Factors influencing quality of life in children with tracheostomy with emphasis on home care visits: a multi-centre investigation.

OBJECTIVE: Only a few studies have assessed the quality of life in children with tracheostomies. This study aimed to evaluate the quality of life and the factors influencing it in these children. METHOD: This cross-sectional, two-centre study was conducted on paediatric patients living in the community with a tracheostomy by using the Pediatric Quality of Life Inventory. Clinical and demographic information of patients, as well as parents' socioeconomic factors, were obtained. RESULTS: A total of 53 patients met our inclusion criteria, and their parents agreed to participate. The mean age of patients was 6.85 years, and 21 patients were ventilator-dependent. The total paediatric health-related quality of life score was 59.28, and the family impact score was 68.49. In non-ventilator-dependent patients, multivariate analyses indicated that social functioning and health-related quality of life were negatively affected by the duration of tracheostomy. The Quality of Life of ventilator-dependent patients was influenced by care visits and the presence of pulmonary co-morbidities. CONCLUSION: Children with tracheostomies have a lower quality of life than healthy children do. Routine care visits by a respiratory therapist and nurses yielded significantly improved quality of life in ventilator-dependent children.

Food habits and associated risk factors of depressed patients with cardiovascular disease.

The present study was carried out to investigate food habits and associated risk factors of depressed patients with cardiovascular disease in Riyadh city, Saudi Arabia. Depressed and healthy females (n = 30 each) and males (n = 30 each) aged 18-65 years were involved in this study. Sociodemographic, anthropometric proxies, and nutritional status were evaluated. Cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-c), and low-density lipoprotein cholesterol (LDL-c) levels of respondents' blood were determined. The respondents were varied according to demographic factors and anthropometric proxies. The majority of depressed males had higher values than healthy ones. The student t-test analysis showed that the average daily intake of fat especially saturated fat, by depressed respondents was higher than that of the healthy ones as well as the dietary requirement intake (DRI). The analysis of respondents' blood showed that the number of depressed females had higher abnormal HDL-c than males, who were observed to have an abnormal level of cholesterol and triglycerides. The correlation of daily nutrient intake and depression duration, depression severity, and age showed that the nutrients responsible for the extension and severity of depression were intake of food rich in dietary fat. Factors including demographics daily nutrient intake appeared to be associated with depression.

Food waste posing a serious threat to sustainability in the Kingdom of Saudi Arabia - A systematic review.

Worldwide, food waste is one of the prime issues threatening food security and the Kingdom of Saudi Arabia (KSA) is not an exception. With 427 kg of food wasted per capita per year, the country ranks among the top food wasters. Ironically, the Kingdom has limited arable lands and scarce water resources to support mass-scale agriculture and to feed its increasing population, KSA relies heavily on imports and subsidized food to meet needs. Yet, food is wasted at restaurants, caterers, cafeterias and, especially, by households such that food waste is the single-largest component of the landfills. The review article is based on the grey and scientific literature published in the English and Arabic languages on the issue of food waste in Saudi Arabia. Information sources like Web of knowledge, online resources and the databases available through the King Saud University, Saudi Arabia were accessed and used to collect information on food waste, its social, cultural, economic and environmental impacts and related topics. Since food items and groceries are abundantly available to all living in KSA and they are highly subsidized, the residents take food for granted. According to a recent survey, about 78% of food purchased in KSA is discarded each week in order to make room for new groceries. The factors responsible for food waste include: lack of awareness; and insufficient and inappropriate planning when shopping. Food waste in restaurants, celebrations, social events and occasions are enormous. Waste is common in festivals and special events where the customs is to provide more food than required. There is a need to change society's food culture, particularly among the women and the youth, as they are largest segment of the society and the prime food wasters. The analysis of the factors responsible for food waste, identified in this article suggests a "Stop Wasting Food" campaign should be launched. It is also recommended to determine and activate the role of extension education to reduce food waste in the KSA through vibrant capacity building programs for youth and women, in particular, and society in general.

Assessment of farmers on their knowledge regarding pesticide usage and biosafety.

