IntroductionMost of the literature related to the effects of Ramadan fasting on physical performance has focused on adults, and only three studies have examined its impact on children’s physical performance.AimsTo examine the effects of Ramadan fasting on first-time fasting boys’ performance in short-term explosive exercises [vertical and horizontal jump tests (VJT and HJT), 20-m and 30-m sprints and medicine-ball throw (MBT)], as well as in sub-maximal endurance [6-min walking distance (6MWD) measured during the 6-min walk test (6MWT)].MethodsEighteen Tunisian boys [mean±standard deviation (SD) of age and body mass (BM): 11.9±0.8 y and 55.4±18.2 kg, respectively] were included. The experimental design comprised four testing phases: 2-weeks before Ramadan (BR), the end of the second week (R2) and the fourth week (R4) of Ramadan, and 10–12 days after the end of Ramadan (AR). At each phase, boys performed two test sessions in the afternoon (15:00–17:00 h) interrupted by 48 h of recovery (first test session: BM, VJT, HJT, and 20-m and 30-m sprint tests; second session: MBT and 6MWT). The study was conducted during the summer of 2012 from July 5 to August 29.Results6MWDs (m) were significantly shorter during R2 (652±101) and R4 (595±123) compared to BR (697±86) and came back to baseline values AR. BM (kg) mean±SD did not significantly change during R2 (52±15) and during R4 (53±15) compared to BR (55±17), and short-term explosive performances were unchanged throughout the study.ConclusionIn non-athletic children, first-ever Ramadan fasting impairs sub-maximal aerobic capacity but has no effect on BM or short-term explosive performance.

BackgroundGestational diabetes mellitus (GDM) is a form of diabetes that occurs during pregnancy. GDM is a well known risk factor for foetal overgrowth, termed macrosomia which is influenced by maternal hypergycemia and endocrine status through placental circulation. The study was undertaken to investigate the implication of growth factors and their receptors in GDM and macrosomia, and to discuss the role of the materno-foeto-placental axis in the in-utero regulation of foetal growth.Methods30 women with GDM and their 30 macrosomic babies (4.75 ± 0.15 kg), and 30 healthy age-matched pregnant women and their 30 newborns (3.50 ± 0.10 kg) were recruited in the present study. Serum concentrations of GH and growth factors, i.e., IGF-I, IGF-BP3, FGF-2, EGF and PDGF-B were determined by ELISA. The expression of mRNA encoding for GH, IGF-I, IGF-BP3, FGF-2, PDGF-B and EGF, and their receptors, i.e., GHR, IGF-IR, FGF-2R, EGFR and PDGFR-β were quantified by using RT-qPCR.ResultsThe serum concentrations of IGF-I, IGF-BP3, EGF, FGF-2 and PDGF-B were higher in GDM women and their macrosomic babies as compared to their respective controls. The placental mRNA expression of the growth factors was either upregulated (FGF-2 or PDGF-B) or remained unaltered (IGF-I and EGF) in the placenta of GDM women. The mRNA expression of three growth factor receptors, i.e., IGF-IR, EGFR and PDGFR-β, was upregulated in the placenta of GDM women. Interestingly, serum concentrations of GH were downregulated in the GDM women and their macrosomic offspring. Besides, the expression of mRNAs encoding for GHR was higher, but that encoding for GH was lower, in the placenta of GDM women than control women.ConclusionsOur results demonstrate that growth factors might be implicated in GDM and, in part, in the pathology of macrosomia via materno-foeto-placental axis.

Objectives: Low back pain is a major occupational problem especially among nursing staff. The objectives of our study are to evaluate the prevalence of low back pain among nurses and to look for physical and psychosocial risk factors. Methods: It is a cross-sectional study based on a self-administered questionnaire destined for all nurses working in Farhat Hached Teaching hospital of Sousse (Tunisia). Results: Our study included 203 nurses with an average age of 39.8 years. The prevalence of low back pain over the last twelve months was 58.1%. The factors that are significantly associated to low back pain were: high BMI, number of pregnancies, arthritis, poor physical condition, daily frequency of inappropriate posture for the activity being performed, and the layout of materials in the workplace. Conclusion: Our study evidenced the high prevalence of LBP among nurses and allowed bringing to light the role of individual and ergonomic physical factors in the genesis of LBP. Such identification permits to undertake targeted preventive actions. The association between psychosocial factors and LBP was not emphasized.

