relationship between body mass index and iron status in obese and overweight children attending Alexandria University children's hospital

Background: obesity and iron deficiency are two of the most common nutritional disorders worldwide. Although these two conditions represent opposite ends of over- and under-nutrition, they appear to be linked

Objective: To investigate the association between body mass index and iron status in obese and overweight children

Methods: It was a case control study that included 40 children aged 2-14 years, 20 overweight [BMI 85th -95th percentile] and 20 obese [BMI more than or equal 95th percentile]. Twenty healthy non obese children of comparable age and sex served as a control group. All studied children were subjected to calculation of body mass index and laboratory investigations including complete blood picture and Iron profile [serum iron, serum ferritin, total iron binding capacity, serum transferring, and transferring saturation]

Results Compared to the control group, hemoglobin, MCV, serum iron and transferrin saturation were significantly lower in the obese and overweight group [p<0.05]. There was a negative correlation between BMI and both serum iron and transferring saturation, while there was a positive correlation between BMI and TIBC within the total sample

Conclusions: There was a relation between BMI and iron status in children. Obese and overweight children had higher rates of iron deficiency than normal-weight children

Study of benefits and hazards of Ranitidine on patients admitted in Pediatricm Intensive Care Unit

Objectives: Patients admitted in intensive care unit [ICU] are at high risk of developing stress gastric ulceration and so are liable to be exposed to ulcer prophylaxis drugs side effects. The aim of the present study was to study the benefits and possible side effects of Ranitidine as acid suppressive drug used in pediatric ICU [PICU]

Methods: This study was carried out on forty patients admitted in PICU at Alexandria University Children's Hospital [AUCH]. patients were divided into 2 groups each was 20 in number, Ranitidine was given only to one group. Both were subjected to full clinical evaluation. Duodenal aspirate was obtained via upper gastrointestinal [GI] endoscopy and examined for bacterial overgrowth in patients received Ranitidine. Stool was examined for occult blood to detect possible mucosal injury for all patients in both groups

Results: Out of 20 children received Ranitidine 9 [45%] showed bacterial colonization in their duodenal aspirate. Fifty five percent of cases who did not receive Ranitidine suffered from stress gastric injury in our study. Mechanical ventilation and shock are possible risk factors for stress gastric injury

Conclusion: Patients admitted to PICU are at high risk to develop stress gastric injury, so acid suppressive therapy is needed. Ranitidine is a good prophylactic drug against stress gastritis with possibility to develop small intestinal bacterial overgrowth [SIBO]

Assessment of physical inactivity and perceived barriers to physical activity among health college students, south-western Saudi Arabia

Physical inactivity is a public health problem in Saudi Arabia. A cross-sectional study was carried out to evaluate the pattern of physical activity, predictors of physical inactivity and perceived barriers to physical activity among health college students in King Khalid University. A total of 1257 students [426 males and 831 females] were recruited. The Arabic short form of the International Physical Activity Questionnaire was used. Overall, 58.0% of the students were physically inactive. Only 13.4% of the students performed vigorous physical activity, 14.8% moderate-intensity physical activity and 29.9% walking activities which met World Health Organization criteria of health-enhancing physical activities. The prevalence of inactive leisure time was 47.5%. The independent predictors of physical inactivity were non-membership of sports clubs and being a medical student. The top reported barrier to physical activity among inactive students was time limitations [51.3%]. Overcoming perceived barriers may increase physical activity among students

Nosocomial infections in a neonatal intensive care unit in south-western Saudi Arabia

A cohort study measured the occurrence and risk factors of nosocomial infections in the neonatal intensive care unit of Abha general hospital, Saudi Arabia. Of 401 neonates who stayed at least 48 hours in the unit, 77 developed infections, a period prevalence of 19.2% and an incidence of 13.7 infections per 1000 patient-days. The most frequent infections were: pneumonia [50.0%], primary bloodstream [40.9%] and skin and soft tissues [6.5%]. In logistic regression analysis, mechanical ventilation [OR = 2.69, 95% CI: 1.39-5.19] and total parenteral nutrition [OR = 5.62, 95% CI: 2.78-11.35] were identified as significant risk factors. Neonates suffering from nosocomial infections had more than 3 times the risk of dying compared to neonates free of infection

