Optimized selection of neodymium laser parameters for successful enlarged veins treatment.

Full clearance and no side effects method of treating enlarged veins was successfully accomplished by one laser session. This is the ambition and dream of both dermatologists and patients. Most vascularity treatment protocols had shown some unpleasant adverse effects. The purpose of the present work is to work out, in advance, the accurate dose of laser pulse duration and fluence in order to treat varicose veins in the face, arms and legs with no adverse effects. This mission required the calculation of the exact rise in temperature of the enlarged vein; prior to laser treatment. These pre-calculated temperature rise values were tested on 20 subjects in order to have the best clinical outcomes; using fundamental frequency (1064 nm) pulsed Nd: YAG laser. This work necessitated the use of pulse length (15-30 ms), spot size (3, 5 mm), fluence (110-190 J/cm2) and skin cooling temperature (3-18 °C). Cooling of the skin before and after the treatment was needed to guarantee ultimate impactful results without side effects.

EXACT LASER FLUENCE FOR SUCCESSFUL TREATMENT OF FACE AND LEG TELANGIECTASIA.

OBJECTIVE: The aim: Facial and leg telangiectasia are usual cosmetic concern for females who have different skin phototypes and ages. Until now, the various treatments for these problem have frequently failed or led to unwanted side-effects. Based on approved pre-calculated doses, the present study highlights the clinical effects and safety of treatment after using the exact laser parameters from 1064-nm Nd: YAG laser. PATIENTS AND METHODS: Materials and methods: Twenty people with facial and leg telangiectasia underwent a single laser treatment, based on pre-calculated laser parameters for each case. RESULTS: Results: All subjects showed visible improvement, with 95-100% clearance of face telangiectasia directly after the first treatment, and 50-100% clearance of the lower extremity vessels after one to three days; with minimal side-effects. CONCLUSION: Conclusions: Treatment of facial and leg telangiectasia by using true, exact, and mathematically pre-calculated parameters of long pulse 1064 nm Nd: YAG laser was an effective and safe procedure of clearing face and leg telangiectasia.

Encouraging junior doctors to work in rural Sudan: a discrete choice experiment.

BACKGROUND: Out-migration of physicians and urban-rural maldistribution are two of the most serious challenges facing the health sector. AIMS: To determine the preference of junior doctors for rural postings in Sudan, and estimate how much junior doctors are willing to trade off from their salaries for nonmonetary incentives. METHODS: The study targeted junior doctors who had completed their internship training and were taking their Medical Licensing Examination at the Sudan Medical Council for permanent registration. Focus group discussions were conducted to identify potentially valued incentives. A computer-based discrete choice experiment and accompanying questionnaire were administered between September and October 2012 at the two licence examination centres in Sudan. RESULTS: Four hundred and fifty-five doctors completed the survey. More than one third of the respondents intended to emigrate from Sudan immediately and another 30% within the next two years. The findings showed that providing scholarships to train abroad, improving the standard of health facilities to an advanced level, and providing on-site supervision were the attributes most preferred by the respondents and they were willing to trade off SDG 3650 (US$ 608), SDG 1997 (US$ 333) and SDG 1948 (US$ 325) of their salaries for these, respectively. Less-preferred attributes were availability of supervision by telephone, followed by a scholarship in family medicine and a 2-year commitment, post-training. CONCLUSIONS: Authorities may consider the above preferences to enhance human resources for attraction strategies in rural areas. Addressing the supervision issue may be more feasible for policy-makers in the short term, when compared to improving salaries and infrastructure.

The importance of hand hygiene education on primary schoolgirls' absence due to upper respiratory infections in Saudi Arabia. A cluster randomized controlled trial.

OBJECTIVES: To quantify the reduction in absence due to upper respiratory infections (URIs) among primary schoolgirls attending Riyadh's schools after delivering a hand hygiene workshop intervention over a period of 5 weeks. Methods: A cluster randomized trial was conducted among girls attending 4 primary schools between January and March 2018. The participants attended a hand hygiene workshop. The schoolgirls' absences were followed up for 5 weeks. Incidence rate, percentage of absence days, and absence rate were calculated for total and URIs absences. Result: Total number of participating schoolgirls was 496. Upper respiratory infections accounted for 15.3% of absence episodes. Schoolgirls lost 521 days of school and 19.4% of them were URIs-related. Absence rate due to URIs were 12.4 and 23.4 as well as 5.62 and 11.72 per 100 schoolgirls in the control (CG) and experimental (EG) groups, respectively. Percentage of absence days were lower in the experimental group (CG: 0.86% and 1.39% versus EG: 0.39% and 0.72%). Incidence rates of absence due to URIs were 0.54 and 1.02 in CG versus 0.24 and 0.51 in EG per 100 schoolgirls per day. Conclusion: There could be further reduction in school absences if education was accompanied by hand soap dissemination. The study could serve as a pilot for major studies in the future. Sustainability of the intervention can be tested in studies with longer durations.

Factors associated with antenatal and delivery care in Sudan: analysis of the 2010 Sudan household survey.

BACKGROUND: Every day, globally approximately a thousand women and girls needlessly die as a result of complications during pregnancy, childbirth or the 6 weeks following delivery. The majority of maternal deaths are avoidable and could be prevented with proven interventions to prevent or manage complications during pregnancy and child birth. The aim of this study was to examine factors associated with underutilization of maternal health services in Sudan. METHODS: Data was obtained from the Sudan Household Health Survey 2010(SHHS). The SHHS collected data from 5730 women, aged 15-49 years and who were pregnant in the last 2 years preceding the survey. The selection of the respondents was through a multi-stage cluster sampling technique. Interviews were conducted with respondents to collect data about their demographic characteristics, reproductive history, pregnancy and child delivery. Univariate analysis and logistic regression were used to analyze the data. RESULTS: The factors associated with receiving antenatal care were, higher educational level (odds ratio (OR) = 3.428, 95% CI 2.473-4.751 - p value 0.001), higher household wealth (OR 1.656, 95% CI: 1.484-1.855 - p value 0.001) and low parity (OR =1.214, 95% CI: 1.035-1.423 - p value 0.017). The factors associated with institutional delivery were higher educational level (OR = 1.929, 95% CI: 1.380-2.697 - p value 0.001), high household wealth (OR = 2.293, 95% CI: 1.988-2.644 p value 0.001), urban residence (OR = 1.364, 95% CI: 1.081-1.721 p value 0.009), low parity (OR = 2.222, 95% CI: 1/786-2.765 p value 0.001), receiving ANC (OR = 3.342, 95% CI: 2.306-4.844 p value 0.001) and complications during pregnancy (OR = 1.606, 95% CI: 1.319-1.957 p value 0.001). CONCLUSIONS: The factors associated with both antenatal care use and institutional delivery are similar and interventions to target these include expanding female education and improving coverage and affordability of health services.