Refractory hypothyroidism.

INTRODUCTION: Persistently elevated thyroid stimulating hormone (TSH) despite levothyroxine (LT4) treatment that exceeds the standard weight-adjusted dose is a common clinical presentation. This may lead to additional testing for LT4 malabsorption or poor LT4 adherence, the latter of which is challenging to confirm because it is predicated on accurate patient accountability. CASE REPORT: A 35-year-old lady, post-radioactive iodine therapy for Graves' disease remained euthyroid for a year on oral LT4. Two years later, she was clinically and biochemically hypothyroid despite claiming LT4 compliance. As all laboratory investigations were within the reference range, pseudomalabsorption was suspected and a LT4 absorption test was done. During the test, her free thyroxine increased significantly at 4 hours, reaching a peak of more than 50% from baseline while TSH decreased appropriately from 0 minute to 360 minutes. This was followed by normalisation of TSH with LT4 treatment under direct observation. DISCUSSION: The LT4 absorption test is a prompt and economical means to rule out true malabsorption, decrease unwarranted subspecialty referrals and validate the weight-adjusted LT4 dose reduction.

[Upregulation of MHC I Antigen Processing Machinery Gene Expression in Breast Cancer Cells by Trichostatin A].

Epigenetic alterations associated with cancer have been shown to facilitate tumorigenesis and promote metastasis. In the study of cancer metastasis, epigenetics has been revealed to play a crucial role in supporting tumour immune evasion. As a result, epigenetic drugs have been identified as potential agents to activate anti-tumour immune responses and reverse tumour immunologically tolerant states. Mounting evidence is showing aberrant expression of MHC class I antigen processing molecules in cancers and their upregulation as a potential indicator for anti-tumour immunity. In this study, we demonstrate that the epigenetic drug Trichostatin A (TSA), a histone deacetylase inhibitor, can restore MHC I antigen presentation machinery (MHC I APM) genes in human breast cancer cells (MCF-7). Treatment with TSA resulted in the upregulation of MHC I, B2M, and PSMB9 in MCF-7 monolayer cells, and MHC I, B2M, PSMB9, PSMB8, TAP1, and TAP2 in MCF-7 spheroid cells. Interestingly, treatment with TSA also increased CD274 expression in these cells and enhanced the invasion ability of the MCF-7 spheroid. This aggressive behaviour was confirmed by increased expression of metastatic-related genes, nNav1.5 and MMP1. In summary, although the restoration of MHCIAPM expression was achieved by TSA, the upregulation of metastatic genes and CD274 also enhanced the invasion ability of breast cancer cells. These findings suggest the need for careful consideration when utilizing epigenetic drugs for breast cancer therapy.

Outcome of cardiopulmonary resuscitation in the emergency department of a tertiary hospital in Malaysia.

INTRODUCTION: There are insufficient data available regarding the outcome of cardiac arrest (CA) resuscitated in the emergency department in Malaysia. This study aims to determine the incidence of CA, the return of spontaneous circulation (ROSC), survival to admission (STA), survival to discharge (STD) and factors influencing the overall outcome of CA. MATERIAL AND METHODS: This is a retrospective observational study done in Hospital Sg Buloh (HSB), a tertiary referral centre in an urban area located north of Kuala Lumpur, Malaysia's capital city, from January until December 2018, involving 289 patients. All cases with CPR and a sustained return of spontaneous circulation (ROSC) were included in the study and followed up until discharged or died in the hospital. RESULTS: Out of 236 patients recruited, 25.8% achieved ROSC, 15.7% survived on admission, and 4.2% of patients were discharged alive. Of 74.1% of witnessed OHCA, only 17.5% received bystander CPR. Factors with favourable outcomes include CA in ED (p<0.001), the initial rhythm of ventricular fibrillation (p=0.003), defibrillation (p=0.024), OHCA witnessed by emergency medical services (EMS) (p=0.024) and intravenous adrenaline administration (p=0.001). When using multivariate regression analysis, positive outcomes were associated with the cardiac and respiratory cause of CA (Adjusted Odd Ratio (AOR) 3.66; 95% Confidence Intervals, 95%CI: 2.52 - 12.61 and AOR 8.76; 95%CI: 5.76- 15.46, respectively) as well as OHCA witnessed by EMS (AOR 10.81; 95%CI: 1.84- 19.52). CONCLUSIONS: Despite being an upper-middle-income country and having advancements in the healthcare system, a relatively lower STD rate among survivors of CA in the ED was observed in this study. There was underutilization of the EMS among patients with CA. The bystander CPR rate among patients with CA in Malaysia is also worryingly low. Aggressive community participation in cardiac arrest awareness programmes is much required. Additionally, in achieving better outcomes, implementing standardized post-resuscitation care protocols with existing resources will be a challenge for physicians managing cardiac arrest cases.

