Gastric pH circadian rhythm in the rural Canzibe area of the Eastern Cape Province, South Africa: a preliminary pilot study

Objective: In this study, an attempt has been made to describe the normal circadian rhythm of gastric pH in the dwellers of Canzibe. The high incidence of esophageal cancer in this region is one of the motivating factors to undertake this study. Esophageal impedance studies carried out earlier has supported this finding. Methods: Gastric pH signals were recorded in 14 healthy volunteers during a 24Hr period using Ohmega ambulatory data logger attached to a unisensor dual pH probe. Results: The gastric pH circadian rhythm for males was characterized by 2 alkaline peaks at 09H00 and 12H00 and 2 nadir points at 15H00 and 03H00, while that for females were defined by only 1 alkaline peak at 09H00 and 1nadir point at 05H00. There were great fluctuations in gastric pH within the nycthemeral in males than in femalesbut with females presenting with higher gastric pH than males (ANOVA, P<0.0001). Conclusion: The peak and nadir of the gastric pH circadian rhythm are noted at 09H00 and 05H00 respectively.Keywords: Gastric pH; circadian rhythm; esophageal cancer; esophageal impedanc

Gastric luminal epidermal growth factor is affected by diet

Objective. Diet is an area of major interest to those investigating the causes of cancer of the oesophagus in  the Transkei. This study looked at the associations between intragastric epidermal growth factor level, diet  and intragastric pH.Setting and subjects. A dietary survey was co-ordinated with studies of gastric luminal epidermal growth  factor and gastric fluid pH in 120 rural Transkeians.Results. Gastric fluid epidermal growth factor was associated with low dietary intake of animal products (p = 0.002) and vegetables (p = 0.026). There was no association with pH.Conclusion. A dietary subgroup has been identified in the Transkei population with high levels of epidermal  growth factor in the upper gastrointestinal lumen. This adds to previously demonstrated diet-related changes in the upper gastrointestinal tract in Transkei. These changes may affect the disease pattern of the population

Investigation of the antinociceptive and anti-inflammatory properties of Heteromorpha arborescens (Apiaceae)

Heteromorpha arborescens belongs to the family Apiaceae. It is commonly known as the parsley tree. One of its uses in the Eastern Cape Province of South Africa is for the treatment of abdominal pains. The therapeutic effects of the methanolic and aqueous root extracts of H. arborescens were investigated at two dose levels respectively on experimental models of pain and inflammation in rodents. The antinociceptive activity was evaluated using the hot-plate, abdominal constriction and formalin tests. The anti-inflammatory properties of these extracts were assessed using albumin and carrageenan as phlogistic agents. Both extracts produced significant (

Addressing health workforce inequities in the Mindanao regions of the Philippines: tracer study of graduates from a socially-accountable, community-engaged medical school and graduates from a conventional medical school

Developing and retaining a high-quality medical workforce in low-resource countries is a worldwide challenge. The Filipino Ateneo de Zamboanga University–School of Medicine (ADZU-SOM) has adopted a strong focus on socially accountable health professional education (SAHPE) in order to address the shortage of physicians across rural and urban communities in the Western Mindanao region. A cross-sectional survey of graduates from two Philippines medical schools: ADZU-SOM in the Mindanao region and a medical school with a more conventional curriculum, found ADZU-SOM graduates were more likely to have joined the medical profession due to a desire to help others (p=0.002), came from lower socioeconomic strata (p¼0.001) and had significantly (p<0.05) more positive attitudes to community service. ADZU graduates were also more likely to currently work in Government Rural Health Units (p<0.001) or be generalist Medical Officers (p<0.001) or Rural/Municipal Health Officers (p=0.003). ADZU graduates were also less likely to work in private or specialist Government hospitals (p=0.033 and p=0.040, respectively) and be surgical or medical specialists (p=0.010 and p<0.001, respectively). The findings suggest ADZU-SOM’s SAHPE philosophy manifests in the practice choices of its graduates and that the ADZUSOM can meet the rural and urban health workforce needs of the Western Mindanao region

Can Score Databanks Help Teaching?

