الطب

Obesity is a major public health concern internationally and this study aims to identify the Prevalence of obesity in mentally disabled children in special education centers in Khartoum state. This study was conducted at the forty special education institutes in Khartoum state including its seven governorates (Khartoum, Jabal Olia, Omdurman, Karary, Ambdh, Bahry, and East Nile). The number of children was 290 children; 190 males and 100 females at age of 10-18 years. This is a descriptive study to identify the Prevalence of obesity in mentally disabled children in special education centers in Khartoum state. Obesity was defined according to the child\\\'s percentage weight for height. All children had an Intelligence Quotient (I.Q) test carried out within the last six months prior to the start of this study. Intelligence Quotient (I.Q) test was conducted using the Stanford – Binet test that was adapted to the Sudanese culture by Malik Badri. The study showed that the prevalence of the obesity in mentally disabled children is 28.3% where it reaches 27.4% in males and 30.0% in females. The prevalence of the obesity is insignificant associated with sex, age or Intelligence Quotient of the children. Nutrition care should be incorporated in the multi-dimensional care for such group of children. Key words: Obesity - Mental retardation - Children - Khartoum state.

Name: Dr. Mohammed Wael Daboul D.D.S, MSc. Biology, MT- Ascp, Laboratory Medicine specialist CHOLESTEROL AND TRIGLYCERIDE STATISTIC AND STUDY The purpose of the topic was to do a statistical analysis of both levels of cholesterol and triglyceride for a sample chosen from people living in Damascus as a screening test. Aiming to identify the average levels of both cholesterol and triglyceride and find out the percentage of any elevation in those levels over the boarder line. Then the study pland to compare the Values between males and females, in our community and with other values from other world communities. The study aimed by a statistical manner to analyze the possibility of having one test, whether cholesterol or triglyceride to be able to replace the other. Additionally, the study aimed to find out an existence of any correlation between the cholesterol and triglyceride concentration in the same individuals in our sample. The total number of the individuals who had cholesterol-screening test was 290, 139 females and 151 males, and for the triglycride, it was as a total of 270, 124 females and 146 males, chosen from people attending the lab for general checkup between Jan- 2004 and Aug-2005. · _ Both the average and standard deviation were taken for cholesterol and triglyceride in all the categories males, females and both and included in a table. _ The percentage of individuals who had elevated level of cholesterol or triglyceride was calculated, _ And I designed a study on 180 individual from both sex whom I did both cholesterol and triglyceride tests on them from the same sample, to find out, whether one of both tests is capable to replace the other, and I used the (F- test) and then (the student T- test) on both sexes to gather and on each sex separately. _ Then it was decided to find out the existence of any kind of correlation between cholesterol and triglyceride levels in each individual of the 180 screened. The results were as follows: The percentage of elevated cholesterol > 200 mg/dl including both males and females sample together, was %56 and the average cholesterol level was 206.5 mg/dl, while the percentage of elevated triglyceride level > 150mg/dl was %47 and the average triglyceride level was 160.1 mg/dl. The t-student test showed in 180 individual from both sex, the value 4.62 and the correlation was 0.276 . While it showed the value of 0.63 on the female alone sample. The purpose of the study was to evaluate and compare the cholesterol and triglyceride levels in a statistical manner on a sample chosen from Syria, with other samples from different parts of the world in order to identify any elevation in both cholesterol and triglyceride level in our sample (which indeed, was found), aiming to draw attention of the community to the importance of establishing a program in Syria that consider reducing the cholesterol and triglyceride levels for better health. Further more, the study found that the cholesterol or the triglyceride tests are independent of each other which means that one test will not be sufficient in any way to express the other test significance. Additionally, the statistical analysis found that a correlation exists between the cholesterol, triglyceride increase / decrees levels on our female samples but not in our males.

