1.  Peer Reviewed Title: Oral contraceptives for functional ovarian cysts. Source: Obstetrics and Gynecology. 2009 Sep;114(3):679-80. Abstract: BACKGROUND:: Functional ovarian cysts are a common gynecological problem among women of reproductive age worldwide. When large, persistent, or painful, these cysts may require operations, sometimes resulting in removal of the ovary. Since early oral contraceptives were associated with a reduced incidence of functional ovarian cysts, many clinicians inferred that birth control pills could be used to treat cysts as well. This became a common clinical practice in the early 1970s. OBJECTIVES:: This review examined all randomized controlled trials that studied oral contraceptives as therapy for functional ovarian cysts. SEARCH STRATEGY:: We searched the databases of CENTRAL, MEDLINE, POPLINE, and EMBASE, as well as clinical trials databases (ClinicalTrials.gov and ICTRP). We also examined the reference lists of articles and wrote to authors of identified trials to seek articles we had missed. SELECTION CRITERIA:: We included randomized controlled trials in any language that included oral contraceptives used for treatment and not prevention of functional ovarian cysts. Criteria for diagnosis of cysts were those used by authors of trials. DATA COLLECTION AND ANALYSIS:: Two authors independently abstracted data from the articles. One entered the data into RevMan and a second verified accuracy of data entry. For dichotomous outcomes, we used Peto odds ratios with 95% confidence intervals (CIs). For continuous outcomes, we calculated mean differences with 95% CI. MAIN RESULTS:: We identified seven randomized controlled trials from four countries; the studies included a total of 500 women. Treatment with combined oral contraceptives did not hasten resolution of functional ovarian cysts in any trial. This held true for cysts that occurred spontaneously as well as those that developed after ovulation induction. Most cysts resolved without treatment within a few cycles; persistent cysts tended to be pathological (e.g., endometrioma or para-ovarian cyst) and not physiological. AUTHORS' CONCLUSION:: Although widely used for treating functional ovarian cysts, combined oral contraceptives appear to be of no benefit. Watchful waiting for two or three cycles is appropriate. Should cysts persist, surgical management is often indicated.Grimes DA, Jones LB, Lopez LM, Schulz KF. Oral contraceptives for functional ovarian cysts. Cochrane Database of Systematic Reviews 2006, Issue 4. Art. No.: CD006134. DOI: 10.1002/14651858.CD006134.pub2. Copyright the Cochrane Collaboration, reproduced with permission. Language: English Keywords: GLOBAL | RESEARCH REPORT | LITERATURE REVIEW | INCIDENCE | OVARIAN CYSTS | ORAL CONTRACEPTIVES | TREATMENT | EXAMINATIONS AND DIAGNOSES | Measurement | Research Methodology | Diseases | Contraceptive Methods | Contraception | Family Planning | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342569 |
2.  Title: Guidelines for prevention and treatment of opportunistic infections in HIV-infected adults and adolescents. Author: Centers for Disease Control and Prevention (CDC) Source: MMWR. Morbidity and Mortality Weekly Report. Recommendations and Reports. 2009 Apr 10;58(RR-4):[216] p.. Abstract: Major changes in the guidelines include 1) greater emphasis on the importance of antiretroviral therapy for the prevention and treatment of opportunistic infections (OIs), especially those OIs for which no specific therapy exists; 2) information regarding the diagnosis and management of immune reconstitution inflammatory syndromes; 3) information regarding the use of interferon-gamma release assays for the diagnosis of latent tuberculosis (TB) infection; 4) updated information about drug interactions that affect the use of rifamycin drugs for prevention and treatment of TB; 5) the addition of a section on hepatitis B virus infection; and 6) the addition of malaria to the list of OIs that might be acquired during international travel. Language: English Keywords: UNITED STATES OF AMERICA | SUMMARY REPORT | STANDARDS | MANUAL | ADULTS | ADOLESCENTS | PERSONS LIVING WITH HIV/AIDS | HIV INFECTIONS | HIV PREVENTION | TREATMENT | ANTIRETROVIRAL THERAPY | DRUG INTERACTIONS | EXAMINATIONS AND DIAGNOSES | Developed Countries | North America | Americas | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Youth | Viral Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV | Drugs Document Number: 339985 |
| 3. Peer Reviewed Title: Sensitivity of paediatric AIDS score vs. WHO case classification in Indian children--a retrospective study. Author: Banerjee T; Pensi T; Banerjee D Source: Journal of Tropical Pediatrics. 2009 Apr;55(2):91-6. Abstract: This study was conducted at the Department of Paediatrics, Dr Ram Manohar Lohia Hospital, to test the statistical significance of existing World Health Organization (WHO) clinical case definition (CCD) for diagnosis of AIDS in areas where diagnostic resources are limited. A total of 360 cases between 18 months and 12 years of age satisfying WHO case definitions of AIDS were included in study group. Our study detected 16.66% (60) of HIV incidence in children visiting the paediatrics outpatient clinic. Twenty percent of cases manifested three major and two minor signs, which had sensitivity of 73.33%; specificity, 90.66% and positive predictive value (PPV), 61.11%. Stepwise logistic analysis identified weight loss, chronic fever >1 month and total lymphocyte count <1500 cells mm(-3) as important predictors. Eighty-six cases (23.89%) showed two major and two minor signs with sensitivity and specificity of 86.66 and 88.66%, respectively. Thus a CCD based on 13 clinical signs/symptoms was proposed for paediatric AIDS with better sensitivity and PPV than the WHO case definition but with almost similar specificity. Language: English Keywords: INDIA | RESEARCH REPORT | RETROSPECTIVE STUDIES | CHILDREN | PERSONS LIVING WITH HIV/AIDS | HIV TESTING | AIDS | LABORATORY PROCEDURES | EXAMINATIONS AND DIAGNOSES | SIGNS AND SYMPTOMS | STANDARDS | Asia, Southern | Asia | Developing Countries | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Laboratory Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 331192 |
| 4. Title: Evaluation of commercial HIV test kits used in Nigeria. Author: Banwat EB; Peter JY; Egah DZ Source: Nigerian Journal of Clinical Practice. 2009 Mar;12(1):11-4. Abstract: BACKGROUND:Accurate and reliable diagnosis of HIV plays a central role in any effective HIV intervention. We decided to evaluate 4 commercial HIV test kits to determine their reliability for use in developing countries. METHODS: Serum samples obtained from clients accessing tertiary health services at the STI clinic, Jos University Teaching Hospital were used to evaluate Sdbioline, Diaspot, Determine and DIALAB Elisa kits. A Western blot was used as the reference kit. RESULTS: DETERMINE kit gave 34 positive and 58 negative reactions and the positive sera were all confirmed by Western blot while DIASPOT kit gave 27 false negative results, which was at variance with the reference kit result. Other kits were SDBIOLINE with 5 false positive and DIALAB Elisa kit, which gave one false positive, and one false negative result. CONCLUSION: We conclude that Determine, SDbioline and DIALAB Elisa kits are reliable for HIV antibody testing in Nigeria and other developing countries. Language: English Keywords: NIGERIA | EVALUATION REPORT | CLIENTS | PROSPECTIVE STUDIES | COMPARATIVE STUDIES | HIV TESTING | EQUIPMENT AND SUPPLIES | RELIABILITY | EXAMINATIONS AND DIAGNOSES | LABORATORY PROCEDURES | SCREENING | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Evaluation | Program Activities | Programs | Organization and Administration | Studies | Research Methodology | Laboratory Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement Document Number: 342689 |
