Iodine deficiency is an important public health problem in Himachal Pradesh. District Kangra is a known iodine deficiency endemic area. A survey conducted in 1956 reported a goitre prevalence of 55 per cent in the district. A more recent pilot study (1994) in four blocks of the district reported the total goitre rate (TGR) as 7 per cent. A continued prevalence of goitre in more than 5 per cent of school-aged children was found in pilot study, in spite of the distribution of iodised salt. The present study was conducted to assess the prevalence of iodine deficiency disorders (IDD) and to estimate the iodine content of salt consumed by the population in district Kangra. The '30 cluster' sampling methodology and indicators for assessment of IDD, as recommended by the joint WHO/UNICEF/ICCIDD consultation, were utilized for the survey. A confidence level of 95 per cent, a relative precision of 10 per cent and a design effect of three were taken into account for calculation of the sample size. A total of 23,348 school children in the age group 6-11 years were included in the study. The total goitre prevalence rate was found to be 12.1 per cent. The median urinary iodine excretion of the children studied was found to the 15.00 mcg/dl. About 12.7 per cent of families consumed salt with an iodine content of less than 15 ppm. The results of the present study indicated that the population of district Kangra is in a transition phase from iodine deficient to iodine sufficient nutrition and that there is a need for further strengthening of the system of monitoring the quality of iodised salt made available to the population to eliminate IDD from the Kangra Valley.
Background: Teething has been associated with varieties of childhood illnesses. Traditional uvulectomy has been an ongoing practice in some societies. Both teething and traditional uvulectomy have strong linkage to beliefs, values and practices. This study aimed at documenting the awareness and perception of society regarding traditional uvulectomy and beliefs about teething in Tanzania. Methods: A cross sectional study was conducted in central region of Tanzania, encompassing adult population, who were obtained by stratified two stage sampling technique. The oldest person per household was interviewed. A questionnaire consisting of questions regarding traditional uvulectomy and beliefs about teething was used to collect data. Analysis of data was done using computer program SPSS version 19 whereby the level of significance for Chi-square was set at p-value of ≤ 0.05. Results: A total of 371 participants were included and of these, 90.3% believed that long uvula may cause ill health. The notion of prolonged cough indicates unhealthy uvula was found in 86.8% of participants. With regard to teething, 60.6% considered a child born with teeth means a curse in family. Symptoms that are perceived to be caused by teething include diarrhoea (84.6%) and fever (54.4%). Other reported symptoms include drooling of saliva, crying vomiting and irritability. Conclusion: Majority of society members still link illnesses in children with either elongated uvula and/or teething. Awareness on traditional ways of treating diseased uvula may be detrimental as people's awareness tends to influence their practice. Deliberate efforts should be put forward to educate pregnant women during their visits to antenatal and natal clinics especially in the rural areas regarding oral health of children.
Background McCune-Albright syndrome (MAS) is a rare multisystem disorder that classically was defined by the triad of polyostotic fibrous dysplasia of bone, café-au-lait skin pigmentation, and precocious puberty. It is a condition that has a gradual onset, slow growth rate and remain painless throughout. The clinical phenotype of MAS is highly variable and no definite treatment is available. Case presentation This article describes two cases, a 10-year-old girl and an 11-year-old boy, both with MAS comprising deforming craniofacial FD. Challenges related to diagnosis and management included late reporting with big lesions, involvement of multiple craniofacial bones, mutilating surgeries and ultimately high degree of morbidity. Conclusion Delayed diagnosis and management of MAS results in devastating physical disabilities and severe morbidity after treatment.
Background Cervicofacial necrotizing fasciitis (NF) is a rare life-threatening infection in the head and neck region that characteristically spreads along the fascial planes to involve subcutaneous tissues, fascia and fat, however, in late stages it can involve muscles and skin. The aim of this study was to determine the occurrence of cervicofacial NF among patients attending treatment at the Muhimbili National Hospital (MNH). Methods This was a prospective descriptive cross-sectional hospital-based study which was carried at Muhimbili National Hospital (MNH) from May 2013 to April 2014. It included 42 patients with cervicofacial NF. They were interviewed for demographic information, chief complaints, symptoms, duration and treatment received before reporting at MNH. A thorough assessment of general health condition of the patients and laboratory investigations were followed by management according to MNH protocol. Data obtained from these patients were analyzed using Statistical Package for Social Sciences SPSS 20. Results During the study period, 151 patients reported at MNH with odontogenic infections. A total of 42 (27.8%) patients satisfied our diagnostic criteria for cervicofacial NF. The age range was 15 years to 83 years (mean 43.95, SD +/− 16.16). Greater (35.7%) proportion was in the age group of 30–39 years with 31 (73.8%) males and 11 (27.2%) females making a male to female ratio of 2.8:1. Fifteen (35.7%) patients had at least one co-existing systemic condition, which included anaemia in 5 (11.9%) patients, followed by diabetes mellitus (DM) and malnutrition 4 (9.5%) patients each and HIV infection 2 (4.8%) patients. Others were combination of; HIV infection and malnutrition, HIV infection and anaemia and diabetes mellitus and anaemia each in one (2.4%) patient. There was a mortality of 42.9% comprising of 14 (33.3%) males and 4 (9.6%) females. Conclusions Cervicofacial NF is a polymicrobial infection, requiring surgery, antibiotics and management of co-existing systemic conditions. Anaemia, diabetes mellitus and malnutrition were the main co-existing systemic conditions. The rather high mortality was mainly attributable to late reporting.
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