Search results for: chronic kidney disease

Authors: Apoorva D. R.

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INTRODUCTION: Hemophagocytic lymphohistiocytosis (HLH) is a severe, potentially fatal syndrome in which there is excessive immune activation. The disease is seen in children and people of all ages, but infants from birth to 18 months are most frequently affected. HLH is a sporadic or familial condition that can be triggered by various events that disturb immunological homeostasis. In cases with a genetic predisposition and sporadic occurrences, infection is a frequent trigger. Because of the rarity of this disease, the diverse clinical presentation, and the lack of specificity in the clinical and laboratory results, prompt treatment is essential, but the biggest obstacle to a favorable outcome is frequently a delay in identification. CASE REPORT: Here we report a case of a 6-month-old male infant who presented to the dermatology outpatient with disseminated skin lesions present over the face, abdomen, scalp, and bilateral upper and lower limbs for the past month. The lesions were insidious in onset, initially started over the abdomen, and gradually progressed to involve other body parts. The patient also had a history of fever which was moderate in grade, on and off in nature for 1 month. There were no significant complaints in the past, family, or drug history. There was no history of feeding difficulties in the baby. Parents gave a history of developmental milestones appropriate for age. Examination findings include multiple well-defined monomorphic erythematous papules with a central crater present over bilateral cheeks. Few lichenoid shiny papules present over bilateral arms, legs, and abdomen. Ultrasound of the abdomen and pelvis showed mild degree hepatosplenomegaly, intraabdominal lymphadenopathy, and bilateral inguinal lymphadenopathy. Routine blood investigations showed anemia and lymphopenia. Multiple X-rays of the skull, chest, and bilateral upper and lower limbs were done and were normal. Histopathology features were suggestive of non-Langerhans cell cutaneous histiocytosis. CONCLUSION: HLH is a fatal and rare disease. A high level of suspicion and an interdisciplinary approach among experienced clinicians, pathologists, and microbiologists to define the diagnosis and causative disease are key to diagnosing this case. Early detection and treatment can reduce patient morbidity and mortality.

Keywords: histiocytosis, non langerhans cell, case report, fatal, rare

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Authors: Temitayo Tosin Alawiye

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Plant disease control is important in maintaining plant vigour, grain quantity, abundance of food, feed, and fibre produced by farmers all over the world. Farmers make use of different methods in controlling these diseases but one of the commonly used method is the use of chemicals. However, the continuous and excessive usages of these agrochemicals pose a danger to the environment, man and wildlife. The more the population growth the more the food security challenge which leads to more pressure on agronomic growth. Agricultural waste also known as green waste are the residues from the growing and processing of raw agricultural products such as fruits, vegetables, rice husk, corn cob, mushroom growth medium waste, coconut husk. They are widely used in land bioremediation, crop production and protection which include disease control. These agricultural wastes help the crop by improving the soil fertility, increase soil organic matter and reduce in many cases incidence and severity of disease. The objective was to review the agricultural waste that has worked effectively against certain soil-borne diseases such as Fusarium oxysporum, Pythiumspp, Rhizoctonia spp so as to help minimize the use of chemicals. Climate change is a major problem of agriculture and vice versa. Climate change and agriculture are interrelated. Change in climatic conditions is already affecting agriculture with effects unevenly distributed across the world. It will increase the risk of food insecurity for some vulnerable groups such as the poor in Sub Saharan Africa. The food security challenge will become more difficult as the world will need to produce more food estimated to feed billions of people in the near future with Africa likely to be the biggest hit. In order to surmount this hurdle, smallholder farmers in Africa must embrace climate-smart agricultural techniques and innovations which includes the use of green waste in agriculture, conservative agriculture, pasture and manure management, mulching, intercropping, etc. Training and retraining of smallholder farmers on the use of green energy to mitigate the effect of climate change should be encouraged. Policy makers, academia, researchers, donors, and farmers should pay more attention to the use of green energy as a way of reducing incidence and severity of soilborne plant diseases to solve looming food security challenges.

Keywords: agricultural waste, climate change, green energy, soil borne plant disease

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Authors: Christine Ysabelle G. Roman, Pauline Torres

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Background: Hypertrophic cardiomyopathy is a disease of marked heterogeneity. It is a genetically determined heart disease characterized by significant myocardium hypertrophy that results in diastolic dysfunction, left ventricular outflow tract obstruction, and an increased risk of arrhythmias. The primary treatment in patients with such conditions is negative inotropic drugs, such as beta-blockers, calcium channel antagonists, and disopyramide. However, for those who remain symptomatic and need septal reduction therapy, surgical septal myectomy or alcohol septal ablation are options. Case Summary: A 19 – year old female presented in the authors’ institution with easy fatigability. The consult was done a year prior, and 2D echocardiography was requested which showed concentric left ventricular hypertrophy, asymmetrically hypertrophied interventricular septum (IVS) with the largest diameter of 3.3cm & subaortic dynamic obstruction with a maximum gradient of 47 mmHg. A repeat echo a year later showed asymmetric septal hypertrophy (IVS measuring at 3cm) with the systolic anterior motion of anterior mitral valve leaflet and left ventricular outflow tract obstruction (peak gradient of 50mmHg). The patient then underwent alcohol septal ablation and was discharged stable after four days of admission. Conclusion: Hypertrophic obstructive cardiomyopathy, a cardiovascular genetic disease, results in various patterns of left ventricular hypertrophy and abnormality of mitral valve apparatus. The patient is managed medically initially. However, despite optimal drug therapy and significant left ventricular outflow tract obstruction, significant heart failure symptoms or syncope require invasive treatment.

Keywords: hypertrophic obstructive cardiomyopathy, left ventricular outflow tract obstruction, alcohol septal ablation, alcohol

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Authors: Vivienne Cloude C. Bersabe, Nuelle Anne Castro, Christy P. Gonzales, Nathalie Ann D. Ocbo, Araceli Chuwaley C. Padcayan, Michelle Gaile Lianne S. Peralta, Cecile A. Perez, Eiden Mae A. Roque, Frances Bea S. Sabaten, Korina Louise A. Saculles, Jada Kristen O. Taska, Jose Reinhard C. Laoingco, Don Leonardo N. Dacumos

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The rationale of the study: Since discussion about sexuality is considered taboo in the Filipino culture, provision of quality holistic care often lacks sexuality aspect. This research was conducted to highlight the need for nurses to incorporate sexuality in their care of older adults. Research Objectives: To measure the levels of older adults’ sexual desire, sexual behavior, and sexual intimacy and relate them to sex, living arrangement, educational level, and presence of chronic illness, whether with or without treatment. Methods: This study is of quantitative descriptive design that utilized purposive sampling. 400 older adults of Baguio City participated. The study used a 30 point researcher-made questionnaire, one-on-one interview and focused group discussion to gather data. Data were treated using weighted mean, t-test, F-test, and Scheffe's test. Results and Conclusions: The overall findings revealed that Filipino older adults have a low level of sexuality expressed by the participants’ sexual desire, behavior, and intimacy. Males have significantly higher level of sexual desire, behavior, and intimacy. Living arrangement does not seem to influence the level of sexuality in all its 3 facets. Sexual desire was significantly higher among those with tertiary education and without chronic illness. Recommendation: It is recommended that nurses carry out their assessment of clients to include the exploration of their sexuality especially the older adults. A similar study may be done to explore other variables like demographic location, i.e., rural or urban setting; socio-cultural factors; and functional performance status. It is also recommended that a similar study may be done exploring the different facets of sexuality among homosexual older persons.

