Eleusine indica L. possesses antioxidant activity and precludes carbon tetrachloride (CCl4)-mediated oxidative hepatic damage in rats

Objectives

The purpose of this study was to evaluate the ability of aqueous extract of Eleusineindica to protect against carbon tetrachloride (CCl₄)-induced hepatic injury in rats.

Methods

The antioxidant activity of E. indica was evaluated using the 1,1-diphenyl-2-picrylhydrazyl (DPPH) free radical scavenging assay. The total phenolic content of E. indica was also determined. Biochemical parameters [e.g. alanine aminotransferase (ALT), aspartate aminotransferase (AST), malondialdehyde (MDA), glutathione (GSH), catalase, glutathione peroxidase, glutathione reductase, glutathione S-transferase and quinone reductase] were used to evaluate hepatic damage in animals pretreated with E. indica and intoxicated with CCl₄. CCl₄-mediated hepatic damage was also evaluated by histopathologically.

Results

E. indica extract was able to reduce the stable DPPH level in a dose-dependent manner. The half maximal inhibitory concentration (IC₅₀) value was 2350 μg/ml. Total phenolic content was found to be 14.9 ± 0.002 mg/g total phenolic expressed as gallic acid equivalent per gram of extract. Groups pretreated with E. indica showed significantly increased activity of antioxidant enzymes compared to the CCl₄-intoxicated group (p < 0.05). The increased levels of serum ALT and AST were significantly prevented by E. indica pretreatment (p < 0.05). The extent of MDA formation due to lipid peroxidation was significantly reduced (p < 0.05), and reduced GSH was significantly increased in a dose-dependently manner (p < 0.05) in the E. indica-pretreated groups as compared to the CCl₄-intoxicated group. The protective effect of E. indica was further evident through decreased histopathological alterations in the liver.

Conclusion

The results of our study indicate that the hepatoprotective effects of E. indica might be ascribable to its antioxidant and free radical scavenging property.     

Effectiveness of diet versus exercise intervention on weight reduction in local Japanese residents

Objective

To evaluate the effect of diet versus exercise intervention on weight reduction.

Methods

Participants were randomly divided by gender, age, and living area into four groups: group DE (diet and exercise, n = 16), group D (diet only, n = 15), group E (exercise only, n = 15), and group C (control, n = 16). This study ultimately aimed to help participants reduce their body mass index (BMI) by 7% of baseline value. Subjects were 62 residents (men and women ranging in age from 40 to 69 years) of two residential areas in Nara Prefecture, Japan, who participated in annual health checkups in 2006. BMI of the participants was ≥24 and <28 kg/m² at baseline examination. All participants agreed to undergo a 6-month intervention between January 2007 and September 2007.

Results

In our intention-to-treat analysis, mean change in BMI from baseline to final examination was as follows: group DE mean BMI decreased 6.6%, group D mean BMI decreased 5.3%, group E mean BMI decreased 2.3%, and group C mean BMI decreased 2.2%. The reduction in BMI from baseline to final examination was significant in all groups (DE, p < 0.001; D, p < 0.001; E, p = 0.009; C, p = 0.019). Further, mean abdominal circumference was significantly reduced in all groups. Blood glucose levels were significantly reduced only in group DE (p = 0.047).

Conclusion

Combined intervention with diet and exercise proved to be effective in weight reduction, whereas exercise intervention alone was not found to be effective.     

Road injuries and relaxed licensing requirements for driving light motorcycles in Spain: a time-series analysis

Objective

To assess differences between the risk of injury for motorcycle riders before and after the passing of a law allowing licenced car drivers to drive light motorcycles without having to take a special motorcycle driving test.

Methods

We carried out a quasi-experimental study involving comparison groups, and a time-series analysis from 1 January 2002 to 30 April 2008. The study group was composed of people injured while driving or riding a light motorcycle (engine capacity 51–125 cubic centimetres), while the comparison groups consisted of riders of heavy motorcycles (engine capacity > 125 cc), mopeds (engine capacity ≤ 50 cc) or cars who were injured in a collision within the city limits. The “intervention” was a law passed in October 2004 allowing car drivers to drive light motorcycles without taking a special driving test. To detect and quantify changes over time we used Poisson regression, with adjustments for trend and seasonality in road injuries and the existence of a driver’s licence penalty point system.

