Tracking Risk Factors Related to an Outbreak of COVID-19 Among Healthcare Workers in a General Medicine Ward.

Background An outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection occurred in a medical ward involving patients and hospital staff from May to June 2020. Aim The aim of this study is to determine risk factors related to the outbreak of SARS-CoV-2 in six healthcare workers (HCWs) in a medical ward with initially unrecognized coronavirus disease 2019 (COVID-19) positive patients. Methods A retrospective cross-sectional study was conducted using a comprehensive questionnaire and personal interviews to determine the risk factors for COVID-19 infection in HCWs. Findings A total of 6/34 HCWs were diagnosed with COVID-19 in a medical ward. There were no differences between COVID-19 negative HCWs and COVID-19 positive HCWs in terms of mean duration of hours worked in the unit during the cluster event (180.2 vs 177.5 hours) (p>0.05), mean total time spent in contact with COVID-19 positive patients (12.8 vs 10.5 hours) (p>0.05), mean total time spent on aerosol-generating procedures (1.9 vs 0.9 hours) (p>0.05), and mean total time spent on non-aerosol generating procedures (10.9 vs 9.6 hours ) (p>0.05). There was no difference in exposure to COVID-19 positive family members among the HCWs (33% vs 3.7%, p=0.08). In contrast, exposure to COVID-19 positive contacts in the community was significantly greater in infected vs non-infected HCWs (16.7% vs 0%, p=0.03). Conclusion There was no significant difference in risk factors for contracting SARs-CoV2 among HCWs due to hospital exposures. COVID-19 positive HCWs were more likely to be exposed to positive individuals in their households and community, indicating that the source of SARS-CoV-2 infection came from outside the hospital.

Clinical and epidemiological features and severity markers in children admitted with multisystem inflammatory syndrome in children (MISC) in a tertiary care center in the United Arab Emirates.

BACKGROUND: Multisystem inflammatory syndrome in children (MISC) is a phenomenon that appeared in children infected with or exposed to severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). The typical onset of MISC is 4-6 weeks following SARS-CoV-2 infection and is formulated to be due to an immune response. METHODS: Our study retrospectively analyzed data from a tertiary center in United Arab Emirates of MISC patients who were admitted to either general pediatric wards or pediatric intensive care (PICU) or who came exclusively for follow-up (post-PICU admission) from May 2020 to August 2021. RESULTS: The total sample size was 50 patients, and the study included a comparison of MISC-PICU admissions with MISC-non-PICU admissions. The MISC-PICU sample size was 18 patients, 50% females, with mean age of 8.3 years all were previously healthy. MISC-PICU patients had deranged blood counts with a lower hemoglobin count, a more pronounced lymphopenia and thrombocytopenia along with hypoalbuminemia. MISC-PICU patients presented with relatively higher inflammatory markers: C-reactive protein, procalcitonin, ferritin, and d-dimer. Immunological studies were significantly higher for interleukin-6 levels in PICU patients. On echocardiography, higher myocardial dysfunction was more notable in MISC-PICU patients. Likewise, MISC-PICU patients were provided with more extensive therapy. As part of our study course, we reevaluated our MISC-PICU patients twice, once at 48 h post-PICU admission and again 4-6 weeks after discharge from the hospital. No deaths have been recorded in the cohort. CONCLUSION: This study evaluated risk factors of MISC and potential severity features. Follow-up of patients on discharge showed improvement across all domains.

Maternal and Fetal Outcome in Pregnant Women With Critical COVID-19 Treated With Tocilizumab in a Tertiary Care Hospital in Dubai.

