Streptococcus mutans carriage in the saliva of mothers and its association with dental caries and Streptococcus mutans carriage in the saliva of children between 6 and 30 months old in a low-income setting in Karachi, Pakistan.

BACKGROUND: Early childhood caries poses a significant health issue in children under 6 years old. It is determined that Streptococcus mutans is a primary etiological agent, likely to be transferred through maternal contact. OBJECTIVES: To determine the association of maternal S. mutans counts with S. mutans counts in their children between 6 and 30 months of age, and to determine the maternal and child DMFT (decayed, missing, and filled teeth) indices. MATERIAL AND METHODS: A community-based cross-sectional study was conducted in Karachi, Pakistan. A sample of 193 dyads of mother-children (6-30 months of age) was selected via purposive sampling. Saliva samples of the dyads were collected to assess S. mutans count. Caries assessment was performed for both using the DMFT index. A pretested questionnaire was used. The association of bottle-feeding, oral hygiene measures, and other factors with S. mutans counts in children were also explored. Zero-inflated negative binomial regression model at a 5% level of significance was applied using STATA version 12.0. RESULTS: Out of 193 children, 109 (56.47%) were males and 84 (43.52%) were females. The mean age of mothers and children was 29.4 ± 6.2 years and 19.54 ± 6.8 months, respectively. Maternal S. mutans counts were not statistically associated with child's S. mutans counts (Mean child's S. mutans count ratio: 1; 95% confidence interval [CI]: 1, 1.01; p = .882). Compared with children who were breastfed, S. mutans counts were higher in children who were bottle-fed (mean S. mutans count ratio= 4.85 [95% CI: 1.53, 15.41], p = .007). Age of mother and present caries status of mothers was significantly associated with the child's S. mutans count. CONCLUSION: No association between maternal S. mutans and child S. mutans was observed. However, maternal age, children who were breastfed, children who did not use pacifiers, and children with mothers who did not have caries, exhibited low S. mutans counts in their saliva.

Factors associated with dengue fever IgG sero-prevalence in South Kordofan State, Sudan, in 2012: Reporting prevalence ratios.

BACKGROUND: Dengue fever (DF) is a vector-borne virus transmitted to humans by infected Aedes mosquitoes. In this study, we identified the most important factors associated with the prevalence of IgG antibodies in a border state between Sudan and the new republic of South Sudan. OBJECTIVES: To quantify the association of specific factors with the prevalence of DF IgG antibodies in Lagawa among subjects aged 16-60 years in 2012. METHODOLOGY: Analytical cross-sectional community-based study conducted in Lagawa in 2012. RESULTS: Indoor mosquito breeding was the most significant predictor affecting DF IgG serology. Household water storage was also strongly associated with the presence of IgG antibodies. Residence in urban areas, younger age and a history of travel to the Red Sea State were significant predictors of DF IgG seroprevalence in South Kordofan state. CONCLUSION: Indoor (household) behaviors associated with DF infection should be modified to mitigate the infection risk in the study area. Awareness should be raised regarding DF in Lagawa to ensure community participation in all control measures, and the surveillance system at the border between Sudan and the republic of South Sudan should be strengthened.

Effect of gender on pain perception and analgesic consumption in laparoscopic cholecystectomy: An observational study.

BACKGROUND: Evidence regarding gender affecting the response to pain and its treatment is inconsistent in literature. The objective of this prospective, observational study was to determine the effect of gender on pain perception and postoperative analgesic consumption in patients undergoing laparoscopic cholecystectomy. MATERIALS AND METHODS: We recruited 60 male and 60 female patients undergoing elective laparoscopic cholecystectomy. Patients were observed for additional intraoperative and postoperative analgesia. Numerical rating scale was documented at 10 min interval for 1 h in post-anesthesia recovery room and at 4, 8, and 12 h postoperatively. Boluses of tramadol given as rescue analgesia were also noted. There were no dropouts. RESULTS: The mean pain scores were significantly higher in female patients at 20 and 30 min following surgery. Mean dose of tramadol consumption was significantly higher in female patients for the first postoperative hour (P = 0.002), but not in the later period. CONCLUSION: Female patients exhibited greater intensity of pain and required higher doses of analgesics compared to males in in the immediate postoperative period in order to achieve a similar degree of analgesia.

Knowledge about Pain Clinics and Pain Physician among General Practitioners: A Cross-sectional Survey.

