Prevalence of P. falciparum Gametocyte Carrying between Two Sympatric Ethnic Groups Living in Seasonal Malaria Transmission Setting of Burkina Faso after Universal Bed Nets Coverage Campaigns

Aims: This study aimed to compare the prevalence of P. falciparumgametocyte carriage in two sympatric ethnic groups living in seasonal malaria transmission setting in Burkina Faso.Study Design: A cross-sectional survey was conducted from September to November 2017 in children aged from 2 to 12 years and living in Barkoundouba, avillage located at the Northeast part of Ouagadougou, capital city of Burkina Faso. The study participants were subject to clinical examination including axillary temperature. Blood samples were collected from finger pricks to performed RDT and blood smears for malaria diagnosis and on filter paper for molecular detection of the parasite. Any case of fever (temperature ≥ 37.5°C) with RDT positive was treated according to national guideline.Methodology:We included 461 patients in this study. P. falciparumpresence and densities were determined by microscopy using Giemsa-stained thick blood smears. The nested PCR was used toconfirm the presence of the asexual parasites assessed by the microscopy. Results: P. falciparumprevalence assessed by microscopy was 83 (32.55%) and 103 (50%) for Fulani and Mossirespectively,whereas the prevalence by nested PCR was 88 (39.11%) for Fulani and 121 (68.75%) for Mossi. The gametocyte carriage in the two ethnic groups was: 3.53% for Fulani and 11.65% for Mossi. The prevalence ratio for P. falciparumasymptomatic and gametocyte carriers was 1.5 and 3 in favor of Mossi group respectively.Conclusion:This study showed that the Fulani have a lower prevalence of P. falciparumcompared to the Mossi group despite the decrease of parasitemia and prevalence in both groups compared to previous studies

Contribución de la temperatura fría y el sabor ácido en la intervención fonoaudiológica de la disfagia orofaríngea / Contribution of cold temperature and sour taste in speech and language intervention of oropharyngeal dysphagia

El fonoaudiólogo es el principal profesional en la rehabilitación no farmacológica y no quirúrgica del usuario con disfagia. Su participación es fundamental tanto para el aminoramiento del riesgo de aspiración o penetración laríngea, como para mejorar o restaurar la función deglutoria. Para este fin, posee opciones terapéuticas directas e indirectas, cuya elección y aplicación dependerá de la patología que curse el usuario, las redes que posea para su recuperación y la motivación intrínseca del mismo. Entre las estrategias de intervención indirecta se encuentra el Tratamiento Sensorio-Motor Oral (OSMT, por sus siglas en inglés), el cual pretende producir una aceleración en el desencadenamiento del proceso deglutorio mediante la ejercitación de los músculos orofaciales en conjunto con diferentes estímulos sensoriales (específicamente la temperatura fría y el sabor ácido). La presente revisión tiene por objetivo dilucidar si la utilización de la temperatura fría y el sabor ácido son útiles como mecanismo de intervención indirecta de la disfagia. Se concluye que las acciones propuestas son efectivas simplemente como mecanismos compensatorios en el proceso deglutorio, puesto que modifican las características del bolo alimenticio e incrementan momentáneamente las sensaciones intraorales.

The speech-language pathologist (SLP) is the main professional in the nonpharmacological and non-surgical rehabilitation of patients with dysphagia. Their role is essential for both reducing the risk of aspiration or laryngeal penetration and improving or restoring the swallowing function. To this end, the SLP has direct and indirect therapeutic options, whose choice and application will depend on the patient’s condition, support networks, and their intrinsic motivation. As part of the indirect intervention strategies, the oral sensorymotor treatment (OSMT) aims to exercise the orofacial muscles, and introduce sensory input by the application of cold temperature and sour taste to increase the triggering speed of the swallowing reflex. This review seeks to determine whether the use of cold temperature and sour taste are effective indirect mechanisms for treating patients with dysphagia. It is concluded that the proposed actions in this review are useful simply as compensatory mechanisms in the swallowing process, as they modify the bolus properties and increase, temporarily, the intra-oral sensations.

The use of virtual reality-based therapy to augment poststroke upper limb recovery

Stroke remains one of the major causes of disability worldwide. This case report illustrates the complementary use of biomechanical and kinematic in-game markers, in addition to standard clinical outcomes, to comprehensively assess and track a patient's disabilities. A 65-year-old patient was admitted for right-sided weakness and clinically diagnosed with acute ischaemic stroke. She participated in a short trial of standard stroke occupational therapy and physiotherapy with additional daily virtual reality (VR)-based therapy. Outcomes were tracked using kinematic data and conventional clinical assessments. Her Functional Independence Measure score improved from 87 to 113 and Fugl-Meyer motor score improved from 56 to 62, denoting clinically significant improvement. Corresponding kinematic analysis revealed improved hand path ratios and a decrease in velocity peaks. Further research is being undertaken to elucidate the optimal type, timing, setting and duration of VR-based therapy, as well as the use of neuropharmacological adjuncts.

Advances in rehabilitation medicine

Rehabilitation medicine is the medical specialty that integrates rehabilitation as its core therapeutic modality in disability management. More than a billion people worldwide are disabled, and the World Health Organization has developed the International Classification of Functioning, Disability and Health as a framework through which disability is addressed. Herein, we explore paradigm shifts in neurorehabilitation, with a focus on restoration, and provide overviews on developments in neuropharmacology, rehabilitation robotics, virtual reality, constraint-induced therapy and brain stimulation. We also discuss important issues in rehabilitation systems of care, including integrated care pathways, very early rehabilitation, early supported discharge and telerehabilitation. Finally, we highlight major new fields of rehabilitation such as spasticity management, frailty and geriatric rehabilitation, intensive care and cancer rehabilitation.

Toxic Effect of Cryoprotectants on Embryo Development in a Murine Model / 대한불임학회지

OBJECTIVES: The aim of this study was to assess toxicities of cryoprotectants. METHODS: Toxicities of two cryoprotectants, dimethyl sulfoxide (DMSO) and 1,2-propanediol (PROH), were investigated using a murine embryo model. Female F-1 mice were stimulated with gonadotropin, induced ovulation with hCG and mated. Two cell embryos were collected and cultured after exposure to either DMSO or PROH. Embryo development was evaluated up to the blastocyst stage. Blastocysts were stained with bis-benzimide to evaluate the cell count and with terminal deoxynucleotidyl transferase mediated dUTP nick labeling (TUNEL) to assess apoptosis. RESULTS: The total cell count of blastocysts that were treated with DMSO at the 2-cell stage was significantly lower than that were treated with PROH (75.9+/-27.0) or the control (99.0+/-18.3) (p<0.001). On comparison of two cryoprotectant treated groups, the DMSO treated group showed a decreased cell count compared with the PROH treated group (p<0.05). Both DMSO (14.2+/-1.5) and PROH (11.2+/-1.4) treated groups showed higher apoptosis rates of cells in the blastocyst compared with the control (6.2+/-0.9, p<0.0001). In addition, the DMSO treated group showed more apoptotic cells than the PROH treated group (p<0.001). CONCLUSIONS: The potential toxicity of cryoprotectants was uncovered by prolonged exposure of murine embryos to either DMSO or PROH at room temperature. When comparing two cryoprotective agents, PROH appeared to be less toxic than DMSO at least in a murine embryo model.

Vitamin B Status and Serum Homocysteine Levels in Infertile Women

Adequate vitamin B(2), vitamin B(6), folate and vitamin B(12) nutrition is known to be important for reproductive function in women of childbearing age. The purpose of this study was to evaluate serum vitamin B(2), vitamin B(6), folate and vitamin B(12) status and serum homocysteine levels in 115 women aged 33.2 +/- 4.0 years, who had been diagnosed with infertility, and 49 women aged 34.5 +/- 3.8 years having at least one born child. Total vitamin B(2) and vitamin B(6) intakes in infertile women were significantly lower than those in control. Serum vitamin B(2), vitamin B(6), folate and vitamin B(12) concentrations were significantly lower in infertile women than those in control and serum homocysteine levels were significantly higher in infertile women than those in control. Thirteen percent in infertile women and zero percent in control were assessed as hyperhomocysteinemic and there was a significant difference in the prevalence of hyperhomocysteinemia between infertile women and control. 41% infertile women were assessed as folate deficiency. Serum folate concentrations was negatively correlated with serum homocysteine of the infertile women and control. Total vitamin B2 intakes was negatively correlated with serum homocysteine of the infertile women and control. Total vitamin B6, folate intakes were negatively correlated with homocysteine of infertile women only. In conclusion, infertile women are needed to intake more B vitamins intakes. Furthermore researches are needed to estimate adequate B vitamin supplementation in infertile women.

