21 research outputs found
Performance of urinary survivin as a non-invasive molecular marker of bladder carcinoma in a schistosomiasis endemic area
Objective: To compare the sensitivity, specificity, positive predictive value, negative predictive value of urinary survivin and that of urine cytology in the diagnosis of bladder carcinoma in a schistosoma endemic area.Design and setting: This is a 12-month prospective study of patients with features of bladder carcinoma as study group and patients with other urologic conditions and healthy volunteers as control group.Participants: Patients with features of bladder carcinoma formed the study group, while patients with other urological conditions and healthy volunteers formed the control group.Results: There were 52 patients in study group and 36 patients in control group. The mean ages of patients in the study and control groups were 47.17 ± 17.00 and 44.19 ± 18.89 years respectively. There were 48 males and 4 females in the study group, giving a male: female ratio of 12:1. Thirty-one (60 %) of the patients were farmers and 44 patients (85%) had history suggestive of schistosomiasis at childhood. The sensitivity of urine cytology and survivin in the study were 29.1% and 100.0% respectively. The specificity of urine cytology and survivin were 100.0%and 100.0% respectively (p= 0.05). The marker was associated with false positive (FP) results in patients with prostate cancer.Conclusion: Urinary survivin is highly sensitive, specific and predictive of bladder carcinoma in our environment. The marker is associated with false positive results in patients with prostate cancer.Funding: By authorsKeywords: survivin, urinary bladder carcinoma, schistosomiasis, sensitivity, specificit
Bladder Calculus Following an Unusual Vesical Foreign Body
Bladder calculus following vesical foreign bodies is uncommon. The usual presentation is presence of lower urinary symptoms. Most of these foreign bodies are either left inadvertently after open bladder operations or migrate from adjacent structures. This is a case report of an unusual self inserted foreign body in a female presenting with bladder calculus and diverticulum. Self inserted foreign body, particularly in females, is one of the important causes of bladder stones. Foreign body in the bladder should be suspected in a female patient with chronic lower urinary tract symptoms even in the absence of trauma or intervention
Key Words: Urinary Bladder, Calculus, Foreign bod
Incidence and pattern of injuries among residents of a rural area in South-Western Nigeria: a community-based study
<p>Abstract</p> <p>Background</p> <p>Despite the high incidence of infectious diseases in developing countries, injuries still contribute significantly to the health burden. There are few reports of rural, community-based injury surveys in Nigeria. This study describes the incidence and pattern of injuries among the residents of a rural area in South-Western Nigeria.</p> <p>Methods</p> <p>It was a community based cross-sectional study. Two of six census areas were randomly selected and all households in the two areas visited. Information on the sociodemographic characteristics, individual injury events and outcomes was obtained with a questionnaire. Data were analyzed using SPSS version 11.</p> <p>Results</p> <p>Information was obtained on the 1,766 persons in 395 households. Fifty-nine injuries were recorded by 54 people, giving an injury incidence of 100 per 1,000 per year (95% CI = 91.4–106.9). Injury incidence among <30 years was 81.6 per 1,000 per year (95% CI = 62.3–83.1); and 126 per 1,000 per year (95% CI = 98.2–137.4) for those ≥ 30 years (p = 0.013). Injury incidence for females was 46 per 1,000 per year; and 159 per 1,000 per year (p = 0.000) for males. A significantly higher proportion of males (5%) sustained injury compared to females (2%) (p = 0.043). Falls and traffic injures, 15 (25%) each, were the leading causes of injury; followed by cuts/stabs 12 (21%), and blunt injuries, 9 (15%). Traffic injuries were the leading cause of injuries in all age groups except among the 5–14 years where falls were the leading cause of injury. In thirty-four (58%) of those injuries, treatment was at a hospital/health centre; while in two (3%), treatment was by untrained traditional practitioners. Thirty-nine (66%) of the injuries were fully recovered from, and 19 (32%) resulted in disability. There were 2 fatalities in the 5-year period, one (2%) within the study period.</p> <p>Conclusion</p> <p>Injuries were common in Igbo-Ora, though resultant disability and fatality were low. Males and those aged ≥ 30 years had significantly higher proportions of the injured. Falls and traffic injuries were the most commonly reported injuries. Appropriate interventions to reduce the occurrences of injuries should be instituted by the local authorities. There is also need to educate the community members on how to prevent injuries.</p
