Epidemiologische Aspekte der cholinergischen Urtikaria

Background: As a specialized center for Cholinergic urticaria (CholU) we see many patients suffering form this common type of urticaria, that is typically triggered by physical exercise. The severity of symptoms and frequency of outbreaks can vary immensely. Some patients show a limited duration of disease with good results upon treatment, while others are suffering for many years. But even though it is assumed to be a common skin disease, little is known about the epidemiology of it. Often the patients are not aware of their condition and doctors fail to diagnose it. A better knowledge of the characteristics of CholU patients could help the understanding and specialized treatment of it. Methods: We were able to collect the data of 200 CholU patients (12 - 76 years old), that were diagnosed and treated by our specialists between 2006 and 2016. Here, we were especially interested in identifying the main characteristics of CholU patients. For the statistical analysis we used SPSS Statistics version 24 and GraphPad Prism version 6 for Windows. Results: In this study we were able to identify two groups of CholU patients with surprising age and gender profiles. In one group the patients were younger than 36 years, when they first had symptoms of CholU, with women and men equally represented. In the other group patients were 36 and older at onset of disease and mainly female (69%). These two groups also differed in other main characteristics. Patients younger than 36 years suffered more frequently from atopic dermatitis (16.9 vs. 5.2%; p= 0.028) and showed higher IgE-Levels (295.5 vs. 267.1 IU/ml; p= 0.020) compared to the older patients. Whereas concomitant other forms of urticaria (48.3 vs. 33.1%; p=0.044) and psychiatric comorbidities (12.1 vs 1.4%; p=0.001) were more common in patients older than 36 years. Furthermore, patients in this group had a shorter duration of disease (48.3 vs. 33.1%; p=0.044), than the younger patients. Conclusion: This study allows the division of CholU patients into two age related subtypes, that differ from each other in some main characteristics like gender distribution and comorbidities. A new group of CholU patients, consisting mainly of females older than 36 years, has been discovered. The distinct features of the two age groups could indicate differences in the pathogenesis of this common skin disease.Einleitung: Als Spezialzentrum für Cholinergische Urtikaria (CholU) sehen wir viele Patienten, die unter dieser typischerweise durch körperliche Aktivität ausgelösten Urtikariaform leiden. Die Ausprägung der Symptome und das Ansprechen auf leitliniengerechte Therapie variieren stark. Während einige Patienten schon nach kurzer Zeit eine Spontanheilung zeigen, leiden andere viele Jahre unter den Symptomen. Obwohl angenommen wird, dass CholU eine hohe Prävalenz in der Bevölkerung hat, ist noch wenig bekannt über die Epidemiologie der Erkrankung. Viele Patienten wissen nicht, dass sie erkrankt sind oder bekommen erst nach mehreren Arztbesuchen die richtige Diagnose. Um eine bessere Versorgung der betroffenen Patienten zu gewährleisten, ist ein besseres Verständnis der Grundcharakteristiken der CholU notwendig. Methodik: Für diese Studie konnten wir die Daten von 200 Patienten erheben (12 - 76 Jahre alt), die zwischen 2006 und 2016 von unseren Spezialisten die Diagnose einer CholU erhielten und damit in unserer Behandlung waren. Hier interessierten uns vor allem die epidemiologischen Informationen des Patientenkollektivs. Für die statistische Auswertung nutzten wir SPSS Statistics Version 24 und GraphPad Prism Version 6. Ergebnisse: In dieser Studie konnten wir zwei Erkrankungsgipfel der CholU mit einer überraschenden Geschlechterverteilung nachweisen. Ein Teil der Patienten erkrankte vor dem 36. Lebensjahr, hier waren Männer und Frauen gleich vertreten. Außerdem zeigte sich eine zweite Gruppe, die erst ab dem 36. Lebensjahr erkrankte und in der Mehrheit weiblich war (69%). Auch in anderen Charakteristiken unterschieden sich diese beiden Gruppen deutlich. Die jüngeren Patienten litten signifikant häufiger an Atopischer Dermatitis (16.9 vs. 5.2%; p= 0.028) und hatten höhere IgE-Gesamtspiegel (295.5 vs. 267.1 IU/ml; p= 0.020), als die älteren Patienten. Die älteren Patienten zeigten hingegen häufiger zusätzlich anderen Urtikariaformen (48.3 vs. 33.1%; p=0.044) und psychiatrischen Erkankungen (12.1 vs 1.4%; p= 0.001) in den Nebendiagnosen. Außerdem wiesen sie eine deutlich kürzere Erkrankungsdauer auf, als die jüngeren Patienten (33.3 vs. 63.7 Monate; p= 0.005). Schlussfolgerung: Anhand dieser Studie gelang uns eine Einteilung der CholU Patienten in zwei Untergruppen, welche sich in einigen Grundcharakteristiken deutlich unterscheiden. Während bisher angenommen wurde, dass die CholU vor allem junge Männer betrifft, konnten wir eine Gruppe an älteren, vorwiegend weiblichen Patienten nachweisen. Die Erkenntnisse bezüglich der Nebendiagnosen und Erkrankungsdauer könnten auf unterschiedliche Pathomechanismen der CholU hinweisen und bei der Entwicklung spezifischer Therapieansätze helfen

