Prevalence of night eating syndrome among inbound call centre employees in Kuala Lumpur, Malaysia.

Background: Night eating syndrome (NES) is described as a disordered eating pattern relative to sleep, where consumption of food occurs in the evening and night. Numerous studies had been conducted in various populations but studies on (NES) among call centre employees are limited. Aim: This study aimed to determine the prevalence of NES and its determinants among selected inbound call centre employees in Kuala Lumpur, Malaysia. Methods: In this cross-sectional study, a total of 217 inbound call centre employees were recruited through random sampling. A self-administered socio-demographic and work-related questionnaire was used to collect data on the background of the respondents. Information on NES and well-being was obtained by using the Night Eating Questionnaire (NEQ) and World Health Organisation-Five Well-Being Index (WHO-5) respectively. Data on dietary intakes, smoking habits, alcohol intakes and life stress were acquired using a Simple Lifestyle Indicator Questionnaire (SLIQ) while eating behaviour of the respondents was studied using the Three-Factor Eating Questionnaire (TFEQ-18). Results: The mean age of the respondents was 24.1 ± 6.0 years. The prevalence of NES was 12.0% (95% CI = 8.12-17.24). The binary logistic regression identified that NES is significantly associated with adequate exercise (AOR = 4.250, p = 0.012) and emotional eating (AOR = 6.510, p = 0.014). Conclusion: This study showed that the prevalence of NES was high in the call centre and repeated nocturnal eating can have multiple adverse health effects. Therefore, promoting healthy eating habits are crucial to reduce the impacts of NES.

Coronary artery bypass grafting in a patient with hereditary hemorrhagic telangiectasia.

Hereditary hemorrhagic telangiectasia (HHT, Osler-Weber-Rendu syndrome) is an autosomal dominant condition which usually presents with recurrent epistaxis, due to the presence of mucocutaneous telangiectasia, and circulatory arteriovenous malformations (pulmonary, hepatic, cerebral and spinal). We present a patient with HHT and coronary artery disease, who underwent coronary artery bypass grafting with a successful outcome.

A review of safety incidents in England and Wales for vascular endothelial growth factor inhibitor medications.

PURPOSE: To learn from patient safety incidents (PSIs) following recent introduction of vascular endothelial growth factor inhibitor medications (anti-VEGF) in ophthalmic care, as reported via a national incident reporting database. METHODS: Thematic retrospective review of anti-VEGF medications PSIs as reported via clinical incident reporting methods in NHS care in England and Wales from 2003 to 2010, ascertained from database mining at the National Patient Safety Agency (NPSA). RESULTS: In all, 166 relevant anti-VEGF incidents were reported. Reports have increased year on year from 2006. Incident severity as reported: 10 were reported as 'severe harm' and 23 as 'moderate harm'. The remainder were 'low' or 'no harm' events. The incident themes and/or causes found and by order of severity included: intra-ocular inflammation/endophthalmitis (n=16); treatment or follow-up delays (n=45); wrong medication (n=26); wrong eye/patient injection (n=17); missing records (n=12). Other problems included medication availability and refrigeration failures. We reflect on potential solutions for addressing the matters found. Systemic safety matters, stroke, subdural hemorrhage, and myocardial infarction (total n=3) followed anti-VEGF treatments. CONCLUSION: Although infrequent, anti-VEGF medication PSIs or errors do occur and are thus a threat to quality. This review also provides supporting evidence to existing concerns and challenges surrounding age-related macular degeneration service pressures and provision. Lessons for improvement of care from a national incident reporting database for a frequently undertaken and recently introduced ophthalmic procedure were found. Suggestions are proposed for improving quality by reducing such problems based on analysis of such reports. Endophthalmitis reports following intra-vitreal injections suggest rigorous infection control measures are required.

Value of FNAC in diagnosis of different types of thyroiditis and its comparison with clinical and biochemical findings.

