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Akhtar Hussain

Publications and source records attributed to Akhtar Hussain.

15 recordsLinked to original sources
PubMed2006

Rising prevalence of type 2 diabetes in rural Bangladesh: a population based study.

The aim of the study was to determine the temporal changes in the prevalence of type 2 diabetes mellitus and its associated risk factors in a rural population of Bangladesh. A total of 4757 subjects age >/=20 years both male and female were enrolled randomly in a cross-sectional study in 1999. The same area and population was reinvestigated in 2004 following the same selection procedure, on a sample of 3981 individuals. Structural and economical changes were noted for the last 5 years in the locality. An increased prevalence of diabetes was found with 6.8% in the present survey compared with 2.3% in the earlier survey (p<0.05). Age, BMI and systolic blood pressure were found to be significant risk factors following both for FBG and for OGTT. WHR was found to be a significant risk factor for men only. A substantial agreement was observed between FBG and OGTT (kappa 0.63) compared to the previous investigation in 1999 (kappa 0.40). Differences in the indices of obesity, that is BMI, WHR and waist girth, may in part explain the increased prevalence, which in turn may explain due to fast-expanded urbanization. The state of affairs warrants immediate measures necessary to prevent the epidemic particularly in the localities that are in the transition phase from rural to semi-urban facilities.

Adult↗
PubMed2006

HIV among pregnant women in Moshi Tanzania: the role of sexual behavior, male partner characteristics and sexually transmitted infections.

BACKGROUND: Women continue to be disproportionately affected by HIV in Tanzania, and factors contributing to this situation need to be identified. The objective of this study was to determine social, behavioral and biological risk factors of HIV infection among pregnant women in Moshi urban, Tanzania. In 2002-2004, consenting women (N = 2654), attending primary health clinics for routine antenatal care were interviewed, examined and biological samples collected for diagnosis of HIV and other sexually transmitted/reproductive tract infections. RESULTS: The prevalence of HIV was 6.9%. The risk for HIV was greater among women whose male partner; had other sexual partners (adjusted odds ratio [AOR], 15.11; 95% confidence interval [CI], 8.39-27.20), traveled frequently (AOR, 1.79; 95% CI, 1.22-2.65) or consumed alcohol daily (AOR, 1.68; 95% CI, 1.06-2.67). Other independent predictors of HIV were age, number of sex partners, recent migration, and presence of bacterial vaginosis, genital ulcer, active syphilis and herpes simplex virus type 2. CONCLUSION: Development of programs that actively involve men in HIV prevention is important in reducing transmission of HIV in this population. Further, interventions that focus on STI control, the mobile population, sexual risk behavior and responsible alcohol use are required.

Journal Article↗
PubMed2006

Type 2 diabetes and impaired fasting blood glucose in rural Bangladesh: a population-based study.

BACKGROUND: Diabetes is a fast expanding global health problem but more so in the developing countries. Therefore, it is of particular interest to study the epidemiological transition of the state and to identify the risk factors in order to recognize the extent of the problem. METHODS: A random sample of 5000 rural individuals (age >/=20 years) were included in a cross-sectional study. Fasting capillary blood glucose levels were measured from 4757 individuals. Height, weight, waist, hips including blood pressure and demographic information was collected. RESULTS: The study population was lean [mean body mass index (BMI) 19.4] with a low prevalence of type 2 diabetes but relatively high impaired fasting glucose. No relationship between type 2 diabetes and BMI in men, but an overall relationship was observed for women (P = 0.04) (data not shown). Age, sex, and waist/hip ratio appeared to be important risk factors for the occurrence of type 2 diabetes in this population. CONCLUSIONS: Low prevalence of type 2 diabetes and relative high impaired fasting blood glucose was observed. The factors associated with the occurrence of diabetes in this population appeared to differ than its known relations with BMI. This may indicate that the risk factors for type 2 diabetes are likely to differ in different population. Our results are likely to be in line with the Indian data suggesting that a revised guideline for anthropometric measures in the South Asian population is called for, in order to classify people at risk.

