CAN WAIST/HIP RATIO BE USED AS A SIMPLE MEASURE OF CARDIOVASCULAR RISK IN THE ARMED FORCES : RESULTS FROM A FIELD EPIDEMIOLOGICAL STUDY

A cross-sectional analytical epidemiologic study was undertaken in the community setting, on 1080 army personnel in a field formation, to study the association between waist/hip ratio (WHR) and certain physiological and biochemical parameters of cardiovascular risk. The study revealed that Junior Commissioned Officers, personnel aged 35 years and above, and personnel from Services had an increased probability of having higher WHR. WHR was consistently, linearly and significantly associated with increasing mean values of serum cholesterol, blood sugar and blood pressure. The optimum cut-off point of WHR from the findings of this study seems to be 0.91 and above. Beyond this value of WHR, the cardiovascular risk increases significantly and becomes more dramatic at WHR values of 0.96 and above.KEYWORDS: Cardio-vascular risk, Central adiposity, Obesity, Waist/hip ratio     

Cross sectional study of the relation between sibling number and asthma, hay fever, and eczema

OBJECTIVES: To document the relation between sibling number and atopic disease, and to assess the contribution of possible confounding factors to the protective effect of siblings in relation to asthma and hay fever. DESIGN AND SUBJECTS: Cross sectional survey by parental questionnaire in Tasmania, Australia, on 6378 children (92% of those eligible) who reached 7 years of age during 1995. METHODS: Exercise challenge lung function testing was conducted on 428 children. Analyses reported were conducted on singleton births only (n = 6158). RESULTS: The prevalences of a history of asthma ever, hay fever, and eczema were 27%, 19%, and 22%, respectively. Asthma and hay fever, but not eczema, were inversely related to sibling number, with evidence of a dose-response trend. The mean age at onset for asthma or wheezy breathing decreased as the number of siblings increased. The inverse association between sibling number and asthma or hay fever persisted after adjustment for several confounders, such as parental smoking or breast feeding, but did not persist after adjustment for household size in 1995. CONCLUSIONS: The protective effect of high sibling number could not be separated from household size at age 7, and it appears to be operating after birth and influences the age at onset of asthma symptoms. Further work to increase knowledge of how the protective effect of the presence of siblings works might have important implications for the understanding of the pathogenesis of asthma.     

Pulse oximetry in sickle cell disease

Patients with sickle cell disease usually have mild hypoxaemia and their oxyhaemoglobin dissociation curve is shifted to the right. It follows that oxygen saturation in sickle cell disease should be lower than normal. Most subjects in this clinic had normal oxygen saturation by pulse oximetry, however. To improve the understanding of this paradox, arterialised capillary oxygen tension (PO2) and oxygen saturation were compared with simultaneously measured pulse oximeter saturation in 20 children with sickle cell disease. In addition, the PO2 at 50% haemoglobin saturation (P50) was compared with saturation measured by pulse oximetry in all 20 patients. It was found that saturation measured by pulse oximetry was, on the whole, similar to that calculated from the sampled blood. Individual deviations were not random, however, and were partly explained by differences in P50 values. It is concluded that pulse oximetry gives variable results in patients with sickle cell disease and should be used with caution to predict arterial saturation in this patient group.     

Erythropoiesis of very low-birth-weight infants dependent on prenatal growth rate and protein status

Kivivuori SM, Järvenpää AL, Salmenperä L, Viinikka L, Siimes MA. Erythropoiesis of very low-birth-weight infants dependent on prenatal growth rate and protein status. Acta Paediatr 1994; 83:13–18. Stockholm. ISSN 0803–5253
This study investigated erythropoiesis in very low-birth-weight infants with special reference to the role of protein status in the regulation of erythropoiesis in 22 appropriate- and 11 small-for-gestational-age infants. Blood sampies were drawn at three and six weeks of age. The serum concentrations of erythropoietin, estimated by a solid-phase enzyme immunoassay, were similar in the two groups at both study ages. The total circulating erythrocyte volume and the serum concentration of prealbumin were higher in the appropriate- than in the small-for-gestational-age infants at three and six weeks of age. The former group had a better protein status, although their protein intake was similar or lower. We conclude that erythropoiesis in very low-birth-weight infants is influenced more by protein status and prenatal growth than by serum concentration of erythropoietin.     

