Chiari Type 1 malformation: A case report

Type I Chiari malformation (CM) is an acquired or congenital disorder characterized by herniation of the cerebellar tonsils through the foramen magnum and into the spinal canal. The resulting anatomic abnormality impairs the flow of cerebral spinal fluid and results in the Chiari symptoms and signs. The purpose of this study was to report a case of successfully treated CM Type 1 that was discovered accidentally during childhood. A 9-year-old female presented to the emergency department complaining of dizziness and headache. Before her admission, she lost balance and collapsed to the ground fainting. A magnetic resonance imaging (MRI) scan of the brain disclosed herniation of cerebellar tonsils through the foramen magnum at 13 mm below the spinal canal. It is very difficult to determine the true frequency of this disorder early in childhood. A definitive diagnosis is generally made after a MRI, where the abnormal protrusion of the cerebellum toward the spinal cord can be seen

Effectiveness of premarital screening program for thalassemia and sickle cell disorders in Ras Al Khaimah, United Arab Emirates

PURPOSE: Genetic disorders can be prevented by basic public health measures and activities that focus primarily on education and approaches in Primary Health Care. Premarital screening is one such approach that can identify asymptomatic carriers of hemoglobinopathies and provide genetic counseling to couples for a healthy reproductive life. This study aimed to estimate the prevalence of beta thalassemia and sickle cell disorders in the adult population screened as a part of the United Arab Emirates Premarital Screening Program and to measure the effectiveness of the program in decreasing high-risk marriages in Ras Al Khaimah (RAK). MATERIALS AND METHODS: A retrospective, population-based study was conducted at the RAK Primary Health Care Center, where the National Premarital Screening Program is implemented. The study included data collected from the premarital screening records of all couples who had applied for a marriage license during 2008-2015. RESULTS: Of the 17,826 individuals screened during the studied period, 4.02% (717) were diagnosed as positive for hemoglobinopathies. The prevalence of beta thalassemia and sickle cell disorders among the total study population was 2.98% and 1.05%, respectively. The hemoglobinopathy trait was more prevalent than the disease. Among these 8,913 couples who were issued certificates for compatibility based on screening tests, 28 (0.31%) couples were declared high-risk (unmatched). Seventy percent of these unmatched couples reported consanguineous marriages. CONCLUSION: The program was successful in achieving its objective of identifying high-risk marriages. In spite of the counseling, however, all of the high-risk couples still married each other.

Evaluation of knowledge change of internal medicine residents following a training program in smoking cessation

One of the major barriers to smoking cessation practice is that many health professionals do not have the knowledge and skills on how to intervene. To assess the effect of a training program on physicians' knowledge about tobacco dependence and cessation interventions. Subjects and Methods: A comprehensive training program was given to internal medicine residents in Cairo University Hospitals, Egypt during 2008-2009. An anonymous, 11-item questionnaire was administered before and after the training program. The training process was evaluated by participants' satisfaction using a 13-item checklist. The objective of the study was adequately explained to participants and their consensus was obtained with assured confidentiality. A total of 163 internists entered the training program. Improvement in overall knowledge was evidenced by higher mean score in the post-test than pre-test [6.2 vs. 4.7 ; p<0.001]. Significant improvement were seen in the participants' knowledge related to assessment of tobacco dependence [61% vs. 27%; p<0.001], interventions for smokers willing to quit [51.6 vs. 28.2%; p<0.001], interventions for smokers unwilling to quit [40.8 vs. 19.6%; p<0.001] and coping skills to handle withdrawal symptoms [52.9 vs. 30.7; p<0.001]. Almost all participants reported that the training was very useful [96%] and applicable [85.6%] in their medical practices. Targeted training of health professionals has a potential to translate into improved smoking cessation counseling and to increase their inclination to intervene. Policy message: Continued medical education and regular/targeted training of health providers should be done

Characteristics of women smoking in water pipe cafes in Cairo, Egypt

Tobacco use is increasing throughout the developing world. In particular, the use of water pipes to smoke tobacco has become increasingly popular among women. Many women water pipe users go to cafes to smoke rather than doing so at home, where it may not be allowed or accepted by family or neighbors. Although effective tobacco control policies will require an understanding of the complex socio-demographic, behavioral, and motivational characteristics of such women, they have been underrepresented in previous surveys of tobacco use. In order to address this knowledge gap, our study was conducted in Cairo, Egypt, to determine the personal and social characteristics of women smokers, their use of cigarettes and water pipes, and their attitudes, beliefs, and knowledge towards tobacco smoking and its health effects. An anonymous self administered questionnaire was given to women who smoked in water pipe caf‚s. A total of 630 subjects participated: 49% were cigarette-only smokers, 23% smoked both cigarettes and water pipes, and 28% exclusively smoked water pipes. The median age was 32.5 years, while those who exclusively smoked water pipes were younger than cigarette smokers on average [29 vs. 37, p<.001]. Cigarette smokers started smoking at a younger age [median 22 years] than water pipe smokers [mean 24 years, p<0.01]. Marital status was strongly associated with many of the surveyed factors: 63% of the unmarried women participants were water pipe smokers, compared to 41% of the married women and 41% of divorced or widowed women [p<0.01]. Being unmarried was also associated with the belief that water pipe smoking is less harmful than cigarettes [44% vs. 38% of married women, and 27% of divorced/widowed]. The results of this study suggest that future tobacco control efforts in Egypt will need to specifically address the use of tobacco products by women in caf‚s, where it is.becoming increasingly popular for women to smoke