Awareness of pelvic organ prolapse and attitude towards its treatment among Malaysian women.

INTRODUCTION: The aim of this study is to determine the level of awareness of pelvic organ prolapse (POP) and factors that influence the attitude towards the treatment of POP among Malaysian women. MATERIALS AND METHODS: This was a cross-sectional study of 400 women from registered non-government organisations (NGOs) in Malaysia who voluntarily answered questionnaires distributed through Google form via emails. Data were analysed using descriptive statistics, independent t-test and one-way ANOVA test. RESULTS: Four hundred respondents participated in this study. The mean age was 40.42 years old (SD=12.566). The mean score for the studied population was 4.96 (SEM 0.124). Only 58 (14.5%) respondents obtained a score of eight or more, and 235 (58.8%) respondents scored between 4 and 7. The rest of 107 (26.7%) respondents scored 3 and less. There were statistically significant differences in the mean score for level of awareness between marital statuses, menopausal status, number of children and occupation. There were only 273 (68%) respondents who will seek treatment if they experience symptoms of POP. The most frequent reasons for not seeking treatment were unawareness of the availability of medical treatment for POP (69 %). CONCLUSION: Majority of the respondents have an inadequate level of awareness on POP. Although more than half of the respondents will seek treatment if they experience symptoms of POP, concerns raised by those who chose not to seek treatment should be addressed by a more effective public awareness programme. This includes the unawareness of the availability of medical treatment and the embarrassment to see medical practitioners.

Missed opportunities for Intermittent Preventive Treatment of Malaria among pregnant women with the recommended number of antenatal care visits in Nigeria: Secondary Analysis of Malaria Indicator Survey 2021.

BACKGROUND AND OBJECTIVES: Missed opportunity (MO) for IPTp SP remains high in Nigeria even among pregnant women with four or more ANC visits. We assessed the current MO rate and its predictors, using data from the 2021 MIS. METHODS: We carried out a secondary analysis of data of women who had at least one live birth and at least 4 ANC visits. Bivariate analyses assessed the relationship between socio-demographic characteristics, type of ANC facility, type of ANC provider, knowledge of malaria prevention, awareness about IPT, and missed opportunity using the Chi-square test. Multivariate analyses were presented as odd ratios at 95% CI, (P value <0.05). RESULTS: Nearly half (47%) had only primary education or none at all. About 30% were poor. Most had their 1st visit ANC in the 2nd trimester (58%). The missed opportunity rate was 55%. Predictors included age 20 to 34 years [aOR 1.3(1.1-1.67)], being very poor [aOR 1.6(1.1-2.4)], late ANC (in 2nd or 3rd trimester) [aOR 0.57(0.4-0.89)], ignorance about malaria prevention [aOR 1.8(1.4-2.4)], ignorance about IPT [aOR 1.3(1.3-2.5)] and residence in the South South and North East [aOR 0.46(0.31-0.68)] regions. CONCLUSIONS: The missed opportunity was high. Place of residence, poor knowledge of malaria prevention and IPT use, late commencement of ANC, poverty, and young age (20 to 34 years) contributed to the burden. Recommendations include stressing the importance of IPT during health talks. Provision of cups and drinking water for the IPT DOT policy by the Government and partners. There is a need for further research to unravel the reasons for the higher MO rates in some regions.

