10Feb
Adverse Pregnancy Outcomes Associated with Three Gram-negative Bacteria Found at Low Frequencies in Female Genital Microbiomes

Three Gram-negative bacterial genera are involved with low frequencies in genital infections, Acinetobacter, Hafnia and Campylobacter, contributing to adverse pregnancy outcomes. This research discusses the microbiological, epidemiological, diagnostic and treatment features of each of these taxa and describes some unique cases of maternal and infant infections, demonstrating the problems faced by these pathogens and in the treatment of maternal and neonatal infections. It is concluded that cultivation-independent studies to classify and characterize the bacteria that cause histological chorioamnionitis and spontaneous preterm birth related intra-amniotic infections would reveal species that warrant further research. This awareness would promote the development of new prevention, diagnosis and treatment strategies in combination with the implementation of enhanced microbial detection methods in the clinical environment.

Author(s) Details

George L. Mendz
School of Medicine, Sydney, The University of Notre Dame Australia, Darlinghurst, NSW 2010, Australia.

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 10Feb
Monitoring the Risk Factors Associated with Asthma among Saudi Adults in Najran

Context: Asthma is a respiratory condition that affects individuals of all ages. Over the last few decades, its prevalence in Saudi Arabia has increased. The goal of this study was to explore common asthma-related risk factors among Saudi adults in Najran between December 2016 and October 2017. In addition to another 184 healthy people as a control group, the research population was one hundred and eighty four patients who were over 18 years of age and who were diagnosed with definite asthma (cases), which balanced the cases in terms of age and sex. A questionnaire was completed by instances as well as by controls as a data collection tool. It consisted of data that included environmental factors that could be possible risk factors for asthma, including personal, family and indoor factors. The mean case and control ages were respectively 21.3 (± 16.5) and 21.7 (± 16.8) years, respectively. There were 108 (58.7 percent) males in each group, alongside 76 (43.3 percent) females. There was no substantial correlation between the incidence of asthma and the degree of education and the P-value >0.05 of indoor plants. On the other hand, multivariate logistic regression analysis found that family history (OR=5.01 and CI=2.09-8.42), using sprays of insecticides or air fresheners (OR=8.5, CI=2.34-11.09), as well as rhinitis (OR=4.76, CI=2.19-6.45) were substantially correlated with asthma incidence. Additionally, active or passive smoking was significantly correlated with asthma among adults in Najran (P-value = 0.041 and 0.012). Based on the findings obtained, it was concluded that there are various trends of risk factors for asthma, those factors seem to play a significant role and are likely to contribute to the severity of this burden. It has been concluded that the most risk factors for developing asthma among Saudi adults are family background, smoking, allergic rhinitis and smoking. Further studies have been recommended for the investigation of other causes. In addition, health education services are widely recommended for educating people about risk factors, preventive measures, early detection and careful management.

Author(s) Details

N. K. Elfaki
Department of Community Health Nursing, Nursing College, Najran University, Saudi Arabia.

A. Y. Shiby
Department. of Medical-Surgical Nursing, Nursing College, Najran University, Saudi Arabia.

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 10Feb
Domestic Violence in Senegal: A Quantitative and Qualitative Study

Introduction: The under-denunciation remains shrill among victims linked to socio-cultural constraints in the face of the predominance of domestic abuse. A descriptive analysis of the epidemiological and clinical dimensions of domestic violence and the experiences of victims in Senegal is the purpose of this research.

Methodology: A mixed procedure was done. The information was compiled from the 2006 to 2015 court reports of female victims of physical and/or sexual assault. It also included female victims of physical and/or sexual abuse at the hands of their husbands who had a court record in one of the high courts of Senegal during this time. For the analysis, all records that met the inclusion criteria were chosen and the information was analyzed using Epi Info 3.3.2. There was a qualitative empirical analysis conducted. The victims were the sample population. In order to gather victims’ experiences of violence, individual interview guides have been made. Content analysis aided by thematic analysis was performed with the program Iramuteq.

