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Impact of Integrating Chronic Kidney Disease Screening in Occupational Medicine Visits: A Pilot Experience in Senegalese Private Sector Workers
No full textIntroduction: Chronic kidney disease (CKD) represents an important cause of death and a burden on health systems particularly in low-income countries. To fight this epidemic early detection and primary prevention in at-risk population are recommended but in many African countries, they are inexistent. In this study we assessed the interest of integrating CKD screening in routine medical visits of private sector workers in Dakar.Methods: We conducted a cross-sectional survey in two major private companies who provided regular medical check-up to their employees. Data were collected during annual medical visits. Prevalence of chronic kidney disease (CKD) and additional costs related to renal screening were calculated. Statistical analyses were performed with SPSS 16.0.Results: We included 402 adults (266 men and 136 women) with a mean age of 46.2 ±7.6 (23-75). The mean estimated glomerular filtration rate was 99.8±23.5 ml/min/1.73m² (ranges 35.7-133.5 ml/min/1.73m²). Prevalence of CKD was 22.4% (22.2 % in women versus 22.8 % in men). Albuminuria was present in 5.5% of them. Hypertension was found in 12.1% of patients and prevalence of diabetes was 9.7% and 16.8% for obesity. Introduction of systematic renal screening helped to detect 90% CKD patients who had no clinical symptom even in those with diabetes and/or high blood pressure. Additional cost of the renal tests was estimated to 03 USD per worker yearly. Risk factors associated with low eGFR were age (OR= 1.15, 95% CI= 1.02 - 2.45; p=0.02) and systolic blood pressure (OR= 1.82, 95% CI=1.10 - 4.36; p=0.03).Conclusion: Despite limited sample size, this study demonstrates that opportunistic screening activities in specific socio-professional groups are helpful alternative in absence of national screening and prevention program
Speech Preparation and Articulation Time in Bilinguals and Men
No full textThe current study investigated the relationship between word utterance preparation time and word articulation duration in young adults. In a stratified sample, 40 monolinguals’ (20 males and 20 females) and 40 bilinguals’ (20 males and 20 females) word pronunciation of English words vs. derived, scrambled non-words as well as the hesitation before speaking were measured in milliseconds. Positive effects of bilingualism were found as these speakers showed significantly faster articulation of new non-words than their monolingual counterparts. Sex differences showed that independently of the number of languages men were able to speak, they needed more speech preparation time than women, but no difference in the duration of their word articulation time was observed. Preparation and articulation were correlated in monolingual speakers, but not in bilingual speakers. This suggests that the phonological loop was circumvented in bilingual speakers. We presume that bilinguals map multi-lingual phonology and were thus not saving time during preparation for articulation, but they appeared to have benefited from knowing multiple fine motor mouth movements of various languages during articulation itself. Future research may benefit from controlling the psychological factor of confidence when preparing to speak
Asperger’s Syndrome and Skin Vibration Sessions: A Theoretical Model
No full textIn the last decades, Asperger’s Syndrome (AS) has received extensive investigation by many researchers worldwide. It belongs to Autism Spectrum Disorders (ASD) domain, and is characterized by a variety of symptoms including intrinsic social attitude and relative preservation of linguistic and cognitive development. So far, the exact cause is unknown but current evidence indicate that, genetic factor to be an important one in the evolution of AS, while many others environmental agents are considered to contribute, as well. All these co-factors seem to affect the final structure and connectivity of the brain resulting in neural circuits malfunction. In this research, we assume an additional mechanism that may be implicated in AS: the AS’s person might have sustained a specific “sentimental stress†produced by his environment unwittingly, and has triggered the progression of the syndrome. It is proposed that the creation of “suitable-music-like†skin vibration sessions may stimulate Thalamus multi-connective neural system so as to harmonize the action of biochemical neurotransmitters implicated in AS
Seroprevalence of Bovine Leptospirosis in Odisha, India