Impacts of missing upper anterior teeth on daily living

Background : Aesthetics and function of the orofacial region are very important aspects of human life which may be affected by tooth loss and impact on the quality of life. The aim of this study was to identify the effects of anterior tooth loss on patients' quality of life and satisfaction with their dentition. Methods : Fifty partially edentulous patients with missing anterior teeth and 50 control subjects who had no missing teeth were recruited into the study. The control subjects matched the patients by age, gender, and level of education. A Dental Impact on Daily Living questionnaire was used to assess dental impacts on daily living and satisfaction with the dentition. Results : Tooth loss has a definite measurable impact on patients' daily living and satisfaction with their appearance, pain levels, oral comfort, general performance, and eating capacities (p=0.000). Age and level of education had no effect on patients' total satisfaction with their dentition and daily living. However, females were less satisfied with appearance, general performance and eating (p=0.003, 0.005 and 0.007 respectively) than males. There were significant correlations between the number of missing anterior teeth and patients' total satisfaction (p=0.028) and patients satisfaction with appearance, oral comfort, general performance, and eating dimensions (p= 0.001, 0.048, 0.011 and 0.009 respectively). Conclusion : Tooth loss has definitive impact on patients' satisfaction with their dentition regardless of personal factors such as age, gender and level of education. The higher the number of missing teeth the lower the levels of satisfaction with the dentition and daily living     

Bilateral acute angle closure glaucoma after hyperopic LASIK correction

Acute angle closure glaucoma is unexpected complication following laser in situ keratomileusis (LASIK). We are reporting a 49-years-old lady that was presented to the emergency department with acute glaucoma in both eyes soon after LASIK correction. Diagnosis was made on detailed clinical history and examination, slit lamp examination, intraocular pressure measurement and gonioscopy. Laser iridotomy in both eyes succeeded in controlling the attack and normalizing the intraocular pressure (IOP) more than 6 months of follow-up. Prophylactic laser iridotomy is essential for narrow angle patients before LASIK surgery if refractive laser surgery is indicated.     

A case of lead poisoning due to snooker chalk

A 3 year, 9 month old child with pica presented with a blood lead concentration of 1.74 micromol/l (360 microg/l). The source of poisoning was snooker chalk (lead content 7200 microg/g). She was treated with intravenous calcium disodium edetate chelation. Thirty months later her blood lead was 0.39 micromol/l (80 microg/l). This case illustrates the need to be vigilant for more unusual causes of lead poisoning in the home.     

Effects of Tobacco Smoking on the Dorsum of the Tongue and Buccal Epithelium

Objective: The aim of this study was to assess the effects of tobacco smoking on the dorsum of the tongue and buccal epithelium. Methodology: This case control cross-sectional study was conducted with 174 smoking and non-smoking volunteers living in the city of Hail, Northern KSA. Cytological Materials were obtained from buccal mucosa and dorsum of the tongue, and assessed using cytopathological methods. Results: In buccal smears, cytological atypia was observed in 17 out of 101 (16.8%) smoker cases but only 3/73(4.1%) of the controls. For cytological atypia in buccal and tongue smears, the adjusted odd ratio (OR) and the 95% confidence interval (CI) were found to be 4.7 (1.3-16.8), P < 0.016)) and 4.3 (0.93- 20.2), P <0.06)), respectively, in the two sites. Conclusion: Tobacco smoking is a major risk factor for occurrence of cytological atypia, which might subsequently develop into oral precancerous and cancerous lesions. Oral exfoliative cytology is an easy and cheap non-invasive procedure which appears highly suitable for screening populations at risk of developing oral cancer.