Value of prolonged scrotal drainage after penile prosthesis implantation: a multicenter prospective nonrandomized pilot study.

We aimed to understand the risks and benefits of post-inflatable penile prosthesis (IPP) implantation drainage and optimal duration. Our patients were divided into 3 groups: Group 1 (n = 114) had no drain placed, Group 2 had a drain placed for 24 h (n = 114) and Group 3 had a drain placed for 72 h (n = 117). Postoperative scrotal hematoma and prosthesis infection rates were compared between the groups. The patients from Group 3 demonstrated a statistically significant lower incidence of hematoma on the 10th postoperative day: (n = 1, 0.9%) compared to Group 2: (n = 11, 9.6%) and Group 1: (n = 8, 7%), (p = 0.013). However, on the 3rd postoperative day, there was a statistically significant lower incidence of hematoma in both Groups 3 and 2: (0.9% and 6.1%, respectively) vs. Group 1: (11.4%), (p = 0.004). Hematoma rates followed the same group order after the first day of surgery: 1.7% (n = 2), 5.3% (n = 6), and 8.8% (n = 10), respectively, (p = 0.05). Five patients (4.4%) in Group 1 and four patients (3.5%) in Group 2 developed an IPP associated infection, opposed to only a single patient (0.85%) in Group 3, (p = 0.210). We concluded that prolonged scrotal drainage for 72 h after virgin IPP implantation significantly reduces hematoma and infection rates.

Effect of locally tailored labour management guidelines on intrahospital stillbirths and birth asphyxia at the referral hospital of Zanzibar: a quasi-experimental pre-post study (The PartoMa study).

OBJECTIVE: To evaluate effect of locally tailored labour management guidelines (PartoMa guidelines) on intrahospital stillbirths and birth asphyxia. DESIGN: Quasi-experimental pre-post study investigating the causal pathway through changes in clinical practice. SETTING: Tanzanian low-resource referral hospital, Mnazi Mmoja Hospital. POPULATION: Facility deliveries during baseline (1 October 2014 until 31 January 2015) and the 9th to 12th intervention month (1 October 2015 until 31 January 2016) [corrected]. METHODS: Birth outcome was extracted from all cases of labouring women during baseline (n = 3690) and intervention months (n = 3087). Background characteristics and quality of care were assessed in quasi-randomly selected subgroups (n = 283 and n = 264, respectively). MAIN OUTCOME MEASURES: Stillbirths and neonates with 5-minute Apgar score ≤5. RESULTS: Stillbirth rate fell from 59 to 39 per 1000 total births (RR 0.66, 95% CI 0.53-0.82), and subanalyses suggest that this was primarily due to reduction in intrahospital stillbirths. Apgar scores between 1 and 5 fell from 52 to 28 per 1000 live births (RR 0.53, 95% CI 0.41-0.69). Median time from last fetal heart assessment till delivery (or fetal death diagnosis) fell from 120 minutes (IQR 60-240) to 74 minutes (IQR 30-130) (Mann-Whitney test for difference, P < 0.01). Oxytocin augmentation declined from 22% to 12% (RR 0.54, 95% CI 0.37-0.81) and timely use improved. CONCLUSION: Although low human resources and substandard care remain major challenges, PartoMa guidelines were associated with improvements in care, leading to reductions in stillbirths and birth asphyxia. Findings furthermore emphasise the central role of improved fetal surveillance and restricted intrapartum oxytocin use in safety at birth. TWEETABLE ABSTRACT: #PartoMa guidelines aided in reducing stillbirths and birth asphyxia at a Tanzanian low-resource hospital PLAIN LANGUAGE SUMMARY: PartoMa guidelines help birth attendants in Tanzania to save lives Every year, 3 million babies die on the day of birth. The vast majority of these deaths occur in the poorest countries. If their mothers had received better care during birth, most babies would have survived. At Mnazi Mmoja Hospital, an East African referral hospital, the PartoMa study shows that use of locally developed guidelines helps birth attendants to deliver better quality of care, which has led to improved survival at birth. At the hospital studied, resources are scarce. Each birth attendant assists four to six birthing women simultaneously, and many have less than 1 year of professional experience. International guidelines are available, but they are often unachievable and seldom applied. The PartoMa guidelines were developed in close collaboration with the birth attendants and approved by seven international experts. The result is an 8-page pocket booklet providing locally achievable and simple decision support for care during birth. Use of the PartoMa guidelines began in February 2015. As the staff group frequently changes, quarterly seminars are conducted where birth attendants are welcomed after working hours to learn about the guidelines. The guidelines have been positively received, and seminar attendance remains high. Use of the PartoMa guidelines is associated with: A decrease by one-third in stillbirths (59 to 39 per 1000 total births) A nearly halving in the number of babies born in immediate poor medical condition (52 to 28 per 1000 live births) The results presented here derive from a comparison of births before using the PartoMa guidelines and during the 9th-12th month of use. Such a 'before-after' study cannot exclude the possibility of other causes of better survival at birth. However, the improved survival is consistent with improved care during birth, which is in line with the PartoMa guidelines.