The Modify Version of Artificial Bee Colony Algorithm to solve Real Optimization problems

The Artificial Bee Colony(ABC) algorithm is one of the best applicableoptimization algorithm. In this work, we make some modifications toimprove the ABC algorithm based on convergence speed of solution. Inorder to, we add some conditions to selected food sources by bees. So, ifsolution have been enough near to optimal solution, then further search existaround the food sources. That, this is near to optimal solution because, wecan replace lower and upper bounds of food sources with smaller valuesrelate to last search. Therefore, the new search is near to optimal solution and after some iteration, optimal solution achieves. Finally, we illustrateconvergence speed of the MABC algorithm that is faster than ABCalgorithm. There are some examples.DOI:http://dx.doi.org/10.11591/ijece.v2i4.42

Prevalence of cryptosporidium spp. infection among children admitted to hospital Tengku Ampuan Afzan

Introduction: Cryptosporidium spp. is identified as an important cause of diarrhoeal morbidity and mortality worldwide particularly in children below five years of age and immunocompromised individuals. Infections are present among cattle and humans. Until now, there is no report on its prevalence in humans in Kuantan. The aim of this study is to record the prevalence and associated risk factors of Cryptosporidium spp. infection among children admitted to Hospital Tengku Ampuan Afzan (HTAA), Kuantan. Methods: This is a cross-sectional study conducted among children admitted to the Paediatrics ward in HTAA between December 2017 and May 2018. Faecal samples were examined using wet smear and Modified Ziehl-Neelsen (MZN) staining techniques. Data on demography and hygiene practices was collected using a pretested questionnaire, and analysed using SPSS version 22. Results: One hundred thirty five children (95.6% were of Malay ethnicity) were included in the study. The overall prevalence of Cryptosporidium spp. infection was 25.2%. The prevalence was slightly higher in females (28.1%) than males (23.1%). The prevalence was higher than expected. This study showed that some risk factors namely children’s age and trash disposal methods were significantly associated with Cryptosporidium spp. infection (p˂0.05). Conclusion: Higher prevalence could possibly be due to an outbreak of this infection or until now undetected

Review Article: Virulence Factors of Mycobacterium Tuberculosis

Mycobacterium tuberculosis (MTB) causes active TB infections that result in pulmonary tuberculosis (PTB), relapse even after treatment, and latent TB. Tuberculosis is a bacterium airborne pulmonary infectious disease. Extra pulmonary tuberculosis (EPTB) results from an illness which is too severe with Mycobacterium tuberculosis entering into the circulatory system. A really bad situation with further multi-drug TB. In the nation, pulmonary TB is spreading as well as reemerging. Recent findings of an increase in cases in the area pose a mortality burden and infection spread risk. The group of bacteria genetically organisms known as the Mycobacterium tuberculosis complex (MTBC) are accountable for human as well as animal tuberculosis. Among the primary reasons of mortality or morbidity worldwide continues to remain this sickness even now. The mycobacteria infiltrate the host via breathing that is phagocytated by macrophage as they reach the respiratory tract. It may cause the bacteria responsible to be quickly destroyed or cause an aggressive TB disease. Precisely a result of its human immunological reaction, multiple distinct virulence indicators have emerged among MTBC subgroups. The purpose of this research is to discuss the bacterial genes or enzymes that are to be crucial to determining the pathogenicity of MTBC strains through in vivo infections paradigm. As a way to eradicate various illnesses as well as get closer to a future without infections such as tuber emerging medicines or therapies must take into account the virulence aspects of MTBC

