Significant Mean Decrease Research Articles

Biological therapy in patients with psoriasis: What we know about the effects on renal function.

Psoriasis is a chronic inflammatory dermatosis affecting 2%-3% of the general population. The link between psoriasis and renal dysfunction has been investigated, demonstrating a common pro-inflammatory pathogenesis. This study is aimed at evaluating renal function in patients with moderate-to-severe chronic plaque psoriasis treated with biological therapy. We analyzed 92 patients, correlating PASI and serum creatinine levels at baseline, after 6 months and after 1 year of continuous treatment with biological therapy. Data were analyzed using paired t-test and the linear mixed model for PASI and serum creatinine levels correlation, whereas the analysis of variances (ANOVA) was used for creatinine levels assessment between the baseline, the 6-months and, 1-year later evaluation. We observed a significant mean decrease in comparing serum creatinine levels after 1 year of biological therapy (p < 0.001). Interestingly, PASI reduction is correlated with creatinine decrease, and the renal function improvement is greater when complete psoriasis remission is attained. Our data suggest that a drop in systemic inflammation, secondary to biological therapy administration, might improve renal function. Future research is needed to confirm and expand our findings.

Transmitted Water Disease, Assessment of Immunopathogenesis of Chronic Hepatitis B and The Carrier State of Disease

The transmission of viral hepatitis type B (HBV) is of significant public health concern. The infection result depends on how well the virus interacts with the host and in particular, on the ability to respond inherently and adaptively to the humoral and cellular immunity. The purpose of this study is to evaluate clinical, immunology and tracer status (viral). This study showed the relationship between the immune and chronic conditions of Iraqi patients who are chronic hepatitis virus B or HBV carriers. The study included (111) chronically-viral hepatitis type (b) and (112) hepatitis virus surface antigen type (b) healthy carriers from out of patients. The result of this study proved that a non-significant correlation was observed between cellular immune response (CD4 and CD8) among chronic hepatitis B patients. For CD8+ lymphocytes: there was a highly significant decrease (P&lt;0.001) in the percentage means of the CD8+ cells in CHB patients, as compared with the carrier groups. For CD4+ lymphocytes: there was a slight decrease in the percentage of these lymphocytes in the peripheral blood of the patients, as compared with the carrier groups, a non-significant importance was recorded between them. The percentage of cytotoxic T-lymphocyte CD8+ was significantly decreased in CHB patients as compared to the carrier group. One of the deciding factors for the form of infection, and the immune response, which developed in accordance with a number of other biochemical factors and genes is chronic hepatitis B immunopathogénesis and carrier condition with the level of cellular immunity.

Effect of posture and body weight loading on spinal posterior root reflex responses.

The posterior root muscle response (PRM) is a monosynaptic reflex that is evoked by single pulse transcutaneous spinal cord stimulation (tSCS). The main aim of this work was to analyse how body weight loading influences PRM reflex threshold measured from several lower limb muscles in healthy participants. PRM reflex responses were evoked with 1-ms rectangular monophasic pulses applied at an interval of 6s via a self-adhesive electrode (9 × 5 cm) at the T11-T12 vertebral level. Surface electromyographic activity of lower limb muscles was recorded during four different conditions, one in decubitus supine (DS) and the other three involving standing at 100%, 50%, and 0% body weight loading (BW). PRM threshold intensity, peak-to-peak amplitude, and latency for each muscle were analysed in different conditions study. PRM reflex threshold increased with body weight unloading compared with DS, and the largest change was observed between DS and 0% BW for the proximal muscles and between DS and 50% BW for distal muscles. Peak-to-peak amplitude analysis showed only a significant mean decrease of 34.6% (SD 10.4, p = 0.028) in TA and 53.6% (SD 15.1, p = 0.019) in GM muscles between DS and 50% BW. No significant differences were observed for PRM latency. This study has shown that sensorimotor networks can be activated with tSCS in various conditions of body weight unloading. Higher stimulus intensities are necessary to evoke reflex response during standing at 50% body weight loading. These results have practical implications for gait rehabilitation training programmes that include body weight support.

