A Comparative Study of Plasma Trace Elements (Copper, Iron and Zinc) Status in Anaemic and Non-anaemic Pregnant Women in Abakaliki, Nigeria

For a comparative study of plasma copper, iron and zinc between anaemic and non-anaemic pregnant women, data for anaemic (n = 223) and non-anaemic (n = 126) pregnant women drawn from a cohort of 351 pregnant Nigerians recruited at gestational age of ≤ 25 weeks for the study of impacts of trace element status on pregnancy outcomes were analysed. With the exception of plasma copper which was significantly (p < 0.05) higher in anaemic women in comparison to the non-anaemic women (10.11 ± 10.15 vs. 8.68 ± 7.92 µmol/l), plasma iron and zinc were lower (p > 0.05) in the former. While plasma copper, iron and zinc concentration were not correlated with maternal haemoglobin concentration, plasma zinc significantly correlated negatively (r = -0.141, p < 0.05) with plasma copper. It is thus concluded that anaemia in pregnant women in this population may partly be due to a combination of trace element deficiencies and their interactions with each other. While interventions should go beyond improving intakes, more research is desired to clearly define these interactions

Comparison between the outcome of trial of labour and elective repeat caesarean section in Kiambu district hospital: a retrospective cohort study

Objective: To determine the pregnancy outcomes in patients with one previous Caesarean section scar who underwent trial of labour as compared to those who had elective repeat Caesarean section at Kiambu District Hospital.Design: A retrospective cohort study.Setting: Post natal wards of Kiambu District Hospital.Subjects: Medical records of all mothers with one previous Caesarean section scar who had delivered in Kiambu District Hospital were obtained and the information used to fill questionnaires. Maternal morbidity was assessed primarily based on post-natal hospital stay. Other maternal morbidity measures assessed included occurrence of uterine rupture, maternal death, need for hysterectomy, maternal blood loss, presence of visceral injury (bladder or gut) and post delivery infectious morbidity. In addition, the failure rate of trial of labour was determined. Foetal outcome was assessed based on APGAR score at five minutes, need for admission to the new born unit and the occurrence of early neonatal death.Results: A total of 142 participants were recruited of which 71 had undergone TOL and 71 had undergone ERCS. Clinical pelvimetry was the most common criteria used for selection of patients for TOL since 100% of all patients in the TOL group were assessed this way as compared to 80.3% in the ERCS group. The success rate of TOL was 50.7% in this study. Successful TOL was associated with less hospital stay since 91.6% stayed for two days or less as compared to ERCS where 84.5% stayed for 3-4days (P&lt;0.001). Similarly, blood loss was less for those who had successful TOL where 97.2% lost less than 500mls as compared to ERCS where 85.9% lost 500mls or more. Maternal outcomes were worse in the 49.7% who failed TOL since only 57.1% of them had a post-natal hospital stay of three to four days as compared to 84.5% in the ERCS group( p=0.029) and 42.9% of the failed TOL group stayed in the hospital for five days or more as compared to only 15.5% in the ERCS group(p=0.002). Foetal outcome was worse in the TOL group since 11.3% had an APGAR score of less than eight at five minutes as compared to only 1.4% in the ERCS group(p=0.016). Similarly, 14.1% of newborns in the TOL group were admitted to the new born unit as compared to only 5.6% in the ERCS group(p=0.091). There were no early neonatal deaths reported in both groups.Conclusion: Overall success rate for TOL was low necessitating emergency Caesarean section of which the maternal outcomes were worse than in the ERCS group. The foetal outcomes were better in the ERCS group as compared to the TOL group.

Remote sensing of aerosol optical characteristics in sub-Sahel, West Africa

We have determined the characteristics of sub-Sahelian aerosols from a 2-year record of continuous ground-based measurements, made at the University of Ilorin, Ilorin (08°19′N, 04°20′E), Nigeria, in cooperation with the Aerosol Robotic Network. Observations of spectral aerosol optical depths during the dusty harmattan season indicate more than a twofold increase, when compared to other seasons. Retrieved columnar volume size distributions show the existence of bimodality with a dominant coarse mode. The retrieved size distributions were grouped according to different ranges of aerosol optical depths to characterize the aerosols for this particular region. Monthly means of retrieved single-scattering albedos show a sharp decrease from ∼0.95 to ∼0.85 at 500 nm from the preharmattan to the harmattan season when biomass burning is also practiced, increasing the presence of absorbing aerosols. On the basis of these comprehensive observations, we propose to augment existing desert aerosol models, as presented in the literature, to better characterize the dust outbreak season in West Africa, which is quite prolonged and overlaps with the biomass burning seaso

Alternative reconstruction after pancreaticoduodenectomy

<p>Abstract</p> <p>Background</p> <p>Pancreaticoduodenectomy is the procedure of choice for tumors of the head of the pancreas and periampulla. Despite advances in surgical technique and postoperative care, the procedure continues to carry a high morbidity rate. One of the most common morbidities is delayed gastric emptying with rates of 15%–40%. Following two prolonged cases of delayed gastric emptying, we altered our reconstruction to avoid this complication altogether. Subsequently, our patients underwent a classic pancreaticoduodenectomy with an undivided <it>Roux-en-Y </it>technique for reconstruction.</p> <p>Methods</p> <p>We reviewed the charts of our last 13 Whipple procedures evaluating them for complications, specifically delayed gastric emptying. We compared the outcomes of those patients to a control group of 15 patients who underwent the Whipple procedure with standard reconstruction.</p> <p>Results</p> <p>No instances of delayed gastric emptying occurred in patients who underwent an undivided <it>Roux-en-Y </it>technique for reconstruction. There was 1 wound infection (8%), 1 instance of pneumonia (8%), and 1 instance of bleeding from the gastrojejunal staple line (8%). There was no operative mortality.</p> <p>Conclusion</p> <p>Use of the undivided <it>Roux-en-Y </it>technique for reconstruction following the Whipple procedure may decrease the incidence of delayed gastric emptying. In addition, it has the added benefit of eliminating bile reflux gastritis. Future randomized control trials are recommended to further evaluate the efficacy of the procedure.</p

Helicobacter pylori and precancerous conditions of the stomach: The frequency of infection in a cross-sectional study of 79 consecutive patients with chronic antral gastritis in Yaoundé, Cameroon

Introduction: The study aimed at determining the different types of precancerous conditions of the stomach and searches the frequency ofHelicobacter pylori in these lesions in patients with chronic antral gastritis in Yaounde, Cameroon.Methods: Five gastric biopsies were performed during upper  gastrointestinal endoscopy for pathology and fixed in formol 10% before being coated in paraffin. Both the modified Giemsa and Periodic acid of Shift – Alkaline blue stains were used for the histological diagnosis of Helicobacter pylori infection. Hematoxylyn and eosin stain was used to determine the activity of gastritis, atrophic gastritis and intestinal  metaplasia in accordance to the Sydney’s classification of gastritis.Data were analysed using both the Epi info 6.04 and Excel 2007 softwares. Means and their standard deviations, medians and their interquartiles(IQR) were calculated. Proportions were established for qualitative variables and chi square analysis done in this study with a p value set at 0.05.Results: Seventy-nine patients with chronic antral gastritis were enrolled, of which 43 (54.4%) were male, median age: 43 years (range from 21 to 70 years). The rate of atrophic gastritis was 74.7% (59/79). The activity of atrophic gastritis was mild in 47.5% (28/59) of cases, moderate in 47.5% (28/59) and severe in 5% (5/59). Intestinal metaplasia and follicular  gastritis were present in 6.3% (5/79), and 10.1% (8/79), respectively.Concerning Helicobacter pylori infection, 71.2% (42/59) of patients with atrophic gastritis tested positive against 28.8% (17/59) who tested negative (p = 0.00003). Helicobacter pylori infection was related to the severity of gastric atrophy (p = 0.0001). Among patients with intestinalmetaplasia and follicular gastritis, the proportion of those who tested positive for Helicobacter pylori infection was 80% (4/5), and 75% (6/8),respectively. There were no significant differences in the occurrence of atrophic gastritis according to age groups (p = 0.908).Conclusion: This study concludes that atrophic gastritis, which is most often caused by Helicobacter pylori, is the most frequent precancerous condition of stomach in Cameroon. Routine gastric sampling for pathologic analysis is mandatory for effective diagnosis and surveillance of Helicobacter pylori infection and precancerous conditions of the stomach

Loneliness, social support and cardiovascular reactivity to laboratory stress

Self-reported or explicit loneliness and social support have been inconsistently associated with cardiovascular reactivity (CVR) to stress. The present study aimed to adapt an implicit measure of loneliness, and use it alongside the measures of explicit loneliness and social support, to investigate their correlations with CVR to laboratory stress. Twenty-five female volunteers aged between 18 and 39 years completed self-reported measures of loneliness and social support, and an Implicit Association Test (IAT) of loneliness. The systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) reactivity indices were measured in response to psychosocial stress induced in the laboratory. Functional support indices of social support were significantly correlated with CVR reactivity to stress. Interestingly, implicit, but not explicit, loneliness was significantly correlated with DBP reactivity after one of the stressors. No associations were found between structural support and CVR indices. Results are discussed in terms of validity of implicit versus explicit measures and possible factors that affect physiological outcomes

Early post-metamorphic, Carboniferous blastoid reveals the evolution and development of the digestive system in echinoderms

Inferring the development of the earliest echinoderms is critical to uncovering the evolutionary assembly of the phylum-level body plan but has long proven problematic because early ontogenetic stages are rarely preserved as fossils. Here, we use synchrotron tomography to describe a new early post-metamorphic blastoid echinoderm from the Carboniferous (approx. 323 Ma) of China. The resulting three-dimensional reconstruction reveals a U-shaped tubular structure in the fossil interior, which is interpreted as the digestive tract. Comparisons with the developing gut of modern crinoids demonstrate that crinoids are an imperfect analogue for many extinct groups. Furthermore, consideration of our findings in a phylogenetic context allows us to reconstruct the evolution and development of the digestive system in echinoderms more broadly; there was a transition from a straight to a simple curved gut early in the phylum's evolution, but additional loops and coils of the digestive tract (as seen in crinoids) were not acquired until much later

Feedhorn-integrated THz QCL local oscillators for the LOCUS atmospheric sounder

The LOCUS atmospheric sounder is a satellite-borne THz radiometer concept, for studying molecular species in the mesosphere and lower thermosphere. We report waveguide-integrated THz quantum-cascade lasers for use as 3.5 THz local oscillators. A waveguide-integration scheme, using an integrated diagonal feedhorn significantly improves power outcoupling. 1.3 mW THz emission is demonstrated in a space-qualified Stirling cryocooler at 57 K, with ∼15° beam divergence

A systematic review and meta-synthesis of the impact of low back pain on people's lives

Copyright @ 2014 Froud et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.Background - Low back pain (LBP) is a common and costly problem that many interpret within a biopsychosocial model. There is renewed concern that core-sets of outcome measures do not capture what is important. To inform debate about the coverage of back pain outcome measure core-sets, and to suggest areas worthy of exploration within healthcare consultations, we have synthesised the qualitative literature on the impact of low back pain on people’s lives. Methods - Two reviewers searched CINAHL, Embase, PsycINFO, PEDro, and Medline, identifying qualitative studies of people’s experiences of non-specific LBP. Abstracted data were thematic coded and synthesised using a meta-ethnographic, and a meta-narrative approach. Results - We included 49 papers describing 42 studies. Patients are concerned with engagement in meaningful activities; but they also want to be believed and have their experiences and identity, as someone ‘doing battle’ with pain, validated. Patients seek diagnosis, treatment, and cure, but also reassurance of the absence of pathology. Some struggle to meet social expectations and obligations. When these are achieved, the credibility of their pain/disability claims can be jeopardised. Others withdraw, fearful of disapproval, or unable or unwilling to accommodate social demands. Patients generally seek to regain their pre-pain levels of health, and physical and emotional stability. After time, this can be perceived to become unrealistic and some adjust their expectations accordingly. Conclusions - The social component of the biopsychosocial model is not well represented in current core-sets of outcome measures. Clinicians should appreciate that the broader impact of low back pain includes social factors; this may be crucial to improving patients’ experiences of health care. Researchers should consider social factors to help develop a portfolio of more relevant outcome measures.Arthritis Research U

A Hidden Feedback in Signaling Cascades Is Revealed

Cycles involving covalent modification of proteins are key components of the intracellular signaling machinery. Each cycle is comprised of two interconvertable forms of a particular protein. A classic signaling pathway is structured by a chain or cascade of basic cycle units in such a way that the activated protein in one cycle promotes the activation of the next protein in the chain, and so on. Starting from a mechanistic kinetic description and using a careful perturbation analysis, we have derived, to our knowledge for the first time, a consistent approximation of the chain with one variable per cycle. The model we derive is distinct from the one that has been in use in the literature for several years, which is a phenomenological extension of the Goldbeter-Koshland biochemical switch. Even though much has been done regarding the mathematical modeling of these systems, our contribution fills a gap between existing models and, in doing so, we have unveiled critical new properties of this type of signaling cascades. A key feature of our new model is that a negative feedback emerges naturally, exerted between each cycle and its predecessor. Due to this negative feedback, the system displays damped temporal oscillations under constant stimulation and, most important, propagates perturbations both forwards and backwards. This last attribute challenges the widespread notion of unidirectionality in signaling cascades. Concrete examples of applications to MAPK cascades are discussed. All these properties are shared by the complete mechanistic description and our simplified model, but not by previously derived phenomenological models of signaling cascades