Fatal pancreatitis secondary to iatrogenic intramural duodenal hematoma: a case report and review of the literature

Intramural duodenal hematoma (IDH) is a rare finding in the adult, especially when related to iatrogenic complications of ulcer treatment. It can lead to biliary obstruction and pancreatitis, which proved fatal in our case. Contrast-enhanced computed tomography (CT) is invaluable in detecting the abnormality and can definitely be diagnostic.     

Fatal pancreatitis secondary to iatrogenic intramural duodenal hematoma: A case report and review of the literature

Intramural duodenal hematoma (IDH) is a rare finding in the adult, especially when related to iatrogenic complications of ulcer treatment. It can lead to biliary obstruction and pancreatitis, which proved fatal in our case. Contrastenhanced computed tomography (CT) is invaluable in detecting the abnormality and can definitely be diagnostic.     

Surname lists to identify South Asian and Chinese ethnicity from secondary data in Ontario,Canada: a validation study

Background  

Surname lists are useful for identifying cohorts of ethnic minority patients from secondary data sources. This study sought to develop and validate lists to identify people of South Asian and Chinese origin.     

Smoking, adolescents and health: Isfahan healthy heart programme-heart health promotion from childhood

To evaluate the effect of some environmental factors on smoking, and to assess some health hazards of smoking in adolescents, this cross-sectional study was performed among 1950 students, agesll-18, selected by multi-stage random sampling from three cities in Iran. According to self-administered questionnaires, 12.9% of boys and 4% of girls reported to be smoker (OR = 3.34, 95% CI: 2.33, 4.77, p < 0.001). The mean values of total- and LDL-cholesterol were higher in smokers and their HDL-C was lower than non-smokers (163.33 +/- 33.83, 90.73 +/- 31 and 46.7 +/- 12.24 vs. 156 +/- 29.53, 85 +/- 26.5 and 49.4 +/- 13.7 mg/dl, respectively, p < 0.05). The mean systolic and diastolic blood pressures were higher in smokers than non-smokers (110.7 +/- 14.5, 67.6 +/- 11.55 vs. 104.9 +/- 14.3, 63.2 +/- 10.8 mmHg, respectively, p < 0.05). The smokers had higher BMI than non-smokers (20.34 +/- 3.84 vs. 19.55 +/- 3.66, p < 0.05). The mean food consumption frequency was lower for fruits and vegetables and higher for fat/salty snacks and fast foods in smokers than non-smokers. Logistic regression analysis showed significant association between sex, age, the number of family members and number of smokers in the family and smoking in students. The findings of this study have implications for future tobacco prevention strategies through community-based interventions.     

Obesity and associated modifiable environmental factors in Iranian adolescents: Isfahan Healthy Heart Program − Heart Health Promotion from Childhood

OBJECTIVE: To evaluate the prevalence of overweight and obesity among Iranian adolescents and their relationship with modifiable environmental factors. METHODS: The subjects of the present study were 1000 girls and 1000 boys, aged between 11 and 18 years selected by multistage random sampling, their parents (n = 2000) and their school staff (n = 500 subjects) in urban and rural areas of two provinces in Iran. Data concerning body mass index (BMI), nutrition and the physical activity of the subjects were analyzed by SPSSV10/Win software. RESULTS: The prevalence of 85th percentile 95th percentile in girls was significantly higher than boys (10.7 +/- 1.1 and 2.9 +/- 0.1%vs 7.4 +/- 0.9 and 1.9 +/- 0.1%, respectively; P < 0.05). The mean BMI value was significantly different between urban and rural areas (25.4 +/- 5.2 vs 23.2 +/- 7.1 kg/m2, respectively; P < 0.05). A BMI> 85th percentile was more prevalent in families with an average income than in high-income families (9.3 +/- 1.7 vs 7.2 +/- 1.4%, respectively; P < 0.05) and in those with lower-educated mothers (9.2 +/- 2.1 vs 11.5 +/- 2.4 years of mothers education, respectively). The mean total energy intake was not different between overweight or obese and normal-weight subjects (1825 +/- 90 vs 1815 +/- 85 kCal, respectively; P > 0.05), but the percentage of energy derived from carbo-hydrates was significantly higher in the former group compared with the latter (69.4 vs 63.2%, respectively; P < 0.05). Regular extracurricular sports activities were significantly lower and the time spent watching tele-vision was significantly higher in overweight or obese than non-obese subjects (time spent watching telelvision: 300 +/- 20 vs 240 +/- 30 min/day, P < 0.05). A significant linear association was shown between the frequency of consumption of rice, bread, pasta, fast foods and fat/salty snacks and BMI (beta = 0.05-0.06; P < 0.05). A significant correlation was shown between BMI percentiles and serum triglyceride, high-density lipoprotein-cholesterol and systolic blood pressure (Pearson's r = 0.38, -0.32 and 0.47, respectively). CONCLUSIONS: Enhanced efforts to prevent and control overweight from childhood is a critical national priority, even in developing countries. To be successful, social, cultural and economic influences should be considered.     

