Screening for neurocognitive deficits in adult populations reliant on toxic cassava as the main source of food

Context and objective. Chronic dietary reliance on improperly processed cyanogenic toxic cassava is widespread in sub-Saharan Africa. The objective of the present study was to screen for neurocognition impairments and daily-life functioning in adults with dietary dependency on cyanogenic cassava as the main source of food. Methods. A cross-sectional design enrolled heads of households (in couples) in the rural district of Kahemba, Democratic Republic of Congo. Participants were screened for neurocognitive impairments using the Community Screening Interview for Dementia (CSID). Detailed neuropsychiatric evaluations were performed and disease entities classified according to the Diagnostic and Statistical Manual of Mental Disorders (DSM IV) criteria when applicable. Cassava cyanogenic exposure was ascertained by urinary concentrations of thiocyanate (SCN). Regression models were used to identify predictors of CSID performance at the 0.05 significance level. Results. For hundred and six households (203 couples, mean age 38.4 ± 11. 4 years) were involved. One hundred thirty-six subjects (33.5 %) [69 women and 67 men, mean age 39 ± 14.4 years)] and 13 (3.2 %) [7 women and 6 men, mean age: 32 ± 2.6 years] fulfilled the criteria for mild cognitive impairment (MCI) and Major Neurocognitive disorder (MNCD), respectively. The overall mean urinary concentration of SCN was 949.5+518.3 mol/l after adjusting Context and objective. Chronic dietary reliance on improperly processed cyanogenic toxic cassava is widespread in sub-Saharan Africa. The objective of the present study was to screen for neurocognition impairments and daily-life functioning in adults with dietary dependency on cyanogenic cassava as the main source of food. Methods. A cross-sectional design enrolled heads of households (in couples) in the rural district of Kahemba, Democratic Republic of Congo. Participants were screened for neurocognitive impairments using the Community Screening Interview for Dementia (CSID). Detailed neuropsychiatric evaluations were performed, and disease entities classified according to the Diagnostic and Statistical Manual of Mental Disorders (DSM IV) criteria when applicable. Cassava cyanogenic exposure was ascertained by urinary concentrations of thiocyanate (SCN). Regression models were used to identify predictors of CSID performance at the 0.05 significance level. Results. For hundred and six households (203 couples, mean age 38.4 ± 11. 4 years) were involved. One hundred thirty-six subjects (33.5 %) [69 women and 67 men, mean age 39 ± 14.4 years)] and 13 (3.2 %) [7 women and 6 men, mean age: 32 ± 2.6 years] fulfilled the criteria for mild cognitive impairment (MCI) and Major Neurocognitive disorder (MNCD), respectively. The overall mean urinary concentration of SCN was . for age, gender, nutritional status, and history of konzo, neurocognition domain-specific deficits were independently associated with either hypertension or USCN (350mol / l incremental increase in excretion Functional impairments in daily-life activities increased as subjects poorly performed at the CSID screening (Spearman r = - .2, p < 0.01). Conclusion. Neurocognitive deficits in adults are common in Congolese adults relying on cyanogenic cassava as the main source of food. Our study findings warrant further studies to elucidate the overall lifespan brain/behavioral burden and mechanisms of cassava toxicity among adults with dietary dependency on cyanogenic cassava as the main source of food

Variations of Arterial Supply of the Liver: C.T. Angiographic Study Among Sudanese Adults

Hepatobiliary surgery through laparoscopic approach is becoming a routine. Knowledge of extrahepatic arterial tree is essential for surgical and imaging procedures. Anatomical complexity is expected since the liver is developed by mergingof lobules with its separate blood supply. This makes a wide range of variations in the pattern of vascular arrangement and so reinforces the need for an accurate understanding of full spectrum of variations. This study aimed to investigate the variations in origin and distribution of extrahepatic arterial supply. Fifty volunteers (32 males and 18 females) aged 20­70 years were randomly recruited from the department of CT scan in Al Amal Hospital, Khartoum North, Sudan. The patients were already candidates for CT angiography with contrast for conditions other than hepatobiliary diseases. The reported data is related to those who accepted to participate in the study. Patients with history of hepatobiliary disease were excluded. 3D views of the scans were treated and the extrahepatic arterial tree was traced in a computer-based software. Key findings suggest that Michel's classification was considered the standard template for description ­ 76% of them showed Michel's type I classification. Types III and V constituted about 2%. About 4% of the cases were represented by types VI and IX. Other types of variations constituted about 12%. To conclude, although type I classification which describes the textbook pattern of hepatic artery distribution was significantly detected among the Sudanese population, other variants were to be considered since they are related to major arteries like aorta and superior mesenteric.