Dietary fat types consumption association with obesity and coronary indices

This article aims to study the different dietary fat types associated with obesity and coronary indices. A sample of 491 healthy adults was included in a cross-sectional manner. Dietary fats intake, obesity indices (conicity index (CI), body adiposity index (BAI), abdominal volume index (AVI), body roundness index (BRI), and weight-adjusted-waist index (WWI)), and cardiovascular indices (cardiometabolic index (CMI), lipid accumulation product (LAP), and atherogenic index of plasma (AIP)) were calculated and studied. Participants with an acceptable intake of omega-3 had a higher BRI score (1⋅90 ± 0⋅06 v. 1⋅70 ± 0⋅06). Participants with an unacceptable intake of cholesterol had a higher CI (1⋅31 ± 0⋅11 v. 1⋅28 ± 0⋅12; P = 0⋅011), AVI (20⋅24 ± 5⋅8 v. 18⋅33 ± 6⋅0; P < 0⋅001), BRI (2⋅00 ± 1⋅01 v. 1⋅70 ± 1⋅00; P = 0⋅003), WWI (11⋅00 ± 0⋅91 v. 10⋅80 ± 0⋅97; P = 0⋅032), and lower AIP (0⋅46 ± 0⋅33 v. 0⋅53 ± 0⋅33; P = 0⋅024). Total fat, saturated fat (SFA), and polyunsaturated fat (PUFA) intake had a significant moderate correlation with AVI and BRI. The monounsaturated fat (MUFA) intake had a significantly weak correlation with CI, AVI, BRI, WWI, and AIP. Cholesterol and omega-6 had weak correlations with all indices. Similar correlations were seen among male and female participants. The different types of fat intake significantly affected obesity and coronary indices, especially SFA and PUFA, as well as omega-3 and cholesterol. Gender and the dietary type of fat intake have a relationship to influence the indicators of both obesity and coronary indices.

Adoption of novel climate-smart farming systems for enhanced carbon stock and carbon dioxide equivalent emission reduction in cattle corridor areas of Uganda

Climate change remains the single major threat to the realization of increased livestock production because of its impact on the quantity and quality of feed crops and forages, water availability, animal reproduction, and biodiversity. To minimize the negative impacts of climate change on livestock, an agroforestry project was implemented in the cattle corridor areas of Uganda. Predominant agroforestry tree species and improved grass were planted. At the age of 1.5 years, the aboveground biomass, aboveground carbon stock, and carbon dioxide equivalent emissions sequestrated by each sapling species strand and grass species were determined. From the results, the aboveground biomass (F = 92.21, p = 0.020), aboveground carbon stock (F = 101.01, p = 0.035), and the carbon dioxide equivalent emissions sequestrated (F = 71.02, p = 0.0401) varied significantly among the studied species. Among the agroforestry saplings, Calliandra callothyrus (10.0 ± 0.7 ton/acre) had the highest aboveground biomass, while Markhamia lutea (4.3 ± 0.3 tons/acre) and Albizia chinense (4.1 ± 0.2 tons/acre) had the lowest aboveground biomass. Similarly, the aboveground carbon stock was the highest in Calliandra callothyrus strand (4.70 ± 0.1 tons/acre) and lowest in the Albizia chinense strand (1.94 ± 0.2 tons/acre). At a strand level, Calliandra callothyrus (17 ± 0.4 ton/acre) sequestrated the highest quantities of carbon dioxide equivalent emissions, followed by Maesopsis eminii (10 ± 0.2 ton/acre) and Grevillea robusta (9 ± 0.5 ton/acre) species strands. Markhamia lutea (7 ± 0.2 ton/acre) and Albizia Chinense (7 ± 0.1 ton/acre) strands sequestrated the lowest quantities of carbon dioxide equivalent emissions. At the age of 1.5 years, the grass species were fully grown but only stored 0.51 ± 0.0 and 0.47 ± 0.0 tons/acre of Aboveground carbon for Chloris gayana and Centrosema pubescens, respectively. The carbon dioxide equivalent emissions sequestrated by the grass: Chloris gayana (1.9 ± 0.0 ton/acre) and Centrosema pubescens (1.7 ± 0.0 ton/acre) were also less than that of the agroforestry saplings. From this study, the agroforestry species with higher wood biomass and fast growth rate are recommended for carbon dioxide emission sequestration.

