Influence of aerobic exercise on inhibitory control of executive functions in children with hemiplegic cerebral palsy: A randomized controlled trial

OBJECTIVE

This study investigates the influence of aerobic exercise training on inhibitory control of executive functions in children with hemiplegic cerebral palsy.

DESIGN

Single-blind randomized controlled trial.

SETTING

Outpatient Physical Therapy Clinic.

PARTICIPANTS

Children aged 7-11 with left-sided hemiplegic cerebral palsy with emotional and behavioral dysregulation evidenced by scores >28 on Paediatric Symptom Checklist and GMFCS I or II (n = 60).

INTERVENTION

Participants were randomly allocated into two equal groups. The control group received standard-of-care physical therapy for 1 h, and the aerobic exercise group received standard-of-care physical therapy for 30 min and moderate-intensity continuous exercise on a bicycle ergometer for 30 min. All groups received treatment three times a week for 12 weeks.

MAIN MEASURES

The Eriksen Flanker test and Stroop Color-Word test were used to assess inhibitory control of executive function at the baseline and after 12 weeks.

RESULTS

Differences between pre- and post-treatment values in the exercise group showed significant improvement in Flanker response accuracy and Stroop response accuracy (p = 0.001) and significant decreases in Flanker congruent reaction time and Stroop congruent reaction time (p < 0.05). However, there were no significant differences between both groups in Flanker incongruent reaction time and Stroop incongruent reaction time (p > 0.05).

CONCLUSIONS

Aerobic exercise has a promising effect on inhibitory control of executive function in children with left-sided hemiplegic cerebral palsy.

SARS-CoV-2 seroprevalence determination in pets and camels in Egypt using multispecies enzyme-linked immunosorbent assay

The coronavirus disease 2019 (COVID-19) pandemic has translated into a worldwide economic recession and public health crisis. Bats have been incriminated as the main natural host for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is the causative agent of the COVID-19 pandemic. However, the reservoir and carrier hosts of the virus remain unknown. Therefore, a cross sectional serosurvey study was performed to estimate antibodies to SARS-CoV-2. To assess IgM antibodies to SARS-CoV-2 nucleocapsid protein (NP), a SARS-CoV-2 Double Antigen Multispecies diagnostic enzyme-linked immunosorbent assay kit was used. The seropositive samples were confirmed and validated by measuring IgG antibody titers in sera. The enrolled animals were from different locations in the Giza governorate, Egypt, and were sampled at the time of the pandemic; they comprised 92 companion animals and 92 domestic camels. The study established that 4.76% (1/21 clinical samples) of dogs, 7.69% of cats (1/13 shelter samples) and 1.08% (1/92) of camels, had measurable SARS-CoV-2 NP IgM antibodies. All IgM-seropositive samples were IgG positive with a measurable titer of 34.5, 28.6, and 25.8 UI/mL for dog, cat, and camels, respectively. According to our best knowledge, this study was the first to assess SARS-CoV-2 seroprevalence in the specific animals investigated in Egypt. These results may herald a promising epidemiological role for pet animals and camels in SARS-CoV-2 virus maintenance. Thus, our study's results ought to be confirmed with a nationwide seroprevalence study, and further studies are required to clarify whether these animals act as active or passive carriers.

Dipstick Method versus Spot Urinary Protein Creatinine Ratio for Evaluation of Massive Proteinuria in Childhood Nephrotic Syndrome

Measurement of massive proteinuria is vital for diagnosis of childhood Nephrotic syndrome. Quantification of 24 hours urinary protein is the gold standard test. Dipstick method of urinary protein measurement gives instant result for massive proteinuria. Spot urinary protein creatinine ratio measurement is variable. This was a hospital based prospective cross sectional study done at Department of Paediatric Nephrology, Rangpur Medical College Hospital from January 2014 to December 2015 to evaluate accuracy of dipstick method versus spot urinary protein-creatinine ratio in estimation of massive proteinuria in childhood nephrotic syndrome. Total 100 children diagnosed as Nephrotic syndrome fulfilling the inclusion and exclusion criteria were enrolled into the study. After collection of spot urine sample, proteinuria was estimated by dipstick method and same sample was sent to laboratory for measuring protein creatinine ratio. All data were collected in individual predetermined case record form and analyzed by SPSS version 17.Dipstick had sensitivity 97%, specificity 70%, positive predictive value 96.7%, negative predictive value 77% and efficacy 95%. There was a significant correlation between spot urinary protein creatinine ratio and dipstick testing of Nephrotic range of proteinuria (p<0.05).The dipstick result of proteinuria significantly correlates with spot urinary protein creatinine ratio. Dipstick method of urinary protein measurement yields accurate result instantly.

