Correlation Of Hematocrit And Hemoglobin With Obesity, Serum Lipids And Aldosterone In Newly Diagnosed Hypertensive Patients

To determine the relationship of obesity indicators with certain hemodynamic and metabolic cardiovascular risk factors, at the initial diagnosisof hypertension in a random population, in search of a treatable causeMethods: A case control study was conducted on 201 subjects aged between 25-60 years, diagnosed primarily as prehypertensive or hypertensive stage Iand II , selected from five general practitioners clinics in Karachi. Estimated of hematocrit, hemoglobin, triglycerides, low density lipoproteins, serumpotassium level and aldosterone was done. Their body mass index and waist hip ratio were calculated by measuring body weight, height, waist and hipcircumference. The values obtained were compared with 75 controls with normal blood pressure.The mean and standard deviation were computed. Analysis was done by SPSS version 15.LSD test was applied to compare pair-wise group. Pearson’scorrelation was applied to find out association of different variables with one another, within each of the four groupsResults: The overall percentages of overweight and obese subjects were higher in all four groups. The mean hematocrit and hemoglobin levels werehighest in HTN stage –I (44.7±5.25 and15.4±2.20 respectively). Hemoglobin was strongly correlated to systolic blood pressure and waist hip ratio in bothhypertension stages-I and II (p<0.01). Whereas hematocrit was positively correlated to body mass index, triglycerides, serum potassium and aldosteronelevels in both stages of hypertension (p<0.01)Conclusion: High hematocrit, hemoglobin, triglyceride levels, visceral fat accumulation and aldosterone secretion are important and independent riskfactors for hypertension

Efecto de la hormona de crecimiento sobre los parámetros seminales, el hemograma parcial y el nivel de testosterona en búfalos Nili Ravi

The purpose of this trial was to examine the possible effects of exogenous growth hormone (GH) on semen quality, hematological variables and serum testosterone concentration in Nili Ravi buffalo. Bulls of the treatment group (n=3) were injected with recombinant GH 500 mg in a 15 day interval for 10 consecutive weeks, while bulls of control group (n=3) received equal volume of normal saline solution. Semen samples were collected twice per week and analyzed for physiological parameters. Blood samples collected fortnightly were analyzed for red blood cells count (RBC), hemoglobin concentration (Hb), packed cell volume (PCV), mean corpuscular volume (MCV), white blood cell (WBC), neutrophils, lymphocytes, and serum testosterone levels. Data were analyzed statistically using t-test. Results indicated that GH treatment of Nili-Ravi buffaloes significantly (p<0.05) increased ejaculatory volume (8.8±0.2 vs 7.7±0.2 ml), sperm motility (72.6±0.4 vs 67.4±0.7%), mass activity (3.35±0.07 vs 2.52±0.08), sperm concentration (982.2±67.8 vs 731.9±50.5 million/ml), live sperm (80.1±0.3 vs 75.8±0.5%) and serum testosterone (4.02±0.21 vs 2.37±0.07 ng/ml) compared to control bulls. Among hematological variables, lymphocytes were increased (p<0.05), but MCV, WBC count, and neutrophils decreased (p<0.05). Hb, RBC and PCV remained unchanged. However, values of these variables were within normal ranges for buffalo bulls. In conclusion, treatment of Nili-Ravi bulls with GH improved semen quality and increased serum testosterone without ostensible adverse effects on the general state.El propósito de este ensayo fue examinar los posibles efectos de la hormona de crecimiento exógena (GH) sobre la calidad del semen, algunas variables del hemograma y la concentración de testosterona en suero de toros bubalinos Nili Ravi. Los búfalos del grupo tratado (n=3) fueron inyectados con 500 mg de somatotropina recombinante cada 15 días durante 10 semanas consecutivas, mientras que los del grupo control (n=3) recibieron igual volumen de solución fisiológica salina. Las muestras de semen fueron tomadas dos veces por semana y analizadas para evaluar los parámetros fisiológicos. Las muestras de sangre colectadas quincenalmente fueron analizadas para establecer el recuento de glóbulos rojos, la  concentración de hemoglobina, el hematocrito, el volumen corpuscular medio (MCV), recuento de glóbulos blancos (WBC), tasa de neutrófilos y linfocitos, así como los niveles séricos de testosterona. Los datos obtenidos fueron analizados estadísticamente por medio del test-t de Student. Los resultados indicaron que el tratamiento con somatotropina aumentó significativamente (p<0,05) el volumen eyaculado (8,8±0,2 versus 7,7±0,2 ml), la motilidad del semen (72,6±0,4 versus 67,4±0,7%), la actividad de masa (3,35±0,07 versus 2,52±0,08), la concentración de espermatozoides (982,2±67,8 versus 731,9±50,5 millones/ml), los espermatozoides vivos (80,1±0,3 versus 75,8±0,5%) y el nivel de testosterona sérica (4,02±0,21 versus 2,37±0,07 ng/ml), comparados con los animales controles. En el hemograma aumentaron los linfocitos (p<0,05) y disminuyeron variables como volumen corpuscular medio, recuento de leucocitos y tasa de neutrófilos (p<0,05). Hemoglobina, concentración de eritrocitos y hematocrito permanecieron inalterados. Todos los parámetros investigados se situaron dentro de los rangos normales para toros bubalinos. En conclusión, el tratamiento de búfalos Nili-Ravi con somatotropina mejoró la calidad del semen y aumentó la testosterona sérica, sin provocar ostensibles efectos adversos en el estado general de los toro