INTRODUCTION: Pregnancy, complicated by coronavirus disease 2019 (COVID-19), results in higher hospitalization and mortality rate. Pathogenesis of COVID-19 is similar to any other systemic inflammatory condition but results in a cytokine storm of higher magnitude causing severe acute respiratory distress syndrome and multiorgan failure. Tocilizumab, a humanized monoclonal antibody, targets soluble and membrane-bound IL-6 receptors and is used in the treatment of juvenile idiopathic arthritis, rheumatoid arthritis, and cytokine release syndrome. However, studies exploring its role in pregnancy are minimal. Hence, this study was done to study the effect of tocilizumab on maternal and fetal outcomes in critical COVID-19 pregnant women. METHODOLOGY: A retrospective study was conducted on 28 pregnant women with critical COVID-19 who received tocilizumab. Clinical status, chest x-ray, biochemical parameters, and fetal well-being were monitored and documented. The discharged patients were followed up through telemedicine. RESULT: On treatment with tocilizumab, improvement was seen in the number of zones and patterns of chest x-ray, along with 80% reduction in the c-reactive protein (CRP) levels. Based on the WHO clinical progression scale, 20 patients improved by the end of first week, and by the end of first month, 26 patients became asymptomatic. Two patients died during the course of the disease. No fetal adverse effects were noted. CONCLUSION: Based on the encouraging response and as tocilizumab did not impart any adverse effects on the pregnancy, tocilizumab may be administered as an adjuvant to critical COVID-19 pregnant women in their second and third trimesters.

Effect from Autoclave Sterilization and Usage on the Fracture Resistance of Heat-Treated Nickel-Titanium Rotary Files.

This study aimed to assess the effect of mechanical loading and heating on the cyclic fatigue and torsional fracture resistances of heat-treated nickel-titanium files after usage and autoclaving. Sixty files (One Curve) were tested for cyclic fatigue and torsional fracture resistances using customized devices. The files were divided into three groups according to the test conditions (n = 10); new (group-N), used for simulated canal shaping (group-U), and sterilized after use (group-S). For cyclic fatigue resistances, the files were freely rotated in a curved metal canal under body temperature; the time elapsed to fracture was recorded and the numbers of cycles to fracture (NCF) were calculated. For the torsional resistances, the file tip was fixed and rotated until the file fractured. The maximum torsional load and distortion angle were recorded. The toughness was calculated. Fracture fragments were examined with a scanning electron microscope. Data were analyzed using a one-way analysis of variance and Tukey's post hoc test at the significance level of 95%. Group-U showed significantly higher NCF than group-S (p < 0.05). However, there was no significant differences between groups-N and -S in the NCF (p > 0.05). Group-N showed a significantly bigger distortional angle and higher torsional toughness than groups-U and -S, but the ultimate torsional strength did not have significant difference between the groups. Under the limitation of this study, autoclave sterilization after single-usage did not improve the fracture resistance of heat-treated One Curve nickel-titanium files.

Knowledge of Physicians about the Interrelationship between Diabetes Mellitus and Periodontitis in the United Arab Emirates.

OBJECTIVE: Diabetes mellitus is a major cause of morbidity in the United Arab Emirates (UAE), highlighting a significant social and economic burden impacting the development of the country. Studies have shown a bidirectional relationship between diabetes and periodontal disease. The awareness of this relationship is imperative not only for dentists but also for the physicians who contribute toward enhancing a diabetic patient's health and lifestyle. There is a general need to highlight the importance of maintaining periodontal health and its positive effect on controlling diabetic health status. The purpose of this study is to investigate the knowledge of the physicians regarding diabetes and periodontal health. MATERIALS AND METHODS: A cross-sectional study involving a questionnaire was distributed to the physicians who were attending the Arab Health Conference in Dubai in 2019. STATISTICAL ANALYSES: A cross-tabulation analysis compared attitude, knowledge, and awareness across sector, gender, and country of graduation. A logistic regression model was used to explain the "knowledge" regarding possible confounding factors. RESULTS: A total of 344 physicians with an average age of 38.11 (9.31) years, comprising of 186 (53.8%) males, participated in the survey. Of those participants, 285 (82.8%) were working in the government sector health care centers versus the private health care organizations. Also, 108 (31.4%) of the participants graduated within the universities based in the UAE, while the remaining 263 (68.6%) participants graduated from medical schools from other countries. At least 265 (77%) of the participants had positive outlook toward referring patients with diabetes to their dental colleagues, while 283 (82.3%) of the physicians acknowledge that diabetes affects periodontal health. While a majority of participants 261 (76%) treat diabetic patients in their clinical practice, only 50 (19%) of the participants admit to referring these patients for a dental consultation. In addition, the survey also revealed that 225 (65.5%) physicians comprehend the bidirectional relationship of periodontal disease and diabetes. CONCLUSION: An appropriate dental referral protocol is recommended for all diabetic patients who visit physicians. This survey demonstrated that although the physicians present with good knowledge, they rarely refer diabetic patients to receive proper periodontal care.

