Stress among medical Saudi students at College of Medicine, King Faisal University.

BACKGROUND: Sources of student stress can be academic pressures, social or personal issues and medical students have to face the challenge of rigorous curriculum and also have to learn how to deal with emotionally difficult experiences. AIM OF WORK: Determination of the prevalence of stress and to identify the risk factors of stress among Saudi medical students at Faculty of Medicine, King Faisal University, Saudi Arabia. METHODS: A survey study design was conducted among medical students at Faculty of Medicine, King Faisal University, Al Ahsaa Governorate, Eastern Province from February-May, 2013. Both male and female students were invited to participate in our study. The total number of students was 650 Saudi medical students, out of them 244 medical students were participated in the current study. All participants were provided a self administered questionnaire. A likert scale with 3 points for responses was used. Questionnaires were given to participants 2 month before end-semester examinations, to minimize the extra stress symptoms A score of stress was calculated. RESULTS: Prevalence of stress was 53% among Saudi students. Gender has no role in stress among medical students (p > 0.05). Logistic regression analysis revealed the most important risk factors of stress, having places for recreation at the University showed a relationship with stress among medical students with a p value = 0.000, there is a statistically significant relationship between stress and having optimal place for studying outside the university p = 0.001, while, comparing number of sleeping hours with stress, we could not find a statistically significant relationship among medical students, p = 0.744. Medical students who had close friends to share with them their stresses and concerns showed a highly statistically significant relationship between stressed and unstressed students p = 0.001. CONCLUSION: Medical students reported high levels of stress. The most frequently occurring stressors among the students were related to academic and psychosocial domains. The associations between stressed cases and gender, occurrence of academic and psychosocial stressors need to be further tested by prospective studies.

Vesicovaginal fistula: a review of nigerian experience.

BACKGROUND: Vesicovaginal fistula is a preventable calamity, which has been an age-long menace in developing countries. OBJECTIVE: To review the causes, complications, and outcome of Vesicovaginal fistula in Nigeria. METHODS: Studies on Vesicovaginal fistula were searched on the internet. Information was obtained on PubMed(medline), WHO website, Bioline International, African Journal of Line, Google scholar, Yahoo, Medscape and e Medicine. RESULTS: Many Nigerian women are living with Vesicovaginal fistula. The annual obstetric fistula incidence is estimated at 2.11 per 1000 births. It is more prevalent in northern Nigeria that southern Nigeria. Obstetric fistula accounts for 84.1%-100% of the Vesicovaginal fistula and prolonged obstructed labour is consistently the most common cause (65.9%-96.5%) in all the series. Other common causes include caesarean section, advanced cervical cancer, uterine rupture, and Gishiri cut. The identified predisposing factors were early marriage and pregnancy, which were rampant in northern Nigeria, while unskilled birth attendance and late presentation to the health facilities was common nationwide. Among the significant contributory factors to high rate of unskilled birth attendance and were poverty, illiteracy, ignorance, restriction of women's movement, non-permission from husband and transportation. All but one Nigerian studies revealed that primiparous women were the most vulnerable group. Pregnancy outcome was dismal in most cases related to delivery with still birth rate of 87%-91.7%. Stigmatization, divorce and social exclusion were common complications. Overall fistula repair success rate was between 75% and 92% in a few centres that offer such services. CONCLUSION: Vesicovaginal fistula is prevalent in Nigeria and obstetric factors are mostly implicated. It is a public health issue of concern.

Concerns, perceived impacts and preparedness of health care workers in a referral hospital in Egypt in facing influenza (H1N1) epidemic.