Keywords: geriatrics, older adults, Philippines, sexuality

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Authors: Sina Mahdavi, Mahdi Asghari Ozma

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Multiple sclerosis (MS) is the most common inflammatory autoimmune disease of the CNS that affects the myelination process in the central nervous system (CNS). Complex interactions of various "environmental or infectious" factors may act as triggers in autoimmunity and disease progression. The association between viral infections, especially human Varicella-zoster virus (VZV) and MS is one potential cause that is not well understood. This study aims to summarize the available data on VZV retrovirus infection in MS disease progression. For this study, the keywords "Multiple sclerosis", " Human Varicella-zoster virus ", and "central nervous system" in the databases PubMed, Google Scholar, Sid, and MagIran between 2016 and 2022 were searched and 14 articles were chosen, studied, and analyzed. Analysis of the amino acid sequences of HNRNPA1 with VZV proteins has shown a 62% amino acid sequence similarity between VZV gE and the PrLD/M9 epitope region (TNPO1 binding domain) of mutant HNRNPA1. A heterogeneous nuclear ribonucleoprotein (hnRNP), which is produced by HNRNPA1, is involved in the processing and transfer of mRNA and pre-mRNA. Mutant HNRNPA1 mimics gE of VZV as an antigen that leads to autoantibody production. Mutant HnRNPA1 translocates to the cytoplasm, after aggregation is presented by MHC class I, followed by CD8 + cells. Of these, antibodies and immune cells against the gE epitopes of VZV remain due to the memory immune response, causing neurodegeneration and the development of MS in genetically predisposed individuals. VZV expression during the course of MS is present in genetically predisposed individuals with HNRNPA1 mutation, suggesting a link between VZV and MS, and that this virus may play a role in the development of MS by inducing an inflammatory state. Therefore, measures to modulate VZV expression may be effective in reducing inflammatory processes in demyelinated areas of MS patients in genetically predisposed individuals.

Keywords: multiple sclerosis, varicella-zoster virus, central nervous system, autoimmunity

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Authors: Ruolan Zhou

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Trisomy of human chromosome 21 is the primary cause of Down Syndrome (DS), and this genetic disease has significantly burdened families and countries, causing great controversy. To address this problem, the research takes an approach in exploring the relationship between genetic abnormality and this disease's symptoms, adopting several techniques, including data analysis and enrichment analysis. It also explores open-source websites, such as NCBI, DAVID, SOURCE, STRING, as well as UCSC, to complement its result. This research has analyzed the variety of genes on human chromosome 21 with simple coding, and by using analysis, it has specified the protein-coding genes, their function, and their location. By using enrichment analysis, this paper has found the abundance of keratin production-related coding-proteins on human chromosome 21. By adopting past researches, this research has attempted to disclose the relationship between trisomy of human chromosome 21 and keratin production abnormality, which might be the reason for common diseases in patients with Down Syndrome. At last, by addressing the advantage and insufficiency of this research, the discussion has provided specific directions for future research.

Keywords: Down Syndrome, protein production, genome, enrichment analysis

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Authors: Rutanachai Thaipratum

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At present, it is widely-known that free radicals are the causes of illness such as cancers, coronary heart disease, Alzheimer’s disease and aging. One method of protection from free radical is the consumption of antioxidant-containing foods or herbs. Several analytical methods have been used for qualitative and quantitative determination of antioxidants. This project aimed to evaluate antioxidant activity of ethanolic and aqueous extracts from cabbage (Brassicca oleracea L. var. capitata L.) measured by DPPH and hydroxyl radical scavenging method. The results show that averaged antioxidant activity measured in ethanolic extract (µmol ascorbic acid equivalent/g fresh mass) were 7.316 ± 0.715 and 4.66 ± 1.029 as determined by DPPH and hydroxyl radical scavenging activity assays, respectively. Averaged antioxidant activity measured in aqueous extract (µmol ascorbic acid equivalent/g fresh mass) were 15.141 ± 2.092 and 4.955 ± 1.975 as determined by DPPH and hydroxyl radical scavenging activity assays respectively.

Keywords: free radical, antioxidant, cabbage, Brassica oleracea L. var. capitata L.

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Authors: Siyuan Cai

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COVID-19 has triggered the planning circles to think about how to improve the city's ability to respond to public health emergencies. From the perspective of the community, this article reviews the risk cases in Wuhan Chenjiadun Community and other communities under the epidemic, and analyzes the response to public health emergencies such as infectious disease outbreaks in the excellent cases of resilient epidemic prevention communities. Then, combined with the planning of the living circle, it demonstrates the necessity of integrating the concept of resilience into the 15-minute community living circle to make up for the shortcomings of infectious disease prevention. Finally, it is proposed to strictly control the source and tail of the epidemic in the layout of the living circle, daily health and epidemic emergency should be taken into account in planning, community medical resources should be decentralized in management, and the application of smart technologies in the planning of living circle should be fully emphasized, so as to improve the community's ability to respond to public health emergencies.

Keywords: pandemic, resilient cities, resilient community, 15-minute community life circle

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Authors: Min Ju Kim, Beom Jin Park, Deuk Jae Sung, Na Yeon Han, Kichoon Sim

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Purpose: The purpose of this study is to determine the significant magnetic resonance (MR) imaging factors of lateral pelvic lymph node (LPLN) on the assessment of survival outcomes of neoadjuvant combined chemotherapy and radiation therapy (CRT) in patients with mid/low rectal cancer. Materials and Methods: The institutional review board approved this retrospective study of 63 patients with mid/low rectal cancer who underwent MR before and after CRT and patient consent was not required. Surgery performed within 4 weeks after CRT. The location of LPLNs was divided into following four groups; 1) common iliac, 2) external iliac, 3) obturator, and 4) internal iliac lymph nodes. The short and long axis diameters, numbers, shape (ovoid vs round), signal intensity (homogenous vs heterogenous), margin (smooth vs irregular), and diffusion-weighted restriction of LPLN were analyzed on pre- and post-CRT images. For treatment response using size, lymph node groups were defined as group 1) short axis diameter ≤ 5mm on both MR, group 2) > 5mm change into ≤ 5mm after CRT, and group 3) persistent size > 5mm before and after CRT. Clinical findings were also evaluated. The disease-free survival and overall survival rate were evaluated and the risk factors for survival outcomes were analyzed using cox regression analysis. Results: Patients in the group 3 (persistent size >5mm) showed significantly lower survival rates than the group 1 and 2 (Disease-free survival rates of 36.1% and 78.8, 88.8%, p < 0.001). The size response (group 1-3), multiplicity of LPLN, the level of carcinoembryonic antigen (CEA), patient’s age, T and N stage, vessel invasion, perineural invasion were significant factors affecting disease-free survival rate or overall survival rate using univariate analysis (p < 0.05). The persistent size (group 3) and multiplicity of LPLN were independent risk factors among MR imaging features influencing disease-free survival rate (HR = 10.087, p < 0.05; HR = 4.808, p < 0.05). Perineural invasion and T stage were shown as independent histologic risk factors (HR = 16.594, p < 0.05; HR = 15.891, p < 0.05). Conclusion: The persistent size greater than 5mm and multiplicity of LPLN on both pre- and post-MR after CRT were significant MR factors affecting survival outcomes in the patients with mid/low rectal cancer.

