Transverse Ultrasound Assessment of Median Nerve Deformation and Displacement in the Human Carpal Tunnel during Wrist Movements

The symptoms of carpal tunnel syndrome, a compression neuropathy of the median nerve at the wrist, are aggravated by wrist motion, but the effect of these motions on median nerve motion are unknown. To better understand the biomechanics of the abnormal nerve, it is first necessary to understand normal nerve movement. The purpose of this study was to evaluate the deformation and displacement of the normal median nerve at the proximal carpal tunnel level on transverse ultrasound images during different wrist movements, to have a baseline for comparison with abnormal movements. Dynamic ultrasound images of both wrists of 10 asymptomatic volunteers were obtained during wrist maximal flexion, extension and ulnar deviation. To simplify the analysis, the initial and final shape and position of the median nerve were measured and analyzed. The circularity of the median nerve was significantly increased and the aspect ratio and perimeter were significantly decreased in the final image compared with the first image during wrist flexion with finger extension, wrist flexion with finger flexion and wrist ulnar deviation with finger extension (p < 0.01). There were significant differences in median nerve displacement vector between finger flexion, wrist flexion with finger extension and wrist ulnar deviation with finger extension (all p's < 0.001). The mean amplitudes of median nerve motion in wrist flexion with finger extension (2.36 ± 0.79 normalized units [NU]), wrist flexion with finger flexion (2.46 ± 0.84 NU) and wrist ulnar deviation with finger extension (2.86 ± 0.51 NU) were higher than those in finger flexion (0.82 ± 0.33 NU), wrist extension with finger extension (0.77 ± 0.46 NU) and wrist extension with finger flexion (0.81 ± 0.58 NU) (p < 0.0001). In the normal carpal tunnel, wrist flexion and ulnar deviation could induce significant transverse displacement and deformation of the median nerve.     

Women's empowerment and fertility preferences of married women: analysis of demographic and health survey’2016 in Timor-Leste

A recently independent state, Timor-Leste, is progressing towards socioeconomic development, prioritizing women empowerment while its increased fertility rate (4.1) could hinder the growth due to an uncontrolled population. Currently, limited evidence shows that indicators of women''s empowerment are associated with fertility preferences and rates. The objective of this study was to assess the association between women empowerment and fertility preferences of married women aged 15 to 49 years in Timor-Leste using nationally representative survey data. The study was conducted using the data of the latest Timor-Leste Demographic and Health Survey 2016. The study included 4040 rural residents and 1810 urban residents of Timor-Leste. Multinomial logistic regression has been performed to assess the strength of association between the exposures indicating women''s empowerment and outcome (fertility preference). After adjusting the selected covariates, the findings showed that exposures that indicate women empowerment in DHS, namely, the employment status of women, house and land ownership, ownership of the mobile phone, and independent bank account status, contraceptive use, and the attitude of women towards negotiating sexual relations are significantly associated with fertility preferences. The study shows higher the level of education, the less likely were the women to want more children, and unemployed women were with a higher number of children. Our study also found that the attitude of violence of spouses significantly influenced women''s reproductive choice. However, employment had no significant correlation with decision-making opportunities and contraceptive selection due to a lack of substantial data. Also, no meaningful data was available regarding decision-making and fertility preferences. Our findings suggest that women''s empowerment governs decision-making in fertility preferences, causing a decline in the fertility rate.     

Three dimensional distribution of Propionibacterium acnes biofilms in human skin

Propionibacterium acnes is regarded as a common member of the human skin microbiota, often occurring in biofilms. Little is known about the size of bacterial biofilms in hair follicles as a few sections of biopsy tissue are routinely evaluated. Transversal sectioning provides a better opportunity for histological analyses of hair follicles which can be followed through the different morphological levels. Direct visualization of P. acnes biofilms in hundreds of consecutive sections allowed insight into the 3D distribution in human hair follicles as well as investigating the depth of biofilm distribution within hair follicles. Four distinct colonization patterns of P. acnes biofilms were revealed. Results have shown that an individual P. acnes biofilm can spread for 1900 μm in a terminal hair follicle. This information can be of help while designing potential antibiofilm treatment.     

Ophthalmic masquerades of the atherosclerotic carotids

Patients with carotid atherosclerosis can present with ophthalmic symptoms. These symptoms and signs can be due to retinal emboli, hypoperfusion of the retina and choroid, opening up of collateral channels, or chronic hypoperfusion of the globe (ocular ischemic syndrome). These pathological mechanisms can produce many interesting signs and a careful history can bring out important past symptoms pointing toward the carotid as the source of the patient''s presenting symptom. Such patients are at high risk for an ischemic stroke, especially in the subsequent few days following their first acute symptom. It is important for clinicians to be familiar with these ophthalmic symptoms and signs caused by carotid atherosclerosis for making an early diagnosis and to take appropriate measures to prevent a stroke. This review elaborates the clinical features, importance, and implications of various ophthalmic symptoms and signs resulting from atherosclerotic carotid artery disease.     