We describe an outbreak of severe subcutaneous infections due to nontuberculous mycobacteria following mesotherapy. Epidemiological studies and molecular comparisons of Mycobacterium chelonae strains from different patients and the environment suggested that contamination may be associated with inappropriate cleaning of the multiple-injection device with tap water. CASE REPORTIn January 2007, a general practitioner notified the health authorities and the regional center for nosocomial infection control of a cluster of subcutaneous infections due to nontuberculosis mycobacteria (NTM) following mesotherapy.A complete screening for all potentially exposed patients who underwent mesotherapy with the practitioner from 1 October 2006 (the date of the first mesotherapy in the medical room suspected of contamination) to 15 January 2007 (the date of disruption of the mesotherapy practice) was designed. Each patient was contacted both by phone and by mail and urged to be examined by a specialist in the department of infectious diseases at a tertiary-care reference hospital in Paris. A retrospective cohort study of all exposed patients was performed to describe the temporal and spatial distribution of cases and identify risk factors. A case was defined as certain if the exposed patient had clinical subcutaneous lesions at the site of mesotherapy injections in association with cultures positive for NTM. A case was defined as probable if the exposed patient had clinical subcutaneous lesions but smear and culture results negative for NTM. An assessment study of hygiene practices was performed by an infection control practitioner at the outpatient clinic to determine potential risk factors to be tested in a comparative epidemiological study. Risk factors included the day of an outpatient visit, a patient's place in a series of patients receiving therapy on the same day, and the site of and reason for injections. For each case, the incubation period was estimated as the time between the last mesotherapy session before the onset of symptoms and the date of the first symptoms of NTM infection. Comparisons of means and proportions were calculated with standard statistics. As the clinic was closed on Wednesdays, Saturdays, and Sundays, visits on the days after closure, i.e., Mondays and Thursdays, were considered as a potential risk factor, expressed as the number of such visits per 100 patient visits. Multivariate analysis was performed using stepwise logistic regression with P-to-enter and P-to-remove values at 0.20. The Hosmer-Lemeshow statistic was used to test the goodness of fit of the model. All calculations were performed using SAS software release 8.02 (SAS Institute, Cary, NC) and considered significant at P of Ͻ0.05.Samples from tap water in the medical examination room, as well as from the injection device and topical creams, were examined to search for mycobacteria. Products used for mesotherapy injections were recovered from the office and analyzed by the laboratory of the French Agency for Sanitary Safety in Health P...

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ObjectivesThe current study aimed to validate and determine the psychometric properties of the Arabic versions of the Beck Depression Inventory-II (BDI-II) and the Edinburgh Postnatal Depression Scale (EPDS) in Qatar.DesignA cross-sectional study design was employed.SettingAntenatal care (ANC) clinics at nine primary healthcare centres.ParticipantsPregnant women (n=128) aged 15–46 years in different trimesters of pregnancy, attending the ANC clinics as well as capable of reading and writing in the Arabic language.ResultsA total of 128 participants were enrolled. On conducting the receiver operating characteristic (ROC) analysis, the EPDS showed a larger area under the curve at 0.951 than the BDI-II tool (0.912). Using Youden’s index, a score>13 on the EPDS (87% sensitivity, 90% specificity) and>19 on the BDI-II (96% sensitivity, 73% specificity) allowed for the greatest division between depressed and non-depressed participants.ConclusionTo address the under-recognition of antenatal depression, physicians at primary healthcare centres in Qatar should be encouraged to utilise the EPDS to screen pregnant women seeking ANC services.

Intra-abdominal hypertension does occur in about 13% of the critically ill children, albeit less frequently than adult patients, probably related to a better compliance of the abdominal wall. The presence of abdominal distension and a plateau pressure of more than 30 cm H2O was found to be independent predictors of IAH. Children with IAH had higher mortality rate and more prolonged ICU stay.

Background Cumulative evidence suggests that early identification of anxiety in pregnancy is important, given that antenatal anxiety has been linked to morbid outcomes in expecting mothers and their offspring. However, the burden of antenatal anxiety is not yet known in Qatar. This research aims to measure the prevalence and determinants of generalized and pregnancy-related anxiety among pregnant women. Methods Eight hundred pregnant women completed a structured interview and self-administrated questionnaires after being selected through probability sampling from nine primary healthcare centers distributed across Qatar. We subjected the data to Binary and Multiple Logistic Regression Analysis. Furthermore, we conducted a Confirmatory Factor Analysis for the utilized scales. Results Out of eight hundred participants, 26.5% reported high pregnancy-related anxiety, while 16.4% had a generalized anxiety disorder. A high level of perceived social support and resilience was shown to mitigate generalized and pregnancy-related anxiety. However, we revealed that different determinants influence the two types of anxiety. Limitations There is no recognized optimal cut-off point to distinguish ‘high risk’ in pregnancy-related anxiety scales. Conclusions Pregnancy-related anxiety is more prevalent than generalized anxiety among pregnant women in Qatar, indicating that stakeholders must include screening for pregnancy-related anxiety in Qatar's clinical guidelines. Tailored interventional studies could focus on increasing resilience and social support to decrease the burden of antenatal anxiety.