This research paper introduces more explanation about the relationship among Glucose , cholesterol and triglyceride and the correlations found . We came into the following conclusions: 1- The presence of both high cholesterol and high triglyceride together, contributes to the increase cases of high glucose in plasma. The study showed in specimen -1- a significant difference in the increase cases of high glucose ( the percentage of increase is 42.52% ) among those who had high cholesterol and high triglyceride concentration when compared to those who had only high cholesterol and normal triglyceride concentration.( the percentage was only 22.08%). 2- No significant difference present in the elevated cases of high glucose concentration between the cases of high cholesterol and high triglyceride concentration association ( the percentage was 42.52%) and just the high triglyceride and normal cholesterol association ( percentage was 46.9%) - specimen 2- . From 1&2 we conclude that the high triglyceride concentration but not the high cholesterol is more important in the association with the increase cases of high glucose concentration in plasma. 3- The high triglyceride alone has a significant effect on the increase cases of high glucose concentration in plasma ( the percentage of high glucose is 46.91%). when compared to high cholesterol association as (the percentage of high glucose is 22.08%).Specimen -3-. 4- Once there is association of both high glucose and high triglyceride , it will be accompanied with an increase cases of high-cholesterol ( 57% high cholesterol cases). Specimen -4-. 5- High triglyceride and high glucose are associated with elevated cases of high cholesterol ( 61.61% cases of high cholesterol), that means that the high triglyceride is a factor in the increase cases of high cholesterol on non diabetic patients. Specimen -5- . 6- Under (1) degree of freedom and 5% level of significance , the results shows no significant difference between the high triglyceride and the high glucose separately effecting the elevated cases of high cholesterol , (specimen 6) , but the elevated cases of high cholesterol percentage was 61.61% with the high triglyceride and normal glucose association , and it was 38.64 % with the high glucose and normal triglyceride association (see the diagram). That means that, there is a difference even it is non significant at 5% level , but once the level of significance is changed to 10% , then the hypothesis is rejected and the difference in the number of cases of high cholesterol is considered significant . And the specimen ,A6, concludes no significant difference between the high glucose normal triglyceride on the increase number of cases of high cholesterol when compared to normal glucose normal triglyceride. The specimen B6 showed a significant difference when comparing the effect of normal glucose normal triglyceride ( 31.1% of increase high cholesterol cases ) with high triglyceride normal glucose ( the percentage of increase high cholesterol is 61.61%). 7-High glucose is primary associated with elevated cases of high triglyceride in plasma. Specimen 7. 8- The company of both high glucose and high cholesterol will associate with increase of high triglyceride cases in plasma when compared to high cholesterol cases only ( specimen 8) . Specimen 8A showed a significant difference between the high cholesterol normal glucose ,and the normal cholesterol normal glucose in the increase cases of high triglyceride in plasma . while the specimen 8B showed a significant difference between the high glucose normal cholesterol and normal cholesterol normal glucose in the increase cases of high triglyceride. And in summary, both high triglyceride and high glucose separately or in association , will associate with increase cases of high triglyceride in plasma. 9- Both high cholesterol and high glucose have similar effect on high triglyceride elevation in plasma and no significant difference in the elevation seen between both. Specimen 9. 10- From table 10 we conclude: High triglyceride cases are mostly elevated when association of high cholesterol and high glucose is present ( the elevation percentage is 308%), then comes High triglyceride elevation with high glucose and normal cholesterol (239%), both are in comparison with the high triglyceride elevation in association with normal levels of glucose and cholesterol . Next comes the high glucose elevated cases in association with high triglyceride and normal cholesterol(the elevation percentage is 278%) and in association with high triglyceride and high cholesterol(the elevation percentage is 250%) . both are compared with the elevation cases of high glucose with normal levels of triglyceride and cholesterol . Then High triglyceride cases are also elevated when association of high cholesterol and normal glucose (219%) when compared to normal cholesterol normal glucose cases of high triglyceride elevation. Next is high cholesterol cases of elevation when associated with high triglyceride and normal glucose (198%) and when associated with high triglyceride and high glucose the percentage of elevation is(183%), in comparison with normal triglyceride normal glucose cases of high cholesterol elevation. But as far as the cases of high glucose elevation in association with high cholesterol and normal triglyceride , the percentage was (130%) when compared to the elevation with normal cholesterol normal triglyceride association , and the cases of high cholesterol elevation in association with high glucose and normal triglyceride comes in the end , the percentage was (124%) when compared to the elevation with normal glucose normal triglyceride association. That means that both the elevations are limited and non significant according to our study , which means that the correlation between high cholesterol and its association with elevated glucose or the opposite, high glucose and its association with elevated cholesterol is highly limited .