| 5. Title: Integrating syndromic case management of sexually transmitted diseases into primary healthcare services in Nigeria. Author: Banwat EB; Egah DZ; Peter J; Barau C; Majang Y; Mafuyai S; Imade GE; Bukbuk DN Source: Nigerian Journal of Medicine. 2009 Apr-Jun;18(2):215-8. Abstract: BACKGROUND: Sexually transmitted diseases (STDs) are a huge public health problem; both the aetiological and clinical approaches to management have limitations. WHO has therefore developed an alternative strategy--the syndromic case management approach. This paper reports a training of healthcare providers at the Primary Health Centers aimed at integrating STD care into other services in the PHCs to improve management at the community level. METHODS: Sixteen nurses, from eight PHCs were trained on this new strategy. The training included: identification of STDs, use of flow charts, patient education and counseling, clinic management issues and record keeping and reporting. RESULTS: Over a period of eight weeks post training, about 731 clients were attended to, 451 (61.7%) had signs and symptoms of various STDs (genital discharge, genital ulcer, genital warts and lower abdominal pains). They were treated using the syndromic case approach. About 18.6% (84/451) were males and 81.4% (367/451) were Females. Singles (never married) constituted 32.8% (148/451) while 28.6% were married. About 26.6% and 12.0% were divorced and separated respectively. Age group 20-35 years was at highest risk of infection CONCLUSION: Syndromic case management of STDs can be conveniently integrated into the primary health care delivery system in Nigeria. Language: English Keywords: NIGERIA | RESEARCH REPORT | CLINICAL RESEARCH | NURSES AND NURSING | SEXUALLY TRANSMITTED DISEASES | SIGNS AND SYMPTOMS | TREATMENT | PRIMARY HEALTH CARE | INTEGRATED PROGRAMS | TRAINING ACTIVITIES | EXAMINATIONS AND DIAGNOSES | COUNSELING | PRE-POST TESTS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Health Personnel | Delivery of Health Care | Health | Reproductive Tract Infections | Infections | Diseases | Medical Procedures | Medicine | Health Services | Programs | Organization and Administration | Training Programs | Education | Clinic Activities | Program Activities | Program Evaluation Document Number: 342684 |
| 6. Title: Worldwide: Incentives for tuberculosis diagnosis and treatment. Author: Beith A; Eichler R; Weil D Source: In: Performance incentives for global health: potential and pitfalls [by] Rena Eichler, Ruth Levine and the Performance-Based Incentives Working Group. Washington, D.C., Center for Global Development, 2009. :237-56. Abstract: Many tuberculosis programs incorporate material (food) and financial performance-based incentives for patients, providers, or both. Findings from a combination of rigorous evaluations and data from routine program monitoring suggest that performance incentives can improve both case detection and treatment adherence. Performance incentives applied to tuberculosis contain lessons for treatment of other extended-duration and chronic conditions. Language: English Keywords: GLOBAL | RESEARCH REPORT | CLIENTS | TUBERCULOSIS | INCENTIVES | EXAMINATIONS AND DIAGNOSES | TREATMENT | DIRECTLY OBSERVED THERAPY SHORT-COURSE (DOTS) | EVALUATION | FOOD AND BEVERAGE | PROGRAM EVALUATION | Program Activities | Programs | Organization and Administration | Infections | Diseases | Policy | Political Factors | Sociocultural Factors | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Nutrition Document Number: 331459 |
| 7. Title: Approach in sexually transmitted diseases. Author: Belda Junior W; Shiratsu R; Pinto V Source: Anais Brasileiros de Dermatologia. 2009 Mar-Apr;84(2):151-9. Abstract: Nowadays, sexually transmitted diseases are one of the most common public health issues. Among its consequences are the possibility of transmission from mother to baby - which may cause miscarriages and congenital disease, male and female infertility, and the increase of HIV infection risk. Therefore, the main goal of these guidelines is to contribute to the improvement of the treatment for sexually transmitted diseases patients by presenting to the medical community how today's science stands on the matter and also what the recommendation for diagnosing and treating a patient are. Language: EnglishPortuguese Keywords: BRAZIL | RECOMMENDATIONS | SEXUALLY TRANSMITTED DISEASES | EXAMINATIONS AND DIAGNOSES | SIGNS AND SYMPTOMS | TREATMENT | CHANCROID | GONORRHEA | South America, Eastern | South America | Latin America | Americas | Developing Countries | Reproductive Tract Infections | Infections | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342656 |
| 8. Title: Causes of death in HIV-infected persons who have tuberculosis, Thailand. Author: Cain KP; Anekthananon T; Burapat C; Akksilp S; Mankhatitham W; Srinak C; Nateniyom S; Sattayawuthipong W; Tasaneeyapan T; Varma JK Source: Emerging Infectious Diseases. 2009 Feb;15(2):258-64. Abstract: Up to 50% of persons with HIV and a diagnosis of tuberculosis (TB) in Thailand die during TB treatment. In a prospective observational study, a team of physicians ascribed the cause of death after reviewing verbal autopsies (interviews of family members about events preceding death), laboratory data, and medical records. Of 849 HIV-infected TB patients enrolled, 142 (17%) died. The cause of death was TB for 38 (27%), including 6 with multidrug-resistant TB and 20 with disseminated TB; an HIV-associated condition other than TB for 50 (35%); and a condition unrelated to TB or HIV for 22 (15%). Twenty-three patients (16%) were judged not to have had TB at all. Death from all causes except those unrelated to TB or HIV was less common in persons receiving antiretroviral therapy (ART). In addition to increasing the use of ART, death rates may be reduced through expanded use of modern TB diagnostic techniques. Language: English Keywords: THAILAND | RESEARCH REPORT | PROSPECTIVE STUDIES | PERSONS LIVING WITH HIV/AIDS | TUBERCULOSIS | CAUSES OF DEATH | AUTOPSY | ANTIRETROVIRAL THERAPY | DRUGS | PNEUMONIA | EXAMINATIONS AND DIAGNOSES | Developing Countries | Asia, Southeastern | Asia | Studies | Research Methodology | HIV Infections | Viral Diseases | Diseases | Infections | Mortality | Population Dynamics | Demographic Factors | Population | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV | Treatment | Pulmonary Effects | Physiology | Biology Document Number: 341840 |