Regular consumption of vitamin D-fortified yogurt drink (Doogh) improved endothelial biomarkers in subjects with type 2 diabetes: a randomized double-blind clinical trial
<p>Abstract</p> <p>Background</p> <p>Endothelial dysfunction has been proposed as the underlying cause of diabetic angiopathy that eventually leads to cardiovascular disease, the major cause of death in diabetes. We recently demonstrated the ameliorating effect of regular vitamin D intake on the glycemic status of patients with type 2 diabetes (T2D). In this study, the effects of improvement of vitamin D status on glycemic status, lipid profile and endothelial biomarkers in T2D subjects were investigated.</p> <p>Methods</p> <p>Subjects with T2D were randomly allocated to one of the two groups to receive either plain yogurt drink (PYD; containing 170 mg calcium and no vitamin D/250 mL, n<sub>1 </sub>= 50) or vitamin D3-fortified yogurt drink (FYD; containing 170 mg calcium and 500 IU/250 mL, n<sub>2 </sub>= 50) twice a day for 12 weeks. Anthropometric measures, glycemic status, lipid profile, body fat mass (FM) and endothelial biomarkers including serum endothelin-1, E-selectin and matrix metalloproteinase (MMP)-9 were evaluated at the beginning and after the 12-week intervention period.</p> <p>Results</p> <p>The intervention resulted in a significant improvement in fasting glucose, the Quantitative Insulin Check Index (QUICKI), glycated hemoglobin (HbA1c), triacylglycerols, high-density lipoprotein cholesterol (HDL-C), endothelin-1, E-selectin and MMP-9 in FYD compared to PYD (<it>P </it>< 0.05, for all). Interestingly, difference in changes of endothelin-1, E-selectin and MMP-9 concentrations in FYD compared to PYD (-0.35 ± 0.63 versus -0.03 ± 0.55, <it>P </it>= 0.028; -3.8 ± 7.3 versus 0.95 ± 8.3, <it>P </it>= 0.003 and -2.3 ± 3.7 versus 0.44 ± 7.1 ng/mL, respectively, <it>P </it>< 0.05 for all), even after controlling for changes of QUICKI, FM and waist circumference, remained significant for endothelin-1 and MMP-9 (<it>P </it>= 0.009 and <it>P </it>= 0.005, respectively) but disappeared for E-selectin (<it>P </it>= 0.092). On the contrary, after controlling for serum 25(OH)D, the differences disappeared for endothelin-1(<it>P </it>= 0.066) and MMP-9 (<it>P </it>= 0.277) but still remained significant for E-selectin (<it>P </it>= 0.011).</p> <p>Conclusions</p> <p>Ameliorated vitamin D status was accompanied by improved glycemic status, lipid profile and endothelial biomarkers in T2D subjects. Our findings suggest both direct and indirect ameliorating effects of vitamin D on the endothelial biomarkers.</p> <p>Trial registration</p> <p>ClinicalTrials.gov: <a href="http://www.clinicaltrials.gov/ct2/show/NCT01236846">NCT01236846</a></p
Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial
Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome
Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial
Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome
IRANIAN DIABETICS MAY NOT BE VITAMIN D DEFICIENT MORE THAN HEALTHY SUBJECTS
"nThere are some reports of decreased serum levels of 25(OH)D in the subjects with impaired glucose tolerance and type 2 diabetes mellitus (T2DM). To assess vitamin D status of the Iranian diabetics, a pilot study was conducted on 90 subjects with either type 1 diabetes mellitus (T1DM) (n= 30), T2DM (n= 30), or apparently healthy subjects (n= 30) during fall and winter of 2005. Serum samples were analyzed for 25-hydroxycholecalciferol using three different methods: high-performance liquid chromatography (HPLC), competitive protein-binding assay (CPBA) and radioimmunoassay (RIA). In this study serum levels of 25(OH)D were categorized as follows: sufficient &ge; 37 nmol/L; 25 nmol/L &le; mild deficiency &lt; 37 nmol/L; 12.5 nmol/L &le; moderate deficiency &lt; 25 nmol/L; severe deficiency &lt; 12.5 nmol/L. Results showed that the occurrence of vitamin D insufficiency was almost the same in patients with T1DM and healthy controls. Mean serum level of 25(OH)D in patients with T2DM was significantly higher than in T1DM, as judged by HPLC (58.2 &plusmn; 8.5 vs. 35 &plusmn; 5 nmol/L, Mann Whitney U-Wilcoxon, P= 0.024). Moreover, both CPBA and RIA showed some over-estimation of serum 25(OH)D, compared to HPLC. Our findings suggest that, at least in the cold seasons, vitamin D status of the healthy subjects may not be higher than that of T1DM patients