Silencing of hepsin and inosine 5-monophosphate dehydrogenase 2 by siRNA reduces prostate cancer cells proliferation.

Prostate cancer (PCa) is a multifactorial disease, which arises from the activation of genes related to cell proliferation and DNA synthesis. Two important genes namely hepsin (HPN) and inosine 5-monophosphate dehydrogenase type 2 (IMPDH2) were studied to understand the pathogenesis of this disease. This study aimed to determine the transcript level of PCa-related genes, HPN and IMPDH2, in archived tissues. Their functional roles were further determined using an in vitro model of PCa. Total RNA extraction was done from formalin-fixed paraffin-embedded PCa tissues, and benign prostatic hyperplasia (BPH) tissues acted as the control. Quantitative real-time polymerase chain reaction (qPCR) was performed to measure HPN and IMPDH2 expression. The functional assay was performed in a prostate cancer cell line (DU145) on these two genes by silencing their RNA. We discovered a significantly higher expression of IMPDH2 in PCa samples compared to non-cancerous tissues (P < 0.001). While HPN expression level showed a downward trend in PCa but the result was not statistically significant compared to the control. SiRNA-mediated knockdown of IMPDH2 expression in the cell line significantly decreased cell proliferation. The silencing of IMPDH2, however, did not affect cell migration, invasion, and apoptosis of the DU145 cell line. Our study demonstrated that IMPDH2 plays an essential role in clinical samples as well as in vitro models of this cancer. Inhibition of this gene through siRNA causes retardation of cell proliferation suggesting that IMPDH2 plays an essential role in prostate cancer.

Clinical assessment and cytokines level in constipation-predominant irritable bowel syndrome participants treated with Lactobacillus-containing cultured milk drink.

BACKGROUND: Gut dysbiosis is linked with the pathophysiology of irritable bowel syndrome (IBS). Manipulation of intestinal microbiota using cultured milk drinks may stimulate the immune system, hence providing beneficial support in IBS treatment. This study aimed to investigate the effects of cultured milk drink on clinical symptoms, intestinal transit time (ITT), fecal pH and cytokines in constipation-predominant IBS (IBS-C) as compared to non-IBS participants. METHODS: Each recruited participant was given three bottles of 125 ml cultured milk drink containing 109 cfu Lactobacillus acidophilus LA-5 and Lactobacillus paracasei L. CASEI-01 consumed daily for 30 days. At pre- and post-30-day consumption, fecal pH, ITT, clinical symptoms, IL-6, IL-8 and TNF-α levels were assessed. Seventy-seven IBS-C and 88 non-IBS were enrolled. RESULTS: Post-consumption, 97.4% of IBS-C experienced improvements in constipation-related symptoms supported by the significant reduction of ITT and decreased fecal pH (p<0.05). All pro-inflammatory cytokines were significantly lower in post as compared to pre-consumption of cultured milk drinks in IBS-C (p<0.05). There was significant reduction in the IL-8 and TNF-α levels in post- as compared to pre-consumption for the non-IBS (p<0.05). CONCLUSION: Cultured milk drink taken daily improved clinical symptoms and reduced cytokines, hence should be considered as an adjunctive treatment in IBS-C individuals.

