Non-classical reproductive tract infections on the rise in women in Dschang, Cameroon

Health promotion and education, wide coverage and pinpointing impediments to the realization of prevailing measures are among primary interventions for sexually transmitted infections (STIs). This work sought to establish STIs burden and related risk factors in women consulting gynecologists and general practitioners in some health centres in Dschang, Cameroon. For seven consecutive months, in a cross-sectional study, 1009 heterosexual women were examined; 353 (35%) symptomatic patients aged 15-46 years (mean 31±3.3years) consented and were interviewed using a questionnaire. Vaginitis was diagnosed by symptoms, positive cultures, and testing of blood and cervical specimens for antibodies to Treponema pallidum and Chlamydia trachomatis respectively. Infections recorded 45% under gynecological care and 14% for general consultations (p< 0.001), with an alarming 84% of general consultation cases without any intention of STIs screens or having future gynecologic appointments. Multiple sexual partners, early sexual debut, poverty, poor sanitation, recurrent infections, tight underwear, no barrier protection or irregular condom use and using chemicals in the vagina were recorded risks. Infectious vaginitis was identified in 300 (30%) patients, 53(5%)cases were non –infectious and 60% had multiple infections. Bacterial vaginosis (28%) and vaginal candidiasis (21%) predominated. Rates for C. trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Phthirus pubis,infectious syphilis, genital warts and genital herpes were < 2%. The present findings portrayed: STIs not given prime consideration under general practice, and a rising trend for non-traditional genital diseases due to poor hygiene and reproductive health knowledge deficiency. Health and sanitary campaigns, and mandatory gynecological exams for individuals of reproductive age were inevitable.Keywords: reproductive tract infections, women, pathogens, risk factors, prevention, Cameroon

Knowledge and Practice of Family Planning in Dschang Municipality, Cameroon

This study was conducted to examine factors which influence contraception in order to ameliorate services. For 12 consecutive months, 706 consenting women on fertility control presenting at the Dschang District Hospital, Cameroon were interviewed and cervical/blood samples collected for analysis. Study respondents were aged 15-50 years (mean 33.61±6.29 years). Levonorgestrel implants (46.7%) and medroxyprogesterone injections (27.6%) were cost effective over the intrauterine copper device (9.5%), Norgestrel (7.8%), Norethisterone enanthate (6.7%), male condoms (6.4%), Progestin only pills (1.4%) and spermicides (1.1%). Lack of expertise precluded tubal ligation or implants and vasectomy. Stigmatization, male rejection, giving or taking methods without adequate laboratory services or regular health checks and failure to recognize or report adverse reproductive health changes impacted on contraception. Genital infections were identified in 33.7% respondents, vaginal candidiasis 20%, bacterial vaginosis 19%, HIV/AIDS 9%, chlamydia 6% and <2% other traditional venereal diseases. Sensitization, education, improved diagnostics and attitude change were adopted.RésuméCette étude a été menée pour examiner les facteurs qui influent sur la contraception dans le but d'améliorer les services. Pendant 12 mois consécutifs, 706 femmes consentantes sur le contrôle de la fertilité qui fréquentent l'hôpital de district de Dschang, au Cameroun ont été interviewées et des échantillons des cols de l’utérus /du sang ont été prélevés pour analyse. Les participantes à l'étude étaient âgées de 15-50 ans (moyenne ± 33,61 6,29 années). Les implants au lévonorgestrel (46,7%) et les injections de médroxyprogestérone (27,6%) étaient rentables sur le dispositif intra-utérin (9,5%), Norgestrel (7,8%), Norethisterone énanthate (6,7%), les préservatifs masculins (6,4%), les pilules progestatives seulement (1,4%) et les spermicides (1,1%). Le manque d'expertise a empêché la ligature des trompes ou des implants et la vasectomie. La stigmatisation, le rejet du mâle, le don ou la prise des méthodes sans des services de laboratoire adéquats ou des bilans de santé réguliers et l'incapacité à reconnaître ou à déclarer des changements défavorables de santé de la reproduction a eu une influence sur la contraception. Les infections génitales ont été identifiées chez 33,7% des personnes interrogées, la candidose vaginale 20%, la vaginose bactérienne 19%, le VIH / sida 9%, 6% et chlamydia <2% d'autres maladies vénériennes classiques. La sensibilisation, l’éducation, ont amélioré les diagnostics et l’on a adopté les changements d'attitude.Keywords: contraception, women, socio-demographics, barriers, genital healt

ACE inhibitor and angiotensin receptor-II antagonist prescribing and hospital admissions with acute kidney injury: A longitudinal ecological study

