Study of the effect of dietary counselling on the improvement of end-stage renal disease patients

Proper nutrition may help to reverse the wasting syndrome in dialysis patients with kidney disease on dialysis. This intervention study aimed to identify malnutrition problems and assess the effect of dietary counselling on improvement of health status of end-stage renal disease patients subjected to haemodialysis. Pre-intervention data were collected from 41 patients attending El Haram dialysis centre, Giza, Egypt; 97.5% of the patients were considered mildly to moderately malnourished and multiple malnutrition problems were detected [protein-energy malnutrition, hypocalcaemia, and anaemia and hyperphosphataemia]. Nutritional counselling sessions resulted in statistically significant post-intervention improvements in Karnofsky performance scale scores, malnutrition inflammation scores and nutritional knowledge of the patients. Providing one-to-one nutrition counselling could be linked to improvements in the patients' nutritional knowledge and practices and to their health status and performance in activities of daily life

Pethidine and the rate of cervical dilatation

This study comprised 141 cases [87 controls and 54 receiving pethidine], all matched in age, parity, presentation, and mode of delivery. Both controls and the studied cases were divided into two groups: A primigravid and a para 1 group. Pethidine was given only at the outset of active labor, intravenously, in a dose of 100 mg diluted in 10 cc saline. The rate of cervical dilatation was recorded for each patient. The results were evaluated statistically by the Student's test. Rates of cervical dilatation of the pethidine treated group were significantly higher than the control group [P <0.001]. This applied for primigravid [P <0.005] as well as para 1 patients [P <0.002]. It is recommended to give pethidine intravenously during the start of the active phase of labor, more specially in primigravid parturients

Utilization of maternal health services [MHS]: a comparative study between residents and nomads

The patterns of utilization of maternal health services [MHS] by Qubah residents [n = 66, 64.71%] and mobile nomads [n = 36, 35.29%] have been compared. Patients were studied who attended the Qubah Primary Health Care Centre [PHCC] in the month of Rajab, 1409H [7 February 1989 to 7 March 1989], a peak time for nomads to aggregate in the surrounding area of Qubah which has two small villages [higars] nearby. The relevant data including age, weight, distance travelled, details regarding registration at PHCCs, antenatal, natal and postnatal follow-up, and laboratory tests performed, were recorded on a semistructured proforma. Following computer data analysis, it was revealed that nomadic women were comparatively underweight [48.9 + 7.14 vs 53.46 + 10.1], had low levels of Hb [11.18 + 1.91 vs 12.33 + 0.41], travelled a long distance [38.89% >40 km], and were underregistered [13.89% vs 1.52%]. They underutilized the MHS prenatally [mean visits 2.10 vs 10.6], and postnatally [mean visits, 0.72 vs 2.8], attended Qubah PHCC at an advanced stage of gestation [61.11% vs 7.58%], had higher rates of home or hut deliveries [52.78% vs 9.09%]. It was concluded that nomadic women, to a significant extent lagged behind in utilizing the MHS. In the light of this pilot study, we propose some recommendations which include the establishment of new health units in higars, with the feasibility of opening maternity waiting homes, upgrading the skills of traditional birth attendants, and last but most important a larger multicentre study