EVALUATION OF URBAN AIR POLLUTION COST A CASE STUDY IN THE COLOMBO CITY

Air pollution is arguably the most important. in terms of economics cost, of thevarious types of pollution caused by transport and industrial activities and itseffects have been widely studied in other countries. However, direct studies havenot been undertaken to measure the economics cost of air pollution in Sri Lanka.Concern for air pollution in Sri Lanka is focused mainly in Colombo. AlthoughColombo air pollution level is less than many Asian countries, recent monitoringresults show that air pollution from particulate matter and Sulfur is well above theWHO recommended levelThe contingent valuation method was used to estimate the air pollution cost anddata was collected from a contingent valuation survey carried out in the Fort andPettah areas. Respondents' willingness to pay values were obtained for ahypothetical market presented. The results were consistent with the economictheory. Aggregated cost of air pollution for the country was Rs.55 million peryear. This value may help cost benefit analysis of air quality managementprogrammes and other related development policy and programs in Sri Lanka.

Characteristics of patients utilizing the Out Patient Department of Colombo South Teaching Hospital and their association with presenting complaints

Objectives: An outpatient department(OPD) serves a vital role in providing health care services. Identification of patient characteristics and their relationship with presenting complaints is important in improving quality of care. Objective of this study was to describe characteristics of patients utilizing OPD at Colombo South Teaching Hospital (CSTH) and their association with presenting complaints.Methods: Cross sectional study was conducted by recruiting 850 subjects who attended OPD by systematic sampling. A pre-tested interviewer administered questionnaire was used. Relevant descriptive statistics were calculated and comparisons were done to elicit statistical significance using p value.Results: Total sample was consisted of 801 subjects giving a non response rate of 5.8%. Mean age was 32.4 (SD+/- 18.5) and highest age group was 26-35. Majority were females (53.6%), were Sinhala (88.6%) Buddhists (79.5%), had secondary education (55.5%), were employed (52.6%) and were married (77.4%). Majority were presented with acute illnesses (75.2%) and also conditions related to respiratory system (48.2%) Cough was the commonest main presenting complaint (18.8%) followed by fever (16.7%) and backache (10.1%). More patients were in younger age group who complained cough as the major problem (p=0.0001). Among those who came with back ache, majority were females (p=0.0003) and from elder age group (p=0.0180).Conclusions: Among patients utilizing OPD of CSTH majority were females, from 26-35 age group, Sinhala, Buddhist, had secondary education and married. Acute respiratory related medical problems were the commonest and cough was the top presenting complaint and most of them were from younger age group

Función paterna en adolescentes en tratamiento por consumo de sustancias psicoactivas: clínica CEMIC- El Faro

La siguiente investigación aborda la importancia de la función paterna en los adolescentes en tratamiento por consumo de sustancias psicoactivas en la clínica CEMIC: el faro, de la ciudad de Cartagena- Bolívar. El consumo de sustancias psicoactivas es un malestar social, familiar y de salud que es muy evidente, teniendo en cuenta que el índice de crecimiento progresivo en diferentes estratos socioeconómicos es elevado. Es importante resaltar que: “El significado de la palabra “droga” varia a menudo, según el contexto en que use. Desde un punto de vista estrictamente científico, la droga es una sustancia química que afecta las funciones de los seres vivientes. Sin embargo en el caso del “abuso” o del “problema” de las drogas, el significado de la palabra adquiere un matiz social más que científico” (Sarason, I., Sarason, B. 1990, p. 383)

Co-causation of reduced newborn size by maternal undernutrition, infections, and inflammation

More than 20 million babies are born with low birthweight annually. Small newborns have an increased risk for mortality, growth failure, and other adverse outcomes. Numerous antenatal risk factors for small newborn size have been identified, but individual interventions addressing them have not markedly improved the health outcomes of interest. We tested a hypothesis that in low-income settings, newborn size is influenced jointly by multiple maternal exposures and characterized pathways associating these exposures with newborn size. This was a prospective cohort study of pregnant women and their offspring nested in an intervention trial in rural Malawi. We collected information on maternal and placental characteristics and used regression analyses, structural equation modelling, and random forest models to build pathway maps for direct and indirect associations between these characteristics and newborn weight-for-age Z-score and length-for-age Z-score. We used multiple imputation to infer values for any missing data. Among 1,179 pregnant women and their babies, newborn weight-for-age Z-score was directly predicted by maternal primiparity, body mass index, and plasma alpha-1-acid glycoprotein concentration before 20 weeks of gestation, gestational weight gain, duration of pregnancy, placental weight, and newborn length-for-age Z-score (p < .05). The latter 5 variables were interconnected and were predicted by several more distal determinants. In low-income conditions like rural Malawi, maternal infections, inflammation, nutrition, and certain constitutional factors jointly influence newborn size. Because of this complex network, comprehensive interventions that concurrently address multiple adverse exposures are more likely to increase mean newborn size than focused interventions targeting only maternal nutrition or specific infections

