Public Knowledge of Oral Cancer and Modelling of Demographic Background Factors Affecting this Knowledge in Khartoum State, Sudan.

OBJECTIVES: Knowledge of oral cancer affects early detection and diagnosis of this disease. This study aimed to assess the current level of public knowledge of oral cancer in Khartoum State, Sudan, and examine how demographic background factors affect this knowledge. METHODS: This cross-sectional study involved 501 participants recruited by systematic random sampling from the outpatient records of three major hospitals in Khartoum State between November 2012 and February 2013. A pretested structured questionnaire was designed to measure knowledge levels. A logistic regression model was utilised with demographic background variables as independent variables and knowledge of oral cancer as the dependent variable. A path analysis was conducted to build a structural model. RESULTS: Of the 501 participants, 42.5% had no knowledge of oral cancer, while 5.4%, 39.9% and 12.2% had low, moderate and high knowledge levels, respectively. Logistic regression modelling showed that age, place of residence and education levels were significantly associated with knowledge levels (P = 0.009, 0.017 and <0.001, respectively). According to the structural model, age and place of residence had a prominent direct effect on knowledge, while age and residence also had a prominent indirect effect mediated through education levels. CONCLUSION: Education levels had the most prominent positive effect on knowledge of oral cancer among outpatients at major hospitals in Khartoum State. Moreover, education levels were found to mediate the effect of other background variables.

Principles and general strabismus surgical rules in cyclovertical eye muscle palsies.

Cyclovertical muscle palsies are very common. We propose rules that help clinicians and resident physicians diagnose easily the affected muscle. We simplified evaluation of the deviation by measuring it only in the cardinal directions of gaze and omit the oblique fields of gaze. Then the Beilschowsky forced head tilt test is done routinely along with measurement of the cyclotorsion by the double Maddox rod test. In oblique muscle palsy, when the vertical deviation is less than 15 prism diopters (PD), the procedure of choice is weakening of the direct oblique antagonist muscle. When the deviation is over 15 PD, the procedure of choice - unless there is spread of comitance - is to weaken, in addition to the antagonist oblique muscle, the contralateral inferior rectus (IR) muscle in superior oblique palsy (SOP) and the contralateral superior rectus (SR) muscle in inferior oblique palsy (IOP). In vertical rectus muscle palsy, the procedure of choice is to weaken the direct antagonist vertical rectus muscle alone when the vertical deviation does not exceed 15 PD. In case it exceeds 15 PD, a recess/resect procedure is done on the vertical rectus muscles. Horizontal rectus muscle transposition surgery is limited to total paralyses of the SR and IR muscles. Spread of comitance is more common in oblique muscle palsy than in vertical rectus muscle palsy. When it takes place, the incomitant vertical deviation in oblique muscle palsy becomes comitant and the rather comitant vertical deviation in vertical rectus muscle palsy becomes incomitant. When cyclotropia is associated with vertical deviation, proper surgery for the vertical deviation almost always corrects the clyclotropia. Isolated cyclotropia is extremely rare in cyclovertical muscle palsies. Despite careful observation to rule out bilaterality, and despite cautious surgery, an apparent palsy of the contralateral superior oblique (SO) may surprisingly and occasionally appear. Nevertheless, surgical overcorrection is not rare.

Cigarettes and waterpipe smoking among medical students in Syria: a cross-sectional study.

OBJECTIVES: To investigate tobacco use, beliefs and attitudes among medical students in Syria. METHODS: A cross-sectional study of a random sample of 570 medical students (first and fifth year) registered at the Damascus University Faculty of Medicine in 2006-2007. We used a self-administered questionnaire for demo-graphic information, smoking behaviour (cigarette, waterpipe), family and peer smoking, attitudes and beliefs about smoking and future role in advising patients to quit smoking. RESULTS: The overall prevalence of tobacco use was 10.9% for cigarettes (15.8% men, 3.3% women), 23.5% for waterpipe (30.3% men, 13.4% women) and 7.3% for both (10.1% men, 3.1% women). Both smoking methods were more popular among the fifth year students (15.4% and 27%) compared to their younger counterparts (6.6% and 19.7%). Regular smoking patterns predominated for cigarettes (62%), while occasional use patterns predominated for waterpipes (83%). More than two thirds of students (69%) thought they might not address or would have difficulty addressing smoking in their future patients. CONCLUSION: The level of tobacco use among Syrian medical students is alarming and highlights the rapidly changing patterns of waterpipe use, especially among female students. Medical schools should work harder to tackle this phenomenon and address it more efficiently in their curricula.