Prevalence of Giardia intestinalis and Hymenolepis nana in Afghan refugee population of Mianwali district,Pakistan

Background

Present study aimed to investigate prevalence of Giardia intestinalis and Hymenolepis nana in Afghan refugees visiting Central Health Unit (CHU), Kot Chandana (Mianwali, Northern Punjab) during two years period (February 2007 to December 2009).

Methods

A total of 687 stool samples were collected from different age groups of both genders. Samples were processed under sterile conditions after gross examination. Microscopic examination was done on same day along with eggs (H. nana), cyst and trophozoites (G. intestinalis) detection after staining.

Results

The prevalence of G. intestinalis was significantly higher (x2=59.54, p<0.001) than that of H. nana. Females were found more likely to be infected as compared to males (OR: 1.40, 95% CI=1.03–1.92). Prevalence of both parasites decreased with age and highest prevalence was observed in young individuals belonging to 1–15 years of age group (41.8% and 48.7% respectively for H. nana and G. intestinalis, p<0.001). Abdominal distress (OR: 1.13, 95%CI=0.83–1.53), vomiting (OR: 1.13, 95%CI=1.13–1.81) and rectal prolapse (OR: 4.26, 95%CI=1.38–13.16) were the gastro-intestinal clinical symptoms observed in G. intestinalis. Whereas, bloody diarrhea (OR: 1.56, 95%CI=1.00–2.43) and rectal prolapse (OR: 5.79, 95%CI=1.87–17.91) were associated with H. nana infections.

Conclusions

Intestinal parasitic infections are common among Afghan refugees and serious preventive measures should be implemented to promote the safety and healthy lifestyle of these people.     

Magnetic resonance imaging in the evaluation of iron overload: a comparison of MRI, echocardiography and serum ferritin level in patients with β-thalassemia major

PurposeThis study aimed to evaluate iron levels in cardiac and hepatic tissues using magnetic resonance imaging (MRI) T2?.MethodsCardiac and hepatic MRI was performed for 93 patients with β-thalassemia major.ResultsCardiac T2? was in the range of 2.9–56.6 ms. Myocardial siderosis was detected in 44% of patients; 25 patients had moderate and severe siderosis with serum ferritin level (SFL) of 576–10,284 ng/ml. There was a significant correlation between SFL and cardiac T2? (p<.001).ConclusionsThe effective role of MRI as a noninvasive producible method in measurement of iron concentration in tissues is not accessible with conventional techniques.     

Effects of aspirin on N-alpha-tosyl L-arginine methyl ester [TAME]-esterase induced contractions on rat aorta in vitro

The present study was designed to investigate whether N-alpha-tosyl L-arginine methyl ester [TAME]-esterase activation could be the result of endothelial dysfunction. Thoracic aorta from rats was mounted in an organ bath containing Krebs solution. Intact and endothelium denuded aortic strips were challenged with different concentrations of TAME (10(-15)-10(-1) m). The effects of aspirin, a cyclo-oxygenase pathway inhibitor, were also studied on [TAME]-esterase induced contraction on rat aorta strips. Our results showed that aspirin definitely blocked TAME-esterase induced contractions on rat aortic strips. In conclusion, the present work supported the hypothesis that [TAME]-esterase induced contraction in rat aorta in vitro was mediated through release of prostaglandin(s) as a result of endothelial dysfunction.     

Impact of specific allergen sensitization on the prevalence of asthma in patients with allergic rhinitis from adjacent distinct geographic areas

BACKGROUND: Patients with allergic rhinitis (AR) and perennial allergen sensitization are at increased risk for asthma. OBJECTIVES: To determine the allergic profile of patients with clinical AR in regions of the coastal Mediterranean compared with the inland southern desert area of Israel and the impact of specific allergen sensitization on the prevalence of asthma in these patients. METHODS: Retrospective evaluation of medical records from patients referred for evaluation during 2002 and 2003 to the allergy clinics of 3 medical centers located in different geoclimatic areas. RESULTS: A total of 479 patients with AR were included (64% from the humid Mediterranean coast and 36% from the arid desert area), with a mean age of 32.8 years (range, 6-84 years). Sixty percent of the patients were male, and 33% had an additional diagnosis of asthma. Mite sensitization was 84%; cockroach, 34%; trees, 43%; weeds, 40%; grasses, 53%; and fungi, 30%. There were no significant differences in the prevalence of sensitization to any of the evaluated allergens except for weeds, which was higher in the arid region. A diagnosis of asthma was significantly associated with mite sensitization in the Mediterranean area (odds ratio, 2.24; 95% confidence interval, 1.14-4.4; P = .02) and mold sensitization in the arid climate zone (odds ratio, 2.18; 95% confidence interval, 1.05-4.6; P = .04). CONCLUSION: Although sensitization to mites is high in the coastal areas and in the Negev desert-like environment, the presence of asthma in patients with AR is associated with mite sensitization in the humid environment but with fungal sensitization in the more arid environment.     

The GLA:D BACK self-management adherence and competence checklist (SMAC Checklist)—Development,content validity and feasibility

Objectives

To unpack the complexity and impact of self-management interventions targeting musculoskeletal health conditions, we need to learn more about treatment delivery in clinical settings. Fidelity evaluation can illuminate how complex treatments are delivered and help understand the elements that lead to the effect. The objective of this study was to develop a checklist for the evaluation of the clinicians’ delivery of structured patient education and exercise intervention for people with persistent back pain, the GLA:D Back intervention. The intent was to provide a checklist adaptable for the general delivery of self-management interventions for musculoskeletal pain.

Methods

We derived items for the treatment delivery fidelity checklist from behaviour change techniques and theory about communication style. We applied a three-step developmental process covering developing a preliminary fidelity intervention framework, validating checklist content and piloting and refining the checklist.

Results

We developed the adaptable fidelity checklist, The GLA:D BACK Self-management Adherence and Competence Checklist (SMAC Checklist). Evaluation of clinical practice using the checklist was feasible and acceptable by clinicians. Preliminary results indicate satisfactory observer agreement during pilot testing of the checklist.

Conclusion

The GLA:D BACK Self-management Adherence and Competence Checklist is a fidelity measurement tool for the assessment of the delivery of a self-management supportive intervention for people with persistent back pain. The intention is that it can be useful as an adaptable tool for use across self-management interventions for musculoskeletal pain.     

Epidemiology of rheumatic diseases: a cohort of 23,550 patients in rheumatology clinics in Burkina Faso

Clinical Rheumatology - The aim of this work is to study the epidemiological characteristics of rheumatic conditions in a cohort of 23,550 patients followed up in Ouagadougou, Burkina Faso. This...