[Maternal health care indicators, causes of maternal mortality and quality of medical records; at Women's Health Hospital, Assiut University, 2012]

Introduction: Maternal mortality is a preventable tragedy; measuring maternal mortality and identifying its causes is essential, and should be calculated regularly for the purpose of planning, monitoring, and evaluation of provided maternal health care

Objectives: To calculate maternal morality ratio, identify causes of maternal mortality, quality of care indicators such as maternal mortality index, case fatality rate and direct obstetric case fatality rate and to identify the main its in medical records

Methodology: A descriptive study was done through reviewing the records maternal mortality cases in the hospital using validated specific criteria published in WHO bulletin [2000] and data of cases that were admitted to the hospital's intensive care unit was collected for one [2012], followed by performing dissemination meetings

Results: In year 2012, there were 479 vaginal deliveries and 9, 908 caesarean sections, and 20,887 live births. The Maternal morality ratio was [225/100,000]. The Leading causes of maternal death were obstetric hemorrhage [38.3%], complications after caesarean sections, [27.7%] and pre-eclampsia/ eclampsia [23.4%].The age of maternal mortality was 29.3 +/- 8.5. Nearly half [42%] of the deaths occurred during vacation days. Quality indicators revealed poor quality of health care. The main deficits in the medical records included no recording of time of informing staff members and start of management, observational chart and management plan

Conclusions and recommendations: Maternal mortality is alarmingly high. Obstetric hemorrhage and complications after caesarean section were the two main causes of death that require strict and quick management protocols

Sporicidal activity of some disinfectants against clostridium perfringens isolated from broiler poultry litter

Necrotic enteritis and the subclinical form of Clostridium perfringens infection in poultry are caused by C. perfringens type A, producing the alpha toxin, and to a lesser extent type C, producing both alpha toxin and beta toxin C and have become serious threats to poultry health. This study was undertaken to determine the activity of 4 commonly available disinfectants against C. perfringens spores after 5,7.5,10,15,30 and 60 minutes of contact under dirty conditions, Of the 4 products tested, calcium hypochlorite 1% and Germicidan KOK 4% achieved the required reduction in microbial viability [>/=10[3]-fold] for relatively long contact times of 30 min, under dirty [3% yeast] conditions, One product [Biosentury 904, 2% conc] achieved the required reduction in microbial viability [>/=10[3]-fold] for contact times of 10 minutes, while Prophyl 75,1% concentration. achieved the required reduction in microbial viability [>/=10[3]-fold] for contact times of 5minutes.Upon addition of formic acid 2% and urea 1% the required reduction improved for [Biosentury 904, 2% conc] and Prophyl 75,1% concentration and achieved after 5 minutes and after 7.5 minutes for Germicidan KOK 4% while calcium hypochlorite was not improved by addition of formic acid 2% or urea 1%. Application of surface test using the four disinfectants was used alone and in combination with formic acid 2% or urea 1% showed nearly the same results obtained in the suspension test

Inactivation of avian influenza virus using commercial chemical disinfectants in small scale poultry production

Two commercial chemical disinfectants which are commonly used currently in the Egyptian markets were tested individually for effectiveness against highly pathogenic avian influenza virus [HPAIV]A/chicken/Egypt/13VIR3729/4/2013 [H5N1]., which currently hit the Egyptian poultry farms at 2013, The tested agents were sodium hypochlorite 5% available chlorine [NaOCL] and PERACLEAN 5%[registered][Peroxyacetic Acid4.9% and hydrogen peroxide 26.5%]. The test was performed in accordance to the guidelines of American environmental protection agency [EPA], using a carrier test with surfaces [coupons] designed specially to mimic the poultry house floor and made from concrete cement, [under dirty condition resembled phase two, step two of European Committee for Standardization [CEN]. At room temperature which mimic the field condition in the Egyptian poultry farms, both sodium hypochlorite with concentration [250ppm], and PERACLEAN 5%[registered]with concentration [1%], were not able to inactivate the virus after 5 minutes contact time, while inactivation was achieved within 30 minutes contact time, which proved one of the golden rules when applying a disinfectant, that was allowing the increase of contact time between the disinfectant and influenza virus

What are the most discriminating two-dimensional and doppler sonographic features in differentiation of benign and malignant adnexal masses?