Findings

The risk of injury among light motorcycle riders was greater after the law than before (relative risk, RR = 1.46; 95% confidence interval, CI: 1.34–1.60). Although less markedly, after the law the risk of injury also increased among heavy motorcycle drivers (RR = 1.15; 95% CI: 1.02–1.29) but remained unchanged among riders of mopeds (RR = 0.92; 95% CI: 0.83–1.01) and cars (RR = 1.06; 95% CI: 0.97–1.16).

Conclusion

Allowing car drivers to drive motorcycles without passing a special test increases the number of road injuries from motorcycle accidents.     

Long-term voluntary exercise, representing habitual exercise, lowers visceral fat and alters plasma amino acid levels in mice

Objectives

To determine the impact of long-term voluntary exercise, representing habitual exercise for the prevention of lifestyle-related diseases, on glucose, lipid, and amino acid metabolism in mice.

Methods

Twenty-four mice aged 6 weeks were divided into three groups. Two groups (16 mice) were housed individually in either cages equipped with a running wheel (8 mice, exercising, Ex-mice) or without (8 mice, sedentary, Se-mice) for 24 weeks. The remaining group (8 mice) was sacrificed at 6 weeks of age. Biomarkers related to glucose, lipid, and amino acid metabolism were examined.

Results

Ex-mice ran voluntarily, predominantly in the dark. The distance per day peaked at 4 weeks and then decreased until 12 weeks to around the level seen at the beginning of the experimental period, and was maintained at 4.9 ± 0.2 km/day from 12 to 24 weeks. Ex-mice showed a similar adrenal weight and vitamin C content to Se-mice but had a significantly lower body weight and higher food intake. Ex-mice also showed a higher skeletal muscle weight, a lower white adipose tissue and liver weight, associated with lower plasma leptin and insulin-like growth factor-1 levels, and a lower hepatic triglyceride content. Analysis of plasma amino acids showed that Ex-mice had significantly higher phenylalanine, tyrosine, and glutamine levels, resulting in a significantly lower Fischer’s ratio.

Conclusions

We present an animal model of long-term voluntary exercise under low stress. Findings related to the effects of long-term voluntary exercise on lipid, and amino acid metabolism in our mouse model indicate that such an exercise regimen may affect pathophysiological states related to appetite and behavior.     

Mortality and health among internally displaced persons in western Kenya following post-election violence, 2008: novel use of demographic surveillance

Objective

To evaluate mortality and morbidity among internally displaced persons (IDPs) who relocated in a demographic surveillance system (DSS) area in western Kenya following post-election violence.

Methods

In 2007, 204 000 individuals lived in the DSS area, where field workers visit households every 4 months to record migrations, births and deaths. We collected data on admissions among children < 5 years of age in the district hospital and developed special questionnaires to record information on IDPs. Mortality, migration and hospitalization rates among IDPs and regular DSS residents were compared, and verbal autopsies were performed for deaths.

Findings

Between December 2007 and May 2008, 16 428 IDPs migrated into the DSS, and over half of them stayed 6 months or longer. In 2008, IDPs aged 15–49 years died at higher rates than regular residents of the DSS (relative risk, RR: 1.34; 95% confidence interval, CI: 1.004–1.80). A greater percentage of deaths from human immunodeficiency virus (HIV) infection occurred among IDPs aged ≥ 5 years (53%) than among regular DSS residents (25–29%) (P < 0.001). Internally displaced children < 5 years of age did not die at higher rates than resident children but were hospitalized at higher rates (RR: 2.95; 95% CI: 2.44–3.58).

Conclusion

HIV-infected internally displaced adults in conflict-ridden parts of Africa are at increased risk of HIV-related death. Relief efforts should extend to IDPs who have relocated outside IDP camps, particularly if afflicted with HIV infection or other chronic conditions.     

Association of TNF-α 308?G/A Polymorphism With Type 2 Diabetes: A Case–Control Study in the Iranian Kurdish Ethnic Group

Objectives

Tumor necrosis factor-α (TNF-α) plays roles in the development of obesity, insulin resistance, and possibility of Type 2 diabetes mellitus (T2DM). The objective of the current study was to evaluate the association of TNF-α promoter−308 G/A polymorphism with T2DM.