| 9. Title: Early diagnosis, follow-up, and prenatal treatment of a case of TRAP sequence occurring in a dichorionic triamniotic triplet pregnancy. Author: Cavoretto P; Serafini A; Valsecchi L; Lanna M; Rustico MA Source: Journal of Clinical Ultrasound. 2009 Jul-Aug;37(6):350-3. Abstract: We are reporting a case of twin reversed arterial perfusion (TRAP) sequence occurring in a dichorionic triamniotic triplet pregnancy with successful percutaneous prenatal treatment and excellent neonatal outcome. TRAP sequence was diagnosed at 11 weeks in a spontaneous dichorionic-triamniotic triplet. Sonographic assessment showed persistent arterial flow and development of hydrops in the acardiac twin. Percutaneous cord interstitial laser coagulation was performed, and the co-twin subsequently developed growth restriction. The 9-month-old twins have a normal developmental course. This report confirms that fetal intervention is indicated in cases of TRAP sequence in which the acardiac twin presents a significant enlargement on follow-up sonographic examinations. Language: English Keywords: ITALY | SUMMARY REPORT | CASE HISTORIES | PREGNANT WOMEN | FETUS | MULTIPLE BIRTH | FETAL MEMBRANES | VASCULAR DISEASES | GROWTH | EXAMINATIONS AND DIAGNOSES | ULTRASONICS | AMNIOCENTESIS | PREGNANCY OUTCOMES | Developed Countries | Europe, Southern | Europe | Data Collection | Research Methodology | Population Characteristics | Demographic Factors | Population | Pregnancy | Reproduction | Diseases | Child Development | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Genetic Techniques | Laboratory Examinations and Diagnoses Document Number: 342793 |
| 10. Peer Reviewed Title: Validation of community health workers' assessment of neonatal illness in rural Bangladesh. Author: Darmstadt GL; Baqui AH; Choi Y; Bari S; Rahman SM; Mannan I; Ahmed AS; Saha SK; Rahman R; Chang S; Winch PJ; Black RE; Santosham M; El Arifeen S Author: Bangladesh Projahnmo-2 (Mirzapur) Study Group Source: Bulletin of the World Health Organization. 2009 Jan;87(1):12-9. Abstract: OBJECTIVE: To estimate the validity (sensitivity, specificity, and positive and negative predictive values) of a clinical algorithm as used by community health workers (CHWs) to detect and classify neonatal illness during routine household visits in rural Bangladesh. METHODS: CHWs evaluated breastfeeding and symptoms and signs of illness in 395 neonates selected randomly from neonatal illness surveillance during household visits on postnatal days 0, 2, 5 and 8. Neonates classified with very severe disease (VSD) were referred to a community-based hospital. Within 12 hours of CHW assessments, physicians independently evaluated all neonates seen in a given day by one CHW, randomly chosen from among 36 project CHWs. Physicians recorded symptoms and signs of illness, classified the illness, and determined whether the newborn needed referral-level care at the hospital. Physicians' identification and classification were used as the gold standard in determining the validity of CHWs' identification of symptoms and signs of illness and its classification. FINDINGS: CHWs' classification of VSD showed a sensitivity of 73%, a specificity of 98%, a positive predictive value of 57% and a negative predictive value of 99%. A maternal report of any feeding problem as ascertained by physician questioning was significantly associated (P < 0.001) with 'not sucking at all' and 'not attached at all' or 'not well attached' as determined clinically by CHWs during feeding assessment. CONCLUSION: CHWs identified with high validity the neonates with severe illness needing referral-level care. Home-based illness recognition and management, including referral of neonates with severe illness by CHWs, is a promising strategy for improving neonatal health and survival in low-resource developing country settings. Language: English Keywords: BANGLADESH | RESEARCH REPORT | VALIDITY | RURAL POPULATION | HEALTH PERSONNEL | NEONATAL DISEASES AND ABNORMALITIES | HOME CARE | PERFORMANCE IMPROVEMENT | CHILD SURVIVAL | CHILD HEALTH | EXAMINATIONS AND DIAGNOSES | Developing Countries | Asia, Southern | Asia | Measurement | Research Methodology | Population Characteristics | Demographic Factors | Population | Delivery of Health Care | Health | Diseases | Care and Support | Health Services | Management | Organization and Administration | Survivorship | Length of Life | Mortality | Population Dynamics | Medical Procedures | Medicine Document Number: 341189 |
| 11. Title: Radiology services for children in HIV- and TB-endemic regions: scope for greater collaboration between radiologists and clinicians caring for children. Author: Dramowski A; Morsheimer MM; Frigati L; Schaaf HS; Rabie H; Sorour G; Cotton MF Source: Pediatric Radiology. 2009 Jun;39(6):541-4. Abstract: There is limited literature documenting the interaction between radiologists and clinicians caring for children, especially in regions where HIV and tuberculosis (TB) are endemic. The dual burden of these diseases in resource-limited settings creates unique challenges for radiographic interpretation and utilization. This review aims to heighten awareness of issues confronting radiologists and clinicians caring for children and to encourage greater collaboration between these two disciplines in HIV- and TB-endemic regions. The Child-Friendly Healthcare Initiative is discussed, emphasizing opportunities to promote child friendliness in radiology services. Language: English Keywords: GLOBAL | CRITIQUE | PHYSICIANS | HIV INFECTIONS | TUBERCULOSIS | CHILD HEALTH SERVICES | EXAMINATIONS AND DIAGNOSES | INTERPERSONAL COMMUNICATION | TECHNOLOGY | PRIVACY | STANDARDS | Health Personnel | Delivery of Health Care | Health | Viral Diseases | Diseases | Infections | Maternal-Child Health Services | Primary Health Care | Health Services | Medical Procedures | Medicine | Communication | Economic Factors | Behavior | Research Methodology Document Number: 342187 |
| 12. Title: Is the process of diagnosing and treating incidental medical findings a barrier to contraceptive acceptance and use? Author: Ekabua JE; Ekabua KJ; Ekanem EI; Iklaki CU Source: Journal of Obstetrics and Gynaecology. 2009 Apr;29(3):237-9. Abstract: The objective of this study is to determine the impact of diagnosing and treating incidental medical disorders on contraceptive acceptance/use. The setting was the University of Calabar Teaching Hospital, a tertiary referral centre for the South-South zone of Nigeria and South-west Cameroon. Subjects were apparently healthy women seeking contraceptive counselling at the Teaching Hospital, Calabar (2001-2005). A total of 4,990 women's records were studied for the diagnosis of incidental medical findings. Two levels of missed opportunity for contraceptive uptake were identified. Incidental medical findings were seen in 26.9% of women. Contraceptive acceptance in women with incidental medical findings was 24.8%. Defaults from the screening process and treatment of incidental medical findings were significantly associated with high parity and low social status (p < 0.5). Incidental medical disorders, although uncommon in women desiring contraception were associated with low contraceptive uptake in women with high parity and low social status. Language: English Keywords: NIGERIA | CAMEROON | RESEARCH REPORT | KAP SURVEYS | CLINICAL RESEARCH | WOMEN IN DEVELOPMENT | EXAMINATIONS AND DIAGNOSES | SCREENING | PSYCHOSOCIAL FACTORS | CONTRACEPTIVE USAGE | MULTIPARITY | SOCIAL CLASS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Behavior | Contraception | Family Planning | Parity | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population | Socioeconomic Status | Socioeconomic Factors Document Number: 330945 |
