Enuresis: prevalence and associated factors among primary school children in Saudi Arabia

The aim of this study was to determine the prevalence of enuresis and the factors associated with it among primary school children. This is a cross-sectional population-based study. Data were collected using a self-administered questionnaire. Six hundred and forty school children aged 6-16 years were selected randomly. Enuresis prevalence was 16.3% among boys and 13.8% among girls. The overall prevalence was 15%. Breastfeeding, first born children, family integrity and stability were found to be protective. Stressful life events before the age of 6 years, deep sleep, acute family psycho-social problems, recurrent urinary tract infection, constipation and congenital defects were found to be strongly associated with enuresis. Enuresis was also found to be associated with family history of enuresis. An important finding is that of the 83 children who had enuresis during sleep, 25 (30.1%) wet their beds during day time sleep (day sleep wetting). The importance of enuresis as a health problem has been affirmed and specific guidelines were suggested.     

Efficacy of common broad spectrum anthelmintics against hook worm, Ascaris and Trichiuris in Hat Yai district, Songkhla Province, Thailand

1. The third therapeutic scheme should be used in the hospital. 2. The second and third therapeutic scheme may be used in mass treatment. 3. The 4th-6th therapeutic scheme is to be considered, reviewed, and evaluated. 4. Model and technology of permanent worms control is to be studied. 5. The treatment and control of Ascaris were simple. Cure with low reinfection rate and long reinfection period was remarkable. 6. The prevalence rate and reinfection rate of Trichiuris was high, and not so sensitive to any antelmintics. 7. The reinfection rate in the second group was not superior to the first group and the third group. This revealed no effectiveness of ovicidal and larvicidal on the helminthiasis. 8. Reinfection rate in the third therapeutic scheme was the least group. 9. Toxicity and side effect were not found in any anthelmintics. 10. Broad Spectrum Anthelmintics are necessary in mass treatment or blind treatment.     

Hepatitis C antibody prevalence and risk factors of some female sex workers in Thailand

One high risk group for hepatitis C virus (HCV) infection is female sex workers (FSWs). A study of HCV antibody prevalence and group risk factors was conducted in 200 FSWs in Ratchaburi Province, Thailand, during June to December 1995. FSWs were interviewed and their blood specimens were collected for determining HCV antibody by second generation EIA (ABBOTT). After the laboratory results, the FSWs were divided into 2 groups, anti-HCV positive and anti-HCV negative. The variables obtained from interviews were analysed by X2-test and Odds Ratio. Prevalence of HCV antibody positives was 9.5%. It tended to be increased by the longer duration of working in the sex trade. The anti-HCV prevalence of FSWs working 9 years or more in the sex trade was significantly higher than that of FSWs working 4 years or less by about 3.5 times (23.08% vs 6.67%, p = 0.008). The anti-HCV positive FSWs had a higher percentage of anti-HIV positivity, but it was not of statistical significance (p = 0.078). The factors associated with high risk for HCV infection in this group were (a) Domicile (Northeast): OR = 3.07, (p = 0.0182), (b) Duration of working (> or = 4 years): OR = 3.13 (p = 0.0216), (c) Having a tattoo: OR = 4.12 (p = 0.0406), and (d) Having a history of STDs in the last 4 years: OR = 3.46 (p = 0.0165).     

Nutritional and environmental risk factors for diarrhoeal diseases in Ecuadorian children

In the first part of this paper, the effects of single administration of nicotine on gastric motility of urethane-anesthetized rats are briefly summarized from our recently reported papers. Then, the effects of repeated administration of nicotine on the nicotine-induced changes in gastric motility and release of hypothalamic noradrenaline, in vitro, are described, with special references to up-regulation of nicotinic receptors. Nicotine 0.1 nmol administered into the dorsal motor nucleus of the vagus (DMV) elicited a dual change, a decrease followed by an increase in gastric motility. Intravenous administration of nicotine 300 nmol/kg decreased gastric motility. This decrease in gastric motility was inhibited by microinjection of hexamethonium into the DMV and was terminated by bilateral vagotomy. In animals pretreated with nicotine 200 nmol intracerebroventricularly (icv) administered once a day for 5 days, nicotine 100 nmol administered icv induced the decrease but not the increase in gastric motility. In conclusion, nicotine activates nicotinic receptors in the DMV and a resultant vagally-mediated dual change in gastric motility occurs. Furthermore, gastric inhibitory mechanisms in the DMV are susceptible to nicotine more than the excitatory mechanisms, and desensitization to nicotine occurs easily in the excitatory mechanisms.     

Cigarette smoking and hearing loss: the epidemiology of hearing loss study

CONTEXT: Clinical studies have suggested that cigarette smoking may be associated with hearing loss, a common condition affecting older adults. OBJECTIVE: To evaluate the association between smoking and hearing loss. DESIGN: Population-based, cross-sectional study. SETTING: Community of Beaver Dam, Wis. PARTICIPANTS: Adults aged 48 to 92 years. Of 4541 eligible subjects, 3753 (83%) participated in the hearing study. MAIN OUTCOME MEASURES: The examination included otoscopy, screening tympanometry, and pure-tone air-conduction and bone-conduction audiometry. Smoking history was ascertained by self-report. Hearing loss was defined as a pure-tone average (0.5, 1, 2, and 4 kHz) greater than 25-dB hearing level in the worse ear. RESULTS: After adjusting for other factors, current smokers were 1.69 times as likely to have a hearing loss as nonsmokers (95% confidence interval, 1.31-2.17). This relationship remained for those without a history of occupational noise exposure and in analyses excluding those with non-age-related hearing loss. There was weak evidence of a dose-response effect. Nonsmoking participants who lived with a smoker were more likely to have a hearing loss than those who were not exposed to a household member who smoked (odds ratio, 1.94; 95% confidence interval, 1.01-3.74). CONCLUSIONS: These data suggest that environmental exposures may play a role in age-related hearing loss. If longitudinal studies confirm these findings, modification of smoking habits may prevent or delay age-related declines in hearing sensitivity.     

Patterns of hearing loss in non-explosive blast injury of the ear

OBJECTIVE: To characterize ambulance utilization in a pediatric population and pediatric emergency physicians' judgement of the medical need for ambulance transport. METHODS: A convenience sample of ambulance transports were studied prospectively during a 5-week period. Exclusion criteria included transfer from another medical facility, study physician not available, need for immediate resuscitation, or trauma team activation. A questionnaire completed by the physician assessed medical need for the ambulance based on chief complaint, general appearance, vital signs, and ambulance run sheet information. A separate questionnaire was administered to the parents regarding reasons for ambulance use and other available means of transportation. Caregivers were contacted by telephone 2-3 days later to determine the mode of transportation home and the clinical outcome. RESULTS: Of 172 eligible patients, 92 (53%) were enrolled. Most (61%; 56/92) transports were considered medically unnecessary. Interestingly, 40% (37/92) of the subjects had no other means of transportation; 86% (32/37) of ambulance transports for this group were judged medically unnecessary. Overall, 86% (79/92) of families had not called their physician. There was no association between having spoken with the physician and medical need for an ambulance. Many (82%; 46/56) Medicaid transports were judged medically unnecessary Overall, follow-up was achieved for 91% (85/92) of the patients. No patient for whom transport was medically unnecessary had a repeat ED visit for the same complaint or required admission. Most patients (74%; 68/92) returned home without any assistance. Among the medically unnecessary transports, 52% (32/60) of the caregivers cited no other means of transportation, yet 34% (11/32) of these patients returned home by private car. CONCLUSIONS: Most pediatric ambulance transports in this sample, which excluded patients requiring immediate resuscitation or trauma team care, were judged to be medically unnecessary. Caregivers often use an ambulance as a convenience or as the only means of transportation. An alternate, less resource-intensive transportation system may be more appropriate for this population.     

An implantable hearing aid for inner ear hearing loss. Short-term implantation of microphone and transducer

A microphone constructed for implantation in the posterior wall of the auditory canal and a piezoelectric transducer serving as the main components of an implantable hearing aid were temporally implanted in five patients during middle ear surgery under local anesthesia. The microphone was positioned beneath the skin of the auditory canal such that it completely covered the microphone membrane. The vibratory element of the transducer was coupled to the malleus in four patients with normal ossicular chains and directly to the stapes in one patient with missing incus. The microphone and transducer were electrically connected with an external battery-driven signal amplifier. Speech material and music were presented in the operation room at a sound level of 65 dB SPL under free-field conditions. The patients had to estimate the quality of speech, music, and their own voice as well as the effects of bone-conducting noises. All patients were able to hear with the system. An intraoperative talk without vision contact was possible without any problems, as was understanding of numerals ("Freiburger Zahlentest"). Perception of music was judged as "clear and undistorted with all broadband component." The estimation was also valid for one patient with a sensorineural hearing loss. One patient declared the music to be "a little of unnatural." Bone-conducted sound was estimated as normal in two patients, better than without an implant in one patient with sensorineural hearing loss, and "somewhat metallic" in another patient. Hearing the own voice was considered "normal" in two cases "monotonous" in one case, and "a little bit roaring" in another case. An amplification factor that can be technically realized in an implantable hearing aid was necessary for one of the patients with sensorineural hearing loss to perceive music at a pleasant volume. On the basis of this study, essential requirements for the construction of a fully implantable hearing aid are fulfilled.     

A rush technique for the initial assessment of hearing disorders in pre-school and school children

A method is proposed for rapid quantitative estimation of auditory sensitivity in children. The method is based on wideband sound signals with short rise time of the amplitude (click trains) used as stimuli under conditions of organized attention of children towards sounds of both high and low (near-threshold) intensities. The method is applicable on equipment made in Russia and is cost-effective.     

Trends in the prevalence of asthma in Scottish and English primary school children 1982-92

BACKGROUND: Some doubts exist as to whether the increase in the prevalence of asthma is real or an artefact. The 10 year trend of asthma up to 1993 in England and Scotland was therefore assessed. METHODS: Information on asthma and bronchitis attacks, occasional wheeze, and persistent wheeze in the last 12 months, was obtained using a self administered questionnaire completed by the parents. Exactly the same questions were asked in 14 study areas in Scotland and 22 study areas in England in 1982 or 1983 and in 1992 or 1993 in 5-11 year old children. RESULTS: The numbers of children with data for all respiratory illness were 5556 (85.2%) and 5801 (87.1%) in England and 3748 (90.4%) and 3738 (90.4%) in Scotland in 1982 and 1992, respectively. There was a significant increase in asthma attacks (approximately three times more in 1992 than in 1982) and occasional wheeze (30-60% more in 1992 than in 1982) in both sexes in England and Scotland. Persistent wheeze also increased in both countries, but the increase was significant only in England (30-40% more in 1992 than in 1982). CONCLUSIONS: The study coincides with others that suggest that the increased prevalence of asthma may be due, in part, to changes in diagnostic behaviour. However, the continuing increase of persistent wheeze in the total sample suggests that part of the increase is real. There was no difference in the increase of persistent wheeze between Scotland and England, but the trend was only significant in England.     

Medical genetic evaluation for the etiology of hearing loss in children

The purpose of the medical genetic evaluation is to identify the etiology of the hearing loss. To do so requires a multidisciplinary team that includes the otolaryngologist, audiologist, medical geneticist, and radiologist. A number of tests and procedures are now available to assist in the search for the cause of hearing losses. The importance of sensitivity when providing genetic counseling is emphasized. Molecular genetics offers potential for continued progress in understanding the etiologies of hearing loss. Recent advances in this area are discussed.     

