Objectives: The purpose of this study is to provide insight into how students are exposed to indoor bio-aerosols in the dormitory rooms and to figure out the major possible factors that govern the contamination levels. Methodology: The Bio-aerosols concentration level of indoor air of thirty dormitory rooms of Jimma University was determined by taking 120 samples. Passive air sampling technique; the settle plate method using open Petri-dishes containing different culture media was employed to collect sample twice daily. Result s: The range of bio-aerosols contamination detected in the dormitory rooms was 511- 9960 CFU/m 3 for bacterial and 531- 6568 CFU/m 3 for fungi. Based on the criteria stated by WHO expert group, from the total 120 samples 95 of the samples were above the recommended level. The statistical analysis showed that, occupancy were significantly affected the concentrations of bacteria that were measured in all dormitory rooms at 6:00 am sampling time (p-value=0.000) and also the concentrations of bacteria that were measured in all dormitory rooms were significantly different to each other (p-value=0.013) as of their significance difference in occupancy (p-value=0.000). Moreover, there were a significant different on the contamination level of bacteria at 6:00 am and 7:00 pm sampling time (p=0.015), whereas there is no significant difference for fungi contamination level for two sampling times (p= 0.674). Conclusion: There is excessive bio-aerosols contaminant in indoor air of dormitory rooms of Jimma University and human occupancy produces a marked concentration increase of bacterial contamination levels and most fungi species present into the rooms air of Jimma University dormitory were not human-borne. Key words : indoor air, bio-aerosol, bacteria, fungi, sedimentation technique, dormitory room.

Background: Hypertriglyceridemia in association with hypernatremia was reported in a few children; however, studies exploring this association are limited.  Objective: To determine the pattern of change in serum triglycerides levels in hypernatremia patients. Design and setting: A prospective case-control study done at North West Armed Forces Hospital, Tabuk, Saudi Arabia from April 2008 to March 2011 Patients and method: A serum triglycerides and sodium were measured in 16 patients with hypernatremic dehydration as a study group and 14 patients with isonatremic dehydration as a control group. The trend of serum sodium and triglycerides was followed during treatment in the study group. Results: There were 6 boys and 8 girls in the control group (isonatremic dehydration). Their age ranged between 4 months and five years (M±SD = 1.7±1.3 years). In the study group (hypernatremic dehydration), there were 6 boys and 10 girls. The age range was 2-14 months (M±SD = 0.6±0.4 years). The serum sodium and triglycerides (M±SD = 165.8±9.1 mmol/l, 5.1±8.1 mmol/l respectively) were significantly higher compared with the control group (M±SD = 137.5±3.9 mmol/l, 0.7±0.3 mmol/l and P < 0.001, P < 0.05 respectively). Duration of symptoms in patients with hypernatremic dehydration (M±SD = 2.9±2.4 days) were comparable to control group (M±SD = 2.0±0.9 days, P = 0.18). Four patients from the study group had normal serum triglycerides (M±SD = 1.1±0.1 mmol/l). With treatment, serum sodium was normalized in all patients followed by serum triglycerides. Conclusion: Hypertriglyceridemia is present in most children with hypernatremia and it disappears when serum sodium returns to normal. Keywords: Dehydration, Hypernatremia, Hypertriglyceridemia.  

Background: Prosopis chilensis is used locally in Sudan for inflammatory conditions of joints; however, literature lacks scientific evidence for anti-inflammatory effect of this plant. Aims: To evaluate anti-inflammatory and analgesic effects of prosopis chilenses. Material and Methods : Edema inhibition percent (EI %) and hot plate method were used to evaluate anti-inflammatory and analgesic effects of Prosopis chilenses in Wistar albino rats. Anti-inflammatory and analgesic effects of Prosopis chilenses were compared to indomethacin and acetylsalicylic acid respectively. Results: Ethanolic extract of prosopis chilensis at a dose of 200and 100mg/kg body weight achieved peak EI% (EI% = 96.1%) and (EI% = 94.4%) three and four hours after oral dosing respectively. The maximum EI% for indomethacin was 97.0% and was recorded after 4 hours following oral administration of the drug at a dose of 5 mg/kg body weight. Prosopis chilensis extracts at doses of 100 and 200 mg/kg body weight significantly increased the rats’ response time to hot plate compared to acetylsalicylic acid at a dose rate of 100mg/kg body weight ( P <0.05). Conclusion: The current results suggest potential anti-inflammatory and analgesic effects of prosopis chilenses. Relevance of these effects to prosopis chilenses phy-to-constituents was discussed. Keywords: analgesic, anti-inflammatory, prosopis chilenses,

