Determinants of inappropriate timing of introducing solid, semi-solid or soft food to infants in Pakistan: secondary data analysis of Demographic and Health Survey 2006-2007

Inappropriate timing of introducing complementary food deprives the infant of optimum nutrition, leading to undernutrition, and increased mortality and morbidity. The aim of this analysis was to identify determinants of inappropriate timing of introduction of solid, semi-solid and soft foods in Pakistan. Data on 941 infants 3.00 to 8.99 months were obtained from the Pakistan Demographic and Health Survey 2006-2007. The prevalence of introduction of foods among infants aged 3.00-5.99 months and 6.00-8.99 months was examined against a set of individual, household and community level variables using univariate analysis. Adjusted odds ratio (AOR) for early introduction in age 3.00-5.99 months and non-introduction in 6.00-8.99 months of age were calculated using backward stepwise logistic regression models. The prevalence of early introduction of complementary foods among 3.00- to 5.99-month-old and timely introduction among 6.00- to 8.99-month-old infants were 10.6% and 39.2%, respectively. Multivariate analyses revealed that mothers who had four or more antenatal clinic visits (AOR=2.68) and who lived in the provinces of Sindh (AOR=2.89) and Baluchistan (AOR=6.75) were more likely to introduce complementary foods early. Mothers from middle-level households (AOR=7.82), poorer households (AOR=4.84) and poorest households (AOR=5.72) were significantly more likely to delay introduction of complementary foods. In conclusion more than half (60.8%) of Pakistani infants do not receive complementary foods at recommended time. Public health interventions to improve the timing of introduction of complementary food are needed at national level with special focus on high risk groups.     

Mapping behavioral traits by use of genome-tagged mice.

OBJECTIVE: Complex trait mapping has been widely used to analyze the genetics of behavior. However, the approach has some disadvantages, including poor gene localization and low replicability. Genome-tagged mice (GTMs) are sets of congenic mouse strains that span the entire mouse genome and are a promising reagent for localization of genes contributing to behavior. METHODS: In order to map behavioral loci of interest, a GTM was investigated in which the middle region of Chromosome 1 from DBA/2J was introgressed onto a C57BL/6J background. The GTM was analyzed for behaviors related to sensorimotor gating, anxiety, depression, pain sensitivity, and learning and memory. RESULTS: The GTM was found to harbor a locus contributing to learning and memory, replicating results from complex trait analysis. CONCLUSIONS: The GTMs should be a valuable resource for mapping and confirmation of loci contributing to complex behavioral traits in the mouse, with ultimate implications for human genomic-based research, as well.     

Anesthetic implications of cervicofacial necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a necrotizing soft tissue infection of face and neck spreading at the level of fascia. It has been described as a putrid ulcer, phagedaena, and hospital gangrene. It has a high mortality rate, and presents a challenge to anesthesiologists who must secure an airway to deliver anesthesia safely. We report a case of cervicofacial necrotizing fasciitis in which the patient underwent repeated radical surgical debridement of face and neck, including a mandibulectomy. These critically ill patients often present with sepsis and multiple system organ failure. Extensive preoperative evaluation, invasive monitoring, and possibly the use of vasopressors and inotropes are essential in treating these patients. The tracheas of these patients should remain intubated after initial debridement. Tracheostomy should be performed early. Antibiotic therapy, nutritional support, early debridement, and hyperbaric oxygen therapy all help to decrease mortality in these patients.     

Spectrum of cytological findings in patients with neck lymphadenopathy--experience in a tertiary care hospital in Pakistan

Introduction: Lymph adenopathy is of great clinical significance as underlying diseases may range froma treatable infectious etiology to malignant neoplasms. In fact it is also essential to establish that the swellingin question is a lymph node. Fine needle aspiration cytology (FNAC) plays a vital role in solving these issues,nowadays being recognized as a rapid diagnostic technique because of its simplicity, cost effectiveness, earlyavailability of results, accuracy and minimal invasion. FNAC is particularly helpful in the work-up of cervicalmasses and nodules because biopsy of cervical adenopathy should be avoided unless all other diagnostic modalitieshave failed to establish a diagnosis. Objective: To determine the epidemiological and cytomorphological patternsof enlarged neck nodes. Study Design: This retrospective observational study was performed at the Section ofHistopathology, Aga Khan University Hospital (AKUH), Karachi, Pakistan. Materials and Methods: ThreeHundred and seventy seven (377) neck swelling specimens obtained over a period of two and a half yearsregistered from different regions of Pakistan were selected. Data were analyzed using SPSS 17. Results: Of atotal of 377 cases of FNAC performed on neck nodes, the most frequent cause of lymphadenopathy was foundto be tuberculosis with 199 cases (52.7%), followed by reactive lymphoid hyperplasia with 61 cases (16.1%).Metastatic carcinoma was found to be the third most common cause with 33 cases (8.7%). A diagnosis oflymphoproliferative disorder was rendered in 21 cases (5.5%). Acute and chronic non-specific inflammation wasseen in 16 cases (4.2%). In 47 cases (12%) FNAC was inconclusive. Conclusion: In our study, the predominantcause of enlarged neck nodes was tuberculous lymphadenitis, followed by reactive lymphadenitis and malignantneoplasm, especially metastatic carcinoma and lymphoma. FNAC was helpful in establishing the diagnosis inapproximately 98% of the cases.     