Basic courses in most medical schools assess students' performance by conferring scores. The objective of this work is to use a large score databank for the early identification of students with low performance and to identify course trends based on the mean of students' grades. METHODOLOGY/PRINCIPAL FINDINGS: We studied scores from 2,398 medical students registered in courses over a period of 10 years. Students in the first semester were grouped into those whose ratings remained in the lower quartile in two or more courses (low-performance) and students who had up to one course in the lower quartile (high-performance). ROC curves were built, aimed at the identification of a cut-off average score in the first semesters that would be able to predict low performances in future semesters. Moreover, to follow the long-term pattern of each course, the mean of all scores conferred in a semester was compared to the overall course mean obtained by averaging 10 years of data. Individuals in the low-performance group had a higher risk of being in the lower quartile of at least one course in the second semester (relative risk 3.907; 95% CI: 3.378-4.519) and in the eighth semester (relative risk 2.873; 95% CI: 2.495-3.308). The prediction analysis revealed that an average score of 7.188 in the first semester could identify students that presented scores below the lower quartiles in both the second and eighth semesters (p<0.0001 for both AUC). When scores conferred by single courses were compared over time, three time-trend patterns emerged: low variation, upward trend and erratic pattern. CONCLUSION/SIGNIFICANCE: An early identification of students with low performance may be useful in promoting pedagogical strategies for these individuals. Evaluation of the time trend of scores conferred by courses may help departments monitoring changes in personnel and methodology that may affect a student's performance

Prostaglandin E2 is raised in kwashiorkor

Objective. Infection is a common occurrence in children with kwashiorkor. It has been suggested that infection in kwashiorkor results from immune depression, and that the immune depression of kwashiorkor is caused by a dietassociated elevation of prostaglandin E2 (PGEZ). The purpose of this study was to determine whether levels of PGEZ are abnormal in children with kwashiorkor.Setting and subjects. Plasma PGEZ and plasma proteins were measured in children admitted with oedematous kwashiorkor, and compared with PGEZ in children with cerebral palsy.Results. Plasma PGEZ was higher in children with kwashiorkor than in control children (7.25 ± 3.5 v. 3.51 ± 1.59, P &lt; 0.01). Within the kwashiorkor study group there was a significant negative correlation between log-transformed serum PGEZ and total plasma protein (r = - 0.59, P &lt; 0.00l), plasma albumin (r =- 0.63, P &lt; 0.001), weight-for-age (r =0.37, P &lt; 0.05), and height-for-age (r = - 0.37, P &lt; 0.05). The difference in mean values of PGEZ in children with kwashiorkor who recovered from the illness and those who died was not significant (7.1 ± 2.6 v. 9.1 ± 4.8, P = 0.36).Conclusion. Significantly higher PGEZ levels in children with kwashiorkor provide adequate reason for the depression of immune function known to occur in these children. Elevated PGEZ levels may also be implicated in other components of the illness

Prevalence of metabolic syndrome in adolescents living in Mthatha, South Africa

Morongwe Annah Sekokotla,1 Nandu Goswami,2 Constance Rufaro Sewani-Rusike,1 Jehu Erapu Iputo,3 Benedicta Ngwenchi Nkeh-Chungag4 1Department of Human Biology, Faculty of Health Sciences, Walter Sisulu University, Mthatha, South Africa; 2Gravitational Physiology and Medicine Research Unit, Institute of Physiology, Medical University of Graz, Graz, Austria; 3Department of Medical Education, Faculty of Health Sciences, Walter Sisulu University, 4Department of Biological and Environmental Sciences, Faculty of Natural Sciences, Walter Sisulu University, Mthatha, South Africa Objective: Metabolic syndrome (MetS), defined as the clustering of three of five risk factors (hypertension, obesity, triglyceridemia, dyslipidemia and hyperglycemia), is being increasingly mentioned among children and adolescents despite there being no consensus on how it should be defined in this set of population. Furthermore, very few studies have focused on MetS in children and adolescents in sub-Saharan populations. This study, therefore, aimed at determining the prevalence of the MetS and contributing risk in adolescents living in Mthatha, South Africa.Research design and methods: Four hundred and ten adolescents (age range: 13&ndash;18 years, both sexes) were recruited into this cross-sectional study. In addition to a lifestyle questionnaire being administered, anthropometric measurements (weight, height and waist circumferences) were carried out for each participant. Fasting venous blood was collected for lipid profile and blood glucose assessments. Blood pressure was also measured. MetS was assessed using appropriate diagnostic criteria for children and adolescents.Results: Complete data sets were collected from 371 participants. Females showed an elevation in the risk factors for MetS. Of the 371 participants, 40.2% were overweight/obese (47.5% females; 22.5% males). MetS was diagnosed in 3.1% female participants compared with 6.0% in male participants.Conclusions: More risk factors for the MetS are seen among the overweight/obese as compared to lean adolescents. Given the fact that childhood overweight/obesity often continues into adulthood, it is important to address the causes of increased risk for MetS earlier in life to prevent the development of disease in adult life. Keywords: metabolic syndrome, adolescent health, overweight, obesit