Prevalence of hepatitis B virus infection among barbers and their knowledge, attitude and practices in the district of Sukkur, Sindh .

Abstract OBJECTIVES: Several occupations in developing countries lag behind in ensuring the safety of their workers in occupational settings. Lack of implementation of safety guidelines at workplaces can expose workers to health risks. In Pakistan, barbers are one of the un-regulated occupational groups. Low literacy, increased frequency of direct skin contact and blade/razors use can expose barbers to body fluids including blood of the customers. We conducted this study in order to determine hepatitis B virus (HBV) prevalence among barbers and their knowledge, attitude and practices in a peri-urban district of Sindh. MATERIAL AND METHODS: Three hundred eighty-five barbers from the Sukkur district were interviewed using a structured questionnaire. Blood samples were collected and tested for HBsAg. A scale was built to determine the proportions of responses to knowledge, attitude and practice items. RESULTS: The prevalence of HBV among barbers was 2.1%. The barbers\u27 knowledge on HBV and its transmission routes was poor. The response to attitude items was good, except that only 35.1% of the participants agreed to have vaccination against HBV. The overall performance on the knowledge and practice scales was poor compared to the attitude scale on which 80% of the barbers performed well. CONCLUSION: The prevalence of HBV among barbers was lower compared to the available national figures for the prevalence among the general population

Chronic bronchitis and chronic obstructive pulmonary disease (COPD) among textile workers in Karachi, Pakistan

Objective: To determine the frequency and predictors of chronic bronchitis and COPD among textile workers in Karachi, Pakistan.Study design: Cross-sectional survey.Place and duration of study: Karachi, Pakistan, from October to December 2009.Methodology: Male textile workers from 15 mills of Karachi were inducted. Data was collected using American Thoracic Society respiratory questionnaire (ATS-DLD-78-a) and spirometry.Results: Out of 372 participants, 29 (7.8%) workers had chronic bronchitis (4, 9.1% aged ≥40 years) and 25 (6.7%) had COPD (12, 27.2% aged ≥40 years). Workers with chronic bronchitis had significantly decreased lung function compared to the healthy workers. Those reporting severe self-perceived dust exposure at work, ≥ 10 pack years of smoking, uneducated, longer duration of work (≥11 years), and ever smokers were more likely to have chronic bronchitis or COPD. In the multivariate analyses, severe self-perceived dust exposure at work (AOR = 7.4; 95% CI: 1.9, 28.0), family history of respiratory illness/symptoms (AOR = 4.8; 95% CI: 1.1, 20.9) and lack of education (AOR = 4.2; 95% CI: 1.1, 16.9) were significant predictors of chronic bronchitis. Duration of work ≥11 years (AOR = 5.5; 95% CI: 1.5, 19.7) and pack years of smoking ≥10 years (AOR = 3.5; 95% CI: 1.1, 11.7) were strong predictors for COPD.Conclusion: There is a high frequency of chronic bronchitis and COPD among textile workers. Multiple important predictors for prevention are identified

Myostatin signals through miR-34a to regulate Fndc5 expression and browning of white adipocytes

Background/Objectives: Myostatin (Mstn) has a pivotal role in glucose and lipid metabolism. Mstn deficiency leads to the increased browning of white adipose tissue (WAT), which results in the increased energy expenditure and protection against diet-induced obesity and insulin resistance. In this study, we investigated the molecular mechanism(s) through which Mstn regulates browning of white adipocytes. Methods: Quantitative molecular analyses were performed to assess Mstn regulation of miR-34a and Fndc5 expression. miR-34a was overexpressed and repressed to investigate miR-34a regulation of Fndc5. Luciferase reporter analysis verified direct binding between miR-34a and the Fndc5 3′-untranslated region (UTR). The browning phenotype of Mstn−/− adipocytes was assessed through the analysis of brown fat marker gene expression, mitochondrial function and infrared thermography. The role of miR-34a and Fndc5 in this browning phenotype was verified through antibody-mediated neutralization of FNDC5, knockdown of Fndc5 by small interfering RNA and through miR-34a gain-of-function and loss-of-function experiments. Results: Mstn treatment of myoblasts inhibited Fndc5 expression, whereas the loss of Mstn increased Fndc5 levels in muscles and in circulation. Mstn inhibition of Fndc5 is miR-34a dependent. Mstn treatment of C2C12 myoblasts upregulated miR-34a expression, whereas reduced miR-34a expression was noted in Mstn−/− muscle and WAT. Subsequent overexpression of miR-34a inhibited Fndc5 expression, whereas blockade of miR-34a increased Fndc5 expression in myoblasts. Reporter analysis revealed that miR-34a directly suppresses Fndc5 expression through a miR-34a-specific binding site within the Fndc5 3′UTR. Importantly, Mstn-mediated inhibition of Fndc5 was blocked upon miR-34a inhibition. Mstn−/− adipocytes showed reduced miR-34a, enhanced Fndc5 expression and increased thermogenic gene expression, which was reversed upon either neutralization of Fndc5 or Fndc5 knockdown. In agreement, Mstn−/− adipocytes have increased mitochondria, improved mitochondrial function and increased heat production. Conclusions: Mstn regulates Fndc5/Irisin expression and secretion through a novel miR-34a-dependent post-transcriptional mechanism. Loss of Mstn in mice leads to the increased Fndc5/Irisin expression, which contributes to the browning of white adipocytes

The Effect of Uncertainty in Exposure Estimation on the Exposure-Response Relation between 1,3-Butadiene and Leukemia

In a follow-up study of mortality among North American synthetic rubber industry workers, cumulative exposure to 1,3-butadiene was positively associated with leukemia. Problems with historical exposure estimation, however, may have distorted the association. To evaluate the impact of potential inaccuracies in exposure estimation, we conducted uncertainty analyses of the relation between cumulative exposure to butadiene and leukemia. We created the 1,000 sets of butadiene estimates using job-exposure matrices consisting of exposure values that corresponded to randomly selected percentiles of the approximate probability distribution of plant-, work area/job group-, and year specific butadiene ppm. We then analyzed the relation between cumulative exposure to butadiene and leukemia for each of the 1,000 sets of butadiene estimates. In the uncertainty analysis, the point estimate of the RR for the first non zero exposure category (>0–<37.5 ppm-years) was most likely to be about 1.5. The rate ratio for the second exposure category (37.5–<184.7 ppm-years) was most likely to range from 1.5 to 1.8. The RR for category 3 of exposure (184.7–<425.0 ppm-years) was most likely between 2.1 and 3.0. The RR for the highest exposure category (425.0+ ppm-years) was likely to be between 2.9 and 3.7. This range off RR point estimates can best be interpreted as a probability distribution that describes our uncertainty in RR point estimates due to uncertainty in exposure estimation. After considering the complete probability distributions of butadiene exposure estimates, the exposure-response association of butadiene and leukemia was maintained. This exercise was a unique example of how uncertainty analyses can be used to investigate and support an observed measure of effect when occupational exposure estimates are employed in the absence of direct exposure measurements

Environmental and Socio-Demographic Determinants of Dengue Fever in Colombo City, Sri Lanka

Dengue fever has increased exponentially in Sri Lanka, from 24.4 cases per 100,000 in 2003 to 165.3 per 100,000 population in 2013. Although early warning systems using predictor models have been previously developed in other settings, it is important to develop such models in each local setting. Further, the ability of these models to be applicable at smaller geographic units will enhance current vector control and disease surveillance measures. The aim of this paper was to identify environmental and socio-economic status (SES) risk factors that may predict dengue fever at the Gram Niladhari Divisions (GND) level (smallest administrative unit) in Colombo city, Sri Lanka. These factors included landcover classes, amount of vegetation, population density, water access and neighborhood SES as determined by roof type. A geographically weighted regression (GWR) was used to develop the prediction model. A total 55 GND units covering an area of 37 sq km were investigated. We found that GND units with decreased vegetation, higher built-up area, higher population density and poor access to tap-water supply were associated with high risk of dengue; the pertinent GND units were concentrated in the center of the city. This is the first study in Sri Lanka to include both environmental and socio-demographic factors in prediction models for dengue fever. The methodology may be useful in enhancing ongoing dengue fever control measures in the country, and to be extended to other countries in the region that have an increasing incidence of dengue fever

Determinants of low birth weight in urban Pakistan

Objective: To identify determinants of low birth weight (LBW) in Karachi, Pakistan, including environmental exposures and nutritional status of the mother during pregnancy. Design: Cross-sectional study. Participants: Five hundred and forty mother-infant pairs. We interviewed mothers about obstetric history, diet and exposure to Pb. We measured birth weight and blood lead level (BLL). We performed multiple log binomial regression analysis to identify factors related to LBW.Results: Of 540 infants, 100 (18.5%) weighed 208.7 mg/d), infants of mothers with MUAC less than or equal to the median and dietary vitamin C intake \u3e 208-7 mg/d (adjPR = 10.80, 95 % CI 1.46, 79.76), mothers with MUAC above the median and vitamin C intak

Irisin is a pro-myogenic factor that induces skeletal muscle hypertrophy and rescues denervation-induced atrophy

Exercise induces expression of the myokine irisin, which is known to promote browning of white adipose tissue and has been shown to mediate beneficial effects following exercise. Here we show that irisin induces expression of a number of pro-myogenic and exercise response genes in myotubes. Irisin increases myogenic differentiation and myoblast fusion via activation of IL6 signaling. Injection of irisin in mice induces significant hypertrophy and enhances grip strength of uninjured muscle. Following skeletal muscle injury, irisin injection improves regeneration and induces hypertrophy. The effects of irisin on hypertrophy are due to activation of satellite cells and enhanced protein synthesis. In addition, irisin injection rescues loss of skeletal muscle mass following denervation by enhancing satellite cell activation and reducing protein degradation. These data suggest that irisin functions as a pro-myogenic factor in mice

Effect of sunlight exposure on cognitive function among depressed and non-depressed participants: a REGARDS cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Possible physiological causes for the effect of sunlight on mood are through the suprachiasmatic nuclei and evidenced by serotonin and melatonin regulation and its associations with depression. Cognitive function involved in these same pathways may potentially be affected by sunlight exposure. We evaluated whether the amount of sunlight exposure (i.e. insolation) affects cognitive function and examined the effect of season on this relationship.</p> <p>Methods</p> <p>We obtained insolation data for residential regions of 16,800 participants from a national cohort study of blacks and whites, aged 45+. Cognitive impairment was assessed using a validated six-item screener questionnaire and depression status was assessed using the Center for Epidemiologic Studies Depression Scale. Logistic regression was used to find whether same-day or two-week average sunlight exposure was related to cognitive function and whether this relationship differed by depression status.</p> <p>Results</p> <p>Among depressed participants, a dose-response relationship was found between sunlight exposure and cognitive function, with lower levels of sunlight associated with impaired cognitive status (odds ratio = 2.58; 95% CI 1.43–6.69). While both season and sunlight were correlated with cognitive function, a significant relation remained between each of them and cognitive impairment after controlling for their joint effects.</p> <p>Conclusion</p> <p>The study found an association between decreased exposure to sunlight and increased probability of cognitive impairment using a novel data source. We are the first to examine the effects of two-week exposure to sunlight on cognition, as well as the first to look at sunlight's effects on cognition in a large cohort study.</p

Pain and analgesic use associated with skeletal-related events in patients with advanced cancer and bone metastases

PURPOSE: Bone metastases secondary to solid tumors increase the risk of skeletal-related events (SREs), including the occurrence of pathological fracture (PF), radiation to bone (RB), surgery to bone (SB), and spinal cord compression (SCC). The aim of this study was to evaluate the impact of SREs on patients' pain, analgesic use, and pain interference with daily functioning. METHODS: Data were combined from patients with solid tumors and bone metastases who received denosumab or zoledronic acid across three identically designed phase 3 trials (N = 5543). Pain severity (worst pain) and pain interference were assessed using the Brief Pain Inventory at baseline and each monthly visit. Analgesic use was quantified using the Analgesic Quantification Algorithm. RESULTS: The proportion of patients with moderate/severe pain and strong opioid use generally increased in the 6 months preceding an SRE and remained elevated, while they remained relatively consistent over time in patients without an SRE. Regression analysis indicated that all SRE types were significantly associated with an increased risk of progression to moderate/severe pain and strong opioid use. PF, RB, and SCC were associated with significantly greater risk of pain interference overall. Results were similar for pain interference with emotional well-being. All SRE types were associated with significantly greater risk of pain interference with physical function. CONCLUSIONS: SREs are associated with increased pain and analgesic use in patients with bone metastases. Treatments that prevent SREs may decrease pain and the need for opioid analgesics and reduce the impact of pain on daily functioning

Pain and analgesic use associated with skeletal-related events in patients with advanced cancer and bone metastases

PURPOSE: Bone metastases secondary to solid tumors increase the risk of skeletal-related events (SREs), including the occurrence of pathological fracture (PF), radiation to bone (RB), surgery to bone (SB), and spinal cord compression (SCC). The aim of this study was to evaluate the impact of SREs on patients' pain, analgesic use, and pain interference with daily functioning. METHODS: Data were combined from patients with solid tumors and bone metastases who received denosumab or zoledronic acid across three identically designed phase 3 trials (N = 5543). Pain severity (worst pain) and pain interference were assessed using the Brief Pain Inventory at baseline and each monthly visit. Analgesic use was quantified using the Analgesic Quantification Algorithm. RESULTS: The proportion of patients with moderate/severe pain and strong opioid use generally increased in the 6 months preceding an SRE and remained elevated, while they remained relatively consistent over time in patients without an SRE. Regression analysis indicated that all SRE types were significantly associated with an increased risk of progression to moderate/severe pain and strong opioid use. PF, RB, and SCC were associated with significantly greater risk of pain interference overall. Results were similar for pain interference with emotional well-being. All SRE types were associated with significantly greater risk of pain interference with physical function. CONCLUSIONS: SREs are associated with increased pain and analgesic use in patients with bone metastases. Treatments that prevent SREs may decrease pain and the need for opioid analgesics and reduce the impact of pain on daily functioning