Keywords: rectal cancer, MRI, lymph node, combined chemoradiotherapy

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Authors: Wissame Gouigah, Amina Medellel, Mahmoud Trachi, Djedjiga Benamara, Salem Benamara

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The purpose of this work is to investigate, by UV/VIS spectrophotometry, the distribution of L-dopa, known as precursor of dopamine which is used in the treatment of Parkinson's disease, in broad beans (Vicia faba) (Vf) and chickpea (Cicer aritinum L.) (CA). In the case of Vf, the different organs were analyzed separately: 1) First, in the fresh state: pod (GF), cotyledons (CF), green shell (EF) and placenta (PF) which is the organ through which the seed is attached to the pod, 2) in the dry state (S): peel of the dry seed (ES) and cotyledons (CS), and 3) in the germinated state: peel (EGe), cotyledons (CGe) and germ (GeVf). Results showed that the content of L-dopa is unevenly distributed between different parts of fresh Vf. But the most important result concerns the predominance of L-dopa in placenta with an L-dopa content (~ 60 mg/g of wet weight, ww) sometimes 7-fold higher (p≤0.05) than those of other considered parts of fresh Vf. In the case of CA, the L-dopa concentration in germinated gains was higher than those found in all analyzed Vf organs, excepted PF.

Keywords: broad bean (Vicia faba L.), chickpea (Cicer aritinum L.), L-dopa, Parkinson disease, placenta

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Authors: Y. Kunitani, Y. Nakashima, S. Yamauchi, Y. Ishigami, K. Naito, K. Numata, M. Mizobe, Y. Homma, J. Takahashi, T. Inoue, T. Shiga, H. Funakoshi

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Background: Japanese Spotted Fever (JSF) is one of the Rickettsial infections, caused by Rickettsia japonica, which is transmitted by ticks. JSF is seen in limited area, such as Japan and South Korea. Its clinical triad is rash, eschar and fever. It often shows leukocytopenia, thrombopenia, elevated transaminase and high C-reactive protein (CRP). Sometimes it can be life-threatening due to disseminated intravascular coagulation or multiple organ failure. Study Aim: The aim of this study is to describe the features of JSF, as this unique infection is rapidly growing in Japan. Methods: This is a case series of JSF from 2009 to 2016, in Mie Prefectural Hospital in Japan. We collected JSF cases, which were diagnosed by polymerase chain reaction (PCR) of the skin or blood serum, or the elevation of the antibody titer of paired blood samples. Results: There were 43 JSF patients (19 male, 24 female) with a median age of 71 years [IQR:65-80]. The median body temperature was 38.1°C[IQR: 37.5-39.0]. 95% had a rash, 67% had eschar and 50% had fever. The median WBC count was 6,700 [IQR: 5,750-8,200] and leukocytopenia was observed in only 7%. The median platelet count was 14x104 [IQR10x104-17x104], thrombopenia was observed in 65%. The median aspartate transaminase (AST) was 53 IU/L [IQR: 41-93]; the median alanine aminotransferase (ALT) was 34 IU/L [IQR: 24-54]; the median CRP was 10.4 mg/dL [IQR:7.2-13.9]; the median lactate dehydrogenase (LDH) was 352IU/L [IQR:282-451]. CRP and LDH were elevated in almost all of the patients. Median length of stay in hospital was 8 days [IQR: 6-11]. All patients were treated with tetracycline and quinolone on the day of the presentation. There was no fatality from JSF. Conclusion: The patients with JSF classically presents with eschar, rash and fever. However, in this study, the half of the patients were afebrile. Although JSF is not a common infectious disease worldwide, if the patient had previously visited Japan or South Korea and presented with rash and eschar with or without fever, we should consider JSF as a potential diagnosis.

Keywords: infectious disease, Japanese spotted fever, Rickettsial disease, Rickettsia japonica

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Authors: Rekha Vijayvergia

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Around seven percent of tribal population of India lives in Rajasthan. Rajasthan has rich cultural diversity and biodiversity. Ethno-botany can be defined as the total natural and traditional relationship and the interactions between man and his surrounding plant wealth from times immemorial, due to sheer, necessity, intuition, observation, and experimentation. Medicinal plants are valuable and are used for the production of various drugs. These plants produce a high diversity of natural products or secondary metabolites like Mahanimbicine, Andrographine, murrayaline, lupeol, and limonin etc. with a prominent function in the protection against diseases like diabetes, kidney stones, osteoporosis, tumours, opthalmia, leucorrhoea, bronchial asthma, diarrhea, cancer, etc. The present report gives an account of traditional medicinal uses of common medicinal plants of Rajasthan. A total of 18 plant species belonging to 13 families are reported, that are being used for various purposes.

Keywords: ethno botany, Rajasthan, secondary metabolites, traditional medicines

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Authors: Josine Beek, S. Agten, R. Del Pozo, B. Balis

