Distribution of lower urinary tract symptoms (LUTS) in adult women

OBJECTIVE: To determine the distribution of lower urinary tract symptoms in adult women and the frequency with which the women consulted a health care provider for their symptoms. DESIGN: Cross-sectional analytical study. PLACE AND DURATION OF STUDY: Community Health Center of Aga Khan University Hospital from November 1st to 30th, 2002. SUBJECTS AND METHODS: A trained interviewer administered a structured questionnaire to women patients or attendants aged 18 years and older coming to the center. RESULTS: Fifty-two percent of the study subjects reported having at least one or more urinary complaints in the past. Stress incontinence was the highest reported complaint (38.4%) followed by burning (34.4%), frequency (26%), painful micturition (20.4%), urge incontinence (18.8 %), incomplete emptying of bladder (14.4%), dribbling (12.4%) and poor stream (8.4%). Forty-three percent of the women with LUTS never consulted a health care provider for their problem.CONCLUSION: Although the distribution of LUTS among females was found to be high, the patients did not consider it important enough to consult a health care provider. There is a need to create awareness among females regarding LUTS and the need to consult a health care provider for their problems

The Influence of Organizational External Factors on Construction Risk Management among Nigerian Construction Companies

Background: Substantial empirical research has shown conflicting results regarding the influence of organizational external factors on construction risk management, suggesting the necessity to introduce a moderator into the study. The present research confirmed whether rules and regulations matter on the relationships between organizational external factors and construction risk management. Methods: Based on discouragement and organizational control theory, this research examined the effects of organizational external factors and rules and regulations on construction risk management among 238 employees operating in construction companies in Abuja and Lagos, Nigeria. A personally administered questionnaire was used to acquire the data. The data were analyzed using partial least squares structural equation modeling. Results: A significant positive relationship between organizational external factors and construction risk management was asserted. This study also found a significant positive relationship between rules and regulations and construction risk management. As anticipated, rules and regulations were found to moderate the relationship between organizational external factors and construction risk management, with a significant positive result. Similarly, a significant interaction effect was also found between rules and regulations and organizational external factors. Implications of the research from a Nigerian point of view have also been discussed. Conclusion: Political, economy, and technology factors helped the construction companies to reduce the chance of risk occurrence during the construction activities. Rules and regulations also helped to lessen the rate of accidents involving construction workers as well as the duration of the projects. Similarly, the influence of the organizational external factors with rules and regulations on construction risk management has proven that most of the construction companies that implement the aforementioned factors have the chance to deliver their projects within the stipulated time, cost, and qualities, which can be used as a yardstick to measure a good project

Distinct regulation of tonsillar immune response in virus infection

Cataloged from PDF version of article.Background: The relationships between tonsillar immune responses, and viral infection and allergy are incompletely known. Objective To study intratonsillar/nasopharyngeal virus detections and in vivo expressions of T-cell- and innate immune response-specific cytokines, transcription factors, and type I/II/III interferons in human tonsils. Methods: Palatine tonsil samples were obtained from 143 elective tonsillectomy patients. Adenovirus, bocavirus-1, coronavirus, enteroviruses, influenza virus, metapneumovirus, parainfluenza virus, rhinovirus, and respiratory syncytial virus were detected using PCR. The mRNA expression levels of IFN-α, IFN-β, IFN-γ, IL-10, IL-13, IL-17, IL-28, IL-29, IL-37, TGF-β, FOXP3, GATA3, RORC2, and Tbet were directly analyzed by quantitative RT-PCR. Results Fifty percentage of subjects reported allergy, 59% had ≥1 nasopharyngeal viruses, and 24% had ≥1 intratonsillar viruses. Tonsillar virus detection showed a strong negative association with age; especially rhinovirus or parainfluenza virus detection showed positive association with IFN-γ and Tbet expressions. IL-37 expression was positively associated with atopic dermatitis, whereas IFN-α, IL-13, IL-28, and Tbet expressions were negatively associated with allergic diseases. Network analyses demonstrated strongly polarized clusters of immune regulatory (IL-10, IL-17, TGF-β, FOXP3, GATA3, RORC2, Tbet) and antiviral (IFN-α, IFN-β, IL-28, IL-29) genes. These two clusters became more distinctive in the presence of viral infection or allergy. A negative correlation between antiviral cytokines and IL-10, IL-17, IL-37, FOXP3, and RORC2 was observed only in the presence of viruses, and interestingly, IL-13 strongly correlated with antiviral cytokines. Conclusions: Tonsillar cytokine expression is closely related to existing viral infections, age, and allergic illnesses and shows distinct clusters between antiviral and immune regulatory genes. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

