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Pregnancy Outcomes Complicated by Preterm Premature Rupture of Membranes: Retrospective Review of Cases in Three Institutions in Kazakhstan
Get PDFIntroduction. Pre-term premature rupture of membranes (PPROM) is one of the leading causes of perinatal morbidity and mortality. This complication is diagnosed in 3% of pregnant women in Kazakhstan, and it is the leading cause of pre-term deliveries. The aim of this study was to determine the outcomes of pregnancies complicated by PPROM in gestation periods between 24 to 32 weeks among three institutions in Kazakhstan.Methods. This is descriptive analysis of 154 cases with PPROM observed between 24 to 32 weeks of gestation at Perinatal Centers #2 and #3 and the National Research Center for Maternal and Child Health, Astana, Kazakhstan. Cases were selected on the basis of retrospective chart review where PPROM diagnosis occurred in 2013. Descriptive statistics were utilized for data analysis.Results. The most frequent complications associated with PPROM were threat of miscarriage (13.6% of cases) and chronic placental insufficiency (7.8%). The mean time between PPROM and onset of spontaneous labor was 12.1 ± 2.3 days. Spontaneous labor within 3 days after PPROM started in patients with an amniotic fluid index of 3.0 ± 0.2 cm. Complications experienced by PPROM women during delivery and early postpartum period included: precipitous labor (6.4%), weakness of labor activity (16.2%), atonic hemorrhage (1.2%), and chorioamnionitis (3.2%). 37.6% of newborns in this study were admitted to the Intensive Care Unit. Their health complications included pneumonia (7.7%), conjunctivitis (1.3%), omphalitis and infectious-toxic shock (3.8%), intraventricular hemorrhage (7.8%), and respiratory distress (10.3% ).Conclusion. Thus, preterm rupture of membranes is associated with preterm delivery and an increase of neonatal morbidity. Therefore, it is necessary to find ways to effectively manage PPROM, including developing new techniques to restore the amniotic fluid volume in women experiencing PPROM during 24 to 32 weeks of gestation.
One Health and Zoonoses: The Evolution of One Health and Incorporation of Zoonoses
Get PDFIntroduction: Zoonotic disease outbreaks have surged in the last two decades. These include severe acute respiratory syndrome (SARS), Hendra virus, Nipah virus, influenza viruses, Middle East Respiratory Syndrome (MERS) coronavirus, and ebola. One Health is the initiative of an inclusive collaboration linking human, animal, and environmental health. One Health is advocated through an intersectoral coordination to combat zoonoses, and the term has evolved over centuries. The primary aim of this literature review was to examine the change in the definition of the term One Health over time, particuarly following the the introduction of the latest definition in 2007 by the American Medical Association and the American Veterinary Medical Association.Methods: This review was conducted in four phases. The first phase consisted of a general PubMed search for the phrase “One Health” for every literature published up to December 2014. Then an advanced search was carried out using “One Health” in conjunction with the terms “zoonosis” and “zoonoses” in PubMed for the time period between January 2007 and December 2014. The articles found were then categorized based on the type of journals in which the articles were published. For the second phase, “One Health” was searched as a Medical subject heading (MeSH) term, which is the National Library of Medicine controlled vocabulary thesaurus used for indexing articles. In the third phase, One Health advocate organizations were found using Google search engine. During the final phase, One Health was searched in Google scholar, examined by Google trends, and analyzed by Google ngram.Results: Before 2007, One Health had many connotations to health in the medical literature with an incomplete adherence to the usage of One Health linking zoonoses. The Google trends analysis shows an overal steady increase of the search of One Health from 2007 to 2014, which is consistent with the findings of articles from Pubmed.Discussion: Our results indicate that the linkage between the terms One Health and zoonoses started in 2007, which correlates with the joint declaration made by the American Medical Association and the American Veterinary Medical Association in 2007. We suggest creating a MeSH term for One Health in the PubMed database to support more specific research on zoonoses, and exploring the possibility of a patent of the term One Health to support global health and evidence based public health.