PURPOSE: Inappropriate application of pesticides is quite common in the study area, causing health issues and in some cases fatalities. The intent of the current study is to gauge the farmers' level of knowledge on the safe usage of pesticides and biosafety to keep the famers healthy through the focused extension programs. METHODOLOGY: The study is carried out in 41 union councils of Tehsil Sahiwal, District Sahiwal, Punjab, Pakistan. Data are collected through a cluster sampling technique by conducting face-to-face interviews. Statistical analysis is used to determine relationships and interpret them. RESULTS: The findings show that the majority of farmers (87.2%) earn their livelihoods from farming and 2.1% are traders. More than half of the respondents (51.8%) own small land-holdings with an area of 4-8 ha, with only 16.4% having a land area of more than 12 ha. The results also reveal that the majority of respondents obtain information from private agents and only about one third (34.4%) respondents get information on the safe usage of pesticides from the Department of Agriculture (Extension). The internet has emerged as a fast and reliable source of information in the new paradigm; however, only 14.4% of the respondents take advantage of this economical and fast information tool/medium. The findings also reveal that the farmers employ unhealthy and poor practices by not following the recommendations regarding the safe usage of pesticides. The study also reveals that more than half of the farmers (54.4%) use unsafe storage practices on their farms, and about 48.2% do not follow the instructions. CONCLUSIONS: Inappropriate application of pesticides can have negative effects on human health and the adoption safety measures are necessary to avoid the harmful effects of pesticides. Due to high illiteracy in the area, farmers mainly seek advice of neighboring farmers, having ignorance on the biosafety issues. Variables like education level, land ownership, total land size and the trainings on safe pesticide usage significantly influence the knowledge level of farmers on the safe usage of pesticides. RECOMMENDATIONS: Farmers do not follow the recommendations of the extension department or the instructions printed on pesticide bottles/containers, therefore educational (formal and informal) and training programs are necessary on the safe pesticide usage to upgrade their skills and expertise on safe usage of pesticides and the importance of biosafety.

Gravitational Field effects on the Decoherence Process and the Quantum Speed Limit.

In this paper we use spinor transformations under local Lorentz transformations to investigate the curvature effect on the quantum-to-classical transition, described in terms of the decoherence process and of the quantum speed limit. We find that gravitational fields (introduced adopting the Schwarzschild and anti-de Sitter geometries) affect both the decoherence process and the quantum speed limit of a quantum particle with spin-1/2. In addition, as a tangible example, we study the effect of the Earth's gravitational field, characterized by the Rindler space-time, on the same particle. We find that the effect of the Earth's gravitational field on the decoherence process and quantum speed limit is very small, except when the mean speed of the quantum particle is comparable to the speed of light.

Tubulointerstitial Nephritis as the Initial Presentation of Crohn's Disease and Successful Treatment with Infliximab.

Tubulointerstitial nephritis (TIN) is not commonly associated in aminosalicylate-naïve patients with Crohn's disease (CD). Our case describes the initial presentation, diagnosis, and management of an adolescent presenting with TIN and underlying CD. Our case emphasizes that CD should be considered in the differential diagnosis of interstitial nephritis as not only a medication-related effect, but also as an extraintestinal manifestation of CD. We also describe successful management of undiagnosed recurring and symptomatic CD-related TIN with infliximab.

Anthelmintic properties of extracts from Artemisia plants against nematodes.

Artemisia plant genus, natural inhabitant of northern Punjab Pakistan, is well known for its anthelmintic properties; many Artemisia species have not been so far scientifically proved. The aim of this study was to assess in vitro anthelmintic activity of Artemisia indica and Artemisia roxburghiana against mixed infection of gastrointestinal nematodes in small ruminants. This study is first scientifically proven study on anthelmintic activity of A. indica and A. roxburghiana. Five different concentrations (50, 25, 12.5, 6.25 and 3.75 mg/mL) accompanied by negative control (PBS) and positive control (albendazole, 10%) were used to carry out the egg hatch inhibition assay, larval mortality assay and adult worm mortality assay. The Baermann technique was used first time in larval mortality assay and proved to be effective. The results revealed that methanolic extracts of both A. indica and A. roxburghiana, showed maximum anthelmintic activity at concentration of 50 mg/ml by egg hatch inhibition (85±21.2; 80±28.3), larvae mortality (18±2.8; 17±4.2) and adult worm mortality (8.5±2.1; 8±2.8) assays. However, at concentration of 50 mg/ml both plant extracts in comparison to albendazole showed statistically insignificant (p≤0.05) results. The A. indica showed higher anthelmintic activity at all concentrations as compared to A. roburghiana. It has been concluded both plants exhibit anthelmintic activity and further evaluation of these plants should be carried out to purify the active ingredients for anthelmintic activity. Moreover, the decoctions of these plants could be used to GINs after confirming anthelmintic properties through in vivo.

Gastrointestinal manifestations in diploid/triploid mixoploidy.