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The objective of the present study was to compare the safety of intramuscular administration of Zuprevo® (tildipirosin, 40 mg/mL) with Draxxin® (tulathromycin, 100 mg/mL) in the treatment of swine respiratory disease at weaning age. The trial was carried out in two farrow-to-finish farms with 300 sows (farm A) and 500 sows (farm B) in a batch-production system. Farm A had no history of respiratory problems, whereas farm B had a history of respiratory outbreaks with increased mortality ( > 2%) in the nursery. Both farms were positive to Pasteurella multocida, Bordetella bronchiseptica, Actinobacillus pleuropneumoniae and Haemophilus parasuis. From each farm, one batch of piglets was included (farm A: 644 piglets; farm B: 963 piglets). One day before weaning (day 0; 18-21 days of age), piglets were identified by an individual ear tag and randomly assigned to a treatment group. At day 0, Group 1 was treated with a single intramuscular injection with Zuprevo® (tildipirosin, 40 mg/mL; 1 mL/10 kg) and group 2 with Draxxin® (tulathromycin, 100 mg/mL; 1 mL/40 kg). For practical reasons, dosage of the product was adjusted according to three weight categories: < 4 kg, 4-6 kg and > 6 kg. Within each farm, piglets of both groups were comingled at weaning and subsequently managed and located in the same facilities and with identical environmental conditions. Our study involved the period from day 0 until 10 weeks of age. Safety of treatment was evaluated by 1) visual examination for signs of discomfort directly after treatment and after 15 min, 1 h and 24 h and 2) mortality rate within 24 h after treatment. Efficacy of treatment was evaluated based on mortality rate from day 0 until 10 weeks of age. Each piglet that died during the study period was necropsied by the herd veterinarian to determine the probable cause of death. Data were analyzed using binary logistic regression and differences were considered significant if p < 0.05. The pig was the experimental unit. In total, 848 piglets were treated with tildipirosin and 759 piglets with tulathromycin. In farm A, one piglet with retarded growth ( < 1 kg at 18 days of age) showed an adverse reaction after injection of tildipirosin: lateral recumbence and dullness for ± 30 sec. The piglet recovered after 1-2 min. This adverse reaction was probably due to overdosing (12 mg/kg). No adverse effect of treatment was observed in any other piglet. There was no mortality within 24 h after treatment. No significant difference was found in mortality rate between both groups from day 0 until 10 weeks of age. In farm A, overall mortality rate was 0.3% (2/644). In farm B, mortality rate was 0.2% (1/502) in group 1 (tildipirosin) and 0.9% (4/461) in group 2 (tulathromycin)(p=0.60). The necropsy of piglets that died during the study period revealed no macroscopic lesions of the respiratory tract. In conclusion, Zuprevo® (tildipirosin, 40 mg/mL) was shown to be a safe and efficacious alternative to Draxxin® (tulathromycin, 100 mg/mL) for the early treatment of swine respiratory disease at weaning age.

Keywords: antibiotic treatment, safety, swine respiratory disease, tildipirosin

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Authors: Bindu I. Somarajan, Viney Gupta, Gagandeep Kaur Walia, Jasbir Kaur, Sunil Kumar, Shikha Gupta, Abadh K. Chaurasia, Dinesh Gupa, Abhinav Kaushik, Aditi Mehta, Vipin Gupta, Arundhati Sharma

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Background: Juvenile onset primary open angle glaucoma (JOAG), affects individuals under the age of 40 years. Studies on a few families of JOAG, that led to the discovery of the Myocilin gene, reported the disease to have an autosomal dominant pattern of inheritance. However, sporadic forms of JOAG been seen to be more common in some populations. Most pathological homozygous mutations in the CYP1B1 gene associated with JOAG have been seen among sporadic cases. Given the higher prevalence of sporadic JOAG cases in our population, we aimed to look for common mutations E229K and R368H, the two most common variants in the CYP1B1 gene associated with glaucoma. Objective: To determine the frequency and evaluate genotype phenotype correlation of CYP1B1 E229K and R368H mutations in a cohort of 120 sporadic Juvenile open angle glaucoma patients.Methods: Unrelated JOAG patients whose first degree relatives had been examined and found to be unaffected were included in the study. The patients and their parents were screened for E229K and R368H mutations. The phenotypic characteristics were compared between probands with and with out these mutations by SPSS v16. Results: Out of 120 JOAG patients included in the study, the E229K mutation was seen in 9 probands (7.5%) and R368H in 7 (5.8%). The average age of onset of the disease (p=0.3) and the highest untreated IOP (p=0.4) among those carrying mutations was not significantly different from those who did not have these mutations. The proportion of probands with angle dysgenesis among those with E229K and R368H mutations was 70% (11 out of 16) in comparison to 65% (67 out of 104) of those who did not harbour these mutations (p=0.56). Similarly the probands with moderate to high myopia among those with E229K and R368H mutations was 20% (3 out of 16) in comparison to 18% (18 out of 104) of those who did not harbour these mutations(p=0.59). Conclusion: The frequency of E229K and R368H mutations of the CYP1B1 gene is low even among sporadic JOAG patients. Moreover there is no clinical correlation between the presence of these mutations and disease severity

Keywords: CYP1B1, gene, IOP, JOAG, mutation

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Authors: Darnetty Baharuddin Salleh

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Fusarium ear rot disease is one of the most important diseases of maize and not only causes significant losses but also produced harmful mycotoxins to animals and humans. A total of 141 strains of Fusarium species were isolated from maize plants showing typical ear rot symptoms in Indonesia, and Malaysia by using the semi-selective medium (peptone pentachloronitrobenzene agar, PPA). These strains were identified morphologically. For strains in Gibberella fujikuroi species complex (Gfsc), the identification was continued by using biological identification. Three species of Fusarium were morphologically identified as Fusarium in Gibberella species complex (105 strains, 74.5%), F. verticillioides (78 strains), F. proliferatum (24 strains) and F. subglutinans (3 strains) and five species from other section (36 strains, 25.5%), F. graminearum (14 strains), F. oxysporum (8 strains), F. solani ( 1 strain), and F. semitectum (13 strains). Out of 105 Fusarium species in Gfsc, 63 strains were identified as MAT-1, 25 strains as MAT-2 and 17 strains could not be identified and in crosses with nine standard testers, three mating populations of Fusarium were identified as MP-A, G. moniliformis (68 strains, 64.76%), MP-D, G. intermedia (21 strains, 20%) and MP-E, G. subglutinans (3 strains, 2.9%), and 13 strains (12.38%) could not be identified. All trains biologically identified as MP-A, MP-D, and MP-E, were identified morphologically as F. verticillioides, F. proliferatum, and F. subglutinans, respectively. Thus, the results of this study indicated that identification based on biological identification were consistent with those of morphological identification. This is the first report on the presence of MP-A, MP-D, and MP-E on ear rot-infected maize in Indonesia; MP-A and MP-E in Malaysia.

Keywords: Fusarium, MAT-1, MAT-2, MP-A, MP-D, MP-E

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Authors: S. F. Kanaan, Fatima Al-Kadi, H. Khrais

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Background: Fibromyalgia is a chronic condition that is characterized by chronic pain that limits physical and functional activities. To our best knowledge, there is currently no key physiotherapy approach recommended to reduce pain and improve function. In addition, there are scarce studies that investigated the effect of manual therapy in the management of Fibromyalgia, and no study investigated the efficacy of Mulligan´s mobilization with movement (MWM) in particular. Methods: A 51-year-old female diagnosed with Fibromyalgia for more than a year. The patient was complaining of generalized pain including neck, lower back, shoulders, elbows, hips, and knees. In addition, the patient reported severe limitation in activities and inability to complete her work as a lawyer. The Intervention provided for the patient consisted of 4 sessions (in two weeks) of MWM for neck, lower back, shoulders, elbows, sacroiliac joint, hips, and knees. The Visual Analogue Scale of pain (VAS), Range of Motion (ROM), 10-minute walk test, Roland Morris Low Back Pain and Disability Questionnaire (RMQ), Disability of the Arm, Shoulder and Hand Score (DASH) were collected at the baseline and at the end of treatment. Results: Average improvement of ROM in the neck, lower back, shoulder, elbows, hips, and knees was 45%. VAS scale changed from pre-treatment to post-treatment as the following: neck pain (9 to 0), lower back pain (8 to 1), shoulders pain (8 to 2), elbows pain (7 to 1), and knees pain (9 to 0). The patient demonstrated improvement in all functional scale from pre-intervention to post-intervention: 10-meter walk test (9.8 to 4.5 seconds), RMQ (21 to 11/24), and DASH (88.7% to 40.5%). The patient did not report any side effect of using this approach. Conclusion: Fibromyalgia can cause joint 'faulty position' leading to pain and dysfunction, which can be reversed by using MWM. MWM showed to have clinically significant improvement in ROM, pain, and ability to walk and a clinically significant reduction in disability in only 4 sessions. This work can be expanded in a larger sample.

