Health education and peer leaders'role in improving low vaccination coverage in Akre district, Kurdistan region, Iraq

The role of religious leaders in improving vaccination coverage has not been well researched. This intervention study investigated the role of a health education campaign and peer spiritual leaders in improving vaccination coverage rates in Akre district in Kurdistan region, Iraq. An information campaign was conducted in 30 villages with low vaccination coverage. The participation of peer spiritual leaders was sought in 15 villages of the Sorchi tribe known to have persistent low coverage rates.The vaccination coverage rates of DPTT, DPT2, DPT3 and measles vaccines during the post-intervention period [January to June 2007] were significantly improved [95.5%, 90.0%, 84.4% and 80.3% respectively] compared with the pre-intervention period [January to June 2006] [55.9%, 42.7%, 21.5% and 27.6% respectively]. The dropout rates of those vaccines were also significantly decreased. Vaccination in villages where spiritual leaders were involved improved significantly more than other villages

Florid Cemento-Osseous Dysplasia As A Possible Aggravating Factor In A Case Of Trigeminal Neuralgia

Differential diagnosis of orofacial pain is crucial, as the course of each process and its clinical management varies markedly. A case is illustrated here of trigeminal neuralgia in a 49-year-old Indian female whose complaint was initially diagnosed as dental pain leading to sequential extractions of her right mandibular and maxillary molars but with no pain abatement. Subsequent neurological assessment diagnosed her complaint as trigeminal neuralgia but pain remained poorly controlled even with high doses of carbamazepine and gabapentin. A dental referral and orthopantomographic examination revealed multifocal sclerotic masses in her jaws, suggestive of florid cemento-osseous dysplasia (FCOD). Right mandibular incisional biopsy confirmed the diagnosis. A decision was made to curette the right mandibular masses and lateralised the right inferior dental nerve. Follow-up disclosed considerable pain reduction. This case raises the issue as to whether the sclerotic bone masses in FCOD may have caused nerve compression which aggravated her neuralgic pain.

Plasma cholesterol and lipoproteins profile in healthy Saudi persons

to study the differences in the concentrations of plasma total cholesterol [TC], triglycerides [TG], LDL-C and HDL-C in normal healthy Saudi persons according to gender, age and lifestyle. For all tested research group the blood was drawn after an overnight fasting period [12-14hrs] using heparinized tubes. Enzymatic colorimetric method were used for analyse and the mean values and standard deviation for all parameters were obtained. The results showed lower T.C, TG and LDL-C levels through childhood group [< 1-14 years] for both sexes with no significant differences between rural and urban areas. With the exception of HDL-C, other parameters increased with increasing of age for both sexes, indicating the effect of diet and lifestyle. However, HDL-C decreases during adolescence reaching its lowest level at the age of 40 years. It remains constant up to the age of 55 years in both sexes, and then it started to rise to a constant level at later ages. This coincided with significant increase of total cholesterol, triglycerides and LDL-C that approached the dangerous levels in both city males and females above 40 years of age. This study suggests that differences in dietary habits and lifestyle were much more effective in the adult groups who lived in cities at an age above 40 years to be at risk of coronary heart disease. This was in line with the significantly higher levels of bad cholesterol and lower levels of the good one

comparison of nearby incremental ground level and in plant concentrations of air pollutants emitted from electronics facilities

Air dispersion modeling by was recently conducted to predict the incremental ground level and in-plant concentrations of toxic organic chemicals due to stack and fugitive emissions from Sama Jaya Free Industrial Zone [SJFIZ], Kuching, Sarawak, Malaysia. Simulations of organic air pollutants emitted from industrial facilities in SJFIZ from years 1996 to 2001 were carried out in September 2004 by members of Faculty of Engineering, Universiti Malaysia Sarawak [UNIMAS]. The results indicated that there were negligible amount of maximum incremental ground level concentrations of less than 3x10-2 micro g/m3 for 365-day average, and less than 18x10-2 micro g/m3 for 24 h. average. For in-plant maximum incremental concentrations, it is found that the simulated results were much lower than TWA values, except xylene. The predicted in plant concentration of xylene was 119.21 [parts per million] ppm as compared to ACGIH TLV-TWA of 100 ppm approximately 19% higher than ACGIH recommended values. From this study, it was concluded that both nearby population and in plant workers were not potentially at risk to exposing organic chemicals far lower than the threshold limit levels set by ACGIH