To determine the two-dimensional and doppler sonographic features that best allow differentiation between malignant and benign adnexal masses, besides develop a new scoring system enable more accurate diagnosis with these features. A cross sectional prospective study was conducted on patients scheduled for surgery due to presence of adnexal masses at Women's Health Hospital, Assiut, Egypt between October 2012 and October 2013. All patients were evaluated by 2D ultrasound for morphological features of the masses aided by doppler examination of their vessels. The final diagnosis was based on histopathological reports used as gold standard. One hundred forty-six patients were recruited, 104 with benign masses, 42 with malignant masses. Features that allowed statistically significant discrimination of benignity from malignancy were; volume of mass, type of mass, presence and thickness of septae, presence and length of papillary projections, location of vessels at colour Doppler and colour score. A scoring formula was supposed combined those features together to develop a new scoring system; Assiut Scoring System [ASS]. The cut-off score with the highest accuracy in detection of malignancy had a sensitivity of 93.5% and specificity of '92.2%. Assiut Scoring System; a multiparameter scoring that use four 2D ultrasound and two doppler features, has a high sensitivity and specificity for prediction of malignancy in adnexal masses

Study of host immunity in patients with Helicobacter pylori-related idiopathic thrombocytopenia

To test the role of T helper cell Th1 immunity we recruited 24 patients with idiopathic thrombocytopenia associated with H. pylori seropositivity. They were divided into 2 groups: 12 with immune-mediated thrombocytopenia [Group 1] and 12 with non-immune mediated thrombocytopenia [Group 2]. We also recruited 10 individuals seronegative for H. pylori [Group 3] as controls. Initial platelet count was significantly lower in Group 1 than Group 2. H. pyloriwas eradicated in 10 of 12 patients in Group 1 and in all patients in Group 2. Transient improvement [< 3 months] in the platelet count occurred in only 2 patients in Group 1 while improvement for > 6 months was observed in all patients in Group 2. There was a statistically significant direct correlation between platelet count and levels of TNF- and IFN-gamma in both study groups, while a non-significant correlation was seen in Group 3. Thus, H. pyloriinfection should be considered in the differential diagnosis of all cases of thrombocytopenia, and should be eradicated in all H. pylori-positive patients with thrombocytopenia

novel approach to improve the air quality predictions of air pollution dispersion modelling systems

The aim of this research paper is the introduction of a novel mathematical approach to improve the accuracy of the results of air pollution dispersion models based on the calibration of input background concentrations. Using the Dunkirk area of the City of Nottingham in the UK as a case study, an air pollution model in ADMS-Roads was created for developing the mathematical approach. The iterative application of this approach to the input background concentrations effectively reduced the error between not only the annual mean, but also the hourly, calculated and monitored air pollution concentrations. The traffic flow profiles of the modelled road network were included in the air pollution model and their impact on the model results, after the application of the calibration approach, was investigated. The inclusion of the traffic flow profiles reduced further the error between the hourly, but not the annual means of, calculated and monitored concentrations

Prospective study of applying testing strategy to platelet concentrate units in a trial to increase platelet shelf life

The extension of platelet storage from five to eight days was based on the functional quality and bacterial safety. It was the aim of the current study to implement a testing strategy for extended platelet shelf life up to 8 days with optimal achievement of patient safety and adequacy of treatment. Twenty random-donor platelet concentrates RDPCs were prepared under routine conditions by platelet-rich plasma [PRP] protocol then stored at 22°C under Constant agitation for 8 days. The storage changes were assessed on days 1, 5 and 8. for morphology [platelet indices and swirling], metabolic function [p1-I and glucose], cell integrity [lactate dehydrogenase "LDH"], and activation markers [flow Cytometrie analysis of CD62 and CDG3]. Correlation analysis, between the studied parameters at previous time-points storage, was performed. Microbiological culture was carried out on days 1 and 8 using automated microbial detection BACTEC system. A significant decrease in platelet counts during storage, accompanied by significant increase in mean platelet volume [MPV], was noticed. Changes in pH, glucose, and swirling were within the acceptable range. LDH levels were significantly increased on days 5 and 8. Although a gradual increase of CD62 and CD63 surface expression was seen with increasing storage time, it was not statistically significant except at day 1 for both markers and day 8 for CD62 only. A correlation between pH and glucose levels at days 5 and 8 was observed and between pH and CD62 and CD63 at days 8 and 5 respectively. All the 20 PC units were culture negative. We concluded that, the in vitro quality of the stored platelets was maintained until day 8 namely platelet Count, indices and swirling phenomena. In addition, pH, glucose remained within the acceptable range, while recorded LDH levels were considerably increased. Platelets were found to be activated at day 1, likely as a consequence of manipulation during collection and processing, but are not further progressively activated with increasing storage time. BACTEC system is suitable as rapid screening bacterial detection device for PCs

