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SUMMARY OBJECTIVE: The objective of this study was to investigate serum Metrnl levels in pregnant women with gestational diabetes mellitus and compare them with pregnant women without gestational diabetes mellitus. METHODS: The gestational diabetes mellitus group consisted of 87 pregnant women diagnosed with gestational diabetes mellitus, and the control group consisted of 93 healthy pregnant women without gestational diabetes mellitus. Serum Metrnl levels were determined by the enzyme-linked immunosorbent assay method. RESULTS: The two groups were similar in terms of demographic features. The median serum Metrnl level was found to be 1.16 ng/mL in the gestational diabetes mellitus group, while it was determined as 2.2 ng/mL in the control group (p=0.001). The two groups were divided into two subgroups based on participants' body mass index, normal weight and overweight. The lowest median Metrnl level was detected in the normal weight gestational diabetes mellitus group, followed by the overweight gestational diabetes mellitus group, normal weight control group, and overweight control group (1.1, 1.2, 2, and 2.4 ng/mL, respectively). Receiver operating curve analysis was performed to determine the value of the serum Metrnl level in terms of predicting gestational diabetes mellitus. The area under the curve analysis of serum Metrnl for gestational diabetes mellitus estimation was 0.768 (p=0.000, 95%CI 0.698-0.839). The optimal cutoff value for serum Metrnl level was determined as 1.53 ng/mL with 69% sensitivity and 70% specificity. CONCLUSION: Serum Metrnl levels in pregnant women with gestational diabetes mellitus were found to be significantly lower than in pregnant women without gestational diabetes mellitus. The mechanisms underlying the decrease in serum Metrnl levels in gestational diabetes mellitus remain unclear for now, and future studies will reveal the role of Metrnl in the pathophysiology of gestational diabetes mellitus.
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In recent years, Glucagon-Like Peptide-1 (GLP-1) receptor agonists have emerged as promising options for weight management, offering not only glycemic control benefits but also significant reductions in body weight. Among these agents, Wegovy (semaglutide) and Ozempic (semaglutide) have gained attention for their efficacy in promoting weight loss, even in individuals without diabetes. However, the off-label use of these medications for weight management raises several questions and concerns regarding their safety, efficacy, and long-term effects. This comprehensive review aims to explore the complexities of GLP-1 agonists in weight management, focusing on their mechanism of action, clinical evidence, safety profile, dosing considerations, potential interactions, and future directions.
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Anthelmintic drugs are used to treat parasitic infections and acknowledge the challenge in developing effective anthelmintics due to the significant homology between parasites and their hosts. Despite the existence of various anthelmintic drugs in the market, the emergence of drug resistance necessitates the continuous development of new and more efficient drugs to combat parasitic infections. The development of anthelmintic drugs involves a multi-faceted process that aims to create effective treatments against parasitic infections. Pyrimidines have been investigated for their potential anthelmintic activity. Therefore, the present study involves the synthesis of derivatives based on pyrimidine. The series of 4-amino-2-hydroxy-6-substituted phenyl pyrimidine-5-carbonitrile was synthesized by treating substituted benzaldehyde with malononitrile and urea. The synthesized compounds were subsequently screened for their anthelmintic efficacy. The chemical structures were confirmed by infrared (IR) and proton nuclear magnetic resonance (1H-NMR) spectroscopy. The anthelmintic activity was performed on the adult Indian earthworm Pheretima posthuma. In-vitro anthelmintic studies revealed that, among all the screened compounds, compound 1f demonstrated significant or appreciable anthelmintic properties. Molecular docking was conducted on quinol-fumarate reductase to elucidate potential interactions between the newly synthesized pyrimidine derivatives and the specific cavity of the quinol-fumarate reductase enzyme. This analysis aimed to gain insights into the binding interactions and the possible mechanism of action of the synthesized compounds.
