Profiling lifetime episodes of upper gastrointestinal bleeding among patients from rural Sub-Saharan Africa where schistosoma mansoni is endemic

© Christopher Kenneth Opio et al.Introduction: Severe chronic hepatic schistosomiasis is a common cause of episodes upper gastrointestinal bleeding (UGIB) in sub-Saharan Africa (SSA). However, there is paucity of data on clinical epidemiology of episodes of UGIB from rural Africa despite on going public health interventions to control and eliminate schistosomiasis. Methods: Through a cross sectional study we profiled lifetime episodes of upper gastrointestinal bleeding and associated factors at a rural primary health facility in sub-Saharan Africa were schistosomiasis is endemic. The main outcome was number of lifetime episodes of UGIB analyzed as count data. Results: From 107 enrolled participants, 323 lifetime episodes of UGIB were reported. Fifty-seven percent experienced ≥ 2 lifetime episodes of UGIB. Ninety-four percent had severe chronic hepatic schistosomiasis and 80% esophageal varices. Alcohol use and viral hepatitis was infrequent. Eighty-eight percent were previously treated with praziquantel and 70% had a history of blood transfusion. No patient had ever had an endoscopy or treatment for prevention of recurrent variceal bleeding. Multivariable analysis identified a cluster of eight clinical factor variables (age ≥ 40, female sex, history of blood transfusion, abdominal collaterals, esophageal varices, pattern x periportal fibrosis, anemia, and thrombocytopenia) significantly associated (P-value < 0.05) with increased probability of experiencing two or more lifetime episodes of UGIB in our study. Conclusion: Upper gastrointestinal bleeding is a common health problem in this part of rural SSA where schistosomiasis is endemic. The clinical profile described is unique and is important for improved case management, and for future research

Pharmaceutical integrated stress response enhancement protects oligodendrocytes and provides a potential multiple sclerosis therapeutic.

Oligodendrocyte death contributes to the pathogenesis of the inflammatory demyelinating disease multiple sclerosis (MS). Nevertheless, current MS therapies are mainly immunomodulatory and have demonstrated limited ability to inhibit MS progression. Protection of oligodendrocytes is therefore a desirable strategy for alleviating disease. Here we demonstrate that enhancement of the integrated stress response using the FDA-approved drug guanabenz increases oligodendrocyte survival in culture and prevents hypomyelination in cerebellar explants in the presence of interferon-γ, a pro-inflammatory cytokine implicated in MS pathogenesis. In vivo, guanabenz treatment protects against oligodendrocyte loss caused by CNS-specific expression of interferon-γ. In a mouse model of MS, experimental autoimmune encephalomyelitis, guanabenz alleviates clinical symptoms, which correlates with increased oligodendrocyte survival and diminished CNS CD4+ T cell accumulation. Moreover, guanabenz ameliorates relapse in relapsing-remitting experimental autoimmune encephalomyelitis. Our results provide support for a MS therapy that enhances the integrated stress response to protect oligodendrocytes against the inflammatory CNS environment

Groundwater resources assessment using numerical model : a case study in low-lying coastal area.

The impacts of climate change and human pressure in groundwater have been greatest threats facing small islands. This paper represents a case study of groundwater responses towards the climate change and human pressures in Manukan Island Malaysia. SEAWAT-2000 was used for the simulations of groundwater response in study area. Simulations of six scenarios representing climate change and human pressures showed changes in hydraulic heads and chloride concentrations. Reduction in pumping rate and an increase in recharge rate can alter the bad effects of overdrafts in Manukan Island. In general, reduction in pumping rate and an increase in recharge rate are capable to restore and protect the groundwater resources in Manukan Island. Thus, for groundwater management options in Manukan Island, scenario 2 is capable to lessen the seawater intrusion into the aquifer and sustain water resources on a long-term basis. The selection of scenario 6 is the preeminent option during wet season. The output of this study provides a foundation which can be used in other small islands of similar hydrogeological condition for the purpose of groundwater resources protection

Severity of psoriasis among adult males is associated with smoking, not with alcohol use

Context: Lifestyle factors such as tobacco smoking and alcohol use can affect the presentation and course of psoriasis. There is a paucity of data on this subject from India. Aims: To find out whether increased severity of psoriasis in adult Indian males is associated with tobacco smoking and alcohol use. Settings and Design: Cross-sectional study in the Department of Dermatology of a Tertiary Care Teaching Hospital. Subjects and Methods: Male patients above 18 years of age attending a psoriasis clinic between March 2007 and May 2009 were studied. Severity of psoriasis (measured using Psoriasis Area and Severity Index - PASI) among smokers and non-smokers was compared. We also studied the correlation between severity of psoriasis and nicotine dependence (measured using Fagerström Test for Nicotine Dependence) and alcohol use disorders (measured using Alcohol Use Disorders Identification Test- AUDIT). Statistical Analysis: Z-test, Odd′s ratio, Chi-square test, Spearman′s correlation coefficient. Results: Of a total of 338 patients, 148 were smokers and 173 used to consume alcohol. Mean PASI score of smokers was more than that of non-smokers (Z-test, z = −2.617, P = 0.009). Those with severe psoriasis were more likely to be smokers (χ2 = 5.47, P = 0.02, OR = 1.8, Confidence Interval 1.09-2.962). There was a significant correlation between PASI scores and Fagerström score (Spearman′s correlation coefficient = 0.164, P 0.05). Conclusions: Increased severity of psoriasis among adult males is associated with tobacco smoking, but not with alcohol use