Many pitfalls in diagnosis of acute intermittent porphyria: a case report

Abstract Background Acute intermittent porphyria is a rare autosomal dominant disorder caused by a deficiency of the enzyme, hydroxymethylbilane synthase. Recognition of acute neurovisceral attacks can be difficult due to the nonspecific nature of symptoms. Case presentation We report a case of 33-year-old male patient who presented with recurrent episodes of severe abdominal pain, nausea, vomiting, constipation and numbness of bilateral lower limb extremities. These nonspecific neurovisceral attacks were subject to medical and surgical misdiagnoses of acute appendicitis, sinus tachycardia, renal calculi, drug-induced acute interstitial nephritis and two episodes of partial intestinal obstruction. The sixth acute attack raised the suspicion of an acute porphyria. Watson and Schwartz test was positive for porphobilinogen in urine. Mutation analysis by DNA sequencing of the extracted DNA of the proband revealed a previously reported missense mutation, c.517C>T encoding p.R173W in the HMBS gene, confirming the diagnosis of Acute Intermittent Porphyria. Four out of five family members who underwent targeted mutation analyses were mutation-positive. Conclusion The most common clinical presentation of Acute Intermittent Porphyria is abdominal pain with neurovisceral manifestations which are common to several medical, psychiatric and surgical pathologies. This leads to underdiagnosis and misdiagnosis of this disorder, incorrect management, and severe complications. Therefore, a high index of suspicion and awareness of front line laboratory investigations are important for diagnosis. Definitive diagnosis enables implementation of strategies to prevent acute attacks, and also triggers genetic testing and genetic counseling of at-risk family members

Plasmodium falciparum Malaria Elicits Inflammatory Responses that Dysregulate Placental Amino Acid Transport

Placental malaria (PM) can lead to poor neonatal outcomes, including low birthweight due to fetal growth restriction (FGR), especially when associated with local inflammation (intervillositis or IV). The pathogenesis of PM-associated FGR is largely unknown, but in idiopathic FGR, impaired transplacental amino acid transport, especially through the system A group of amino acid transporters, has been implicated. We hypothesized that PM-associated FGR could result from impairment of transplacental amino acid transport triggered by IV. In a cohort of Malawian women and their infants, the expression and activity of system A (measured by Na+-dependent 14C-MeAIB uptake) were reduced in PM, especially when associated with IV, compared to uninfected placentas. In an in vitro model of PM with IV, placental cells exposed to monocyte/infected erythrocytes conditioned medium showed decreased system A activity. Amino acid concentrations analyzed by reversed phase ultra performance liquid chromatography in paired maternal and cord plasmas revealed specific alterations of amino acid transport by PM, especially with IV. Overall, our data suggest that the fetoplacental unit responds to PM by altering its placental amino acid transport to maintain adequate fetal growth. However, IV more profoundly compromises placental amino acid transport function, leading to FGR. Our study offers the first pathogenetic explanation for FGR in PM

Estrogen receptor-Beta activated apoptosis in benign hyperplasia and cancer of the prostate is androgen independent and TNF-alpha mediated

Prostate cancer (PCa) and benign prostatic hyperplasia (BPH) are androgen-dependent diseases commonly treated by inhibiting androgen action. However, androgen ablation or castration fail to target androgen-independent cells implicated in disease etiology and recurrence. Mechanistically different to castration, this study shows beneficial proapoptotic actions of estrogen receptor–β (ERβ) in BPH and PCa. ERβ agonist induces apoptosis in prostatic stromal, luminal and castrate-resistant basal epithelial cells of estrogen-deficient aromatase knock-out mice. This occurs via extrinsic (caspase-8) pathways, without reducing serum hormones, and perturbs the regenerative capacity of the epithelium. TNFα knock-out mice fail to respond to ERβ agonist, demonstrating the requirement for TNFα signaling. In human tissues, ERβ agonist induces apoptosis in stroma and epithelium of xenografted BPH specimens, including in the CD133+ enriched putative stem/progenitor cells isolated from BPH-1 cells in vitro. In PCa, ERβ causes apoptosis in Gleason Grade 7 xenografted tissues and androgen-independent cells lines (PC3 and DU145) via caspase-8. These data provide evidence of the beneficial effects of ERβ agonist on epithelium and stroma of BPH, as well as androgen-independent tumor cells implicated in recurrent disease. Our data are indicative of the therapeutic potential of ERβ agonist for treatment of PCa and/or BPH with or without androgen withdrawal

WHO Public Health Research Agenda for Managing Infodemics

An “infodemic” is an overabundance of information – some accurate and some not – that occurs during an epidemic. It spreads between humans in a similar manner to an epidemic, via digital and physical information systems. It makes it hard for people to find trustworthy sources and reliable guidance when they need it. An infodemic is propagated by the fundamentally interconnected ways in which information is disseminated and consumed: through social media platforms, online and through other channels. In the context of the COVID-19 pandemic, it is exacerbated by the global scale of the emergency. During epidemics, more so than in normal times, people need accurate information so that they can adapt their behaviour and protect themselves, their families and their communities against infection. Infodemics affect citizens in every country and addressing them is a new and centrally important challenge in responding to disease outbreaks. The current COVID-19 infodemic, given its scale and profile, is an important opportunity to find and adapt new preparedness and response tools.peer-reviewe