Results: The average age of the victims was 30.6 ± 10.1 years, according to the court reports of 148 female victims of domestic abuse. Over 3⁄4 (76.4%) of the victims were housekeepers, of whom 82.4% were uneducated. The average age of the offenders was 40.4 ± 11.4 years and, in 47.3% of cases, they were self-employed in the informal sector. Moreover, more than 3⁄4 (78.4 percent) of the suspects were uneducated. Eleven women were raped while pregnant (8 percent of the victims). Physical violence was prevalent (95.3%), whereas sexual assault-related violence accounted for 4.7% of instances. Of the 7 cases of sexual violence reported, 3 were cases of unwanted sexual intercourse and all cases of physical violence were cases of battery and assault. In 81.8 percent of cases, the abuse occurred at the perpetrators’ house. Victims obtained treatment and care within 24 hours or less in 84.7 percent of the cases. 73 percent of the victims showed clinical lesions. Contusions, hematomas and penetrating wounds were the most common, comprising 23.1%, 19.4% and 13.9% of cases, respectively. The key aggressor, the husband, is at the center of all forms of abuse. He beats his wife, for instance (physical violence), he abuses his wife (verbal abuse), or he refuses to have sex with his partner. Sometimes, women hide the abuse experienced by those around them for fear of divorce and deny any denunciation.

CONCLUSION: Despite the low number of cases reported in the justice system over the past ten years, there has been a lot more violence without the victims being condemned. Therefore, it seems necessary to increase community understanding and crack socio-cultural barriers that obstruct the recognition of the rights of women in the couple.

Author(s) Details

Mamadou Makhtar Mbacké Leye
Department of Preventive Medicine and Public Health, Cheikh Anta Diop University of Dakar, Senegal.

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 10Feb
The Lifespan Hormesis Phenomenon in a Population does not Make It’s Healthier

Radiation hormesis, when total-body irradiation (TBI) is administered at a cumulative dose of 1.5 Gy at around 0.1 Gy/day, has recently been considered a type of useful cancer therapy. Many studies have linked hormesis to immune system potentiation. The aim of this research was to examine the impact of natural variation on the signs of hormesis in the regenerative state of dog tissues, which are visible across the life span following complete body exposure to low daily doses of external gamma radiation. Ninety beagle dogs of both sexes, from 1 year after birth to death, were irradiated with cobalt 60 at 0.003 Gy/day. Control (n = 169) and irradiated animals underwent clinical examination and autopsy during their entire life and were then retrospectively divided into two subgroups with (W) or without benign tumors or tumors of unknown nature (WO) that were clinically reported throughout the entire lifespan on a single day. Radiation hormesis was observed only in subgroup WO, which in the absence of radiation had a life span (LS) of 10.7 years. In the WO subgroup (p<0.05), the radiogenic prolongation of life to 11.8 years was close to that in the W control and irradiated W subgroups (11.8 and 11.5 years, respectively). The number of solid malignancies found in the control WO subgroup upon autopsy was smaller (39.5%) than that evident in the control W subgroup (60 percent ). The irradiation of the WO subgroup was followed by a small increase (1.14-fold) in the amount of solid malignancies visible during autopsy and in the clinical signs of tissue atrophy and body weight loss (2.4-fold and 2.4-fold respectively) relative to the irradiated W subgroup, but was accompanied by a sharp decrease in the degree of anemia and hematoblastosis (>10-fold for both). The data exclude the notion that radiation is associated with recovery, but suggest that only in poorer animals can such pathologies (e.g., hematoblastosis) be replaced with other less severe somatic diseases. It implies that, at least in mammals, the notion of radiobiological “stimulation” is unacceptable.

Author(s) Details

Aleksey N. Shoutko
Laboratory for Improvement of the Radiation Treatment Methods, Granov’ Russian Research Center for Radiology and Surgical Technologies, 197758, 70, Leningradskaya str., Pesochny, St. Petersburg, Russia.

Ludmila P. Ekimova
Laboratory for Improvement of the Radiation Treatment Methods, Granov’ Russian Research Center for Radiology and Surgical Technologies, 197758, 70, Leningradskaya str., Pesochny, St. Petersburg, Russia.

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 10Feb
Reporting a Case of Bone Tuberculosis on Child

One of the type of extrapulmonary tuberculosis that affects, above all, the spine, long bones and joints is bone tuberculosis (TB). The authors report a case involving a 12-year-old child with a pain and deformity complaint that had lasted for two years in the lower thoracic zone. In addition to the positivity of the molecular test based on the polymerase chain reaction, clinical, epidemiological and laboratory features associated with photos of obvious damage to the T9-T10 and T11-T12 vertebrae acquired by thoracic spine radiography and nuclear magnetic resonance, tuberculous spondylitis was diagnosed and specific therapy was initiated. After thirty days, the vertebral biopsy culture was positive for Mycobacterium tuberculosis. Measures that assist with patient prognosis are the early identification of illness and referral to a specialist facility for rapid diagnostic investigation. Pediatricians should be vigilant when they experience chronic instances of back pain and arthralgia in endemic areas.