TOXOPLASMA GONDII NUTRIENT ACQUISITION AND UTILIZATION

Toxoplasma gondii is a widely pervasive parasite that infects 1/3 of the world’s population. It is capable of invading any mammalian cell it encounters and can exist in a dormant state for the entirety of the host’s life, waiting for the immune landscape to become favorable to activate into a destructive stage of its life cycle, capable of lysing precious neurons, cardiac tissue, skeletal muscle, or cells of the eye and more. Although this danger exists, very little is known about how this parasite exploits its host to survive for decades undetected, and therefore our inquiry aims to understand the nutrients Toxoplasma needs for its survival, how it acquires them, and what is the full scope of its utilization of them. We do this first by focusing on nutrients essential for Toxoplasma gondii’s growth, for example cholesterol and phosphate. We follow these essential nutrients from the extra-parasitic environment and into the parasite to gain valuable insight into its utilization in hopes of uncovering essential pathways that could potentially become drug targets for intervention. We show how cholesterol is scavenged through the selective hijacking of the host’s endocytic pathway by recruitment of subpopulations of Rab11 vesicles which are characterized by different effectors. To elucidate the full scope of utilization of scavenged cholesterol, we study two proteins implicated in steroidogenesis that have homology with proteins that can interact with cholesterol or other cholesterol-derived byproducts. We also show how phosphate is acquired via a single phosphate transporter that serves multiple roles, bulk phosphate acquisition and mobilization of internal phosphate stores for osmoregulation. We create methodologies and tools for the study of this stage in physiologically relevant and a hugely understudied setting of infection, the heart. Lastly, we aim to understand chronic infection more fully by creating in-vivo models capable of measuring cardiomyopathies that exist due to chronic infection. Untangling the complex web of nutrient acquisition and metabolism, specifically during encystation, can equip us with an understanding of pathways yet discovered, which could hopefully lead to advancements in drug discovery that have thus far been stagnant for several decades

Analyzing the Relationship between News Consumption and Media Literacy of High School Students in Tehran

With the advent and ubiquity of modern media, the problem of fake news has become increasingly important. Younger people, especially students, are more vulnerable to cyberspace. The purpose of this study is analyzing the type and amount of news consumption and media literacy of high school students as well as their parents' caring behavior. The statistical population was high school students of Tehran from which 466 students were selected by cluster sampling method. The data were collected using a questionnaire based on Craft, Ashley and Maksl Research and James Potter's Cognitive Media Literacy Model. The results have shown that the students' media literacy is moderate. There is a relationship between the diversity and amount of news consumption, educational area and parents' occupations with students' media literacy. But no significant relationship between gender and media literacy has been detected. It has been found that 38% of parents do not do anything for protecting their children against the media, while the rest content themselves with mere talk about it. Finally, 57% of students said that their high school Thought and Media Literacy course was not helpful

A glycosylphosphatidylinositol-anchored carbonic anhydrase-related protein of Toxoplasma gondii is important for rhoptry biogenesis and virulence

Carbonic anhydrase-related proteins (CARPs) have previously been described as catalytically inactive proteins closely related to α-carbonic anhydrases (α-CAs). These CARPs are found in animals (both vertebrates and invertebrates) and viruses as either independent proteins or domains of other proteins. We report here the identification of a new CARP (TgCA_RP) in the unicellular organism Toxoplasma gondii that is related to the recently described η-class CA found in Plasmodium falciparum. TgCA_RP is posttranslationally modified at its C terminus with a glycosylphosphatidylinositol anchor that is important for its localization in intracellular tachyzoites. The protein localizes throughout the rhoptry bulbs of mature tachyzoites and to the outer membrane of nascent rhoptries in dividing tachyzoites, as demonstrated by immunofluorescence and immunoelectron microscopy using specific antibodies. T. gondii mutant tachyzoites lacking TgCA_RP display a growth and invasion phenotype in vitro and have atypical rhoptry morphology. The mutants also exhibit reduced virulence in a mouse model. Our results show that TgCA_RP plays an important role in the biogenesis of rhoptries

