Search results for: prevalence proportion

Authors: N. Khursheed, M. Fatima, S. Jamal, A. Raza, S. Rattani, Q. Ahsan, A. Rasheed, M. Jawed

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Introduction: Antibiotics are among the commonly prescribed medicines to treat bacterial infections. Their misuse intensifies resistance, and overuse incurs heavy losses to the healthcare system in terms of increased treatment costs and enhanced disease burden. Studies show that 40% of empirically used antibiotics are irrationally utilized. The objective of this study was to evaluate prescribing pattern of antibiotics at six public sector tertiary care hospitals across Pakistan. Methods: A multicenter cross-sectional point prevalence survey (PPS) was conducted in selected wards of six public sector tertiary care hospitals in Pakistan as part of the Clinical Engagement program by Fleming Fund Country Grant Pakistan in collaboration with Indus Hospital & Health Network (IHHN) from February to March 2021, these included Jinnah Postgraduate Medical Center and Dr. Ruth K. M. Pfau Civil Hospital from Karachi, Sheikh Zayed Hospital Lahore, Nishtar Medical University Hospital Multan, Medical Teaching Institute Hayatabad Medical Complex Peshawar, and Provincial Headquarters Hospital Gilgit. WHO PPS methodology was used for data collection (Hospital, ward, and patient level data was collected). Data was entered into the open-source Kobo Collect application and was analyzed using SPSS (version 22.0). Findings: Medical records of 837 in-patients were surveyed, of which the prevalence of antibiotics use was 78.5%. The most commonly prescribed antimicrobial was Ceftriaxone (21.7%) which is categorized in the Watch group of WHO AWaRe Classification, followed by Metronidazole (17.3%), Cefoperazone/Sulbactam (8.4%), Co-Amoxiclav (6.3%) and Piperacillin/Tazobactam (5.9%). The antibiotics were prescribed largely for surgical prophylaxis (36.7%), followed by community-acquired infections (24.7%). One antibiotic was prescribed to 46.7%, two to 39.9%, and three or more to 12.5 %. Two of six (30%) hospitals had functional drug and therapeutic committees, three (50%) had infection prevention and control committees, and one facility had an antibiotic formulary. Conclusion: Findings demonstrate high consumption of broad-spectrum antimicrobials and emphasizes the importance of expanding the antimicrobial stewardship program. Mentoring clinical teams will help to rationalize antimicrobial use.

Keywords: antimicrobial resistance, antimicrobial stewardship, point prevalence survey, antibiotics

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Authors: H. El-Messiry, M. El-Zainy, D. Abdelkhalek

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Cone-beam computed tomography (CBCT) provides high-quality 3-dimensional images of dental structures because of its high spatial resolution. The study of dental morphology is important in research as it provides information about diversities within a population. Many studies have shown different shapes and numbers of roots canals among different races, especially in molars. The aim of this study was to determine the morphology of root canals of mandibular first and third molars in a sample of Egyptian population using CBCT scanning. Fifty mandibular first Molars (M1) and fifty mandibular third (M3) extracted molars were collected. Thick rectangular molds were made using pink wax to hold the samples. Molars were embedded in the wax mold by aligning them in rows leaving arbitrary 0.5cm space between them. The molds with the samples in were submitted for CBCT scan. The number and morphology of root canals were assessed and classified according to Vertucci's classification. The mesial and the distal roots were examined separately. Finally, data was analyzed using Fisher exact test. The most prevalent mesial root canal frequency in M1 was type IV (60%) and type II (40 %), while M3 showed prevalence of type I (40%) and II (40%). Distal root canal morphology showed prevalence of type I in both M1 (66%) and M3 (86%). So, it can be concluded that CBCT scanning provides supplemental information about the root canal configurations of mandibular molars in a sample of Egyptian population. This study may help clinicians in the root canal treatment of mandibular molars.

Keywords: cone beam computed tomography, mandibular first molar, mandibular third molar, root canal morphology

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Authors: R. O. Babatunde, O. M. Igbalajobi, F. Matambalya

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Moderate economic growth in developing and emerging countries has led to improvement in the food consumption and nutrition situation in the last two decades. Nevertheless, about 870 million people, with a quarter of them from Sub-Saharan Africa, are still suffering from hunger worldwide. As part of measures to reduce the widespread poverty and hunger, cash transfer programmes are now being implemented in many countries of the world. While nationwide cash transfer schemes are few in Sub-Saharan Africa generally, the available ones are more concentrated in East and Southern Africa. Much of the available literature on social protection had focused on the poverty impact of cash transfer schemes at the household level, with the larger proportion originating from Latin America. On the contrary, much less empirical studies have been conducted on the poverty impact of cash transfer in Sub-Saharan Africa, let alone on the food security and nutrition impact. To fill this gap in knowledge, this paper examines the impact of cash transfer on food security in Nigeria. As a case study, the paper analysed the Ekiti State Cash Transfer Scheme (ECTS). ECTS is an unconditional transfer scheme which was established in 2011 to directly provide cash transfer to elderly persons aged 65 years and above in Ekiti State of Nigeria. Using survey data collected in 2013, we analysed the impact of the scheme on food availability and dietary diversity of the beneficiary households. Descriptive and Propensity Score Matching (PSM) techniques were used to estimate the Average Treatment Effect (ATE) and Average Treatment Effect on the Treated (ATT) among the beneficiary and control groups. Thereafter, a model to test for the impact of participation in the cash transfer scheme on calorie availability and dietary diversity was estimated. The results indicate that while households in the sample are clearly vulnerable, there were statistically significant differences between the beneficiary and control groups. For instance, monthly expenditure, calorie availability and dietary diversity were significantly larger among the beneficiary and consequently, the prevalence and depth of hunger were lower in the group. Econometric results indicate that the cash transfer has a positive and significant effect on food availability and dietary diversity in the households. Expanding the coverage of the present scheme to cover all eligible households in the country and incorporating cash transfer into a comprehensive hunger reduction policy will make it to have a greater impact at improving food security among the most vulnerable households in the country.

Keywords: calorie availability, cash transfers, dietary diversity, propensity score matching

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Authors: Noor A. Hakim

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Several studies in the developed countries investigated the prevalence of diabetes and obesity among individuals from different socioeconomic levels and suggested lower rates among the higher socioeconomic groups. However, studies evaluating diabetes risk and prevalence of obesity among the population of middle- to high-income status in developing countries are limited. The aim of this study is to evaluate the risk of developing type-2 diabetes mellitus (T2DM) and the weight status of female students in private universities in Jeddah City, Saudi Arabia. This is a cross-sectional study of 121 female students aged ≤ 25 years old was conducted; participants were recruited from two private universities. Diabetes risk was evaluated using the Finnish Diabetes Risk Score. Anthropometric measurements were assessed, and body-mass-index (BMI) was calculated. Diabetes risk scores indicated that 35.5% of the female students had a slightly elevated risk, and 10.8% had a moderate to high risk to develop T2DM. One-third of the females (29.7%) were overweight or obese. The majority of the normal weight and underweight groups were classified to have a low risk of diabetes, 22.2% of the overweight participants were classified to have moderate to high risk, and over half of the obese participants (55.5%) were classified to be at the moderate to high-risk category. Conclusions: Given that diabetes risk is alarming among the population in Saudi Arabia, healthcare providers should utilize a simple screening tool to identify high-risk individuals and initiate diabetes preventive strategies to prevent, or delay, the onset of T2DM and improve the quality of life.