Arthroscopic Anterior Cruciate Ligament Reconstruction with Triplet Autograft of Semitendinosus Tendon

Anterior cruciate ligament (ACL) is the most commonly injured ligament occurs in young adult population, which markedly reduces activity level. Anterior cruciate ligament rupture is a threat to the homeostasis of the knee. So, reconstruction of the ACL is necessary to make them fit and return to their pre-injury activity level. The choice of graft for ACL reconstruction is a matter of debate, with the BPTB graft and quadruple graft of ST-G being the two most popular options. Use of triplet graft of semi-tendinosus tendon alone without sacrificing gracilis is another option. So hypothesis was Arthroscopic ACL reconstruction with triplet autograft of semi-tendinosus tendon alone is an effective procedure. This prospective interventional study was conducted from October 2011 to March 2013 at Dhaka Medical College Hospital, Dhaka, Bangladesh. Fourteen patients who had a unilateral anterior cruciate ligament rupture underwent arthroscopic reconstruction with triplet graft of semi-tendinosus tendon. Accelerated ACL reconstruction rehabilitation protocol was followed and final outcome evaluation done at 24 weeks according to IKDC knee examination form and Lysholm knee scoring scale. Preoperative Lysholm knee score was 52.64 and postoperative score was 90, that shows significant improvement (p<0.05). According to Lysholm knee scoring scale, excellent results (95-100 points) were obtained in 33% patients, good results (85-94 points) in 53% patients, fair and poor (7% each). For arthroscopic ACL reconstruction, choice of semi-tendinosus tendon alone preserving gracilis, comparable outcome as with BPTB/ST-G graft, can be achieved, minimizing the hamstring strength deficit. Moreover gracilis being reserved for future use in revision ACL reconstruction and/or in other reconstructive surgery.

Serum C-reactive Protein (CRP) Level in Tuberculous Patients

The present prospective case control study was carried out to assess the role of C-reactive protein (CRP) level as a diagnostic and prognostic tool of tuberculous patients. The study was conducted in the Department of Paediatrics over a period of one year. Total 60 persons were included. Case was 30 and control was 30. Out of 30 tuberculosis patients 18(60%) had pulmonary tuberculosis, 6(20%) had abdominal TB, 3(10%) had pleural effusion and 3(10%) had tubercular lymphadenopathy. CRP was positive>6 mg/L in 25(83.3%) cases. CRP level was negative after 4 weeks of treatment. There is significant difference at p<0.001 in serum CRP level in between tuberculosis and healthy children. The study concluded that CRP level is a useful indication for diagnosis and prognosis of tuberculous patients.

Development of swine-specific DNA markers for biosensor-based halal authentication

The pig (Sus scrofa) mitochondrial genome was targeted to design short (15-30 nucleotides) DNA markers that would be suitable for biosensor-based hybridization detection of target DNA. Short DNA markers are reported to survive harsh conditions in which longer ones are degraded into smaller fragments. The whole swine mitochondrial-genome was in silico digested with AluI restriction enzyme. Among 66 AluI fragments, five were selected as potential markers because of their convenient lengths, high degree of interspecies polymorphism and intraspecies conservatism. These were confirmed by NCBI blast analysis and ClustalW alignment analysis with 11 different meat-providing animal and fish species. Finally, we integrated a tetramethyl rhodamine-labeled 18-nucleotide AluI fragment into a 3-nm diameter citrate-tannate coated gold nanoparticle to develop a swine-specific hybrid nanobioprobe for the determination of pork adulteration in 2.5-h autoclaved pork-beef binary mixtures. This hybrid probe detected as low as 1% pork in deliberately contaminated autoclaved pork-beef binary mixtures and no cross-species detection was recorded, demonstrating the feasibility of this type of probe for biosensor-based detection of pork adulteration of halal and kosher foods.

Botanicals to control soft rot bacteria of potato

Extracts from eleven different plant species such as jute (Corchorus capsularis L.), cheerota (Swertia chiraita Ham.), chatim (Alstonia scholaris L.), mander (Erythrina variegata), bael (Aegle marmelos L.), marigold (Tagetes erecta), onion (Allium cepa), garlic (Allium sativum L.), neem (Azadiracta indica), lime (Citrus aurantifolia), and turmeric (Curcuma longa L.) were tested for antibacterial activity against potato soft rot bacteria, E. carotovora subsp. carotovora (Ecc) P-138, under in vitro and storage conditions. Previously, Ecc P-138 was identified as the most aggressive soft rot bacterium in Bangladeshi potatoes. Of the 11 different plant extracts, only extracts from dried jute leaves and cheerota significantly inhibited growth of Ecc P-138 in vitro. Finally, both plant extracts were tested to control the soft rot disease of potato tuber under storage conditions. In a 22-week storage condition, the treated potatoes were significantly more protected against the soft rot infection than those of untreated samples in terms of infection rate and weight loss. The jute leaf extracts showed more pronounced inhibitory effects on Ecc-138 growth both in in vitro and storage experiments.