No full textIn this study, a total of 120 non purposive serum samples (Cows-68; Bullocks-32; Bulls-20) randomly collected from different breeds of bovine (Cross breed- 41; Indigenous- 61 and Non-descript-18) in six districts (Bargarh-40; Angul-15, Koraput-22, Boudh-14, Nayagarh-11, Jagatsinghpur-18) of Odisha by field veterinary officers during surveys from April to May 2013 were included. These samples were tested at 1:100 dilution in microscopic agglutination test (MAT) using live antigens of 14 reference leptospiral serovars in order to investigate the seroprevalence of bovine leptospirosis. The overall seroprevalence of 42.5% (51/120=CI: 95% 34.0 to 51.4) with 48.5% in cows, 28.1% in bullocks and 45.0% in bulls was observed. The overall analysis of chi-square test revealed that seroprevalance in bovine are associated with age (χ2 =5.78, p<0.10), whereas not associated with breed type and health status. Among the targeted districts, high prevalence was observed in Nayagarh (81.8%) followed by Bargarh (47.5%), Jagatsinghpur (44.4 %) and Boudh (42.8%). In general, the prevalence across the sample regions was significant (χ2 =12.45, p<0.05) indicating the prevalalence was associated with regions. Out of 51 reacted sera, 13 samples showed reactivity with more than one serovars representing 25.5%. The predominant leptospiral antibodies determined against frequency distribution of the serovars were: Australis (50.9%); Hardjo (23.5%); Canicola, Tarassovi and Kaup (7.8%); Pomona, Hurstbridge (5.9%); Bankinang, Javanica, Hebdomadis and Pyrogenes (3.9%); and Icterohaemorrhagiae, Grippotyphosa and Shermani (2.0%). This study supports that bovines may have a role in maintaining Australis serovar apart from being a well known reservoir for Hardjo serovar in Odisha state, Indi
Endonasal Endoscopic Simultaneous Surgical Repair for Recurrent Multiple Traumatic Bilateral Cerebrospinal Fluid Rhinorrhea
No full textAbstract: Background: recurrent multiple traumatic cerebrospinal fluid (CSF) fistulas in the same patient are rare lesions. Although many skull base defects occur after trauma or surgery, otolaryngologists must be aware of the potential for multiple traumatic (CSF) fistulas Objectives/Hypothesis: We present our experience with this unusual condition and illustrating the endoscopic endonasal approach used with the technique of repair, the grafting material and surgical outcome.Methods: this is a retrospective study carried outin tertiary hospitals. Two males and a female patients with recurrent multiple traumatic bilateral cerebrospinal fluid rhinorrhea after road traffic accident (RTA) with previous unsuccessful surgery to repair the leak were investigated and operated on. Their medical history, rhinologic with enodonasal endoscipc examination, radiographic images, technique of repair, insertion of lumbar drain and postoperative follow up data were analyzed.Results: combined underlay and overlay techniques through endoscopic endonasal approach with the use of nasal turbinate tissue and temporary insertion of lumbar drain were effective for sealing the leaks for all patients. The follow up period were: 4 years in 2 patients and 3 years for the 3rd one.Conclusions: simultaneous surgical repair for recurrent multiple traumatic CSF fistulas can be safely and successfully done using combined underlay and overlay techniques through endoscopic endonasal approach in one sitting. In cases with traumatic CSF rhinorrhea (especially after RTA) it is mandatory to investigate for presence of multiple fistulas sites
Maxillary Sinus Asymmetry in Children: Report of Two Cases and Literature Review
No full textAsymmetry of the Maxillary Sinus in children can be caused by various benign and malignant pathologies. Facial asymmetry is part of the clinical picture of these patients and sufficient investigation is necessary. We present a case of idiopathic asymmetry of the maxillary sinus and a case of hypoplasia of the maxillary sinus as well as a description of the main differential diagnoses
HIV/AIDS Gender-Specific Risk Assessment Differentials of African American Women: A Comparative Study of Two Unequal US Inner-City Communities
No full textObjective: We appraised the differences and similarities in awareness, attitude, beliefs, misconceptions and the various high-risk behaviors that influence the rate of infectiousness of HIV/AIDS among African American (AA) women in two unequal US inner-city communities of Baltimore, Maryland and Dover, Delaware.Methods: A cross-sectional convenience-sample survey of 449 African-American women was conducted in Baltimore, MD and Dover, DE between 2009 and 2011. With the main outcome dependent variables of knowledge, attitude, feelings, behavior/practices and potentials for behavior change among the subjects, we administered a 50-item ethnically-sensitive &, gender-specific instrument (AKFBQ) to subjects via person-to-person interview method. The instrument was initially developed by Dancy (1992) and modified by authors to meet the current study criteria. Results: Of the 449 respondents, (Baltimore=53%; Dover=47%), none in the two communities indicated homosexual or bisexual tendency. Number of respondent’s sex partners in the previous 12 months were: 1-2 (53%); 3-4 (25.7%); 5 and higher (20.5%). Statistically significant differences were observed between the two populations on HIV/AIDS knowledge (p< 0.001), HIV/STIs testing history (p < 0.001), unprotected intercourse with drug users (p< 0.001) , unprotected casual sex (p < 0.001), communication with potential sex partners regarding sexual limits prior to intercourse (p = 0.348), and respondents’ attitudes toward stigmatization of HIV/AIDS patients (p = 0.025).Conclusions: Although the level of knowledge of HIV/AIDS was higher among subjects in smaller inner-city Dover, than those of greater Baltimore metropolis, the overall respondents’ beliefs, attitude/feelings, behavior and potentials for behavioral change did not differ significantly among the women in the two un-identical urban communities. Studies with wider population samples have been advocated
