1 Epidemiology and etiology of sexually transmitted disease (STD) and HIV/AIDS among hotel-based workers in Karachi, Pakistan, Rubina Ghani
Background: The prevalence of sexually transmitted Disease (STDs) among hotel-based sex workers (HBSWs) in Karachi, Pakistan, was studied. These hotel workers are considered as high risk group because of their age, economic independence, low education and residence in a place away from their family. Objective: In poor countries, data on STDs and related complications are limited, which causes a substantial under estimation of the burden of these diseases. The aim of this study was to access in health care facilities for diagnosis and treatment of STDs. Material and Methods: The focus of this study was to understand the sexual behavior among categories of hotel workers in the context of HIV/AIDS and STD. 100 respondents were selected randomly from 25 different hotels from different parts of city and these were receptionists, waiters, room-service persons and security guard. Result: The 26 years of age of the responders were taken in this study. 37% of the subjects ever visited commercial sex workers, 80% of the subjects were un-married who visited hotel-based sex workers and never used condom, 3.3%. used it consistently were as 16.6% used occasionally. Only 3 hotels workers reported homosexual/bisexual experience. On further information 85% of all the responders had heard about AIDS and there were misconceptions. Conclusion: These data suggest that the time trends in HIV and STD prevalence are partly due to the changing sex work milieu. Prevention programme aimed at male sex workers should be highly prioritized and the screening program for HIV/AIDS and STD should be done Keywords: Sexual behavior, hotel employees, HIV/AID, Sexual transmitted disease (STD)
2 Cancer profile in B.P. Koirala institute of health sciences, Dharan, Nepal: A five-year study, Kafle SU
This study was done to find the most common cancers diagnosed as malignant among males and females attending this hospital. All histopathology and cytopathology cases reported as malignant from January 2005 to Dec 2009 were included in the study. A total of 3491 patients were diagnosed with malignancy. 1693(48.5%) were males and 1798(51.5%) were females with male to female ratio of 1.062. The top five districts with populations vulnerable to malignant conditions were Sunsari (893), Morang (598), Jhapa (512), Saptari (168) and Ilam (162). 225 patients were from India. Most patients (782) were 51-60 years of age. Males (398) were predominantly from 61-70 years age group while females (432) were mostly from 51-60 years age group. The most common cancers in females were of breast, cervix and gall bladder in descending order. In males the most common were hematolymphoid, gastric and lung malignancies. Keywords: cancers, breast, cervix, gall bladder, hematolymphoid, gastric, lung malignancies
3 The effects of red guava (Psidium guajava L) fruits on lipid peroxidation in hypercholesterolemic rats, Sugeng Maryanto
Background: Lipid peroxidation is a mechanism of cell injury, characterized by the formation of free radicals including malondialdehyde (MDA). To prevent or reduce the injury by free radicals, antioxidants are needed. Red Guava Fruit (Psidium guajava L) contains high antioxidants including vitamin C. This study aimed to determine the effects of red guava fruit on lipid peroxidation in hypercholesterolemic rats. Method: This study, a randomized Pre test-Post test control group design, was done on hypercholesterolemic Sprague Dawley rats. The rats were treated with 0.72 g red guava flour and vitamin C supplements equal to that in the red guava flour as a comparison for 14 days. SOD was measured by using the reaction of xanthine and xanthin oxidase (XOD). MDA was measured with tiobarbiturat acid (TBA) reaction. Data were analyzed by using a t-test and one way Anova with 5% level of significant. Result: There were an increase of SOD and decrease of MDA at both groups at almost the same percentage, 73% to 74% and 61% to 62% respectively. The mean of SOD and MDA post supplementation values of guava and vitamin C groups were almost at the same level with the group receiving standard diet, which were significantly higher and lower than the high cholesterol diet group respectively. Conclusion: Red guava fruit has the same antioxidant potency as vitamin C. Keywords: red guava fruit, SOD, MDA, lipid peroxidation.
4 Gelsolin and Annexin 7 proteins correlates with lymph node metastasis (LNM) in carcinoma cell, Asma Saleem Qazi
Background: There has been a tendency to focus on subcellular proteomes concerning specific subcellular compartments and macromolecular structures of the cell. Subcellular proteomics, as an important step to functional proteomics, has been a focus in proteomic research. Aim: To find whether LNM associated proteins perform their functions in some association with each other as some binding or interacting partners. Comparison of ratio of difference of their expression levels on the basis of their sub-cellular expression sites. Methods: Sub-cellular structures were focused to investigate two calcium dependent phospholipid binding proteins. The effect of their expression levels on each other were analyzed by increasing and decreasing regulation of protein on each other and further evaluation by SDS-PAGE. Results: LNM associated proteins were expressed at different sub-cellular location with different expression levels with higher expression in high potential cell lines for LNM. Up-regulation has increased and down-regulation has decreased their expression levels. Conclusion: The separation of cells into its compartments can increase the probability of detecting even low expression levels of proteins at different sites which not only tells the whole protein content of that specific fraction rather helps in understanding their structures, functions and binding associations with each other. Keywords: lymph nodes, metastasis, hepatocellular carcinoma, proteomics, subcellular fractions.
5 Emotional, behavioral and cognitive mechanisms in rehabilitation of romantic love neuro-cognitive process, Zarghi A
Neuro-cognitive assessment of romantic love is confined. The identifying theories and mechanisms involved in these complex feelings helps to better understanding of its neurobiology. The aim of this study is to investigate systemic emotional, behavioral, and cognitive mechanisms in rehabilitation of romantic love neuro-cognitive processes. It is not surprising that activities occur in brain areas which are also active in other emotional states but stimulated activity pattern is unique here. While expression and experience of love is very broad and different, its study can easily be far from the advantage of effective and powerful magnifier which researchers provide. Multi-dimensional nature of this feeling forces researchers to use always theorizing and research methods and combine different levels of analysis in a way that pay attention to fundamental aspects of love from personal perspectives and so utilize greater integration of multiple disciplines for assessing this feeling. Previous studies indicate that scientific investment should be in a right direction to develop understanding toward this outstanding individual phenomenon and it can be used as a solution in emotion rehabilitation. Keywords: rehabilitation, romantic love, emotional, behavioral and cognitive mechanisms
6 Haematological pictures in full term new born children in Sudan, Sana E. Abdalla
Background Anemia can occur when red blood cells are broken down too rapidly, too much blood is lost, or the bone marrow does not produce enough red blood cells. Normally, the bone marrow does not produce new red blood cells between birth and 3 or 4 weeks of age, causing a slow drop in the red blood cell count (called physiologic anemia) over the first 2 to 3 months of life. Very premature newborns have a slightly greater drop in red blood cell count. More severe anemia can occur when red blood cells are broken down too rapidly, a lot of blood is taken from preterm infants for blood tests, too much blood is lost during labor or delivery or the bone marrow does not produce blood cells. (Arthur E., et al 2009) The aim of this study are to measure Hb level, RBCs indices, serum iron, total iron binding capacity and serum ferritin in newborns at the time of delivery. Methods: 80 blood samples were collected from new born cord blood, complete blood count was measure using Sysmex Kx-21. Serum iron and total iron binding capacity (TIBC) were measured by an automatic instrument (BTS- 370 Plus), which performs spectrometric measurements. Serum ferritin was estimated by ELIZA technique. Results: this study showed that 18 (22.5%) babies had low Haemoglobin level, while 62 (77%) had normal level, 70 (87.5%) had normal MCV, while 10 (12.5%) had low MCV, 79(98.7%) had normal MCH, while 1(1.3%) had low MCH while all studied babies (80) had normal MCHC. Eight (10%) babies had low S. ferritin, while 69 (86.3%) babies had normal S. ferritin, and 3 (3.7%) babies had high S. Ferritin while four (5%) babies had low S. iron, 54(67.5%) babies had normal S. iron and 18(22.5%) had high S. iron. TIBC showed that 5(6.3%) babies had low TIBC, while 67(83.7%) had normal TIBC and 8(10%) babies had high TIBC. Conclusion: This study concluded that anaemia in newborn babies is not uncommon and early cord clamping should always be taken in to consideration, if other causes could not be found. Keywords: Haemoglobin, indices, iron, ferritin.
7 Haematological pictures in full term new born children in Sudan, Sana E. Abdalla
Background Anemia can occur when red blood cells are broken down too rapidly, too much blood is lost, or the bone marrow does not produce enough red blood cells. Normally, the bone marrow does not produce new red blood cells between birth and 3 or 4 weeks of age, causing a slow drop in the red blood cell count (called physiologic anemia) over the first 2 to 3 months of life. Very premature newborns have a slightly greater drop in red blood cell count. More severe anemia can occur when red blood cells are broken down too rapidly, a lot of blood is taken from preterm infants for blood tests, too much blood is lost during labor or delivery or the bone marrow does not produce blood cells. (Arthur E., et al 2009) The aim of this study are to measure Hb level, RBCs indices, serum iron, total iron binding capacity and serum ferritin in newborns at the time of delivery. Methods: 80 blood samples were collected from new born cord blood, complete blood count was measure using Sysmex Kx-21. Serum iron and total iron binding capacity (TIBC) were measured by an automatic instrument (BTS- 370 Plus), which performs spectrometric measurements. Serum ferritin was estimated by ELIZA technique. Results: this study showed that 18 (22.5%) babies had low Haemoglobin level, while 62 (77%) had normal level, 70 (87.5%) had normal MCV, while 10 (12.5%) had low MCV, 79(98.7%) had normal MCH, while 1(1.3%) had low MCH while all studied babies (80) had normal MCHC. Eight (10%) babies had low S. ferritin, while 69 (86.3%) babies had normal S. ferritin, and 3 (3.7%) babies had high S. Ferritin while four (5%) babies had low S. iron, 54(67.5%) babies had normal S. iron and 18(22.5%) had high S. iron. TIBC showed that 5(6.3%) babies had low TIBC, while 67(83.7%) had normal TIBC and 8(10%) babies had high TIBC. Conclusion: This study concluded that anaemia in newborn babies is not uncommon and early cord clamping should always be taken in to consideration, if other causes could not be found. Keywords: Haemoglobin, indices, iron, ferritin.