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Oral pulsatile drug delivery systems (PDDS) are intended to induce programmable lag phases before a quick and quantifiable, repeated, or prolonged medication release. As a result, they are gaining popularity due to their inherent suitability for achieving chronotherapeutic goals, which have just been highlighted concerning several prevalent chronic illnesses characterized by typical night or early-morning recurring symptoms (e. g. bronchial asthma, heart attack, rheumatoid arthritis, early-morningawakening). Furthermore, time-based colonic release is possible when pulsatile delivery devices are correctly modified to overcome unexpected gastric emptying and give delay periods that roughly match the small intestine transit time. Oral pulsatile administration is accomplished using several release platforms, including reservoir, capsular, and osmotic devices. The current review article addressed the topics that followed: the reason pulsatile drug delivery systems have been invented; diseases for which pulsatile release is necessary; classification, advantages and disadvantages; methods used in the current systems; the situation nowadays and its potential for the future; recent advancements, and especially, the previous five to ten years of research on pulsatile drug delivery conducted by researchers using a variety of drugs for a variety of diseases.
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Abstract Objectives: to analyze neonatal deaths according to avoidability and to analyze the temporal trend of neonatal mortality rate (NMR) in Niterói/RJ, 2012-2022. Methods: ecological time series study. Data from Sistema de Informação sobre Nascidos Vivos and Sistema de Informação sobre Mortalidade. NMRs were calculated according to maternal and neonatal variables and trends were estimated using the joinpoint regression. Results: the annual number of live births (LB) fell, with a decreasing trend among adolescents and those with low education level. Of the 324 deaths, most occurred early (0-6 days), by preventable causes in 68.6%, predominating those reducible by adequate care during pregnancy. The overall NMR remained stable, ranging from 4.2 to 6/1,000 LB, being higher at the extremes of maternal age (12.7 and 8.6/1,000 LB in 2022, adolescents and over 35 years old, respectively), in low education level mothers (27.6/1,000 LB in 2022), in neonates <1,500g and <32 weeks (293.1 and 250/1,000 LB in 2022, respectively). NMR trend was upward in low schooling women, white-colored, adolescents and those ≥35 years, in babies weighing <1,500g and >2,500g, and for avoidable causes. Conclusions: the high proportion of preventable causes reveals the reduction potential. There was inequality in NMR and its trend, demanding more equitable health actions.
Resumo Objetivos: analisar os óbitos neonatais segundo evitabilidade e a tendência temporal da taxa de mortalidade neonatal (TMN) em Niterói/RJ, de 2012-2022. Métodos: estudo ecológico de série temporal. Dados provenientes do Sistema de Informações sobre Nascidos Vivos e Sistema de Informação sobre Mortalidade. As TMN foram calculadas segundo variáveis maternas e neonatais e as tendências estimadas pela regressão joinpoint. Resultados: o número anual de nascidos vivos (NV) diminuiu, com tendência decrescente entre mães adolescentes e de baixa escolaridade. Dos 324 óbitos, a maioria ocorreu precocemente, por causas evitáveis (68,6%), predominando aquelas reduzíveis por adequada atenção à gestação. A TMN global mostrou estabilidade, entre 4,2 e 6,0/1000NV, mais elevada nos extremos etários maternos (12,7 e 8,6/1.000 NV em 2022, adolescentes e maiores de 35 anos, respectivamente), nas mães com baixa escolaridade (27,6/1.000 NV em 2022), nos neonatos <1.500g e <32 semanas (293,1 e 250/1.000 NV em 2022, respectivamente). A tendência da TMN foi crescente entre mulheres de baixa escolaridade, brancas, adolescentes e ≥35 anos, nas faixas de peso <1.500g e >2.500g, e por causas evitáveis. Conclusões: a elevada proporção de causas evitáveis revela o potencial de redução. Houve desigualdade da TMN e sua tendência, demandando ações de saúde mais equânimes.
