Health habits and behaviour of adolescent school children, Taif, Saudi Arabia

The aim of this study was to provide data regarding habits, behavior, problems and needs regarding health in adolescent children from a military community at Al Hada and Taif, Saudi Arabia which could guide school health programmes. We carried out a cross-sectional study on 284 preparatory and secondary school students. Prevalence of smoking was 21.3% among males and 4.9% among females. The rate of overweight was 20.8%. Driving without a license was reported by 68.8% of students, and 82.3% said they didn't fasten seat belts. However, we recorded a high rate of physical activity, 75.0% overall

National health research system mapping in 10 Eastern Mediterranean countries

Health research systems in the Eastern Mediterranean Region are not well developed to generate and use knowledge to improve health, reduce inequity and contribute to economic development. This study aimed to provide core data on National Health Research Systems [NHRS] in 10 Eastern Mediterranean countries in order to inform actions to strengthen health research system governance and management. Whilst there were examples of good practice, few countries had a formal NHRS and many basic building blocks needed for an effective system had not been put in place. Although limited in focus, the study provides useful information for countries to initiate action to strengthen their NHRS

Assessment of laboratory services in PHC units and first referral level hospitals in 5 governorates, Egypt 2002

Parallel to the development in the promotive, preventive; curative services in primary health care are expected to achieve more specially with the concomitant implementation of the referral system and family health record. Aim of this study is to assess the laboratory services in PHC and district hospitals and to evaluate the referral link as regards laboratory services between the two levels. This was across sectional descriptive study during 2002. In this study, all laboratories either in PHC units or hospitals in the five districts assigned for the Health System Upgrading Project II. A pre-designed pre-tested questionnaire form including data about the laboratory workers, their qualifications, and training experience. In addition, data about laboratory basic sanitary requirements, equipments, supplies and its logistics was collected. Referral system between the two levels will be investigated among a sub-sample of PHC laboratory in each district to explore the aspects of strengths and weakness if it is actually exists. Manpower was mainly laboratory technicians who were evenly distributed in different districts. The 2[nd] majority was assistant laboratory technician and they were mainly in Dyrute and Somosta [upper Egypt] 51/62 [82.3%]. Unqualified laboratory worker comes third. Doctors were only 8, and there was one District hospital [somosta] laboratory without a clinical pathologist. Although the mean duration of work as a laboratory Personnel was 13.3 +/- 9.6 years for PHC workers and 11.9 +/- 9.5 years for hospital laboratory personnel, the percentage of those not attending any training course was 54.2% [116/214]. A declining percentage for attending one course, two courses and three courses among PHC personnel and still lower of hospital personnel. Basic sanitary needs: were almost satisfactory except for few PHC units in Dyrute and kantara Gharb. Laboratory equipment and laboratory materials: PHC laboratory and hospital laboratory are generally satisfactory. Some vital equipment are deficient in some hospitals. The need for maintenance besides is vital training of available personnel to use such equipment. Materials for its proper utilization are essential. Needs for redistribution of some materials between hospital laboratories is recommended. Laboratory registration forms: Registration book is the only format we can consider satisfactory. Other format is either not available or available and neglected in some PHC and Hospital lab. The need for maintenance is vital, training of available personnel to use such equipment. Materials for its utilization are essential. Need for redistribution of some materials between hospital laboratories is recommended. Foundation for referral link is vital

Anemia and nutritional status of schoolchildren living at Saudi high altitude area

To estimate the prevalence and possible risk factors for anemia and abnormal anthropometric measurements among schoolchildren in Al-Hada Area, Taif, Kingdom of Saudi Arabia. We conducted the study between January and April, 2005 at Al-Hada area. A nested case-control study was conducted to estimate risk factors for anemia and abnormal anthropometric measurements. From 5 schools, 513 students were recruited. The mean hemoglobin concentration was 13.4 +/- 0.9 g/dL, while the prevalence of anemia was 11.6% and 15.5% based on hemoglobin and hematocrit values. At the same time, underweight affected 14.2% of the students, and stunting affected 12.2%. Moreover, 9.8% of the students were obese and 13.8% suffered from wasting. Most of the victims of anemia and erroneous anthropometric measurements were females, except for wasting which was more prevalent among males. Anemia is highly prevalent among these schoolchildren, which is seriously affecting the growth of 6-14 year-old children. Similarly, malnutrition seems to be a significant health problem among those children as estimated by anthropometric measurements, where all forms of abnormal body measurements affected at least 9.8% of the studied group. An in-depth investigation of the etiological factors of iron deficiency and malnutrition is urgently needed, and suitable nutrition-education and iron supplementation programs are recommended

Ropivacaine 0.5 percents versus levobupivacaine 0.5 percents for bilateral paravertebral block for anterior abdominal wall hernias repair in hepatic insufficiency patients

In this study, the efficacy of BPVB via a catheter technique was prospectively compared with the use of two different local anesthetics, ropivacaine 0.5% and levobupivacaine 0.5%, for midline hernias in hepatic insufficiency patients due to schistosomal and non- schistosomal etiology. Thirty-four patients were randomly allocated into two groups to receive BPVB either with ropivacaine 0.5% or levobupivacaine 0.5%. The variables of efficacy were the postoperative pain measured on a visual analog scale, postoperative nausea and vomiting [PONV], recovery time and the patient satisfaction. The postoperative pain visual analogue scale scores in groups I and II were comparable in the postoperative period. In both groups, PONV was nearly absent. There was no difference in the recovery time. Patient satisfaction was similar in both groups. There was one inadvertent epidural block and one inadvertent pleural puncture in group II. Meanwhile, BPVB resulted in a good postoperative pain relief with a low incidence of PONV considering that the technique has a minimal complication rate

Clinical prognostic factors in patients with advanced stage of prostate cancer

Objectives: To determine the prognostic factors that could predict patient outcome in patients with advanced stage prostate cancer

Patients and Methods: In this study we retrospectively evaluated the medical record data of 222 patients with advanced stage prostate cancer treated by hormonal therapy [either castration or total androgen blockade [TAB]]. All pre- and post- treatment data records were evaluated with respect to patient age, prostate and tumor size, tumor grade, stage, PSA, alkaline and acid phosphatase and the number of bone lesions. The response to the hormonal treatment was evaluated either early [12 months after treatment] or late [over all follow-up visits until the last visit or death]. Descriptive statistics, student T test, multivariate and Kaplan Meier's curve were used for data analysis

Results: Within 12 months of treatment 70% of the cases showed an improvement with a significant decrease of their pre-treatment values after hormonal therapy. Patient age, tumor stage, the number of bone lesions, serum alkaline and acid phosphatase levels in the pre-treatment data were significantly independent predictors of the overall survival outcome [p= 0.0015, 0.002, 0.001, 0.0002 and 0.028, respectively], while the pre-treatment PSA serum level, tumor grade and the type of hormonal treatment used [either castration or TAB] were no predictors of patient outcome [p= 0.18, 0.82 and 0.47, respectively]. Importantly, the PSA serum level and the number of bone lesions in the first 12 months of patient follow-up were significant predictors of the overall disease survival status [p=0.001 and 0.028, respectively]. The mean follow-up period of alive cases was 39.42 months ranging from 6 - 171 months. Of the 222 cases 110 [51.6%] had overall disease progression during a mean of 59.4 months, while mortality was reported in 118 cases [53.2%] in the course of a mean of 59.9 months

Conclusion: The pre-treatment patient age, tumor stage, serum alkaline and acid phosphatase, as well as the post-treatment PSA level and the number of bone lesions were significant independent predictors of the overall patient outcome in patients with advanced stage prostate cancer. However, a survival analysis in relation to the treatment type did not reveal a statistically significant difference between the outcomes of castration and TAB

Skin bridge a new operation for coronal urethrocutaneous fistula [Al Gyoushy operation]

To evaluate our novel reconstructive technique to solve the problems of coronal and juxta-coronal penile fistula. Eleven patients 5 to 22 years old [mean age 14 years] underwent one stage skin bridge operation for repair of coronal urethrocutaneous fistula of different etiologies between 1998 and 2002.The size of fistula ranged from 4 to 20 mm in maximum diameter. Result of follow up revealed that nine of 11 patients [82%] had complete healing with good urine stream. One patient developed small fistula and was treated by simple closure while another patient failed due to graft infection. One stage Skin bridge operation is a highly successful option for repairing coronal urethrocutaneous fistulae even recurrent ones, whatever their etiology and size