8 Neuroscience and Neuro-cognitive Rehabilitation, Afsaneh Zarghi
Cognitive rehabilitation is a group of designed techniques that is for the promotion of cognitive domains in people with disease or disability. Cognitive rehabilitation therapy (CRT) is the science of restoring cognitive processing and learning compensatory strategies and it affects the molecular and cellular recovery rehabilitation by integration of behavioral and cognitive changes. The promotion of rehabilitation science of cognitive neuroscience has made it a priority by the help of full range of effected interventional procedures. And it has been able to achieve the desired goals in the chain of theoretical and experimental science on the basis of behavioral interventions which is made of neuroscience, cognitive neuroscience, psychology, physiology, pharmacology, medical imaging, and other medical disciplines and achieved some success in compensatory and medical strategies after surgery. Cognitive impairment after brain surgery is huge health challenges beyond the common disorders associated with diseases. Our approach to CRT is on the assumption that treatment would be the most effective way when focusing on the cognitive sub-systems after neurosurgery and these are also affected by other aspects of life as a patient emotions, nutrition, health, stress, and social performance. Intervention in the passive skills can lead to neuro-cognitive rehabilitation that includes designed experience on the basis of nerve and brain function and structure. A failure of cognitive or brain processing during or after surgery is an abnormal result and these impairments are treated better with CRT. This method on the basis of neuroplasticity, reorganization of damaged cortical through morphological and physiological responses of nerve reconstruction ways by techniques in neuro-cognitive disorders due to illness, injury or disability, even in healthy individuals which are affected by environment, the complexity of stimulation, repeated tasks and motivation. Keywords: Neuroscience, Neuro-cognitive, Rehabilitation
9 Superscan us?ng F-18 FDG pet ?n breast cancer pat?ent, Hatice Uslu
The SuperScan of bone scintigraphy is well-known phenomenon which is included intense activity in the bones and diminished soft tissue and renal parenchymal activity. Here we demonstrate a patient with postoperative right breast cancer of Fluorine-18 (F-18) fluorodeoxyglucose positron emission tomography (FDG PET) SuperScan showing extensive hypermetabolic lesions throughout the skeletons but only faint visualizations of the liver, renal cortex, and soft tissue, similar to the superscan of bone scintigraphy. Keywords: FDG PET/CT, PET SuperScan, Extensive Metastasis, Breast cancer
10 Classification models for predicting the source of gastrointestinal bleeding in the absence of hematemesis, Nazziwa Aisha
Management of acute gastrointestinal bleeding necessitates the identification of the source of bleed. The source of bleeding which is clear in patients presenting with hematemesis, is unclear in the absence of it. Logistic regression, decision tree, naïve Bayes, LogitBoost and KNN models were constructed from non endoscopic data of 325 patients admitted via the emergence department (ED) for GIB without hematemesis. The performance of the models in predicting the source of bleeding into upper gastrointestinal bleeding or lower gastrointestinal bleeding was compared. Overall the models demonstrate good performance with regards to sensitivity specificity, PPV, NPV and classification accuracy on the simulated data. On the GIB data, the naive Bayes model performed best with a prediction accuracy and sensitivity of 86%, specificity of 85% and area under curve of 92%. Classification models can help to predict the source of gastrointestinal bleeding for patients presenting without hematemesis and may generally be useful in decision support in the ED. The models should be explored further for clinical relevance in other settings. Keywords: Upper Gastrointestinal bleeding, Emergency department, Hematemesis, Classification models, Naïve Bayes, Weka, Naive Bayes classifier, Random Forest, Decision tree, Logit boost, k nearest neighbour, Logistic regression.
11 Congenital cervical scoliosis in a Holstein Friesian calf, Sakhaee E
An abnormal vertebral development that results in a lateral curvature of the spine is classified as congenital scoliosis. The type and region of the malformation determines severity of the scoliosis. The name "scoliosis" comes from the Greek word meaning curvature. In November 2012, an 8-day-old male Holstein Friesian calf was referred to the Hospital of Kerman Veterinary Medicine Faculty, Iran. The calf, which weighed approximately 50 kg, had a C -shaped scoliosis that occurred in the neck vertebrae and not associated with trauma, and we did not identify any evidence of trauma or fractures on radiographs. On physical examination, the animal was found to be alert, there is no neurologic damage and breathing difficulties. The rectal temperature and heart rate were 38.9 °C and 88 pulses / min, respectively. The natural history of congenital scoliosis plays a vital role in the prognosis and treatment of the defect. Congenital scoliosis presents a major challenge to the Veterinarian as a result of the possibility of a wide variety of primary and secondary abnormalities. These abnormalities develop during fetal life, and thus treatment of these patients often necessitates numerous tests and thorough repetitive examination by the Veterinarian. Keywords: Congenital cervical scoliosis - Calf
12 Current management of overactive bladder: Insight from developing country, Dwi Ngestiningsih
Overactive bladder (OAB) is a chronic, debilitating and highly prevalent condition occurred in all age, especially among elderly affecting quality of life such as socioeconomic, psychological, occupational, domestic, physical and sexual functioning. The management of OAB can be nonpharmacologic interventions, pharmacologic interventions or combination of both. There are several substances involving smooth muscle relaxants, tricyclic antidepressants herbal medicine that can be used to encourage this OAB but still uncovered, this is a challenge for clinicians to investigate further regarding herbal medicine for OAB in order to suppress cost of OAB management because herbal medicine especially in Indonesia is cheaper than synthetic substances. The successful of management of OAB is influenced by many factors, especially from developing country such as Indonesia is the compliance of patients. The comprehensive and better understanding of this disorder is needed in order to manage OAB comprehensively. This article discuss about the comprehensive approach for managing OAB based on the clinical experience among developing country. Keyword: Overactive bladder. Elderly, herbal medicine
13 Clinical evaluation of the pediatric airway obstruction and radioimaging, Nitin Sharma
Acute airway obstruction due to any cause can be life threatening. Evaluation and management of a child with an airway obstruction is urgency, recognition of the condition and appropriate management at right time is what is required. In this review we have tried to compile the common causes of pediatric airways obstruction and the management protocol for these conditions. An extensive data search was done in pubmed, medline and google scholar regarding available literature and protocols on the topic and the results have been complied. Keywords: Respiratory distress, airway obstruction, pediatric assessment triangle
14 Evaluation of Liver biochemical parameters in manganese miners, Razavian M.H
Background and objective: Manganese (Mn) related jobs may cause Manganism especially in miners. Side effects include neural and pathological disorders. In spite of liver is the main organ that filters Mn (99%) but few studies has performed about Mn toxicity in liver so no specific biochemical indicator is available. In this study, the relation between blood, urine and saliva Mn level and its hepatotoxic effects is evaluated. Materials and methods: Blood, urine, saliva of 50 accidently selected miners collected in acid washed tubes for an experience study. Samples were used to evaluation not only biochemical parameters by pars azmoon kits but also Mn concentration by mass spectroscopy. Findings: Miners Mn concentration in all samples in addition to blood AST, ALT, ALP increased significantly (P
15 Implant failure within 3 days after plating of fracture shaft humerus, Rakesh John
Fracture shaft of humerus is a relatively common long bone fracture accounting for 10 percent of long bone fractures. But unlike other long bone fractures, the uniqueness of this fracture is that most fractures are managed conservatively rather than operatively. Excellent functional outcomes and high rates of bony union have been reported by numerous studies for conservatively managed fractures. Nevertheless, in the subset of fractures that require open reduction and internal fixation, plating is the gold standard among surgeries with 92 to 96 percent success rate. Implant backing out after plating is rare and causes can be mechanical, biological, poor surgical technique, excessive/insufficient construct stiffness etc. But backing out of a plate usually appears after repeated cycles of mechanical loading and is a gradual process. Presented here is a rare case in which the plate backed out within 3 days after surgery and a discussion regarding the causes of this drastic complication. Keywords: implant failure, fracture humerus
16 The impact of maternal socioeconomic class on maternal measles antibodies of mother-infant pairs at birth in a Nigerian city, Baba Usman Ahmadu
Background: Maternal measles antibodies (MMA) are passed from mother to child across the placenta. Comparison of MMA of mother-infant pairs and maternal socioeconomic class (SEC) in previous studies has not been consistent. In this study, the relationship between maternal SEC and MMA of mother-infant pairs at birth was investigated. Methods: One hundred and seventy seven mother-infant pairs were enrolled using systematic random sampling method. Maternal SEC and MMA of mother-infant pairs were determined and mean MMA was compared using the Student t test. Results: Significant correlation existed between MMA of mother-infants pairs at birth (r = 0.208, p = 0.006). However, comparison of mean MMA of mother-infant pairs and maternal SEC was not significant (p = 0.718) for mothers and (p = 0.565) for newborn infants. Conclusion: Data from present study revealed that majority of mothers belonged to low SEC whose mean MMA was higher than those of high SEC mothers. But this relationship was not significant. Further study on this subject matter is hereby recommended. Keywords: Maternal socioeconomic class, Maternal measles antibodies, Mother-Infant pairs, Maiduguri, North-Eastern Nigeria.
17 Pharmacognostical, phytochemical and Anti oxidant studies of the aerial parts of Urena lobata L., R.Thirumalaikumaran
The present study is to determine the pharmacognostical phytochemical and antioxidant studies of Urena lobata Linn. In Pharmacognostical studies microscopical characteristics of leaf and stem, analytical parameters such as ash values extractive value, analysis of major elements and anti oxidant studies were carried out. The ethanolic and ethyl acetate extracts showed significant DPPH (71.35%, 69.74%) activity compared to chloroform extract (53.85%) at 200 mcg. A biphasic response with ethanolic and ethyl acetate extract (81.94%, 78.30) and a dose dependent antioxidant activity with chloroform extract (42.58%) at 1000 mcg by nitric oxide scavenging. Keywords: Urena lobata, Malvaceae, pharmacognostic, phytochemical analysis and antioxidant studies.
18 Comprehensive care of epilepsy: Involvement of psychological assessment and wada test, Santoso Jaeri
Epilepsy is a diagnosis applied to a variety of neurological disorders characterized by recurrent seizures. According to a World Health Organization (WHO) survey, epilepsy accounts for 1% of the global burden of disease. There are many non-medical problems on the people with epilepsy including cognitive alteration, psychiatric disturbances and difficulty coping in social, scholastic and vocational spheres. Regarding these complicated problems, A comprehensive epilepsy treatment program is a key concept in management of epilepsy including neuropsychological assessment in order to improve the patient’s quality of life. Several tools are available for assessing psychological disturbance resulted from epilepsy which consist of five board areas of neuropsychological functioning such as intelligence, cognition, sensory or motor function, affect and coping or adaptation and language. This review will be discussed about the equipment of psychological assessment which may have benefit in order to assess cognitive function among epilepsy patients including wada test. Keyword: Epilepsy, Comprehensive Care, Seizures, Neuropsychology, Wada Test, Memory, Intelligence, cognition.