Sujet(s)
Humains , Femelle , Grossesse , Nouveau-né , Grossesse de l'adolescente , Mortalité infantile , Études de Séries Temporelles , Cause de décès , Niveau d'instruction , Études Écologiques , Naissance vivante/épidémiologie , Brésil , Disparités de l'état de santé , Systèmes d'information sur la santé , Facteurs sociodémographiquesRÉSUMÉ
This study examined the role of Kabat Rehabilitation and laser therapy in Bell's palsy patient, and its effectiveness in physical and social function. Individuals with Bell's palsy, which produces the facial mimicry, it’s crucial for rehabilitation of facial muscle paralysis. PNF enforces and encourages the muscular action on the weaker side of the face, it enables patients with Bell's palsy perform better physically and socially. Therefore, the effectiveness of Kabat therapy in conjunction with Laser was proven in this investigation. The study was conducted at the outpatient department (OPD), Neuro Physiotherapy, Dr. APJ AK COPT. Patient received the Kabat rehabilitation therapy, as well as laser therapy. In this study, results were found significant in HBS and FDI scale comparing pre and post scores by progressing from moderate to normal on grading and progression of 30% on FDI scale. Hence, we conclude that this intervention could be an adjunct intervention in rehabilitation of Bell’s palsy. Physiotherapy Program including Laser therapy and Kabat rehabilitation for 3 weeks had shown significant on the treatment of Bell’s palsy. Hence, it has proven that it could be used as an adjunct intervention on patient with Bell’s palsy.
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In-silico molecular docking studies and QSAR study of benzoxazole derivatives synthesized by Kakkar et al. was done. Comparative studies of docking of 5-flurouracil and 20 compounds revealed presence of considerable interactions which indicates the affinity of newly synthesized compounds for thymidylate synthase. The statistically significant 2D-QSAR models were developed using molecular design suite (VLifeMDS 4.6). The study was performed with 20 compounds (data set) using sphere exclusion (SE) algorithm, random selection and manual selection methods used for the division of the data set into training and test set. Multiple linear regression [MLR] methodology with stepwise (SW) forward-backward variable selection method was used for building the QSAR models. The results of the 2D-QSAR models were further compared with 3D-QSAR models generated by kNN-MFA, (k-Nearest Neighbor Molecular Field Analysis) investigating the substitutional requirements for the favourable anticancer activity against HCT 116 cell line and providing useful information in the characterization and differentiation of their binding sites. The results derived may be useful for further designing of benzoxazole derivatives as anticancer agents prior to synthesis.
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This comprehensive review focuses on the role of bio-regulators in the growth and development of fruit and vegetable crops. Bio-regulators, also known as plant growth regulators or plant hormones, play a crucial role in regulating various physiological processes in plants, including cell division, elongation, differentiation, and fruit ripening. The review explores the major types of bio-regulators commonly used in fruit and vegetable cultivation, including auxins, gibberellins, cytokinins, abscisic acid, and ethylene. It examines their functions and effects on plant growth, flowering, fruit set, fruit development, and post-harvest characteristics. The review also discusses the widespread application of bio-regulators in horticultural practices, including seed treatment, foliar application, and post-harvest treatments. It highlights the potential benefits of using bio-regulators, such as improving crop yield, enhancing fruit quality traits, delaying senescence, and reducing post-harvest losses. Moreover, the review delves into the mechanisms of action of bio-regulators at the molecular, physiological, and biochemical levels. It investigates their interactions with various plant growth processes, signaling pathways, and gene expression patterns. Furthermore, the review addresses the challenges and limitations associated with the use of bio-regulators in fruit and vegetable production, such as dosage optimization, application timing, and potential negative impacts on the environment.
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Genetic diversity was assessed for 2 popular varieties and 5 promising lines of rabi sorghum by using11 SSR markers. The marker Xiabt312 reported 100% polymorphism rate followed by Xtxp15 (85.70%) and mSbCIR300 (85.71%). The sorghum varieties studied for this analysis showed the polymorphism information content (PIC) ranged from 0.25 to 0.87 with a mean of 0.67 indicates higher diversity within them. Clustering analysis based on the genetic dissimilarity grouped the 7 lines into 2 major and 4 sub clusters and grouping was in good agreement with pedigree. Cluster II was the largest cluster with 4 genotypes followed by cluster I with 3 genotypes. The rabi sorghum genotypes viz., M35-1, RSV-1876 and RSLG-2422 were placed in cluster I and Phule Anuradha, RSV-2371, RSV-1910 and RSV-1988 placed in cluster II. Clustering based on SSR molecular profile of the genotypes shows that there is a distinct variability among the genotypes under this study. The selected markers have great potential in DNA fingerprinting in sorghum which in future could be integrated with DUS data descriptors for effective cultivar identification and differentiation.
