PHD theses : Medicine
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Item Knowledge, Attitude and Practice of Under Five Years Children's Health among Mothers, Al-Mukalla- Yemen- 2022(ALNEELAIN UNIVERSITY, 2022) Maeesa Saeed Abdulkheer Al-NobanAbstract Introduction:00000 Improving the health of the child occupies a distinguished position in the importance of the childhood period as a basic stage and affecting the successive stages of life. In line with global recommendations, the childhood stage constitutes the basic building block and the opportunity to take measures to achieve the optimal growth of the child. The appropriate knowledge, behaviors and practices of mothers play a major role in establishing and maintaining good health habits that help in building a healthy child, which is reflected in the level of morbidity and mortality. Our aim in this study is to determine the level of knowledge, attitudes and practices of mothers related to the health of children under the age of five and what are the factors associated with them. Methods: House to house community- based cross sectional study was conducted on urban and rural areas of AL Mukalla/ Hadhramout. Five hundred eighty-one mothers were enrolled in the study using the Random Walk Method. The knowledge, attitude and practice of mothers were evaluated by standardized administered questionnaire containing different types of questions regarding nutrition, acute respiratory infection, diarrhoea and vaccination. The data was analyzed using Statistical Package for the Social Sciences (SPSS) version 20. Bivariate and multivariate logistic regressions were used to analyze the associations between the dependent and independent variables. Results: Out of 581 mothers, a higher proportion of them were of primary education (44.2%), married (96.2%), and not working (84%). In this study mothers knew about exclusive breast feeding and the importance of colostrum. The contaminated water/ food and incomplete immunization were the most common causes of diarrhoea (76.9% and 58% respectively). 93% of urban mothers recognized critical signs of dehydration, while 60.4% of rural mothers were not able to recognized it. Around 80% of urban mothers knew about the benefit of giving oral rehydration solution compared with rural mothers. The non-immunization rate in rural areas was 42.6% compared to urban area (37.6%). Good knowledge and positive attitude were comparatively higher among urban mothers regarding nutrition, acute respiratory infection, diarrhoea and immunization than rural mothers. However, the urban mothers had fair practice, while rural mothers had good practice about nutrition of children. In addition; the unsatisfactory practice about acute respiratory infection showed no great difference among both urban and rural mothers (80.7%, 77.3% respectively). Conclusions: The findings revealed that, despite having good or fair knowledge about under five children's health in both areas, a large percentage of mothers, particularly in rural areas, had a negative attitude and poor practice. In addition, occupation, education level, age, and level of understanding of mothers were factors that influenced child health. Furthermore, there were gender disparities in immunization and coverage disparities among different areas. Recommendation: Continuous collaboration between health care providers and policymakers is a great prerequisite for developing a system of accurate and efficient health education, with special attention to the population in remote or rural areas. It is also critical to continue to encourage mothers how deal with child, and to encourage community health providers to educate mothers during pregnancy and immediately after delivery. In addition, greater emphasis should be placed on better understanding mothers' behaviors and views on childhood immunization and gender disparity, particularly in rural areas. مستخلص الدراسة المقدمة: يحتل النهوض بصحة الطفل مكانة متميزة بالأهمية التي تكتسيها