Feasibility and acceptability of an electronic mobile device application among physicians from the private sector for reporting cases to the national TB program

Introduction@#In the 2016 National TB Prevalence Survey, the prevalence-to-notification ratio for smear-positive pulmonary tuberculosis was 3.1. In the TB registry, 94% of cases were reported by public providers, suggesting insufficient reporting from private physicians. This study describes the feasibility and acceptability of an electronic mobile device application for possible use among private physicians for reporting their TB cases.@*Methods@#This interventional, pre-, and post-test study uses an electronic mobile device application to report TB cases. Using the application, physicians collected and uploaded specific information for reporting cases. The participants were duly-licensed physicians and board certified in any of the following: Internal Medicine, Adult Infectious Diseases, Adult Pulmonology, Pediatrics, Pediatric Infectious Diseases, or Pediatric Pulmonology. The participants used an electronic mobile device application for reporting TB cases. Feasibility and acceptability were assessed using a questionnaire and through a focus group discussion. Data were summarized with mean and standard deviation for continuous variables and proportions for categorical variables.@*Results@#The study was conducted at the Research Institute for Tropical Medicine, a government hospital with a Tuberculosis Directly Observed Treatment Short-Course (TB DOTS) facility. Of the 30 physicians invited to participate, 24 provided consent, but only 15 downloaded the application (age range 34-61, mean 39 years, 11 females). Eleven of 15 physicians (73%) assessed the mobile application as easy to navigate and felt that information encoded was relevant to patient care. However, the internet connection affected the speed of the application. The physicians said they had no time, were too busy, or simply forgot to encode patient data.@*Conclusion@#The use of the application is acceptable but not feasible for use by private physicians. Modification to the application may be done to improve uptake by private physicians.

Occupational health and safety challenges among artisanal and small-scale diamond miners in Kimberley, South Africa

Background: Artisanal and small-scale mining (ASM) is a laborious process often executed with rudimentary low-technology mining equipment. It exposes miners to a myriad of occupational hazards, which may increase health and safety disparities between them and formally employed mine workers. Objectives: The objectives of the study were to identify workplace hazards and the associated risks; and to assess the effects of mining activities on the health and environment of artisanal diamond miners in Kimberley, Northern Cape province. Methods: This was an interdisciplinary observational ethnographic study. A workplace assessment was undertaken at seven sites in Kimberley. Participants were conveniently selected; snowballing was used to recruit additional participants. Field notes were recorded from observations. Interview questions included those about the duration of artisanal mining, and the risks faced in the workplace. Data collection included photographic documentation. An inductive and deductive process was used to analyse the data and thematic analysis was conducted. Results: The observed occupational hazards included physical (ultraviolet radiation exposure, injuries due to trauma), respiratory (silica dust exposure), biomechanical (heavy lifting, repetitive movement), and psychological (work-related stress, anxiety) hazards. There was a paucity of access to, and use of, personal protective equipment (PPE). Workers improvised ways to protect themselves, e.g. by using cloths as masks. There was no recourse to formal occupational health services and social safety networks. Conclusion: Occupational health and safety challenges included physical, biomechanical, respiratory, and psychosocial hazards. The mining activities had a detrimental impact on the environment.

Antibacterial efficacy of methanolic extract of molave (Vitex parviflora A. Juss) leaves against Streptococcus mutans

Background@#Antibacterial drugs are used for suppressing harmful bacteria. However, some are reported to have side effects which led researchers to investigate plants with antimicrobial properties as potential alternatives. One such indigenous plant is the Vitex parviflora A. juss, “molave” or “mulawin” tree. @*Objective@#This study determined and compared the antibacterial efficacy of 50 mg/ml and 100 mg/ml concentrations of fresh local molave leaves methanolic extract with 0.12% chlorhexidine, distilled water, and 95% methanol on growth inhibition of S. mutans. @*Methodology@#Five hundred grams of fresh molave leaves were collected and subjected to methanolic extraction. In vitro antimicrobial susceptibility test by disk diffusion of 50 mg/ml and 100 mg/ml molave extract concentrations, 0.12% chlorhexidine, distilled water, and 95% methanol on 18 Mueller-Hinton agar (MHA) plates inoculated with S. mutans was done. For cost-efficiency, the total sample size of 80 plates was reduced by placing 5 test groups in one plate divided into five portions done in 18 replicates. After 48 hours of incubation in anaerobic conditions, resulting zones of inhibition were measured. Data were analyzed through one-way ANOVA and Bonferroni tests. @*Results@#The mean diameter of inhibition zones produced by 100 mg/ml and 50 mg/ml concentrations of molave methanolic leaves extract and 0.12% chlorhexidine was 15.78 mm, 11.63 mm, and 21.44 mm, respectively. Distilled water and 95% methanol did not inhibit bacterial growth. The 100 mg/ml concentration has stronger antibacterial properties than the 50 mg/ml. @*Conclusion@#The Vitex parviflora A. Juss methanolic leaves extract has the ability to inhibit the growth of S. mutans in vitro. Both concentrations were relatively weaker compared to chlorhexidine.

An analytical cross-sectional study on the knowledge, attitudes, and practices (KAP) on biomedical waste management among nurses and medical technologists in the Philippines / The Health Sciences Journal

INTRODUCTION@#Unregulated biomedical waste management is an emerging public health problem in the Philippines. This study aimed to differentiate the knowledge, attitudes, and practices of nurses and medical technologists toward biomedical waste management.@*METHODS@#Using an analytic cross-sectional study design, an online survey of nurses and medical technologists from hospitals around the Philippines was conducted. A 27-item questionnaire covering knowledge, attitudes and practices was used. The percentages of correct answers and mean scores in each domain was compared between the nurses and medical technologists.@*RESULTS@#A total of 196 respondents consisting of 77 registered nurses and 119 medical technologists were included in the study. Medical technologists had significantly better knowledge scores than nurses on disposal procedures for expired blood units and by-products waste (55% vs. 19%, p = 0.026). Both had low correct responses on adequate disposal of human tissue remains, throwing blood waste into domestic waste, and throwing of expired medications in domestic waste. There was no significant difference in the attitude of nurses and medical technologists. Nurses had significantly better practice scores on disposal of liquid waste in bags (84.4% vs. 68.9, p = 0.018), but medical technologists fared better at disposal of human tissue together with other waste (13.0% vs. 2.5%, p = 0.006). @*CONCLUSION@#Both nurses and medical technologists had adequate knowledge of some aspects but were lacking in others. There was no significant difference in the attitude of nurses and medical technologists towards biomedical waste management. Half of the respondents practiced proper biomedical waste management.

Nonsecretory intestinocystoplasty: postoperative outcomes of 25 years

ABSTRACT Objective The objective of bladder augmentation (BA) is to create a low-pressure reservoir with adequate capacity. Despite its benefits, the use of intestinal patches in bladder enlargement provides a high risk of developing complications and BA with demucosalised bowel represents a potential alternative. Therefore, this study evaluated urological parameters and long-term clinical follow-up of patients submitted to non-secretory BA in a single center with 25 years of experience. Materials and Methods Patients treated with BA underwent urological evaluation, which included history, physical examination and urodynamic study. The main urodynamic parameters (bladder capacity and bladder compliance) were assessed in the pre and postoperative moments, and compared by the Wilcoxon Signed Rank test. The main long-term complications were described. Results 269 patients (mean age 14±13 years, 47% male) underwent BA with the use of demucolised intestinal segments. Among the patients in the sample, 187 (69.52%) had neurogenic bladder, 68 (25.28%) had bladder exstrophy, nine had tuberculosis (3.34%), four had a posterior urethral valve (1.49%) and one with hypospadia (0.37%). After the surgical procedure, a significant increment in both urodynamic parameters was found, with a 222% increase in bladder capacity and 604% in bladder compliance (p <0.001 in both analyzes). Mean follow-up time ranged from 2 to 358 months, with a median of 72 months (IQR 74-247). Among all patients, 5 presented spontaneous perforation. Conclusion The study showed statistically significant increase in both compliance and bladder capacity after non-secretory BA, with a low rate of severe complications.

