Raised 17-hydroxyprogesterone levels in congenital adrenal hyperplasia

Congenital adrenal hyperplasia (CAH) refers to autosomal recessive diseases resulting from deficiency of enzymes involved in the production of cortisol by the adrenal glands. This study was designed to determine the frequency of suspected congenital adrenal hyperplasia patients by evaluating the laboratory data of blood 17-OHP. The study was conducted at Chemical Pathology Section of Department of Pathology at the Aga Khan University, Karachi. The basic demographic data of 2282 subjects was recorded, screened for blood 17-OHP levels from January 2007 to December 2010. A cutoff of ≥ 4 ng/ml was considered as suggestive of CAH. The results showed 17-OHP levels ≥ 4 ng/ml were found predominantly among infants (14.4%) and in females (18.2%)

Characterization of individuals residing in the province of Newfoundland and Labrador who consume native grown and locally available foods

Indigenous foods are cheap and highly nutritious. The present study is a secondary analysis of data collected by the Newfoundland and Labrador nutrition (NNL) survey, 1996. The NNL survey was a province wide cross-sectional study that collected data on the dietary habits of residents of the province. The specific objectives of the present study were to see how prevalent was the consumption of indigenous foods by the population of the province and to compare consumers with nonconsumers. A multistage stratified cluster design was used to sample males and females, 18-74 years inclusive. Excluded were institutionalized individuals, people living on reserves, and pregnant and lactating women. The statistical program, SPSS, was used to analyze the data, collected on 1927 randomly selected adults. Analysis of data revealed that 93% and 79.5% of respondents respectively, claimed to have consumed wild berries and game meat during the previous year. Chi squared analysis showed a significant association of game meat consumption with sex (p<0.001), age (p<0.001), area of residence (p<0.001) and education level (p<0.001). Game meat was most often consumed by males, aged 55-64 years, less educated, rural residents in the low income adequacy group (p<0.001). Chi squared analysis of data on berry consumers showed a significant association with sex (p=0.006) but not with the other factors tested. In addition to the frequency of consumption of indigenous foods and their amounts were also calculated. Median serving size of moose meat was found to be 137g and median serving size of blueberries was 18g. Of those who consume large game meat, 41% said they consumed at least 2 portions per month. Of those who consume berries, 25 % said they consumed more than 4 servings of berries per month. Analysis of health behaviour indicators showed that non-smokers were more likely to be berry consumers (p<0.001) whereas there was no difference between physical activity or intake of vitamin/mineral supplement between consumers and nonconsumers. Indigenous foods appear to be consumed by and thus accessible to a variety of people. Consequently their consumption can be practically encouraged to address food insecurity and health issues in Newfoundland and Labrador. Specific characteristics of consumers of local berries and wild game can be used to aid in the development of strategies to promote the intake of these foods

Agreement between Serology and Histology for detection of Helicobacter pylori infection

Objective: To determine the percentage agreement between serology and histology for detection of Helicobacter (H.) pylori infection. Study Design: Cross-sectional analytical study. Place and Duration of Study: Department of Pathology and Microbiology, The Aga Khan University and Hospital, Karachi, from January to December 2009. Methodology: Fifty subjects were selected by non-probability purposive sampling from laboratory data who had serological testing of H. pylori IgG antibody, prior to histological evaluation of endoscopic gastric or/and duodenal biopsies. Serological Quantification of H. pylori IgG was carried out with HpG screen ELISA kit (Genesis Diagnostics, UK), using an enzyme linked immunosorbent assay for detection of IgG antibodies against H. pylori. Manufacturer\u27s recommended cutoff value was used and results were considered positive when greater than 7 U/ml. For histological diagnosis, an expert histopathologist characterized the presence of spiral bacteria in the mucosal layer or the surface of epithelial cells on microscopic examination, as a positive test. Results: An agreement of 0.72 was found by Kappa statistics between serology and histopathology results and a good diagnostic accuracy (86%) of serological testing was observed for the diagnosis of H. pylori infection. Conclusion: A substantial agreement was found between serology and histopathology results to detect the H. pylori infection. Laboratory-based serologic testing using ELISA technology to detect IgG antibodies is inexpensive, noninvasive and convenient method to detect the H. pylori infection in primary care setting