Comparing the Use of Uterine Artery Embolization to Gonadotropin-Releasing Hormone Agonists in Shrinking Fibroid Size: A Pilot Study in Kazakhstan
Get PDFIntroduction: Uterine fibroids are the most common benign tumor in women in Kazakhstan. In the past two decades, endoscopic surgery has played an important role in the development of gynecologic surgery, particularly in the treatment of uterine fibroids. The goal of this paper is to evaluate whether uterine artery embolization (UAE) or gonadotropin-releasing hormone agonists (GnRHa) prior to myomectomy was more effective in decreasing fibroid size and improving surgical outcomes in a pilot study of women in Kazakhstan.Methods: This pilot investigation included 24 patients separated into 2 groups: medication group (pre-treatment with GnRHa – 13 patients) and embolization group (pre-treatment with UAE – 11 patients). All patients had uterine fibroids, 3-10 cm in diameter, and were treated with myomectomy at the National Research Center for Maternal and Child Health, Astana, Kazakhstan. All patient data were obtained by a retrospective medical records review. Descriptive statistics were utilized to characterize participant demographics data. Independent t-tests were used to analyze continuous variables, and Chi-square and Fisher’s exact tests were used where appropriate for count data.Results: The group treated with GnRHa had an operating time of 40±10 minutes longer than the group treated with UAE, due to the peri-operative difficulties encountered by surgeons in detecting the layer between the myometrium and fibroid capsule. The group treated with UAE experienced better patient outcomes (less blood loss, less surgical time, and reduced use of anesthesia) and was a technically easier surgery due to visible differences in uterine layers.Conclusions: Despite the fact that both treatments (GnRHa and UAE) were effective for fibroid shrinking, embolization resulted in more optimal surgical time and improved patient outcomes. Results of this pilot study need to be confirmed in a randomized clinical trial, specifically focused on Kazakhstan and the Central Asian Region.
Quantifying Socioeconomic and Lifestyle Related Health Risks: Burden of Cardiovascular Disease Among Indian Males
Get PDFBackground: Non-communicable diseases account for a significant disease burden in the South East Asia region. India is facing an increased incidence of lifestyle-related diseases, such as cardiovascular disease. Socioeconomic and lifestyle risk factors for cardiovascular disease (CVD) have been under investigated in India. This study was designed to explore risk factors contributing to the development of cardiovascular disease among Indian males.Methods: A population-based cross-sectional study was conducted among 2,235 males in the age group of 18-60 years across three states of India. A household survey was used to collect demographic and socioeconomic status information in addition to lifestyle-related attributes such as smoking, alcohol consumption, diet, and physical activity. Descriptive statistics and logistic regression were performed to identify the role of various factors that may be associated with the development of cardiovascular disease in this population.Results: The prevalence of cardiovascular disease among the male respondents contacted through a household survey was reported to be 9.8%. Logistic regression revealed that males with higher education and higher income were more likely to report CVD. With age as a strong predictor of CVD, the risk of CVD was found to be five times higher in the older age group. Current smokers were 1.3 times more likely to have CVD compared to those who never smoked. Those who were engaged in physical activity were less likely to have CVD; however, the adverse effects of smoking and excessive consumption of red meat showed a stronger association with CVD than the protective effects of physical activity.Conclusion: In developing countries, where the increase in earning capacity and change in lifestyle has been found to be accompanied by substantial risk of heart disease for males, public health measures like health promotion programs need to be implemented to decrease CVD burden
Kainar Syndrome: History of the First Epidemiological Case-control Study of the Effect of Radiation and Malnutrition
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Asymptomatic Bacteriuria in Pregnant Women in Outpatient Facilities
Get PDFUrinary tract morbidity has increased by 7% in Kazakhstan between 2007 to 2011. Pregnant women with extragenital pathologies or kidney diseases had the greatest prevalence of morbidity. Asymptomatic bacteriuria (AB) is one of the most important risk factors of pyelonephritis development in pregnant women, and it can affect the course and outcome of pregnancy, delivery, and postnatal period. AB prevention requires prevention of pregnancy complications including early diagnostic of urinary tract infections, timely optimization of therapy at outpatient facilities, and dynamic follow-up
Prevalence of Psychiatric Disorders among the Rural Geriatric Population: A Pilot Study in Karnataka, India