Genetic dissection of sympatric populations of brown planthopper, Nilaparvata lugens (Stål), using DALP-PCR molecular markers

Direct amplified length polymorphism (DALP) combines the advantages of a high-resolution fingerprint method and also characterizing the genetic polymorphisms. This molecular method was also found to be useful in brown planthopper, Nilaparvata lugens species complex for the analysis of genetic polymorphisms. A total of 11 populations of Nilaparvata spp. were collected from 6 locations from Malaysia. Two sympatric populations of brown planthopper, N. lugens, one from rice and the other from a weed grass (Leersia hexandra), were collected from each of five locations. N. bakeri was used as an out group. Three oligonucleotide primer pairs, DALP231/DALPR′5, DALP234/DALPR′5, and DALP235/DALPR′5 were applied in this study. The unweighted pair group method with arithmetic mean (UPGMA) dendrogram based on genetic distances for the 11 populations of Nilaparvata spp. revealed that populations belonging to the same species and the same host type clustered together irrespective of their geographical localities of capture. The populations of N. lugens formed into two distinct clusters, one was insects with high esterase activities usually captured from rice and the other was with low esterase activities usually captured from L. hexandra. N. bakeri, an out group, was the most isolated group. Analyses of principal components, molecular variance, and robustness also supported greatly to the findings of cluster analysis.

Isolation, characterization, and identification of biological control agent for potato soft rot in Bangladesh

A total of 91 isolates of probable antagonistic bacteria of potato soft rot bacterium Erwinia carotovora subsp. carotovora (Ecc) were extracted from rhizospheres and endophytes of various crop plants, different soil varieties, and atmospheres in the potato farming areas of Bangladesh. Antibacterial activity of the isolated probable antagonistic bacteria was tested in vitro against the previously identified most common and most virulent soft rot causing bacterial strain Ecc P-138. Only two isolates E-45 and E-65 significantly inhibited the in vitro growth of Ecc P-138. Physiological, biochemical, and carbon source utilization tests identified isolate E-65 as a member of the genus Bacillus and the isolate E-45 as Lactobacillus sp. The stronger antagonistic activity against Ecc P-138 was found in E-65 in vitro screening and storage potatoes. E-65 reduced the soft rot infection to 22-week storage potatoes of different varieties by 32.5–62.5% in model experiment, demonstrating its strong potential to be used as an effective biological control agent for the major pectolytic bacteria Ecc. The highest (62.5%) antagonistic effect of E-65 was observed in the Granola and the lowest (32.7%) of that was found in the Cardinal varieties of the Bangladeshi potatoes. The findings suggest that isolate E-65 could be exploited as a biocontrol agent for potato tubers.

Food assimilated by two sympatric populations of the brown planthopper Nilaparvata lugens (Delphacidae) feeding on different host plants contaminates insect DNA detected by RAPD-PCR analysis

Contamination of insect DNA for RAPD-PCR analysis can be a problem because many primers are non-specific and DNA from parasites or gut contents may be simultaneously extracted along with that of the insect. We measured the quantity of food ingested and assimilated by two sympatric populations of brown planthopper (BPH), Nilaparvata lugens, one from rice and the other from Leersia hexandra (Poaceae), a wetland forage grass, and we also investigated whether host plant DNA contaminates that of herbivore insects in extractions of whole insects. Ingestion and assimilation of food were reduced significantly when individuals derived from one host plant were caged on the other species. The bands, OPA3 (1.25), OPD3 (1.10), OPD3 (0.80), OPD3 (0.60), pUC/M13F (0.35), pUC/M13F (0.20), BOXAIR (0.50), peh#3 (0.50), and peh#3 (0.17) were found in both rice-infesting populations of brown planthopper and its host plant (rice). Similarly, the bands, OPA4 (1.00), OPB10 (0.70), OPD3 (0.90), OPD3 (0.80), OPD3 (0.60), pUC/ M13F (0.35), pUC/M13F (0.20), and BOXAIR (0.50) were found in both Leersia-infesting populations of brown planthopper and the host plant. So, it is clear that the DNA bands amplified in the host plants were also found in the extracts from the insects feeding on them.

Nanoparticle sensor for label free detection of swine DNA in mixed biological samples

We used 40 ± 5 nm gold nanoparticles (GNPs) as colorimetric sensor to visually detect swine-specific conserved sequence and nucleotide mismatch in PCR-amplified and non-amplified mitochondrial DNA mixtures to authenticate species. Colloidal GNPs changed color from pinkish-red to gray-purple in 2 mM PBS. Visually observed results were clearly reflected by the dramatic reduction of surface plasmon resonance peak at 530 nm and the appearance of new features in the 620-800 nm regions in their absorption spectra. The particles were stabilized against salt-induced aggregation upon the adsorption of single-stranded DNA. The PCR products, without any additional processing, were hybridized with a 17-base probe prior to exposure to GNPs. At a critical annealing temperature (55 °C) that differentiated matched and mismatched base pairing, the probe was hybridized to pig PCR product and dehybridized from the deer product. The dehybridized probe stuck to GNPs to prevent them from salt-induced aggregation and retained their characteristic red color. Hybridization of a 27-nucleotide probe to swine mitochondrial DNA identified them in pork-venison, pork-shad and venison-shad binary admixtures, eliminating the need of PCR amplification. Thus the assay was applied to authenticate species both in PCR-amplified and non-amplified heterogeneous biological samples. The results were determined visually and validated by absorption spectroscopy. The entire assay (hybridization plus visual detection) was performed in less than 10 min. The LOD (for genomic DNA) of the assay was 6 µg ml(-1) swine DNA in mixed meat samples. We believe the assay can be applied for species assignment in food analysis, mismatch detection in genetic screening and homology studies between closely related species.

Single dose (400 mg) versus 7 day (200 mg) daily dose itraconazole in the treatment of tinea versicolor: a randomized clinical trial

Tinea (pityriasis) versicolor is a superficial fungal infection and one of the most commonly found pigmentary disorders of skin caused by the yeast Malassezia. Multiple topical as well as systemic therapies are available for treatment. Systemic therapies are used for extensive disease, frequent relapse or where topical agents have failed. The aim that translates the rationale of the study was to compare the efficacy, safety, tolerability and cost effectiveness of single dose 400mg versus 7 day 200 mg daily dose of itraconazole in the treatment of tinea versicolor. A clinical study was done to compare the efficacy of single dose (400 mg) of itraconazole and 7 day 200 mg daily dose of itraconazole in the treatment of extensive tinea versicolor. Total 60 patients (aged 18-50 years) were selected for the study during the period of June 2007 to May 2008 in the department of Dermatology of three different hospitals in Bangladesh. Cases having with extensive involvement, diagnosed clinically and confirmed by wood's lamp and KOH microscopy were taken. Patients were randomly allocated into equal groups. Group A was given single dose 400 mg itraconazole and Group B was given 7 day 200 mg daily itraconazole. Fifty three (88%) male and 7(12%) female were included in the study. The mean age of group A was 32.37+/-9 years and in group B 33.23+/-8 years. The mean duration of the disease in group A was 2.63+/-2 months and 2.76+/-2 months in group B. In group A clinical responders was found cure 22(73.33%) and improvement 5(16.33%) and in group B it was found cure 24(79.99%) and improvement 4(13.33%). The measure at the End point (EP1) equals to 90% response and in-group B it was found cure 24 (79.99%) and improvement 4(13.33%). (Here the End point EP2) equals to 93.33%. The EP clinical analysis however shows 91.66% response. Both single dose and 7 day daily dose of itraconazole can be effective in the treatment of tinea versicolor with extensive involvement but single dose appears to be better for improving compliance and decreasing the cost of treatment.

Heparin-induced thrombocytopenia type II: a serious hazard in preemptive renal transplantation: a case report

Heparin-induced thrombocytopenia (HIT) type II (HIT II), is an immune-mediated complication of heparin therapy, associated with arterial and venous thrombosis. Herein we have reported a case of a 23-year-old woman who developed HIT following a living related donor, preemptive, renal transplantation. The patient was preoperatively exposed to both unfractionated and low-molecular-weight heparin as she underwent five hemodialysis sessions. HIT caused right common and external iliac vein and renal graft artery thrombosis, resulting in graft loss. Heparin-free hemodialysis was continued, and the patient was successfully treated with anticoagulation by the direct thrombin inhibitor lepirudin for both the thromboses and for hemodialysis. Finally, she was accepted for the continuous ambulatory peritoneal dialysis program. This report highlighted the importance of clinical awareness as far as previous heparin exposure is concerned for establishing an early diagnosis and delivering treatment of this life-threatening prothrombotic complication of heparin administration.

Olmsted syndrome

Olmsted syndrome is a rare disorder characterized by symmetrical sharply marginated mutilating keratoderma of palms & soles & hyperkeratotic plaques around the body orifices, onychodystrophy, ainhum & amputation of digital phalanges, flextion deformities of the fingers, localized alopecia, leukokeratosis of the tongue, shortness of stature & laxity of large joints. Inheritance is autosomal dominant, although sporadic cases have been reported. Here we describe two cases of this rare disorder with thickened hyperkeratotic lesion over palm & soles & along with amputation of 3rd , 4th & 5th toes in one case. In one of our case (case no. 2) the immediate younger brother has got the same disease. Both of them were treated with tab. Neotegason 25 mg orally daily for 3 months & there was significant improvement after treatment.

