Nutritional Characteristics of Pregnant Women and its Relation with Anemia during Pregnancy in a Sample of Kurdish Women/Iraq

Anemia in pregnancy is a major public health problem, especially in developing countries. This study aimed to assess the nutritional characteristics of pregnant women and find out its relationship with anemia during pregnancy. A descriptive, cross-sectional study was conducted on 600 pregnant women who attended four primary health-care centers which randomly selected according to the geographical area. A specially designed questionnaire was prepared by the researcher after extensive review of relevant literature. The severity of anemia is determined according to Alene and Dohe. Estimation and calculation of dietary characteristics was done according to food frequency questionnaire, frequencies and percentage, mean and standard deviations, and Chi-square test of association and regression analysis. There was a highly statistically significant association between anemia with eating vegetables and chicken, and a high significant relation of anemia with eating beef and eating nuts. Furthermore, there was a highly significant association between severity of anemia with eating nuts, and a significant association with eating vegetables, while there was no significant association with other variables. Logistic regression analysis revealed that eating less than normal of vegetables, beef, and nuts were indicated risks of anemia. Eating less than normal of vegetables, beef, and nuts were indicated risks of anemia during pregnancy

Basal cell carcinoma mimicking pilonidal sinus: A case report with literature review

AbstractIntroductionPilonidal sinus is a common benign disease that accounts for almost 15% of anal suppurations while basal cell carcinoma is the most common malignancy of the sun-exposed area occurring mainly on the head and neck. We report a case of basal cell carcinoma presented with signs and symptoms of PNS. A 40-year-old male presented with swelling of the lower back for 2 years. On examination, there was a round, mobile, soft 4×2.5cm mass on the sacrococcygeal area. Ultrasound showed subcutaneous cystic lesion. Clinical diagnosis of PNS was done and excisional biopsy was performed under local anesthesia. The result of the histopathological examination was suggestive for basal cell carcinoma.ConclusionBasal cell carcinoma should not be forgotten in differential diagnosis of superficial mass and abscesses

Study ABO / Rh Systems with IL-18 & IL-33 in Iraqi Patients with Diabetes Mellitus Type II

Type 2 diabetes mellitus (DM) is a group of metabolic disorder disease. The inflammatory markers act as a new risk factor for development of type 2 diabetes with a possible association with ABO/Rh blood groups. Human ABO genes are located on chromosome 9q34.1-q34.2. The aim of this study was to investigate the possible association between inflammatory markers, interleukin (IL) -18 and IL-33 in type 2DM and ABO blood groups. Sixty four patients with newly diagnosed type2 DM and control group consist of twenty healthy Iraqi individual. Laboratory test were include ABO blood groups using standard serological procedures and detection IL-18 and IL-33 in serum by ELISA kits. The Present data showed a significant increase in the serum level of IL-18 between type 2 DM patients and control, while there was no significant difference in the serum level of IL-33. At the same time both study blood groups O patients & control showed lowest level of serum IL-18, while blood group A with allele A showed less concentration of IL-33 in patients & control. Blood group O showed the highest percentage in patients & control, also Rh positive showed higher percentage. In conclusion, positive relation between IL-18 concentration and risk of type 2 DM, thus may be a predictor for newly diagnostic diabetic patient, while Serum levels of IL-33 might be a predictor marker of disease progression. No associations were found between ABO & Rh groups with type 2 DM

THE EFFECT OF COGNITIVE RESTRUCTURING INTERVENTION ON TOBACCO SMOKING AMONG ADOLESCENTS IN SENIOR SECONDARY SCHOOL IN ZARIA KADUNA STATE, NIGERIA

This study employs a quasi-experiment, non-equivalent control group, pretest-posttest design in investigating the effect of Cognitive Restructuring Intervention Program on tobacco smoking among adolescents in senior secondary school in Zaria Educational Zone of Kaduna State, Nigeria. The sample was 129 (71 male and 58 females) schooling Adolescents drawn from four schools in Zaria Educational zone. An instruction tagged cognitive behaviours intervention scale (CBIS) was adopted and used for the study. Data were analyzed using means t-test and analysis of covariance (ANCOVA). Findings indicate that cognitive restructuring intervention program (CRIP) significantly affects tobacco usecessation. Recommendations are by made which include a call for psychologists/counselors to be employed in schools and taught how to use new skills in curtailing tobacco smoking among students

CHALLENGES FACING QUALITY APPLICATION IN HIGHER EDUCATION INSTITUTIONS IN SUDAN

This paper aims to review the main challenges which are facing quality application in higher education institutions and universities in Sudan. These challenges became as obstacles, in ensuring the quality of the output of the educational process, so as to achieve the objectives of sustainable development, and meet the needs and requirements of labor market, locally and internationally. So the paper has stated the constraints and challenges in these institutions and provided some suggestions to deal with them

The impact of senior doctor assessment at triage on emergency department performance measures: systematic review and meta-analysis of comparative studies.

