Comparison of lung function during different phases of the menstrual cycle among young female asthmatics and non-asthmatics

Bronchial asthma is a chronic lung disease that causes significant morbidity and poor quality of life. The incidence of asthma is higher in boys before puberty and higher in females following puberty. Female preponderance is maintained into adulthood and morbidity due to asthma is greater in females. With this background we assessed the lung function with spirometry parameters of young asthmatic and non-asthmatic healthy females during different phases of the menstrual cycle. A case control study was conducted among well controlled asthmatic (N=60) and comparable (age and BMI matched) non – asthmatic healthy females (N=60) between 19 -25 years from June 2017- June 2020. The asthmatics were recruited from the asthma clinic, National Hospital of Sri Lanka, the Family Practice Centre and the medical Centre, University of Sri Jayewardenepura (USJ) while the non-asthmatic females (controls) were recruited from volunteering undergraduates of the university. Although ethnicity was not a criterion for recruitment of participants, the final recruited participants were all from the Sinhalese ethnicity. The sociodemographic data and the relevant information on asthma were obtained through an interviewer administered questionnaire. Forced Expiratory Volume in the first second (FEV1), Forced Vital Capacity (FVC), FEV1/FVC ratio, Peak Expiratory Flow Rate (PEFR) and Forced Expiratory Flow Rates, were measured during menstrual, follicular and luteal phases of the menstrual cycle. Spirometry parameters (means), were compared in asthmatics and non-asthmatics, with independent sample t-test. Analysis of variance (ANOVA) was used to analyze differences within the menstrual cycle within the groups. In all three phases, all spirometry parameters (except FVC) were lower in asthmatics (p<0.05). The spirometry parameters showed a cyclical pattern but did not change significantly between the three phases of the menstrual cycle in both groups. In asthmatics, the mean values of FEV1, FEV1/FVC%, FEF 25-75, FEF50, FEF75 were lowest in the menstrual phase and highest in the luteal phase and in non-asthmatics, the FEV1 was lowest in the menstrual phase and highest in the luteal phase.   KEYWORDS:  menstrual cycle, lung functions, spirometry, asthma, young female

Detecting the Glyphosate Contamination in Manihot esculenta (Variety Alu Peradeniya) Grown in Sri Lanka

Cassava is a popular local yam in Sri Lanka which is an important source of energy and a raw material for snack foods. A survey on cassava cultivation revealed that the most common cassava variety is “Alu Peradeniya” and there is a heavy usage of “Glyphosate” as a weedicide during the cultivation. This study was done to detect the contamination of glyphosate in outer peel, inner peel and starchy flesh of the M. esculenta variety as it directly relates with the human health.Tubers of variety “Alu peradeniya” were collected from local farmers from Colombo, Matara, Embilipitya, Galle, Anuradhapura and Ampara in Sri Lanka and control samples without glyphosate and with glyphosate were cultivated in my home in Mattegoda, which belongs to Colombo district. Glyphosate levels in samples were determined by a spectroscopic method using ninhydrin in the presence of sodium molybdate to give a Ruhemann’s purple product having visible absorption at 570 nm and further confirmation of results was done by using LC-MS at ITI.Due to the presence of free amino acids in inner peel and starchy flesh, ninhydrin test for glyphosate was limited to the outer peel of the tuber because ninhydrin gives a positive response with amino acids. Outer peel of the control sample with glyphosate showed a concentration of 10.1 mg/kg, which was the least concentration detected. The highest concentration of the glyphosate in outer peel was observed in one of the Colombo samples, which was 20.1±0.1 mg/kg. The amount was recorded twice than that of the recommended amount. Samples from Galle and Matara showed similar values as control sample with glyphosate, which has grown having the permitted amount. Outer peels of some of the samples did not show positive responses indicating that the usage of glyphosate is minimum or absence of glyphosate usage. Further confirmation using LC-MS for selected samples reveals that there is a possibility of penetration of glyphosate among the tuber because both inner peel and starchy flesh were positive for the detection of glyphosate. Due to the repetitive application of Glyphosate and its long half-life in the soil, the impact of the agrochemical on environment and on human life is becoming more pertinent.Keywords: Cassava, Glyphosate, Penetratio

Assessment of the Existing Level of Pollution due to Selected Heavy Metals in Surface Sediments of Negombo Lagoon, Sri Lanka