Get PDFBackground: Increasing life expectancy around the world, an outstanding achievement of our century, has brought with it new public health challenges. India is the second most populous country in the world, with over 72 million inhabitants above 60 years of age as of 2001. The life expectancy in India increased from 32 years in 1947 to over 66 years in 2010, with 8.0% of the population now reaching over 60 years of age. Few studies in India target the health, especially mental health, of this geriatric population. This study aims to estimate the current prevalence of psychiatric disorders in the geriatric population of the rural area of Singanodi,Karnataka, India.Methods: This cross sectional, epidemiological, community-based study was conducted in a rural health training area of Singanodi, Raichur District, Karnataka, India.The General Health Questionnaire-12, Mini Mental State Examination, and Geriatric Depression Scale were administered to 366 participants. Chi square tests with Yates correction were utilized for statistical analysis using SPSS 19.0 software.Results:We found that 33.9% of the geriatric population in the selected province were above the threshold for mental illness based on the GHQ-12 questionnaire. Females had a higher prevalence of mental disorder at 77.6% (152 out of 196) as compared to males who had a prevalence of 42.4% (72 out of 170). The most common psychiatric disorder was depression (21.9%), and generalized anxiety was present in 10.7% of the study population. Prevalence of cognitive impairment was 16.3%, with a significantly higher percentage of affected individuals in 80+ age group.Conclusion: Mental disorders are common among elderly people, but they are not well documented in rural India. The assessment of psychiatric disorder prevalence will help strengthen psycho-geriatric services and thus improve the quality of life of the elderly. A system that ensures comprehensive health care will have to be developed for this purpose as part of our future efforts
Proximity Utilizing Biotinylation of Nuclear Proteins in vivo
Get PDFIntroduction. The human genome consists of roughly 30,000 genes coding for over 500,000 different proteins, of which more than 10,000 proteins can be produced by the cell at any given time (the cellular “proteome”). It has been estimated that over 80% of proteins do not operate alone, but in complexes. These protein-protein interactions (PPI) are regulated by several mechanisms. For example, post-translational modifications (methylation, acetylation, phosphorylation, or ubiquitination) or metal-binding can lead to conformational changes that alter the affinity and kinetic parameters of the interaction. Many PPIs are part of larger cellular networks of interactions or interactomes. Indeed, these interactions are at the core of the entire interactomics system of any living cell, and so, aberrant PPIs are the basis of multiple diseases, such as neurodegenerative diseases and cancer. The objective of this study was to develop a method of monitoring protein-protein interactions and proximity dependence in vivo.Methods. The biotin ligase BirA was fused to the protein of interest, and the Biotin Acceptor Peptide (BAP) was fused to an interacting partner to make the detection of its biotinylation possible by western blot or mass spectrometry.Results. Using several experimental systems (BirA.A + BAP.B), we showed that the biotinylation is interaction/proximity dependent. Here, A and B are the next nuclear proteins used in the experiments – 3 paralogues of heterochromatin protein HP1a (CBX5), HP1b (CBX1), HP1g (CBX3), wild type and transcription mutant factor Kap1, translesion DNA polymerase PolH and E3, ubiquitin ligase RAD18, Proliferative Cell Nuclear Antigen (PCNA), ubiquitin Ub, SUMO-2/3, different types and isoforms of histones H2A, H2Az, H3.1, H3.3, CenpA, H2A.BBD, and macroH2A. The variant of this approach is termed PUB-NChIP (Proximity Utilizing Biotinylation with Native Chromatin Immuno-precipitation) and is designed to purify and study the protein composition of chromatin in proximity to the nuclear protein of interest. Using the RAD18 protein as a model, we demonstrated that the RAD18-proximal chromatin is enriched in some H4 acetylated species. Moreover, the RAD18-proximal chromatin containing a replacement histone H2Az has a different pattern of H4 acetylation.Conclusion. Progress in the last decade in cancer drug therapy has led us to the conclusion that the nucleus of eukaryotic cells is an active site for many cellular processes important to the development of cancer. These processes include changes in genetic and epigenetic landscape (e. g. methylation of DNA, modification of histones) and the expression levels of transcription factors, which regulates gene products (e.g. hypoxia-inducible factor 1? (HIF-1?) in chronic anemia, etc.) where protein-protein interactions play important role. Understanding the nature of protein-protein interactions may improve design strategies for small-molecule PPI modulators. PPI assay technologies that closely reflect physiological conditions hold the key to developing specific anti-cancer drugs.