An alternative explanation for the density depletions observed by Freja and Viking satellites

In this paper, we have studied the linear and nonlinear propagation of ion acoustic waves in the presence of electrons that follow the generalized (r,q) distribution. It has been shown that for positive values of r, which correspond to a flat-topped electron velocity distribution, the nonlinear ion acoustic waves admit rarefactive solitary structures or density depletions. It has been shown that the generalized (r,q) distribution function provides another way to explicate the density depletions observed by Freja and Viking satellites previously explained by proposing Cairns distribution function.In this paper, we have studied the linear and nonlinear propagation of ion acoustic waves in the presence of electrons that follow the generalized (r,q) distribution. It has been shown that for positive values of r, which correspond to a flat-topped electron velocity distribution, the nonlinear ion acoustic waves admit rarefactive solitary structures or density depletions. It has been shown that the generalized (r,q) distribution function provides another way to explicate the density depletions observed by Freja and Viking satellites previously explained by proposing Cairns distribution function

Architectural Design and Prototyping of Co-PPGIS: A Groupware-Based Online Synchronous Collaborative PPGIS to Support Municipality Development and Planning Management Workflows

Co-PPGIS has a wide variety of applications like municipal planning, emergency response, public health and security, etc. The main focus of this chapter is on the development and design of a Web Collaborative PPGIS (Co-PPGIS) infrastructure. As part of municipality’s planning and management services, Co-PPGIS is developed for real-time map sharing application system. Co-PPGIS is an effective and essential online meeting system for supporting group collaborations on geographic information such as maps and imageries, and capturing and sharing of local/domain knowledge in real time. Co-PPGIS permits amalgamation of geospatial data and collaborator’s input in the form of geo-referenced notations. It incorporates coherent components as map sharing, real-time chat, video conferencing, geo-referenced textual and graphical notations. The study aims to focus on public participation and geo-collaboration facilitated with information sharing, interactive geo-conferencing, real-time map, and data sharing with tools to draw features or add annotation to the map while discussions, uploading documents, and live communication. Co-PPGIS provides an efficient and reliable platform that will significantly reduce the time to acquire, process, and analyze data. The significance of this study is to contribute to existing public participation practices, to municipal planning, to decision-making, or to geographic information science

Diabetes Prevalence Survey of Pakistan (DPS-PAK): prevalence of type 2 diabetes mellitus and prediabetes using HbA1c: a population-based survey from Pakistan

Objectives: We conducted a Pakistan-wide community-based survey on the prevalence of type 2 diabetes using glycated haemoglobin (HbA1c) as the screening test. The aim was to estimate diabetes prevalence across different demographic groups as well as all regions of Pakistan. Design, settings and participants: Multistaged stratified cluster sampling was used for the representative selection of people aged ≥20 years, residing in 378 sampled clusters of 16 randomly selected districts, in this cross-sectional study. Eligible participants had blood drawn for HbA1c analyses at field clinics near to their homes. The oral glucose tolerance test (OGTT) was conducted on a subsample of the participants. Overall and stratified prevalence of type 2 diabetes and its association with risk factors were estimated using logistic regression models. Main outcome measures: Prevalence of prediabetes and type 2 diabetes. Results: Of 18 856 eligible participants the prevalence of prediabetes was 10.91% (95% CI 10.46 to 11.36, n=2057) and type 2 diabetes was 16.98% (95% CI 16.44 to 17.51, n=3201). Overall, the mean HbA1c level was 5.62% (SD 1.96), and among newly diagnosed was 8.56% (SD 2.08). The prevalence was highest in age 51–60 years (26.03%, p\u3c0.001), no formal education (17.66%, p\u3c0.001), class III obese (35.09%, p\u3c0.001), family history (31.29%, p\u3c0.001) and female (17.80%, p=0.009). On multivariate analysis, there was a significant association between type 2 diabetes and older age, increase in body mass index and central obesity, positive family history, and having hypertension and an inverse relation with education as a categorical variable. On a subsample (n=1027), summary statistics for diagnosis of diabetes on HbA1c showed a sensitivity of 84.7%, specificity of 87.2% and area under the receiver operating characteristic curve 0.86, compared with OGTT. Conclusions: The prevalence of type 2 diabetes and prediabetes is much higher than previously thought in Pakistan. Comprehensive strategies need to be developed to incorporate screening, prevention and treatment of type 2 diabetes at a community level