19 Fibroplasia in oral surgical wounds submitted to topical Brazilian Propolis, Dhelfeson Willya Douglas de Oliveira
Studies have demonstrated that propolis is an effective substance for wound healing, however there is little evidence regarding its efficacy in the mechanisms of fibroplasias. The present investigation determined whether an ethanolic extract of propolis applied topically accelerates the healing process of oral surgical wounds. Forty-eight hamsters were distributed into the groups: I (n=16) received 30% ethanolic extract of propolis; Group II (n=16) received 0.01% dexamethasone; and Group III (n=16) received pure orabase cream. A localized incision was then made on the dorsum of the tongue and these wounds were submitted to the topical administration of the substances used in each group. Twelve animals were sacrificed at 3, 7, 14 and 28 days postoperative, for histopathological analysis was used Masson’s trichrome staining. Significant differences in fibroplasia were found among the groups on Days 7 and 14 (p=0.001), andthe group I achieved the highest collagen deposition (p=0.040). Under the present conditions, the poropolis can accelerates the healing process of oral wounds in hamsters. Keywords: Propolis, oral ulcer, wound healing and collagen.
20 Laminaria japonica Polysaccharide Reduces Lipids and Leptin Levels in Hyperlipedemic Mice, Yunliang Guo
The aim of this study is to examine the effects of Laminaria japonica polysaccharide (LJPS) on lipids and leptin metabolism in hyperlipidemic mice. The hyperlipemia models were established by feeding fat-rich forage to Kunming mice for four weeks and administered with different doses of LJPS (75mg/d, 150mg/d, 300mg/d). Triglyceride (TG) and total cholesterol (TC) in serum were determined with enzymic method and cholesterol oxidation method. The free fatty acid (FFA) and leptin in serum were determined by enzyme linked immunosorbent assay (ELISA). The results showed that the serum levels of TG, TC, FFA and leptin in the hyperlipidemic group were higher than those in control group (P
21 Quantitative evaluation of the mast cell population in border of ulcers in America Cutaneous Leishmaniasis–ACL, Cláudio Gleidiston Lima da Silva
American Cutaneous Leishmaniasis (ACL) is an infectious disease with a broad spectrum of presentation, has two clinical poles, one anergic and other hyperergic. The inflammatory response to the etiologic agent is complex and involves several cell lines, especially lymphocytes, plasma cells, histiocytes, and antigen-presenting cells. Other cells are observed in inflammatory exudate in a lesser degree, such as eosinophil and mast cells – MC. Several studies have sought to investigate the role of mast cells in cutaneous Leishmaniasis. This study evaluated 64 skin biopsies of leishmanial ulcer edge. The number of mast cells and leishmania were observed in the timeline. It was found that the number of mast cells and leishmania decline with age of the lesion, there is a negative correlation p
22 The application of logistic regression in modeling of survival chances of HIV-positive patients under highly active antiretroviral therapy (HAART): A Case of Nyakach District, Kenya, Ojunga Okoth Samson1,, Mose Nyandwaki, Peter Mutwiri, Otulo Wandera, Omollo, Oriema and Edgar Otumba
In Kenya the number of persons requiring antiretroviral Therapy (ART) in 2012 was over 90,000 while globally more than 1.4 million were under ART in the year 2012. Though ART treatment has decreased mortality of HIV associated deaths, there is still need for funding of ART services by donors and Ministry of health so as to prevent the loss caused by AIDS related deaths in the society. This study modeled using logistic regression the survival chances of the HIV positive patients under ART treatment in within Nyakach district. The study outlined the various socio-economic factors affecting the survival or death of the patients using logistic regression model. The sample of 320 patients was considered from patients from Katito health center from Nyakach district for a period of six months. The analysis of the data showed that risk factors consisting TB infection, kind of drug regimen, distance from the health facility, access to tap and portable water, the kind of marital status of patients and counselling session attendance by patients on ART affected their survival. Thus, the survival of patients under ART programs can be improved if we improve the access to socioeconomic factors like access to water, setting up many health facilities too provide health services at close distance to the affected and also we can bring behavioral change among HIV patients to attend counselling session and get pieces of advices on correct health measures and be-haviours. Keywords: odds ratio, logistic regression, Log likelihood
23 Haemoglobnin level, RBCs Indices, and iron status in pregnant females in Sudan, Enaam A. Abdelgader, Tayseer A. Diab, Anwar A. Kordofani, Sana E. Abdalla
Iron deficiency anaemia is the most common nutritional deficiency in the world. Because of the increased iron requirements of pregnancy and growth, pregnant women and infants are recognized as the groups most vulnerable to iron deficiency anaemia. Anaemia is considered when haemoglobin (Hb) is less than 11g/dl for pregnant women. Iron deficiency anaemia during pregnancy is associated with higher rates of premature birth and low birth weight. The aim of this study is to measure the haematological parameters in pregnant females, by measuring Hb level and RBCs indices and to determine iron status of pregnant females by measuring serum iron, total iron binding capacity, and serum ferritin. Methods: Eighty blood samples were collected from pregnant females and twenty samples from healthy women were taken as controls. Complete blood count was done using a Sysmex™ Kx21n Haematolobical Analyser. Peripheral blood picture was done; Serum iron, TIBC and serum ferritin were measured. Results: out of 80 pregnant females, 8 (10%) of them had low Hb level, while 72 (90%) had normal Hb level. RBC indices showed 62 (77.5%) mothers had normal MCV, while 18 (22.5%) mothers had low MCV. 63 (78.8%) had normal MCH, while 17 (21.2%) had low MCH, 78 (97.5%) had normal MCHC, while 2 (2.5%) had low MCHC. Biochemical finding in the studied anaemic pregnant females showed that 2 (25%) had normal serum ferritin, while 6 (75%) had low serum ferritin, 5 (62.5%) had normal serum iron, while 3(37.5%) had low serum iron, and 4(50%) had normal TIBC, while 4(50%) had low TIBC. Conclusion: Iron deficiency anaemia is common in Sudanese females in the child – bearing age and latent anaemia is quite high (60%). Ferritin level is the best parameter for assessment of iron status, while TIBC and serum iron are unreliable during pregnancy. Combined reduction of MCV, MCH is more sensitive to detect iron deficiency anaemia while MCHC reduction comes late. Keywords: Haemoglobin, pregnancy, anaemia, iron, serum ferritin.
24 How often should we trust the low level of vitamin B12?, Sema Akinci, Abdulkadir Basturk, Tuba Hacibekiroglu, Muhammed Bulent Akinci, Kamile Silay, Tekin Guney, Fatma Betul Asan, Imdat Dilek
Vitamin B12 deficiency is very common in clinical practice. The levels of metabolites such as homocysteine and methylmalonic acid increases in Vitamin B12 deficiency. This study aim to demonstrate how often plasma vitamin B12 levels reflect functional B12 deficiency. Homocysteine levels measured in 100 patients who had low plasma vitamin B12 levels. While 59 patients had normal levels, 41 patients had high levels of homocysteine. We found that approximately half of the patients with vitamin B12 deficiency, the serum Vitamin B12 levels doesn’t express tissue B12 level truly. This study demonstrates that value of serum B12 level is a limited method to determine B12 deficiency and it is inappropriate to start long term replacement therapy based on that level. Measuring homocysteine or methylmalonic acid levels with plasma vitamin B12 levels despite the increase in cost, might be supportive for the diagnosis in cases which has borderline levels. Keywords: vitamin B12 levels, homocysteine
25 How often should we trust the low level of vitamin B12?, Sema Akinci, Abdulkadir Basturk, Tuba Hacibekiroglu, Muhammed Bulent Akinci, Kamile Silay, Tekin Guney, Fatma Betul Asan, Imdat Dilek
Vitamin B12 deficiency is very common in clinical practice. The levels of metabolites such as homocysteine and methylmalonic acid increases in Vitamin B12 deficiency. This study aim to demonstrate how often plasma vitamin B12 levels reflect functional B12 deficiency. Homocysteine levels measured in 100 patients who had low plasma vitamin B12 levels. While 59 patients had normal levels, 41 patients had high levels of homocysteine. We found that approximately half of the patients with vitamin B12 deficiency, the serum Vitamin B12 levels doesn’t express tissue B12 level truly. This study demonstrates that value of serum B12 level is a limited method to determine B12 deficiency and it is inappropriate to start long term replacement therapy based on that level. Measuring homocysteine or methylmalonic acid levels with plasma vitamin B12 levels despite the increase in cost, might be supportive for the diagnosis in cases which has borderline levels. Keywords: vitamin B12 levels, homocysteine
26 Perception of parents whose children have rheumatic heart disease at a referral hospital, Kenya, Myra Koech, Titus Ngeno
Objectives; Rheumatic heart disease remains a leading cause of morbidity and mortality in Africa, especially amongst the young population. This paper set out to explore the views of parents whose children have rheumatic heart disease, in regard to their experiences in taking care of the affected child and its overall effect on their families. Study design; Focused group discussion. Methods; This was a study carried out at the Moi teaching and referral hospital, pediatrics cardiology clinic between October 2011 to October 2012.Ten parents comprising five mothers and five fathers of different children were randomly selected from a pool of telephone records of patients with rheumatic heart disease and were attending the pediatric clinic. Two separate focused groups comprising fathers and mothers were formed and piloted open ended questions were used to conduct the discussion. Results; Living with a child who has rheumatic heart disease causes financial difficulties’ and uncertainities,and parents are unable to afford the cost of surgery. The genesis of rheumatic heart disease is not well understood and there is a constant fear of the child’s impending death. Conclusions; For children with already set in rheumatic heart disease , subsidies for surgical care needs to be provided immediately so as to avoid complications and the chronicity associated with uncorrected rheumatic heart disease. Families need psychological support upon diagnosis of a child with rheumatic heart disease. Keywords: rheumatic heart disease, parental perceptions, referral hospital
27 Designing of Species-specific inhibition: The cysteine residues of triosephosphate isomerase , Ashok Kumar Yadav, Kishore Kumar, Mukesh Verma, Mukesh Kumar, Manoj Kumar
Enzymes from different species that have identical catalytic activities are usually very similar in their amino-acid sequences and three-dimensional structures. This is particularly true at the catalytic site, where the amino acids that form the active site and participate in catalysis are highly conserved. The similarities between homologous enzymes have hampered the design of species-specific inhibitors, in particular those directed toward the active centre. To circumvent this problem, attention has been given to regions that are close to the catalytic site but show individual structural features. This strategy has been used to design selective inhibitors against enzymes aimed at regions that are critical for enzyme stability. Keywords: Triosephosphate isomerise, dihydroxyacetone phosphate (DHAP), cysteine, methylmethane thiosulphonate (MMTS), parasites.
