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Background Globally, coffee is one of the most consumed beverages and recently, it has been a target of researchers to understand its effect on human health whether good or bad. Even though there is controversy on coffee consumption effect in cardiovascular diseases, several reports pointed out that coffee has a positive effect on the occurrence and progression of chronic non-communicable diseases including cardiovascular diseases. However, the impact of Ethiopian coffee Arabica consumption on cardiovascular diseases has not been well investigated thoroughly. Objective The aim of the present study was to investigate the effect of habitual consumption of Ethiopian Arabica coffee on the risk of cardiovascular diseases among non-diabetic individuals in Addis Ababa. Materials and methods A cross-sectional study was conducted in 70 healthy individuals in Addis Ababa. The participants were 35 coffee drinkers (16 males; 19 females) and 35 non-drinkers (15 males; 20 females). Coffee consumption and demographic data were obtained by using questionnaires. Anthropometric measurements were measured according to World Health Organization standards. Blood samples were collected by trained laboratory technicians through aseptic and sterile techniques for the analysis of biochemical parameters. Serum was separated via centrifugation and transported to Addis Ababa University, College of Health Sciences, Biochemistry laboratory with an ice pack for analysis or stored at -80 °C. Results were compared between coffee consumers and non -consumers using appropriate statistical parameter. Result The main finding of this study was that consumption of Ethiopian origin Arabica coffee leads to a significant increase in serum free fatty acids (FFAs) and high density lipoprotein (HDL) as well as a significant decrease in triacylglycerides (TAGs) but has no significant effect in both total cholesterol (TC) and low density lipoprotein (LDL). The magnitude of the effect is similar in both sexes. Conclusion The present study demonstrated that Ethiopian coffee Arabica consumption significantly affected most serum lipid levels and so it may be possible to say it has a protective effect against risks of cardiovascular diseases (CVDs). However, the correlations between coffee consumption habits and serum lipid levels require further investigation through experimental and epidemiological studies with larger sample size, including different age groups and nutritional habits., Food Science; Food Analysis; Cardiology; Coffee; Lipid; Cardiovascular diseases; Fatty acids; Lipoprotein

Introduction In Niger, breast cancer is the first cancer related morbidity and mortality within female population. While awareness can contribute to early diagnosis and disease mortality reduction, Niger women's knowledge of breast cancer is not well documented. In this study, we assessed the awareness, attitudes and practices of women in relation to breast cancer and identify the factors associated with it. Methods The study was conducted through a cross sectional survey in Zinder and Niamey regions. A random sampling was used to select women in households within health districts. We defined a breast cancer knowledge score and used a generalized linear model to assess factors associated with it. Results Overall women's knowledge of breast cancer was found to be low, only 41.2% (37.5–45.0) were aware of breast cancer. 65.0% (61.3–68.7) of women demonstrated an awareness of symptoms. Insufficient level of knowledge was observed on knowledge of risk and protection factors with 27.4 % (24.0–31.0), breast cancer good practice with 16.9% (14.2–19.7). Age OR = 0.98 (0.96–0.99), practicing clinical breast examination OR = 2.25 (1.31–3.16), breastfeeding 3.34 (2.12–5.26), not having a history of participation in breast cancer screening and living in rural and peri-urban areas were found to be associated with awareness of breast cancer. Conclusion Niger women were found to have a relatively low level of breast cancer awareness. While not acquainted with self and clinical breast examination, Niger women knowledge of breast cancer symptoms was acceptable. Awareness programs can promote clinical breast examination as mammography is not common and promote early detection procedures., Health Sciences; Social Sciences; Breast cancer, awareness, KAP-Study, Niger, early detection

Introduction There has been an increase in the global prevalence of diabetic polyneuropathy and research evidence suggests that insulin resistance plays an important role in its development and prognosis. However, there seem to be a dearth of information in understanding the likely interplay between beta endorphin, insulin resistance and pain perception especially in the setting of painful diabetic neuropathy. Method This study recruited 120 volunteers divided into four groups (30 per group): group 1 healthy volunteer (control); group 2 DM type 2 without neuropathy (DM group); group 3 DM type 2 with painful neuropathy (DPN group); group 4 DM type 2 without painful neuropathy (DN). All subjects were evaluated for pain threshold and neuropathy using an ischemia-induced pain model and biothesiometer respectively. Their beta-endorphin, glycated hemoglobin, fasting plasma insulin, and HOMA values were determined and means compared using ANOVA. Result Serum beta-endorphin is significantly reduced in DN and DPN (∗p < 0.001) compared with the control and DM group. Also, DPN and DN patients have significantly increased insulin resistance compared to those without neuropathy (∗p < 0.001; ∗p < 0.0001 respectively). There is a significant positive correlation between the pain threshold and beta-endorphin in all the groups except DN group. The correlation between beta-endorphin and insulin resistance was negative and significant in control and DM groups only. Suggestive that the fact that insulin resistance plays an important role in diabetes polyneuropathy, does not alone explain the chronic pain perception noticed in the DPN patients. Conclusion The present study demonstrates that diabetic neuropathy patients have a poor endogenous opioid peptide system which is associated with increased pain perception and high insulin resistance. However, insulin resistance alone does not explain the chronic pain perception noticed in the DPN patients. Thus, further study is required., Diabetic neuropathy, β-Endorphin, Ischemic-induced pain model, Pain threshold, Insulin resistance, Environmental science, Biological sciences, Neuroscience, Veterinary medicine, Health sciences

Objective Physical traumas can lead to unconscious neuropsychical alterations, which can compromise rehabilitation result and functional recovery. Aim of this interventional study is to verify if neurobiological Radio Electric Asymmetric Conveyer (REAC) treatments Neuro Postural Optimization (NPO) and Tissue Optimization (TO) are able respectively to improve neuro psychomotor strategies and facilitate recovery process in medial collateral ligaments (MCL) lesions of the knee. Patients and methods 45 healthy subjects, 32 males and 13 females, with knee MCL lesion, diagnosed with MRI or ultrasound. Within 4 days after the trauma, subjects were clinically evaluated (T0), both through medical and subjective assessments. Clinical evaluation was repeated after the REAC NPO treatment (T1) and at the end of 18 REAC TO treatments (T2) and at the 30 days follow-up (T3). Results In comparison with the results commonly found in clinical practice, all REAC treated patients recovered much faster. They reported functional recovery, pain relief and joint stability, regardless of the severity of the lesion. Conclusion The combined use of REAC NPO and TO can envisage a new rehabilitative approach, which aims not only at recovering the outcomes of the physical trauma, but also at improving the neuropsychical state that can condition the rehabilitation result., Health Sciences; Musculoskeletal System; Behavioral Medicine; Evidence-Based Medicine; Clinical Research; Knee; Medial Collateral Ligament; Functional Recovery; Psychomotor Performance

Getting men to be actively involved in Antenatal Care (ANC) has been acknowledged by the World Health Organisation as a key indicator for better maternal health outcomes. We investigated the perception of women about barriers to male involvement in ANC in Sekondi, Ghana. Dwelling on cross-sectional design, we used a sample of 300 pregnant women (adolescents excluded) who had ever attended ANC in five fishing communities in Sekondi. The study was underpinned by a conceptual framework adapted from Doe's conceptual framework of male partner involvement in maternity care. We used questionnaire for the data collection. Both descriptive-frequencies and percentages; and inferential-binary logistic regression analyses were carried out. Seven out of ten (70%) participants indicated high male involvement in ANC. Respondents whose partners were aged 50–59 were less likely to report high male involvement in ANC compared to those whose partners were aged 20–29 years (OR = 0.47, 95% CI = [0.35–0.86], p = 0.03). Those living together with their partners were about two times more likely to report high male involvement in ANC compared to those who did not live with their partners (OR = 1.63, 95% CI = [1.18–3.19], p = 0.01). Participants who identified long waiting time at the health facility as a determinant of male involvement in ANC were less likely to report high male involvement in ANC compared to those who disagreed (OR = 0.57, 95% CI = [0.38–0.85], p = 0.01). The outcome of our study calls for male partner friendly policy driven environment at the various ANC visit points that would make men more comfortable to accompany their partners in accessing ANC services., Perception; Sekondi; Ghana; Male involvement; Antenatal care, Education; Health sciences; Public health; Quality of life; Sociology; Women's health.