Willingness and motivations towards volunteering during the COVID-19 pandemic: A cross-sectional survey among final year medical students in Lagos, Nigeria

Introduction

Increasing manpower capacity to meet the demands in the healthcare system is important during health emergencies. Medical students have roles to play during a pandemic but their involvement in these duties should be voluntary. The objective of this study was to assess the willingness and motivations of final year medical students in Lagos, Nigeria towards volunteering during the COVID-19 pandemic.

Methods

A descriptive cross-sectional study was conducted among medical students in their sixth (final) year of study at the two public Universities in Lagos, Nigeria using total population sampling technique. A web-based questionnaire was used for data collection and data were analysed using SPSS. Logistic regression analysis was used to predict the willingness to volunteer.

Results

The mean age of the respondents was 23.4 years ± 2.6SD and 62.6% were female. About 65.9% of the medical students were willing to volunteer. Motivational factors which include self-rated good health status [OR: 2.1(95%CI: 1.16-3.6)], self-rated competence to work as a COVID-19 volunteer [OR: 6.5(95%CI: 3.61-11.54)] and availability of adequate protection and personal protective equipment [OR: 3.3(95%CI: 1.74-6.33)] significantly increased the odds of willingness to volunteer after controlling for other variables. Respondents' opinions on settings where medical students can serve as volunteers during the COVID-19 pandemic include case management (21.7%) and telemedicine (85.8%).

Conclusion

Medical students are willing to volunteer during the COVID-19 pandemic. There is a need to prepare and motivate the final year medical students by developing their skills to improve their competence and by providing adequate protection for the willing students to function as volunteers.

Anti-salmonella properties of kefir yeast isolates: An in vitro screening for potential infection control

The rise of antibiotic resistance has increased the need for alternative ways of preventing and treating enteropathogenic bacterial infection. Various probiotic bacteria have been used in animal and human. However, Saccharomyces boulardii is the only yeast currently used in humans as probiotic. There is scarce research conducted on yeast species commonly found in kefir despite its claimed potential preventative and curative effects. This work focused on adhesion properties, and antibacterial metabolites produced by Kluyveromyces lactis and Saccharomyces unisporus isolated from traditional kefir grains compared to Saccharomyces boulardii strains. Adhesion and sedimentation assay, slide agglutination, microscopy and turbidimetry assay were used to analyze adhesion of Salmonella Arizonae and Salmonella Typhimurium onto yeast cells. Salmonella growth inhibition due to the antimicrobial metabolites produced by yeasts in killer toxin medium was analyzed by slab on the lawn, turbidimetry, tube dilution and solid agar plating assays. Alcohol and antimicrobial proteins production by yeasts in killer toxin medium were analyzed using gas chromatography and shotgun proteomics, respectively. Salmonella adhered onto viable and non-viable yeast isolates cell wall. Adhesion was visualized using scanning electron microscope. Yeasts-fermented killer toxin medium showed Salmonella growth inhibition. The highest alcohol concentration detected was 1.55%, and proteins with known antimicrobial properties including cathelicidin, xanthine dehydrogenase, mucin-1, lactadherin, lactoperoxidase, serum amyloid A protein and lactotransferrin were detected in yeasts fermented killer medium. These proteins are suggested to be responsible for the observed growth inhibition effect of yeasts-fermented killer toxin medium. Kluyveromyces lactis and Saccharomyces unisporus have anti-salmonella effect comparable to Saccharomyces boulardii strains, and therefore have potential to control Salmonella infection.

Safety and Efficacy of Saroglitazar in Nonalcoholic Fatty Liver Patients With Diabetic Dyslipidemia-A Prospective, Interventional, Pilot Study

BACKGROUND

Saroglitazar-a unique dual peroxisome proliferator-activated receptor agonist was approved marketing authorization in India in 2013 for diabetic dyslipidemia. Postmarketing studies have additionally shown improvement in liver parameters in diabetic dyslipidemia patients with nonalcoholic fatty liver disease (NAFLD) who received saroglitazar.