Keywords: mobilization, fibromyalgia, dysfunction, manual therapy

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Authors: Mohammadjavad Mehrabanpour, Maryam Ranjbar Bushehri, Dorsa Mehrabanpour

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Respiratory diseases are the most important problems in the country’s poultry industry, particularly when it comes to broiler flocks. Ornithobacterium rhinotracheale (ORT) is a species that causes poor performance in growth rate, egg production, and mortality. This pathogen causes a respiratory infection including pulmonary alveolar inflammation, and pneumonia of birds throughout the world. Newcastle disease (ND) is a highly contagious disease in poultry, and also, it causes considerable losses to the poultry industry. The aim of this study was to evaluate the simultaneous occurrence of ORT and ND and NDV isolation by inoculation in embryonated eggs and confirmed by RT-PCR in broiler chicken flocks in Fars province. In this study, 318 blood and 85 tissue samples (brain, trachea, liver, and cecal tonsils) were collected from 15 broiler chicken farms. Survey serum antibody titers against ORT by using a commercial enzyme-linked immunosorbent assay (ELISA) kit performed. Evaluation of antibody titer against ND virus is performed by hemagglutination inhibition test. Virus isolation with chick embryo eggs 9-11 and RT-PCR method were carried out. A total of 318 serum samples, 135 samples (42.5%) were positive for antibodies to ORT and titer of HI antibodies against NDV in 122 serum samples (38/4%) were 7-10 (log2) and 61 serum samples (19/2%) had occurrence antibody titer against Newcastle virus and ORT. Results of the present study indicated that 20 tissue samples were positive in embryonated egg and in rapid hemagglutination (HA) test. HI test with specific ND positive serum confirmed that 6 of 20 samples. PCR confirmed that all six samples were positive and PCR products of samples indicated 535-base pair fragments in electrophrosis. Due to the great economic importance of these two diseases in the poultry industry, it is necessary to design and implement a comprehensive plan for prevention and control of these diseases.

Keywords: ELISA, Ornithobacterium rhinotracheale, newcastle disease, seroprevalence

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Authors: Sandeep Goyal, Sandeep Saluja

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Natural antioxidants have major role in maintenance of health. Green tea extract principally contains epigallocatechin-3-gallate (EGCG), as its abundant antioxidant constituent. Green tea is consumed daily worldwide as antioxidant to combat CNS diseases and has traditional importance also. EGCG has neuroprotective potential in various animal models of Parkinson disease, Alzheimer’s disease etc. but its exact mechanism has not been ruled out. The present study has been designed to investigate the anti-inflammatory, antioxidant and mitochondrial modulating mechanism of neuroprotective effect of epigallocatechin-3-gallate against rodent model of rotenone induced Parkinson’s disease (PD). The behavioural alterations were assessed by using open field test apparatus, Chatilon’s grip strength test apparatus and elevated plus maze for determining the locomotor activity, grip strength and cognition respectively. Biochemically, various parameters to assess oxidative stress, neuroinflammation and neurochemical estimations were performed on rat brain homogenates. A histological examination of rat brain striatum was done to check the neurodegeneration. Epigallocatechin-3-gallate (EGCG) at 10 & 20 mg/kg, were investigated for their neuroprotective potential along with levodopa as a standard agent. Minocycline, a microglial activation inhibitor, was administered alone and in combination with EGCG. EGCG and minocycline produced ameliorative effect against rotenone induced PD like symptoms by significantly reduced behavioral, biochemical and histological alterations. Results of our study reveal the neuroprotective effect of EGCG and minocycline against rotenone induced PD. Results of our study indicate that EGCG exerted neuroprotective effect against rotenone induced PD via its antioxidant, anti-inflammatory and mitochondrial modulating mechanisms and substantiate its previously reported and traditional claims for its use in CNS diseases.

Keywords: antioxidants, neurotoxicity, rotenone, EGCG

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Authors: Sadaf H. Khan, Jyoti Kumar

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Sick Building Syndrome (SBS) is a situation in which inhabitants of a building develop illness symptoms or get infected with a chronic disease as a result of the building in which they reside or work. Certain symptoms tend to get more severe as an individual spends more time in the building; however, they generally improve with time or even disappear when they leave that space. Though ‘Design of Built-Spaces’ is a crucial factor in regulating these symptoms but it still needs to be identified further as to what specific design features of a ‘Built-Space’ trigger sick building syndrome (SBS). Much of the research work present to date is focused on the physiological or physical sickness caused due to inappropriate built-space design. In this paper, the psychological aspects of sick building syndrome (SBS) will be investigated across the adult population, more specifically graduate students in India trying to settle in back to their previous physical work environments, i.e., campus, classrooms, hostels, after a very long hold which lasted more than a year due to lockdowns during Covid-19 crisis all over the world. The study will follow an analytical approach and the data will be collected through self-reported online surveys. The purpose of this study is to enquire causal agents, diagnosable symptoms and remedial design of built spaces which can enhance the productive level of built environments and better facilitate the inhabitants by improving their psychological wellbeing, which is the most uprising concern. The fact that SBS symptoms can be studied only within the initial few weeks as an occupant starts interacting with a built-environment and leaves as the occupant leaves that space or zone, the post-lockdown incoming of students back to their respective campuses provides an opportunity to clearly draw multiple conclusions of the relationship that exist between the Design of Built-Spaces and Psychological Sickness Syndrome associated with it. The study will be one of a kind approach for understanding and formulating methods to improve psychological wellbeing within a built-setting by better identifying factors associated with these psychological symptoms, including anxiety, mental fatigue, reduced attention span and reduced memory span as refined symptoms of SBS discussed in 1987 by Molhave within his study.

