Weight-To-Height Ratio In Association To Lipid Profile Among Adolescent In Kabanjahe, North Sumatera: A Cross-Sectional Study

Weight-to-height ratio (WtHR) as a central adiposity marker is well-established in predicting cardio-metabolic risk in adults, nevertheless, epidemiological data for this association in children are still not well dened. Cross-sectional study was conducted in October-December 2018 on adolescents aged 10-16 years in SMP Negeri th 1 Kabanjahe, North Sumatera, Indonesia. Students with BMI ≥ P85and met the inclusion and exclusion criterias were randomly selected. Sample were divided into two groups (WtHR <0.6 and WtHR ≥0.6) and lipid prole examination were subsequently performed. Data were available for 63 subjects consisted of 10 (15,9%) overweight students and 53 (84.1%) obese students. Based on WtHR, the subjects were categorised as WtHR <0.6 and ≥0.6 which were 34 (54%) and 29 (46%), respectively. Elevated total serum cholesterol levels, elevated serum triglycerides levels, elevated serum low-density lipoproteins (LDL) levels, and decreased serum high-density lipoproteins (HDL) levels were observed among 51.4% (P=0.451;OR=1.7), 51.1% (P=0.279; OR=2.3), 52.9% (P=0.348;OR=1.8), and 31.6% (P=0.216; OR= 0.4) of subjects with WtHR ≥0.6, respectively. The mean value for WtHR for all the subjects was 0.59 (range: 0.50-0.75). The mean values for total cholesterol, HDL, LDL and triglycerides were 175.44mg/dl, 51.27mg/dl, 114.40 mg/dl, and 122.75 mg/dl, respectively. Chi square test were carried out with 95% condence interval and P<0.05 was dened as statistically signicant. There is no statistically signicant association found between WtHR and the lipid prole of overweight and obese adolescents in this study.

Enterocutaneous Fistula: a Tanzanian Experience in a Tertiary Care Hospital

Background: Enterocutaneous fistulae pose a therapeutic challenge to general surgeons all over the world and contribute significantly to high morbidity and mortality. The aim of this study was to describe our experience in the management of enterocutaneous fistulas; outlining the causes; fistula characteristics; treatment outcome and prognostic factors for fistula closure and mortality in our local setting. Methods: A prospective study of patients with enterocutaneous fistulae was conducted at Bugando Medical Centre between December 2007 and November 2009. After informed written consent for the study and HIV testing; all patients who met the inclusion criteria were consecutively enrolled into the study. Data were collected using a pre-tested; coded questionnaire and analyzed using SPSS software version 11.5. Results: Ninety two patients were seen during the study. There were 54 males (58.7) and 38 (41.3) females (M: F ratio = 1.4:1). Post-operative complication was the commonest cause of enterocutaneous fistulae in 91.3of cases. The majority of patients (63.0) had high output fistulae and the jejuno-ileum was commonly affected (60.9). The complication rate was 34.8and sepsis was the most common complication. Sixteen patients (17.4) had HIV infection. Fistula closure was successfully achieved in 64 patients (69.6). Of these; 42 patients (65.6) had spontaneous closure and 22 patients (34.4) underwent surgical closure. Mortality rate was 30.4. Using multivariate logistic regression; the cause of fistula; fistula output; presence of complications and institutional origin of the patient were found to be significant predictors of spontaneous closure (p-value 0.001); where as surgical closure was significantly associated with presence of complications and pre-morbid illness (p-value 0.001). Fistula output; institutional origin of the patient; presence of complications and premorbid illness; HIV positivity and CD4 count were significant predictors of mortality. Conclusion: Enterocutaneous fistulae pose a therapeutic challenge at BMC and contribute significantly to high morbidity and mortality. A multidisciplinary approach focusing on fluid resuscitation; nutritional supplementation; electrolyte replenishment; control of sepsis; containment of effluent; skin integrity and surgery at appropriate time is necessary to lessen morbidity and mortality with a higher fistula closure rate. The high rate of postoperative enterocutaneous fistulae resulting from anastomotic breakdown in patients referred from peripheral hospitals calls for urgent surgical skill training course in this region. The high rate of HIV infection in these patients needs further studies

Isolation of cryptococcus, candida, aspergillus, rhodotorula and nocardia from meningitis patients in Egypt

Meningitis occurs throughout Egypt and is largely attributed to bacterial pathogens, but there is little information on fungal etiologies of meningitis. We, therefore, investigated fungal infections among Egyptian patients with acute and subacute meningitis who tested negative for bacterial and viral agents. A total of 1000 cerebrospinal fluid [CSF] samples collected from nine governorates of Egypt during 1998-2002 were initially stained with Gram's, India ink, and lacto-phenol cotton-blue stains, and examined under light microscope to detect fungal elements. All CSF samples were cultured on brain heart infusion, Wickerham and Staib agar media for fungus isolation. CSF with suspected Cryptococcus neoforntans infections were also tested by latex agglutination test for antigen detection. Species identification of selected isolates was carried out at the Mycotic Diseases Branch, CDC, Atlanta, Georgia, USA. Fungal agents were detected microscopically and by culture in 17 of 1000 [1.7%] CSF samples tested. Ten of 17 were identified as C. neoformans var grubii [serotype A], 4 as Candida albicans, and one each of Aspergillus candidus, Rhodotorula mucilaginosa [rubra] and Nocardia spp [actinomycetes]. Out of the 17 cases with fungal CSF infection, 8 died [Cryptococcus-3. Candida-2, AspergiUus, Rhodotorula and Nocardia] and 2 suffered neurological sequelae. Of the 10 cryptococcal meningitis patients, 4 were HIV positive and one was diagnosed with lymphoma. To our knowledge, this is the first study on isolation of fungi other than Cryptococcus from CSF of Egyptian patients with acute/subacute meningitis. Consideration must now be given to cryptococcosis and candidiasis as potential etiologies of meningitis in Egypt