CONTEXTE: Les opportunités manquées (OM) pour le TPIp SP restent élevées au Nigéria, même parmi les femmes enceintes ayant effectué quatre visites ou plus aux soins prénatals. Nous avons évalué le taux actuel d'OM et ses prédicteurs en utilisant les données de l'Enquête sur les Indicateurs du Paludisme de 2021. MÉTHODE: Nous avons réalisé une analyse secondaire des données des femmes ayant eu au moins une naissance en vie et au moins quatre visites de soins prénatals. Les analyses bivariées ont évalué la relation entre les caractéristiques sociodémographiques, le type d'installation de soins prénatals, le type de prestataire de soins prénatals, la connaissance de la prévention du paludisme, la sensibilisation à propos du TPIp, et les opportunités manquées en utilisant le test du chi-carré. Les analyses multivariées ont été présentées sous forme de cotes ajustées avec un intervalle de confiance de 95 % (valeur de p<0,05). RÉSULTATS: Près de la moitié (47 %) avaient seulement une éducation primaire ou n'en avaient pas du tout. Environ 30 % étaient pauvres. La plupart ont effectué leur 1ère visite prénatale au cours du 2ème trimestre (58 %). Le taux d'opportunités manquées était de 55 %. Les prédicteurs comprenaient l'âge de 20 à 34 ans [aOR 1,3 (1,1-1,67)], être très pauvre [aOR 1,6 (1,1-2,4)], début tardif des soins prénatals (au 2ème ou 3ème trimestre) [aOR 0,57 (0,4-0,89)], ignorance de la prévention du paludisme [aOR 1,8 (1,4-2,4)], ignorance du TPIp [aOR 1,3 (1,3-2,5)] et résider dans les régions du Sud-Sud et du Nord-Est [aOR 0,46 (0,31-0,68)]. CONCLUSION: Les opportunités manquées étaient élevées. Le lieu de résidence, la méconnaissance de la prévention du paludisme et de l'utilisation du TPIp, le début tardif des soins prénatals, la pauvreté et l'âge jeune (20 à 34 ans) ont contribué à cette charge. Les recommandations incluent de souligner l'importance du TPIp lors des entretiens de santé. La fourniture de gobelets et d'eau potable pour la politique de l'administration directe du TPI par le gouvernement et les partenaires. Il est nécessaire de poursuivre la recherche pour découvrir les raisons des taux plus élevés d'OM dans certaines régions. Mots-clés: Paludisme pendant la grossesse, traitement préventif intermittent, sulfadoxine-pyriméthamine, opportunité manquée, soins prénatals.

Knowledge of Healthcare Professionals on Hepatitis B Virus Infection and Vaccination Uptake in a Tertiary Hospital in Nigeria.

BACKGROUND/OBJECTIVES: Healthcare professionals (HCPs) play a key role in the prevention of hepatitis B virus (HBV) infection. HCPs are expected to have adequate basic knowledge of HBV and readily uptake HBV vaccination as they are a high-risk group, especially those that have direct contact with blood and/or blood products. This study was aimed at assessing the knowledge of and vaccination uptake of HBV among HCPs in a Nigerian tertiary hospital. METHODS: This was a cross-sectional study in which self-administered questionnaires were used to obtain data from different categories of HCPs in a tertiary hospital. The associations between categorical variables were tested using Chi-square test and a P value of 0.05 or less was considered significant. RESULTS: A total of 355 HCPs comprising 149 medical doctors, 180 nurses and 26 laboratory scientists participated in the study. Majority (90.0%) of the respondents correctly identified blood and/or blood products transfusion, needle stick injury, sharing of sharps and vertical transmission as routes of HBV transmission. About 83.4% of the participants were aware that HBV could be transmitted through unprotected sex. However, 39.2% and 15.8% of the participants reported kissing and HBV vaccination as routes of transmission, respectively. Their knowledge and uptake of HBV vaccination was, however, good. CONCLUSION: While majority of the HCPs had good knowledge of the routes of HBV transmission, few still had misconceptions about the routes of transmission, a situation which may cause social discord in the society especially among closely related individuals and potentially result in poor uptake of the highly effective HBV vaccine.