A process evaluation of the National Youth Development Agency’s grant programme with respect to the beneficiaries of the Western Cape for the period 2013-2014

Masters in Public Administration - MPAYouth today are constantly faced with enormous challenges and are continually faced with job uncertainty and scarce opportunities with almost no means to personal growth. Faced with bleak future livelihood prospects, youth make up a large number of the world’s working poor. Inadequate youth education and lack of labour market preparation still pose challenges for South African youth. They face sizeable constraints to entrepreneurship such as a lack of entrepreneurship culture; lack of entrepreneurship knowledge through formal and informal education; relevant business development services, unsatisfactory business support and insufficient access to financing. Despite this, the extent of research on youth entrepreneurship in Africa is deficient, even non-existent in some contexts. In response to the alarming rate of youth unemployment, the South African government had embarked on realising some of the aspects of the National Youth Policy through youth empowerment via a number of interventions. The implementing agency of all youth development policies and interventions is the National Youth Development Agency (NYDA). The agency has rolled out a number of interventions to address various issues pertinent to the state of the youth in South Africa. However, the specific interventions this study addresses are those related to entrepreneurship, specifically the NYDA Grant programme. Under the Grant programme, a number of issues are addressed such as provision of physical capital, access to resources in the form of advice, guidance and mentorship made available by the National Youth Development Agency to the unemployed youth in the Western Cape. While many youth development programmes have been rolled out both around the world and in South Africa, very little monitoring and evaluation has been conducted in identifying which programmes are effective and sustainable in the long run. At the time of this research, limited information had been accessible with respect to the benefits of entrepreneurship development programmes in South Africa. This research is significant in the sense that it bridges the gaps in the literature on youth entrepreneurship interventions and practical interventions in the field. Furthermore, it provides a lens with which to determine whether they are indeed a sustainable way forward for unemployed youth. Therefore this study conducted a process evaluation using qualitative research methods in order to ascertain if the NYDA is efficiently and effectively executing its mandate with respect to the Grant programme. The research objectives of this study were 1) to conduct a process evaluation of the National Youth Development Agency’s Grant programme, 2) to develop a theoretical and legislative framework underpinning youth in South Africa, 3) to describe and analyse the NYDA’s Grant programme, 4) to highlight the opportunities and challenges that affect the current implementation of the Grant programme and 5) to present recommendations. The findings suggest that the Grant programme has been relevant, timely and useful to young aspiring entrepreneurs providing them with the necessary support through the provision of stock, physical capital and other business support services such as mandatory entrepreneurial training. Despite this, young entrepreneurs still face challenges in sustaining their businesses financially and struggle with establishing a physical space in which they can trade. A number of recommendations were made from the perspectives of the beneficiaries and the NYDA Cape Town Branch implementing staff, namely: increasing staff to improve the administration of the Grant Programme, increasing the grant turnaround time, providing recourse to further funding and physical space and uploading the grant application process onto the internet to save time and money for both beneficiaries and implementing staff

An Efficient Adaptive Noise Cancellation Scheme Using ALE and NLMS Filters

The basic theme of our paper is to implement a new idea of noise reduction in the real time applications using the concepts of adaptive filters.  Our model which is presented as one of the solutions is based on two stages of operation with the first stage based on the ALE (Adaptive Line Enhancer) filters and the second stage on NLMS (Normalized Least Mean Square) filter. The first stage reduces the sinusoidal noise from the input signal and the second stage reduces the wideband noise. Two input sources of voice are used; one for the normal speech and the other for the noise input, using separate microphones for both signals. The first signal is of the corrupted speech signal and the second signal is of only the noise containing both wideband and narrowband noise. In the first stage the narrowband noise is reduced by using the ALE technique. The second stage gets a signal with ideally only the wideband noise which is reduced using the NLMS technique.  In both the stages the concerned algorithms are used to update the filter coefficients in such a way that the noise is cancelled out from the signal and a clean speech signal is heard at the output.DOI:http://dx.doi.org/10.11591/ijece.v2i3.24