Study of serum electrolytes in preterm infants with RDS, on intravenous fluids, during the first 48 hours of age

Disorders in fluid and electrolyte balance are among the most commonly encountered problems in the care of preterm infants especially with RDS. The aim of this study is to assess the most important serum electrolytes [Na, K and Cl] in preterm infants with RDS, on intravenous fluids, during the first 48 hours of age. Thirty preterm infants with RDS on intravenous fluid therapy were included in this study. They were classified into 4 groups: group 1 [NBW] included 5 preterms, group 2 [LBW] included 16 preterms, group 3 [VLBW] included 5 preterms and group 4 [ELBW] included 4 preterms. All of them were subjected to full history perinatal taking, thorough clinical examination and lab investigations including serum electrolytes [serum Na, K and Cl] on admission [initial sample] and after 48 hours [follow-up sample]. The results of the study revealed that hyponatremia was more prevalent in the initial sample [50-80%] than the follow-up sample [37-60%] in all studied groups, and the percentage persisted as much as 50% in ELBW in both samples. Hyperkalemia was also present with high percentage in the initial and the follow-up samples [20-60%] in all studied groups. Hypochloremia appeared in NBW and VLBW infants in the initial sample [20% and 40% respectively], while in the F.U. sample decreased to 20% in VLBW and disappeared in NBW infants. In LBW group, there was a statistically significant increase in serum sodium in F.U. sample compared to the initial sample [P < 0.05], while there was no significant difference between serum sodium levels in both samples in the other studied groups [P > 0.05]. No significant difference was found between the initial sample and F.U. sample regarding serum potassium and chloride levels in all studied groups [P > 0.05]. In conclusion, each of prematurity and RDS by itself enhance the occurrence of electrolyte abnormalities due to many factors. So, serial F.U. measurement of S.E. since delivery till establishment of adequate oral feeding helps in early detection of S.E. abnormalities and adjustment of IVF therapy

Prevalence of neuropathic pain among patients suffering from chronic low back pain in Saudi Arabia

The aim of this study was to assess the prevalence of neuropathic pain among patients suffering from chronic low back pain using the Leeds assessment of neuropathic symptoms and signs [LANSS] pain scale. This was a pilot study collected from 10 centers in the Middle East Region, with each center enrolling 10 patients between November 2004 and January 2004. In total, 100 patients with chronic low back pain were included in the study. The LANSS clinical assessment score was used to assess the presence of neuropathic pain. Patients with score >/= 12 were considered to have neuropathic pain, while patients with score a less than 12 were considered as having nociceptive pain. We found that 41% of the chronic low back pain patients had neuropathic pain and 59% had nociceptive pain. The ability to identify neuropathic pain mechanisms should lead to individualized treatment resulting in improved pain control in this group of patients with chronic low back pain

Serum and synovial fluid levels of vascular endothelial growth factor in patients with inflammatory and degenerative arthritis

This work conducted to evaluate the clinical utility of measuring vascular endothelial growth factor [VEGF] by enzyme-linked immunosorbent assay in serum and synovial fluid [SF] samples from patients with early rheumatoid arthritis [RA], other recent-onset inflammatory arthritides, established RA and osteoarthritis [OA], as well as non-arthritic healthy controls. The study, also, investigated whether serum and SF VEGF had any relation with the standard clinical, laboratory and radiological markers of RA disease. The results showed that serum VEGF levels were elevated in patients with RA, inflammatory arthritis and OA in comparison with non-arthritic controls. Patients with recent-onset RA had the highest VEGF values both in serum and SF. In early and established RA groups, VEGF levels were higher in SF than in the serum. In the early inflammatory arthritides and the OA groups, the opposite occurred. Serum and SF VEGF were higher in active than inactive RA disease, with a positive correlation between their levels and each of ESR and disease activity grade. Moreover, values of VEGF in SF, but not in serum correlated well with the development of radiological damage in the established RA group

