Screening Procedure for Hemihypertrophy: Preliminary Results of International Multicenter Prospective Study

Introduction: Isolated or congenital hemihypertrophy is a rare disorder characterized by asymmetric overgrowth of one side of the body. This article describes the protocol and preliminary results of a lateral body asymmetry (hemihypertrophy) screening procedure performed in healthy adolescents in a multicenter study. The reported incidence of hemihypertrophy varies between different publications and standardized protocols are needed to improve research in this area.Methods: Our screening program is taking place in Australia, Israel, Mexico, Ukraine and USA. Procedure includes two steps:  (1) “three measurements – three questions” screening, or assessment of face, palms, and shins; (2) in-depth assessment of selected cases in order to exclude localized, lesional, and syndrome-related cases as well as body asymmetry within normative range and to select suspected cases of isolated hemihypertrophy. This step includes measurements of various anatomical regions and a detailed questionnaire.Results: At this stage, the screening procedure is completed and the selected participants are advised to refer to medical institutions for further clinical and genetic follow up to exclude possible tumors and other accompanying disorders.Conclusion: We present an easy-to-use selection tool to identify children with suspected IH, which results in the selection of the risk group that may benefit from referral to a pediatrician and a clinical geneticist

Evaluation of micronuclei in oral mucosa of individuals exposed to ionizing radiation: a pilot study from Celaya, México

Introduction: Occupational exposure to ionizing radiation can potentially lead to adverse health effects, including cancer and genetic defects. Genetic damage caused by radiation can be detected if micronuclei are observed. The objective of this pilot study was to detect the presence of micronuclei in cells of the oral mucosa in inidividuals occupationally exposed to ionizing radiation.Methods:  We implemented a pilot case-control study in which we compared oral mucosa micronuclei in 30 medical and nursing personnel in radiology centers in Celaya, Mexico, with 30 volunteers not exposed to ionizing radiation recruited from a public University. The oral mucosa was brushed and the amount of micronuclei was quantified. Chi-square test or t-test for two proportions were used to compared ionizing radiation and genetic damage between exposed and non-exposed groups.Results: The exposed group had an average of 5.37 ± 3.49 micronuclei and the non-exposed had 0.37 ± 0.61 (P<0.01). In the exposed group, 90% of participants exhibited genetic damage compared to 6.67% in the unexposed group (P<0.05).Conclusion: In this pilot study, medical and nursing staff from radiology centers presented with higher genetic damage compared to control group. Further studies are needed to identify the prevalence of genetic damage due to occupational radiation exposure in Mexico

Prevalence of overweight, obesity, and associated risk factors in healthy female adolescents in Tehran, Iran

Introduction: Obesity is an important health concern worldwide and is a growing problem in Iran. Adolescent  obesity has a major role in development of adulthood obesity and its complications. The present study was conducted to evaluate the prevalence of overweight, obesity, and associated risk factors in female adolescents living in Tehran, Iran.Methods: This cross-sectional study was carried out among 2,132 female adolescents aged 14-17 years in Tehran recruited between 2017 and 2018. Weight and height were measured and body mass index (BMI) was calculated. Underweight, overweight, and obesity were considered as < 5th, ? 85th, and ? 95th percentile, respectively, of CDC BMI-for age and sex criteria. Adolescents and their mothers filled in the questionnaires on physical activity, computer use, duration of breastfeeding, total sleep time, and family socioeconomic status. Statistical analysis was performed using SPSS version 22.0 software. P < 0.05 was considered statistically significant.Results: The overall prevalence rates of overweight and obesity were 24.1% and 6.5%, respectively. The prevalences of overweight and obesity were highest in the South District (28.9% and 7.7%, respectively) and were lowest in the North District (19.1% and 5.2%, respectively). There were significant differences in physical activity level (P < 0.001), total sleep time (P < 0.001), duration of breastfeeding (P < 0.01), and daily computer use (P < 0.001) among the four groups (underweight, normal, overweight, and obese). Regarding the socioeconomic status, parental education level and economic status were significantly higher in those who had normal weight compared to other weight groups (in both, P < 0.001).Conclusion: This study showed that overweight and obesity among female adolescents in Tehranhave become a major public health concern. Level of physical activity, computer use, sleep duration, breastfeeding duration, levels of parental education, and economic status were associated with overweight and obesity prevalence

Hydatid Disease in the Central Region of Iran: A 5-year Epidemiological and Clinical Overview

Introduction: Hydatid cyst is caused by an infection by the larval stage of Echinococcus granulosus. Patients with cystic echinococcosis often remain asymptomatic until the hydatid cysts grow large enough to cause symptoms and signs. The cysts grow in the course of several years before reaching maturity and the rate of growth depends on the location of the cyst. Methods: This study was conducted in the Central region of Iran and involved all patients diagnosed with hydatid disease from 2012 to 2016 with the records identifed from 10 centers for disease control. Descriptive statistics including range and percentage were used in analyzing the patient characteristics. Results: Hydatid disease was confirmed in 84 cases. The mean age of patients was (23.1±5.1) years (range: 15-53 years) and 55.9% of cases were female. Single organ involvement was found in 86.9% of cases. 98.8% cases were successfully treated. The most common sites of infection were lung (42.9%), followed by liver (38.1%), and joint liver/lung (10.7%). The diagnosis was established by abdominal ultrasound, abdominal CT, and serology in all patients. The diagnosis was confirmed by histology in 80 (95.2%) of cases. All of cases were treated with albendazole, and 80 (95.2%) of cases had surgical intervention. The prevalence of human hydatidosis in our study was 1.16 per 100,000 population. Conclusions: Hydatid disease is common in Iran and should be a focus of public health interventions. The organ sites affected in this study include lung and liver

Prevalence of Chronic Kidney Disease in Adults with Type 2 Diabetes Mellitus from Oxcutzcab, Yucatán

Introduction: The complications of type 2 diabetes mellitus (T2DM), such as chronic kidney disease (CKD), are the second leading cause of death in Oxcutzcab municipality of Yacatan, Mexico. The objective of the study was to estimate the burden of chronic kidney disease in a sample of patients with T2DM from Oxcutzcab municipality of Yacatan, Mexico, region characterized by high amound of poverty and vulnerabidity.Methods: This is a descriptive study involving 108 adult patients between 26 and 79 years old with T2DM who attended the PROSPERA, social protection program under the direction of Ministry of Social Development of Mexico (88% female and 12% male). Weight, height, BMI, and years of post T2DM diagnosis were measured. Estimated glomerular filtration rate (eGFR) was calculated using the Cockcroft-Gault formula. Results: We found that 39.81% of participants had stage one kidney damage, 34.26% stage two, 24.07% stage three, one case of stage four, and one of stage five. BMI measurements indicated that 40.74% of participants were obese (?30kg/m2), 35.19% were overweight, and 1.85% were underweight. In terms of years since diagnosis, 37.04% of the participants were diagnosed five years ago and less, 29.63% of participants were diagnosed 6-10 years ago, 22.22% between 11-15 years ago, 8.33% between 16-20 years ago, and 2.78% of participants over 20 years ago.Conclusions: Most participants were in stages one to three of kidney damage, where the main objective of the medical team was medical treatment of T2DM and comorbidities, as well as nutritional support to prevent further complications. There was only one case in stage four and five each, where dialysis and kidney transplantation became necessary. Both cases presented had a history of T2DM for over 20 years. It is important to identify early kidney damage to improve quality of life, reduce the treatment costs, and lower mortality

Knowledge and Perception of Diabetes and Available Services among Diabetic Patients in the State of Qatar

Introduction: Diabetes is a major public health concern in Qatar. This study examined diabetes knowledge and perception of available services for diabetes control among diabetic patients in Qatar.Methods: Data from 300 diabetic patients were collected through face-to-face interviews using a semi-structured questionnaire between February and May 2015 at Hamad Medical Corporation healthcare facilities in Qatar. Survey responses were represented as frequencies, and Chi-square tests were used to compare proportions across gender. A p-value of 0.05 was considered statistically significant.Results: 31% of patients had Type 1 Diabetes (T1D) (females 36.6%, males 26.5%) and 54% had Type 2 Diabetes (T2D) (males 56.6%, females 50%). Knowledge about diabetes types did not differ by sex (P=0.16). 32.3% of patients were treated for diabetes-related complications including: high cholesterol (39.2%), vision problems (33.1%), hypertension (30.0%), and foot problems (25.1 %). Most patients were diagnosed at primary care clinics (41.7%). During visits, 78.3% of patients reported that they were fully advised about different diabetes tests. 57.0% of patients had ?4 visits for diabetes checkups in the past 12 months. 66.7% of patients reported that they were confident or very confident in managing their diabetes as a result of their healthcare visits in the past year. The majority of patients reported receiving diabetes-related guidance from physicians (89.7%).Conclusions: Study participants had variable knowledge of diabetes, its complications and risk factors, and services available to diabetics. More comprehensive education and awareness about diabetes is recommended for both patients and family members. At the provider level, further improvement in patient counseling and promotion of available services can be beneficial

Estimating Maternal Mortality in Remote Rural Regions: an Application of the Sisterhood Method in Tajikistan

Introduction: The sisterhood method of maternal mortality data collection and analysis provides a validated framework for estimating maternal mortality ratios in situations of limited infrastructure. The aim of this study is to assess sub-national maternal mortality in the Badakhshan region of Tajikistan using the sisterhood method as part of a larger ethnographic study on maternal risk.Methods: In 2006-2007, 1004 married women of reproductive age in Gorno-Badakhshan Autonomous Oblast, Tajikistan were surveyed using the sisterhood method. Respondents were asked eleven questions about the sex, age and survivorship of all children born to the respondent’s mother.Results: Using a national total fertility rate (TFR) estimate of 4.88, the maternal mortality ratio (MMR) in Tajik Badakhshan was 141 maternal deaths per 100,000 live births (95% CI 49-235). The lifetime risk of maternal death was 1 in 141 (95% CI 34-103).Conclusion: Given the inherent time-lag of the sisterhood method, precise estimates of maternal mortality are dependent on accurate TFRs, which may vary based upon regional experiences of demographic transitions. Socio-political instability and the dismantling of Soviet welfare programs and civil war following Tajikistan’s independence from the Soviet Union in 1991 likely impacted TFR in Tajik Badakhshan. Socio-political trends influencing TFR in rural regions compared to urban, and the investigation of factors associated with maternal mortality, require additional investigation

Trends in the leading causes of childhood mortality from 2004 to 2016 in Qatar

Introduction: Childhood mortality is an important health indicator that reflects the overall health status of a population. Despite the decrease in global childhood mortality rates over the past decades, it still remains an important public health issue in Qatar.Methods: The data from 2004-2016 were extracted from the Qatar Ministry of Public Health Birth and Death Database. International Classification of Diseases (ICD-10) was used for coding the causes of death. The childhood mortality rate was defined as the probability of a child dying between the first and the fifth birthday, expressed as the number of deaths per 1,000 children surviving to 12 months of age. The sex ratio was calculated by dividing the mortality rate of males by that of females. Mann-Kendall trend test was performed to examine time trends. Relative risks were calculated to examine differences by nationality (Qatari and non-Qatari) and sex.Results: A significant decrease in mortality rate of children aged one to five was observed from 1.76 to 1.05 per 1000 children between 2004 and 2016 (Kendall tau=-0.6, p=0.004). Three prominent causes of mortality were motor vehicle accidents, congenital malformations of the circulatory system, and accidental drowning/submersion. A statistically non-significant decrease in childhood mortality from motor vehicle accidents was oberved for all nationalities (total (Kendall tau=-0.03), Qatari (Kendall tau=-0.14), and non-Qatari (Kendall tau=-0.12)). A significant decrease was seen for total accidental drowning and submersion (Kendall tau=-0.54, p=0.012), while no statistically significant decrease was seen for total congenital malformations of the circulatory system (Kendall tau=-0.36, NS). The Qatari population did have a significant decrease in childhood mortality due to congenital malformations of the circulatory system (Kendall tau=-0.67, p=0.003) and accidental drowning and submersion (Kendall tau=-0.55, p=0.016).Conclusion: The study is a first attempt to evaluate childhood mortality statistics from Qatar and could be useful in supporting Qatar’s ongoing national health strategy programs

Discovery of Actinomycetes from Extreme Environments with Potential to Produce Novel Antibiotics

Introduction: Antimicrobial-resistant pathogens pose serious challenges to healthcare institutions and health of the public. Thus, there is an urgent need for the discovery of new and effective antimicrobial agents.  Microorganisms that exist in extreme environments such as those with high salinity or alkalinity, are known as extremophiles, and include various species of actinomycetes. The goal of this study is to discover novel antibiotics from extremophiles found in Kazakhstan that are effective against drug resistant pathogens.Methods: Soil from extreme environments of Kazakhstan was collected, and pure cultures of actinomycetes were isolated and cultured in modified Bennett’s broth with either high concentrations of salt or high pH to mimic extreme environments. Extracts obtained from selected actinomycetes strains were used to test for antimicrobial activity against Staphylococcus aureus, Escherichia coli and Aspergillus niger.Results: A total of 5936 strains of extremophile actinomycetes were isolated; from these, 2019 strains were further isolated into pure cultures. Of these, 415 actinomycetes strains that demonstrated antagonistic antibacterial activities were selected.  These actinomycetes were further classified into groups and subgroups based on their responses to different culture conditions. Antimicrobial antagonism activity for some of the actinomycetes strains was dependent on culture conditions and development of  aerial mycelia under extreme conditions.Conclusion: We identified several interesting candidate extracts with putative antimicrobial activities against several strains of drug resistant pathogens. Our research of the actinomycetes’ ability to produce antibiotics in the near-natural conditions provides a great opportunity to assess their biodiversity and distribution in the Central Asian region and to develop new methodological approaches to the screening of new antimicrobial agents

Burden of the Cardiovascular Diseases in Central Asia

Cardiovascular diseases (CVD) are now the number one cause of death in low- and middle-income countries, including those in Central Asia (CA). Low- and middle- income countries (LMICs) bear a disproportionate and growing burden of CVD, which constitutes a challenge to national development. CVD account for more than 43% of cases of disability and 9.0% of cases of temporary disability in many developing countries. The high burden of CVD oftentimes results from insufficient preventive care and a lack of education about the prevention and treatment of these diseases. The rapidly growing burden of CVD and other major non-communicable diseases (NCDs) is a global public health threat, especially in Central Asia. Information on cardiovascular risk factors, including hypertension, diabetes, tobacco use, and alcohol use, is traditionally obtained from studies conducted in Europe and North America, which limits our understanding of these factors in Central Asia. In this review, we collected all published information on CVD in Central Asia from 2000 to 2015, which included the websites of the Ministries of Health, the World Health Organization, PubMed, and other published sources.This narrative review describes CVD burden, stroke incidence, and common CVD risk factors in the five post-Soviet countries of Central Asia (Kazakshstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan)