Noncommunicable Disease Risk Factors Among Adolescent Boys and Girls in Bangladesh: Evidence From a National Survey

Objectives@#To assess the prevalence of noncommunicable disease (NCD) risk factors and the factors associated with the coexistence of multiple risk factors (≥ 2 risk factors) among adolescent boys and girls in Bangladesh. @*Methods@#Data on selected NCD risk factors collected from face to face interviews of 4,907 boys and 4,865 girls in the national Nutrition Surveillance round 2018-2019, was used. Descriptive analysis and multivariable logistic regression were performed. @*Results@#The prevalence of insufficient fruit and vegetable intake, inadequate physical activity, tobacco use, and being overweight/obese was 90.72%, 29.03%, 4.57%, and 6.04%, respectively among boys; and 94.32%, 50.33%, 0.43%, and 8.03%, respectively among girls. Multiple risk factors were present among 34.87% of boys and 51.74% of girls. Younger age (p < 0.001), non-slum urban (p < 0.001) and slum residence (p < 0.001), higher paternal education (p = 0.001), and depression (p < 0.001) were associated with the coexistence of multiple risk factors in both boys and girls. Additionally, higher maternal education (p < 0.001) and richest wealth quintile (p = 0.023) were associated with the coexistence of multiple risk factors in girls. @*Conclusion@#The government should integrate specific services into the existing health and non-health programs which are aimed at reducing the burden of NCD risk factors.

Noncommunicable Disease Risk Factors Among Adolescent Boys and Girls in Bangladesh: Evidence From a National Survey

Objectives@#To assess the prevalence of noncommunicable disease (NCD) risk factors and the factors associated with the coexistence of multiple risk factors (≥ 2 risk factors) among adolescent boys and girls in Bangladesh. @*Methods@#Data on selected NCD risk factors collected from face to face interviews of 4,907 boys and 4,865 girls in the national Nutrition Surveillance round 2018-2019, was used. Descriptive analysis and multivariable logistic regression were performed. @*Results@#The prevalence of insufficient fruit and vegetable intake, inadequate physical activity, tobacco use, and being overweight/obese was 90.72%, 29.03%, 4.57%, and 6.04%, respectively among boys; and 94.32%, 50.33%, 0.43%, and 8.03%, respectively among girls. Multiple risk factors were present among 34.87% of boys and 51.74% of girls. Younger age (p < 0.001), non-slum urban (p < 0.001) and slum residence (p < 0.001), higher paternal education (p = 0.001), and depression (p < 0.001) were associated with the coexistence of multiple risk factors in both boys and girls. Additionally, higher maternal education (p < 0.001) and richest wealth quintile (p = 0.023) were associated with the coexistence of multiple risk factors in girls. @*Conclusion@#The government should integrate specific services into the existing health and non-health programs which are aimed at reducing the burden of NCD risk factors.

Cytotoxicity and antimicrobial activity of alkaloids extracted from Catharanthus roseus associated endophytic fungi

Aims@#The aim of this study was to isolate the endophytic fungi from Catharanthus roseus and screen the cytotoxicity and antimicrobial activity of alkaloids extracted from these fungi. @*Methodology and results@#A total of 56 endophytic fungal isolates were screened from C. roseus plant parts. Aspergillus fumigatus and Fusarium oxysporum were the most frequent species. Determinations of alkaloids extracted from the most dominant endophytic fungal species were done. The highest significant total alkaloids productions were by A. fumigatus and Aspergillus niger, while the least significant one was by Botrytis cinera. Antimicrobial assay of endophytic fungal extracts indicated that both A. niger and F. oxysporum exhibited significant antimicrobial activities, while A. fumigatus exerted the least activity. In vitro cytotoxicity assay of the endophytic fungal extracts was done against human breast cancer (MCF-7) and liver cancer (HEPG-2) cell lines using SRB assay method. A. niger extract showed potential cytotoxic effect on MCF-7 cell line with IC50 value of 42.1 μg/mL, while the least cytotoxic effect was exhibited by F. oxysporum on MCF-7 cell line with IC50 value of 66.9 μg/mL. Gas Chromatography Mass Spectroscopy (GC-MS) was used for analysis of alkaloids in mycelial and filtrate extracts of A. niger, where eleven compounds were detected. @*Conclusion, significance and impact of study@#Alkaloids extracted from Catharanthus roseus associated endophytic fungi had cytotoxic and antimicrobial activities.

critical review on risks versus benefits of bariatric surgery

Background: bariatric surgery refers to a series of weight loss procedures that an obese individual can have in order to reduce their food intake, therefore causing them to lose weight. Obese patients lose more weight with bariatric surgery than with medical weight-loss treatment. The laparoscopic Roux-en-Y gastric bypass procedure results in more short-term weight loss than laparoscopic adjustable gastric banding, but the latter has fewer postoperative complications and a lower mortality rate; long-term comparative data are currently lacking. The decision regarding which procedure to perform should be based on individual patient and surgeon factors

