Effects of copper nanoparticles on performance, muscle and bone characteristics and serum metabolites in broilers.

Three hundred and twenty day old Hubbard broilers were randomly allocated to four treatments (8 replicates, 10 birds/pen) and were raised under standard management conditions. Birds in the first group served as control and were fed a corn based diet, while birds in the remaining three groups i.e.; A, B and C were fed with a basal diet supplemented with copper nanoparticles (CuNP) at 5, 10 and 15 mg /kg of diet respectively for 35 days. Supplementation of CuNP linearly increased (P≤0.05) body weight (BW), average daily weight gain (ADWG) and feed intake (FI) in broilers. Uric acid, glucose levels in blood and feed conversion ratio (FCR) reduced linearly (P≤0.05) with CuNP supplementation in diet. Supplementation of CuNP in the diet also linearly increased (P≤0.05) tibia weight, length, diameter, weight/length index (W/L) and Tibiotarsal index (TT index). Inclusion of CuNP in broilers diet linearly increased the measured parameters of muscle i.e.; pH, fiber diameter, fiber cross-sectional area, fascicle diameter, fascicle cross-sectional area (P≤0.05). Concentration of copper, iron, calcium and phosphorous in blood also increased line-arly (P ≤ 0.05) with CuNP supplementation. Overall, CuNP positively affected the growth performance, histological characteristics of muscles, bone strength and serum metabolites in broilers.

Microbial Colonization of Pneumatic Tourniquets in the Orthopedic Operating Room.

Background The rate of surgical site infections following orthopedic procedures is approximately 2% globally. Potential sources of contamination in the operating room include pneumatic tourniquets, blood pressure cuffs, and stethoscopes, among others. Our study aims to investigate microbial colonization on reusable pneumatic tourniquets stored and used in the orthopedic department of our institution and evaluate the efficacy of the cleaning protocols employed. Methods Over a course of two weeks, 26 samples were obtained. A total of 14 pneumatic tourniquets were sampled preoperatively on Monday morning following the weekly cleaning protocol of soaking the tourniquets in sodium hypochlorite for 30 minutes while 12 tourniquets were cultured immediately following the postoperative cleaning protocol of wiping the tourniquet clean with a cloth soaked in sodium hypochlorite. Samples were cultured on MacConkey and sheep blood agar and incubated at 37-degrees centigrade for a total of 48 hours. Organisms were identified and colony count was documented. The analysis was performed using the Fisher Exact test on SPSS v23 (IBM Corp., Armonk, NY, US). Results All 14 samples obtained after being soaked in sodium hypochlorite for 30 minutes cultured negative. However, four out of 12 (33%) samples obtained after simply wiping the pneumatic tourniquet with a cloth soaked in sodium hypochlorite cultured coagulase-negative Staphylococci. The difference between the two was significant (p=0.002). Conclusion Postoperative tourniquets, wiped with a cloth soaked in sodium hypochlorite and ready to be used on the next patient, were found to be contaminated with coagulase-negative Staphylococcus. This species is notorious for causing surgical site infections following implant-related surgeries potentially through direct inoculation and cross-infections intraoperatively and in storage. Efforts to identify the relationship with postoperative surgical site infections need to be made to suggest more aggressive cleaning protocols.

Rydberg-atom based radio-frequency electrometry using frequency modulation spectroscopy in room temperature vapor cells.

Rydberg atom-based electrometry enables traceable electric field measurements with high sensitivity over a large frequency range, from gigahertz to terahertz. Such measurements are particularly useful for the calibration of radio frequency and terahertz devices, as well as other applications like near field imaging of electric fields. We utilize frequency modulated spectroscopy with active control of residual amplitude modulation to improve the signal to noise ratio of the optical readout of Rydberg atom-based radio frequency electrometry. Matched filtering of the signal is also implemented. Although we have reached similarly, high sensitivity with other read-out methods, frequency modulated spectroscopy is advantageous because it is well-suited for building a compact, portable sensor. In the current experiment, ∼3 µV cm-1 Hz-1/2 sensitivity is achieved and is found to be photon shot noise limited.

Omitting histopathology in wrist ganglions. A risky proposition.

OBJECTIVES: To identify incidence and utility of histopathology in wrist ganglions.  METHODS: A retrospective study of 112  patients operated for wrist swellings between January 2009 and March 2014 at Aga Khan University Hospital, Karachi, Pakistan, was conducted. Medical records were reviewed for demographics, history, location and associated symptoms, provisional diagnosis and operative details. Histopathology reports were reviewed to confirm the final diagnosis.  RESULTS: One hundred and twelve patients were included in the study (34 males and 78 females) with a mean age of 28 ± 12 years. Ninety-five percent of ganglia were dorsally located and 85% were solitary in nature. Histopathology reports confirmed 107 as ganglion cysts, whereas 3 had giant cell tumor of tendon sheath and 2 were reported to be tuberculous tenosynovitis.  CONCLUSION: Although most of the time the clinical diagnosis conforms to the final diagnosis, the possibility of an alternate diagnosis cannot be ignored (4% in this study). We suggest routine histopathological analysis so that such diagnoses are not missed.

The role of MR myelography with intrathecal gadolinium in localization of spinal CSF leaks in patients with spontaneous intracranial hypotension.

BACKGROUND AND PURPOSE: Localization of spinal CSF leaks in CSF hypovolemia is critical in directing focal therapy. In this retrospective review, our aim was to determine whether GdM was helpful in confirming and localizing spinal CSF leaks in patients in whom no leak was identified on a prior CTM. MATERIALS AND METHODS: Forty-one symptomatic patients with clinical suspicion of SIH were referred for GdM after undergoing at least 1 CTM between February 2002 and August 2010. A retrospective review of the imaging and electronic medical records was performed on each patient. RESULTS: In 17 of the 41 patients (41%), GdM was performed for follow-up of a previously documented leak at CTM. In the remaining 24 patients (59%), in whom GdM was performed for a suspected CSF leak, which was not identified on CTM, GdM localized the CSF leak in 5 of 24 patients (21%). In 1 of these 5 patients, GdM detected the site of leak despite negative findings on brain MR imaging, spine MR imaging, and CTM of the entire spine. Sixteen of 17 patients with previously identified leaks underwent interval treatment, and leaks were again identified in 12 of 17 (71%). CONCLUSIONS: GdM is a useful technique in the highly select group of patients who have debilitating symptoms of SIH, a high clinical index of suspicion of spinal CSF leak, and no demonstrated leak on conventional CTM. Intrathecal injection of gadolinium contrast remains an off-label use and should be reserved for those patients who fail conventional CTM.

Perceptions about the cause of schizophrenia and the subsequent help seeking behavior in a Pakistani population - results of a cross-sectional survey.

BACKGROUND: There is a cultural variability around the perception of what causes the syndrome of schizophrenia. Generally patients with schizophrenia are considered dangerous. They are isolated and treatment is delayed. Studies have shown favorable prognosis with good family and social support, early diagnosis and management. Duration of untreated psychosis is a bad prognostic indicator. We aimed to determine the perceptions regarding the etiology of schizophrenia and the subsequent help seeking behavior. METHODS: This cross-sectional study was carried out on a sample of 404 people at the out patient departments of Aga Khan University Hospital Karachi. Data was collected via a self-administered questionnaire. Questions were related to a vignette of a young man displaying schizophrenic behavior. Data was analyzed on SPSS v 14. RESULTS: The mean age of the participants was 31.4 years (range = 18-72) and 77% of them were males. The majorities were graduates (61.9%) and employed (50%). Only 30% of the participants attributed 'mental illness' as the main cause of psychotic symptoms while a large number thought of 'God's will' (32.3%), 'superstitious ideas' (33.1%), 'loneliness' (24.8%) and 'unemployment' (19.3%) as the main cause. Mental illness as the single most important cause was reported by only 22%. As far as management is concerned, only 40% reported psychiatric consultation to be the single most important management step. Other responses included spiritual healing (19.5%) and Sociachanges (10.6) while 14.8% of respondents said that they would do nothing. Gender, age, family system and education level were significantly associated with the beliefs about the cause of schizophrenia (p < 0.05). While these variables plus 'religious inclination' and 'beliefs about cause' were significantly associated with the help seeking behavior of the participants. CONCLUSION: Despite majority of the study population being well educated, only a few recognized schizophrenia as a mental illness and many held superstitious beliefs. A vast majority of Pakistanis have non-biomedical beliefs about the cause of schizophrenia. Their help seeking behavior in this regard is inappropriate and detrimental to the health of schizophrenic patients. Areas for future research have been identified.

Atypical idiopathic scoliosis: MR imaging evaluation.

The authors analyzed the clinical and imaging findings in 30 consecutive pediatric, adolescent, and young adult patients who underwent MR imaging because of atypical features of idiopathic scoliosis. Atypical clinical and plain radiographic features included early onset (n = 4), rapid progression (n = 19), pain (n = 17), other neurologic symptoms or signs (n = 12), associated syndromes (n = 4), a convex left thoracic or thoracolumbar curve (n = 18), a kyphotic component (n = 7), and pedicle thinning (n = 4). MR imaging demonstrated 17 abnormalities in 11 patients: lumbar disk protrusions (n = 1), patulous intradural space (dural ectasia) (n = 3), hydrosyringomyelia (n = 7), Chiari I malformation (n = 5), and cord astrocytoma (n = 1). Significant associations with abnormal MR imaging findings were shown for patients with pain, weakness, abnormal neurologic findings, and atypical curvatures. Furthermore, there was a striking association of convex left thoracic or thoracolumbar scoliosis with hydrosyringomyelia (six of seven cases). On the basis of these results, "atypical" spinal curvatures at radiography and "atypical" clinical features should prompt performance of additional diagnostic studies.

Contraceptive use in Matlab, Bangladesh: the role of gender preference.

Research in several Asian societies has suggested that sons are generally preferred over daughters. The implications of gender preferences for actual fertility behavior have not been adequately investigated, however. This analysis examines the effect of the sex composition of surviving children on the acceptance and discontinuation of contraception in a sample of 3,145 women in Matlab, Bangladesh, who were observed for 60 months. Hazards regression analyses are employed in the analysis. Strong and highly significant effects of gender preference on contraceptive use are observed. The preference is not monotonically son-biased but is moderated toward a balanced composition, because parents desire to have several sons and at least one daughter. These findings suggest that gender preferences, particularly a preference for sons, represent a significant barrier to fertility regulation in rural Bangladesh.

PIP: Research in several Asian societies has shown that sons are preferred over daughters. This paper explores the effect of sex composition of surviving children on the acceptance and discontinuation of contraception in a sample of 3145 women in Matlab, Bangladesh, observed over a period of 60 months. Data were analyzed via hazards regression. Strong and significant effects of gender preference were found on contraceptive use. Specifically, parents have a strong preference for sons and a moderate preference for daughters. This conclusion is based upon bivariate analysis which revealed contraceptive acceptance and continuation rates to be higher among couples who have at least 1 surviving son than among couples who have no son; rates steadily increased with the number of surviving sons. Acceptance and continuation are lower, however, among couples who have only sons than among those who have children of both sexes. Parental sex preference is therefore moderated toward a balanced composition of several sons and at least 1 daughter. These preferences pose a significant barrier to fertility regulation in rural Bangladesh. Related literature is reviewed and the study are described.

Impact of measles vaccination on childhood mortality in rural Bangladesh.

This study examines the impact of measles vaccination on childhood mortality, based on longitudinal data from the Matlab maternal and child health/family planning programme in rural Bangladesh. It analyses the mortality experience of 8135 vaccinated and 8135 randomly matched nonvaccinated children aged 9-60 months, who were observed from March 1982 to October 1985. The results indicate that measles vaccination had a pronounced impact on both short- and long-term survival--the mortality rates for vaccinated children were as much as 46% less than those for nonvaccinated children. Immunization of children aged up to 3 years with measles vaccine appears to improve significantly their subsequent chances of survival. The findings underscore the need to give greater priority to measles vaccination within primary health care programmes in settings such as rural Bangladesh.

Contraceptive use patterns in Matlab, Bangladesh: insights from a 1984 survey.

An experimental maternal and child health and family planning programme has been in existence in Matlab for almost 10 years. During this time the project has achieved remarkable success in the area of family planning. Based upon a 1984 survey, this study examines the pattern of contraceptive use in the Matlab treatment area, and contrasts it with the regular government programme in the neighbouring comparison area. Important differences between the two areas are observed, with the treatment area characterized by substantially higher levels of current contraceptive use, greater reliance upon temporary methods for birth spacing and, among acceptors of sterilization, more prior experimentation with other methods. In the comparison area lower rates of contraceptive use are observed, with heavy reliance upon tubectomy for limiting family size. The findings suggest that an intensive and innovative family planning programme in rural Bangladesh can achieve success not only in terms of contraceptive prevalence, but can also attract users interested in child spacing and others wanting to limit their family size, by offering the widest range of contraceptive methods.

Size at birth of live-born Saudi infants.

Anthropometric measurements were done on 967 singleton live-born Saudi infants of gestational age 33 to 42 weeks who belonged to the high and middle social classes and who were born consecutively in Riyadh University Hospital. The 914 infants born at term (greater than or equal to 37 weeks) had a mean birthweight of 3.31 kg (SD 0.45), a mean length of 49.74 cm (SD 2.5) and a mean head circumference of 34.4 cm (SD 1.4). Values were significantly higher in males than females. Effect of sex in this study was not apparent until 40 weeks and later. Difference in body size was significant between the first-born and second infants but the trend was unimpressive with greater parity. Fifty-three (5.5%) of the infants were born preterm. Twenty-one of the preterm babies and 18 of the term infants weighed less than 2500 g, an overall incidence of low birthweight of 4%. Results were compared with studies from Saudi Arabia and other countries. It is concluded that there was no significant difference between birthweights of upper-class Saudis and Europeans.