Introduction Helicobacter pylori (H. pylori) is a Gram-negative bacteria that is harbored in the stomach and linked to chronic gastritis, peptic ulcer disease, and gastric malignancy. Most Helicobacter infections are acquired during early infancy. This study aimed to establish the prevalence of H. pylori infection in Jordanian children using the 13C-urea breath test. Materials and methods We prospectively enrolled children between the ages of 4 and 17 years from April 2019 to July 2019. Enrolled children were patients with nongastrointestinal complaints at the pediatric clinics of two hospitals and at community centers caring for healthy children in Irbid, Jordan. Questionnaires obtaining data on sociodemographics, clinical symptomatology, and hygienic risk factors were completed. Recruited children underwent a urea breath test (UBT). Results Of 340 children who were recruited, 328 (96.5%) were included in the final analysis. The mean age (±standard deviation) was 9.56 (±3.98) years (range, 4.0–17 years), and 168 (51.2%) were males. Only 48 children (14.6%) tested positive. There were no gender differences. Living in an urban area and a family history of previous H. pylori infection were risk factors for the acquisition of infection (P = 0.007 and 0.001, respectively). Although gastrointestinal symptoms were more common in H. pylori-infected children, only hiccups and constipation were statistically significant (P = 0.035 and 0.038, respectively). Conclusion H. pylori infects at least 15% of Jordanian children, suggesting a significant drop in infection rates in this group. Larger-scale studies combined with clinical evaluations will be important for further understanding the reasons for the observed decrease in H. pylori infections in Jordanian children.

Objective Osteoarthritis (OA) is a widespread degenerative joint disease leading to progressive loss of function and pain. Available treatments do not provide long-term relief or improvement. This study aimed to assess the safety and efficacy of a novel intra articular supplement, made of high molecular-weight hyaluronic acid (HA) uniquely conjugated to either purified (RegenoGel) or autologous plasma-derived fibrinogen (RegenoGel-OSP), as a long-term treatment for knee OA. Methods Sixty-seven consecutive participants (mean age 67.26 ± 7 years) with symptomatic OA were randomly assigned to receive intraarticular injections of either RegenoGel, RegenoGel-OSP or saline solution (placebo). The active treatment groups received a second, repeat injection of the corresponding treatment at the 3-month evaluation, at which time, the placebo group was divided into two subgroups, one receiving RegenoGel and the other receiving RegenoGel-OSP. The OA symptoms were assessed by VAS, WOMAC, and IKDC questionnaires at baseline and at 1, 3, 4, and 6 months following the first injection. OA-related quality of life was evaluated by the SF-12 survey. Results Our preliminary data suggests that both fibrin-HA formulations have positive effects on OA symptoms for all assessed parameters with the most prominent trend for reduction in OA-associated pain. Pooled data analysis of RegenoGel and RegenoGel-OSP shows significantly improved VAS scores compared to placebo at three months after the first injection, and sustained for another three months after the second injection. Both RegenoGel, RegenoGel-OSP had an excellent safety profile. Conclusions Interim analysis results indicate that RegenoGel and RegenoGel-OSP are safe and are potentially effective for at least six months in alleviating pain and symptoms of knee OA., Health sciences; Rehabilitation; Knee osteoarthritis, Hyaluronic acid, Viscosupplement, Hydrogel, Plasma fibrinogen, Intraarticular injection, Regenerative medicine.

Aim To study the relationship between melatonin levels and Melatonin membrane receptor 1A (MTNR1A) SNP (rs13140012) in end-stage renal disease patients (ESRD) in Alexandria, Egypt on maintenance hemodialysis with or without atherosclerosis. Materials and methods 40 end-stage renal disease patients on regular hemodialysis were divided into 2 subgroups, one with (n = 20) and one without atherosclerosis (n = 20) and normal subjects (n = 40). Serum melatonin, carotid intimal medial thickness (CIMT) were measured. Melatonin membrane receptor 1A (MTNR1A) SNP (rs13140012) genotyping was done using 5'nuclease Allelic discrimination. Results Serum melatonin was significantly lower in ESRD patients [1.6 to 11.30 (pg/mL) with a median of 2.5] than the control group [20.50 to 56.40 (pg/mL) with a median of 35.20]. Serum melatonin was significantly lower in atherosclerotic patients subgroup [1.6–2.50 (pg/mL) with a median value of 2.30] than non-atherosclerotic patients subgroup [2.0–11.30 (pg/mL) with a median of 4.9]. No significant association was found between serum melatonin and (MTNR1A) SNP (rs13140012) (p = 0.633). Conclusion These results lead us to suggest that melatonin production is impaired in ESRD patients (included in this pilot study), and this impairment is more evident in atherosclerotic ESRD patients., Health sciences; Renal system; Internal medicine; Endocrinology; Clinical research; Diagnostics; Melatonin; Single nucleotide polymorphism (SNP); rs13140012; Atherosclerosis; End-stage renal disease (ESRD); Hemodialysis (HD); Carotid intima-media thickness (CIMT)

Background There are limited data and conflicting guideline recommendations regarding the role of neuroimaging in the pretreatment evaluation of non-small cell lung cancer (NSCLC). Methods We performed a retrospective, pragmatic cohort study of patients with NSCLC diagnosed between January 1 and December 31, 2015. Eligible patients were identified from an institutional tumor registry. We collected all records of pretreatment neuroimaging within 12 weeks of diagnosis, including CT head (CT) and MRI brain (MRI). We abstracted the indication for neuroimaging, presence of central neurologic symptoms and cancer stage (with and without neuroimaging findings) from the tumor registry and the electronic health record. Results We identified 216 evaluable patients with newly diagnosed NSCLC. 157 of 216 patients (72.7%) underwent neuroimaging as part of initial staging, and 41 (26%) were found to have brain metastases. Of 43 patients with central neurologic symptoms at the time of neuroimaging, 28 (67%) had brain metastasis. In patients without central neurologic symptoms, brain metastases were discovered in 0 of 33 patients with clinical stage I or II, 4 of 36 (11%) with clinical stage III and 9 of 45 (20%) with clinical stage IV disease. Conclusions In patients with early stage NSCLC (i.e. clinical stage I and II) without central neurologic symptoms, brain metastases are unlikely. The continued use of neuroimaging in the pretreatment evaluation of clinical stage I patients without central neurologic symptoms is not needed., Health Sciences; Oncology; Medical Imaging; Radiology; Diagnostics; Non-small cell lung cancer; MRI brain; pretreatment evaluation; CT head; staging; outcomes.