Prevalence of hypertension and associated factors in Jalalabad City, Nangarhar Province, Afghanistan
Get PDFBackground: Hypertension affects an estimated one billion people, worldwide. It is a public health challenge characterized by increased morbidity, mortality, as well as cost to the community and health systems. The goal of this study is to determine the prevalence of hypertension and characterize associated risk factors in an urban setting in Afghanistan.Methods: A cross-sectional study of adults aged 25-65 years was conducted in Jalalabad city from May to June 2013 using the World Health Organization STEPwise approach to surveillance (WHO STEPS). A multistage technique was used to enroll 1,200 participants in the study. Demographic and socio-economic variables were collected via individual interviews using the WHO STEPS survey, after which blood samples were collected using a locally developed standard operating procedure (SOP). Bivariate and multivariable analyses were performed to explore the association between hypertension and associated factors.Results: A total of 1,180 adults (40% males, 60% females) of 25-65 years of age were surveyed. The response rate was 98.5 % and the prevalence of hypertension was 28.4. Independent risk factors of hypertension were found to be: age ? 50 (AOR = 3.42, 95% CI: 2.50 – 4.76); sex (AOR = 0.58, 95% CI: 0.38 – 0.88); obesity (AOR = 2.1, 95% CI 1.49 – 2.94); and diabetes (AOR = 1.75, 95% CI: 1.10 – 2.79). Independent protective factors were physically demanding occupations (AOR = 0.55, 95% CI: 0.36 – 0.85); physical activity itself (AOR = 0.69, 95% CI: 0.47 – 0.99) and consuming more vegetables (AOR = 0.59, 95% CI: 0.38 – 0.93).Conclusion: This urban setting in Afghanistan evidenced a high prevalence of hypertension; age, obesity, and diabetes were identified as risk factors and physical activity and consuming more vegetables were protective. These findings have implications for future public health intervention and clinical efforts
Studies of Health Effects from Nuclear Testing near the Semipalatinsk Nuclear Test Site, Kazakhstan
Get PDFThe nuclear bomb testing conducted at the Semipalatinsk nuclear test site in Kazakhstan is of great importance for today’s radiation protection research, particularly in the area of low dose exposures. This type of radiation is of particular interest due to the lack of research in this field and how it impacts population health. In order to understand the possible health effects of nuclear bomb testing, it is important to determine what studies have been conducted on the effects of low dose exposure and dosimetry, and evaluate new epidemiologic data and biological material collected from populations living in proximity to the test site. With time, new epidemiological data has been made available, and it is possible that these data may be linked to biological samples. Next to linking existing and newly available data to examine health effects, the existing dosimetry system needs to be expanded and further developed to include residential areas, which have not yet been taken into account. The aim of this paper is to provide an overview of previous studies evaluating the health effects of nuclear testing, including some information on dosimetry efforts, and pointing out directions for future epidemiologic studies