Does a child's mid‐upper arm circumference‐for‐age z‐score represent another nutritional indicator of childhood malnutrition status?

Child wasting is defined as a weight‐for‐height/length z‐score (WLZ/WHZ) < −2, and this indicator of nutritional status is used worldwide. However, a precise measurement is required for the assessment of a child''s nutritional status, which may not always be possible due to expensive instruments, especially in poor resource settings. In some instances, mid‐upper arm circumference‐for‐age z‐score (MUACZ) is also being used for screening purposes, which is a simple and useful nutritional indicator. The objective of this paper is to identify the optimal cut‐off point for the MUACZ to identify wasted children, and also to determine if the same factors are associated with MUACZ and wasting. Data were derived from the Suchana evaluation data. The optimal cut‐off value was estimated via receiver operating characteristic (ROC) curve analysis using acute malnutrition as a gold standard with maximum sensitivity and specificity. Multiple logistic regression was used to assess the associated factors with the MUACZ. Using the gold standard indicator of nonwasting (WLZ ≥ −2), a positive outcome, the optimal cut‐off point for the MUACZ was −1.27. The area under the ROC curve was 0.88, indicating that the model had a power of 88% to differentiate between the positive and negative classes. It implies that a child''s MUACZ was correlated with WLZ, and a MUACZ below −1.27 appeared to accurately identify wasting among children aged 3–23 months. MUACZ < −1.27 might be another useful indicator of childhood wasting than a WLZ < −2.     

Use of jet ventilation in thoracoscopic tracheo‐esophageal fistula repair—can both surgeons and anesthesiologists be happy?

Laparoscopic and open thoracic surgery in the neonate typically results in hypercapnea and low cardiac output with often poor surgical visualization as the anesthesiologist attempts to correct the respiratory derangements usually seen. We describe three cases in which jet ventilation provided not only superior ventilation with a return to normocapnea but also ideal operating conditions. In addition, jet ventilation utilizes lower mean airway pressures which typically results in improved cardiac output.     

Vaginal fluid adenosine 3',5'-cyclic monophosphate (cAMP) in the rat: interaction with sperm cAMP-dependent protein kinase regulatory subunits

Cyclic AMP (adenosine 3',5'-cyclic monophosphate) concentrations were determined in rat vaginal fluids throughout the estrous cycle. Radioimmunoassay results demonstrated that estrus and early metestrus vaginal fluids had significantly (p less than 0.01) elevated cAMP concentrations compared to proestrus, late metestrus, and early and late diestrus. Ovariectomy reduced RIA-detectable cAMP in vaginal fluid. When cauda sperm were preincubated for 5 min with vaginal fluids from each stage of the estrous cycle, results demonstrated that only estrus- and early metestrus-stage vaginal fluids caused a decrease in [32P]-8N3cAMP (8-azido photoaffinity analogue of cAMP) photolabeling of sperm cAMP-dependent protein kinase regulatory subunits RI and RII. To examine if this reduction in [32P]-8N3cAMP photoincorporation by sperm RI and RII could be due to endogenous cAMP, vaginal fluids were boiled, trypsinized, and/or incubated with EGTA or phosphodiesterase. Only phosphodiesterase-treated vaginal fluids restored sperm regulatory subunit photoincorporation of [32P]-8N3cAMP. It is suggested that cAMP is present in rat vaginal fluids during the estrous cycle in a concentration sufficient to bind the regulatory subunits of rat sperm cAMP-dependent protein kinase.     

Perinatal outcome in relation to mode of delivery in meconium stained amniotic fluid

Meconium staining of the amniotic fluid is a common complication during labour. When facilities like electronic monitoring, foetal blood sampling are not available, it is difficult to decide whether labour should be allowed to continue or caesarean section should be done. Even when caesarean section is done, meconium aspiration syndrome (MAS) can still occur and considerable morbidity and mortality may result in the newborn. Amnioinfusion is being considered as useful in decreasing MAS and its sequelae. Before resorting to amnio infusion, we decided to analyse the perinatal outcome in meconium stained liquor to compare whether early caesarean section offered any advantage. This is a retrospective study of 150 labours complicated by thick meconium stained liquor, during a 12 month period (1992–93).     

Study of fungi and their toxigenic potential isolated from wheat and wheat bran

The present study was designed to investigate the fungi and their toxigenic potentials isolated from the wheat and wheat brans. A total of 67 samples of wheat and 17 samples of wheat bran were collected from Faisalabad district of Pakistan. Forty-five (67.16%) samples of wheat yielded fungi. Frequency distribution based on total samples, Aspergillus was the highest (44.77%) genus followed by Penicillium, Fusarium and Alternaria. Penicillium verucosum (30.64%) was the most frequently isolated species followed by A. niger aggregates, A. flavus, A. parasiticus, P. chrysogenum, A. ochraceous, A. carbonarius and A. fumigatus. Among Aspergilli, A. niger aggregates (46.67%) were most frequently isolated species. Out of 30 Aspergilli isolates from wheat samples, 17 (56.66%) were found toxigenic. AFB1 produced by aflatoxigenic Aspergilli varied from 1.44 to 836.3?ng/g, while ochratoxin A levels varied from 0.037 to 15 045?ng/g. Among Penicillium species, P. verrucosum (63.15%) were found ochratoxigenic and OTA levels were varied from 7.31 to 8400?ng/g. In wheat bran, 10 (58.82%) samples yielded fungi. Based upon total samples, frequency distribution of Aspergillus (35.28%) was the highest followed by Penicillium and Fusarium. Similar pattern was observed in relative density of isolates. A. niger aggregates and P. verrucosum were predominant species (23.07%) isolated from wheat bran. Among Aspergilli, A. niger aggregates (50%) were the most frequently isolated species followed by A. flavus, A. fumigatus and A. ochraceous (16.67%) each. The OTA levels of fungi isolated from wheat bran varies from 0.292 to 2500?ng/g. Isolation of toxigenic A. niger aggregates from wheat indicates that these species should be considered as possible contributors of OTA contamination in wheat and its by-products in Pakistan.     