Hospitalization is associated with handgrip strength decline in older adults: a longitudinal study

Hospitalization episodes in older people are considered critical events because they act in a complex interaction among immobilization effects. The purpose of this study was to evaluate the effects of hospitalization on older adults' handgrip strength (HGS) and to identify factors related to its performance on the test. A cohort study was conducted in a hospital in Natal, Brazil, and enrolled all patients aged 60years and older between January 2014, and April 2015.Cognitive (Leganés Cognitive Test) and functional status (Katz Index, Lawton Scale and Functional limitation Nagi), physical performance (HGS and gait speed) and depressive symptom assessment (GDS-15) were evaluated at admission and discharge time, as well as information about health and functional status prior to hospitalization. Linear Mixed Models were used to create a predictive model for handgrip strength. A total of 1168 hospitalized older adults were evaluated. A significant decrease in HGS means was observed between admission and discharge time for men (28.12 ± 10.35 and 20.22 ± 14.08 Kgf, p < 0.01) and for women (19.18 ± 7.87 and 14.88 ± 9.79 Kgf, p < 0.01). Undergoing surgery and basal values of the Katz Index were associated with worse HGS performance at discharge. A significant decline in handgrip strength during the hospitalization period was observed, which was more pronounced in men. Performing surgery during hospitalization was an important factor for HGS decline in men and women. This study reinforces the importance of early mobilization and muscle strength loss prevention protocols in hospitalized older patients.

Intraocular Pressure Reduction by Femtosecond Laser Created Trabecular Channels in Perfused Human Anterior Segments.

PurposeThis study investigated the initial feasibility of using femtosecond laser trabeculotomy (FLT) to create open channels through the trabecular meshwork into Schlemm's canal to lower intraocular pressure (IOP) in a perfused anterior segment model.MethodsHuman anterior segments (12 eyes) were assigned to either treatment (n = 6) or sham treatment (n = 6) groups. Both groups were perfused until a baseline IOP was recorded upon which a direct FLT treatment or a sham treatment was administered. IOP was recorded before and after the treatment. Spectral domain optical coherence tomography and second harmonic generation imaging we used to investigate the FLT channels.ResultsIn the FLT group, there was a significant mean decrease in the IOP of 22% compared with the pre-FLT IOP (7.13 ± 2.95 mm Hg to 5.34 ± 1.62 mm Hg; P < 0.05). In the control group, the post-sham IOP remained relatively unchanged compared with the pre-sham IOP (6.39 ± 3.69 mm Hg to 6.67 ± 4.12 mm Hg).ConclusionsThe results of this study indicate that FLT treatment can significantly decrease the IOP in a perfusion model and may provide a potential noninvasive treatment option for primary open angle glaucoma.Translational RelevanceInvestigating the use of femtosecond lasers for photodisrupting the trabecular meshwork can lead to a clinically relevant alternative to current glaucoma procedures.

The effects of acute incremental hypocapnia on the magnitude of neurovascular coupling in healthy participants.

The high metabolic demand of cerebral tissue requires that local perfusion is tightly coupled with local metabolic rate (neurovascular coupling; NVC). During chronic altitude exposure, where individuals are exposed to the antagonistic cerebrovascular effects of hypoxia and hypocapnia, pH is maintained through renal compensation and NVC remains stable. However, the potential independent effect of acute hypocapnia and respiratory alkalosis on NVC remains to be determined. We hypothesized that acute steady‐state hypocapnia via voluntary hyperventilation would attenuate the magnitude of NVC. We recruited 17 healthy participants and insonated the posterior cerebral artery (PCA) with transcranial Doppler ultrasound. NVC was elicited using a standardized strobe light stimulus (6 Hz; 5 × 30 s on/off) where absolute delta responses from baseline (BL) in peak, mean, and total area under the curve (tAUC) were quantified. From a BL end‐tidal (PET)CO2 level of 36.7 ± 3.2 Torr, participants were coached to hyperventilate to reach steady‐state hypocapnic steps of Δ‐5 Torr (31.6 ± 3.9) and Δ‐10 Torr (26.0 ± 4.0; p < 0.001), which were maintained during the presentation of the visual stimuli. We observed a small but significant reduction in NVC peak (ΔPCAv) from BL during controlled hypocapnia at both Δ‐5 (−1.58 cm/s) and Δ‐10 (−1.37 cm/s), but no significant decrease in mean or tAUC NVC response was observed. These data demonstrate that acute respiratory alkalosis attenuates peak NVC magnitude at Δ‐5 and Δ‐10 Torr PETCO2, equally. Although peak NVC magnitude was mildly attenuated, our data illustrate that mean and tAUC NVC are remarkably stable during acute respiratory alkalosis, suggesting multiple mechanisms underlying NVC.

The advantages of abdominal compression with shallow breathing during left-sided postmastectomy radiotherapy by Helical TomoTherapy.