Aim and Intervention of the study: to review the history of bariatric surgery in order to compare the different bariatric operations, to list the current indications for these procedures, to evaluate the outcomes, and to consider the risks

Position: a critical review of controlled randomized studies has provided evidence that bariatric surgery produces durable weight loss exceeding 100 lb [46 kg], full and long-term remission of type 2 diabetes in over 80% with salutary effects on the other comorbidities as well with significant reductions in all-cause mortality

Conclusion: bariatric surgery is the therapy of choice for patients with severe obesity

Safety of Cupping Therapy in Studies Conducted in Twenty One Century: A Review of Literature.

Background: Cupping therapy is a well-known traditional treatment modality, and has been used in various diseases around the world since ancient times. This method is reported to have a better clinical as well as adverse events (AEs) profile as found in various studies conducted around the world. Aim: This study identifies, assesses, and classifies the adverse events profile of various types of cupping therapies in studies conducted in twenty one century. Methods: Using electronic and hand searches, three databases including Pub Med, Google Scholar and Cochrane library were searched from the year 2000 to 2016. Studies were included in this review provided they reported adverse effects related to cupping therapy. Observational studies were assessed using the WHO-UMC causality scale. Randomized controlled trials were assessed in accordance to the quality of reporting for harm data. Results: Nine hundred seventy nine (n=979) articles were identified. Based on exclusion and inclusion criteria and extensive review of all retrieved articles by two independent reviewers, only 25 studies that included six RCTs, sixteen single case reports and three case series were finally selected. The mostly observed adverse events of cupping therapy were scar formation reported in four studies that described fifty nine cases, and burns reported in two studies described sixteen cases, respectively. The adverse events of cupping therapy could be classified into local and systemic adverse events. Conclusion: Cupping therapy adverse events were infrequently reported, but they were not rare. Most of adverse effects were mild to moderate in severity. Some of the cupping therapy adverse events were preventable by following the general infection control guidelines, hygienic techniques, safety protocols and rigorous training of cupping therapists. Cupping adverse events should be reported in all studies on cupping, and this therapy should be practiced only by qualified medical professionals.

Knowledge, attitude and practice of patients with type 2 diabetes mellitus towards complementary and alternative medicine / 中西医结合学报

<p><b>OBJECTIVE</b>The use of complementary and alternative medicine (CAM) is relatively common among patients with type 2 diabetes mellitus (T2DM) around the world. Like many other countries, Saudi Arabia has a high incidence of T2DM, and incorporates the use of CAM in its treatment. This study explores the knowledge, attitude and practice (KAP) of CAM therapies among patients with T2DM and explores the relationships between sociodemographics and the KAP of CAM modalities.</p><p><b>METHODS</b>This is a hospital-based, observational, cross-sectional study that selected 302 outpatients with T2DM, from Diabetic Center of King Salman bin Abdul-Aziz Hospital, in Riyadh city, in May 2014. Patients were interviewed using a predesigned questionnaire.</p><p><b>RESULTS</b>The mean age of patients was (51.6 ± 10.6) years and 43.4% of them were males. The prevalence of CAM practices was 30.5%; 30.39% of them used herbs, 20.58% used wet cupping and 17.64% used nutritional supplements and other therapies. The factors found to predict the use of CAM therapies among patients with T2DM were: age above 51 years, unemployment and the participants± knowledge about the effectiveness of CAM products.</p><p><b>CONCLUSION</b>This preliminary study estimated the prevalence of CAM use, revealed positive attitude towards CAM and found three significant predictors of CAM use among patients with T2DM, which is consistent with regional data. A community-based research with a larger sample that targets T2DM population is needed in Saudi Arabia.</p>

Electronic Health Records, Electronic Prescribing and Medication Errors: A Systematic Review of Literature, 2000-2014.

Background: The electronic prescribing system, either standalone or embedded in the electronic health record, is a powerful tool in the hands of healthcare providers, as it reduces half of medication errors caused by handwritten prescribing. Objective: This article synthesizes the international literature on electronic health records (EHRs), e-prescribing (EP) and medication errors (MEs) and provides a platform to World Health Organization Eastern Mediterranean Region (WHO-EMR) countries for implementing EHRs and EP in healthcare system. Methods: Computer searches of PubMed, MEDLINE, Quertle®, Google Scholar, Web Knowledge and International Pharmacy Abstract databases were conducted for the years 2000–2014 using several single- and combined-keyword strategies, with 184 articles retained for evaluation. Results: Although e-prescribing integrated with EHR reduces medication errors at all healthcare levels, decreases morbidity and mortality, enhances patient and healthcare provider satisfaction by reducing costs and improving quality of life, it produces different types of medication errors at various stages of the prescription process. An EHR with EP that has a clinical decision support system (CDSS), dose-limit range, drug–drug interaction alert protocols, and formulary decision support helps to improve EP and ensures greater patient safety and other multiple applications. Conclusion: EHRs with EP systems should be implemented in healthcare systems for the sake of better quality healthcare and patient safety throughout the WHO-EMR countries especially in the Kingdom of Saudi Arabia. Evidently there is limited data in these countries and hence further studies are needed to assess impact of EHRs and EP system (EPSs) on medication errors, quality of healthcare, patient safety and outcome, morbidity and mortality rates, patients’ and healthcare providers’ acceptance, and especially its cost-effectiveness.

Hyperextension of the big toe at metatarsophalangeal joint [MTPJ]: a sign of the undercorrection of cavus in idiopathic clubfoot in Ponseti method

Hyperextension of the big toe is described here as a simple and reliable sign to predict undercorrection of cavus deformity of clubfoot in the Ponseti Method. This retrospective study was conducted on children with clubfoot who were treated successfully by Ponseti Method in the King Fahad Hospital, Saudi Arabia, and Emam Reza Hospital, Mashad, Iran, from 2003 through 2008. The total number of the patients in our study was 191, with 306 affected feet. Of them, 115 children had bilateral clubfeet [230 feet] and 76 had unilateral clubfoot. There were 119 males and 72 females. Hyperextension of the big toe at MTPJ was present in five cases of clubfoot. The average follow-up period was 20 months [range: 8-38 months]. The authors observed that hyperextension of bit toe at MTPJ had a linear relationship with the severity of cavus deformity of clubfoot. One the other hand, the big toe had a normal relationship with other toes after satisfactory treatment of the initial or relapsed cavus deformity by Ponseti Method. Hyperextension of the big toe at MTPJ can be regarded as a reliable prognostic sign for detecting the severity, correction, and the number of castings needed for cavus deformity correction in clubfoot treatment in the Ponseti Method

Visiting holy shrines; a survey to assess the common reasons by devotees in Karachi, Pakistan

There are frequent visits of the devotees to the holy shrines mainly for the purpose of mental healing. The people with various beliefs and religions attribute divine powers to the graves of their saints. This study surveyed the purpose of the visits to shrines, their beneficial effects, and also the sanctity violated by drug addicts and others. 1] To assess the common reasons of visiting holy shrines. 2] To determine the use / misuse of these visits. Cross-sectional. One most commonly visited shrine in Karachi. 01-06-2008 to 30-07-2008. 120 visitors. Visitors of 20 years age or older, who consented to participate. Visitors of less than 20 years age and who did not agree to participate. Total number of study subjects was 120, with male to female ratio of 58: 42. Their age varied from 20 to 80 years. They belonged to various socioeconomic and ethnic groups with varying educational level. Majority of the visitors come frequently. The purpose of visits included reward [swab], poverty, domestic problems, infertility, ill health, in addition to see lovers to have an access to commercial sex workers and narcotics. Some devotees had a mishap during the visit. Most of the visitors come for mental healing and relaxation with the hope of getting solutions for their problems, and a few use these sacred places for their wrong doings

Insulin resistance and metabolic syndrome in pediatric systemic lupus erythematosus patients: correlation with disease activity and serum leptin

To assess the occurrence of insulin resistance and metabolic syndrome and their correlation with disease activity and serum leptin in patients with pediatric SLE. This study included 30 non-diabetic pediatric SLE patients diagnosed according to ACR revised criteria for SLE and 10 age and sex matched controls. Patients were subjected to full history taking, thorough clinical examination and evaluation of disease activity using SLEDAI. Fasting serum insulin, glucose, leptin, high sensitivity C-reactive protein [HS-CRP] and lipid profile were measured. Insulin resistance [IR] was calculated with the homeostasis model assessment [HOMA-IR]. Patients were divided according to International Diabetes Federation [IDF] criteria for metabolic syndrome in children and adolescents into patients with and without metabolic syndrome who were compared regarding disease activity and serum leptin. Metabolic syndrome was detected in 9 patients [30%]. There was a non-significant difference regarding SLEDAI and HS-CRP between patients with and without metabolic syndrome. Serum leptin was non-significantly higher among patients with metabolic syndrome than in patients without. There were significantly higher fasting serum insulin and HOMA-IR in patients in comparison to controls. Stepwise multiple regression analysis of factors associated with HOMA-IR revealed that BMI, serum triglycerides and leptin level were the most sensitive independent predictors for IR. Pediatric SLE patients are susceptible to insulin resistance and metabolic syndrome regardless of disease activity. Management of metabolic syndrome in these young patients is beneficial to prevent its complications such as type II diabetes and cardiovascular disease