Adult↗
PubMed2006

Inequalities in health: a comparative study between ethnic Norwegians and Pakistanis in Oslo, Norway.

BACKGROUND: The objective of the study was to observe the inequality in health from the perspective of socio-economic factors in relation to ethnic Pakistanis and ethnic Norwegians in Oslo, Norway. METHOD: Data was collected by using an open and structured questionnaire, as a part of the Oslo Health Study 2000-2001. Accordingly 13581 ethnic Norwegians (45% of the eligible) participated as against 339 ethnic Pakistanis (38% of the eligible). RESULTS: The ethnic Pakistanis reported a higher prevalence of poor self-rated health 54.7% as opposed to 22.1% (p < 0.001) in ethnic Norwegians, 14% vs. 2.6% (p < 0.001) in diabetes, and 22.0% vs. 9.9% (p < 0.001) in psychological distress. The socio-economic conditions were inversely related to self-rated health, diabetes and distress for the ethnic Norwegians. However, this was surprisingly not the case for the ethnic Pakistanis. Odd ratios did not interfere with the occurrence of diabetes, even after adjusting all the markers of socio-economic status in the multivariate model, while self-reported health and distress showed moderate reduction in the risk estimation. CONCLUSION: There is a large diversity of self-rated health, prevalence of diabetes and distress among the ethnic Pakistanis and Norwegians. Socio-economic status may partly explain the observed inequalities in health. Uncontrolled variables like genetics, lifestyle factors and psychosocial factors related to migration such as social support, community participation, discrimination, and integration may have contributed to the observed phenomenon. This may underline the importance of a multidisciplinary approach in future studies.

Journal Article↗
PubMed2006

Predictors of failure to return for HIV test results among pregnant women in Moshi, Tanzania.

Identification of HIV-infected women is a prerequisite in HIV perinatal prevention programs. The aim of this study was to determine the predictors of failure to return for HIV posttest results among pregnant women (N=2654) receiving antenatal care at primary health clinics in Moshi urban district, Tanzania. Consenting pregnant women, who were in the third trimester of pregnancy, received individual pretest counseling, followed by interview and screening for HIV. Posttest counseling and results were given after 1 week. A total of 182 (7%) failed to return for their HIV test results. Women were less likely to return for test results if their partners did not come for testing (adjusted odds ratio [AOR], 12.6; 95% CI, 3.1-51.4), if their partners consumed alcohol (AOR, 1.8; 95% CI, 1.3-2.7), and if they had never discussed reproductive health matters with their partners (AOR, 1.7; 95% CI, 1.1-2.7). Additionally, the site of recruitment, age, alcohol consumption, and advanced gestation age predicted failure to return for HIV test results. These results indicate that male partner factors were important in determining whether women returned for results. We therefore recommend promotion of antenatal couple counseling and strengthening of community awareness of the availability of perinatal interventions, with special efforts targeting men. Furthermore, the predictors for failure to collect test-results need to be addressed during pretest counseling.

Adolescent↗
PubMed2005

The use of hydroxyapatite cement and a pericranial/deep temporal fascia graft for cranioplastic reconstruction of translabyrinthine craniectomy defects.

Most translabyrinthine temporal bone defects are reconstructed with free abdominal fat grafts, with or without the use of hydroxyapatite cement. However, these procedures are associated with considerable morbidity at the graft donor site, with a 6 to 15% incidence of cerebrospinal fluid (CSF) leaks, and with postoperative headaches. We have developed a new technique for reconstructive cranioplasty that involves the use of hydroxyapatite cement and a pericranial/deep temporal fascia graft. This technique obviates the need for an abdominal fat graft and therefore circumvents the morbidity associated with it; it may also significantly reduce the incidence of CSF leaks and postoperative headaches. We describe the results of our use of this technique in a series of 10 patients. Based on our early findings, we believe that this technique holds great promise for reconstructive cranioplasty following translabyrinthine craniectomy.

Adult↗
PubMed2005

HIV and sexually transmitted infections among women presenting at urban primary health care clinics in two cities of sub-Saharan Africa.