| 13. Title: Migraine: a question and answer review. Author: Evans RW Source: Medical Clinics of North America. 2009 Mar;93(2):245-62, vii. Abstract: Internists commonly treat migraine, which affects more than 29 million Americans yearly. This article reviews epidemiology, pathophysiology, comorbidity, clinical features, diagnostic testing, acute and preventive treatment, and women's issues. Physicians and migraineurs would like to see more effective and more tolerable medications. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | CLASSIFICATION | CELEBRITIES | PREVALENCE | MIGRAINE | SEX FACTORS | AGE FACTORS | GENETICS | COMPLICATIONS | EXAMINATIONS AND DIAGNOSES | SIGNS AND SYMPTOMS | HEADACHE | Developed Countries | North America | Americas | Research Methodology | Influentials | Knowledge Sources | Communication | Measurement | Vascular Diseases | Diseases | Population Characteristics | Demographic Factors | Population | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 341118 |
| 14. Title: Neurological disorders in HIV-infected children in India. Author: Gupta S; Shah DM; Shah I Source: Annals of Tropical Paediatrics. 2009 Sep;29(3):177-81. Abstract: There are few studies of HIV-related neurological disorders from centres in low-income countries where facilities are available for detailed investigation. METHODS: Records of all patients attending the paediatric HIV outpatient department at B. J. Wadia Hospital for Children, Mumbai between April 2000 and March 2008 were reviewed. Of 668 HIV-infected patients, 48 (7.2%) had neurological manifestations and are included in this study. RESULTS: Twenty-six (54.2%) children had HIV encephalopathy. Other causes of neurological manifestations include febrile convulsion in five (10.4%), bacterial meningitis in three (6.3%), epilepsy in two (4.2%), tuberculous meningitis and progressive multi-focal encephalopathy in two (4.2%) each and toxoplasmosis, vasculitis, acute demyelinating encephalomyelitis, anti-phospholipid antibody syndrome, Down's syndrome, birth asphyxia, herpes simplex encephalopathy and mitochondrial encephalopathy in one (2.1%) each. Mean (SD) age at presentation was 4.36 (3.38) years with a range of 2 months to 15 years. The common subtle neurological manifestations were abnormal deep tendon reflexes and extensor plantar reflexes. The common symptomatic manifestations were delayed milestones in 21 children (43.8%) and seizures in 19 (39.6%). Seizures were more common in males (54%) than in females (25%) (p=0.038). In children <5 years, delayed milestones was the most common manifestation while focal neurological deficits were more common in older children. Of the 13 children who received HAART, nine (60.23%) improved. CONCLUSION: Early diagnosis of neurological disorders in HIV-infected children is important for appropriate investigation and management, especially the introduction of HAART. Language: English Keywords: INDIA | RESEARCH REPORT | RECORDS | CHILDREN | PERSONS LIVING WITH HIV/AIDS | HIV INFECTIONS | NEUROLOGIC EFFECTS | MENINGITIS | TUBERCULOSIS | SIGNS AND SYMPTOMS | EXAMINATIONS AND DIAGNOSES | TREATMENT | MANAGEMENT | ANTIRETROVIRAL THERAPY | Asia, Southern | Asia | Developing Countries | Information Processing | Information | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Physiology | Biology | Central Nervous System Effects | Central Nervous System | Infections | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Organization and Administration | HIV Document Number: 342530 |
| 15. Title: Challenges in providing HIV care to paediatric age group in India. Author: Haldar P; S Reddy DC Source: Indian Journal of Medical Research. 2009 Jan;129(1):7-10. Abstract: To ensure comprehensive paediatric HIV care in India, in addition to expansion of the availability of skilled paediatricians and laboratory infrastructure for diagnosis at specialist centres, the capacity building of health care workers at primary and secondary levels should be a priority. This would immensely improve access to treatment, care and co-trimoxazole (CTX) prophylaxis for children living with HIV/AIDS (CLHA) in India. Appropriate guidelines for management and referral at different levels need to be developed and distributed. An integrated approach with the ongoing scale up of Prevention of Parent to Child Transmission (PPTCT) in India would also be important to impart effective primary prevention for children since more than 95 per cent of children acquire HIV infection from mother by perinatal transmission. (excerpt) Language: English Keywords: INDIA | SUMMARY REPORT | DATA COLLECTION | CHILDREN | PERSONS LIVING WITH HIV/AIDS | PRIMARY HEALTH CARE | CHILD HEALTH | EXAMINATIONS AND DIAGNOSES | TREATMENT | HIV INFECTIONS | AGE FACTORS | Asia, Southern | Asia | Developing Countries | Research Methodology | Youth | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Health Services | Delivery of Health Care | Health | Medical Procedures | Medicine Document Number: 341546 |
| 16. Title: Disappearance of female genital mutilation from the Bedouin population of Southern Israel. Author: Halila S; Belmaker RH; Abu Rabia Y; Froimovici M; Applebaum J Source: Journal of Sexual Medicine. 2009 Jan;6(1):70-3. Abstract: INTRODUCTION: Recently, clinicians in Southern Israel perceived that the practice of female genital mutilation had disappeared entirely in the Bedouin population. We previously studied the prevalence of this practice in 1995. AIM: We decided to survey again the Bedouin population focusing on those tribes previously reported to perform this practice. METHODS: Eighty percent of the interviews were done by an Arabic-speaking psychiatrist and 20% were done by an Arabic speaking nurse in the gynecologic clinic of a large Bedouin township or the gynecologic clinic of a smaller Bedouin township. Women were asked if they would be willing to answer a few questions about their past and if they were willing to have the gynecologist, with no additional procedure, note whether any operation had been performed on their genitalia. MAIN OUTCOME MEASURES: Physical examination by gynecologist and an oral questionnaire. RESULTS: One hundred and thirty two women were examined. No cases of any scarring of the kind reported in the previous study were found on physical examination. CONCLUSIONS: FGM has apparently disappeared over 15 years in a population in which it was once prevalent. Language: English Keywords: ISRAEL | RESEARCH REPORT | INTERVIEWS | WOMEN | INDIGENOUS POPULATION | FEMALE GENITAL CUTTING | EXAMINATIONS AND DIAGNOSES | Developed Countries | Middle East | Data Collection | Research Methodology | Demographic Factors | Population | Population Characteristics | Harmful Traditional Practices | Traditional Health Practices | Culture | Sociocultural Factors | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342101 |