AIM

The aim of this study was to evaluate the effect of saroglitazar on liver function test, liver fibrosis score by FibroScan, lipid profiles, HbA1c in NAFLD patients with diabetic dyslipidemia in southern India.

METHODOLOGY

A prospective, interventional, pilot study was performed to study the safety and efficacy of saroglitazar in NAFLD patients having type 2 diabetes mellitus. About 97 patients were screened, of which 85 patients were involved in the study based on the inclusion criteria. The clinical parameters and liver stiffness were measured at the baseline and also after 12 weeks of treatment with administration of saroglitazar 4 mg once daily. The change in the parameters at the baseline and after the end of the treatment was measured and was subjected to statistical analysis using SPSS software.

RESULTS

The recruited patients received saroglitazar and were followed up for a period of 12 weeks. The clinical parameters such as fasting blood sugar, postprandial blood sugar, HbA1c, total cholesterol, triglycerides, SGPT, and liver stiffness showed significant difference after 12 weeks of treatment when compared with the baseline values. No adverse drug reaction was reported in patients receiving saroglitazar during the study.

CONCLUSION

Saroglitazar was found to show significant improvement in liver parameters in NAFLD patients with a significant reduction in liver fibrosis and triglycerides level.

Logit model in prospective coronary heart disease (CHD) risk factors prediction in Saudi population

Analysis through logistic regression explored to investigate the relationship between binary or multivariable ordinal response probability and in one or more explanatory variables. The main objectives of this study to investigate advanced prediction risk factor of Coronary Heart Disease (CHD) using a logit model. Attempts made to reduce risk factors, increase public or professional awareness. Logit model used to evaluate the probability of a person develop CHD, considering any factors such as age, gender, high low-density lipoprotein (LDL) cholesterol, low high-density lipoprotein (HDL) cholesterol, high blood pressure, family history of CHD younger than 45, diabetes, smoking, being post-menopausal for women and being older than 45 for men. Logit concept of brief statistics described with slight modification to estimate the parameters testing for the significance of the coefficients, confidence interval fits the simple, multiple logit models. Besides, interpretation of the fitted logit regression model introduced. Variables showing best results within the scientific context, good explanation data assessed to fit an estimated logit model containing chosen variables, this present experiment used the statistical inference procedure; chi-square distribution, likelihood ratio, Score, or Wald test and goodness-of-fit. Health promotion started with increased public or professional awareness improved for early detection of CHD, to reduce the risk of mortality, aimed to be Saudi vision by 2030.

HIV-related perceived stigma and associated factors among patients with HIV, Dilla, Ethiopia: A cross-sectional study

Introduction

Understanding HIV-related perceived stigma has importance in improving the quality of patients and provides a better tackling of HIV stigma. Therefore; the study aimed to assess the prevalence and associated factors of perceived stigma among Patients with HIV attending the clinic at Dilla University Referral Hospital in Ethiopia 2019.

Method

In this Institution based cross-sectional study, a 10-item perceived HIV stigma scale was used to assess HIV-related perceived stigma. Oslo social support scale was used to assess social support related factors. Bivariate and multivariate binary logistic analysis was done to identify associated factors to HIV-related perceived stigma.

Results

The prevalence of HIV-related perceived stigma by using perceived HIV stigma scale among patients with living HIV was 42.7%. Patients who are age groups 25-30 years (AOR = 2.8, 95% CI: 5.72-11.5), age groups 31-39 years (AOR = 1.11, 95% CI: 1.26,4.65), Females (AOR = 2.4, 95% CI: 1.28-4.33), divorced marital status (AOR = 8.9, 95% CI: 3.52-10.61), widowed marital status (AOR = 3.0, 95% CI: 2.74-7.60), Primary educational status (AOR = 7.5,95% CI: 3.45-9.74) and Study participants those who use alcohol (AOR = 1.0 95% CI: 1.57-2.11) were more likely to have HIV-related perceived stigma.

Conclusion

This calls a holistic approach to the prevention and intervention of HIV-related perceived stigma. Emphasis should also be given for HIV-related perceived stigma.

Registration

This study was registered research registry with the registration number (researchregistry7112).

