A Retrospective Comparative Study of Del Nido Versus Intermittent St Thomas Hospital Blood Cardioplegia Solutions in Aortic-Mitral Double Valve Replacement

Introduction: It is not uncommon in patients, havingrheumatic mitral and aortic valve disease, to undergo mitralvalve replacement with aortic valve replacement that is,double valve replacement (DVR) operation who oftenhave severe cardiac dysfunction optimized with medicalmanagement before surgery. In this retrospective studywe investigated 60 such patients, who underwent DVRoperation with either conventional cold blood cardioplegiawith St Thomas 2 solution (STH), or del Nido cardioplegia(DN) over five years and compared the effects of the twotypes of cardioplegia during perioperative and postoperativeperiod with simultaneous comparative study betweenchanges of cardiac performances in the patients with largerleft ventricle as compared to those with less enlargedones.Material and methods: For this retrospective study, the dataof 60 patients of DVR over five years, in Medical College,Kolkata, India, were retrieved for study. The cases wereplaced into 2 groups: STH and DN according to cardioplegiaused during DVR. Demographic, echocardiographic, andseveral perioperative and postoperative data of the two groupsof patients, were collected. Differences between perioperativebehaviour between STH and DN groups and post operativechanges in the echocardiographic parameters betweenpredominantly mitral stenosis (MS) and mitral regurgitation(MR) patients, were analyzed.Results: The aortic cross clamp (CC) and cardiopulmonarybypass (CPB) time in both predominant MS and MR patientswas shorter in the DN than the STH groups. There was lessarrhythmia, less inotropic and ventilator support in the DNgroup. There was 10% mortality in the series with majoritybeing in the STH and MR predominant patients. Postoperativeimprovement of LVEF, reduction of LVIDS and LVIDDwere also observed in MS predominant in comparison toMR predominant patients after DVR in both STH and DNgroups.Conclusion: Use of DN has been found to have a betteroutcome and survival when compared to STH cardioplegiasolution. DVR could reversely remodel depressed heartswith relatively smaller LV volume and restore LV functionof relatively smaller LV of predominant MS patients betterin comparison to MR predominant patients with relativelydilated hearts.

Prevalence and Associated Risk Factors of Soil-Transmitted Helminthiases among Primary School-going Children in Rarieda, Siaya County-Kenya

Background and Aim: It is certain that without readily available water in sufficient quantity, and free of pathogens, man's progress is tremendously hindered. In Muyuka, Cameroon, though there exist public taps littered “here and there”, the population most often find themselves fetching water from nearby streams raising to surface the question of sustainability of the available water systems which was the aim of this study.Methods:This was a cross-sectional, analytic study targeting household heads and water committee members in the rural communities of Muyuka. Three communities were randomly selected and from each, five quarters were randomly selected. In the quarters, convenience sampling technique was used for the household heads while snowball sampling technique was used to get the water committee members. An interviewer administered questionnaire was used and data analyzed using R.Results:A total of 371 persons participated in the study. The average number of years lived in the community was 22.08 (SD=10.61) and ranged from 10 to 66. Only 13.00% of the participant didn’t see the water system as challenging while 81.5% finds it to be severely problematic. Utilization of water averaged far less than the 50L/person/day and the situation worsened as the household size increased. Close to half (49.6%) of participants did not participate at any stage in the development of the water system. According to the participants, water systems breaks down averagely 3 times in a year and last for about 67 days before being repaired. Water committee members reported difficulties in accessing spare parts and inadequacy in their training.Conclusion:Frequent breakdown of the water schemes compounded by the unavailability of spare parts and hence delays in repairs, and in expansion, user dissatisfaction and unwillingness to pay their bills; inadequacy in training of water committee members, has resulted in poor sustainability of the water system

Efication Of Zinc Supplementation On Differences Of Weight And Height In School Children Post Infected Soil Transmitted Helminth

The prevalence of STH in Indonesia in general is still very high at 60%, especially in the underprivileged population who have a high risk of contracting this disease. STH infection showed an association with zinc concentration. Factors inuencing child growth differ between populations and may depend on prevalences of STH species and zinc deciency. This study was a randomized, non-disguise clinical trial conducted to assess zinc effectiveness on differences of weight and height of children after infection with the Soil Transmitted Helminth (STH) in February-May 2017. All data is recorded in the status of the study, collected and then processed using SPSS 16.0 for Windows computer software. Of the 200 students, 70 met the inclusion criteria and 39 students were willing to measure their weight and height. Based on research using paired T test found signicant differences in mean body weight and height at the beginning and end of the study in each group of zinc supplementation and without zinc supplementation. Based on this study there were signicant differences in mean weight and height at the beginning and end of the study in each group of zinc supplementation and without zinc supplementation.