28 Comparative study between methylprednisolone and dexamethasone as submucosal injection for control of edema, trismus and pain of third molar surgery, Ahmed Gamal Hafez, Eman A. Elsharrawy, Abdelbadee Abdalla
Background: Third molar surgery involves injury to the surrounding tissues, producing edema, trismus and pain. Clinical trials in Oral Surgery have supported the hypothesis that preemptive corticosteroids are effective in delaying and preventing many postoperative sequelae. This study aimed to compare between methylprednisolone and dexamethasone as submucosal injection for control of edema, trismus and pain after third molar surgery. Method: This randomized prospective study was done on forty patients required class B mesioangular impacted lower third molar surgery. 4mg dexamethasone, 40 mg, 80 mg, or 120 mg methylprednisolone was submucosally injected preoperatively. Facial width was measured in one dimension, preoperatively and on 2nd and 7th postoperative days. The distance between upper and lower right central incisors during maximal mouth opening was measured, preoperatively and on 2nd and 7th postoperative days. Pain was evaluated using a 10cm VAS during the postoperative week. Result: Edema and pain were greater with dexamethasone, then with 40 mg, then 80 mg and then 120 mg methylprednisolone. Trismus was greater on 2nd postoperative day with 40 mg methylprednisolone, then with dexamethasone, then with 80 mg and then 120 mg methylprednisolone. It was greater on 7th day with 40 mg, then with 80 mg methylprednisolone, then with dexamethasone and then with 120 mg methylprednisolone. 120 mg and 80 mg methylprednisolone were significantly better. Conclusion: Submucosal 80 mg methylprednisolone controls edema, trismus and pain better than 40 mg methylprednisolone or dexamethasone. Increasing methylprednisolone dose from 80 mg to 120 mg provided no significant benefit. Keywords: edema, trismus, pain, dexamethasone, methylprednisolone, submucosal injection
29 Honey as a potent natural supplement for diverse human ailments, Surekha L. Chavan, Revati S. Deshmukh, Harsh Parekh and Pratap N. Mukhopadhyaya
The use of natural honey (NH) as a medicinal agent is associated with a vast range of health benefits and therapeutic promises. The tradition of using honey as a potent food supplementation and medicinal component exist in several countries cutting across traditions and civilizations. This review revisits the wide spectrum of medicinal properties that are associated with honey in the light of modern research and attempts to impart the much needed data required to provide this natural food the status of evidence based medicine. Subjects as diverse as diabetes, cardiology and ophthalmology were covered where beneficial medical properties of honey has been demonstrated and the review was concluded by identifying few safety aspects that are required to be known while using natural, unprocessed honey. Keywords: Honey, medicine, diabetes, cardiovascular, dental
30 The effects of inhaled Fluticasone on inflammatory markers in asthmatic patients, Hossein Hadinedoushan, Abolhassan Halvani, Elieh Abdollahi
Inhaled corticosteroids are the most effective anti-inflammation drugs that are used in asthma treatment. This study investigated the effects of inhaled Fluticasone on C-reactive protein (CRP) serum levels and peripheral eosinophils in asthmatic patients. We studied 30 non-smoker adult asthmatic patients before and after using 500 µg twice daily dose of inhaled Fluticasone for 4 weeks. Serum CRP levels were examined by enzyme-linked immunosorbent assay method. Also, peripheral eosinophil percentage was determined using automated cell counter. We used a paired t test to compare serum CRP values and peripheral eosinophils before and after the inhaled Fluticasone usage. Our results showed that serum CRP levels were significantly different before using inhaled Fluticasone (2.39±1.98µg/ml) compared with 4-week treated inhaled Fluticasone (1.58±1.37 µg/ml) (p=0.001). Moreover, there were significant differences between blood eosinophils before (6.3±4.6%) and after (3.4±2.1%) using inhaled Fluticasone (p=0.001). No significant correlations were found between serum CRP levels and percentage of blood eosinophils before and after inhaled Fluticasone treatment. Besides, there was no significant correlation between serum CRP levels and gender before and after using Fluticasone. Our findings indicate that inhaled Fluticasone with decrease serum CRP and number of eosinophils may improve local and systemic inflammation in asthmatic patients. Keywords: Asthma, CRP, Eosinophil, Fluticasone, Inflammation
31 Veno-Venosus-ECMO support in a patient with ARDS after aortic dissection surgery: A novel double finding, Truscelli G, Iaconi M, Collacchi D, Manganelli C, Crespini C, Lamarra S, Vita S, Costanzo F, Piscioneri F, Morabito S, Tritapepe L
Veno-Venosus-ECMO (vv-ECMO) represents a life support treatment in patients with an acute respiratory failure. The association between H1N1 and ECMO is reported. However, the correlation between vv-ECMO with post-operative acute respiratory failure, following aortic dissection was not found. So, we describe a double novel finding: a post-operative ARDS, after aortic dissection, treated with vv-ECMO in a patient with H1N1 infection. Keyword: Vv-ECMO, H1N1, acute aortic dissection, ARDS, Sofa score, Oxygentation index, multiorgan failure, Sofa “delta score”
32 The bacterial biofilm and importance to human health, Marcos Flores-Encarnación, Jennifer Yanine-Gutiérrez González, José Luis Meza de la Rosa, Carlos Cabrera-Maldonado, Ricardo Carreño-López, Rosa María Nava Nolazco, Silvia García-García, Gloria León-Tello
Biofilms are a population of cells that grown attached to a surface involved in exopolysaccharide matrix which protects them from attack by antibiotics or immune system. Over 60% of all microbial infections are caused by biofilms which increasing the resistance to antimicrobials throungh of several mechanisms including: synthesis of extracellular polymers (physical barrier effect), enzymatic modification of antimicrobials, decrease of bacterial growth rate, phenotypic changes in bacterial cells as a result of the acquisition of resistance genes within the biofilm, and the persistence of a small group of cells in the bacterial community. Biofilm is usually associated with the infectious processes, however it is clear that some of them may have a protective role as is the normal flora. Keywords: Biofilms, Bacterium, Antimicrobial, Exopolysaccharydes, Matrix
33 Evaluation of pseudothrombocytopenia causes, Sema Akinci, Tuba Hacibekiroglu, Tekin Guney, Kamile Silay, Abdulkadir Basturk, Sule Mine Bakanay, Muhammed Bulent Akinci, Arife Ulas, Imdat Dilek
A?m: In this single center study, subjects who had thrombocytopenia on the complete blood count were evaluated for pseudothrombocytopenia. We aim to evaluate the reasons of pseudothrombocytopenia who referred to outpatient hematology clinic for further investigation. Methods: A total of 220 patients who were referred to hematology outpatient clinics with low platelet counts (< 150x109/L) were included in the study. 107 (48,6%) were female and 113 (51,4%) were male. Initially; the patients complete blood counts (CBC) were studied with ROCHE SYSMEX EX 2100 device. Then peripheric smears of these blood samples were reviewed by experienced hematologist to evaluate thrombocyte count and morphology. Pseudothrombocytopenia was defined if the trombocyte count was found higher than CBC with peripheral smear. Results: In this study, we have demonstrated that 16,8% of the patients with thrombocytopenia (
34 Presence of Leptospira in aquatic environments , Marcos Flores-Encarnación, Angélica Ramírez-Águila, Brenda González-Luna, Ricardo Carreño-López, Carlos Cabrera-Maldonado, Silvia García-García, Mariano Sánchez-Cuevas, Alejandro Ulises Herrera-Romero, Claudia Ixtepan-Tejero
Leptospirosis is a serious global health problem. It is an underdiagnosed zoonotic infection which has been considered traditionally as a rural disease of tropical and subtropical weather. It can be acquired through direct contact with urine of infected animals with pathogenic Leptospira spp., and also for an inadequate management of waste in households. In recent years, leptospirosis has been considered as an emerging disease. Major outbreaks of leptospirosis in urban areas of the world were detected and associated with the presence of pathogenic Leptospira spp. in aquatic environments, which were previously contaminated by urine or other waste from infected animals by pathogenic Leptospira spp. The increased rainfall due to global warming has caused overflowing rivers and floods in large urban areas causing the migration of this pathogen from infected ground to rivers, streams, lakes, wells, etc, where the bacteria can remain viable for long periods of time raising the incidence of leptospirosis in humans. Keywords: Leptospira, leptospirosis, water, pathogenic, bacteria.
35 Economic impact on families with children with rheumatic heart disease at a referral hospital, Kenya, Myra Koech, Titus Ngeno
Objectives: The commonest pediatric heart diseases in Africa, rheumatic fever and rheumatic heart disease, occur due to conditions that exist with poverty. They also act to perpetuate poverty by disabling a significant percentage of the most productive members of the society, thus diminishing chances of economic progress. This paper set out to determine the financial implications on families whose children have rheumatic heart disease and possible solutions in the context of limited resources. Methods: This was a cross sectional study done at the pediatric cardiology clinic at the Moi teaching and referral hospital, Eldoret Kenya. All children attending the clinic between September 2011 and September 2012 with Rheumatic heart disease were eligible for the study. Results: Results; A total of 99 children with median age of 11 years were recruited. In the presiding year, 48% of them had been admitted a t least once and 40% of whom needed surgical intervention. The cost of one inpatient admission was the equivalent of 3 times the median monthly income of 60% of the families, while an outpatient visit needed 10% of this same income. None of the children who needed surgery had undergone due to financial constraints; a single mitral valve replacement would cost at least 10 times the family monthly income. Conclusion: For poor families with an erratic income flow, rheumatic heart disease is an extremely expensive disease, which they may have no capacity to finance out of pocket. Government subsidies and a national insurance fund may be an option for these children. Keywords: Rheumatic fever/ rheumatic heart disease, familial economic impact, government subsidies.
