Aframomum subsericeum and Aframomum alboviolaceum leaf essential oils exhibit testosterone antagonistic and oestrogen synergic effects in male Wistar rats: potential candidates for prostate cancer treatment

Background: Aframomum species are routinely used as spices in many traditional Cameroonian meals due to their sweet fragrance. Many species of the Aframomum species are also used to treat cancer, pain, arthritis, and stomach disorders. This work was performed to determine the chemical composition, antiandrogenic, and estrogenic properties of Aframomum subsericeum and Aframomum alboviolaceum leaf essential oils. Methods: The chemical components of A. subsericeum and A. alboviolaceum essential oils were identified by gas chromatography-mass spectroscopy. The anti-androgenic and estrogenic properties were investigated in vivo in physically and chemically castrated Wistar rats, respectively. Results: Fifteen compounds versus nine compounds were identified in A. subsericeum and A. alboviolaceum essential oils, respectively. The main compounds of Aframomum subsericeum were cyclohexene, 1-methyl-4-(1-methylethylidene) (10.03%), ?-terpine (12.22%), and myrtenyl acetate (8.52%), while those of Aframomum alboviolaceum were ?-terpinene (20.07%), caryophyllene (11.58%), myrtenyl acetate (7.22%), and (1R)2, 6, 6 trimethylbicyclo [3.1.1] hept-2-ene (6.97%). The results of the anti-androgenic test reveal that both A. subsericeum and A. alboviolaceum induced a significant decrease in androgen-dependent organs, especially the prostate and seminal vesicle, at doses of 200 mg/kg and 100 mg/kg. Interestingly, A. alboviolaceum showed oestrogen synergic effects on the above organs. Conclusions: So, this study reveals mainly the presence of diterpenoids in both A. subsericeum and A. alboviolaceum, which are potential candidates for prostate cancer treatment. The in vivo results show that Aframomum leaf essential has antiandrogenic and oestrogen synergic properties, suggesting that the oils could provide a safe natural drug for prostate cancer treatment.

Assessment and early warning signs of deterioration in hospitalized patients

Efficient assessment methods and early warning systems are crucial to prevent events like arrest, unexpected transfers to the intensive care unit (ICU) or even death. This in-depth review delves into the aspects of evaluating and handling early warning indicators of deterioration among patients admitted to hospitals. The primary emphasis lies in identifying any signs of decline by observing and tracking indicators, like heart rate, blood pressure, respiratory rate, body temperature and oxygen saturation. Standardized assessments like the modified early warning score (MEWS) play a role in assessing the seriousness of a patient’s condition while rapid response teams (RRTs) provide interdisciplinary interventions. Personalized care plans, customized medication management and the inclusion of support highlight an approach. Continuously reevaluating patients and providing education for healthcare professionals underscores the nature of patient care. Despite advancements in technology that enable real time monitoring challenges such as alarm fatigue and the need for consistent staff training persist. This review concludes that a comprehensive strategy combining expertise standardized assessments and technological support is vital for managing early warning signs of deterioration to ultimately enhance patient outcomes in hospital environments.

Aqueous Extract of the Leaves of Ocimum gratissimum (Lamiaceae) (False Basil) as an Alternative to the Chemical Antibiotics Used in Breeding Cobb-500 Broiler Chickens in the Department of Azaguie, Côte d’Ivoire

In order to propose a plant extract as an alternative to the use of antibiotics used in broiler breeding, an experimental study was carried out in the department of Azaguié and the choice fell on the aqueous extract leaves of Ocimum gratissimum L (EAOG). To achieve this objective, fifty (50) broiler chicks of Cobb-500 strains were divided into two (02) batches of twenty-five (25) each. Thus, batch I received only the aqueous extract of Ocimum gratissimum L., while batch II received the prophylaxis recommended for rearing in this locality. Phytochemical screening revealed the presence of sterols and polyterpenes, polyphenols, flavonoids, alkaloids and catechin tannins in Ocimum gratissimum L. The acute toxicity study carried out on broilers showed that EAOG is not toxic by the oral route in a single dose at a dose of 2000 mg/kg BW. The EAOG caused a significant increase (p<0.05) in the live weight of the treated chickens compared to the controls. In addition, the results showed a significant reduction in the mortality rate and feed conversion ratio of chickens treated with EAOG compared to controls. Finally, concerning the biochemical and leukocyte parameters, the results showed a significant increase in the levels of urea and AST, lymphocytes, white blood cells, neutrophils and basophils of chickens treated with the extract compared to those treated with the usual antibiotics. The aqueous extract of the leaves of Ocimum gratissimum could be recommended to poultry farmers as an alternative to the usual antibiotics.