Outcomes of pregnancies complicated by early vaginal bleeding

The association between early gestational bleeding and suboptimal pregnancy outcome was examined. Postpartum women were interviewed during January-October 1998 at the two main obstetric hospitals in Alexandria, Egypt. Of 1503 singleton deliveries, 10.6% reported bleeding; 63.5% and 36.5% during first and second trimesters respectively. Bleeding was more frequent among women of age >33 years, with history of low-birth-weight babies or previous miscarriage. Suboptimal outcomes occurred more often among women reporting bleeding than among those who never bled and the risk of such outcomes significantly increased with second trimester bleeding. Risk of a low-birth-weight baby, preterm delivery and perinatal death significantly decreased with increasing interpregnancy interval for women with first trimester or second trimester bleeding

Investigation of the free sugars and mucilage of euphorbia pseudocasts A. Berger and euphorbia pubica N.E.BR.

Free sugars of the aerial parts of Euphorbia pseudocactus and Euphorbia nubica were isolated. Identification was carried out by paper chromatography [PC] and gas liquid chromatography [GLC] which revealed the presence of arabinose, rhamnose, xylose, fructose, galactose, glucose and glucuronic acid in a ratio of [16: 20: 12: 4: 16: 3: 1] in E. pseudocactus, as well as arabinose, rhamnose, xylose, fructose, galactose, glucose, galacturonic acid and glucuronic acid were detected in a ratio of [2: 1: 14: 5: 2: 18: 2: 1] in E. nubica. Mucilage of each plant was separately extracted by cold and hot methods and weighed. PC and GLC analysis of the mucilage hydrolyzates revealed the presence of arabinose, rhamnose, xylose, galactose, glucose, and galacturonic acid in different ratios in the four mucilage hydrolyzates of the two plants

Free sugars, mucilage and amino acids of leaves of hibiscus esculentum L. var. lady finger

Free sugars, mucilage and amino acids contents of leaves of Hibiscus esculentus L., var. Lady's finger [Adelmoschus esculentus Moench, okra] were studied. GLC and PC analysis of free sugars and mucilage hydrolysates revealed the presence of rhamnose, arabinose, xylose fructose, glucose, galactose, galacturonic acid and glucuronic acid. Moreover, analysis of free amino acids content and total amino acids of protein hydrolysate was carried out by HPLC technique. The major free amino acid is tyrosine [0.76%], while glutamic acid [2.22%], aspartic acid [1.76%] and arginine [1.21%] constitute the main amino acids in the protein hydrolysate of the leaves of H. esculentus L., var. Lady's finger

Hyperendemicity of diarrhea in a valley area, Asir region, Southwestern Saudi Arabia

A random sample of 781 subjects living around a valley in Shebaa area, southwestern Saudi Arabia, and 1284 subjects from the rest of Shebaa, along with a sample of 1095 from a nearby urban community in Abha city have been studied following a notification of a suggestive increase of diarrhea in the valley. This was to determine whether the prevalence of diarrhea was high in the valley and to formulate hypotheses about possible implicated factors. The family head was interviewed about episodes of diarrhea among family members during the 2-week period preceding the interview, about source of drinking water, an. about some demographic variables. Observations were made and data were collected on presence and frequency of flies in the house, methods of excreta and refuse disposal, valley and wells water, and the nearby agricultural farms. The 2-week diarrhea episode rate per subject was significantly [p < 0.0001] highest, in the valley [0.20], was 0.09 in the rest of Shebaa, and was lowest in the urban community area [0.05]. The rate decreased by age [p < 0.001] and increased by frequency of flies in the house [p < 0.0001], particularly in the valley. Drinking only from the desalinated water was associated with diarrhea episode rate of 0.12 as compared to 0.05 for drinking only from bottled water or from any other combination of sources [p < 0.01]. The valley and wells water was grossly polluted and was regularly used for irrigating and washing fresh fruits and vegetables from nearby farms. Hypotheses for the factors possibly contributing to this hyperendemicity of diarrhea in the valley include inadequate excreta and refuse disposal, contamination of the valley and wells water, contamination of the, desalinated water during transportation or storage and abundance of flies

Bacteriologic portability of the drinking water in a diarrhea hyperendemic area in Southwestern Saudi Arabia