Keywords: risk of type 2 diabetes, weight status, college students, socioeconomic status

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Authors: Soroush Pakniyat-Jahromi, Jessica Bucciarelli, Souparno Mitra, Neda Motamedi, Ralph Amazan, Samuel Rothman, Jose Tiburcio, Douglas Reich, Vicente Liz

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Violence is defined as an act of physical force that is intended to cause harm and may lead to physical and/or psychological damage. Violence toward healthcare workers (HCWs) is more common in psychiatric settings, emergency departments, and nursing homes; however, healthcare workers in medical setting are not spared from such events. Workplace violence has a huge burden in the healthcare industry and has a major impact on the physical and mental wellbeing of staff. The purpose of this study is to compare the prevalence of patient agitation and violence in medical-surgical settings in BronxCare Hospital (BCH) Bronx, New York, one year before and during the COVID-19 pandemic. Data collection occurred between June 2021 and August 2021, while the sampling time was from 2019 to 2021. The data were separated into two separate time categories: pre-COVID-19 (03/2019-03/2020) and COVID-19 (03/2020-03/2021). We created frequency tables for 19 variables. We used a chi-square test to determine a variable's statistical significance. We tested all variables against “restraint type”, determining if a patient was violent or became violent enough to restrain. The restraint types were “chemical”, “physical”, or both. This analysis was also used to determine if there was a statistical difference between the pre-COVID-19 and COVID-19 timeframes. Our data shows that there was an increase in incidents of violence in COVID-19 era (03/2020-03/2021), with total of 194 (62.8%) reported events, compared to pre COVID-19 era (03/2019-03/2020) with 115 (37.2%) events (p: 0.01). Our final analysis, completed using a chi-square test, determined the difference in violence in patients between pre-COVID-19 and COVID-19 era. We then tested the violence marker against restraint type. The result was statistically significant (p: 0.01). This is the first paper to systematically review the prevalence of violence in medical-surgical units in a hospital in New York, pre COVID-19 and during the COVID-19 era. Our data is in line with the global trend of increased prevalence of patient agitation and violence in medical settings during the COVID-19 pandemic. Violence and its management is a challenge in healthcare settings, and the COVID-19 pandemic has brought to bear a complexity of circumstances, which may have increased its incidence. It is important to identify and teach healthcare workers the best preventive approaches in dealing with patient agitation, to decrease the number of restraints in medical settings, and to create a less restrictive environment to deliver care.

Keywords: COVID-19 pandemic, patient agitation, restraints, violence

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Authors: Innocent Atuhe, Babra Nalwadda, Grace Mulyowa Kitunzi, Annabella Haninka Ejiri

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Background: Atopic Dermatitis (AD) is one of the most prevalent and growing chronic inflammatory skin diseases in African prisons. AD care is limited in African due to lack of information about the disease amongst primary care workers, limited access to dermatologists, lack of proper training of healthcare workers, and shortage of appropriate treatments. We designed and implemented the Prisons Telederma project based on the recommendations of the International Society of Atopic Dermatitis. Our overall goal was to increase access to dermatologist-led care for prisoners with AD through teledermatology in Uganda. We aimed to; i) to increase awareness and understanding of teledermatology among prison health workers; and ii) to improve treatment outcomes of prisoners with atopic dermatitis through increased access to and utilization of consultant dermatologists through teledermatology in Uganda prisons: Approach: We used Store-and-forward Teledermatology (SAF-TD) to increase access to dermatologist-led care for prisoners and prisons staff with AD. We conducted a five days training for prison health workers using an adapted WHO training guide on recognizing neglected tropical diseases through changes on the skin together with an adapted American Academy of Dermatology (AAD) Childhood AD Basic Dermatology Curriculum designed to help trainees develop a clinical approach to the evaluation and initial management of patients with AD. This training was followed by blended e-learning, webinars facilitated by consultant Dermatologists with local knowledge of medication and local practices, apps adjusted for pigmented skin, WhatsApp group discussions, and sharing pigmented skin AD pictures and treatment via zoom meetings. We hired a team of Ugandan Senior Consultant dermatologists to draft an iconographic atlas of the main dermatoses in pigmented African skin and shared this atlas with prison health staff for use as a job aid. We had planned to use MySkinSelfie mobile phone application to take and share skin pictures of prisoners with AD with Consultant Dermatologists, who would review the pictures and prescribe appropriate treatment. Unfortunately, the National Health Service withdrew the app from the market due to technical issues. We monitored and evaluated treatment outcomes using the Patient Oriented Eczema Measure (POEM) tool. We held four advocacy meetings to persuade relevant stakeholders to increase supplies and availability of first-line AD treatments such as emollients in prison health facilities. Results: Draft iconographic atlas of the main dermatoses in pigmented African skin Increased proportion of prison health staff with adequate knowledge of AD and teledermatology from 20% to 80% Increased proportion of prisoners with AD reporting improvement in disease severity (POEM scores) from 25% to 35% in one year. Increased proportion of prisoners with AD seen by consultant dermatologist through teledermatology from 0% to 20% in one year. Increased the availability of AD recommended treatments in prisons health facilities from 5% to 10% in one year

Keywords: teledermatology, prisoners, reaching, un-reachable

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Authors: Maria Barbano Acevedo-Gomez, Elena Sonsoles Rodriguez-Lopez, Sofia Olivia Calvo-Moreno, Angel Basas-Garcia, Cristophe Ramirez

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Introduction: Urinary incontinence (UI) is defined as the involuntary leakage of urine. In persons who practice sport, its prevalence is 36.1% (95% CI 26.5%-46.8%) and varies as it seems to depend on the intensity of exercise, movements, and impact on the ground. Such high impact sports are likely to generate higher intra-abdominal pressures and leading to pelvic floor muscle weakness. Even though the emphasis of this research is on female athletes, all women should perform pelvic floor muscle exercises as a part of their general physical exercise. Pelvic floor exercises are generally considered the first treatment against urinary incontinence. Objective: The main objective of the present study was to determine the knowledge of the pelvic floor and of the UI in elite athletes and know if they incorporate pelvic floor strengthening in their training. Methods: This was an observational study conducted on 754 elite athletes. After collecting questions about the pelvic floor, UI, and sport-related data, participants completed the questionnaire International Consultation on Incontinence Questionnaire-UI Short-Form (ICIQ-SF). Results: 57.3% of the athletes reflect not having knowledge of their pelvic floor, 48.3% do not know what strengthening exercises are, and around 90% have never practiced them. 78.1% (n=589) of all elite athletes do not include pelvic floor exercises in their training. Of the elite athletes surveyed, 33% had UI according to ICIQ-SF (mean age 23.75 ± 7.74 years). In response to the question 'Do you think you have or have had UI?', Only 9% of the 754 elite athletes admitted they presently had UI, and 13.3% indicated they had had UI at some time. However, 22.7% (n=171) reported they had experienced urine leakage while training. Of the athletes who indicated they did not have UI in the ICIQ-SF, 25.7% stated they did experience urine leakage during training (χ² [1] = 265.56; p < 0.001). Further, 12.3% of the athletes who considered they did not have UI and 60% of those who admitted they had had UI on some occasion stated they had suffered some urine leakage in the past 3 months (χ² [1] = 287.59; p < 0.001). Conclusions: There is a lack of knowledge about UI in sport. Through the use of validated questionnaires, we observed a UI prevalence of 33%, and 22.7% reported they experienced urine leakage while training. These figures contrast with only 9% of athletes who reported they had or had in the past had UI. This discrepancy could reflect the great lack of knowledge about UI in sports and that sometimes an athlete may consider that urine leakage is normal and a consequence of the demands of training. These data support the idea that coaches, physiotherapists, and other professionals involved in maximizing the performance of athletes should include pelvic floor muscle exercises in their training programs. Measures such as this could help to prevent UI during training and could be a starting point for future studies designed to develop adequate prevention and treatment strategies for this embarrassing problem affecting young athletes, both male and female.