STUDY QUESTION: To determine if placing a senior doctor at triage versus standard single nurse in a hospital emergency department (ED) improves ED performance by reviewing evidence from comparative design studies using several quality indicators. DESIGN: Systematic review. DATA SOURCES: Cochrane Library, MEDLINE, EMBASE, CINAHL, Cochrane Effective Practice and Organisation of Care (EPOC), Web of Science, Clinical Trials Registry website. In addition, references from included studies and citation searches were used to identify relevant studies. REVIEW METHODS: Databases were searched for comparative studies examining the role of senior doctor triage (SDT), published from 1994 to 2014. Senior doctor was defined as a qualified medical doctor who completed high specialty training in emergency medicine. Articles with a primary aim to investigate the effect of SDT on ED quality indicators such as waiting time (WT), length of stay (LOS), left without being seen (LWBS) and left without treatment complete (LWTC) were included. Articles examining the adverse events and cost associated with SDT were also included. Only studies with a control group, either in a randomised controlled trial (RCT) or in an observational study with historical controls, were included. The systematic literature search was followed by assessment of relevance and risk of bias in each individual study fulfilling the inclusion criteria using the Effective Public Health Practice Project (EPHPP) bias tool. Data extraction was based on a form designed and piloted by the authors for dichotomous and continuous data. DATA SYNTHESIS: Narrative synthesis and meta-analysis of homogenous data were performed. RESULTS: Of 4506 articles identified, 25 relevant studies were retrieved; 12 were of the weak pre-post study design, 9 were of moderate quality and 4 were of strong quality. The majority of the studies revealed improvements in ED performance measures favouring SDT. Pooled results from two Canadian RCTs showed a significant reduction in LOS of medium acuity patients (weighted means difference (WMD) -26.26 min, 95% CI -38.50 to -14.01). Another two RCTs revealed a significant reduction in WT (WMD -26.17 min, 95% CI -31.68 to -20.65). LWBS was reduced in two Canadian RCTs (risk ratio (RR)=0.79, 95% CI 0.66 to 0.94). This was echoed by the majority of pre-post study designs. SDT did not change the occurrence of adverse events. No clear benefit of SDT in terms of patient satisfaction or cost effectiveness could be identified. CONCLUSIONS: This review demonstrates that SDT can be an effective measure to enhance ED performance, although cost versus benefit analysis is needed. The potential high risk of bias in the evidence identified, however, mandates more robust multicentred studies to confirm these findings

Production of Lettuce Edible Vaccine for Cholera Disease Using Chloroplast Genetic Engineering.

Lettuce is one of the most important edible plant worldwide. At the timethat lettuce isthe candidate plant to carry the foreign vaccine gene forhuman. The B subunits of toxin of Vibrio cholerae(CTB) are candidatevaccine antigens. This research was conduct to express CTB gene in lettucechloroplast. Genesrequired in this study were obtained by polymerase chain reaction (PCR)technique using specific forward and reverse primers, and these genes wereCTB, BADH, prrnpromoter and many other regulatory genes. Some ofthese genes were isolated from their hosts and some were obtained fromprevious work available at Daniell laboratory. All these genes beside manytechniques for ligation, extension, sequencing, orientation confirmationwere used to construct the cassette vector pLS-BADH-LS-CTB whichcarries the gene of interest. In this work the CTB gene with BADH genewere transferred to the chloroplast of lettuce plant and selection oftransgenic plant was performed on the MS medium containing BA andNaCl without any antibiotic selectable marker. Integration of an unmodifiedCTB-coding sequence into chloroplast genomes (up to 1000 copies per cell)resulted in the accumulation of up to 6.2% of total soluble lettuce leavesprotein as functional oligomers (620-fold higher expression levels than thatof the unmodified CTB gene expressed via the nuclear genome). PCR andSouthern blot analyses confirmed stable integration of the CTB gene andBADH gene into the chloroplast genome in addition to the integration in theright orientation and in specific region between trnaI rnA.Western blotanalysis showed that the chloroplast synthesized CTB assembled intooligomers and were antigenically identical with purified native CT

Improvement of Lactuca sativa slat Tolerance by Plastid Transformation with BADH Gene