Opportunistic intestinal protozoal infections in immunocompromised children

Hundred immunocompromised children and 100 house contact controls were chosen. Patients included: 52 nephrotic syndrome children receiving corticosteroids for more than one month (age 5.28 +/- 2.32 years), 14 protein-calorie malnutrition (PCM) patients (8 cases of marasmus aged 6 +/- 2.27 months and 6 cases of marasmic kwashiorkor aged 1.39 +/- 0.88 years) and 34 lymphomas patients (22 cases of Hodgkin's disease and 12 cases of non-Hodgkin's lymphoma; age 4.5 +/- 3.54 years). Examination of concentrated stool was done using iodine stain of fresh mounts and modified Ziehl-Neelsen (cold acid-fast) to fixed smears. T-cell subsets were counted after staining with mouse monoclonal antibodies against CD4 and CD8 labeled with fluorescein. Both nephrotic syndrome and lymphomas groups showed affection of cellular immunity in the form of significant decrease in T-helper and H/S ratio and significant increase in suppressor T-cell subsets. Giardia lamblia, Entamoeba histolytica, Cryptosporidium parvum and Blastocystis hominis were the most frequent in patients group and were significantly more prevalent among patients than controls. No significant difference in the prevalence of Entamoeba coli and Chylomastix mesnili between the two groups. C. parvum infection were strictly confined to groups with T-cell subsets abnormalities i.e. nephrotic syndrome and lymphomas groups.

Studies on culicini larvae in Mansoura Center, Dakahlia Governorate, Egypt

Culicini larvae were collected from different water bodies in Mansoura Center, mainly Awish El Hagar, Gedilah, Mansoura City, Meet Badr Khames and Sandoub. Ten species of culicini larvae were collected. They were Culex adairi, Cx. antennatus, Cx. deserticola, Cx. pusillus, Cx. pipiens, Cx. univittatus, Aedes caspius, Ae. detritus, Culiseta longiareolata and Uranotaenia uniguiculata. The most common larvae in descending order were those of Cx. univittatus, Cx. antennatus and Ae. caspius. The highly infected area was Meet Badr Khames and the least was Mansoura city. The highly infested water body was the canals and the least was the sewage wells. Rice fields were only infested with Cx. antennatus (P > 0.05). The whole results were discussed.

Risk factors and morbidity in patients with placenta previa accreta compared to placenta previa non-accreta

BACKGROUND

Placenta accreta is associated with high morbidity and most cases occur with placenta previa. This study was carried out in an attempt to define risk factors for placenta accreta in cases of placenta previa and to quantify the increased morbidity of placenta previa accreta in comparison to placenta previa alone.

METHODS

The records of all patients delivered by cesarean section (CS) for placenta previa and accreta during the seven-year period from 1990 to 1996, inclusive, were reviewed. Data regarding the demographic features, previous CS, the incidence of hysterectomy and postpartum morbidity were analyzed.

RESULTS

Out of 23070 deliveries 110 (0.48%) had placenta previa, twelve (0.05%) of whom had placenta previa accreta. There was no significant difference in age and parity. Patients with a history of previous CS showed a significant increase in the incidence of placenta previa accreta (p=0.001). The percentage of accreta increased linearly from 4.1% in patients with no CS to 60% in patients who had had three or more CS. Postpartum hemorrhage and emergency hysterectomy were significantly higher among the previa accreta patients compared with the previa patients alone (p<0.001; p<0.001, respectively).

CONCLUSION

In the presence of a previous history of CS, patients with antepartum diagnosis of placenta previa are considered to be at a greater risk for having placenta accreta. The risk increases with the increase in the number of previous CS. Patients with placenta previa accreta have a significantly higher incidence of PPH and are more likely to undergo emergency hysterectomy.

Measles in pregnancy: maternal morbidity and perinatal outcome

OBJECTIVE

In this article, we studied the maternal morbidity and the perinatal outcome of 40 women who had measles in pregnancy and that was compared to 120 women who had pregnancy without measles and 37 women who had measles without pregnancy.

METHOD

The medical records of all the case and control subjects were reviewed and significance was tested at the 5% level.

RESULTS

The 40 cases of measles with pregnancy had significantly more hospital admission for pneumonia and fever when compared to cases of measles with no pregnancy (P < 0.001). The perinatal morbidity is significantly higher in cases of measles with pregnancy as expressed by the higher incidence of prematurity, neonatal hospital admission and length of stay in hospital (P < 0.003, P < 0.0005 and P < 0.0001, respectively).

CONCLUSION

Formulation of an appropriate strategy utilizing the available resources for measles vaccination is mandatory.

Post-malarial cerebellar ataxia in adult Sudanese patients

In this study the clinical manifestation and the effect of corticosteroids on the course and the outcome of post malaria cerebellar ataxia on thirty adult Sudanese patients wr investigated. Twenty four patients with delayed ataxia, that is, ataxia occurring shortly after full recovery from otherwise uncomplicated, documented malaria and six patients who were found to be ataxic on recovery from cerebral malaria were included in the study. The distribution of the age, sex and various clinical aspects were outlined. Twelve randomly selected patients were given oral prednisolone. The corticosteroid was found to shorten the period of ataxia. It was also found that in patients who demonstrated cerebellar infarction or atrophy on computerised tomography the duration of ataxia was significantly long.

