Risk factors of diabetic foot in central Saudi Arabia

To identify the risk factors of diabetic foot [DF] in diabetic patients. In a case-control study, medical records of 50 patients with DF, and 50 diabetic controls without DF were selected randomly from the patients seen at King Abdulaziz Medical City [KAMC], Riyadh, Kingdom of Saudi Arabia. Selected vascular, neuropathic, metabolic, health care, and lifestyle risk factors were investigated. Multiple logistic regression was used to relate these potential risk factors to the odds of DF. Diabetic foot was significantly associated with: gender, age, education, type of diabetes, duration of disease, level of erythrocyte sedimentation rate [ESR], presence of peripheral neuropathy, peripheral vascular disease, chronic renal diseases, ischemic heart diseases, hypertension, and previous history of diabetic foot. After adjusting for the potentially confounding effects of age and gender by using the logistic regression analysis, independent predictors of DF were: the duration of diabetes, presence of neuropathy, and ESR level. In the prediction of DF, receiver operating characteristic curves [ROC] were applied to identify the most valid cut-off points of the duration of diabetes [11 years], and ESR level [54 mm/hr]. These findings could help diabetologists recognize early, and manage DF, and thus reduce the risk of limb amputation, and the cost that accompanies limb loss in this prevalent condition

Recurrent visits and admissions of children with asthma in central Saudi Arabia

To identify the pediatric age group and most affected gender by asthma, and to determine the significant predictors of severity of asthma, and assess the appropriateness of asthma medication administration. This cross-sectional study was carried out at Emergency Department [ED] of children's hospital at King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia from January to March 2009. Interviews were carried out with the parents of 185 children, who presented to the hospital with asthma exacerbation more than once over the last 6 months, to collect data of possible risk factors, and appropriateness of medication administration technique. Most patients were males 71.9%, aged 1-6 years [58.9%], and 8.1% of them presented to the ED because of asthma exacerbation more than once over the last 6 months. Approximately two-thirds [65.9%] of the parents explained the way of meter dose inhaler administration correctly. Infants were significantly the least affected group [p=0.02]. Severity was significantly higher among appropriate users of medications [p=0.046]. Appropriateness of medications administration was significantly associated with severity. However, this may not be considered a valid predictor of severity, as parents of children with recurrent attacks may have a better chance of being taught how to use medications

Assessment of health related quality of life among school children with cancer in Alexandria

In recent years, the necessity of measuring health related quality of life [HRQOL] among children with cancer has been stressed. The aim of the present work was to assess the HRQOL in terms of physical, emotional and social functioning, to identify some predictors of QOL and to describe the scholastic achievement and nutritional status among schooI children with cancer in Alexandria. A cross-sectionaI study of 215 students with cancer who attended the oncology school health insurance clinic of Sporting Student's Hospital in Alexandria governorate within a period of one month [June 20051 was conducted. Every child was subjected to the Pediatric Oncology Quality Of Life scale to assess the quality of life with cancer. Anthropometric measurements including weight and height were measured for each child and BMI was calculated. Review of records of each child was done to take the Iast hearnoglobin level. Lymphoma was the most common tumour [34.9%], followed by leukemia [24.2%], brain tumour [13.0%], osteosarcoma [7.9%], and Wilmfs tumour [7%]. About one third of the sample [36.7%] reported poor QOL which was more evident in the physical domain [54.4%], as compared to 34.4% in emotional domain and 26% in the social domain. Sex [p<0.05], age [p<0.05], complications [p<0.01], place of treatment [p<0.05], place of diagnosis [p<0.05] and treatment [p<0.05] were all significantly associated with QOL. However after adjustment for other variables, poor QOL was more likely among students of younger age, students with cornplications, and students whose diagnosis was done at the student hospital. About two thirds of the sample [68.5%] reported poor scholastic achievement, 25.1% were underweight and 87.4% were anemic. HRQOL measurement should be done as a routine for all children with cancer in order to identify specific therapies that require modifications in uldnagrrnent. More efforts are needed to improve the health care in the studentfs hospital, especially for young children with cancer

