Merit Research Journal of Medicine and Medical Sciences

060-065

Authors: Mohammed O. Mohammed, Kosar M. Ali, Ali M. Jabari, Ahmed Saed and Aumaid U. Uthman

The aim of this study was to describe the clinical characteristics, risk factors, laboratory investigations and outcome of patients with Influenza A (H1N1) during the Global Pandemic in 2010, and to perform viral sequencing to see if same global strain of H1N1 is responsible to the epidemic at the Centre of Infectious Disease in Sulaimani city. This study conducted between 1st January to 1st March 2010. Patients, who presented with clinical feature of flu and had positive Influenza A rapid test, and proved to have influenza A (H1N1) by real-time reverse transcriptase polymerase-chain-reaction(PCR-test) were included in the study. Molecular biology examination of H1N1 has been performed at Kurdistan Centre for Strategic studies and scientific researches. A total of 157 patients were enrolled in the study, 71(45.2%) were males and 86 (54.8%) were females. Most of them were from city of Sulaimani. 37% were smoker and 8% were pregnant. Cough and fever were the common presenting symptoms (92.8% and 66.2% respectively). History of contact with a person with recent Flu infection was positive in 21% of patients. Chest X-rays were abnormal in 28.6% of them. 5 patients died in hospital and the death rate was 3.2%. Single mutation have been detected at amino acid sequence of Haemagglutinin gene 267 changing Valine to Isoleucine. Sulaimani City was part of the H1N1 pandemic in 2010; only 7.6% of the patients had required mechanical ventilation; this was very low compared with other studies, which might reflect early initiation of treatment and good management plan in our Unit. Single mutation have been detected which indicate the possibility of antigenic drift. Keywords: H1N1, Swine flu, PCR test, Virus sequencing.

049-059

Authors: Bisharat Bishara M.D, MPH, Nur Abu-Ahmad Nur M.Sc and *Bowirrat Abdalla M.D., Ph.D.

Obesity and overweight are an important adaptable risk factor for many chronic diseases and are the fifth leading risk for global deaths. Remarkably increased prevalence and escalating levels of overweight and obesity over the last 3 to 4 decades give it the character of modern pandemic phenomenon and the major public health crisis challenge worldwide, that is beginning to replace undernutrition, hunger and infectious diseases as the most significant contributor to chronic diseases. In Arab world the effects of overweight and obesity are widely recognized as one of Arab’s leading health concerns, involving all ages and socioeconomic groups. To estimate the prevalence of obesity, covariates associated factors, diet composition and the eating habits among adults Arab population in Israel. A population-based cross-sectional study was performed with a total of 287 hospitalized patients at E.M.M.S hospital (Nazareth) from different departments (Internal, surgical and orthopedics words) aged 18 years and older (123 males and 164 females). Demographic data, anthropometric assessments, dietary assessment, socioeconomic and lifestyle characteristics, BP measurements, and biochemical assessment were collected using standard methods and techniques. Metabolic abnormalities were identified. The mean BMI results were compared between males and females (28.4±0.53) versus (30.31±0.46), respectively (P-value < 0.2). The measurement of WC among males and females was as follow: (104.3±1.67) versus (101.4±1.57) respectively, (P-value = 0.8). High and low risk for hypertension and type 2 diabetes by gender according to waist circumferences (high risk WC > 88 cm for females and WC > 94 males) was shown and illustrate that women with WC > 88 cm had (74.7%) risk for hypertension and diabetes versus (64.9%) risk among males with WC > 94; (P-value =0.03). Comparing the prevalence of type 2 diabetes among high risk group: WC > 88 cm for females and WC > 94 males and low risk group WC < 88 cm for females and WC < 94 for males was 35 (71.5%) vs. 13(26.5%) respectively, P-value = 0.002). Comparing the prevalence of hypertension among high risk group: WC > 88 cm for females and WC > 94 males and low risk group WC < 88 cm for females and WC < 94 for males was 45(70.3%) vs. 19(29.7%) respectively, P-value = 0.003). Median intake of refined grain and the whole grain intake (serving/day) in both genders was examined and showed that the median consumption of refined grain is significantly higher than the whole grain in both genders (P-value < 0.0001). In addition, we compared the median intake of highly fat dairy products in both genders with low fat dairy (serving/day). We observed that the consumption of high fat dairy products is statistically higher than low fat dairy products (P-value <0.0001). Regarding diabetes and food consumptions: we observed that the consumption of refined bread by diabetics patients was significantly lower comparing with non diabetics subjects (P-value <0.001), and the consumption of whole bread by diabetics patients was significantly higher compared with non diabetics patients (P-value <0.024). The median consumption of low fat products (cheese 5%), by diabetics patients was significantly higher compared with the non diabetics subjects (P-value <0.023), in addition, the consumption of soft sweet drinks by diabetic patients was significantly lower than non diabetic subjects (P-value <0.008). The results of this study indicate that rates of abnormal waist circumference in all age groups are high, both in males and females. WC in females over the age 65 continues to increase while in men is decreased. Interestingly, we noticed that the Arab population eating regime is disorganized and usually without awareness and control. Indeed, we observed that unhealthy diet dominate in Arabic kitchens such as high carbohydrates, low fiber and high fat diet consumption. Cultural attitudes may partially underlie the high prevalence of obesity and changes in the economy, modernization, industrialization and socioeconomic status in addition to the influence effect of the surrounding western diet style consumed by the majority population in the country. “Dietary acculturation” or adapting the eating patterns of the majority resulted in rapid changes in diet and physical activity patterns. Adopting less healthy dietary patterns, and relinquishing healthy dietary prototypes, such as higher intake of fibre-rich products in form of legumes and whole grain products are both negative parts of the acculturation process. These results are in conflict with the famous known healthy diet in the Middle East known as “Mediterranean diet”, rich in vegetables, fruits, high fiber and low fat diet. Keywords: BMI, waist circumference, Obesity, Whole-wheat intake: Diet quality, Adult Arabs