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A field experiment was carried out in 2020-21 at Instructional Farm, Department of Vegetable Science, Dr. PDKV, Akola with the objective to find out superior genotype of cluster bean for its quality parameters and cost of production i.e., gum content (%), protein content (%), test weight (g) and economics respectively. The experiment was laid out in Randomized Block Design (RBD) with three replications and twelve treatments as genotypes. With respect to quality parameters, genotype IC-329639(T4) recorded maximum gum content (32.86 %), while maximum protein content (38.33 %) was found in genotype IC-298638(T8) and maximum (3.98 g) test weight in the genotype IC-421837(T7). Consequently, with regards to economics, highest gross returns (Rs 174000 ha-1), net returns (Rs 129137.7 ha-1) and B:C ratio (3.87) was recorded in the genotype IC-329639(T4).
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Male infertility implies a man can't begin a pregnancy with his female accomplice. Male infertility can have many causes. You may not make sufficient sperm or sound sperm. You might have a hereditary issue like cystic fibrosis. You might have a blockage in your genital plot. According to the latest WHO statistics, approximately 50– 80 million people worldwide suffer from infertility, and male factors are responsible for approximately 20– 30% of all infertility cases. The diagnosis of infertility in men is mainly based on semen analysis. the incidence of male infertility has increased worldwide. Infertility is characterized as the failure of couples to have a child following one year of customary unprotected intercourse, influencing 10 to 15% of couples. It is necessary to study the factors that influence male infertility in each area/region for better management. This paper represents various factors based on behavioral and non-behavioral conditions prompting for male infertility augmentation rapidly.
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Background and Objectives: Pathology is a broad subject consisting of various branches, such as hematology, clinical pathology, biochemistry, histopathology, cytology, blood banking, and others. All the subspecialties are difficult to cover in depth in a 3-year MD Pathology course and curriculum. Hence, it was decided to investigate whether the MD Pathology curriculum is able to meet the challenges of today's laboratory medicine practice. So, a survey was conducted among newly qualified pathologists who have passed their exam within last 5 years. Purpose was to know their views about MD Pathology curriculum with special emphasis on challenges they face during their day-to-day practice. Materials and Methods: Study is designed as cross-sectional survey conducted via web-based Google forms questionnaire. Study population is pathologists qualified within last 5 years. A convenience sample of eligible pathologists was taken by sending a web-based Google form to various pathology groups on social media apps. Data were collected in the Google spreadsheet software and various responses were summarized as percentages, graphs, and pie-charts as necessary. Chi square test was used to find the significance of difference in responses from government, private, and deemed university respondents. Results: Different numbers of responses were received to different survey questions. Out of 187 respondents, 65 (34.8%) worked in a hospital-based laboratory, 61 (32.6%) did jobs in a private laboratory, 49 (26.2%) worked in a medical college, and 37 (19.8%) worked in their own private laboratories. Out of 193 respondents, 158 (81.9%) were working in hematology, 149 (77.2%) in clinical pathology, 139 (72%) in cytopathology, 118 (61.7%) in histopathology, whereas 103 (53.4%) worked in clinical biochemistry, and least number of respondents, i.e., 38 (19.7%) were working in blood bank. Almost all the respondents had overlapping work in hematology and other areas. The level of confidence rated by the respondents was best in hematology, followed by clinical pathology; it was least for clinical biochemistry and blood bank. Out of 192 respondents, 64.1% (123) felt that the curriculum does not equip them for lab management and administration, 21.9% (42) felt that the curriculum somewhat equipped them; whereas only 14.1% (27) felt that curriculum equips them for this task. There were 191 responses to the question regarding satisfaction with MD Pathology curriculum; out of which, 51.8% (99) were not satisfied, 24.6% (47) said they may be satisfied, whereas 23.6% (45) were satisfied with the curriculum. There was no significant difference in responses from government, private, and deemed university respondents. Conclusions: The graduating MD Pathology students expressed confidence in reporting routine cases of hematology, clinical pathology, routine cytology, and histopathology. However, there is difficulty in clinical biochemistry, blood banking, and reporting of malignancies. The laboratory management and administration, communication skills, and quality assurance are also other areas of weakness. MD Pathology program needs more focus on these weaknesses, so that newly qualified graduate would feel confident in day-to-day laboratory working.
