Association Between the Prevalence of Schistosomiasis in Elementary School Students and Their Parental Occupation in Sudan

Global efforts to identify groups at high risk for schistosomiasis have mainly concentrated on identifying their geographical distribution. Investigations on the socioeconomic characteristics of high-risk groups are relatively scarce. This study aimed to explore the associations between schistosomiasis among students and their parents’ occupations. A nationwide cross-sectional survey was conducted targeting 105,167 students in 1,772 primary schools across Sudan in 2017. From these students, 100,726 urine and 96,634 stool samples were collected to test for Schistosoma haematobium and S. mansoni infection. A multi-level mixed effect analysis was used with age and sex as fixed factors, and school as a random factor. The odd ratios (ORs) of practicing open defecation among farmers’ children were almost 5 times higher than their counterparts whose parents were government officials (OR=4.97, 95% confidence intervals (CIs): 4.57-5.42, P<0.001). The ORs of contacting water bodies for watering livestock among farmers’ children were more than 4 times higher than those of children whose parents were government officials (OR=4.59, 95% CIs: 4.02-5.24, P<0.001). This study shows that schistosomiasis represents a disease of poverty and that farmers’ children constituted a high-risk group.

Population Dynamics of Intermediate-Host Snails in the White Nile River, Sudan: A Year-Round Observational Descriptive Study

We aimed to explore the population dynamics of snail in 3 sites of the White Nile in Sudan. More specifically, we aimed to investigate the annual patterns of snail populations that act as intermediate hosts of schistosomes and monthly snail infection rates and ecological characteristics presumably related to snail populations. We collected snails for 1 year monthly at 3 different shore sites in the vicinity of El Shajara along the White Nile river in Khartoum State, Sudan. In addition, we measured air and water temperatures, water turbidities, vegetation coverages, and water depths and current speeds. Most of the collected snails were Biomphalaria pfeifferi and Bulinus truncatus. The population densities of snails and their infection rates varied across survey sites. The collected snails liberated S. mansoni and S. haematobium cercariae as well as Amphistome and Echinostome cercariae. Infected snails were found during March-June. The ecological characteristics found to be associated with the absence of snails population were: high turbidity, deep water, low vegetation coverage (near absence of vegetation), high water temperature, and high current speed. To our knowledge, this is the first longitudinal study of the snail population and ecological characteristics in the main basin of the White Nile river.

Population Dynamics of Intermediate-Host Snails in the White Nile River, Sudan: A Year-Round Observational Descriptive Study

We aimed to explore the population dynamics of snail in 3 sites of the White Nile in Sudan. More specifically, we aimed to investigate the annual patterns of snail populations that act as intermediate hosts of schistosomes and monthly snail infection rates and ecological characteristics presumably related to snail populations. We collected snails for 1 year monthly at 3 different shore sites in the vicinity of El Shajara along the White Nile river in Khartoum State, Sudan. In addition, we measured air and water temperatures, water turbidities, vegetation coverages, and water depths and current speeds. Most of the collected snails were Biomphalaria pfeifferi and Bulinus truncatus. The population densities of snails and their infection rates varied across survey sites. The collected snails liberated S. mansoni and S. haematobium cercariae as well as Amphistome and Echinostome cercariae. Infected snails were found during March-June. The ecological characteristics found to be associated with the absence of snails population were: high turbidity, deep water, low vegetation coverage (near absence of vegetation), high water temperature, and high current speed. To our knowledge, this is the first longitudinal study of the snail population and ecological characteristics in the main basin of the White Nile river.

Immediate Breast Reconstruction vs. Mastectomy Alone in Locally Advanced Breast Cancer; Local Recurrence and Distant Recurrence

PURPOSE@#The oncologic safety of immediate breast reconstruction (IBR) has been demonstrated. However, the outcome of IBR for locally advanced breast cancer (LABC) is still under debate. We compared the survival outcome of LABC patients who underwent IBR vs. mastectomy alone.@*METHODS@#We retrospectively analyzed a total of 248 patients with stage III breast cancer who were treated with mastectomy between 2004 and 2015. The study subjects were divided into 2 groups: patients who received IBR (n=77) or mastectomy alone (MA) (n=171). We compared disease-free survival (DFS) of both groups.@*RESULTS@#Median follow-up duration was 49 months and the mean age of patients was 49 years. Patients in the IBR group were significantly younger and had lower body mass index (BMI) than those in the MA group. In a univariate analysis, IBR group showed better DFS than the MA group (DFS 81.3 months vs. 49.8 months, p<0.001). There was no delay in adjuvant treatment in the IBR group. In a multivariate analysis, IBR was associated with better DFS (hazard ratio (HR) for recurrence: 0.37, 95% CI 0.20–0.69, p=0.002) when adjusted for potential prognostic factors. In a subgroup analysis performed according to disease stage (IIIA and IIIB/IIIC), DFS was significantly better in IBR than MA group in both stage subgroups (p<0.001).@*CONCLUSION@#We demonstrated that patients who underwent IBR showed better DFS outcome compared with patients who underwent mastectomy alone. Our results can help surgeons to determine if IBR is an option in patients with LABC.