The Effect of Chlorhexidine on Bacterial Contamination of Hall Technique Elastomeric Orthodontic Separators and Gingival Health: A Pilot Study

ABSTRACT Objective: To study the effect of chlorhexidine on elastomeric orthodontic separators (EOS) bacterial-colonisation and gingival-health in Hall technique (HT) patients. Material and Methods: Prospective in-vivo pilot clinical study of EOS bacterial colonisation and primary-molar gingival health assessment in 20 patients (mean age 5.45±1.27 years) requiring bilateral HT crowns (40 teeth). One side received 1-minute 0.12% chlorhexidine-soaked-EOSs (Chx-EOSs), and the other side dry-EOSs (NoChx-EOSs). The EOSs were removed five-days later and underwent a bacterial enumeration technique. Plaque (PI) and Gingival (GI) indices were assessed pre-, five-days and three-months post-treatment. Wilcoxon-Signed-Rank/McNemar-Chi-square statistics were used (p<0.05). Results: Baseline unused/packaged EOSs' sterility check yielded zero colony-forming-units (CFU) per millilitre, but 100% of the used EOSs became colonised by oral-microorganisms. An overall trend of lower mean CFU count in Chx-EOSs (3.415± 0.78 x105 CFU/ml) compared to NoChx-EOSs (6.157±1.48 x105 CFU/ml) was observed (p=0.009). Both NoChx-EOSs and Chx-EOSs insertion sites showed evidence of gingivitis with no difference between PI and GI indices by site over time. Conclusion: There was a lower trend of bacterial colonization in chlorhexidine treated EOSs and an occurrence of gingivitis pre/post HT-treatment regardless of EOS type. The lack of difference in the gingival health may be inconclusive due to this pilot's low power suggesting the need for robust large scale studies.

The Shortened Dental Arch Concept: Awareness, Knowledge, and Practice of Dentists in Dubai and the Northern Emirates, United Arab Emirates.

Methods: This is a cross-sectional study utilizing an online questionnaire anonymously to investigate the awareness and views of dentists about SDA. The questionnaire was sent to all 901 dentists registered with the Emirates Medical Association (EMA). The questionnaire consists of 17 questions, which comprise demographics, awareness, and application in dental practice, preferred treatment modality, and risks and benefits associated with SDA. The data were analyzed using SPSS Statistics. Results: The response rate reported was 40.3%. Two-thirds of the respondents (65.8%) were aware of the SDA concept; however, it was not usually applied in clinical practice (n = 196, 54.7%). Specialists were more aware of the concept (p ≤ 0.001) and applied it more frequently in their clinical practice (p=0.041) than general dental practitioners (GDPs). Respondents agreed that SDA was associated with the risks of teeth migration (n = 211, 59.9%), tooth wear (n = 196, 55.8%), and/or temporomandibular disorder (TMD) (n = 163, 45.3%). The implant was the treatment of choice for many of the participants (n = 169, 46.6%) to replace missing molars, followed by the acrylic removal partial denture (RPD) (n = 129, 35.5%). Conclusions: Most dentists who responded to this survey were aware of the SDA concept and had a positive attitude about it. However, they did not apply it frequently in their clinical practice.

Fracture Resistance of Heat-Treated Nickel-Titanium Rotary Files After Usage and Autoclave Sterilization: An In Vitro Study.

