Effects of spinal manipulation or mobilization as an adjunct to neurodynamic mobilization for lumbar disc herniation with radiculopathy: a randomized clinical trial.

OBJECTIVES: To determine the long-term clinical effects of spinal manipulative therapy (SMT) or mobilization (MOB) as an adjunct to neurodynamic mobilization (NM) in the management of individuals with Lumbar Disc Herniation with Radiculopathy (DHR). DESIGN: Parallel group, single-blind randomized clinical trial. SETTING: The study was conducted in a governmental tertiary hospital. PARTICIPANTS: Forty (40) participants diagnosed as having a chronic DHR (≥3 months) were randomly allocated into two groups with 20 participants each in the SMT and MOB groups. INTERVENTIONS: Participants in the SMT group received high-velocity, low-amplitude manipulation, while those in the MOB group received Mulligans' spinal mobilization with leg movement. Each treatment group also received NM as a co-intervention, administered immediately after the SMT and MOB treatment sessions. Each group received treatment twice a week for 12 weeks. OUTCOME MEASURES: The following outcomes were measured at baseline, 6, 12, 26, and 52 weeks post-randomization; back pain, leg pain, activity limitation, sciatica bothersomeness, sciatica frequency, functional mobility, quality of life, and global effect. The primary outcomes were pain and activity limitation at 12 weeks post-randomization. RESULTS: The results indicate that the MOB group improved significantly better than the SMT group in all outcomes (p < 0.05), and at all timelines (6, 12, 26, and 52 weeks post-randomization), except for sensory deficit at 52 weeks, and reflex and motor deficits at 12 and 52 weeks. These improvements were also clinically meaningful for neurodynamic testing and sensory deficits at 12 weeks, back pain intensity at 6 weeks, and for activity limitation, functional mobility, and quality of life outcomes at 6, 12, 26, and 52 weeks of follow-ups. The risk of being improved at 12 weeks post-randomization was 40% lower (RR = 0.6, CI = 0.4 to 0.9, p = 0.007) in the SMT group compared to the MOB group. CONCLUSION: This study found that individuals with DHR demonstrated better improvements when treated with MOB plus NM than when treated with SMT plus NM. These improvements were also clinically meaningful for activity limitation, functional mobility, and quality of life outcomes at long-term follow-up. TRIAL REGISTRATION: Pan-African Clinical Trial Registry: PACTR201812840142310.

Availability of Drinking Water Source and the Prevalence of Diarrhea among Nigerian Households.

Diarrhea is highly prevalent in Nigeria and accounts for 16% of deaths among Nigerian children. The WHO classifies water source into two categories: improved and unimproved. This study aimed to examine the association between type of water source and the prevalence of diarrhea among members of a nationally representative sample of Nigerian households while controlling for key sociodemographic and household factors. This study used cross-sectional data from 22,571 households participating in the 2018 Water, Sanitation and Hygiene-National Outcome Routine Mapping survey. Data collectors visited and interviewed household members across all 36 states in the country. Logistic regression was used to assess associations between water source type and the odds of a family member reporting diarrhea, after controlling for financial status, availability of soap/detergent for handwashing, availability of a refrigerator in the home, toilet type, and urban/rural status. After controlling for explanatory variables in the adjusted model, having an unimproved water source was associated with greater odds of diarrhea among a family member (odds ratio, 1.59; 95% CI, 1.44-1.77). Not having a refrigerator and not having soap/detergent for handwashing were also associated with greater odds of diarrhea. In summary, this study found an association between water-source type and diarrhea prevalence among Nigerian households. This study is in line with prior studies in Nigeria and elsewhere, and the results call for greater commitment and action by stakeholders to improve water sources and, ultimately, reduce the prevalence of diarrhea in Nigeria.

Community-Level Factors Associated With Geographic Access to Food Retailers Offering Nutrition Incentives in Chicago, Illinois.

INTRODUCTION: Nutrition incentive programs provide low-income populations with a monetary resource to make healthy foods affordable and accessible. This study aimed to use geospatial analysis to evaluate availability of the Link Match nutrition incentive program in Chicago, Illinois, to determine whether underresourced communities have access. METHODS: We obtained 2018 spatial data on census tract-level sociodemographic characteristics in Chicago. Fifty-seven retailers (eg, farmers markets, food cooperatives) offered Link Match across the city's 801 census tracts. We examined ordinary least squares and spatial lag regression models to identify census tract-level variables associated with distance (in miles) from the nearest Link Match retailer. Variables of interest included percentage of non-Hispanic Black residents, percentage of Hispanic residents, median household income, violent crime rate, per capita grocery store availability, and walkability. RESULTS: Most Link Match retailers were located on Chicago's South and West sides. Ordinary least squares regression models indicated that low-income census tracts were on average closer to a Link Match retailer than higher-income tracts were (P < .001). Tracts in the highest quartile of violent crime were also significantly closer to a Link Match retailer than tracts in the lowest quartile (P < .001). After accounting for spatial dependency of census tracts, only violent crime rate was significantly associated with distance to nearest Link Match retailer. CONCLUSION: Link Match retailers in Chicago appear to be in underresourced communities. However, these areas have high violent crime rates, which may negatively influence program use. Additional research is needed on how social and environmental factors influence availability and use of nutrition incentive programs.

Comparative studies of semen quality traits and sperm kinematic parameters in relation to fertility rate between 2 genetic groups of breed lines.