FNAC has developed tremendous improvement in the diagnosis of thyroiditis. The present study was designed to asses the usefulness of FNAC to diagnose various types of thyroiditis and to study their smear patterns. Over a period of one-year, 70 cases of thyroiditis have been evaluated on the basis of cytomorphological criteria and clinical findings of patients. The age ranged from 12-60 years. Majority of the cases were between 21 to 30 years of age with female preponderance in each group of thyroiditis. Among 70 cases, 26(37.14%) cases were Hashimoto's thyroiditis, 21(30%) cases were lymphocytic thyroiditis, seven (10%) cases as granulomatous thyroiditis and 16(22.8%) were non-specific thyroiditis. Further study was carried out in these 70 cases regarding biochemical thyroid status, ultrasonography and radionucleotide scan. Blood was drawn from all patients for estimation of antibody titer to compare with cytological diagnosis. It was found that, clinical examination and history of patients had limited value in the diagnosis of thyroiditis. Ultrasonography and thyroid scan could not reliably differentiate between patients with autoimmune thyroiditis and those with simple and nodular goiter. Biochemically hypothyroidism is more frequently evaluated with Hashimoto's diseases. On the other hand, hyperthyroidism was observed in most other types of thyroiditis. Cytologically diagnosed 78.72% cases of autoimmune thyroiditis had positive antibody titer. From the present study it is concluded that FNAC is a safe, reliable, cost effective and time saving method in the diagnosis of thyroiditis. Being a benign condition also reduce the rate of unnecessary operation, which can be treated conservatively.

Bioluminescence emissions of the firefly Luciola praeusta Kiesenwetter 1874 (Coleoptera : Lampyridae : Luciolinae).

We recorded the in vivo emission and time-resolved spectra of the firefly Luciola praeusta Kiesenwetter 1874 (Coleoptera : Lampyridae : Luciolinae). The emission spectrum shows that the full width at half maximum (FWHM) value for this particular species is 55 nm, which is significantly narrower than the in vivo half-widths reported till now. The time-resolved spectrum reveals that a flash of about 100 ms duration is, in fact, composed of a number of microsecond pulses. This suggests that the speed of the enzyme-catalysed chemiluminescence reaction in the firefly for the emission of light is much faster than was previously believed.

Prevalence of hypertension and its risk factors in a tea garden community of Dibrugarh District, Assam.

A cross-sectional study was conducted during August 2003- July 2004 to assess the prevalence of hypertension among a tea garden population in a district of Assam and to ascertain the identified risk factors. 510 labourers aged 20-59 years were studied. Overall prevalence of hypertension was 33.3% with no significant sex difference. 30.2% had history of smoking and 76.7% of tobacco chewing; 78.4% consumed alcohol (regular and occasional), 5.7% were overweight and 14.3% underweight. Waist hip ratio was normal in 89.2% subjects. The association between increasing age and hypertension could be established in univariate analysis. On multiple logistic regression analysis regular alcohol intake was also found to be significantly associated factor with hypertension.

In vitro and in vivo effects of easily administered, low-toxic retinoid and phenylacetate compounds on human neuroblastoma cells.

