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Article
Sociological Risk Factors in the Development of Gallstones for Women in the Childbearing Age a Case-control study
عوامل الخطورة الاجتماعية في حدوث حصوات المرارة للنساء في سن الإنجاب

Authors: Mozahim K. Al-Kayatt د.مزاحم الخياط --- Dhafer B. Al-Youzbaki د.ظافر اليوزبكي --- Amaema A. Al-Zubeer اميمة الزبير
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2008 Volume: 21 Issue: 2 Pages: 97-103
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Gallstones are highly prevalent in most countries all over the world. Although most of gallstones are asymptomatic, complicated stones lead to important morbidity and complications, and to high costs of medical care, making gallstone prevention highly desirable. The exact etiology of gallstones formation is still unknown, but there are many risk factors that have been proved scientifically to be important contributors for gallstones occurrence. Most of these risk factors are highly related to the ways of human living in modern ages such as unhealthy dietary behaviors and sedentary life. This suggests that sociological backgrounds play a crucial role in the initiation of this disease and the keys for the prevention of gallstones may be through the context of human life. Aim & Objective: To examine sociological risk factors in the development of asymptomatic gallstones of women at childbearing ages attending X-ray department for doing abdominal ultrasound examination for other reason. Study design: Case-control study, where 110 women with asymptomatic gallstones for the first time diagnosed by ultrasound examination without previous episodes of acidity and right hypochondrial pain were allocated as cases. Another 110 women proved to be without gallstones by ultrasound examination and without previous history of acidity or right hypochondrial pain episodes. Matching is done for age ± 5 years. Unpaired sampling technique had been used. Study period: from 1st. October 2006 to 1st. February 2007.Questionnaire: The questionnaire included assessment of sociological factors such as personal characteristics (social identity, personal habits and psychological make-up), life events (stress, social discontinuities and geographical mobility) and social context (economic factors, social integration, urbanization). In addition, body mass index, waist to hip ratio was also estimated and the state of parity for each woman participated in this research. Results: Regarding Personal Characteristics; positive family history was found in this study to be highly associated with the development of gallstones (OR= 2.63, P-value= 0.004, 95%C.I.= 1.73-5.06), as well as sedentary life (OR= 3.97, P-value=0.0001and 95%C.I.= 1.99-7.91), unhealthy dietary behaviors (OR= 3.27, 0.0001, 95%C.I.= 1.89-5.67) and active smoking (OR= 3.32, P-value=0.019 and 95%C.I.= 1.22-9.05). According to Life Events; exposure to stress was found to be associated with the occurrence of gallstones (OR=3.00, p-value= 0.0001, 95%C.I. = 1.70-5.29), and social discontinuities (OR=2.62, p-value= 0.002, 95%C.I. = 1.43-4.79). Central obesity was also found to be associated with the development of gallstones (OR=2.18, P-value=0.004, 95% C.I. =1.27-3.73) as well as high parity (OR=3.47, P-value=0.0001, 95% C.I. = 2.01-6.00). Conclusion: Positive family history, sedentary life, unhealthy dietary behavior, active smoking, stress, social discontinuities, abdominal obesity, and high parity all are among the important sociological risk factors in the development of gallstones for women in childbearing ages.Key words: Sociological risk factors, gallstones, women, childbearing ages.

المقدمة: إن حصوات المرارة تتواجد في اغلب البلدان في العالم, وبالرغم من أن اغلب حصوات المرارة بدون أعراض مرضية, إلا أن مضاعفات حصوات المرارة تؤدي امراضات و مضاعفات مهمة و كذلك إلى ارتفاع تكلفة العناية الطبية مما تجعل الوقاية من حصوات المرارة أمرا مطلوبا. السبب الرئيسي لحدوث حصوات المرارة لا يزال مجهولا, لكن هناك عدة عوامل خطورة و التي تم إثباتها علميا لها علاقة مهمة في حدوث حصوات المرارة. أغلب عوامل الخطورة تلك لها ارتباط قوي في طرق حياة الإنسان في العصور الحديثة مثل عادات الغذاء غير الصحي, و أسلوب الحياة غير النشيطة. هذا يقدم إلى إن الخلفية الاجتماعية تلعب دورا حيويا في عملية نشوء هذا المرض و إن مفاتيح الوقاية من حصوات المرارة قد تكون في سياق طرق حياة الإنسان.الهدف: فحص عوامل الخطورة الاجتماعية في حدوث حصوات المرارة للنساء في عمر الإنجاب.تصميم الدراسة:دراسة العينة و الشاهد.فترة الدراسة:من الفاتح من أكتوبر 2006 إلى الفاتح من شباط 2007.استمارة الاستبيان:تضمنت تسجيل العوامل الاجتماعية كالصفات الشخصية و الحوادث الحياتية إضافة إلى السياق الاجتماعي.النتائج:تاريخ العائلة الايجابي وجد في هذه الدراسة مرتبط بحدوث حصوات المرارة و كذلك قلة الحركة و الغذاء غير الصحي و التدخين و الإجهاد و عدم الاستمرارية الاجتماعية, كل العوامل السابقة وجدت في هذه الدراسة مرتبطة بحدوث حصوات المرارة. كما وجد أن السمنة و كثرة الإنجاب كانت عوامل مرتبطة أيضا ارتباطا ايجابيا بحدوث حصوات المرارة.الاستنتاجات:إن العوامل الاجتماعية مهمة في حدوث مرض حصوات المرارة عند النساء في سن الإنجاب و كثير من تلك العوامل هي عوامل غير ثابتة و من الممكن أن تتجنبها النساء في سن الإنجاب لتفادي حدوث مرض حصوات المرارة.