فترة الطفولة كمرحلة أساسية ومؤثرة على مراحل الحياة المتعاقبة. تماشيا مع التوصيات العالمية فان مرحلة الطفولة تشكل اللبنة الاساسية والفرصة لاتخاذ الاجراءات لتحقيق النمو الأمثل للطفل. تلعب معارف وسلوكيات وممارسات الامهات الملائمة الدور الكبير في ترسيخ والحفاظ على العادات الصحية الجيدة التي تساعد في بناء الطفل بشكل صحي مما ينعكس على مستوى المراضة والوفيات. هدفت هذه الدراسة الى معرفة مستوى المعارف، والمواقف والممارسات عند الامهات المتعلقة بصحة الأطفال دون سن الخامسة وماهي العوامل المرتبطة بها. المنهجية: دراسة وصفية للقاعدة المجتمعية من منزل إلى منزل أجريت على المناطق الحضرية والريفية في المكلا / حضرموت. اشتركت خمسمائة وواحد وثمانون من الأمهات في هذه الدراسة باستخدام طريقة المشي العشوائي. تم تقييم معارف، سلوكيات وممارسات الأمهات من خلال استبيان منظم مطبوع مسبقًا يحتوي على أنواع مختلفة من الأسئلة المتعلقة بالتغذية وعدوى الجهاز التنفسي الحادة والإسهال والتطعيم. تم تحليل البيانات باستخدام الإصدار 20 من SPSS. تم استخدام الانحدار اللوجستي ثنائي المتغير ومتعدد المتغيرات لتحليل الارتباط بين المتغيرات التابعة والمستقلة. النتائج: من أصل 581 أم، كانت الغالبية منهن حاصلات على تعليم ابتدائي (44.2%)، متزوجات (96.2%) ولا يعملن (84%). عرفت الأمهات في هذه الدراسة عن الرضاعة الطبيعية الحصرية وأهمية اللبأ. فيما يتعلق بأمراض الإسهال، كان الماء / الطعام الملوث والتحصين غير الكامل أكثر أسباب الإسهال شيوعًا (76.9٪ و58٪ على التوالي). 93٪ من الأمهات في المناطق الحضرية لاحظن علامات الجفاف الحرجة، في حين أن 60.4٪ من الأمهات لم تتمكن من التعرف عليه. عرف حوالي 80٪ من الأمهات في المناطق الحضرية فائدة إعطاء محلول معالجة الجفاف عن طريق الفم مقارنة بالأمهات الريفيات. بلغ معدل عدم التطعيم في الريف 42.6٪ مقارنة بالحضر (37.6٪). كانت المعرفة الجيدة، السلوكيات الإيجابية عالية بين الأمهات في المناطق الحضرية فيما يتعلق بالتغذية وعدوى الجهاز التنفسي الحادة والإسهال والتحصين مقارنة بالأمهات الريفيات. ومع ذلك، فإن الأمهات في المناطق الحضرية لديهن ممارسة عادلة، في حين أن الأمهات الريفيات لديهن ممارسات جيدة بشأن تغذية الأطفال. أيضا؛ ظهرت الممارسة غير المرضية حول عدوى الجهاز التنفسي الحادة بين الأمهات في المناطق الحضرية والريفية (80.7٪، 77.3٪ على التوالي). الخلاصة: كشفت النتائج أنه على الرغم من وجود معرفة جيدة أو عادلة حول صحة الأطفال دون سن الخامسة في كلا المنطقتين، فإن نسبة كبيرة من الأمهات، لا سيما في المناطق الريفية، لديهن موقف سلبي وممارسات سيئة. بالإضافة إلى ذلك، كانت المهنة ومستوى التعليم والعمر ومستوى فهم الأمهات كلها عوامل أثرت على صحة الطفل. علاوة على ذلك، كانت هناك تفاوتات بين الجنسين في التمنيع والتفاوت في التغطية بين مختلف المناطق.Item The Effects of Gum Arabic on Fertility in Obese Female Rats(ALNEELAIN UNIVERSITY, 2022-01) Shahenaz Seifaldeen Musafa SattiABSTRACT Introduction: Obesity and its related health concems is increasing worldwide, evidence of etiological links between the obesity and reproductive problems such as infertility, ovulation dysfunction, preterm delivery, fetal growth disorders were reported , The mechanisms linking obesity to these pathologies are related to metabolic derangement and oxidative and nitrosative stress in the body Gum Arabic has proven a safe dietary fibre . The aim of this research is to study the potential effects of Gum Arabic on reproductive health problems associated with obesity induced by western diet. Materials and methods: Females Westar rats weight about 120 -130 gram, were divided randomly into two groups distinguished by dietary composition, Control group (n=l 0). were fed only standard rodent chew diet. Obese group n=20 were fed Cafeteria diet (varying menu of sausage, cheese, snacks, peanuts, chocolate, biscuits) for 8 weeks, By the end of week 8, 10 obese rats as indicated by 20 % Of initial weight randomly selected and received addition of 10% Gum Arabic dissolved in tap water (100 g/l). Food intake, weight gain, glucose tolerance test (GTT )and the insulin tolerance test (ITT) were recorded at two weeks interval . Then rats were transferred to a mating cage and cohabite with proven fertility male rats ( 1:1). Mating, fertility, fecundity index were calculated. The number of live pups and their body weights were recorded. In the