The study of threshold of pain sensation in rats born from normal mothers and mothers with metabolic acidosis

زمینه و هدف: اسیدوز متابولیک یکی از مهمترین بیماری هایی است که بر دستگاه عصبی تأثیر می گذارد. این مطالعه با هدف بررسی تغییرات احتمالی در آستانه حسی درد در فرزندان متولد شده از مادران مبتلا به اسیدوز متابولیک در مقایسه با فرزندان متولد شده از مادران سالم انجام شده است. روش بررسی: در این مطالعه تجربی 50 سر موش صحرایی ماده سالم به طور تصادفی به پنج گروه مساوی (شاهد بدون تیمار، شاهد با دوز حداقل، شاهد با دوز متوسط، اسیدوز با دوز حداقل و اسیدوز با دوز متوسط) تقسیم شدند. برای ایجاد اسیدوز از محلول کلرید آمونیوم به جای آب آشامیدنی و در گروه های شاهد از محلول کلرید سدیم استفاده گردید. تمام حیوانات با جفت گیری طبیعی باردار شدند و 20 روز قبل و تا پایان بارداری موش ها، برای گروه های با دوزهای حداقل و متوسط به ترتیب مقادیر 15/0 و 3/0 مولار از محلول های مورد نظر استفاده شد. آزمایشات درد ناشی از فرمالین روی فرزندان نر بالغ انجام شد. نمره درد در سه مرحله حاد، اینترفاز و مزمن ثبت و مقایسه گردید. یافته ها: نتایج بیانگر افزایش معنی دار نمره درد مراحل حاد و مزمن آزمون فرمالین در فرزندان نر متولد شده از مادران اسیدوز می باشد (05/0>P). نمره درد در مرحله اینترفاز در گروه های اسیدوز با گروه های شاهد تفاوت معنی داری نداشت(05/0>P). نتیجه گیری: نتایج نشان داد اثرات اسیدوز متابولیک باعث کاهش آستانه حسی درد در فرزندان متولد شده از مادران مبتلا به اسیدوز متابولیک و افزایش درد در آن ها شده است. بنابراین با جلوگیری از بروز اسیدوز متابولیک مادران باردار می توان از کاهش آستانه حسی درد در فرزندان آن ها جلوگیری به عمل آورد کرد

The effects of relaxation on the psychological symptoms in women with multiple sclerosis

Background and aims: Multiple sclerosis (MS) patients compared to healthy subjects have much higher levels of psychological disorders such as depression, anxiety and stress that greatly affect their quality of life and significant role in stimulating the onset of MS, worsening symptoms and increasing fatigue. Relaxation in complementary medicine is the most common treatments with low cost. This study aimed to determine the effects of relaxation on depression, anxiety, stress and in women suffering of MS. Methods: This study is a randomized clinical trial that was carried out on 50 patients with MS referred to MS Clinic of Kashani Hospital in Isfahan, Iran. After simple non-random sampling, participants were randomly assigned by minimization method to three groups: Reflexology, relaxation, and control groups. In the experimental group was performed relaxation intervention within 4 weeks, twice a week for 40 min and the control group were received care and routine medical treatment as directed by a doctor? Data were collected through DASS-21 questionnaire before, immediately and 2 months after interventions in two groups. Data analysis was performed by SPSS using descriptive and inferential statistics. Results: Mean scores of stress, anxiety, and depression before the intervention showed no significant difference in the two groups (P>0.5), but immediately after the intervention, independent t-test showed significant difference between mean scores of stress (P=0.001), anxiety (P=0.02) and depression (P=0.02) between groups while two months after the intervention there was only a significant difference between the mean score of stress in the two groups (P=0.003). Also, findings obtained from repeated measures analysis of variance showed that the severity stress, anxiety and depression during the different times in experimental group had significant difference (P0.05). Conclusion: It seems that relaxation technique as intervention in reducing stress, anxiety and depression is effective in women with MS. However, the technique has long-term effects on stress. So, this method as effective technique can be recommended