We have investigated the effects of the low-toxic retinoid, all-trans retinoyl beta-glucuronide (RAG) alone and in combination with the phenylacetate (PA) derivative 4-chloro-phenylacetate (4-CPA) on the human neuroblastoma cell line, LA-N-5. In vitro studies demonstrated that RAG and 4-CPA treatments alone showed differentiation-inducing activity on LA-N-5 cells, with 4-CPA found to be about three-fold more potent than the PA parent compound in inducing morphologic differentiation and growth inhibition. As previously reported for retinoic acid (RA) and PA, RAG and 4-CPA were significantly more effective in their antiproliferative effects on the cells than either agent alone. Pharmacologic studies of 4-CPA in mice demonstrated that blood plasma levels reached peak concentrations 4 h after bolus administration of the compound and showed slow clearance characteristics with an apparent half-life of 4-8 h. As opposed to PA, 4-CPA was found to be essentially odourless and readily consumed in drinking water, giving rise to steady-state blood plasma levels of 4-CPA in the near mM range. Continuous consumption of 4-CPA in this manner for up to 5 months demonstrated no apparent adverse effects on the mice. Long-term RAG- and/or 4-CPA-treatment of nude mice injected with LA-N-5 cells demonstrated that both compounds alone exhibit potent antitumour activity. Together, RAG plus 4-CPA was the most effective treatment for inhibiting established tumour growth. In contrast, 4-CPA alone was equally as effective as the combination for preventing tumour development. The potent in vivo antitumour effects of 4-CPA could not be accounted for by the known ability of PA compounds to induce expression of the RA nuclear receptor beta (RARbeta) suppressor gene. Taken together, these findings demonstrate the possibility that RAG and/or 4-CPA may serve as effective, less-toxic alternatives to 13-cis RA, which is presently being utilised for nb therapy.

Xanthophyll epoxides, unlike beta-carotene monoepoxides, are not detectibly absorbed by humans.

Increased intake of fruits and vegetables is associated with reduced risk of cancer and other chronic diseases. Epoxycarotenoids are widely distributed in nature and constitute major dietary carotenoids in a number of fruits and vegetables. Previous studies have shown that beta-carotene 5,6-epoxide was absorbed well by humans, and was much more active than beta-carotene in inducing the differentiation of NB4 cells. Xanthophyll epoxides such as neoxanthin, violaxanthin and lutein 5,6-epoxide, are more abundant than epoxy-hydrocarbon carotenes in a number of vegetables and fruits that humans consume. To determine whether xanthophyll epoxides are also absorbed by humans, lutein 5,6-epoxide (taraxanthin) and zeaxanthin 5,6,5'6'-diepoxide (violaxanthin) were chemically prepared, dissolved in corn oil and orally administered to three human subjects. Analysis of plasma for carotenoids within 9 h after a single oral dose of either violaxanthin or taraxanthin failed to show any violaxanthin, taraxanthin or any of their metabolites.

Fetal gastrointestinal malformations.

In an audit to evaluate fetal gastrointestinal (GIT) malformations, case sheets of all mothers who gave birth to newborns with GIT malformations were analysed regarding the maternal history, prenatal ultrasound and the postnatal structural malformations and perinatal management. In 1999, eleven babies were born with gastrointestinal malformations, one was a still birth. Nine had associated malformations of other systems, two had trisomy 21. Eight babies were operated in the immediate newborn period, 5 survived. Ultrasound was not very accurate in the diagnosis of GIT anomaly in this series. In view of associated chromosomal and structural anomaly a fetal ECHO and genetic amniocentesis is warranted. Most of these babies require immediate surgery after birth, so they need to be delivered in a centre which is equipped with good neonatal and pediatric surgery care.

Inflammation and glandular proliferation in hyperplastic prostates: association with prostate specific antigen value.

A series of 73 cases of surgically resected prostatic tissue were histologically diagnosed as nodular hyperplasia, of which 10 (13.69%) cases had chronic prostatitis. The mean value of prostate specific antigen in prostatic hyperplasia without chronic prostatitis and prostatic hyperplasia with chronic prostatitis were 6.09 ng/ml and 13.61 ng/ml respectively. A statistically significant difference of prostate specific antigen level between these two groups were noted (P<.05). The degree of glandular proliferation in nodular hyperplasia was subjectively assessed and was recorded as mild, moderate or severe degree of proliferation. The mean value of prostate specific antigen were 3.28 ng/ml in patients with mild proliferation, 7.21 ng/ml in those with moderate proliferation and 14.78 ng/ml in those with severe proliferation. A significant association between prostate specific antigen level and degree of glandular proliferation was found (P<.05). Chronic prostatitis and glandular proliferation are the two important factors contributing to serum prostate specific antigen elevation in hyperplastic prostates.

Pharmacokinetics of chronically administered all-trans-retinoyl-beta-glucuronide in mice.

After the subcutaneous injection of retinoyl beta-glucuronide (RAG), both RAG and retinoic acid (RA), formed by the hydrolysis of RAG in vivo, achieved peak plasma concentrations within 1-2 h. Thereafter, RA was rapidly cleared from the plasma whereas RAG was eliminated much more slowly. No significant changes were noted in the peak (2 h) plasma levels of RAG for treatment periods up to 56 days (one injection of RAG/day), in the clearance rate of RAG from plasma, or in plasma retinol concentrations. Similarly, no consistent decrease in plasma levels of the RA hydrolysis product was observed. Mice undergoing these long-term chronic treatments with RAG did not show any clinical manifestations of retinoid toxicity. Taken together, our findings that chronic dosing with RAG produces sustained levels of both the parent compound and the RA hydrolysis product, combined with the apparent low toxicity of RAG, suggest that RAG could be a safe and useful alternative to some retinoids which are presently being utilized in the clinic.

Effects of epoxycarotenoids, beta-carotene, and retinoic acid on the differentiation and viability of the leukemia cell line NB4 in vitro.

Three all-trans epoxides of beta-carotene (beta-Car), namely, 5,6-epoxy-beta-carotene (5,6-EC), 5,8-epoxy-beta-carotene (5,8-EC) and 5,6,5',6'-diepoxy-beta-carotene (5,6,5',6'-DEC) were synthesized by treatment of beta-carotene with 3-chloroperoxybenzoic acid, were purified chromatographically, and were characterized. The relative potencies (mean +/- S.D.) of 1 microM compounds in inducing the differentiation of NB4 cells, a cell line that contains the chromosomal transposition t(15;17) characteristic of acute promyelocytic leukemia, after 4 days of incubation were: RA: 1.35 +/- 0.16, 5,6-EC: 0.29 +/- 0.01, 5,8-EC: 0.22 +/- 0.05, 5,6,5',6'-DEC: 0.11 +/- 0.02, beta C: 0.09 +/- 0.01, and the control: 0.06 +/- 0.01. The same order of potencies existed at other concentrations tested and at other incubation times. P values for the differences between the inducing activities of successive pairs of compounds at 1 microM were: RA vs. 5,6-EC, < 0.001; 5,6-EC vs. 5,8-EC, < 0.01; 5,8-EC vs. 5,6,5',6'-DEC, < 0.01; 5,6,5',6'-DEC vs. beta-Car, < 0.10; beta-Car vs. control, < 0.005. Similar P values were also obtained for studies at other concentrations and at other incubation times. The viable cell mass at 4 days was inversely proportional to the extent of differentiation (rs = -1.0). The inducing activities of all compounds were dose-dependent. Thus, the 5,6-monoepoxide of beta-carotene, which has not previously been studied as an inducer, showed higher activity in NB4 cell differentiation than the 5,8-monoepoxide, the 5,6,5',6'-diepoxide, or beta-carotene. Possible explanations of these observations are discussed.

Intestinal absorption of epoxy-beta-carotenes by humans.

An increased intake of fruits and vegetables has been shown to be associated with reduced risk of cancer. In epidemiological studies, supplements of beta-carotene, which is abundant in fruits and vegetables, were not found to be beneficial in reducing the incidence of lung cancer in high-risk groups. Epoxycarotenoids are abundant in nature. 5,6-Epoxy-beta-carotene was much more active than beta-carotene in the induction of differentiation of NB4 cells [Duitsman, Becker, Barua and Olson (1996) FASEB J. 10, A732]. Epoxycarotenes may, therefore, have protective effects against cancer. In order to do this, however, epoxycarotenoids must be absorbed by the human body. There is no evidence that epoxycarotenoids, despite their abundance in dietary fruits and vegetables, are absorbed by humans. In this paper, it is demonstrated that orally administered dietary or synthetic epoxy-beta-carotenes are absorbed by humans, as indicated by their appearance in the circulating blood.