Keywords: athletes, pelvic floor, performance, prevalence, sport, training, urinary incontinence

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Authors: Billy Angel B. Bayot, Hubert Clyde Z. Guillermo, Daniela Eve Margaret S. Olano, Lian Angeli Kaye E. Suarez

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A utilization of Nipa palm fibers (Nypa fruticans) and Asian green mussel shells (Perna viridis) as additive materials in making fiber-reinforced concrete was carried out. The researchers collected Asian green mussel shells and Nipa palm fibers as additive materials in the production of fiber-reinforced concrete and were used to make 3 Setups containing 20g, 15g, and 10g of Nipa palm fiber varying to 10g, 20g, 30g of Asian green mussel shell powder and a traditional concrete with respect to curing period 7, 14, and 28 days. The concrete blocks were delivered to the UP Institute of Building Materials and Structures Laboratory (CoMSLab) following each curing test in order to evaluate their compressive strength. Researchers employed a Two-Way Analysis of Variance (ANOVA) and determined that curing days, concrete mixture, and the combined curing days with concrete have an effect on the compressive strength of concrete. ANOVA results indicating significant differences had been subjected to post hoc analysis using Tukey's HSD. These results then yielded the comparison of each curing time and different concrete mixtures with traditional concrete, which comes to the conclusion that a longer curing period leads to a higher compressive strength and Setup 3 (30g Asian green mussel shell with 10g Nipa palm fiber) has the larger mean compressive strength, making it the best proportion among the fiber-reinforced concrete mixtures and the only proportion that has significant effect to traditional one. As a result, the study concludes that certain curing times and concrete mix proportions of Asian green mussel shell and Nipa palm fiber are critical determinants in determining concrete compressive strength.

Keywords: Asian green mussel shells (Perna viridis), Nipa palm fibers (Nypa fruticans), additives, fiber-reinforced concrete

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Authors: Abanda Wilfred Chick

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Background: According to World Health Organization (WHO), the role of Information and Communication Technologies (ICT) in health sectors of developing nations has been demonstrated to have had a great improvement of fifty percent reduction in mortality and or twenty-five-fifty percent increase in productivity. The objective of this study was to assess the use of information and communication technologies in enhancing health care delivery for Human Immunodeficiency Virus (HIV) patients in Bamenda Health District. Methods: This was a descriptive-analytical cross-sectional study in which 388 participants were consecutively selected amongst health personnel and HIV patients from public and private health institutions involved in Human Immunodeficiency Virus management. Data on socio-demographic variables, the use of information and communication technologies tools, and associated challenges were collected using structured questionnaires. Descriptive statistics with a ninety-five percent confidence interval were used to summarize findings, while Cramer’s V test, logistic regression, and Chi-square test were used to measure the association between variables, Epi info version7.2, MS Excel, and SPSS version 25.0 were utilized for data entry and statistical analysis respectively. Results: Of the participants, one-quarter were health personnel, and three-quarters were HIV patients. For both groups of participants, there was a significant relationship between the use of ICT and demographic information such as level of education, marital status, and age (p<0.05). For the impediments to using ICT tools, a greater proportion identified the high cost of airtime or internet bundles, followed by an average proportion that indicated inadequate training on ICT tools; for health personnel, the majority said inadequate training on ICT tools/applications and half said unavailability of electricity. Conclusion: Not up to half of the HIV patients effectively make use of ICT tools/applications to receive health care. Of health personnel, three quarters use ICTs, and only one quarter effectively use mobile phones and one-third of computers, respectively, to render care to HIV patients.

Keywords: ICT tools, HIV patients, health personnel, health care delivery

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Authors: Chinyama Lukama, Million Phiri, Namuunda Mutombo

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Background: Improving access and utilization to high-quality sexual and reproductive health (SRH) information and services, including family planning (FP) commodities, is central to the global developmental agenda of sub-Saharan Africa (SSA). Despite the importance of family planning use in enhancing maternal health outcomes and fertility reduction, the prevalence of adolescents and young women using modern contraception is generally low in SSA. Zambia is one of the countries in Southern Africa with a high prevalence of teenage pregnancies and fertility rates. Despite many initiatives that have been implemented to improve access and demand for family planning commodities, utilization of FP, especially among adolescents and young women, has generally been low. The objective of this research agenda was to better understand the determinants of modern contraceptive use in adolescents and young women in Zambia. This analysis produced findings that will be critical for informing the strengthening of sexual and reproductive health policy strategies aimed at bolstering the provision and use of maternal health services in order to further improve maternal health outcomes in the country. Method: The study used the recent data from the Demographic and Health Survey of 2018. A sample of 3,513 adolescents and young women (ADYW) were included in the analysis. Multilevel logistic regression models were employed to examine the association of individual and contextual factors with modern contraceptive use among adolescents and young women. Results: The prevalence of modern contraception among sexually active ADYW in Zambia was 38.1% [95% CI, 35.9, 40.4]. ADYW who had secondary or higher level education [aOR = 2.16, 95% CI=1.35–3.47], those with exposure to listening to the radio or watching television [aOR = 1.26, 95% CI=1.01–1.57], and those who had decision-making power at household level [aOR = 2.18, 95% CI=1.71–2.77] were more likely to use modern contraceptives. Conversely, strong neighborhood desire for large family size among ADYW [aOR = 0.65 95% CI = 0.47–0.88] was associated with less likelihood to use modern contraceptives. Community access to family planning information through community health worker visits increased the likelihood [aOR = 1.48, 95% CI=1.16–1.91] of using modern contraception among ADYW. Conclusion: The study found that both individual and community factors were key in influencing modern contraceptive use among adolescents and young women in Zambia. Therefore, when designing family planning interventions, the Government of Zambia, through its policymakers and sexual reproductive health program implementers at the Ministry of Health, in collaboration with stakeholders, should consider the community context. There should also be deliberate actions to encourage family planning education through the media.

Keywords: adolescents, young women, modern contraception use, fertility, family planning

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Authors: Arshad Hussain

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Background: Sukh Initiative is a multi-donor funded, family planning and reproductive health project, primed by Aman Healthcare Services; implemented through a consortium of local and international organizations, in a selected one million underserved peri-urban population of Karachi, Sindh; which aims at increasing modern contraceptive prevalence rate by 15 percentage point. Objective: To empower women to access contraception by increasing knowledge, improving quality of services and expanding the basket of choices; contributing to the goals of FP2020. Methods: A five years project has a multi-pronged approach with door to door services by LHWs and CHWs in an LHWs covered population and provision of quality FP/RH services both at public and private health care facilities. The project engages youth (12-16 years) both with community and at secondary schools to mentor them for responsible adulthood with life skilled base initiative. A 24/7 availability of youth and FP helpline service provides counselling, referrals in addition with a follow-up mechanism. Results: 131,810 MWRAs were reached by 191 community health workers through 29,693 of community support group meetings and 166,775 house hold visits. These MWRAs were counselled on FP related myths and misconception and referred to 216 providers trained for quality family planning services and maintaining average 64% quality scores in 43 public health and 35 private facilities in the project area. Of those referred 26% MWRAs opted modern contraception with 17.56% in LARCs and 41% PPFP as compared to baseline. Aman TeleHealth is linked with 24/7 counselling, referrals and post services follow-ups to clients, showing 14% proportion of FP call volume. Sukh has a unique role in engaging all partners on youth SRHR issues through family life education sessions, 30 higher sec. schools in Sukh area have been provided LSBE to 16,000 students (aged 15-17), and in community approximately 10, 496 girls and boys have received SRHR information. Conclusion: Through individual counselling, access to quality family planning services and involvement of stakeholders, Suk created an enabling environment to rapid increase in family planning in the project intervention area.

Keywords: family planning and reproductive health, married women with reproductive age, urban squatter, Pakistan

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Authors: Maisa Haj-Tas, Jehad Alaraifi

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The significance of the study: This retrospective study examined the speech and language profiles of patients who received clinical services at the University of Jordan Hearing and Speech Clinic (UJ-HSC) from 2009 to 2014. The UJ-HSC clinic is located in the capital Amman and was established in the late 1990s. It is the first hearing and speech clinic in Jordan and one of first speech and hearing clinics in the Middle East. This clinic provides services to an annual average of 2000 patients who are diagnosed with different communication disorders. Examining the speech and language profiles of patients in this clinic could provide an insight about the most common disorders seen in patients who attend similar clinics in Jordan. It could also provide information about community awareness of the role of speech therapists in the management of speech and language disorders. Methodology: The researchers examined the clinical records of 1140 patients (797 males and 343 females) who received clinical services at the UJ-HSC between the years 2009 and 2014 for the purpose of data analysis for this study. The main variables examined in the study were disorder type and gender. Participants were divided into four age groups: children, adolescents, adults, and older adults. The examined disorders were classified as either speech disorders, language disorders, or dysphagia (i.e., swallowing problems). The disorders were further classified as childhood language impairments, articulation disorders, stuttering, cluttering, voice disorders, aphasia, and dysphagia. Results: The results indicated that the prevalence for language disorders was the highest (50.7%) followed by speech disorders (48.3%), and dysphagia (0.9%). The majority of patients who were seen at the JU-HSC were diagnosed with childhood language impairments (47.3%) followed consecutively by articulation disorders (21.1%), stuttering (16.3%), voice disorders (12.1%), aphasia (2.2%), dysphagia (0.9%), and cluttering (0.2%). As for gender, the majority of patients seen at the clinic were males in all disorders except for voice disorders and cluttering. Discussion: The results of the present study indicate that the majority of examined patients were diagnosed with childhood language impairments. Based on this result, the researchers suggest that there seems to be a high prevalence of childhood language impairments among children in Jordan compared to other types of speech and language disorders. The researchers also suggest that there is a need for further examination of the actual prevalence data on speech and language disorders in Jordan. The fact that many of the children seen at the UJ-HSC were brought to the clinic either as a result of parental concern or teacher referral indicates that there seems to an increased awareness among parents and teachers about the services speech pathologists can provide about assessment and treatment of childhood speech and language disorders. The small percentage of other disorders (i.e., stuttering, cluttering, dysphasia, aphasia, and voice disorders) seen at the UJ-HSC may indicate a little awareness by the local community about the role of speech pathologists in the assessment and treatment of these disorders.

Keywords: clinic, disorders, language, profile, speech

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Authors: Ngawang Tsering

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Traditional Tibetan medicine is primarily focused on promoting health and keeping away diseases from its unique in prescribing specific diet and lifestyle. The prevalence of chronic diseases has been rising day by day and kills a number of people due to the lack of proper nutritional design in modern times. According to traditional Tibetan medicine, chronic diseases such as diabetes, cancer, cardiovascular diseases, respiratory diseases, and arthritis are heavily associated with an unwholesome diet and inappropriate lifestyles. Diet and lifestyles are the two main conditions of diseases and healthy life. The prevalence of chronic diseases is one of the challenges, with massive economic impact and expensive health issues. Though chronic diseases are challenges, it has a solution in the preventive measurements by using proper nutrition design based on traditional Tibetan medicine. Until today, it is hard to evaluate whether traditional Tibetan medicine nutrition strategy could play a major role in preventive measurement as of the lack of current research evidence. However, compared with modern nutrition, it has an exclusive valuable concept, such as a holistic way and diet or nutrition recommendation based on different aspects. Traditional Tibetan medicine is one of the oldest ancient existing medical systems known as Sowa Rigpa (Science of Healing) highlights different aspects of dietetics and nutrition, namely geographical, seasonal, age, personality, emotional, food combination, the process of individual metabolism, potency, and amount of food. This article offers a critical perspective on the preventive measurement against chronic diseases through nutrition design using traditional Tibetan medicine and also needs attention for a deeper understanding of traditional Tibetan medicine in the modern world.

Keywords: traditional Tibetan medicine, nutrition, chronic diseases, preventive measurement, holistic approach, integrative

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Authors: Afsaneh Mohammadnejad, Marianne Nygaard, Jan Baumbach, Shuxia Li, Weilong Li, Jesper Lund, Jacob v. B. Hjelmborg, Lene Christensen, Qihua Tan

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Cognitive impairment in the elderly is a key issue affecting the quality of life. Despite a strong genetic background in cognition, only a limited number of single nucleotide polymorphisms (SNPs) have been found. These explain a small proportion of the genetic component of cognitive function, thus leaving a large proportion unaccounted for. We hypothesize that one reason for this missing heritability is the misspecified modeling in data analysis concerning phenotype distribution as well as the relationship between SNP dosage and the phenotype of interest. In an attempt to overcome these issues, we introduced a model-free method based on the generalized correlation coefficient (GCC) in a genome-wide association study (GWAS) of cognitive function in twin samples and compared its performance with two popular linear regression models. The GCC-based GWAS identified two genome-wide significant (P-value < 5e-8) SNPs; rs2904650 near ZDHHC2 on chromosome 8 and rs111256489 near CD6 on chromosome 11. The kinship model also detected two genome-wide significant SNPs, rs112169253 on chromosome 4 and rs17417920 on chromosome 7, whereas no genome-wide significant SNPs were found by the linear mixed model (LME). Compared to the linear models, more meaningful biological pathways like GABA receptor activation, ion channel transport, neuroactive ligand-receptor interaction, and the renin-angiotensin system were found to be enriched by SNPs from GCC. The GCC model outperformed the linear regression models by identifying more genome-wide significant genetic variants and more meaningful biological pathways related to cognitive function. Moreover, GCC-based GWAS was robust in handling genetically related twin samples, which is an important feature in handling genetic confounding in association studies.

Keywords: cognition, generalized correlation coefficient, GWAS, twins

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Authors: C. Nakib, N. Ammouchi, A. Otmani, A. Djekoun, J. M. Grenèche

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B2-structured FeAl was synthesized by an abrupt reaction during mechanical alloying (MA) of the elemental powders of Fe, Al and Ni. The structural, microstructural and morphological changes occurring in the studied material during MA were investigated by X-ray diffraction (XRD) and scanning electron microscopy (SEM). Two crystalline phases were found, the major one corresponding to FeAl bcc phase with a crystallite size less than 10 nm, a lattice strain up to 1.6% and a dislocation density of about 2.3 1016m-2. The other phase in low proportion was corresponding to Fe (Al,Ni) solid solution. SEM images showed an irregular morphology of powder particles.