Full-term birth weight and placental morphology at high and low altitude

OBJECTIVE

To study the association between placental morphology and full-term birth weight at high and low altitude.

SUBJECTS

Twenty normal pregnant women living permanently at high altitude (3100 m) and 20 normal pregnant women living permanently at low altitude (500 m) in Southern Saudi Arabia.

METHOD

For each subject in the two groups the mean hemoglobin concentration and hematocrit values throughout pregnancy were estimated and these were used as indices for maternal hypoxia. After delivery, the birth weight of each fetus was determined together with the placental weight. Placentas were then examined histologically using sections stained by periodic acid-Schiff and hematoxylin-eosin. The mean percentages of villi with syncytial knots, cytotrophoblastic cells and fetal capillaries were determined.

RESULTS

The mean hemoglobin concentration and hematocrit values were significantly greater at high altitude than at low altitude (P < 0.001 for both). The mean birth weight and placental weight were significantly greater at low altitude compared to high altitude (P < 0.025 and 0.001, respectively). The placentas from high altitude showed histological changes suggestive of placental hypoxia i.e. significant increase in the incidence of syncytial knots, cytotrophoblastic cells and fetal capillaries at high altitude compared to low altitude (P < 0.005, 0.001 and < 0.05, respectively). At both high and low altitude the incidences of syncytial knots and cytotrophoblastic cells showed positive and significant correlations with mean maternal hemoglobin (r = 0.5 and 0.6, P < 0.01 and < 0.001, respectively) and hematocrit (r = 0.5 and 0.6, P < 0.01 and 0.001, respectively) during pregnancy and negative and significant correlations with fetal birth weight (r = -0.4 and -0.6, P < 0.01 and P < 0.001, respectively).

CONCLUSION

The low birth weight observed at high altitude compared to low altitude appeared to be mainly secondary to placental hypoxia resulting from maternal hypoxia which in turn was caused by high altitude hypoxia.

Motor neurone disease in the tropics: findings from Sudan

In this clinical study the presentation, electromyography and nerve conduction studies were described in different types of motor neurone disease in 28 Sudanese patients seen at El Shaab and Khartoum Teaching Hospitals. The three major clinical subtypes encountered were amyotrophic lateral sclerosis (n = 19), progressive bulbar palsy (n = 7) and progressive muscular atrophy (n = 2). Family history of the disease was found in four patients and those mainly presented with bulbar symptoms. Sudanese patients were found to have an earlier age of onset and a better prognosis of the disease than their caucasian counterparts.

Does hypercapillarization influence the branching pattern of terminal villi in the human placenta at high altitude?

This study tests the hypothesis that exposure of the placenta to hypobaric hypoxia at altitude results in an altered branching pattern of the villous tree. Histological material from 20 term placentae delivered at altitudes over 3000 m was compared with matched controls from 500 m. Estimates of the mean star volume of intermediate and terminal villous domains were 1.40 x 10(6) microns3 (s.d. 0.63) in the high altitude group and 1.90 x 10(6) microns3 (s.d. 0.34) in the controls (F = 9.07, P < 0.005). The volume fraction of the villous tree occupied by trophoblastic bridges and syncytial knots was 8.1 per cent (s.d. 3.5) in the high altitude group and 3.2 per cent (s.d. 1.6) in the controls (F = 29.45, P < 0.0001). Previous studies have shown that the majority (80 per cent) of bridges are artefacts caused by the plane of section passing tangentially through the trophoblast layer at points of villous bending or branching. The results are, therefore, consistent with the hypothesis that peripheral villi are shorter, knob-like protrusions at high altitude, clustered more closely together. This modified branching pattern was confirmed by scanning electron microscopy. The change in architecture may be due to enhanced angiogenesis stimulated by the lower partial pressure of oxygen prevailing at high altitude.

Lipid peroxidation and human sperm motility: protective role of vitamin E

Asthenospermia is the main factor of male infertility among patients consulting the Asir Infertility Center in Abha, Saudi Arabia. Lipid peroxidation occurring in both the seminal plasma and spermatozoa was estimated by malondialdehyde (MDA) concentration. Spermatozoal MDA concentration was higher in men with decreased sperm motility. The MDA concentration in the seminal plasma exhibited no relationship with sperm concentration, sperm motility, the number of immotile spermatozoa, or even the absence of spermatozoa. The MDA concentration in sperm pellet suspensions of asthenospermic and oligoasthenospermic patients was almost twice that of the normospermic males. The MDA concentration in the sperm pellet suspension from normospermic or oligospermic patients was about 10% that in the seminal plasma. However, the MDA concentration in the sperm pellet suspension of asthenospermic or oligoasthenospermic patients was about 15% that in the seminal plasma. Treatment of asthenospermic patients with oral Vitamin E significantly decreased the MDA concentration in spermatozoa and improved sperm motility. Eleven out of the 52 treated patients (21%) impregnated their spouses; nine of the spouses successfully ended with normal term deliveries, whereas the other two aborted in the first trimester. No pregnancies were reported in the spouses of the placebo-treated patients.