CONTEXTE/OBJECTIFS: Les professionnels de la santé jouent un rôle clé dans la prévention de l'infection par le virus de l'hépatite B (VHB). On s'attend à ce qu'ils aient des connaissances de base suffisantes sur le VHB et qu'ils acceptent facilement la vaccination contre le VHB car ils constituent un groupe à haut risque, en particulier ceux qui sont en contact direct avec du sang et/ou des produits sanguins. Cette étude visait à évaluer les connaissances et l'acceptation de la vaccination contre le VHB parmi le personnel soignant d'un hôpital tertiaire nigérian. MÉTHODES: Il s'agit d'une étude transversale dans laquelle des questionnaires auto-administrés ont été utilisés pour recueillir des données auprès de différentes catégories de professionnels de la santé dans un hôpital tertiaire. Les associations entre les variables catégorielles ont été testées à l'aide du test du chi carré et une valeur P de 0,05 ou moins a été considérée comme significative. RÉSULTATS: Au total, 355 professionnels de la santé, dont 149 médecins, 180 infirmières et 26 laborantins, ont participé à l'étude. La majorité (90,0 %) des personnes interrogées ont correctement identifié la transfusion de sang et/ou de produits sanguins, les blessures par piqûre d'aiguille, le partage d'objets tranchants et la transmission verticale comme étant des voies de transmission du VHB. Environ 83,4 % des participants savaient que le VHB pouvait être transmis lors de rapports sexuels non protégés. Cependant, 39,2 % et 15,8 % des participants ont déclaré que le baiser et la vaccination contre le VHB étaient des voies de transmission, respectivement. Leur connaissance et leur participation à la vaccination contre le VHB étaient cependant bonnes. CONCLUSION: Alors que la majorité des professionnels de santé avaient une bonne connaissance des voies de transmission du VHB, quelques-uns avaient encore des idées fausses sur les voies de transmission, une situation qui peut causer des discordes sociales dans la société, en particulier parmi les personnes étroitement liées, et potentiellement entraîner une faible utilisation du vaccin hautement efficace contre le VHB. Mots-clés: Virus de l'hépatite B, Professionnels de la santé, Vaccination, Connaissances.

Application of Piszkiewicz model on the electron transfer reaction of dithionite ion and bis-(2-pyridinealdoximato)dioxomolybdate(IV) complex.

The need to better understand the binding mode of antioxidants (sulfur oxyanions) kinetically is a concern in medicine. Hence, a spectrophotometric method was used to study the application of the Piszkiewicz model on the electron transfer reaction of dithionite ion (S2O42-) and bis-(2-pyridinealdoximato)dioxomolybdate(IV) complex at 303 K and an absorption maxima of 560 nm. It follows an acid dependent reductive pathway that is medium sensitive. Charge distribution from the reaction species contributes to the redox efficiency of the system, resulting in a primary salt effect (NaCl) with an enhanced reaction rate. Alteration of the reaction medium with ethanol led to an elevation of reduction time as the charge catalysis was distorted by a drop in the system permittivity. Likewise, sodium dodecyl sulfate in the system decreased the reduction rate of the complex due to the low impact of hydrophobic and ion interaction between the micelle and substrates. First order reaction kinetics was observed in the concentration of the redox partners and a 2:1 (complex: S2O42-) stoichiometry was obtained with the involvement of hydrogenated sulfite radical which resulted in the formation of sulfur dioxide and a Mo2+ deactivated complex. The occurrence of counterion catalysis is pronounced in the reaction system owing to the participation of like-charged substrates in the rate-controlling phase. The standard enthalpy (69.12 [Formula: see text] 0.05 kJ mol-1) and Gibbs energy (80.10 [Formula: see text] 0.07) kJ mol-1 suggest that the process is endothermic dependent. The investigation of the anionic surfactant effect on the reaction medium was quantitatively ascertained from the Piszkiewicz model of the complex interaction sequence.

Detection of extended spectrum beta-lactamase genes in strains of Escherichia coli and Klebsiella pneumoniae isolated from recreational water and tertiary hospital waste water in Zaria, Nigeria.

Extended spectrum beta-lactamase (ESBL) producing bacteria pose a severe health risk globally. This study focused on detecting ESBL genes in Escherichia coli and Klebsiella pneumoniae isolated from a recreational water source and the waste water from a tertiary hospital in Zaria, Kaduna State, Nigeria. The isolates (twenty-two) were screened phenotypically for extended spectrum beta lactamase production using the double disk synergy test. Of the isolates, 13 (59.1%) were E. coli, while 9 (40.9%) were Klebsiella pneumoniae; 17 (77.3%) were isolated from the waste water and 5 (22.7%) were isolated from the recreational water. Six (27.2%) of them showed ESBL production phenotypically; however, PCR amplification of the ESBL genes showed that only five of them had at least one of the genes. The presence of ESBL bacteria in hospital waste water and surface waters highlights that water matrices are important routes of transmission of antibiotic resistant bacteria.