Keywords: built-environment psychology, built-space design, healthcare architecture, psychological wellbeing

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Authors: M. A. Munteanu, A. M. Lungu, A. I. Chivescu, V. Teodorescu, E. Tufanoiu, C. Nicolae, T. I. Nanea

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Introduction: Sodium-glucose co-transporter 2 inhibitors (SGLT2i), which were first developed as antidiabetic medications, have demonstrated numerous positive benefits on the cardiovascular system, especially in the prevention of heart failure (HF). HF is a challenging, multifaceted disease that needs all-encompassing therapy. It should not be viewed as a limited form of heart illness but rather as a systemic disease that leads to multiple organ failure and death. SGLT2i is an extremely effective tool for treating HF by using its pleiotropic effects. In addition to its use in patients with diabetes mellitus who are at high cardiovascular risk or who have already experienced a cardiovascular event, SGLT2i administration has been shown to have positive effects on a variety of HF manifestations and stages, regardless of the patient's presence of diabetes mellitus. Material and Methods: According to the guide, 110 patients (83 males and 27 females) with heart failure with mildly reduced ejection fraction (HFmrEF), with T2D and neoplasia, were enrolled in the prospective study. The structural and functional state of the left ventricle myocardium and ejection fraction was assessed through echocardiography. Patients were randomized to receive once-daily dapagliflozin 10 mg. Results: Patients with HFmrEF were divided into 3 subgroups according to age. 7% (8) patients aged < 45 years, 35% (28) patients aged between 46-59 years, and 58% (74) patients aged> 60 years. The most prevalent comorbidities were hypertension (43.1%), coronary heart disease (40%), and obesity (33.2%). Study drug discontinuation and serious adverse events were not frequent in the subgroups, in either men or women, until now. Conclusions: SGLT-2 inhibitors are a novel class of antidiabetic agents that have demonstrated positive efficacy and safety outcomes in the setting of HFmrEF. Until now, in our study, dapagliflozin was safe and well-tolerated irrespective of sex.

Keywords: diabetes mellitus type 2, Sodium-glucose co-transporters-2 inhibitors, heart failure, neoplasia

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Authors: Mimoza Canga, Edit Xhajanka, Irene Malagnino

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The COVID-19 pandemic has had a significant influence on the lives of millions of people and is a threat to public health. SARS-CoV-2 infection has been associated with a number of health problems, including damage to the lungs and central nervous system damage. Additionally, it can also cause oral health problems, such as pain and weakening of the chewing muscles. The purpose of the study is the assessment of the masticatory muscle function in young adults between 18 and 29 years old following SARS-CoV-2 infection. Materials and methods: This study is quantitative cross-sectional research conducted in Albania between March 2023 and September 2023. Our research involved a total of 104 students who participated in our research, of which 64 were female (61.5%) and 40 were male (38.5%). They were divided into four age groups: 18-20, 21-23, 24-26, and 27-29 years old. In this study, the students willingly consented to take part in this study and were guaranteed that their participation would remain anonymous. The study recorded no dropouts, and it was carried out in compliance with the Declaration of Helsinki. Statistical analysis was conducted using IBM SPSS Statistics Version 23.0 on Microsoft Windows Linux, Chicago, IL, USA. Data were evaluated utilizing analysis of variance (ANOVA), with a significance level set at P ≤ 0.05. Results: 80 (76.9%) of the participants who had passed COVID-19 reported chronic masticatory muscle pain (P < 0.0001) and masticatory muscle spasms (P = 0.002). According to data analysis, 70 (67.3%) of the participants had a sore throat (P=0.007). 74% of the students reported experiencing weakness in their chewing muscles (P=0.003). The participants reported having undergone the following treatments: azithromycin (500 mg daily), prednisolone sodium phosphate (15 mg/5 mL daily), Augmentin tablets (625 mg), vitamin C (1000 mg), magnesium sulfate (4 g/100 mL), oral vitamin D3 supplementation of 5000 IU daily, ibuprofen (400 mg every 6 hours), and tizanidine (2 mg every 6 hours). Conclusion: This study, conducted in Albania, has limitations, but it can be concluded that COVID-19 directly affects the functioning of the masticatory muscles.

Keywords: Albania, chronic pain, COVID-19, cross-sectional study, masticatory muscles, spasm

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Authors: Kobus-Cisowska Joanna, Flaczyk Ewa, Gramza-Michalowska Anna, Kmiecik Dominik, Przeor Monika, Marcinkowska Agata, Korczak Józef

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Cereal products, including mainly bread is a staple food known from the beginning of history throughout the world. It is now believed that there is no replacement of the basic food. Bread, due to the high content of starch is the energy source for the proper functioning of our body. It also contains proteins, fats, vitamins, especially of the B group and vitamin E, a number of minerals, and fiber. The aim of the study was to evaluate the antioxidant activity of new developed bread premixes with mulberry fruits for people with anemia, diabetes, obesity and cardiovascular disease. From the finished product-bread, aqueous and methanol extracts was prepared, which in next step were analyzed to assess the activity of the radical DPPH test, ABTS, chelating activity, the ability to reduce metals. Extracts were prepared from bread were acquired with premixes directly after production and stored for three months. The resulting trial breads effect by different mechanisms of antioxidant. They showed the ability to scavenge radicals ABTS and DPPH and chelating activity. Methanol extracts showed significantly greater antioxidant activity in comparison with aqueous extracts, and the largest effect was estimated for sample of bread for anemia, diabetes and cardiovascular disease. The greatest ability to scavenging ABTS radicals showed breads for anemia, diabetes and cardiovascular disease, while smaller for anemia and control sample. It was shown that the methanol extracts of the breads samples showed no ability to chelate iron (II). These properties are observed only in the aqueous extracts. The greatest ability attempt had anemia while the lowest control sample. Financial supported by the UE Project no POIG 01.01.02-00-061/09.

Keywords: morus alba, antioxidant activity, free radicals, polyphenols

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Authors: Gamith Mendis

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Even though the doctors are knowledgeable, there's a gap between knowing and being ethical. This is a barrier to establish an ethical doctor-patient relationship. Current health system has oriented in a way that gives a meaning to both the doctor and the patient through intermediate entities. For the doctor, the meaning of the doctor-patient relationship is given through the financial benefits, promotions, and social status. For the patient, the meaning is given through curing of the disease. It is obvious that both are independent entities between the doctor and the patient. As the philosophers like Husserl and Heidegger have pointed out, our subjective world will give the immediate meaningfulness to us. We should seek this immediate meaningfulness of the doctor-patient relationship. The present research has used the existential methodology as guided self-reflections on the lived experiences of a doctor and his students. In this approach, two important aspects have been understood. The first is, establishing the fact that being ethical is itself giving meaningfulness to the doctor’s being without any mediate entities. Simply, it is enjoying being an honest being. The second is by being-with-the-patient while treating the disease; both the doctor and the patient can enjoy the meaningfulness of their human relationship. The medical students and the doctors should focus on this meaningfulness. For that, this discussion should be actively incorporated into the medical curriculum with programs of practical guidance to medical students and should be discussed in patient-care reviews in the health setting within a satisfactory framework.