Left-sided post-mastectomy radiotherapy (PMRT) certainly precedes some radiation dose to the cardiopulmonary organs causing many side effects. To reduce the cardiopulmonary dose, we created a new option of the breathing adapted technique by using abdominal compression applied with a patient in deep inspiration phase utilizing shallow breathing. This study aimed to compare the use of abdominal compression with shallow breathing (ACSB) with the free breathing (FB) technique in the left-sided PMRT. Twenty left-sided breast cancer patients scheduled for PMRT were enrolled. CT simulation was performed with ACSB and FB technique in each patient. All treatment plans were created on a TomoTherapy planning station. The target volume and dose, cardiopulmonary organ volume and dose were analyzed. A linear correlation between cardiopulmonary organ volumes and doses were also tested. Regarding the target volumes and dose coverage, there were no significant differences between ACSB and FB technique. For organs at risk, using ACSB resulted in a significant decrease in mean (9.17 vs 9.81 Gy, p<0.0001) and maximum heart dose (43.79 vs 45.45 Gy, p = 0.0144) along with significant reductions in most of the evaluated volumetric parameters. LAD doses were also significantly reduced by ACSB with mean dose 19.24 vs 21.85 Gy (p = 0.0036) and the dose to 2% of the volume (D2%) 34.46 vs 37.33 Gy (p = 0.0174) for ACSB and FB technique, respectively. On the contrary, the lung dose metrics did not show any differences except the mean V5 of ipsilateral lung. The positive correlations were found between increasing the whole lung volume and mean heart dose (p = 0.05) as well as mean LAD dose (p = 0.041) reduction. The ACSB technique significantly reduced the cardiac dose compared with the FB technique in left-sided PMRT treated by Helical TomoTherapy. Our technique is uncomplicated, well-tolerated, and can be applied in limited resource center.

Physical activity, patient-reported symptoms, and clinical events: Insights into postprocedural recovery from personal digital devices

BackgroundPersonal digital devices may offer insights into patient recovery and an approach for remote monitoring after procedures.ObjectiveTo examine associations between activity measured using personal digital devices, patient-reported outcome measures (PROMs), and clinical events among patients after catheter ablation for atrial fibrillation (AF) or bariatric surgery.MethodsWe aggregated personal digital device, PROM, and electronic health record data in a study conducted at 2 health systems. We used Fitbit devices for step count assessments, KardiaMobile for cardiac rhythm assessments, and PROMs for pain and palpitations over 5 weeks.ResultsAmong 59 patients, 30 underwent AF ablation and 29 bariatric surgery. Thirty-six patients (63%) reported pain. There was no difference in median [interquartile range] daily steps between patients with and those without pain (4419 [3286–7041] vs 3498 [2609–5888]; P = .23). Among AF ablation patients, 21 (70%) reported palpitations. Median daily steps were lower among those with palpitations than among those without (4668 [3021–6116] vs 8040 [6853–10,394]; P = .03). When accounting for within-subject correlation, recordings of AF were associated with a significant mean decrease in median daily steps (–351; 95% confidence interval –524 to –177; P <.01). Patients who received a new antiarrhythmic drug prescription had AF recorded in a median of 5 [5–5] of 5 total weeks, whereas patients who did not receive a new antiarrhythmic recorded AF in a median of 1 [0–3] week (P = .02).ConclusionPersonal digital device and PROM data can provide insight into postprocedural recovery outside of usual clinical settings and may inform follow-up and clinical decision-making. (ClinicalTrials.gov Identifier: NCT03436082)

COMPARATIVE STUDY OF CROSS LINKING VERSUS STROMAL PUNCTURE IN KERATOCONUS

Background: Keratoconus is a non-inflammatory condition where the cornea assumes a conical shape because of thinning and protrusion of the corneal stroma. The corneal thinning induces irregular astigmatism, myopia, and corneal protrusion, leading to mild to marked impairment in the quality of vision. Symptoms are highly variable and, in part, depend on the stage of progression of the disorder. Objective: To compare refractive and topographic outcomes between cross-linking (CXL) and corneal stromal puncture in stiffening the cornea and halt the progression of Keratoconus. Patients and Methods: This randomized controlled study included 19 patients (30 eyes) with keratoconus. They were not presenting with any eye disease and had never undergone eye surgery. The total number of subjects meeting the inclusion and exclusion criteria. They were divided into 2 groups, group (A) 9 patient: 15 eyes received cross-linking and group (B) 10 patient: 15 eyes received corneal puncture. All examination, investigation and the procedure were done at El Sayed Galal Hospital and Nour al Hyaa eye Hospital, Cairo. Results: The results showed significant improvement in postoperative value of UCVA, BCVA, than its preoperative value. In addition, a statistically significant decrease of postoperative K1 in both group than its preoperative value while there was a statistically significant increase of K2 postoperative value compared to preoperative value in puncture group, K2 showed significant decease postoperative in CXL group. There was significant increase in corneal thickness postoperatively compared to preoperative values in puncture group, corneal thickness showed significant decrease postoperatively in CXL group. Comparing both groups, there was significant improvement in postoperative UCVA, postoperative BCVA in puncture group than in CXL group. On the other hand, there was a significant decrease in mean of postoperative corneal thickness in CXL group than puncture group. Conclusion: Overall, the results of this study continue to support the efficacy of CXL in progressive keratoconus and explored new modality of its treatment by anterior stromal puncture (ASP), with an improvement in UCVA, and BCVA 3 months after operation.

Teratogenic effect of clarithromycin on rabbit,s foeti

Objective: To evaluate the teratogenic effects of clarithromycin on developing rabbit.Design: Randomized controlled study.Animals: Twenty one female New Zealand rabbits. Procedure: The pregnant female rabbits (21) were allocated into 4 groups. Control group (G1) (6 rabbits) received placebo. Other groups received clarithromycin (at a dose of 30 mg/kg b.wt orally) for ten days during the first stage (group2, n=6), the second stage (group3, n=6) or the third stage (group 4, n=3) of pregnancy. Three rabbits from each group were slaughtered on 20th and 30th days of pregnancy. Teratogenic effects were evaluated morphologically and histopathologically. Results: The therapeutic dose of clarithromycin exhibited morphological malformations, significant decrease (P≤0.05) in viable foeti mean, the mean values of the body weight and the fetal crown-rump length. However there was significant increase (P≤0.05) in dead foeti, fetal resorption rate, pre and post-implantation death in different stages of pregnancy. Visceral fetal abnormalities revealed dilatation of lateral ventricles of brain, thickening of the ventricular wall of the heart, and slight unilateral or bilateral widening of the renal pelvis. Skeleton fetal malformations showed incomplete ossification of 5th sternipri with absence of last ribs. Histopathological examination confirm teratogenic effects of clarithromycin. Conclusion and clinical relevance: The use of clarithromycin during pregnancy should be prohibited.

A Study to Assess the Dosimetric Impact of the Anatomical Changes Occurring in the Parotid Glands and Tumour Volume during Intensity Modulated Radiotherapy using Simultaneous Integrated Boost (IMRT-SIB) in Head and Neck Squamous Cell Cancers.

BackgroundAnatomical variations in head and neck cancer during IMRT leads to volume shrinkage, results in dosimetric variations in tumour and normal tissue including parotid glands, with a risk of radiation toxicities.Methods30 patients with a stage II–IV head and neck squamous cell carcinoma (HNSCC) were treated with definitive IMRT‐SIB and concomitant chemotherapy. Volumetric and dosimetric variations were evaluated during the period of IMRT by recalculating and obtaining dose‐volume histograms of re‐contoured target volumes and parotid glands on repeat CT scans taken multiple times during treatment (CT1, CT2, CT3 and CT4).ResultsResult showed significant (p < 0.001) mean decrease in both primary and nodal tumors volume with time whereas increase (p < 0.01 or p < 0.001) in respective V100 (%) and D2% (Gy). The mean parotid gland dose increased (p < 0.01 or p < 0.001) with time, whereas parotid gland volume and distance between plan isocenter and centre of mass of parotid glands decreased (p < 0.05 or p < 0.001) with time. Patient's mean weight and neck circumference both decrease (p < 0.001) with time whereas ECOG score increase (p < 0.001) with time. The mucosal toxicity increased significantly (p < 0.001) with time. The change in both weight and neck circumference showed significant (p < 0.001) and direct (positive correlation) association with change in parotid gland volume.ConclusionIf the PTV and normal anatomy are changing with time, adaptive IMRT would be beneficial radiation dose delivery where possible.