Author(s) Details

Fabiana Cristina Fulco Santos
Laboratório de Imunoepidemilogia, Departamento de Imunologia, Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brazil.

André Luiz Alves do Nascimento
Laboratório de Imunoepidemilogia, Departamento de Imunologia, Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brazil.

Laís Ariane de Siqueira Lira
Laboratório de Imunoepidemilogia, Departamento de Imunologia, Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brazil.

Juliana Figueirêdo da Costa Lima
Laboratório de Imunoepidemilogia, Departamento de Imunologia, Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brazil.

Rosana de Albuquerque Montenegro
Laboratório de Imunoepidemilogia, Departamento de Imunologia, Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brazil.

Lilian Maria Lapa Montenegro
Laboratório de Imunoepidemilogia, Departamento de Imunologia, Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brazil.

Haiana Charifker Schindler
Laboratório de Imunoepidemilogia, Departamento de Imunologia, Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brazil.

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 10Feb
Assessment of Cardiovascular Risk Factors in Adult General Out-patient Clinics in Nigeria: A Country Analysis of The Africa and Middle East Cardiovascular Epidemiological (ACE) Study

Context: Demographic and epidemiological changes have become significant determinants for the emergence of cardiovascular disease with globalization and rapid urbanization (CVD). In recent decades, cardiovascular disease (CVD) has emerged as a significant cause of morbidity and mortality globally. An estimated 17 million deaths worldwide were attributed to CVD in 2002, and by 2020, CVD or stroke is expected to become the world’s leading cause of morbidity and mortality.

Objective: To estimate the prevalence in urban and rural Nigeria of CVD risk factors in adult outpatients attending general practice and non-specialist clinics. Methods: A cross-sectional epidemiological analysis of the presence of hypertension, diabetes mellitus, dyslipidemia, obesity, smoking and abdominal obesity in Nigeria was performed as part of the Africa and Middle East Cardiovascular Epidemiological (ACE) Study.

Results: Overall, 303 subjects were analyzed from 8 out-patient general practice clinics, 184 (60.7%) were female and 119 (39.3%) were male. The mean age was 42.7±13.1 years; 51.8% were <45 years of age; 4% were <65 years of age. Of 6 selected modifiable cardiovascular risk factors, over 90 percent of subjects had around 1: 138 (45.6 percent) had 1-2; 65 (21.5 percent) had 3; 60 (19.8 percent) had 4; and 11 (3.6 percent) had 5 concurrent risk factors. Screening reported 206 dyslipidemia subjects (68.0 percent) who did not have a previous diagnosis.

Conclusion: In Nigerian subjects visiting out-patient clinics, cardiovascular risk factors are extremely prevalent. In addition, several participants were undiagnosed and thus unaware of their state of cardiovascular risk. In adults attending general out-patient clinics in Nigeria, cardiovascular risk factors are highly prevalent, many of which were undiagnosed and thus unaware of their cardiovascular risk status prior to screening. In addition to intensive national, multisectoral education or risk factor education, opportunistic screening should be required, nationally scaled up and implemented in both urban and rural communities in Nigeria.

Author(s) Details

Geoffrey C. Onyemelukwe
Department of Medicine, Ahmadu Bello University Teaching Hospital Zaria, Zaria, Nigeria.

Oluwagbenga Ogunfowokan
Department of Family Medicine, National Hospital Abuja, Abuja, Nigeria.

Amam Mbakwem
Department of Medicine, Lagos University Teaching Hospital, Lagos, Nigeria.

A. Kayode Alao
Department of Family Medicine, Federal Medical Centre Keffi, Nigeria.

Kodjo Soroh
Pfizer Specialties Ltd, Nigeria/East Africa Region, Lagos, Nigeria.

Osahon Omorodion
Pfizer Specialties Ltd, Nigeria/East Africa Region, Lagos, Nigeria.

Paula Abreu
Pfizer Inc, New York, NY, USA.

