Delay in DOTS for new pulmonary tuberculosis patient from rural area of Wardha District, India

Vast majority of active tuberculosis patients seeks treatment, do so promptly, still many patients spend a great deal of time and money “shopping for health” and too often they do not receive either accurate diagnosis or effective treatment, despite spending considerable resources. Objective: To find out the time taken to, for diagnosis of tuberculosis and to put patient on DOTS from the onset of symptoms and pattern of health seeking behavior of new pulmonary tuberculosis patients. A cross-sectional rapid assessment using qualitative (FGD) and quantitative (Interview) methods conducted at DOTS center of tertiary care hospital from rural Wardha. Participants: 53 pulmonary tuberculosis patients already on DOTS, in intensive phase. Main outcome measure: Delay in initiation of DOTS & health seeking behavior Results: Median total delay for starting DOTS was 111 days, (range: 10 to 321 days). Patient delay was more than provider delay. Patients delay was more in patients above 60 years, illiterate, per-capita income below 650 Rupees and HIV TB co-infection. Pattern of health seeking behavior was complex. Family physician was the preferred health care provider. Patient visited on an average four providers and spent around 1450 rupees (only direct cost) before DOTS begin. Time taken from the onset of symptoms and start of DOT is a cause of concern for the tuberculosis control program. Early case detection is important rather than mere achieving target of 70% new case detection. Program manager needs to implement locally relevant & focused strategies for early case detection to improve the treatment success, especially in rural area of India

Phytoplankton population structure of the Anzali wetland (2010 and 2011)

Phytoplankton groups are very important producers in the Anzali wetland having a significant role in the quality and need to be constantly studied in term of their sequence and density. This survey was conducted at 6 stations between March 2011 and February 2012. According to the results, 67 different genera (22 Bacillariophyta, 26 Chlorophyta, 9 Cyanobacteria, 5 Cryptophyta, 1 Euglenophyta, 2 Chrysophyta, 1Dinoflgellata and 1 Xanthophyta) were identified. Most observed in Sorkhankol and Karkan stations with the annual average of 24.4±5.6 and 20.4± 5.4 cells/ liter respectively. The Bacillariophyta particularly Cyclotella was dominant in all of the stations, but high abundance of Cyanobacteria in Karkan station from July to mid-October caused the annual average of this phylum to be more than Bacillariophyta. The highest and lowest phytoplankton abundances were observed in September and December, respectively. The number of phytoplankton genera and diversity in this study were less than previous studies

Serum vitamin D in patients with mild cognitive impairment and Alzheimer's disease

Objectives: To determine the relevance of Mini-Mental State Examination (MMSE), serum 25-hydroxyvitamin D (25(OH)D3), and 1,25(OH)2D3 concentrations to mild cognitive impairment (MCI) and various stages of Alzheimer's disease (AD). Materials and Methods: The study included 230 participants (>74 years) allocated to three main groups: 1-healthy subjects (HS, n = 61), 2-patients with MCI (n = 61), and 3- patients with Alzheimer's disease (AD) subdivided into three stages: mild (n = 41), moderate (n = 35), and severe AD (n = 32). The cognitive status was evaluated using MMSE. Serum 25 (OH)D3 (ng/ml) and 1,25(OH)2D3 concentrations (pg/ml) were determined by competitive radioimmunoassay. Results: MMSE scores and 25(OH)D3 were decreased in MCI and all stages of the AD in both genders. MMSE variability was due to gender in HS (11%) and to 25(OH)D3 in MCI (15%) and AD (26%). ROC analysis revealed an outstanding property of MMSE in diagnosis of MCI (AUC, 0.906; CI 95%, 0.847–0.965; sensitivity 82%; specificity, 98%) and AD (AUC, 0.997; CI 95%, 0.992–1; sensitivity, 100%; specificity, 98%). 25(OH)D3 exhibited good property in MCI (AUC, 0.765; CI 95%, 0.681–0.849; sensitivity, 90%; specificity, 54%) and an excellent property in diagnosis of AD (AUC, 0.843; CI 95%, 0.782–0.904; sensitivity, 97%; specificity, 79%). Logistic analyses revealed that, in MCI, MMSE could predict (or classify correctly) with 97.6% accuracy (Wald, 15.22, β, −0.162; SE, 0.554; OR = 0.115:0.039–0.341; p =.0001), whereas 25(OH)D3 with 80% accuracy (Wald, 41,013; β, −0.213; SE, 0.033; OR = 0.808: 0.757–863; p =.0001). 25(OH)D3 was the only significant predictor for the severe AD and contributed to MMSE variability. Age and gender were significant predictors only in the moderate AD. In patients with MCI, 25(OH)D3 and 1,25(OH)2D3 were correlated men, but in case of the AD, they were correlated in women. Conclusions: MMSE and serum 25(OH)D3 concentrations could be useful biomarkers for prediction and diagnosis of MCI and various stages of the AD. The results support the utility of vitamin D supplementation in AD therapy regimen. © 2018 The Authors. Brain and Behavior published by Wiley Periodicals, Inc