INTRODUCTION: This study aimed to evaluate the dynamic cyclic fatigue resistance of heat-treated nickel-titanium (NiTi) files after usage and autoclaving. METHODS: Two heat-treated NiTi file systems with tip sizes of #25 (ie, ProTaper Gold F2 [Dentsply Sirona, Charlotte, NC] and TruNatomy Prime [Dentsply Sirona]) were selected. Files of each system were divided into 3 experimental subgroups (n = 10). For subgroup 1, new files were tested to establish the baseline number of cycles to failure (NCF). For subgroup 2, files underwent canal instrumentation in a simulated J-shaped canal block with 35° of curvature and a 16.5-mm length. The simulated canals were pre-enlarged using stainless steel files #10K and #15K. After instrumentation, the files were tested. For subgroup 3, files underwent canal instrumentation as in subgroup 2 followed by autoclave sterilization and then were tested for cyclic failure. The cyclic fatigue test was performed in dynamic pecking motion under body temperature. The time to fracture was recorded and calculated into NCF. Fracture fragment lengths were measured using a digital microcaliper. Statistical analysis was conducted using the independent t test and multifactorial analysis of variance with 95% significance. Scanning electron microscopy was used to examine the topographic characteristics after cyclic fatigue tests. RESULTS: There were no significant differences between file systems in subgroup 1 using new files (P < .05). Although PG reduced the NCF after use, TN showed a significantly increased NCF (P < .05). However, after sterilization, TN showed a reduced NCF compared with the used one (P < .05). CONCLUSIONS: Cyclic loading by usage and heat treatment during sterilization may result in different cyclic fatigue resistance according to the geometry and alloy characteristics.

Characteristics of Pediatric Dental Treatment Provided under General Anesthesia in Dubai, United Arab Emirates: A Retrospective Analysis.

Background: Dental general anesthesia (DGA) is a widely utilized technique in pediatric dentistry and is indicated for a variety of cases such as very young children and children with special healthcare needs (SHCN). In the United Arab Emirates (UAE), there is a paucity of studies relating to this subject. Objective: To analyze the characteristics of DGA treatment in special healthcare needs and healthy children in the only postgraduate dental hospital in Dubai, UAE. Materials and Methods: A retrospective analysis was conducted on the electronic records of all Dubai Dental Hospital (DDH) pediatric patients who underwent DGA in the period between January 1st, 2016, and 29th of February 2020. Results: The study population consisted of 98 children. A total of 26 children had a medical condition and were categorized as SHCN. The most common justification for DGA was dental caries and a lack of cooperation due to young age. SHCN patients received significantly more preventive measures and significantly fewer pulp therapies than healthy patients. Conclusion: We found that the services provided under DGA for healthy pediatric patients differ from those provided to SHCN patients. Frequently missing recall appointments following DGA increased the likelihood of the need for further restorative dental treatment. These results highlight the importance of robust prevention and follow-up programs for children treated under GA.

COVID-19 under 19: A meta-analysis.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic continues to cause global havoc posing uncertainty to educational institutions worldwide. Understanding the clinical characteristics of COVID-19 in children is important because of the potential impact on clinical management and public health decisions. METHODS: A meta-analysis was conducted for pediatric COVID-19 studies using PubMed and Scopus. It reviewed demographics, co-morbidities, clinical manifestations, laboratory investigations, radiological investigations, treatment, and outcomes. The 95% confidence interval (CI) was utilized. RESULTS: Out of 3927 articles, 31 articles comprising of 1816 patients were selected from December 2019 to early October 2020 and were defined by 77 variables. Of these studies 58% originated from China and the remainder from North America, Europe and the Middle East. This meta-analysis revealed that 19.2% (CI 13.6%-26.4%) of patients were asymptomatic. Fever (57%, CI 49.7%-64%) and cough (44.1%, CI 38.3%-50.2%) were the most common symptoms. The most frequently encountered white blood count abnormalities were lymphopenia 13.5% (CI 8.2%-21.4%) and leukopenia 12.6% (CI 8.5%-18.3%). Ground glass opacities were the most common radiological finding of children with COVID-19 (35.5%, CI 28.9%-42.7%). Hospitalization rate was 96.3% (CI 92.4%-98.2%) of which 10.8% (CI 4.2%-25.3%) were ICU admissions, and 2.4% (CI 1.7%-3.4%) died. CONCLUSION: The majority of pediatric patients with COVID-19 were asymptomatic or had mild manifestations. Among hospitalized patients there remains a significant number that require intensive care unit care. Overall across the literature, a considerable level of understanding of COVID-19 in children was reached, yet emerging data related to multisystemic inflammatory syndrome in children should be explored.

Dentists' knowledge, attitudes, and professional behavior toward the COVID-19 pandemic: A multisite survey of dentists' perspectives.