Profiling lifetime episodes of upper gastrointestinal bleeding among patients from rural Sub-Saharan Africa where schistosoma mansoni is endemic

© Christopher Kenneth Opio et al.Introduction: Severe chronic hepatic schistosomiasis is a common cause of episodes upper gastrointestinal bleeding (UGIB) in sub-Saharan Africa (SSA). However, there is paucity of data on clinical epidemiology of episodes of UGIB from rural Africa despite on going public health interventions to control and eliminate schistosomiasis. Methods: Through a cross sectional study we profiled lifetime episodes of upper gastrointestinal bleeding and associated factors at a rural primary health facility in sub-Saharan Africa were schistosomiasis is endemic. The main outcome was number of lifetime episodes of UGIB analyzed as count data. Results: From 107 enrolled participants, 323 lifetime episodes of UGIB were reported. Fifty-seven percent experienced ≥ 2 lifetime episodes of UGIB. Ninety-four percent had severe chronic hepatic schistosomiasis and 80% esophageal varices. Alcohol use and viral hepatitis was infrequent. Eighty-eight percent were previously treated with praziquantel and 70% had a history of blood transfusion. No patient had ever had an endoscopy or treatment for prevention of recurrent variceal bleeding. Multivariable analysis identified a cluster of eight clinical factor variables (age ≥ 40, female sex, history of blood transfusion, abdominal collaterals, esophageal varices, pattern x periportal fibrosis, anemia, and thrombocytopenia) significantly associated (P-value < 0.05) with increased probability of experiencing two or more lifetime episodes of UGIB in our study. Conclusion: Upper gastrointestinal bleeding is a common health problem in this part of rural SSA where schistosomiasis is endemic. The clinical profile described is unique and is important for improved case management, and for future research

Rapport final de l'atelier de formation des formateurs en mobilisation des ressources, Dakar, 10-13 juillet 2007

© Christopher Kenneth Opio et al.Introduction: Severe chronic hepatic schistosomiasis is a common cause of episodes upper gastrointestinal bleeding (UGIB) in sub-Saharan Africa (SSA). However, there is paucity of data on clinical epidemiology of episodes of UGIB from rural Africa despite on going public health interventions to control and eliminate schistosomiasis. Methods: Through a cross sectional study we profiled lifetime episodes of upper gastrointestinal bleeding and associated factors at a rural primary health facility in sub-Saharan Africa were schistosomiasis is endemic. The main outcome was number of lifetime episodes of UGIB analyzed as count data. Results: From 107 enrolled participants, 323 lifetime episodes of UGIB were reported. Fifty-seven percent experienced ≥ 2 lifetime episodes of UGIB. Ninety-four percent had severe chronic hepatic schistosomiasis and 80% esophageal varices. Alcohol use and viral hepatitis was infrequent. Eighty-eight percent were previously treated with praziquantel and 70% had a history of blood transfusion. No patient had ever had an endoscopy or treatment for prevention of recurrent variceal bleeding. Multivariable analysis identified a cluster of eight clinical factor variables (age ≥ 40, female sex, history of blood transfusion, abdominal collaterals, esophageal varices, pattern x periportal fibrosis, anemia, and thrombocytopenia) significantly associated (P-value < 0.05) with increased probability of experiencing two or more lifetime episodes of UGIB in our study. Conclusion: Upper gastrointestinal bleeding is a common health problem in this part of rural SSA where schistosomiasis is endemic. The clinical profile described is unique and is important for improved case management, and for future research

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Not AvailableThe groundwater status of Vijayapura district is under semi-critical to over-exploited category and optimal application of irrigation water is needed for the sustainable water management in this region. In the present study, the rainfall, temperature, evapotranspiration variability and irrigation requirement of major crops was analyzed for three future scenarios, namely, 2020’s (2010 to 2039), 2050’s (2040 to 2069) and 2080’s (2070 to 2099) with respect to the baseline period (1976-2005). The ENSEMBLE data corresponding to four different emission scenarios was used. Rainfall and temperature are important factors governing the irrigation requirement and the rainfall is predicted to increase from 590 mm during baseline period to 611, 646 and 677 mm under RCP 4.5 (medium emission scenario) and 617, 674 and 742 mm under high emission scenario (RCP 8.5). The maximum temperature is predicted to increase by 0.8, 1.6, 2.00C under RCP 4.5 and 0.9, 2.0, 3.60C under RCP 8.5. The minimum Temperature is predicted to increase by 1.0, 1.8, 2.30C under RCP 4.5 and 1.1, 2.5, 4.20C under RCP 8.5 respectively. Correspondingly, the evapotranspiration values (ET0) are estimated to increase from 1851 to 1877, 1900 and 1916 mm under RCP 4.5 and 1876, 1912 and 1958 mm under RCP 8.5. The irrigation requirement of rabi sorghum is predicted to increase from 434 to 440, 447 and 449 mm under RCP 4.5 and 438, 445 and 453 mm under RCP 8.5. Similarly, the irrigation requirement of rabi maize is predicted to increase from 667 to 678, 688 and 694 mm under RCP 4.5 and 679, 694 and 712 mm under RCP 8.5, respectively. No considerable increase in the irrigation requirement for kharif crops was predicted in Vijayapura. In order to ensure long-term and sustainable groundwater utilization in the region, proper estimation of crop water requirement and its application are needed.ICAR-NICR