Smoking and its association with cryptorchidism in Down syndrome

Summary Introduction: Cryptorchidism is a common and prevalent condition in patients with Down syndrome. Environmental factors, such as smoking, can be associated with malformations during fetal development. The study of the prevalence of cryptorchidism and its association with parental tobacco use in Down syndrome can contribute to alert health care professionals, patients and family members regarding the prevention of the harms caused by cryptorchidism and its possible predisposing factors. Objective: To evaluate the prevalence of cryptorchidism in Down syndrome and its association with maternal and paternal smoking. Method: Forty (40) patients of a public clinic specialized in Down syndrome were evaluated, using a semi-structured questionnaire for evaluation of antecedents and sociodemographic characteristics, as well as physical and complementary examinations. Results: Cryptorchidism was observed in 27.5% of the patients (95CI 15.98-42.96). Of these, 55% (5/9) were the children of mothers who smoked during pregnancy, and 19.35% (6/31) were the children of mothers who did not smoke during pregnancy (OR = 5.26 [95CI 1.06-25.41]; p=0.032). Similarly, paternal smoking was also observed in greater frequency among the parents of cryptorchid patients compared with subjects with descended testis, 63.36% (7/11) and 31.03% (9/29), respectively (OR = 3.89 [95CI 0.91-16.73]; p=0.060). Conclusion: The prevalence of cryptorchidism is high in patients with Down syndrome. We can show a strong association between smoking parents and the occurrence of cryptorchidism, especially when it comes to maternal smoking.

Knowledge and practices of pregnant women regarding exercise during pregnancy : a comparison between private and public sector

Introduction: Evidence suggests that pregnant women who lead sedentary lifestyles and have a poor knowledge of exercise during pregnancy are at risk of developing diseases like gestational diabetes, pre-eclampsia and low back pain along with many other chronic conditions. An exercise program during pregnancy has benefits for both the mother and the child. No studies have ascertained the knowledge and practices of exercise in pregnant women in South Africa, furthermore, there was a need to conduct research regarding exercise amongst South African pregnant women, particularly to determine whether any barriers to physical activity exist. Aim: To compare the knowledge and practices of pregnant women regarding exercise during pregnancy between a selected private practice and public clinic. Methodology: A quantitative, descriptive, cross sectional survey was used in this research study. The population consisted of pregnant women (n = 400) attending both public and private sector antenatal care in the Ethekwini municipal area of KwaZulu-Natal, South Africa. Public sector participants were drawn from the Addington Hospital public antenatal clinic and private sector participants were drawn from the gynaecological practice of Dr D Sankar. Purposive, stratified sampling was used. Following the signing of an informed consent form, data was collected by means of a self-administered questionnaire. A minimum sample size of 324 patients was calculated by the statistician. Descriptive statistics, such as frequencies and percentages were used to describe the demographic profile of respondents and their physical activities. Inferential statistics, including Chi-Square tests of association and student t-tests were used to determine differences in proportions and means respectively between the two categories of participants. Odds ratios (OR) were calculated to ascertain the measure of association between a risk factor and an outcome. Results: There were 198 (57.6%) participants from the private gynaecological practice and 146 (42.4%) from the public clinic at Addington Hospital. The mean age of the study population was 27.65 ± 5.3 years. Almost half of the study population were Indians (46.2%). Blacks made up the second largest proportion of the study population (39.2%). More than half of the study participants were involved in exercise during their pregnancy (57.1%). However, only 37% of the study population met the international criteria of physical activity, which is 30 minutes of moderate -intensity aerobic exercise, per day, for 5 days a week, during pregnancy as set out by the American College of Obstetrics and Gynecologists (2002). However, there was evidence of unstructured physical activity which increased the level of acceptable physical activity in the majority of participants 82.1%. Walking was the most common activity that the women engaged in from both the private sector (88.8%) and public clinic (89.3%). The average time spent on walking was more than 30 minutes a day. Household chores and climbing stairs also increased the levels of physical activity within the participants. Only a minority of participants (35.4%) stated that they were diagnosed with an adverse health condition, which prevented them from exercising. Some participants who did not exercise reported that fatigue was the reason for not being physically active (51.6%). Conclusion: Interventions need to be implemented to increase the knowledge of physical activity amongst pregnant women and the benefits that are associated with it. An attempt needs to be made by health practitioners to try and increase the level of physical activity among pregnant women, so that they may benefit from its effects.

Prevalence of STI symptoms and high levels of stigma in STI healthcare among men who have sex with men in Dar es Salaam, Tanzania: a respondent-driven sampling study

Symptoms of sexually transmitted infections (STIs), whether they are presented for treatment or diagnosis, and how they are received by the clinician where they are presented, may be concomitants of stigma associated with homosexuality in homophobic climates. We analyzed respondent-driven sampling data from a study on 200 young men who have sex with men (MSM) in Dar es Salaam, Tanzania to examine sample prevalence, treatment and clinician response to 10 symptoms potentially associated with STIs. Survey measures included 10 self-reported STI symptoms, further specified according to location (genital, anal, oral), further specified according to place of diagnosis, place of, treatment whether there was pharmacy treatment or self-medication, healthcare worker (HCW) inquiries about source of infection and whether the HCW was polite. Most common symptoms reported were genital pain, burning urination, genital itching/burning, penile discharge, and groin swelling. Anal symptoms had the lowest proportion of treatment at public clinics and among the highest proportion of pharmacy treatment; anal sores had the highest proportion of self-medication. HCWs were reported as not being polite in response to 71–90% of the symptoms, (median = 82%). The findings suggest that stigma and negative HCW response are barriers to public clinic treatment for MSM in Tanzania and that these may have implications for both STI treatment and the HIV cascade.