Soluble intercellular adhesion molecule-1 and lymphocyte function associated antigen-1 in viral related chronic liver diseases

We attempted to assess the relationship between soluble intercellular adhesion molecules-I [sICAM-1] in serum and ascitic fluid and its counterpart ligand, lymphocyte function associated antigen-1 [LFA-1] on peripheral blood lymphocytes, accompanied by biochemical and haematological markers of disease activity in patients with viral related chronic liver disease [CLD] classified into Child-Pugh class A to C. Serum and ascitic fluid levels of sICAM using enzyme-linked immunosorbent assay and LFA-1 expression on peripheral lymphocytes using monoclonal antibodies by flow cytometry, were measured in 44 viral-related CLD patients, and 16 healthy controls. All patients were positive for HCV-RNA in their sera, with coexistence of HBV in 5 patients. According to standard criteria of Child-Pugh classification, patients were divided into 3 groups; Child A class [17 cases], B [16 cases] and C [11 cases]. Only 17 out of 44 patients, had ascitis complicating liver cirrhosis [6 from group B and all group C] and their ascitic fluid samples were tested for bacterial detection besides sICAM. Correlation analyses between studied parameters were performed. A significant gradual increase of serum sICAM-1 level was observed in all patients compared to the control, with highest values in Child C group. Serum sICAM exhibited significant direct correlations with prothrombin time [PT], ALT and LFA-1 expression on lymphocytes while inversely correlated with serum albumin and absolute lymphocytic counts. Concentration of sICAM-1 in the uninfected ascitic fluid of the studied cirrhotic patients was tremendously lower than that in serum. Statistically significant reduction of the% of LFA-1 expression on lymphocytes was noticed on comparing Child A group to the control followed by a gradual irrelevant increase with progressing Child grading. In chronic viral hepatitis, serum levels of sICAM-1 has a prognostic significance of the synthetic capacity of the liver, also it could be considered as an additional useful marker of necro-inflammatory activity subsequently, may be helpful, especially in patients in which liver biopsy is not possible. Conversely, measurement of sICAM in the uninfected ascitic fluid is unpredictable marker being present in trace amounts. The increased serum sICAM-1 concomitant with increased LFA-1 expression on peripheral lymphocytes with advancement of the disease can reflect the increased adhesion of these cells to their ligand on endothelial cells

Efficacy of Match[registered sign] and Baycidal [registered sign] as insect growth regulators [IGRs] against adults of Culex pipiens L. mosquitoes

To evaluate the biological effects of two IGRs, Match [registered sign] and Baycidal [registered sign], on Culex pipiens mosquitoes, adults were fed on sugar solution mixed with 0.05, 0.25 and 0.5 ppm of each compound. Some delayed effects of these treatments were also determined. The results indicated that the use of the tested IGRs caused a reduction in the blood-feeding activity of mosquito females compared with the contrls. The reduction were 30.4, 39.1 and 47.8% when using Match and 36.9, 45.6 and 54.3% when using Baycidal [registered sign], respectively at corresponding concentrations. The reduction in biting activity of mosquito females may lead to a decrease in the number of fully engorged females and accordingly affect their reproductive capacity. The use of Match [registered sign] and Baycidal [registered sign] at tested concentrations caused a marked prolongation in the time needed for blood meal to be digested by C pipiens females. The prolongation percentages were 40.5, 69.0 and 71.4% when using Match [registered sign] and 61.9, 69.0 and 73.8% when using Baycidal [registered sign], respectively. Also, treatments caused a reduction in the reproductive capacity. The maximum decreasing in egg production was 34.5% at 0.5 ppm of Match [registered sign]. The result showed that the treatment by Baycidal [registered sign] at 0.05, 0.25 and 0.5 ppm led to a remarkable reduction in the egg production by 45.3, 49.3 and 55.9%, respectively, in addition, the hatchability was reduced in the treated females. A subsequent study was carried out to investigate the delayed effect of Match [registered sign] and Baycidal [registered sign] as IGRs on the newly emerged larvae. The result showed that the larval development was inhibited by 32.5, 58.0 and 89.8% when using Match [registered sign] at 0.05, 0.25 and 0.5 ppm, respectively. on the other hand the larval development was completely inhibited after the treatment of adults fed on 0.5 ppm Baycidal [registered sign]. The larvae developed till the 2nd instar but completely failed in molting to the 3rd instar. Subsequent study was conducted on the effect of Match [registered sign] and Baycidal [registered sign] on the longevity of the emerged mosquito adults, but not significant differences in the mean of adult longevity between treatments and control