firstl estrous phase after the intervening day, rats were anathatazied and dissected afterwards, ovaries were removed. One ovary was for antioxidant and nitric oxide measurements and the others was fixed in 10 % fonnaldehyde for 24 hours, dehydrated, embedded in paraffin for histopathological assessments. Results: Results showed Cafeteria fed-rats developed obesity when compared to control group mean (334.7 i 8.0) (138.2 i 1.5) (P < 0.05). The rats fed a cafeteria diet showed significant increase in food intake compared to those fed standard chow diet (p<0.05), Gum Arabic oral supplementation significantly lowered weight in week 12, weight had retumed to normal by week 17 also significantly reduces the quantity of food ingested by rats in the experimental group which aligns with weight reduction. Obese rats exhibited disturbed glucose and insulin tolerance test (GTT) (ITT) compared to controls (P <.00l). ln week 10 substantial improvement in glucose tolerance and insulin resistance were noticed (P = .001) . Regarding lipid profile, Triacylegleceride (TAG) and cholesterol levels were significantly higher in the CAF-fed rats compared to the control group TGA mean (70.70i1.20) (lll.40:k2.50) p (.0001) while cholesterol (67. 50il. 19) (85. 5011. 36) p value (. 000l);CAF diet-induced obesity resulted in a considerable increase in LDL levels and significant reduction in HDL level . A substantial drop in LDL and a rise in HDL was seen in obese rat treated with Gum Arabic (p <0.05). The mating index was found to be 100% in all groups. The fertility index and fecundity index were lower in obese rats( p<0.05) and significantly increased in obese rats treated with GA. Number of live fetuses were declined by obesity (mean 12 1 0.97) in comparison to rats female fed standard diet (l5 11.45) (P< 0.05). Ovaria.n Malondialdehyde (MDA) and Nitric Oxide (NO) concentrations raised in CAF diet group compared to control , Mean MDA (27. i 3.0) ( 50.4i5.3)( P =.001) and mean NO level (49.4=kl 1.0) (l SO.lil9.4)( p . 0001) for control and obese respectively ,While catalase level was decreased in ovarian tissues mean (1 .4i0.3)(l .01 0.2) (P<0.05) for control and obese group correspondingly. GA treatment significantly lowered ovarian MDA and NO and lead to increased catalase (p<0.0S) . There was a statistically significant difference in NO level in obese treated with a GA and a control group (p =. 002). Obese rats, on the other hand, had a remarkable cyst-like appearance of follicles, thickened follicular walls and decreased granulosa cell layers, fewer antral follicles, but more fluid, After four weeks of gum Arabic follicular walls were thinner and cystic changes were less visible. Conclusions: Gum Arabic oral administration improves the reproductive outcome that was disturbed by obesity induced by westem diet, this was through strong antioxidant effect on ovarian tissues which correlated to weight reduction and improvement in glucose intolerance, insulin resistance and lipid profile.Item Indicators of metabolic syndrome among patients with bronchial asthma(Al-Neelain University, 2021) Hanadi Abdelgadir Ahmed SourgABSTRACT Background: Much evidence suggests epidemiological and etiological links between the metabolic syndrome (MS) and bronchial asthma (BA). Hyperglycemia, hyperinsulinemia, insulin resistance (IR), hypertension, dyslipidemia, and obesity were all described in the pathophysiological mechanisms of BA. Objectives: To compare anthropometric measurements and other indicators of body fat distribution, blood pressure (BP), fasting blood glucose (FBG) level, fasting blood insulin (FBI) level, quantitative insulin sensitivity check index (QUICKI), and a serum lipid profile between asthmatic patients and healthy control subjects. Method: One hundred twenty asthmatic patients were recruited from chest referral clinic (Military Hospital, Khartoum, Sudan) and served as the test group. Another 59 non-asthmatic subjects were recruited by co-patients, or by university