Potential biomarkers in NASH-induced liver cirrhosis with hepatocellular carcinoma: A preliminary work on roles of exosomal miR-182, miR-301a, and miR-373.

INTRODUCTION: Recent studies have published the roles of exosomal miRNAs in the pathogenesis of various type of malignancies and can be developed as potential biomarkers for diagnostic, prognostic and therapeutic purposes. The aim of this study was to identify the expression level of selected miRNAs (miR-182, miR-301a, and miR-373) in exosomes of the serum and ascitic fluid in patients with non-alcoholic steatohepatitis (NASH)-related liver cirrhosis with or without hepatocellular carcinoma (HCC). MATERIALS AND METHODS: A literature search was performed to identify potential miRNAs involved in the pathogenesis of HCC. Unpaired serum and ascitic fluid were obtained from 52 patients with NASH related liver cirrhosis (n=26 for each group of with and without HCC). Exosomal miRNA was isolated from all samples. Expression levels of miR-182, miR-301a and miR- 373 were determined using quantitative real-time PCR. RESULTS: Serum-derived exosomal mir-182, miR-301a and miR-373 were significantly up-regulated with fold change of 1.77, 2.52, and 1.67 (p< 0.05) respectively in NASH-induced liver cirrhosis with HCC as compared to NASH-induced liver cirrhosis without HCC. We identified the expression levels of ascitic fluid-derived exosomal mir-182, miR-301a, and miR-373 were significantly up-regulated with fold change of 1.6, 1.94 and 2.13 respectively in NASH-induced liver cirrhosis with HCC as compared to NASH-induced liver cirrhosis without HCC (p <0.05). There was poor correlation expression of all the selected exosomal miRNA between serum- and ascitic fluid-derived in HCC group. CONCLUSIONS: This preliminary data showed significant increase in the expression levels of exosomal miR-182, miR-301a and miR- 373 in both serum and ascetic fluid suggesting the possible roles of these miRNAs as circulating biomarkers for NASH-induced liver cirrhosis with hepatocellular carcinoma.

The role of biochemical testing in cystic fibrosis.

INTRODUCTION: Cystic fibrosis (CF) is a life-limiting autosomal recessive disorder as a result of CF transmembrane conductance regulator gene mutation. It has a wide range of disease severity in patients with the same genotype. CASE REPORT: A 5-year-old Malay boy with a history of recurrent pneumonia, presented with productive cough, fever and worsening tachypnoea. Physical examination revealed coarse crepitations, reduced breath sounds and clubbing. Biochemical investigations showed that he had respiratory type 2 failure as a result of bronchiectasis. Sweat conductivity done twice was raised supporting a diagnosis of CF. Other investigations such as bronchoscopy to look for congenital anomaly of the lung, infectious disease screening and tuberculosis, fungal and viral culture and sensitivity were negative. Further cascade screening revealed high sweat conductivity results in his siblings. DISCUSSION: Although CF prevalence is low in Malaysia, it is nevertheless an important diagnosis to be recognised as it is associated with increased morbidity.

Cervical cancer and pap smear screening: knowledge, attitude and practice among working women in northern state of Malaysia.