OBJECTIVE: In Egypt, influenza A (H1N1) cases have been detected and deaths have been reported. The aim of this study was to investigate concerns, perceived impacts and preparedness of Physicians and Nurses of Chest Specialty Hospital in Cairo (Egypt) concerning Influenza A (H1N1). METHODS: A questionnaire was applied to a total of 72 Physicians and 41 Nurses from Chest Specialty Hospital in Cairo (Egypt). RESULTS: More than half of physicians (55.6%) were men, while most of nurses (92.7%) were women. The mean age in years of physicians was 36.6 +/- 11.3 compared to 26.5 +/- 8 in nurses. Physicians feel that they are at greater risk by their job to the pandemic 100% compared to 87.6% among nurses and the difference is highly significant. More than one third of the studied physicians reported that they are not ready to face H1N1 pandemic. Residents feel less ready to face the danger of lnfluenza A(H1N1) compared with Consultants and Specialists/Assistant Specialists, with no statistical significant difference. In concordance, Residents reported less Personal Protective Equipment training compared with Consultants and Specialists/Assistant Specialists, with no statistical significant difference. All Consultants received Seasonal Influenza Vaccine compared with Specialists/Assistant Specialists (68.2%) and Residents (44.7%). CONCLUSION: Higher work related and non work related stress was found among physicians compared to nurses, which reflects the demand of more information and training courses for physicians about the pandemic nature and its consequences, complications, and methods infection prevention.

Vesicovaginal Fistula: a Review of Nigerian Experience

BACKGROUND: Vesicovaginal fistula is a preventable calamity; which has been an age-long menace in developing countries. OBJECTIVE: To review the causes; complications; and outcome of vesicovaginal fistula in Nigeria. METHODS: Studies on vesicovaginal fistula were searched on the internet. Information was obtained on Pubmed (medline); WHO website; Bioline Innternational; African Journal on Line; Google scholar; Yahoo; Medscape and e Medicine. RESULTS: Many Nigerian women are living with vesicovaginal fistula. The annual obstetric fistula incidence is estimated at 2.11 per 1000 births. It is more prevalent in northern Nigeria than southern Nigeria. Obstetric fistula accounts for 84.1-100of the vesicovaginal fistula and prolonged obstructed labour is consistently the most common cause (65.9-96.5) in all the series. Other common causes include caesarean section; advanced cervical cancer; uterine rupture; and Gishiri cut. The identified predisposing factors were early marriage and pregnancy; which were rampant in northern Nigeria; while unskilled birth attendance and late presentation to the health facilities was common nationwide. Among the significant contributory factors to high rate of unskilled birth attendance were poverty; illiteracy; ignorance; restriction of women's movement; non-permission from husband; and transportation. All but one Nigerian studies revealed that primiparous women were the most vulnerable group. Pregnancy outcome was dismal in most cases related to delivery with still birth rate of 87-91.7. Stigmatization; divorce and social exclusion were common complications. Overall fistula repair success rate was between 75and 92in a few centres that offer such services. CONCLUSION: Vesicovaginal fistula is prevalent in Nigeria and obstetric factors are mostly implicated. It is a public health issue of concern

Post traumatic cerebral oedema in severe head injury is related to intracranial pressure and cerebral perfusion pressure but not to cerebral compliance.

This was a prospective cohort study, carried out in the Neuro Intensive Care Unit, Department of Neurosciences, Hospital Universiti Sains Malaysia, Kubang Kerian Kelantan. The study was approved by the local ethics committee and was conducted between November 2005 and September 2007 with a total of 30 patients included in the study. In our study, univariate analysis showed a statistically significant relationship between mean intracranial pressure (ICP) as well as cerebral perfusion pressure (CPP) with both states of basal cistern and the degree of diffuse injury and oedema based on the Marshall classification system. The ICP was higher while CPP and compliance were lower whenever the basal cisterns were effaced in cases of cerebral oedema with Marshall III and IV. In comparison, the study revealed lower ICP, higher mean CPP and better mean cerebral compliance if the basal cisterns were opened or the post operative CT brain scan showed Marshall I and II. These findings suggested the surgical evacuation of clots to reduce the mass volume and restoration of brain anatomy may reduce vascular engorgement and cerebral oedema, therefore preventing intracranial hypertension, and improving cerebral perfusion pressure and cerebral compliance. Nevertheless the study did not find any significant relationship between midline shifts and mean ICP, CPP or cerebral compliance even though lower ICP, higher CPP and compliance were frequently observed when the midline shift was less than 0.5 cm. As the majority of our patients had multiple and diffuse brain injuries, the absence of midline shift did not necessarily mean lower ICP as the pathology was bilateral and even when after excluding the multiple lesions, the result remained insignificant. We assumed that the CT brain scan obtained after evacuation of the mass lesion to assess the state basal cistern and classify the diffuse oedema may prognosticate the intracranial pressure and cerebral perfusion pressure thus assisting in the acute post operative management of severely head injured patients. Hence post operative CT brain scans may be done to verify the ICP and CPP readings postoperatively. Subsequently, withdrawal of sedation for neurological assessment after surgery could be done if the CT brain scan showed an opened basal cistern and Marshall I and II coupled with ICP of less than 20 mmHg.