Objectives: To determine the prevalence of endometriosis among adolescent school girls with severe dysmenorrhea. Methodology: Data was collected via interviewed questionnaire. Patients with symptoms and signs suggestive of endometriosis were further evaluated by abdominal ultrasonography (AUS), serum cancer antigen 125 (CA125). Laparoscopy was done for confirmation in those who agreed. Those who declined laparoscopy were offered magnetic resonance imaging (MRI). Results: A total number of 654 adolescents were interviewed. Their mean age was 15.2 ±3.53 SD years. The mean duration of cycles and flow days was 29 ± 8.4 SD and 4 ± 2.8 SD respectively. The age of menarche in years was 13 ± 1.2 SD. Cycles were regular in 77.4 % (n=506) while irregular in 22.6 % (n=148). Of all studied girls, 48.9% (n=320) had menstrual pain of varying degree of severity. Severe dysmenorrhea was reported in 68.8 % (n=220/320) of them. Fifty six of these cases (25.5 %) had ultrasound findings suggestive of endometriosis. CA 125 was elevated in41.5 % (n= 27/56) of them. Patients accepted laparoscopic confirmations were 34, of them 79.4%, (n=27) had positive histo-pathological evidence of endometriosis. MRI was offered to those declined laparoscopy (n=22). Endometriosis was suggested in 77.3% of them. Conclusion: The study concluded the prevalence of endometriosis in adolescents with severe dysmenorrhea was 12.3 % despite some declined laparoscopy. The unacceptability of laparoscopy and unfeasibility of local examination and trans-vaginal ultrasound add more to the difficulty of diagnosis. Key words: Adolescent, endometriosis, severe dysmenorrhea.

Objective: Oral cancer constitutes a major health issue in developing countries, representing the leading cause of death. Quantitative assessment by sophisticated diagnostic techniques is becoming increasingly important. Hence, a histochemical staining procedure and morphometric evaluation is used to obtain optimal information on the cellular events. The objective of present study is to assess the variation in cellular area, nuclear area, cellular diameter, nuclear diameter and nuclear/cytoplasmic ratio respectively in normal subjects, smokeless tobacco users smokers, combination and oral squamous cell carcinoma patients. Methods: Total 125 number of individual were divided into five groups, each comprising 25 individuals of more than 40 years of age. These groups were:  a. Normal, b. smokeless tobacco users, c. smoking d. combination and e. oral squamous cell carcinoma.’ Oral smears were obtained, stained with Feulgen stain and the cells were measured cytomorphometrically using Nikon imaging software. Results: Our study showed a significant reduction in the cellular diameter, cellular area and increase in the nuclear diameter, nuclear area and nuclear/ cytoplasmic ratio in oral squamous cell carcinoma patients as compared to tobacco users and normal patient. Significant changes were found in group I, II, III and IV when compared with group V but as such no significant inter-group variation was found in cellular and nuclear dimensions in smokers, smokeless tobacco users, combination and control group. Conclusion: Quantitative parameters could be assessed by cytomorphometry. Cytomorphological changes in exfoliated squames could serve as a useful adjunct in the early diagnosis of oral squamous cell carcinomas. Keywords: Cancer Cytomorphometry; Exfoliative cytology; Feulgen reaction; Imaging software;  Papanicolaou stain;  Premalignant lesion; Tobacco. 

Background: Currently, widespread HIV testing is the best preventive action against further spread of the HIV epidemic. However, over 40% of the U.S. population has never been tested for HIV and 25% of those with HIV have never been tested. To increase testing rates, in 2006 the CDC advised healthcare settings to conduct testing on an opt-out basis. Methods: Qualitative, semi-structured interviews with ten seropositive patients and ten seronegative were conducted to address the lack of studies investigating patients’ acceptance of and attitude towards this and more novel testing models, e.g. incentivized or anonymous mandatory testing. Participants were asked about their HIV testing history and attitudes towards opt-out, incentivized, and mandatory anonymous HIV testing. Results: Major themes were identified using grounded theory data analysis. All participants were receptive to opt-out testing, and saw the removal of separate written consent as beneficial as long as patients were given the opportunity to consent in some form. Conclusion: Ultimately, both mandatory and opt-out testing were equally indicated by participants as being the most effective testing model at increasing testing rates. A firm understanding of patients’ perspectives allows for development of effective HIV testing initiatives that are patient-sensitive and can substantially reduce HIV infection rates. Keywords: HIV testing, opt-out HIV testing, incentivized HIV testing, mandatory HIV testing, patient education.  