Effect of different housing systems and route of vaccination on the immune response of birds against avian influenza vaccine

Immune response of birds reared under different housing systems and vaccinated against avian influenza [Al] was studied using 10 layer and 3 broiler-breeder flocks reared in either deep litter or cage systems. Blood samples were collected at intervals during rearing period and different production periods [start, peak and end of production], and haemagglutination inhibition test [HI] was carried out for all serum samples to determine antibody titers. All Birds reared in deep litter system recorded lower mean HI titers; [6.52 to 8.20 in layers, and 1.53 to 5.31 in breeders] than those reared in cages [8.69 to 10.38 in layers, and 3.27 to 8.83 in breeders]. However higher CV% were recorded in birds on deep litter [17.42 to 27% in layers, and 33.09 to 136.58% in breeders] than those in cages [7.90 to 8.84% in layers, and 10.16 to 8 1.25% in breeders]. During peak egg production all birds showed lower titers [6.52 and 10.12], with broiler-breeders showed the lowest titers [4.30 and 3.84]. On the other hand, the effect of the route of vaccination [I/M vs SIC] in broiler-breeders was also evaluated and results revealed that I/M vaccination induced better immune response [7.28] and more uniform titers [lower CV% 23.19%] than S/C route [3.86, 67.87%]. These results indicated that cage system provided better environment that enhanced the immune response of birds than those reared in deep litter system. However, the period of peak egg production could be considered as stress factor that reduce immune response. On the other hand, variation between I/M and S/C injection could be due to ill-trained vaccination teams in Egypt; who were more experienced with I/M administration of vaccines and antibiotics rather than the use of S/C route. It was concluded from this study that immune response of vaccinated poultry could be influenced by the type of housing provided for birds and also signifies the importance of the experience of team responsible for vaccine administration in order to achieve the best protective and hornogenous antibody titers in broiler-breeder birds, which will be transmitted to progeny

Isolation and sequencing of insulin-like growth factor 1 [IGF-1] from Egyptian buffalo via RT-PCR

Insulin-like growth factor 1 [IGF 1] is a member of a heterogeneous group of peptides with important growth-promoting effects in vitro as well as in vivo. It plays a fundamental role in postnatal mammalian growth as a major mediator through which growth hormone exerts its biological effects. We report the isolation and sequencing of full-length IGF-1 cDNA from bovine liver, encoding the IGF-1 protein. RT-PCR reaction was performed in which gene-specific primers corresponding to IGF-1 were utilised employing Pfu, a proof reading and high-fidelity thermostable DNA polymerase. A PCR product of 543 bp, including the open reading frame of IGF -1 gene corresponding to the expected theoretical product size, was successfully amplified. Sequencing of the purified PCR product and its double alignment against a previously known bovine gene identified it as a cDNA corresponding to IGF-1 with the open reading frame encoding the entire IGF-1 precursor of 154 amino acids

Phytotherapeutic effects of Echinacea purpurea in gamma-irradiated mice

Echinacea (E.) purpurea herb is commonly known as the purple coneflower, red sunflower and rudbeckia. In this paper, we report the curative efficacy of an Echinacea extract in gamma-irradiated mice. E. purpurea was given to male mice that were divided into five groups (control, treated, irradiated, treated before irradiation & treated after irradiation) at a dose of 30 mg/kg body weight for 2 weeks before and after irradiation with 3 Gy of gamma-rays. The results reflected the detrimental reduction effects of gamma-rays on peripheral blood hemoglobin and the levels of red blood cells, differential white blood cells, and bone marrow cells. The thiobarbituric acid-reactive substances (TBARs) level, Superoxide dismutase (SOD) and glutathione peroxidase (GSPx) activities and DNA fragmentation were also investigated. FT-Raman spectroscopy was used to explore the structural changes in liver tissues. Significant changes were observed in the microenvironment of the major constituents, including tyrosine and protein secondary structures. E. purpurea administration significantly ameliorated all estimated parameters. The radio-protection effectiveness was similar to the radio-recovery curativeness in comparison to the control group in most of the tested parameters. The radio-protection efficiency was greater than the radio-recovery in hemoglobin level during the first two weeks, in lymphoid cell count and TBARs level at the fourth week and in SOD activity during the first two weeks, as compared to the levels of these parameters in the control group.

