Effect of Gum Arabic in Management of Malnourished Children Aged 6 – 59 Months

Background: Malnutrition is globally the most important risk factor for morbidity and mortality, contributing to more than half of deaths in children worldwide. Gum Arabic is indigestible food ingredient with a potential effect as prebiotic and antidiarrheal. Aim of the study: To determine the effect of gum Arabic in management of malnourished children aged 6- 59 months and its effect on edema, diarrhea, and mood changes among them. Method:  This is an interventional, open-label randomized, controlled trial, hospital-based study conducted among 162 malnourished child admitted to Ahmed Gasim Teaching Hospital and Mohammed Elamin Hamid Pediatric Hospital during Jan. – July 2015. Participants were selected randomly, and equally distributed to control group (81 malnourished children) who were managed as guided by the WHO developed protocol for managing malnutrition and study group (81 malnourished children) received gum Arabic in addition to management protocol and the both groups received management for 2 weeks (30 mg/day for children > 1 year and 15 mg/day for children < 1 year). Results: Out of 162 malnourished children, 54.3% had age of 13- 24 months, males were 64.2%. On starting, 72.8% had weight for height <-3SD, 46.3% of them had diarrhea, 35.2% had edema, 65.4 were irritable and 24.1% were apathetic. On 14th day, in study and control groups, mean WFH increased by 9.26% and 7.6% respectively, diarrhea stopped in 97.06% and 78.05% respectively, edema subsided in 96.7% and 57.1% respectively, Also, 98.6% from study group and 73.2% from control group were active and smiling. The variation in the 4 assessed variables was revealed statistically significant (P value < 0.05). Conclusion and recommendation: Gum Arabic found to have positive effect when added to the WHO management protocol for severe acute malnutrition. Wide and well-established use of gum Arabic as Prebiotic will increase its economic values. Keywords: Gum Arabic, Malnourished, Childre

The Effect of HIV Education Program on Changing the Attitude of Secondary School Students Towards HIV/AIDS Sufferers Khartoum State (2014)

HIV/AIDS seriously affects adolescents throughout the world. One-third of all currently infected individuals are youth ages 15 to 24, and half of all new infections occur in same age youth. This is an Interventional Quasi study, aimed to assess the effect of health education program of Human Immune -Deficiency virus on changing attitude towards HIV and AIDS among secondary school students in Khartoum state. Five hundred students were enrolled by using multi stage random sampling, the study was done in three phases: phase one used questionnaire of 32 questions. Phase two was implementing the Sudanese National Aids Program (SNAP'S) which is a health education program in secondary schools alongside the curriculum for students in the selected secondary schools for 8 months. Phase three was Re- Evaluation by the same questionnaire used in phase one. The study revealed that few students were willing to care of a family member or friend who suffers with AIDS (25.6%) in the pre-test however the percentage increased to  (79.2%)  after intervention, (42.6%)  thought that HIV positive people should not be allowed to mix with people at mosque or church , the percentage decreased to (39.2%) after the intervention. 63.8% of students said that a teacher who is HIV positive should not be allowed to continue teaching in their school, while only (86.2%) of the students changed their mind after intervention. Also prior to intervention (27.6%) of the students accepted sharing same class with HIV infected student while (50.0%) agreed after the intervention. The study concluded that education intervention program was effective and statistically significant in the Improvement of students' attitude towards HIV/AIDS positive (P value= 0.001). معظم اصابات فيروس  مرض نقص المناعة المكتسب تحدث وسط الشباب من عمر 14-24 سنه هذه دراسه تدخليه تهدف الى تقييم أثرتدريس كتيب البرنامج القومى السودانى للايدز للتثقيف الصحى على سلوك  عينة من طلاب المدارس الثانوية بولاية الخرطوم تجاه  المصابين بالفيروس أو مرضى الأيدز و التى اشترك فيها (500) طالب تم اختيارهم عشوائيا بطريقة التعدد المرحلى . نفذت الدراسة على ثلاثة مراحل : المرحلة الأولى تم فيها جمع المعلومات بواسطة استبيان مكون  من(32) سؤال , ثم مرحلة التدخل عن طريق تدريس الذى وضع بواسطه البرنامج السودانى القومى للايدز  لمدة سته اشهر, ثم المرحلة الثالثة و التى جمعت فيها البيانات بنفس الاستبيان الأول . توصلت الدراسة الى النتائج الآتية: 25.6% من الطلاب كانوا موافقين على رعاية مريض ايدز ينتمى الى الأسرة قبل التدخل بينما ارتفعت النسبة الى 79.2% بعد التدخل . 42.2% رأوا أن المصاب بالفيروس لا يجب ان يختلط بالناس فى المسجد و قد نقصت النسبة بعد التدخل الى 39.2%. 63.8% من الطلاب قبلوا بتلقى الدراسة من معلم مصاب بالفيروس قبل التدخل و قد ارتفعت النسبة الى 86.2% بعد التدخل. كما لم يمانع 27.6% منهم على وجود زميل لهم بالفصل مصاب بالفيروس قبل التدخل  و ارتفعت النسبه الى 50.0% بعد التدخل . خلصت الدراسة الى أن منهج التثقيف الصحى للطلاب ذو أثر بالغ احصائيا  فى تحسين إتجاهات طلاب المدارس الثانوية  تجاه المصابين بفيروس نقص المناعة المكتسب أو تجاه مرضى الايدز

Radiographic morphometry of the Foot in clinically normal Donkeys (Equus asinus)

Radiography of the foot is considered a golden standard technique enables the veterinarians to render a subjective evaluation of the foot in donkeys. The current study aimed to characterize objectively the baseline radiometric data of normal forefeet in donkeys to assess both of the nature and extent of anatomical changes occurring in foot affections. Lateromedial and dorsopalmar radiographic examination were performed on 48 forefeet of 24 clinically normal donkeys of both sexes. Four angles and 10 morphometeric distances were measured in latromedial radiographs and 10 morphometric measurements were measured in dorsopalmer radiographs. All hoof components appeared in the radiographic films were described and morphometric measurements were reported as minimum and maximum values, mean ± standard deviation (SD). The study presented a descriptive reference data for morphometric radiographic parameters of the forefeet from lateromedial and dorsopalmer radiographs in clinically normal donkeys, to assess any changes in hoof conformation and biomechanics associated with hoof affections

Medical doctors\u27 offline computer-assisted digital education: Systematic review by the digital health education collaboration

Background: The widening gap between innovations in the medical field and the dissemination of such information to doctors may affect the quality of care. Offline computer-based digital education (OCDE) may be a potential solution to overcoming the geographical, financial, and temporal obstacles faced by doctors.Objective: The objectives of this systematic review were to evaluate the effectiveness of OCDE compared with face-to-face learning, no intervention, or other types of digital learning for improving medical doctors\u27 knowledge, cognitive skills, and patient-related outcomes. Secondary objectives were to assess the cost-effectiveness (CE) of OCDE and any adverse effects.Methods: We searched major bibliographic databases from 1990 to August 2017 to identify relevant articles and followed the Cochrane methodology for systematic reviews of intervention.Results: Overall, 27 randomized controlled trials (RCTs), 1 cluster RCT (cRCT), and 1 quasi-RCT were included in this review. The total number of participants was 1690 in addition to the cRCT, which included 24 practices. Due to the heterogeneity of the participants, interventions, and outcomes, meta-analysis was not feasible, and the results were presented as narrative summary. Compared with face-to-face learning, the effect of OCDE on knowledge gain is uncertain (ratio of the means [RM] range 0.95-1.17; 8 studies, 495 participants; very low grade of evidence). From the same comparison, the effect of OCDE on cognitive skill gain is uncertain (RM range 0.1-0.9; 8 studies, 375 participants; very low grade of evidence). OCDE may have little or no effect on patients\u27 outcome compared with face-to-face education (2 studies, 62 participants; low grade of evidence). Compared with no intervention, OCDE may improve knowledge gain (RM range 1.36-0.98; 4 studies, 401 participants; low grade of evidence). From the same comparison, the effect of OCDE on cognitive skill gain is uncertain (RM range 1.1-1.15; 4 trials, 495 participants; very low grade of evidence). One cRCT, involving 24 practices, investigated patients\u27 outcome in this comparison and showed no difference between the 2 groups with low-grade evidence. Compared with text-based learning, the effect of OCDE on cognitive skills gain is uncertain (RM range 0.91-1.46; 3 trials with 4 interventions; 68 participants; very low-grade evidence). No study in this comparison investigated knowledge gain or patients\u27 outcomes. One study assessed the CE and showed that OCDE was cost-effective when compared with face-to-face learning if the cost is less than or equal to Can $200. No trial evaluated the adverse effect of OCDE.Conclusions: The effect of OCDE compared with other methods of education on medical doctors\u27 knowledge and cognitive skill gain is uncertain. OCDE may improve doctors\u27 knowledge compared with no intervention but its effect on doctors\u27 cognitive skills is uncertain. OCDE may have little or no effect in improving patients\u27 outcome

The Impact of the First Wave of the COVID-19 Pandemic on University Staff Dietary Behaviours, Sleeping Patterns, and Well-Being: An International Comparison Study

This study assessed the impact of the first wave of the COVID-19 pandemic on well-being by measuring the changes to food security, dietary behaviour, and sleeping patterns of university staff in England, Poland, Saudi Arabia, and China. Using a cross-sectional study design, participants in four universities in the respective countries were surveyed between June and July 2020. The mean age of the 902 participants was 42 years old and 67% were female. The findings indicate a reduction in emotionally driven food behaviour [t (901.00) = −20.87, p <  0.001], food acquisition location [t (901.00) = −51.55, p < 0.001], skipping meals [t (901.00) = −24, p < 0.001], and consumption of canned fruit and vegetables [t (901.00) = −10.18, p < 0.001]. However, home cooking [t (901.00) = 36.61, p < 0.001] and the food shopping experience [t (901.00) = 4.53, p <  0.001] markedly increased during lockdown. The participants had higher levels of well-being during the pandemic and experienced a significant increase in sleeping hours (p < 0.001). Increased age and sleeping hours were positively associated with overall well-being. Conversely, emotionally driven food behaviour (i.e., buying and eating more food out of boredom/fear or anxiety) and skipping meals decreased the overall well-being. Lockdown had beneficial effects on dietary behaviours, sleeping patterns, and well-being, but there were variations between countries

Outcome of risk-reducing salpingo-oophorectomy in BRCA carriers and women of unknown mutation status

ObjectiveTo compare surgical outcomes and occult cancer rates at risk-reducing salpingo-oophorectomy in BRCA carriers and high-risk women who had not undergone genetic testing.DesignProspective cohort study.SettingTertiary high-risk familial gynaecological cancer clinic.PopulationWomen undergoing risk-reducing salpingo-oophorectomy between January 2005 and November 2009.MethodsWomen at high-risk of ovarian/tubal cancer were identified on the basis of the inclusion criteria for the UK Familial Ovarian Cancer Screening Study. Risk management options discussed with 1456 high-risk women included risk-reducing salpingo-oophorectomy. A strict histopathological protocol with serial slicing was used to assess tubes and ovaries.ResultsIn total, 308 high-risk women (191 with unknown mutation status; 117 known BRCA1/BRCA2 carriers) chose risk-reducing surgery; 94.5% of procedures were performed laparoscopically. The surgical complication rate was 3.9% (95% CI 2.0-6.7). Four ovarian and ten tubal occult invasive/in situ cancers were found. The overall occult invasive cancer rate was 5.1% (95% CI 1.9-10.83) in BRCA1/BRCA2 carriers and 1.05% (95% CI 0.13-3.73) in untested women. When tubal in situ cancers were included, the overall rate was 4.55% (95% CI 2.5-7.5). Two untested women with tubal carcinoma in situ were subsequently found to be BRCA carriers. The median ages of BRCA carriers (58 years; IQR 13.4 years) and untested women (49.5 years; IQR 20.6 years) with occult invasive/in situ cancer were not significantly different (P = 0.454).ConclusionsBoth high-risk women of unknown mutation status and BRCA carriers have a significant (although higher in the latter group) rate of occult invasive/in situ tubal/ovarian cancer, with a similar age distribution at detection. The data has important implications for counselling high-risk women on the likelihood of occult malignancy and perioperative complications at risk-reducing salpingo-oophorectomy. Women with occult disease should be offered genetic testing