Methods

In all, 1038 patients with T2DM and 1023 normoglycemic controls were included in this study. All participants were genotyped using the polymerase chain reaction-restriction fragment length polymorphism method. Genotypic and allelic frequencies were then analyzed in each group. Serum lipids, fasting glucose, fasting serum insulin, homeostatic model assessment of insulin resistance, and hemoglogin A1c levels were determined by conventional methods.

Results

The allelic frequency of the A allele was significantly different between case and control participants (p = 0.006). Genotypes GA and AA were found to be significantly associated with 2.24- and 3.18-fold increased risk for T2DM, respectively. Similarly, the dominant model of -308 G/A polymorphism was found to have a higher risk for T2DM (odds ratio = 2.34, p = 0.001). Individuals with T2DM carrying the GA + AA genotypes of -308 G/A variation had significantly lower fasting plasma insulin than those carrying GG genotype.

Conclusion

Our findings revealed that there is an association between the TNF-α promoter -308 G/A polymorphism and T2DM in this population.     

Ivermectin versus benzyl benzoate applied once or twice to treat human scabies in Dakar, Senegal: a randomized controlled trial

Objective

To compare the effectiveness of oral ivermectin (IV) and two different modalities of topical benzyl benzoate (BB) for treating scabies in a community setting.

Methods

The trial included patients aged 5–65 years with scabies who attended the dermatology department at the Institut d’Hygiène Sociale in Dakar, Senegal. The randomized, open trial considered three treatments: a single application of 12.5% BB over 24 hours (BB1 group), two applications of BB, each over 24 hours (BB2 group), and oral IV, 150–200 µg/kg (IV group). The primary endpoint was the disappearance of skin lesions and itching at day 14. If necessary, treatment was repeated and patients were evaluated until cured. Results were analysed on an intention-to-treat basis. A pre-planned intermediate analysis was carried out after the BB1, BB2 and IV groups had recruited 68, 48 and 65 patients, respectively.

Findings

At day 14, 33 patients (68.8%) in the BB2 group were cured versus 37 (54.4%) in the BB1 group and 16 (24.6%) in the IV group (P < 10^–6). Bacterial superinfection occurred more often in the IV group than in the BB1 and BB2 groups combined (28% versus 7.8%, respectively; P = 0.006). At day 28, 46 patients (95.8%) in the BB2 group were cured versus 52 (76.5%) in the BB1 group and 28 (43.1%) in the IV group (P < 10^–5). These clear findings prompted early study cessation.

Conclusion

Topical BB was clearly more effective than oral IV for treating scabies in a Senegalese community.     

Arsenic speciation analysis of urine samples from individuals living in an arsenic-contaminated area in Bangladesh

Objectives

Chronic inorganic arsenic (iAs) exposure currently affects tens of millions of people worldwide. To accurately determine the proportion of urinary arsenic metabolites in residents continuously exposed to iAs, we performed arsenic speciation analysis of the urine of these individuals and determined whether a correlation exists between the concentration of iAs in drinking water and the urinary arsenic species content.

Methods

The subjects were 165 married couples who had lived in the Pabna District in Bangladesh for more than 5 years. Arsenic species were measured using high-performance liquid chromatography and inductively coupled plasma mass spectrometry.

Results

The median iAs concentration in drinking water was 55 μgAs/L (range <0.5–332 μgAs/L). Speciation analysis revealed the presence of arsenite, arsenate, monomethylarsonic acid (MMA), and dimethylarsinic acid in urine samples with medians (range) of 16.8 (7.7–32.3), 1.8 (<0.5–3.3), 13.7 (5.6–25.0), and 88.6 μgAs/L (47.9–153.4 μgAs/L), respectively. No arsenobetaine or arsenocholine was detected. The concentrations of the 4 urinary arsenic species were significantly and linearly related to each other. The urinary concentrations of total arsenic and each species were significantly correlated with the iAs concentration of drinking water.

Conclusions

All urinary arsenic species are well correlated with each other and with iAs in drinking water. The most significant linear relationship existed between the iAs concentration in drinking water and urinary iAs + MMA concentration. From these results, combined with the effects of seafood ingestion, the best biomarker of iAs exposure is urinary iAs + MMA concentration.     

