Assessment of the knowledge, attitude, and practice related to visceral leishmaniasis among residents of Al-Suwaira city, Wasit Governorate, Middle East of Iraq

Introduction: It is important to assess the knowledge, attitudes, and practice (KAP) towards visceral leishmaniasis (VL) to implement an effective control program. Hence, this study aimed to shed light in KAP among residents at Al-Suwaira city, Wasit Governorate, Middle East of Iraq. Methods: During March to May 2021, a cross-sectional study was done on 121 randomly selected residents. A normal self-administered questionnaire was used to measure the KAP. The results were expressed using descriptive analysis. Results: Overall, participants indicated average knowledge towards VL. However, the incubation period of VL (23.9%), the symptoms of VL (57.9%), and the diseases' transmission ways (54.5%) were recognized as knowledge gaps. The participants had favorable attitude towards VL, as majority of them (more than 70.0%) agreed that VL causes health problems in the local populations and local communities should be actively involved in the fight against VL. Also, majority of the participants agreed that VL is a treatable. Regarding practice towards VL, 110 (90.9%) participants had used preventive measures against sand fly bites. The majority of people (44.6%) chose cleanliness as a disease-prevention technique. The main sources of information used by participants to educate themselves about the condition were the internet (57.0%) and television (19.8%). Conclusion: Overall, the participants had good knowledge, positive attitudes, and good practice when it came to VL prevention. However, there were some gaps. Hence, it is recommended that knowledge-based strategies be strengthened and rigorously rolled out in order to raise awareness among the residents of the region

Índice de massa corporal para predizer hiperglicemia e alterações lipídicas em adolescentes brasileiros

OBJECTIVE: To determine the best cut-offs of body mass index for identifying alterations of blood lipids and glucose in adolescents. METHODS: A probabilistic sample including 577 adolescent students aged 12-19 years in 2003 (210 males and 367 females) from state public schools in the city of Niterói, Southeastern Brazil, was studied. The Receiver Operating Characteristic curve was used to identify the best age-adjusted BMI cut-off for predicting high levels of serum total cholesterol (&gt;150mg/dL), LDL-C (&gt;100mg/dL), serum triglycerides (&gt;100mg/dL), plasma glucose (&gt;100mg/dL) and low levels of HDL-C (< 45mg/dL). Four references were used to calculate sensitivity and specificity of BMI cut-offs: one Brazilian, one international and two American. RESULTS: The most prevalent metabolic alterations (&gt;50%) were: high total cholesterol and low HDL-C. BMI predicted high levels of triglycerides in males, high LDL-C in females, and high total cholesterol and the occurrence of three or more metabolic alterations in both males and females (areas under the curve range: 0.59 to 0.67), with low sensitivity (57%-66%) and low specificity (58%-66%). The best BMI cut-offs for this sample (20.3 kg/m² to 21.0 kg/m²) were lower than those proposed in the references studied. CONCLUSIONS: Although BMI values lower than the International cut-offs were better predictor of some metabolic abnormalities in Brazilian adolescents, overall BMI is not a good predictor of these abnormalities in this population.OBJETIVO: Determinar los mejores puntos de corte del índice de masa corporal (IMC) para identificar alteraciones en el perfil lipémico y glicérico en adolescentes. MÉTODOS: Fueron evaluados 577 adolescentes de 12 a 19 años (210 niños y 367 niñas) en una muestra probabilística de estudiantes de escuelas estaduales de la ciudad de Niteroi, Sureste de Brasil, en 2003. Fue utilizada una curva Receiver Operating Characteristic para identificar el mejor punto de corte, ajustado a la edad, para predecir valores elevados de colesterol total sérico (=150mg/dL), LDL-C (=100mg/dL), triglicéridos (=100mg/dL), glicosis plasmática (&gt;100mg/dL) y bajos valores de HDL-C (OBJETIVO: Determinar os melhores pontos de corte do índice de massa corporal (IMC) para identificar alterações no perfil lipêmico e glicêmico em adolescentes. MÉTODOS: Foram avaliados 577 adolescentes de 12 a 19 anos (210 meninos e 367 meninas) em uma amostra probabilística de estudantes de escolas estaduais da cidade de Niterói (RJ), em 2003. Foi utilizada a curva Receiver Operating Characteristic para identificar o melhor ponto de corte, ajustado para idade, para predizer valores elevados de colesterol total sérico (&gt;150mg/dL), LDL-C (&gt;100mg/dL), triglicérides (&gt;100mg/dL), glicose plasmática (&gt;100mg/dL) e baixos valores de HDL-C

Knowledge, attitude, and hygiene practices of food handlers related to food safety in Al-Suwaira City, Wasit Province in Iraq

Background and Aim: Food safety and hygiene are global health concerns, particularly in underprivileged nations, due to the increased incidence of foodborne diseases (FBDs) and associated mortality. This study aimed to evaluate the food handlers’ knowledge, attitude, and hygiene practices toward food safety in Al-Suwaira City, Wasit governorate, Iraq. Materials and Methods: In this cross-sectional study, researchers interviewed 130 food handlers to assess their knowledge, attitude, and hygiene regarding food safety in Al-Suwaira, Wasit governorate, Middle Eastern Iraq, from October 2022 to March 2023. The data regarding their age, sex, place of residence, education, employment history, marital status, and monthly income were collected through a questionnaire, as were details on their knowledge, attitudes, and hygiene habits about food safety. Results: Overall, most participants demonstrated poor knowledge of food hygiene and preservation but showed good knowledge of personal hygiene. Knowledge gaps were identified about the healthy ways to clean and use cooking utensils (35.38%), storage of food in the refrigerator (33.85%), and the possible exposure to foodborne pathogens when utensils are reused to cook vegetables and meat (12.31%). Nearly all participants in this study had positive attitudes toward food safety. Most participants (n = 100, 76.7%) agreed that separating raw and cooked food is the best way to avoid spreading germs. Moreover, 109 respondents (83.85%) agreed that washing hands before preparing food efficiently reduces the spread of FBDs. Furthermore, 117 participants (90%) disagreed that disposing of expired perishable foods is necessary, while 91.54% disagreed that monitoring meals for cleanliness and health is important. Our findings showed that 57.15% of the participants had low-to-intermediate competence in food safety procedures, such as avoiding cross-contamination, checking food temperatures, and washing hands thoroughly before and after handling food. Conclusion: The participants in this study exhibited poor compliance and awareness of food safety procedures and practices, respectively. Therefore, educational opportunities and training are necessary to enhance their knowledge, attitudes, and cleanliness levels

Estado nutricional de pacientes com neoplasias bucais, de cabeça e pescoço: uma revisão narrativa / Nutritional status of patients with oral, head and neck neoplasms: a narrative review

O câncer já é considerado uma atribuição de saúde pública, devido ao crescimento demográfico e o envelhecimento populacional, em paralelo ao desenvolvimento socioeconômico. Nas últimas décadas, o registro de câncer tem acrescido o número de novos casos. A World Health Organization (WHO) estimam que taxas de câncer possam ter crescido 50% entre 2000 e 2020, passando de 10 para 15 milhões de novos casos. Quando a região acometida é a cervical e/ou a cavidade oral existem outras dificuldades enfrentadas. Um importante fator que deve ser posto em consideração é a questão nutricional e a capacidade de alimentação dos pacientes, haja vista a dificuldade de se alimentar e a consequente queda de aporte nutricional desses pacientes. Isso representa um maior risco de desnutrição entre os pacientes oncológicos. O objetivo deste estudo é estabelecer uma revisão de narrativa da literatura acerca do perfil alimentar e estado nutricional de pacientes com neoplasia cervicais e bucais. Para a realização deste trabalho foram analisadas obras nacionais e internacionais, publicadas entre os anos de 1991 a 2020. Se tratando de uma pesquisa exploratória observacional retrospectiva de abordagem qualitativa em que foi utilizado o método da leitura analítica e comparada da literatura. Tanto os pacientes submetidos a intervenções cirúrgicas, quanto quimioradioterápicas apresentaram alguma redução da ingesta de alimentos. A perda de peso relacionada ao câncer é bem conhecida pelo fato de contribuir para a piora do bem estar do paciente. Logo, é possível constatar os danos e o pior desfecho de pacientes com perda ponderal associados à doença neoplásica e apontar o prognóstico mais favorável de pacientes que recebem um acompanhamento mais efetivo e individualizado de sua dieta

Effect of tibolone on the morphology of skeletal muscle, liver enzymes and blood glucose level in castrated female rats

INTRODUÇÃO: O fígado é uma estrutura de elevada complexidade e é fundamental entender como determinadas substâncias podem afetar sua estrutura e suas funções. OBJETIVO: Analisar a influência da tibolona no metabolismo hepático por meio da avaliação de enzimas e metabólitos comumente utilizados em provas de função hepática. MÉTODOS: Foram utilizadas dez ratas Wistar, divididas em dois grupos: controle (n = 4) e tibolona (n = 6), em status de menopausa cirúrgica. A tibolona (1 mg) foi administrada diariamente por gavagem durante 20 semanas, com avaliação periódica do peso corporal. Após sedação, efetuou-se coleta de sangue para avaliação bioquímica de albumina (Alb) sérica, fosfatase alcalina (FA), transaminases (aspartato aminotransferase e alanina aminotransferase [AST/ALT]), gama-glutamiltranspeptidase (GGT) e glicose, mediante espectrofotometria. O músculo esquelético da coxa foi avaliado por histomorfometria em cortes histológicos corados com hematoxilina e eosina (HE). RESULTADOS: Os animais do grupo tibolona mostraram menor peso corporal, alterações musculares esqueléticas e discretas alterações bioquímicas. Além disso, AST e FA estavam diminuídas e GGT estava mais elevada, porém sem significância estatística. A histomorfometria do músculo revelou uma tendência de menor volume celular nesse grupo. CONCLUSÃO: A tibolona, administrada em alta dose e por tempo prolongado, não interfere de forma significativa nas funções metabólicas e de síntese hepáticas, bem como na permeabilidade da membrana celular, entretanto parece modular a expressão genômica da GGT. A tibolona apresenta influência sistêmica associada a menor peso e diminuição da massa muscular e aumento significativo no peso relativo do fígado, além de alteração da glicogenólise hepática e muscular, da gliconeogênese hepática e dos níveis de glicose circulante

Is the creatine kinase isoenzyme MB level a marker of myocardial ischemia in ventilated premature infants?

ABSTRACT INTRODUCTION: It is not clear whether the levels of troponin I (TI) and creatine kinase isoenzyme MB (CK-MB) are changed in premature infants (PI) without evidence of myocardial ischemia (MI). OBJECTIVES: To investigate whether TI and CK-MB change their levels in newborns without MI while on mechanical ventilation (MV). METHODS: We conducted a prospective cohort study in which 165 PI were divided into control group ([CG]; n = 68), mechanical ventilated group ([VG]; n = 21) and a surfactant therapy group ([SG]; n = 76), and had their TI, creatine kinase (CK) and CK-MB levels were determined. After the division, within the first four hours after the introduction of the mechanical ventilation (MV) and one hour after the withdrawal of it, we performed a new measurement of TI, CK and CK-MB to all PI from VG and VS. We used the chi-square test to evaluate the association among qualitative variables and the Kruskall-Wallis test to compare the serum levels of TI, and CK-MB among the groups, before, during and after MV using the statistical package SPSS 16.0 software. RESULTS: TI, CK, and CK-MB serum values before the groups were divided were considered normal. The TI concentration among the groups before and after MV (p > 0.05) did not changed; however, the CK-MB levels were higher in VG when compared to the CG (p = 0.009). CONCLUSION: The increase of CK-MB serum levels in VG and SG seems to indicate an increased work of thoracic skeletal muscle and do not represent a MI signal, which invalidate its use as a marker

O nível sérico de creatinofosfoquinase fração MB serve como marcador de isquemia miocárdica em recém-nascidos prematuros ventilados

Introdução: Não está claro se os níveis séricos de troponina I (TI) e de creatinoquinase fração MB (CK-MB) estão alterados em recém-nascidos prematuros (RNP) sem indícios de isquemia miocárdica (IM). Objetivo: Investigar se os níveis de TI e CK-MB se alteram nos RNP sem IM quando em ventilação mecânica (VM). Métodos: Coorte prospectiva com 165 RNP que, antes de serem divididos em grupo-controle ([CG]; n = 68), ventilado ([VG]; n = 21) e surfactante ([SG]; n = 76), tiveram seus níveis séricos de TI, creatinoquinase (CK) e CK-MB determinados. Após a divisão, dentro das primeiras 4 horas do início da VM e 1 hora após sua retirada, realizamos nova dosagem de TI, CK e CK-MB nos RNP dos VG e VS. Foram utilizados o teste do Qui-quadrado para avaliar a associação entre as variáveis qualitativas e o teste de Kruskall-Wallis para comparar os valores séricos de TI e CK-MB entre os grupos, antes, durante e depois da VM, usando o pacote estatístico SPSS 16.0. Resultados: Os valores séricos de TI, CK e CK-MB antes dos grupos serem divididos foram considerados normais. As concentrações de TI entre os grupos antes e depois da VM não se alteraram (p > 0,05), entretanto as de CK-MB foram maiores nos ventilados em relação aos do CG (p = 0,009). Conclusão: A elevação dos níveis séricos de CK-MB nos VG e SG parece indicar aumento do trabalho da musculatura torácica e não um sinal de IM, o que inviabiliza o uso desta como um marcadorSimIntroduction: It is not clear whether the levels of troponin I (TI) and creatine kinase isoenzyme MB (CK-MB) are changed in premature infants (PI) without evidence of myocardial ischemia (MI). Objectives: To investigate whether TI and CK-MB change their levels in newborns without MI while on mechanical ventilation (MV). Methods: We conducted a prospective cohort study in which 165 PI were divided into control group ([CG]; n = 68), mechanical ventilated group ([VG]; n = 21) and a surfactant therapy group ([SG]; n = 76), and had their TI, creatine kinase (CK) and CK-MB levels were determined. After the division, within the first four hours after the introduction of the mechanical ventilation (MV) and one hour after the withdrawal of it, we performed a new measurement of TI, CK and CK-MB to all PI from VG and VS. We used the chi-square test to evaluate the association among qualitative variables and the Kruskall-Wallis test to compare the serum levels of TI, and CK-MB among the groups, before, during and after MV using the statistical package SPSS 16.0 software. Results: TI, CK, and CK-MB serum values before the groups were divided were considered normal. The TI concentration among the groups before and after MV (p > 0.05) did not changed; however, the CK-MB levels were higher in VG when compared to the CG (p = 0.009). Conclusion: The increase of CK-MB serum levels in VG and SG seems to indicate an increased work of thoracic skeletal muscle and do not represent a MI signal, which invalidate its use as a marke