Asthma knowledge and behaviours among mothers of asthmatic children in Aseer, south-west Saudi Arabia

Mothers of children with bronchial asthma consecutively admitted to Aseer central hospital, Saudi Arabia [n = 171], were interviewed using a questionnaire based on the Chicago Community Asthma Survey to study their knowledge and behaviours concerning bronchial asthma. The least known information among mothers was the complications of bronchial asthma. Breathing exercises during asthma attacks were the least practised behaviour. In a multivariate analysis, significant risk factors for poor knowledge and behaviours among mothers were female sex of the child, illiterate mother and young age of mother [< 30 years]. More education is needed to help the mothers of asthmatic children to acquire the necessary knowledge and practices to care for their chiIdren

Injection safety at primary health care level in south-western Saudi Arabia

In a study of injection safety in Abha health district, Saudi Arabia, data were collected from 47 physicians and 85 nurses at 24 primary health care centres, using an observation checklist and an interview questionnaire. All centres used individually packed disposable syringes and puncture-proof containers to collect used needles. Needlestick injury in the previous year was reported by 14.9% of physicians and 16.5% of nurses [0.21 and 0.38 injuries/person/year respectively]. Logistic regression analysis identified recapping the needle after use [physicians and nurses] and bending the needle before disposal [physicians] as significant risk factors for injury

Altitude and bronchial asthma in south-western Saudi Arabia

Through a house-to-house survey, 1325 people aged 11+ years registered at 2 primary health care centres [1 at high altitude and 1 at sea level] in Asir region, Saudi Arabia, were interviewed and examined for weight, height and peak expiratory flow rate. The prevalence of bronchial asthma at sea level [19.5%] was significantly higher than at high altitude [6.9%]. Illiteracy, low income, use of coal and wood for heating, having a mud or tent house, lack of electricity inside dwellings and presence of sheep were also significant risk factors for bronchial asthma. In multivariate logistic regression, only altitude was found to be significantly associated with bronchial asthma [adjusted odds ratio = 3.94]

Primary health care emergency services in Abha district of southwestern Saudi Arabia

To study emergency services delivery in all 30 primary health care centres in Abha district of Asir region, Saudi Arabia, data were collected about equipment and facilities, physicians' practices and attitudes, and patients' utilization of and satisfaction with emergency services. Two centres had no devoted place for emergency services. Lack of some essential equipment and drugs was evident. The greatest continuing medical education need for doctors was the management of cardiovascular emergencies [72.3%]. Many doctors [40.4%] did not consider the majority of cases as true emergencies. Many patients [43.7%] used the centres for emergency services, the most common being trauma, burns and orthopaedics [47.8%]. Most patients were satisfied overall with emergency services [82.2%]

Prevalence and risk factors of gallstone disease in a high altitude Saudi population

To study the prevalence of gallstone disease and related risk factors in a Saudi Arabian population a cross-sectional community-based study was made of 291 people from Abha district, Asir region. A structured interview collected background data and all participants had upper abdominal ultrasonography to detect gallstones. The overall prevalence of gallstone disease was 11.7%. Using logistic regression multivariate analysis, the following were significant risk factors for gallstone disease: female sex, family history of gallstone disease and past history of pancreatitis. Age, education, blood pressure, smoking, coffee intake, overweight, diabetes mellitus, number of pregnancies and use of oral contraceptives were not significant risk factors. Discriminant analysis of symptoms showed that only right hypochondrium pain was significantly associated with gallstone disease

Compliance with good practice in prescription writing at outpatient clinics in Saudi Arabia