Objectives: To evaluate the expectations of pregnant women on the role of the male partner during conception and delivery. Methodology: A prospective multi-centre observational study comprising 506 pregnant women at eight health facilities in Ilorin, Nigeria from January to June 2014. Consenting women were recruited at antenatal clinics using multistage purposive sampling and a self-administered questionnaire was administered with provision for interpreters in local dialects for those without western education. The data was analyzed using SPSS using percentages and chi-square test; p <0.05 was termed significant. Results: Participants were aged 17 to 49 years (mean 30.23±4.81), 82.4% desire male partners company during antenatal clinic visits and 59.1% experienced this in index pregnancy. During labour and delivery, 427(84.4%) want company; 345(80.8%) chose the male partner with 211(57.7%) hoping men will appreciate the value of females afterwards although 27.9% feared the men may disturb the health workers, 72(14.2%) male partners attended previous delivery and 84.8% of the women were satisfied with the experience. Significant predictors of support for male partner’s presence at delivery were maternal age (p=0.001), secondary or higher education (p=0.001) and parity less than four (p=0.001); religion (x 2 1.010; p>0.001) and social status (p>0.001) were statistically insignificant. Pregnant women wanted education for male partners on care of pregnant women (77.0%) and sex during conception (25.2%). Conclusion: Parturient desire male partners’ presence at deliveries but their past participation was low; health facility modifications and education for men are required to meet the desires. Keywords: Male partner, Parturient, Company in labour, Pregnancy, labour and delivery

Objectives: The present study aims at assessing nursing and sanitation staff knowledge and practice regarding Healthcare Waste (HCW) management before and after the implementation of an educational intervention program at the main hospitals of the White Nile State in Sudan. Methodology: Quasi-experimental study design was applied to assess the impact of an intervention program on knowledge and practice regarding HCW management. The same questionnaire used in the pre-test was used immediately after the end of the intervention program and then again three months later for a second post-test.   Results: The results showed that the majority of nursing and sanitation staff had fair knowledge regarding HCW management before the educational intervention program (17% good, 58% fair, and 25% poor). After implementation of the educational program, the majority had good knowledge (56% good, 34% fair, and 10% poor) in the immediate post-test, and also in the post-test three months later (59% good, 35% fair, and 6% poor). More than half the nursing and sanitation staff had fair level of practice before the educational intervention program (42% good, 55% fair, and 3% poor). After the implementation of the intervention program, the immediate post-test showed a similar result (45% good, 54% fair, and 1% poor), while the post-test three months later showed that the majority demonstrated good practice level (55% good, 42% fair, and 3% poor).   Conclusion: The nursing and sanitation staff at the main hospitals of the White Nile State in Sudan recorded significant improvement in their knowledge and practice with regard to HCW management immediately after the educational intervention program and three months later.  

     Type 2 diabetes mellitus is a growing, worldwide public health concern. The countries of Arabic Gulf appear to have a higher prevalence of diabetes than the global average. The recent and rapid socio-economic development of these countries has been associated with this rising prevalence. Although the rate of type 2 diabetes management based on glycosylated hemoglobin level in the countries of Arabic Gulf is labeled as poor, the outcomes are almost similar to those reported from elsewhere. Unfortunately, overweight and obesity are driving the global diabetes epidemic. A minority of patients with type 2 diabetes had a normal body weight which might make the control of diabetes difficult. Anyhow, Greater efforts are urgently needed to properly manage diabetes early in order to prevent short and long-term complications. Practical strategies aimed at more effective management of type 2 diabetes patients are strongly needed.

Objective : Improve efficiency and profitability in academic medical centers Methods : Academic medical centers across the United States are experiencing lower payments with increasing work hours and patient volumes for many faculty physicians. Department chairpersons find themselves caught in the middle, trying to improve clinical efficiency and profitability while retaining satisfied physicians. During a meeting with the chairperson, one faculty member reported frustration with the inability to meet targets for incentive pay. He agreed to add six slots to his scheduling template each half day if he could have a second LPN/RN for support. The hypothesis: productivity as measured by charges, work relative value units, and collections would increase and be greater than the cost of the additional employee. Data was collected over eight months, with the physician having one assistant during the first half and two assistants during the second half. Results : There was a 30% increase in completed visits, 39% increase in wRVU’s, and 33% increase in gross payments received. Conclusion : This experiment demonstrated that, when allowed to have input regarding structure of their own clinics, physicians are predictably able to see more patients and generate more income.

Hand-foot syndrome (palmoplantar erythrodysesthesia or Burgdorf reaction), is a distinctive skin toxicity affecting the palms and soles after certain chemotherapeutic drugs. Docetaxel induced hand-foot syndrome is rare, dose-dependent adverse event. Here in we report a case of Docetaxel induced grade III hand-foot syndrome at low doses (75/m 2 ).   Key words: Hand-foot syndrome, Docetaxel, low dose

Among the spectrum of venous thrombo-embolic disease, acute pulmonary embolism accounts for the most life threatening manifestations with mortality exceeding 50%. It can affect many patient populations across various disciplines, hence immediate attention and aggressive treatment is crucial. With the advancement of technologies, various catheter-based devices are available to treat massive or submassive PE. In this paper we report two patients of acute pulmonary embolism with neurological issues where the life threatening emergency was successfully managed by utilizing endovascular directed thrombolytic reperfusion therapy.  

