Effects of airborne Aspergillus on serum aflatoxin B1 and liver enzymes in workers handling wheat flour.

OBJECTIVE: The present work aimed to investigate the relationship between occupational exposure to airborne molds, serum aflatoxin B1 (AFB1), and liver enzymes of workers handling wheat flour. METHODS: The study included 90 bakers, 100 flour milling workers, and 100 controls with no exposure to flour dust. Workplace aspects such as temperature and relative humidity were measured. Airborne fungi were collected and identified. In all subjects included, the serum levels of AFB1, serum albumin (Alb), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (ALP) were measured. RESULTS: Air temperature and relative humidity were found to be higher in bakeries than in flour mill sections. Airborne Aspergillus species were isolated in dust particles <8 µm in size. The concentration of Aspergillus flavus and Aspergillus niger were higher in bakeries than in the flour mill sections. They were higher in the grinding section than in other mill sections. The serum AFB1-Alb adduct and ALP levels were significantly higher in bakers compared to milling workers (p < 0.0001, p = 0.05), respectively. The liver enzymes AST and ALT were significantly higher among milling workers and bakers than controls (p < 0.05, p < 0.0001), respectively. The duration of exposure was significantly correlated with serum AFB1 in bakers. Moreover, there was significant correlation between serum AFB1, each of ALT and AST levels in bakers. CONCLUSIONS: chronic occupational exposure to high concentrations of Aspergillus in workplaces may cause elevations in serum levels of AFB1 and liver enzymes in workers exposed to flour dust. Hence, worker protection measures should be consistently adopted and enforced at the workplace.

Association of ADAM33 gene polymorphism and arginase activity with susceptibility to ventilatory impairment in wood dust-exposed workers.

ADAM33 represents an important gene of susceptibility for lung function impairment. This work aimed to evaluate the association between genetic polymorphism of ADAM33 at four single nucleotide polymorphisms (T1, T2, S1, and Q1) and arginase activity with respiratory functions impairment in wood workers. The study was done to compare ventilatory functions and arginase activity of 82 wood workers and 81 controls. Genotyping was determined by using the polymerase chain restriction fragment length polymorphism method. Forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), and peak expiratory flow rate (PEF) of the workers were significantly reduced compared with the controls. T1 single nucleotide polymorphism (SNP) was associated with obvious decline in the FEV1, FVC, and PEF in wood workers, while T2 SNP was associated with decline in FEV1 and PEF. A significant increase in arginase activity was found in T2 and S1 SNPs of the exposed workers. Increase in duration of exposure was correlated with the decline in ventilatory functions. This inverse correlation was significant for pulmonary function indices in AA and GG genotypes of T1 and T2, respectively. Moreover, significance was detected for FVC and FEV1 in AA and GA genotypes of S1 and Q1. A positive correlation between arginase activity and duration of exposure was found to be significant in GG genotype of S1 SNP. An association between ADAM33 gene polymorphism and impaired lung functions was detected in wood dust-exposed workers. Arginase activity may play an associated important role in increasing this impairment in wood workers.

Glenoid Bone Loss Measurement in Recurrent Shoulder Dislocation: Assessment of Measurement Agreement Between CT and MRI.

BACKGROUND: Shoulder instability can cause both soft tissue injury and bone defects, requiring both computed tomography (CT) and magnetic resonance imaging (MRI) for a thorough workup, which results in high patient costs and radiation exposure. Prior studies in cadaveric and nonclinical models have shown promise in assessing preoperative bone loss utilizing MRI. PURPOSE: To evaluate the utility of MRI in detecting and evaluating glenoid bone defects in a clinical setting. The aim was to establish whether similar information could be determined by utilizing MRI and CT in a population with recurrent instability. STUDY DESIGN: Cohort study (diagnosis); Level of evidence, 2. METHODS: CT and MRI scans of 22 shoulders were read by 4 orthopaedic surgeons. The CT images were obtained on a 2-dimensional CT scanner. Vertical measurements were taken from the superior glenoid tubercle and directed inferiorly along the glenoid; horizontal measurements were taken across the widest part of the face of the glenoid and were perpendicular within one-half of 1° to the vertical measurement. The same protocol was followed for MRI measurements. An intraclass correlation coefficient (ICC) was calculated. RESULTS: There was a moderate amount of agreement between examiners for the height measurements on MRI (ICC, 0.53) and a substantial agreement for the CT images (ICC, 0.64). The width measurements for MRI had a moderate amount of agreement (ICC, 0.41), while the CT images had a fair agreement (ICC, 0.39). The height measurements between the measurements of MRI and CT images had an overall ICC of 0.43, while the width measurements had an overall ICC of 0.41, both of which were considered a moderate amount of agreement. CONCLUSION: There is moderate correlation between MRI and CT scans when measuring the glenoid, indicating that taking the length-to-height ratio measurements across the glenoid is a promising way to estimate the glenoid defect. At present, a complete workup of a patient with shoulder instability includes both a CT scan and an MRI. Future research that establishes precisely how MRI misestimates CT measurements of the glenoid can perhaps obviate the need for 2 scans.