Fetus-in-fetu in a 6-month-old.

Fetus-in-fetu is a malformed parasitic monozygotic diamniotic twin found inside the body of the living child or adult. We report a case of lumbar mass having superficial rudimentary phallus, labioscrotal fold, testes, pedunculated thumb-like digit and rudimentary pelvis in addition to bowel loops in a 6-month-old Nigerian girl. The mass was excised and the baby did well. We propose based on these that dizygotic parasitic foetiform twin could exist.

Prevalence and risk factors for hearing disorders in secondary school students in Ismailia, Egypt.

This study estimated the prevalence of hearing disorders and associated risk factors in a 10% sample of all secondary-school students in Ismailia city, Egypt. All participants were given a questionnaire and Weber and Rinne tests for hearing disabilities. Among 2633 students, the prevalence of hearing loss was 22.2%, mostly sensorineural hearing loss. More students at technical schools had mixed sensorineural and conductive hearing loss (46.2%) than students at general (28.6%) or commercial (25.3%) schools. Multivariate logistic regression analysis identified the number of attacks of otitis media, history of ear disease treatment, history of admission to fever hospital and history of ear surgery as independent risk factors for sensorineural hearing loss.

Prevalence and risk factors for hearing disorders in secondary school students in Ismailia, Egypt

This study estimated the prevalence of hearing disorders and associated risk factors in a 10% sample of all secondary-school students in Ismailia city, Egypt. All participants were given a questionnaire and Weber and Rinne tests for hearing disabilities. Among 2633 students, the prevalence of hearing loss was 22.2%, mostly sensorineural hearing loss. More students at technical schools had mixed sensorineural and conductive hearing loss [46.2%] than students at general [28.6%] or commercial [25.3%] schools. Multivariate logistic regression analysis identified the number of attacks of otitis media, history of ear disease treatment, history of admission to fever hospital and history of ear surgery as independent risk factors for sensorineural hearing loss

PAH-DNA adducts in a petrol refinery in Egypt.

Epidemiological surveys in occupationally exposed populations postulate that long-term exposure to polycyclic aromatic hydrocarbons (PAHs) is carcinogenic. We studied the ability of PAHs to induce the formation of adducts in the DNA of white blood cells of petrol refinery workers exposed at the workplace. Our study included a random sample of 56 workers exposed to PAHs and 37 non-exposed workers. In the univariate analysis, the DNA adduct level of PAH-exposed workers (42.22 +/- 45.11) was significantly increased (P < 0.05) compared with that in the non-exposed group (20.90 +/- 22.56). However, we could not identify either current smoking or absence of glutathione S-transferase class Mu as possible risk factors for DNA adducts. Linear regression analysis identified degree of exposure to PAHs as the only DNA adducts risk factor. Further research with a larger sample size is under investigation to identify the DNA adduct levels and relationship between the different types of PAHs.

Cochlear otosclerosis: statistical analysis of relationship of spiral ligament hyalinization to hearing loss.

This paper presents an analysis of the relationship of the amount of hyalinization of the spiral ligament, secondary to cochlear otosclerosis (spongiosis), to the amount of hearing loss. This relationship was previously studied by Parahy and Linthicum. It was found that the larger the amount of hyalinization, the greater the hearing loss. This hyalinization is a measure of the amount of toxic enzymes being excreted into the inner ear fluid. These enzymes are suspected to affect the metabolic function of the hair cells.

Hydrops due to syphilitic endolymphatic duct obliteration.

Three pairs of temporal bones with otologic syphilis were studied histopathologically to detect obliteration of the endolymphatic duct and the associated hydrops. All cases showed infiltration and obliteration of the endolymphatic duct by round cells, giant cells, and fibrous tissue. These findings may be related to failure of medical treatment and sac surgery to arrest or alleviate symptoms of advanced syphilis.