Epidemiological Characteristics of Strongyloidiasis in Inhabitants of Indigenous Communities in Borneo Island, Malaysia

Epidemiological study on strongyloidiasis in humans is currently lacking in Malaysia. Thus, a cross-sectional study was carried out to determine the prevalence of Strongyloides stercoralis infection among the inhabitants of longhouse indigenous communities in Sarawak. A single stool and blood sample were collected from each participant and subjected to microscopy, serological and molecular techniques. Five species of intestinal parasites were identified by stool microscopy. None of the stool samples were positive for S. stercoralis. However, 11% of 236 serum samples were seropositive for strongyloidiasis. Further confirmation using molecular technique on stool samples of the seropositive individuals successfully amplified 5 samples, suggesting current active infections. The prevalence was significantly higher in adult males and tended to increase with age. S. stercoralis should no longer be neglected in any intestinal parasitic survey. Combination of more than 1 diagnostic technique is necessary to increase the likelihood of estimating the ‘true’ prevalence of S. stercoralis.

Epidemiological Characteristics of Strongyloidiasis in Inhabitants of Indigenous Communities in Borneo Island, Malaysia

Epidemiological study on strongyloidiasis in humans is currently lacking in Malaysia. Thus, a cross-sectional study was carried out to determine the prevalence of Strongyloides stercoralis infection among the inhabitants of longhouse indigenous communities in Sarawak. A single stool and blood sample were collected from each participant and subjected to microscopy, serological and molecular techniques. Five species of intestinal parasites were identified by stool microscopy. None of the stool samples were positive for S. stercoralis. However, 11% of 236 serum samples were seropositive for strongyloidiasis. Further confirmation using molecular technique on stool samples of the seropositive individuals successfully amplified 5 samples, suggesting current active infections. The prevalence was significantly higher in adult males and tended to increase with age. S. stercoralis should no longer be neglected in any intestinal parasitic survey. Combination of more than 1 diagnostic technique is necessary to increase the likelihood of estimating the ‘true’ prevalence of S. stercoralis.

Prevalence of Schistosomes and Soil-Transmitted Helminths among Schoolchildren in Lake Victoria Basin, Tanzania

The objectives of this study was to conduct a survey on schistosomiasis and soil-transmitted helminth (STH) infections in order to come up with feasible control strategies in Lake Victoria basin, Tanzania. Depending on the size of the school, 150-200 schoolchildren were recruited for the study. Duplicate Kato-Katz stool smears were prepared from each child and microscopically examined for Schistosoma mansoni and STHs. Urine specimens were examined for Schistosoma haematobium eggs using the filtration technique. After the survey, mass drug administration was done using praziquantel and albendazole for schistosomiasis and STHs infections, respectively. A total of 5,952 schoolchildren from 36 schools were recruited for the study and had their stool and urine specimens examined. Out of 5,952 schoolchildren, 898 (15.1%) were positive for S. mansoni, 754 (12.6%) for hookworms, 188 (3.2%) for Ascaris lumblicoides, and 5 (0.008%) for Trichuris trichiura. Out of 5,826 schoolchildren who provided urine samples, 519 (8.9%) were positive for S. haematobium eggs. The results revealed that intestinal schistosomiasis, urogenital schistosomiasis, and STH infections are highly prevalent throughought the lake basin. The high prevalence of intestinal and urogenital schistosomisiasis in the study area was a function of the distance from Lake Victoria, the former being more prevalent at localities close to the lake, whilst the latter is more so away from it. Control of schistosomiasis and STHs in the study area requires an integrated strategy that involves provision of health education to communities, regular treatments, and provision of adequate safe water supply and sanitation facilities.