Dissection of Arteria Lusoria during Transradial PCI: A Rare Complication revealed and followed by Multidetector CT
No full textThough the radial artery is an ideal site of access for coronary percutaneous interventions (PCI), anatomical variations may render this procedure more challenging. An aberrant right subclavian artery (arteria lusoria) arising from the descending aorta is an uncommon congenital variant that occurs in about 0.2–1.7% of the population. In such cases, the angulated retroesophageal course of this artery to the descending aorta imposes difficulties in advancing a guide wire to the ascending aorta during right transradial catheterization. Performing angioplasty by the same way becomes also a difficult task, and requires greater perseverance and skills. We present a report of a iatrogenic dissection of the arteria lusoria during right transradial coronary percutaneous intervention evaluated and confirmed by multidetector computed tomography. This imaging modality is useful to assess the severity and extension of the dissection in order to guide the clinical management of this complication
Single Centre Experience and Outcome of Primary Percutaneous Coronary Intervention for Patients with ST-Segment-Elevation Myocardial Infarction
No full textBackground: Primary percutaneous coronary intervention is an emergent coronary angiography and mechanical reperfusion of the infarct-related artery performed in patients with ST-segment elevation myocardial infarction. The present study aimed to determine the outcomes of primary percutaneous coronary intervention in a tertiary care cardiac centre.Aims: The present study carried out with the aim to determine the outcomes of primary percutaneous coronary intervention in a tertiary care cardiac centre.Methods: We evaluated 548 patients presented treated for ST-segment elevation myocardial infarction with primary percutaneous coronary intervention at Sri Venkateswara Institute of Medical Sciences, Tirupati, India from January 2011 to December 2012.Results: Total 548 patients were included in this study. Mean age of patients was 54.5 ± 11.5 years. Cardiogenic shock, complete heart block and ventricular tachycardia / ventricular fibrillation was encountered in 31 (5.7%), 40 (7.3%) and 49 (8.9%) patients respectively at hospital admission. The average door to balloon time was 62.5 ± 15.0 minutes. Thrombus aspiration was performed in 159 (29.0%) patients during the index procedure. During hospital stay, in-hospital mortality was 20 (3.6%) out of which 15 (2.7%) patients died from cardiac cause. Target vessel revascularization, major bleeding and minor bleeding observed in 5 (0.9%), 5 (0.9%) and 11 (2.0%) cases respectively. Result of this six-month outcome of the studied showed 5 (0.9%) deaths and 5 (0.9%) incidence of target vessel revascularization.Conclusions: Our data suggest that primary percutaneous coronary intervention for ST-segment elevation myocardial infarction can be safely performed in a regional institution with acceptable door to balloon time and low major adverse cardiac event rates
Prevalence of Antibiotic Resistance and Minimum Inhibitory Concentrations of Helicobacter pylori Isolates from Clinical Gastritis Patients, Saudi Arabia
No full textBackground: Establishing effective and acceptable treatment regimens for patients infected with Helicobacter pylori continues to pose problems for physician and patient alike in Saudi Arabia. The aim of the study was to assess the antibiotics resistance and to find out the MICs of the drugs which are commonly used against H. Pylori.Methods: A total of one hundred antral biopsy specimens were collected and processed from which seventy-six strains of H. pylori were isolated. All the isolates were performed antibiotics sensitivity and E-test.Results: The antibiotics result revealed that of H. pylori isolates 72% strains were resistant to metronidazole and 8% of isolates were resistant to clarithromycin. On the basis of antibiotics resistant a five different antibiotics phenotypes were found among H. pylori isolates. The distribution of metronidazole MICs was high in the range between 32 to128 mg/L. However all other antibiotics showed the effective MICs range was below 1 mg/L.Conclusions: Our findings suggested that resistance to metronidazole has been increasing in the Saudi population. The resistance may be linked to the frequentuse of these antimicrobial agents for treating parasitic infections. The E test results revealed that the most effective antibiotic MICs were amoxicillin and clarithromycin against H. Pylori infection.Keywords: Peptic ulcer, Helicobacter pylori, Antral biopsy, Antibiotics, Resistance