Keywords: mechanical alloying, ternary composition, dislocation density, structural properties

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Authors: Aditya Soni, Nimesh Parikh, R. A. Thakrar

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Background: A cross-sectional study looked to focus body image satisfaction, heretofore under investigated arena in our setting. This study additionally examined the relationship of body mass index, influence of media and self-esteem. Our second objective was to assess whether there was any relationship between body image dissatisfaction and gender. Methods: A cross-sectional study using body image satisfaction described in words was undertaken, which also explored relationship with body mass index (BMI), influence of media, self-esteem and other selected co-variables such as socio-demographic details, overall satisfaction in life, and particularly in academic/professional life, current health status using 5-item based Likert scale. Convenience sampling was used to select participants of both genders aged from 17 to 32 on a sample size of 303 participants. Results : The body image satisfaction had significant relationship with Body mass index (P<0.001), eating attitude (P<0.001), influence of media (P<0.001) and self-esteem (P<0.001). Students with low weight had a significantly higher prevalence of body image satisfaction while overweight students had a significantly higher prevalence of dissatisfaction (P<0.001). Females showed more concern about body image as compared to males. Conclusions: Generally, this study reveals that the eating attitude, influence of the media and self-esteem is significantly related to the body image. On an empowering note, this level needs to be saved for overall mental and sound advancement of people. Proactive preventive measures could be started in foundations on identity improvement, acknowledgement of self and individual contrasts while keeping up ideal weight and dynamic life style.

Keywords: body image, body mass index, media, self-esteem

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Authors: Mona T. Kashef, Omneya M. Helmy

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Multidrug resistant (MDR) bacteria have become a significant public health threat. The prevalence rates, of Gram negative MDR bacteria, are in continuous increase. However, few data are available about these resistant strains. Since, third generation cephalosporins are one of the most commonly used antimicrobials, we set out to investigate the prevalence, different mechanisms and clonal relatedness of multidrug resistance among third generation resistant Gram negative clinical isolates. A total of 114 Gram negative clinical isolates, previously characterized as being resistant to at least one of 3rd generation cephalosporins, were included in this study. Each isolate was tested, using Kirby Bauer disk diffusion method, against its assigned categories of antimicrobials. The role of efflux pump in resistance development was tested by the efflux pump inhibitor-based microplate assay using chloropromazine as an inhibitor. Detecting different aminoglycosides, β-lactams and quinolones resistance genes was done using polymerase chain reaction. The genetic diversity of MDR isolates was investigated using Random Amplification of Polymorphic DNA technique. MDR phenotype was detected in 101 isolates (89%). Efflux pump mediated resistance was detected in 49/101 isolates. Aminoglycosides resistance genes; armA and aac(6)-Ib were detected in one and 53 isolates, respectively. The aac(6)-Ib-cr allele, that also confers resistance to floroquinolones, was detected in 28/53 isolates. β-lactam resistance genes; blaTEM, blaSHV, blaCTX-M group 1 and group 9 were detected in 52, 29, 61 and 35 isolates, respectively. Quinolone resistance genes; qnrA, qnrB and qnrS were detectable in 2, 14, 8 isolates respectively, while qepA was not detectable at all. High diversity was observed among tested MDR isolates. MDR is common among 3rd generation cephalosporins resistant Gram negative bacteria, in Egypt. In most cases, resistance was caused by different mechanisms. Therefore, new treatment strategies should be implemented.

Keywords: gram negative, multidrug resistance, RAPD typing, resistance genes

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Authors: Samwel Boaz Otieno, Fred Were, Ephantus Kabiru, Kaunda Waza

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A study was done to establish determinants of selenium intake in a high HIV prevalence fishing community in the Pala Bondo district, Kenya. It was established that most of the respondents (61%) were small holder Farmers and Fishermen {χ² (1, N=386) p<0.000}, and that most of them (91.2%) had up to college level education {χ².(1, N=386) p<0.000}, while the number of males and females were not significantly different {χ (1, N=386) p=0.263} and 83.5% of respondents were married {χ² (1, N=386) p=0.000}. The study showed that adults take on average 2.68 meals a day (N=382, SD=0.603), while children take 3.02 meals (N=386, SD=1.031) a day, and that in most households (82.6%) food is prepared by the women {χ² (1, N=386) p=0.000} and further that 50% of foods eaten in that community are purchased {χ² (1, N=386)=0.1818, p=0.6698}. The foods eaten by 75.2% of the respondents were Oreochromis niloticus, Lates niloticus, and Sorghum bicolour, 64.1% vegetables and that both children and adults eat same types of food, and further that traditional foods which have become extinct are mainly vegetables (46%). The study established that selenium levels in foods eaten in Pala sub-locations varies with traditional vegetables having higher levels of selenium; for example, Laurnea cornuta (148.5 mg/kg), Cleome gynandra (121.5 mg/kg), Vignia ungulata (21.97 mg/kg), while Rastrineobola argentea (51 mg/kg), Lates niloticus (0), Oreochromis niloticus (0) Sorgum bicolour (19.97 mg/kg), and Sorgum bicolour (0). The study showed that there is an inverse relationship between foods eaten and selenium levels {RR=1.21, p=0.000}, with foods eaten by 75.2% of respondents (Oreochromis niloticus/Lates niloticus) having no detectable selenium. The four soil types identified in the study area had varying selenium levels with pleat loam (13.3 mg/kg), sandy loam (10.7 mg/kg), clay (2.8 mg/kg) and loam (4.8 mg/kg). It was concluded from this study that for the foods eaten by most of the respondents the selenium levels were below Daily Reference Intake.

Keywords: determinants, HIV, food, fishing, Selenium

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Authors: Diana M. Torres, Anngie K. Hernandez, Andrea Villareal, Magda R. Gomez, Sadao Kobayashi

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Colombian Garlic crops exhibited mild mosaic, yellow stripes, and deformation. This group of symptoms suggested a viral infection. Several viruses belonging to the genera Potyvirus, Carlavirus and Allexivirus are known to infect garlic and lower their yield worldwide, but in Colombia, there are no studies of viral infections in this crop, only leek yellow stripe virus (LYSV) has been reported to our best knowledge. In Colombia, there are no management strategies for viral diseases in garlic because of the lack of information about viral infections on this crop, which is reflected in (i) high prevalence of viral related symptoms in garlic fields and (ii) high dispersal rate. For these reasons, the purpose of the present study was to evaluate the viral status of garlic in Colombia, which can represent a major threat on garlic yield and quality for this country 55 symptomatic leaf samples were collected for virus detection by RT-PCR and mechanical inoculation. Total RNA isolated from infected samples were subjected to RT-PCR with primers 1-OYDV-G/2-OYDV-G for Onion yellow dwarf virus (OYDV) (expected size 774pb), 1LYSV/2LYSV for LYSV (expected size 1000pb), SLV 7044/SLV 8004 for Shallot latent virus (SLV) (expected size 960pb), GCL-N30/GCL-C40 for Garlic common latent virus (GCLV) (expected size 481pb) and EF1F/EF1R for internal control (expected size 358pb). GCLV, SLV, and LYSV were detected in infected samples; in 95.6% of the analyzed samples was detected at least one of the viruses. GCLV and SLV were detected in single infection with low prevalence (9.3% and 7.4%, respectively). Garlic generally becomes coinfected with several types of viruses. Four viral complexes were identified: three double infection (64% of analyzed samples) and one triple infection (15%). The most frequent viral complex was SLV + GCLV infecting 48.1% of the samples. The other double complexes identified had a prevalence of 7% (GCLV + LYSV and SLV + LYSV) and 5.6% of the samples were free from these viruses. Mechanical transmission experiments were set up using leaf tissues of collected samples from infected fields, different test plants were assessed to know the host range, but it was restricted to C. quinoa, confirming the presence of detected viruses which have limited host range and were detected in C. quinoa by RT-PCR. The results of molecular and biological tests confirm the presence of SLV, LYSV, and GCLV; this is the first report of SLV and LYSV in garlic plants in Colombia, which can represent a serious threat for this crop in this country.