Construction of intrauterine growth curves in a high altitude area of Saudi Arabia

The aim of the present study was to construct intrauterine percentile growth curves for body weight, length and head circumference for local use in a high altitude area of Saudi Arabia. This is a cross-sectional study of all Saudi births from Abha General Hospital over a 6-year period from 1999 to 2004. We included a total of 6,035 Saudi births in the present study after eliminating babies that were stillbirths, twins or those with major congenital anomalies. The gestational age of the infants ranged from 26-42 weeks. The anthropometric measurements included birth weight, crown-heel length and head circumference. We calculated the 10th, 25th, 50th, 75th, and 90th percentiles for weight, length and head circumference against the periods of gestation. We also calculated the mean weight and mean +/- 2SD. We determined the curves of best fit for weight, length and head circumference measurements at different weeks of gestation by polynomial regression of the following general form to construct the clinical curves: Y = a + bX + cX2. We derived intrauterine growth curves for weight, length and head circumference from measurements made on infants born at each week of gestation in the latter half of pregnancy. By calculating mean values and deviations around these [expressed either as centiles or standard deviations], we constructed distance [size attained] growth curves. The mean values for weight and length of births of the present study are lower than those of published charts in all gestational periods. However, for head circumference, evident appeared only before 32 weeks of gestation. The mean values of head circumference were nearly comparable. Constructed smoothed gestational curves are a useful tool for assessing the intrauterine growth of births in high altitude areas of Saudi Arabia

Psychosocial characteristics of diabetic students at Sporting Students Hospital in Alexandria

Type 1 diabetes mellitus is a chronic disease that may have an impact on children's psychosocial adjustment. The aim of the present work was to study the psychosocial characteristics of diabetic students and to determine predictors of diabetes control. A cross-sectional study of 150 diabetic students who attended the diabetic school health insurance clinic of Sporting Student's Hospital in Alexandria governorate within a period of one month was conducted. A pre-designed interviewing questionnaire was used to collect - from the child and / or his / her parents - personal data, data about the child social relationships and school and disease characteristics. School adjustment index and stress symptom index were used to assess the school performance and the stress symptoms respectively. The result revealed that 34% of the diabetic students were maladjusted to school and 31.3% were symptomatic based on the stress index. Generally speaking, diabetic children reported good relationship to peers [65.3%], parents [57.3%] and siblings [51.3%], most of them have good friendship [82%] and those involved in one or more kind of hobby were about three fourth of all. Both age [P<0.05], sex [P<0.05], social class [P<0.05], disease duration [P<0.05] and stress symptoms [P<0.05] were all significantly associated with the disease control. However after adjustment for other variables, students of low social class families [OR=5.1, p<0.01] and those of longer disease duration [6-10 years] [OR=7.9, p<0.05] were significant predictors of diabetes control. In conclusion diabetes-per se might have no significant association with academic performance or social relationship. Students with large diabetic duration-especially those of low social class families- are at increased risk of suboptimal glycaemic control and should be targeted for interventional strategies

Pattern of erectile dysfunction in Jeddah city

The aim of this study was to determine the demographic features of erectile dysfunction patients attending different specialized clinics in Jeddah city, and to identify possible risk factors associated with erectile dysfunction problem. All newly erectile dysfunction patients [n=388] who attended 6 andrology and urology clinics within a period of 3 months were subjected to a modified structural interview questionnaire to collect demographic data and risk factors for erectile dysfunction. The study revealed the following results among erectile dysfunction patients; Saudi patients constituted [81%]. The age ranged from 20-86 years with mean age of 43.23 +/- 12.56 years, 73% were married with one wife, 23.5% married with two wives, and 8% were single. About one-half [43%] were less than secondary education level. Retired patients constituted [13%] of all patients. Lack of exercise was the most frequent risk factor among 82% of patients, followed by smoking [56%], use of regular medication [44%], diabetes [30%], hypertension [15%], history of pelvic surgery [14%] alcoholism [13%], and drug addict [8%]. Erectile dysfunction is a problem of not only old age but also of middle and young age. This might be attributed to the high frequency of some risk factors such as diabetes mellitus, hypertension, smoking, alcohol consumption, and drug addiction. This finding may reflect the necessity for construction of prevention strategies

