Khat chewing and bladder neck dysfunction. A randomized controlled trial of alpha 1-adrenergic blockade.

OBJECTIVE: To assess whether the effect of chewing khat leaves (Catha edulis) on the urodynamics of healthy males is altered by the selective alpha 1-adrenergic blocking agent indoramin in a prospective randomized double-blind controlled trial. SUBJECTS AND METHODS: The urodynamics of 11 healthy males were studied before and during a khat chewing session preceded by indoramin or placebo. RESULTS: Khat chewing produced a fall in average and maximum urine flow rate. This effect was inhibited by indoramin. CONCLUSIONS: The urinary side-effects of khat chewing are probably mediated through stimulation of alpha 1-adrenergic receptors.

Towards minimizing postoperative wound infection.

The rate of postoperative wound infection was found to be low at 1.12% overall in a prospective study. This was achieved by careful preoperative preparation, judicious use of cheap prophylactic antibiotics which are included in the WHO model list of essential drugs, and meticulous operative technique.

Stunting and tissue depletion in Yemeni children.

With the aim of assessing whether stunting was associated with depletion of labile tissues such as fat and muscle as an indicator of ongoing malnutrition, we investigated 1176 children 0-7 years of age in PDR Yemen, who participated in a national nutrition survey conducted in 1982-3 and its pilot study from 1978. Arm circumference and triceps fatfold have been measured and upper arm fat area (UFA) and upper arm muscle area (UMA) were calculated to estimate the body stores of fat and muscle. Stunting, defined as a stature shorter than -2 SD of the reference mean, was found in one-third of the children. The average length/height for age deviated progressively from the reference mean up to age group 12-15 months. Exclusively breast-fed infants also deviated in length, although less conspicuously than infants fed in other ways. There was a consistent pattern of smaller UFA and UMA in stunted children compared to equally tall children who were not stunted below 84 cm of height for boys and 102 cm for girls. The difference was statistically significant in a few of the height groups. It is suggested that stunting is accompanied by a slight reduction of fat and muscle tissues during the first years of life.

Mortality among children in rural areas of the People's Democratic Republic of Yemen.

A prospective study on health and mortality of children under 7 years of age was conducted in rural parts of PDR Yemen during 1982-84. Altogether, 2071 children and 976 mothers were followed for 1 year and visited twice. The infant mortality rate (IMR), child mortality rate and under-5 mortality rate were 86, 11 and 129 per 1000, respectively. Sixty per cent of all deaths occurred during infancy. Diarrhoea commonly preceded death during infancy, and symptoms of measles during the 2nd year of life. The mothers of the deceased children were younger than the average rural mother (P less than 0.05) and more often primiparae, whereas illiteracy rates and median income did not differ from families which had not experienced death of a child. The risk of dying within 1 year was three times greater for wasted children in general, but 24 times greater for 1-2-year-olds. No increased risk was found for stunted children at any age. The prevalence of bottle feeding up to 18 months of age was high, and exclusive breastfeeding below 6 months of age was rare in the villages with the highest IMR (P less than 0.05). Infections seemed to be the trigger factor for death, but wasting predisposed to death at least after infancy.

Growth and malnutrition among preschool children in Democratic Yemen.

A cross-sectional anthropometric study of children aged 0-84 months was performed in 1982-83 in Democratic Yemen. The total sample included 3407 children, representing populations from urban, rural, and slum areas of the country. NCHS/WHO growth data were used for reference purposes.A high overall prevalence of wasting (8.7%) and stunting (35.2%) was found among the children. However, rural children exhibited a satisfactory weight-for-height during the first 6 months of life compared with both the reference and the urban and slum children. Slum children had a high prevalence of wasting during the first 18 months of life.For the younger age groups, rural children were shorter than urban children, but at 7 years of age all the children were similar, with a mean height-for-age corresponding to -1.7 standard deviations of that for the reference population. Mothers in the urban area weighed significantly more than those from the slum or rural areas (P<0.001), but all mothers had similar heights.