Ceftriaxone-resistant Salmonella Typhi Outbreak in Hyderabad City of Sindh, Pakistan: High Time for the Introduction of Typhoid Conjugate Vaccine

Background. The Aga Khan University clinical microbiology laboratory identified an outbreak of ceftriaxone-resistant Salmonella Typhi in Hyderabad, Pakistan, through antimicrobial resistance surveillance. An outbreak investigation was carried out to identify the risk factors and institute control measures. Here we report the preliminary findings of this outbreak investigation, using data collected from 30 November 2016 to 28 March 2017. Methods. The design for the investigation was a case-control study that included identification of culture-proven ceftriaxoneresistant S. Typhi cases, suspected cases from the households or neighborhood of the confirmed cases, and enrollment of controls matched by age to identify the risk factors. Data were collected through face-to-face interviews using a structured questionnaire. Blood cultures were obtained from all suspected cases. Drinking water samples from each household of cases and controls were obtained for microbiological testing. Geographic Information System coordinates were obtained for all cases and controls. Results. Only 2 subdistricts of Hyderabad (Latifabad and Qasimabad) were affected. A total of 101 confirmed cases of ceftriaxone- resistant S. Typhi had been reported in 4 months with the first case reported on 30 November 2016. Median age was 48 (interquartile range, 29-84) months. The majority (60% [61/101]) of the cases were 6-60 months old. More than half (56% [57/101]) of the cases were male. About 60% of the cases were admitted to hospital and treated as inpatient. More than half (57/101) of the patients developed complications related to typhoid. Conclusions. Community awareness was raised regarding chlorination of drinking water and sanitation measures in Hyderabad. These efforts were coordinated with the municipal water and sewage authority established to improve chlorination at processing plants and operationalize fecal sludge treatment plants. Outbreak investigation and control efforts have continued. Immunization of children with typhoid conjugate vaccine within Hyderabad city is planned

Diabetes Prevalence Survey of Pakistan (DPS-PAK): prevalence of type 2 diabetes mellitus and prediabetes using HbA1c: a population-based survey from Pakistan

Objectives: We conducted a Pakistan-wide community-based survey on the prevalence of type 2 diabetes using glycated haemoglobin (HbA1c) as the screening test. The aim was to estimate diabetes prevalence across different demographic groups as well as all regions of Pakistan. Design, settings and participants: Multistaged stratified cluster sampling was used for the representative selection of people aged ≥20 years, residing in 378 sampled clusters of 16 randomly selected districts, in this cross-sectional study. Eligible participants had blood drawn for HbA1c analyses at field clinics near to their homes. The oral glucose tolerance test (OGTT) was conducted on a subsample of the participants. Overall and stratified prevalence of type 2 diabetes and its association with risk factors were estimated using logistic regression models. Main outcome measures: Prevalence of prediabetes and type 2 diabetes. Results: Of 18 856 eligible participants the prevalence of prediabetes was 10.91% (95% CI 10.46 to 11.36, n=2057) and type 2 diabetes was 16.98% (95% CI 16.44 to 17.51, n=3201). Overall, the mean HbA1c level was 5.62% (SD 1.96), and among newly diagnosed was 8.56% (SD 2.08). The prevalence was highest in age 51–60 years (26.03%, p<0.001), no formal education (17.66%, p<0.001), class III obese (35.09%, p<0.001), family history (31.29%, p<0.001) and female (17.80%, p=0.009). On multivariate analysis, there was a significant association between type 2 diabetes and older age, increase in body mass index and central obesity, positive family history, and having hypertension and an inverse relation with education as a categorical variable. On a subsample (n=1027), summary statistics for diagnosis of diabetes on HbA1c showed a sensitivity of 84.7%, specificity of 87.2% and area under the receiver operating characteristic curve 0.86, compared with OGTT. Conclusions: The prevalence of type 2 diabetes and prediabetes is much higher than previously thought in Pakistan. Comprehensive strategies need to be developed to incorporate screening, prevention and treatment of type 2 diabetes at a community level

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead