An overview of dengue viral infection circulating in Pakistan

Background & objectives: Dengue virus (DENV) is an RNA virus that infects approximately 2.5 billion people around the world. The incidence of dengue fever has rapidly increased at an alarming rate in the last few years and has affected thousands of people in Pakistan. This review explores the prevalence, serotypes and pathogenesis of dengue virus circulating in Pakistan. Methods: A systematic review of observational studies published between 1994 and December 2019 was performed. All records of the confirmed outbreak of dengue fever in Pakistan were reviewed and articles containing no primary data were excluded. Results: Four identified serotypes of dengue virus (DENV 1-4) circulate in different regions of the world causing epidemics. The most prevalent serotype, which is still epidemic and dominant in Pakistan, is DENV-2. Many factors like over-population, rapid urbanization, travelling, lack of vector control in dengue endemic areas and inadequate health-care are responsible of dynamic and huge raise of dengue in Pakistan. Interpretation & conclusion: Currently there is no specific treatment for prevention of dengue virus. Recently some antiviral compounds were being tested to eradicate this disease. There is a need to develop an efficient and safe vaccine for all four serotypes to combat dengue viral infection globally and particularly in Pakistan.

Vulnerability to human immunodeficiency virus infection and associated factors among married women in northwest Ethiopia: a cross-sectional study

This study investigated the vulnerability to human immunodeficiency virus (HIV) infection and associated factors among married women in northwest Ethiopia.Methods: A community-based cross-sectional survey (n=657) was conducted from April 1 to 15,2020, in Metema District, northwest Ethiopia, in four randomly selected kebele administrations (thelowest level of local government). The inclusion criteria were married women aged ≥18 years residing with their husbands. Logistic regression analysis was conducted to identify factors associatedwith married women’s vulnerability to HIV infection.Results: Participants were on average 33.70±9.50 years and nearly one-fourth (n=148, 22.5%) wereidentified as vulnerable to HIV infection (i.e., experienced sexually transmitted disease symptoms oran extramarital affair of either spouse within the past 12 months). Only 18.9% reported sexual communication with their husband. Respondents who did not discuss the risk of HIV infection withtheir husbands had fivefold odds of vulnerability (adjusted odds ratio [AOR], 5.02; 95% confidenceinterval [CI], 1.43–17.5). Those who did not have premarital sex (AOR, 0.20; 95% CI, 0.05–0.77)had no worries about HIV infection (AOR, 0.27; 95% CI, 0.08–0.94), sufficient income (AOR,0.56; 95% CI, 0.16–0.86), and less than four children (AOR, 0.69; 95% CI, 0.50–0.97) had decreased odds of being vulnerable to HIV than their counterparts.Conclusion: Not discussing risk of HIV infection with husband was a major factor of vulnerabilityto HIV infection as was premarital sex, worry about HIV, income, and number of children. Measuresto strengthen couple’s sexual communication and support economical stability is important for decreasing HIV vulnerability

Nutrition Characteristics and Delivery in Relation to 28-day Mortality in Critically Ill Patients

@#Introduction: The limited data regarding nutrition characteristics and the delivery of critically ill patients in South Asia is intriguing. This study was conducted to investigate the nutrition characteristics and delivery in relation to 28- day mortality in mechanically ventilated patients. Methods: This prospective observational study was conducted in the intensive care unit (ICU) of the Maldives government referral hospital. Data about nutrition characteristics and delivery were collected from the ICU charts, and each patient was followed for a maximum of 28 days. Results: We recruited a total of 115 patients (mean age: 61.57±17.26 years, 52% females, mean BMI: 25.5±6.19kg/m2), of which 61 (53%) of them died within 28 days of ICU admission. Mean energy intake was 681.15±395.37 kcal per day, and mean protein intake was 30.32±18.97g per day. In the univariate logistic regression analysis, length of stay in ICU (OR = 0.950, 95% CI: 0.908 – 0.994, p = 0.027), and received intervention by a dietitian (OR = 0.250, 95% CI: 0.066 – 0.940, p = 0.040) were associated with 28-day mortality. None of the factors in the multivariate regression analysis remains significant when adjusted for sex, SOFA total score, daily energy and protein dosage. Conclusion: 28-day mortality was much higher in this study than in similar studies in South Asia, Asia and around the globe. None of the variables was significantly associated with 28-day mortality in the multivariate logistic model. However, there was a trend towards higher mortality for patients with shorter length of stay in the ICU, larger mean gastric residual volume, and no intervention by a dietitian.

Quality of Life after Chronic Post Stroke Patients

Background/objectives: To assess the quality of life among patients presented with chronic post-stroke patients in our population. Materials and methods: This was a survey type study conducted at physiotherapy department of Liaquat University of Medical and Health Science. Study duration was six months from June 2014 to November 2015. All the patients with the chronic stage of stroke, age 20 to 60 years and patient should not have any disability other than stroke were included study. Patient’s demographic data and information regarding quality of life was assessed by self-maid questioner. Data were analyzed by SPSS version 16.0. Results: Total 100 cases were selected in the study, their mean age was 45.35+3.4 years, most of the cases 73 (73.0%) were with right side affected by stroke. Majority of the cases 47 (47.0%) had acceptable health and 18 (18.0%) patient’s health was poor. 66 (66.0%) patients presented with a history of previous stroke. Most of the patients were moved by help of someone, almost half of patients can move by himself, few patients can’t move and they were completely dependent on others. When patients were interviewed psychologically 41 (41.0%) patients feeling lonely and 31 (31.0%) were depressed and unhappy, 19 (19.0%) had suicidal thought. When patients were interviewed regarding behavior with your family 36 (36.0%) answered as not good behavior of family members, these cases justified that they belong to the poor families and they are as a burden. Conclusion: It was concluded that there was poor quality of life among chronic post-stroke patients especially patients belongs to poor families

Drug utilization study in post operative patients in surgical ward of tertiary care teaching hospital

Background: This study was aimed to evaluate the drug prescription pattern and to analyze the drug usage in post operative surgical patients with appendicitis, cellulitis, diabetic foot ulcer, hernia and hydrocele in tertiary care teaching hospital.Methods: A prospective observational study was conducted over a period of six months in post-operative surgical patients at Mahatma Gandhi Memorial Hospital, Warangal, Telangana, India, which was approved by Institutional Ethics Committee. The data obtained was analyzed using graph pad prism 7.0 and the conclusions were drawn using descriptive analysis.Results: A total of 429 cases were recruited during the following study period of which, parenteral drugs were pantoprazole 399 (93%), ceftriaxone 319 (74.35%), metronidazole 239 (55.71%). Oral drugs were multivitamin 400 (93.24%), serratiopeptidase 299 (69.69%), voveran 162 (37.76%). Majority of the drugs prescribed were intravenous fluids, antacids, antibiotics, analgesics were accounted. The percentage encounters with generic drugs was 99% in present study.Conclusions: The present study provides valuable insight about the overall pattern of drug use profile in postoperative patients in the surgical unit of a tertiary care hospital. The study is useful in decreasing the irrational prescription, which helps to decrease the morbidity and health care burden in the society. The prescribing pattern was according to the National Essential Drug List is very low and needs improvement.

Effects of Diaphragmatic Breathing Exercises on Blood Sugar Levels in Working Class Females with Type-2 Diabetes Mellitus

Background: Type 2 Diabetes mellitus is a metabolic syndrome that leads to hyperglycemia and complications in many organ systems. There are many ways to control hyperglycemia including diet, exercise, drugs, and insulin. Aim of the study: The purpose of this study was to determine the effects of diaphragmatic breathing exercises on blood sugar levels and to identify the effects of regular diaphragmatic breathing exercise on HbA1c. Subjects and Methods: The study design used was a randomized controlled trial. Random sampling technique was used. Data was collected from working female nurses of Services Hospital Lahore and Jinnah Hospital Lahore who had type-2 diabetes mellitus. By using Ballot method 64 subjects were selected and equally divided into 2 groups randomly (32 subjects were in an interventional group and 32 in the control group). Data were analyzed using SPSS version 20. Mean difference was measured by using independent sample t-test and paired t-test to see the pre and post effects of the same group. Results were summarized as mean and standard deviation. Results: The study results indicated that there was a significant reduction in fasting blood sugar level (p=0.009), post prandial blood sugar level (p=0.002) and post interventional blood sugar level (p=0.000) in the 9th week of the activity (breathing exercise). Pre and post the interventional mean difference in fasting blood sugar level was highly significant in the 12th week of intervention (p=0.000). No significant difference was found in the results of HbA1c (p=0.963). Conclusion: Diaphragmatic breathing exercise has favorable effects in controlling blood sugar levels among diabetes type-2 patients if it is combined with other exercises or therapies. Only breathing component cannot maintain the normal blood sugar level.

Clinical Research Guidelines for Treatment of Hyperlipidemia with New Uyghur Medicine (Draft) / 中国中医药信息杂志

Based on medical ethics, retrospective multi-center study on medical records of Uyghur Medicine diagnosis and treatment program of hyperlipidemia was done and demographic, diagnostic, therapeutic, efficacy evaluation, nursing data and other information were collated. The main and secondary disease manifestations of hyperlipidemia were analyzed inductively and hyperlipidemia were divided into 4 types in Uyghur Medicine field, which were surplus and sticky Kan type, Chuchumal Balgham type, Gaisiman Balgham type, and Koygan Savda type. Therefore, Uighur Medicine syndrome type standards of hyperlipidemia were established. Treatment efficacy was evaluated with the combination of laboratory observation parameters and main and secondary disease manifestations. On this basis, in accordance with the technical requirements of the national medicine review, this study developed clinical research guidelines for the treatment of hyperlipidemia with new Uyghur Medicine (draft).

Relationship of coronary heart disease and fibrinogen,homocysteine,uric acid / 中国基层医药

In recent years,coronary heart disease(CHD)as a common frequent disease,increasingly aroused people's attention,became an important reason for the threat to human survival.In our country,the prevalence of CHD is presented rising trend,but the etiology and pathogenesis of CHD is not completely elucidated.With the rapid devel-opment of medical science,many scholars performed study on correlation between CHD and fibrinogen,homocysteine, uric acid,and achieved unprecedented results.Here,we reviewed research progress of the correlation between CHD and fibrinogen,homocysteine,uric acid.

Effect of serum uric acid on short-term outcome in ischemic stroke patients treated w ith intravenous recombinant tissue plasminogen activator / 国际脑血管病杂志

ObjectiveToinvestigatetheeffectofserumuricacid(SUA)levelonshort-term outcomes of recombinant tissue plasminogen activator (rtPA) for intravenous thrombolysis in patients w ith ischemic stroke. Methods The patients w ith acute ischemic stroke treated w ith intravenous rtPA thrombolysis w ere enrol ed. The demographic data, clinical data, and laboratory parameters w ere compared and analyzed according to the modified Rankin scale (mRS) scores at discharge. A good outcome was defined as a 3-month mRS score of 0 in patients w ith a baseline National Institute of Health Stroke Scale (NIHSS) score≤7, a score of 0–1 in those w ith a baseline NIHSS score of 8-14, and a score of 0–2 in those w ith a baseline NIHSS score ≥ 15. Results A total of 108 patients w ith acute ischemic stroke treated w ith intravenous rtPA thrombolysis w ere enrol ed. There w ere 66 patients (61.11%) in the good outcome group and 42 (38.89%) in the poor outcome group. The constituent ratios of age (62.21 ±10.25 years vs. 57.83 ±10.457 years; t=2.138, P=0.035), the baseline NIHSS scores (median and interquartile range, 10 [8-12] vs.4 [3-7]; Z=5.537, P<0.001), type 2 diabetes mel itus (40.48%vs.12.12%; χ2 =11.600, P=0.001), and previous history of stroke (9.52%vs.9.09%;χ2 =4.366, P=0.037) of the poor outcome group w ere significantly higher than those of the good outcome group, w hile the SUA level (323.119 ±87.869 mmol/L vs.385.961 ±76.166 mmol/L; t=3.936, P<0.001) w as significantly low er than that of the good outcome group. Multivariate logistic regression analysis show ed that the previous history of diabetes melitus type 2 (odds ratio [OR] 5.471, 95%confidence interval [CI] 1.472-20.334;P=0.011) and higher baseline NIHSS score (OR 1.306, 95%CI 1.147-1.486; P<0.001) were the independent risk factor for short-term clinical outcomes, w hile higher SUV level ( OR 0.992, 95%CI 0.986-0.998; P=0.015) w as an independent protective factor for poor short-term outcome. Conclusions The increased SUA level is an independent protective factor for good short-term outcome in patients treated w ith intravenous rtPA.

NDM-1 (New Delhi metallo beta lactamase-1) producing Gram-negative bacilli: Emergence & clinical implications.

Backgound & objectives: resistance to carbapenems in Gram-negative bacteria conferred by NDM-1 is a global health problem. We investigated the occurrence of NDM-1 in clinical isolates of gram-negative bacilli in a tertiary care hospital in Kashmir valley, India. Methods: Gram-negative bacilli from different clinical isolates were included in the study. Antimicrobial susceptibility was performed by Kirby Bauer disk diffusion method and interpreted using Clinical Laboratory Standards Institute (CLSI) guidelines. Isolates resistant to carbapenems were subjected to different phenotypic test such as modified hodge test (MHT), boronic acid and oxacillin based MHT (bA-MHT and OXA-MHT), combined disk test and minimum inhibitory concentration (MIC) with imipenem and imipenem -EDTA for determination of class B metallo enzymes. Presence of blaNDM-1 gene was established by PCR and confirmed by sequencing. Results: Of the total 1625 gram-negative isolates received, 100 were resistant to imipenem. Of the 100 isolates, 55 (55%) were positive by modified Hodge test indicating carbapenemase production. Of the 100 isolates tested by MHT, BA-MHT and OXA-MHT, 29 (29%) isolates belonged to Class A and 15 (15%) to Class B, while 56 (56%) isolates were negative. Of the 15 class B metallo beta lactamase producers, nine carried the blaNDM-1 gene. NDM-1 was found among escherichia coli (2 isolates), Klebsiella pneumoniae (2 isolates), Citrobacter freundii (3 isolates), Acinetobacter spp (1 isolate), and one isolate of Pseudomonas aeruginosa. Isolates were resistant to all antibiotic tested except polymyxin B and tigecycline. Interpretation & conclusions: Our study showed the presence of clinical isolates expressing NDM-1 in Srinagar, Jammu & Kashmir, India. These isolates harbour plasmid mediated multiple drug resistant determinants and can disseminate easily across several unrelated genera. To halt their spread, early identification of these isolates is mandatory.

Overview of application and research of Echinops genus in Chinese medicine / 中国中药杂志

Asteraceae Echionopos (Echinops genus) is one of the world's plants commonly used in traditional Chinese medicine herbs. In this paper, a lot of literature on the basis of domestic and foreign, and modern research on the application of medicinal plants in different ethnic groups in our country Echionopos made a brief presentation and evaluation, and its in Chinese Han, Mongolian, Uygur, Kazak, Korean and other ethnic groups in the application of traditional medicine and related research conducted profiles. To further comprehensive and accurate use of the abundant plant resources and research, in order to find biologically active natural products, provide reference basis for the clinical application of new drugs developed and expanded drug source.