This is the final version. Available from the publisher via the DOI in this record.Background: ACE Inhibitors (ACE-I) and Angiotensin-Receptor Antagonists (ARAs) are commonly prescribed but can cause acute kidney injury (AKI) during intercurrent illness. Rates of hospitalization with AKI are increasing. We aimed to determine whether hospital AKI admission rates are associated with increased ACE-I/ARA prescribing. Methods and Findings: English NHS prescribing data for ACE-I/ARA prescriptions were matched at the level of the general practice to numbers of hospital admissions with a primary diagnosis of AKI. Numbers of prescriptions were weighted for the demographic characteristics of general practices by expressing prescribing as rates where the denominator is Age, Sex, and Temporary Resident Originated Prescribing Units (ASTRO-PUs). We performed a mixed-effect Poisson regression to model the number of admissions for AKI occurring in each practice for each of 4 years from 1/4/2007. From 2007/8-2010/11, crude AKI admission rates increased from 0.38 to 0.57 per 1000 patients (51.6% increase), and national annual ACE-I/ARA prescribing rates increased by 0.032 from 0.202 to 0.234 (15.8% increase). There was strong evidence (p<0.001) that increases in practice-level prescribing of ACE-I/ARA over the study period were associated with an increase in AKI admission rates. The increase in prescribing seen in a typical practice corresponded to an increase in admissions of approximately 5.1% (rate ratio = 1.051 for a 0.03 per ASTRO-PU increase in annual prescribing rate, 95%CI 1.047-1.055). Using the regression model we predict that 1,636 (95%CI 1,540-1,780) AKI admissions would have been avoided if prescribing rates were at the 2007/8 level, equivalent to 14.8% of the total increase in AKI admissions. Conclusion: In this ecological analysis, up to 15% of the increase in AKI admissions in England over a 4-year time period is potentially attributable to increased prescribing of ACE-I and ARAs. However, these findings are limited by the lack of patient level data such as indication for prescribing and patient characteristics. © 2013 Tomlinson et al.Cambridge Biomedical Research InstituteBritish Heart Foundatio

The accuracy of diagnostic coding for acute kidney injury in England - A single centre study

This is the final version. Available on open access from BMC via the DOI in this recordBackground: Acute kidney injury (AKI) is an independent risk factor for mortality and is responsible for a significant burden of healthcare expenditure, so accurate measurement of its incidence is important. Administrative coding data has been used for assessing AKI incidence, and shows an increasing proportion of hospital bed days attributable to AKI. However, the accuracy of coding for AKI and changes in coding over time have not been studied in England. Methods. We studied a random sample of admissions from 2005 and 2010 where ICD-10 code N17 (acute renal failure) was recorded in the administrative coding data at one acute NHS Foundation Trust in England. Using the medical notes and computerised records we examined the demographic and clinical details of these admissions. Results: Against a 6.3% (95% CI 4.8-7.9%) increase in all non-elective admissions, we found a 64% increase in acute renal failure admissions (95% CI 41%-92%, p<0.001) in 2010 compared to 2005. Median age was 78 years (IQR 72-87), 11-25% had a relevant pre-admission co-morbidity and 64% (55-73%) were taking drugs known to be associated with AKI. Over both years, 95% (91-99%) of cases examined met the Kidney Disease: Improving Global Outcomes criteria for AKI. Conclusions: Patients with hospital admissions where AKI has been coded are elderly with multiple co-morbidities. Our results demonstrate a high positive predictive value of coding data for a clinical diagnosis of AKI, with no suggestion of marked changes in coding of AKI between 2005 and 2010. © 2013 Tomlinson et al; licensee BioMed Central Ltd.Cambridge Biomedical Research InstituteBritish Heart Foundatio

Phytosanitary practices and evaluation of 17 pesticides residues in tomatoes fruits produced in Foumbot District Western Highland-Cameroon

The involvement of pesticides in agriculture requires the implementation of best phytosanitary practices in order to guarantee the health of populations and preserve the environment. This study focused on the assessment of phytosanitary practices of tomato producers in Foumbot, Western Highlands-Cameroon, and evaluated the residues of 17 pesticides in tomatoes. The methodological approach consisted of field investigations by survey, collection of samples, pesticide residue extraction using QuEChERS method, and their analysis by gas chromatography tandem mass spectrometry (GC-MS). Survey of 100 farmers showed that, they did not comply with the instructions for the use of plant protection products: 56% of farmers interviewed increased the dose of products when they noticed its ineffectiveness; 93% did not the respect pre-harvest intervals; while 77% increased the application frequency at the time of fruiting. All the producers work without personal protective equipment (PPE) and 68% of them use empty packaging for packaging consumable including water, red oil and palm wine. The reuse of empty packaging could expose populations (producers and consumers) to numerous health risks. Regarding pesticides residues, 03 actives ingredients were detected and quantified in the samples, all the samples were contaminated by lambda-cyhalothrin, 86.66% by cypermethrin and 66.66% by acetamiprid. Moreover, residue concentrations above the maximum residue limit (MRL) were found in all the positive samples of lambda-cyhalothrin, and 92.30% of cypermethrin positive samples. This study shows that utilization of plant protection products in Foumbot requires extensive monitoring with producers, in order to reduce risk of consumers exposure