In a cross-sectional study, 786 consenting women from two cities in Africa, Harare and Moshi, attending primary health care clinics were interviewed, examined and tested for HIV and other sexually transmitted infections (STIs). The aim of the study was to assess and compare differences in the characteristics that may affect the prevalence of HIV/STIs among women in the two cities. Multivariate analysis was used to generate odds ratio. STIs and behaviour characteristics among this low risk group of women could not fully explain the higher HIV prevalence in Zimbabwe, 29.3% compared to 11.5% in Tanzania (p < 0.01). Interventions should target identified risk factors with particular attention to youths.

Adolescent↗
PubMed2005

Preservation of the superficial lobe for deep-lobe parotid tumors: a better aesthetic outcome.

Deep-lobe parotid tumors are relatively uncommon. Most of these tumors present as external masses. They can also present in the oral cavity or oropharynx. Magnetic resonance imaging and ultrasound-guided fine-needle aspiration for biopsy and cytology have made it possible to establish a definitive diagnosis and identify the exact location of the tumor in almost all cases before surgery. Traditionally, deep-lobe tumors have been managed by a formal superficial parotidectomy and identification and preservation of the facial nerve, followed by removal of the deep lobe that contains the tumor Superficialparotidectomy is associated in most cases with periauricular depression secondary to a loss of volume, leading to variable aesthetic deformities. A complete parotidectomy is more likely to be associated with a larger aesthetic deficit secondary to a greater loss of tissue volume. The incidence of gustatory sweating is high after superficial parotidectomy, particularly in the early postoperative period. We hypothesize that if the superficial lobe is preserved, there is less likelihood of gustatory sweating because of the interposition of tissue between the skin and the cut ends of the secretomotor fibers. Approximately 80% of parotid tissue volume is made up of the superficial lobe, and therefore preservation of the superficial lobe should be associated with less postparotidectomy depression. Therefore, we decided to preserve the superficial lobe of the gland for deep-lobe tumors. Nine patients underwent deep-lobe parotidectomy with preservation of the superficial lobe over a 6-year period. Patients were studied prospectively with regard to technical difficulty, complications, and cosmetic outcome. Follow-up ranged from 12 months to 6 years. We did not experience any undue technical difficulty, and there were no cases of facial weakness. One patient developed gustatory sweating, which almost completely resolved over a 2-year period. There were no cases of post parotidectomy depression, and both patients and surgeons were satisfied with the cosmetic appearance. We present our technique and experience.

Adenoma, Pleomorphic↗
PubMed2005

Schwannoma of the larynx: a case report.

Neurogenic tumors of the larynx are rare. We report a case of supraglottic schwannoma in a 59-year-old woman. We excised the tumor via a lateral thyrotomy approach.

Female↗
PubMed2004

Modified submandibular sialoadenectomy.

Submandibular sialoadenectomy is a common head and neck procedure. Indications include the presence of benign and malignant tumors and inflammatory disease with or without intraglandular sialolithiasis. The standard technique involves a variably sized incision. The facial artery and vein are usually ligated and transected during the procedure, and either suction or nonsuction wound drainage is generally instituted. We describe a modified sialoadenectomy technique that involves a minimal incision, preserves the facial artery and vein, and does not require wound drainage because the surgical site is closed in three layers. We performed this procedure on 19 patients and observed only 1 postoperative complication--mild paresis of the right marginal mandibular branch of the facial nerve following the excision of a Warthin's tumor: This patient recovered fully 3 months postoperatively.

Adenoidectomy↗
PubMed2003

Seroprevalence and correlates of herpes simplex virus type 2 among urban Tanzanian women.