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Duchenne muscular dystrophy is one of the most common dystrophinopathies known. It is the most common hereditary neuromuscular disorder and is inherited in an X-linked recessive manner. Incidence is 1:3500 live male infants, characterised by progressive weakness of a selective group of muscles without involvement of nervous system. Age of onset being 3-10 years, many children unable to walk before 18 months of age. The patient usually dies by 18-20 years of age. 80% carries have high CPK values with female being the one. Dystrophin gene is the largest human gene with 79 exons, codes for protein dystrophin required for stabilisation of protein complex at sarcolemma, the abnormal DMD gene is on X chromosome at Xp21 locus. Dystrophin deficiency thus, leads to destruction of muscle fibres and progressive muscular weakness. Corticosteroids are the only medications that have shown to alter the course of DMD but have side effects like weight gain, decreased appetite, increase changes of cataract and osteoporosis. The present study is about management 8 years old male child with B/L lower limb weakness and calf muscle hypertrophy.etc, so according to Ayurvedic management with Panchkarma procedures and internal medicines given the case was managed. Successful improvement in CPK values along with the signs and symptoms was observed. As per Ayurvedic Siddhant and Samprapti application considering Adibalapravrittavyadhi and the Beejabhaga avayava dushti the management done. There is no treatment in any system of medicine and prognosis being unpreventable, Ayurveda instills a regenerative mechanism in neuromuscular disorders with special concern of Panchkarma, Rasayanas, Rasa aushadhi, etc. By this the deterioration can effectively be prolonged and quality of life improved.
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Background: Every teaching technique has its limitations and the need to evolve with changing times is required. A combination of these techniques may be useful to solve the problems that these methods have individually. However, there are no studies which provide a comparison between the three modes of teaching, that is, blackboard and Power Point presentation (PPT) combined, blackboard only and PPT only. Aim and Objectives: In this study, we aim to find out the difference between the three modes of teaching, that is, blackboard and presentation combined, blackboard only and presentation only in terms of academic performances of the students in the subject of pharmacology and the feedback received from them. Materials and Methods: The total batch of 150 students was divided into three groups of 50 students each. Each group was taught one topic through only one mode of teaching such that alternatively every group is exposed at least once to every mode of teaching. Pre-test was taken from all students before the start of the topic and post-test was taken after the end of the topic. Every group also filled a pre-validated feedback form with answers in either yes or no, at the end of the topic. The data were analyzed between the three groups in the form of percentages. One-way ANOVA test was used to find the comparison between mean values of marks scored in the tests and feedback between the three groups. Results: Blackboard and PPT combined (96.05%) received the highest positive feedback response followed by blackboard only (90.48%) and PPT only (87.42%) modes. The average scores in all the post-tests in all groups were higher than the pre-tests score;, however, the difference between them was not significant. Conclusion: In this study, we conclude that the combination of blackboard and presentation technique is the best mode of teaching to the students in the subject of pharmacology because it provides the interaction of classroom as well as the visual aid of important topics and images.
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Background: One of the most prevalent chronic liver ailments is non-alcoholic fatty liver disease (NAFLD). The correction of numerous genes connected to various metabolic diseases depends heavily on Vitamin D. Aims and Objectives: This investigation was intended to look at the relationships among those with NAFLD serum levels of Vitamin D, parathyroid hormone (PTH), insulin, and insulin resistance (IR). Materials and Methods: Two hundred and fifty patients with NAFLD and 250 age-matched participants without NAFLD served as the study’s control group. Serum Vitamin D, PTH, insulin, and fasting blood glucose (FBG) levels were measured after 8–12 h of not eating or drinking. By controlling for the independent factors, the multivariate logistic regression analysis model was utilized to assess the relationship between Vitamin D, PTH, and IR in the occurrence of NAFLD. Results: When compared to controls, patients with NAFLD had significantly lower serum Vitamin D levels and higher levels of PTH, insulin, and FBG (P = 0.001). Confounders had no impact on the association between NAFLD and the lower Vitamin D readings. Conclusions: Our findings demonstrated that raised insulin and IR values and lower serum Vitamin D concentrations were each independently related with an increased risk of having NAFLD.