BACKGROUND: COVID-19 continues to affect the dental community worldwide. The authors conducted a cross-sectional electronic study using a multisite survey to examine dentists' knowledge, attitudes, and professional behavior toward COVID-19 and the affect on their livelihood. METHODS: A questionnaire was circulated via e-mail and social media platforms to dentists in North America, Europe, Eastern Mediterranean, and Western Pacific regions. It covered demographic characteristics and questions about the COVID-19 outbreak related to dentists' levels of comfort for preventive and safety measures, provision of treatment, affect on work, and financial implications. Responses were tabulated and analyzed by means of χ2 or Fisher exact test. Mann-Whitney and Kruskal-Wallis tests were used to compare means. P < .05 was considered significant. RESULTS: A total of 1,251 dentists responded. General dentists represented 63.9% of the respondents and 62.5% worked in private practice. The global score for level of comfort with the preventive measures and provisions of treatment during the COVID-19 pandemic was low (14 of 30), and differences between regions were significant (P < .01); dentists working in private practice and general dental practitioners were less comfortable (P < .01). CONCLUSIONS AND PRACTICAL IMPLICATIONS: The respondents reported a lack of preparedness to confront a highly infectious respiratory disease. A new level of protective armamentarium in the dental operatory and updated operational guidance and policies are required, necessitating educators and regulators to ensure the delivery of knowledge and skills to oral health care providers. Dentists need to address the sustainability of their practices and have a robust business plan.

Incidence of Contrast-Induced Nephropathy after Coronary Procedures in the United Arab Emirates: A Single-Center Study.

Contrast-induced nephropathy (CIN) is a major cause of morbidity and mortality in patients undergoing coronary procedures. The reported incidence of CIN ranges from ~3% to 30%. The profile of patients undergoing coronary procedures in the United Arab Emirates (UAE) differs from those included in published reports of CIN, and the incidence of CIN after coronary procedures in the UAE remains unknown. We conducted a retrospective analysis of all adult patients who underwent coronary procedures at a large tertiary care facility in the UAE in 2013-2014. Patients on dialysis or missing creatinine values were excluded. CIN was defined as an increase of creatinine of ≥44 µmol/L within 48-72 h after coronary procedures. Most patients (84.8%) underwent coronary procedures for urgent/emergent indications. The incidence of CIN was 44 out of 1010 (4.35%), with 17 out of 44 (38%) of CIN patients requiring dialysis. After adjusting for baseline differences, older patients, use of angiotensin-converting enzyme inhibitors, and oxygen use during the procedure were associated with a 20.6% increased risk of development of CIN. The risk of in-hospital mortality was significantly higher in the CIN group (29.5% vs. 1.8%).

Family medicine training in Saudi Arabia: Are there any variations among different regions?

AIMS: The aim was to compare Eastern, Makkah, and Asir regions in term of residents' perception of the achievement of training objectives, and to assess various rotations based on residents' perception. SETTINGS AND DESIGN: This cross-sectional study was done among family medicine residents in the Eastern, Makkah, and Asir regions. METHODOLOGY: A questionnaire was developed by the investigator and validated by two experts. All residents, except R1 residents, were included. All data were collected by the investigator by direct contact with the residents. STATISTICAL ANALYSIS USED: Cronbach's alpha, analysis of variance, t-test, and univariate regression model as appropriate, were used. RESULTS: Reliability of the questionnaire was found to be 75.4%. One hundred and seven (response rate: 83.6%) residents completed the questionnaire. There were 51 (47.7%), 27 (25.2%), and 29 (27.1%) residents in the program in the Eastern region, Makkah, and Asir, respectively. The mean age was 29.1 ± 2.5 years; half of the residents were male, most of (83.2%) were married, and more than half (54.2%) of had worked in primary health care before joining the program. Overall, 45% of the residents perceived that they had achieved the training objectives. The highest rotations as perceived by the residents were psychiatry and otolaryngology while the lowest were orthopedics and ophthalmology. There were significant differences among the study regions with regard to the rotations in family medicine, internal medicine, orthopedics, general surgery, and emergency medicine. CONCLUSIONS: Overall, a good percentage of the residents perceived that they had achieved the training objectives. The rotations differed in the studied regions. Psychiatry and otolaryngology had the highest percentage of family medicine residents who perceived that they had achieved the training objectives while lowest was in internal medicine and obstetrics and gynecology. The highest rotations as perceived by the family medicine residents were psychiatry and otolaryngology while lowest were orthopedics and ophthalmology. Sharing of experience and further studies are needed to improve the program rotations.

