Adenopathies cervicales metastatiques d'un carcinome non retrouve

Introduction : Les adenopathies cervicales metastatiques d'un carcinome non retrouve representaient 3 a 5 des cancers de la tete et du cou. Cette entite pose un probleme de prise en charge. But : Soulever les difficultes diagnostiques et therapeutiques et degager les principaux facteurs pronostiques regissant le controle local de la pathologie et surtout la survie. Materiels et methodes: Cette etude retrospective a ete portee sur une serie de 80 cas d'adenopathies cervicales metastatiques primitives colliges entre 1980 et 2007. Resultats : Tous les malades ont eu un examen clinique complet; une panendoscopie des VADS avec des biopsies systematiques. Une cytoponction a l'aiguille fine a ete realisee chez 65 de nos malades. Tous les patients ont eu une cervicotomie avec examen histologique. Le carcinome epidermoide etait retrouve dans 70 des cas; alors que 11 des malades avaient un adenocarcinome et 1;5 avaient un melanome. La chirurgie a ete indiquee pour 25 malades. Une radiotherapie post operatoire aete appliquee pour 21 malades. Le protocole associant a la radiotherapie; une chimiotherapie neo adjuvante etait indique chez 27 malades. La survie globale moyenne etait de 2;5 ans. Conclusion : Le pronostic etait significativement aggrave par : l'age superieur a 65 ans; le stade N3 et l'envahissement ganglionnaire avec rupture capsulaire

Carcinome epidermoide du larynx chez la femme

Le cancer du larynx est assez rare chez la femme. Cependant; il risque d'etre en recrudescence a cause de l'augmentation du tabagisme feminin. Peu de travaux se sont consacres a rechercher les specificites du cancer du larynx chez la femme. But: Analyser le profil epidemiologique et clinique des femmes porteuses d'un carcinome epidermoide du larynx et degager les caracteristiques therapeutiques; evolutives et les facteurs pronostiques chez cette population. Methodes: etude retrospective portant sur 50 femmes prises en charge pour un carcinome epidermoide du larynx sur une periode de treize ans (1994-2006). Resultats : L'age moyen de nos patientes etait de 63;5 ans. L'intoxication tabagique etait retrouvee chez 32;6 des patientes. Chez 30 de nos patientes aucun facteur de risque n'a ete retrouve. Les signes cliniques etaient domines par la dysphonie suivie de la dyspnee et la dysphagie. Les tumeurs prenaient naissanceau depend de l'etage glottique dans 55;8 des cas. Nous avons releve que 60;4 des tumeurs etaient vus a un stade evolue T3-T4 et que 95;3des tumeurs etaient initialement classees N0. La chirurgie a ete pratiquee chez 47;5 des patientes tandis que 16;2 ont recu une radio-chimiotherapie. La survie globale cumulee etait de 78;8 a 3 ans et de 73;5 a 5 ans. Conclusion : L'absence des facteurs de risque classiques chez un grand nombre de nos patientes laisse supposer le role d'autres facteurs etiopathogeniques dans la genese du cancer du larynx chez la femme. Toute dysphonie chez la femme doit etre exploree meme en l'absence de facteurs de risque. La prise en charge et le pronostic semblent superposables a celui de l'homme