Prevalence of ocular morbidity among tribal children in Jawadhi hills, southern India: A cross-sectional study

Purpose: Childhood blindness is second to cataract in terms of blind person years; population-based prevalence of ocular morbidity among tribal children has not been studied. We conducted this study to determine the prevalence of ocular morbidity in tribal children age 15 years or younger in Jawadhi hills, southern India. Methods: A population-based cross-sectional study was conducted in four tribal villages where all children below 15 years of age were invited to participate in the study. After appropriate consent/assent, an optometrist assessed uncorrected vision refraction and best-corrected visual acuity using suitable techniques. A comprehensive ophthalmic examination was also done by an ophthalmologist to determine the presence of ocular morbidity. Children requiring cycloplegic refraction or further treatment were referred to the base hospital. Results: Among 260 children examined, the prevalence of ocular morbidity was 10.8% [95% confidence interval (CI): 6.3–13.7]. Vitamin A deficiency (VAD) was the foremost morbidity: 4.6% (95% CI 1.6–6.3) followed by refractive error (2.7%). Three (10.7%) children had more than one ocular morbidity. Nearly 1 in 10 tribal children suffer from ocular morbidity and 1 in 57 had low vision. Conclusion: VAD is a public health problem in this tribal region which requires immediate intervention with prophylaxis and treatment. Uncorrected refractive errors in school-age children also need to be attended.

Tidal breathing analysis as a tool for asthma diagnosis in children aged six months to five years

@#<p style="text-align: justify;"><strong>BACKGROUND:</strong> The diagnosis of asthma is difficult to establish using spirometry in children below 5 years old. Tidal breathing analysis (TBA) can provide useful information about lung function in infants and young children, as it is effort-independent. </p><p style="text-align: justify;"><strong>OBJECTIVES:</strong> To determine if baseline and post-bronchodilator ratios of the time and volume until peak expiratory flow to the total expiratory time and volume, (tPEF/tE and V PEF/V E) can distinguish asthmatics from normal children.</p><p style="text-align: justify;"><strong>METHODS:</strong> This is a cross-sectional study wherein 146 children ages 6 months to 5 years old completed TBA before and 15 minutes after administration of 250?g of salbutamol via nebulization. Children 3 years old and below who did not cooperate were given sedation with oral diphenhydramine (1mg/kg/dose). The tPEF/tE and VPEF/VE were compared between the controls and asthmatics.</p><p style="text-align: justify;"><strong>RESULTS:</strong> In children below 2 years old, the baseline tPEF/tE of asthmatics and non-asthmatics were 29.6  ± 13.8and 22.0 ± 6.6. The area under the curve (AUC) was 0.649 attPEF/tEof 32.250, with a sensitivity and specificity of 50% and 97%. The baseline VPEF/VE of asthmatics and non-asthmatics were 32.7 ±12.4 and 26.0 ± 4.9.AUC was 0.661 at VPEF/VEof34.500, with a sensitivity and specificity of 50% and 97%.In subjects 2 to 5 years old, the baseline tPEF/tE of asthmatics and non-asthmatics were 35.3 ± 14.7 and 35.0 ± 13.1. The baseline VPEF/VE were 37.0 ± 12.3 and 36.7 ± 10.7. After salbutamol nebulization, the tPEF/tE of asthmatics and non-asthmatics in all ages were 30.9±13.7 and 27.9± 10.8. The VPEF/VE were 34.1± 11.4 and 30.9± 9.0.</p><p style="text-align: justify;"><strong>CONCLUSION</strong>: Baseline tPEF/tE and VPEF/VE can distinguish asthmatics from non-asthmatics in children below 2 years old. However, baseline tPEF/tE and VPEF/VE in children 2 to 5 years old and post-bronchodilator tPEF/tE and VPEF/VE in all ages could not distinguish asthmatics from non-asthmatics after nebulization with 250?g of salbutamol.</p>