| 17. Title: Maternal mortality due to cardiac disease in Sri Lanka. Author: Haththotuwa HR; Attygalle D; Jayatilleka AC; Karunaratna V; Thorne SA Source: International Journal of Gynaecology and Obstetrics. 2009 Mar;104(3):194-8. Abstract: OBJECTIVE: To investigate Sri Lankan maternal deaths due to heart disease and to consider low-cost interventions to reduce these deaths. METHODS: A qualitative study based on retrospective audit of all maternal deaths and late maternal deaths in Sri Lanka caused by cardiac disease in 2004. RESULTS: A total of 145 maternal deaths were recorded in 2004, for a maternal mortality rate of 38 per 100,000. There were 42 indirect deaths, 25 of which were due to cardiac disease; 23 deaths had a specific cardiac cause listed. Standard care was identified in prepregnancy counseling, contraception, and prenatal community and specialist care. CONCLUSION: Cardiac disease is a major cause of maternal mortality in Sri Lanka, second only to postpartum hemorrhage. Rheumatic mitral valve disease is responsible for more than a third of maternal deaths from cardiac disease. Substandard care was identified in all cases; strategies to improve care could allow a reduction in maternal cardiac deaths. Language: English Keywords: SRI LANKA | RESEARCH REPORT | RETROSPECTIVE STUDIES | PREGNANT WOMEN | MATERNAL MORTALITY | HEART DISEASES | QUALITY OF HEALTH CARE | EXAMINATIONS AND DIAGNOSES | CAUSES OF DEATH | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Mortality | Population Dynamics | Diseases | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 341384 |
| 18. Peer Reviewed Title: What is the fate of the missing intrauterine contraceptive device? Author: Ibitoye BO; Aremu AA; Onuwaje MA; Ayoola OO Source: Tropical Doctor. 2009 Oct;39(4):221-3. Abstract: An intrauterine contraceptive device (IUCD) is one of the most common forms of contraception in use worldwide today. It is associated with a myriad of problems and complications, one of which is the missing IUCD. It is a known fact that IUCDs can perforate the uterus resulting in its subsequent relocation in other organs within the pelvis and the abdomen. This study showed that more than 50% of clinically diagnosed cases of a missing IUCD are still located within the endometrial cavity. It is therefore being proposed that a clinical diagnosis of 'missing string' be made until adequate radiological investigations, such as ultrasonography, plain X-rays and computerized tomography, have been carried out. Language: English Keywords: GLOBAL | NIGERIA | RESEARCH REPORT | INCIDENCE | WOMEN | IUD | IUD COMPLICATIONS | IUD MIGRATION | EXAMINATIONS AND DIAGNOSES | ULTRASONICS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Measurement | Research Methodology | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342764 |
| 19. Peer Reviewed Title: Performance of clinical algorithms for HIV-1 diagnosis and antiretroviral initiation among HIV-1-exposed children aged less than 18 months in Kenya. Author: Inwani I; Mbori-Ngacha D; Nduati R; Obimbo E; Wamalwa D; John-Stewart G; Farquhar C Source: Journal of Acquired Immune Deficiency Syndromes. 2009 Apr 15;50(5):492-8. Abstract: BACKGROUND: Ninety percent of HIV-1-infected children live in sub-Saharan Africa. In the absence of diagnosis and antiretroviral therapy, approximately 50% die before 2 years. METHODS: We evaluated sensitivity and specificity of clinical algorithms for diagnosis of HIV-1 infection and antiretroviral therapy initiation among HIV-1-exposed children aged less than 18 months. Children were identified with routine HIV-1 testing and assessed using 3 sets of criteria: (1) Integrated Management of Childhood Illnesses (IMCI), (2) World Health Organization Presumptive Diagnosis (WHO-PD) for HIV-1 infection, and (3) CD4 T-lymphocyte cell subsets. HIV-1 infection status was determined using DNA polymerase chain reaction testing. FINDINGS: A total of 1418 children (median age 5.4 months) were screened for HIV-1 antibodies, of whom 144 (10.2%) were seropositive. Of these, 134 (93%) underwent HIV-1 DNA testing and 80 (60%) were found to be HIV-1 infected. Compared with HIV-1 DNA testing, sensitivity and specificity of the IMCI criteria were 19% and 96% and for WHO-PD criteria 43% and 88%, respectively. Inclusion of severe immune deficiency determined by CD4% improved sensitivity of IMCI and WHO-PD criteria to 74% and 84%, respectively; however, specificity declined to 43% and 41%, respectively. INTERPRETATION: Diagnosis of HIV-1 infection among exposed children less than 18 months in a high-prevalence resource-limited setting remains a challenge, and current recommended algorithms have low sensitivity. This underscores the need for rapid scale-up of viral assays for early infant diagnosis. Language: English Keywords: KENYA | RESEARCH REPORT | CLINICAL RESEARCH | INFANT | HIV | EXAMINATIONS AND DIAGNOSES | EXPOSURE | LABORATORY PROCEDURES | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Risk Factors | Laboratory Examinations and Diagnoses Document Number: 331222 |
| 20. Peer Reviewed Title: Challenges in managing postpartum hemorrhage in resource-poor countries. Author: Karoshi M; Keith L Source: Clinical Obstetrics and Gynecology. 2009 Jun;52(2):285-98. Abstract: Managing postpartum hemorrhage depends in part on having a prepared mind, a complement of trained coworkers, and full access to modern therapies. The last 2 components are rare in resource-poor areas and their absence may be accentuated by climatic instability and lack of basic transportation. Greater use of the active management of third stage of labor and administration of misoprostol by nontrained birth attendants will provide beneficial reductions in hemorrhage rates in resource-poor areas. Additional improvements depend on increasing public awareness, facilitating existing nongovernmental organizations in their community-related, upgrading training of traditional birth attendants, and providing cell phone communication to workers in remote areas, in addition to providing better access to blood. Language: English Keywords: DEVELOPING COUNTRIES | RESEARCH REPORT | TRADITIONAL BIRTH ATTENDANTS | POSTPARTUM WOMEN | BLEEDING | EXAMINATIONS AND DIAGNOSES | TREATMENT | MANAGEMENT | Health Personnel | Delivery of Health Care | Health | Puerperium | Reproduction | Signs and Symptoms | Diseases | Medical Procedures | Medicine | Health Services | Organization and Administration Document Number: 342241 |