Ambulatory Surgery Centers and Their Intended Effects on Outpatient Surgery

Objectives

To assess the impact of ambulatory surgery centers (ASCs) on rates of hospital-based outpatient procedures and adverse events.

Data Sources

Twenty percent national sample of Medicare beneficiaries.

Study Design

A retrospective study of beneficiaries undergoing outpatient surgery between 2001 and 2010. Health care markets were sorted into three groups—those with ASCs, those without ASCs, and those where one opened for the first time. Generalized linear mixed models were used to assess the impact of ASC opening on rates of hospital-based outpatient surgery, perioperative mortality, and hospital admission.

Principal Findings

Adjusted hospital-based outpatient surgery rates declined by 7 percent, or from 2,333 to 2,163 procedures per 10,000 beneficiaries, in markets where an ASC opened for the first time (p < .001 for test between slopes). Within these markets, procedure use at ASCs outpaced the decline observed in the hospital setting. Perioperative mortality and admission rates remained flat after ASC opening (both p > .4 for test between slopes).

Conclusions

The opening of an ASC in a Hospital Service Area resulted in a decline in hospital-based outpatient surgery without increasing mortality or admission. In markets where facilities opened, procedure growth at ASCs was greater than the decline in outpatient surgery use at their respective hospitals.     

Effects of Fenugreek Seed Extract and Swimming Endurance Training on Plasma Glucose and Cardiac Antioxidant Enzymes Activity in Streptozotocin-induced Diabetic Rats

Objective

Diabetes mellitus is a group of metabolic diseases characterized by chronic hyperglycemia condition resulting from defective insulin secretion or resistance insulin action, or both. The purpose of this study was to evaluate the effect of 6 weeks swimming training and Trigonella foenum-graecum seed (fenugreek) extract, alone and in combination, on plasma glucose and cardiac antioxidant enzyme activity of streptozotocin-induced diabetic rats.

Methods

Fifty male Wistar rats were divided into five groups: diabetic control (DC, n = 8); healthy control (HC, n = 11); swimming training (S, n = 11); swimming training + fenugreek seed extract (1.74 g/kg body weight; SF1, n = 11); and swimming training + fenugreek seed extract (0.87 g/kg body weight; SF2, n = 9). Streptozotocin was used for the induction of diabetes. Results were analyzed using one-way analysis of variance followed by Tukey test.

Results

In comparison with the DC group, all groups exhibited a significant decrease in body weight (p < 0.05), except for the HC group. SF1 and HC groups showed significant decreases in plasma glucose levels compared with the DC group (p < 0.05). S, SF1, SF2, and HC groups showed significant elevations in cardiac antioxidant enzymes activity in comparison with the DC group.

Conclusion

The results indicated that the combination of endurance swimming training and fenugreek seed extract can significantly reduce the plasma glucose levels and increase cardiac antioxidant enzymes activity in diabetic rats. Our findings suggest that this combination could be useful for the treatment of hyperglycemia and cardiac oxidative stress induced by diabetes mellitus.     

Mid-upper arm circumference at age of routine infant vaccination to identify infants at elevated risk of death: a retrospective cohort study in the Gambia

Objective

To determine the predictive value for death before 12 months of age of mid-upper arm circumference (MUAC) and weight-for-length Z score (WFLz).

Methods

A retrospective cohort analysis of infants living in Keneba, in rural Gambia, was conducted. Anthropometric measures were obtained from demographic surveillance system records for infants registered between February 1974 and July 2008 who had had MUAC and WFLz recorded at 6–14 weeks of age and vital status recorded at least once more. Hazard ratios (HRs), population attributable fractions and areas under receiver operating characteristic (ROC) curves were estimated to assess the predictive value for death in infancy of MUAC and WFLz.

Findings

Of 2876 infants included in the analysis, 40 died before the age of 12 months. The HR for death in this group versus in well-nourished infants was 5.8 (95% confidence interval, CI: 1.6–21) for a WFLz < −3. HRs for MUACs below the thresholds of 115 mm, 110 mm and 105 mm were 4.5 (95% CI: 1.4–15), 9.5 (95% CI: 2.6–35) and 23 (95% CI: 4.2–122), respectively. The attributable fractions for a MUAC < 130 mm and a WFLz < 0 were 51% and 13%, respectively. The areas under the ROC curve for death in infancy were 0.55 (95% CI: 0.46 to 0.64) for WFLz and 0.64 (95% CI: 0.55 to 0.73) for MUAC.