Asessment of platelet activation in coupled schistosomiasis and viral hepatitis infection: contribution to complexity of course and development of complications

This study assessed platelet activation and possible contribution to the pathogenesis of liver cirrthosis [LC], heaptocellular carcinoma [HCC] and portal vain thrombosis [PVT].forty five patients with LC caused by dual schistosomsis and viral hepatitis infections were enrolled in the study, 15 had LC only, 15 were complicated with HCC, and 15 were complicated with PVT, addition to healthy controls. Platelet morphological parameters including platelet count, platelet crit, mean platelet volume [MPV] and platelet distribution width [PDW], as well as platelet activation as evidenced by measuring soluble platelet selectin [sP-selectin] level and the release of beta thromboglobulin [beta-TG], transforming growth factor beta-1 [TGF-beta1] and platelet derived factor-AA [PDGF-AA] were evaluated. The results obtained revealed significant reduction in platelet count, platelet crit and MPV while PDW was significantly increased in all LC patients in comparison to controls. sP selectin, beta-TG, TGF-beta1 and PDGF-AA revealed significant increase in all diseased when compared to control group. Patients complicated with HCC or PVT demonstrated significant increase in the aforementioned parameters in comparison to patients with LC only patients with PVT showed significant increase versus HCC patients. These findings indicate that platelet activation is a prominent feature in LC and its serious complication HCC and PVT This activation can play an important role the in pathogenesis of LC, HCC and PVT in patients with mixed schistosomiasis and viral hepatitis infections such patients need careful medical attention and effective treatment. Stabilization of the activated platelets and the dual suppression of PDGF and TGF-beta1 could be new therapeutic strategies against LC and its sequels.

Percutaneous nephrolithotripsy [PCNL] in morbidly obese patients: a special experience

Morbidly obese patients have an increased risk of morbidity with open stone surgery. ESWL failure rates have been recorded in obese patients in many centers. This study is designed to evaluate the feasibility of PCNL in this group of patients. Purpose to evaluate the role of PCNL in the management of uorinary stones in morbidly obese patients. Material and Thirty-eight [38] PCNLs were performed on 35 patients. Their age ranged from 40-70 years with a mean age of 50 +/- 13.7 years. BMI [body mass index] ranged from 40-58.6 Kg/m2 with a mean of 45.15 +/- 6.4 Kg/m2. PCNL was done equally on both sides [19 each]. Four patients presented with ureteric stones [upper 1/3rd], 9 patients with staghorn stones, 1 patient with multiple stones in a solitory kidney, and 24 patients with single renal stone. All patients were treated in the prone position. In most cases, the upper or the middle posterior calyceal approach was preferred. A specially designed Amplatz sheath was used. A Pneumatic Lithoclast was used in all the procedures. Residual stones were found in only 4 cases [10.6%] while the remaining 34 cases were stone free [89.4%]. None of patients had significant bleeding and no blood transfusion was required. No major intraoperative anesthetic problems occured. Operative time ranged from 100-185 minutes with a mean of 145 +/- 19.3 minutes. All patients were discharged in the first post-operative day. PCNL is a feasible procedure for treating urinary stones in morbidly obese patients. This option should be offered even in small renal stones in this group of patients

Biochemical markers, a recent trend in the evaluation of the effects of some environmental xenobiotics in experimental animals

This experimental work was conducted to determine whether such biomarkers are actually involved in the process of liver fibrosis and cell damage, hence it can be considered as an important tool to predict early latent liver cell damage. It was found that transforming growth factor beta 1 [TGF-B1] was significantly increased in sera of the exposed and recovery groups compared with the control non-exposed group. It was concluded that TGF-beta 1 was a good biomarker for early liver cell damage together with both AST and ALT enzymes

Plasma thromboxane-B2, proaccelerin activity and free fatty acids pattern in chronic liver disease, a correlative study