Prevalence of Schistosomes and Soil-Transmitted Helminths and Morbidity Associated with Schistosomiasis among Adult Population in Lake Victoria Basin, Tanzania

The objective of this study was to carry out a community survey on schistosomiais and soil-transmitted helminth (STH) infections in order to suggest feasible and effective intervention strategies in Lake Victoria basin, Tanzania. A total of 37 communities selected from 23 districts of the 4 regions in the Lake Victoria basin of Tanzania were involved in the study. From each of the selected locality, 50 adult community members, 25 males and 25 females, were recruited for the study. Each study participant was requested to submit stool and urine specimens. From each stool specimen, duplicate Kato-Katz thick smears were prepared and microscopically examined for Schistosoma mansoni and STH eggs. Urine specimens were processed by the filtration technique and microscopically examined for Schistosoma haematobium eggs. Ultrasound examination for morbidity due to schistosomiasis was performed. Mass treatment was done using praziquantel and albendazole for schistosome and STHs infections, respectively. Out of 1,606 adults who provided stool specimens, 199 (12.4%) were positive for S. mansoni, 349 (21.7%) for hookworms, 133 (8.3%) for Ascaris lumbricoides, and 33 (2.0%) for Trichuris trichiura. Out of 1,400 participants who provided urine specimens, 25 (1.8%) were positive for S. haematobium eggs. Because of the co-endemicity of these afflictions and their impact on vulnerable population groups, the helminthiasis could be simultaneously treated with 2 drugs, praziquantel for schistosomiasis and albendazole for STHs.

Frecuencia de parásitos intestinales y evaluación de métodos para su diagnóstico en una comunidad marginal de Medellín, Colombia / Frequency of intestinal parasites and evaluation of methods for their diagnosis in a marginal community of Medellin, Colombia

Introducción: las parasitosis intestinales siguen siendo un problema de salud pública, que ha sido poco estudiado en Medellín, Colombia. Objetivo: determinar la frecuencia de parasitismo intestinal en habitantes de una comunidad marginal de Medellín y evaluar la validez, el desempeño, la eficiencia y la confiabilidad del examen directo en su diagnóstico. Materiales y métodos: estudio transversal y de evaluación de pruebas diagnósticas con fuente de información primaria. Se calcularon las proporciones con su intervalo de confianza y se hicieron pruebas de estadística no paramétrica y análisis de sensibilidad, especificidad, valores predictivos, razón de verosimilitud negativa y kappa. Resultados: la frecuencia global de parásitos, según el examen por concentración, fue 74,4%; la evaluación se hizo para parasitismo general y para las categorías protozoos, helmintos, comensales y patógenos; se hallaron sensibilidad superior al 68%, especificidad y valor predictivo positivo del 100%, valor predictivo negativo mayor de 74%, razón de verosimilitud negativa menor de 0,32, kappa superior a 0,77 y eficiencia superior al 90%. Conclusión: el problema del parasitismo intestinal amerita una pronta intervención por parte de las autoridades sanitarias dado que su frecuencia sigue siendo tan elevada como hace tres décadas y las pruebas disponibles para estudiarlo, incluyendo el examen directo de la materia fecal, tienen alto valor diagnóstico.

Background: Intestinal parasitism is still a public health problem. It has not been thoroughly studied in Medellin, Colombia. Objective: To determine the prevalence of intestinal parasites in residents of a marginal community in Medellin and to evaluate the validity, efficiency and reliability of direct examination in its diagnosis. Methods:Cross-sectional study and evaluation of diagnostic tests. Data were collected from a primary information source. Proportions with their confidence intervals were calculated; non-parametric statistical tests and analysis of sensitivity, specificity, predictive values, negative likelihood ratio and kappa were done. Results: Prevalence of parasites, according to the results of the concentration test, was 74.4%. Evaluation was done for intestinal parasites in general and for the following categories: protozoa, helminthes, commensals and pathogens. Sensitivity war over 68%, specificity and positive predictive value were 100%, negative predictive value was over 74%, negative likelihood ratio was less than 0.32, kappa was greater than 0.77 and efficiency was over 90%. Conclusion: Prevalence of intestinal parasitism is as high as it was three decades ago; its solution needs prompt and effective intervention of health authorities. The tests available for its study, including direct examination of stools, are of high diagnostic value.