Amelioration of immunosuppressive effects of aflatoxin and ochratoxin A in White Leghorn layers with distillery yeast sludge

The present study was carried out with the objectives to thrash immunotoxic effects of moldy feed in commercial White Leghorn layers and to know either addition of distillery yeast sludge (DYS) in moldy feed ameliorates the immunotoxic effects or not. For this purpose, moldy feed was prepared containing OTA and AFB1 56 and 136?μg/kg, respectively. For this purpose, 100, 40-week-old White Leghorn hens were procured and kept under standard management conditions. Birds were divided into five equal groups. Birds were kept on moldy feed (ochratoxin A: 56?μg/kg and aflatoxin B1: 136?μg/kg) mixed with 0%, 0.5%, 1% and 2% DYS/kg moldy feed. Group A served as control. Blood was collected without anticoagulant to separate serum. Serum ALT, creatinine and blood urea levels significantly increased in moldy-fed group as compared to control group, while nonsignificantly different readings of serum ALT, creatinine and blood urea were recorded in moldy feed?+?2% DYS and control group. Immune parameters, that is, lymphoproliferative response to PHA-P, phagocytic potential and total protein and IgG titers against sheep RBCs were significantly decreased in birds receiving moldy feed as compared to control group. Almost all parameters studied were normal compared to control group with the addition of 2% DYS in moldy feed, while 1% DYS partially ameliorated the immunotoxic effects of mycotoxins.     

Rare,Protein-Altering Variants in AS3MT and Arsenic Metabolism Efficiency: A Multi-Population Association Study

Background: Common genetic variation in the arsenic methyltransferase (AS3MT) gene region is known to be associated with arsenic metabolism efficiency (AME), measured as the percentage of dimethylarsinic acid (DMA%) in the urine. Rare, protein-altering variants in AS3MT could have even larger effects on AME, but their contribution to AME has not been investigated.Objectives: We estimated the impact of rare, protein-coding variation in AS3MT on AME using a multi-population approach to facilitate the discovery of population-specific and shared causal rare variants.Methods: We generated targeted DNA sequencing data for the coding regions of AS3MT for three arsenic-exposed cohorts with existing data on arsenic species measured in urine: Health Effects of Arsenic Longitudinal Study (HEALS, n=2,434), Strong Heart Study (SHS, n=868), and New Hampshire Skin Cancer Study (NHSCS, n=666). We assessed the collective effects of rare (allele frequency <1%), protein-altering AS3MT variants on DMA%, using multiple approaches, including a test of the association between rare allele carrier status (yes/no) and DMA% using linear regression (adjusted for common variants in 10q24.32 region, age, sex, and population structure).Results: We identified 23 carriers of rare-protein-altering AS3MT variant across all cohorts (13 in HEALS and 5 in both SHS and NHSCS), including 6 carriers of predicted loss-of-function variants. DMA% was 6–10% lower in carriers compared with noncarriers in HEALS [β=−9.4 (95% CI: −13.9, −4.8)], SHS [β=−6.9 (95% CI: −13.6, −0.2)], and NHSCS [β=−8.7 (95% CI: −15.6, −2.2)]. In meta-analyses across cohorts, DMA% was 8.7% lower in carriers [β=−8.7 (95% CI: −11.9, −5.4)].Discussion: Rare, protein-altering variants in AS3MT were associated with lower mean DMA%, an indicator of reduced AME. Although a small percentage of the population (0.5–0.7%) carry these variants, they are associated with a 6–10% decrease in DMA% that is consistent across multiple ancestral and environmental backgrounds. https://doi.org/10.1289/EHP8152     

An evaluation of OSOM BV blue test in the diagnosis of bacterial vaginosis

ObjectiveTo determine the prevalence of bacterial vaginosis (BV) in patients with vaginal discharge and evaluate the efficacy of OSOM BV blue test in diagnosis.MethodsOSOM BV blue test, a rapid diagnostic test based on the principle of detection of bacterial sialidase activity in vaginal fluid specimens was conducted. A total of 405 patients in the reproductive age group (15–45 years) having vaginal discharge were included in the study along with 10 healthy age-matched controls. Two high vaginal swabs were collected aseptically from each patient. One swab was used to make smear for gram staining, and the other was for OSOM BV blue test. Amine test and vaginal pH test were taken as well.ResultsThe prevalence of bacterial vaginosis was 60.7%. OSOM BV blue test showed good efficacy, as compared with gram staining in diagnosing BV. The sensitivity and specificity of OSOM BV blue test were 97.6% and 97.5% respectively. Amsel's criteria diagnosed 180 (44.4%) cases of BV and had sensitivity and specificity of 67.1% and 90.6% respectively. Thus the performance of OSOM BV blue was better than the methods based on Amsel's criteria.ConclusionsOSOM BV blue test is an efficacious bed side test, helpful in rapidly making an accurate diagnosis of BV in setups lacking laboratory facilities or expert microbiologists.