Keywords: doctor-patient relationship, medical education, medical ethics, medical humanities, qualitative health research

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Authors: C. Scurr, J. Jeans, S. Srivastava

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Introduction: Acute type two respiratory failure (T2RF) has become a common presentation over the last two decades primarily due to an increase in the prevalence of chronic lung disease. Acute exacerbations can be managed either medically or in combination with non-invasive ventilation (NIV) which should be monitored with regular arterial blood gas samples (ABG). Arterial lines allow more frequent arterial blood sampling with less patient discomfort. We present the experience from a teaching hospital emergency department (ED) and level 2 medical high-dependency unit (HDU) that together form the pathway for management of acute type 2 respiratory failure. Methods: Patients acutely presenting to Charing Cross Hospital, London, with T2RF requiring non-invasive ventilation (NIV) over 14 months (2011 to 2012) were identified from clinical coding. Retrospective data collection included: demographics, co-morbidities, blood gas numbers and timing, if arterial lines were used and who performed this. Analysis was undertaken using Microsoft Excel. Results: Coding identified 107 possible patients. 69 notes were available, of which 41 required NIV for type 2 respiratory failure. 53.6% of patients had an arterial line inserted. Patients with arterial lines had 22.4 ABG in total on average compared to 8.2 for those without. These patients had a similar average time to normalizing pH of (23.7 with arterial line vs 25.6 hours without), and no statistically significant difference in mortality. Arterial lines were inserted by Foundation year doctors, Core trainees, Medical registrars as well as the ICU registrar. 63% of these were performed by the medical registrar rather than ICU, ED or a junior doctor. This is reflected in that the average time until an arterial line was inserted was 462 minutes. The average number of ABGs taken before an arterial line was 2 with a range of 0 – 6. The average number of gases taken if no arterial line was ever used was 7.79 (range of 2-34) – on average 4 times as many arterial punctures for each patient. Discussion: Arterial line use was associated with more frequent arterial blood sampling during each inpatient admission. Additionally, patients with an arterial line have less individual arterial punctures in total and this is likely more comfortable for the patient. Arterial lines are normally sited by medical registrars, however this is normally after some delay. ED clinicians could improve patient comfort and monitoring thus allowing faster titration of NIV if arteral lines were regularly inserted in the ED. We recommend that ED doctors insert arterial lines when indicated in order improve the patient experience and facilitate medical management.

Keywords: non invasive ventilation, arterial blood gas, acute type, arterial line

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Authors: Lubomir Vecera, Tomas Gabrhelik, Benjamin Tolmaci, Josef Srovnal, Emil Berta, Petr Prasil, Petr Stourac

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Cancer is the second leading cause of death worldwide and colon cancer is the second most common type of cancer. Currently, there are only a few studies evaluating the effect of postoperative analgesia on the prognosis of patients undergoing radical colon cancer surgery. Postoperative analgesia in patients undergoing colon cancer surgery is usually managed in two ways, either with strong opioids (morphine, piritramide) or epidural analgesia. In our prospective study, we evaluated the effect of postoperative analgesia on the presence of circulating tumor cells or minimal residual disease after colon cancer surgery. A total of 60 patients who underwent radical colon cancer surgery were enrolled in this prospective, randomized, two-center study. Patients were randomized into three groups, namely piritramide, morphine and postoperative epidural analgesia. We evaluated the presence of carcinoembryonic antigen (CEA) and cytokeratin 20 (CK-20) mRNA positive circulating tumor cells in peripheral blood before surgery, immediately after surgery, on postoperative day two and one month after surgery. The presence of circulating tumor cells was assessed by quantitative real-time reverse transcriptase-polymerase chain reaction (qRT-PCR). In the priritramide postoperative analgesia group, the presence of CEA mRNA positive cells was significantly lower on a postoperative day two compared to the other groups (p=0.04). The value of CK-20 mRNA positive cells was the same in all groups on all days. In all groups, both types of circulating tumor cells returned to normal levels one month after surgery. Demographic and baseline clinical characteristics were similar in all groups. Compared with morphine and epidural analgesia, piritramide significantly reduces the amount of CEA mRNA positive circulating tumor cells after radical colon cancer surgery.

Keywords: cancer progression, colon cancer, minimal residual disease, perioperative analgesia.

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Authors: Ravinder Kaur

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Introduction Global cerebrovascular reactivity (CVR) mapping is a promising clinical assessment for stress-testing the brain using physiological challenges, such as CO₂, to elicit changes in perfusion. It enables real-time assessment of cerebrovascular integrity and health. Conventional imaging approaches solely use steady-state parameters, like cerebral blood flow (CBF), to evaluate the integrity of the resting parenchyma and can erroneously show a healthy brain at rest, despite the underlying pathogenesis in the presence of cerebrovascular disease. Conversely, coupling CO₂ inhalation with phase-contrast MRI neuroimaging interrogates the capacity of the vasculature to respond to changes under stress. It shows promise in providing prognostic value as a novel health marker to measure neurovascular function in disease and to detect early brain vasculature dysfunction. Objective This exploratory study was established to:(a) quantify the CBF response to CO₂ in hypocapnia and hypercapnia,(b) evaluate disparities in CVR between internal carotid (ICA) and vertebral artery (VA), and (c) assess sex-specific variation in CVR. Methodology Phase-contrast MRI was employed to measure the cerebrovascular reactivity to CO₂ (±10 mmHg). The respiratory interventions were presented using the prospectively end-tidal targeting RespirActTM Gen3 system. Post-processing and statistical analysis were conducted. Results In 9 young, healthy subjects, the CBF increased from hypocapnia to hypercapnia in all vessels (4.21±0.76 to 7.20±1.83 mL/sec in ICA, 1.36±0.55 to 2.33±1.31 mL/sec in VA, p < 0.05). The CVR was quantitatively higher in ICA than VA (slope of linear regression: 0.23 vs. 0.07 mL/sec/mmHg, p < 0.05). No statistically significant effect was observed in CVR between male and female (0.25 vs 0.20 mL/sec/mmHg in ICA, 0.09 vs 0.11 mL/sec/mmHg in VA, p > 0.05). Conclusions The principal finding in this investigation validated the modulation of CBF by CO₂. Moreover, it has indicated that regional heterogeneity in hemodynamic response exists in the brain. This study provides scope to standardize the quantification of CVR prior to its clinical translation.