High altitude and spontaneous preterm birth

OBJECTIVE

To study the association between high altitude and spontaneous preterm birth.

METHODS

Eleven placentas from cases of high altitude (3000 m) spontaneous preterm deliveries with no clinical predisposing cause were collected in Abha, a city of southern Saudi Arabia. The placentas were examined histologically using sections stained by periodic acid-Schiff and hematoxylin-eosin. The mean percentages of villi with syncytial knots and cytotrophoblastic cells were determined.

RESULTS

Histology of the placenta samples showed an excessive formation of syncytial knots (45.4 +/- 13.3%) and cytotrophoblastic cells (52.7 +/- 15.2%) at terminal villi.

CONCLUSION

The enhanced formation of syncytial knots and cytotrophoblastic cells is a histological feature of placental hypoxia, which may be secondary to maternal hypoxia resulting from high altitude hypoxia. Since placental hypoxia is associated with an increased incidence of spontaneous preterm birth, we suggest that high altitude may be involved in the etiology of spontaneous preterm birth.

Body composition and blood pressure: which indices of fatness show the strongest correlation?

We studied the strength of association of different indices of body composition with blood pressure (BP) in 430 healthy persons (222 males, 208 females) living in southern Saudi Arabia. The percentage of fat, fat mass (FM), fat mass index (FMI) and body mass index (BMI), but not the fat free mass (FFM) were greater in women than in men. All these indices were significantly correlated with BP except height and triceps fold thickness. However, the highest correlation with BP existed with the body weight, followed by FFM and BMI and the lowest correlation existed with FM and fat free index (FFI). Thus, this study showed that weight-related body composition indices are better correlated with BP than height-related ones. This may be of importance when addressing BP relation with the degree of fatness.

Deleterious effects of khat addiction on semen parameters and sperm ultrastructure

The semen parameters and sperm ultrastructural morphology have been described in semen samples from two groups of Yemeni subjects. The first 'exposed' group comprised 65 khat addicts, while the second control group included 50 non-khat addict subjects. The mean age was 39.94 +/- 13.85 and 35.72 +/- 11.35 years in the exposed and control groups respectively, without a significant difference. The mean duration of khat addiction among the addicts was 25.34 +/- 12.96 years (range 6.00-48.00). Statistically significant differences were detected between the semen parameters of the two groups. Such parameters, including semen volume, sperm count, sperm motility, motility index and percentage of normal spermatozoa, were lower among addicts. Significant negative correlation was also found between the duration of khat consumption and all semen parameters (r ranged from -0.30 to -0.74). At the transmission electron microscopy level, a counting system was incorporated to compare the numbers of normal spermatozoa with deformed and dead spermatozoa in ultrathin plastic sections. The total mean percentage of deformed spermatozoa was approximately 65%. Different patterns of sperm deformation were demonstrated, and included both the head and flagella in complete spermatozoa, aflagellate heads, headless flagella and multiple heads and flagella. Deformed heads showed aberrated nuclei with immature nuclear chromatin and polymorphic intranuclear inclusions; these were associated with acrosomal defects. The deformed flagella demonstrated numeric aberrations of the axonemal 9 + 2 configuration and structural defects of their associated elements. Persistent cytoplasmic droplets were observed frequently. This study has shown for the first time the deleterious effects of khat addiction on semen parameters in general and sperm morphology in particular of all addicts, especially those who have consumed khat for longer periods of time.

Pattern of blood pressures among high and low altitude residents of southern Saudi Arabia

The patterns of blood pressures and their correlates in 499 Saudi nationals aged 10-72 years living at high altitude (3150 m above sea level) and 594 Saudi nationals aged 10-76 years living at low altitude (500 m above sea level) were prospectively studied. The average BPs were significantly higher in highlanders compared with lowlanders. In both high and lowland residents the BPs rose with age although males in both groups showed a drop in both SBP and DBP beyond the age of 50 years. Hypertension (> 160/95 mmHg) was not detected among lowlanders and only 1.4% of all highlanders were found to be hypertensive. These differences in BPs are attributed to the significantly higher body mass index values and packed cell volume levels in the highlanders.