Semen quality is important for roosters' fertility. The correlations between semen quality traits and fertility has less been analyzed, impeding the selection of effective parameters for roosters selection. This research aimed to investigate the variation in semen quality traits in relation to fertilization capacity between 2 chicken breeds. A total of 156 Rhode Island Red (n = 78) and White Leghorn (n = 78) roosters of 53 wk were selected for semen quality estimation including semen volume, pH, sperm concentration, motility, viability, abnormal sperm percentage, and sperm kinematic parameters. Individual fertility was measured by artificial insemination using each 30 birds from 2 breeds. Significant variations were observed between breeds in semen volume, pH, sperm motility (MOT), viability, and abnormal sperm percentage (P < 0.05). The volume, MOT, and viability in Rhode Island Red were higher than those of White Leghorn roosters (P < 0.001). In addition, sperm kinematic parameters such as curvilinear velocity (VCL), straight line velocity (VSL), amplitude lateral head displacement (ALH), and average path velocity (VAP) in Rhode Island Red were higher than those of White Leghorn (P < 0.001). Fertility rate was positively correlated with MOT (r = 0.57), concentration (r = 0.43), viability (r = 0.39), VSL (r = 0.36), ALH (r = 0.43), and ALH (r = 0.38) for Rhode Island Red roosters (P < 0.05). Fertility rate of White Leghorn roosters was positively correlated with MOT (r = 0.71), concentration (r = 0.39), VCL (r = 0.52), ALH (r = 0.50), and VAP (r = 0.39) (P < 0.05). Principal component analysis of sperm kinematic descriptors revealed 2 principal components explaining more than 65% of total variance. In addition, for both genetic lines, the whole population was divided into 3 independent clusters. These results indicated that selection of roosters based on semen quality traits for may improve the fertility, and multivariate analysis may help to precise selection by comprehensive usage of different measures of sperm quality.

Grewia mollis Leaf Extracts and Fractions Demonstrated Good Inhibitory Activity on Pro-Inflammatory Enzymes and with Lower Cytotoxicity in vitro.

INTRODUCTION: Plant extracts are used to treat illnesses, promote health, and maintain general well-being in traditional medicine. Grewia mollis Juss (Malvaceae) is one of the medicinal herbs that is used traditionally to treat chronic diseases and related pain because currently used anti-inflammatory drugs may cause severe side effects, and naturally occurring compounds with reduced cytotoxicity could be explored for therapeutic goals. MATERIALS AND METHODS: Dried leaf of G. mollis was extracted with aqueous and organic solvents and partitioned based on polarity using solvent-solvent methods. The extracts were tested in anti-inflammatory assays against cyclooxygenases and lipoxygenase, and the safety profile was determined in a cell-based in-vitro assay. RESULTS: The n-hexane fraction of G. mollis leaf extracts had significant activity against both COX-1 (IC50 =0.97±1.9 µg/mL) and COX-2 (IC50 =1.13±0.2 µg/mL) better than the indomethacin positive control (IC50 =1.3±0.6 and 1.52±0.2 µg/mL), respectively (p≤ 0.05). Also, all the extracts and fractions of G. mollis tested inhibited the activity of 15-LOX (IC50 =12.48±2.9 to 29.43±9.9 µg/mL) better than the quercetin reference control (IC50 =61.82±5.5 µg/mL), with the butanol fraction demonstrating the best anti-15 LOX action (IC50 =12.48±2.9 µg/mL). Furthermore, all the extracts and fractions of G. mollis had relatively lower cytotoxicity on vero monkey kidney cells (LD50 =30.56-479±0.07 µg/mL) compared to the doxorubicin positive control (LD50 =2.59 µg/mL), but the selectivity index (SI=1.04-1.89) determination suggested that some of the extracts may contain toxic constituents. CONCLUSION: Organic extracts of the leaves of Grewia mollis contained bioactive molecules with potent action on COX-2 and 15-LOX. Targeted high-resolution high-performance liquid chromatographic (HPLC) methods have streamlined and enhanced bioactive compound isolation and purification process. This allows for the separation of undesirable compounds that could cause metabolic cytotoxicity in the plant extract mixtures. The method could be used to develop an alternative therapeutic strategy to manage pain associated with chronic inflammation where the use of NSAID is problematic.

Neurocysticercosis in people with epilepsy in Sub-Saharan Africa: A systematic review and meta-analysis of the prevalence and strength of association.

PURPOSE: We analyzed studies on neurocysticercosis (NCC) and epilepsy across Sub-Saharan Africa (SSA) to determine the prevalence of NCC in people with epilepsy (PWE) and the strength of association of NCC with epilepsy in the region. METHODS: We conducted a systematic review of the existing literature on NCC and epilepsy in SSA. Diagnostic methods for NCC in the studies selected for our analysis included one or more of the following: positive brain CT, serum ELISA and serum EITB. A common prevalence and overall odds-ratio were then estimated using meta-analysis. RESULTS: A total of 25 (overall) and 20 (case-control) studies met the inclusion criteria for the prevalence and strength of association estimation, respectively. The overall prevalence estimate of NCC in PWE was 22 % [95 % confidence interval [CI]: 17-27.0 %). The figures were higher in the Southern and Eastern Africa sub-region (45 % and 25 % respectively) but lower in the Central and Western Africa sub-region (6 % and 15 % respectively). The prevalence of NCC estimate in PWE varied with method of diagnosis; with 29 % 18 % and 15 % in studies that used a minimum of Brain CT, ELISA and EITB respectively. The overall odds ratio was 2.4 (95 % CI 2.1-2.8), p < 0.0001. CONCLUSION: The overall prevalence of NCC in PWE in SSA was 22 %. The prevalence figure varied with the sub-region of SSA. The odd of NCC in PWE in SSA was 2.4. In spite of the sub-regional variation in NCC prevalence, this meta-analysis suggests that neurocysticercosis contributes significantly to epilepsy in SSA.