Perceptions of radiation safety training among interventionalists in South Africa

Exposure to ionising radiation may have deterministic and stochastic health effects, which include skin changes, chromosomal aberrations, cataracts and carcinomas. Formalised training in radiation safety and protection improves knowledge on the subject and facilitates greater compliance in safety practices. This qualitative study included 54 interventionalists (adult and paediatric cardiologists, and interventional radiologists). The participants were purposively selected and interviewed to explore their perceptions about radiation safety. A thematic analysis of the transcripts was done using a deductive and inductive approach. Findings showed participating cardiologists had less knowledge about radiation safety than participating radiologists. Cardiologists reported little or no formal training on radiation safety and did not display a culture of radiation safety. There was no consensus on how the training gap should be addressed. There is a perceived need to change and enhance the radiation safety culture among interventionists, and the participants proffered some ideas. These included the need for re-curricularisation of cardiologists' training to create awareness of radiation safety practices

Improving current helminth control strategies: Lessons from a baseline prevalence survey of soil-transmitted helminth infections in adolescent females and pregnant women in selected local government units in the Philippines

OBJECTIVES: This study utilized a cross-sectional study design to determine the prevalence and intensity of STH infections among adolescent females and pregnant women, to describe the nutritional status of the two population groups in selected study sites in the Philippines, and to propose a scheme for classification of endemic sites as basis for conduct of control strategies. METHODS: Parasitologic assessment was conducted through examination of collected stool samples using the Kato-Katz technique, while nutritional status was assessed through primary height and weight measurements.RESULTS: Results of the parasitologic assessment in adolescent females showed an overall cumulative prevalence of 30.4% (12.5% - 61.8%) and a prevalence of heavy intensity infection of 7.9% (0.7% - 22.6%). In pregnant women, overall cumulative prevalence was 31.5% (13.2% - 75.8%) and prevalence of heavy intensity infection was 10.2% (0.9%- 39.6%). CONCLUSION: Significant differences in prevalence in the different sentinel sites suggest the need to consider a modified classification scheme for endemic communities to determine the most cost-effective strategies for morbidity control. The utilization of this classification scheme alongside regular sentinel surveillance will help validate the scheme and contribute towards the development of more appropriate program guidelines for nationwide implementation.

Evaluation of solanum nigrum leaf extract as a corrosion inhibitor and reductant for the green synthesis of gold nanoparticles.

Eco-friendly green methodologies have attracted the attention in every field of research owing to environmental pollution and the alarming development of global warming. In search for eco-friendly materials for the synthesis of metal nanoparticles and corrosion inhibition, the leaf-extract of Solanum nigrum have identified, as it displays remarkable antioxidant property. The leaf-extract was investigated by weight-loss method and potentio-dynamic polarization technique in carbon steel to study the corrosion inhibition. Surface and protective film analysis was carried out using scanning electron microscopy (SEM). The antioxidant property of the leaf-extract was exploited for synthesis of gold nanoparticles (GNPs). Excellent results were obtained when the leaf-extract was used to reduce AuCl4. The formation of GNPs was rapid and within a few hours AuCl4 was reduced into fine GNPs as evidenced by the appearance of deep ruby red colloidal dispersion. The UV–visible spectral analysis revealed the reduction of AuCl4 and showed a peak at ~545 nm originating from the surface plasmon resonance of GNPs. The GNPs were characterized using SEM with energy-dispersive X-ray spectroscopy, powder X-ray diffraction and zeta potential analysis. The average size, geometrical shape and the zeta potential were discussed.