047-048

Authors: Tsun-Cheng Kuo and Feng-Ming Ho

From the researches in the past decade, we have found that acupuncture can effectively enhance the immunity. For the efficacy of acupuncture in enhancement of immunity, we introduce an aspect, in which human body considers the acupuncture as an acute stress to react the trigger of mechanism for enhancement of immunity. Facing the adversity, the body can enhance the immunity by over-mobilization to prepare for following greater harms. Acupuncture sometimes will result in a wound and the needles may stir deep nerve in twirling. The body will interpret the enormous wound. The trauma is a very important acute stress, which will trigger the anti-bacterial mechanism. Acupuncture is an acute stress since they have the same mechanism. The acute stress will enhance immunity through autonomic nervous system (ANS) and acupuncture does the same way. Both acute stress and acupuncture can activate the ANS axis and modulate immunity system throughout the limbic system, including the extended amygdale. Keywords: Acupuncture, Acute stress, Immunity, Adversity, Wound

043-046

Authors: Nwoire A., Madubuko E. F., Eze U. A., Oti-Wilberforce R. O., Azi S. O., Ibiam G. A., Egwu I. H., Okereke E. C. and Obi I. A.

Staphylococcus aureus is an important pathogen in human infections and has become public health concern. This study investigated the incidence of Staphylococcus aureus in various clinical samples from in- and out-patients attending Federal Teaching Hospital, Abakaliki. Clinical isolates from the hospital was confirmed as Staphylococcus aureus using standard bacteriological techniques. This study reports the isolation and identification of Staphylococcus aureus, coagulase negative staphylococci and catalase negative cocci in clinical samples at Federal Teaching Hospital Abakaliki. Out of a total of 144 putative isolates of Staphylococci from urine, ear and wounds screened for Staphylococcus aureus, 87 of them were confirmed as S. aureus, 30 were coagulase negative staphylococci while 27 were catalase negative cocci. The high incidence of S aureus in this study compared to other staphylococci demonstrates the versatility and propensity of S. aureus to cause diseases. This is worrisome because of thehigh mortality and morbidity often associated with infections of this bacterium. It therefore calls for proper handling of specimen suspected to contain the organism or patients who might be at risk of infection. This is to avoid transmission to other patients and healthy individuals especially health workers as they might constitute vehicles for the spread of the organism. Further studies are recommended because of the small sample size in this study. This would help to establish whether this was peculiar to the Federal Teaching Hospital Abakaliki or wide spread in other hospitals in the State. Keywords: Methicillin-resistant Staphylococcus aureus, Clinical isolates, Catalase negative cocci, coagulase negative staphylococci, mortality, Infections.

028-042

Authors: Prof. Dr. Bowirrat Abdalla M. D., Ph. D, Yassin Mustafa M. D., Bishara Bisharat M.D., Muneer Sharaf M. D., Aysha Heib MPH and Armaly Zaher M. D.

To investigate the enormity of prostate cancer in the North West-Bank, and shed light on underlying risk factors affecting its distribution. We performed a retrospective study among hospitalized patients in West-Bank. 70.000 men aged 40 years or older were our study target. Analysis was based on patient admissions, and statistical methods (ANOVA Test, T-test, Correlation, Chi squire test, Descriptive statistics and frequencies and percentile methods) were used. 78 prostate cancers were reported with incidence rate of 10.4 per 100.000 populations. We revealed that the majority of patients (64.1%) were diagnosed in Nablus town and the lowest (6.4%) in Tulkarem town. Risk factors such as type of occupation, number of children, Age and obesity, showed a Pearson correlation and statistical significance at P-Value = 0.05 which was respectively (p=0.016, p=0.018, p= 0.003, p=0.004). Significant relationship was found between age and infection (P-value = 0.032) and between cancer stage and age (0.021). Prostatic carcinoma strikes disproportionately in different regions in west-Bank, employment types, extended families; aging and obesity were found to be risk factors and vegetarian diet as protective factor. However, lower prevalence was observed when we compared our results with Western Countries. Impact Screening with PSA testing, digital rectal examination and traditional Mediterranean diets with lower consumption of saturated fat altogether may decrease, and hold the promise for early detection and sustained decline in prostate cancer mortality. Keywords: Vegetarians diet, Prostate Cancer, Epidemiology, Risk Factors, North-West – Bank.