PIP: An attempt to determine the mean birthweight of Saudi infants compared with infants from other countries is reported. Anthropometric measurements were performed on 967 singleton liveborn Saudi infants of 33-42 weeks' gestational age who belonged to the high and middle social classes. The 914 infants born at term (37 weeks or above) had a mean birthweight of 3.31 kg, a mean length of 49.74 cm, and a mean head circumference of 34.4 cm. Values were significantly higher in males than in females. The overall incidence of low birthweight in this series was 4%, which is comparable to that found among the British, US whites, and Iraqis. However, this figure would have been higher had the study population encompassed Saudi infants from the lower socioeconomic classes. Overall, these data show no significant differences between Saudi and European infants from the upper class in terms of standards of birthweight and suggest that race per se is not a major determinant of body size.

Sterilization in Bangladesh: mortality, morbidity, and risk factors.

Although surgical sterilization in Bangladesh is common and has been designated as the primary means of helping the country slow its population growth, no reliable information exists regarding the procedure's safety. To define the types and rates of medical complications associated with sterilization, we followed 5042 women and 264 men undergoing sterilization. The problems that increased most markedly after the procedure compared with before included painful urination, shaking chills, fever for at least 2 days, and frequent urination. Most of the postoperative problems could be predicted by the presence of the same problem before the operation. Factor analysis of complaints in those persons who did not have a specific preoperative complaint showed that complaints clustered into three groups: urinary tract symptoms (urinary urgency and frequency), skin problems (bleeding from the incision, sore with pus, and stitches or skin breaking open), and general complaints (weakness and dizziness). The patient's sex, the sponsor and patient load of the sterilization center, and the dose of sedatives administered to women were significantly associated with specific postoperative complaints. Five women died during the study, resulting in a death-to-case rate of 9.9/10,000 procedures tubectomies; four deaths were due to respiratory arrest caused by oversedation.

PIP: Data were collected from February-June 1980 on 5042 women and 264 men undergoing surgical sterilization in Bangladesh to define the types and rates of medical complications associated with sterilization. The major findings of this study are that: 1) one of every 1000 women undergoing sterilization in Bangladesh dies as a result of the procedure; 2) overuse of systemic sedatives is common and was the principle contributor to 5 deaths that occurred; and 3) chief health complaints are urinary tract symptoms, skin problems, and systemic complaints. The death-to-case rate of 9.9/10,000 procedures in this study is similar to the 10.0 deaths/10,000 cases estimated on the basis of a 1979 follow-up study in an Indian female sterilization camp. The presence of a complaint before the operation was generally a good predictor of postoperative complaints. Centers performing fewer than 200 procedures were associated with more complaints.

Use-effectiveness of standard-dose and low-dose oral contraceptives in Dacca.

Five hundred women accepting oral contraceptives at an urban clinic were alternately prescribed standard-dose (50 microgram of estrogen) or low-dose (30 microgram of estrogen) combined pills. Life-table continuation rates at 12 months were approximately 40% for both groups, with no significant differences between or within the two groups after controlling for sociodemographic variables and nutritional status. Approximately three fifths of those who discontinued using both formulations cited medical reasons, especially dizziness. The low-dose oral contraceptive appeared to be as acceptable to these urban Bangladeshi women as the higher-dose pill.

PIP: Results of an urban comparative study of continuation rates and reasons for discontinuation of standard-dose and low-dose oral contraceptives are presented. 500 females were alternately given standard-dose (0.5 mg of DL-norgestrel with 50 ug of ethinyl estradiol) or low dose (0.15 mg of levonorgestrel with 30 ug of ethinyl estradiol) pills. Nutritional status was measured according to Huffman's method. 110 women were excluded from the analysis for various reasons, leaving 192 standard-dose and 198 low-dose acceptors. Cumulative life-table rates show a slightly higher, but statistically insignificant continuation rate for low-dose acceptors at 3, 6, 9 and 12 months (40% for both groups). When age, parity and nutritional status were controlled, no significant differences in continuation rates were observed either between or within the 2 groups. Medical reasons, especially dizziness, accounted for nearly 1/2 of standard-dose discontinuation, and for about 1/3 of low-dose discontinuation. Low-dose pills were just as acceptable as the standard dose in this urban setting.