A sample of prescription orders received from outpatient departments by a hospital pharmacy in Asir, Saudi Arabia, were analysed over 1 year for the essential elements of prescriptions. The prescriber's name, address and signature were on 83.3%, 9.6% and 81.9% of prescriptions respectively. The patient's name, age and sex were on 94.6%, 77.3% and 51.3%. No prescription contained the patient's address and weight. Generic drug names were used in only 15.1% and strength of medication and dose units were included in 26.6% and 55.6% of prescriptions. Most prescriptions [94.0%] had no quantity indicated and had only partial instructions for patient use [90.7%]; the diagnosis was included in about two-thirds. The prescriber's handwriting was illegible in 64.3% of prescriptions. Measures to improve the situation are suggested

Primary health care services utilization and satisfaction among the elderly in Asir region, Saudi Arabia

Use of primary health care [PHC] services and satisfaction among elderly people [60 + years] in Asir was studied in 26 PHC centers. They visited PHC centers significantly less often than younger adults but they were referred significantly more often to secondary and tertiary care and for more laboratory tests. A r and om sample of 253 elderly people attending the centers was interviewed about accessibility, continuity, humaneness, informativeness and thoroughness of care. Overall, 79.0% were satisfied with the services provided. The leading 3 items of dissatisfaction were: not enough audiovisual means for health education [65.1%], long time spent in the centre [46.4%], and not enough specialty clinics [42.5%]

Reproductive tract infections among married women in Upper Egypt

In a house-to-house survey using cluster sampling, 1344 married women from urban and rural areas of Upper Egypt [Minia, Assiut and Sohag] were interviewed and examined to study the magnitude and determinants of reproductive tract infections. Overall prevalence was found to be 52.8%, with the most prevalent forms being Candida albicans [28.0%], Trichomonas vaginalis [8.7%], Aspergillus species [7.4%], streptococci [4.6%] and Chlamydia trachomatis [4.2%]. Multivariate analysis identified certain groups of women at high risk of developing reproductive tract infections [those currently using an intrauterine device, those who regularly practised internal vaginal washing]. Discriminant analysis showed that symptoms were of low discriminating value. There is a great need to increase community and women's understanding of reproductive tract infections

Reproductive health of married adolescent women in squatter areas in Alexandria, Egypt

Through a house-to-house survey, 455 married adolescent women [< 20 years] and 455 married women aged 20-45 years from squatter areas in Alexandria were interviewed. Determinants of early marriage were consanguinity, illiteracy and unawareness of reproductive health. Of the currently pregnant adolescents, 22% were receiving antenatal care compared with 40% of the older women. Family planning methods were currently being used by 39% of the adolescents and 63% of the older wives. Determinants of non-use were: adolescence, illiteracy and previous miscarriage/stillbirth. There is a need to increase public awareness of reproductive health and change the behaviour of both groups of women in this under-privileged sector

Referral system in the Asir region, Saudi Arabia: a study on hospital' referral coordination offices

Coordination offices for referring patients to hospital are relay stations for afferent and efferent communications with primary health care centres. Fourteen referral coordination offices in the Asir region were studied. The physical structure of the offices was such as to enable the staff to work in optimal conditions. The study revealed a lack of telephones in half of the offices. The numbers of persons employed [2.7 +/- 1.3] was satisfactory. On the other hand a lack of qualified trained workers and a high turnover of staff deprived the offices of the experience needed to maintain a good performance. A review of the registers showed that sufficient information was recorded in the form of personal data but there was a deficiency of data related to the referring centres. The knowledge and attitude of staff [38 persons] towards the referral system were assessed. The objective of feedback seemed to be clear and the majority showed a positive attitude towards the referral system and workload. The study revealed a lack of formal regulations and job descriptions. Immediate plans to upgrade the quality of the staff are mandatory if the quality of referral system and hence comprehensive patient care is to be guaranteed