Molecular characterization of 21 hydroxylase deficiency congenital adrenal hyperplasia in Egyptian children: a pilot study

Defective steroid synthesis due to derangements of 21-hydroxylase gene [CYP21] constitutes the most frequent cause of congenital adrenal hyperplasia [CAH] and is one of the most frequent inborn errors of metabolism world wide. The molecular basis of CYP21 mutations is complicated. During meiosis gene conversion occurs and transfers deleterious point mutations from the inactive [CYP21P] to the corresponding sequence of the CYP21 gene causing either complete or partial inactivation of 21-hydroxylase activity. Allele specific polymerase chain reaction [ASPCR] was used for the detection of the 4 most common mutations in CYP21 gene: Intron 2 splice mutations [IVS2-13], 8bp deletion in exon 3 [del-8bp], I172N mutation in exon 4 and V281L mutation in exon 7, in 11 salt wasting SW-CAH Egyptian infants. In the examined 22 alleles, 2 alleles were carrying del-8bp, 3 were carrying IVS2-13 mutation, 4 with I172N, 4 with V281L. In the present study the percentage of undetectable mutations was 50%. The wide range of genetic mutations reported for CYP21 gene reconfirm the marked heterogeneity of the disorder among Egyptian and calls for more extensive molecular work

High prevalence of the Cyp21 V281L mutation in Egyptian lean women with polycystic ovaries and infertility

This study included 42 females [in the childbearing period] were who presented with irregular menstruation and infertility and had ultrasonographic findings of polycystic ovaries. Clinical evaluation was done including body mass index [BMI] calculation. Measurement of morning fasting blood levels of testosterone, 17 alpha hydroxyprogesterone [OHP], follicle stimulating hormone, luteinizing hormone, glucose and insulin was done on the 5th post-menstrual day. Insulin resistance [IR] was estimated using the homeostasis model assessment [HOMA] method. Genomic DNA was extracted from peripheral blood leukocytes and allele specific polymerase chain reaction was used to screen for the exon 7 V281L missense mutation. In conclusion, NC-21OHD due to V281L mutation has been shown to be a major underlying etiology among Egyptians presenting with PCO and infertility. This calls for the importance of screening for this adrenal disorder among this patient group in order to institute proper therapeutic strategies

novel mutation in the androgen receptor gene causing partial androgen insensitivity syndrome

In the present study, a novel mutation in exon 7 of the androgen receptor [AR] gene in an Egyptian patient with partial androgen insensitivity syndrome [PAIS] was described. A male patient aged seven months was presented with ambiguous genitalia; the parents were not consanguineous. The patient had 46, XY karyotype and normal testosterone levels. Both basal and after human chorionic gonadotrophin [HCG] testosterone/dihydrotestosterone ratio was within normal suggesting normal 5-alpha reductase activity. Sequencing analysis of the AR gene revealed a novel mutation [P817A] within the ligand-binding domain [LBD]

Allele profiles of short tandem repeat loci in Egyptians

In this study, relative allele frequencies of 4 short tandem repeats [STR] loci in 47 unrelated subjects from Egyptian population as a primary step for forming a nationwide database was reported. The sample represented various geographical, ethnic and religious backgrounds that constituted contemporary Egyptian population. DNA was extracted from whole blood using salting out method. The allele patterns in Egyptian sample showed high levels of heterozygosity over 74% in 3 loci. The interpopulation differences were least detected with Caucasians and most with Asian and Hispanic Americans

Assessment of bone turnover by measurement of serum estradiol and interleukin-6

This study included twenty-six postmenopausal women and twenty premenopausal ones in a trial to understand how estrogen performs its antiosteoporotic action. Serum estradiol, interleukin 6 [IL-6] and osteocalcin were measured. A highly significant difference in serum estradiol and IL-6 was found between the two groups. It could be concluded that estrogen exerted its antiosteoporotic effect by modulating the production of IL-6, thus inhibiting its stimulatory effect on osteoblasts

Exercise and the immune system

The effect of 8 weeks of bicycle training on the immune system was evaluated in 20 healthy volunteers and 10 patients with rheumatoid arthritis [RA]. Resting levels of serum IL[6] [by ELISA] and serum Ig[G] [by single RID technique] were measured before and then after 8 weeks of training. The study revealed a highly statistical significant increase [P<0.01] in the concentration of serum IL-[6] in the healthy individuals after training compared to its resting [baseline] level [240.62 +/- 281.62 versus 102.5 +/- 209.11]. On the contrary, there was non-significant decrease [P>0.05] in the concentration of serum Ig[G] [23.97 +/- 0.23 versus 27.43 +/- 8.06]. The decrease in the post exercise concentration of serum IgG was significantly correlated with the age of individuals. In RA patients, 8 weeks bicycle training didn't induce any significant effect either on the concentration of serum IL-[6] [116.67 +/- 61.21] or Ig[G] [27.99 +/- 7.95] as compared to their pre-exercise levels [100 +/- 142.55, 29.97 +/- 61.21 respectively]. A significant positive correlation [P<0.05] was found between the post-exercise IL-6 levels and the disease duration and between post-exercise Ig[G] levels and the duration of morning stiffness. There was also a significant negative correlation [P< 0.05] between the difference in the concentration of serum IL-[6] and that of Ig[G] in relation to training. It can be concluded that 8 weeks bicycle training induced an enhancing effect on the cellular and not humoral immune system in healthy individuals. On the other hand, this training didn't influence either the cellular or humoral immune system of patients with RA