Prevalence and risk factors of ibs among medical and nonmedical students in the jouf university.

BACKGROUND: Irritable bowel syndrome is common in the community and its prevalence is higher among the medical students. AIM: The current study was carried out to estimate the prevalence and evaluate the risk factors of irritable bowel syndrome among medical and nonmedical students of the Jouf University. SUBJECTS AND METHODS: This cross-sectional study was carried out among medical and nonmedical students of the Jouf University. Study targeted 200 medical and nonmedical students using the convenience sampling technique. A self-administered questionnaire was adopted for the study and consisted of three parts with questions on demographic characteristics, lifestyle, eating habits, academics, and irritable bowel syndrome. Descriptive statistics were carried out to present the demographic characteristics. Chi-square test, odds ratio with 95% CI was calculated for analyzing differences between study variables using SPSS version-16. Multivariate analysis of lifestyle and dietary predictors of IBS was carried out by the enter method. RESULTS: With a response rate of 90.5%, 181 students completed the questionnaire. Around 53 (29.28%) were found to be suffering from IBS with 41 (77.35%) being males. Male gender, married status, and living status of participants were significantly associated with the occurrence of IBS. Prevalence of IBS was found to be more in students who were from the medical college (P = 0.000), students who smoke (P = 0.003), who slept less than 8 h (P = 0.042), and students who often take carbonated drinks (P = 0.003). Smoking, frequency of exercise, coffee intake, and intake of carbonated drinks were strong predictors of IBS on multivariate analysis of lifestyle and dietary factors. CONCLUSION: We conclude that there is an increased prevalence of irritable bowel syndrome among medical students. Male gender, married status, living in hostel, smoking, less than 8 h sleep, and carbonated drinks were predictive factors for IBS in our study. We recommend screening of medical students for irritable bowel syndrome and institution of interventional measures.

Diagnostic accuracy of FNAC and cyto-histopathological correlation in testicular and paratesticular mass lesions.

OBJECTIVE: FNAC has a definitive role and has proved extremely useful in diagnosis of testicular and paratesticular mass lesions. In view of the dearth of literature of studies involving large cohorts of patients, the present study describes at length the detailed cytological evaluation of testicular and paratesticular mass lesions. METHODS: Our study consisted of 85 cases in 5-year retrospective and 1-year prospective analyses carried out in the Department of Pathology, Government Medical College, Jammu. The study depicts cytomorphological findings of testicular and paratesticular mass lesions. We evaluate the concordance rate of cytological diagnosis with the histological diagnosis as a percentage and assess the diagnostic accuracy of FNAC by calculating sensitivity and specificity. RESULTS: Out of 85 cases, inflammatory lesions comprised the largest group comprising 47 cases (55.29%) followed by 20 cases (23.5%) of cystic lesions. In addition, there were 10 cases (11.76%) of malignant tumours and three cases (3.5%) of benign tumours. Overall, acute orchitis was the most common inflammatory lesions (12.94%) followed by tubercular epididymitis (9.4%). The most common cystic lesion was benign epididymal cyst (10.5%) and the most common malignant tumours were seminoma and embryonal carcinoma. Cytohistological correlation was available for 16 (18.82%) cases only and cytological diagnosis was concordant with the histological diagnosis in all these cases. Sensitivity and specificity of FNAC was 100% in our study. CONCLUSION: FNAC is a useful diagnostic modality for testicular and paratesticular mass lesions due to its high sensitivity and specificity in discriminating between different types of lesions and high concordance rates with histopathological diagnosis.

Causes of mortality in diabetes mellitus: data from a tertiary teaching hospital in India.

BACKGROUND: Mortality studies can show the relative contribution of diabetes to mortality in the total population, and they can provide important descriptions of the changes in causes and frequency of diabetes mortality over time. OBJECTIVE: To find the mortality pattern in people with diabetes admitted to a tertiary care hospital in a developing country, using underlying/contributory causes of death. METHODS: In this retrospective study, mortality trends among people with diabetes admitted to Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India were reviewed by screening the hospital records of all people with diabetes who died over the last 9 years, carrying forward earlier observations from the same centre. RESULTS: Of 234 776 people admitted to the centre during the review period, 16 690 (7.11%) died; 741 (383 men) of these had diabetes mellitus mentioned on the death certificate. The mean (SD) age at death for people with diabetes was 60.07 (13.62) years in men and 57.36 (13.40) years in women. The leading contributory causes of death were infections (40.9%), chronic renal failure (33.6%), coronary artery disease (16.9%), cerebrovascular disease (13.2%), chronic obstructive pulmonary disease (6.9%), acute renal failure (6.2%), malignancy (4.2%), hypoglycaemia (3.5%) and diabetic ketoacidosis (3.4%). The cause of death could not be ascertained in 2.8% of cases; in 52.9%, 36.3% and 8.0% cases one, two and three or more causes, respectively, were recorded as the cause of death. CONCLUSIONS: The aetiological spectrum of mortality in people with diabetes at this Indian centre continues to be dominated by infections and renal failure, which is different from that in the developed world, where coronary artery disease and cerebrovascular disease are the principal causes of death in people with diabetes.