A comprehensive review on fused deposition modelling of polylactic acid.

Fused Deposition Modelling (FDM) is one of the additive manufacturing (AM) techniques that have emerged as the most feasible and prevalent approach for generating functional parts due to its ability to produce neat and intricate parts. FDM mainly utilises one of the widely used polymers, polylactic acid, also known as polylactide (PLA). It is an aliphatic polyester material and biocompatible thermoplastic, with the best design prospects due to its eco-friendly properties; when PLA degrades, it breaks down into water and carbon dioxide, neither of which are hazardous to the environment. However, PLA has its limitations of poor mechanical properties. Therefore, a filler reinforcement may enhance the characteristics of PLA and produce higher-quality FDM-printed parts. The processing parameters also play a significant role in the final result of the printed parts. This review aims to study and discover the properties of PLA and the optimum processing parameters. This review covers PLA in FDM, encompassing its mechanical properties, processing parameters, characterisation, and applications. A comprehensive description of FDM processing parameters is outlined as it plays a vital role in determining the quality of a printed product. In addition, PLA polymer is highly desirable for various field industrial applications such as in a medical, automobile, and electronic, given its excellent thermoplastic and biodegradability properties.

A kinetic study and mechanisms of reduction of N, N'-phenylenebis(salicyalideneiminato)cobalt(III) by L-ascorbic acid in DMSO-water medium.

The kinetics of reduction of N, N 1 -phenylenebis-(salicylideneiminato)cobalt (III), referred to as [Co(Salophen)]+ by L-ascorbic acid (H2A) was studied in mixed aqueous medium (DMSO:H2O; 1:4 v/v) under pseudo-first-order conditions at 33 ± 1 °C, µ = 0.1 mol dm-3 (NaCl) and λ max = 470 nm. L-ascorbic acid was oxidized to dehydroascorbic acid with kinetics that was first order in both the [H2A] and [Co(Salophen)+] and second-order overall. The reaction involves two parallel reaction pathways; an acid-dependent and the inverse acid-dependent pathways. The inverse acid pathway shows that there is a pre-equilibrium step before the rate determining-step in which a proton is lost. The kinetics followed negative Brønsted-Debye salt effect. Evidence was obtained for the presence of free radicals but none to support the formation of an intermediate complex of significant stability during the reaction. Overall, the data obtained suggest an outer-sphere mechanism for the reaction. A plausible mechanism is proposed.

The ACCEPT-study: design of an RCT with an active treatment control condition to study the effectiveness of the Dutch version of PEERS® for adolescents with autism spectrum disorder.

BACKGROUND: Social skills interventions are commonly deployed for adolescents with autism spectrum disorder (ASD). Because effective and appropriate social skills are determined by cultural factors that differ throughout the world, the effectiveness of these interventions relies on a good cultural fit. Therefore, the ACCEPT study examines the effectiveness of the Dutch Program for the Education and Enrichment of Relational Skills (PEERS®) social skills intervention. METHODS/DESIGN: This study is a two-arm parallel group randomized controlled trial (RCT) in which adolescents are randomly assigned (after baseline assessment) to one of two group interventions (PEERS® vs. active control condition). In total, 150 adolescents are to be included, with multi-informant involvement of their parents and teachers. The ACCEPT study uses an active control condition (puberty psychoeducation group training, focussing on social-emotional development) and explores possible moderators and mediators in improving social skills. The primary outcome measure is the Contextual Assessment of Social Skills (CASS). The CASS assesses social skills performance in a face to face social interaction with an unfamiliar, typically developing peer, making this a valuable instrument to assess the social conversational skills targeted in PEERS®. In addition, to obtain a complete picture of social skills, self-, parent- and teacher-reported social skills are assessed using the Social Skills improvement System (SSiS-RS) and Social Responsiveness Scale (SRS-2). Secondary outcome measures (i.e. explorative mediators) include social knowledge, social cognition, social anxiety, social contacts and feelings of parenting competency of caregivers. Moreover, demographic and diagnostic measures are assessed as potential moderators of treatment effectiveness. Assessments of adolescents, parents, and teachers take place at baseline (week 0), intermediate (week 7), post intervention (week 14), and at follow-up (week 28). CONCLUSION: This is the first RCT on the effectiveness of the PEERS® parent-assisted curriculum which includes an active control condition. The outcome of social skills is assessed using observational assessments and multi-informant questionnaires. Additionally, factors related to social learning are assessed at several time points, which will enable us to explore potential mediators and moderators of treatment effect. TRAIL REGISTRATION: Dutch trail register NTR6255 (NL6117). Registered February 8th, 2017 - retrospectively registered.