The aim of this study was to show the possible biochemical changes and abnormalities in different stages of liver disease and relate these parameters to the degree of liver cell affection. Seventy patients of chronic liver diseases were included in this study and classified into three groups according to the severity of liver cell affection. All the cases and the healthy control subjects were studied for plasma thromboxane-B2 [TXB2] and proaccelerin activity. Plasma free fatty acids levels using gas liquid chromatographic technique were also studied in all cases. It was clear that plasma TXB2 level, proaccelerin activity, oleic and linoleic acids levels in hepatic patients were positivity correlated. Also, the levels of these biochemical parameters were related to the extent of liver cell affection. So, these parameters can be used as a good indicator for the severity of liver disease

Assessment of fibrinolytic system in uremic patients under regular haemodialysis treatment

In order to clarify, the status of fibrinolytic system in patients with chronic renal failure undergoing regular haemodialysis, palsmingen [PLG], tissue plasminogen activator [tPA], alpha [1]. Antitrypsin [alpha [1]-AT], alpha Antiplasmin [alpha [2], AP] and Plasmingen activator inhibitor -I [PAI] had been estimated immediately before and after haemodialysis in 20 patients with primary chronic renal failure on regular haemodialysis undergoing 4-5 hours of regular haemodialysis treatment [RDT] [3] times a week. Duration of haemodialysis [HD] was 8-99 months. These values were compared with those obtained from 20 matched healthy control subjects. PLG, alpha [2] AP and PAI values decreased in CRF patients under RDT than normal control values, while no significant differences had been found before and after dialysis. No significant differences had been found between control group and CRF patients under RDT in case of tPA and alpha [1], AT. Also no difference had been found before and after dialysis in case of alpha [1] AT. However, a highly significant increase had been found between before and after dialysis in case of tPA. So, increased fibrinolytic activity druing HD is probably chiefly due to the effect of extracoporal circulation using the artificial kidney with the release of tPA from vessel walls and consequent consumption of PAI-l. It is probable that plasminogen activator is a feature of many, if not all, forms of extracorporal circulation

ECG changes in asphyxia neonatorum

A total of 25 asphyxiated term neonates, weighing over 2 kg, were divided according to the degree of asphyxia as mild [11 cases], moderate [10 cases] and severe [4 cases]. A control group consisted of 25 healthy term babies was chosen. Both groups were submitted to an adequate history thorough examination to exclude congenital heart disease and neonatal complications, and appropriate investigations [CBC, RBS, serum electrolytes, e.g. Na, K and Ca] were carried out. ECG tracings [12 lead] were done at birth on both groups, and at 2-week intervals for one month in asphyxiated cases and only one month later in control cases, aiming to illustrate the effect of asphyxia neonatorum on neonatal heart using ECG tracings

bacteriologic aid in the differential diagnosis of periapical and periodontal abscesses

The aim of the present investigation was to determine whether spirochaetal count could help differentiate between periodontal and periapical abscesses. 23 draining abscesses were included, where 15 were diagnosed as periodontal and 8 as periapical, based on clinical and radiographic data. Exudate samples were collected aseptically and examined by both dark field microscopy and Gram-stained smear. The results revealed a statistically high increase in spirochaetal count in periodontal abscesses compared to periapical ones. The obvious difference appeared adequate to differentiate both lesions and establish a rapid chairside diagnostic aid

Biochemical study of anxiety among secondary school adolescents

This work was carried out on 376 adolescent students of the first and second grades of secondary schools in Mansoura District. They were chosen through a stratified cluster sample. Anxiety score was done according to the standardized Arabic translation of Taylor's Test. Relevant data to anxiety were fulfilled through a structured questionnaire. 41.5% of these 376 students were sampled. The results revealed that, male adolescents with severe anxiety had significantly higher levels of total cholesterol [TC] and low density lipoprotein cholesterol [LDL-C] and significant decrease of high density lipoprotein [HDL-C]. Regarding corresponding lipoprotein values in female adolescents, there were no significant differences in different anxiety scores. From the questionnaire, 33.5% and 41.8% of adolescent pupils were suffering from severe and mild to moderate anxiety. Also, urban residence, lower socioeconomic standard of the family and absence of friends all are important factors contributing to anxiety state. So, mental and physical health care is recommended for this neglected age group as well as education and guidance programs are advisable