36 Thrombocytopenia due to Plasmodium Palciparum malaria in children in paediatrics department, Alamal National Hospital, Sudan, Omer Saeed Magzoub, Satti Abdelrahim Satti
Malaria is a major public health problem in Sudan. Thrombocytopenia has been reported to be associated with malaria with incidence between 24-94% in some studies. Usually it runs a benign course and causes no bleeding. It responds usually to anti-malarial treatment. Case reports: 28 patients were treated in paediatric department diagnosed as having malaria due to plasmodium falciparum infection and one patient had mixed infection (falciparum and vivax) from September 2012 to March 2013 (7 months). Their age ranged from 10 months to 15 years. 15 patients (53.5%) had malaria associated with thrombocytopenia (one of them was treated as out-patient). Only 2 patients (13.33%) had severe thrombocytopenia (7,000 and 19,000/ cumm). The rest (13 = 86.66%) had mild and moderate thrombocytopenia i.e. ? 20,000/ cumm. 10 patients (66.66%) treated with quinine (I.V. and oral) and 5 patients (33.33%) treated with IM Artemether. All patients (15 = 100%) recovered from malaria and thrombocytopenia and discharged home. No one of them had bleeding from any site. Conclusion: In general, mild and moderate thrombocytopenia is very common in falciparum malaria and has got a benign course and improves with treatment. Severe thrombocytopenia is uncommon and rarely associate with bleeding. Malaria should be considered in febrile patients with low platelets. Keywords: falciparum malaria, children, thrombocytopenia, Sudan.
37 Epidemiological study of mental disorders in Gharb Region (North-West) of Morocco, Dakir Zahra, Azzaoui Fatima-Zahra, Ahami Ahmed, Hoddah Hanaâ, Sadek Sanae, Bouchikh Khalid, El kebir Hanane
Survey of Moroccan Health Ministry found that 48.9% of 5600 persons in the general population had a mental disorder and 26.5% were depressed. Objectives: The objective of this epidemiological study is to identify the socioeconomic and neuropsychiatrical profiles of patients examined at the Hospital Moulay El Hassan of Kenitra city (Northwest of Morocco) for psychiatric disorders. Subjects and Methods: This research is a retrospective study conducted between February 2010 and December 2013, among 5618 patients (between 1 and 90 years of age). The study is realized on the basis of social and clinical data existing in patients’ records. Results: The most important obtained results show that in 5618 cases studied, about 50% of women and about 50% of men patients had suffered from psychiatric disorders. Moreover, mood disorders were the most common reasons for hospitalization (38.24%). The other psychiatric disorders were schizophrenia and psychotic disorders (17.55%), followed by anxiety disorders (13.65%). In addition, 71% of patients don’t have parents alive and 51.62% of patients suffering from mood disorders are married and 51.61% are divorced. The proportion of illiterate patients is 42.98% and inactive or unemployed patients (85.87%). Conclusion: The prevalence of mental disorders in the Gharb region is important. It affects both men and women and are more developed in some socioeconomic categories. However, deeper investigations are needed in order to identify the factors that contribute to raising of these disorders in the society. Keywords: Mental disorders, Hospital, Kenitra, Morocco.
38 Assessment of nurses’ tools for patients’ pain assessment at federal teaching in Mehr General Hospital, Tehran, Iran, Morteza Alibakhshi Kenari
The study was conducted to assess the tools used by nurses in assessment of their patient’s pains using a cross – sectional descriptive research design. The instrument used was questionnaire developed by researchers with Validity of 0.86. 450 nurses used in the study were randomly selected from Federal Teaching in Mehr General Hospital. The results show that majority of the nurses use mainly patients’ verbal report of pains (87%) and simple descriptive pain intensity scale (57%) as their pain assessment tools. This revealed that despite the number of pain assessment tools available nurses only use the subjective method to assess their patients’ pains. It was recommended that intensive training on pain assessment be organized for nurses to improve their use of pain assessment tools. Keywords: Nurses’ pain assessment, patients’ Pain, Assessment Tool.
39 Comparative assessment of memory performance between children with epilepsy and healthy children , Zarghi A, Zali A, Ashrafi F, Bandegani N, Moazzezi S, Lotfi M
Backgrounds: This current research study which was done with the purpose of memory performance comparison between two different groups of healthy children and children with epilepsy (25 girls and 25 boys) took place in Tehran with the age range of 10-12 years old. Methods: The students were selected through simple random sampling method. They were all assessed in the medical center of children and Tehran’s Andishe primary school (boys and girls branches). Benton test and Wechsler memory sub-test (Form A) were the applied tools for data gathering. Results: The gathered data displayed a significant difference between scores of Benton test and Wechsler memory sub-tests including personal and general information, orientation, mind control, logical memory, repeating numbers straigtly or reversely, learning and memory) between healthy children and those with epilepsy. Conclusion: The performance of memory in healthy children was greater than children with epilepsy. Generally, considering the memory deficit and attention disorder, epilepsy children require both memory and attention rehabilitation for a better quality of life. Keywords: Memory, Impairment, children, Epilepsy
40 Antioxidants (vitamin E and gallic acid) as valuable protective factors against myocardial infarction, Mohamad Sayyed Bakheet, Sameh Soltan, Ahmad Gadalla, Haredy Hassan Haredy, Maher Abdel Shakoor
Myocardial infarction is acute condition of necrosis of the myocardium that occurs as a result of imbalance between coronary blood supply and myocardial demand. It is the leading cause of death in high or middle income countries and second only to lower respiratory infections in lower income countries. Reactive oxygen species participate in normal cell signaling as mediators that regulate vascular function. In the vascular wall, ROS are produced by all layers including endothelium, smooth muscle and adventitia. Under physiological condition, ROS are produced in law concentrations and act as signaling molecule that regulate VSMC contraction and relaxation, and participate in VSMC growth under pathophysiological conditions, these free radicals play important role in various conditions, including atherosclerosis, ischemic heart diseases, arrhythmias, cardiomyopathy and congestive heart failure. So, pharmacological studies in the present work were done to evaluate the protective effects of different antioxidants (vit. E and gallic acid) on cardiac marker enzymes (AST, ALT, CK and LDH), CTnI, lipid peroxidation and antioxidant parameters in isoprenaline-induced MI in rats. In this study fifty six adult male albino rats were divided into four groups (14 rats each), Group I: Negative control rats were subcutaneously injected with saline twice at an interval of 24 hours. Group II: positive control rats were subcutaneously injected with ISO (100 mg/kg) twice at an interval of 24 hours, it serves as control for group III and IV. Group III: rats were pretreated with gallic acid (15mg/kg) once daily orally for 10 days and then subcutaneously injected with ISO at an interval of 24 h for 2 days. Group IV: rats were pretreated with vitamin E (100 mg/kg) once daily orally for 30 days and then subcutaneously injected with ISO at an interval of 24 h for 2 days. At the end of the experimental period, blood samples was collected for estimation of cardiac marker enzymes, hearts were homogenized for the assay of MDA, SOD, GSH and histopathological examinations were done. The results of the present study showed that: 1- Prior treatment with vitamin E and gallic acid significantly decrease the activity of serum cardic marker enzymes in ISO induced MI in rats: 2- Prior treatment with vitamin E and gallic acid significantly increase the levels of antioxidants in ISO induced MI in rats: 3- Prior treatment with vitamin E and gallic acid significantly decrease the level of lipid peroxidation in ISO induced MI in rats. So, the use of antioxidants (vit. E and gallic acid) have a valuable protective role against MI through overcoming free radicals. Keywords: Myocardial infarction, lipid peroxidation, antioxidants, vitamin E and gallic acid
41 We should not underestimate Vitamin B12 and folic acid deficiencies in oldest old , Sema Akinci, Kamile Silay, Tuba Hacibekiroglu, Arife Ulas, Abdulkadir Basturk, Sule Mine Bakanay, Tekin Guney, Muhammed Bulent Akinci, Imdat Dilek
Aim: It was aimed to investigate hemogram parameters, ferritin, vitamin B12 and folic acid levels of patients above age 80 who applied to the internal medicine outpatient clinic. Methods: Leukocyte, hemoglobin, platelet, ferritin, vitB12 and folic acid levels of total 200 patients (108 (54%) female and 92 (46%) male) age 80 and older were investigated retrospectively. Results: Out of 200 patients, 54 (27%) patients had normal hemogram. Hemoglobin levels of 58 (29%) cases were found normal, 138 (69%) were found low and 4 (2%) were found high. Leukocyte levels were normal in 144 (72%), leukopenia was detected in 28 (14%), and leukocytosis in 28 (14%) cases. Platelet levels of 129 (64.5%) cases were normal, 52 (26%) were assessed as thrombocytopenia and 19 (9.5%) as thrombocytosis. The deficiency anemia detected in 81 (58.7%) cases and the number of patients who has ferritin, vitB12 and folic acid deficiencies were 16 (19.7%), 27 (33.3%), and 19 (23.5%) respectively. Pancytopenia was detected in 18 (9%) patients and bicytopenia was detected in 30 (15%). Conclusion: The frequency of anemia is increased in the geriatrics population above age 80, deficiency anemia in particular. The present study is different from the literature since the most common deficiency was vitB12, following folic acid and iron deficiency. The importance of supportive treatment with vitB12 and folic acid replacement should not be underestimated in this population. Keywords: elderly, blood count, ferritin, vitB12, folic acid deficiency
