Detection of occult HBV infection by nested PCR assay among chronic hepatitis C patients with and without hepatocellular carcinoma

Occult hepatitis B virus infection (OBI) has been reported among patients with chronic hepatitis C virus (HCV) infection and hepatocellular carcinoma (HCC). This study aimed to evaluate the prevalence of OBI in chronic hepatitis C patients with and without hepatocellular carcinoma. A total of 40 chronic hepatitis C patients who were negative for HBsAg, were enrolled into the study. They were classified into two groups: Group I which included 20 patients with chronic hepatitis C only whereas Group II included 20 patients with chronic hepatitis C and HCC. Detection of HBV DNA was done by nested-PCR using two sets of primers specific for surface and X viral genomes in serum and liver tissue of patients. Genotyping system based on PCR using type-specific primers was done for HBV-DNA positive intrahepatic samples. OBI was detected in the liver tissue in 23/40 (57.5%) of chronic HCV infected patients, 18 (78.3%) of whom belonged to group II, conferring a 90% prevalence of this group. In serum, HBV-DNA was detected in 9/40 patients (22.5%), 7 (77.8%) of whom belonged to group II. Among the 23 positive intrahepatic HBV-DNA samples studied, HBV-genotype D (34.8%) and B (26.1%) were more predominant, whereas HBV-genotype C (13.1%) and A (8.7%) infections were the least observed, respectively; mixed genotypes were detected in 17.4% (n= 4), 3 of them were with HBV-genotype D and B, and 1 was with HBV-genotype C and A. In conclusion OBI is a fact in our community; it was detected in liver tissue of chronic HCVinfected patients, especially in cases of chronic HCC. In addition, OBI might be related to severity of necroinflammatory activity and fibrosis. Large studies are needed to confirm that co-infection could determine a worse progress of chronic liver disease in this population. Also, detection of intrahepatic HBV-DNA is more useful in diagnosis of OBI.Keywords: Occult hepatitis B virus infection (OBI); Chronic hepatitis C virus infection (CHC); Hepatocellular carcinoma (HCC); HBV-DNA; Nested PC

Knowledge and Attitudes of Population Towards HIV/Aids in Four States, Sudan

Back ground: HIV/AIDS is a public health problem in the Sudan. The country is the most severely affected in North Africa and the Middle East with an estimated 500,000 people living with HIV/AIDS. The objectives of the study were to determine knowledge and attitude of the localpopulation in selected states about HIV/ AIDS and to determine the relation between knowledge and attitude towards HIV/AIDS and associated social factors.Methodology: Design was descriptive, cross-sectional, community- based study conducted in Gezira, Sinnar, River Nile and Northern states. The population was those found in their settings during the visits in April 2009. Both sexes were enrolled and children below the age of 15 years ofboth sexes were excluded from the study. Data were collected by a pre- coded and pre -tested questionnaire and were analyzed by the computer using SPSS, version 13, soft ware.Results: Knowledge of the population in the selected four states about HIV/AIDS was favorable (73%). Tolerant attitude towards HIV-infected people was low (40%). Results showed that males acquired better knowledge than females (76.2% versus 71.8%) but females were more tolerant towards HIV/AIDS than males (42% versus 37.4%). Results showed that HIV/AIDS Knowledge increased as the educational level increased. Level of knowledge was higher among university graduates (92.6%) followed by basic and secondary (76.7%). Illiterates acquired the least level of knowledge (42.4%). The study showed that tolerance of population towards PLWHA increased according to the level of education. The university graduated was more tolerant (55.1%) than thebasic/secondary (40.5%) and the illiterates (21.9%). It was shown that the single population was more tolerant towards PLWHA, followed by the married, the divorced and the widowed constituting 41.6%, 40.4%, 31.4% and 25% respectively.Conclusion: The study concluded that, level of knowledge about HIV/AIDS of the population in the selected states was good. Level of knowledge among males, the working force and the single population was higher than the females, those without jobs and the married. Level of HIV/AIDSknowledge increased according to the level of education, was higher among university graduates followed by basic / secondary and Illiterates. Attitude of the population in the selected states towards people living with HIV/AIDS “PLWHA” was low, only 40% had more tolerant attitude.Females, the highly educated and the working population were more tolerant towards HIV/AIDS than males, the less educated, and the nonworking population

Evaluation of the Perception of Community Pharmacists Regarding their Role in Pakistan's Healthcare System: A Qualitative Approach

Purpose: To explore the perception of community pharmacists regarding their role in Pakistan's healthcare system.Methods: A qualitative study design was adopted. A semi-structured interview guide was developed and face to face interviews were conducted. The participants were community pharmacists and were recruited through one of the researcher’s personal contacts in two cities of Pakistan (Islamabad and Lahore) from April to June 2008. The interviews were conducted at the pharmacists’ work-place. Arrangements for the time and place of interview were made during initial contacts. Written consent was obtained from the participants prior to the interview.Results: Among the respondents interviewed, seven were male and three female community pharmacists aged between 25 and 50 years. All the participants regularly dispensed > 50 prescriptions daily. Thematic content analysis yielded 5 major themes: (a) provision of pharmacy services to consumers, (b) counseling at pharmacy, (c) application of Good Pharmacy Practice (GPP), (d) Pakistan Pharmacy Association (PPA) contribution towards pharmacy profession, and (e) strategies to improve community pharmacies.Conclusion: Community pharmacies in Pakistan currently face shortage of pharmacists. This has resulted in non-provision of patient counseling; rather services are more focused more on the management of pharmacies than clients. As a result, there is little public awareness of the pharmacist’s role in health care.Keywords: Perception, Community pharmacist, Patient care, Pakistan, Qualitative methodology

Iron Deficiency Anaemia In Reproductive Age Women Attending Obstetrics And Gynecology Outpatient Of University Health Centre In Al-Ahsa, Saudi Arabia

Background: Iron deficiency is the most common nutritional disorder in the world. The aim of this questionnaire based survey study was to determine the prevalence of iron deficiency anemia in reproductive age women, and their relation to variables such as age, marital status, education with those attending obstetrics and gynecology outpatient of King Faisal University Health Centre in Al-Ahsa in eastern region of Kingdom of Saudi Arabia.Materials and Methods: This study was conducted for the period of 6 month staring from September 2012 to February 2013. The questionnaire had three sections on personal information: their educational indicators, gynecological clinical history, and hematological indices.Results: The average age was 25.97±7.17 years. According to the  gynecological clinical history of the respondents, 15 (48.4%) respondents were pregnant while 16 (51.6%) were not pregnant. There was significant effect of pregnancy status on Hb level. Majority of the anemic respondents 15/17 were married. Moreover 14/17 anemic women were experiencing severe menstrual bleeding, 11/17 respondents were pregnant. 54.8% of respondents were hemoglobin deficient while 77.4% were found to have low Hct. In 87.1 % of the respondents, transferrin saturation was found to be abnormal.Conclusion: In this study iron deficiency anemia is quite prevalent in the university community especially among pregnant women. The fetus’s and newborn infant’s iron status depends on the iron status of the pregnant woman and therefore, iron deficiency in the mother-to-be means that growing fetus probably will be iron deficient as well. Thus iron deficiency anemia during pregnancy in well-educated set up needs more attention by the concerned authorities.Keywords: Iron deficiency Anemia (IDA), Hemoglobin, Female, Reproductive Age

Chromatographic and spectral studies of jetsam and archived ambergris

<p>We describe determination of the dichloromethane-soluble components of 12 samples of the natural product, ambergris, using capillary gas chromatography–mass spectrometry (GC–MS). Ambergris is produced <i>in vivo</i> in about 1% of Sperm whales and is used in perfumery and for odour fixation. Whilst descriptions of ambergris chemistry appeared until about 40 years ago, few accounts of analyses of whole extracts of multiple samples of ambergris by GC–MS have been published before. As expected, our analyses revealed that the major component (up to 97% of the dichloromethane-soluble material) was ambrein, with co-occurring, variable proportions of steroids. Moreover, we report apparently for the first time, mass spectra and retention indices of derivatised ambrein. These data should now allow reliable, rapid confirmation of even small amounts of jetsam, archived museum and customs samples of ambergris and an assessment of ambergris ‘quality’.</p