Association of overweight and obesity with decline in academic performance among female high-school students, Riyadh, Saudi Arabia.

The aim of this study was to evaluate the association between overweight/obesity and future academic performance among high-school students in Saudi Arabia. This was a retrospective cohort study of 257 12th grade female students in Alabna (Ministry of Defence) high schools in Riyadh during 2013/14. Overweight/obesity was based on weight and height at 10th grade. Decline in academic performance was defined as a reduction by > 1 standard deviation in marks between 10th and 12th grades. One hundred and five students were overweight/obese and 30 had declined academic performance. Self-esteem scale was similar in both groups. In a multiple logistic regression model adjusted for sociodemographic characteristics, study-related lifestyle and self-esteem, overweight/obesity was associated with declining academic performance. Other independent associates included paternal and maternal education, and living outside governmentally provided housing. We report a negative independent association between overweight/obesity and subsequent academic performance among female high-school students in Saudi Arabia. The results highlight the need for community and school programmes to target overweight/obesity among high-school students.

In vivo Hepato-protective Properties of Purslane Extracts on Paracetamol-Induced Liver Damage.

This investigation is designed to evaluate the potential hepato-protective effect of ethanolic and aqueous extracts of air-dried leaves of Purslane against paracetamol-induced hepato-toxicity, in an attempt to understand its mechanism of action, which may pave the way for possible therapeutic application. Paracetamol (1g/kg bw) administration to rats resulted in massive elevation in serum and hepatic lactate dehydrogenase (LDH) activity and thiobarbituric acid reactive substances (TBARS) as well as in serum tumor necrosis factor-alph (TNF-α) levels, with a significant decrease in serum and hepatic protein thiols (Pr-SHs) and reduced glutathione (GSH) superoxide dismutase (SOD) and glutathione peroxidase (GPx) in blood and liver. Oral administration of both the leaves extracts at a concentration of 150 mg/kg bw daily for 15 days showed significant protection against an induced increase in serum and hepatic LDH and TBARS as well as serum tumor necrosis factor-alph (TNF-α) levels. The treatment also resulted in a significant increase in serum and hepatic Pr-SHs as well as GSH, SOD and GPx in blood and liver. The results of the present study suggest that the ethanolic and aqueous extracts of Purslane leaves can generate antioxidants.The effect was more pronounced in ethanolic extract compared to aqueous extract.

Hypertension among attendants of primary health care centers in Al-Qassim region, Saudi Arabia.

OBJECTIVE: The aims of the present work were to determine the prevalence of hypertension among attendants of primary health care centers in Al-Qassim region, Kingdom of Saudi Arabia. Also to investigate sociodemographic associates, and assess awareness among hypertensives. METHODS: Through cluster sampling 30 primary health care centers were selected. Forty attendants were chosen randomly from each center. A questionnaire inquiring sociodemographic characteristics and awareness was completed by interview with each participant. Using standardized methods the blood pressure, height and weight were measured. RESULTS: The study sample amounted to 1114 persons, 338 (30%) were hypertensives (blood pressure >140/90), 24% stage 1, 4% stage 2 and 2.5% stage 3. The prevalence increased with age. It was higher in males (33%), single persons (44%), illiterate (33%), merchants (45%) and obese persons (35%). Age above 40 years, illiteracy, overweight and obesity were independently associated with hypertension with statistically significant value. Less than one 4th (23%) of hypertensives were aware of their hypertension. CONCLUSION: Hypertension is a major public health problem. A routine measurement of blood pressure of all attendants of primary health care centers with periodic examination of those aged more than 40 years particularly overweight and obese persons should be implemented.

Malnutrition among pre-school children in Alexandria, Egypt.

The study was conducted in Alexandria, Egypt, to assess the current status of malnutrition among 1,217 pre-school children aged 6-71 months. A two-stage cluster-sampling technique was used for selecting the sample. Data on sociodemographic and environmental characteristics of the family, morbidity profiles, and breast-feeding patterns were collected from mothers of the children. Anthropometric measurements were performed, and the prevalence of malnutrition was assessed using three indicators, such as stunting, under-weight, and wasting, following the WHO guidelines and cut-off points. Simple and multiple regression analyses were done for examining the factors associated with the occurrence of malnutrition using principal component factor analysis with varimax rotation. Stunting, under-weight, and wasting were observed in 15%, 7.3%, and 3.6% of the children respectively. High-socioeconomic condition was associated with low prevalence of stunting and underweight (OR = 0.67, confidence interval (CI) = 0.55-0.8 and OR = 0.75, CI = 0.58-0.96 respectively). Good environmental condition was associated with a lower stunting rate (OR = 0.83, CI = 0.72-0.96). Increased age of child and living in a non-squatter area were associated with wasting (OR = 1.02, CI = 1.001-1.03 and OR = 0.38, CI = 0.15-0.97 respectively). Interventions to improve socioeconomic and environmental situations are recommended to reduce the already low level of protein-energy malnutrition further.