Dental caries: experience in relation to wasting and stunted growth among schoolboys in Abha, Saudi Arabia

The aim of this study was to assess the dental health status of Saudi schoolboys in an urban city in the southwestern region of Saudi Arabia, and to investigate the association of dental caries with wasting and stunted growth. Patients and A two-stage stratified random sample of 959 schoolboys representative of the 6 to 13 year-old school population in Abha were subjected to dental examination. Using the WHO criteria, decayed, missing and filled teeth were determined, and the prevalence of caries for each age group was determined by means of decayed and filled primary teeth [dft], and decayed, missing and filled permanent teeth [DMFT] epidemiological indices. The children were also subjected to weight and height measurements and their values were compared with the local growth standards. The total prevalence of caries-free children was 14.6%. The mean dft values at ages 6, 9 and 12 years were 6.53, 3.97 and 1.07, respectively [P<0.001], while the mean DMFT values were 0.16, 0.83 and 1.23 for such ages [P<0.001]. After adjusting for age and social class, the wasted children were found to have a higher caries prevalence in the primary dentition than the well-nourished children [P<0.01], while children with stunted growth exhibited lower caries prevalence in the permanent teeth [P<0.05]. Comparisons with international goals for oral health by the year 2000 show that the goal for 12- year-olds with respect to the status of the permanent dentition has been attained, but not the goal for 5-6 yearolds with respect to caries-free primary teeth. It is likely that nutritional status may have different effects on susceptibility to caries of deciduous and permanent teeth

Smoking habit of king sang university students in Abha, Saudi Arabia

The aim of this study was to estimate the prevalence of smoking among university students of King Saud University in Abha City, to determine ecological factors for the problem, and to assess the students' knowledge about the health effects of smoking, and attitudes towards public action against smoking. All medical students at the University College of Medicine [MC] [n=202], and a representative sample of students of the College of Education [CE] [n=300], were subjected to a modified Arabic version of the World Health Organization standard questionnaire for young people to study their knowledge, attitudes and practices of smoking. The study revealed the following results among students of the CE and those of the MC, respectively. Prevalence of regular smoking [17.5% vs. 13.6%; P=0.25]; heavy smokers [39.5% vs. 27.8%; P=0.38]; smokers of moderate- to high-nicotine yield [92.7% vs. 50%, P=0.0004], and tar, yield [48.8% vs. 16.7%, P=0.02]. Curiosity was the main reason for initiation of smoking [41.2% vs. 51.9%], followed by the desire to show off [27.5% vs. 51.9%, P=0.03], and peer pressure [27.5% vs. 7.4%, P=0.04]. Friends were the main source of the first cigarette [53.1% vs. 55.6%], followed by parents [2% vs. 40.7%, .P=0.0001]. Most students were knowledgeable about smoking and had favorable attitudes against it. However, MC students were significantly more knowledgeable than those of the CE. Smoking still constitutes a major problem among university students in Abha, in spite of their knowledge of its hazards. This may be due to the addictive effect of smoking, peer pressure, negative parental attitudes and other reasons. There is a need to implement an anti-smoking program for college students, and possibly legislation to limit the amount of tar and nicotine in cigarettes

Smoking intervention programme for male secondary-school students in south-western Saudi Arabia

A one-day antismoking programme was conducted for 289 students in a male secondary school in Abha, Saudi Arabia. The one-group pretest/post-test design to evaluate the programme was based on an Arabic version of the WHO standard questionnaire for young people. The results showed that the prevalence rate of regular smoking was 14.5%. The students showed marked variability in correct responses to various factual items. The programme had a significant impact on nonsmokers [P < 0.01] and prespecialty students [P < 0.01]. With the exception of smokers, the students showed an overall positive attitude towards public action, but the impact of the one-day programme was less than satisfactory