Evaluation of osteogenic potentials of avian demineralized bone matrix in the healing of osseous defects in pigeons

Objectives: To evaluate avian allogeneic demineralized bone matrix (DBM) in the healing of long bone defects as a function of geometry and time in a pigeon model. Study design: Experimental. Animals: Adult rock pigeons (n = 60). Methods: Midshaft ulnar osseous defects were grafted with 2 geometric forms of DBM (tubular vs. chipped) and stabilized with a hybrid fixator. Autologous chips of sternal keel were used in a third group as control. Outcomes were evaluated by radiography and histology/histomorphometry at 4, 8, 12, and 24 weeks postoperatively. Results: Despite an early rapid healing response, autografts plateaued (histologic score and new bone area) by 8 weeks with no significant improvement afterwards. Conversely, allogeneic DBM implants demonstrated continuous temporal improvement in bone healing, and tubular DBM finally outpaced autograft implants after week 12 with values for metrics achieving statistical significance by week 24. Chip DBM was inferior to tubular DBM and autograft. Conclusions: Avian DBM is osteogenic, biocompatible, and safe in orthotopic sites with potential usefulness in avian bone grafting. Implant geometry (shape and size) affects such osteogenic potentials

Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990–2019 : A systematic analysis for the Global Burden of Disease Study 2019

Background Achieving universal health coverage (UHC) involves all people receiving the health services they need, of high quality, without experiencing financial hardship. Making progress towards UHC is a policy priority for both countries and global institutions, as highlighted by the agenda of the UN Sustainable Development Goals (SDGs) and WHO's Thirteenth General Programme of Work (GPW13). Measuring effective coverage at the health-system level is important for understanding whether health services are aligned with countries' health profiles and are of sufficient quality to produce health gains for populations of all ages. Methods Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we assessed UHC effective coverage for 204 countries and territories from 1990 to 2019. Drawing from a measurement framework developed through WHO's GPW13 consultation, we mapped 23 effective coverage indicators to a matrix representing health service types (eg, promotion, prevention, and treatment) and five population-age groups spanning from reproductive and newborn to older adults (≥65 years). Effective coverage indicators were based on intervention coverage or outcome-based measures such as mortality-to-incidence ratios to approximate access to quality care; outcome-based measures were transformed to values on a scale of 0–100 based on the 2·5th and 97·5th percentile of location-year values. We constructed the UHC effective coverage index by weighting each effective coverage indicator relative to its associated potential health gains, as measured by disability-adjusted life-years for each location-year and population-age group. For three tests of validity (content, known-groups, and convergent), UHC effective coverage index performance was generally better than that of other UHC service coverage indices from WHO (ie, the current metric for SDG indicator 3.8.1 on UHC service coverage), the World Bank, and GBD 2017. We quantified frontiers of UHC effective coverage performance on the basis of pooled health spending per capita, representing UHC effective coverage index levels achieved in 2019 relative to country-level government health spending, prepaid private expenditures, and development assistance for health. To assess current trajectories towards the GPW13 UHC billion target—1 billion more people benefiting from UHC by 2023—we estimated additional population equivalents with UHC effective coverage from 2018 to 2023. Findings Globally, performance on the UHC effective coverage index improved from 45·8 (95% uncertainty interval 44·2–47·5) in 1990 to 60·3 (58·7–61·9) in 2019, yet country-level UHC effective coverage in 2019 still spanned from 95 or higher in Japan and Iceland to lower than 25 in Somalia and the Central African Republic. Since 2010, sub-Saharan Africa showed accelerated gains on the UHC effective coverage index (at an average increase of 2·6% [1·9–3·3] per year up to 2019); by contrast, most other GBD super-regions had slowed rates of progress in 2010–2019 relative to 1990–2010. Many countries showed lagging performance on effective coverage indicators for non-communicable diseases relative to those for communicable diseases and maternal and child health, despite non-communicable diseases accounting for a greater proportion of potential health gains in 2019, suggesting that many health systems are not keeping pace with the rising non-communicable disease burden and associated population health needs. In 2019, the UHC effective coverage index was associated with pooled health spending per capita (r=0·79), although countries across the development spectrum had much lower UHC effective coverage than is potentially achievable relative to their health spending. Under maximum efficiency of translating health spending into UHC effective coverage performance, countries would need to reach $1398 pooled health spending per capita (US$ adjusted for purchasing power parity) in order to achieve 80 on the UHC effective coverage index. From 2018 to 2023, an estimated 388·9 million (358·6–421·3) more population equivalents would have UHC effective coverage, falling well short of the GPW13 target of 1 billion more people benefiting from UHC during this time. Current projections point to an estimated 3·1 billion (3·0–3·2) population equivalents still lacking UHC effective coverage in 2023, with nearly a third (968·1 million [903·5–1040·3]) residing in south Asia. Interpretation The present study demonstrates the utility of measuring effective coverage and its role in supporting improved health outcomes for all people—the ultimate goal of UHC and its achievement. Global ambitions to accelerate progress on UHC service coverage are increasingly unlikely unless concerted action on non-communicable diseases occurs and countries can better translate health spending into improved performance. Focusing on effective coverage and accounting for the world's evolving health needs lays the groundwork for better understanding how close—or how far—all populations are in benefiting from UHC

Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background Achieving universal health coverage (UHC) involves all people receiving the health services they need, of high quality, without experiencing financial hardship. Making progress towards UHC is a policy priority for both countries and global institutions, as highlighted by the agenda of the UN Sustainable Development Goals (SDGs) and WHO's Thirteenth General Programme of Work (GPW13). Measuring effective coverage at the health-system level is important for understanding whether health services are aligned with countries' health profiles and are of sufficient quality to produce health gains for populations of all ages. Methods Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we assessed UHC effective coverage for 204 countries and territories from 1990 to 2019. Drawing from a measurement framework developed through WHO's GPW13 consultation, we mapped 23 effective coverage indicators to a matrix representing health service types (eg, promotion, prevention, and treatment) and five population-age groups spanning from reproductive and newborn to older adults (≥65 years). Effective coverage indicators were based on intervention coverage or outcome-based measures such as mortality-to-incidence ratios to approximate access to quality care; outcome-based measures were transformed to values on a scale of 0–100 based on the 2·5th and 97·5th percentile of location-year values. We constructed the UHC effective coverage index by weighting each effective coverage indicator relative to its associated potential health gains, as measured by disability-adjusted life-years for each location-year and population-age group. For three tests of validity (content, known-groups, and convergent), UHC effective coverage index performance was generally better than that of other UHC service coverage indices from WHO (ie, the current metric for SDG indicator 3.8.1 on UHC service coverage), the World Bank, and GBD 2017. We quantified frontiers of UHC effective coverage performance on the basis of pooled health spending per capita, representing UHC effective coverage index levels achieved in 2019 relative to country-level government health spending, prepaid private expenditures, and development assistance for health. To assess current trajectories towards the GPW13 UHC billion target—1 billion more people benefiting from UHC by 2023—we estimated additional population equivalents with UHC effective coverage from 2018 to 2023. Findings Globally, performance on the UHC effective coverage index improved from 45·8 (95% uncertainty interval 44·2–47·5) in 1990 to 60·3 (58·7–61·9) in 2019, yet country-level UHC effective coverage in 2019 still spanned from 95 or higher in Japan and Iceland to lower than 25 in Somalia and the Central African Republic. Since 2010, sub-Saharan Africa showed accelerated gains on the UHC effective coverage index (at an average increase of 2·6% [1·9–3·3] per year up to 2019); by contrast, most other GBD super-regions had slowed rates of progress in 2010–2019 relative to 1990–2010. Many countries showed lagging performance on effective coverage indicators for non-communicable diseases relative to those for communicable diseases and maternal and child health, despite non-communicable diseases accounting for a greater proportion of potential health gains in 2019, suggesting that many health systems are not keeping pace with the rising non-communicable disease burden and associated population health needs. In 2019, the UHC effective coverage index was associated with pooled health spending per capita (r=0·79), although countries across the development spectrum had much lower UHC effective coverage than is potentially achievable relative to their health spending. Under maximum efficiency of translating health spending into UHC effective coverage performance, countries would need to reach $1398 pooled health spending per capita (US$ adjusted for purchasing power parity) in order to achieve 80 on the UHC effective coverage index. From 2018 to 2023, an estimated 388·9 million (358·6–421·3) more population equivalents would have UHC effective coverage, falling well short of the GPW13 target of 1 billion more people benefiting from UHC during this time. Current projections point to an estimated 3·1 billion (3·0–3·2) population equivalents still lacking UHC effective coverage in 2023, with nearly a third (968·1 million [903·5–1040·3]) residing in south Asia. Interpretation The present study demonstrates the utility of measuring effective coverage and its role in supporting improved health outcomes for all people—the ultimate goal of UHC and its achievement. Global ambitions to accelerate progress on UHC service coverage are increasingly unlikely unless concerted action on non-communicable diseases occurs and countries can better translate health spending into improved performance. Focusing on effective coverage and accounting for the world's evolving health needs lays the groundwork for better understanding how close—or how far—all populations are in benefiting from UHC

Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and developm nt investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens

Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950-2019 : a comprehensive demographic analysis for the Global Burden of Disease Study 2019

Background: Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of fertility, mortality, migration, and population for 204 countries and territories and selected subnational locations from 1950 to 2019. Methods: 8078 country-years of vital registration and sample registration data, 938 surveys, 349 censuses, and 238 other sources were identified and used to estimate age-specific fertility. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate age-specific fertility rates for 5-year age groups between ages 15 and 49 years. With extensions to age groups 10–14 and 50–54 years, the total fertility rate (TFR) was then aggregated using the estimated age-specific fertility between ages 10 and 54 years. 7417 sources were used for under-5 mortality estimation and 7355 for adult mortality. ST-GPR was used to synthesise data sources after correction for known biases. Adult mortality was measured as the probability of death between ages 15 and 60 years based on vital registration, sample registration, and sibling histories, and was also estimated using ST-GPR. HIV-free life tables were then estimated using estimates of under-5 and adult mortality rates using a relational model life table system created for GBD, which closely tracks observed age-specific mortality rates from complete vital registration when available. Independent estimates of HIV-specific mortality generated by an epidemiological analysis of HIV prevalence surveys and antenatal clinic serosurveillance and other sources were incorporated into the estimates in countries with large epidemics. Annual and single-year age estimates of net migration and population for each country and territory were generated using a Bayesian hierarchical cohort component model that analysed estimated age-specific fertility and mortality rates along with 1250 censuses and 747 population registry years. We classified location-years into seven categories on the basis of the natural rate of increase in population (calculated by subtracting the crude death rate from the crude birth rate) and the net migration rate. We computed healthy life expectancy (HALE) using years lived with disability (YLDs) per capita, life tables, and standard demographic methods. Uncertainty was propagated throughout the demographic estimation process, including fertility, mortality, and population, with 1000 draw-level estimates produced for each metric. Findings: The global TFR decreased from 2·72 (95% uncertainty interval [UI] 2·66–2·79) in 2000 to 2·31 (2·17–2·46) in 2019. Global annual livebirths increased from 134·5 million (131·5–137·8) in 2000 to a peak of 139·6 million (133·0–146·9) in 2016. Global livebirths then declined to 135·3 million (127·2–144·1) in 2019. Of the 204 countries and territories included in this study, in 2019, 102 had a TFR lower than 2·1, which is considered a good approximation of replacement-level fertility. All countries in sub-Saharan Africa had TFRs above replacement level in 2019 and accounted for 27·1% (95% UI 26·4–27·8) of global livebirths. Global life expectancy at birth increased from 67·2 years (95% UI 66·8–67·6) in 2000 to 73·5 years (72·8–74·3) in 2019. The total number of deaths increased from 50·7 million (49·5–51·9) in 2000 to 56·5 million (53·7–59·2) in 2019. Under-5 deaths declined from 9·6 million (9·1–10·3) in 2000 to 5·0 million (4·3–6·0) in 2019. Global population increased by 25·7%, from 6·2 billion (6·0–6·3) in 2000 to 7·7 billion (7·5–8·0) in 2019. In 2019, 34 countries had negative natural rates of increase; in 17 of these, the population declined because immigration was not sufficient to counteract the negative rate of decline. Globally, HALE increased from 58·6 years (56·1–60·8) in 2000 to 63·5 years (60·8–66·1) in 2019. HALE increased in 202 of 204 countries and territories between 2000 and 2019

The Role of Iron-Chelation and Hypoxia-Inducible Factor 1α in Metabolism and Obesity

Adipose tissue has an essential role in the regulation of systemic energy balance. Mammals have two types of adipose tissue, white adipose tissue (WAT) and brown adipose tissue (BAT). BAT is a specialized to produce heat and protect the body against hypothermia and obesity through non-shivering thermogenesis. BAT can also profoundly affect body weight and glucose metabolism in animal models. Iron plays an important role in oxidative stress and free radical pathology. In this study the effects of an oral iron chelator deferasirox (DFS) were examined. The findings showed mice fed high fat diet (HFD) with DFS exhibited an increase in metabolic rate which prevented high fat diet-induced obesity. Deferasirox showed positive impacts on glucose metabolism, insulin resistance, and energy expenditure at 16 weeks. Increase in pro-thermogenic genes and reduction in classic white adipose tissue mRNAs were associated with higher oxygen consumption rate and energy expenditure. In obesity, hyperplasia and hypertrophy of adipocytes can result in relative hypoxia in white and brown adipose tissues. This study also investigated the role of hypoxia inducible factor 1α (Hif1α) in brown/beige adipocytes. Transgenic mice with floxed Hif1α alleles (FC) were bred with UCP1-Cre mice to generate brown/beige-fat Hif1α-null (bfhif). In this study bfhif mice fed HFD were resistant to HFD-induced obesity. Consistent with body weight results, bfhif mice revealed lower fat mass and body fat percentage, with higher basal oxygen consumption rate. The novelty of this study is that results have shown that deletion of Hif1α in brown / beige adipocytes improved HFD-induced obesity, glucose tolerance and mitochondrial respiration. Therefore both iron chelation, and the therapeutic deletion of Hif1α in brown / beige adipocytes are potential therapies for preventing or treating obesity and related metabolic disorders

Plasma zinc concentration in cord blood and associated factors of infant birth weight among mothers who delivered in Fatemieh Hospital, Hamadan, Iran