42 Prevalence of pulmonary tuberculosis among patient attending some selected hospitals at Maiduguri Metropolis, Borno State, Nigeria, H. S. Bello, M. A. Isa, M. Bintube and Z. Hassan
Tuberculosis has been declared a global emergency by the World Health Organization (WHO) and it is the most important communicable disease worldwide. Therefore, this study was aimed to determine prevalence of Pulmonary Tuberculosis among patients attending some selected hospitals, Maiduguri Metropolis, Nigeria. out of three thousand two hundred and seventy two (3272) patients whom attended some selected hospitals (University of Maiduguri Teaching Hospital (UMTH) and Chest Disease Screened Centre (CDSC)) at Maiduguri Metropolis were screened for pulmonary tuberculosis, 2676 (81.8%) were positive. Therefore, more pragmatic effort has to be put in place to alleviate poverty and social exclusion in the study area. Keywords: Pulmonary, Tuberculosis, UMTH, CDSC and Prevalence
43 Link between the occurrence of various forms of cancer and chronic exposure to pesticides, Ghulam Nabi, Bashir Ahmad, Ghufran, Akhtar Hussain, Sikandar Khan
The occurrence of cancer in human is strongly associated with chronic exposure to various pesticides. Users may be exposed to pesticides through different ways, such as inhalation (absorption through the lungs) dermal contact (absorption through the skin or eyes) or ingestion (through the mouth). The pesticides such as, arsenic pesticides, dicamba, dieldrin, carbofuran, carbamate, organophosphate, phenyoxyaceticacid, furans, dioxin, pendimethlin and metolachlor are associated with lung cancer. Chronic exposure of dioxin, herbicides, maneb/mancozeb, parathion and carbaryl are extensively associated with the development of melanoma. Similarly the occurrence of prostate cancer is linked with organochlorine, triazine and organophosphates. Pancreatic cancer can be caused by chronic exposure to DDT, DDD ethylan, pendimethalin and overall organochlorine pesticides while breast cancer is strongly linked with organochlorines. This mini review focuses some of the commonly used pesticides and its association with the development of various forms of cancers. Keywords: Cancer, Arsenic, Pesticides
44 Autoimmune disorders associated with type 1 diabetes mellitus in Saudi children and adolescent , Nasir A. M. Al-Jurayyan
Background: Patients with type 1 diabetes mellitus are at increased risk of developing other autoimmune disease. Objectives: To determine the prevalence of various autoimmune disorders in 305 patients with type 1 diabetics. Design: A retrospective, hospital based-study. Materials and Methods: The associations of other autoimmune disorders in type 1 diabetic were reviewed. Diagnosis of CD was based on positivity of screening serum, and proved by histopathological findings of intestinal biopsy specimen. Thyroid dysfunction was assessed by anti-microsomal peroxilase (TPO) and antithyroglobulin (anti-TG) antibodies coupled with diagnostic thyroid function (TSH and FT4), while for adrenal dysfunction was based on low serum cortisol and high serum ACTH. Results: The cohort includes 305 Saudi children and adolescents, 163 (53.4%) were females and 142 (46.6%) males. Thyroid dysfunction was evident in 65 (21.3%) patients, of those, 26 (8.5%) patients had evidence of overt hypothyroidism. Thirty-nine (12.8%) patients had sub-clinical hypothyroidism. Thyroid microsomal peroxilase (TPO) and thyroglobulin (TG) antibodies were done in the sera of 114 (37.4%) patients. Seventy-six (66.7%) patients were euthyroid, 20 (17.5%) patients with overt-hypothyrodism and 10 (15.8%) patients with sub-clinical hypothyroidism. Interestingly, in 16 (80%) patients with overt hypothyroidism were positive for both TPO and TG antibodies) while the majority of the euthyroid patients (93.2%) both TPO and TG antibodies were negative. Sixty-two (20.3%) patients were referred for endoscopy and biopsy. In 26 (8.5%) patients, the biopsies were abnormal. Only one patient was found to be adrenal insufficient with autoimmune polyendocrinopathy syndrome (APSI). Conclusion: The prevalence of other organ-specific disorders is high in patients with type 1 diabetics. After autoimmune thyroiditis, the second most commonly reported is celiac disease. Although, further follow-up period is needed to determine the natural history of these autoantibodies in patients with type 1 diabetes mellitus. The current strategy for screening should be reviewed. Keywords: Autoimmune disorders, type 1 diabetes mellitus, Saudi, children, adolescent
45 Patterns and co morbidity of attention deficit/hyperactivity disorder among school children in Khartoum state-Sudan, Amira Mohamed Osman, Abdalla Abderahman, Elham Mohamed Omer, Sana Eltahir Abdalla
Background: Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental childhood disorder characterized by inappropriate poor attention span or age-inappropriate features of hyperactivity and impulsivity and/or both. The aim of this study is to estimate the prevalence of attention-deficit hyperactivity disorder among Sudanese schools children to explore the comorbid conditions with ADHD and to identify the associated factors. Methods: 1200 students (boys and girls) of the age range of 7-14 years were randomly selected out of 75003 total number of students enrolled in 190 general basic schools in Khartoum State. Using SNAP-IV-C teacher and parent rating scale, which is a revision of the Swanson Nalon and Pelham (SNAP) questionnaire. Screening for attention deficit hyperactivity disorder, which is a triad of inattention, hyperactivity and impulsivity. Results: The total (the overall) prevalence in this study for both parents and teachers scale for inattentive, impulsive and or both subtypes are 9.4 %. And the prevalence of (ODD) among students who had ADHD, both inattentive and impulsive symptoms in both settings is 2.3%. Conclusion: The study showed the prevalence of ADHD symptoms among school children in Sudan was high in both settings, teacher and parent. ADHD symptoms are more common among boys than girls and more prevalent among late childhood. Keywords: childhood, attention, teacher, parents.
46 Responses of human osteoblastic cells to natural zeolite biomimetic coat on nanoporous titania plate, Sahar A.Fadlallah, H. F. Yousef, Q. Mohsen and Nahla S. El-Shanawy
Previously, natural zeolite coat/ nanoporous titania (ZNT) plates has been shown to induce osteoblast differentiation in rabbit bone marrow cells in our lab. The present study investigated the effect of continuous immersion of different titanium (Ti) – plate treatment on osteoblast differentiation of human osteoblast-like cells (HOB). Primary culture and first passage were cultured in media with or without plates. During the culture period, cells were incubated at 37 ºC in humidified atmosphere of 5% CO2 and 95% air. Cell proliferation, cell viability, total protein content and alkaline phosphatase (ALP) activity were evaluated at 7, 14, and 21 days. The different plates did not affect cell viability and total protein content, but reduced cell proliferation. ALP activity was increased by the end of experiment in cell culture with ZNT in comparison to the other groups. The results indicate that, for HOB, in the ZNT appear to be required for development of the osteoblast phenotype and did not interfere with osteoblast differentiation expressed by reduced cell proliferation and increased ALP activity. Keywords: Natural zeolite; Nanoporous titania; Cell proliferation; Osteogenic markers.
47 Screening for asymptomatic proteinuria and haematuria in children in El-ferdous Village / White Nile State/ Sudan, Elsharif Ahmed Bazie, Omer Saeed Magzoub
Mass screening for proteinuria and haematuria enhances the awareness of renal diseases and improves the chances for an early diagnosis and therapy. Early diagnosis is the cornerstone for prevention of kidney failure. Even if progression cannot be slowed, patients who have been diagnosed early have better survival when commencing renal replacement therapy. Objectives: The objective of this study is to determine asymptomatic renal disease in children in particular proteinuria and haematuria in asymptomatic children. Subjects and methods: It is a community based study of prevalence of asymptomatic proteinuria and haematuria in children at Elferdous village-White Nile State where 213 children aged 2-18 years were included. A detailed history, a thorough clinical examination, a questionnaire and a full renal profile was done for each child with proteinuria, haematuria or both. The data was collected and analyzed using SPSS version 18. Results: The data was collected from 213 children. Male to female ratio was 1.31:1. Their age ranged from 2-18 years. 25 children (11.7%) were found to have proteinuria. Those with haematuria were also found to be 25 children (11.7%). 7 children (3.3%) of those with haematuria had schistosomiasis and 14 children (6.5%) had both proteinuria and haematuria. All of them had normal renal profile and normal GFR. Conclusion and recommendation: The prevalence of proteinuria and haematuria was significant. Urinary screening programmes in children must be a routine especially in school age children. Those with proteinuria need more renal investigations while those with haematuria we need to look for other causes for haematuria e.g. bilharsiasis. Keywords: asymptomatic proteinuria, haemtaturia, children Sudan.