Behaviour disorders among urban schoolboys in south-western Saudi Arabia

Behaviour disorders among 305 schoolboys aged 8-12 years in Abha were assessed using the children's behaviour questionnaire developed by Rutter. The frequency of behaviour disorders was 13.4%. Children's parents were interviewed to obtain social and demographic information about the family. Behaviour disorder was associated with family size, crowding index, parents' education, birth order, parental death and social class. When multiple regression analysis was applied, these factors jointly contributed 12.8% of the variance in total behaviour score. However, mother's illiteracy was the only significant predictor of maladjusted children [P = 0.02]. Poor academic performance of children was strongly associated with behaviour disorder

Throat culture screening for Beta-haemolytic streptococci among schoolboys in Saudi Arabia

This study was designed to estimate the carrier rate of beta-haemolytic streptococci among 972 primary-school boys in a high-altitude area of Saudi Arabia, and its association with social class, crowding index and body mass index, and also to determine the seasonal variation of infection. A carrier rate of 13.1% for beta-haemolytic streptococci was detected. The carrier rate was significantly higher in spring than in winter. The association between streptococcal infection and social class, crowding index, or body mass index was statistically not significant. The low prevalence of streptococcal infection might be attributed to the high altitude but further studies are needed to determine whether this is the case

Growth pattern of Saudi schoolboys in a high-altitude area of Saudi Arabia

The aim of the present study was to examine the growth of schoolboys in a high-altitude area of Saudi Arabia, and to investigate the appropriateness of using the US National Center for Health Statistics [NCHS] standards for the assessment of children's growth in such areas. The study concluded that the use of NCHS standards is not appropriate for the assessment of growth of schoolboys in Asir Region. Further studies are needed to determine whether the findings of this study are altitude-dependent or not

School absenteeism: a study of some risk factors

The aim of this study was to investigate some risk factors for prolonged and/or repeated school absence. A case-control study was carried out in the largest male secondary school in Alexandria city. A total of 100 absentees [absent from school for at least 8 days] were recruited by the end of the academic year 1993/1994. A control group of 300 randomly selected regular school attendants were matched for age and grade level. School absenteeism risk was shown to increase significantly with student's illness [OR=11.2 P<0.01], school failure [OR=3.3 P<0.01], non participation in athletic activities [OR=3.2, P<0.01], cigarette smoking [OR=1.9, P=<0.05], moderate to high family income [OR=1.9, P<0.05] and low level of mother's education [OR=7.0, P<0.01]. School absence risk did not appear to be related to the student's body mass index [BMI] or to father's education. Home was the favorite place to stay-in while absent from the school for 84% of the absent students. Besides student's illness, lack of transport to school, unsatisfactory school curriculum, school day and school personnel were contributing factors for such problem

Parasitic infections and gastrointestinal symptoms among preschool children in day care centers in Alexandria, Egypt

There is a considerable amount of speculations concerning the presence of symptoms in various parasitic infections. The aim of the present study was to determine the prevalence of different parasitic infections among children in day care centers [DCCs], and to establish the relation of such infections to gastrointestinal symptoms. A total of 623 stool samples were collected from 700 preschool children aged 2-5 years who attended 3 DCCs of different soocial classes in Alexandria. These samples were tested for parasitic infection by the conventional microscopy. Parents were interviewed as regards the gastrointestinal symptoms frequently suffered from by their children included in the sample during the 3 months period preceding the interview. The prevalence rate of parasitic infection was 56.0%. Giardiasis was the. commonest infection [34.7%], followed by Ascariasis [24.4%] and Trichuriasis [4.6%]. Boys showed a significantly higher prevalence than girls [58.3% vs. 52.9%, p < 0.01]. Social. children were more infected with G. lamblia than unsocial ones [39.6% vs. 22.1%, p < 0.01]. Vomiting was strongly associated with 0. lamblia infection [OR = 7.1, p < 0.01], diarrhea with multiple infections [OR = 48.2, p < 0.01], while abdominal pain was not significantly associated with any of these infections. The high prevalence of Giardiasis in DCCs emphasizes the need for increased surveillance for G. lamblia. as a cause of vomiting in Children, especially among active and social boys. Routine and periodic administration of a protozoan treatment to such Children is recommended