Prise en charge des cancers primitifs des glandes submandibulaires

Introduction :Les tumeurs malignes de la glande submandibulaire se caracterisent par une grande diversite histologique. de ce travail est de rapporter notre experience dans la prise en charge de ces tumeurs et de suggerer une attitude therapeutique apres revue de la litterature. Patients et methode : Il s'agit d'une etude retrospective a propos de 20 patients colliges sur 17 ans. La decision therapeutique etait prise au sein d'un comite multidisciplinaire. Les moyens therapeutiques etaient la chirurgie tumorale et ganglionnaire; la radiotherapie et la chimiotherapie. Les pieces operatoires ont ete adressees pour examen anatomopathologique extemporane et definitif. Une surveillance clinique et radiologique a ete realisee. Le recul moyen etait de 35 mois. Resultats: L'age moyen etait de 60;75 ans. Le delai moyen de consultation etait de 6;15 mois. La tumefaction submandibulaire etait le motif de consultation chez tous les patients. Des adenopathies cervicales etaient notees chez 8 patients (40). Seize patients avaient beneficie d'une tomodensitometrie cervicale et du massif facial et un autre d'une Irm. La radiographie du thorax montrait un aspect de lacher de ballon chez un patient et une opacite mediastinale chez un autre. L'abstention chirurgicale avait ete decidee pour 2 patients. Les patients metastatiques ont ete operes uniquement dans un but diagnostique. Dix-huit patients (85) ont eu une submandibulectomie; dont une elargie a la mandibule. Pour le geste ganglionnaire; 11 patients ont eu un curage selectif triangulaire et 3 un curage fonctionnel complet. Une radiotherapie postoperatoire a ete realisee chez 14 patients (70). Une radiotherapie palliative isolee a ete realisee chez 2 patients. Une chimiotherapie palliative a ete indiquee chez les 2 patients presentant des metastases a distance lors du diagnostic; mais n'a ete administree que dans un cas. La remission complete etait notee dans 11 cas (55). Un seul patient avait presente une poursuite evolutive. Une recidive loco-regionale avait ete decelee chez 2 patients. Deux patients avaient developpe secondairement des metastases a distance. Le taux de mortalite dans notre serie etait de 25. Conclusion: Les cancers de la glande submandibulaire representent une pathologie peu frequente. Le diagnostic a grandement beneficie de l'apport de l'imagerie. La strategie therapeutique depend du stade tumoral au moment du diagnostic et de l'etat general du patient. Le pronostic de ces tumeurs reste toujours reserve; surtout pour les tumeurs de haut grade diagnostiquees a un stade avance

Shisha smoking: knowledge and perception among male medical university students in dammam city, Saudi Arabia

There is growing evidence that tobacco use other than cigarettes is spreading across all world regions. Few reports have been published about shisha smoking among university students. It is important that medical students, the future medical practitioners, have adequate knowledge of smoking-related diseases and skills in smoking cessation. Was to assess the level of knowledge about shisha smoking and to identify behaviors and perceptions concerning shisha smoking among male medical students at University of Dammma, Eastern Province, Saudi Arabia. This was a cross-sectional study conducted at University of Dammma, among male medical students of the three Colleges namely, Medicine, Applied Medical Sciences, and Dentistry. A total of 371 students were included in the study. Data were collected through an interviewer-administered questionnaire pertaining to the following: socio-demographic characteristics, prevalence of shisha smoking, knowledge about hazardous effects of shisha and students' perceptions concerning reasons of initiation, continuation and future plans of shisha smoking. Descriptive statistics and Chi-square test were used for statistical analysis. The majority of students were Saudis [98.8%] and single [97.8%]. The overall knowledge score about the adverse health consequences of shisha smoking showed that 21.6% had poor knowledge and 78.4% had good knowledge. The students of college of Medicine [85.3%] had better knowledge than Applied Medical Sciences [71.6%] and Dentistry [60.8%] college students, [P<0.001]. Poor knowledge about shisha smoking was found among 28.0% of first level students in comparison with 18.2% and 15.7% second and third level students consecutively, [P=<0.05]. About 57.4% of shisha smokers were thinking of quitting smoking, while the remaining 42.6% were not thinking or had no future plans to quit smoking. There is unsatisfactory level of knowledge ajboylh shisha smoking hazards among male university students in medical colleages with poor intention to quit

Water pipe [shisha] smoking among male students of medical colleges in the eastern region of Saudi Arabia

Shisha smoking, one of the commonest methods of smoking tobacco among Arabs, increases the risk of cardiovascular and respiratory diseases. The objective of this study was to determine the prevalence of shisha smoking among male students of three colleges and to identify factors associated with shisha smoking. This cross-sectional study included 500 male students of three colleges [medicine, applied medical sciences and dentistry]. Data were collected from 371 students using a self-administered questionnaire. The overall prevalence of shisha smoking was 12.6% [8.6% shisha only and 4.0% both shisha and cigarettes]. Thirty students [63.8%] started shisha smoking at ages of 16 to 18 years. Seven students [15%] smoked shisha daily. Cafes or restaurants were the favorite places for smoking [70.2% of students]. There was a high prevalence of shisha smoking among students whose mothers had a secondary [19.1%] and higher [53.3%] education. There was a high prevalence of shisha smoking among university students. The majority of students started shisha smoking at a young age. Public health measures, including the banning of smoking in public places are recommended

Knowledge of diabetes risk factors and preventive measures among attendees of a primary care center in eastern Saudi Arabia