48 Pica among Sudanese children with sickle cell anemia, Fathelrahman Elawad Ahmed, Hadia Osman Gaboli, Bakhieta Attalla
Pica is common in children with sickle cell anemia (SCA). We aimed to determine the frequency of pica and its characterization among Sudanese Children with SCA. This was a case-control, hospital-based study done over 6 months at a central children hospital in Khartoum, Sudan. Children with SCA who presented to the sickle cell outpatient clinic age two years or older without handicap related to diseases other than SCA were enrolled in this study. Apparently healthy preliminary school children with genotype (AA) were enrolled as a control group. Demographic, socioeconomic and clinical data were collected using a questionnaire. Each patient had complete blood count, hemoglobin electrophoresis, serum zinc and serum iron level done. Pica was reported in 102(66.2%) out of 154 study patients. This was significantly higher than that reported in the control group (66.2% vs 40% p 0.001). Common ingested items included clay, ice and coal. More than one item were sometimes ingested. Hemoglobin level was significantly lower and reticulocyte count was significantly higher in those who had pica. Serum zinc was low in all studied patients but was significantly lower in those with pica (p 0.00). Patients with pica were significantly lighter and shorter. Keywords: Pica, sickle cell, anemia, trait, Zinc, iron
49 The frequency of subarachnoid hemorrhage from very small cerebral aneurysms (, Parviz Dolati, Daniel Pittman, William F Morrish, John H Wong, and Garnette R Sutherland
Background: The prevailing view amongst neurosurgeons is that the larger the aneurysm, the higher the chance of rupture. This implies that very small aneurysms rarely rupture. To investigate this theory, we conducted a population-based analysis of aneurysmal subarachnoid hemorrhage, with an emphasis on aneurysm size at the time of rupture. Methods: We retrospectively reviewed hospital records and radiological tests of all patients admitted to Foothills Medical Center, Calgary, Alberta, with a ruptured saccular aneurysm from January 2008 to January 2012. The size of the dome and neck (in millimeters), aspect ratio (aneurysm depth to aneurysm neck), and location of the aneurysms were determined using preoperative computed tomography angiography and digital subtraction angiography. Findings: One hundred and twenty three patients with a ruptured saccular aneurysm were identified. The average size of the dome, neck, and aspect ratio was 6.6±4.4 mm (range 1.5-26 mm), 3.1 mm, and 2.6±0.9, respectively. Forty-six patients (37%) had a ruptured aneurysm with dome size
50 Primary nocturnal enuresis in children presenting to the outpatient Department of Khartoum ENT Teaching Hospital with adenotonsillar hypertrophy, Khartoum, Sudan, Satti Abdelrahim Satti, Safaa A. Medani, Mohamed A. Elabyad
Background: Primary Nocturnal Enuresis (PNE) is a common health problem seen in childhood. It has many risk factors that can play a role in its etiology including an untreated adenotonsillar hypertrophy (ATH) which is the most common etiology of obstructed sleep apnea (OSA). Objective: This study was undertaken to determine the prevalence of PNE in children with adenotonsillar hypertrophy (ATH) and to reveal the relation of PNE with severity of ATH in Sudanese children. Material and Methods: A total of two hundreds and ninety patients diagnosed with ATH were recruited in this prospective study with age ranging from 5 to 15 years. The study was conducted in Khartoum ENT teaching hospital from Jan. to May 2012. Results: From 290 patients with adenotonsillar hypertrophy, 114 (39.3%) were proved to have primary nocturnal enuresis. From these 114 children, 86 (75.4%) were wetting their beds at least once a week. Almost half of the study population had grade 3 adenotonsillar hypertrophy. However, no statistically significant relationship was found between frequency of primary nocturnal enuresis and grading of adenotonsillar hypertrophy. Conclusion: Prevalence of primary nocturnal enuresis in children with adenotonsillar hypertrophy was high (40%). Children presenting with nocturnal enuresis should be evaluated for adenotonsillar hypertrophy. There is no association between primary nocturnal enuresis and severity of upper airway obstruction caused by adenotonsillar hypertrophy. Keywords: Adenotonsillar hypertrophy, Primary nocturnal enuresis, Upper airway obstruction, Children
51 Occupational health and safety studies and assessment of asthma in employees working in yarn making sector of a textile industry near Wan-Radha-Ram, Hina Chaudhry, Maryam Ijaz, Alina Khan
The importance of health and safety at work cannot be denied as sound health is prerequisite for efficient performance and productive work. Workers in yarn making industries are constantly exposed to cotton dust and are liable to develop impairment of lungs functions. Numerous studies have investigated the effects of exposure to cotton dust on pulmonary functions. Occupational asthma is one of the respiratory problems associated with the exposure to cotton dust whether this exposure is for long term or short term. Physical hazards and prevalence of occupational asthma in yarn making department of the textile industry in Wan-Radha-Ram were assessed for four months and for three months respectively. The physical hazards and prevalence of occupational asthma in workers of the industry were assessed with the help of instruments and data was also collected through personal observations and questionnaires. Both qualitative and quantitative results were obtained. The measured values were compared with their respective standards. The results revealed that physical parameters were not within permissible limits set by Occupational Safety and Health Administration (OSHA) during the study period. Especially the noise level in ring department and relative humidity in packing department was 93-95 dB and 91-95% respectively. The risk of prevalence of asthma was high in the female workers which were working in mixing department and card rooms were more vulnerable to get affected with the low and short term exposure to cotton dust as compared to male workers working in the same department and with the same social status. The outcome of the study indicated that here is lack of health and safety measures in yarn making department. Precautions have to be taken to prevent the workers from exposure to cotton dust. Strict compliance for the use of personal protective equipments such as respirators and ear muffs is required. Keywords: Yarn making industry, Physical hazards, Occupational asthma
52 Risk factors for neonatal sepsis in paediatric ward at Khartoum North Teaching Hospital, Sudan, Mohamed Awadelkrim Ahmed, Omer Saeed Magzoub
Infections are a frequent and important cause of neonatal morbidity and mortality. It was found that neonatal deaths account for a third of global child mortality and those infections are a major cause of neonatal mortality. Objectives: The aim of this study is to determine the common risk factors associated with neonatal sepsis and its relation to site and mode of delivery, birth weight, gestational age, onset of sepsis and the causative organisms in paediatric ward at Khartoum North Teaching Hospital. Methods: A cross-sectional prospective hospital based study was conducted on 120 neonates presented with neonatal sepsis who had been admitted to Khartoum North Teaching Hospital general pediatrics ward from January 2013 to of July 2013. History and physical examination were carried out, samples of blood were taken for blood culture and full blood count. Data was analyzed using the Statistical Package for Social Sciences (SPSS). Results: One hundred twenty neonates were studied. Sepsis was confirmed by clinical and laboratory measures. Sixty-seven (55.8%) neonates were males and 53(44.2%) were females. Fourteen (11.7%) were preterm, 99 (82.5%) were full term and 7(5.80%) were post dated. Early onset sepsis was detected in 79 (65.8%) neonates while late onset sepsis was detected in 41 (34.2%) neonate. The common risk factors were being delivered in the hospital 88(73.3%), history of fever or infection during pregnancy in 53(44.2%), low birth weight (LBW) 39(32.5%), neonatal resuscitation 33(27.5%), and prolonged rupture of membranes 21(17.5%). Conclusion: The common risk factors for neonatal sepsis in paediatric ward at Khartoum North Teaching Hospital were being delivered in hospital, history of fever or infection during pregnancy, low birth weight, neonatal resuscitation and prolonged rupture of membranes. Keywords: neonatal sepsis, risk factors, Sudan
53 Pesticides increases soil fertility but compromises human fertility: A mini review, Ghulam Nabi, Muhammad Amin, Hazir Muhammad, Akhtar Hussain, Sikandar Khan
In human, fertility is compromised by several exogenous and endogenous factors. The most important exogenous cause is chronic exposure to endocrine-disrupting compounds (EDCs), which includes a wide range of pesticides. Chronic exposure to these pesticides such as, endosulfans, dieldrin, aldrin, DDT, herbicides atrazine and the fungicide vinclozoline causes reproductive toxicities thatlead to infertility in both sexes, high rate of miscarriage and altered sex ratio. This review article link the relationship between fertility and long term exposure to various pesticides. Keywords: Fertility, Pesticides, miscarriage
54 The coccoid forms of Helicobacter pylori: A permanence mechanism, Marcos Flores-Encarnación, Rosa María Nava-Nolazco, Germán Rubén Aguilar-Gutiérrez, Jennifer Yanine González-Gutiérrez, Alejandro Ulises Herrera-Romero, Carlos Cabrera-Maldonado
Helicobacter pylori is a spiral pathogenic bacterium that colonizes the stomach of more than 50% of the world population. Although there are numerous articles reported on H. pylori not yet been clarified the full route of transmission of the bacteria to the host, which can be fecal-oral, oral-oral and today has also emerged as a possible vehicle of transmission hydric via. Thanks to these theories it has emerged a new knowledge about H. pylori. It has been described its non-culturable viable stage (coccoid form of H. pylori), decreasing bacterial metabolism and changing its morphology as a response mechanism to environmental stress. Keywords: Helicobacter pylori, Cocoid form, Resistance, Environmental, Permanence, Stress.
55 Acute loss of vision-an uncommon presentation of decompression sickness (DCS). A case report and review of literature , Nasser B. Al Sharari*, Imran Sadiq, Yousef Al Oufi, Omar Khan
Decompression Sickness (DCS) results from gas bubble formation in the tissues of individuals who undergo a reduction in ambient pressure without adequate time to eliminate excess inert gas from body. These gas bubbles cause vascular/cellular insufficiency which is responsible for all types of clinical manifestations. DCS occurs in divers and also in those who work in compressed- air as in caissons and tunnels. It can also result from a reduction of normal barometric pressure, such as breathing in an unpressurized aircraft at high altitude. DCS has been classified as Type I , Type II and Type III named as Arterial Gas Embolism( AGE) ; In Type I, Limb and joints pain is present; while in Type II, systemic symptoms or signs, caused by the involvement of the CNS or Cardiopulmonary systems are dominant. Divers usually present with Type I DCS which can be easily recognized because of the symptom of joints pain while the neurological symptoms of Type II DCS mostly are not recognized early, while in case AGE patient have almost similar symptoms as in Type II DCS but these symptoms are more severe and rapid in onset. Neurological manifestations of DCS comprise symptoms from Cerebral hemisphere, the spinal cord, vestibular, retinal/optic nerve involvement. Retinal or optic nerve involvement results in monocular loss of vision, homonymous hemianopia, nystagmus, papilledema and rarely loss of vision. But fortunately with Hyperbaric oxygen therapy (HBOT) the recovery is rapid and complete. Keywords: Acute vision loss, Hyperbaric Oxygen Therapy (HBOT), Decompression Sickness (DCS), Central Retinal Artery Occlusion.
56 Comparative assessment of working memory among patients with parkinson disease and healthy adults with WMCT , Zarghi A, Zali A, Ashrafi F, Moazzezi S, Bandegani N
Background: Patients with Parkinson have working memory changes, so they need assessment and rehabilitation and treatment is required for them. The purpose of current study is to determine the effect of neuro-cognitive assessment and rehabilitation computerized test on these impairments. Methods: A cross-sectional study was done on a sample of 40 to 70 years old of 120 patients with PD and 120 healthy Iranians. Participants of both groups were physically and mentally examined and approved by neurologists and psychiatrists and they all entered the study after completing the questionnaires by being referred and introduced to the neuroscientist for performing the working memory computerized test (WMCT). Results: a significant difference was identified in neuro-cognitive assessment and rehabilitation computerized test’ scores (P
57 Assessment of sexual function by DSFI among the Iranian married individuals, Baniasad MH, Noughani F, Taghadosi Maral, Sadeghi N
Sexual functions are affected by biopsychosocial factors: Internal and external genital organs, hormone, neurohormons, intra psychic dynamics, interpersonal relationships, socio-economy status, social ritual influence on sexual tendency. 384 married individual aged between 15-49 years old randomly selected by stratified sampling from 5 regions in Tehran, including south, North West, east and center. Participants were assessed by Derogatis test. T-test was used for comparing the men and women. Analysis of variance (ANOVA) and Scheffe were used to compare the age categories. There were no significant difference between men and women in drive and gender role, but there were significant differences in other scales (p
58 Application TCD for technical research of risk factors in SAH, Zali A, Zarghi A, Ghorbani E, Ashrafi F
Background: The purpose of current study is to determine the relationship between vasospasm risk factors following aneurysmal subarachnoid hemorrhage and changes in flow velocity of middle cerebral artery (MCA) through Ultrasonography Transcranial Doppler (TCD). Methods: The present descriptive-analytical study was conducted on 21 of vasospasm patients who were qualified for inclusion underwent study. Number and severity of the risk factors present in each individual, values of MCA Flow Velocity (MCAFV) achieved by TCD and results of examinations were recorded in each turn. Results: It is reported that in investigating by TCD in 38.8% of participants, Modified fisher grade was low, in 59.1% Hunt and Hess grade was average, GCS was between 10 to 15, in 36.4% there was hypertension history, in 40.9% of them aneurysm size was between 2.25 cm . Diastolic blood pressure on admission was between "100 to 118", aneurysm size mean was 2.25 cm and maximum flow velocity of LMCA, LACA, RACA and RMCA is more than 120. Conclusions: Vasospasm risk factors after aneurysmal SAH and Changes in MCA Flow Velocity using TCD showed a significant relationship with age, Modified fisher grade, Hunt and Hess grade, HTN, GCS and aneurysm size. Keywords: Vasospasm, Subarachnoid Hemorrhage, Risk Factors, Middle Cerebral Artery
59 Food allergies in patients with down syndrome disorder in Khartoum- Sudan, Hussam Ibrahim, Safaa A. Medani, Maha I. GadAlla, Yasir Y. Abbas, Abdulla H.Shareef, and Ahmed K. Bolad
Background: Down syndrome (DS) is the most frequent trisomy in humans, being universally present across racial, gender or socioeconomic lines, and affecting approximately 1 in 800 live births. Down syndrome usually causes varying degrees of intellectual, physical disability and associated medical issues. The association of Down syndrome and food allergies has been shown in several studies outside Sudan, the evidence from these studies suggested that, (DS) patients suffer from multiple food allergies. Objective: This study was undertaken to look for the association and frequency of food allergy among Sudanese patients with Down syndrome and to study the different types of food antigens among them. Material and method: This was a cross-sectional study done in three rehabilitation centers in Khartoum state from January to February 2011. A total of 100 individuals were recruited, of those thirty-six were (DS) patients who had symptoms of food allergy, thirty-six (DS) patients without symptoms of food allergy and twenty eight healthy individuals as a control group. Blood Immunoglobulin E (IgE) levels were semi–quantitatively measured using immunoblotting technique. Results: All Down syndrome patients with symptoms of food allergy showed positive results for IgE antibodies specific for one or more type of food antigen (100%), thirty two (89%) Down syndrome patients without symptoms of food allergy were positive for specific food antigen in one or more types of antigen and only two (7.1%) individuals from the control group were positive for one antigen of food allergy. Conclusion: The association between Down syndrome and food allergies in our study population was very significant; it is therefore of utmost importance to evaluate all (DS) children for food allergies. Key words: Down syndrome, food allergy, immunoglobulin E, Sudanese patients, immunoblotting technique.