In summary Dr. Mohammed Wael Daboul (D.D.S, MSc. Biology, MT- Ascp, Laboratory Medicine specialist.) A Study of the correlation in the elevation of , Glucose , cholesterol and triglyceride in human plasma This research paper introduces a scientific study with a statistical manner to evaluate the correlation and relationship among the three parameters , Glucose , cholesterol and triglyceride through their concentration in blood and the effect of concentration change of one of the parameters, on the others. We have chosen our sample which counts 438 individuals males and females who attended our lab for either periodical checkup or type (2) diabetes patients, excluding those who are under insulin treatment , and diabetic type (1) patients. The purpose of that exclusion is to restrict the influential factors in our study and to concentrate on relationship of the three parameters mentioned above. 27 specimen have been studied which carried out all the possible correlations among the three parameters . In each specimen , we compared the three different categories according to the following hypothesis ( there is no significant difference among the elevated cases in the category A, or B, or C under 5% level of significance and under (x) degree of freedom .) . We used the CHI- SQUARE test as away of analyzing our data and confirming or rejecting the hypothesis. Our research results came into the following conclusions: 1- On normal non diabetic individual, there is a correlation between the triglyceride and cholesterol , as the elevation in cholesterol concentration in plasma is associated with an increase cases of triglyceride elevation over 150 mg/dl in blood and vies versa , the elevation in triglyceride concentration in is associated with an increase cases of cholesterol elevation over 200 mg/dl in plasma . 2- In diabetic patients , ( glucose > 110 mg/ dl ) the study showed that ,elevation in triglyceride concentration will not be necessarily associated with an increase cases of cholesterol elevation over 200 mg/dl in plasma , and the elevation in cholesterol concentration in plasma will not be necessarily associated with an increase cases of triglyceride elevation over 150 mg/dl in blood.( but according to the tow tables in specimen 2 and 3 , the results show that, the elevation in cholesterol concentration in plasma is associated with an increase cases of triglyceride elevation over 150 mg/dl in blood , but any how , the the CHI- SQUARE test showed no significant difference ) . We conclude that in diabetic situation , cholesterol and triglyceride elevation act independently and not necessarily in correlation ( table specimen 4 , 8). 3- 3-The elevation of cholesterol concentration alone , will have no effect on increasing the elevated glucose cases in plasma , which means that the elevation in glucose is independent from the cholesterol concentration alone in blood, so our studies did not prove any direct relation between cholesterol and its effect on diabetes ( specimen table 9,10,11,12). 4- Glucose elevation in blood has an effect on the increase cases of elevated triglyceride in blood > 150 mg/dl ( once the cholesterol concentration is normal < 201 mg/dl) . but once the cholesterol is elevated > 200 mg/dl , then our study conclude no direct effect for glucose elevation alone on the increase cases of elevated triglycerides ( specimen table 13,14,15,16). 5- No direct correlation between glucose elevation and the elevation in the number of cases of cholesterol elevated > 200 mg/dl no matter what the triglyceride concentration is. That concludes that diabetes alone , should not be considered a cause for cholesterol elevation in plasma.(table 17,18,19,20 6- Our Statistical results tells that the elevation in triglyceride concentration in plasma, is strongly correlated with elevation in the number of cases of glucose elevated > 110 mg/dl no matter what the cholesterol concentration is , which means , that triglyceride alone regardless of cholesterol , is strongly related with diabetes development. ( specimen , table 21,22,23,24 ). 8- 7-Our study also has shown that , the combination of elevation of any of the two parameters mentioned , should absolutely associate with the elevation in the number of cases of the elevated concentration of the third factor where we see : A- The combination elevation in both triglyceride and cholesterol concentration is associated with increase cases of glucose elevated > 110 mg/dl ( specimen , table 25) . B- And The combination elevation in both triglyceride and glucose concentration is associated with increase cases of cholesterol elevated > 200 mg/dl ( specimen , table26) . C- And The combination elevation in both cholesterol and glucose concentration is associated with increase cases of elevated triglyceride > 150 mg/dl ( specimen , table27) .