Article
Sociological Risk Factors in the Development of Knee Osteoarthritis among Women > 50 years Case-Control Study
عوامل الخطورة الاجتماعية في حدوث سوفان مفصل الركبة عند النساء اللاتي اعمارهن تتجاوز الخمسين سنة

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Abstract

Background: Osteoarthritis is now firmly established as a public health problem. It is the most disabling diseases in many countries. Knee osteoarthritis is regarded as the most common form of the disease in adult. Elderly women are found to be more affected by this disorder. From the available evidences, it is now reasonable to consider this disease as one of the most important among the chronic non-communicable diseases and investigation for the risk factors that are associated with this disorder is very important. Aim: To examine sociological risk factors in the development of symptomatic knee osteoarthritis for women > 50 years. Study design: Case-control study, where 76 women with symptomatic knee osteoarthritis proved by clinical and radiological evidences were allocated as cases. Another 116 women proved to be without clinical or radiological evidence of knee osteoarthritis was allocated as controls. Study period: 1st March 2007 to 1st December 2007.Questionnaire: Including, assessment of sociological factors such as personal characteristics (social identity, personal habits and psychological make-up), life events (stress, social discontinuities and geographical mobility) and social context (economic factors, social disintegration, urbanization). In addition, body mass index, previous history of surgical operation, the use of contraceptive pills and the presence of one or more of chronic non-communicable diseases, were also gained. Results: Regarding Personal Characteristics; unhealthy dietary behaviors appeared in this study to be highly associated with development of knee OA (OR= 7.19, P-value= 0.001, 95%C.I. = 2.08-18.60), the same thing was applied to women with personality type A (OR= 2.84, P-value= 0.009, 95% C.I. = 1.29-6.23). The habit of cigarette smoking appeared unexpectedly negatively associated with occurrence of knee OA (OR= 0.41, P-value=0.035 and 95%C.I. = 0.18-0.94). According to Life Events; stress was negatively associated with the development of knee OA (OR=0.24, p-value= 0.002, 95%C.I. = 0.10-0.59). The geographical mobility appears in this table to be protective against the development of knee OA (OR= 0.15, P-value= 0.000, 95%C.I. = 0.07-0.31). Dramatic change in economic factor, appeared to be negatively highly associated with the development of knee OA (OR= 0.12, P-value= 0.000, 95%C.I. = 0.04-0.34). Urban citizens, in this study appeared to be more prone to develop knee OA than rural citizens (OR= 3.04, P-value= 0.017, 95%C.I. = 1.22-7.57). General obesity (BMI > 25) is valid predictor for the development of knee OA (OR= 8.88, P-value= 0.000, 95%C.I. = 3.08-25.60). The presence of one or more of chronic non-communicable diseases appear to be associated with the occurrence of knee OA (OR=2.60, P-value=0.002, 95% C.I. = 1.43-4.72). Contraceptive pills users among women appear to be associated with the development of knee OA (OR= 3.21, P-value= 0.0001, 95%C.I. = 1.64-5.94). Conclusion: Women with unhealthy dietary behavior, personality type urbanization, general obesity, with one or more of chronic non-communicable diseases and contraceptive pills users are at high risk of development of knee OA. Cigarette smoking, stress, geographical motilities and unexpected change in economic status appeared to be negatively associated with the occurrence of knee OA in women > 50 years.Key words: Sociological risk factors, Knee, Osteoarthritis, Women, > 50 years.

الخلفية:ان مرض سوفان المفاصل هو الان يعتبر مشكلة طبية عامة. و هو اكثر الامراض المعوقة في عدة بلدان. سوفان الركب يعتبر اكثر شكل عام للسوفان عند الكبار. و النساء المسنات يعتبرن الاكثر تأثرا بهذا المرض. من الادلة المتوفرة, الان من المعقول اعتبار هذا المرض كاحد اهم الامراض ضمن الامراض المزمنة غير الانتقالية و البحث في عوامل خطورة هذا المرض هو من الاشياء المهمة.الهدف:فحص عوامل الخطورة الاجتماعية في تطور مرض سوفان الركب عند النساء في اعمار اكثر من 50 سنة.تصميم الدراسة:دراسة العينة و الشاهد.وقت الدراسة:من الاول من اذار 2007 الى الاول من كانون الاول 2007.النتائج:النساء اللاتي يتبعن نظاما غذائيا غير صحي, واللاتي يمتلكن نوع الشخصية ب, و ساكنات الحضر, وذوات سمنة عامة,ولديهن احد او اكثر من الامراض المزمنة غير الانتقالية, و اللاتي كن قد استعملن حبوب منع الحمل هن في خطر كبير لحدوث سوفان الركب لديهن.