Salinity is one of the major factors that limits geographical distribution of plants and adversely affects crop productivity and quality.Here high-level expression of betaine aldehyde dehydrogenase (BADH) was reported in cultured explantsof lettuce via plastid genetic engineering. Lettuce (Lactucasativa) plant was primarilyexperimented for tolerance of betaine aldehyde (BA) and soudium chloride(NaCl) by tissue culture technique and it was found that the wild typelettuce tolerated 10 and 75 mM from each substance respectively. Genesrequired in this study were amplified by polymerase chain reaction (PCR)technique using specific forward and reverse primers, and these genes wereBADH, prrn promoter and many other regulatory genes. Some ofthese genes were isolated from their hosts and some were obtained fromprevious work available at Daniell laboratory. All these genes beside manytechniques for ligation, extension, sequencing, orientation confirmationwere used to construct the cassette vector pLS-BADH-LS whichcarries the gene of interest. Homoplasmic transgenic plants exhibiting high levels of salt tolerance were regenerated from bombarded cell cultures via somatic embryogenesis. Transgenic lettuce plants expressing BADH grew in the presence of high concentrations of NaCl (up to 150mM), the highest level of salt tolerance reported so far among genetically modified lettuce, and the tolerance to betaine aldehyde was 30 mM

Networked information technologies and patient safety: a protocol for a realist synthesis.

BACKGROUND:There is a widespread belief that information technologies will improve diagnosis, treatment and care. Evidence about their effectiveness in health care is, however, mixed. It is not clear why this is the case, given the remarkable advances in hardware and software over the last 20 years. This review focuses on interoperable information technologies, which governments are currently advocating and funding. These link organisations across a health economy, with a view to enabling health and care professionals to coordinate their work with one another and to access patient data wherever it is stored. Given the mixed evidence about information technologies in general, and current policies and funding, there is a need to establish the value of investments in this class of system. The aim of this review is to establish how, why and in what circumstances interoperable systems affect patient safety. METHODS:A realist synthesis will be undertaken, to understand how and why inter-organisational systems reduce patients' clinical risks, or fail to do so. The review will follow the steps in most published realist syntheses, including (1) clarifying the scope of the review and identifying candidate programme and mid-range theories to evaluate, (2) searching for evidence, (3) appraising primary studies in terms of their rigour and relevance and extracting evidence, (4) synthesising evidence, (5) identifying recommendations, based on assessment of the extent to which findings can be generalised to other settings. DISCUSSION:The findings of this realist synthesis will shed light on how and why an important class of systems, that span organisations in a health economy, will contribute to changes in patients' clinical risks. We anticipate that the findings will be generalizable, in two ways. First, a refined mid-range theory will contribute to our understanding of the underlying mechanisms that, for a range of information technologies, lead to changes in clinical practices and hence patients' risks (or not). Second, many governments are funding and implementing cross-organisational IT networks. The findings can inform policies on their design and implementation. SYSTEMATIC REVIEW REGISTRATION:PROSPERO CRD42017073004

Effects of interorganisational information technology networks on patient safety: a realist synthesis

Objective: Health services in many countries are investing in interorganisational networks, linking patients’ records held in different organisations across a city or region. The aim of the systematic review was to establish how, why and in what circumstances these networks improve patient safety, fail to do so, or increase safety risks, for people living at home. Design: Realist synthesis, drawing on both quantitative and qualitative evidence, and including consultation with stakeholders in nominal groups and semistructured interviews. Eligibility criteria: The coordination of services for older people living at home, and medicine reconciliation for older patients returning home from hospital. Information sources: 17 sources including Medline, Embase, CINAHL, Cochrane Library, Web of Science, ACM Digital Library, and Applied Social Sciences Index and Abstracts. Outcomes: Changes in patients’ clinical risks. Results: We did not find any detailed accounts of the sequences of events that policymakers and others believe will lead from the deployment of interoperable networks to improved patient safety. We were, though, able to identify a substantial number of theory fragments, and these were used to develop programme theories. There is good evidence that there are problems with the coordination of services in general, and the reconciliation of medication lists in particular, and it indicates that most problems are social and organisational in nature. There is also good evidence that doctors and other professionals find interoperable networks difficult to use. There was limited high-quality evidence about safety-related outcomes associated with the deployment of interoperable networks. Conclusions: Empirical evidence does not currently justify claims about the beneficial effects of interoperable networks on patient safety. There appears to be a mismatch between technology-driven assumptions about the effects of networks and the sociotechnical nature of coordination problems. PROSPERO registration number: CRD42017073004