Eukaryotic initiation factor 6 regulates mechanical responses in endothelial cells

The repertoire of extratranslational functions of components of the protein synthesis apparatus is expanding to include control of key cell signaling networks. However, very little is known about noncanonical functions of members of the protein synthesis machinery in regulating cellular mechanics. We demonstrate that the eukaryotic initiation factor 6 (eIF6) modulates cellular mechanobiology. eIF6-depleted endothelial cells, under basal conditions, exhibit unchanged nascent protein synthesis, polysome profiles, and cytoskeleton protein expression, with minimal effects on ribosomal biogenesis. In contrast, using traction force and atomic force microscopy, we show that loss of eIF6 leads to reduced stiffness and force generation accompanied by cytoskeletal and focal adhesion defects. Mechanistically, we show that eIF6 is required for the correct spatial mechanoactivation of ERK1/2 via stabilization of an eIF6-RACK1-ERK1/2-FAK mechanocomplex, which is necessary for force-induced remodeling. These results reveal an extratranslational function for eIF6 and a novel paradigm for how mechanotransduction, the cellular cytoskeleton, and protein translation constituents are linked

Classical novae from the POINT-AGAPE microlensing survey of M31 -- I. The nova catalogue

The POINT-AGAPE survey is an optical search for gravitational microlensing events towards the Andromeda Galaxy (M31). As well as microlensing, the survey is sensitive to many different classes of variable stars and transients. Here we describe the automated detection and selection pipeline used to identify M31 classical novae (CNe) and we present the resulting catalogue of 20 CN candidates observed over three seasons. CNe are observed both in the bulge region as well as over a wide area of the M31 disk. Nine of the CNe are caught during the final rise phase and all are well sampled in at least two colours. The excellent light-curve coverage has allowed us to detect and classify CNe over a wide range of speed class, from very fast to very slow. Among the light-curves is a moderately fast CN exhibiting entry into a deep transition minimum, followed by its final decline. We have also observed in detail a very slow CN which faded by only 0.01 mag day$^{-1}$ over a 150 day period. We detect other interesting variable objects, including one of the longest period and most luminous Mira variables. The CN catalogue constitutes a uniquely well-sampled and objectively-selected data set with which to study the statistical properties of classical novae in M31, such as the global nova rate, the reliability of novae as standard-candle distance indicators and the dependence of the nova population on stellar environment. The findings of this statistical study will be reported in a follow-up paper.Comment: 21 pages, 13 figures, re-submitted for publication in MNRAS, typos corrected, references updated, figures 5-9 made cleare

Comparative risk judgements for oral health hazards among Norwegian adults: a cross sectional study

BACKGROUND: This study identified optimistic biases in health and oral health hazards, and explored whether comparative risk judgements for oral health hazards vary systematically with socio-economic characteristics and self-reported risk experience. METHODS: A simple random sample of 1,190 residents born in 1972 was drawn from the population resident in three counties of Norway. A total of 735 adults (51% women) completed postal questionnaires at home. RESULTS: Mean ratings of comparative risk judgements differed significantly (p < 0.001) from the mid point of the scales. T-values ranged from -13.1 and -12.1 for the perceived risk of being divorced and loosing all teeth to -8.2 and -7.8 (p < 0.001) for having gum disease and toothdecay. Multivariate analyses using General Linear Models, GLM, revealed gender differences in comparative risk judgements for gum disease, whereas social position varied systematically with risk judgements for tooth decay, gum disease and air pollution. The odds ratios for being comparatively optimistic with respect to having gum disease were 2.9, 1.9, 1.8 and 1.5 if being satisfied with dentition, having a favourable view of health situation, and having high and low involvement with health enhancing and health detrimental behaviour, respectively. CONCLUSION: Optimism in comparative judgements for health and oral health hazards was evident in young Norwegian adults. When judging their comparative susceptibility for oral health hazards, they consider personal health situation and risk behaviour experience

Giant anharmonicity and non-linear electron-phonon coupling in MgB2_{2}; A combined first-principles calculations and neutron scattering study

We report first-principles calculations of the electronic band structure and lattice dynamics for the new superconductor MgB$_{2}$. The excellent agreement between theory and our inelastic neutron scattering measurements of the phonon density of states gives confidence that the calculations provide a sound description of the physical properties of the system. The numerical results reveal that the in-plane boron phonons (with E$_{2g}$ symmetry) near the zone-center are very anharmonic, and are strongly coupled to the partially occupied planar B $\sigma$ bands near the Fermi level. This giant anharmonicity and non-linear electron-phonon coupling is key to explaining the observed high T$_{c}$ and boron isotope effect in MgB$_{2}$Comment: In this revised version (to appear in PRL) we also discuss the boron isotope effect. Please visit http://www.ncnr.nist.gov/staff/taner/mgb2 for detail