Effects of aging and sex steroids on the localization of T cell subsets in the ovary of chicken, Gallus domesticus.

The goal of this study was to determine the effects of aging and sex steroids on the frequency of T cells in hen ovary. Cryostat sections of ovarian tissues of immature and laying hens and those of immature hens treated with or without diethylstilbestrol (DES) or progesterone were immunostained for T cells using mouse anti-chicken CD3 (antigen of mature T cells), CD4 (antigen of helper T cells), and CD8 (antigen of cytotoxic T cells) monoclonal antibodies. Positive cells were observed under a light microscope and counted using a computer-assisted image analyzer. The frequency of CD3(+), CD4(+), and CD8(+) cells in the ovarian stroma and theca of primary follicles was significantly greater in young laying hens than in immature and old laying hens (P < 0.01). The CD4:CD8 ratio was significantly higher in the ovarian stroma of old laying hens than that of immature hens (P < 0.01), which was due to a greater decrease of CD8(+) cells than of CD4(+) cells. The frequency of CD3(+), CD4(+), and CD8(+) cells was significantly greater in the stroma and theca of primary follicles of DES-treated birds than in those of progesterone-treated and control birds (P < 0.01). Progesterone had no significant effect on the population of each subset of T cells. These results suggest that T cell frequency increases in association with sexual maturation and decreases thereafter during aging with an increase of CD4:CD8 ratio. Also, it is likely that estrogen is one of the factors which stimulates the influx of T cells in the hen ovary.

Localization of macrophages in the ovarian follicles during the follicular growth and postovulatory regression in chicken, Gallus domesticus.

Macrophages may be a potential regulator of ovarian functions. The goal of this study was to determine the changes in the macrophage frequency (number of cells per unit square of tissue) during follicular growth, ovulation, and postovulatory follicular regression in chickens. Cryostat sections of ovarian stroma containing primary follicles, small white follicles, and preovulatory and postovulatory follicles of laying hens were immunostained for macrophage using mouse anti-chicken macrophage monoclonal antibody. Macrophages were observed under a light microscope and counted by a computer assisted image analyzer. The frequency of macrophages in the theca layer was significantly greater in the small white follicles than in the primary follicles (P < 0.01) and also greater in the preovulatory follicles than in the small white follicles (P < 0.01). No significant differences were observed in the macrophage frequency between the third largest and largest preovulatory follicles. In the theca layer of postovulatory follicles, macrophage frequency was significantly greater than in that layer in the preovulatory follicles (P < 0.01); however, the frequency of macrophages decreased significantly in the Day 3 postovulatory follicles as compared with Day 1 postovulatory follicle (P < 0.05). These results suggest that macrophages may play an important role in the follicular development and regression of postovulatory follicles.

Effects of ageing and oestrogen on the localization of immunoglobulin-containing cells in the chicken ovary.

Immunoglobulins in the chicken ovary are important for transfer of immunity to chicks through the egg and for protection of the ovary from infection. The aim of this study was to examine the effects of ageing and oestrogen on the population of Ig-containing cells in the chicken ovary. The ovarian tissue of immature, young laying and old laying hens and that of immature birds treated with diethylstilboestrol (DES), progesterone or sesame oil (vehicle) was processed for paraffin wax sections. The sections were stained for IgG, IgM and IgA by an indirect immunostaining method and the population of cells positive for each Ig was analysed under a light microscope. The number of cells positive for IgG, IgM and IgA was significantly greater in the ovarian stromal tissue of young laying hens than in immature or old laying hens (P < 0.01). The number of IgG- and IgM-positive cells in the thecal layer of primary follicles of young laying hens was significantly greater than that in immature and old laying hens (P < 0.01) and there were significantly more (P < 0.05) IgA-positive cells in young laying hens than in immature birds. The number of IgG-, IgM- and IgA-positive cells was significantly (P < 0.01) greater in both the stromal tissue and the thecal layer of DES-treated birds than in the vehicle-treated birds. Progesterone had no significant effect (P < 0.05) on the population of Ig-positive cells. These results indicate that the number of Ig-positive cells increases as chickens mature and decreases with ageing, and that oestrogen may be involved in this process.