60 Acute Ischemic Enteritis due to Polyarteritis Nodosa: A rare case report , Awad Ali M. Alawad
Polyarteritis nodosa is a form of vasculitis that affects several organs. Gastrointestinal involvement is frequent, but cases in which the gastrointestinal tract is the only site of disease are rare. In this paper, we report a case of a 40 -year- old patient with polyarteritis nodosa restricted to small part of the small intestine, which underwent resection and anastomosis. Laparotomy was performed despite normal radiological findings. He underwent resection of the infracted segment. Histopathological examination confirmed the diagnosis. Thus, a pathological diagnosis of ischaemic infarction due to polyarteritis Nodosa (PAN) was made. The patient had no other signs of chronic vasculitis and for this reason surgical treatment resolved the clinical symptoms. Keywords: polyarteritis nodosa, gastrointestinal vasculitis, ileal necrosis
61 Morinda lucida leaf and fruit extracts may attenuate diarrhea arising from ebola , Adejo GO, Akintayo CO and Obinna M
Morinda lucida, a tropical West Africa rainforest tree also called Brimstone tree has been claimed to have medicinal properties including anti-diarrheal. This study is therefore aimed at evaluating the anti-diarrheal properties of the leaf and fruit extracts of this plant in albino Wistar rats. Preliminary phytochemical screening revealed the presence of tannins, flavonoids, alkaloids, steroids, terpenoids, saponins, glycosides, and anthraquinones. Acute toxicity test on both extracts showed non toxicity at 5000mg/kg. In the anti-diarrheal examination, diarrhea-induced albino Wistar rats were administered with different concentrations (20mg/kg, 40mg/kg and 60mg/kg) of aqueous extracts of the leaf and fruit of Morinda lucida, and there was a significant reduction in faecal spot in a dose dependent manner. The 20mg/kg leaf extract group had a reduced faecal spot of 9.33±0.88 (diarrheal freq.) over a 6 hourly - three days treatment, while the 60mg/kg leaf extract group reduced the faecal spot to 1.00±0.41 (diarrheal freq.). A similar trend was seen in the rats treated with the fruit extract of the plant. No significant difference was observed in the extracts groups and the positive control group but there was significant difference between the extracts group and the negative control group. It could thus, be deduced that Morinda lucida leaf and fruit can be used in the effective management and treatment of diarrhea. This work, which seems to justify the traditional use of Morinda lucida in treatment of diarrhea may also be useful in managing diarrhea in ebola patients. Keywords: Morinda lucida, Anti-diarrheal, Extract, Castor oil.
62 Human endometrial stem cells (hEnSCs) differentiation into germ cell-like cells by encapsulating in fibrin scaffold, Maryam Roya Ramzgouyan, Seyed Mohammad Tvangar, Jamshid Hajati, Nasrin Lotfibakhshaiesh, Fardin Amidi, Somayeh Ebrahimi-Barough, Roya Karimi, Reza Roozafzoon, Mina Jafarabadi, Ahmad Jafar Bekloo, Jafar Ai
In recent years, stem cells differentiation into germ cells has focused on infertility topics. A good alternative for gamete production in clinical trials would be pluripotent cells isolated from adult tissues. Herein, we identified the suitable conditions which promoted human endometrial stem cells (hEnSCs) differentiation into germ cell-like cells by adjusting the best concentration of retinoic acid (RA) in 2D medium and cultured them in fibrin as a 3D scaffold afterwards. The optimum concentration of RA was 10-5 M for differentiation after 7 days. Characteristic cell markers such as DAZL, DDX4 and Dppa3 were assessed by immunofluorescence and real-time PCR. The mechanical properties of the fibrin were examined by rheology analysis. After encapsulating the hEnSCs-derived germ cell-like cells in fibrin hydrogel, cell viability, specific markers expression and the cells' integrity in fibrin were assessed by using MTT assay, immunofluorescence staining and SEM analysis respectively. We propose that hEnSCs can be differentiated into germ cell-like cells in a medium containing 10-5 M RA in which the specific markers were expressed properly in both 2D and 3D medium cultures. In addition, fibrin hydrogel could offer a proper 3D scaffold for hEnSCs-derived germ cell-like cells regarding tissue engineering of gonads. Keywords: Human Endometrial Stem Cells (hEnSCs), Differentiation, Retinoic Acid (RA), Fibrin Hydrogel, Germ Cells
63 Correlation between prostate volume and lower urinary tract symptoms in Sudanese patients with benign prostatic hyperplasia, Awad Ali M. Alawad, Shihab Mohamed Elamin, Faisal H. Younis
Background: Benign prostatic hyperplasia (BPH) is now recognized as one of the principal medical problems facing the male population in Sudan. Assessment of patients with prostatic enlargement still remains a challenge for doctors. Objective: The aim of this study was to correlate the prostate volume with international prostate symptom score (IPSS) and age in patients with benign prostatic hyperplasia (BPH). Materials and Methods: This is retrospective observational case-detection hospital based study. Eighty eight consecutive patients presented with lower urinary tract symptoms attending the urology clinic at University Teaching Hospital were enrolled. All patients were interviewed using standardized questionnaires for International Prostate Symptom Score. Trans-abdominal ultrasonogram was used to assess the prostatic volume. Results: The mean age was 63.36 years with minimum of 27 and a maximum of 90. The mean volume of prostate was 42.38 cm3. Most of the patients had severe symptoms with a mean IPSS of 10.52. The correlation between the prostate volume and age was statistically significant in contrast to the correlation between prostate volume and IPSS which was not significant. Similarly, correlation between IPSS score and age was not significant. Conclusion: We concluded that prostate volume had a correlation with age, and no correlation with symptoms score, and there was no correlation between age and the symptoms score. Keywords: Serum prostate specific antigen; prostate volume; benign prostatic hyperplasia
64 Interventions assessment of increase health resiliency in disaster, Khankeh HR, Ghanaat Pisheh E
This study aimed to examine the contents of the evidence about evaluation of interventions of increase health resiliency in disaster that increases health after the disaster by using the concept of resiliency. Response to disaster is accompanied by the management, logistics, technical, medical and mobile challenges. The main obstacle is the lack of a crisis management plan for resiliency with different concepts. Analysis and preparation of a plan for crisis management in a specific resiliency is valuable. The result of certain resiliency in crisis management is very helpful. In this study, the gaps in the evidence for specific health interventions to increase the resiliency of disaster are highlighted. Keywords: interventions, resiliency, health, disaster
65 Clinical presentation of neonatal sepsis in paediatric ward at Khartoum North Teaching Hospital, Sudan, Omer Saeed Magzoub, Mohamed Awadelkrim Ahmed, Yahia Shakir Abdelgadir
World Health Organization (WHO) estimates that globally there are about 5 million neonatal deaths per year. Ninety eight percent of them are occurring in developing countries in the first week of life. Infections are frequent and important cause of neonatal morbidity and mortality. Objectives: The aim of this study is to determine the common presenting symptoms and signs of neonatal sepsis in neonates admitted from emergency room to pediatrics ward in Khartoum North Teaching Hospital. Methods: A cross-sectional prospective hospital based study was conducted on 120 neonates presented with neonatal sepsis who had been admitted to Khartoum North Teaching Hospital general pediatrics ward over six months period (January 2013 to July 2013). History and physical examination were carried out and samples of blood were taken for blood culture and full blood count. Data was analyzed using the Statistical Package for Social Sciences (SPSS). Results: 120 neonates were included in this study. The sepsis was confirmed by clinical and laboratory measures. 67 (55.8%) neonates were males and 53(44.2%) were females. Early onset sepsis was detected in 79 (65.8%) neonates while late onset sepsis was detected in 41 (34.2%). Fever was the most presenting feature found in 76 (63.3%), respiratory distress present in 53 (44.2%), 48 (40%) neonates were lethargic, 47 (39.2%) had impaired feeding, and 39 (32.5%) had refusal of feeding. 38 (31.7%) neonates had neonatal jaundice and Moro reflex was absent in 25 (20.8%). Conclusion: The common presenting features of neonates with neonatal sepsis in the paediatric ward at Khartoum North Teaching Hospital were being fever, respiratory distress, lethargy, impaired or refusal of feeding, jaundice, absent Moro reflex, hypothermia, convulsions bleeding disorder and bulging fontanel. Keywords: neonatal sepsis, clinical presentation, Sudan