The way forward to public health in Gulf Cooperation Council (GCC) countries: a need for public health systems and law

Introduction: Public health systems in the Gulf Cooperation Council (GCC) Countries are not well established. The existing systems do not match with the current health challenges and with the use of innovative technology in healthcare (diagnosis, treatment or rehabilitation). This paper is intended to give an overview of the public health situation in these countries. It discusses the need for effective and integrated system of public health laws that plays important role in addressing high priorities in public health. Conclusion: The GCC countries have the infrastructure for estab¬lishing a national public health system. However it needs an effective integrated and organized mechanism to shape this system; based on acceptable guidelines and criteria in such a way that they are institutional and capable of meeting the population needs. This system should be cost- effective and investment in health sector should be looked upon as a sustained investment in human and societal development. Despite the great efforts exerted and achievements made, there are great challenges ahead that can be overcome by exhibiting a strong political will and having a united approach of all stakeholders

Access to person-centered care: a perspective on status, barriers, opportunities and challenges from the Eastern Mediterranean Region

Background: Access to Person-Centered care is a major area of concern throughout the world including the Eastern Mediterranean Region. Objective: This networking paper reviews current status, barriers, opportunities, challenges and future directions with regards to Access to Person-Centered care in the Eastern Mediterranean Region. Methods: The lead Author from the Working Party on Research of Eastern Mediterranean Region invited members through its ya-hoo group to participate in this networking project. Objectives and work plan were developed by the lead Author and shared with interested contributors. Co-Authors and Advisors were invited to contribute and timelines were set for contributors to submit their report. Submissions were collected by lead authors and put into a draft that was shared with contributors for feedback. After incorporating feedback, the final draft was edited by the Editor before submission for publication consideration. Results: Access to Person-Centered care in the Eastern Mediterranean Region shows extreme variations. At one end there are oil and gas rich countries that offer advanced health care services to the majority of their local population while on the other end are impoverished countries that are unable to provide even minimum required services to their people. Inequalities in health status have been growing since the mid-1990s and have resulted in an increasing gap between the most advantaged and disadvantaged social groups. There are social, cultural, religious and economical barriers that may impede access to healthcare. It warrants a need to address these barriers on a priority basis so that Universal access to Person-Centered care may be made available to the population of the region. Conclusion: A well planned and evidence based approach is the only way forward to ensure universal access to all populations in the Eastern Mediterranean Region. Access to Person-Centered care is the need of the hour in the region. Provision of health care services through a well deined health system with a prime focus on a primary care model delivered by trained family doctors is the single most appropriate step to achieve health for all

Association between infant swimming and rhinovirus-induced wheezing.

