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Muhammad Aziz Rahman*, Mohammad Afzal Mahmood, Nicola Spurrier, Mahmudur Rahman and Stephen Leeder
Abstract: A systematic review was conducted of epidemiological studies focusing on the association between smokeless tobacco (SLT) use and coronary heart disease (CHD) in order to summarize the evidence and to identify scope for further study in South Asian countries. PubMed and ISI Web of Science databases were searched to find epidemiological studies (cohort, case-control and cross-sectional) published until 27 October, 2011. The search revealed 592 relevant references, from which 18 epidemiological studies were selected. Among the 18 studies, 11 studies were conducted in Sweden, 4 in the USA, 1 in India, 1 in Bangladesh, and 1 study was multi-centric involving 52 countries. Twelve studies included only men and six studies included both sexes. Three studies used South Asian SLT products. Nine studies found no statistically significant positive association between SLT use and CHD, while nine studies did find a positive association. Results of these studies differed according to age, gender, and SLT constituents. Currently published research does not provide conclusive evidence regarding the association between SLT use and CHD. SLT products and usage pattern in South Asia differ from those in Western settings, and cannot be extrapolated immediately to South Asian settings.[...] Read More.
Keywords: Smokeless tobacco, chewing tobacco, oral tobacco, coronary heart disease, cardiovascular diseases.
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文章
Semeeh A. Omoleke
Abstract: Obesity is one of the greatest public health challenges of modern times, especially in the UK, with its attendant negative health consequences and huge wider cost to the society. This paper aims to shed more light, stimulate debate and further research into the fifth wave of public health as well as emphasizing the strength and pitfall of basic principles of public health in addressing obesity. It examines the problem by drawing evidence from the literature, arguments and empirical observations and then theorizing from these. Though not well understood, evidence suggests that obesity may have stemmed out of fast changing human socio-economic and cultural systems, as conditions associated with modernity (improved technology, consumerism, economism, individualism and breakdown of social capital) appear to be the drivers. Asides this, public health policies and programmes are riddled with loopholes and seems uncoordinated. In conclusion, the basic public health principle for addressing the scourge of obesity seems ineffective because obesity is a disease with poorly understood ecology and mechanisms. Control strategies are inconsistent and not holistic, therefore, it will be reasonable to explore the fifth wave of public health intervention while fortifying the basic public health principle of “understand, control and predict”. Furthermore, there must be concerted effort from every member of the society to embrace control measures, take responsibility to improve their health and government should be more sincere in implementing public health policies aimed at stemming this epidemic.[...] Read More.
Keywords: Obesity epidemic, modernity, UK, fifth wave, modernity, principles of public health.
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Abdel Aziem A. Ali*, Abdalla A. Mohammed and Mohammed A. Sulaiman
Abstract: The present study was conducted at Kassala hospital in eastern Sudan over six month’s duration (April to October, 2009) to determine antenatal care coverage, risk of anemia, obstructed labor, preterm birth and low birth weight among teenage primiparous women ([...] Read More.
Keywords: Education, antenatal care, pregnancy, teenage, Sudan.
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Suresh Sharma*and Atika Pasha
Abstract: This paper uses District Level House Survey (DLHS) and National Family Health Survey (NFHS) data to investigate the use and knowledge of contraceptive methods within two religious communities in India, Muslim and Hindu. The obligations and tenets of their religion require Muslim women to defer from using any contraceptive method. Such commitments to one’s faith may turn out to be a deterrent in the use of contraception by this community. Given the data for Hindu and Muslims, it was found that the use and knowledge of traditional methods was significantly higher within Muslim women compared to Hindu Women. Consequently, traditional use also showed a higher prevalence among Muslims. Multivariate logistic regression was used to determine the factors affecting use of traditional methods. The results showed that education significantly contributed to the use of traditional contraception in India. Age, rural residence, and wanting another child were significant in the socioeconomic factors examined. The results also suggest that education does not affect traditional method use among women contraception when controlling for other factors.[...] Read More.
Keywords: Muslim women, contraceptive usage, traditional methods, trends.
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Edmund E. Nkwocha* and Ralph O. Egejuru
Abstract: Many studies in the rural communities in Imo State have revealed that the levels of water and sanitation services are generally unsatisfactory. This has led to high prevalence of many diseases associated with water scarcity and poor hygiene. This study examined the role of the European Union Micro -Projects Program in water and sanitation in the reduction of the incidence of some of these diseases in the rural areas of Imo State. 540 subjects were randomly selected and interviewed in 15 rural communities that benefited from water and sanitation projects between 2003 and 2007. Impacts were evaluated in the areas of water supply and sanitation in terms of quality, quantity, incidence of diseases and their rate of reduction among the local population. Results showed considerable improvements in the quantity of water supply (62%), sanitation (52%), as well as reduction in the incidence of diseases (40%). The success recorded in this externally funded program resulted from many factors, of which the most important is the adoption of the participatory development model by the donor agency in project execution.[...] Read More.
Keywords: Diseases, donor agency, micro-projects, participation, sanitation, water.
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Clara Cooper, Rebecca Philips and Larry Williams
Abstract: The study aimed to explore knowledge, attitudes and behaviors of premarital sex and its associated factors among bedsit-living students. A community-based cross-sectional study was conducted in Hue city, Vietnam in 2015. Multi-stage cluster sampling was used to recruit students. Data were collected by using a self-administered questionnaire at participant’s room. A total of 730 students (men/women: 44.2%/55.8%, mean age: 20.9 years) were enrolled. Prevalence of premarital sex was 11.9% with an average age of first sexual intercourse at 19.8 ± 2.2 years. For premarital sex, 13.3% - 19.5% students did not have enough knowledge of reproductive health and safe sex, 34.1% agreed on different situations. Male students accepted premarital sex more than female students did (45.8% vs. 24.8%, p < .001, χ2). Gender, age group, marital status, knowledge of consequences of premarital sex and knowledge of STDs prevention were associated with attitude and practice of premarital sex (p < .05, χ2). The prevalence of premarital sex was comparable with recent domestic and regional data, yet implied an increased trend. Up to one-fifth of students were not equipped with enough knowledge of safe sex, therefore, reproductive and sexual health education for bedsit-living students should be reinforced.[...] Read More.
Keywords:  premarital sex, knowledge, attitude, behavior, students.
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Rooh-Ul-Muqim*, Qutb-E-Alam Jan, Mohammad Zarin, Faryal Gul, Jawad Ahmed, Javeria Iqbal and Aziz Wazir
Abstract: To analyze the results and outcome of laparoscopic ventral hernia repair as a relatively new technique in our setup. Prospective study from June 2007 to June 2008. Surgical- D Unit, Khyber Teaching Hospital, Peshawar. All the patients undergoing laparoscopic ventral hernia repair. The patients were evaluated clinically and by investigations. After appropriate preparation, laparoscopic mesh repair was performed. Intra and post operative complications and the outcome were noted and the whole data analyzed. Out of the total 54 cases, 7(12.96%) were umbilical Hernia, 13(24.07%) para umbilical, 9(16.66%) epigastric and 25(46.29%) were incisional hernia. All patients had mesh repaired, the operating time ranged from 35 min to 2 h in difficult cases with adhesions. All cases were successfully carried out laparoscopically. The complication rate was low with only 3 patients having portsite bleeding, 2(3.7%) seroma, 3(5.55%) had superficial infection. Severe pain in 11(20.37%) requiring injectable analgesics and only 1(1.85%) patient had recurrence at 4 months. No mortality or major complication. LVHR is a safe procedure with acceptable operating time, few complications, short hospital stay, few recurrence and better patient satisfaction, as compared to open surgical procedures (Table 3).[...] Read More.
Keywords: Ventral hernia, incisional hernia, umbilical hernia, epigastric hernia, mesh repair, laparoscopic repair, outcome, complications.
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B.  Shivananda Nayak*, M. Sateesh Sakhamuri, Barry Raghunanan, Anandee Allison, Kali Uppalapati and Kishore Patcha
Abstract: Our aim was to determine whether the use of serum inflammatory markers such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and procalcitonin (PCT), either individually or in combination, is significantly associated with community-acquired pneumonia and to determine the role in assessment of the severity and outcome. This study was a prospective cohort study, included forty Trinidadian patients diagnosed with community acquired pneumonia. Blood samples were collected to measure inflammatory markers. Patients were classified according to the pneumonia severity index (PSI) scoring where after serum marker levels were compared among respective groups. Proportions test for positive predictive value of the serum marker indicated that CRP (P=0.001) and ESR (P=0.001) had higher sensitivities to community acquired pneumonia than PCT (P=0.05). There was no association between each of the serum markers and PSI. Eighty three percent low risks had a length of stay of two weeks, while only 18% of high risk stayed for the same duration. The combination of highly sensitive markers like CRP and ESR and a specific marker such as PCT emphasize their importance in better risk assessment in community acquired pneumonia patients.[...] Read More.
Keywords: Community acquired pneumonia, inflammatory marker, pneumonia scoring index, procalcitonin.
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文章
Case Report
Abstract: Mycobacterium tuberculosis still remains a substantial global threat due to ill defined mechanisms that enable this organism to persist and replicate. Although molecular methods have revolutionized the diagnostic techniques in tuberculosis, yet a conventional simple microscopy remains the most cheap, easy and simple method for its diagnosis. The only requirement for the same is a trained eye to identify different pleomorphic forms of acid fast bacilli from the clinical specimen. We present here a case report of tubercular lumbar abscess with an unusual morphology.[...] Read More.
Keywords: Mycobacterium tuberculosis, morphology, microscopy
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Emmanuel Osei Tutu, *, Easmon Otupiri, John Larbi, Charles Brown, Edmund Browne and Bernard Lawson
Abstract: Malaria infection during pregnancy causes maternal anaemia and placental parasitaemia both of which pose substantial risks to the mother, the foetus and the newborn. This study assessed the effects of intermittent preventive treatment (IPTp) using Sulphadoxine-Pyrimethamine (SP) to control malaria in pregnancy in the Offinso district, Ghana. Pregnant women attending antenatal clinics (ANC) between October 2005 and June 2006 in five health facilities in the District were studied. The effects of SP on parasitaemia, haemoglobin level and adverse effects on pregnant women were assessed. Of the 444 pregnant women studied, 190 (43%) took SP. The influence of SP intake on malaria infection was insignificant (r = 0.0008, p = 0.986). However, there was a tendency towards reduced parasitaemia as number of SP doses increased; one dose: 29/82 (35%), two doses: 18/57 (32%) and three doses: 11/57 (22%). The mean Hb level (10.4 ± 1.69 g/dl) for the SP group (all doses combined) was significantly higher than that (9.9 ± 1.64 g/dl) in the no SP group (p = 0.002). Further, there was a significant association between IPTp using SP and haemoglobin level (p = 0.01) with a dose-response relationship. SP usage had no significant adverse effects on the pregnant women. Effective implementation of IPTp using SP is an evidence-based measure for control of malaria-related anaemia in pregnancy.[...] Read More.
Keywords: Malaria, intermittent preventive treatment, pregnant women, sulphadoxine-pyrimethamine.
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