Risk factors for venous thrombosis: prevalence, risk, and interaction

Annually, 1 in 1,000 individuals is affected by venous thrombosis. Risk factors that are known to increase the risk of thrombosis may be either genetic or acquired, or have a combined origin. Many of these risk factors are very frequent, among which several have been recently identified, such as resistance to activated protein C by factor V Leiden, hyperhomocysteinemia, high levels of factors VIII, as well as the classical acquired risk factors, such as surgery and malignancies. When the prevalence of risk factors is high, it becomes likely that in some individuals two or more risk factors will be present simultaneously. The question "What happens to the risk in these circumstances?" is one involving interaction, also known as effect modification or synergy. In this article we review the prevalence and risk estimates for the various genetic and acquired risk factors for venous thrombosis, discuss the concept of interaction, and give an overview of the evidence for interaction of these risk factors.     

Changes in dental caries prevalence of school children in Araraquara, SP, Brazil

Previous reports indicate that venous thrombosis is an infrequent problem in patients with HIV infection. Despite this, various HIV-related factors have been proposed as potentially thrombogenic and an HIV-related hypercoagulability has been suggested. At the present time, there exists no consensus of opinion regarding prophylaxis against venous thrombosis for hospitalized patients with HIV. This article aims to provide an overview of venous thrombosis in HIV infection with particular reference to published and personal evidence for possible risk factors and their implications for prophylaxis.     

Analysis of air pollution and prevalence rate of allergic diseases among elementary school children in Kawaguchi and Hatogaya city

Kawaguchi and Hatogaya City are located on the northern edge of Tokyo. We analysed between air pollution and prevalence rate of allergic diseases among elementary school children in this area. A prevalence rate of allergic diseases in 1996 May and June was as follows; bronchial asthma 13.5%, atopic dermatitis 24.5%, allergic rhinitis and/or conjunctivitis 22.8%, urticaria 12.4%, food allergy 7.8% and drug allergy 2.2%, respectively. Air pollution of this area was analysed to check the levels of nitrogen dioxide (NO2), sulfur dioxide (SO2) and suspended particulate matters (SPM). NO2 pollution was relatively high in urban area, and SPM pollution was especially high around the highways. SO2 pollution was lower than the environmental standard. No relationship was found between the prevalence rate of bronchial asthma, atopic dermatitis, allergic rhinitis and/or conjunctivitis and air pollution, but it was found that these diseases are slightly related to population density (p < 0.1, p < 0.01, p < 0.1, respectively).     

Risk factors for the prevalence of malnutrition among urban children in Ghana

Alternative splicing has been shown to occur at the metabotropic glutamate receptor 1 (mGluR1) gene. Three main isoforms that differ in their carboxy-termini have been described so far and named mGluR1alpha, mGluR1beta and mGluR1c. These variants when expressed in recombinant systems all activate phospholipase C, although the [Ca2+] signals generated have different kinetics. Tissue distribution studies of specific mGluR1 splice variants are limited to the mGluR1alpha isoform. In the present work, we examined the localization of mGluR1beta in the adult rat and mouse forebrain by using a specific antipeptide antibody. Furthermore, the mGluR1beta immunostaining was compared with that obtained with antibodies specific for mGluR1alpha or with a pan-mGluR1 antibody which recognizes all isoforms. mGluR1beta-like immunoreactivity (LI) was found confined to the neuropil and neuronal perikarya and appeared discretely distributed in the rodent forebrain. Differential cellular distribution between mGluR1alpha and mGluR1beta was observed. In the hippocampus, mGluR1alpha-LI was restricted to non-principal neurons in all fields, whereas mGluR1beta-LI was strongest in principal cells of the CA3 field and dentate granule cells but absent in CA1. We have also shown that the vast majority of neurons in the striatum express mGluR1. The predominant form appeared to be mGluR1beta, with a distribution pattern reflecting the patch-matrix organization of the striatum. The specificity of the immunoreactivity described for mGluR1 splice variants was confirmed in mGluR1-deficient mice. The observation of a different cellular and regional distribution of mGluR1 splice variants, in particular in the hippocampus, suggests that they may mediate different roles in synaptic transmission.     