Healthcare professionals' knowledge of modifiable stroke risk factors: A cross-sectional questionnaire survey in greater Gaborone, Botswana

Background

Stroke remains the second leading cause of deaths and disability globally, with highest mortality in Africa (low- and middle-income countries). It is crucial for healthcare professionals to have sufficient stroke risk factors' knowledge in order to reduce the stroke burden.

Aims

We investigated healthcare professionals' knowledge of modifiable stroke risk factors, and identified demographic factors influencing this knowledge.

Methods

In this cross-sectional survey study from Botswana (upper middle-income country), structured questionnaires reflecting recent stroke guidelines were administered to a representative selection of healthcare workers in greater Gaborone. The response rate was 61.4%, comprising 84 doctors, 227 nurses and 33 paramedics. Categorical data were described using percentages and Chi-square tests. Associations between stroke risk factors' knowledge and demographic factors were analyzed with one-way ANOVA using SPSS 25 statistical software.

Results

Awareness rate of individual stroke risk factors was highest for hypertension (96.5%), followed by obesity (93.3%), smoking (91.9%), elevated total cholesterol (91.0%), physical inactivity (83.4%), elevated low-density lipoprotein (LDL) cholesterol (81.1%), excessive alcohol drinking (77.0%), and lowest for diabetes (73.3%). For all-8 risk factors, doctors had the highest knowledge, followed by nurses and paramedics lowest (7.11 vs 6.85 vs 6.06, P < 0.05).

Conclusion

In Botswana, specific healthcare professionals' subgroups need to be targeted for continuing education on stroke risk factors for improving stroke prevention and reducing stroke-related disability and mortality.

•

This is the first study in Africa assessing knowledge of stroke risk factors among the three healthcare professions concurrently

•

Understanding stroke risk factors is crucial for healthcare professionals as counsellors and managers of stroke

•

Doctors had highest stroke knowledge, followed by nurses and lowest paramedics.

•

Low knowledge was associated with paramedics, private sector, 0–1 year’ clinical experience and female gender.

•

Continuing education on ischemic stroke risk factors is needed

Recovery of pre-injury functional state following operative treatment of displaced femoral neck fractures; a prospective cohort study

Background

The incidence of fracture neck of femur (FNF) has been projected to increase significantly. This study sought to determine the recovery of preinjury functional state following operative treatment of displaced FNF.

Materials and methods

A six-month prospective cohort study was conducted at Kenyatta National Hospital (KNH) and PCEA Kikuyu Mission Hospital (KMH) between November 2008 and May 2009. Sixty patients were enrolled using a pre-tested questionnaire. The Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) scores were used. The functional outcome measures included pain, stiffness and activities of daily living (ADL). Stratification and subgroup analysis were done especially based on age. Student's t-test and χ² test were used for comparison between variables as appropriate with a p < 0.05 being considered statistically significant.

Results

Majority of the patients recruited were males (68%) with a mean age of 51.6 years. Eighty eight percent of the patients had a mean negative early functional outcome score. Hemiarthroplasty (HA) and Total Hip Arthroplasty (THA) had comparable early post-operative functional outcome while Osteosynthesis (OS) had a poorer ADL outcome. Prolonged hospital stay was associated with a poor ADL outcome (p = 0.020). Use of the antero-lateral approach to the hip was associated with a better ADL outcome in patients older than 50 years (p = 0.007).

Conclusions

At three months post-operatively, most patients have not fully recovered their pre-injury level of function and independence. Both HA and THA are associated with better early functional outcome compared to OS.

Study type

Original research.

Is pull-through an acceptable replacement for low anterior resection for rectal cancers in low-income setting? A case-control study

Background

Colorectal cancers are the second most common cancers overall and are the third deadliest cancers. Complete resection is the treatment of choice for rectal cancers and chemoradiotherapy (CRT) is strongly recommended in stage 2 and 3. Low anterior resection (LAR) is the most common procedure used, but it requires the use of stapler which might be very expensive as one study estimated the median cost of LAR inpatients to be over 13.000 USD. However, coloanal pull-through (PT) used to be the common procedure before introducing staplers in the twentieth century and can be less expensive, but with higher complication rates.