A cross sectional study on nomophobia among medical students in Tirupati, Andhra Pradesh

Background: Medical students are using more applications of smartphones in their course besides the primary purpose of communication. The excessive usage of smartphone has given rise to a condition known as “nomophobia”. The objectives of the study are to estimate the prevalence of nomophobia and to evaluate the determinants of nomophobia among participants. Methods: A cross-sectional study was conducted from July to August 2022 among 320 undergraduate medical students of Sri Venkateswara Medical College, Tirupati. NMP-Q questionnaire used as a tool for data collection. Ethical clearance was obtained from the Institutional Ethical Committee and informed consent was taken from the participant. Collected data was coded and entered into a Microsoft excel and analysed using statistical package for the social sciences (SPSS) software version 21.0. Results: Prevalence of nomophobia among study subjects was found to be 100% (320); of which 59% showed moderate nomophobia followed by mild (35%) and severe nomophobia (6%). Nearly 60% of the students are using smart phone for communication, 56% for entertainment and 46% for study purpose. Conclusions: All participants were suffering from nomophobia with different grades of severity. It was significantly associated with age, year of study, number of apps used, average time spent with mobile and messages sent per day. Most of them were using smart phone for communication, entertainment and study purpose.

Efficacy of polyetheretherketone rod hybrid surgery in preventing proximal junctional failure after adult spinal deformity surgery / 中华外科杂志

Objective: To investigate the clinical outcome and preventive effect of polyetheretherketone(PEEK) rod hybrid surgery on proximal junction failure(PJF) after long-segment fusion of adult spinal deformity. Methods: A retrospective study was conducted to analyze patients with degenerative scoliosis/kyphosis who underwent long-segment decompression and fusion surgery at Department of Orthopedics, Peking University First Hospital from January 2017 to December 2021. A total of 75 patients were included in the study, including 14 males and 61 females, aged (67.2±6.8)years (range:55 to 84 years). According to the operation method chosen by the patients, the patients were divided into PEEK rod hybrid group (20 cases) and traditional titanium rod group (55 cases). The general information of the patients was collected, and the coronal and sagittal parameters of the spine were measured before operation, at 1 month after operation, and at the last follow-up. The clinical effect of surgery was judged by the visual analogue scale (VAS) and Oswestry disability index (ODI). Whether proximal junctional kyphosis (PJK) and PJF occurred during the follow-up and the time of occurrence were recorded. Comparisons between groups were performed using independent sample t test, Mann-Whitney U test, χ2 test and Fisher's exact probability method. The data before and after surgery in the same group were compared using the paired sample t test and the Wilcoxon test. Results: There were no significant differences in age, gender, body mass index, bone mineral density, distal instrumented vertebrae, surgical segments, osteotomy method, operation time, and intraoperative bleeding between the two groups (all P>0.05). The follow-up time of the PEEK rod group was shorter(M(IQR)16.5(4.8) vs. 25.0(12.0),Z=-4.230,P<0.01). There were no significant differences in coronal, sagittal parameters, VAS and ODI between the two groups before operation (all P>0.05). Postoperative coronal Cobb angle, pelvic incidence, pelvic tilt, sacral slope, lumbar lordosis, thoracic kyphosis, sagittal vertical axis (SVA), VAS and ODI were significantly improved in both groups(all P<0.05). At the last follow-up, the SVA of the PEEK rod hybrid group was(3.74±2.40)cm, which was significantly lower than that of the titanium rod group (6.28±4.06)cm (t'=-3.318, P=0.002). At the last follow-up, the ODI of the PEEK rod hybrid group was 30.7±6.1, significantly better than the titanium rod group 39.3±17.2(t=-3.203, P=0.046). PJK occurred in 2 patients (10.0%) in the PEEK rod hybrid group, and no PJF phenomenon was observed. In the titanium rod group, 18 patients (32.7%) developed PJK, and 11 patients (20.0%) developed PJF. There was a statistically significant difference in the incidence of PJF between the PEEK rod hybrid group and the titanium rod group (P=0.031). Conclusions: PEEK rod hybrid surgery can achieve good clinical results in the treatment of adult spinal deformities. Compared with traditional titanium rod surgery, it can significantly reduce the incidence of postoperative PJF and improve the clinical function of patients.

Changes of antioxidant enzymes in the kidney after cardiac arrest in the rat model

Globally, cardiac arrest (CA) is a leading cause of death and disability. Asphyxial CA (ACA)-induced kidney damage is a crucial factor in reducing the survival rate. The purpose of this study was to investigate the role of antioxidant enzymes in histopathological renal damage in an ACA rat model at different time points. A total of 88 rats were divided into five groups and exposed to ACA except for the sham group. To evaluate glomerular function and oxidative stress, serum levels of blood urea nitrogen (BUN) and creatinine (Crtn) and malondialdehyde (MDA) levels in renal tissues were measured. To determine histopathological damage, hematoxylin and eosin staining, periodic acid-Schiff staining, and Masson's trichrome staining were performed. Expression levels of antioxidant enzymes including superoxide dismutase-1 (SOD-1), superoxide dismutase-2 (SOD-2), catalase (CAT), and glutathione peroxidase (GPx) were measured by immunohistochemistry (IHC). Survival rate of the experimental rats was reduced to 80% at 6 h, 55% at 12 h, 42.9% at 1 day, and 33% at 2 days after return of spontaneous circulation. Levels of BUN, Crtn, and MDA started to increase significantly in the early period of CA induction. Renal histopathological damage increased markedly from 6 h until two days post-CA. Additionally, expression levels of antioxidant enzymes were significantly decreased at 6 h, 12 h, 1 day, and 2 days after CA. CA-induced oxidative stress and decreased levels of antioxidant enzymes (SOD-1, SOD-2, CAT, GPx) from 6 h to two days could be possible mediators of severe renal tissue damage and increased mortality rate.

Phenological, Morphological and Agronomic Characterization of Bambara Groundnut Genotypes on Plinthite Soil in East-centre Area, Burkina Faso

Bambara groundnut has long been a neglected and understudied crop. Thanks to the new orientations for the d関eloppement of agriculture and achievement of food security in Burkina Faso, in recent years, studies on Bambara groundnut have experienced renewed interest. Despites nutritional, agronomic and socio-economic importance and some studies carried out on this crop. The diversity within Bambara groundnut cultivated remains poorly understood. The objective of this study was to assess phenological morphological and agronomic characterization of 20 Bambara groundnut accessions from National Institute for the Environment and Agricultural Research (INERA) genebank. The experimental device used was a completely randomized Fisher blocks with four replications on the site of University Centre of Tenkodogo. These accessions were evaluated on 23 morphological characters including four qualitative characters and 19 quantitative characters. Qualitative traits showed high proportion of oval terminal leaflet shape (70%), cream coloured seeds (45%) and 80% presence of eyes of various shapes and colours. The analysis of quantitative characters showed all the characters are discriminating except the plant spread (PlS) at the 5% treshold with regard to morphological, physiological and agronomic traits and low coefficient of variation (CV) values for the different phenological characters, except for the number of days from sowing to 50% plantlet emergence (EMG50). Pearson correlation matrix indicated positive and negative correlation. Most of the negative correlation was observed between phenological and agronomic traits The dendrogram showed organization of the variability in three different groups on the basis of the physiological, phenological and agronomic traits. The variability expressed among INERA gene bank genotypes showed important variability, which can be exploited in Bambara groundnut breeding programs using the clustering and associations of characters.

Academy of Medicine, Singapore clinical guideline on endoscopic surveillance and management of gastric premalignant lesions

Gastric cancer (GC) has a good prognosis, if detected at an early stage. The intestinal subtype of GC follows a stepwise progression to carcinoma, which is treatable with early detection and intervention using high-quality endoscopy. Premalignant lesions and gastric epithelial polyps are commonly encountered in clinical practice. Surveillance of patients with premalignant gastric lesions may aid in early diagnosis of GC, and thus improve chances of survival. An expert professional workgroup was formed to summarise the current evidence and provide recommendations on the management of patients with gastric premalignant lesions in Singapore. Twenty-five recommendations were made to address screening and surveillance, strategies for detection and management of gastric premalignant lesions, management of gastric epithelial polyps, and pathological reporting of gastric premalignant lesions.

Rapamycin Improves Vascular Remodelling in a Controlled Rat Model of Monocrotaline-Induced Pulmonary Hypertension

ABSTRACT Background: Pulmonary arterial hypertension (PAH) is a serious disease characterized by the progressive elevation of the pulmonary arterial resistance, leading to the right ventricular failure and death. Objective: To evaluate the effect of rapamycin (RAPA), a potent cell-cycle inhibitor, on exercise capacity, right ventricular hypertrophy and pulmonary vascular remodelling on rats. Methods: A total of 39 nine-week-old male Wistar rats (160-240 g) were divided into three groups: the control (n = 10), PAH control (n = 15) and PAH-RAPA (n = 14) groups. On the 1st day, 60 mg/kg monocrotaline was injected intraperitoneally to induce PAH in the PAH control group and PAH-RAPA groups. On the 21st day, 3 mg/kg/day RAPA was started orally, and the animals were followed for 35 days. On the 35th day, the exercise capacity of the rats was analysed through a modified forced swimming test. After measuring their right ventricular systolic pressure using an open-chest method, their hearts and lungs were excised and analysed histopathologically for right ventricular hypertrophy and pulmonary vascular remodelling. Results: Rapamycin treatment provided limited and insignificant improvements in exercise capacity, right ventricular systolic pressure and right ventricular hypertrophy of the rats. However, there was significant recovery in the rats' pulmonary artery muscular layer thickness with the RAPA treatment (p < 0.049). On the 35th day, the mortality rate was 0% in the control group, 53.1% in the PAH control group and 42.9% in the PAH-RAPA group. No statistically significant decrease was observed in their mortality rates with the RAPA treatment (p > 0.16); however, a significant recovery was noted in terms of the rats' median life span (p < 0.006). Conclusion: Pulmonary artificial hypertension is a progressive disease that is not curable with current therapies. Rapamycin may have the potential to reverse vascular remodelling and prolong life expectancy in cases of pulmonary hypertension.

Study of Management of Scalp Defect- Our Experience in a Tertiary Care Center of Vindhya Region, a Remote Area of MP.

Aetiology of the scalp defects may be burns, trauma, avulsion, infection, resection for neoplasm or congenital defects, the goals & principles are similar, and their repair is dependent upon their location, size and depth. In the case of the scalp, the repair of even small defects is complicated. We wanted to assess the epidemiology, etiological factors, type and site of distribution, various modalities, overall cosmetic effect and function of both donor as well as recipient sites of scalp defects. We also wanted to evaluate the epidemiological and aetiological factors influencing the various modalities of scalp defect management and the overall cosmetic effect on both donor as well as recipient site. METHODSA descriptive study was conducted at Sham Shah Medical College and associated SGM Hospital, Rewa, which is also known as Vindhya region of Madhya Pradesh. A total of 44 cases of scalp defects, that were treated in the department of surgery over a period of 18 months from May 2018 to November 2019 constitute the material of this study. Patients were included in the study after obtaining an informed consent. One-year follow-up of the patients was done, RESULTS26 cases [59.01%] of scalp defect were repaired with transposition flap; rotation flap was done in 2 cases [4.45%], bipedicled flap was done in 2 cases [4.45%], double opposing rotational flap was done in 01 case [2.27], S.T.G. was done in 7 cases [15.9%], and primary closure was done in 6 cases [13.63%]. In our study 59.09% cases are due to trauma and occur in second to fourth decade out of which 26 patients have exposed bone, and out of 26 patients, 09 patients have fracture of bone. CONCLUSIONSScalp reconstruction depends on the nature and the region of the defect. A range of reconstruction techniques have been described. The quality of the residual scalp is critical for performing a local flap. Local flaps are the reference for the reconstruction of such defects. Knowledge of scalp anatomy is essential for preparing these flaps. The parietal zone is the location offering the greatest flap mobilization possibilities. A review is provided of the different techniques for the reconstruction of large scalp defects.

Antimicrobial Susceptibility Pattern of Bacterial Isolates in Burn Patients in a Tertiary Care Center: A Prospective Study

Background: Burn injuries and deaths pose a major public health concern globally, especially in developing and underdevelopedcountries. As burn patients have lost their primary barrier and exposed to microorganism invasion continually and chronically,Staphylococcus aureus becomes one of the greatest causes of nosocomial infection in burn patients though it is a normalskin flora. The cases of antibiotic resistance have increased, and resistant species such as methicillin-resistant S. aureus(MRSA) provide additional challenges in the form of virulence factors. Multimodal infection control concept is required to limitthe spread of infection with multidrug-resistant organism including MRSA in a burn unit. The common pathogens isolated fromburn wounds are S. aureus, Pseudomonas aeruginosa, Streptococcus pyogenes, Acinetobacter baumannii, and various coliformbacilli. Hence, antimicrobial susceptibility pattern of bacterial isolates in burn patients plays a key role in the management ofthese patients.Materials and Methods: This prospective observational study involved the collection of wound swabs from burn patientsfrom June 2018 to May 2019. All patients with burn wounds irrespective of age and sex, admitted through surgery outpatientdepartment or casualty, during the period of study were included in the study.Results: Maximum prevalence was found for P. aeruginosa, i.e., 37.5% followed by S. aureus, for which the prevalencewas found to be 18.75%. The organism least commonly cultured was Acinetobacter; the prevalence of MRSA was found tobe 57.14% and the prevalence of methicillin resistance was found to be 42.8% in patients with Staphylococcus epidermidis.Overall, the prevalence of methicillin resistance was 51.72%. The drugs most effective against P. aeruginosa, the most commonisolate, were meropenem (97.62%) and piperacillin/tazobactam (90.48%) followed by gentamicin (64.29%). Meropenem andpiperacillin/tazobactam showed 100% efficacy against the other Gram-negative bacilli isolated as well. MRSA isolates showed100% sensitivity to vancomycin and linezolid closely followed by piperacillin-tazobactam combination. Klebsiella pneumoniaeshowed 100% sensitivity to meropenem and piperacillin/tazobactam.Conclusions: The overall isolation rate was 75%. Only solitary isolates were studied. Overall, Gram-negative organisms(66.66%) were more common than Gram-positive organisms (33.33%). P. aeruginosa (37.5%) was the most commonisolate followed by S. aureus (18.75%). The prevalence of MRSA was 57.14%, but all the MRSA isolates showed 100%sensitivity to vancomycin and linezolid. On antibiotic sensitivity testing, piperacillin/tazobactam (95.24%) was found to bethe most effective drug against all the organisms isolated. Meropenem (99.40%) was the most effective drug against theGram-negative organisms. Vancomycin (100%) and linezolid (100%) were the most effective drugs for the Gram-positiveorganisms.

Prediction of Difficult Laparoscopic Cholecystectomy Based on Clinical and Ultrasonographic Parameters

Background: Cholelithiasis is the most common biliary pathology. The definitive treatment for cholelithiasis is either open/ laparoscopic cholecystectomy (LC). The objective of this study was to predict difficulty in doing LC based on clinical and ultrasonographic parameters. Materials and Methods: A hundred patients admitted with a diagnosis of cholelithiasis in surgical wards in the Department of Surgery, Shyam Shah Medical College and Associated Sanjay Gandhi Memorial Hospital, Rewa, from June 1, 2018, to May 31, 2019, were included in the study. All necessary investigations were carried out. X-ray, ultrasonography (USG) abdomen, and blood investigations were done. Patients underwent LC, and a careful record of pre-operative and post-operative findings was made and carefully filled in the pro forma. Results: In the present study, body mass index >27.5 kg/m2 (27%) shows a correlation with predicting difficult LC and conversion to open procedure. Clinical parameters such as guarding and rigidity (8%) with mass (12%) were a sign of acute inflammation, associated with ultrasonography findings favor for difficult cholecystectomy. Gallbladder wall thickness (38%) and pericholecystic fluid collection (16%) in USG are strong predictors of difficulty. Conclusion: Clinical and USG findings help to predict difficulty in laparoscopic cholecystectomy and leading to the conversion of LC to open cholecystectomy.

Recent Advances in Intra-peritoneal Chemotherapy for Gastric Cancer

Peritoneal metastasis (PM) frequently occurs in patients with gastric cancer (GC) and confers a dismal prognosis despite advances in systemic chemotherapy. While systemic chemotherapy has poor peritoneal penetration, intraperitoneal (IP) chemotherapy remains sequestered, resulting in high peritoneal drug concentrations with less systemic side-effects. The first application of IP treatment was hyperthermic intraperitoneal chemotherapy (HIPEC) with cytoreductive surgery (CRS) for gastric cancer peritoneal metastasis (GCPM); but was associated with an increased morbidity and mortality rate without significantly improving overall survival (OS). While CRS confers limited benefit, the potential role of prophylactic HIPEC and laparoscopic neoadjuvant HIPEC are currently being evaluated. Combination systemic and IP chemotherapy (SIPC) gained popularity in the 1990s, since it provided the benefits of IP treatment while reducing surgical morbidity, demonstrating promising early results in multiple Phase II trials. Unfortunately, these findings were not confirmed in the recent PHOENIX-GC randomized controlled trial; therefore, the appropriate treatment for GCPM remains controversial. Small observational studies from Japan and Singapore have reported successful downstaging of PM in GC patients receiving SIPC who subsequently underwent conversion gastrectomy with a median OS of 21.6–34.6 months. Recently, the most significant development in IP-directed therapy is pressurized IP aerosol chemotherapy (PIPAC). Given that aerosol chemotherapy achieves a wider distribution and deeper penetration, the outcomes of multiple ongoing trials assessing its efficacy are eagerly awaited. Indeed, IP-directed therapy has evolved rapidly in the last 3 decades, with an encouraging trend toward improved outcomes in GCPM, and may offer some hope for an otherwise fatal disease.

Evaluation of Loop Mediated Isothermal Amplification (LAMP) for Diagnosis of Plasmodium falciparum in Wad Medani City, Gezira State, Sudan

Plasmodium falciparumconsidered as the most serious form of species causes malaria compared with other species. Diagnosis of falciparummalaria in Sudan remain a major problem, the laboratory diagnosis depends solely on microscopy and RDTs. Loop mediated isothermal Original Research Article amplification (LAMP) assay is a molecular technique done in isothermal temperature using simple, inexpensive instruments for detection of falciparummalaria. The aim of the study is to evaluate the diagnostic performance of loop mediated isothermal amplification (LAMP) assay for detection ofP. falciparumand compare with microscopic detection. A cross sectional hospital based study conducted on 220 blood samples collected from participants suspected to have falciparum malaria attending Wad Medani Teaching Hospitalsand 26 healthy participants during the period November 2018 to January 2019. Thick blood films were done and used for P. falciparum detection. The extracted DNA by TE buffer was amplified by LAMP assay targeting 18S rRNA gene. Data were analyzed using Medical calculator (MedCalc) programs (V. 16). The results showed that the sensitivity, specificity, positive predictive value, negative predictive values were 99.1%, 84.6%, 53.2%, 99.8% respectively. Validation of LAMP diagnostic performance revealed that area under the curve is 0.919, while Weighted Kappa is 0.866. The study concluded that the LAMP assay had the identical diagnostic performance compared with microscopy in diagnosis of Plasmodium falciparum malaria. This gives a relative effortlessness application of LAMP assay in Sudan after availing the required logistics

Assessment of depression and its correlates among college students in Rishikesh Uttarakhand

Background: Depression is a major contributor to the overall global burden of disease and is the leading cause of disability worldwide. Objective: To assess the levels of depression and its correlate among college students in Rishikesh, Uttarakhand. Methodology: Community based cross sectional study was conducted from February 2018 to April 2018 among 126 students of a Government PG College Rishikesh belonging to age 18 -26 years. A pre-validated semi- structured pretested Physical Health Questionnaire (PHQ-9) was applied for this purpose. Results: Mean age of the participants was 22.84±1.5 years. Overall prevalence of depression among study population was 74.60% among them 4% were severely depressed. 58% of females and 40% males had suicidal ideations. Majority of participants were stressed with the undue peer pressure followed by career pressure. Physical activity for atleast 30 minutes a day for 5 days in a week was found to be significantly (p<0.02, odds ratio 0.20 (0.06-0.7 at 95%CI) beneficial for depression. Conclusion: Depression is prevalent among college going population. Peer pressure, academic stress, career pressure, financial stress in home, undue parental expectations on students are associated with depression among college going students.