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Background: The prevalence of chronic renal failure has increased, as has the need for renal replacement therapy, as both diabetes and hypertension have become more prevalent. Patients’ mortality rates from cardiac causes have increased despite effective monitoring and care. Dyslipidemia significantly contributes to the risk of arteriosclerotic cardiovascular disease, the main cause of death in people with chronic kidney disease (CKD). Aims and Objectives: The objectives of this study were to measurement of hyperlipidemia in patients with CKD on hemodialysis/conservative management. Materials and Methods: The investigation was conducted on 250 patients with CKD at all stages who were receiving hemodialysis and conservative of both sexes aged 20 years or more and sex-matched healthy control subjects. Lipid profiles of each subject were measured in specimens. Results: In our study, dyslipidemia was identified as having high levels of total cholesterol, triglycerides, and low-density lipoprotein and low levels of high-density lipoprotein. Conclusion: The significance of dyslipidemia as a standalone risk factor for coronary artery disease (CAD) in CKD patients was examined in this study. Hence, based on the evidence presented above, we conclude that close monitoring of the ideal cholesterol levels in CKD patients is necessary to reduce the risk of CAD-related death. In CKD patients, monitoring and treating dyslipidemia can reduce mortality.
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Background: Yoga is a practice which amalgamates the emotional, mental, physical and spiritual aspects of the human body through physical postures(asanas), breathing exercises (pranayama), concentration and meditation (dharana and dhyana). Evaluation of databases suggests a positive role of yoga in pregnancies associated with depression, anxiety and lumbosacral pain and also in reducing antepartum complications and pain score during labor. These beneficial effects of yoga are suggested but more systematic researches are required to validate it. With the background of above researches, we undertook the study to evaluate the effect of prenatal yoga and meditation on maternal and fetal outcomes. Aim of the study was to determine the effect of antenatal meditation and yoga on obstetric and fetal outcome.Methods: This was a prospective randomized trial conducted in the antenatal OPD of the institute. Sixty primigravida women with low risk pregnancy between 18 to 26 weeks gestation were included in the trial.They were randomly divided into two equal groups; interventional group underwent meditation and yoga sessions of 30 minutes twice in a week till delivery. Obstetric outcomes including gestational age, antepartum and intrapartum complications, cord blood cortisol levels at delivery and neonatal outcomes were recorded.Results: Thirteen women went post-dated as compared to 3 in the interventional group which was statistically significant (p=0.0003). APGAR scores of neonates in the interventional group showed a highly significant improvement with p=0.0013 as compared to the control group. Cord blood cortisol levels were higher than 10 ng/ml in 16 women in the control group compared to 7 in the group who performed yoga and meditation with p=0.01. NICU admissions were significantly more (p=0.002) in the control group.Conclusions: Meditation and yoga during pregnancy improves maternal and neonatal outcomes.
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Background: Adolescence in girls has been recognized as a special period that signifies the transition from girlhood to womanhood. Good hygienic practices such as the use of sanitary pads and adequate washing of the genital area are essential during menstruation. Hygiene-related practices of women during menstruation are of considerable importance, as it has a health impact in terms of increased vulnerability to reproductive tract infections. Methods: Cross-sectional, descriptive, and comparative study was carried out in randomly selected Private, Government, and Tribal schools of the Amravati district. Results: A total of 450 adolescent girls from Government, Private, and Tribal schools participated in the study. The mean age at menarche of government, private, and Tribal school girls were 12.98 years ± 0.79 years, 12.55 years ± 0.81 years, and 13.07 years ± 1.23 years respectively. The menstrual cycle was regular in the majority of girls from government, private, and tribal schools girls. Menstrual flow lasted for 2 days-7 days in 86% and 82.7% of government and private school girls respectively while the flow was less than 2 days in 78.7% of trial school girls. Adolescent girls from government, private and tribal schools (92.7%, 98%, and 55.3% respectively) used sanitary pads during menstruation. Conclusions: Menstrual cycle was regular in the majority of girls from government, private, and tribal schools girls. Nearly all girls from government and private schools knew about menstruation before menarche and the source of information were mothers or sisters and radio and television. Almost all girls from the government, the private school used sanitary pads during menstruation but girls from tribal schools used reusable clothes mainly.