Few studies have been conducted in Saudi Arabia to assess the level of awareness and knowledge of the population about diabetes mellitus [DM] risk factors and preventative meassures. The objective of this study was to measure this knowledge among attendees of a primary care center in eastern Saudi Arabia. A sample of 300 male and female Saudis aged 18 years and older from the catchment area of the Aqrabya Primary Care Center were randomly selected for this cross-sectional survey. Data were collected through a structured face-to-face interview using a pre-piloted Arabic instrument. Regression analysis was used to identify the predictors of knowledge. The 288 participants interviewed included 100 males and 188 females. The mean [SD] age was 44.7 [12.6] years for males and 33.8 [12.4] years for females. Fewer than 50% of participants knew about DM risk factors and preventive measures. In a regression model that included age, sex and education, education had a statistically significant positive association with knowledge of risk factors [odds ratio 12.5, 95% CI 6.26-25.2, P < .001] and preventive measures [odds ratio 7.6, 95% CI 4.01-14.2, P < .001], and age had a statistically significcant negative association with knowledge of DM risk factors [odds ratio 0.377, 95% CI 0.207-0.685, P = .001] and prevention [odds ratio 0.407, 95% CI 0.231-0.717, P = .001]. The main risk factor stated by participants was obesity [35.8%], while the main preventive measure mentioned was weight reduction [37.9%]. Attendees had poor knowledge of DM risk factors and preventive measures. The level of educattion and age were important predictors of knowledge. Programs for health education of the community about DM risk factors and preventive measures are needed

Avian flu: knowledge of primary health care centers attendees in Al-Khobar City, Eastern Saudi Arabia

Avian influenza is considered as a global health problem. Knowledge of the people about avian flu is important to implement different prevention and control measures and to raise the level of their awareness. Aim of the study was to assess the level of knowledge about avian flu among Primary Health Care Centers [PHCCs] attendees, and to determine possible associations between knowledge and some socio-demographic characteristics. This was a cross-sectional study conducted in two randomly selected PHCCs in Al-Khobar city, Kingdom of Saudi Arabia [KSA] during 2009. The total sample size was 1420 persons. Data collection was accomplished through using an interviewer-administered questionnaire which was composed of 2 knowledge score was divided into 2 equal categories: poor and good knowledge. Descriptive statistics, Chi-square test and stepwise logistic regression analysis were used. The majority of the attendees were Saudis [89.4%], of young age [15<30 years] [56.2%] and were married [50.8%]. About 41.5% were unemployed, and 42.7% had university or higher education. About three quarters [74.4%] of the PHCCs attendees had good level of knowledge and only 25.6% had poor knowledge regarding avian flu. The stepwise logistic regression analysis showed that the following factors were found to be independently significantly associated with increased level of knowledge: male gender [OR=1.44, CI=1.098- 1.890], higher level of education [OR=1.7, 95% CI=1,439-2.009] and younger age [OR=1.546, 95% CI= 1.257-1.902]. PHCCs were mentioned by only 2.9% of the attendees as a source of information about avian influenza. Although the majority of PHCCs attendees had good knowledge about avian flu, yet more efforts are needed to give priority to those who had poor knowledge [females, lower educational level, low monthly income and elderly people]. Health messages should be designed in a way that they could be understood by all people using all available channels. PHCCs should have more roles in educating the public about avian flu

Health-related quality of life in type 2 diabetic patients

Health-related quality of life [HRQOL] is an important health outcome, representing one of the most important goals of all health interventions. The objectives of this study were to determine HRQOL and the factors affecting it in type 2 diabetic patients. This cross-sectional study was conducted in five primary health care [PHC] centers in the Al-Khobar area. From a random sample of 225 type 2 diabetic patients, 216 patients were included in the study along with 216 age-, sex- and nationality-matched controls. Nine patients refused to participate. Type 2 diabetic patients and controls were interviewed with the translated Arabic SF-12 questionnaire. The mean ages were 50.0 +/- 10.0 years for cases and of 49.3 +/- 10.3 years for controls [P=.526]. Type 2 diabetic patients had lower socioeconomic status and educational level than controls. Obesity was significantly higher in diabetics than controls. HRQOL in type 2 diabetic patients was significantly lower than controls. The mean physical component score was 41.3 +/- 8.9 for cases vs. 47.5 +/- 9.5 for controls [P<.001], and the mean menttal component score 47.8 +/- 9.1 in cases vs. 51.5 +/- 9.4 in controls [P<.001]. HRQOL was significantly lower in females than males [P<.001]. HRQOL was impaired in uncontrolled patients [fasting plasma glucose [FPG]>130 mg/dL] in comparison with controlled patients [FPG?130 mg/dL] [P<.05]. HRQOL was lower in type 2 diabetic patients than controls and was affected by many factors. Females had lower HRQOL than males, possibly because of a higher incidence of obesity. Uncontrolled diabetic patients had a lower HRQOL than controlled diabetics. Improving HRQOL in diabbetic patients is important