Risk factors of bronchial asthma in bahrah, saudi arabia.

BACKGROUND: Asthma is a common health problem whose prevalence in Saudi Arabia has risen over the last few decades. Brick factories in the city of Bahrah have exacerbated the problem, and increasing numbers of asthma cases are attending local primary health care centers. OBJECTIVE: Determine the risk factors of asthma in Bahrah. MATERIALS AND METHODS: The study was comprised of 110 cases of bronchial asthma resident in Bahrah who were diagnosed by the treating physicians and 110 healthy controls matched in age and sex. A questionnaire was completed from cases and controls, consisting of data regarding personal, familial, indoor and outdoor environmental factors that may be potential risk factors to asthma. Bivariate and multivariate logistic regression analyses were done to assess risk factors. RESULTS: The mean ages of cases and controls were 22.4 (± 16.7) and 22.8 (± 16.1) years, respectively. Each group consisted of 64 males (58%) and 46 (42%) females. There was a significant association between distance from houses to brick factories and bronchial asthma (Chi square for linear trend = 26.6, p<0.001). Multivariate logistic regression analysis showed that living within one kilometer of a brick factory (OR=5.1, CI=2.33-11.16), family history (OR=4.6, CI=2.16-9.78), allergic rhinitis (OR=3.39, CI=1.49-7.69), skin atopy (OR=4.6, CI=1.53-13.87) and recurrent respiratory tract infections (OR=4.1, CI=1.79-9.22) were independent risk factors for asthma in Bahrah. CONCLUSIONS AND RECOMMENDATIONS: Brick factories, family history and history of rhinitis, skin atopy, or recurrent respiratory tract infections are risk factors of bronchial asthma. An in-depth study to asses air pollution in Bahrah is recom-mended. People are advised not to live near brick factories.

SEROPREVALENCE OF RIFT VALLEY FEVER AMONG SLAUGHTERHOUSE PERSONNEL IN MAKKAH DURING HAJJ 1419h (1999).

OBJECTIVES: Determine the sero-prevalence of rift valley fever (RVF) among slaughterhouse personnel in Makkah during Hajj and define personal and work place correlates. MATERIALS AND METHODS: A sample of 294 participants were chosen randomly from slaughterhouse personnel in Makkah during Hajj 1419 (1999). Data were collected through personal interviews using a pre-designed questionnaire consisting of personal and work place variables, e.g. age, nationality, type and hours of work. A blood sample was collected from each participant and tested by enzyme immuno-assay for IgG antibody using killed antigen for rift valley virus. RESULTS: Of the total sample, 17% was seropositive for RVF. The rate of infection varied with country of origin: Syria (10.6%), Egypt (21.2%), Bangladesh (22.6%), Mali (47.1%) and Niger (50%). The number of animals slaughtered per hour and daily hours of work were significantly associated with prevalence of RVF (p<0.05).Multivariate logistic regression analysis showed that nationality and daily hours of work predicted 84.1% of the occurrence of RVF. RECOMMENDATIONS: Sero-surveys should be done among slaughterhouse personnel in Saudi Arabia and other countries particularly in countries known to be free from RVF, e.g. Syria and Bangladesh to assess the situation of RVF. The importation of animals from endemic areas should be banned.

Selection of susceptible lines of Biomphalaria alexandrina and Bulinus truncatus snails to S.mansoni and S.haematobium infection.

Selection of progenies from infected B.alexandrina and B.truncatus snails resulted in higher infection rates. This observation was consistent when the source of micardia were from either infected human or hamsters. Infection rate of B.alexandrina increased up to 88.2% while B.truncatus did not. Compatibility between the parasites and their intermediate hosts were also studied.

Efficiency of tuberculin as a tool to determine the prevalence of tuberculosis.

Among 1937 first grade primary school children followed, the results of tuberculin test, the prevalence rate of TB infection was 4.49% with an estimated annual infection rate of 0.75%. Household contacts of tuberculin positive pupils gave a prevalence rate of infection of 30.6%. As for the efficiency of tuberculin screening test, data of this work showed a positive predictive value of 13.3%. Out of 10 diagnosed tuberculous patients, 4 cases were diagnosed for the first time during this study.