| 21. Title: Use of the internet by patients attending specialist clinics in Sri Lanka: a cross sectional study. Author: Kommalage M Source: BMC Medical Informatics and Decision Making. 2009;9:12. Abstract: BACKGROUND: The internet is a relatively new medium of disseminating health information. Studies on Internet usage for health information are mainly done in developed countries and very few studies have been carried out in developing countries. METHODS: The Internet usage of patients who were attending specialist clinics in Teaching Hospital Karapitiya and Southern Hospital in Galle, Sri Lanka was investigated. The study was carried out on the following specialities; General Medicine, Pediatrics, General Surgery and Cardiothoracic surgery. Information was collected using an investigator-administered questionnaire while patients were waiting for a consultation. RESULTS: Three hundred and fifty five patients (or guardians in the Pediatric clinic) participated in the study. One hundred seventy two (48.3%) participants have heard about the Internet. There was a relationship between awareness of the Internet and age, educational level and the clinic attended. There was no difference of awareness depending on the gender or the hospital. Only three participants (0.97%) have used the Internet to find information about their disease conditions. Close relatives searched the Internet about the conditions of two participants. Altogether, the Internet was used to search information on the disease condition of five participants (1.4%). CONCLUSION: Very low usage of the Internet for health information retrieval in this study is probably due to low awareness of the Internet and low educational level. This low usage of Internet and the associated reasons shown in this study can be generalized to Sri Lanka and probably to other low-income countries that have lower educational level than Sri Lanka. Language: English Keywords: SRI LANKA | RESEARCH REPORT | KAP SURVEYS | CROSS SECTIONAL ANALYSIS | TARGET POPULATION | INTERNET | INFORMATION SOURCES | AGE FACTORS | EDUCATIONAL STATUS | CLINIC ACTIVITIES | EXAMINATIONS AND DIAGNOSES | HEALTH EDUCATION | Developing Countries | Asia, Southern | Asia | Surveys | Sampling Studies | Studies | Research Methodology | Program Design | Programs | Organization and Administration | Information Networks | Communication | Information | Population Characteristics | Demographic Factors | Population | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Program Activities | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Education Document Number: 331071 |
| 22. Peer Reviewed Title: The effect of interrupted 5-day training on Integrated Management of Neonatal and Childhood Illness on the knowledge and skills of primary health care workers. Author: Kumar D; Aggarwal AK; Kumar R Source: Health Policy and Planning. 2009 Mar;24(2):94-100. Abstract: The conventional 8-day Integrated Management of Neonatal and Childhood Illness (IMNCI) training package poses several operational constraints, particularly due to its long duration. A 5-day training package was developed and administered in an interrupted mode of 3 days and 2 days duration with a break of 4 days in-between, in a district of Haryana state in northern India. Improvement in the knowledge and skills of 50 primary health care workers following the interrupted 5-day training was compared with that of 35 primary health care workers after the conventional 8-day IMNCI training package. The average score increased significantly (P < 0.05) from 46.3 to 74.6 in 8-day training and from 40.0 to 73.2 in 5-day training. Knowledge score improved for all health conditions, like anaemia, diarrhoea, immunization, malnutrition, malaria, meningitis and possible severe bacterial infection, and for breastfeeding in 8-day as well as in 5-day training. Average skills score for respiratory problems increased from 38 to 57 in 8-day training and from 41 to 91 in 5-day training. Corresponding increases in skill scores for diarrhoea assessment were from 28 to 67 and 48 to 75, and for breastfeeding assessment from 33 to 84 and 42 to 86 in 8-day and 5-day training, respectively. Average counselling skill score also rose from 42 to 89 in 8-day and from 37 to 70 in 5-day training. A direct cost saving of US$813 for a batch of 25 trainees and an indirect cost saving of 3 days per trainee and resource person makes the interrupted 5-day IMNCI training more cost-effective. Language: English Keywords: INDIA | RESEARCH REPORT | KAP SURVEYS | COMPARATIVE STUDIES | COST BENEFIT ANALYSIS | HEALTH PERSONNEL | TRAINING PROGRAMS | NEONATAL DISEASES AND ABNORMALITIES | CHILD HEALTH | INTEGRATED PROGRAMS | TIME FACTORS | PRIMARY HEALTH CARE | KNOWLEDGE | EXAMINATIONS AND DIAGNOSES | COST EFFECTIVENESS | Asia, Southern | Asia | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Quantitative Evaluation | Evaluation | Delivery of Health Care | Health | Education | Diseases | Programs | Organization and Administration | Population Dynamics | Demographic Factors | Population | Health Services | Sociocultural Factors | Medical Procedures | Medicine | Evaluation Indexes Document Number: 331230 |
| 23. Title: Acute myocardial infarction in two young women without significant risk factors. Author: Lawal L; Lange R; Schulman S Source: Journal of Invasive Cardiology. 2009 Jan;21(1):E3-5. Abstract: Spontaneous coronary artery dissection is an uncommon cause of acute coronary syndrome in young healthy females, with pregnancy and the use of oral contraceptive pills as recognized predisposing factors. We present two cases of acute myocardial infarction in two young females without significant risk factors and review the literature on spontaneous coronary artery dissection including diagnosis and treatment options. Language: English Keywords: UNITED STATES OF AMERICA | MARYLAND | SUMMARY REPORT | CASE HISTORIES | WOMEN | MYOCARDIAL INFARCTION | CARDIOVASCULAR EFFECTS | EXAMINATIONS AND DIAGNOSES | TREATMENT | ORAL CONTRACEPTIVES | TOBACCO USE | Developed Countries | North America | Americas | Data Collection | Research Methodology | Demographic Factors | Population | Heart Diseases | Diseases | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Methods | Contraception | Family Planning | Behavior Document Number: 341133 |
| 24. Title: [Late diagnosis of HIV infection in the Fann, Dakar clinic of infectious diseases: testing circumstances, therapeutic course of patients, and determining factors] Depistage tardif de l'infection a VIH a la clinique des maladies infectieuses de Author: Manga NM; Diop SA; Ndour CT; Dia NM; Mendy A; Coudec M; Taverne B; Diop BM; Sow PS Source: Medecine Et Maladies Infectieuses. 2009 Feb;39(2):95-100. Abstract: BACKGROUND AND METHODOLOGY: The delay in the diagnosis of HIV infection is a major obstacle to optimal care for this disease. To deal with this problem, we conducted this study among newly diagnosed HIV patients hospitalized in the Fann University Hospital Infectious Diseases Clinic in Dakar. The epidemiological, clinical, biological and outcome aspects are described and patient history reviewed. A qualitative socio-anthropological study was made to understand and describe the logic of the decision processes in the patient's search for treatment. RESULTS: One hundred patients were included, with a mean age of 39.5+/-11.1 years and a sex-ratio: 1.08. The transmission was mainly heterosexual (90%), and chronic diarrhea (64%) and/or chronic cough (66%) were the principal symptoms leading to diagnosis. The mean delay before diagnosis was 5+/-4.27 months. The major opportunistic diseases were tuberculosis (44 cases) and infectious diarrhea (23 cases). Most patients were diagnosed at the AIDS stage (97%) and the death rate was 30% among hospitalized patients after admission. Sixty-eight percent of patients had consulted at least three times, generally a "traditional practitioner", at first and 43% had been hospitalized at least once. The qualitative investigation revealed that the "representation" or the "feeling of severity" of the disease were the principal justifications for consulting the "traditional practitioner" or the physician, respectively. CONCLUSION: Better information for health workers and global population is necessary for an earlier diagnosis of HIV infection in Dakar. Language: French Keywords: INDIA | RESEARCH REPORT | EPIDEMIOLOGY | CLIENTS | HIV TESTING | EXAMINATIONS AND DIAGNOSES | SIGNS AND SYMPTOMS | INFORMATION | NEEDS ASSESSMENT | Asia, Southern | Asia | Developing Countries | Public Health | Health | Program Activities | Programs | Organization and Administration | Laboratory Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Diseases | Evaluation Document Number: 331200 |