Dietary fat intake and lipid profiles of Iranian adolescents: Isfahan Healthy Heart Program--Heart Health Promotion from Childhood

OBJECTIVES: To assess the serum lipid profiles of Iranian adolescents and their correlation with dietary fat intake and to evaluate the knowledge, attitude, and practice (KAP) of students, parents, and school staff. METHODS: The subjects of this cross-sectional study were 2000 students (1000 girls and 1000 boys), ages 11-18 years, selected by multistage random sampling, and one of their parents (2000 subjects), as well as 500 school staff in urban and rural areas of two provinces in Iran (one for further interventions and the other for reference). The data were obtained by questionnaires, anthropometric measurements, 3-day food record form, and a 20-item food frequency questionnaire (FFQ). All serum lipids were determined in the same laboratory. RESULTS: Although the percentage of fat intake (21.2 +/- 0.4%) among the adolescents was within the recommended daily allowance (RDA < or = 30%), in most cases, the percentiles of serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglyceride (TG) were significantly higher and the percentiles of high-density lipoprotein cholesterol (HDL-C) were lower than standard values according to Lipid Research Clinics (LRC) data; for example, the mean TC values for girls in the 11- to 14- and 15- to 18-year age groups were significantly higher than LRC standard values (169 and 172 vs. 160 and 159 mg/dl, respectively, P < 0.05). This difference was also significant in boys (167 and 168 vs. 160 and 153 mg/dl, respectively) at the P < 0.05 level. A significant linear association was shown between adolescents' dyslipidemia and the frequency of intake of hydrogenated fat, fast foods, cheese puffs, and potato chips (P < 0.05). Although the protein intake was lower than the RDA (13.4 +/- 0.9% vs. 15%, P < 0.05), because of the highly prevalent consumption of fatty lamb meat, the frequency of red meat intake had a direct association with dyslipidemia (P < 0.05). CONCLUSION: The improper intake of high amounts of saturated fat and the observed serum lipid profile of Iranian adolescents are likely placing them at increased risk for cardiovascular disease (CVD) and necessitate developing guidelines and community-based interventions.     

Modifications in Class I and Class II Div. 1 malocclusion during orthodontic treatment and their association with TMD problems

ABSTRACT

Objective: To observe changes in tooth movements of patients with Class I and Class II malocclusion during the first 6 months of orthodontic treatment and to investigate the relation between TMJ problems and these changes.

Methods: The sample was comprised of 63 individuals (20 control, 25 Class I malocclusion, 18 Class II Div. 1 malocclusion). Occlusion analysis was performed through T-Scan® record and chewing pattern examination before and after the 6-month period. The existence of TMD was evaluated using joint vibration analysis (JVA). Patients with malocclusion had active fixed orthodontic treatment.

Results: Disclusion time reduced in the patients group during the treatment period. No association was observed between the first 6-month period of the orthodontic treatment and TMD.

Discussion: It is suggested that occlusion analyses should be done before any orthodontic treatment, and disclusion time should be minimized as much as possible.     

The Impact of Ethnicity on Awareness and Knowledge of and Attitudes Towards the Human Papillomavirus and Vaccine Among Adult Women

ObjectiveTo determine whether ethnicity affects awareness, knowledge, and attitudes regarding the human papillomavirus (HPV) and the HPV vaccine.MethodsEnglish speaking women (n = 172) aged 18 and older were recruited from an outpatient gynaecology clinic to complete a self-administered cross-sectional questionnaire that gathered information about (1) virus awareness and knowledge, (2) vaccine awareness and knowledge, (3) attitudes towards the vaccine and (4) participant demographics. Subjects received a virus knowledge score (0 to 6), a vaccine knowledge score (0 to 10) and an attitudes score (8 to 40), with a higher score indicating more positive attitudes towards the vaccine.ResultsVirus and vaccine awareness was significantly higher in Caucasian respondents than in non-Caucasian respondents: 93% versus 69% (P < 0.001) and 94% versus 64%, (P < 0.001), respectively. In a multivariate logistic regression model, the Caucasian ethnic group, higher education status, and greater number of years in Canada each emerged as independent predictors of vaccine awareness. Both virus and vaccine knowledge scores were significantly higher in Caucasian than non-Caucasian women: 4.6 versus 3.89 (P = 0.001) and 7.2 versus 6.4, (P = 0.042), respectively. Caucasian women had significantly higher (more positive) attitudes towards the vaccine than non-Caucasians (31.4 vs. 29.2, P = 0.021). Higher HPV vaccine knowledge was positively associated with an interest in vaccination (r² = 0.26, P < 0.01) and a more positive vaccine attitudes score (r² = 0.40, P < 0.001).ConclusionVirus and vaccine awareness were both higher in Caucasian women than in non-Caucasian women. Improving HPV vaccination knowledge has the potential to improve attitudes and vaccine uptake.