Soil transmitted helminth infection among children admitted to Hospital Tengku Ampuan Afzan, Kuantan, Pahang

Introduction: Soil-transmitted helminth (STH) infections by Ascaris lumbricoides, Trichuris trichiura and hookworms still persist in rural and urban areas of developing communities. Recent studies in Malaysia focused on Orang Asli communities and none in the hospital settings. This study aimed to investigate the prevalence and associated risk factors for STH among children admitted to Paediatric ward of the Hospital Tengku Ampuan Afzan (HTAA). Materials and Methods: This study was conducted among 135 (78 males, 57 females) patients in HTAA from December 2017 to May 2018. Faecal samples were examined using wet smear, Kato-Katz, Harada-Mori and sedimentation techniques. Demographic data and hygiene practice information were collected using a pre-tested questionnaire. Results: The overall prevalence of STH was 5.9% (A.lumbricoides 5.2%, T.trichiura 0.7%, and hookworms 0.7%). Prevalence among males was 3.8% and females 8.8%. Majority (95.6%) were Malays. Chi square analysis showed that factors significantly associated with STH infections are household monthly income (p<0.05), education level of mother (p<0.05) and father (p<0.05), the source of drinking water (p<0.05), the method of garbage disposal (p<0.05). Logistic regression analysis confirmed garbage disposal via burning as a risk factor of STH infections (p= 0.021, OR=23.8, 95% CI=1.6- 350.06). Conclusion: This study shows that the prevalence of STH infections is low in children probably due to the effective implementation of control programs and good hygiene practice. Differences in individual lifestyles and the humid weather condition are probable reasons for sporadic infection to still exist

Immunomodulatory of Cordia myxa (L.) Aqueous Extract Fruit in Immunized Mice with Hydatid Cyst Fluid

Human cystic echinococcosis caused by Echinococcus granulosus is one of most important and widespread parasitic zoonoses in the world. The present study was aimed to identify the immunomodulatory activity of aqueous extract of Cordia  myxa fruit since this plant considers one of medically important plants, which is widely used for treatment of numerous diseases, that correlate with the effectiveness of  immunized by hydatid cyst fluid antigen HCFAg. Forty Balb/c mice were divided into equal groups, first group was immunized with HCFAg, the second group was treated with aqueous extract of C. muxa fruit, the third  group was immunized  and treated, the fourth  group was  as a control. Delayed type hypersensitivity (DTH), Mitotic index (MI) and histopathological change in spleen in all groups were studied. A higher increase of thickness was showed in immunized mice and treated after 10 days of treatment with aqueous extract of C.myxa fruit after 10 days(3rd group), that reached 1.23± after 3 hrs.The MI of bone marrow and spleen cells was significantly increased as a post immunized and treatment mice (88.57±1.40), (94.7±0.76) respectively in comparison with the other groups. Histopathological examination of spleen showed marked hyperplasia of lymphoid corpuscles, confused some times to form large follicle. The successive aqueous extract was found to stimulate cell mediated and immune responses in mice/ Keywords: HCF, C. myxa, DTH, M

How do foreign entrepreneurs adapt to local corruption norms in the Middle East? Institutional multiplicities and individual adaptation

Foreign entrepreneurs encounter institutional complexities resulting from differences between their home and host countries. On one hand, foreign entrepreneurs must adapt to local norms in a host environment that might be novel and different; on the other, foreign entrepreneurs bring institutional legacies from their home environments. In this article, we critically examine how such tensions affect norm adaptation by foreign entrepreneurs, focusing upon their attitudes towards corruption–defined as corruption propensity. While imprints from home institutions can be ‘sticky’ and persistent, learning about host institutions requires foreign entrepreneurs to adapt their corruption propensity. We find that corruption propensity has an inverted U-shaped relationship with performance and conclude by analysing the implications of such propensity.</div