Maternal obesity and its relation with the cesarean section: A hospital based cross sectional study in Iraq

BACKGROUND: Obesity during pregnancy is reported in approximately one in five pregnant women worldwide. It increases the risk of pregnancy complications many of which necessitate Cesarean section (CS). This study determines the association between obesity and type of delivery. METHODS: A cross-sectional study involving 404 pregnant women was carried out at Al-Yarmouk Teaching Hospital, Baghdad, Iraq. Women with hypertension, diabetes, preterm labor, fetal presentation other than cephalic presentation and multiple gestations were excluded from the study. BMI and past obstetric history were recorded. RESULTS: The overall rate of CS was 38%. The overall mean body mass index (BMI) was 25.0 ± 4.52 Kg/m(2) and it was significantly higher among women who delivered by cesarean section. Significantly high rate of CS was found in primigravida and multigravida women with high BMI. Moreover, all obese multigravid women with history of previous CS were delivered by CS. The rate of CS was higher in women with primary level education when compared to women with secondary or tertiary education. CS was significantly lower in women with a previous history of abortion. CONCLUSION: Obese women with or without a previous history of CS are at a higher risk of having a CS and should therefore be considered as high risk and managed appropriately during pregnancy. Weight management prior to or during pregnancy could help reduce the need for CS

Symptomatic dry eye disease among university students

Background: Dry eye disease (DED) is a multifactorial condition often characterized by a reduction in tear film quantity or quality. This study aimed to determine the frequency of DED and its associated subjective symptoms among students of Mu’tah University. Methods: In this cross-sectional study conducted at Mu’tah University, Mu’tah, Jordan, from January to April 2022, 489 students completed an online patient-reported DED symptom questionnaire and the ocular surface disease index (OSDI) questionnaire. Moreover, 106 participants underwent clinical examinations using the Schirmer test I and fluorescein tear breakup time (TBUT). Results: Approximately 74.6% of the students self-reported experiencing DED symptoms, and 72.6% had an OSDI score > 12, which is considered the threshold for an abnormal ocular surface. Clinical examinations revealed low Schirmer test scores (< 10 mm) in 26.4% (n = 28) and 25.5% (n = 27) of the right and left eyes, respectively. We observed low TBUT scores (< 5 s) in 19.8% (n = 21) and 18.9% (n = 20) of the right and left eyes, respectively. We noted significant differences between the self-reported DED symptoms and the Schirmer test scores (P = 0.003 for both right and left eyes), TBUT (P < 0.001 for both right and left eyes), and OSDI score (P < 0.001 for each self-reported DED symptom). We observed a weak significant positive correlation between Schirmer test scores and TBUT in the right (r = + 0.30; P = 0.002) and left (r = + 0.34; P < 0.001) eyes; a negligible significant inverse correlation between OSDI scores and Schirmer test scores in the right (r = - 0.24; P = 0.013) and left (r = - 0.23; P = 0.019) eyes; and a negligible significant inverse correlation between the OSDI score and TBUT of the left eye (r = - 0.25; P = 0.011) but not of the right eye (r = - 0.17; P = 0.077). Conclusions: The frequency of DED symptoms in this study was higher than that previously reported based on foreign statistics. The presence of self-reported DED symptoms was significantly associated with higher OSDI scores. Self-reported DED symptoms were more frequent than the abnormalities detected using objective methods. Therefore, a combination of subjective and objective measures may provide a higher diagnostic yield for DED. Further studies are required to confirm this hypothesis

The Malaysia DREEM: perceptions of medical students about the learning environment in a medical school in Malaysia

BACKGROUND: Students’ perceptions of their learning environment, by defining its strengths and weaknesses, are important for continuous improvement of the educational environments and curriculum. Therefore, the aim of this study was to explore students’ perceptions of their learning environment, among medical students in Malaysia. Various aspects of the education environment were compared between year levels and sex. METHODS: This cross-sectional study was conducted at the Management and Science University, Shah Alam, Malaysia in 2012. A total number of 438 medical students participated in this study, and the response rate was 87.6%. Data were analyzed using SPSS. Comparisons of the mean scores of Dundee Ready Education Environment Measure (DREEM) subscales were calculated. The t-test was used to determine statistically significant differences. RESULTS: The majority of the study participants were female, Malay, and from year 3 (68.7%, 65.3%, and 55.7%; respectively). Analysis of each of the 50 items of the DREEM inventory showed that 47 items scored ranged between 2.00 and 3.00, and three items scored below 2.00. These were identified as problem areas in this medical school that are required to be critically addressed. The overall score showed that the medical students’ perceptions were positive. The students’ perception toward educational environment was positive for all five DREEM subscales. CONCLUSION: The study found that, in general, the perceptions of the participants about the learning environment were positive. Nevertheless, the study also found there is a need for curriculum improvement in this school and identified priority areas for such improvement

Is dental extraction a risk factor for contracting HCV infection : abs, RNA and genotype detection

The medical risk factor associated with hepatitis C virus (HCV) infection such as blood transfusion and surgery had been intensely studied in many countries. Up to 40% of patients infected with HCV may have non identifiable routes of viral acquisition. Dental extraction may be one of these risk factors. The purpose of the present study was to determine the existence of infection and the predominated HCV genotype among subjects with dental extraction. Material and methods: A case-control study involving pregnant women with and without history of dental extraction (n=776, n=2715, respectively). HCV antibodies (anti-HCV) were tested using subsequently third generation enzyme immunoassay (EIA-3) and immunoblot assay (Lia Tek-111). In addition 94 serum samples were subjected to molecular analysis using RT-PCR and DNA enzyme immunoassay (DEIA) method for HCV-RNA and genotypes. Results: Anti-HCV seroprevelance was significantly higher (6.3%) among cases with dental extraction (cases) than their counter control group (control) (2.63%) (p=0.00001). Dental extraction act as a risk factor for HCV infection (OR=2.73; 95% CI=1.8-3.9). HCV-RNA was found to be significantly higher (74.6%) in cases than (38.7%) control group (p=0.0016). No significant association between HCV genotypic and the history of tooth extraction but HCV-1b showed higher rate (90%) among dental extraction cases. Conclusion: Our study showed that dental extraction acts as a risk factor for acquiring HCV. Complete sterilization and cleaning of equipment is necessary

Attitudes towards colorectal cancer (CRC) and CRC screening tests among elderly Malay patients

Background: Colorectal cancer (CRC) is the third most common malignancy in Malaysia, where data are limited regarding knowledge and barriers in regard to CRC and screening tests. The aim of the study was to assess these parameters among Malaysians. Materials and Methods: The questionnaires were distributed in the Umra Private Hospital in Selangor. The questionnaire had four parts and covered social-demographic questions, respondent knowledge about CRC and colorectal tests, attitude towards CRC and respondent action regarding CRC. More than half of Malay participants (total n=187) were female (57.2%) and 36.9% of them were working as professionals. Results: The majority of the participants (93.6%) never had a CRC screening test. The study found that only 10.2% of the study participants did not consider that their chances of getting CRC were high. A high percentage of the participants (43.3%) believed that they would have good chance of survival if the cancer would be found early. About one third of the respondents did not want to do screening because of fear of cancer, and concerns of embarrassment during the procedure adversely affected attitude to CRC screening as well. Age, gender, income, family history of CRC, vegetable intake and physical activity were found to be significant determinants of knowledge on CRC. Conclusions: The major barriers identified towards CRC screening identified in our study were fear of pain and embarrassment. The findings have implications for understanding of similarities and differences in attitude to CRC amongst elderly patients in other cultural/geographic regions