Keywords: cerebrovascular disease, neuroimaging, phase contrast MRI, cerebrovascular reactivity, carbon dioxide

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Authors: Mulugeta Shegaze, Mekitie Wondafrash, Alemayehu A. Alemayehu, Shikur Mohammed, Zewdu Shewangezaw, Mukerem Abdo, Gebresilasea Gendisha

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Background: The 2004 World Health Assembly called for specific actions to halt the overweight and obesity epidemic that is currently penetrating urban populations in the developing world. Adolescents require particular attention due to their vulnerability to develop obesity and the fact that adolescent weight tracks strongly into adulthood. However, there is scarcity of information on the modifiable risk factors to be targeted for primary intervention among urban adolescents in Ethiopia. This study was aimed at determining the magnitude and risk factors of overweight and obesity among high school adolescents in Addis Ababa. Methods: An institution-based cross-sectional study was conducted in February and March 2014 on 456 randomly selected adolescents from 20 high schools in Addis Ababa city.  Demographic data and other risk factors of overweight and obesity were collected using self-administered structured questionnaire, whereas anthropometric measurements of weight and height were taken using calibrated equipment and standardized techniques. The WHO STEPS instrument for chronic disease risk was applied to assess dietary habit and physical activity. Overweight and obesity status was determined based on BMI-for-age percentiles of WHO 2007 reference population. Results: The prevalence rates of overweight, obesity, and overall overweight/ obesity among high school adolescents in Addis Ababa were 9.7% (95%CI = 6.9-12.4%), 4.2% (95%CI = 2.3-6.0%), and 13.9% (95%CI = 10.6-17.1%), respectively. Overweight/obesity prevalence was highest among female adolescents, in private schools, and in the higher wealth category. In multivariable regression model, being female [AOR(95%CI) = 5.4(2.5,12.1)], being from private school [AOR(95%CI) = 3.0(1.4,6.2)], having >3 regular meals [AOR(95%CI) = 4.0(1.3,13.0)], consumption of sweet foods [AOR(95%CI) = 5.0(2.4,10.3)] and spending >3 hours/day sitting [AOR(95%CI) = 3.5(1.7,7.2)] were found to increase overweight/ obesity risk, whereas high Total Physical Activity level [AOR(95%CI) = 0.21(0.08,0.57)] and better nutrition knowledge [AOR(95%CI) = 0.160.07,0.37)] were found protective. Conclusions: More than one in ten of the high school adolescents were affected by overweight/obesity with dietary habit and physical activity are important modifiable risk factors. Well-tailored nutrition education program targeting lifestyle change should be initiated with more emphasis to female adolescents and students in private schools.

Keywords: adolescents, NCDs, overweight, obesity

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Authors: Roshanim Koris, Norashidah Mohamed Nor, Sharifah Azizah Haron, Normaz Wana Ismail, Syed Mohamed Aljunid Syed Junid, Amrizal Muhammad Nur, Asrul Akmal Shafie, Suraya Yusuff, Namaitijiang Maimaiti

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An ageing population has huge implications for virtually every aspect of Malaysian societies. The elderly consume a greater volume of healthcare facilities not because they are older, but because of they are sick. The chronic comorbidities and deterioration of cognitive ability would lead the elderly’s health to become worst. This study aims to provide a comprehensive estimate of the direct and indirect costs of health care used in a nationally representative sample of community-dwelling elderly with dementia and as well as the determinants of healthcare cost. A survey using multi-stage random sampling techniques recruited a final sample of 2274 elderly people (60 years and above) in the state of Johor, Perak, Selangor and Kelantan. Mini Mental State Examination (MMSE) score was used to measure the cognitive capability among the elderly. Only the elderly with a score less than 19 marks were selected for further analysis and were classified as dementia. By using a two-part model findings also indicate household income and education level are variables that strongly significantly influence the healthcare cost among elderly with dementia. A number of visits and admission are also significantly affect healthcare expenditure. The comorbidity that highly influences healthcare cost is cancer and seeking the treatment in private facilities is also significantly affected the healthcare cost among the demented elderly. The level of dementia severity is not significant in determining the cost. This study is expected to attract the government's attention and act as a wake-up call for them to be more concerned about the elderly who are at high risk of having chronic comorbidities and cognitive problems by providing more appropriate health and social care facilities. The comorbidities are one of the factor that could cause dementia among elderly. It is hoped that this study will promote the issues of dementia as a priority in public health and social care in Malaysia.

Keywords: ageing population, dementia, elderly, healthcare cost, healthcare utiliztion

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Authors: Christiana Frimpong, Mpundu Makasa, Lungowe Sitali, Charles Michelo

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Background: Toxoplasmosis is a neglected zoonotic disease which is prevalent among pregnant women especially in Africa. This study aimed to determine the seroprevalence and determinants of the disease among pregnant women attending the antenatal clinic at the University Teaching Hospital (UTH). Method: A cross-sectional study was employed where 411 pregnant women attending the antenatal clinic at UTH were interviewed using closed-ended questionnaires. Their blood was also tested for Toxoplasma gondii IgG and IgM antibodies using the OnSite Toxo IgG/IgM Combo Rapid Test cassettes by CTK Biotech, Inc, USA. Result: The overall seroprevalence of the infection (IgG) was 5.87%. There was no seropositive IgM result. Contact with cats showed 7.81 times the risk of contracting the infection in the pregnant women and being a farmer/being involved in construction work showed 15.5 times likelihood of contracting the infection. Socio-economic status of the pregnant women also presented an inverse relationship (showed association) with the infection graphically. However, though there were indications of the association between contact with cats, employment type as well as the socioeconomic status of the pregnant women with the infection, there was not enough evidence to suggest these factors as significant determining factors of Toxoplasma gondii infection in our study population. Conclusion: There is a low prevalence of Toxoplasma gondii infection among pregnant women in Lusaka, Zambia. Screening for the infection among pregnant women can be done once or twice during pregnancy to help protect both mother and child from the disease. Health promotion among women of child bearing age on the subject is of immense importance in order to help curb the situation. Further studies especially that of case-control and cohort studies should be carried out in the country in order to better ascertain the extent of the condition nationwide.

Keywords: determinants, pregnant women, seroprevalence, toxoplasmosis, University Teaching Hospital (UTH), Zambia

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Authors: Iahtasham Khan, Vania Lucia De Assis Santana, Marcilia Maria Alves De Souza, Mabel Hanna Vance Harrop, Fernando Leandro Dos Santos, Cecília Maria Souza Leão E. Silva, Pedro Paulo Silveira, Marcelo Brasil, Marcus Vinícius, Hélio Cordeiro Manso Filho, Muhammad Younus, Aman Ullah Khan

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Glanders ranks high on clinical lists in some regions of Brazil as a cause of respiratory and lymphatic disease in equids. Glanders is caused by Burkolderia mallei (B. mallei) Gram-negative bacterium. B. mallei was first biological agent used in World War I in 20th century. The complement fixation test (CFT) is a serodiagnostic tool prescribed by the World Organization for Animal Health (OIE)for the diagnosis of glanders in the international trade of equids. The aim of the present study was to monitor the serological responses in equines naturally infected with B. mallei using the CFT. A total of 574 equids were tested with CFT, 30 days apart in a total of 12 samplings. One hundred thirty-four sera tested negative in all samplings; 192 sera tested positive in one sampling and 125 sera tested positive in two or more samplings. Remaining 123 samples showed uncertain results. Thus, CFT results can vary over a period of time. These variations could be the consequence of the effects of the natural immune response in each animal. The findings of the present study demonstrate difficulties regarding the simultaneous implementation of CFT and test and slaughter policies to eradicate glanders. Another constraint to control this disease is the presence of carrier/transitory CFT-negative animals, which are a potential source of disease in glanders-free areas. Serodiagnostic tests of higher sensitivity and specificity like immunobloat should be implemented to achieve success in the eradication of glanders.

Keywords: glanders, equids, horses, immunological, mules

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