-59 age group [NS=23%]. The prevalence of HCV is higher among replacement blood donors than those in campaign blood donors [8.9%, 3.9% respectively, OR=2.9]. It is also higher among blood donors living in rural areas than those living in urban areas [14.1%, 6.8% respectively, OR=2.3]. Age adjusted rates of HCV among the blood donors were; totally 10.6% [NS=14.7%], males 12.5% [NS=15.1%], females 8.5% [NS=14.5%]. Age and gender standardized HCV prevalence ratio [blood donors/NS] was; total ratio=0.7. Among the different age groups the ratio was; 18-29 years=0.8, 30-39 years=0.5, 40-49 years=0.9, and the 50-59 years age group=0.8. In conclusion, as a sentinel group, the total - as well as the female- population of blood donors have a lower prevalence of HCV with comparison to the National survey. However, with regards to the male population in the 18-29 years age group of blood donors, after age standardization, the rate of HCV among them is equal to that of the National survey, suggesting that male blood donors aged 18-29 years may provide an appropriate group for monitoring HCV prevalence in males of same age group in the general population

Magnetic resonance imaging in differentiation between usual and unusual cerebellopontine angle lesions

To assess the role*of MRI in differentiation between usual and unusual cerebellopontine angle [CPA] lesions.The study was conducted on 40 patients with signs and symptoms pointing to CPA lesions and subjectedto MRI examination.MRI showed usual lesions such as Schwannoma in 14 patients and meningioma in eight patients. Lessfrequent lesions include glomus tumour in five patients and chordoma in five patients. Unusual lesions such asepidermoid cyst, arachnoid cyst, ependymoma, medulloblastoma, expophytic glioma, papillary adenocarcinoma ofendolymphatic sac, metastatic adenocarcinoma and atherosclerotic basilar artery in one patient for each entity.MRI could differentiate between usual and unusual lesions by proper identification of the site, extentand signal characteristic of each lesion

trend of maternal mortalities in Egypt from 1990 to 2000, impact of maternal health services

The safe motherhood initiative was launched by WHO 1987 as a global effort with the target of reducing maternal mortality and morbidity by fifty percent by the year 2000. Despite this progress, pregnancy related deaths remain a significant public health issue, because one third to one half of pregnancy related deaths are considered preventable. Also, it was estimated that the highest risk occurs in Africa with 40% of the world maternal deaths. So the aim of this work is to study changes in the maternal mortality ratio and its underlying causes over the last ten years in Egypt Also, to study the effect of family planning services on such trend by examining some impact and process indicators. Data about maternal deaths, demographic data, fertility data and maternal health services were collected from official sources for the period from 1990-2000. Maternal Mortality Ratio [MMR], Proportionate Maternal Mortality Rate [PMM] and cause specific maternal mortality ratio were also calculated. The result of the study revealed that there was a continuous declining trend of all studied ratios and haemorrhage was the leading contributor to maternal mortality in Egypt through the studied period account for more than 50% of maternal deaths. As regard the trend of some maternal health care facilities provided by ministry of health and population [MOH and P], there was an increase in the trend over the studied years. The number of family planning units had also increased. There was a steady decline trend in the early 1990s of both Total Fertility Rate [TFR] and age specific fertility rates, while in late 1990s the trend was more or less raising. The trend of early pregnancy showed slight increase while at the same time the trend of late pregnancy showed slight decrease. So we can say that the health policy in Egypt was in line with the global health policy which aimed to achieve health for all the year 2000. The study also concluded that the maternal mortality ratios in Egypt decreased during the study period 1990-2000 which coincided with the increase in health services particularly those related to mothers

Defective monocyte phagocytic function as a possible genetic marker for heumatic susceptibility

The activity of the monocyte phagocytic system in children with rheumatic heart disease [RHD], their parents, their normal siblings and in nonrheumatic families was investigated. Phagocytic activity of isolated monocytes was assessed using luminol-dependent chemiluminescence. The count per minute of emitted light was measured before and after stimulation with zymosan solution. The results indicate that one-third of the siblings of children with RHD were genetically free while two-thirds, as well as the parents, were heterozygous, and that children with RHD were homozygous for [a] mutant gene[s] responsible for the defective function of the monocyte phagocytic system. The findings are strongly suggestive of autosomal recessive inheritance

Study of serum magnesium level in patients with ventricular dysrhythmia after AMI

Forty patients were divided into two groups each of which consisted of 20 patients. Patients of the first group suffered from acute MI without ventricular dysrhythmia during the observation period. The second group consisted of 20 patients who had acute MI complicated by different types of ventricular dysrhythmias. Both groups were subjected to thorough clinical examination with evaluation of the serum cardiac enzymes blood urea, serum creatinine, serum potassium and serum magnesium. A resting E.C.G was done to every patient and showed changes of acute M I. The serum Mg was estimated by the atomic absorption spectrophotometry method. The serum Mg level in the group of patients with acute M.I. and ventricular dysrhythmia [the 2nd group] was less than that of the 1 st group but the difference was insignificant. There was no correlation between the level of serum Mg and the type of ventricular dysrhythmia i.e. bigeminy; trigeminy or ventricular tachycardia.This study showed that although the serum Mg level in patients who developed ventricular dysrhythmia during course of AMI was normal. The prevelance of that dysrhythmias were more in those patients [25% versus 5%] who had low normal serum Mg level it was perviously mentioned that the intracellualr Mg level is a more specific parameter than the serum Mg level to determine depletion of Mg from the body

Abnormal zinc metabolism in diabetes mellitus type II

This study included 20 adult patients with type II diabetes mellitus and 10 normal controls. We estimated serum glucose and zinc [Fasting and at 60, 120, 180 minutes after oral ingestion of gelatin capsule containing 25 mg zinc sulfate], serum creatinine, creatinine clearance, urine volume/ 24 hours and its contents of zinc, glucose and protein. We found that all patients had diminished serum zinc concentrations, and all demonstrated hyperzincuria as compared to the control group. Urinary loss was greater when proteinuria was present. Studies of gastrointestinal zinc absorption suggested zinc mal-absorption in patients with type II diabetes mellitus. Glucose metabolism was improved by zinc supplementation. It is concluded that zinc deficiency in our diabetics may be due to malabsorption of zinc, hyperzincuria, or both. We also concluded that glucose metabolism was improved by addition of zinc