Detection of extended spectrum beta-lactamases-producing isolates and effect of AmpC overlapping.

INTRODUCTION: Few reports about the prevalence and genetic basis of extended spectrum beta-lactamases (ESBLs) are available from Saudi Arabia. We sought to determine the prevalence of ESBL-producing Enterobacteriaceae in a university hospital in eastern Saudi Arabia and to characterize the ESBLs produced by these isolates at the molecular level. METHODOLOGY: All clinical isolates of Escherichia coli, Klebsiella spp., and Proteus spp. collected over two years were evaluated for susceptibility to a panel of antimicrobials and were analyzed for the ESBL phenotype using screening and confirmatory tests. ESBL-positive isolates were then screened for the presence of genes encoding CTX-M, SHV, and TEM beta-lactamases by PCR. RESULTS AND CONCLUSIONS: The overall prevalence of ESBL-producing isolates was 4.8% (253/5256). Most isolates (80%) were from the inpatient department. The ESBL phenotype was more frequently detected in K. pneumonia. CTX-M genes were the most prevalent ESBL genes, detected in 82% of the studied isolates. The ESBL producers demonstrated a high multidrug resistance rate (96.6%). In transconjugation assay, the same ESBL gene pattern was transmitted from 29.7% of K. pneumoniae donors to the recipient strain, and the latter exhibited concomitant decreased aminoglycosides and co-trimoxazole susceptibility. We observed the presence of ESBL screen-positive but confirmatory-negative isolates (8.9%). Phenotypic tests for the production of AmpC ß-lactamase tested positive in 52% of these isolates. Further studies are needed for appropriate detection of concomitant ESBL and AmpC enzyme production among such isolates. Continued surveillance and judicious antibiotic usage together with the implementation of efficient infection control measures are absolutely required.

Diabetic heel ulcer in the Sudan: determinants of outcome.

Heel ulceration, on average, costs 1.5 times more than metatarsal ulceration. The aim of this study was to analyze the determinant factors of healing in diabetic patients with heel ulcers and the late outcomes at Jabir Abu Eliz Diabetic Centre Khartoum, Khartoum, Sudan. Data were collected prospectively for 96 of 100 diabetic patients presenting with heel ulcers at the Jabir Abu Eliz Diabetic Centre Khartoum from May 2003 to January 2005. Late outcome was assessed 3 years later (February 2008). Heeling was achieved in one half of the patients (n = 48). In the remaining 48 patients, 22 ended with major lower extremity amputation and 22 were still receiving wound care. A total of 8 patients died, 4 in each group, the healed and unhealed. The most significant determinants of healing using a logistic multivariate regression model, 95% confidence intervals, and odds ratios included a shorter duration of diabetes (p < .009), adequate lower limb perfusion (p < .043), and a superficial foot ulcer (p < .012). Three years later, of the 88 patients who could be traced, 78 were alive and 59 had healed ulcers (7 had died of unrelated causes and 3 of diabetic-related complications), and no additional lower extremity amputation was recorded. Mortality in the series was 18 patients, of whom 14 had undergone a previous lower extremity amputation. Superficial heel ulcers in diabetic patients with a short history of diabetes and with good limb circulation are more likely to heal within an average duration of 25 weeks. At 3 years of follow-up, 75% showed a favorable outcome for ulcer healing, and 22 patients underwent lower extremity amputation (25%), of whom 14 were dead within 3 years.

Symptoms of neck, shoulder, forearms, and hands: a cohort study among computer office workers in Sudan.