INTRODUCTION: Cervical cancer is among the most common cancers in women worldwide. The Pap smear test is the primary screening procedure used to detect abnormal cells that may develop into cancer. OBJECTIVES: This study analysed the knowledge, attitudes and practices of working women in Kedah state, Malaysia, about cervical cancer and Pap smear tests and the associations of knowledge, attitudes and practices with socio-demographic factors. METHODS: This cross-sectional questionnaire study analysed knowledge, attitudes and practices among 210 female entrepreneurs who received funding from Amanah Ikhtiar Malaysia (AIM) in Kedah state. Women were included if they were married or previously married, aged 20-65 years and had not been diagnosed with cervical cancer. RESULTS: Most subjects could not recall common symptoms of cervical cancer, such as bleeding between periods, and did not know or were unsure of the suitable age for Pap smear tests and the interval between tests. Although most subjects agreed that Pap smear tests were necessary, some gave priority to other issues. About half (55.2%) had undergone Pap smear tests, but only 38.6% had been tested within the previous five years. Use of hormonal contraceptives, higher knowledge score, and higher attitude score were associated with Pap smear testing within the previous 5 years. CONCLUSIONS: Knowledge regarding cervical cancer and Pap smear testing and attitudes toward testing were poor among most participants. These factors were significantly associated with lack of actual testing.

Force delivery of NiTi orthodontic arch wire at different magnitude of deflections and temperatures: A finite element study.

NiTi arch wires are used widely in orthodontic treatment due to its superelastic and biocompatibility properties. In brackets configuration, the force released from the arch wire is influenced by the sliding resistances developed on the arch wire-bracket contact. This study investigated the evolution of the forces released by a rectangular NiTi arch wire towards possible intraoral temperature and deflection changes. A three dimensional finite element model was developed to measure the force-deflection behavior of superelastic arch wire. Finite element analysis was used to distinguish the martensite fraction and phase state of arch wire microstructure in relation to the magnitude of wire deflection. The predicted tensile and bending results from the numerical model showed a good agreement with the experimental results. As contact developed between the wire and bracket, binding influenced the force-deflection curve by changing the martensitic transformation plateau into a slope. The arch wire recovered from greater magnitude of deflection released lower force than one recovered from smaller deflection. In contrast, it was observed that the plateau slope increased from 0.66N/mm to 1.1N/mm when the temperature was increased from 26°C to 46°C.

Effect of different stent configurations using Lattice Boltzmann method and particles image velocimetry on artery bifurcation aneurysm problem.

Proper design of stent for application at specific aneurysm effect arteries could help to reduce the issues with thrombosis and aneurysm. In this paper, four types of stent configuration namely half-Y (6 mm), half-Y (4 mm), cross-bar, and full-Y configuration will implanted on real 3D artery bifurcation aneurysm effected arteries. Comparisons were then conducted based on the flow patterns after stent placement using both LBM-based solver and PIV experimental findings. According to the data obtained from all 4 stent designs, the flow profiles and the computed velocity from both methods were in agreement with each other. Both methods found that half-Y (6 mm) stent configuration is by far the best configuration in reducing the blood velocity at the vicinity of the aneurysm sac. The analysis also show that the half-Y (6 mm) stent configuration recorded the highest percentage of velocity reduction and managed to substantially reduce the pressure at the bifurcation region. This high flow velocity reduction through the use of half-Y stent could consequently promote the formation of thrombus thereby reducing the risk of rupture in the aneurysm sac.

Treatment effects of Reverse Twin-Block and Reverse Pull Face Mask on craniofacial morphology in early and late mixed dentition children.

OBJECTIVE: Reverse Twin-Block (RTB) and Reverse Pull Face Mask (RPFM) appliances are used to correct Class III malocclusion in growing patients. Aim of this retrospective study was to compare and analyse craniofacial changes produced by RTB and RPFM in the early and late mixed dentition in Malay children with Class III malocclusion. METHODS: Data consisted of pre- and post-treatment lateral cephalograms of 95 children, 49 patients with RTB and 46 patients with RPFM, divided into an early (8-9 year) and late (10-11 year) group. Treatment changes were assessed by the Ricketts analysis using CASSOS software, where 71 anatomic landmarks were identified in each cephalogram. Paired and independent t tests were performed for statistical comparison. RESULTS: Paired t test revealed significant changes in facial axis, facial angle, MD plane to FH, lower facial height, mandibular arc, maxillary convexity, U1 to APog, L1 to APog, L1 to APog angle and upper lip to E-plane measurements in RPFM, whereas significant changes were found in facial taper, U1 to APog and lower lip to E-plane values with RTB in the early treatment group. Independent t test revealed significant changes in U1 to APog, L1 to APog and U6 to PtV values in the RTB group. Post-treatment comparison of RTB and RPFM showed significant differences in L1 to APog and L1 to APog angle values. CONCLUSIONS: RPFM revealed more favourable craniofacial changes than RTB, particularly in the late mixed dentition stage.

