The reliability of smartphone goniometry technology in measuring postural changes in South African female youths carrying head loads

Background: Four empirical studies have measured the impact of head-loading on female African porters posture using expensive radiography and manual kin anthropometry and goniometry. The reliability of cheaper, pragmatic smartphone goniometric technology as an alternate clinical tool to assess posture is needed. Objectives: This study was designed to test the inter-rater reliability of smartphone goniometry technology against manual goniometry in measuring selected sagittal postural angles in South African female youth who habitually head-load. Methods: Female South African youth who habitually headload voluntarily participated in the study (N = 100) and were randomly allocated into experimental (n = 50) and control (n = 50) groups. An observational randomized control design involving a pre-test post-test crossover was used, after which the control group crossed over into the experimental group and vice versa. The control group stood in the unloaded phase without a head load, while the experimental group carried the head load. The daily head loads and body mass were measured on an electronic scale. Demographic characteristics (age, body mass, and stature) were recorded and selected biomechanical angles were measured on the right side. Results: The mean age of the study participants was 12.3 ± 2.5 years; average body mass was 44.5 ± 13.7 kg. The average head load habitually carried was 8.0 ± 2.5 kg. The inter-rater reliability between the smartphone goniometry technology and manual goniometry was 0.9. Conclusion: The findings support the use of smartphone goniometry as a pragmatic method for assessing sagittal plane postural changes among rural South African youth who habitually head-load. Further studies are needed to validate these findings.

Current and future strategies for the treatment of chronic hepatitis C

Chronic hepatitis C infection is a major cause of liver disease and hepatocellular carcinoma worldwide. While hepatitis C has been treated for decades with some success, the introduction of direct acting antiviral agents has revolutionized the treatment of hepatitis C with finite, highly effective, well-tolerated therapy and there are few populations that cannot be successfully treated now or are complicated to manage. The World Health Organization has released elimination targets in an effort to eliminate viral hepatitis and reduce dramatically the morbidity and mortality caused by both viral hepatitis. While hepatitis C is straightforward to treat, it remains problematic to eliminate on a global scale. Diagnosis of hepatitis C remains the major gap in the cascade of care and numerous screening strategies will be required to reduce this gap. While historically, treatment of hepatitis C has been centralized, decentralized approaches will be required to diagnose, evaluate, and link to care the large population of individuals worldwide with hepatitis C across low-, middle-, and high-income countries. With the introduction of multiple pangenotypic treatment options and reduced cost for these therapies, assessment and treatment for those with hepatitis C has been simplified and made more accessible worldwide. There are multiple populations for whom care models are being developed and refined, including those when inject drugs, those who are incarcerated, those who present with sexually transmitted disease including the men who have sex with men population, amongst many others. While a vaccine for hepatitis C remains elusive these efforts continue. Multiple successful elimination efforts have been reported.

Current and future strategies for the treatment of chronic hepatitis C

Chronic hepatitis C infection is a major cause of liver disease and hepatocellular carcinoma worldwide. While hepatitis C has been treated for decades with some success, the introduction of direct acting antiviral agents has revolutionized the treatment of hepatitis C with finite, highly effective, well-tolerated therapy and there are few populations that cannot be successfully treated now or are complicated to manage. The World Health Organization has released elimination targets in an effort to eliminate viral hepatitis and reduce dramatically the morbidity and mortality caused by both viral hepatitis. While hepatitis C is straightforward to treat, it remains problematic to eliminate on a global scale. Diagnosis of hepatitis C remains the major gap in the cascade of care and numerous screening strategies will be required to reduce this gap. While historically, treatment of hepatitis C has been centralized, decentralized approaches will be required to diagnose, evaluate, and link to care the large population of individuals worldwide with hepatitis C across low-, middle-, and high-income countries. With the introduction of multiple pangenotypic treatment options and reduced cost for these therapies, assessment and treatment for those with hepatitis C has been simplified and made more accessible worldwide. There are multiple populations for whom care models are being developed and refined, including those when inject drugs, those who are incarcerated, those who present with sexually transmitted disease including the men who have sex with men population, amongst many others. While a vaccine for hepatitis C remains elusive these efforts continue. Multiple successful elimination efforts have been reported.