Transcriptomic profiling of bovine IVF embryos revealed candidate genes and pathways involved in early embryonic development

<p>Abstract</p> <p>Background</p> <p>Early embryonic loss is a large contributor to infertility in cattle. Although genetic factors are known to affect early embryonic development, the discovery of such factors has been a serious challenge. The objective of this study was to identify genes differentially expressed between blastocysts and degenerative embryos at early stages of development.</p> <p>Results</p> <p>Using microarrays, genome-wide RNA expression was profiled and compared for in vitro fertilization (IVF) - derived blastocysts and embryos undergoing degenerative development up to the same time point. Surprisingly similar transcriptomic profiles were found in degenerative embryos and blastocysts. Nonetheless, we identified 67 transcripts that significantly differed between these two groups of embryos at a 15% false discovery rate, including 33 transcripts showing at least a two-fold difference. Several signaling and metabolic pathways were found to be associated with the developmental status of embryos, among which were previously known important steroid biosynthesis and cell communication pathways in early embryonic development.</p> <p>Conclusions</p> <p>This study presents the first direct and comprehensive comparison of transcriptomes between IVF blastocysts and degenerative embryos, providing important information for potential genes and pathways associated with early embryonic development.</p

Factors Affecting Tourists Satisfaction of Jordan as a Tourism Destination

This study aimed to examine the factors affecting tourist’s satisfaction of Jordan as a tourism destination. A Convenience sample of 500 tourists was selected from those who visited different Jordanian places. They asked to answer a set-scale questionnaire that measure tourist expectation and his/her perception toward destination image, emotional involvement, perceived outcome, self image and his satisfaction. Findings of the study indicated that Perceived outcomes, Jordan image and the emotional involvement had a significant impact on the tourists’satisfaction/ dissatisfaction. While self image, and perceived expectations had no influence. Furthermore, findings indicated that tourist’s satisfaction levels do not change according to gender, martial status, and education levels. But with different nationalities, ages, and monthly income the tourists had different level of satisfaction. Finally, many recommendations were recommended as follows: 1- Giving more attention to the Gulf of Aqaba and Dead Sea beaches and work on developing suitable protection and maintenance programs. 2 - Focusing on the development of promotional programs which aim to inform tourist about different festivals in Jordan. Also, spreading the festivals to all seasons of the year. 3- Increasing co-operation between tourism organizations in Jordan and other Arab countries in order to develop a good package of tourism programs at competitive prices. 4- Focusing on exploring new Foreign and Arab markets to attract tourists to visit Jordan

Development and validation of spectrophotometric and spectrofluorimetric methods for determination of cilnidipine

Purpose: To develop simple and reliable quantitative methods for the determination of cilnidipine (CLD) in pharmaceutical tablets.Methods: Two simple and sensitive methods (spectrophotometric and spectrofluorimetric) were developed for the determination of cilnidipine (CLD) in pure form and in a pharmaceutical preparation. Spectrophotometric method (A) is based on oxidation of CLD with a known excess amount of Nbromosuccinamide (NBS) in acidic medium, followed by addition of methyl orange indicator and absorbance measurement at 510 nm. The spectrofluorimetric method (B) is based on oxidation of CLD to cerium (IV), followed by measurement of fluorescence emission of Ce (III) at 350 nm. Factors that affect the performance of the two methods were studied and optimized.Results: The spectrophotometric and spectrofluorimetric procedures were successfully used for measuring CLD levels in pharmaceutical dosage form, in the ranges of 2.0 - 25.0 and 0.25 - 11.2 μg/mL, at detection limits of 1.05 and 0.13 μg/mL, respectively. There were no significant differences between the proposed methods and a standard reference method (p &lt; 0.05).Conclusion: The developed methods provide simple and reliable procedures for quantitative measurement of CLD in bulk and tablet forms. Keywords: Cilnidipine, Oxidation, Spectrophotometric, Spectrofluorimetric, Drug formulatio

Challenges for Malaria Elimination in Zanzibar: Pyrethroid Resistance in Malaria Vectors and Poor Performance of Long-Lasting Insecticide Nets.