Conventional versus Doxorubicin-Eluting Beads Transarterial Chemoembolization for Unresectable Hepatocellular Carcinoma: a Tertiary Medical Centre Experience in Malaysia.

BACKGROUND: Hepatocellular carcinoma (HCC) is a common cancer that is frequently diagnosed at an advanced stage. Transarterial chemoembolisation (TACE) is an effective palliative treatment for patients who are not eligible for curative treatment. The two main methods for performing TACE are conventional (c-TACE) or with drug eluting beads (DEB-TACE). We sought to compare survival rates and tumour response between patients undergoing c-TACE and DEB-TACE at our centre. MATERIALS AND METHODS: A retrospective cohort study of patients undergoing either treatment was carried out from January 2009 to December 2014. Tumour response to the procedures was evaluated according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST). Kaplan-Meier analysis was used to assess and compare the overall survival in the two groups. RESULTS: A total of 79 patients were analysed (34 had c-TACE, 45 had DEB-TACE) with a median follow-up of 11.8 months. A total of 20 patients in the c-TACE group (80%) and 12 patients in the DEB-TACE group (44%) died during the follow up period. The median survival durations in the c-TACE and DEB-TACE groups were 4.9 ± 3.2 months and 8.3 ± 2.0 months respectively (p=0.008). There was no statistically significant difference noted among the two groups with respect to mRECIST criteria. CONCLUSIONS: DEB-TACE demonstrated a significant improvement in overall survival rates for patients with unresectable HCC when compared to c-TACE. It is a safe and promising approach and should potentially be considered as a standard of care in the management of unresectable HCC.

Lattice Boltzmann Model of 3D Multiphase Flow in Artery Bifurcation Aneurysm Problem.

This paper simulates and predicts the laminar flow inside the 3D aneurysm geometry, since the hemodynamic situation in the blood vessels is difficult to determine and visualize using standard imaging techniques, for example, magnetic resonance imaging (MRI). Three different types of Lattice Boltzmann (LB) models are computed, namely, single relaxation time (SRT), multiple relaxation time (MRT), and regularized BGK models. The results obtained using these different versions of the LB-based code will then be validated with ANSYS FLUENT, a commercially available finite volume- (FV-) based CFD solver. The simulated flow profiles that include velocity, pressure, and wall shear stress (WSS) are then compared between the two solvers. The predicted outcomes show that all the LB models are comparable and in good agreement with the FVM solver for complex blood flow simulation. The findings also show minor differences in their WSS profiles. The performance of the parallel implementation for each solver is also included and discussed in this paper. In terms of parallelization, it was shown that LBM-based code performed better in terms of the computation time required.

Sphincter saving and abdomino-perineal resections following neoadjuvant chemoradiation in locally advanced low rectal cancer.