Cancer du sein : immunohistochimie et pronostic au CHU Gabriel Touré de Bamako-Mali

Le sein est le deuxième siège du cancer chez la femme au Mali. Les examens immunohistochimiques sont peu réalisés dans nos pays africains. Objectifs: Décrire l'aspect immunohistochimique et déterminer le pronostic du cancer du sein. Méthodologie : C'est une étude descriptive à collecte rétrospective (mars 2006­juillet 2016) dans le service de chirurgie générale du CHU Gabriel TOURE de Bamako au Mali. L'examen immunoihistochimique a été réalisé chez tous les malades grâce à la collaboration de nos partenaires allemands. Résultats: Nous avons colligé 98 malades (95 femmes et 3 hommes) avec un âge moyen de 40,04 ± 13,07 ans. Vingt-deux malades (22,44 %) avaient un antécédent personnel de pathologie bénigne du sein. Chez 16 malades (16,33 %), il y avait une notion familiale de cancer du sein. La prise d'œtroprogestatifs a été évoquée chez 28 femmes (28,57%). Les types histologiques les plus fréquents étaient le carcinome canalaire infiltrant avec 84 (85,72%) et le carcinome lobulaire infiltrant dans 9 cas (9,18%). L'immunohistochimie a permis de trouver une prédominance du triple négatif avec quarante neuf malades (50%) suivi du sous type Luminal A avec 26 cas (26,23%).Selon la classification TNM, 44 patients (44,90 %) ont été reçus au stade III. La médiane de survie a été de 60 mois dans le groupe des patients ayant bénéficié d'une hormonothérapie versus 28 mois pour le groupe sans hormonothérapie (p=0.007). Conclusion: l'immunohistochimie est essentielle pour la prise en charge adéquate des cancers du sein. Sa réalisation nous a permis d'améliorer le pronostic des cancers hormono dépendant

Relationship between fall and frailty index in elderly adults of urban community in Beijing / 中华流行病学杂志

Objective: To evaluate the frailty status and understand the relationship between the incidence of fall and frailty status in the elderly in Beijing. Methods: A cross-sectional study was conducted in old people aged ≥60 years in Longtan community of Dongcheng district in Beijing from November 2015 to January 2016. The information about any fall during the past year and frailty status of the elderly were collected with a standardized structured questionnaire in face-to-face interviews. The frailty status of elderly people was assessed with frailty index (FI) method. Logistic regression analysis was used to explore the relationship between fall and frailty status among the elderly. Results: Among 1 557 old people surveyed, the incidence of fall was 17.8% (277/1 557) during the past year. The incidence of fall in women (21.0%, 192/277) was statistically higher than that in men (13.3%, 85/277) (χ(2)=15.288, P=0.000). The median (quartile) value of FI of the elderly surveyed was 0.09 (0.08); and women had a higher FI median value than men [0.10 (0.08) versus 0.08 (0.07)](Z=5.376, P=0.000). The median FI value (quartile range) of 277 old people with history of fall in previous year was 0.12 (0.11), which was higher than the median FI value of 0.08 (0.07) of 1 280 old people without fall history (Z=7.501, P=0.000). Logistic regression analysis showed that higher FI value was associated with more risks for fall; and FI value showed the greatest impact on the incidence and frequency of fall (OR=1.093, 2.234) compared with other related factors of fall, such as age and gender. Conclusion: Frailty status has a greater impact on both incidence and frequency of fall compared with other factors in elderly people in Beijing; more attention should be paid to weak and old adults in the prevention of fall.