Article
Women and Smoking: General and Social Perspectives
النساء والتدخين منظور اجتماعي وعام

Authors: Faris B. Al-Sawaf د. فراس السواف --- Dhafer B. Al-Youzbaki د. ظافر اليوزبكي --- Maha A. Al-Nuemai د. مها النعيمي
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2008 Volume: 21 Issue: 4 Pages: 308-314
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Tobacco is the second major cause of death in the world. It is currently responsible for the death of one in ten adults' worldwide (about 5 million deaths each year). If current smoking patterns continue, it will cause some 10 million deaths each year by 2020. Half the people that smoke today -that are about 650 million people- will eventually be killed by tobacco. Tobacco is the fourth most common risk factor for disease worldwide. The economic costs of tobacco use are equally devastating. In addition to the high public health costs of treating tobacco-caused diseases, tobacco kills people at the height of their productivity, depriving families of breadwinners and nations of a healthy workforce. Nonetheless regarding women smoking currently depriving families from main care givers causing many preventable diseases among women and their babies. Aim: To examine the impact of different socio-economic and medical characteristics on the development of smoking habit among women. Study design: Case-control study, where 110 currently smoker women with, were allocated as cases. Another 110 non-smoker women were considered as controls. Study period: From the 1st. March 2007 to 1st December 2007.Data collection tools: Including, assessment of socio-economic features such as personal characteristics, life events and social context. In addition, previous history of abortion and the presence of one or more of chronic non-communicable diseases were also gained. Results: Regarding Personal Characteristics; positive family history was found to be significantly associated with the development of smoking behavior (P=0.001), the same thing was applied to abnormal marital status (P=0.001) and personality type A (P=0.002). According to Life Events; stress, social discontinuities, geographical mobility and catastrophic life events in this work appeared to be significantly associated with the development of smoking behavior (P= 0.010, P=0.001, P=0.001, P=0.001 respectively). Regarding Social Context, sudden change in economic status was also found to be significantly related to the initiation and promotion of smoking behavior (P=0.001), moreover, living alone and urbanization appeared to have similar significant effects (P=0.03, P=0.02 respectively). According to Other Variables, the presence of one or more of chronic non-communicable diseases is found to be associated with smoking (P=0.016), and previous obstetric history of abortion also was associated with smoking (P=0.007). Lastly, women who are belonging to social class I and II (professional and semiprofessional) appeared to be protected significantly (P=0.009, P=0.03 respectively) against the habit of smoking, unlike women who are belonging to social class IV (semiskilled manual worker) appeared to be significantly (P=0.005) prone to the development of smoking habit. Conclusion: Women with positive family history, with abnormal marital status, personality type a, stress, social discontinuities, geographical mobility, catastrophic life events, economic factor, and urbanization, chronic diseases, previous history of abortion, social class IV are at risk for development of smoking habit. Nevertheless, women from social class I and II are more immune against development of smoking habit. Key words: General, social, risk, factors, smoking, women.

الخلفية:تدخين التبغ هو السبب الاساسي الثاني للوفاة في العالم. و الان هو المسؤول عن وفاة واحد من عشرة من البالغين في العالم. واذا استمرت نسب التدخين كما هي الان فانه من المتوقع ان يتسبب في وفاة 10 ملايين شخص في عام 2020 كل سنة. بالاضافة للتكلفة العامة العالية لعلاج الامراض الناتجة من التدخين, فان التدخين يقتل الناس في ذروة انتاجهم حارما بذلك العوائل من كاسبي لقمة العيش و الدول من القوى العاملة. و ليس اخيرا و بالنسبة للنساء فان التدخين يحرم العوائل من الرعاية الاساسية لللامهات ومؤديا الى عدد كبير من الامراض التي يمكن الوقاية منها لهن و لاطفالهن.تصميم الدراسة:دراسة العينة و الشاهد.وقت الدراسة:من الاول من اذار 2007 الى الاول من كانون الاول 2007.النتائج:النساء اللاتي لهن الصفات التالية مثل : تاريخ العائلة الايجابي للتدخين, وضعية زواج غير طبيعية, نوع الشخصية ا, الاجهاد, عدم التواصل الاجتماعي, الهجرة, الحوادث المفجعة, التحضر, العوامل الاقتصادية, الامراض المزمنة غير الانتقالية, الاجهاد, التاريخ السابق لحالة اجهاض, ومن المستوى الاجتماعي الرابع , كل تلك النساء معرضات لخطر تطور عادة التدخين لديهن.

Keywords

General --- social --- risk --- factors --- smoking --- women.

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