Reaction of N, N 1 -phenylenebis(salicyalideneiminato)cobalt(III) and l-cysteine in mixed aqueous medium: kinetics and mechanism.

The redox kinetics involving the reaction of N, N'-phenylenebis(salicyalideneiminato)cobalt(III) ([CoSalophen]+) and l-cysteine (LSH) was studied using pseudo-first order approach under the following conditions, [H+] = 1.0 × 10-3 mol/dm3, µ = 0.1 C2 mol/dm3 (NaCl), λmax = 470 nm and T = 27 ± 1 °C in DMSO: H2O; 1:4 v: v medium. The redox reaction was 1st order in both [CoSalophen+] and [LSH], with the overall 2nd order. Hydrogen ion concentration effect revealed the activeness of both the protonated and deprotonated form of the reductant, positive Brønsted-Debye salt effect and was also ion catalyzed. There was no evidence suggesting an intermediate complex of significant stability in the reaction. Free radical was detected to take part and as such the reasonable mechanistic pathway for the reaction is suggested to be outer-sphere, hence proposed.

Photocatalytic activity and doping effects of BiFeO3 nanoparticles in model organic dyes.

The studies of advanced materials in environmental remediation and degradation of pollutants is rapidly advancing because of their wide varieties of applications. BiFeO3 (BFO), a perovskite nanomaterial with a rhombohedral R3c space group, is currently receiving tremendous attention in photodegradation of dyes. The photocatalytic activity of BFO nanoparticle is a promising field of research in photocatalysis. BFO nanomaterial is a photocatalyst enhanced by doping because of its reduce bandgap energy (2.0-2.77 eV), multiferroic property, strong photoabsorption and crystal structure. The material has proven to be very useful for the degradation of dyes under visible light irradiation among other photocatalysts. Its exceptional nontoxicity, suitability, low cost and long term excellent stability makes it an efficient photocatalyst for the degradation of effluents from textile and pharmaceutical industries which ended-up in the environment and now a major concern of the modern world. This mini-review attempts to provide some detailed synthetic routes of BFO and BFO related nanomaterials and the notable achievements so far on the effect of doping the material. It also discusses the effect of crystallite size of the material and other photophysical properties and how they influence the photocatalytic process of model organic dye pollutants, to date.

Molecular detection of human adenovirus among hospitalized patients with lower respiratory tract infection in Hospital Sungai Buloh, Malaysia.

Human adenovirus (HAdV) is one of the common pathogens that are responsible for a wide variety of infectious diseases. There are about 54 different adenovirus serotypes that are responsible for respiratory infections in humans. The prevalence of lower respiratory tract infection (LRTI) - associated with HAdV varies throughout different regions. The prevalence of HAdV in Malaysia is rarely investigated and reported despite severity of infection worldwide. This study was undertaken to identify the HAdV types associated with lower respiratory tract infection (LRTI) in Hospital Sungai Buloh, Malaysia between April 2013 until January 2014, a total of 210 specimens were collected from patients hospitalized with LRTI. Human adenovirus was detected using polymerase chain reaction (PCR). The positive products were sequenced and phylogenetic analysis of the virus was performed. Eighteen of 210 specimens (8.57%) were positive with HAdV infection. Based on the phylogenetic analysis study, HAdV-7 strains were the most common serotype with 11 cases, followed by HAdV-1, HAdV-2 and HAdV-4 with 2 cases each and one case of HAdV-5. The HAdV strains in this study were closely related to strains in Singapore and India. In this study, HAdV infection from LRTI patients in Hospital Sungai Buloh Malaysia were caused by different types of adenovirus mainly HAdV-7. This study will become a reference for further epidemiological study in this country.