Man with situs inversus

This is a case of a 47-year-old male, diagnosed with situs inversus with dextrocardia, who had episodes of chest heaviness. He was referred for a myocardial perfusion imaging using the rest and stress protocol. SPECT short axis, vertical and horizontal long axis projections were acquired after injection of Tc99m Tetrofosmin. One hundred eighty degree imaging was performed on a dual-head camera from the left anterior oblique to right posterior oblique, instead of the usual right anterior oblique to left posterior oblique. Results showed mild stress-induced myocardial ischemia in the apex. Non-invasive cardiac imaging acquisition in this case requires protocol adjustment to correctly acquire and process the data.

Visual outcomes and higher-order aberrations of wavefront vs. combined wavefront aspheric

Objective@#We compared the efficacy, safety, refractive and visual outcomes, and aberrometry results of wavefront-guided aspheric treatment (WTA) versus wavefront-guided treatment (WT).@*Methods@#This prospective, contralateral, comparative study included 60 eyes of 30 patients who underwent myopic LASIK. One eye of each patient was randomized to either WTA or WT. Patients were followed up for 3 months postoperatively. Two-tailed paired t-test was used to determine statistical significance.@*Results@#At 3 months, 93% of eyes in the WTA group and 83% in the WT group had high-contrast uncorrected distance visual acuity (UDVA) of 20/20, while 87% in both groups achieved low-contrast UDVA of 20/40 or better. Sixty-four percent in the WTA gained 1 or more lines of low-contrast corrected distance visual acuity (CDVA) compared to 50% in the WT group. The mean sphere was 0.17D in the WTA and 0.14D in the WT (p = 0.63). The mean spherical equivalent was –0.04D for WTA and –0.03D for WT (p = 0.88). All eyes in both groups were within ±1.00D of the target emmetropia. The mean change in total higher-order aberration (HOA) was 0.07 μm in the WTA compared to 0.15 μm in the WT group (p = 0.04). The mean change in spherical aberration was –0.01 μm in the WTA and 0.18 μm in the WT group (p < 0.001). The mean change in Q value was significantly lower in the WTA (0.31) than in the WT group (0.63) (p < 0.001).@*Conclusion@#Wavefront aspheric LASIK (WTA) is a safe and effective treatment for myopic astigmatism. Refractive and visual outcomes were similar for both groups. WTA had less induction of higher-order aberration, lower spherical aberration, and better preservation of corneal asphericity (Q value). This translated to more lines of low-contrast vision gained compared to WT. Keywords: LASIK, Wavefront-guided, Aspheric, Spherical aberration, higher-order aberration, Corneal curvature

A review of studies on the impact of 18F-FDG PET/CT in the evaluation of metastatic colorectal carcinoma

The use of 18F-fluoro-2-deoxy-D-glucose positron emission tomography with multiple slice spiral computed tomography scanners provides the opportunity to integrate morphologic information and functional information. It may allow the definition of new parameters for assessment of the treatment response of the tumor in one patient sitting. This will also facilitate the use of PET/CT in research studies as well as in clinical practice. This paper summarizes the results of recent studies with 18F-FDG PET/CT after chemotherapy or before and after surgery of metastatic colorectal carcinoma, and its impact on patient management. The purpose of this study was to evaluate the possible contribution of 18F-FDG PET/CT as compared to contrast-enhanced computerized tomography alone as a surrogate marker to evaluate liver metastases in vivo. Information retrieval for this review was through computerized literature search. Comparison of the results of each study was through statistical analysis. Results show that 18F-FDG PET/CT is better than CT as a diagnostic modality in the evaluation of the status of metastatic colorectal carcinoma. The review concludes with a position on how 18F-FDG-PET/CT could make a difference in drug development and clinical management for patients.

