BACKGROUND: Hypertension is a major public health challenge worldwide. This study aims to estimate the prevalence and characterize factors associated with hypertension in Mazar Sharif, Afghanistan.

METHODS: A cross-sectional study was conducted in Mazar Sharif from April to May 2015 using the World Health Organization (WHO) STEP-wise approach. Data on demographic, socioeconomic and lifestyle factors were collected including blood samples for testing blood glucose and lipids.  Bivariate and multivariable analyses were undertaken to explore the association between hypertension and potential predictors.

 RESULTS: Of the 1,231 participants, 664 (53.9%) were females. The prevalence of hypertension was 30.9% (95% CI: 28.3 – 33.4). Factors independently associated with hypertension were: age groups of 35 – 45, 45 – 55 and 55+ (OR=2.63, 95 % CI: 1.80 – 3.84; OR=5.32, 3.52 – 8.04; OR=10.99, 7.19 – 16.81) compare to 25-34 age group; gender (male) (OR=1.67, 95%CI:1.21 – 2.32); marital status (OR=3.12, 95%CI:1.21 – 8.05), reclining ≤  3 hours per day (OR=0.63, 95%CI:0.46 – 0.85); central obesity (OR=2.16, 95%CI:1.53 – 3.04); BMI ≥ 30Kg/m2 (OR=2.33, 95%CI: 1.61 – 3.36).

 CONCLUSION: We found high prevalence of hypertension in this study cohort. As in other studies, we found that age, gender, marital status, staying at home, central and general obesity were predictors of hypertension. It is likely that strategies aimed at lowering blood pressure in other parts of the world will be useful in our study population.

 Benign mucous membrane pemphigoid (MMP) is an autoimmune disease characterized by chronic vesiculo-bullous eruptions, predominantly on mucous membranes but occasionally on the skin. The diagnosis is hard to achieve due to similarity in clinical picture with other vesiculo-bullous lesions such as pemphigus or bullous pemphigoid, thereby, posing a diagnostic dilemma for the clinician. Histopathology can confirm the diagnosis; however, corticosteroids can be started to relieve the symptoms while confirmatory reports are not available as it is common treatment for most mucosal lesions. After histopathology report, if diagnosis of MMP is established, anti-leprotic drug can be started along with corticosteroids. We report a case of MMP in a 43 year-old female who presented with difficulty in eating and pain in her mouth (buccal mucosa). Skin lesions were also present on legs and shoulder. Oral mucosal lesions were managed with anti-leprotic drug (dapsone), and topical and systemic corticosteroids. Such approaches not only result in immediate relief of symptoms and improved clinical outcomes but also provide a better quality of life for patients.

Supernumerary teeth are the teeth present in addition to the normal set of teeth and are not uncommon in the general population. Presence of supernumerary teeth may affect the aesthetics of an individual and hence need appropriate management. It is however rare to find multiple supernumerary teeth which are not associated with any syndromes. Non-syndromic multiple supernumerary teeth have a predilection to occur in the mandibular premolar region. This paper reports an unusual case of an 18 year old boy with two completely erupted additional premolars on either side of the mandibular arch.

BACKGROUND: Hearing impairment is a major disability. The otologic assessment together with high-resolution CT images is an important step to obtain precise diagnostic profile of ear malformations. This study was conducted to obtain the detailed anatomy and objective assessment of the ear in patients presenting with hearing loss in a tertiary care otologic center using high-resolution CT scan. 

METHODS: A cross-sectional study of 55 patients with hearing loss who had undergone high-resolution CT scans at Hospital Universiti Sains Malaysia from 1^st January 2008 until 31^st May 2014. Patients with temporal bone fractures, malignancy, post-operative ear and cholesteatoma were excluded.

RESULTS: Nine patients noted to have external ear anomaly on right ear and 7 patients on left ear. Middle ear abnormality in both ears was seen in 2 patients. Patients noted to have cochlear anomaly on the right ear (R) were 8 and left ear (L) were 4. Measurements of vestibular aqueduct diameter were 0.08 ± 0.09 cm (R) and 0.06 ± 0.04 cm (L), lateral semicircular canal diameter 0.10 ± 0.03 cm (R) and 0.10 ± 0.02 cm (L), vestibule diameter 0.30 ± 0.06 cm (R) and 0.31 ± 0.05 cm (L), bone width between the lateral vestibular wall and the inner wall of the lateral semicircular canal diameter 0.35 ± 0.07 cm (R) and (L) and internal acoustic meatus diameter 0.40 ± 0.08 cm (R) and 0.41 ± 0.08 cm (L).

One patient had cochlear aplasia and common cavity deformity, 2 patients had lateral semicircular dehiscence and internal acoustic meatus stenosis, 4 patients had cochlear ossification and 5 patients were noted to have enlarged vestibular aqueduct. 

CONCLUSION: High-resolution CT scan image is a good single imaging modality to obtain an objective measurement of the ear as well as to detect subtle or underestimated ear anomalies.