The effects of age and sex steroids on the macrophage population in the ovary of the chicken, Gallus domesticus.

The role of macrophages in the function of the hen ovary has not yet been described, although these cells may be an important regulator of ovarian function in mammals. The aim of this study was to determine the changes in the frequency of macrophages during ageing and follicular atresia, and the effects of sex steroids on the macrophage population in the hen ovary. Cryostat sections of ovarian tissues of immature, young laying and old laying hens and those of immature hens treated with or without diethylstilboestrol (DES) or progesterone were immunostained for macrophage cells using mouse anti-chicken macrophage monoclonal antibody. Macrophages were observed under a light microscope and counted using a computer assisted image analyser. The frequency of macrophages in both the stroma and theca of primary follicles was significantly greater in young laying hens than in immature and old laying hens and these cells were more frequent in old laying hens than in immature hens (P < 0.01). Macrophages were more frequent in atretic follicles than in normal follicles (P < 0.01). The number of macrophages in both the stroma and theca of primary follicles of DES-treated birds was significantly greater than in those of progesterone-treated and control birds (P < 0.01). Progesterone had no significant effect on the population of macrophages. These results suggest that macrophages in the ovary increase in association with sexual maturation of birds and atresia of follicles and decrease during ageing. Oestrogen may be one of the factors that affect the population of macrophages in the hen ovary.

Retinoyl beta-glucuronide: a biologically active form of vitamin A.

Retinoyl beta-glucuronide is a naturally occurring, biologically active metabolite of vitamin A. Although retinoyl beta-glucuronide is regarded as a detoxification product of retinoic acid, it plays several roles in the functions of vitamin A. It can serve as a source of retinoic acid, and it may be a vehicle for transport of retinoic acid to target tissues. Topically applied retinoyl beta-glucuronide is comparable in efficacy to retinoic acid in the treatment of acne in humans, without the same side effects. Retinoyl beta-glucuronide may or may not be teratogenic, depending on the mode of administration and the species in which it is used. It may be a valuable therapeutic compound for the treatment of skin disorders and certain types of cancers.

IgA nephropathy in teaching hospitals of Dhaka.

A light and immunofluorescence microscopic study on renal biopsies were performed on 42 patients. Nephrotic syndrome with accompanying microhematuria and recurrent hematuria (Macroscopic/microscopic) with or without renal failure were the commonest indications for renal biopsy. Primary IgA nephropathy was diagnosed in five cases. Among the IgA nephropathy patients, the commonest light microscopic finding was mesangial proliferative glomerulonephritis. Macroscopic hematuria with proteinuria was the commonest feature. Three of the patients had hypertension at the time of renal biopsy. The age of the patients ranged from 19-38 years with a mean of 26 years. The high frequency of hypertension, degree of proteinuria and associated renal failure in one patient that it is a progressive disease. This preliminary study revealed that IgA nephropathy exists in Bangladesh. Larger samples need to be studied with a view to find out its prevalence and its peculiarities in this part of the world.

Chemotherapy of acute myeloblastic leukaemia with DAM regimen.

32 patients of denovo-ANLL were treated with Doxorubicin, Ara-C and 6-Mercaptopurine (DAM) regimen. Remission induction was instituted with 1-3 cycles of DAM regimen and maintenance was given by 6-MP continuously with intermittent DA (1,5) regimen. In the remission induction, Doxorubicin 30 mg/m2 for 3 days, Ara-C 150 mg/m2 for 5 days and 6-Mp 100 mg/m2 daily was given. Complete remission (CR) was observed in 60% cases. The probability of 2 years disease-free survival of patients with complete remission is 56.73%.