The pilocarpine animal model of status epilepticus is a well-established, clinically translatable model that satisfies all of the criteria essential for an animal model of status epilepticus: a latency period followed by spontaneous recurrent seizures, replication of behavioural, electrographic, metabolic, and neuropathological changes, as well as, pharmacoresistance to anti-epileptic drugs similar to that observed in human status epilepticus. However, this model is also characterized by high mortality rates and studies in recent years have also seen difficulties in seizure induction due to pilocarpine resistant animals. This can be attributed to differences in rodent strains, species, gender, and the presence of the multi-transporter, P-glycoprotein at the blood brain barrier. The current paper highlights the various alterations made to the original pilocarpine model over the years to combat both the high mortality and low induction rates. These range from the initial lithium-pilocarpine model to the more recent Reduced Intensity Status Epilepticus (RISE) model, which finally brought the mortality rates down to 1%. These modifications are essential to improve animal welfare and future experimental outcomes., Pilocarpine, Animal model, Status epilepticus, Seizure, Neuroscience, Behavioral neuroscience, Cellular neuroscience, Cognitive neuroscience, Molecular neuroscience, Systems neuroscience, Health sciences.

Amoxicillin dispersible tablet (DT) is now recommended by the WHO as a first-line drug for the treatment of pneumonia in children below 5 years. The study aim was to compare acceptability, adherence and clinical outcome of amoxicillin DT and amoxicillin oral suspension (OS) in the treatment of children aged 2–59 months with pneumonia in Kenya. We conducted a two-arm cluster randomized controlled trial and utilized quantitative methods. The community unit was the unit of randomization. Children aged 2–59 months with pneumonia were enrolled and treated with either amoxicillin DT or OS. Acceptability was defined as the perception of taste of medication as the same or better compared to other medicines and expression of willingness of caregivers to use DT/OS in future, adherence was measured based on the dose, frequency, and duration of treatment, and clinical outcome as complete resolution of symptoms without change of antibiotic treatment. Equivalence was defined as a difference of ≤8% between study arms. We found high levels of acceptability among both DT (93.9%) and OS (96.1%) arms (difference 2.3%, 90% CI -2.6-7.3). The objective measure of adherence on day four and the overall objective measure were significantly higher among children on DT compared to children on OS (88.7% vs. 41.5% (difference 47.2%, 90% CI 31.0–63.3) & 83.5% vs. 39% (difference 44.5%, 90% CI 27.9–60.9), respectively). Cure rates were high in both arms (DT (99.5%), OS (98.1%), difference 1.4%, 90% CI -0.2-3.2). There is reported better adherence to Amoxicillin DT compared to OS and equivalence in acceptability and clinical outcomes., Health sciences; Public health; Infectious disease; Clinical research; Acceptability; Adherence; Pneumonia; Dispersible tablets; Oral suspension

Background Oral health problems may have numerous effects on general health, including physical fitness and performance. In this review, we aimed to systematically review the available evidence to assess the effect of oral health on general physical fitness. Methods We systematically performed a literature search in two different databases (PUBMED and EMBASE) without restriction to the year of publication. Articles were included if the subjects were humans and the primary aim was to assess the effects of dental and/or oral health problems on physical activity using either objective physical measurements or physical performance tests. The quality of the studies was then assessed using a Joanna Briggs Institute (JBI) Critical Appraisal tool. Results A total of 2651 articles were initially retrieved from the systematic search of the literature. Of these, a final total of 11 articles following the inclusion criteria were included in the review. All of the 11 articles included in the review had good methodological quality. Of the 11 articles, ten articles suggested a correlation between dental and oral condition toward physical fitness, body balance, cardiorespiratory function, and also cognitive function. Only one article found contradictory results, which showed that periodontal conditions did not correlate with the cardiorespiratory function. Malocclusion, including the number of remaining teeth, was reported in five studies (45.4%), periodontal disease was evaluated in six studies (54.5%), along with slight evaluation of periapical inflammation. Conclusion This review suggests that there is a negative effect of poor dental and/or oral health on physical fitness and performance., Health sciences; Public health; Physical activity; Physiology; Dentistry; Oral disease; Dental disease; Physical fitness; Physical performance

Objective The aim of this study was to evaluate the effect of platelet-rich plasma (PRP) on the rate of implantation and pregnancy in women with repeated failed implantation during frozen embryo transfer. Methods This study was conducted on 50 infertile women candidates (who were referred to the Infertility Treatment Center of Besat Hospital in Sanandaj) with a history of failed implantation for the purpose of frozen embryo transfer. The participants were randomly divided into two groups (n = 25). In the first group (control), the intrauterine infusion of 0.5 ml of Ringer serum was done 48 h before embryo transfer. In the second group (treatment), the intrauterine infusion of 0.5 ml of PRP was performed 48 h before embryo transfer. Results In this study, there was no significant difference between the two groups in the rate of chemical and clinical pregnancy. The rate of chemical pregnancy was 28% in the treatment group and 36% in the control group, while the rate of clinical pregnancy was 28% in the treatment group and 24% in the control group. Conclusion The intrauterine infusion of PRP before frozen embryo transfer in infertile women with a history of failed implantation will not make any significant effect on the result of pregnancy., Obstetrics and gynecology; Health sciences; Pharmacology; Women's health; Reproductive system; Clinical research; Platelet-rich plasma, Frozen embryo transfer, Implantation, Pregnancy.

Background While the incidence of gastric cancer has decreased worldwide in recent decades, the incidence of poorly cohesive carcinoma (PCC) is rising. The prognostic significance of gastric PCC remains a subject of debate. Objective To analyze the prognosis of gastric PCC in a Tunisian cohort. Methods A total of 122 gastric adenocarcinoma patients who underwent curative gastrectomy from 2001 to 2014 at Habib Thameur hospital in Tunis, Tunisia were included. The clinicopathological parameters and prognosis of PCC were analyzed in comparison with non PCC (NPCC). Results Sixty one patients (50%) presented PCC. Patients were younger in PCC group (p = 0,001). There was no difference in sex distribution between the two groups. PCC was more likely to be stage T4 (55.7% vs 34.4%; p = 0.033), N3 (67.8% vs 30%; p < 0.001) and have a higher metastatic lymph node ratio (p < 0.001). Hepatic metastases were more frequent in NPCC group (p = 0.031) whereas peritoneal carcinomatosis was more common in PCC group (p = 0.004). Perineural invasion was more frequent in PCC group (p = 0.001). Resection margins were more often positive in PCC group (31.1% vs 9.8%; p = 0.004). There was no difference in recurrence rate between the 2 groups (p = 0.348). The 5-year survival was similar in the NPCC and PCC (respectively 43% vs 23 %; p = 0.247). Survival rates were also comparable in early stage (100% vs 80% respectively for PCC and NPCC; p = 0.527) as well as for advanced stage (16% vs 35% respectively for PCC and NPCC; p = 0.538). PCC was not a prognostic factor for survival. Interestingly, advanced age, adjacent structures invasion, positive resection margins were specific prognostic factors for PCC. Conclusion In our study PCC was not a prognostic factor for survival. Advanced age, adjacent structures invasion and positive resection margins were specific prognostic features for this histological subtype., Biological sciences; Health sciences; Pathology; Abdominal surgery; Cancer surgery; Gastric cancer, Poorly cohesive carcinoma, Prognosis, Survival.

Aims Brain derived neurotrophic factor (BDNF) is essential for cognitive function. It is also found in non-neuronal tissues with various regulatory actions, including metabolic. Physical fitness (PF) is associated with improved synthesis and secretion of BDNF and reduced obesity. However, the importance of PF for the relationship of BDNF with obesity has not been investigated. This study aims at examining the relationship of PF with BDNF and obesity in 174 young (age = 25.30 ± 9.2 years) healthy adults. Main methods Serum BDNF was evaluated using ELISA while obesity was determined using body weight (BW), BMI, and waist circumference (WC). Six minute walk distance (6MWD) test was used to estimate PF. Key findings Serum BDNF was greater (p = 0.000) in the participants with high (Hi6MWD) versus low (Lw6MWD) PF group. Additionally, 6MWD explained 6.8% of serum BDNF. Obesity measures were greater (p < 0.05) in the participants with low versus high BDNF. In regression analyses, serum BDNF explained 4.7% of BW (p = 0.004), 3.8% of BMI (p = 0.011), and 6.2% of WC (p = 0.001). However, when the participants were divided into Hi6MWD and Lw6MWD, BDNF explained 8.2% of BW (p = 0.009), 6.0% of BMI (p = 0.03), and 7.0% of WC (p = 0.013), only in the Hi6MWD, but not in the Lw6MWD (p > 0.05) groups. Significance The finding confirms the relationship of BDNF with obesity. Additionally, it further suggests the importance of PF level to this relationship among young adults. Future studies are needed to confirm these findings., Biological sciences; Proteins; Biochemistry; Molecular biology; Toxicology; Pathophysiology; Health sciences; Public health; Physiology; Six minute walk distance; Fitness; BDNF; Obesity; BMI; Waist circumference.

Background An assessment of the adverse health effects of obesity in children with Down's syndrome (DS) is required to develop programs that facilitate the acquisition of healthy behaviors. Individuals with DS are often obese. These individuals must develop health related behaviors in childhood. For this reason, it is necessary to clarify the factors associated with obesity in children with DS. Aims This study had two purposes. The first was to assess the obesity and to evaluate the sedentary behavior (SB) and physical activity of Japanese elementary school children with Down's syndrome. The second was to investigate the association between obesity and SB or moderate to vigorous physical activity (MVPA). Methods and procedures Ninety-three children (male/female: 51/42) with DS in elementary school grades 1 to 6 (aged 7–12 years) participated in this study in Japan. Physical characteristics were obtained from the questionnaire completed by their parents. The questionnaire provided information on regular school checkups. SB and MVPA were evaluated using a triaxial accelerometer. Results Approximately 20% of the children with DS were obese. Nearly half of the children with DS achieved 60 min of MVPA. SB time was significantly longer in the upper grades (aged 11–12 years) than in the lower grades (aged 7–8 years). Comparing weekdays and weekend days, the middle (aged 9–10 years) and upper grades had significantly shorter MVPA times on weekend days. The frequency of obesity was significantly associated with shorter MVPA times in the lower grades and longer SB time in the middle grades. Conclusions and implications Children with DS may increase their SB time as their age group (grade category) increases. Increasing opportunities for MVPA during weekends may increase physical activity. The observed relationship between obesity and SB time or MVPA time may apply only to younger and middle grade children with DS. Further investigation is necessary to confirm these relationships., Disability; Health Education; Health Sciences; Nutrition; Physical Activity; Elementary schoolchildren; Down's syndrome; accelerometer; Physical Activity; Obesity; japan.

To identify determinants of medication adherence among patients with type 2 diabetes based on the health action process approach. This cross-sectional study was conducted among 734 patients with type 2 diabetes attending to south Tehran health centers during June to December 2018. Data were gathered using the Morisky Medication Adherence Scale (MMAS-8-Item) and the health action process approach questionnaire. We used Mann-Whitney, Pearson Chi-Squared, Fisher's Exact and Independent Samples Tests for comparison of adherence medication by demographic characteristics; and linear regression analysis to predict factors related to medication adherence based on HAPA. P-value less than 0.05 considered statistically significant. A total of 232 men and 502 women participated in the study, Mean age was 61.61 ± 9.74. Most participants (82.3%) reported low medication adherence (females: 68.4%). Medication adherence was significantly associated with gender (p = 0.03). Medication adherence was significantly predicted by intention (β = 0.172, p = 0.0001), task self-efficacy (β = 0.172, p = 0.01), copping planning (β = 0.6, p = 0.0001) and copping self-efficacy (β = -0.244, p = 0.001). The level of adherence to medications among type 2 diabetes patients was low. The behavior intention, task self-efficacy, copping planning and copping self-efficacy were significant determinants contributed to the medication adherence. HAPA inventory includes various factors, especially types of self-efficacy. Thus, utilization of this comprehensive model in interventional studies is suggested. These determinants should be considered in developing interventional programs to improve adherence., Diabetes; Diet; Health profession; Health sciences; Health promotion; Insulin; Determinants, Medication adherence, Type 2 diabetes, Health action process approach, Iran

This preliminary study was designed to contribute to the evaluation of reliability of plasma lactate concentration (PLC) and its clearance as predictive and prognostic factors of gastric necrosis and clinical outcome of dogs affected by gastric dilatation-volvulus (GDV). Main aims of the study were: 1) to evaluate the prognostic reliability of PLC at presentation (T0) in dogs with GDV, 2) to compare the obtained data and considerations with the veterinary literature, and 3) to introduce the possible validity of PLC values at 24 (T24) and 48 (T48) hours after surgery as a predictive factor. Dogs with GDV were retrospectively evaluated. PLC at T0, T24 and T48 were recorded and correlated to the presence or absence of macroscopic necrosis of the stomach and to outcome. Forty-five dogs met the inclusion criteria. Significant differences were not detected in the mean values between the initial PLC in dogs with and without necrosis of the gastric wall, as well as between surviving and non-surviving dogs; these values were not associated with higher risk of gastric necrosis or death. At T24 and T48 no significant differences were recorded between necrosis and non-necrosis, and surviving and non-surviving categories. A median plasma lactate concentration clearance from arrival to T24 ≥ 50% was identified in both groups (with and without necrosis), and this parameter failed in identifying dogs that survived to discharge. In conclusion, the results presented here failed to detect PLC at T0 and its clearance at T24 as prognostic factors in this population of dogs with GDV., Surgery; Veterinary Medicine; Health Sciences; Surgery; Abdominal Surgery; Emergency Medicine; Plasma lactate concentration; Prognostic factor; Gastric dilatation-volvulus; dog; Gastric necrosis

Background Culture-independent next generation sequencing has identified diverse microbial communities within the cystic fibrosis (CF) airway. The study objective was to test for differences in the upper airway microbiome of children with CF and healthy controls and age-related differences in children with CF. Methods Oropharyngeal swabs and clinical data were obtained from 25 children with CF and 50 healthy controls aged ≤6 years. Bacterial DNA was amplified and sequenced for the V4 region of 16S rRNA marker-gene. Alpha diversity was measured using operational taxonomic units (OTUs), Shannon diversity, and the inverse Simpson's index. Beta diversity was measured using Morisita-Horn and Bray-Curtis and Jaccard distances. General linear models were used for comparison of alpha diversity measures between groups to account for differences in demographics and exposures. Mixed effects general linear models were used for longitudinal comparisons 1) between children with CF of different ages and 2) between children with CF receiving CF transmembrane conductance regulator (CFTR) modulators, children with CF not receiving CFTR modulators, and healthy controls to adjust for repeated measures per subject. Results Children with CF were more likely to have received antibiotics in the prior year than healthy controls (92% vs 24%, p < 0.001). Controlling age, race, ethnicity, length of breastfeeding, and having siblings, children with CF had a lower richness than healthy controls: OTUs 62.1 vs 83, p = 0.022; and trended toward lower diversity: Shannon 2.09 vs 2.35, p = 0.057; inverse Simpson 5.7 vs 6.92, p = 0.118. Staphylococcus, three Rothia OTUs, and two Streptococcus OTUs were more abundant in CF children versus healthy controls (all p < 0.05). Bray-Curtis and Jaccard distances, which reflect overall microbial community composition, were also significantly different (both p = 0.001). In longitudinally collected samples from children with CF, Morisita-Horn trended toward more similarity in those aged 0–2 years compared to those aged 3–6 years (p = 0.070). In children >2 years of age, there was a significant trend in increasing alpha diversity measures between children with CF not receiving CFTR modulators, children with CF receiving CFTR modulators, and healthy controls: OTUs 63.7 vs 74.7 vs 97.6, p < 0.001; Shannon 2.11 vs 2.34 vs 2.56, p < 0.001; inverse Simpson 5.78 vs 7.23 vs 7.96, p < 0.001. Conclusions Children with CF have lower bacterial diversity and different composition of organisms compared with healthy controls. This appears to start in early childhood, is possibly related to the use of antibiotics, and may be partially corrected with the use of CFTR modulators., Health sciences; Respiratory system; Infectious disease; Microbiology; Epidemiology; Pediatrics; Cystic fibrosis; Human microbiome; Pulmonary medicine.

Background Inflammatory cytokines are involved in the pathophysiology of acute coronary syndromes (ACS) and have been associated with major adverse cardiovascular events (MACE). We systematically reviewed studies investigating the ability of multiple cytokines to predict MACE in ACS patients with follow-up of at least one year. Methods A Medical Subject Heading search criteria was applied on Ovid Medline(R), EMBASE, EMBASE Classic and Cochrane Library to systematically identify relevant studies published between 1945 and 2017 that had an observational study design or were randomised controlled trials. Studies were excluded if only one cytokine was analysed, follow-up period was less than one year, subjects were non-human, or blood samples were taken more than 10 days from symptom onset. Results Ten observational studies met the inclusion criteria. Six had acceptable internal validity when evaluated for quality. The studies were varied in terms of study methods (time of blood collection, study population, cytokines assessed, MACE definition, follow-up length) and result reporting, so a meta-analysis could not be conducted. Six of the studies found significant associations between individual cytokines and MACE. Four studies measured the combined effects of multiple cytokines to predict MACE, and all had statistically significant results. Conclusion A combination of multiple cytokines had a better association with MACE than individual cytokines. It appears promising for future studies to determine the optimal multi-marker methodology and confirm its predictive value., Clinical research; Cardiology; Inflammation; Health sciences; Biomarkers; Outcomes; Acute coronary syndromes; Cytokines

Background Quality of Life (QoL), for long, has been a multifactorial concerning issue in oncology. The aim of this study was to determine QoL of cancer patients and its association with nutrition, and performance status. Methodology This was a hospital based cross-sectional study carried out at 2 cancer centers and one tertiary level hospital in Dhaka city during the months of July to December, 2019. Data was collected through structured interviews and analyzed by SPSS-25 statistical package software. Results Among 279 participants, 14(5.02%) had high QoL, 35(12.54%) had average QoL, 150(53.76%) had low QoL, and remaining 80(28.67%) had very low QoL. The prevalence of severe malnutrition was 12.5% and 43.7% of patients had poor performance status. A statistically significant association between QoL and, nutritional and performance status was identified (p < 0.05). The ANOVA also indicated a statistically significant variation in QoL score among nutritional categories (P < 0.01) and performance status (P = 0.013). Conclusion A relatively higher prevalence of poor QoL was identified in this study which varies among nutritional categories and performance statuses. The proper management of predictors of QoL is imperative during treatment procedures., Health sciences; Public health; Psychiatry; Oncology; Clinical research; Quality of life; Nutrition; Treatment; Performance status; Dhaka city

Background The painful conditions of the Upper quarter region (UQR) such as chronic Craniofacial Pain (CFP) and Cervicobrachial Pain (CBP) usually occur with a plethora of symptoms. Although biological and psychosocial factors are attributed to such conditions, the involvement of the Deep Cervical Fascia (DCF) is ambiguous and needs further exploration. Objective We reported a case of CFP and CBP with an intent to showcase the possible involvement of impaired DCF in such presentations and to explore the short-term effect of Fascia directed approach (Fascial Manipulation). Methods This is a report of a 25-year-old female college student with chronic head, temporomandibular, neck, and arm pain over the past four years with acute pain exacerbation. After identifying the densified Centre of Coordination points along the myofascial continuum of the DCF, Fascial Manipulation (FM) was performed by deep manual friction. The patient-reported outcomes such as the Numerical Pain Rating Scale (NPRS), Temporomandibular disability index (TMDI), and Patient-Specific Functional Scale (PSFS) were assessed. Results Following FM treatment, there is a reduction in pain and improved function between the baseline and follow up evaluation after one week based on all the outcomes (NPRS, PSFS, and TMDI). Conclusion This case report highlights the possible role of dysfunction of the DCF and the importance of assessing myofascial chains in patients with pain in the UQR. The report has also shown that FM may be beneficial and can be considered an adjunct in the rehabilitation of chronic CFP and CBP. Nevertheless, future studies with multiple sessions and follow-ups are imperative., Anatomy; Clinical research; Evidence-based medicine; Eye-ear-nose-throat; Health sciences; Musculoskeletal system; Ophthalmology; Respiratory system; Cervical pain; Connective tissue; Facial pain; Headache; Myofascial pain; Orofacial pain.

Objectives To assess the knowledge of dentists regarding medication-related osteonecrosis of the jaw (MRONJ). Methods In this cross-sectional study, 74 dentists from governmental hospitals in Riyadh (Dental University Hospital in King Saud University, Military Hospital, National Guard Hospital), Jeddah (King Abdulaziz University Hospital, Ministry of Health Hospital), and the Eastern region of Saudi Arabia (Ministry of Health Hospitals in Dammam and Al-Ahsa) completed a two-part questionnaire. The first part gathered demographic data, such as sex and specialty. The second part included questions about bisphosphonate drugs and their indications; the identification of patients at risk of MRONJ; other medications associated with jaw necrosis; as well as the definition of MRONJ and its clinical features, risk factors, and preventive methods. Results Of the participating dentists, 60.8% knew about MRONJ, but only 35.1% were able to define it correctly. Most (79.7%) had never encountered MRONJ patients. Only 18.9% knew of the relationship between the risk of MRONJ in osteoporotic patients and long-term (>4 years) use of oral bisphosphonates or intravenous zoledronate, while 68.9% were unaware, and others answered incorrectly. Most participants did not know of MRONJ-predisposing medications, and 59.5% cited radiotherapy as the cause. Most participants identified dentoalveolar surgery as a major local factor, and the mandible as a common anatomic location. Conclusion Dentists at the surveyed institutions had poor knowledge of MRONJ, although their knowledge of preventive measures was good. There is an urgent need for the optimization of educational programs pertaining to MRONJ, and its related dental management considerations. Clinical significance Dentists in the surveyed institutions in Kingdom of Saudi Arabia have poor knowledge of MRONJ management; thus, greater effort should be taken to educate undergraduate and postgraduate students regarding this pathology., Biological sciences; Health sciences; Surgery; Dental surgery; Pharmacology; Dentistry; Antiresorptive agent, Bisphosphonate, Dentist, Knowledge, Medication-related osteonecrosis of the jaws.