Relationship of body weight to altitude in Saudi Arabia

Measurement of weight and height in 451 Saudi nationals ages 17 to 72 years, born and living permanently at high altitude (3150 meters) and Saudi nationals ages 17 to 76 years, born and living permanently at low altitude (500 meters) are reported. The native highlanders were significantly heavier (P<0.005 for men and <0.001 for women) and taller (P<0.001 for both men and women) than lowlanders. Body mass index (BMI=kg/m(2)) was used for assessment of normal weight, overweight or obesity, and underweight or thiness in the two communities. Only 30.8% of all highlanders and 34% of all lowlanders were found to have normal weight. The prevalence of overweight or obesity was significantly greater among highlanders (55.7%) than among lowlanders (42.9%) (P<0.01), while underweight or thiness was significantly more common among lowlanders (23.1%) as compared to highlanders (13.5%) (P<0.01). Among highlanders, overweight or obesity was significantly more common in women than men (P<0.01) while underweight or thiness was more common among men than women, although the difference was not statistically significant. This sex difference in the prevalence of overweight or obesity and underweight or thiness was not apparent among lowlanders. The percentage of overweight or obese highland and lowland men and women increased after the age of 39 years; conversely, the incidence of underweight or thiness in highland and lowland men and women decreased after the age of 39 years. The findings of this study indicate that overweight or obesity and, to a lesser extent, underweight or thiness are major nutritional problems in the two groups studied.

Assessment of chloroquine resistance of Plasmodium falciparum in children of Wad Medani (Central Sudan)

The study reports on chloroquine resistance of Plasmodium falciparum among Sudanese children (6 month to 16 years) living at Wad Medani, Central Sudan. All RI-III levels of resistant response were confirmed, while in vitro sensitivity test indicated that 25 per cent of P. falciparum isolates examined had exhibited maturation of schizonts at CQ level greater than or equal to 1.6 pmol/microliters blood. CQ was sufficiently retained for 7 days after drug administration whereas an average peak level of CQ in blood (348 ng/ml) was recorded on day 1. Patients were successfully treated by an age-measured dose of parenteral quinine (10 mg/kg).

Functional health development model: a tool for planning

This paper describes a functional model (gross style) taking available information about the health sector e.g. indicators of health status, types of service utilization, source allocations and placing these quantities into a systematic framework as a tool for planning for health services in a developing area. The major advantages of functional models over trial-and-error for planning have been presented. The functional model described could contribute to the sorting out of desirable from less desirable policy alternatives for a specific population. The output from the model is useful for matching resources to program development, taking into consideration costs and effectiveness.

Effect of integrated use of organic manures with chemical fertilizers in the rice-rice cropping system and its impact on soil health

A field experiment was conducted during 2003-2004 at Bangladesh Agricultural University farm, Mymensingh to evaluate the suitability of different sources of organic materials for integrated use with chemical fertilizers for the Boro-Fallow-T. Aman rice cropping pattern. The experiment was set up in a randomized complete block design (RCBD) with three replications. Eight-treatments, formulated from organic manure and chemical fertilizers have been imposed. The treatment combinations are T1: control, T2: 70% NPKS, T3: 100% NPKS, T4: 70% NPKS + rice straw (RS) @ 5 t/ha, T5: 70% NPKS + dhaincha (DH) @ 15 t/ha, Tb: 70% NPKS + mungbean residue (MBR) @ 10 t/ha, T7: 70% NPKS + cowdung (CD) @ 5 t/ha and T8: 70% NPKS + poultry manure (PM) @ 3 t/ha. Organic manure or crop residue was applied to T. Aman rice and their residual effects were observed in the following Boro rice. Application of 70% NPKS + PM produced the highest grain yield of T. Aman rice, which was identical to that obtained with 100% NPKS with no manure. In Boro season. application of 100% NPKS produced the highest grain yield of 6.87 t/ha, which was identical with the application of 70% NPKS + PM (6.57 t/ha). The total grain yield in the cropping pattern ranged from 5.14 t/ha in T1 (control) treatment to 12.29 t/ha in the 100% NPKS. The application of 3 t/ha PM with 70% NPKS (T8) produced the total yield of 12.09 t/ha followed by 11.59 t/ha in the treatment containing 10 t/ha MBR plus 70% NPKS (T6). It appears that the application of 3 t/ha PM once in a year with 70% NPKS can reduce the use of 30% NPKS as fertilizers. There were negative balances for N and K with the highest mining of K, while the balances for P and S were positive. The economic analysis reveals that most of the treatments produced BCR (benefit-cost ratio) of more than 3.0 showing that they all are economically viable. The integrated use of fertilizers and manure resulted in considerable improvement in soil health by increasing organic matter, available P, and S contents of soils. The overall findings of the study indicate that the integrated use of chemical fertilizer and manure is important for sustainable crop yield in a rice-rice cropping pattern. Key Words: Organic manures; chemical fertilizer; soil health. DOI: 10.3329/bjar.v34i1.5757Bangladesh J. Agril. Res. 34(1) : 81-90, March 2009