BACKGROUND: The improvement in surgical techniques alongside neoadjuvant chemoradiation enabled more patients with low rectal cancer to have sphincter preservation. STUDY AIM: To compare the oncologic and functional outcome in patients with locally advanced low rectal cancer treated by neoadjuvant chemoradiation followed by sphincter saving resection (SSR) against those who underwent abdomino-perineal resection (APR). PATIENTS AND METHODS: A total of 111 patients with low rectal cancer were included in the study. Sixty-one consented patients who prospectively underwent SSR, from Jan 2008 to Jan 2013, and a retrospective group, formed of 50 patients, selected from cases seen at NCI, with comparable demographic, clinical and pathologic criteria, who underwent APR from Jan 2003 to Jan 2008. All lesions were <5 cm from anal verge. All 111 patients received preoperative chemoradiation and total mesorectal excision. RESULTS: All tumors were located at a median of 3.6 cm (range 2.5-4.5 cm) for the SSR group, and 3.5 cm (range 2.5-4.6 cm) for the APR group, from the anal verge. The median follow-up was 34 months (range 1-60 months) for both groups. The difference in disease recurrence and OS between the APR and SSR groups were both statistically insignificant. CONCLUSION: In low rectal cancer, the sphincter preservation appears to have nearly the same oncologic outcome compared to APR, this might be attributed to the small sample size and short follow up period. However, patients with sphincter preservation have certainly demonstrated an indisputable better functional outcome, in terms of stoma avoidance and adequate continence.

Development and validation of bioelectrical impedance analysis equations for predicting total body water and fat-free mass in North-African adults.

BACKGROUND/OBJECTIVES: Accuracy of the bioelectrical impedance analysis (BIA) depends on population-specific prediction equations. The aim of our study was to develop prediction equations for assessing total body water (TBW) and fat-free mass (FFM) in healthy North-African adults. SUBJECTS/METHODS: In all, 250 participants (194 women, 56 men) aged 18-64 years were included in the analysis. BIA variables were measured by a tetra-polar device. TBW and FFM were assessed by the dilution of deuterium (D2O). The participants were sorted by gender and randomly split into development and validation subgroups. The validity of other published equations was also tested using Bland and Altman procedure, proportional bias and pure error. RESULTS: The prediction equations derived were: TBW (l)=5.68+0.267 height(2)/resistance+4.42 sex (male=1, female=0) + 0.225 weight-0.052 age (R(2)=0.92, root mean square error (RMSE)=1.75 l, RMSE%=5.65); and FFM (kg)=7.47 + 0.366 height(2)/resistance+6.04 sex + 0.306 weight-0.063 age (R(2)=0.92, RMSE=2.38 kg, RMSE%=5.61). The new equations provided nonsignificant proportional bias values, and better agreement than other tested equations. Bias and pure error values were 0.36 and 1.88 l for men and 0.00 and 1.82 l for women, for TBW equation. For FFM equation, bias values were 0.43 and -0.04 kg, and pure errors were 2.57 and 2.46 kg for men and women, respectively. CONCLUSIONS: The new prediction equations provide reliable estimates of TBW and FFM in North-African adults and are recommended for use in these populations.

Development of automated image stitching system for radiographic images.

Standard X-ray images using conventional screen-film technique have a limited field of view that is insufficient to show the full bone structure of large hands on a single frame. To produce images containing the whole hand structure, digitized images from the X-ray films can be assembled using image stitching. This paper presents a new medical image stitching method that utilizes minimum average correlation energy filters to identify and merge pairs of hand X-ray medical images. The effectiveness of the proposed method is demonstrated in the experiments involving two databases which contain a total of 40 pairs of overlapping and non-overlapping hand images. The experimental results are compared with that of the normalized cross-correlation (NCC) method. It is found that the proposed method outperforms the NCC method in classifying and merging the overlapping and non-overlapping medical images. The efficacy of the proposed method is further indicated by its average execution time, which is about five times shorter than that of the other method.

Cytotoxicity of triphenyltin(IV) methyl- and ethylisopropyldithiocarbamate compounds in chronic myelogenus leukemia cell line (K-562).