Estimating the burden of influenza-associated hospitalization and deaths in Oman (2012-2015).

BACKGROUND: Influenza is a serious vaccine-preventable disease with high incidence, hospitalization, and mortality in high-risk groups. The epidemiology, seasonality, and risk factors for influenza are well defined in most of the temperate countries, but estimating influenza burden in the World Health Organization (WHO) Region for the Eastern Mediterranean is scarce. In Oman, despite the advancements in influenza surveillance, the clinical burden and seasonality of influenza remain not fully understood. OBJECTIVES: To estimate the incidence of influenza-associated hospitalizations and in-hospital death in Oman. PATIENTS AND METHODS: Influenza-associated hospitalizations and in-hospital deaths were estimated using hospital discharge records based on ICD-10 codes (J09-J18), results of virological analysis and population census for the period between 2012 and 2015. RESULTS: During 2012 and 2015, we identified a total of 19 405 influenza-associated hospitalization and 847 deaths. Influenza positivity percentage ranged from 6.4% in 2013 to 20.6% in 2015. Influenza-associated hospitalization incidence rate was 7.3 (95% CI: 6.4-8.1) per 100 000 in 2013 and 27.5 (95% CI: 25.9-29.1) per 100 000 in 2015 with an overall rate of 20.6 (95% CI: 19.9-21.3) per 100 000. The highest incidence of influenza-associated death was among those aged ≥65 years and ranged between 39.5 (95% CI: 27.3-51.8) per 100 000 in 2014 and 11.3 (95% CI: 7.5-15.1) in 2015. CONCLUSIONS: Influenza causes a substantial number of hospitalizations and deaths in Oman. Hospitalization rates were highest among children, and adults ≥65 years showed the highest death rate. The potential value of using seasonal influenza vaccine in these groups should be considered.

Factors associated with prelacteal feeding practices in a rural northern Nigerian setting

Introduction: Prelacteal feeding practice contravenes the recommendation of World Health Organisation that breastfeeding be initiated within an hour of childbirth. Consequently, the health, social, emotional and economic benefits of optimal breastfeeding are limited. Therefore, to break this vicious cycle of prelacteal feeding and suboptimal breastfeeding, factors associated with the practice must be identified. Objective: To assess prelacteal feeding practices and its associated factors in a rural community with the view to generate data for community-level interventions that will promote optimal breastfeeding.Methods: Data was collected during a community-based surveillance for maternal, newborn and child health project in Tsibiri,a rural community in north-western Nigeria. The survey questionnaire was uploaded into mobile devices running on an android operating system. Trained female interviewers collected the data over a period of one week in 2011.Results: A total of 270 out of 309 interviewed women had experienced childbirth and were included in the analysis. Majority (85.2%) of respondents utilised prelacteal feeds for their newborns. Plain water was the most common prelacteal feed (44.7%).Prelacteal feeding was associated with births assisted by unskilled birth attendants (AOR 5.322, 95%CI 1.634-17.333); while operative delivery reduced the likelihood of the practice (AOR 0.168, 95%CI 0.060-0.470). No statistically significant association was found between use of prelacteal feed and women's age, education or access to income.Conclusion: The predominance of prelacteal feeding practices underscores the need for innovative strategies that create awareness among mothers and health care providers, with emphasis on health facility deliveries, advantages of breastfeeding and risks of prelacteal feeding

Incidence and economic burden of acute otitis media in children aged up to 5years in three Middle Eastern countries and Pakistan: A multinational, retrospective, observational study.