Sociodemographic differences in the prevalence of self-reported stomach pain in school children

The study considered the prevalence of experienced stomach pain in a nationwide random sample of 2161 Icelandic 11-12 and 15-16-year-old school children. It found an 18.4% prevalence of at least weekly stomach pain and a 53.4% overall prevalence. The prevalence of stomach pain was significantly higher among younger children (P < or = 0.001). Higher prevalence (P < or = 0.001) of stomach pain was seen in girls in the overall sample and the gender difference was significant in both age groups. No overall class or residential differences were detected. However, the findings suggest some age-related links between social status and the experience of stomach pain. The frequency of stomach pain was moderately and significantly associated with medication use. The theoretical and clinical implications of the results are briefly discussed. CONCLUSION: The high prevalence of frequent stomach pain found in this study calls for future research documenting further the epidemiology of stomach pain and various bio-psycho-social factors related to the experience and extent of this pain in school children.     

The prevalence of risk factors among women in the United States by race and age, 1992-1994: opportunities for primary and secondary prevention

OBJECTIVE: To analyze the prevalence of 11 modifiable behavioral risk factors, including multiple risk factors, among white, black, Asian and Pacific Islander, American Indian, and Hispanic women in the United States. DESIGN: We used Behavioral Risk Factor Surveillance System (BRFSS) data for 1992 to 1994 to examine risk factors (smoking; obesity; diabetes; heavy alcohol consumption; sedentary lifestyle; and inadequate use of seat belts, pap smears, consumption of fruits or vegetables, mammography and colorectal screening, and immunization), among women age 18 to 49, 50 to 64, and 65 and older. We also conducted a multiple regression analysis, comparing the odds of having either 1-2 versus 0 or 3 or more versus 0 risk factors among racial/ethnic groups, controlling for education and family income, to see if racial/ethnic differences can be attributed to socioeconomic differences. RESULTS: US women engage in a variety of behaviors that place them at risk for many causes of morbidity and mortality. Risk profiles vary substantially among racial/ethnic populations: Pacific Islanders have relatively low prevalences of most major risk factors, while blacks and American Indians have relatively high prevalences of many major risk factors. Prevalence differences among racial/ethnic populations are diminished but not eliminated when socioeconomic factors are accounted for. CONCLUSIONS: Appropriately designed programs to help women reduce their behavioral risk factors are needed. Action by health care providers, communities, and policy makers can substantially improve the health of women in the United States.     

The prevalence of the main risk factors in hypertension patients

Incidence was studied of risk factors (RF) in 669 patients with stage I and II hypertensive disease (as per WHO classification). There has been developed a risk-factor HD module. The prevailing RFs among HD patients include meteorolability, hereditary predisposition, hyperlipidemia, blood hypercoagulation, surplus body mass, hypodynamia, mental/nervous overstrain, consumption of salt going up, smoking, hyperglycemia, alcoholic liquor abuse, with n = 485 (72.5%), 417 (62.3%), 360 (53.8%), 335 (50.1%), 324 (48.4%0), 218 (32.6%), 166 (24.8%), 144 (21.5%), 84 (12.6%), 39 (5.8%), 8 (1.2%) respectively. A pathogenetic relation was found between RFs and HD clinical pattern determined by the RFs number and aggressiveness. The "mutual aggravation" phenomenon has been disclosed, its main point being to the effect that if a HD patient has several RFs, these would create certain conditions for development of each of them through affecting each other in a negative way.