Search PubMed⌕ Search

Biomedical subjects

H Yusuf

Publications and source records attributed to H Yusuf.

At least 19 recordsLinked to original sources

Oral submucous fibrosis in a 12-year-old Bangladeshi boy: a case report and review of literature.

Oral submucous fibrosis is commonly seen in the adult population of the ethnic minorities in the UK, although its presentation in a child is rare. Whilst the condition is considered multifactorial and irreversible, we present a case of oral submucous fibrosis in a 12-year-old Bangladeshi boy whose cessation of habitual betel nut chewing and forcible mouth chewing exercises led to an improvement in his mouth opening, although his ability to protrude his tongue remained unaltered. The clinical features, pathogenesis and management of submucous fibrosis are described. The widespread use of betel quid among Asians in the UK is summarized and the importance of its recognition as a precancerous condition is emphasized.

Areca↗

Hepatitis B vaccination practices in hospital newborn nurseries before and after changes in vaccination recommendations.

BACKGROUND: Routine use of hepatitis B vaccine for low-risk newborns was suspended on July 7, 1999, because of concern about the potential risk of thimerosal, a mercury-containing vaccine preservative. Reinstatement of the birth dose was recommended when a thimerosal-free vaccine became available. OBJECTIVE: To explore changes in hepatitis B vaccination practices for newborns related to the revised recommendations for low-risk infants (in this study, the terms newborn and infant are used interchangeably). DESIGN: A telephone survey of a random sample of 1000 US hospitals. PARTICIPANTS: Nurse managers, nursery directors, and staff nurses of the newborn nurseries. MAIN OUTCOME MEASURES: Nursery vaccination practices before and after July 7, 1999, and the availability and use of thimerosal-free vaccine. RESULTS: Interviews were conducted with 773 (87%) of 886 eligible hospitals. Before July 7, 1999, 78% of the hospitals reported vaccination practices that were consistent with recommendations at that time, although only 47% vaccinated all low-risk infants at birth. After July 7, 1999, almost all hospitals discontinued vaccination of low-risk infants, in accordance with the recommendation change; however, there was a 6-fold increase in the number of hospitals that were not vaccinating all high-risk infants. After the introduction of thimerosal-free vaccine, only 39% of the hospitals reported vaccinating all low-risk infants. CONCLUSIONS: Most hospital nurseries altered their newborn hepatitis B vaccination practices consistent with changes in national recommendations. However, unintended consequences included the failure of some hospitals to continue vaccinating all high-risk infants and the delay in reintroducing vaccination for low-risk newborns after the introduction of a thimerosal-free vaccine. Assessments of the appropriateness of this country's response to the threat of thimerosal in vaccines should consider these findings.

Data Collection↗

Hepatitis B vaccination coverage among United States children.

BACKGROUND: In 1991 the Advisory Committee on Immunization Practices recommended vaccination of all infants with three doses of hepatitis B virus vaccine (HepB) by 18 months of age as a key component of a comprehensive strategy to eliminate hepatitis B virus transmission in the United States. The American Academy of Pediatrics and the American Academy of Family Physicians published similar recommendations soon afterward. METHODS: Data were obtained from the National Immunization Survey, a survey that began in 1994 and is conducted quarterly by the Centers for Disease Control and Prevention to estimate vaccination coverage among noninstitutionalized US children 19 to 35 months of age. RESULTS: The 1999 National Immunization Survey data indicate that approximately 88.1% (95% confidence interval, 87.4, 88.8) of children 19 to 35 months of age had received at least three doses of HepB (HepB3). There has been a consistent increase in HepB3 coverage since 1994. However, the rate of increase has slowed in recent years and HepB3 coverage remains lower than coverage attained with three doses of diphtheria-tetanus-pertussis and Haemophilus influenzae vaccines. HepB3 coverage varied slightly by race/ethnicity and was highest among white and Asian children (89%). Coverage also varied by state; 26 states had levels of at least 90%. CONCLUSIONS: Since the 1991 recommendations for universal hepatitis B vaccination, there has been a dramatic increase in coverage levels among children 19 to 35 months of age. However, the Childhood Immunization Initiative goal of 90% coverage has not been reached. Therefore continued efforts are needed to protect US children against this serious but preventable infection.

Child↗

Attitudes, practices, and preferences of pediatricians regarding initiation of hepatitis B immunization at birth.