Background Hypoxia-inducible factor-1α (HIF-1α) is a transcription factor which maintains cellular homeostasis in response to hypoxia. It can trigger apoptosis while stimulating angiogenesis process and decrease neurological deficit after an ischemic stroke. Up until now, this protein complex has not been widely investigated especially in stroke patient. Objective Here, we examined the potential of HIF-1α as a marker for neuroplasticity process after ischemic stroke. Methods Serum HIF-1α were measured in acute ischemic stroke patients. National Institute of Health Stroke Scale (NIHSS) were assessed on the admission and discharge day (between days 7 and 14). Ischemic stroke divided into 2 groups: large vessel disease (LVD, n = 31) and small vessel disease (SVD, n = 27). Statistical significances were calculated with Spearman rank test. Results A total of 58 patients, 31 with large artery atherosclerosis LVD and 27 with small vessel disease (SVD) were included in this study. HIF-1α level in LVD group was 0.5225 ± 0.2459 ng/mL and in SVD group was 0.3815 ± 0.121 ng/mL. HIF-1α was higher (p = 0.004) in LVD group than in SVD group. The initial NIHSS score in LVD group was 15.46 ± 2.61 and discharge NIHSS score was 13.31 ± 3.449. Initial NIHSS score in SVD group was 6.07 ± 1.82 and the discharge NIHSS was 5.703 ± 1.7055. In both SVD and LVD group, HIF-1α were significantly correlated with initial NIHSS (both p < 0.001) and discharge NIHSS (p < 0.0383 r = 0.94, p < 0.001, r = 0.93, respectively). Conclusions HIF-1α has a strong correlation with NIHSS and it may be used as predictor in acute ischemic stroke outcome., Health sciences; Clinical genetics; Neurology; Nervous system; Clinical research; Acute ischemic stroke, HIF 1-α, NIHSS, Outcome, Small vessel disease, Large vessel disease.

Background Early diagnosis of breast cancer is essential for mitigating its related morbidity and mortality. Therefore, high awareness is required. Objectives We aimed to evaluate the knowledge, awareness and perceived barriers among females in Bangladesh regarding breast cancer. Methods A hospital-based survey was performed from April 2019 to June 2019. A total of 500 females aged >18 years were recruited to the study. The participants were selected by trained personnel and physicians via simple random sampling. Results The mean participant age was 37.13 ± 12.66 years. Among all the participants, 79% were married, 4% were single, 3% were divorced and 14% were widowed. We observed that 80.6% of respondents were housewives, 5% were students and 14.4% were working women. The participants had a severe lack of knowledge and awareness, and perceived barriers regarding breast cancer screening. Breast cancer was more linked to personal history, occupation and, marital status. Shyness, fear, lack of knowledge and deficient awareness programs were the major perceived barriers. Conclusion Educational interventions and proper, appropriate and socially acceptable awareness programs will help to ameliorate knowledge and awareness by addressing barriers regarding breast cancer among the females in Bangladesh., Cancer Research; Epidemiology; Health Sciences; Public Health; Clinical Research; Education; breast cancer; awareness; Knowledge; barriers; females; Bangladesh.

Diabetes is very common all over the world, but still not curable and controlled; it causes alteration in all over body. It needs serious concern for the scientific community to find out some control measures. The current work was planned to explore the possible defensive effect of melatonin against the diabetes induced changes in whole blood profile. For this study albino rats were treated with streptozotocin [(STZ) (15 mg/kg for 6 days)] to induce diabetes. Induction was confirmed by blood glucose and serum sugar assessment. Total 36 rats were randomly selected for the experimental purpose and were divided into two major groups. Major group-1 consisting eighteen (18) and were further sub-divided into three (3) different groups viz. group-I served as normal control, group-II served as melatonin treated, group-III served as glibenclamide treated. Major group-2 consisting eighteen (18) rats were given streptozotocin (STZ) injection (15 mg/kg) for 6 days. After confirmation of diabetes by measuring blood glucose level, animals having blood glucose level above 250 mg/dl) confirmed as diabetic. Eighteen (18) Diabetic rats were three subdivided into following sub-groups and were given different therapeutic treatments, Viz group-IV served as Diabetic control, group-V treated with melatonin, group-VI treated with glibenclamide, respectively. Diabetic rats demonstrated inflection in all hematological variables. Diabetic animals revealed considerable reduction in RBCs count, HB content and its associated indices (HCT, RDW, MCV, MCH and MCHC). Decrease in WBCs and its related indices (polymorphs and lymphocytes). Platelet count showed significant increase, but platelet distribution width (PDW %) was found decreased. However administration of melatonin restored all the alterations in hematological parameters. Therefore, it can be concluded that melatonin will be better therapeutic molecule to revive hematological alterations during diabetes., Biocheminstry; Food science; Veterinary medicine; Health sciences; Diabetes, Melatonin, Hematology, Hepatorenal, Antioxidative status, Biochemistry, Streptozotocin, Blood glucose, Protection.

Acute progesterone injection has been shown to reduce brain edema following traumatic brain injury (TBI) due to its neuroprotective effect. We investigated the effects of sustained release of progesterone through implantation of subcutaneous capsules on rat's brain edema and alteration of cerebrospinal fluid (CSF), and serum ratio of NGF/IL-6 after TBI. This experiment was performed on ovariectomized (OVX) rats and the brain injury was induced by Marmarou's method. A high and a low dose of progesterone (HP and LP) was injected intraperitoneally two h after the brain injury. In addition, in the capsule progesterone-treated group (CP), the intervention was implemented 6 h after the brain injury. Brain edema, NGF and IL-6 biomarkers in serum and cerebrospinal fluid (CSF) were measured 48 h after the TBI in injection groups and one week after the TBI in the CP group. No significant difference was found in the two groups or in the admonition methods. After TBI, the NGF level increased and IL-6 level decreased by injection of both doses, as well as by taking the capsule. Ratio of NGF/IL-6 in CSF increased significantly by all forms of progesterone administration. The increase in the level of NGF and IL-6 after TBI was higher in CSF than in serum. These results indicated that effects of progesterone in capsule form were better than the injection form. Progesterone probably works by increasing NGF and reducing IL-6. Future studies should investigate the ratio of these biomarkers as a variable to determine the neuroprotective effects of another drug., Neuroscience; Endocrinology; Health sciences; Physiology; Nervous system; Reproductive system; Progesterone; Traumatic brain injury; Brain edema; IL-6; NGF/IL-6

Background Anogenital HPV is the most frequent sexually transmitted disease (STD) worldwide. There is no obligation to officially register HPV infections in Germany and thus the epidemiology of condylomata acuminata (CA) is not well characterized. Objectives To provide a better understanding of the epidemiology of CA and outline the treatment options that are available to patients with this disease. Methods Data of 1124 patients with a confirmed diagnosis of CA, presenting in our university hospital outpatient consultation between 2011 and 2015 were retrospectively evaluated and the efficacy of various types of treatments was addressed. Results A large patient cohort of 1124 predominately young (mean age 36.5 years old), male (83.9 %), single (50.2 %), heterosexual (92.8 %) Germans (62.5 %) received consults in our outpatient clinic for STDs. Nearly 60 % of the diagnosed patients presented with first-time CA, indicating a considerable proportion of roughly 40 % recurrent infections as well. Only 13.7 % of patients were previously immunized against HPV. Conclusions The evaluation of a large patient cohort provided a better understanding of the present epidemiology of CA in an outpatient hospital setting in Germany. An effective three-scale therapeutic regime and preventive measures were outlined., Health sciences; Public health; Epidemiology; Infectious disease; Virology; HPV; Genital warts; Condylomata accuminata; Treatment, Therapy.