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Resumo Objetivou-se investigar a magnitude e a tendência da mortalidade de crianças de 5 a 14 anos por causas, no estado do Rio de Janeiro, de 2000 a 2019. Estudo ecológico de tendência temporal utilizando dados do Sistema de Informações sobre Mortalidade (SIM). Calcularam-se taxas de mortalidade por 100 mil crianças, por capítulos, grupos e categorias (CID-10). Estimou-se a série temporal por regressão joinpoint. As taxas de mortalidade de 10 a 14 anos foram superiores às da faixa de 5 a 9 anos. As cinco principais causas foram as mesmas de 5 a 14 anos, com diferente ordem de importância. As duas principais foram causas externas e neoplasias (31% e 15% para 5 a 9 anos; 45% e 11% para 10 a 14 anos). De 5 a 9 anos, a tendência da mortalidade teve declínio anual (8%) entre 2011 e 2015. De 10 a 14 anos, o declínio anual foi 1,3%, de 2000 a 2019. A mortalidade por causas externas decresceu em ambas as faixas, menos para a categoria "Agressão por arma de fogo" (meninos,10-14 anos) e "Afogamento" (meninos, 5-9 anos). A mortalidade por neoplasias ficou estável para todos. Doenças infecciosas e respiratórias decresceram de forma diferenciada entre os grupos. A maioria das causas de morte é evitável ou tratável, apontando necessidade de investimentos em saúde e intersetoriais.
Abstract This study investigated the magnitude and trends of cause-specific mortality among children 5 to 14 years of age in the state of Rio de Janeiro (RJ) from 2000 to 2019. We performed an ecological study, using data from the Mortality Information System (MIS). We calculated mortality rates per 100,000 children by chapters, groups, and categories of causes of death (ICD-10). Trends were estimated by joinpoint regression. Mortality rates among children aged 10 to 14 years were higher than those among children 5 to 9. The five leading causes of death were the same in both age groups, but they ranked differently. The two leading ones were external causes and neoplasms (31% and 15% among children aged 5 to 9 years; 45% and 11% among children aged 10 to 14 years). Among children 5 to 9 years, the mortality trend showed an annual decline (8%) from 2011 to 2015. Among children aged 10 to 14 years, the annual decline was 1.3% from 2000 to 2019. Mortality due to external causes decreased in both age groups, except for the category "Assault by unspecified firearm" (boys, 10 to 14 years) and "Unspecified drowning and submersion" (boys, 5 to 9 years). Mortality caused by neoplasms remained steady in both age groups. Infectious and respiratory diseases decreased differently between the two groups. Most causes of death are preventable or treatable, indicating the need for health and intersectoral investments.
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Hemoglobin and glycosylated hemoglobin (HbA1C) are frequently monitored health indicators in population based studies for information about the status of nutrition and diabetes control. We present here possibly for the first time the findings of simultaneous estimation of Hemoglobin and HbA1C on Dried blood spot (DBS) samples by a single test. Validation was done by turbidimetric inhibition immunoassay (TINIA) using Roche Integra 400 plus instrument. Paired whole blood and DBS samples were tested for HbA1C estimation by Integra 400 plus. Total hemoglobin values obtained during HbA1C estimation were compared with hemoglobin values estimated by Coulter AcT 5 Diff CP Hematology counter. Agreement in HbA1C and hemoglobin values between paired whole blood and DBS samples was found to be high with R2 values of 0.994 and 0.9349, respectively. Intra- and inter- assay precision was found to be within 10% for both parameters. Values obtained after assaying DBS samples prepared by spotting proficiency samples on Whatman 903 protein saver cards demonstrated acceptable standard deviation indices resulting in successful participation in EQAS programs for both these parameters. The results reveal the potential of TINIA for simultaneous estimation of hemoglobin and HbA1C from a single punch of the DBS samples.