     Diabetes Mellitus (DM) is one of the fastest-growing health problem in the world, which is now reaching to epidemic proportion in some countries. It is mainly due to consequence of life-style as lack of exercise, unhealthy diet, obesity and overweight. Over the past four decades major socio-economic changes have occurred in Saudi Arabia. The growth and prosperity have brought pronounced changes in the lifestyle of the people. Most notably, eating habits are less healthful and the level of physical activity has declined. There is increased consumption of fast foods and sugar-dense beverages (e.g., sodas). Simultaneously, technological advances – cars, elevators, escalators, remotes - have led to a decrease in level of activity. Traditional dependence on locally grown natural produce such as fruits, vegetables and wheat has also shifted. This has resulted in the dramatic increase in the diabetes prevalence. (1)      Globally in 2013, it is estimated that almost 382 million people suffer from diabetes with a prevalence of 8.3%. Top 10 countries with higher prevalence of diabetes are Tokelau (37.5%), Federated States of Micronesia (35%), Marshall Islands (34.9%), Kiribati (28.8%), Cook Islands (25.7%), Vanuatu (24%), Saudi Arabia (23.9%), Nauru (23.3%), Kuwait (23.1%) and Qatar (22.9%). So Saudi Arabia is among top ten countries of the world with highest prevalence. (2)      A community-based national epidemiological health survey was conducted among Saudi subjects in the age group of 30-70-years of selected households over a 5-year period. Data were obtained from history, fasting plasma glucose levels, and body mass index. The data were analyzed to classify individuals as diabetic, impaired fasting glucose and normal. A total of 17232 Saudi subjects were selected in the study, and 16917 participated (98.2% response rate). Four thousand and four subjects (23.7%), out of 16917 were diagnosed to have DM. Thus, the overall prevalence of DM obtained from this study is 23.7% in KSA. Diabetes mellitus was more prevalent among Saudis living in urban areas than rural and male study participants. (3, 4)      Globally Diabetes imposes a large economic burden on the individuals, national healthcare systems, and countries. Healthcare expenditures due to diabetes account for 11% of the total healthcare expenditures in the world in 2011. In Saudi Arabia national healthcare burden because of diabetes is likely to exceed $0.87 billion, it omits the indirect costs associated with diabetes, such as absenteeism, lost of productivity from disease-related complications, unemployment due to disability and early mortality by disease. The social cost such as pain and suffering and care provided by caregivers as well as healthcare system administrative costs, cost of medications, clinician training programs, and research and infrastructure development is also omitted from this research study. Further studies are needed to confirm the present findings and to improve our understanding of economic costs of diabetes and its related complications. (5, 6)      Experts gathered at the International Conference on Healthy Lifestyles and Non-communicable Diseases (NCDs) in the Arab World and the Middle East, held in Riyadh, Kingdom of Saudi Arabia, in September 2012, recommended the following in Riyadh Declaration: (7)      a. An annual screening for metabolic syndrome (pre-diabetes, overweight, pre-hypertension, tobacco addiction) should be available to all asymptomatic adults from age 25 years, through primary health care facilities.      b. Individuals diagnosed through the screening package should be referred to adequate and accessible care.      c. Schools must be recognized as a major venue for Non Communicable Diseases (NCD) prevention. Accreditation or rehabilitation of educational facilities for boys and girls should be based on the criteria of World Health Organization Health Promoting Schools.      d. Impose nutritional labelling on all fast food items. Sale of fresh fruits and vegetables as well as low-calorie products should be promoted.       e. Increase the taxation on items with negative health effects (energy drinks, tobacco products), and earmark obtained funds to NCD prevention programs.      f. New residential developments have to include environments that promote walking, biking, social gathering, and safe space to allow physical activity for the citizens specially women, elderly persons, and children.      Diabetes should be treated under a close collaboration between patients and healthcare providers in order to prevent long-term complications such as damage to the eyes, kidney, feet and heart. People with diabetes must be treated to avoid early death. Aggressive promotion of public awareness, continued screening and early intervention are pivotal to boosting a positive response. Special attention should also be given to the role of diabetic awareness programs, community-based screening campaigns and different health educational programs in reducing health problems caused by diabetes, which in the long run, helps to reduce the national burden of this disease. (8)