| 25. Title: HAART and risk of tuberculosis in HIV-infected South African children: a multi-site retrospective cohort. Author: Martinson NA; Moultrie H; van Niekerk R; Barry G; Coovadia A; Cotton M; Violari A; Gray GE; Chaisson RE; McIntyre JA; Meyers T Source: International Journal of Tuberculosis and Lung Disease. 2009 Jul;13(7):862-7. Abstract: SETTING: Four human immunodeficiency virus (HIV) clinics located at South African tertiary hospitals. OBJECTIVE: To assess the effectiveness of highly active antiretroviral therapy (HAART) in reducing incident tuberculosis (TB) in HIV-infected children. DESIGN: Retrospective cohort. RESULTS: A total of 1132 children's records were included in the study. At entry to the cohort, the median (interquartile range [IQR]) age, CD4%, CD4 count and viral load of all children was respectively 6.3 years (4.1-8.8), 15% (9.0-22.2), 576 cells/mm(3) (287-960) and 160 000 copies/ml (54 941.5-449 683); 75.9% were started on HAART. The male:female ratio was 1:1, and median follow-up time was 1.7 years. In children whose follow-up included both pre-HAART and on-HAART periods, the incidence of clinically diagnosed TB was respectively 21.1 per 100 person-years (py; 95%CI 18.2-24.4) and 6.4/100 py (95%CI 4.8-8.1), and when restricted to confirmed cases, respectively 3.1/100 py (95%CI 2.2-4.2) and 0.8/100 py (95%CI 0.5-1.4). Only 23% of all cases of TB were microbiologically confirmed. Multivariate analyses showed that HAART reduced incident TB by approximately 70%, both for confirmed and all TB cases. CONCLUSIONS: In this high TB burden country, the incidence of diagnosis of TB in HIV-infected children is at least as high as that of adults. HAART reduces incident TB, but further prospective TB preventive and diagnostic studies are urgently needed in children. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | RETROSPECTIVE STUDIES | CHILDREN | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | TUBERCULOSIS | RISK FACTORS | INCIDENCE | EXAMINATIONS AND DIAGNOSES | IMMUNOLOGICAL EFFECTS | TIME FACTORS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | HIV | Infections | Health | Measurement | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Immunity | Immune System | Physiology | Biology | Population Dynamics Document Number: 342821 |
| 26. Peer Reviewed Title: Coexistent lithopedion and live abdominal ectopic pregnancy. Author: Massinde AN; Rumanyika R; Im HB Source: Obstetrics and Gynecology. 2009 Aug;114(2 Pt 2):458-60. Abstract: BACKGROUND:: Abdominal pregnancy is a rare, life-threatening variant of ectopic pregnancy, and thus its diagnosis and management remain controversial. CASE:: A multigravida was admitted for complaints of abdominal swelling that had been occurring for 2 years and symptoms of pregnancy in the 3 months before admission. Radiologic studies revealed a live intraabdominal pregnancy at 15 weeks of gestation with a concurrent lithopedion of advanced gestation. The patient underwent laparotomy, removing both fetuses; the placenta was left in situ. She was discharged 1 week later in good condition. CONCLUSION:: The case of a concurrent lithopedion of advanced gestation and a live intraabdominal ectopic pregnancy was successfully managed. Language: English Keywords: TANZANIA | SUMMARY REPORT | CASE HISTORIES | CLIENTS | PREGNANCY, ABDOMINAL | PREGNANCY, ECTOPIC | EXAMINATIONS AND DIAGNOSES | PRODUCTS OF CONCEPTION, RETENTION | LAPAROTOMY | ULTRASONICS | FETAL MEMBRANES | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Data Collection | Research Methodology | Program Activities | Programs | Organization and Administration | Pregnancy Complications | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Surgery | Treatment | Fetus | Pregnancy | Reproduction Document Number: 342273 |
| 27. Title: Diffusion Weighted Imaging of the Uterus: Regional ADC Variation with Oral Contraceptive Usage and Comparison with Cervical Cancer. Author: Messiou C; Morgan VA; De Silva SS; Ind TE; Desouza NM Source: Acta Radiologica. 2009 May 15;:1-6. Abstract: Background: There is growing interest in diffusion weighted magnetic resonance imaging (MRI) of cervical carcinoma but normal uterine appearances and effects of the oral contraceptive pill (OCP) have not been described. Purpose: To establish apparent diffusion coefficient (ADC) values for normal regions of uterus, determine the effect of the OCP on these values, and compare them with ADCs from cervical cancer. Material and Methods: Twenty-seven premenopausal women (19 taking the OCP) with cervical intraepithelial neoplasia (CIN) were studied with T2W and diffusion weighted MRI (DW-MRI). Regions of interest were drawn on ADC maps by visual matching with T2W images on different zones of the uterus and values compared between women not taking and taking the OCP. A further group of 25 women with clinically obvious tumors of the cervix were also studied with T2W and DW-MRI and ADC values of tumor were compared with ADC values of cervical epithelium and stroma. Results: The ADC values of adjacent zones of the uterus and cervix were significantly different from one another (P<0.001). The junctional zone was seen as a band of restricted diffusion between endometrium and outer myometrium. The ADC value of the junctional zone of the uterus was significantly greater (P<0.001) in patients taking the OCP than those patients not taking the OCP. There was no significant affect of the OCP on the ADC values of other uterine zones. Conclusion: The zonal anatomy of the uterus is well demonstrated by DW-MRI with hormonal effects secondary to the OCP affecting junctional zone alone. ADC of cervical tumor is significantly different to cervical epithelium and stroma indicating a role in cervical cancer detection and local staging. Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | WOMEN | SCREENING | CERVICAL CANCER | ORAL CONTRACEPTIVES | SIDE EFFECTS | UTERINE EFFECTS | EXAMINATIONS AND DIAGNOSES | Developed Countries | Europe, Western | Europe | Demographic Factors | Population | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Cancer | Neoplasms | Diseases | Contraceptive Methods | Contraception | Family Planning | Treatment | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology Document Number: 341253 |