Epidemiological aspects of hepatitis B and C markers in blood donors in Kazakhstan; 2000-2011

Background: Transfusion-transmissible infections such as hepatitis B and hepatitis C are among the greatest threats to blood safety for transfusion recipients and pose a serious public health problem. The aim of this study was to assess the epidemiological aspects of hepatitis B and C in Kazakhstani donor's blood over the period 2000-2011

Methods: The data were obtained from the annual reports of the Republican Blood Center. The retrospective study was conducted from 2000 to 2011

Results: Over the study period in the republic a growth of volumes of procured blood from 312.4 to 398.0 units was noted, in total equaled to 4,277.8 units. The proportion of blood wasted increased from 8.3% to 8.7%. In the dynamics the proportion of viral hepatitis among all causes of blood wasted decreased from 29% to 15.5% [HBV] and from 33.5% to 9.9% [HCV]. The proportion of HBV and HCV in whole blood decreased considerably, in plasma and red cell concentrate the rates changed slightly. The average annual prevalence of HBV and HCV were 2.1% and 1.8%, respectively

Conclusion: Despite the reduction of viral hepatitis rates among blood donors in Kazakhstan the prevalence still remains high. The HBV prevalence is higher compared to HCV, which needs further investigations in the general population to address the issue

Antimicrobial resistance; hospital staff awareness at a tertiary care health facility

Antimicrobial resistance is a global problem and awareness hospital staff to it is limited. To study the awareness among hospital staff at a tertiary care health facility regarding knowledge of antimicrobial resistance. It is a prospective observational study. Sheri Kashmir institute of medical sciences which is a tertiary care medical centre in Indian part of Kashmir. Study was done over 6 month period from January 2011 to June 2011. A study was conducted in a tertiary care hospital among the hospital staff through a personal interview regarding their knowledge about antimicrobial resistance. 86% of the hospital staff interviewed considered antimicrobial resistance is a significant national problem but only 52% considered it a problem in their own hospital. Clinicians considered that antimicrobial resistance is a problem more than other professionals. Majority of health professionals including clinician's rating of the knowledge of awareness of antimicrobial resistance was average or low. The most important force/factor to prescribe any antibiotic was patient's condition, while clinician's profit interest is having the least influence. This study concluded that the knowledge of awareness of antimicrobial resistance among health care professionals indicate that it is a national problem but far less a problem at their own hospital. The in-service education regarding antimicrobial resistance among the hospital staff was not up to the mark

Comparison of acid reducing property of tramadol and ranitidine given before cesarean section under general anesthesia

Intramuscular tramadol has been shown to reduce gastric acid secretion. We aimed to investigate its role in reducing the gastric acid contents and compared it with ranitidine in patients undergoing elective cesarean sections under general anesthesia. Sixty ASA-II parturients undergoing elective cesarean section were included in a randomixed double-blind study. The patients were randomly allocated to receive either tramadol 100 mg [n=30] or ranitidine 50 mg IM [n=30] 1 hour before general anesthesia. Gastric contents were collected using blind gastric aspiration after induction and at the end of the procedure. The patients receiving tiamadol had a lower, mean gastric fluid pll after induction and before recovery as compared to patients treated with ranitidine [3.5 +/- 1.7 vs. 5.8 +/- 1.5], and the difference was significant [P value=0.001]. A significantly higher proportion of newborns had a lower APGAR at 1 min in tramadol group as compared to ranitidine group [P value= 0.026] Nalbuphine consumption in first 12 hours after operation was reduced in the tramadol group. There was no significant difference in the incidence and severity of nausea, vomiting or any other side effect between the two groups. In comparison with ranitidine, the administration of tramadol in patients undergoing elective cesarean sections under GA resulted in significantly greater volume and acidity of the gastric contents, lower neonatal APGAR at 1 minute, reduced post operative opioid consumption and no change in the frequency of PONY

26-year review of emergency peripartum hysterectomy in a tertiary teaching hospital in Kuwait - years 1983-2011