A Case of Catabacter hongkongensis and Alistipes indistinctus Isolated from Blood Cultures of a Patient with Acute Appendicitis

Catabacter hongkongensis is an anaerobic gram-positive coccobacillus that was first isolated in Hong Kong. It is infectious and causes high mortality in patients with rare but underlying diseases. Alistipes indistinctus is an anaerobic gram-negative coccobacillus. This bacterium is a common member of the human intestinal microbiota. We report a case of C. hongkongensis and A. indistinctus isolated from blood cultures of a patient with acute appendicitis. A 35-year-old female patient with no specific medical history was admitted to the hospital due to abdominal pain, vomiting, nausea, and diarrhea experienced on the day before admission. On admission, laboratory tests revealed leukocytosis, neutropenia, and elevated C–reactive protein and procalcitonin levels. Following an abdominal computed tomography showing acute appendicitis with suspected perforation, emergency surgery was performed. Growth was observed in two anaerobic blood culture bottles after four days. After further culturing of the bacteria on Brucella Blood Agar, two types of bacteria were obtained. The two bacterial isolates, one gram-positive and one gram-negative, were unable to be identified using matrix assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). Thus, 16S rRNA gene sequence analysis was performed, resulting in identification of the bacteria as C. hongkongensis and A. indistinctus. The patient was administered antibiotics and discharged two days after surgery. Although MALDI-TOF MS enables fast and accurate identification of bacteria, C. hongkongensis and A. indistinctus were not listed in the spectral library, and 16S rRNA gene sequence analysis was useful for identifying the two bacteria.

Effects of Eating Behavior of Preschool Children Using a Direct Visual Stimulating Program on Vegetables and Nutrition Education with Vegetable Playing

The purpose of this study was to examine 1) the relationship between the vegetable eating behavior of care givers and that of children, 2) the effectiveness of nutrition education with vegetable playing using direct visual stimulating programs on vegetable eating behavior of preschool children, and 3) the times and period of nutrition education with vegetable playing for significant changes on vegetable eating behavior. A total number of 56 individuals, aged 42 to 66 months old, participated in this study in which three kinds of vegetables (30 g)/meal were served per individual, and vegetable eating behavior was measured by the residue on the dish during 5 weeks (25 days). To the simple visual stimulating group, vegetable dish was served without education, and other groups included education 1 group (nutrition education 1 time/week), education 2 group (nutrition education 2 times/week), and education 3 group (nutrition education 3 times/week) with simple visual stimulation by the vegetable dish. The results showed 1) the significant relationship (P < 0.001) between the vegetable eating behavior of the care giver and that of children by analysis of the questionnaire, 2) the effectiveness of nutrition education using vegetable playing on vegetable eating behavior of preschool children (P < 0.05), and 3) the significant changes in vegetable eating behavior by the 3rd week in the education 3 group. This study shows that food neophobia caused behavior problems in children regarding vegetable eating and repeated exposure was able to reduce food neophobia.

Pleiotrophin (PTN) expression in osteoblastic cells

An Electroretinographic Changes of Laser-induced Experimental Branch Retinal Vein Occlusion in the Rabbits

To verify whether laser-induced branch retinal vein occlusion in the rabbit can be used as the experimental model for the human study. The temporal retinal vein of the right eye was occluded with argon laser photocoagulator with parameters of 500 micrometerspot size, 0.2 second duration, 150-200 microWatt power in twelve pigmented rabbits. The left eye was used as a control. An electroretinogram was taken before and 1,3,7,15 and 28 days after vein occlusion. B/a ratio and oscillatory potentials increased in the eyes with occluded veins. Comparing the pre-occlusion values with those of post-occlusion, the changes were not statistically significant. But differences between the values of right and those of left eye were significant. We can suppose that the discrepancies may result from the difference in timing of examination. In conclusion, the rabbit model of laser-induced experimental branch retinal vein occlusion may not be adequate for the study of clinical branch retinal vein occlusion.