Comparative study of clinical signs, haematology and prevalence of trypanosomiasis in Holstein Friesian and White Fulani Zebu cattle exposed to natural infection in a rain forest zone of Nigeria

A comparison of the symptomatology, haematology and prevalence of trypanosomiasis in Holstein Friesian and White Zebu cattle exposed to natural infections on a ranch in a rain forest zone of Nigeria is presented. 23 (44%) of the adult Friesians had trypanosome infections with a generally heavy parasitaemia. Infection was light in the Friesian calves and the Zebus with infection rates of 2 (6.9%) and 3 (15%) respectively. Trypanosoma vivax was the sole species encountered on the farm. There was a general unthrifty appearance in the adult Friesian herd as well as classical signs of trypanosomiasis. The Friesian calves and Zebus were generally in good conditions with an appearance of good health except one each of the infected animals which showed apparent symptoms of the disease. There was a marked reduction of the red cell values of the infected adult Friesian and Zebu cattle. The red cell values of the uninfected adult Friesians were equally depressed suggesting cryptic infections or that they were cured parasitologically by the recently administered trypanocide. The Friesian calves had normal red cell values for both the infected and uninfected. Leucocyte counts were generally high on the Farm and higher for the infected animals.     

The effects of insulin glargine treatment and an educational programme on glycaemic control in type 2 diabetes patients in clinical practice

OBJECTIVE: This retrospective analysis was performed to establish the effect of initiating insulin glargine (LANTUS; sanofi-aventis, Paris, France), a once-daily basal insulin analogue, in combination with an educational programme on glycaemic control and body weight in sub-optimally controlled patients with Type 2 diabetes in clinical practice. RESEARCH DESIGN AND METHODS: We undertook a retrospective review of the medical records of 46 patients (mean age 61.5 +/- 8.6 years) with Type 2 diabetes. These patients had previously been treated with oral antidiabetic agents (OADs; n = 18) or insulin only (n = 28) and had then received insulin glargine in combination with OADs or prandial insulin, for 30 months. Records of metabolic control and body weight data were analysed at 9 and 30 months. Patients had taken part in a diabetes educational programme before initiation of insulin glargine and received continued physician consultations throughout. RESULTS: Following initiation of insulin glargine, patients showed a significant decrease in HbA1c from 8.14 +/- 1.7% to 7.18 +/- 0.9% at 30 months (p < 0.001). When the results were analysed by pre-treatment, patients pre-treated with OADs showed a reduction in HbA1c of 2.3% at 30 months (p < 0.001), while patients pre-treated with insulin only showed a decrease in HbA1c of 0.4% (p < 0.005). There was no significant change in body weight. No unexpected adverse events or episodes of severe hypoglycaemia (blood glucose < 40 mg/dL [< 2.2 mmol/L]) occurred. CONCLUSIONS: Insulin glargine in combination with educational support and close clinical supervision significantly improved metabolic control without significant weight change in patients with Type 2 diabetes in clinical practice over 30 months. Additional studies are required to establish if similar results can be obtained in a larger cohort of patients.     

Testicular morphology and antispermatogenic effects of 2,4-dichlorophenoxyacetic acid (2,4-D) in male West African Dwarf (WAD) goats

This study investigated the testicular morphology as well as the gonadal and extra-gonadal sperm reserves of West African Dwarf (WAD) goats exposed to graded levels of 2,4-dichlorophenoxyacetic acid (2,4-D). Twenty male WAD goats of five goats per group were used for this study. Goats in groups A, B and C received low [75?mg/kg body weight (BW)], medium (100?mg/kg BW) and high (125?mg/kg BW) dose levels of 2,4-D, respectively. The group D goats served as the control. On day?112, goats in the four groups were sacrificed and the testicular and epididymal sperm reserves were determined. Histopathologic changes in the testis of the 2,4-D-exposed and control goats were also assessed. The mean number of spermatozoa in the testes and the various segments of the epididymides decreased significantly (p?<?0.05) in all the treatment groups relative to the control. Combined testicular sperm reserve per millilitre for the treatment groups (group A—19.61?±?2.63?×?10⁸, group B—12.02?±?1.02?×?10⁸ and group C—9.95?±?0.97?×?10⁸) reduced significantly (p?<?0.05) relative to the mean value (23.52?±?4.43?×?10⁸) of the control—group D. The total epididymal sperm reserve per millilitre in the treatment groups (group A—24.25?±?4.19?×?10⁸, group B—17.18?±?2.57?×?10⁸ and group C—17.88?±?2.89?×?10⁸) was also found to be significantly (p?<?0.05) lower than the mean value (40.85?±?11.24?×?10⁸) for the control—group D. This reduction in the testicular and epididymal sperm counts of the 2,4-D-exposed WAD goats in this study suggest disruption in spermatogenic activity, which may lead to low productivity. Variable degrees of circulatory disturbances were observed in the testis sections of 2,4-D-exposed goats.