Attention deficit hyperactivity disorder [ADHD]: Is it a health problem among male primary school children

The aim of this study was to determine the prevalence of Attention Deficit Hyperactivity Disorder [ADHD] among male primary school children. Cross-sectional study. Male primary schools, Dammam, Saudi Arabia. One thousand two hundred and eighty-seven students, aged 6-13 years, in 67 government and 10 private primary schools were selected by multistage systematic random sampling. Data were collected using two types of questionnaires: the modified Arabic version of the Attention Deficit Disorders Evaluation Scale [ADDES] school version, and Parents' questionnaire to diagnose the three main subtypes of ADHD namely: inattention, hyperactivity-impulsivity, and combined ADHD. It was found that the majority of the boys were from government schools [83.0%], aged 6-<9 years [40.5%] and of Saudi nationality [80.7%]. One thousand two hundred and sixty-eight out of 1287 completed all parts of the questionnaire concerned with diagnosing all the three types of ADHD. The overall prevalence of combined ADHD was 16.4% [208], 12.4% [157] hyperactivity-impulsivity and 16.3% [207] inattention disorders respectively. The study also revealed a variety of socioeconomic factors to be significantly associated with the development of ADHD. These included parents' low level of education, mother's occupation, and low socioeconomic status. In this study, the overall prevalence of ADHD was higher than previous studies in Saudi population. ADHD prevention and control should be an integral part of the primary health care [family medicine] system. Education and training programs for parents, school teachers, and caregivers regarding different aspects of ADHD should be established

Knowledge and attitudes of female school students on medications in eastern Saudi Arabia

To assess the knowledge and attitude of female students on medications in Al-Khobar city, the eastern province of the Kingdom of Saudi Arabia [KSA]. The target population consisted of the third-grade intermediate, and all the 3 grades of secondary school female students in the Al-Khobar area, KSA. A multistage stratified sampling design was adopted at the end of 2001. At the first stage, 13 schools were selected, of which classes were selected in each level using a simple random sampling design. All students in the selected classes were included in the study. The total number of selected students was 1331 females. The mean age of students was 16.1 +/- 1.7 years. Students from the government schools constituted 72.8%. Two-thirds of the students were in the secondary school grade. The Saudi single students constitute the majority. The study shows that self-administration of medications by female students was highly prevalent. Thirty-eight percent of the students have used over-the-counter [OTC] medications. Only 153 [11.5%] of the students used medications under medical supervision. Paracetamol was used as a painkiller during menstruation by a high proportion [576 students, 43.3%], while 43.5% used antibiotics during the previous year. Television was the main source of knowledge on medications and health. Age and knowledge of medication's side effects were the main variables found to be significantly associated with the use of antibiotics and OTC medications. Self-administration of medication was widespread among adolescent girls. There is an immediate need to better understand, and improve the knowledge and medications usage in the schools

Self-reported knowledge and pattern of physical activity among male school students and their teachers in Al Khobar, Saudi Arabia

The aim of this study was to determine self-reported knowledge and practice of physical activity among male school students and their teachers in Al Khobar, Saudi Arabia. This was a cross-sectional study conducted in the Al Khobar area, Eastern Province of Saudi Arabia. The target population consisted of third grade intermediate and all three grades of male secondary school students. A multistage stratified self-weighting sampling design was adopted. All students, a total of 1240, in the selected classes as well as their teachers [142] in the selected schools were included in the sample. Two sets of self-administered questionnaires were used: one for male students and the other for teachers. The questionnaire contained demographic data and data on knowledge and practice of physical activity. The majority of male students knew that physical activity was protective against diseases in general [[92.8%] and was helpful in the prevention of obesity [74.4%]. Teachers had significantly better knowledge about the benefits of physical activity. Both students and teachers had poor knowledge about the role of physical activity in the prevention of diabetes mellitus and hypertension [36.6% and 28.8% for students vs. 43.0% and 46.5% for teachers respectively]. The frequency and duration of practice of effective physical activity were significantly better than their teachers [45.6% and 71.3% for students vs. 23.1% and 36.6% for teachers respectively]. Age and the knowledge that exercise protects from obesity were the main determinants of practice of physical activity among male students. Youthfulness was statistically significantly associated with practice of physical activity. Teachers had significantly better knowledge about the benefits of physical activity than their students. Both students and teachers had poor knowledge about the role of physical activity in the prevention of diabetes mellitus and hypertension. Health education should concentrate on clarifying this area. Students practiced effective physical activity significantly more than their teachers. Programs to increase regular physical activity were suggested