OBJECTIVES: To explore practices and attitudes of pediatricians toward administration of the first dose of hepatitis B vaccine to infants, and to identify factors influencing the decision of pediatricians to initiate immunization at birth versus at 1 to 2 months of age. METHODS: A random sample of 600 pediatricians obtained from the American Academy of Pediatrics membership database was surveyed by mail. RESULTS: Three hundred eighty (68%) of the 563 pediatricians who were located responded to the survey. Of these 380 pediatricians, 279 provided routine immunizations to children. Of the 270 pediatricians who vaccinated children with hepatitis B vaccine and indicated their practice regarding the birth dose, 50% offered the first dose of hepatitis B vaccine at birth to all infants; the rest either offered the vaccine at birth only to infants of hepatitis B surface antigen-positive mothers and mothers whose serostatus is unknown, or did not offer the birth dose to any infants at all. Practicing in the inner city, working for a medical school or government hospital, and living in a state with universal immunization supply policies were associated with the respondent giving the birth dose. The strongest perceived barriers to giving the birth dose in the hospital were the difficulty tracking these vaccines (39%), the increased cost (27%), and the lack of reimbursement from insurance companies (26%). If a combination vaccine that includes hepatitis B; diphtheria, tetanus, pertussis (diphtheria and tetanus toxoids and acellular pertussis vaccine); and polio (inactivated poliovirus vaccine) antigens become available in the near future, then 38% of physicians who currently give the birth dose to all infants would prefer to wait until 2 months of age to initiate hepatitis B immunization. CONCLUSIONS: Efforts to achieve high implementation of hepatitis B birth dose administration may falter once a hepatitis B-containing pentavalent combination vaccine becomes available. Programmatic efforts should ensure prevention of perinatal hepatitis B virus transmission through universal prenatal hepatitis B surface antigen screening and immunoprophylaxis of high-risk newborn infants.

Health Knowledge, Attitudes, Practice↗

Median lip fissures and their management.

Median lip fissures are an uncommon condition and usually give rise to pain and episodes of bleeding. We report three cases of median lip fissures which were treated by surgical excision.

Adolescent↗

Oral self-mutilation by a 17-month-old child with Lesch-Nyhan syndrome.

We report a 17-month-old boy who was a known case of Lesch-Nyhan syndrome and presented with self-inflicted oral ulcerations of his lips and cheeks. He had a normal complement of caries-free deciduous teeth. Initially a conservative approach was planned and a bite plate made, but as a result of poor compliance and persistent ulceration and after consultation with his parents it was decided to extract all deciduous teeth.

Cheek↗

Progress toward integrating hepatitis B vaccine into routine infant immunization schedules in the United States, 1991 through 1994. Connecticut Hepatitis B Project Group.

OBJECTIVE: We assessed progress toward universal infant immunization against hepatitis B, which was first recommended in November 1991. METHODS: Multiple data sources were used to describe vaccination policies and trends in infant hepatitis B vaccine coverage. RESULTS: As of June 1993, 51% of the 63 local, state, and territorial immunization programs recommended hepatitis B vaccination of all newborns shortly after birth. The number of first dosages of hepatitis B vaccine administered to infants in public sector clinics increased rapidly from late 1992 to 1993, and at the end of 1993 was approximately two thirds the number of first dosages of other infant antigens. In a nationwide survey of hospital nurseries 47% offered hepatitis B vaccine to all newborns. Of 3982 sampled newborns in these hospitals, 36.2% had been vaccinated before discharge. In San Francisco and Connecticut, where public health officials encouraged hospitals to offer hepatitis B vaccination, first-dose coverage at discharge was 82.3% in 1994 and 69.1% in 1993, respectively. Coverage was higher in healthier infants and lower in infants of older or better-educated mothers. Results from the National Health Interview Survey demonstrate that three-dose completion at 12 months of age increased form less than 1% of children born in 1989 to 40% of children born in the fourth quarter of 1992. Vaccination at birth increased from less than 1% of infants born in 1989 to 32% of infants born in the second half of 1993. CONCLUSIONS: Infant hepatitis B vaccination has expanded rapidly since national recommendations were made; however, universal coverage has not been achieved.

Connecticut↗

Observations on 25 patients treated with ball-retained overdentures using the Astra Tech implant system.

Twenty-five adult patients with fully edentulous jaws, aged from 44 to 80 years were treated with seventy-one 3.5 mm diameter Astra Tech dental implants in the parasymphseal region. The length of these implants varied from 9 mm to 15 mm. Either two or three implants were inserted, subsequently exposed after a minimum period of 3 months, abutments and ball attachments placed. Full lower dentures incorporating gold alloy housings for ball-attachments were constructed. The average time that the implants were in situ was 4 years and 2 months, ranging from 1 year 3 months to 5 years and 7 months. Of the 71 implants placed, 67 achieved osseointegration-a success rate of 94%. The main complication was that of the ball-attachments becoming loose.

Adult↗

A mandibular fracture triggering trigeminal neuralgia.

The authors describe a case in which an elderly patient, who had previously been treated for trigeminal neuralgia, developed a subsequent fracture of the mandible at the site of a further trigger point. This presented difficulty in management of the case, and the necessary treatment is reviewed.

Aged↗