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 10Feb
Emphasizing the Health Care Ethics: Overview of the Basics

Medicine and health care deals with human health, life and death, and medical ethics deal with ethical standards for medicine and health care practice, or how it can be done so that medical ethics questions are among the most relevant and consequential topics in human life. We address such questions in this summary in order to raise awareness of the fundamental ethics of health care: what is ethics, what are the different areas of ethics involved with medical practices, what are the forms of ethical methods in relation to medical practice. Conclusion: It is possible to raise knowledge of medical ethics in health care by recognizing the fundamentals of ethics.

Author(s) Details

Dr. Ahmed Bait Amer
Sultan Qaboose University Hospital, Muscat, Oman.

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 10Feb
Descriptive Study on Benchmarking of the Results from the Performed Activities in the Preventive Medicine in Schools in Some Regions of Republic of Bulgaria

Introduction: The Strategy for the Efficient Functioning of Maternity, Child and School Health requires steps for coordinated systemic approach and advertising for the health of children. The health status of the population depends, for the most part, on factors whose impact begins in infancy. It is also a reflection of the argument that child health care is an investment in future healthy generations, as the foundations for human health are laid in childhood and the health behavior of each person is created, ensuring the national human capital’s higher quality of life and health. Health promotion and prevention steps taken in early childhood, because of their progressive and long-term impact, can be expected to dramatically and permanently limit the pandemic of chronic and other diseases. The goal of the present work is to research, by benchmarking, the health and dental status of pupils aged 7 to 15 from the municipalities of Kardzhali and Sandanski.

Materials and methods: Schools from the municipalities of Kardzhali and Sandanski are included in the study, decided by a system of random selection. 1594 children aged from 7-15 years are included in the study. Physician-specialists: a pediatrician, an otorhinolaryngologist, an ophthalmologist and a dentist were involved in the tests. The “Dental Treatment/ Examination Form” and “Medical History and Screening Form” are used for registration of data from prophylactic examinations. Fisher’s criterion is used for the statistical analysis of data.

Results and Discussion: The comparative study of the health and dental status results of the children studied from the municipalities of Kardzhali and Sandanski indicates a statistically important difference in the early development of children from both municipalities in favor of children from the municipalities of Kardzhali and Sandanski (94 percent against 1 percent for Sandanski). There is a large difference in allergies between them, 1.38 percent and 15.44 percent, respectively. Diseases (heart disease and diabetes) were also identified in children from Kardzhali. The physician-otorhinolaryngologist test shows substantially lower levels of all the markers of the Kardzhali children tested. In contrast with the children of Sandanski, the visual acuity of the children of Kardzhali is 79 percent versus 64 percent with better values. The primary proportion of color deficiency cases is also lower in Kardzhali-0.13 percent than 1.29 percent . Esotropia/exotropia cases indicate higher levels of Kardzhali in the patients studied (4 percent against 0.4 percent ). The dental condition of the children from Kardzhali is stronger as a whole (64% versus 53%), but more favorable values of the children from Sandanski are observed by indicators: the incidence of caries, gingivitis and orthodontic problems.

Conclusion: The findings shown are alarming and there is a need to implement an intervention program that incorporates preventive measures aimed at encouraging wellness and health improvements in the community and children’s way of life.

Author(s) Details

J. Staykova
Preventive Medicine Department, Medical University, Sofia, Bulgaria.

R. Chilingirova
Regional Health Inspectorate, Kardzhali, Bulgaria.

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 10Feb
Detailed Study on Age Related Pattern of Awareness and Basic Knowledge on Zika Virus Disease among Women Visiting Children Immunization Unit in Enugu State University Teaching Hospital, Southeast Nigeria

Background: The Zika virus, which re-emerged in 2015, is an infectious agent of considerable public health significance. In certain infants of infected mothers, it is spread by mosquito bite, and is associated with microcephaly and some other neurological malformations. In the past, mild infections with this virus have been reported in the Americas, Asia, Africa, and the Pacific region, but it re-emerged in Brazil as a disease of real public health significance in 2015. On February 1, 2016, WHO declared Zika virus outbreak a “Public Health Emergency of International Concern” but in November of the same year, the emergency declaration was lifted.

Objectives: The aim of this study was to examine the age-related trend of Zika virus infection awareness and basic knowledge among women bringing children for immunization at a teaching hospital in southeastern Nigeria.