INTRODUCTION: There is an on-going debate about what qualifies one to be called a "pain physician" and who can run the "pain clinic". Currently, the discipline of anesthesiology is producing the majority of pain physicians. A literature search was unable to find data for any Pakistani or other South Asian countries with regards to general practitioner (GP) knowledge about pain clinics and pain physicians. The main objective of this study was to assess the awareness of GPs regarding the existence of the pain clinic and pain physician. METHODS: A total of 411 GPs were included in this cross-sectional survey. A questionnaire consisting of ten questions was designed to identify their knowledge about the existence of pain clinics and pain physicians. Questionnaires were completed in the field and edited for the inconsistencies and in-completeness. RESULTS: The results showed that only 52.6% of GPs were aware of the existence of pain clinics. The survey showed that 37.5% believe neurologists are the pain physicians and only 10.9% know that pain clinics are run by anesthesiologist. The vast majority (85.0%) are unaware of the modern pain relieving methods used in pain clinics. CONCLUSION: The survey indicates that nearly half of the GPs are unaware of the existence of pain clinics and pain physicians, and the majority of GPs are unaware of new pain relieving methods.

Quantitative and Qualitative Analysis of PubMed-Indexed Biomedical Publications in Oman from years 2005-2009.

OBJECTIVES: Research activities are promoted at the government and the institutional levels in Oman. However, the quantity and quality of research conducted in various institutes of Oman has not been measured. Therefore, this study was conducted to analyze the quantity and quality of biomedical publications emanating from Oman over the last five years (2005-2009). METHODS: Data regarding the biomedical publications of Omani origin published from January 2005 to December 2009 were retrieved from Pubmed. All abstracts were manually checked to exclude false retrievals. The journal impact factor (IF) for 2008 was applied for every publication. Full-length original articles, review articles and publications mentioning new research methods/new technique were assigned full IF of the journal. However, half of the journal IF were assigned to correspondences/commentaries, case reports/series and short communications. RESULTS: Of biomedical publications, 752 were retrieved from Pubmed and 519 publications were included for final analysis after excluding false positives. The number of biomedical publications steadily increased over the last five years, but it was not statistically significant. Original research articles constituted more than half (54.3%) of all the publications, followed by case reports/series (30.1%). Sultan Qaboos University (SQU) contributed more than half of the biomedical publications (51.5%), followed by the Ministry of Health (MoH), which contributed 38% of the publications. Interestingly, the mean IF of the publications was not significantly different throughout the years. CONCLUSIONS: The number of publications emanating from Oman increased over the last five years; however, the quality of research has not improved. Furthermore, the research in Oman is mainly conducted by the government-run institutions and there is hardly any contribution from the private institutions.

Drug-prescribing patterns during pregnancy in the tertiary care hospitals of Pakistan: a cross sectional study.

BACKGROUND: The rationale for use of drugs during pregnancy requires a careful assessment as in addition to the mother, the health and life of her unborn child is also at stake. Information on the use of drugs during pregnancy is not available in Pakistan. The aim of this study was to evaluate the patterns of drug prescriptions to pregnant women in tertiary care hospitals of Pakistan. METHODS: This was a cross-sectional study conducted at five tertiary care hospitals of Pakistan. Copies of outpatient medicinal prescriptions given to pregnant patients attending the antenatal clinics were collected. The drugs were classified according to the pharmacological class and their teratogenic potential. RESULTS: All the pregnant women attending the antenatal clinics received a prescription containing at least one drug. A total of 3769 distinct prescriptions given to different women were collected. Majority of the women who received the prescriptions belonged to third trimester (55.4%) followed by second (33.6%) and first trimester (11.0%). On an average, each prescription contained 1.66 +/- 0.14 drugs. The obstetricians at Civil Hospital, Karachi and Chandka Medical College Hospital, Larkana showed a tendency of prescribing lesser number of drugs compared to those in other hospitals. Anti-anemic drugs including iron preparations and vitamin and mineral supplements (79.4%) were the most frequently prescribed drugs followed by analgesics (6.2%) and anti-bacterials (2.2%). 739 women (19.6%) received prescriptions containing drugs other than vitamin or mineral supplements. Only 1275 (21.6%) of all the prescribed drugs (n = 6100) were outside this vitamin/mineral supplement class. Out of these 1275 drugs, 29 (2.3%) drugs were prescribed which are considered to be teratogenic. Misoprostol was the most frequently prescribed (n = 6) among the teratogenic drugs followed by carbimazole (n = 5) and methotrexate (n = 5). Twenty nine pregnant women (0.8% of all the women studied) were prescribed these teratogenic drugs. CONCLUSION: Less than one percent of the pregnant women attending tertiary care hospitals in Pakistan are prescribed teratogenic drugs. The prescribing practices of Pakistani physicians are similar to those in western countries.