Previous studies have reported clinical characteristics of hoarding disorder (HD), such as early onset, a chronic course, familiality, high unmarried rate, and high rates of comorbidities. However, clinical research targeting Japanese HD patients has been very limited. As a result, there is a low recognition of HD in Japan, leading to insufficient evaluation and treatment of Japanese HD patients. The aim of the current study was to delineate the clinical characteristics of Japanese HD patients. Thirty HD patients, 20 obsessive-compulsive disorder (OCD) patients, and 21 normal controls (NC) were targeted in this study. The HD group had a tendency toward higher familiality, earlier onset, and longer disease duration compared to the OCD group. In addition, the HD group showed a significantly higher unmarried rate than the NC group. The top two comorbidities in the HD group were major depressive disorder (56.7%) and attention-deficit/hyperactivity disorder (26.7%). The HD group had significantly higher scores on hoarding rating scales and lower scores on the Global Assessment of Functioning Scale than the other two groups. The current study showed a clinical trend in Japanese HD patients similar to previous studies in various countries, suggesting that HD may be a universal disease with consistent clinical symptoms., Public health; Psychiatry; Health sciences; Clinical research; Diagnostics; Hoarding disorder; Japanese patients; Clinical characteristics.

Background In mild to moderate gallstone pancreatitis, cholecystectomy is the most appropriate treatment for prevention of further biliary attacks. However, the timing of cholecystectomy is not precisely determined. The present study was conducted to compare outcomes of very early (within 48 h) versus delayed (more than 1 week) laparoscopic cholecystectomy in patients with acute biliary pancreatitis (ABP). Methods This randomized clinical trial study was conducted in Shahid Beheshti Hospital of Kashan University of Medical Sciences from September 2016 to Mar 2019. Two hundred and eight cases with mild to moderate ABP were randomly assigned to 2 groups, with 104 patients in group 1 (operation within 48 h) and 104 in group 2 (operation after one week). Age, sex, biochemical parameters, clinical manifestation at the time of admission, operation time, recurrent biliary problems, relapse, peri-operative complications, conversion rate, and hospital length of stay in the two groups were recorded and compared. In addition, Ranson's score and Revised Atlanta criteria, the American Society of Anaesthesiologists Physical Status ASA-PS, Charlson Co-Morbidity Index (CCI), complexity of surgery and Clavien-Dindo score were also determined. Results There were no differences in demographics, peri-operative complications 4 (4%) vs. 4 (4%), P = 1), conversion rate (10.6% vs. 11.5%; P = 0.825) and procedure time (83 vs. 81 minutes, P = 0.110) between the two groups. There were no deaths in either group; however, the length of hospital stay was shorter in the early group compared to the delayed one, (3.66 ± 1.12 vs. 10.35 ± 1.76, P < 0.001). Conclusion Cholecystectomy within 48 h decreases significantly the length of hospital stay, without any difference in conversion rate, procedure time, or complication rate., Biological sciences; Health sciences; Surgery; Internal medicine; Acute biliary pancreatitis; Laparoscopic cholecystectomy; Mild to moderate acute biliary pancreatitis.

Complex regional pain syndrome (CRPS) is a condition of neuropathic pain, which is characterized by significant autonomic and inflammatory features. CRPS occurs in patients who have limb surgery, limb fractures, or trauma. Many patients may have pain resolve within twelve months of the inciting incident; however, a small subset progresses to the chronic form. This transitional process often happens by changing from warm CRPS with dominant inflammatory phase to cold CRPS, in which autonomic characteristics or manifestations dominate. Several peripheral and central mechanisms are involved, which might vary among individuals over a period of time. Other contributors include peripheral and central sensitization, autonomic alterations, inflammatory and immune changes, neurochemical changes, and psychological and genetic factors. Although effective management of the chronic CRPS form is often challenging, there are a few high quality randomized controlled trials that support the efficacy of the most commonly used therapeutic approaches., Neuroscience; Health sciences; Neurology; Surgery; Pain research; Pain management, CRPS; Pain; Pathophysiology; Treatment; Future therapy.

Background Uncorrected congenital heart lesions in children keep them in a state of constant hypoxia with compromised quality of life and reduced life expectancy. This requires early diagnosis and interventions including prevention and treatment of the resultant anaemia. Unfortunately, congenital heart disease (CHD) often goes unrecognized and thus untreated. Objectives We determined the occurrence of CHD in children below 15 years at the Komfo Anokye Teaching Hospital (KATH), assessed the prevalence of relative iron deficiency anaemia in that cohort and the use of iron supplementation in these patients. Methods We conducted a cross-sectional study, using a structured data collection tool, by retrospectively reviewing patient records from December 2015 to January 2010. Data was also obtained prospectively from January 2016 to March 2016. Results Eighty cases (44 females and 36 males) of CHD were encountered. Tetralogy of Fallot was the most common (48.8%) CHD. Cases of cyanotic congenital heart disease were reported at autopsy. Of the 80 cases, 48 (72.7%) had signs of relative iron deficiency. Thirty (62.5%) of the 48 patients did not receive iron supplementation. In 14 cases, full blood count was not determined and yet 10 patients received iron at sub-optimal doses (, Health sciences; Cardiology; Cardiovascular system; Emergency medicine; Laboratory medicine; Congenital; Cyanotic; Hypoxia; Erythropoietin; Anaemia

The aim of these investigations was to study vitamin E supplement effect in male albino rats after 30 days of repeated treatment. Four groups of six male rats were orally administered distilled water (control), 500, 1000 and 2000 mg/kg body weight vitamin E daily for 30 days. The impact of the treatment on percent body weight and mortality was determined and compared to the control group. Some hematological analysis, biochemical parameters and histological examination of different body organs were assessed. The rats treated with different doses of vitamin E supplement showed no deaths recorded in 30 days. The treatment with higher dose Vitamin E supplementation" caused significant alteration at the hematological, biochemical and histological level. Therefore, oral administration of vitamin E supplement in rats for 30 days was not safe for the liver and kidney and in the other hand, safe for the testes therefore that side effect on the liver and kidney should be considered when recommended vitamin E for therapeutic purpose. Care should be taken in taking high doses of vitamin E., Biochemistry; Toxicology; Clinical toxicology; Health sciences; Organ system; Vitamin E supplement; Liver; Kidney; Testes

The purpose of the study was to explore the dietary intake, fruit, vegetable and energy intake and lifestyle behaviors among Mauritian children. A validated questionnaire was used, assessing dietary intake, mean energy intake, mean body mass index (BMI), lifestyle behaviors as well as nutritional knowledge (NK) among males and females. 336 children aged 6–12 years (165 males and 171 females) from 8 public primary schools were recruited. Statistical analyses revealed that children consumed less nutritious foods such as fruits, vegetables and whole grains and more of refined and calorie-laden foods, with no significant differences across genders. Mean energy intake of children was 1522 ± 282.4 kcal per day while mean BMI was 17.5 ± 4.03 kg/m2. Majority of children had a low-to-moderate physical activity level (PAL), with males being more active than females on average (P = 0.021). 88.7% of children watched TV for more than an hour daily, with 84.8% of them reporting to be eating during the process. Females were more likely to be breakfast skippers (P = 0.003). Maximum frequency of snacking was twice daily (72.7%) while consumption of fast food was once or twice weekly (44.0%). Results indicate the need for intervention with aim of improving the dietary and life quality of children in Mauritius.