UNLABELLED: Studies on the discovery of new cancer treatment by using metal-based compounds such as tin (Sn) has now greatly being synthesized and evaluated to identify their effectiveness and suitability to be developed as a new anticancer drug. APPROACH: This study was carried out to evaluate the cytotoxicity of triphenyltin(lV) methylisopropyldithiocarbamate (compound 1) and triphenyltin(IV) ethylisopropyldithiocarbamate (compound (2) on chronic myelogenus leukemia cells. The determination of their cytotoxicity (IC50) at different time of exposure and concentration was carried out through the employment of 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyl-tetrazolium bromide (MTT) assay. RESULTS: The IC50 values obtained for compound 1 and 2 following treatment at 24, 48 and 72 h were 0.660, 0.223, 0.370 microM and 0.677, 0.306, 0.360 microM, respectively. Cell morphological changes such as apoptotic and necrotic features were also been observed. CONCLUSION: The compounds tested were found to give cytotoxic effect against chronic myelogenus leukemia (K-562) cell at a micromolar dose. Thus, further study on their specific mechanism of actions in the human cells should be carried out to elucidate their potential as an anticancer agent.

Prediction of fat-free mass by bioelectrical impedance analysis in older adults from developing countries: a cross-validation study using the deuterium dilution method.

OBJECTIVE: Several limitations of published bioelectrical impedance analysis (BIA) equations have been reported. The aims were to develop in a multiethnic, elderly population a new prediction equation and cross-validate it along with some published BIA equations for estimating fat-free mass using deuterium oxide dilution as the reference method. DESIGN AND SETTING: Cross-sectional study of elderly from five developing countries. METHODS: Total body water (TBW) measured by deuterium dilution was used to determine fat-free mass (FFM) in 383 subjects. Anthropometric and BIA variables were also measured. Only 377 subjects were included for the analysis, randomly divided into development and cross-validation groups after stratified by gender. Stepwise model selection was used to generate the model and Bland Altman analysis was used to test agreement. RESULTS: FFM = 2.95 - 3.89 (Gender) + 0.514 (Ht2/Z) + 0.090 (Waist) + 0.156 (Body weight). The model fit parameters were an R2, total F-Ratio, and the SEE of 0.88, 314.3, and 3.3, respectively. None of the published BIA equations met the criteria for agreement. The new BIA equation underestimated FFM by just 0.3 kg in the cross-validation sample. The mean of the difference between FFM by TBW and the new BIA equation were not significantly different; 95% of the differences were between the limits of agreement of -6.3 to 6.9 kg of FFM. There was no significant association between the mean of the differences and their averages (r= 0.008 and p= 0.2). CONCLUSIONS: This new BIA equation offers a valid option compared with some of the current published BIA equations to estimate FFM in elderly subjects from five developing countries.

[Impact of flour fortification with elemental iron on the prevalence of anaemia among preschool children in Morocco]. / Impact de l'enrichissement de la farine en fer élémentaire sur la prévalence de l'anémie chez les enfants en âge préscolaire au Maroc.

Anaemia is a public health problem in Morocco. To limit this problem, Morocco developed a national programme based on fortification of flour with electrolytic elemental iron. To evaluate the programme's impact on the prevalence of anaemia in children between 2 and 5 years, 4 surveys were conducted, between 2006 and 2008, throughout the country. The results showed a significant improvement in the mean rate of haemoglobin accompanied by a significant decrease in the prevalence of anaemia. This improvement appears to be the result of several mutually reinforcing actions in addition to the fortification of flour with iron, including the promotion of a diversified diet rich in micronutrients and the promotion of public health measures.

Impact of flour fortification with elemental iron on the prevalence of anaemia among preschool children in Morocco

Anaemia is a public health problem in Morocco. To limit this problem, Morocco developed a national programme based on fortification of flour with electrolytic elemental iron. To evaluate the programme's impact on the prevalence of anaemia in children between 2 and 5 years, 4 surveys were conducted, between 2006 and 2008, throughout the country. The results showed a significant improvement in the mean rate of haemoglobin accompanied by a significant decrease in the prevalence of anaemia. This improvement appears to be the result of several mutually reinforcing actions in addition to the fortification of flour with iron, including the promotion of a diversified diet rich in micronutrients and the promotion of public health measures