Hearing loss and other ear problems among school boys in Abha, Saudi Arabia

The aim of this work was to determine the prevalence of hearing loss [HL] and its association with different ear problems among schoolboys in Abha City, Asir Region, Saudi Arabia. A representative sample of 974 schoolboys ages six to 12 years were subjected to both audiometric and otoscopic examinations. Audiometric examination identified 43 children with HL [40 conductive and three sensorineural], making a prevalence of 4.4% [1.7% mild, 2% moderate and 0.7% severe HL]. Otoscopic examination revealed ear problems among 26.9% of schoolboys with the following prevalences: wax [21.3%], acute otitis media [1.9%], chronic otitis media [1.0%], foreign body [0.7%], otitis externa [0.7%], and congenital anomaly of the auricle [0.4%]. Impacted wax accounted for reversible HL among a quarter [25.6%] of the hearing impaired children, whereas chronic otitis media accounted for 11.6%; acute otitis media 9.3%; otitis media with effusion, foreign body and congenital anomaly of the auricle each accounted for 2.3%. A significantly higher frequency of HL was detected among children with otitis media than among children without ear conditions [29.4% vs. 2.8%, M3.01]. The prevalence of HL among Abha schoolboys was comparable to that in developed countries, but was lower than that in developing countries. Such prevalence was mostly caused by impacted wax and otitis media. Thus, attention should be given to regular screening for early detection and removal of the impacted wax for correcting the high prevalence of reversible HL due to such conditions. Children of low social class should be regarded as a high risk group for whom regular hearing screening is recommended

Preventive and clinical aspects of cardiac problems among school children in Alexandria

A retrospective study of cardiac problems among school children in Alexandria has been done to determine some aspects of the pattern of the problem and to assess the secondary prophylaxis and follow-up measures. Of the 398 cases [mean age of 12.1 +/- 2.2 years] registered in the cardiac clinic of the student hospital in the city, 258 children [64.8%] were rheumatic heart disease [RHD] cases, while 51 children [12.8%] were congenital heart disease [CHD]. Other cases were rheumatic arthritis [13.8%], rheumatic chorea [5.0%], rheumatic fever [1./5%], and functional murmur [2.1%]. Mitral insufficiency was the major functional defect in RHD children [48%], while the ventricular septal defect [VSD] was the main lesion among CHD children [48%]. Within the last year of follow up, the RHD children experienced drop-out rate of secondary penicillin prophylaxis of 28.6% mainly due to parental ignorance [14.6%] and fear of penicillin injection [10.9%], while the recurrence rate of rheumatic fever among them was 29.4%, which increased significantly [P <0.01] to 48.6% among the dropout cases. Non-participation in school physical education was evident among 72.2% and 80% of RHD and CHD children, mainly due to the doctor's certificate and parental over-protection. It was concluded that rheumatic heart disease is the most common cause of heart diseases among school children in the city, and the drop-out of penicillin prophylaxis relatively high. A plan was recommended to improve secondary penicillin prophylaxis and participation in physical education by such group

Prevalence of amblyopia among schoolboys in Abha city, Asir region, Saudi Arabia

The aim of this study is to estimate the prevalence of amblyopia among schoolboys in Abha City and to examine its relations with anisometropia and strabismus. A total of 971 male school children were selected randomly from the elementary schools for male in the city. Using the criterion of a visual acuity of 6/9 or worse, with no obvious structural disease of the eye, to define amblyopia, 18 cases have been found to have the condition, with a prevalence of 1.85%. Those cases consisted of 7[47%] with anisometropic amblyopia and strabismus, and 2[13%] with deprivation amblyopia. Amblyopia showed a prevalence equal to 27% and 31% among children with anisometropia and those with strabisimus respectively. An effective screening program for early detection of amblyopia through the well baby clinics is recommended