Keywords: SLV, GCLV, LYSV, leek yellow stripe virus, Allium sativum

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Authors: Abidi Sourour, Ben Salem Hichem, Zoghlemi Aziza, Mezni Mejid, Nasri Saida

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In Tunisia, there is an urgent need to maintain food security by reversing soil degradation and improving crop and livestock productivity. Conservation Agriculture (CA) can be helpful in enhancing crop productivity and soil health. However, the demand for crop residues as animal feed are among the major constraints for the adoption of CA. Thus, the objective of this trial is to test the nutritional value of new forage mixture hays as alternative to cereal residues. Two tri-specific cereal-legume mixture were studied and compared to the classic Vetch-Oat one. They were implemented at farm level in four regions characterized by sub-humi climatic: V70-A15-T15 (Vetch70% - Oat15% -Triticale15%) installed in two sites (Zhir and safasaf), V60-A7-T33 (Vetch60% - Oat7% -Triticale33%) and V70-A30 (Vetch70%-Oat30%). Results revealed a significant variation between mixtures V70-A15-T15 installed at Safsafa, recorded the highest forage yield with 12t DM ha-1 than V60A7T33 and V70A30 installed, respectively in ksar cheikh and Fernana with 11.6 and 11.2.tMSha-1. The same mixture installed in Safsafa gave 22% less yields than the one installed in Safsafa. In fact, the month of March was dry in Z'hir. Moreover, these yields in DM can be comparable to those observed by Yucel and Avci (2009). The CP contents of the samples studied vary significantly between the mixtures (P<0.0003). V70-A15-T15 installed in Safsaf and V70A30 present higher contents of CP (respectively 14.4 and 13.7% DM) compared to the other mixtures. These contents are explained by the high proportion of vetch in the fourth mixture and by the low proportion of weeds in the second. In all cases, the hay produced from these mixtures is significantly richer in protein than that of oats in pure culture (Abdelraheem et al., 2019). The positive correlation between the CP content and the proportion of vetch explains this superior quality. The NDF and ADF contents were similar for all mixtures. These values were similar to those reported in the literature (Abidi and Benyoussef, 2019; Haj-Ayed and al., 2000). In general, the Land Equivalent Ratio (LER) was significantly greater than 1 for the vetch-oat-triticale mixture at Zhiir and Safsafa and also for the vetch-oat a at Fernana, proving that they are more productive in intercropping than in pure culture. For the Ksar Cheikh site, the LER value of the vetch-oat-triticale mixture is maintained at around 1. Proving the absence of the advantage of mixture culture compared to pure culture. This proves the massive presence of weeds interferes with the two partners of the mixture increases. The LER for the vetch-oat mixture reached its maximum in March 13 and decreases in April but remained above 1. This proves that the tutoring power of oats showed itself in a constant way until an advanced stage since the variety used is characterized by very thick stems, protecting it from the risk of lodging. These forages mixture present a promising option, a high nutritional quality that could reduce the use of concentrate and, therefore, the cost of feed. With such feed value, these mixtures allow good animal performance.

Keywords: soybean, lupine, vetch, lamb-ADG, meat

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Authors: Ruttayaporn Ngasaman, Saowakon Indouang, Usa Chethanond

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Leptospirosis is a public health concern zoonosis in Thailand. Human and animals are often infected by contact with contaminated water. The infected animals play an important role in leptospira infection for both human and other hosts via urine. In humans, it can cause a wide range of symptoms, some of which may present mild flu-like symptoms including fever, vomiting, and jaundice. Without treatment, Leptospirosis can lead to kidney damage, meningitis, liver failure, respiratory distress, and even death. The prevalence of leptospirosis in stray animals in Thailand is unknown. The aim of this study was to investigate leptospira infection in stray animals including dogs and cats in Songkhla province, Thailand. Total of 434 blood samples were collected from 370 stray dogs and 64 stray cats during the population control program from 2014 to 2018. Screening test using latex agglutination for the detection of antibodies against Leptospira interrogans in serum samples shows 29.26% (127/434) positive. There were 120 positive samples of stray dogs and 7 positive samples of stray cats. Detection by polymerase chain reaction specific to LipL32 gene of Leptospira interrogans showed 1.61% (7/434) positive. Stray cats (5/64) show higher prevalence than stray dogs (2/370). Although active infection was low detected, but seroprevalence was high. This result indicated that stray animals were not active infection during sample collection but they use to get infected or in a latent period of infection. They may act as a reservoir for domestic animals and human in which stay in the same environment. In order to prevent and reduce the risk of leptospira infection in a human, stray animals should be done health checking, vaccination, and disease treatment.

Keywords: leptospirosis, stray animals, risk reduction, Thailand

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Authors: Mohan H., C. Elajchet Senni

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In the present of high energy consumption in every sphere of life, renewable energy sources are emerging as alternative to conventional fuels for energy security, mitigating green house gas emission and climate change. There has been a world wide interest in searching for alternatives to petroleum derived fuels due to their depletion as well as due to the concern for the environment. Vegetable oils have capability to solve this problem because they are renewable and lead to reduction in environmental pollution. But high smoke emission and lower thermal efficiency are the main problems associated with the use of neat vegetable oils in diesel engines. In the present work, performance, combustion and emission characteristics of CI engine fuelled with 20% by vol. methyl esters mixed with Karanja seed Oil, and Fuel injection pressures of 200 bar and 240 bar, injection timings (21°,23° and 25° BTDC) and Proportion B20 diesel respectively. Vegetable oils have capability to solve this problem because they are renewable and lead to reduction in environmental pollution. But, high smoke emission and lower thermal efficiency are the main problems associated with the use of neat vegetable oils in diesel engines. In the present work, performance, combustion and emission characteristics of CI engine fuelled with 20% by vol. methyl esters mixed with Karanja seed Oil, and Fuel injection pressures of 200 bar and 240 bar ,Injection timings (21°,23° and 25° BTDC) and Proportion B20 diesel respectively. Various performance, combustion and emission characteristics such as thermal efficiency, and brake specific fuel consumption, maximum cylinder pressure, instantaneous heat release, cumulative heat release with respect to crank angle, ignition lag, combustion duration, HC, NOx, CO, exhaust temperature and smoke intensity were measured.

Keywords: karanja oil, injection pressure, injection timing, karanja oil methyl ester

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Authors: Joseph L. Mathew, Shourjendra N. Banerjee, R. K. Ratho, Sourabh Dutta, Vanita Suri

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Background: In India and many other developing countries, a single dose of measles vaccine is administered to infants at 9 months of age. This is based on the assumption that maternal transplacentally transferred antibodies will protect infants until that age. However, our previous data showed that most infants lose maternal anti-measles antibodies before 6 months of age, making them susceptible to measles before vaccination at 9 months. Objective: This prospective study was designed to compare susceptibility in pre-term vs term infants, at different time points. Material and Methods: Following Institutional Ethics Committee approval and a formal informed consent process, venous blood was drawn from a cohort of 45 consecutive term infants and 45 consecutive pre-term infants (both groups delivered by the vaginal route); at birth, 3 months, 6 months and 9 months (prior to measles vaccination). Serum was separated and anti-measles IgG antibody levels were measured by quantitative ELISA kits (with sensitivity and specificity > 95%). Susceptibility to measles was defined as antibody titre < 200mIU/ml. The mean antibody levels were compared between the two groups at the four time points. Results: The mean gestation of term babies was 38.5±1.2 weeks; and pre-term babies 34.7±2.8 weeks. The respective mean birth weights were 2655±215g and 1985±175g. Reliable maternal vaccination record was available in only 7 of the 90 mothers. Mean anti-measles IgG antibody (±SD) in terms babies was 3165±533 IU/ml at birth, 1074±272 IU/ml at 3 months, 314±153 IU/ml at 6 months, and 68±21 IU/ml at 9 months. The corresponding levels in pre-term babies were 2875±612 IU/ml, 948±377 IU/ml, 265±98 IU/ml, and 72±33 IU/ml at 9 months (p > 0.05 for all inter-group comparisons). The proportion of susceptible term infants at birth, 3months, 6months and 9months was 0%, 16%, 67% and 96%. The corresponding proportions in the pre-term infants were 0%, 29%, 82%, and 100% (p > 0.05 for all inter-group comparisons). Conclusion: Majority of infants are susceptible to measles before 9 months of age suggesting the need to anticipate measles vaccination, but there was no statistically significant difference between the proportion of susceptible term and pre-term infants, at any of the four-time points. A larger study is required to confirm these findings and compare sero-protection if vaccination is anticipated to be administered between 6 and 9 months.

Keywords: measles, preterm, susceptibility, term infant

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Authors: Maryam M. Bashir, Luai A. Ahmed, Meera R. Alshamsi, Sara Almahrooqi, Taif Alyammahi, Shooq A. Alshehhi, Waad I. Alhammadi, Fatima H. Alhammadi, Hind A. Alhosani, Rami H. Al-Rifai, Fatma Al-Maskari

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Obesity in the Middle East and North Africa (MENA) region has exponentially increased over the past five decades due to rapid urbanization and unhealthy lifestyle changes. It has been well established that overweight and obesity increase the risk of non-communicable diseases (NCDs) and are the leading cause of mortality and economic burden locally, and globally. In the United Arab Emirates (UAE), there is a growing epidemic of obesity and other chronic diseases like type 2 diabetes mellitus and cardiovascular diseases. Prevalence of overweight and obesity in UAE range up to 70% depending on the group being studied. Hence, there is a need to explore their patterns in the country for more targeted and responsive interventions. Our study aimed to explore the patterns of overweight and obesity and some self-reported chronic diseases among university students in Abu Dhabi, the capital city of UAE. A validated online self-administered questionnaire was used to collect data from UAE University (UAEU) students, 18years and above, from August to September 2021. Students’ characteristics were summarized using appropriate descriptive statistics. Overweight, obesity and self-reported chronic diseases were described and compared between male and female students using chi-square and t tests. Other associated factors were also explored in relation to overweight and obesity. All analyses were conducted using STATA statistical software version 16.1 (StataCorp LLC, College Station, TX, USA). 902 students participated in the study. 79.8% were females and mean age was 21.90 ± 5.19 years. Majority of the respondents were undergraduate students (80.71%). The prevalence of self-reported chronic diseases was 22.95%. Obesity (BMI≥30kg/m2), Diabetes Mellitus, and Asthma/Allergies were the commonest diseases (12.48%, 4.21% & 3.22%, respectively). Approximately 5% of the students reported more than one chronic disease. Out of the 833 participating students who had complete weight and height data, prevalence of overweight and obesity was 34.81% (22.33% and 12.48%, respectively). More than half of the male students (54.36%) were overweight or obese. This is significantly higher than in female students (30.56%, p=0.001). Overweight/obesity when compared to normal weight is associated with increasing mean age [23.40 vs 21.01, respectively (p=0.001)]. In addition to gender and age, being married [57.63% vs 31.05% (p=0.001)], being a postgraduate student [51.59% vs 30.92% (p=0.001)] and having two or more chronic diseases [65.85% vs 33.21% (p=0.001)] were also significantly associated with overweight/obesity. Our study showed that almost a quarter of the participating university students reported at least one chronic disease. Obesity was the commonest and more than 1 in 3 students were either overweight or obese. This shows the need for intensive health promotion and screening programs on obesity and other chronic diseases to meet the health needs of these students. This study is also a basis for further research, especially qualitative, to explore the relevant risk factors and risk groups for more targeted interventions.

Keywords: chronic disease, obesity, overweight, students, United Arab Emirates

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Authors: C. A Osunla, A. I. Okoh

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Treated wastewater effluent has been found to encompass high levels of pollutants, including disease-causing bacteria such as Vibrio pathogens. The current study was designed to evaluate the physicochemical qualities and prevalence of Vibrio pathogens in treated effluents of two wastewater treatment plants (WWTP) in Eastern Cape Province, South Africa over the period of six months. Parameters measured include pH, temperature, electrical conductivity, salinity, turbidity, total dissolved solid (TDS), dissolved oxygen (DO), and free chlorine; and these parameters were simultaneously monitored in the treated final effluents of the two wastewater treatment plants using standard methods. The ranges of values for the physicochemical are: pH (7.0–8.6), total dissolved solids (286.3–916.5 mg/L), electrical conductivity (572.57–1704.5 mS/m), temperature (10.3–28.6 °C), turbidity (4.02–43.20 NTU), free chlorine (0.00–0.19 mg/L), dissolve oxygen (2.06–6.32 mg/L) and biochemical oxygen demand (0.1–9.0 mg/L). The microbiological assessment for both WWTPs revealed the presence of Vibrio counts ranging between 0 and 8.76×104 CFU/100 mL. The obtained values of the measured parameters and Vibrio loads of the treated wastewater effluents were found outside the compliance levels of the South African guidelines and World Health Organization tolerance limits for effluents intended to be discharged into receiving waterbodies. Hence, we conclude that these WWTPs are important point sources of pollution in surface water with potential public health and ecological risks.

Keywords: effluents, public health, South Africa, Vibrio, wastewater

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Authors: Muhammad Tahir Riaz, Khalid Mehmood, Ahmad Waseem Akhtar, Tariq Abbas, Sadaqat Ali, Muhammad Altaf

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Livestock sector contributes around 55.9 and 11.8% to agriculture and GDP respectively, according to economic survey of Pakistan 2013-2014. The goats population has been estimated about 66.6 million (M). Parasitic infestation is a major health problem in goats causing loss in body weight, poor body condition, low birth weights, and difficulty in kidding. Keeping in view the utilization of these animals in the country, a pilot epidemiological survey was conducted to find out the major parasitic problems of goats in and around Derawar fort area, Cholistan. Data regarding 662 fecal samples of goats was collected from 25 tobas of Cholistan during June 2012 to June 2013. All the fecal samples were examined through Direct Smear Method and Salt Flotation Technique for the presence of helminth eggs. External parasites were taken from the various components of the carcass of goat and were conserved in 70% alcohol in hygienic, properly enclosed glass jars that were tagged thoroughly. The collected date was analyzed statistically by Chi-square test to find out the prevalence in goats. Out of 662 goats, 261 (39.42%) were found positive for parasites. 233 (35.20%) goats were found positive for gastrointestinal parasites while 28 (4.23%) were positive for external parasites including ticks 20 (3.02%) and mange 8 (1.21%). The higher prevalence of parasites in the study area may be due to pasture grazing, poor management and lack of extension work. In this regards proper management and control measures should be adopted to minimize the Parasitic Problems.