Early colonization pattern of maize (Zea mays L. Poales, Poaceae) roots by Herbaspirillum seropedicae (Burkholderiales, Oxalobacteraceae)

The bacterium Herbaspirillum seropedicae is an endophytic diazotroph found in several plants, including economically important poaceous species. However, the mechanisms involved in the interaction between H. seropedicae and these plants are not completely characterized. We investigated the attachment of Herbaspirillum to maize roots and the invasion of the roots by this bacterium using H. seropedicae strain SMR1 transformed with the suicide plasmid pUTKandsRed, which carries a mini-Tn5 transposon containing the gene for the Discosoma red fluorescent protein (Dsred) constitutively expressed together with the kanamycin resistance gene. Integration of the mini-Tn5 into the bacterial chromosome yielded the mutant H. seropedicae strain RAM4 which was capable of expressing Dsred and could be observed on and inside fresh maize root samples. Confocal microscopy of maize roots inoculated with H. seropedicae three days after germination showed that H. seropedicae cell were attached to the root surface 30 min after inoculation, were visible in the internal tissues after twenty-four hours and in the endodermis, the central cylinder and xylem after three days.

Expression, purification and DNA-binding activities of two putative ModE proteins of Herbaspirillum seropedicae (Burkholderiales, Oxalobacteraceae)

In prokaryotes molybdenum is taken up by a high-affinity ABC-type transporter system encoded by the modABC genes. The endophyte â-Proteobacterium Herbaspirillum seropedicae has two modABC gene clusters and two genes encoding putative Mo-dependent regulator proteins (ModE1 and ModE2). Analysis of the amino acid sequence of the ModE1 protein of H. seropedicae revealed the presence of an N-terminal domain containing a DNA-binding helix-turn-helix motif (HTH) and a C-terminal domain with a molybdate-binding motif. The second putative regulator protein, ModE2, contains only the helix-turn-helix motif, similar to that observed in some sequenced genomes. We cloned the modE1 (810 bp) and modE2 (372 bp) genes and expressed them in Escherichia coli as His-tagged fusion proteins, which we subsequently purified. The over-expressed recombinant His-ModE1 was insoluble and was purified after solubilization with urea and then on-column refolded during affinity chromatography. The His-ModE2 was expressed as a soluble protein and purified by affinity chromatography. These purified proteins were analyzed by DNA band-shift assays using the modA2 promoter region as probe. Our results indicate that His-ModE1 and His-ModE2 are able to bind to the modA2 promoter region, suggesting that both proteins may play a role in the regulation of molybdenum uptake and metabolism in H. seropedicae.

Evaluación y seguimiento de los niños y adolescentes sobrevivientes de cancer pediátrico / Evaluation and follow up of children and adolescents who survived cancer

El pronóstico de los niños oncológicos ha mejorado en la últimas décadas, más de un 65 de los pacientes que padecieron alguna forma de cáncer pedíátrico llegara adulto. El objetivo del siguiente trabajo fue la descripción de los resultados de la evaluación y seguimiento a largo plazo de los sobrevivientes de una neoplasia en la infancia. Material y Métodos: Se realizó la evaluación y seguimiento de los sobrevivientes en el período comprendido entre junio de 2003 a mayo de 2006. Se seleccionaron para esta publicación los pacientes ingresados en los protocolos LLA 87, LLA 90 RMS 95. Resultados: el número de pacientes analizados fue de 175 distribuidos 39 mujeres y 61 varones; 17 pacientes RMS, el 65 tenía como localización del sitio primario cabeza y cuello parameningeos, el 80 recibió tratamiento combinado de quimioterapia y radioterapia, el 100 de los parameningeos recibió tratamiento con radioterapia presentaron una o más de las siguientes secuelas: estética, sinusitis crónica, compromiso visual y endocrinológico; 23 pacientes LLA 87, el 5 presento cardiotoxicidad que requirió medicaicón y en el 70 de los pacientes no se detecto nincuna secuela; 135 pacientes LLA 90 el 77 no presento ninguna secuela a largo plazo. Conclusión: El impacto del tratamietno en la calidad de ivda de estos pacintes está siendo evaluada permanentemente para detectar deterioros en las funciones cognitivas, físicas, emocionales y sociales que conllevan a una disminución de la misma. Para ello y esencialmente para ofrecer la mejor calidad de vida posible a los niños curados de cáncer se impone como herramienta un segumiento clínico con enfoque multidisciplinario y muy prolongado en el tiempo.