A girl infant was delivered by cesarean section at 32 weeks of gestation because of growth arrest and poor movement patterns. The infant had feeding problems, which were based on gastroesophageal reflux, laryngomalacia, and decreased gut motility. Hypotonia was notable from the outset, and the patient eventually displayed significant delays in both motor and cognitive milestones. Meanwhile, lymphocytes had yielded a normal karyotype (46,XX), but at 2 years of age the patient underwent a skin biopsy and mosaicism because a 68,XX cell line was discovered in fibroblasts. At the age 6.4 years, the patient is short of stature below the 3rd percentile but has a weight at the 42nd percentile and head circumference above the 97th percentile. Other phenotypic features include low-set ears, piebald irides and scalp hair, eyelid ptosis, strabismus, broad nasal bridge, anteverted nares, upswept eyebrows, hypoplastic teeth, pectus excavatum, hypoplastic labia, scoliosis, 3-4 finger syndactyly, and 2-3 toe syndactyly. We present this case with a review of the literature for mixoploidy (the rare event of mosaicism for diploid and triploid cell lines). We add to the existing data on the clinical features of diploid/triploid mixoploidy. The complexities of the gastrointestinal problems make this case unusual.

An insight into functional genomics of transgenic lines of tomato cv Rio Grande harbouring yeast halotolerance genes.

Tomato cv Rio Grande plants were transformed with yeast halotolerance genes (HAL I or HAL II) using pPM7HAL I or pJRM16HAL II, with p35GUSINT as control. Transformation efficiency varied in the three constructs, with highest transformation found with p35GUSINT. Final selection of the transgenic plants was made on the basis of PCR. Transgene integration and copy number were assessed by Southern hybridisation. The primary transformants were allowed to self-pollinate and the expected Mendelian ratios were studied in second-generation progeny. Five independent homozygous lines each of HAL I and HAL II, as well as the control, were characterised to study inter-transformant expression variability. The transformants showed considerable variability in expression of the respective genes, as shown by salt tolerance assays, chlorophyll content and peroxidase activity. The transgene expression in transgenic lines was analysed by semi-quantitative RT-PCR. In response to different salt concentrations, transgenic plants over-expressing HAL I and HAL II had significantly (α=0.05) better performance than the control This study presents the comparative responses of the three constructs under the same transformation conditions and suggests possible mechanisms governed by yeast HAL I and HAL II genes, which seem to work in a coordinated manner by relatively decreasing osmotic and oxidative shock at different rates. Our results suggest that the yeast HAL I increases K(+) /Na(+) selectivity and has a more functional role than HAL II in improving salt tolerance of the tomato cv Rio Grande grown in Pakistan.

Conservative management of a grade V injury to an ectopic pelvic kidney following blunt trauma to the lower abdomen: a case report.

INTRODUCTION: Ectopic pelvic kidneys represent an anatomic variant that remains clinically asymptomatic in most patients. While there is some literature to suggest that ectopic kidneys may be more predisposed to blunt trauma injuries, there are few examples to guide the management of these injuries. To our knowledge, we present the first case of a grade V renal injury to an ectopic pelvic kidney managed successfully with conservative measures. CASE PRESENTATION: We present a case of grade V renal injury to an ectopic pelvic kidney in a 21 year-old African-American male. The clinical and radiographic findings are presented, along with the patient's conservative hospital course. CONCLUSION: We suggest that management of grade V renal injuries to ectopic pelvic kidneys can be treated similarly to that of kidneys in normal anatomic position. Conservative measures may be considered in properly selected patients.

High-quality plant DNA extraction for PCR: an easy approach.

Polymerase chain reaction has found wide applications in modern research involving transformations and other genomic studies. For reproducible PCR results, however, the quantity and quality of template DNA is of considerable importance. A simple and efficient plant DNA extraction procedure for isolation of high-quality DNA from plant tissues is presented here. It requires maceration of plant tissue of about 1.0 cm(2) (e.g. of a leaf blade) in DNA extraction buffer (100 mM Tris-HCl, 100 mM EDTA, 250 mM NaCl) using 1.5-mL microfuge tubes, followed by cell lysis with 20% SDS, and DNA extraction with phenol: chloroform: iso-amyl alcohol (25:24:1). Hydrated ether is then used to remove polysaccharides and other contaminants from the DNA preparation. Average DNA yield is 20-30 microg cm(-2) for fresh tissues, and ratio of absorbance at 260 nm to absorbance at 280 nm is 1.5-1.8. The DNA is quite suitable for PCR using microsatellites, RAPD and specific markers for recombinant selection. Amplifications have been obtained for these markers by using template DNA extracted from fresh as well as frozen leaf tissues of various plants, including barley, oat, potato and tomato. DNA stored for more than 2 years has been successfully amplified with microsatellite markers, which shows suitability of this method after long-term storage of DNA. Besides, the ease of use and cost-effectiveness make the procedure attractive.