Materials and Methods: The research was performed between November 2016 and February 2017 in the Immunization unit of a Teaching Hospital, Southeast Nigeria. It was a cross-sectional, quantitative, empirical, descriptive study involving randomly chosen 256 women who brought children for immunization. The pre-tested, interviewer-administered, standardized questionnaire was used; the data was analyzed for windows using SPSS version 20.0.

Results: The largest number of respondents [112 (43.8 percent)] was between the ages of 30 and 39, followed by those between the ages of 20 and 29 [108(42.2 percent)]. Up to 38.3% of respondents had never heard of Zika virus, but compared to the 61.7% who were aware of Zika virus disease (P = 0.92), this was not statistically important. The highest number of people listened to it on TV[57(36.1%)]. Overall, respondents between the ages of 20 and 29 years reported an average percentage of basic information of 54.6 percent, while those between the ages of 30 and 39 years reported 49.8 percent.

Conclusions: Many respondents had never heard of the Zika virus before, and many also had low basic knowledge of Zika virus disease. Only those within the age range of 20 to 29 registered a mean percentage basic knowledge score of over 50.0 percent among respondents within the child bearing age group (54.6 percent ). Therefore, good strategies to address these gaps in awareness and knowledge among women of childbearing age who are mostly affected by Zika virus disease should be created.

Author(s) Details

Edmund O. Ndibuagu
Department of Community Medicine and Primary Health Care, Enugu State University College of Medicine, Parklane, Enugu, Nigeria and Esucom Health Care Delivery Research Initiative, Enugu State University College of Medicine, Parklane, Enugu, Nigeria.

Innocent I. Okafor
Esucom Health Care Delivery Research Initiative, Enugu State University College of Medicine, Parklane, Enugu, Nigeria and Department of Obstetrics and Gynaecology, Enugu State University College of Medicine, Parklane, Enugu, Nigeria.

Sussan U. Arinze-Onyia
Department of Community Medicine and Primary Health Care, Enugu State University College of Medicine, Parklane, Enugu, Nigeria and Esucom Health Care Delivery Research Initiative, Enugu State University College of Medicine, Parklane, Enugu, Nigeria.

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 10Feb
An Overview of Candida-associated Gastric Ulcer Until Yesterday, Today, and from Tomorrow — In Quest of the Etiology —

Gastric ulcer associated with Candida, although formerly thought to affect only weakened people, has been reported to occur in seemingly healthy people. While nothing but unspecific endoscopic features have been documented, the disease sometimes exhibits an apparently typical finding designated by the author as a candidarium. Helicobacter pylori (H. pylori)-negative, apparently immunocompetent patient without prior ulcers or history of lesions who have not been given non-steroidal anti-inflammatory drugs (NSAIDs), antibiotics, antineoplastics The natural history of the disease has been unclear, however the ulcer has been shown not only to occur but also to recur in a different location with a different form in a non-diabetic, Helicobacter pylori (H. pylori) In relation to candidiasis, immune deficiency has been recently identified, which may explain the cause of intractable gastric ulcer associated with Candida. Candida albicans has recently been shown in the oropharyngeal area to secrete a previously unknown cytolytic peptide pore-forming toxin (PFT), candidalysin, into an epithelial pocket that penetrates and triggers the mitogen-activated protein kinase (MAPK)/MAPK phosphatase 1 (MKP1)/c-Fos pathway, causing damage and immune cytokines to be published. Although the PFT directly injures the tissue with weakened cytokines, exerting an effect also on the neighboring cells, it induces immune counterparts to cause polymorphonuclear leukocytes (PMN) to ultimately end inflammation, resulting in the restitution or eradication of the fungus to the commensal state. As it can not be argued that such a phenomenon exists in the gastric mucosa, a potentially strong probability has emerged that Candida-induced ulcer is possibly the so-called Candida-associated gastric ulcer. A scientifically conclusive possibility has arisen that the so-called Candida-associated gastric ulcer is a Candida-induced ulcer due to recent developments in microbiology, molecular biology, and immunology. The disease has entered a point in which the etiology should be re-examined and the disease itself should be re-examined in the light of not only the character of the pathogens but also the immunological status of the hosts. The disease should therefore be re-examined in the light of recent immunological, microbiological and molecular biological findings.

Author(s) Details

Kenji Sasaki
Department of Internal Medicine, Midtown Medicare Clinic, Japan.

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