Nitrofurantoin and Fosfomycin, effective oral empirical treatment options against multidrug resistant Escherichia coli

ObjectiveThe present study is designed to monitor antibiotic susceptibility pattern of Escherichia coli to assist in forecasting empirical therapy of urinary tract infection.MethodologyIt is a retrospective cross sectional study. It was carried out at Dow Diagnostic Research and Reference Laboratory for a period of 3 months from February 2017 to April 2017. A data of total 5000 urine culture and sensitivity test reports was taken from the medical record. The data was analyzed by SPSS version 16.ResultsOut of 5000 urine samples processed, 1565 showed significant bacterial growth. Escherichia coli was the most common pathogen isolated. Meropenem, Amikacin, Fosfomycin and Nitrofurantoin respectively were found to be the most sensitive antibiotics against Escherichia coli.Conclusion Fosfomycin and Nitrofurantoin are effective oral antibiotics against Escherichia coli causing urinary tract infection. The present study may help clinicians in making rational choice of empirical treatment of the patients

Synthesis and antioxidant potential of some biscoumarin derivatives

Purpose: To synthesize and screen some 3-substituted-bis-2H-chromen-2t-ones in a search for possible new antioxidants for use in food and pharmaceuticals industries.Methods: 2-Hydroxycoumarin was allowed to react with various substituted aromatic aldehydes in the presence of base as a catalyst to obtain to obtain 3-substituted-bis-2H-chromen-2t-ones. The chemical structures of the synthesized compounds were confirmed by Fourier transform infra-red (FT-IR) spectroscopy, proton nuclear magnetic resonance (1H NMR), mass spectrometry (MS) and elemental analysis. The synthesized biscoumarin derivatives were screened by three parallel antioxidant assays, namely, 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radical scavenging activity, reducing power, and linoleic acid lipid peroxidation. Further, the half minimal inhibitory concentration (IC50) of the compounds was also determined. Butylatedhydroxy toluene (BHT) was used as a standard reference in the antioxidant assay.Results: A library of ten biscoumarin analogues (3a-3j) were synthesized and evaluated for their antioxidant potential. The highest DPPH activity was shown by 3,3'-(3-hydroxy-4- methoxyphenylmethylene)-bis-4-hydroxy-2H-chromen-2-one (3g) and 3,3'-(4-methoxyphenylmethylene)- bis-4-hydroxy-2H-chromen-2-one (3h) with IC50 values of 53.33 ± 6.12 and 68.44 ± 2.67 μg/mL, respectively, compared to the standard compound BHT (butylatedhydroxy toluene) with IC50 of 71.00 ± 0.82 μg/mL. The strongest inhibition of linoleic acid peroxidation was by 3,3'-(3-hydroxy-4- methoxyphenylmethylene)-bis-4-hydroxy-2H-chromen-2-one (3g) and 3'-(4-hydroxy-3-methoxyphenylmethylene)- bis-4-hydroxy-2H-chromen-2-one (3d) with inhibition values of 70.34 and 69.87 %, respectively. Compound 3g demonstrated the highest reducing power with an absorbance of 0.49 at 10 mg/mL concentration (p &lt; 0.001). It was observed that the change in substitution greatly affected the antioxidant potential of the compounds, with the presence of the methoxy group at position-4 of aryl moiety along with 2-hydroxycoumarin being critical for antioxidant activity.Conclusion: The synthesized biscoumarin derivatives, 3g and 3h, are superior antioxidants to standard (BHT) and are suitable lead molecules for further development.Keywords: Antioxidant, Biscoumarins, DPPH, Ferric reducing assay, linoleic acid lipid peroxidation assa

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London