Epidemiological data on acute otitis media (AOM), an infectious disease frequently affecting children, are lacking in some countries. This study was undertaken to assess the incidence of AOM in children ≤5years in Saudi Arabia, Oman, Pakistan, and Turkey, as well as the economic burden from a parent/caregiver perspective. Medical records of 4043 children (Saudi Arabia=1023, Oman=998, Pakistan=1022, Turkey=1000) were retrospectively reviewed and the incidence of AOM episodes calculated from suspected and confirmed cases. Using a standardized Health Economics Questionnaire, parents recorded resource use and expenses incurred per AOM episode [in local currency and converted to US dollars (USD)]. The overall incidence of AOM episodes per 1000 person-years was: Saudi Arabia, 207 [95% confidence interval (CI): 178-238]; Oman, 105 (95% CI: 85-127); Pakistan, 138 (95% CI: 116-163); and Turkey, 99 (95% CI: 79-123). The mean total out-of-pocket healthcare expense incurred by parents/caregivers per episode was: Saudi Arabia USD67.1 [standard deviation (SD)=93.0], Oman USD16.1 (SD=16.4), Pakistan USD22.1 (SD=20.5), and Turkey USD33.6 (SD=44.9). The incidence of AOM episodes varied across all four countries, probably due to different diagnostic and management practices. Nevertheless, our results confirm that AOM causes a substantial burden to public health, reinforcing the need for cost-effective prevention strategies.

Age at menarche and its association with overweight/obesity among adolescents in Kano

Background: There was a dramatic decline of adolescents' menarcheal age worldwide; Africa is witnessing a secular trend of this reducing menarcheal age among its black adolescents. A transition of overweight/obesity among adolescent is believed to be associated with reduced menarcheal age. Materials and Methods: It was a descriptive cross-sectional study that was conducted among female adolescent girls from January to December, 2016. Ethical approval was obtained from the management concerned. All consenting adolescents were recruited for the survey. Information was recorded on a structured, pretested questionnaire. Their respective weight and height were also measured. Body mass index (BMI) was calculated using the formula: BMI = weight (kg)/height (m2). The data obtained were analyzed using the Statistical Package for the Social Sciences version 18.0 (SPSS Inc., SPSS Statistics for Windows, Chicago, IL, USA). Fishers' exact test was used, and the P ≤ 0.05 was considered statistically significant. Results: Two hundred and nineteen female adolescents participated in the survey. The mean age ± SD at menarche was 12.83 ± 1.312 years. The median and modal ages were both 13 years. There was no statistically significant association between the mean age at menarche and the ethnic groups (P(Fishers') = 0.150). However, mean age at menarche was statistically associated with their BMI (P(Fishers') = 0.00). Obesity was associated with reduced menarcheal age. Conclusion: The median and mean ages at menarche were 13.0 and 12.8 years respectively, which were in accordance with secular trend of reduced menarcheal age among black adolescents. Our study also showed an inverse association between the age at menarche and overweight or obesity among adolescents

[The clinical impact of treatment discrepancies recorded for 200 patients in an acute geriatric unit]. / Impact clinique des divergences de traitement constatées chez 200 patients conciliés dans un service de gériatrie aiguë.

INTRODUCTION: Medication reconciliation is a process used to identify and prevent medication errors at care transition points in hospitals. The present study's main objectives were to quantify the frequency of inadvertent discrepancies (IDs) per patient and estimate the seriousness of the IDs' clinical impact. PATIENTS AND METHODS: This was a prospective, single-center study performed in a 38-bed acute geriatric unit. All patients hospitalized over a 70-day period were included in the study. RESULTS: Over a 70-day period, 200 patients were included (mean±SD age: 85.5±5.9). A total of 316 IDs were recorded in 117 patients (58.5%, i.e. 1.58 per patient). One third of the IDs were considered to be serious or even life-threatening. Omission was the most common type of ID (58%). Cardiovascular drugs were most frequently involved in IDs (33%). CONCLUSION: We observed an average of more than one ID per patient, when comparing drug treatment at home and drug treatment upon admission to hospital. A third of these IDs may be clinically significant. Geriatric populations with polypharmacy and multiple comorbidities are particularly sensitive to this type of error. Medication reconciliation can detect and correct IDs. Collaboration between physicians and pharmacists will improve the quality of patient care and reduce the iatrogenic risk.

Knowledge, attitudes, and practices regarding travel health among Muscat International Airport travelers in Oman: Identifying the gaps and addressing the challenges.