High prevalence, of diarrhea was reported among people living in a semiurban community in Shebaa area in Southwestern Saudi Arabia. This was in comparison to prevalence in a nearby urban community in Abha, the capital city of The Southwestern Region of Saudi Arabia. Contamination of the desalinated water, commonly used for drinking, was one possible hypothesis for occurrence of this diarrhea problem. The objective of the present study was to test bacteriological potability of desalinated water in both Shebaa and Abha areas and to determine whether any contamination occurred during transportation from water distribution stations to houses or during storage in house reservoirs. -Water samples were collected and analyzed by the Presumptive Coliform Test from a sample of water tankers transporting water and from tap water originating from house reservoirs in a sample of houses in the two areas. Source of drinking water was recorded for each of such houses. Of 117 water samples from 39 tankers transporting water, only one sample was positive bacteriologically and non-potable [potability = 99%]. Whereas among 201 tap water samples from a random sample of houses, 26.4% showed contamination. Bacteriological non-potability was -found in a significantly higher proportion of houses in Shebaa area [38.4%] than in Abha city [7.9%], [p < 0.001]. Also, desalinated water was used for drinking significantly more in Shebaa than in Abha [p < 0.001]. It is concluded that transportation of the desalinated water by water tankers has not significantly contributed to its contamination. Such contamination rather obviously occurred during storage in house reservoirs, and was possibly implicated, at least partly, in the increased prevalence of diarrhea in Shebaa

influence of light on the accumulation of phenylic acids, [-] -epicatechin and tannis during germination of Ricinus communis L

The changes in phenolic acids. [-]-epicatechin and tannins during germina ion of Ricinus communis L. under various light treatments were studied. Under the light/dark photoperiod, phenolic acids, [-]-epicatechin and tannins were first detected only towards the last stages of germination. Continuous illumination with white or fluorescent light promoted the production of phenolic acids and tannins by Ricinus seedlings. On the other hand, previous exposure of the seedlings to red light enhanced the formation of phenolic acids and tannins, whereas blue light inhibited their biosynthesis. During the different stages of germination under all light treatments, roots contained no or only trace amounts;henolic acids and tannins

Health profile and utilization of health services in selected communities in Abha Part 1: introduction and methodology

Valuable information about community health problems and evaluation of health services can be obtained through health surveys. This study was planned to determine the health profile, prevalence of some specific health problems [e.g. dental caries and intestinal parasites], immunization coverage, and the utilization of health services for two urban communities in Abha City. A 20% simple random sample including 146 families and 942 individuals was selected and studied from AI-Manhal and Serthabta Communities served by AI-Manhal Primary Health Care Center. The methodology included interviewing the head of the household, the examination of teeth of children below 12 years of age and stool analysis for parasites. Key problems and methodological issues discovered during the survey are discussed. Detailed results will be published in separate reports

Relationship of intestinal parasites in urban communities in Abha to socioenvironmental factors

The prevalence of intestinal parasites and their relationship to family income, level of education, and source of drinking water was studied in a 20% random sample in two urban communities in Abha City. The sample included 942 individuals, and stool specimens were obtained and examined from 722 of them [76.7% response]. Only two pathogenic parasites [Giardia Iamblia and Entamoeba histolytica] were detected in this sample, with prevalence rates of 3.6% and 1.7% respectively. The non-pathogenic Entamoeba coli was detected in 7.9% of the sample. Higher parasitic prevalence rates were associated with lower income and with lower educational level. Higher infection rate with G. lamblia seems to be linked to the consumption of well-water for drinking

