Assessment of Trachoma in Cambodia: Trachoma Is Not a Public Health Problem.

PURPOSE: To determine whether trachoma is a public health problem requiring intervention in Cambodia. METHODS: Based on historical evidence and reports, 14 evaluation units (EUs) in Cambodia, judged to be most likely to harbor trachoma, were selected. The Global Trachoma Mapping Project methodology was used to carry out rigorous surveys to determine the prevalence of trachomatous inflammation-follicular (TF) and trichiasis in each EU. RESULTS: The EU-level prevalence of TF among 25,801 1-9-year-old children examined ranged from 0% to 0.2%. Among the 24,502 adults aged 15+ years examined, trichiasis was found in 59 people. Age- and sex-adjusted prevalences of trichiasis in all ages in the EUs studied ranged from 0% to 0.14%; five EUs had a prevalence of trichiasis ≥0.1%. CONCLUSIONS: There appears to be no need nor justification at this time for implementing public health measures to control trachoma in Cambodia

Identification of novel mutations causing pediatric cataract in Bhutan, Cambodia, and Sri Lanka

Background: Pediatric cataract is an important cause of blindness and visual impairment in children. A large proportion of pediatric cataracts are inherited, and many genes have been described for this heterogeneous Mendelian disease. Surveys of schools for the blind in Bhutan, Cambodia, and Sri Lanka have identified many children with this condition and we aimed to identify the genetic causes of inherited cataract in these populations.Methods: We screened, in parallel, 51 causative genes for inherited cataracts in 33 probands by Ampliseq enrichment and sequencing on an Ion Torrent PGM. Rare novel protein coding variants were assessed for segregation in family members, where possible, by Sanger sequencing.Results: We identified 24 rare (frequency Conclusion: This study found that 20%-30% of patients in these countries have a mutation in a known cataract causing gene, which is considerably lower than the 60%-70% reported in Caucasian cohorts. This suggests that additional cataract genes remain to be discovered in this cohort of Asian pediatric cataract patients

Características da marcha de um paciente com osteoartrose de quadril com e sem auxílio de bengala

O objetivo deste estudo foi comparar características espaciais, temporais e espaço-temporais da marcha de um paciente com osteoartrose de quadril com e sem o auxílio de dispositivo (bengala). O caso é o de um sujeito com osteoartrose de quadril esquerdo de 63 anos, 97,8 kg e 1,76 m. Um sistema de reconstrução tridimensional de movimento foi utilizado para análise da marcha. Foram registrados três ciclos completos da marcha com e sem a utilização da bengala, sendo analisadas variáveis espaciais, temporais e espaço-temporais. Foi feita análise estatística, com nível de significância de 5%. Os principais resultados indicam que o comprimento de passo direito (CPD) e esquerdo (CPE), bem como o comprimento total do ciclo, foram superiores com o uso da bengala durante a marcha; o CPE foi significativamente maior do que o CPD quando o sujeito utilizava a bengala; todas as variáveis temporais foram estatisticamente menores com o uso da bengala; a cadência da marcha e a velocidade foram estatisticamente superiores com a bengala. Pode-se concluir que o uso da bengala gerou diferenças significativas no comportamento das variáveis espaciais, temporais e espaço-temporais durante a marcha, melhorando de forma significativa a eficiência do movimento do paciente com osteoatrose de quadril.The purpose of this study was to compare cane-assisted and non-assisted gait temporal, spatial and spatiotemporal features in a patient with hip osteoarthrosis. The patient studied, with left hip osteoarthrosis, was 63 years old and had 97.8 kg and 1.76 m. A three-dimensional analysis system was used for the analysis of gait. Three complete gait cycles with and without cane assistance were recorded, where temporal, spatial and spatiotemporal variables were analysed. Descriptive statistics was used with the level of significance set at 5%. Main results show that left step length (LSL), right step length (RSL) and stride length were greater during cane-assisted gait; LSL was significantly longer than RSL when the patient used the cane; all temporal variables were statistically lesser in cane-assisted gait; and cadence and walking speed were statistically higher during cane-assisted gait. It may thus be said that use of the cane by the patient with hip osteoarthrosis caused significant differences in spatial, temporal and spatiotemporal variables during gait and significantly improved efficiency of the movement

Short and long term outcome of bilateral pallidal stimulation in chorea-acanthocytosis

BACKGROUND: Chorea-acanthocytosis (ChAc) is a neuroacanthocytosis syndrome presenting with severe movement disorders poorly responsive to drug therapy. Case reports suggest that bilateral deep brain stimulation (DBS) of the ventro-postero-lateral internal globus pallidus (GPi) may benefit these patients. To explore this issue, the present multicentre (n=12) retrospective study collected the short and long term outcome of 15 patients who underwent DBS. METHODS: Data were collected in a standardized way 2-6 months preoperatively, 1-5 months (early) and 6 months or more (late) after surgery at the last follow-up visit (mean follow-up: 29.5 months). RESULTS: Motor severity, assessed by the Unified Huntington's Disease Rating Scale-Motor Score, UHDRS-MS), was significantly reduced at both early and late post-surgery time points (mean improvement 54.3% and 44.1%, respectively). Functional capacity (UHDRS-Functional Capacity Score) was also significantly improved at both post-surgery time points (mean 75.5% and 73.3%, respectively), whereas incapacity (UHDRS-Independence Score) improvement reached significance at early post-surgery only (mean 37.3%). Long term significant improvement of motor symptom severity (≥ 20 % from baseline) was observed in 61.5 % of the patients. Chorea and dystonia improved, whereas effects on dysarthria and swallowing were variable. Parkinsonism did not improve. Linear regression analysis showed that preoperative motor severity predicted motor improvement at both post-surgery time points. The most serious adverse event was device infection and cerebral abscess, and one patient died suddenly of unclear cause, 4 years after surgery. CONCLUSION: This study shows that bilateral DBS of the GPi effectively reduces the severity of drug-resistant hyperkinetic movement disorders such as present in ChAc

Effect of prenatal and early postnatal androgens on adult hippocampal pyramidal neuron count and morphology of preoptic area in rats

Abstract Not Availabl

Effects of Multiple Stressors, Pristine or Sulfidized Silver Nanomaterials, and a Pathogen on a Model Soil Nematode <i>Caenorhabditis elegans</i>

Previous research using the model soil nematode Caenorhabditis elegans has revealed that silver nanoparticles (AgNP) and their transformed counterpart, sulfidized AgNP (sAgNP), reduce their reproduction and survival. To expand our understanding of the environmental consequences of released NP, we examined the synergistic/antagonistic effects of AgNP and sAgNP along with AgNO3 (ionic control) on C. elegans infected with the pathogen Klebsiella pneumoniae. Individual exposures to each stressor significantly decreased nematode reproduction compared to controls. Combined exposures to equitoxic EC30 concentrations of two stressors, Ag in nanoparticulate (AgNP or sAgNP) or ionic form and the pathogen K. pneumoniae, showed a decline in the reproduction that was not significantly different compared to individual exposures of each of the stressors. The lack of enhanced toxicity after simultaneous combined exposure is partially due to Ag decreasing K. pneumoniae pathogenicity by inhibiting biofilm production outside the nematode and significantly reducing viable pathogens inside the host. Taken together, our results indicate that by hindering the ability of K. pneumoniae to colonize the nematode’s intestine, Ag reduces K. pneumoniae pathogenicity regardless of Ag form. These results differ from our previous research where simultaneous exposure to zinc oxide (ZnO) NP and K. pneumoniae led to a reproduction level that was not significantly different from the controls

A survey of visual impairment and blindness in children attending four schools for the blind in Cambodia

Purpose: To identify the causes of blindness and severe visual impairment (BL/SVI) in children attending four schools for the blind in Cambodia and to provide spectacles, low vision aids, orientation and mobility training and ophthalmic treatment. Methods: Children<16 years of age were recruited from all 4 schools for the blind in Cambodia. Causes of visual impairment and blindness were determined and categorized using World Health Organization methods. Results: Of the 95 children examined, 54.7% were blind (BL) and 10.5% were severely visually impaired (SVI). The major anatomical site of BL/SVI was the lens in 27.4%, cornea in 25.8%, retina in 21% and whole globe in 17.7%. The major underlying etiologies of BL/SVI were hereditary factors (mainly cataract and retinal dystrophies) in 45.2%, undetermined/unknown (mainly microphthalmia and anterior segment dysgenesis) in 38.7% and childhood factors in 11.3%. Avoidable causes of BL/SVI accounted for 50% of the cases; 12.9% of the total were preventable with measles being the commonest cause (8.1% of the total); 37.1% were treatable with cataracts and glaucoma being the commonest causes (22.6% and 4.8% respectively). More than 35% of children required an optical device and 27.4% had potential for visual improvement with intervention. Conclusion: Half of the BL/SVI causes were potentially avoidable. The data support the need for increased coverage of measles immunization. There is also a need to develop specialized pediatric ophthalmic services for the management of surgically remediable conditions, to provide optometric, low vision and orientation and mobility services. Genetic risk counseling services also may be considered.David I.T. Sia, James Muecke, Michael Hammerton, Meng Ngy, Aimee Kong, Anna Morse, Martin Holmes, Horm Piseth, Carolyn Hamilton and Dinesh Selv

A survey of visual impairment and blindness in children attending four schools for the blind in Cambodia

Poster abstract #6David Sia, Horm Piseth, Carolyn Hamilton, Dinesh Selva, James Muecke, Michael Hammerton, Meng Ngy, Aimee Kong, Anna Morse, Martin Holme

Refractive error in school children in an urban and rural setting in Cambodia

PurposeTo assess the prevalence of refractive error in schoolchildren aged 12-14 years in urban and rural settings in Cambodia's Phnom Penh and Kandal provinces.MethodsTen schools from Phnom Penh Province and 26 schools from Kandal Province were randomly selected and surveyed in October 2010. Children were examined by teams of Australian and Cambodian optometrists, ophthalmic nurses and ophthalmologists who performed visual acuity (VA) testing and cycloplegic refraction.ResultsA total of 5527 children were included in the study. The prevalence of uncorrected, presenting and best-corrected VA ≤ 6/12 in the better eye were 2.48% (95% confidence interval [CI] 2.02-2.83%), 1.90% (95% CI 1.52-2.24%) and 0.36% (95% CI 0.20-0.52%), respectively; 43 children presented with glasses whilst a total of 315 glasses were dispensed. The total prevalence of refractive error was 6.57% (95% CI 5.91-7.22%), but there was a significant difference between urban (13.7%, 95% CI 12.2-15.2%) and rural (2.5%, 95% CI 2.03-3.07%) schools (P ConclusionsThe prevalence of refractive error was significantly higher in urban Phnom Penh schools than rural schools in Kandal Province. The prevalence of refractive error, particularly myopia was relatively low compared to previous reports in Asia. The majority of children did not have appropriate correction with spectacles, highlighting the need for more effective screening and optical intervention.Zoe Gao, Ngy Meng, James Muecke, Weng Onn Chan, Horm Piseth, Aimee Kong, Theresa Jnguyenphamhh, Yalda Dehghan, Dinesh Selva, Robert Casson, and Kim An