Conclusion

Among infants aged 6 to 14 weeks, unadjusted MUAC showed good performance in identifying infants at increased risk of death.     

Association Between Serum Vitamin D and Metabolic Risk Factors in Korean Schoolgirls

Objectives

Vitamin D, a key regulator of bone metabolism, has been recently been linked with energy homeostasis and metabolic disorders in western countries. However, few studies have focused on the association of vitamin D with metabolic risk factors among Asian children. We studied the prevalence of vitamin D insufficiency and the association of 25-hydroxyvitamin D [25(OH)D] with metabolic risk factors in Korean schoolgirls.

Methods

The sample consisted of 320 13-year-old girls recruited from two middle schools in the city of Gwacheon, Korea (latitude 37°N), in July 2011. Anthropometric and blood biochemistry data were obtained for this cross-sectional observational study. We also obtained lifestyle data from questionnaires and dietary data from 3-day food diaries.

Results

Vitamin D deficiency [25(OH)D < 20 ng/mL] was noted in 63.8% of participants. The mean 25(OH)D level was not significantly lower in the overweight group. Level of physical activity and vitamin D intake did not significantly affect 25(OH)D. However, 25(OH)D levels were positively correlated with milk intake and negatively correlated with soft drink intake. Serum 25(OH)D had a negative relationship with fasting glucose and insulin resistance index (homeostasis model assessment-insulin resistance; HOMA-IR) after adjustment for physical activity and body mass index z score (r = −0.144, p = 0.015), and with metabolic risk score similarly (r = −0.141, p = 0.012). Levels of insulin, HOMA-IR, and systolic blood pressure were higher in girls with deficient 25(OH)D levels than in those with sufficient levels.

Conclusion

We found that low 25(OH)D levels were associated with higher blood glucose and insulin resistance. Korean girls with low 25(OH)D levels could be at increased risk for metabolic disorders.     

Assessment of training effects on autonomic modulation of the cardiovascular system in mature rats using power spectral analysis of heart rate variability

Objective

To clarify the effects of forced or voluntary exercise on autonomic modulation of the cardiovascular system, we monitored changes in autonomic nervous activity in a mature rat by spectral analysis of the heart rate (HR) during a 10-week training period.

Methods

Male Wistar rats implanted with a radio-telemetry system were divided into three groups at 18 weeks of age: (1) Control group (n = 8); (2) Voluntary group (n = 6), which were housed separately in a cage with a running wheel; (3) Forced group (n = 6), which were exercised on a treadmill (35 m/min, 15 min/day, 5 days/week). The electrocardiogram was analyzed by the maximum entropy method into two main oscillations, low-frequency (LF) and high-frequency (HF) oscillations, respectively. LF and HF are considered to be markers of both sympathetic and parasympathetic modulations and parasympathetic modulation, respectively.

Results

Average running distances of the Voluntary group were more than twofold higher than those of the Forced group. HR levels in the Forced group were lower than those in the Control group. LF and HF levels in the Control and the Forced groups were almost the same during the experiment, and those in the Voluntary group showed a tendency to decrease.

Conclusion

The results in the Voluntary and the Forced groups suggest that cardiovascular adjustments are not simply caused by the quantity of exercise. In the Voluntary group, both sympathetic and parasympathetic activity may decrease with a predominance of sympathetic activity. Conversely, in the Forced group, the baroreflex may be hyper-activated by the undesired treadmill running and handling stress.     

A revised method for determination of dialkylphosphate levels in human urine by solid-phase extraction and liquid chromatography with tandem mass spectrometry: application to human urine samples from Japanese children

Objectives

Biological monitoring of organophosphorus insecticide (OP) metabolites, specifically dialkylphosphates (DAP) in urine, plays a key role in low-level exposure assessment of OP in individuals. The aims of this study are to develop a simple and sensitive method for determining four urinary DAPs using high-performance liquid chromatography with tandem mass spectrometry (LC–MS/MS), and to assess the concentration range of urinary DAP in Japanese children.