Introduction and objectives: Cutaneous leishmania is spreading fast in the Middle East. New foci are being discovered continually. In order to achieve treatment, it is then, important to find easy, cheap and highly sensitive diagnostic methods that can help in diagnosing the cutaneous leishmania. Though, the traditional microscopic method is considered the reference method in leishmania diagnosis, its sensitivity is considered low, and the method cannot detect more than 70% of the true positive cases. This study aims at developing the microscopic method to achieve a full detection of all positive cases of leishmania. Methods: 50 human cases had been studied, 43 cases were males and 7 were females. Samples were taken from the secretions of the skin lesion. The slides were investigated for any unfamiliar microscopic structures or components that may have a possible diagnostic significance. Microscopic photos were taken for the presumed unfamiliar figures and structures and they were identified, classified according their presence rate among the different cases in a specified table. Results: The mononuclear cells with tails are present in cutaneous leishmania samples at (98% rate). They are associated with LD bodies in 50% of the cases studied. The polygonic figures and the spherical forms are present in cutaneous leishmania samples at the same rate (60%). They both are associated with LD bodies in 24% of the cases studied. The small promastigote like forms are seen in cutaneous leishmania samples at (76%) rate. They are usually associated with LD bodies in 26% of the cases studied. While the giant promastigotes like forms are available in (80% rate) and are associated with LD bodies in 28% of the cases studied. Candle flame forms are present at (40% rate) and are associated with the LD bodies in 21% of the cases. Discussion: It is possible to make use of those discovered figures and microscopic structures in diagnosing cutaneous leishmania especially in cases when the LD bodies are totally absent in the microscopic slide. The presence of those microscopic structures and figures and their association with the LD bodies availability is an absolute clue that the infection with cutaneous leishmania is associated with those figures appearance and hens, they can be considered as signs of exposure to the cutaneous leishmania. When performing the microscopic procedure for leishmania diagnosis, it is suggested that, not only one, but at least, three different types or even more of those figures must be seen in the microscopic slide in order to diagnose the disease in case of LD bodies absence. In case LD bodies are present, then it is sufficient enough to only observe them in order to diagnose the disease. It is then; appropriate to say that this study helped in elevating the classical microscopic method sensitivity into 100% in addition to increasing the specificity in to a higher rate.

Nurses’ Social Ranks and Roles in the Medical Field Dr. Abdul Aziz Ali Khazali Abstract The aim of the present paper is to study nursing social ranks and roles via investigating the developmental stages of nursing and the changes through which the nursing social ranks and roles undergo in medical field of Jordan. 219 subjects holding various medical roles have been chosen to give their views about a number of points raised in the questionnaire. The points concern the nature of medical job, salaries, the merits of the job, psychological stability and security, respectability, relationship with colleagues, etc. The points concerning social ranks and roles have been numerically arranged in accordance with their importance to nurses. The paper has concluded that these social ranks and roles vary if these points vary too, and nurses give their utmost priority to wages and salaries.