Landmine injuries at the Emergency Management Center in Erbil, Iraq

<p>Abstract</p> <p>Background</p> <p>Landmines can cause death, injury and disability in addition to many indirect public health consequences. This study aimed at understanding the trends, demography and other epidemiological characteristics of hospitalized landmine injured patients in Erbil governorate.</p> <p>Methods</p> <p>The case records of landmine injured patients who had been admitted to the Emergency Management Centre in Erbil city from July 1998 to July 2007 were reviewed and descriptively analyzed.</p> <p>Results</p> <p>Two hundred eighty five landmine injured patients were admitted to the center, their mean ± SD age was 26.5 ± 13.2 years (range 6-71 years), 95.1% were males, nearly 50% were between 19 to 35 years of age and 96.8% were civilians. Around 72% of victims sustained limb amputations; 58.6% lower limb and 13.3% upper limb out of the total. The hospital mortality rate was 2.1%. The number of admissions for landmine injury was steadily decreasing between July 1998 and July 2001, followed by prominent increase between July 2002 and July 2003. The highest proportion of admissions occurred in summer (35.4%) and majority of incidents occurred along the borders with Iran and Turkey (61.8%).</p> <p>Conclusion</p> <p>Civilian male adolescents and young adults constituted the majority of hospitalized landmine victims in Erbil governorate. While a high proportion of victims sustained lower limb amputations, upper limb amputations particularly among children and injury to head and face were relatively common which might be attributed to handling explosives. This emphasizes the need to examine the reasons behind handling explosives.</p

Treatment of synthetic textile wastewater containing dye mixtures with microcosms

The aim was to assess the ability of microcosms (laboratory-scale shallow ponds) as a post polishing stage for the remediation of artificial textile wastewater comprising two commercial dyes (basic red 46 (BR46) and reactive blue 198 (RB198)) as a mixture. The objectives were to evaluate the impact of Lemna minor L. (common duckweed) on the water quality outflows; the elimination of dye mixtures, organic matter, and nutrients; and the impact of synthetic textile wastewater comprising dye mixtures on the L. minor plant growth. Three mixtures were prepared providing a total dye concentration of 10 mg/l. Findings showed that the planted simulated ponds possess a significant (p &lt; 0.05) potential for improving the outflow characteristics and eliminate dyes, ammonium-nitrogen (NH4-N), and nitrate-nitrogen (NO3-N) in all mixtures compared with the corresponding unplanted ponds. The removal of mixed dyes in planted ponds was mainly due to phyto-transformation and adsorption of BR46 with complete aromatic amine mineralisation. For ponds containing 2 mg/l of RB198 and 8 mg/l of BR46, removals were around 53%, which was significantly higher than those for other mixtures: 5 mg/l of RB198 and 5 mg/l of BR46 and 8 mg/l of RB198 and 2 mg/l of BR46 achieved only 41 and 26% removals, respectively. Dye mixtures stopped the growth of L. minor, and the presence of artificial wastewater reduced their development

Detection and follow-up of chronic obstructive pulmonary disease (COPD) and risk factors in the Southern Cone of Latin America. the pulmonary risk in South America (PRISA) study

<p>Abstract</p> <p>Background</p> <p>The World Health Organization has estimated that by 2030, chronic obstructive pulmonary disease will be the third leading cause of death worldwide. Most knowledge of chronic obstructive pulmonary disease is based on studies performed in Europe or North America and little is known about the prevalence, patient characteristics and change in lung function over time in patients in developing countries, such as those of Latin America. This lack of knowledge is in sharp contrast to the high levels of tobacco consumption and exposure to biomass fuels exhibited in Latin America, both major risk factors for the development of chronic obstructive pulmonary disease. Studies have also demonstrated that most Latin American physicians frequently do not follow international chronic obstructive pulmonary disease diagnostic and treatment guidelines. The PRISA Study will expand the current knowledge regarding chronic obstructive pulmonary disease and risk factors in Argentina, Chile and Uruguay to inform policy makers and health professionals on the best policies and practices to address this condition.</p> <p>Methods/Design</p> <p>PRISA is an observational, prospective cohort study with at least four years of follow-up. In the first year, PRISA has employed a randomized three-staged stratified cluster sampling strategy to identify 6,000 subjects from Marcos Paz and Bariloche, Argentina, Temuco, Chile, and Canelones, Uruguay. Information, such as comorbidities, socioeconomic status and tobacco and biomass exposure, will be collected and spirometry, anthropometric measurements, blood sampling and electrocardiogram will be performed. In year four, subjects will have repeat measurements taken.</p> <p>Discussion</p> <p>There is no longitudinal data on chronic obstructive pulmonary disease incidence and risk factors in the southern cone of Latin America, therefore this population-based prospective cohort study will fill knowledge gaps in the prevalence and incidence of chronic obstructive pulmonary disease, patient characteristics and changes in lung function over time as well as quality of life and health care resource utilization. Information gathered during the PRISA Study will inform public health interventions and prevention practices to reduce risk of COPD in the region.</p