This study was conducted to evaluate the existing level of pollution with respect to selected heavy metals (Fe, Mn, As, Pb, Zn and Cu) in surficial sediments of Negombo Lagoon in Sri Lanka, which is constantly exposed to diverse human induced stresses. Additionally, this study investigated the application of X-ray fluorescence spectroscopy and pollution indices in assessment of heavy metal pollution. A total of 32 surface sediment samples covering the entire lagoon were collected using a grabber sampler and the concentrations of selected heavy metals were analysed using X-ray fluorescence spectroscopy. Furthermore, the concentrations of these heavy metals were used to assess the pollution status of the Negombo Lagoon by an integrated approach using pollution indices such as Enrichment Factor, Geoaccumulation Index and Pollution Load Index. The concentrations of the heavy metals studied were compared with the Canadian sediment quality guidelines which indicate the toxic concentrations of pollutants in sediments that affect aquatic organisms. The mean concentrations of all the heavy metals analysed were higher than the Threshold Effect Level (TEL) while the mean concentration of Arsenic (As) is greater than the Probable Effect Level (PEL) stated in the sediment quality guidelines. The results of Enrichment Factor revealed that the entire Negombo Lagoon is severely enriched by As, while minor enrichment of Copper (Cu) and Zinc (Zn) was observed across the lagoon, suggesting the contribution of anthropogenic sources for metal pollution in surface sediments of the lagoon. Moreover, the calculated Geoaccumulation Indices of the metals studied confirmed that surface sediments of the entire Negombo Lagoon is contaminated with As, Zn and Cu, emphasizing the influence of anthropogenic contamination. However, the concentrations of Manganese (Mn), Iron (Fe) and Lead (Pb) in surface sediments were within their natural range, evidently showing terrigenous origin. The calculated Pollution Load Index revealed that the Negombo Lagoon is considerably polluted by the heavy metals investigated. In conclusion, Arsenic (As) has shown a greater contribution to metal pollution while Zn and Cu were identified as minor enriched contaminants in surface sediments of Negombo Lagoon. The results of this study, while being useful as a reference data base, emphasized the need of effective management strategies for conservation of the lagoon before the pollution level becomes irreversible.Keywords: Heavy metal, Pollution, Coastal contamination, Surface sediments, X-ray fluorescenc

The Need for Accreditation in Medical Education to be based on Regional and National Health Priorities

In this paper, we argue that it is time to review the relationship between global ideas about the quality of medical education and actual local need. We suggest that a conversation is needed to rebalance the focus of activity from international to regional, and to take control of quality and its accreditation within our own contexts

Prevalence of gastro-oesophageal reflux disease symptoms and reflux-associated respiratory symptoms in asthma

<p>Abstract</p> <p>Background</p> <p>Gastro-oesophageal reflux disease (GORD) symptoms are common in asthma and have been extensively studied, but less so in the Asian continent. Reflux-associated respiratory symptoms (RARS) have, in contrast, been little-studied globally. We report the prevalence of GORD symptoms and RARS in adult asthmatics, and their association with asthma severity and medication use.</p> <p>Methods</p> <p>A cross-sectional analytical study. A validated interviewer-administered GORD scale was used to assess frequency and severity of seven GORD symptoms. Subjects were consecutive asthmatics attending medical clinics. Controls were matched subjects without respiratory symptoms.</p> <p>Results</p> <p>The mean (SD) composite GORD symptom score of asthmatics was significantly higher than controls (21.8 (17.2) versus 12.0 (7.6); <it>P </it>< 0.001) as was frequency of each symptom and RARS. Prevalence of GORD symptoms in asthmatics was 59.4% (95% CI, 59.1%-59.6%) versus 28.5% in controls (95% CI, 29.0% - 29.4%). 36% of asthmatics experienced respiratory symptoms in association with both typical and atypical GORD symptoms, compared to 10% of controls (<it>P </it>< 0.001). An asthmatic had a 3.5 times higher risk of experiencing a GORD symptom after adjusting for confounders (OR 3.5; 95% CI 2.5-5.3). Severity of asthma had a strong dose-response relationship with GORD symptoms. Asthma medication use did not significantly influence the presence of GORD symptoms.</p> <p>Conclusions</p> <p>GORD symptoms and RARS were more prevalent in a cohort of Sri Lankan adult asthmatics compared to non-asthmatics. Increased prevalence of RARS is associated with both typical and atypical symptoms of GORD. Asthma disease and its severity, but not asthma medication, appear to influence presence of GORD symptoms.</p

Assessment of the proportion of neonates and children in low and middle income countries with access to a healthcare facility: A systematic review