To identify the risk factors and study the incidence, indications and complications of emergency peripartum hysterectomy [EPH]. This was a retrospective case-control study. The cases consisted of all women who underwent EPH between January 1983 and January 2011. Two controls per case were randomly selected from the remaining deliveries by using a random number table. Case records were retrieved from the medical records. Among 150,993 deliveries, there were 59 EPHs [cases], giving a rate of 0.390 per 1,000. Of the 59 cases, only 56 were analysed because 3 files were unavailable. These women were older [mean age 36 +/- 5.7 vs. 22 +/- 5.3 years, p < 0.01] and had delivered more than 1 child [p = 0.02]. Thirty-seven [66%] cases had had previous caesarean sections [CSs] and the number of CSs in this group was greater than in the controls [21%, p < 0.01]. More index cases had a history of atonic postpartum haemorrhage [46 vs. 4%, p < 0.001] and placenta praevia [34 vs. 4%, p < 0.01]. More cases than controls were delivered by CS [73 vs. 29%; p = 0.003]. The leading indications for EPH were haemorrhage due to uterine atony and placenta praevia. Independent risk factors were older age, multiparity, history of one or more CSs and placenta praevia. There were 2 maternal deaths from coagulopathy following massive obstetric haemorrhage. The main complications of EPH were febrile morbidity: 12 [21%], wound infection: 8 [14%] and bladder or ureteric injury: 8 [14%]. CSs, especially repeat CSs in women with placenta praevia and persistent uterine atony, significantly increased the risks of peripartum hysterectomy

Hemodialysis. Socio-economic impact of hemodialysis on patients undergoing dialysis at DHQ Teaching Hospital Sargodha

Chronic renal failure/ End stage renal disease is not only a medical illness but it also has wide ranging effects on the patients and his family. The objective of the study was to evaluate socio-economic impact of hemodialysis on patients undergoing dialysis. DHQ Teaching Hospital, Sargodha. Cross Sectional survey. The study was carried out at our dialysis center. All 60 patients who were on dialysis schedule were included in the study. A structured questionnaire for socioeconomic impact of dialysis was employed to collect the required data. By a third party i.e. a teacher and students of departments of Social Work, University of Sargodha, who were not involved in any part of the patient's management, to avoid Physician bias and free expression by the patients. Data was collected on questionnaire and analyzed. A total of 60 patients were interviewed with male to female ratio of 3:1. Average age was 45.92 years. Sixty five percent lived in joint family. Majority of the patients had hypertension as the cause of renal failure. HCV was positive in fifty five percent. Eighty percent patients were started on dialysis with a central venous access catheter. Sixty one percent were satisfied by their life. About half the patients had economic stress. Forty one percent said that they have become isolated. Fifty one percent were depressed. Fifteen percent were not satisfied by the quality of medicine provided by NGO. Hemodialysis for ESRD is an expensive endeavor. No government can cope with the ever increasing number of patients with ESRD. Community participation in terms of social groups and financial assistance is an important factor to help this group of ailing population

Oral gabapentin reduces hemodynamic response to direct laryngoscopy and tracheal intubation

Laryngoscopy and tracheal intubation increase blood pressure [BP] and heart rate [HR]. We studied the effect of gabapentin 800 mg given orally one hour before surgery on hemodynamic responses to laryngoscopy and tracheal intubation. Sixty patients were randomly allocated to one of the two groups. Group I received 800 mg of gabapentin and Group II received placebo with sip of water one hour before the induction of anaesthesia. After standard induction technique, study variables, pulse and noninvasive BP [systolic, diastolic and mean] and HR were noted every minute for first five minutes then at 10 and 15 minutes. Relevant demographic data and study variables were recorded. Mean systolic BP with Gabapentin was lower compared to placebo but it was significant at 1min [136 +/- 22vs149 +/- 23], 2min [120 +/- 21vs136 +/- 24], 10min [107 +/- 12vs118 +/- 16] and 15 min [106 +/- 13vs116 +/- 13] after intubation [P<0.05]. Mean diastolic BP with gabapentin was significantly lower at 3min [69 +/- 15vs74 +/- 17] after intubation with P<0.05. Mean BP with gabapentin was significantly lower at 2min [91 +/- 18vs103 +/- 18], 10min [79 +/- 12vs88 +/- 13] and 15 min [79 +/- 14vs86 +/- 12] after intubation at P<0.05. Decrease in HR with gabapentin was significant at 10min [92 +/- 15vs101 +/- 18] and 15 min [87 +/- 14vs99 +/- 16] after intubation [p<0.05]. Oral gabapentin decreases the response to laryngoscopy and intubation on systolic BP at 2 min and 15 min; mean arterial pressure at 2, 10 and 15 min and HR at 10 and 15 min following laryngoscopy