Plasma lipids and plasma apolipoproteins in nephrotic patients

Ten euthyroid, non diabetic, non uremic nephrotic patients with normal liverandninenormalcontrols were investigated for serum apolipoproteins and serum lipid pattern. Age of both groups did not differ significantly.Nephrotic patients had a significantly higher total serum lipids [P<0.01], serum triglycerides [P<0.05] and serum cholesterol [P<0.01] than normal controls HDL cholesterol of patients did not differ significantly from controls [patients 65.95+ and - 36.3, controls61.5+ and - 29.4 mg/dl] VLDL cholesterol of patients was significantly [P<0.05] lower than controls [patients 150.4+ and - 173.1, controls20.2+ and - 9.3 mg/dk].LDL cholesterol of patients was significantly higher [P< 0.01] than controls [patients 329.2 + and - 192.9, control 109.2+ and - 26.2 mg/dl]. Patients apolipoprotein A ranged between 19.2 - 197.6 mg/dl [with a mean of 97 + and - 52.5 mg.dl] which was significantly lower than controls [which ranged between 117.6-248 mg/dl with a mean of 176.4+ and - 52.8 mg /dl].Apolipoprotein B of nephrotic patients ranged between 102-124.6 mg.dl [with a mean of 112.2+ and -6.68 mg/dl] which was significantly higher [P<0.001] than that of controls [which ranged between 8-94.2 mg/dl with a mean of 58.5+ and - 26.3 mg/dl]. So nephrotic patients have a lower level of Apo. A and a higher level of Apo.B. Low Apo.A may be due to increased production with no loss urine with HDL. The high Apo. B may be due to increased production with no loss in urine. Hence Nephrotic patients are at high risk of atherosclerosis because of increase Apo.B and low Apo.A

Serum reverse triiodothyronine in nephrotic patients

This work included fifteen nephrotic patients [eight females and seven males] in addition to ten healthy control subjects [six females and four males]. Patients and controls were subjected to the following investigations; serum thyroxine, triiodothyronine, thyroxine binding globulin, thyroid stimulating hormone and reverse triiodothyronine. The results showed that patients with nephrotic syndrome had low mean total serum thyroxine T4[5.99 +/- 0.41 Ugm/dl] and thyroxine binding globulin TBC levels [23.1 +/- 0.38 Ugm/dl]. The mean serum reverse triiodothyronine levels were within normal, while T3/T4 ratio was higher in nephrotic patients than the control subjects. Patients with nephrotic syndrome and ascites had a lower TBG than nephrotic patients with no ascites. Patients with nephrotic syndrome with serum creatinine levels more than 2 mg/dl had a significantly higher rT3 than nephrotic patients with normal kidney functions

effect of bicarbonate dialysis on lactate/ pyruvate ration after minimal exercise in regular dialysis patients

Muscle handling of lactate is known to be impaired in regular dialysis treatment [RDT] patients on acetate hemodialysis [AHD].This study was undertaken to evaluate the late after effect of bicarbonate hemodialysis [BHD] on lactate/pyruvate [L/P] ratio as an indicator of anaerobic muscle metabolism following minimal exercise. It included five normal volunteers and eight patients on RDT.The latter was first tested on conventional AHD and again after ten sessions of BHD. Assessment was done three-four days after dialysis, just before the next session.All subjects were exercised by walking on a tread-mill at 0 grade, 5 km/hr for 10 min. BCN, serum creatinine, Ca, Kand blood lactate and pyruvate were determined before and immediately after exercise. Basal L/P ratio was more or less similar in the controls and uremic patients whether on AHD or BHD. L/P changes in the AHD group were highly significantly different from the controls immediately and 10 min post exercise. L/P changes in BHD did not differ from the controls and significantly differ from AHD immediately and 10 min post exercise. None of the parameters tested [BCN, serum creatinine, serum Ca and potassium] correlated with L/P ratio. It was concluded that BHD led to sustained correction of the disturbed aerobic muscle glycolysis seen in AHD

Lymphocyte transformation in nephrotic patients

Lymphocyte transformation has been shown to be inhibited by sera of nephrotic patients in vitro. The inhibition of lymphocyte transformation by nephrotic sera was attributed to hypoalbuminemia or hyperlipoproteinemia. In the present work we studied the effect of sera of patients suffering from nephrotic syndrome on blastoid transformation in vitro. The role of hypoabuminemia and hyperlipoproteinemia was investigated. Ten cases of nephrotic syndrome and ten normal controls were included. They were subjected to complete blood picture, complete urine analysis, blood urea, serum creatinine, 24-hours urinary protein excretion, total serum proteins and serum proteins electrophoresis, total serum lipids, serum triglycerides, total serum cholesterol and high density lipoprotein cholesterol electrophoresis, in addition to lymphocyte studies which included separation, culture and blastoid transformation of patient's lymphocyte in the presence of the mitogen [phytohemagglutinin] and the effect of nephrotic sera on this process. Blastoid transformation was studied in the presence of whole patient's serum, patient's after albumin substitution to 4.5 gm/dl; serum of the patient after separation and removal of lipoprotens; serum of the patients after lipoprotein separation and albumin substitution