Quality of life in a sample of hypertensive patients attending primary health care facilities in Al-Khobar, Saudi Arabia

Hypertension is one of the most prevalent chronic conditions in Saudi Arabia. It is the leading risk factor for cardiovascular diseases and a major reason for visits to clinic and prescription of medications. Inspite of this, the degree of its control is not to the optimum. This could be due to its impact on patients' quality of life [QOL]. Impaired physical and psychological well-being may lead to noncompliance or ever, the withdrawal of treatment. The aim of this study was to assess QOL of hypertensive patients registered in Al-Khobar. The QOL of hypertensive patients was compared with QOL of a control group. A total of 404 subjects [202 cases and 202 controls] were interviewed. The cases and controls were matched for age and sex. Patients' self-assessment of QOL was measured with an Arabic version of SF-36, a 35-item Short Form Health, Survey Questionnaire encompassing two main dimensions, physical and mental. The QOL of hypertensive patients was substantially impaired in comparison to the control group. The mean scores for the physical component summary scale [PCS] were 39.3 and 50.8 for cases and controls respectively. The mean scores for the mental component summary scale [MCS] were 43.7 and 50.8 for cases and controls respectively. The burden of hypertension was concentrated in the physical dimension of health. Older age, female gender, unmarried patients, patients with hypertension complications, comorbid DM use of Aldomet and shorter duration of hypertension were independently related to poorer QOL. The variability of the two summary measures explained by selected demographic and clinical characteristics was 24.3% and 10% for the PCS and MCS respectively. Conclusions and recommendations: The QOL of hypertensive patients was substantially unpaired in comparison to the control group. Notably, the total explained variation of QOL by the selected characteristics was small, suggesting that the determinants of QOL are multi-factorial. Further research to explore the determinants and indices of QOL in hypertensive patients is warranted. From a clinical perspective, QOL should be considered in the monitoring of hypertensive patients to estimate the burden of hypertension and monitor their outcome

Maternity care and nutrition in a rural area of bangladesh: a household surgery

Determine knowledge, attitude and practice of mothers about maternity care and nutrition during pregnancy and lactation and knowledge and practice of traditional birth attendants about obstetric care. Research Design and Cross-sectional household survey. All households in which there was a child 12 months of age or below in three villages were included. Seventy-six mothers and twelve traditional birth attendants were interviewed using standard questionnaires. Setting: Palongkhali Union, a rural area in Cox's Bazar District, Bangladesh. The majority of mothers [92.1%] did not visit a health worker during their last pregnancy. Mothers had false beliefs about food, such as fish and eggs during pregnancy and lactation. Although traditional birth attendants attended the majority of deliveries [77.6%], their knowledge and training about maternity care were inadequate. Mothers of Palongkhali Union had poor knowledge and false beliefs about food and nutrition during pregnancy and lactation. Health care and services for pregnant mothers were inadequate. Knowledge and attitudes of traditional birth attendants about maternity care were poor. Improvement of maternal and child health services and appropriate training of traditional birth attendants are needed

Pilot study of the risk factors for coronary heart disease in Sudanese subjects

Results of a detailed case-control study of the risk factors for coronary heart disease [CHD] in 63 Sudanese subjects [32 patients and 31 age- and sex-matched controls], showed that comparing to patients and controls only diabetes mellitus, hyperuricaemia and possibly family history of CHD were significantly more common in patients. A marginally significant difference was noted in hypertension, total serum cholesterol and low density lipoproteins. No significant difference in triglycerides level, obesity [Quetelet's Index], cigarette smoking, alcohol consumption and psychological factors [short type A scale] was found. Interestingly, none of the patients had a raised total Cholesterol or triglyceride level. Reassuringly, more than half of the smokers in both patients and controls smoked less than 20 cigarettes per day. From available data regarding the major risk factors of CHD probably the glucose/CHD relationship is particularly strong in the Sudanese. Otherwise it is possible that risk-factors for CHD in Sudan are not the same as those in the developed countries. However, monitoring of more individuals is needed fully to elucidate the situation