Materials and methods

This is a retrospective case-control study from patients’ records who underwent either LAR or PT for their rectal cancer in Syria. All patients had either stage 2 or 3 cancer and were treated by the same group of surgeons and received the same adjuvant and neoadjuvant CRT protocol. Patients from both groups had the same prognosis and stages.

Results

This study included 60 participants, of which, 30 had LAR and 30 had PT. They all had successful removal of the cancer and follow-ups were for 1 year after the surgery. There were no significant differences between the two procedures in post-operative leak, urinary retention, stricture, sexual function and recurrence (p > 0.05). However, post-operative incontinence was more frequent with PT (p = 0.027).

Conclusion

PT can be an acceptable substitute of LAR in low income settings despite having higher incidence of incontinence.

•

Low anterior resection (LAR) is the preferred surgery for rectal cancers.

•

Coloanal pull-through (PT) used to be preferred before LAR.

•

PT has higher complications rates, but it is much cheaper.

•

PT might have similar survival outcomes compared to LAR.

Counter-regulatory responses to Telfairia occidentalis-induced hypoglycaemia

Background

Telfairia occidentalis (TO) has many biological activities including blood glucose regulation. Thus, it is being used in the treatment of diabetes mellitus. TO has been shown to cause insulin-mediated hypoglycaemia, which leads to post-hypoglycaemic hyperglycaemia. However, the mechanism involved in the post-hypoglycaemic hyperglycaemia is still poorly understood.

Objective

This research was designed to determine the response of glucoregulatory hormones and enzymes to TO treatment.

Methods

Thirty-five male Wistar rats were divided into seven oral treatment groups (n = 5/group), which received either of 100 mg/kg or 200 mg/kg TO for 7-, 10- or 14 days.

Results

The 7-day treatment with TO significantly increased the levels of insulin, glucagon, and glucose-6-phosphatase (G6Pase) activity but decreased the levels of glucose, adrenaline, and glucokinase (GCK) activity. The 10-day treatment with 100 mg/kg TO increased glucose and decreased GCK activity while 200 mg/kg for the same duration increased glucose, insulin, GCK and G6Pase activities but reduced glucagon. The 14-day treatment with 100 mg/kg TO decreased glucose and glucagon but increased cortisol, while 200 mg/kg TO for same duration increased insulin, but reduced glucagon and GCK activity.

Conclusion

The TO's post-hypoglycaemic hyperglycaemia results from increased glucagon and G6Pase activity, and reduced GCK activity. Moreover, the glucagon response mainly depends on glucose rather than insulin.

Efficacy of lidocaine versus mepivacaine in the management of myofascial pain

Objectives

There are many treatment modalities for myofascial pain, and recent findings reported in the literature highlight the superiority of using local anesthetics as the treatment of choice. The objective of the present study was to compare the effectiveness of two of the most used local anesthetic agents—lidocaine and mepivacaine—in the management of myofascial pain.

Materials and methods

Thirty patients (20 females, 10 males) were randomly assigned to one of two groups: 50% received lidocaine and 50% received mepivacaine. Trigger point injections in the orofacial region were administered 4 times, 10 days between each injection, with 4 weeks of follow-up after the end of the treatment course. Pain levels were recorded using a visual analog scale (VAS) at the time of follow-up and 30 min after injection.

Results

All patients exhibited statistically significant improvement when comparing pre- and post-treatment mean values. Both local anesthetics (i.e., lidocaine and mepivacaine) were similarly effective for the management of myofascial pain (p = 0.875). The mepivacaine-treated group exhibited significantly lower post-injection tenderness than the lidocaine group (p = 0.038). There was no relationship between sex and treatment response. Female and male patients both reported similar responses in terms of VAS scores (p = 0.818).

Conclusion

No drug was superior in the long term; thus, the clinician’s choice can be based on drug availability and patient medical history.

Differential expression of salivary S100A7 in oral submucous fibrosis

Aim

To investigate the expression of salivary S100A7 levels among patients with oral submucous fibrosis (OSF) and healthy controls.

Method

A total number of 60 participants were included in the study (30 OSF cases and 30 healthy controls). Demographic data was collected using a structured baseline questionnaire. Salivary S100A7 levels were quantified using enzyme-linked immunosorbent assay. Data was analyzed using Student t-test. Pearson correlation test was used to evaluate correlation between S100A7 levels and independent variables such as frequency and duration of areca nut use, gutka use, and mouth opening.