OBJECTIVES: Complaints of the arms, neck, and shoulders in general and computer-related disorders in particular affect many office workers in economically developed countries. However, with the increased use of computer systems in developing countries, the associated musculoskeletal symptoms and risk factors are yet to be investigated. The study investigates the relationship between work-related physical and psychosocial characteristics and symptoms of the arms, neck, and shoulders in an African economically developed worksite. METHODS: A prospective cohort study with 1-year follow-up was conducted. Data were used from 250 computer office workers in Khartoum, Sudan. Data were collected using the Arabic version of the Maastricht Upper Extremity Questionnaire. Prevalence rates for symptoms were calculated and the categories of risk factors being evaluated consisted of physical, psychological, and individual risk factors. Multivariable logistic regression analysis was used to identify risk factors associated with complaints that were expressed as odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS: The 1-year follow-up prevalence rate was 0.63 (95% CI: 0.58-0.70) for neck symptoms, 0.56 (95% CI: 0.45-0.66) for shoulder symptoms, and 0.46 (95% CI: 0.42-0.59) for symptoms of the forearms/hands. Three main risk factors were significantly associated with the presence of symptoms: (1) time pressure [OR: 1.31 (1.00 to 1.90) P=0.05], (2) task difficulty [OR: 1.85 (1.73 to 1.99) P=0.03], and (3) previous history of symptoms [OR: 4.62 (2.20 to 9.35) P=0.01]. CONCLUSIONS: The targeted office workers in Sudan are reporting symptoms in the neck, shoulders, and forearms. Work-related psychological factors predicted more significantly the presence of symptoms in the targeted population.

Prevalence and risk factors for anaemia in pregnant women of eastern Sudan.

The prevalence and possible risk factors for anaemia were investigated in 744 pregnant Sudanese women attending the antenatal clinic of New Halfa teaching hospital, eastern Sudan between October 2003 and April 2004. Of those, 466 (62.6%) had anaemia (haemoglobin [Hb]: <11 gm/dl); 52.4% had mild anaemia (Hb: 9.0-10.9 gm/dl); 8.1% had moderate anaemia (Hb: 7.0-8.9 gm/dl); and 2.2% had severe anaemia (Hb: <7 gm/dl), respectively. The prevalence of anaemia (73.2%) was significantly high in grandmultigravidae. Univariate and multivariate analysis showed that age and parity were not significantly associated with anaemia. Malaria (OR = 4.5, 95% CI 2.5-8.1; P < 0.0001) and pica (OR = 1.6, 95% CI 1.05-2.6; P = 0.03) were the risk factors for anaemia. Thus, preventive measures against malaria (chemoprophylaxis and insecticide-treated bednets) may be needed for all pregnant women irrespective of their age or parity.

Prevalence and risk factors for Plasmodium falciparum malaria in pregnant women of eastern Sudan.

BACKGROUND: Pregnant women are more susceptible to malaria, which is associated with serious adverse effects on pregnancy. The presentation of malaria during pregnancy varies according to the level of transmission in the area. Our study aimed to demonstrate the prevalence and risk factors for malaria (age, parity and gestational age) among pregnant women of eastern Sudan, which is characterized by unstable malaria transmission. METHODS: The prevalence and possible risk factors for Plasmodium falciparum malaria were investigated in 744 pregnant Sudanese women attending the antenatal clinic of New Haifa Teaching Hospital, eastern Sudan, during October 2003-April 2004. RESULTS: A total 102 (13.7%) had P. falciparum malaria, 18(17.6%) of these were severe cases (jaundice and severe anaemia). Univariate and multivariate analysis showed that, age and parity were not associated with malaria. Women who attended the antenatal clinic in the third trimester were at highest risk for malaria (OR = 1.58, 95% CI = 1.02-2.4; P < 0.05). Women with malaria had significantly lower mean haemoglobin (9.4 g/dl, 95% CI 9.1-9.7 versus 10.7, CI 10.6-10.8, P < 0.05). A significantly lower haemoglobin was observed in those with severe falciparum malaria compared to non-severe form (8.3 g/dl, 95% CI 7.6-9.1 versus 9.4, 95% CI 9.1-9.7, P = or < 0.05). CONCLUSION: The results suggest that P. falciparum malaria is common in pregnant women attending antenatal care and that anaemia is an important complication. Preventive measures (chemoprophylaxis and insecticide-treated bednets) may be beneficial in this area for all women irrespective of age or parity.