Effect of injecting saline into epidural space before catheter insertion on frequency of intravascular placement

The objective of the study was to determine if injecting 10 ml saline before threading epidural catheter can decrease the accidental intravascular placement in epidural space. Interventional: experimental study. Department of Anaesthesia, Hameed Latif Hospital Lahore, affiliated with College of Physicians Surgeons Pakistan, from September 2008 to August 2009. One hundred healthy women requesting Epidural labour analgesia were prospectively randomized to receive either no epidural injection [dry group, n = 50] acting as a control or epidural 10 ml saline injection [saline group, n = 50] before epidural catheter placement. A nylon multiport catheter was then threaded 3 cm into the epidural space and the needle was removed. We diagnosed iv catheter placement if blood was freely aspirated, or if the mother became tachycardic after injection of epinephrine 15 microg. The groups were similar in age [P value=0.32]. We identified iv catheter placement in 2/50 saline group and 7/50 dry group patients [4% vs 14%, P value= 0.16]. Intravenous catheter placement was identified by initial blood aspiration [two saline, seven dry group patients]. No anesthetic complications occurred, including hypoxemia,patient complaint of difficulty swallowing, intrathecal catheter placement, respiratory arrest, or subsequent iv or intrathecal catheter migration. Our study results have shown that injecting 10 ml saline before threading epidural catheter has insignificant effect on decreasing the accidental intravascular placement in epidural space

Prevalence and determinants of blindness, low vision, deafness and major bone fractures among elderly Omani population of Nizwa Wilayat (Nizwa elderly population study – 2005).

Aim: We conducted a survey in 2005 to estimate the prevalence and determinants of visual and hearing impairment in a population aged 60 years and above, from the Nizwa Wilayat of Oman. We also correlated them with major bone fracture. Study Design: Cross-sectional survey. Materials and Methods: Vision was tested on Snellen's 'E' chart. Persons with vision less than 20/200 were reexamined by an ophthalmologist to find cause of impairment. Hearing was tested by a screening audiometer. Self-reported information on fracture of major bones was confirmed by review of case records. The prevalence, 95% confidence intervals (CI), and number of visually impaired individuals were calculated. Statistical Analysis: Univariate method and parametric tests were used for analysis. Results: We examined 1,639 (80.3%) Omani persons aged 60 years and above. The prevalence of blindness (vision less than 20/200 in the better eye) was 37.4% (95% CI 35.7–39.1). Blindness was significantly higher in females (Odd's Ratio = 2.1) but was similar in urban and rural Nizwa (OR = 0.73). The prevalence of vision impairment (20/60 to 10/200) was 36.0% (95% CI 34.3–37.7). Cataract was the principal cause in 50% of the blind. The prevalence of glaucoma, corneal opacity, and chronic trachoma was 3.1%, 66.8%, and 53.2%, respectively. Among participants, 36.1% had diabetes. Hearing impairment was noted in 33.5% and profound hearing loss was noted in 3.6% of participants. In the past year, 1.4% of participants had a major bone fracture. Conclusion: Visual and hearing impairment and blinding eye diseases were common among senior Omani citizens.