Influence of the nature of the T-DNA insertion region on transgene expression in Arabidopsis thaliana.

In the experiment reported here, effect of the nature of T-DNA integration region on the activity of the transgenes was studied by using a colour marker gene in Arabidopsis thaliana. For this purpose a pale homozygous ch-42 mutant was transformed with the wild-type copy of the gene (CH-42) using kanamycin resistance gene as a selectable marker. Two independent lines were identified in which CH-42 transgene was inactive. The T-DNA flanking sequences were recovered from these inactive and two active lines. These flanking sequences were used to examine copy number and DNA methylation of the T-DNA insertion site in active and inactive lines. Southern blots produced by using MspI/HpaII digested genomic DNA showed signs of methylation in both inactive lines. Furthermore, in one of the inactive line the T-DNA flanking sequence probe hybridized to highly repetitive sequence. The results suggest some correlation between silencing of the transgene and methylation of its insertion region.

Treatment of facial superficial basal cell carcinomas with imiquimod 5% cream.

Basal cell carcinoma (BCC) is the most common form of skin cancer and occurs predominantly as two forms, nodular or superficial. We report cases of two females who presented with facial BCCs, one with a 2-month history of superficial BCC with a dual growth pattern (superficial BCC overlying a deep micronodular pattern BCC), and the other with a 4-year history of superficial BCC. Both patients had undergone previous unsuccessful treatments. Differing responses of facial superficial BCCs were observed following daily treatment with imiquimod 5% cream over 6 weeks. This included a treatment failure in the BCC with a dual growth pattern and complete clearance of the other superficial BCC.

Antimicrobial susceptibility in community-acquired bacterial pneumonia in adults.

OBJECTIVES: To determine the antimicrobial susceptibility patterns of Streptococcus pneumoniae and Haemophilus influenzae, two bacterial pathogens commonly associated with community-acquired pneumonia. DESIGN: Cross-sectional study. SETTING: Bacterial isolates were obtained from adults suspected to have community-acquired pneumonia and who sought treatment at two city council clinics in Nairobi, Kenya. Susceptibility to antimicrobial agents was performed using a microdilution broth method, according to the criteria set by the National Committee for Clinical Laboratory Standards. RESULTS: A total of 277 S. pneumoniae and 58 H. influenzae were obtained from 536 adults examined in the period January 1998 to December 1999. Of the 277 S. pneumoniae, only 56.7% were susceptible to penicillin and 7.6% of strains were resistant to two or more antimicrobial agents. Of the 58 H. influenzae strains, 91.4% were sensitive to ampicillin, with 6.8% resistant to two or more antimicrobial agents. 8.6% were beta-lactamase producers and accounted for the entire ampicillin-resistant population. CONCLUSION: The prevalence of resistance to penicillin and other commonly used antibiotics among pneumococci is high and the large number of multi-resistant strains among H. influenzae is a cause for concern. The prudent use of antibiotics in treatment of pneumonia and other infections should be advocated to minimise spread of resistance.

Porcine neural xenografts in rats and mice: donor tissue development and characteristics of rejection.

Embryonic ventral mesencephalic tissue from the pig is a potential alternative donor tissue for neural transplantation to Parkinson's disease patients. For stable graft survival, the host immune response has to be prevented. This study was performed in order to analyze the mechanisms and dynamics of neural xenograft rejection, as well as neurobiological properties of the donor tissue. Adult normal mice and rats, and cyclosporin A-treated rats, received intrastriatal transplants of dissociated embryonic ventral mesencephalic pig tissue that was 27 or 29 embryonic days of age (E27 and E29). The animals were perfused at 2, 4, 6, and 12 weeks after grafting and the brains were processed for immunohistochemistry of dopaminergic (tyrosine hydroxylase positive) neurons, CD4(+) and CD8(+) lymphocytes, natural killer cells, macrophages, microglia, and astrocytes. Thirty-five rats received daily injections of BrdU for 5 consecutive days at different time points after transplantation and were perfused at 6 weeks. These animals were analyzed for proliferation of cells in the donor tissue, both in healthy and in rejecting grafts. No tyrosine hydroxylase-positive cells proliferated after grafting. Our results demonstrated that E27 was superior to E29 donor tissue for neurobiological reasons. Cyclosporin A immunosuppression was protective only during the first weeks and failed to protect the grafts in a long-term perspective. Grafts in mice were invariably rejected between 2 and 4 weeks after transplantation, while occasional grafts in untreated rats survived up to 12 weeks without signs of an ongoing rejection process. CD8(+) lymphocytes and microglia cells are most likely important effector cells in the late, cyclosporin A-resistant rejection process.