Etiological profile of nephrotic syndrome in Kashmir.

Our study aimed to obtain a comprehensive insight into the etiology of nephrotic syndrome in our patient population. We analyzed medical records of 290 patients with diagnosis of nephrotic syndrome as defined by International Study of Kidney Disease in Children (ISKDC), between January 1987 and December 2000, at the Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar. Primary glomerular disease was found to be the most prevalent, accounting for 91.73% of all glomerular diseases. Among primary glomerular diseases, minimal change disease (MCD) was the most common histological lesion (43.79%). Most patients presented within 3 months duration (61.4%) and the most common symptom was puffiness of face (98.45%) followed by pedal edema (91%). Focal segmental glomerulosclerosis (FSGS) was the second most common lesion (16.89%) followed by membranous glomerulonephritis (GN) (13.4%) and membranoproliferative GN (11.72%). Amongst secondary glomerular diseases, diabetes mellitus was the most prevalent (4.48%), followed by lupus nephritis (3.1%). In conclusion, primary glomerular diseases constituted the most common group encountered and the prevalence of MCD was quite high with males, children and young adults. FSGS was associated with a high prevalence of end-stage renal disease (ESRD; 26.53%), hypertension (71.42%) and hematuria (81.63%).

The realization of a project aimed at reducing the plasmatic lipid level in a large Italian population improves the mean calcium daily intake: the Brisighella Study.

OBJECTIVES: Evaluation of the impact of a coronary heart disease prevention program on calcium, magnesium, phosphorus and vitamin D dietary intake in respect of recommended daily allowances in a large Italian rural population. DESIGN: Retrospective analysis of the Brisighella Study dietary data. The Brisighella Study started in 1972 as a longitudinal study on atherosclerosis risk factors. SETTING: Brisighella, a rural North Italian village. SUBJECTS: The Brisighella population's dietary habits were monitored from 1980 every 4 h through a dietary record sheet. 1,350 constantly tested subjects were subdivided according to NHI Consensus Conference on Calcium RDA. INTERVENTION: In 1986, the studied subjects were invited to reduce their consumption of animal fats and cholesterol through a Nutrition Educational Program (NEP). RESULTS: Before NEP, calcium intake was low in each sex and age category: 20-40% of the populatioin had a daily intake < 550 mg. In 1988, among the 1350 subjects who constantly completed the questionnaire (M = 651, F = 699), the mean calcium intake significantly rose in all age categories: M = 1,003 (25-65 y) and 877 ( > 65) mg/24h (P < 0.001 vs 1984); F = 923 (25-50), 860 (51-65) and 767 (> 65)mg/24h (P < 0.05). In 1992, 3y after the NEP conclusion, calcium intake dropped in each sex and age category. The NEP influenced vitamin D, phosphorus and magnesium intakes less. CONCLUSIONS: A collective NEP aimed at lowering saturated fats and cholesterol intakes, improves the calcium intake; in order to maintain their efficacy on nutritional habit changes, these programs must become an ongoing item.

[Epidemiologic model for the assessment of health needs]. / Un modello epidemiologico per la valutazione dei bisogni di salute.

Health is a high priority in public health planning, a process by which health, services and resources are connected to each other. Assessing peoples health needs is one of the most difficult tasks, because of the lack of information on the spread of diseases, the seriousness of them and their capacity to disable, as well as the lack of timely and appropriate information on them. The epidemiological model put forward describes the volume of resources necessary to maintain the health needs of a population as depending upon the prevalence of diseases, the health services used to combat these diseases and the consequent human and financial resources employed. According to this model the management of the supply of health services depends on monitoring the relationship between population, disease, health services and resources.

A prospective study of electrocardiographic features in adult black hypertensive patients at the Kenyatta National Hospital, Nairobi.

A prospective study of electrocardiograms (ECG's) was carried out on 102 adult hypertensive African patients at the Kenyatta National Hospital. Their mean age was 45.2 years. All the patients had normal sinus rhythm. Forty seven percent of the patients had sinus bradycardia, although this could be attributable to the drugs they were taking. The duration of the P wave increased with the severity of hypertension. Twenty five percent of the patients had evidence of first degree A-V block. This was an expected finding as most of the patients were on treatment with B-adrenoreceptor blocking agents. Two patients had LBBB and none had RBBB. There were 13 patients with evidence of left axis deviation (LAD) and the incidence increased with the severity of hypertension. S-T, T changes were noted in 12.8% and 29% of patients respectively. Q-Tc duration did not increase with severity of hypertension. Left ventricular hypertrophy was noted in 27.5% of the patients using the criteria devised by Romhilt et al.