BACKGROUND: Data on herpes simplex virus type 2 (HSV-2) among women in the general population of developing countries are limited. GOALS: The goal of the study was to determine the seroprevalence of HSV-2 and to identify clinical, demographic, and behavioral correlates among women attending primary health care clinics. STUDY DESIGN: This was a cross-sectional survey of 382 randomly chosen women aged 15 to 49 years. RESULTS: The seroprevalence of HSV-2 was 39%. Only 2% had a history of genital herpes. HSV-2 was associated with antibody to HIV-1 (OR=2.3 [CI, 1.1-4.7]), syphilis (OR=4.7 [CI, 1.4-4.7]), and genital ulcers (OR=9.7 [CI 2.5-36.9]). Age, sexual debut, number of sex partners, and history of spontaneous abortion were found to be significantly associated with HSV-2. Eighty-two percent of the women with genital ulcers were HSV-2-seropositive, while syphilis accounted for 6% of cases. HSV-2 may thus be the most common cause of genital ulcers in this population. CONCLUSION: In view of the high HSV-2 seroprevalence and its association with HIV-1 and genital ulcers, integration of HSV-2 therapeutic management in STD syndromic algorithms is recommended. Counseling on symptom recognition, asymptomatic shedding, and preventive measures is needed.

Adolescent↗
PubMed2003

Extra-abdominal fibromatosis: a case report.

Head and neck fibromatosis is a rare disease with a variable clinical picture. We report the case of a 40-year-old woman who had a 1-week history of a painless mass overlying her right neck. Histology confirmed a diagnosis of extra-abdominal fibromatosis. Two unusual features of this case were the site of the lesion and its rapid growth. In this article, we discuss the clinical picture of head and neck fibromatosis, its etiology and pathology, and current opinion regarding its treatment.

Adult↗
PubMed2002

Reproductive tract infections and the risk of HIV among women in Moshi, Tanzania.

OBJECTIVES: The objectives of the study were to determine the prevalence of HIV and reproductive tract infections (RTIs); to compare the occurrence of RTIs among HIV-infected and non-infected women; and to assess the association of HIV with RTIs and behavioral factors among women aged 15-49 years. METHODS: A cross-sectional study was conducted in late 1999 among 382 consenting women attending three primary healthcare clinics. They were interviewed and screened for HIV-1 and RTIs. RESULTS: The prevalence of HIV-1 was 11.5%. Sixty-four percent of the women had one ongoing treatable RTI. Endogenous and sexually transmitted RTIs were higher in HIV-positive than negative women and 84% of the HIV seropositive women were co-infected with one treatable RTI. HIV was significantly associated with cervicitis (chlamydial or gonococcal) [OR = 3.2 (CI 1.1-13.2)], HSV-2 [OR = 2.6 (CI 1.3-5.1)], bacterial vaginosis [OR = 1.9 (CI 1.1-4.1)], genital warts [OR = 4.8 (CI 1.1-22.2)], and presence of vaginal discharge [OR = 2.7 (CI 1.3-5.2)]. Having more than one lifetime sexual partner, a history of infant mortality or a partner who had other wives or resided away from home > 6 months, were risk factors for HIV infection. CONCLUSION: HIV-1 and RTIs are a major public health problem among women in this population. Integration of routine screening and treatment of RTIs in the reproductive health clinics will be an important strategy to combat HIV in the area. Further, innovative behavior interventions targeting both men and women, preferably as couples are needed.

Adolescent↗
PubMed2002

Female genital cutting in Kilimanjaro, Tanzania: changing attitudes?

OBJECTIVES: To study the prevalence, type, social correlates and attitudes towards female genital cutting (FGC) among urban women in Kilimanjaro, Tanzania; and to examine the association between FGC and gynaecological problems, reproductive tract infections (RTIs) and HIV. METHODS: In 1999, 379 women attending reproductive health care clinics were interviewed and underwent pelvic examination. Specimens for RTI/HIV diagnosis were taken. RESULTS: Seventeen per cent had undergone FGC, mostly clitoridectomy (97%). Female genital cutting prevalence was significantly lower among educated, Christian and Chagga women. Women aged >or=35 were twice as likely to be cut as those < 25 years. Seventy-six per cent of those who had undergone FGC intend not to perform the procedure on their daughters. Age < 25 years (P < 0.0001) and low parity (P < 0.01) were predictors of that intention. There was no association between RTIs, HIV or hepatitis B and FGC. CONCLUSION: FGC is still fairly common but there is evidence of a change of attitude towards the practice, especially among young women. The opportunity to educate women who attend reproductive health care facilities on FGC should be taken.

Adolescent↗