Micronutrient deficiency is one of the most prevalent nutritional problems all over the world, especially in the developing countries. Nowadays, more than 2 billion persons are deprived of getting the minimum micronutrients intake needed for health. Zinc is an essential trace element that has an important role in normal growth and development. Zinc deficiency during pregnancy may have an adverse effect on pregnancy outcome, especially low birth weight (LBW) and some malformation such as cleft palate and anencephaly. The World Health Organization reported that 20 million infants were born with LBW in 2008. LBW increases the risk of infant mortality. The goal of the millennium development goals (MDG) until 2015 is to reduce child mortality. The objective of this study was to determine the analysis of plasma zinc concentration in cord blood and associated factors of infant birth weight among mothers who delivered in Fatemieh Hospital, Hamadan, Iran using the case-control study design. The cases were healthy infants 2500 g and the controls were healthy infants >2500 to 4000 g at time of birth. A total of 268 (134 cases, 134 controls) infants and their mothers were selected at the time of birth at the Fatemieh teaching hospital which admits high risk mothers and has a neonatal intensive care unit (NICU) ward in Hamadan, Iran. The data collection of this study started from 6tl December 2009 and ended on 18th October 2010. Cord blood zinc was collected at the time of delivery from venous cord blood Plasma zinc concentration was determined by Atomic Absorption Spectrophotometry (AAS) method. Data was analyzed using SPSS version 16. Total of 268 mothers infant pair participated in the study about zinc level in the cord blood among these mothers, 3.7% had severe zinc deficiency, 7.8% had mild to moderate zinc deficiency and 88.5 % had normal plasma zinc concentration. The independent sample t-test showed that there was no significant difference between plasma cord blood zinc among LBW and normal birth weight infants ( t= -0.083, P-value= 0.934) at the P level of 0.05. The mean birth weight among low birth weight infant (LBW) was 2267.5 ± 324 g and in normal infants was 3311± 323 g. The meal gestational age in LBW and normal infants were 35.85 ± 3 and 39 ± 1.4 weeks, respectively. There was a significant association between the plasma cord blood zinc concentration in LBW and normal weight infants (X2 (df: 2) = 6.934, P=0.031). Hierarchical multiple logistic regressions showed that plasma cord blood zinc, maternal pre-pregnancy BMI, maternal weight gain during pregnancy, maternal age, previous LBW, and parity significantly predicted infant birth weight. Overall, there was no statistically significant relationship between plasma cord blood zinc concentration and infant birth weight. Infants with severe zinc deficiency (S 60 g /dl) were more than 12 times at higher risk of LBW compared to infants with normal plasma cord blood zinc levels (OR = 12.234,95% CI 1.22, 133.39, P= 0.040). In conclusion, there was a significant association between severe zinc deficiencies in plasma cord blood and infant birth weight. There was also significant association between maternal pre-pregnancy BMI, maternal weight gain during pregnancy, maternal age, previous history of LBW, and parity with infant birth weight

Molecular identification and prevalence of ehrlichia canis and anaplasma platys in dogs in selected areas of Malaysia

Ehrlichia species are the etiological agents of emerging and life-threatening tick-borne diseases of both humans and animals. They have been implicated in serious and fatal infections in companion animals and livestock and the potential to cause severe life-threatening diseases emphasizes the need for early diagnosis of ehrlichiosis. Limited studies have been conducted to investigate tick-borne diseases in Malaysia, and only two studies have been published on Ehrlichia canis thus far, the first one relied solely on light microscopic detection techniques and the other on immunofluorescence antibody test (IFA) test for diagnosis. The objective of this study was to carry out a molecular study of the 16S rRNA gene of Ehrlichia canis (E. canis) and Anaplasma platys (A. platys) infections in dogs in Malaysia using the polymerase chain reaction (PCR) technique which is known to be the most sensitive and specific method for the diagnosis of canine ehrlichiosis worldwide. For this purpose, canine blood samples were collected from pet dogs (n=323) presented to veterinary clinics and stray dogs (n=177) from February 2009 to February 2010. After DNA extraction, standard PCR was performed with a genus-specific set of primers EHR16SD, and EHR16SR followed by E. canis spices-specific PCR (CANIS/ GA1UR), and A. platys species-specific PCR (PlatysF/ PlatysR). Analysis of PCR products revealed that 2.0% (n=10) of dogs were positive for E. canis, (1.2% among the clinic group, and 3.4% among the stray dogs), and 4.6% (n=23) were positive for A. platys (1.2% and 10.73% among clinic group and stray dogs respectively). The sex, age, and breed of the clinical cases were noted and hematological and serum biochemical results were also obtained for the clinic group. Statistical analysis showed no consistent significant differences between E.canis or A.platys infection status, sex, age, breed, and clinical or hematological abnormalities. In order to achieve a larger size for sequence analysis, all positive samples were amplified with another set of primers (FD1/RP2). Sequence analysis of positive samples for both E.canis and A.platys showed 100% identity to a number of registered strains in NCBI GenBank. In conclusion the present study revealed for the first time the presence of genetically confirmed E. canis and A. platys pathogens with an overall prevalence rate of 2.0% and 4.6%, respectively in naturally infected dogs in Malaysia