Effects of immunosuppressive treatment on host responses against intracerebral porcine neural tissue xenografts in rats.

BACKGROUND: Embryonic xenogeneic neural tissue is an alternative for transplantation in Parkinson's disease, but immune responses limit the application. The aims of this study were to enhance the in vitro viability rates by donor tissue pretreatment; to compare the efficacy of cyclosporine A (CsA) and tacrolimus (FK) in inhibiting xenograft rejection in rats; to evaluate additional inductive therapy with prednisolone (PRE) or mycophenolate mofetil (MMF). METHODS: Tirilazad (a lipid peroxidase inhibitor) or FK and acYVAD-cmk (a caspase inhibitor), were added to embryonic porcine ventral mesencephalic tissue and viability was assessed in vitro. Tirilazad-treated tissue was grafted to the striatum of rats that were either left untreated or immunosuppressed with FK (1 mg/kg) or CsA (15 mg/kg) alone or in combination with a 2-week PRE (20 mg/kg) or MMF (40 mg/kg) induction course. Xenograft survival and host responses were determined using immunohistochemistry. RESULTS: Pretreatment with tirilazad enhanced tissue survival in vitro. After transplantation into untreated controls, there was no graft survival at twelve weeks. Neural cell counts were significantly improved in immunosuppressed recipients, but there were no differences between the treatment groups. Additional inductive treatment reduced the infiltration with CD4+ and CD8+ cells, and macrophage infiltration was reduced compared with animals given CsA or FK alone. CONCLUSION: Pretreatment of the donor tissue with free-radical scavengers reduces cell loss caused by tissue trauma. Porcine neural tissue xenografts survive significantly better in animals immunosuppressed with either FK or CsA. Additional inductive treatment with PRE or MMF reduced the infiltration of host cells into the xenografts.

The absence of reactive astrocytosis is indicative of a unique inflammatory process in Parkinson's disease.

Virtually any neurological disorder leads to activation of resident microglia and invasion of blood-borne macrophages, which are accompanied by an increase in number and change in phenotype of astrocytes, a phenomenon generally termed reactive astrocytosis. One of the functions attributed to activation of astrocytes is thought to involve restoration of tissue damage. Hitherto, the role of astrocytes in the inflammatory reaction occurring in Parkinson's disease has not received much attention. In the present study, we examined the inflammatory events in autopsies of the substantia nigra and putamen from Parkinson's disease patients using age-matched autopsies from normal patients as controls. In the substantia nigra, activation of microglia was consistently observed in all Parkinson's disease autopsies as verified from immunohistochemical detection of CR3/43 and ferritin. Activation of resident microglia was not observed in the putamen. No differences were observed between controls and Parkinson's disease autopsies from the substantia nigra and putamen, in terms of distribution, cellular density or cellular morphology of astrocytes stained for glial fibrillary acidic protein or metallothioneins I and II, the latter sharing high affinity for metal ions and known to be induced in reactive astrocytes, possibly to exert anti-oxidative effects. Together, these findings indicate that the inflammatory process in Parkinson's disease is characterized by activation of resident microglia without reactive astrocytosis, suggesting that the progressive loss of dopaminergic neurons in Parkinson's disease is an ongoing neurodegenerative process with a minimum of involvement of the surrounding nervous tissue. The absence of reactive astrocytosis in Parkinson's disease contrasts what follows in virtually any other neurological disorder and may indicate that the inflammatory process in Parkinson's disease is a unique phenomenon.

Saline-induced dilutional acidosis in a maintenance hemodialysis patient.

A patient with end-stage renal disease developed severe hyperchloremic acidosis (venous serum total CO2 level of 10 mmol/L) after treatment with 16 L of isotonic saline. Analysis of this case and published literature indicates that dilutional acidosis may result when very large volumes of isotonic saline are administered intravenously, especially in patients with impaired or absent renal function.