Long-lasting insecticide treated nets (LLINs) and indoor residual house spraying (IRS) are the main interventions for the control of malaria vectors in Zanzibar. The aim of the present study was to assess the susceptibility status of malaria vectors against the insecticides used for LLINs and IRS and to determine the durability and efficacy of LLINs on the island. Mosquitoes were sampled from Pemba and Unguja islands in 2010--2011 for use in WHO susceptibility tests. One hundred and fifty LLINs were collected from households on Unguja, their physical state was recorded and then tested for efficacy as well as total insecticide content. Species identification revealed that over 90% of the Anopheles gambiae complex was An. arabiensis with a small number of An. gambiae s.s. and An. merus being present. Susceptibility tests showed that An. arabiensis on Pemba was resistant to the pyrethroids used for LLINs and IRS. Mosquitoes from Unguja Island, however, were fully susceptible to all pyrethroids tested. A physical examination of 150 LLINs showed that two thirds were damaged after only three years in use. All used nets had a significantly lower (p < 0.001) mean permethrin concentration of 791.6 mg/m2 compared with 944.2 mg/m2 for new ones. Their efficacy decreased significantly against both susceptible An. gambiae s.s. colony mosquitoes and wild-type mosquitoes from Pemba after just six washes (p < 0.001). The sustainability of the gains achieved in malaria control in Zanzibar is seriously threatened by the resistance of malaria vectors to pyrethroids and the short-lived efficacy of LLINs. This study has revealed that even in relatively well-resourced and logistically manageable places like Zanzibar, malaria elimination is going to be difficult to achieve with the current control measures

Identification of cardiotoxicity related to non-small cell lung cancer (NSCLC) treatments: A systematic review

Introduction In the last few decades, there has been a rapid development in cancer therapies and improved detection strategies, hence the death rates caused by cancer have decreased. However, it has been reported that cardiovascular disease has become the second leading cause of long-term morbidity and fatality among cancer survivors. Cardiotoxicity from anticancer drugs affects the heart’s function and structure and can occur during any stage of the cancer treatments, which leads to the development of cardiovascular disease. Objectives To investigate the association between anticancer drugs for non-small cell lung cancer (NSCLC) and cardiotoxicity as to whether: different classes of anticancer drugs demonstrate different cardiotoxicity potentials; different dosages of the same drug in initial treatment affect the degree of cardiotoxicity; and accumulated dosage and/or duration of treatments affect the degree of cardiotoxicity Methods This systematic review included studies involving patients over 18 years old with NSCLC and excluded studies in which patients’ treatments involve radiotherapy only. Electronic databases and registers including Cochrane Library, National Cancer Institute (NCI) Database, PubMed, Scopus, Web of Science, ClinicalTrials.gov and the European Union Clinical Trials Register were systematically searched from the earliest available date up until November 2020. A full version protocol of this systematic review (CRD42020191760) had been published on PROSPERO. Results A total of 1785 records were identified using specific search terms through the databases and registers; 74 eligible studies were included for data extraction. Based on data extracted from the included studies, anticancer drugs for NSCLC that are associated with cardiovascular events include bevacizumab, carboplatin, cisplatin, crizotinib, docetaxel, erlotinib, gemcitabine and paclitaxel. Hypertension was the most reported cardiotoxicity as 30 studies documented this cardiovascular adverse event. Other reported treatment-related cardiotoxicities include arrhythmias, atrial fibrillation, bradycardia, cardiac arrest, cardiac failure, coronary artery disease, heart failure, ischemia, left ventricular dysfunction, myocardial infarction, palpitations, and tachycardia. Conclusion The findings of this systematic review have provided a better understanding of the possible association between cardiotoxicities and anticancer drugs for NSCLC. Whilst variation is observed across different drug classes, the lack of information available on cardiac monitoring can result in underestimation of this association. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020191760, identifier PROSPERO CRD42020191760