Prevalence of consanguineous marriages in South Sinai, Egypt.

A total of 3961 married couples from six major geographical areas representing the South Sinai governorates in Egypt were studied to assess the rate of consanguineous marriage. The population of six selected areas (St Catherines, Nuweiba, Abu Rudeis, Ras Sudr, El Tor and Abu Zenima) were subdivided into Bedouin, urban and mixed populations. A questionnaire-based interview was conducted showing that the consanguinity rate in this region is 37.5%, with the highest rate recorded in Abu Rudeis (52.3%) and lowest rate in Nuweiba (24.1%). Consanguinity was significantly higher among the Bedouin population compared with the urban population in Abu Rudeis, Ras Sudr, El Tor and Abu Zenima, while in St Catherines and Nuweiba there was no statistically significant difference. Among consanguineous couples, 5%, 60% and 35% were double first cousins, first cousins and second cousins respectively. The mean inbreeding coefficient α of the studied population was 0.01845.

Climate change and predicted trend of fungal keratitis in Egypt.

Rising rates of invasive fungal infections may be linked to global climate change. A study was made of the trend of ophthalmic fungal corneal keratitis in the greater Cairo area of Egypt and its association with climate records during the same period. Data on diagnosed cases of fungal keratitis were collected from records of ophthalmic departments of Cairo University hospital and atmospheric temperature and humidity for the greater Cairo area were obtained from online records. Statistical analysis showed a significant increase in the relative frequency of keratomycosis during 1997-2007. The rise correlated significantly with rises n min,mum temperature and the maximum atmospheric humidity in the greater Cairo area over the same period (after exclusion of the effect of the maximum atmos pheric temperature). The predicted increase in keratomycosis up to the year 2030 corresponds to predicted increases in CO2 emissions and surface temperature from climate change models for Egypt.

Effect of an intervention to improve the management of patients with diabetes in primary care practice.

OBJECTIVE: To assess the effect of an intervention targeted at primary care physicians (PCPs) in order to improve their management of diabetic patients. METHODS: Diabetic patients seen by PCPs in King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia from January 2008 to July 2009 were included in this prospective cohort study. The PCPs were divided into intervention and control groups. The intervention group with the help of an assistant, utilized a customized designed computer program generating a checklist for the PCPs. The list included clinical and biochemical screening tests needed for the patients current visit, according to evidence-based diabetes guidelines. For the control group, no assistant was used. At the end of one year, an independent reviewer evaluated the patients' files in both groups to assess the adherence to diabetes guidelines. RESULTS: We enrolled 162 patients in the control group and 517 patients in the intervention group. The intervention significantly improved the percentage of patients being screened for diabetic complications; retinopathy from 24.7-98.5%, neuropathy from 25.9-92%, and nephropathy from 37.8-73.7%. There was no improvement in glycemic control in both groups and glycosylated hemoglobin level (HbA1c) values were still above the 7% target. CONCLUSION: Management of diabetic patients in the primary care clinics is below standard. The intervention applied was effective in promoting better adherence to evidence-based diabetes guidelines.

Climate change and predicted trend of fungal keratitis in Egypt

Rising rates of invasive fungal infections may be linked to global climate change. A study was made of the trend of ophthalmic fungal corneal keratitis in the greater Cairo area of Egypt and its association with climate records during the same period. Data on diagnosed cases of fungal keratitis were collected from records of ophthalmic departments of Cairo University hospital and atmospheric temperature and humidity for the greater Cairo area were obtained from online records. Statistical analysis showed a significant increase in the relative frequency of keratornycosis during 1997-2007. The rise correlated significantly with rises in minimum temperature and the maximum atmospheric humidity in the greater Cairo area over the same period [after exclusion of the effect of the maximum atmospheric temperature]. The predicted increase in keratornycosis up to the year 2030 corresponds to predicted increases in CO[2] emissions and surface temperature from climate change models for Egypt