Measurement of an individuals ability to respond to polysaccharide antigens is a crucial test to determine adaptive immunity. Currently the response to Pneumovax® is utilized but with the success of Prevnar®, measurement of the response to Pneumovax may be challenging. The aim of the study was to assess the response to Typhi Vi vaccination in both children and adult control groups and patients with primary immunodeficiency (PID). In the control groups, >95% of the individuals had pre Typhi Vi vaccination concentrations 94% achieving ≥3 fold increase in concentration (FI). The response to Typhi Vi vaccination was significantly lower in both children (p = 0.006) and adult (p = 0.002) PID groups when compared to their control groups. 11% and 55% of the children and adult PID groups respectively did not obtain a response >3FI. There were no significant differences between the responses obtained in the children and adult PID groups. When all individuals with PID were separated into those with either hypogammaglobulinemia (HYPO) or common variable immunodeficiency (CVID), both groups had a significantly lower median FI than the control group (19, 95%CI 5–56 vs 59, 95%CI 7–237; p = 0.01 and 1, 95%CI 1–56 vs 32, 95%CI 5–136; p = 0.005). Further, a >3FI differentiated the antibody responses between both the CVID and HYPO groups and their control groups (AUC: 0.83, 95%CI: 0.65–1.00, p = 0.005 and 0.81, 95% CI: 0.65–0.97, p = 0.01). The data suggests that measurement of the response to Typhi Vi vaccination could represent a complementary assay for the assessment of the response to a polysaccharide vaccine.

Background Acute viral hepatitis E (AVH-E) can often result in acute liver failure (ALF) during pregnancy. microRNAs serve as mediators in drug induced liver failure. We investigated their role as a biomarker in predicting ALF due to HEV (ALF-E). Methods We performed next generation sequencing and subsequent validation studies in PBMCs of pregnant (P) self limiting AVH-E, ALF due to HEV (ALF-E) and compared with AVH-E in non-pregnant (NP) females and healthy controls. Findings Eleven microRNAs were significantly expressed in response to HEV infection; importantly, miR- 431, 654, 1468 and 4435, were distinctly expressed in pregnant self-limiting AVH-E and healthy females (p = 0.0005), but not in ALF-E. Sixteen exclusive microRNAs differentiated ALF-E from self limiting AVH-E in pregnant females. miR-450b which affects cellular proliferation and metabolic processes through RNF20 and SECB was predominanlty upregulated and correlated with poor outcome (ROC 0.958, p = 0.001). Interpretation Our results reveal that a specific microRNA profile can predict fatality in ALF-E in pregnancy. These microRNAs could be exploited as prognostic biomarkers and help in the development of new therapeutic interventions.

High blood glucose and type 2 diabetes are associated with a range of adverse health and cognitive outcomes. One factor that contributes to high blood glucose and type 2 diabetes is dietary intake. This study investigated the relationship between dietary patterns, fasting blood glucose and diabetes status in a sample of 209 participants aged 60–65. Blood plasma glucose was measured from venous blood samples. Individual Prudent and Western dietary patterns were estimated from a self-completed food frequency questionnaire. The relationship between dietary patterns, diabetes, and blood glucose was assessed via general linear model analyses controlling for age, sex, height, and total caloric intake. Results indicated that there was no association between Prudent diet and fasting blood glucose levels, or type 2 diabetes. In contrast, an individual in the upper tertile for Western dietary score had a significantly higher risk of having diabetes than an individual in the lower tertile for Western dietary score. However, there was no significant association between Western diet and fasting blood glucose. Western diet may be associated with type 2 diabetes through mechanisms beyond impacting blood plasma glucose directly. The fact that the association between Western diet and type 2 diabetes remained even when total caloric intake was controlled for highlights the need for policy and population health interventions targeting the reduction of unhealthy food consumption.

Background In cancer patients with symptomatic venous thromboembolism (VTE) (deep-vein thrombosis (DVT) and/or pulmonary embolism (PE)), clinical factors that influence the benefit-risk balance of anticoagulation need to be identified so treatment intensity and duration can be optimally adjusted for the individual patient. Methods Using clinical data for cancer patients with VTE obtained from the RIETE registry, we compared how rates of fatal PE and fatal bleeding during and after anticoagulation vary depending on patients‘ clinical characteristics. Results Data were analysed from the 10,962 cancer patients with VTE (5,740 with PE with or without DVT; 5,222 with DVT alone) in RIETE registry as of March 2016. Fatal PE occurred in 2.18% of patients, while fatal bleedings occurred in 1.55%. During the 12 months from initial VTE, fatal PE was the most common cause of death, after disseminating cancer, and bleeding the fourth most common. In patients initially presenting with PE, fatal PE during anticoagulation was 4-fold more frequent than fatal bleeding (204 vs 51 deaths) and occurred mostly during the first month of treatment (196/223, 88%). In patients initially presenting with DVT, fatal PE was 3-fold lower than fatal bleeding during (25 vs 85 deaths) and after anticoagulation treatment (8 vs 37 deaths). During the 12-month follow-up, other characteristics of cancer patients with VTE were identified as more common in fatal cases of PE and/or bleeding than in surviving cases. Interpretation Baseline clinical characteristics may determine anticoagulation outcomes in cancer patients with VTE and should be further investigated as possible factors for guiding changes in current practices of anticoagulation, such as adjusting anticoagulation intensity and duration in selected patients.

Despite improvements made in stroke rehabilitation, motor impairment and gait deficits persist at discharge. New interventions are needed. Mirror therapy has promise as one element of a rehabilitation program. The primary objectives were to 1) describe a bilateral, lower extremity mirror therapy (LE-MT) device and training protocol and 2) investigate the feasibility of LE-MT. A LE-MT device was constructed to train bilateral LE movements for 30 min, 3 times/week for 4 weeks, as an adjunct to physiotherapy in three individuals post-stroke. Sessions were digitally recorded and reviewed to extract feasibility measures; repetitions, rests and session duration. Pre and post measures of gait and motor impairment were taken. Two participants completed 100% of the sessions and a third completed 83% due to a recurrence of pre-existing back pain. Repetitions increased and session duration was maintained. Number of rests decreased for two participants and increased for one participant. Participants reported fatigue and mild muscle soreness but also that the intervention was tolerable. Positive gait changes included increased velocity and decreased variability. LE motor impairment also improved. A bilateral LE-MT adjunct intervention for stroke is feasible and may have positive effects. A history of low back pain should be a precaution.