Methods

Deuterium-labeled DAPs were used as internal standards. Urinary dimethylphosphate (DMP) and diethylphosphate (DEP), which passed through the solid-phase extraction (SPE) column, and dimethylthiophosphate (DMTP) and diethylthiophosphate (DETP), which were extracted from a SPE column using 2.5 % NH₃ water including 50 % acetonitrile, were prepared for separation analysis. The samples were then injected into LC–MS/MS. The optimized method was applied to spot urine samples from 3-year-old children (109 males and 116 females) living in Aichi Prefecture in Japan.

Results

Results from the validation study demonstrated good within- and between-run precisions (<10.7 %) with low detection limits (0.4 for DMP and DMTP, 0.2 for DEP and 0.1 μg/L for DETP). The geometric mean values and detection rates of the urinary DAPs in Japanese children were 14.4 μg/L and 100 % for DMP, 5.3 μg/L and 98 % for DMTP, 5.5 μg/L and 99 % for DEP, and 0.6 μg/L and 80 % for DETP, respectively.

Conclusions

The present high-throughput method is simple and reliable, and can thereby further contribute to development of an exposure assessment of OP. The present study is the first to reveal the DAP concentrations in young Japanese children.     

Simultaneous changes in high-fat and high-cholesterol diet-induced steatohepatitis and severe fibrosis and those underlying molecular mechanisms in novel SHRSP5/Dmcr rat

Objectives

The aim of this study was to identify the molecular mechanisms underlying high-fat and high-cholesterol (HFC) diet-induced steatohepatitis and associated liver fibrosis progression in a novel stroke-prone, spontaneously hypertensive 5/Dmcr (SHRSP5/Dmcr) rat model.

Methods

SHRSP5/Dmcr rats were given the control or HFC-diet for 2, 8, and 16 weeks. Plasma and hepatic gene expression of key molecules involved in fatty acid oxidation, inflammation, oxidative stress, and fibrosis were subsequently analyzed.

Results

Rats fed the HFC-diet showed increased plasma tumor necrosis factor-α (TNF-α) and hepatic p50/p65 signals, but reduced hepatic Cu²⁺/Zn²⁺-superoxide dismutase across the treatment period and reduced plasma total adiponectin at 8 weeks. In HFC-diet-fed rats, transforming growth factor-β1 (TGF-β1) was elevated prior to the appearance of obvious liver fibrosis pathology at 2 weeks, followed by elevations in platelet-derived growth factor-B (PDGF-B) and α-smooth muscle actin (α-SMA), corresponding to evident liver fibrosis, at 8 weeks and by α₁ type I collagen production at 16 weeks. The HFC-diet increased hepatic total cholesterol accumulation, although hepatic triglyceride declined by 0.3-fold from 2 to 16 weeks due to reduced hepatic triglyceride synthesis, as suggested by the diacylglycerol acyltransferase 1 and 2 measurements.

Conclusions

TNF-α and p50/p65 molecular signals appeared to be major factors for HFC-diet-induced hepatic inflammation and oxidative stress facilitating liver disease progression. While the up-regulation of TGF-β1 prior to the appearance of any evident liver fibrosis could be an early signal for progressive liver fibrosis, elevated PDGF-B and α-SMA levels signified evident liver fibrosis at 8 weeks, and subsequent increased α₁ type I collagen production and reduced triglyceride synthesis indicated extensive liver fibrosis at 16 weeks in this novel SHRSP5/Dmcr model.

Electronic supplementary material

The online version of this article (doi:10.1007/s12199-012-0273-y) contains supplementary material, which is available to authorized users.     

Adult mortality and antiretroviral treatment roll-out in rural KwaZulu-Natal, South Africa

Objective

To investigate trends in adult mortality in a population serviced by a public-sector antiretroviral therapy (ART) programme in rural South Africa using a demographic surveillance system.

Methods

Verbal autopsies were conducted for all 7930 deaths observed between January 2000 and December 2006 in a demographic surveillance population of 74 500 in the Umkhanyakude district of northern KwaZulu-Natal province, South Africa. Age-standardized mortality rate ratios (SMRRs) were calculated for adults aged 25 to 49 years, the group most affected by HIV, for the 2 years before 2004 and the 3 subsequent years, during which ART had been available.