Annual outpatient hysteroscopy and endometrial sampling (OHES) in HNPCC/Lynch syndrome (LS)

Background: LS women have a 40-60 % lifetime risk of endometrial cancer (EC). Most international guidelines recommend screening. However, data on efficacy are limited. Purpose: To assess the performance of OHES for EC screening in LS and compare it with transvaginal ultrasound (TVS) alone. Methods: A prospective observational cohort study of LS women attending a tertiary high-risk familial gynaecological cancer clinic was conducted. LS women opting for EC screening underwent annual OHES and TVS. Histopathological specimens were processed using a strict protocol. Data of women screened between October 2007 and March 2010 were analysed from a bespoke database. Histology was used as the gold standard. Diagnostic accuracy of OHES was compared with TVS using specificity, and positive (PLR) and negative (NLR) likelihood ratios. Results: Forty-one LS women underwent 69 screens (41 prevalent, 28 incident). Four (three prevalent, one incident) women were detected to have EC/atypical endometrial hyperplasia (AEH), five had endometrial polyps and two had endometrial hyperplasia (EH) on OHES. TVS detected two of four EC/AEH. OHES had similar specificity of 89.8 % (CI 79.2, 96.2 %), but higher PLR 9.8 (CI 4.6, 21) and lower NLR (zero) compared to TVS: specificity 84.75 %(CI 73, 92.8 %), PLR 3.28 (CI 1.04, 10.35) and NLR 0.59 (CI 0.22, 1.58). No interval cancers occurred over a median follow-up of 22 months. The annual incidence was 3.57 % (CI 0.09, 18.35) for EC, 10.71 % (CI 2.27, 28.23) for polyps and 21.4 % (CI 8.3, 40.1) for any endometrial pathology. Conclusions: Our findings suggest that in LS, annual OHES is acceptable and has high diagnostic accuracy for EC/AEH screening. Larger international studies are needed for confirmation, given the relatively small numbers of LS women at individual centres. It reinforces the current recommendation that endometrial sampling is crucial when screening these women. © 2012 Springer-Verlag

A comprehensive structural, biochemical and biological profiling of the human NUDIX hydrolase family

The NUDIX enzymes are involved in cellular metabolism and homeostasis, as well as mRNA processing. Although highly conserved throughout all organisms, their biological roles and biochemical redundancies remain largely unclear. To address this, we globally resolve their individual properties and inter-relationships. We purify 18 of the human NUDIX proteins and screen 52 substrates, providing a substrate redundancy map. Using crystal structures, we generate sequence alignment analyses revealing four major structural classes. To a certain extent, their substrate preference redundancies correlate with structural classes, thus linking structure and activity relationships. To elucidate interdependence among the NUDIX hydrolases, we pairwise deplete them generating an epistatic interaction map, evaluate cell cycle perturbations upon knockdown in normal and cancer cells, and analyse their protein and mRNA expression in normal and cancer tissues. Using a novel FUSION algorithm, we integrate all data creating a comprehensive NUDIX enzyme profile map, which will prove fundamental to understanding their biological functionality