ABSTRACT
Background and study aims: Obesity is a recognised risk factor for poor bowel preparation in retrospective studies whilst corresponding data in prospective trials are marginally reported. Aims are to evaluate the relation between body mass index [BMI] and preparation quality in retrospective and interventional prospective settings and within a single centre
Patients and methods: Data from a recent colorectal cancer screening registry were retrospectively analysed for the relation between BMI and adequacy of preparation. Patients were categorised as underweight [BMI < 20 kg/m2], normal [20-25 kg/m2], overweight [25-30 kg/m2], and obese [>30 kg/m2]. Data from a recent prospective colon preparation trial were similarly analysed
Results: 541 registry patients were included. Multivariate analysis showed BMI to be an independent risk factor for inadequate preparation. Obesity was associated with odds ratio [OR] of 5.3 [95% confidence interval [CI] 1.4-19.8; p = 0.01] compared to normal BMI. A significant difference was also noted in underweight but otherwise healthy individuals [OR = 11.1, 95% CI 2-60; p = 0.005]. In the prospective study of 195 patients, obese patients had comparable rates of inadequate preparation to normal-weight individuals [OR = 0.7, 95% CI 1.1-3.96; p = 0.68]. Underweight patients had a significantly worse preparation compared to normal BMI individuals [OR = 8, 95% CI 1.1-58; p = 0.04]
Conclusions: In real life, bowel preparations in obese individuals have a lower quality in comparison to normal individuals. This finding is not replicated in clinical trials. This discrepancy is likely the result of focused patient education suggesting that this is primarily a dietary compliance phenomenon. Underweight individuals appear to have worse quality of preparation independent of study design or setting
ABSTRACT
Case detection, diagnosis and treatment of tuberculosis [TB] in children are challenging issues worldwide. This study in Afghanistan aimed to evaluate paediatric TB case management, including contact investigation, at health facilities where all diagnostic processes were available. In 7 out of 8 regions of the country 1 province was selected. Documents used for management of paediatric TB cases were reviewed in 15 distinct hospitals and 8 provincial hospitals in the selected provinces. The key issues which emerged were: a low suspect rate among total outpatients [0.4%] and a very low suspect rate among children aged < 5 years; low performance of suspect management [68.5% suspects received further examinations]; low utilization of other diagnostic methods; a high early defaulter rate [14.0%]; and insufficient coverage of contact management [74.0%]. This survey indicated that the Afghanistan national TB programme needs to develop plans to improve the quality of diagnosis, suspect management and contact management in paediatric TB cases
Subject(s)
Humans , Male , Female , Pediatrics , Hospitals, District , Disease Management , Retrospective Studies , ChildABSTRACT
A new method for anodic stripping voltammetric determination of silver [I] using unmodified carbon paste electrode is described. In this method, the silver sample containing 10% phthalic acid solution is pre-concentrated on the electrode at -400 mV for 30 s. The deposited metal is then oxidized by anodic stripping voltammetric sweep. Chemical and electrical parameters affecting the voltammetric measurements are optimized. The peak current is proportional to the Ag [I] concentration over the range 0.5-50 ng/ml [r = 0.997], and the detection limit is 0.2-ng/ml. The relative standard deviation is 2% for 50 ng/ml [four replicates]. Satisfactory results are obtained on applying the proposed method to the determination of Ag [I] in digested samples of topical creams containing 1% silver sulphadiazine. No interference due to many cations is observed. In contrast, 10-fold excess of Cu ions has been shown serious interference, but on adding either 0.2 mM 4-[pyridyl-2-azo] resorcinol [PAR] or thiocyanate, the overlapped peaks can be separated into two well-defined peaks and consequently both cations, Ag and Cu can be determined simultaneously