Keywords: Cholistan, goats, parasite, surveillance

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Authors: Jelka Pleadin, Greta Krešić, Tina Lešić, Ana Vulić, Renata Barić, Tanja Bogdanović, Dražen Oraić, Ana Legac, Snježana Zrnčić

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Fish has been acknowledged as an integral component of a well-balanced diet, providing a healthy source of energy, high-quality proteins, vitamins, essential minerals and, especially, n-3 long-chain polyunsaturated fatty acids (n-3 LC PUFA), mainly eicosapentaenoic acid (20:5 n-3 EPA), and docosahexaenoicacid, (22:6 n-3 DHA), whose pleiotropic effects in terms of health promotion and disease prevention have been increasingly recognised. In this study, the fatty acids composition of three commercially important farmed fish species: sea bream (Sparus aurata), sea bass (Dicentrarchus labrax) and dentex (Dentex dentex) was investigated. In total, 60 fish samples were retrieved during 2015 (n = 30) and 2016 (n = 30) from different locations in the Adriatic Sea. Methyl esters of fatty acids were analysed using gas chromatography (GC) with flame ionization detection (FID). The results show that the most represented fatty acid in all three analysed species is oleic acid (C18:1n-9, OA), followed by linoleic acid (C18:2n-6, LA) and palmitic acid (C16:0, PA). Dentex was shown to have two to four times higher eicosapentaenoic (EPA) and docosahexaenoic (DHA) acid content as compared to sea bream and sea bass. The recommended n-6/n-3 ratio was determined in all fish species but obtained results pointed to statistically significant differences (p < 0.05) in fatty acid composition among the analysed fish species and their potential as a dietary source of valuable fatty acids. Sea bass and sea bream had a significantly higher proportion of n-6 fatty acids, while dentex had a significantly higher proportion of n-3 (C18:4n-3, C20:4n-3, EPA, DHA) fatty acids. A higher hypocholesterolaemic and hypercholesterolaemic fatty acids (HH) ratio was determined for sea bass and sea bream, which comes as the consequence of a lower share of SFA determined in these two species in comparison to dentex. Since the analysed fish species vary in their fatty acids composition consumption of diverse fish species would be advisable. Based on the established lipid quality indicators, dentex, a fish species underutilised by the aquaculture, seems to be a highly recommendable and important source of fatty acids recommended to be included into the human diet.

Keywords: dentex, fatty acids, farmed fish, sea bass, sea bream

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Authors: Patcharapa Thaweekul, Paskorn Sritipsukho

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Background: During the training period of the 6-year medical curriculum, medical students seem to have many risk behaviors of developing obesity. This study aims to demonstrate the prevalence and risk behavior of obesity and related metabolic disorders among the final-year medical students of Thammasat University as well as the change in nutritional status during studying program. Methods: 123 participants were asked to complete the self-report questionnaires. Weight, height, waist circumference and blood pressure were obtained. Blood samples were drawn for total cholesterol, high-density lipoprotein, low-density lipoprotein, triglycerides and plasma glucose. Body weight and height of the medical students in the first year were obtained from the medical report at the entry. Results: The prevalence of overweight and obesity at the entry to medical school was 22.0% and increased to 30.1% in the final year. Two obese students (5.4%) was diagnosed as metabolic syndrome. During 6-year curriculum, the BMI gained in male medical students were more significant as compared to female students (1.76±1.74 and 0.43±1.82 kg/m2, respectively; p <.001). The current BMI is significantly correlated with the BMI at entry. Serum LDL-C in the overweight/obese students was significantly higher as compared to the normal weight and underweight group. Sleep deprivation was a significantly frequent behavior in the overweight/obese students. Conclusion: Medical students, as having high-risk behaviors, should be assessed for the nutritional status and metabolic parameters. Medical schools should promote the healthy behaviors to increase the healthy eating and exercise habits and reduced the risk behaviors among them.

Keywords: medical students, metabolic syndrome, obesity, risk behaviors

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Authors: Majeda Hammoud

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Background: Anemia during pregnancy increases the risk of delivery by cesarean section, low birth weight, preterm birth, perinatal mortality, stillbirth, and maternal mortality. In this study, we aimed to assess the prevalence of anemia in pregnant women and its associated factors in the Kuwait birth cohort study. Methods: The Kuwait birth cohort (N=1108) was a prospective cohort study in which pregnant women were recruited in the third trimester. Data were collected through personal interviews with mothers who attend antenatal care visits, including data on socio-economic status and lifestyle factors. Blood samples were taken after the recruitment to measure multiple laboratory indicators. Clinical data were extracted from the medical records by a clinician including data on comorbidities. Anemia was defined as having Hemoglobin (Hb) <110 g/L with further classification as mild (100-109 g/L), moderate (70-99 g/L), or severe (<70 g/L). Predictors of anemia were classified as underlying or direct factors, and logistic regression was used to investigate their association with anemia. Results: The mean Hb level in the study group was 115.21 g/L (95%CI: 114.56- 115.87 g/L), with significant differences between age groups (p=0.034). The prevalence of anemia was 28.16% (95%CI: 25.53-30.91%), with no significant difference by age group (p=0.164). Of all 1108 pregnant women, 8.75% had moderate anemia, and 19.40% had mild anemia, but no pregnant women had severe anemia. In multivariable analysis, getting pregnant while using contraception, adjusted odds ratio (AOR) 1.73(95%CI:1.01-2.96); p=0.046 and current use of supplements, AOR 0.50 (95%CI: 0.26-0.95); p=0.035 were significantly associated with anemia (underlying factors). From the direct factors group, only iron and ferritin levels were significantly associated with anemia (P<0.001). Conclusion: Although the severe form of anemia is low among pregnant women in Kuwait, mild and moderate anemia remains a significant health problem despite free access to antenatal care.

Keywords: anemia, pregnancy, hemoglobin, ferritin

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Authors: Agumah N. B. Orji, M. U., Oru C. M., Ugbo, E. N., Onwuliri E. A Nwakaeze, E. A.,

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ERG11 gene has been reported to be one of the genes whose expression is responsible for resistance of Candida to various triazole drugs, which are first line treatment for candidiasis. This study was carried out to determine the prevalence of Triazole (Fluconazole and voriconazole) resistant Candida albicans expressing ERG11 gene from adult females in Abakaliki. Urine and vaginal swab samples were randomly collected from volunteers after obtaining their consent to participate in the study. A total of 565 adult females participated in the study. A total of 340 urine specimens and 288 vaginal swab specimens were collected. Direct wet mount technique, as well as culture in Trichomonas broth, were used to examine the urine and vaginal swab specimens for the presence of motile Trichomonads. The Trichomonas broth used was selective for both T. vaginalis and C. albicans. Broths that yielded budding yeast cells after microscopy were subcultured on to Sabouraud dextrose agar, after which Germ tube test was carried out to confirm the presence of C. albicans. Biochemical tests, including carbohydrate fermentation and urease utilization, were also performed. Antibiogram of C. albicans isolates obtained from this study was carried out using commercially available azole drugs. Fluconazole and voriconazole were selected as Triazole drugs used for this study. Nystatin was used as a tangential control. An MIC test was carried out with E-strips on some of the resistant C. albicans isolates A total of 6 isolates that resisted all the azole drugs were selected and screened for the presence of ERG11 gene using Reverse transcriptase polymerase chain reaction technique. The total prevalence recorded for C. albicans was 13.0%. Frequency was statistically higher in Pregnant (7.96%) than non pregnant (5.09%) volunteers (X2=0.94 at P=0.05). With respect to clinical samples, frequency was higher in vaginal swabs samples (7.96%) than Urine samples (5.09%) (X2=9.05 at P=0.05). Volunteers within the age group 26-30 years recorded the highest prevalence (4.46%), while those within the age group 36-40 years recorded the lowest at 1.27%(X2=4.34 at P=0.05). In pregnant female participants, the highest frequency was recorded with those in their 3rd trimester (4.14%), while lowest incidence was recorded for those in their first trimester (0.80%). Antibiogram results from this study showed that C. albicans isolates obtained from this study resisted Fluconazole (72%) more than Voriconazole (57%). Only one out of the six selected isolates yielded resistance in the MIC test. Results obtained from the RT-PCR showed that there was no expression of ERG11 gene among the fluconazole resistant isolates of C. albicans. Observed resistance may be due to other factors other than expression of ERG11 gene.

Keywords: candida, ERG11, triazole, nigeria

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