Gestational trophoblastic disease: The Philippine experience / Philippine Journal of Obstetrics and Gynecology

@#The first documented description of hydatidiform mole dates back to 400 BC when Hippocrates (470–410 BC) explained its formation through the consumption of dirty water by the pregnant woman. Interestingly, in 1276, the countess of Henneberg reportedly died after giving birth to “as many children as there were days in the year”. In 1752, William Smelie coined the terms mole and hydatidiform to describe the pathology as a bunch of grapes consisting of different sizes. Indeed, this condition that we have come to recognize as a hydatidiform mole (HM) has fascinated humans for centuries. But, it was not until 1903 when it was formally recognized as a clinical entity.

The effect of the Elderly Development Program on the quality of life of elderly individuals / The Health Sciences Journal

Introduction @#The increasing aging population of the Philippines impacts on the socioeconomic development of the country, prompting a deeper look into their quality of life. This study sought to determine the effect of the Elderly Development Program on the quality of life of the elderly population of Los Baños.@*Methods @#A 4-month prospective cohort study of the elderly population in Los Baños, Laguna compared the quality of life scores of a group enrolled in the Elderly Development Program and an unexposed control, using the World Health Organization Quality of Life Abbreviated Version for Filipino Older Persons questionnaire.@*Results @#Quality of life scores where higher for the EDP group during the four months of observation. In Month 2, significant differences were found in all domains except for the psychological domain. Only the physical health domain score was significant in the EDP group for Month 3 (p = 0.003) and Month 4 (p = 0.029). Both the EDP and control groups had higher overall and domain scores in Month 4 compared with baseline.@*Conclusion @#The Elderly Development Program may improve the overall quality of life of elderly persons, specifically in the physical health domain. These improvements are likely due to the focus of the program on the physical aspect of the elderly.

The Therapeutic Approaches for Hepatitis C Virus: Protease Inhibitors and Polymerase Inhibitors

The current standard of care for hepatitis C infection is peginterferon/ribavirin (PegIFN/RBV). We are entering the era where direct-acting antiviral agents (DAAs) will be added to PegIFN/RBV, leading to higher sustained response rates in genotype 1 infected individuals. Currently DAAs are directed toward specific proteins involved in hepatitis C replication with NS3/NS4A protease inhibitors furthest in development. Telaprevir and boceprevir are both NS3/NS4a inhibitors that significantly improve sustained response when added to PegIFN and RBV. The hepatitis C virus (HCV) polymerase inhibitors are another promising DAA class. These molecules are divided into nucleoside/nucleotide polymerase inhibitors and nonnucleotide/nucleoside polymerase inhibitors. Nucleoside/nucleotide polymerase inhibitors have a high barrier to resistance and appear to be effective across a broad range of genotypes. Nonnucleoside polymerase inhibitors have a lower barrier of resistance and appear to be genotype specific. Preliminary data with these compounds are also promising. A third class, NS5A inhibitors, has also shown potent HCV RNA suppression in preliminary studies as monotherapy and with PegIFN and RBV. Combinations of these agents are also entering clinical trials and indeed a preliminary report has demonstrated that the combination of an NS3/4A protease inhibitor and NS5B polymerase inhibitor can effectively suppress virus in genotype 1 individuals. Future studies will concentrate on combinations of direct-acting antiviral agents without and with PegIFN and RBV. Clinicians will need to be familiar with managing side effects as well as resistance as we enter this new era.

Prognostic factors influencing pregnancy rate after stimulated intrauterine insemination

To determine the prognostic factors such as age, diagnosis, number of cycle attempts and semen parameters on the pregnancy rate of controlled ovarian hyperstimulation (COH) /intrauterine insemination (IUI). Three hundred and seventeen women who underwent 507 consecutive COH/IUI cycles were recruited from 1st January 2002 to 31st December 2005 inclusively. This retrospective study was done in University Malaya Medical Centre, a tertiary care academic centre. The main outcome measure was pregnancy rate according to age, infertility diagnosis, duration of infertility, semen parameters, and the number of treatment cycles. The overall pregnancy rates were 16.9% per cycle and 25.9% per couple. Pregnancy rates decreased with advancing maternal age. Pregnancy rate was also significantly lower in patient with postwash total motile sperm count (TMSC) 20 million/ml. The cumulative pregnancy rates varied greatly by diagnosis from 16% for patients with male factor infertility to 60% for patients with ovulatory disorder. Pregnancies among patients with male infertility, tubal factors infertility and endometriosis were achieved during the first three cycles. There is a clear age-related decline in fecundity associated with COH/IUI treatment. Women of > 40 years old, couple with postwash TMSC < or = 20 million/ml, severe endometriosis and tubal factors have a particularly poor prognosis.