OGG1 gene sequence variation in head and neck cancer patients in Pakistan

In Pakistani culture tobacco use is very high and a well known risk factor for developing head and neck cancer (HNC), tobacco smoke containing high quantities of chemical carcinogens such as aromatic amines and reactive oxygen species. OGG1 is the primary enzyme in the base excision repair (BER) pathway, responsible for the excision of 7, 8-dihydro-8-oxoguanine, a mutagenic base byproduct that occurs as a result of exposure to reactive oxygen species. Groups of 300 already diagnosed HNC patients along with normal controls were included in this study. PCR-single-strand conformation polymorphism and DNA sequencing were used to analyze the whole coding region of OGG1 gene. Sequence analysis revealed eight novel mutations (six missense and two frame shift mutations). Frequencies of missense mutations, Asp267Asn, Ser279Gly and Ile253Phe were 0.12, 0.13 and 0.06 respectively. Frequencies of other missense mutations, 1578A> T, 1582C> T and Ala399Glu (1542C> A) were 0.13, 0.13 and 0.16, whereas values for the frame shift mutations 1582insG and 1543-1544delCT were 0.13 and 0.16. In our study, incidence of these mutations was found higher in oral cancers (p<0.002) and in smokers (p<0.002) when compared with other sites of HNC and nonsmokers, respectively. Our finding suggests that these germline mutations in OGG1 gene contribute to risk of developing HNC.     

Role of miRNAs in breast cancer

miRNAs belong to an important class of endogenous molecules which are present in a wide range of organisms including animals, plants and viruses. They are involved in regulating expression of several genes inside a cell due to presence of complementary region against specific mRNA molecules. Altered expression patterns cause progression of multiple diseases inside an organism. They have also been confirmed to be involved in different cancers including breast cancer. In this review, we discuss role of miRNAs with respect to uncontrolled division of cells, promotion, progression and metastasis in breast cancer.     

Studies on anti-inflammatory and analgesic activities of betel nut in rodents

Ethnopharmacological relevance

Areca catechu, commonly known as betel nut, is very famous for its medicinal use in multiple disorders. It is also popular as a remedy against inflammatory disorders in the Unani (Greco-Arab) system of medicine.

Objective of the study

This study was aimed at investigating the anti-inflammatory and analgesic activities of the crude extract of Areca catechu and its respective fractions.

Materials and methods

Paw edema, formalin-induced nociception and acetic acid-induced writhing assays were carried out in vivo. Free radical scavenging activity of the plant extract was performed in vitro.

Results

Preliminary experiments using a single dose (100 mg/kg) of Areca catechu and its respective fractions demonstrated an anti-inflammatory effect on carrageenan-induced edema in mice and rats, the aqueous fraction being distinctly more effective. When studied on prostaglandin E₂ (PGE₂), arachidonic acid, histamine, or serotonin (5HT)-induced edema in rats, Areca catechu and its aqueous fraction markedly repressed only the PGE₂ and arachidonic acid-induced inflammation. When studied for analgesic activity, the crude extract and its aqueous fraction produced a dose-dependent (10-100 mg/kg) inhibitory effect on formalin-induced nociception in mice and acetic acid-induced writhing in rats, similar to aspirin. In DPPH assay, Areca catechu and its aqueous fraction exhibited free radical scavenging activity with respective IC₅₀ values of 5.34 μg/ml (4.93-5.78, CI; 95%, n = 5) and 7.28 μg/ml (6.04-7.95, n = 4), like that of rutin with IC₅₀ value of 4.75 μg/ml (3.89-5.42, n = 4).

Conclusion

These results indicate the anti-inflammatory and analgesic effects of Areca catechu and provide a rationale for its medicinal use in inflammatory disorders.     

Evaluating the Knowledge of Breast Cancer Screening and Prevention among Arab-American Women in Michigan

Arab-American women are more likely to be diagnosed with advanced staged breast cancer. We analyzed data from 100 women utilizing a breast cancer literacy assessment tool aimed at understanding functional literacy levels about breast-self exams (BSE), clinical breast exams (CBE), and mammograms. The educational program improved women's knowledge of BSE (OR = 0.15; 95% CI = 0.04, 0.50) and CBE (OR = 0.15; 95% CI = 0.04, 0.54), more for women with higher education. Consideration of women's educational status is an important factor in planning educational programs to improve knowledge on breast cancer screening and prevention in this minority population.     

Characterization of monoclonal antibodies to the plasma cell alloantigen ENPP1

The ectonucleotide pyrophosphatase phosphodiesterase 1 (ENPP1) has documented roles in mineralization, nucleotide recycling, and insulin resistance. While ENPP1 was first identified as an alloantigen on mouse plasma cells (PCs), later studies revealed expression in many tissues. Previously described monoclonal antibodies against ENPP1 expressed at the cell surface recognized cells only from mice bearing the a allotype, ENPP1(a), precluding studies of mice bearing the alternative allele, ENPP1(b). Here, we characterize a novel anti-ENPP1 monoclonal antibody that recognizes both alleles and can be used for flow cytometry.