Antikeratin antibodies [AKAS]: Usefulness in differentiation between rheumatoid arthritis and hepatitis C virus associated arthritis

Among the different clinical disorders associated with hepatitis C virus [HCV] infection, articular involvement is a frequent complication. Symmetric polyarthritis associated with HCV infection frequently displays a rheumatoid arthritis [RA] like clinical picture. Thus, differentiating patients with HCV related symmetric polyarthritis from patients with RA represents both a diagnostic and a therapeutic challenge. Our aim was to investigate whether antikeratin antibodies [AKAs] could be useful markers in differentiating patients with rheumatoid arthritis [RA]; from patients with hepatitis C virus [HCV,] associated polyarthritis who are seropositive for rheumatoid factor [RF]. Serum AKAs were determined in two groups of patients; all were RF seropositive. Group [I]: 25 patients with HCV associated symmetric polyarthralgia or arthritis: Group [II]: 25 patients with RA [ACR revised criteria for diagnosis of RA, 1988]. Fifteen healthy individuals, age and sex matched, served as controls. AKAs were tested using an indirect immunofluorescence technique with 1:10 serum dilution. The study revealed that AKAs were detected in 15/25 [60%] patients with true RA and in only 3/25 [12%] patients with HCV associated arthritis [p<0.0001]. AKAs were not found in the sera of the healthy controls. AKAs can be useful markers in differentiating patients with true RA from those with HCV arthritis

Methyl jasmonate induced overproduction of eleutherosides in somatic embryos of Eleutherococcus senticosus cultured in bioreactors

This study was concentrated on the production of eleutherosides and chlorogenic acid in embryogenic suspension cultures of Eleutherococcus senticosus by exposing them to different concentrations (50-400 µM) of methyl jasmonate (MJ) during the culture period. In the bioreactor cultures, eleutheroside content increased significantly by elicitation of MJ, however, the fresh weight, dry weight and growth ratio of embryos was strongly inhibited by increasing MJ concentrations. The highest total eleutheroside (7.3 fold increment) and chlorogenic acid (3.9 fold increment) yield was obtained with 200 µM MJ treatment. There was 1.4, 3.4 and 14.9 fold increase in the eleutheroside B, E, and E1 production respectively with such elicitation treatment. These results suggest that MJ elicitation is beneficial for eleutheroside accumulation in the embryogenic cell suspension cultures.

Colonoscopy in children

Pediatric colonoscopy is routinely performed in most hospitals in Saudi Arabia and yet published data are scarce. The objective of this report is to describe our experience in the practice of pediatric colonoscopy in Saudi Arabia. Retrospective analysis of data of all patients below 18 years of age who underwent colonoscopy over a 10-year period. From 1414 H [1993 G] to 1423 H [2002 G], two hundred and seventeen colonoscopies, of which 183 diagnostic procedures, were performed on 183 children. The majority [94%] were Saudi nationals, the age range was between 5 months and 18 years, and the female to male ratio was 1: 0.8. Colonoscopy was total in 58 [32%] and limited in 125 patients [68%]. The commonest reason for not completing the procedure was securing the diagnosis in 45/125 patients [36%]. The commonest indication was rectal bleeding [35%]. The highest yield was in children with bloody diarrhea [91%] and the lowest in those with abdominal pain [27%] with an overall yield of 44%. Colitis was the most common diagnosis occurring in 66% of the children this report highlights the role of colonoscopy in the recognition of diseases of the colon in our community and identifies some of the problems areas associated with the performance of this procedure in our institution

Carcinoma larynx--topographical distribution.

One hundred and sixty subjects were included in our study, collected from four hospitals in Dhaka City. The mean age (+/- SD) of study subjects were 54.67 +/- 11.27 years. Out of 160 subjects 155 was males and 5 were females, and male to female ratio was 31:1. The highest number of study subjects was related to cultivation (40.62%). The majority of study subjects were from the low socio-economic status (68.72%). Carcinoma larynx is a multifactorial disease. Smoking and chewing habit are the most important factors associated with carcinoma larynx. Most of the male (93.12%) subjects were smoker. One hundred and fifteen (71.87%) subjects were found chewing habit of betel leaves with other ingredients. Hoarseness of voice was the commonest symptom 65.62%. Regional distribution of tumour showed supraglottic carcinoma topping the list (69.38%) followed by glottic carcinoma (30.62%) and there was no subglottic carcinoma. Site involvement in supraglottic carcinoma was found in combined location topping the list (89.20%). In glottic carcinoma majority was found glottic with supraglottic extension (65.31%). In majority cases growth were exophytic 52.50%. Palpable lymph mode was found in 48.75% of cases. All the carcinoma of larynx was found histologically of squamous cell type.