<p>Abstract</p> <p>Background</p> <p>Comprehensive antenatal, perinatal and early postnatal care has the potential to significantly reduce the 3.58 million neonatal deaths that occur annually worldwide. This paper systematically reviews data on the proportion of neonates and children < 5 years of age that have access to health facilities in low and middle income countries. Gaps in available data by WHO region are identified, and an agenda for future research and advocacy is proposed.</p> <p>Methods</p> <p>For this paper, "utilization" was used as a proxy for "access" to a healthcare facility, and the term "facility" was used for any clinic or hospital outside of a person's home staffed by a "medical professional". A systematic literature search was conducted for published studies of children up to 5 years of age that included the neonatal age group with an illness or illness symptoms in which health facility utilization was quantified. In addition, information from available Demographic and Health Surveys (DHS) was extracted.</p> <p>Results</p> <p>The initial broad search yielded 2,239 articles, of which 14 presented relevant data. From the community-based neonatal studies conducted in the Southeast Asia region with the goal of enhancing care-seeking for neonates with sepsis, the 10-48% of sick neonates in the studies' control arms utilized a healthcare facility. Data from cross-sectional surveys involving young children indicate that 12 to 86% utilizing healthcare facilities when sick. From the DHS surveys, a global median of 58.1% of infants < 6 months were taken to a facility for symptoms of ARI.</p> <p>Conclusions</p> <p>There is a scarcity of data regarding the access to facility-based care for sick neonates/young children in many areas of the world; it was not possible to generalize an overall number of neonates or young children that utilize a healthcare facility when showing signs and symptoms of illness. The estimate ranges were broad, and there was a paucity of data from some regions. It is imperative that researchers, advocates, and policy makers join together to better understand the factors affecting health care utilization/access for newborns in different settings and what the barriers are that prevent children from being taken to a facility in a timely manner.</p

A review on computer vision based defect detection and condition assessment of concrete and asphalt civil infrastructure

To ensure the safety and the serviceability of civil infrastructure it is essential to visually inspect and assess its physical and functional condition. This review paper presents the current state of practice of assessing the visual condition of vertical and horizontal civil infrastructure; in particular of reinforced concrete bridges, precast concrete tunnels, underground concrete pipes, and asphalt pavements. Since the rate of creation and deployment of computer vision methods for civil engineering applications has been exponentially increasing, the main part of the paper presents a comprehensive synthesis of the state of the art in computer vision based defect detection and condition assessment related to concrete and asphalt civil infrastructure. Finally, the current achievements and limitations of existing methods as well as open research challenges are outlined to assist both the civil engineering and the computer science research community in setting an agenda for future research

Faecal microbiota and antibiotic resistance genes in migratory waterbirds with contrasting habitat use.

Migratory birds may have a vital role in the spread of antimicrobial resistance across habitats and regions, but empirical data remain scarce. We investigated differences in the gut microbiome composition and the abundance of antibiotic resistance genes (ARGs) in faeces from four migratory waterbirds wintering in South-West Spain that differ in their habitat use. The white stork Ciconia ciconia and lesser black-backed gull Larus fuscus are omnivorous and opportunistic birds that use highly anthropogenic habitats such as landfills and urban areas. The greylag goose Anser anser and common crane Grus grus are herbivores and use more natural habitats. Fresh faeces from 15 individuals of each species were analysed to assess the composition of bacterial communities using 16S rRNA amplicon-targeted sequencing, and to quantify the abundance of the Class I integron integrase gene (intI1) as well as genes encoding resistance to sulfonamides (sul1), beta-lactams (blaTEM, blaKPC and blaNDM), tetracyclines (tetW), fluoroquinolones (qnrS), and colistin (mcr-1) using qPCR. Bacterial communities in gull faeces were the richest and most diverse. Beta diversity analysis showed segregation in faecal communities between bird species, but those from storks and gulls were the most similar, these being the species that regularly feed in landfills. Potential bacterial pathogens identified in faeces differed significantly between bird species, with higher relative abundance in gulls. Faeces from birds that feed in landfills (stork and gull) contained a significantly higher abundance of ARGs (sul1, blaTEM, and tetW). Genes conferring resistance to last resort antibiotics such as carbapenems (blaKPC) and colistin (mcr-1) were only observed in faeces from gulls. These results show that these bird species are reservoirs of antimicrobial resistant bacteria and suggest that waterbirds may disseminate antibiotic resistance across environments (e.g., from landfills to ricefields or water supplies), and thus constitute a risk for their further spread to wildlife and humans. Copyright © 2021 Elsevier B.V. All rights reserved