Equivalence trials for sepsis in newborns and young infants: review of the statistical aspects of trials claiming

Serious bacterial infections are a major cause of neonatal and young-infant deaths worldwide. Identification is difficult, andstandard-of-care treatment is demanding. Several trials have examined simplified treatment regimes that include oral antibiotics.In this report, four recently published randomized trials were analysed for their statistical power to demonstrate equivalence ofsimplified antibiotic regimens with the standard of care among children with bacterial infection. These trials were found to beunderpowered in terms of both overall sample size and number of included children with bacterial infection. They cannot supportthe conclusion that the alternative antibiotic regimens studied are equally effective. Much larger sample sizes and more selectiveinclusion criteria are needed. The conclusion that simpler treatment regimens for the treatment of newborn sepsis are effective isnot warranted, based on the published trials. The promotion of such regimens as an alternative to established treatments needsto be stopped.

Postmenopausal symptoms among Egyptian geripausal women

Increases in life expectancies mean that women are spending longer periods of their life in a hypo-oestrogenic state. A cross-sectional study was designed to assess the prevalence of postmenopausal symptoms among elderly Egyptian women in the geripausal phase. A sample of 400 community-dwelling elderly women aged > 65 years were recruited from 6 geriatric social clubs in Cairo. A full personal and medical history was taken from all participants. The menopause rating scale was applied to all participants after translation and linguistic validation in the Arabic language. The most prevalent postmenopausal symptoms were joint pain [90.3%], followed by sleep problems [84.0%] and physical and mental exhaustion [80.0%]. A statistically significant positive correlation was found between total menopause rating scale score and age, duration of menopause andj number of chronic diseases but not with age of menopause

Postnatal depression among Bahraini women: prevalence of symptoms and psychosocial risk factors

The prevalence of postnatal depression in Bahrain is unknown and screening for known risk factors does not take place. This study estimated the prevalence of postnatal depressive symptoms and the associated risk factors among a random sample of Bahraini women attending primary health care centres with their babies for the 8-week child check-up. The Arabic version of the Edinburgh Postnatal Depression Scale [EPDS] was used with a cut-off score of >/=12 for depression. The prevalence of postnatal depressive symptoms among 237 mothers was 37.1%. No significant relationships were identified between depression symptoms and any of demographic variables or pregnancy/birth characteristics studied. However, several psychosocial risk factors were significantly associated with postnatal depression and, after multiple regression analysis, a history of depressive symptoms and perceived lack of support from the husband remained significant factors. Further studies that include diagnostic assessments are needed to confirm these findings

Women's perception and experience of menopause: a community-based study in Alexandria, Egypt

To determine symptoms, perceptions and practices after natural menopause by women aged 50-59 years, we conducted a cross-sectional study of 450 women from Alexandria. The most frequently recalled symptoms were tiredness [96.0%], headache [95.1%], hot flushes [90.7%], skin wrinkles [90.7%] and decreased sexual desire [89.1%]. About 91% of women had never heard about hormone replacement therapy; 42.7% would expose their body to the sun; 12.4% were moderately active the year before menopause. Multiple regression analysis indicated that women's knowledge about menopause was related to marital status, education and employment status; practices were related to pattern of menopause, age of menopause and income

Good clinical diagnostic practice: a guide for clinicians in developing countries to the clinical diagnosis of disease and to making proper use of clinical diagnostic services

Physicians in developing countries usually take a syndromic approach to diagnosing a patient. Today, we observe increasing microbial resistance to drugs, particularly in developing countries. This worsening situation puts a heavy obligation on medical professionals to improve their clinical diagnosis. Clinical diagnostic services provide more accurate information on a patient based on physical and biochemical investigations. However, in many countries there is little communication between the physicians and the laboratory and diagnostic imaging services. Occasionally, medical staff feel that diagnostic imaging and even more so laboratory services report results that are inappropriate or even erroneous. Consequently, the service provided by the laboratory is wasted, placing an unacceptable burden on the diagnostic services, which is of no benefit to the health service. This manual has been written to improve the clinical and diagnostic skills of physicians. The manual assumes that clinicians have been trained in history-taking, physical examination and use of laboratory investigations and also have access to basic clinical diagnostic equipment and to essential laboratory tests