| 28. Peer Reviewed Title: STI prevalence and associated factors among urban men in Pakistan. Author: Mir AM; Wajid A; Reichenbach L; Khan M Source: Sexually Transmitted Infections. 2009 Jun;85(3):199-200. Abstract: OBJECTIVES: To measure the prevalence of selected sexually transmitted infections (STIs) among urban men in Pakistan and identify associated factors. METHODS: A cross-sectional survey of 2400 urban men aged 16-45 years was carried out in six cities of Pakistan. Respondents were selected through a multistage systematic sampling design. After obtaining informed consent a structured behavioural questionnaire was administered. Blood and urine samples were also collected and tested for HIV (ELISA), HSV-2 (ELISA) syphilis (RPR and TPHA), chlamydia (PCR) and gonorrhoea (PCR). RESULTS: Of the 2383 respondents whose results were received, 4.4% (n = 106) tested positive for at least one of the five STIs. The prevalence of the individual organisms was as follows: syphilis, 1.3%; HIV, 0.1%; HSV-2, 3.4%; gonorrhoea, 0.8% and chlamydia, no cases. City-wise, the highest prevalence was in Karachi (8.5%) followed by Lahore (5.3%), Faisalabad (4.0%) Quetta (4.3%), Rawalpindi (2.5%) and Peshawar (2.0%). At the univariate and multivariate level, older age, less schooling, and having more than four sexual partners were significantly associated with the presence of an STI. 92% of men who tested positive for any STI were asymptomatic. CONCLUSIONS: HIV prevalence in Pakistan remains low, however, the emergence of genital herpes is a matter of concern as it could lead to a future conduit for HIV spread. Health education messages should target less educated segments of society and specifically advocate safe sex practices and early diagnosis. Language: English Keywords: PAKISTAN | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PREVALENCE | URBAN POPULATION | MEN | RESPONDENTS | LABORATORY PROCEDURES | SEXUALLY TRANSMITTED DISEASES | HERPES GENITALIS | EXAMINATIONS AND DIAGNOSES | TESTING | Developing Countries | Asia, Southern | Asia | Research Methodology | Measurement | Population Characteristics | Demographic Factors | Population | Surveys | Sampling Studies | Studies | Laboratory Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Reproductive Tract Infections | Infections | Diseases Document Number: 342670 |
| 29. Title: Population-based assessment of Mycoplasma genitalium in Vietnam--low prevalence among married women of reproductive age in a rural area. Author: Olsen B; Lan PT; Stalsby Lundborg C; Khang TH; Unemo M Source: Journal of the European Academy of Dermatology and Venereology. 2009 May;23(5):533-7. Abstract: OBJECTIVE: To analyse the prevalence of Mycoplasma genitalium infection in a population-based study among married women from a demographic surveillance site in a rural geographical area of Vietnam. MATERIALS AND METHODS: Women, aged 18-49 years, were randomly selected to participate. DNA was isolated from endocervical swabs sampled from 990 participating women. The M. genitalium MgPa adhesion gene was detected using a real-time polymerase chain reaction with TaqMan probe. RESULTS: Eight (0.8%; 95% confidence interval, 0.25-1.35%) of the included women were infected with M. genitalium. Two of these positive women reported clinical symptoms. One additional M. genitalium-positive but symptom-free woman, however, showed clinical signs of vaginitis. None of the M. genitalium-positive women was concomitantly infected with Chlamydia trachomatis, Neisseria gonorrhoeae, syphilis or human immunodeficiency virus (HIV). Furthermore, there was no obvious association between M. genitalium infection and vaginal douching, use of intrauterine device, or occurrence of bacterial vaginosis, candidiasis, or Trichomonas vaginalis. CONCLUSIONS: The prevalence of M. genitalium among married women in Vietnam was relatively low. However, more large, well-designed and appropriately performed studies in other population groups including unmarried women and men, and in other geographical areas, rural as well as urban, are crucial in order to extract any evidence-based conclusions regarding the overall prevalence of sexually transmitted infections (STIs), including M. genitalium infections, in the Vietnamese society. The present study compiled with such future studies may form the basis for a national sexual health strategy for prevention, diagnosis, and surveillance of STIs, including M. genitalium infections, in Vietnam. Language: English Keywords: VIETNAM | RESEARCH REPORT | PREVALENCE | RURAL POPULATION | WOMEN | CURRENTLY MARRIED | SEXUALLY TRANSMITTED DISEASES | EXAMINATIONS AND DIAGNOSES | Asia, Southeastern | Asia | Developing Countries | Measurement | Research Methodology | Population Characteristics | Demographic Factors | Population | Marital Status | Nuptiality | Reproductive Tract Infections | Infections | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342511 |
| 30. Peer Reviewed Title: Clinico-pathological discrepancies in the diagnosis of causes of maternal death in sub-Saharan Africa: retrospective analysis. Author: Ordi J; Ismail MR; Carrilho C; Romagosa C; Osman N; Machungo F; Bombi JA; Balasch J; Alonso PL; Menendez C Source: PLoS Medicine. 2009 Feb 24;6(2):e1000036. Abstract: BACKGROUND: Maternal mortality is a major public-health problem in developing countries. Extreme differences in maternal mortality rates between developed and developing countries indicate that most of these deaths are preventable. Most information on the causes of maternal death in these areas is based on clinical records and verbal autopsies. Clinical diagnostic errors may play a significant role in this problem and might also have major implications for the evaluation of current estimations of causes of maternal death. METHODS AND FINDINGS: A retrospective analysis of clinico-pathologic correlation was carried out, using necropsy as the gold standard for diagnosis. All maternal autopsies (n = 139) during the period from October 2002 to December 2004 at the Maputo Central Hospital, Mozambique were included and major diagnostic discrepancies were analyzed (i.e., those involving the cause of death). Major diagnostic errors were detected in 56 (40.3%) maternal deaths. A high rate of false negative diagnoses was observed for infectious diseases, which showed sensitivities under 50%: HIV/AIDS-related conditions (33.3%), pyogenic bronchopneumonia (35.3%), pyogenic meningitis (40.0%), and puerperal septicemia (50.0%). Eclampsia, was the main source of false positive diagnoses, showing a low predictive positive value (42.9%). CONCLUSIONS: Clinico-pathological discrepancies may have a significant impact on maternal mortality in sub-Saharan Africa and question the validity of reports based on clinical data or verbal autopsies. Increasing clinical awareness of the impact of obstetric and nonobstetric infections with their inclusion in the differential diagnosis, together with a thorough evaluation of cases clinically thought to be eclampsia, could have a significant impact on the reduction of maternal mortality. Language: English Keywords: AFRICA, SUB SAHARAN | RESEARCH REPORT | RETROSPECTIVE STUDIES | MATERNAL MORTALITY | CAUSES OF DEATH | EXAMINATIONS AND DIAGNOSES | VALIDITY | DELIVERY OF HEALTH CARE | PREVENTION AND CONTROL | PROGRAM EVALUATION | Africa | Developing Countries | Studies | Research Methodology | Mortality | Population Dynamics | Demographic Factors | Population | Medical Procedures | Medicine | Health Services | Health | Measurement | Diseases | Programs | Organization and Administration Document Number: 341026 |
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