Although the majority of travel-associated communicable diseases can be prevented, the public health burden of these diseases remains significant. Relatively little is known about how travelers know and perceive the health risks associated with travel and how they utilize preventive measures before and while traveling abroad. This study was conducted to determine the level of the knowledge, attitudes, and practices (KAP) of Muscat International Airport travelers about travel health in order to assess the knowledge gap and the need for travel health services in Oman. A cross-sectional study was conducted over a period of 1week using a self-administered questionnaire. The overall level of knowledge about vaccine-preventable diseases, food safety, and preventive measures against insect bites of the participants was inadequate. The practice concerning preventive travel health measures, such as the use of specific immunizations and antimalarial prophylaxis, was very limited, and influenced by some personal and travel-related factors. The inadequate level of travelers' knowledge and poor utilization of travel medicine services highlights the need for the provisions of specialized travel medicine services at the national level and to develop educational materials promoting the importance of pre-travel health advice.

Prevalence of cytomegalovirus, and its effect on the expression of inducible and endothelial nitric oxide synthases in Fallopian tubes collected from women with and without ectopic pregnancy.

To measure the prevalence of cytomegalovirus (CMV) infection in ectopic pregnancy (EP) and its effect on the expression of inducible and endothelial nitric oxide synthases (iNOS, eNOS) by Fallopian tubes (FT) bearing an EP. This was a prospective case-control study. Blood and tubal samples were collected from 84 Eps and 51 controls (20 total abdominal hysterectomy (TAH) during the luteal phase and another 31 tubal ligations). CMV IgM and IgG antibodies were measured by ELISA, and an IVD CE PCR kit was used to detect CMV in the FTs. iNOS and eNOS were measured by immunohistochemistry and quantitative RT-PCR in FTs obtained from CMV-positive EP (n = 12), and the results were compared with those obtained from CMV-negative EP (n = 11) and TAH (n = 8). The frequencies of CMV IgM (51.2 % vs 17.6 %), IgG (77.4 % vs 52.9 %) or both antibodies (41.6 % vs 11.7 %) were significantly higher in EP compared with control. CMV was more common by PCR in FTs from EP (21.4 %) than controls (5.9 %). Twelve women from the PCR positive EP cases (66.6 %) were also simultaneously positive for both CMV IgM & IgG antibodies and had higher expression of eNOS and iNOS at the protein and gene levels compared with negative EP and TAH. Tubal infection with CMV may lead to EP by increasing the production of endothelial and inducible NOS by the FT epithelial cells. Further studies are required to illustrate the role of CMV in the pathogenesis of EP.

Epidemiology of travel-associated infections in Oman 1999-2013: A retrospective analysis.

BACKGROUND: The number of travelers in Oman has increased significantly in the last 2 decades with an increase in the expatriate population workforce leading to the emergence of infections related to travel. This paper aims to highlight the burden of travel-related infections in Oman. METHOD: Our study is a descriptive record-based review and analysis of travel-associated diseases over a 14 year time period from 1999 to 2013. The data was sourced from the communicable disease surveillance system, and central public health laboratory results. RESULTS: From 1999 to 2013 there were a combined total of 7022 cases of cholera, chikungunya, dengue, filariasis, leptospirosis, meningococcal infection, poliomyelitis, measles, schistosomiasis, viral hepatitis (A), typhoid and para-typhoid reported to and subsequently investigated by the Department of Communicable Diseases. Among these cases, 558 (7.9%) were attributed to travel. Fifty percent of these patients were admitted to hospitals. CONCLUSION: Travel-associated infections account for about 8% of notifiable infections in Oman and have low mortality rate. However, some travel-associated infections are considered as a threat to polio eradication and measles elimination programs. Furthermore, some can cause outbreaks that can overwhelm the healthcare system.

Perspectives on glenohumeral joint contractures and shoulder dysfunction in children with perinatal brachial plexus palsy.

Shoulder joint deformities continue to be a challenging aspect of treating upper plexus lesions in children with perinatal brachial plexus palsy (PBPP). It is increasingly recognized that PBPP affects the glenohumeral joint specifically, and that abnormal scapulothoracic movements are a compensatory development. The pathophysiology and assessment of glenohumeral joint contractures, the progression of scapular dyskinesia and skeletal dysplasia, and current shoulder imaging techniques are reviewed.