AIM Infant swimming has been considered as a risk factor for wheezing, but the role that respiratory viruses play is unclear. We explored the effects of infant swimming on the risk of all wheezing illnesses and wheezing associated with rhinoviruses. METHODS We followed up a birth cohort of 1827 children until 17 months of age, collecting data on infant swimming, other risk factors and physician-diagnosed bronchiolitis or recurrent wheezing. Viral diagnostics were performed in a subset of children with all respiratory tract infections. RESULTS Data on infant swimming were obtained for 1038 children, with viral follow-up for 635 children. At least one wheezing illness was documented in 45/469 (9.6%) swimming children versus 39/569 (6.9%) nonswimming children (p = 0.11), and rhinoviruses were associated with wheezing in 11/296 (3.7%) swimming children versus 4/339 (1.2%) nonswimming children (p = 0.04). In adjusted logistic regression analyses, swimming had an odds ratio of 1.71 (p = 0.05) for bronchiolitis and 3.57 (p = 0.06) for rhinovirus-associated wheezing. An association between infant swimming and rhinovirus-associated wheezing was detected for children with atopic eczema (p = 0.006). CONCLUSION There may be a link between infant swimming and rhinovirus-induced wheezing illnesses in atopic infants.</p

Duration of shedding of respiratory syncytial virus in a community study of Kenyan children

Background: Our understanding of the transmission dynamics of respiratory syncytial virus (RSV) infection will be better informed with improved data on the patterns of shedding in cases not limited only to hospital admissions. Methods: In a household study, children testing RSV positive by direct immunofluorescent antibody test (DFA) were enrolled. Nasal washings were scheduled right away, then every three days until day 14, every 7 days until day 28 and every 2 weeks until a maximum of 16 weeks, or until the first DFA negative RSV specimen. The relationship between host factors, illness severity and viral shedding was investigated using Cox regression methods. Results: From 151 families a total of 193 children were enrolled with a median age of 21 months (range 1-164 months), 10% infants and 46% male. The rate of recovery from infection was 0.22/person/day (95% CI 0.19-0.25) equivalent to a mean duration of shedding of 4.5 days (95%CI 4.0-5.3), with a median duration of shedding of 4 days (IQR 2-6, range 1-14). Children with a history of RSV infection had a 40% increased rate of recovery i.e. shorter duration of viral shedding (hazard ratio 1.4, 95% CI 1.01-1.86). The rate of cessation of shedding did not differ significantly between males and females, by severity of infection or by age. Conclusion: We provide evidence of a relationship between the duration of shedding and history of infection, which may have a bearing on the relative role of primary versus re-infections in RSV transmission in the community

Larvicidal activity of acetone extract and green synthesized silver nanoparticles from Allium sativum L. (Amaryllidaceae) against the dengue vector Aedes aegypti L. (Diptera: Culicidae)

Mosquito vectors of major human diseases are currently controlled using chemical and biological products. Extensive insecticide use has led to resistance development and human/environmental health risks, and alternative sustainable control options are needed; in this study, activity of an extract of garlic (Allium sativum; Amaryllidaceae), and silver nanoparticles (AgNPs) synthesized from the extract, were evaluated against 2nd and 3rd instar larvae of the yellow fever mosquito, Ae. aegypti (Diptera: Culicidae). Synthesis of AgNPs was confirmed using UV–Vis spectroscopy, and characterised using powdered X-ray diffraction, Fourier transform infrared spectroscopy, and scanning electron microscopy. Larvae were exposed to five concentrations (50, 100, 150, 200, 250 ppm) of garlic extract or synthesized AgNPs, with distilled water and silver nitrate solution (1 mM) as controls. The mortality of larvae was recorded after 6, 12, 24, 36, and 48 h following addition of the respective extracts. Dose- and time-dependent toxicity were recorded in both treatment groups with no mortality in control groups. Exposure to AgNPs at 250 ppm for 48 h yielded 100% mortality for both larval instars, with corresponding LC50 values of 44.77 (2nd) and 62.82 ppm (3rd). Exposure to garlic extract resulted in similar 48-hour mortality (99 ± 0.77% (2nd) and 98 ± 1.10% (3rd), but consistently higher LC50 values after all exposure times compared to AgNPs (e.g. 48-hour exposure: 108.42 ppm (2nd), 129.11 ppm (3rd), suggesting that AgNPs may potentially be used at lower concentrations for Ae. aegypti control