Role of macrophage inflammatory protein-1 alpha in wheezy infants

To identify the role of macrophage inflammatory protein-1alpha [MIP-lalpha], a member of CC-chemokine subfamily, in the pathogenesis of bronchial hyper-reactivity, peri-bronchial cell infiltration and airway obstruction in bronchial asthma and acute viral bronchiolitis and to correlate its level with the severity of the disease process. 15 asthmatic children and 15 children with acute viral bronchiolitis compared to 15 normal children with matched age and sex. Measurement of plasma MIP-lalpha level by ELISA and Quantitative estimation of total serum IgE by I MX Microparticle Enzyme Immunoassay. The mean plasma MIP-l alpha was significantly higher in asthmatic and acute bronchiolitis cases [93.4 +/- 46.3 pg/mL and 80.7 +/- 34.49 pg/mL, respectively] than in the controls [15.71 +/- 3.3 pg/mL], p value < 0.01. Mean while, MIP-lalpha level showed significant elevation with advanced severity of asthma where it was 64.0 +/- 20.07 pg/mL, 90.86 +/- 30.35 pg/mL and 157.33 +/- 54.55 pg/mL in the intermittent, mild persistent and moderate persistent subgroups. In addition, when the sample member was classified according to the seventy of the attack, MIP-la level was significantly higher in the severe attack [132.7 +/- 48.5 4 pg/mL] than in moderate [72.14 +/- 18.55 pg/mL] and mild attacks [50.0 +/- 4.24 pg/mL], p value < 0.01.In cases of acute bronchiolitis, the mean plasma MIP-lalpha showed positive correlation with the grade of respiratory distress where it was 49.0 +/- 5.70 pg/mL, 83.67 +/- 4.80 pg/mL and 116.0 +/- 46.01 pg/mL in mild, moderate and severe cases, respectively, p value < 0.01. Mean plasma IgE level in asthmatics [195.24 +/- 191.53 IU/mL] was also significantly elevated compared to the controls [12.20 +/- 10.56 IU/mL]. Within the asthmatic group, the mean plasma IgE level correlates positively with the degree of severity of the asthmatic attack. Plasma MIP-lalpha participates in creation of bronchial hyper-reactivity, airway inflammation and obstruction in wheezy infants during asthmatic and acute bronchiolitis attacks. Inhibition of such chemokine effects might be beneficial for designing new therapeutic strategies directed at immunomodulation of bronchial asthma and respiratory syncytial viral bronchiolitis

Prediction and early diagnosis of pulmonary tuberculosis with a normal chest radiograph in the pediatric age group

Pulmonary tuberculosis in the absence of chest radiographic abnormalities has been reported recently frequently by many researchers, and its clinical features and methods of detection have not been well described in pediatrics. This is of prime importance in children, as the borders between tuberculosis infection and disease are on a continuum and often indistinct. The objective of this work is to put a strategy for early anticipation and prompt diagnosis of pulmonary TB with a normal chest radiograph in the pediatric age group. This study was conducted on 18 infants and children [5 males and 13 females], their ages ranged from 7 months to 12 years. We selected cases diagnosed as pulmonary TB with a normal chest radiograph from the chest clinic and internal sections, Cairo University Children's Hospital. The mean duration of symptoms before the time of diagnosis was 9.9 13.2 months. Proper history taking, thorough clinical examination, and investigations [CBC, ESR, Tuberculin skin test, Plain chest radiograph, and others according to each case] were done for all patients. Results revealed that pulmonary TB with a normal X-ray chest represented 24.7% of those with pulmonary extrapulmonary TB cases; TB adenitis [mostly cervical] was present in 88% of them. All patients were symptomatic at the time of diagnosis; cough and fever were the commonest symptoms [100% and 89% respectively]. Most of cases [89%] presented with? three symptoms. On the contrary, only 11% had auscultatory chest signs [wheezing]. We documented weight loss in 61% of patients, most of them [82%] with? 10[th] percentile. Twenty two percent of our patients gave a positive history of contact to an infectious adult, 75% of which were tuberculin positive. BCG scar was present in 33% of cases. In conclusion, pulmonary TB with a normal chest radiograph is not uncommon in pediatrics, it is important to establish a correct diagnosis of tuberculosis disease in children at an early stage. The patient will benefit from early diagnosis and treatment in terms of outcome and complications. Predictive factors or scoring systems should be devised based on clinical symptoms, contact tracing, and investigations. These are of crucial importance when the X-ray chest is normal or out of reach, as in rural and isolated areas; or when the sputum culture is negative, a common finding in children

Clinical and sonographic findings of hepatic masses in infancy and childhood

Thirty patients having liver lesions were studied and their symptoms and physical findings were analyzed. Ultrasonography was done to all of them and focal lesions detected and described. The diagnosis was confirmed by further investigations such as computed tomography, tumor markers and liver biopsy for needle aspiration. Sixteen cases were found to have malignant masses, four cases were hepatocellular carcinoma, five cases were hepatoblastoma and seven cases were metastatic tumors. One case was found to have benign tumor of vascular origin. Simple cysts were diagnosed in five patients and hydatid cysts in one case. Four cases of pyogenic abscesses and three cases of amebic abscesses were included. Finally, the study concluded that ultrasonography is the most readily available simple and cheap investigation and can be considered as primary investigation in every case of hepatomegaly. Ultrasonography may be the only clue to recognize certain disease conditions such as hemangioma and also early hepatocellular carcinoma. Under the guide of sonography, biopsy can be taken from a mass or aspiration from a cyst to provide conclusive pathological diagnosis

Study on abdominal pain in children

This study analyzed the commonest causes of abdominal pain. It was done on 170 children [89 males and 81 females] who suffering from abdominal pain, their ages ranged from 2 to 12 years. Every patient was subjected to detailed history, thorough general and local examination and routine investigations as stool, urine analyzes and complete blood picture. Other laboratory investigations [X- ray, ultrasound, CT scan, endoscopy and biopsy] were done, when needed. Abdominal pain in patients was either acute or recurrent, 30 patients were presenting with acute abdominal pain, 18 of them had surgical causes and 12 had medical causes