students/employees, and served as the control group. Following clinical and spirometric evaluation of the subjects, the following items were measured: body weight, height, waist circumference (WC), hip circumference (HC), triceps skinfold (TSF), biceps skinfold (BSF), subscapular skinfold (SSSF) and suprailiac skinfold (SISF) thicknesses – as well as the ratio between waist and hip circumference (WHR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial blood pressure (MABP), FBG and FBI levels, the QUICKI, and a serum lipid profile. Body fat percent (BF %) and body mass index (BMI) were also calculated. Based on BMI, studied subjects were categorized in four classes: underweight, normal weight, overweight, and obese. Cigarette smoking, pregnancy, those below 20 years or above 40 years, diabetes mellitus and hypertension, and other chronic diseases were excluded from all studied groups. Results: Although BMI, HC, TSF, BSF, SSSF, SISF, and BF% were higher in asthmatic patients compared to non-asthmatic subjects, the difference for each of these parameters did not reach statistical significance. WC and WHR were significantly higher in asthmatic patients (88.50 (78.00-101.75), 83.00 (78.47- 90.17)) compared to non-asthmatic subjects (81.00 (72.00- 92.00), 80.00 (75.67- 85.10), P = 0.004, 0.003). BA symptoms in underweight subjects was comparable to normal BMI subjects (OR=1.05). However, BA prevalence increases steadily in overweight (OR=1.46) and obese subjects (OR=2.67), compared to normal BMI subjects. The presence of symptoms during the study increased in underweight (OR=3.55), overweight (OR=2.13), as well as obese (OR=3.43), versus normal BMI subjects. QUICKI and MABP were lower in asthmatic patients (0.310 (0.283- 0.338), 86.66 (83.33- 93.33)) compared to non-asthmatic subjects [0.320 (0.297-0.353), 93.33 (83.33- 93.33)], P < 0.05). BMI, FBG, low density lipoprotein (LDL), high density lipoprotein (HDL), and total cholesterol were comparable in the studied group except triglyceride (TG) which was high in asthmatic patients. Conclusions: Study results provide further evidence of the association between BA and central obesity. All indicators of body fat distribution were higher in asthmatic patients compared to non-asthmatic subjects, although only WC and WHR reached statistical significance: this points to the relevance of abdominal obesity in the pathophysiology of BA. The present findings also suggest that hypertriglyceridemia, hyperinsulinemia, and IR may be interacting, thereby increasing the risk of BA in normotensive, normoglycemic asthmatic subjects. ARABIC ABSTRCT المستخلص الخلفية: تشير العديد من الأدلة الوبائية والسببية الي وجود رابط بين متلازمة الأيض والربو الشعبي. وصف ارتفاع السكر والأنسولين و ضغط الدم واضطراب شحوم الدم والسمنة بارتباطهم بالفيزيولوجيا المرضية للربو الشعبي. الاهداف: مقارنة القياسات البشرية ونسبة توزيع الدهون في الجسم وضغط الدم وسكر الدم الصائم وهرمون الانسولين ومؤشر فحص حساسية الانسولين الكمي ومعالم الدهون بين مرضي الربو الشعبي والاصحاء. الطريقة: أجريت هذه الدراسة في 120 من مرضى الربو الشعبي الذين يترددون على العيادة المحولة في المستشفى العسكري بالخرطوم و59 صحيح من مرافقين للمرضي والعاملين وطلاب الجامعات من نفس الفئة العمرية (20-40 سنه) من الجنسين. بعد اجراء الفحص السريري وقياس وظائف الرئة للخاضعين للدراسة تم قياس العناصر التالية: وزن الجسم، والطول، محيط الخصر والحوض، وسمك طيات الجلد من اربعة نقاط، ضغط الدم، تركيز السكر والانسولين ومعالم الدهون في الدم بعد الصيام، مؤشر فحص الحساسية الانسولين الكمي، نسبة الدهون في الجسم ومؤشر كتلة الجسم. وتم تقسيم المرضي علي اساس مؤشر كتلة الجسم وتم استبعاد كل من المدخنين، والحوامل، مرضي السكري وضغط الدم والامراض المزمنة. النتائج: وجد أن محيط الخصر ونسبة محيط الخصر للحوض في مرضي الربو الشعبي (88.50 (78.00-101.75)، 83.00 (78.47- 90.17)) ذو اهمية احصائية عالية مقارنة بالأصحاء (81.00 (72.00- 92.00)، 80.00 (75.67- 85.10)، (P= 0.004, 0.003). غير أن ارتفاع مؤشر كتلة الجسم، ومحيط الخصر وسمك ثنية الجلد من اربعة نقاط الذي سجل في مرضي الربو الشعبي مقارنة بالأصحاء ليست بذات اهمية احصائية.