Results

The mean value of salivary S100A7 for OSF group was 0.275 ng/ml, whereas mean value of salivary S100A7 for healthy controls was 0.195 ng/ml. Student t-test indicated that there was statistically significantly higher levels of S100A7 in OSF group as compared to healthy controls (p < .001). When the clinical variables of individual groups were analysed, a significant negative correlation was found between salivary S100A7 and duration of areca nut (p = .009) and gutka chewing (p = .03), whereas a significant positive correlation was found for mouth opening (p = .04).

Conclusion

OSF presented higher levels of salivary S100A7 levels as compared with healthy individuals and may be used as surrogate measure to identify subjects at risk for OSF.

How practical is the application of percutaneous nephrolithotomy scoring systems? Prospective study comparing Guy's Stone Score, S.T.O.N.E. score and the Clinical Research Office of the Endourological Society (CROES) nomogram

Objective

To prospectively compare the Guy’s Stone Score (GSS), S.T.O.N.E. [stone size (S), tract length (T), obstruction (O), number of involved calices (N), and essence or stone density (E)] score and the Clinical Research Office of the Endourological Society (CROES) nephrolithometric nomogram to predict percutaneous nephrolithotomy (PCNL) success rate and assess the correlation with perioperative complications.

Patients and methods

We prospectively evaluated all consecutive PCNL patients at our institute between 1 November 2013 and 31 May 2015. The above scoring systems were applied to preoperative non-contrast computed tomography and the practical difficulties in such applications were noted. Perioperative complications and the stone-free rate (SFR) were also recorded. Receiver operating characteristic curves were drawn and the areas under curves were compared and appropriate statistical analysis done.

Results

In all, 48 renal units were included in the study. The overall SFR was 62.2%. The presence of staghorn stones (β = 27.285, 95% confidence interval 1.19–625.35; P = 0.039) was the only significant variable associated with the residual stones on multivariate analysis. Stone-free patients had significantly lower median GSS (2 vs 4) and S.T.O.N.E. scores (6 vs 10) and higher median CROES scores (83% vs 63%) (all P < 0.001) compared to residual-stone patients. All scoring systems were significantly associated with SFR (all P < 0.001). There was no significant difference in the areas under curves of the scoring systems (0.858, 0.923, and 0.931, respectively). Furthermore, all scoring systems had weak correlations with Clavien–Dindo classified complications (r = 0.29, P = 0.045; r = 0.40, P = 0.005 and r = −0.295, P = 0.04, respectively). We found no standardisation for the measurement of stone dimensions, tract length, Hounsfield units, and staghorn definition.

Conclusions

All scoring systems equally predicted SFR and had a weak correlation with Clavien–Dindo complications. Standardisation is needed for the variables in which they have been found deficient.

Outcome of radiotherapy for pituitary adenomas

AIM

The aim of this study was to analyze the outcome and toxicities and its correlation to patient related and treatment related factors.

BACKGROUND

Pituitary adenomas are treated by radiation therapy (RT) as one of the modalities along with surgery and medical therapy. RT to pituitary adenomas is a challenge due to adjacent dose limiting structures such as optic apparatus and hypothalamus.

MATERIALS AND METHODS

Between January 2004 and December 2010, 94 patients treated for pituitary adenoma with RT who had hospital records of a minimum follow-up of 1 year were included in the analysis. Tests of correlation were done with regards to treatment factors.

RESULTS

Male preponderance was noted in our patient population. Nonfunctioning and functioning tumors were equal in number in this series. Hypopituitarism was associated in 58.5% of patients prior to RT. Radiological tumor progression was seen in one patient (1/94) who had a nonfunctioning tumor. Among functioning tumors, biochemical remission was seen in 93.6% of patients at a median follow-up of 6 years.

CONCLUSIONS

Visual complication was seen in 5.3% of patients and worsening or new onset hypopituitarism was seen in 6.4%. Conventional 3-field technique was associated with significantly more visual complication compared to Stereotactic Radiation Therapy (SRT) technique. Doses ≤50.4 Gy showed a trend of reduced rate of visual and endocrine complications with no compromise in efficacy.