Age-related modification effect on the association between body mass index and the risk of hypertension: A Cohort Study on Chinese people living in the rural areas / 中华流行病学杂志

Objective: To study the modification effect of age on the association between body mass index and the risk of hypertension. Methods: People age ≥18 years old were selected by clusters, from a rural area of Henan province. In total, 20 194 people were recruited at baseline during 2007 and 2008, and the follow-up study was completed from 2013 to 2014. Logistic regression model was used to assess the risk of incident hypertension by baseline BMI and age-specific BMI. Results: During the 6-year follow-up period, 1 950 hypertensive persons were detected, including 784 men and 1 166 women, with cumulative incidence rates as 19.96%, 20.51%, and 19.61%, respectively. Compared with those whose BMI<22 kg/m(2), the RRs of hypertension were 1.09 (0.93-1.27), 1.17 (1.01-1.37), 1.34 (1.14-1.58) and 1.31 (1.09-1.56) for participants with BMI as 22-, 24-, 26- and ≥28 kg/m(2), respectively. In young and middle-aged populations, the risk of hypertension gradually increased with the rise of BMI (trend P<0.05). However, in the elderly, the increasing trend on the risk of hypertension risk was not as significantly obvious (trend P>0.05). Conclusion: The effect of BMI on the incidence of hypertension seemed to depend on age. Our findings suggested that a weight reduction program would be more effective on young or middle-aged populations, to prevent the development of hypertension.

A cohort study on body mass index and risk of all-cause mortality among hypertensive population / 中华流行病学杂志

Objective: To investigate the relationship between body mass index (BMI) and all-cause mortality in hypertensive population. Methods: All participants were selected from a prospective cohort study based on a rural population from Henan province, China. Cox proportional hazards regression models were used to estimate the associations of different levels of BMI stratification with all-cause mortality. Restricted cubic spline models were used to detect the dose-response relation. Results: Among the 5 461 hypertensive patients, a total of 31 048.38 person-years follow-up was conducted. The median of follow-up time was 6 years, and 589 deaths occurred during the follow-up period. Compared to normal weight group (18.5 kg/m(2)<BMI<24.0 kg/m(2)) the multivariate-adjusted hazard ratios for all-cause mortality associated with BMI levels (<18.5 kg/m(2), 24-28 kg/m(2), and ≥28 kg/m(2)) were 0.83 (95%CI: 0.37-1.87), 0.81 (95%CI: 0.67-0.97), and 0.72 (95%CI: 0.56-0.91), respectively. The dose-response analysis showed a nonlinear, reverse "S" shaped relationship (non-linearity P<0.001). Conclusion: Overweight or obese might have a protective effect on all-cause mortality in hypertensive population, which supports the "obesity paradox" phenomenon.

Association between congenital heart disease and medication taken during pregnancy among women of childbearing age / 中华流行病学杂志

Objective: To analyze the relationship between medication taken during pregnancy and congenital heart disease of the newborns. Methods: A large cross-sectional survey was conducted between August and November 2013. A questionnaire survey was conducted among the childbearing aged women, selected through multistage stratified random sampling in Shaanxi from 2010 to 2013. All of the childbearing aged women under study were in pregnancy and with definite pregnancy outcomes. Multivariable Poisson regression was conducted for data analyses. Results: A total of 28 680 cases were included in this study. The proportion of medication taken at any time during pregnancy was 16.0%, and the prevalence of congenital heart disease among the newborns was 67.9/10 000. After adjustment for factors as general demographic characteristic, history of heart disease and drug allergy and the situation of disease during pregnancy of these women, results from the multivariable Poisson regression showed that, factors as taking drugs (RR=1.95, 95%CI: 1.42- 2.68), cold medicine (RR=1.68, 95%CI: 1.07-2.64), antibiotics (RR=1.90, 95%CI: 1.25-2.90), salicylates (RR=5.01, 95%CI: 1.84-13.64) and antifungal drugs (RR=10.22, 95%CI: 3.25-32.19) during pregnancy were all related to congenital heart disease, and with the history of taking cold medicine (RR=1.90, 95%CI: 1.01-3.61), antibiotics (RR=2.18, 95%CI: 1.17-4.06), salicylates (RR=6.07, 95%CI: 1.45-25.41), antifungal drugs (RR=21.01, 95%CI: 4.17-105.87) and other drugs (RR=2.31, 95%CI: 1.19-4.47) during early pregnancy. These factors were with higher risks for congenital heart disease. Conclusion: Women of childbearing age who took cold medicine, antibiotics, salicylic acid drugs, antifungal drugs and other drugs during early pregnancy would increase the risks related to congenital heart diseases.