Effect of nutritional rickets on the gross motor development of infants

To verify the role of rickets as a cause contributing to delays in the gross motor development of Infants, Design: Case-Control Study. Setting: The study was conducted in Al-Khansa Maternity and Children's Teaching Hospital in Mosul during the period from October 1997 to September 1998. Subjects: Fifty-nine infants under the age of 2 years with rickets who attended the out-patient clinic were studied Fifty-five non rachitic sex and age matched infants were selected as controls Data on the age, sex, feeding patterns, clinical presentations and gross motor developmental assessments were evaluated. The ages of all rachitic cases were under 2 years. No sex difference was found among rachitic Infants. Most of the cases [81.3%] were exclusively breast-fed, [13.5%] were on mixed diet and [5.1%] of the cases were bottle-fed. The most common clinical presentations were bronchopneumonia [22%] and gastroenteritis [20%]. More than half of the rachitic cases [54.2%] were delayed in their gross motor development while only [5.4%] of the controls were delayed. Males showed more delay than females [P< 0.01] with a sex ratio of 1.6:1 Rickets may be an important cause for delayed gross motor development in Infants

Stature and head size of childern with nutritional rickets

To measure the strength of association of nutritional rickets with short stature and head enlargement in children. Design: Case-control study. Setting: Al-Khansa Maternity and Children's Teaching Hospital in Mosul, during the period from June to December 1998. Participants: Seventy-one children under the age of 2 years with rickets who attended the out-patients clinic formed the cases. Sixty-two age- and sex-matched children attending the same clinic due to minor illnesses but without clinical evidences of rickets were selected as controls. Main outcome measures: Data on: feeding patterns, clinical signs of rickets are collected. Supine lengths and head circumferences of the cases of rickets and controls were compared in order to measure the strength of association of exposure to rickets with the short stature and the head enlargement. Majority of rachitic cases [73.2%] were exclusively breast-fed. The commonest clinical signs of rickets were: rachitic rosary, wrist widening and frontal bossing of the head. Strong association between nutritional rickets and short stature was observed [RR: 6.2, patients P < 0.001, 95% CI 2.5-13.9]. No such association was proved between nutritional rickets and head enlargement [RR: 1.1, patients: P- NS, 95% CI 0.3-4.3]. Nutritional rickets is strongly associated with short stature, but not with head entargement

Electrophysiological and ultra structural study of nerve biopsies from cytotoxic induced peripheral neuropthy in children

Forty male children with non-Hodgkin's lymphoma [NHL] were included in this study. Their mean age was 9.83 years +/- 1.59 and disease duration was 1.68 years +/- 0.71. They were on vincristine [VCR] that was given in courses, each course for 2-4 weeks during which a single intravenous dose of VCR was given [1[1/2] mg/m[2]] for 8 courses. We had two groups of patients: The first group included 20 children who had ended their courses [8 courses]. The second group comprised 20 children who were still on treatment seven children had four courses, six children had three courses, and seven children had two courses. A control group of 10 healthy volunteers who were matched for age and sex was added. Six patients of both groups had infrequent muscle cramps. All patients of both group were neurologically free. Fifteen children of the first group and only two of the second group had evidence of denervation potentials on electromyographic [EMG] study. Also motor nerve conduction velocity [MNCV] and sensory nerve conduction velocity [SNCV] showed more delay in the first group than in the second group. The mean +/- SD of MNCV was 33.2 m. /sec. +/- 2.8 and 38.1 +/- 4.2 in both groups respectively. SNCV was 29.9 m. /sec +/- 3.1 and 43.2 +/- 5.6 in both groups respectively. Ultrastructural study of nerve biopsies showed more degeneration of the nerve axons with fibrosis as well as degenerative changes in some areas through the myelin sheath in the first group than that of the second group as compared to the normal findings in the control group