Findings

Between 2002–2003 (the period before ART) and 2004–2006 (the period after ART), HIV-related age-standardized mortality declined significantly, from 22.52 to 17.58 per 1000 person-years in women 25–49 years of age (P < 0.001; SMRR: 0.780; 95% confidence interval, CI: 0.691–0.881), and from 26.46 to 18.68 per 1000 person-years in men 25–49 years of age (P < 0.001; SMRR: 0.706; 95% CI: 0.615–0.811). On sensitivity analysis the results were robust to the possible effect of misclassification of HIV-related deaths.

Conclusion

Overall population mortality and HIV-related adult mortality declined significantly following ART roll-out in a community with a high prevalence of HIV infection. A clear public health message of the benefits of treatment, as revealed by these findings, should be part of a multi-faceted strategy to encourage people to find out their HIV serostatus and seek care.     

Assessment of Antisecretory,Gastroprotective, and In-vitro Antacid Potential of Daucus carota in Experimental Rats

Objectives

In Indo China, carrots have been reported to regulate the functions of the stomach and intestines. The objective of the present investigation was to unravel the therapeutic potential of 50% ethanol extract from Daucus carota roots (EDC) on antisecretory, gastroprotective, and in vitro antacid capacity using experimental rats.

Methods

Assessment of EDC antisecretory and in vivo antacid capacities was carried out using a pyloric ligation induced ulcer model. The gastroprotective effect was assessed with an absolute ethanol induced ulcer model. The integrity of gastric mucosa was evaluated using the estimation of glutathione and gastric mucus level and with histopathological examination of gastric mucosal cells. The in-vitro antacid capacity was evaluated using a titration method. The effect of the extract on the liver was assessed by measuring serum biochemical parameters.

Results

The EDC significantly (p < 0.01–0.001) reduced gastric lesions in both models. Furthermore, the EDC also significantly (p < 0.05–0.001) reduced the volume of gastric content whereas the total acidity was significantly (p < 0.05–0.001) reduced with the doses of 100 mg/kg and 200 mg/kg EDC. Moreover, the mucus content and glutathione level increased significantly (p < 0.05) in the absolute alcohol-induced ulcer. The EDC also showed in-vitro antacid capacity. Histopathological studies further confirmed the potential of EDC by inhibiting congestion, edema, hemorrhage, and necrosis in gastric mucosa.

Conclusion

The EDC exerted antisecretory, gastroprotective, and in vitro antacid potential. These activities could be attributed due to the presence of glycosides, phenolics, tannins, alkaloids, and flavonoids.     

Changes in mental health and quality of life with dental implants as evaluated by General Health Questionnaire (GHQ) and Health Utilities Index (HUI)

Objectives

The purpose of this study was to assess and compare the improvement in oral and systemic conditions and health-related quality of life in patients with missing teeth receiving dental implants and conventional treatment.

Methods

A total of 97 patients with missing teeth, of whom 59 received dental implants and 38 received conventional treatment, were included in this study. The patients were divided into two age groups for a more detailed analysis: a 30- to 59-year age group (young) and a >60-year age group. The changes in oral condition, mental health, and health utility level before and after (pre- and post-, respectively) the procedures were assessed using an original questionnaire, the General Health Questionnaire 12 (GHQ12), and Health Utilities Index Mark 3.

Results

Responses to the GHQ12 indicated that treatment with implants significantly improved the oral health of patients in all treatment groups, except for the young group receiving partial dentures (PD). The mental state improved with a lower GHQ score; in terms of pre- versus post-procedure, mental state improved after the procedure in the young group receiving full dentures (FD) (1.75 ± 2.12 vs. 0.88 ± 2.10, p < 0.05), in the old group receiving PD (2.61 ± 3.91 vs. 0.72 ± 1.71, p < 0.05), and in the old group receiving FD (2.63 ± 3.12 vs. 0.44 ± 0.27, p < 0.05). The sleep score also improved by implant in FD of the old group (2.00 vs. 1.00, p < 0.05); it also is better with a lower score.

Conclusions

Recovery of oral function and oral stability in middle-aged people who did not receive implants was possible with PD. However, the results suggest that implant treatment in edentulous denture cases and particularly in elderly people with dentures has a certain efficacy on the physical condition mediated through an improvement in aspects of the mental state.