Effect of an Obstetric Hemorrhage Bundle on Clinical Outcomes and Clinician Perceptions

ObjectiveTo examine the effect of an obstetric hemorrhage (OBH) safety bundle on health outcomes and to explore nurses’ and physicians’ perceptions of using the bundle. DesignDescriptive longitudinal study, including review of electronic health records for 79,509 births, and clinician surveys. SettingNine hospitals in the southwestern United States. Participants685 maternity nurses and 210 obstetricians. Interventions/MeasurementsRetrospective and prospective data collection over 3.5 years to examine selected health outcomes before and after implementing an OBH bundle. A 10-item questionnaire was used to survey clinicians for their perceptions of bundle use. The Hospital Survey on Patient Safety Culture was used to explore nurses’ views of the safety climate before and after bundle implementation. ResultsStatistically significant decreases in mean documented blood loss were observed with bundle use. Blood loss rates of less than 500 ml and greater than 1,000 ml increased, and blood loss rates of 500 to 1,000 ml decreased. Use of postpartum hemorrhage medications increased. When adjusted for multiple tests, there was no statistically significant difference in the rates of postpartum hysterectomies or ICU admissions or in length of stay. Clinicians’ perceptions of bundle use were positive, with scores ranging from 6 to 8 on a scale of 1 to 10. However, Hospital Survey on Patient Safety Culture results indicated a decrease in nurses’ perceptions of safety after bundle implementation. ConclusionOBH bundles provide tools and guidance to improve perinatal care and outcomes. Our findings of lower mean blood loss, increased use of postpartum hemorrhage medications, and positive perceptions of the bundle differed from findings of previous studies. Nurses’ perceptions of safety decreased, yet clinicians reported that care was safer with the OBH bundle. Nurses’ commitment and collaboration are vital to the success of bundle implementation.

593-P: Effectiveness of Digital Therapeutics to Improve Clinical Outcomes in Patients with Type 2 Diabetes Mellitus on Insulin Therapy

Background: Diabetes self-management education and support (DSMES) is integral towards maintaining continuity of care between physician visits especially for patients on insulin therapy to facilitate healthy coping. The present study explores the usage patterns and real-world effectiveness of the Wellthy CARE™ digital therapeutic (WDTx) platform in achieving glycemic control among patients with type 2 diabetes mellitus (T2DM) on insulin therapy. Methods: The WDTx platform consists of a smartphone application with a 52-week program to provide DSMES through self-monitoring of blood glucose, access to evidence-based content regarding insulin usage and remote guidance by a health coach to enable lifestyle modifications and healthy coping. All app interactions were analyzed at baseline and during the program to determine factors driving patient engagement and clinical outcomes. Results: Study participants (n=106) had a mean age of 51.4 years (SD 14.0 years) and consisted of 39 females (36.8%). Overall, a significant mean decrease in average blood sugar (ABS) by 29.9 mg/dl (95%CI 16.6-43.3 mg/dl, P&amp;lt;0.001) was observed with a 31.9% reduction in proportion of hypoglycemia logs and an average of 6.1 app interactions per patient per week on the platform thus proving continuity of care provided through WDTx. Users in the highest tertile for early app interactions (within week 1) demonstrated a significant mean decrease in ABS by 30.8 mg/dl (95%CI 7.5-54.0 mg/dl, P&amp;lt;0.01) while no significant change was seen in the corresponding lowest tertile. Over the entire program, users in the tertile with highest app engagement showed a significant mean decrease in ABS of 27.4 mg/dl (95%CI 8.8-46.1 mg/dl, P&amp;lt;0.01) as compared to no significant change in the lowest tertile. Conclusion: This study thus demonstrates the effectiveness of the WDTx platform to impart critical DSMES, maintain continuity of care and improve clinical outcomes in patients with T2DM on insulin therapy. Disclosure R. R. Adhikary: Employee; Self; Wellthy Therapeutics Pvt Ltd. S. Kolwankar: Employee; Self; Wellthy Therapeutics Pvt Ltd. R. Verma: Consultant; Self; Wellthy Therapeutics Pvt Ltd. J. Bhatt: Employee; Self; Wellthy Therapeutics Pvt Ltd. K. L. Pakhale: None. R. Sahay: Advisory Panel; Self; Cipla Inc., USV Private Limited, Speaker's Bureau; Self; Eli Lilly and Company, Novo Nordisk Pharma Ltd.

Long-term periodontal changes associated with oral appliance treatment of obstructive sleep apnea.

To characterize the mandibular anterior teeth crown height as a marker of periodontal changes and bone loss as a side effect of an oral appliance worn for a minimum of 4.5 years. This retrospective study conducted in patients with healthy baseline periodontium recruited participants among consecutive sleep apnea patients treated with an oral appliance between 2004 to 2014. Eligible participants were recalled for a follow-up visit at which a periodontal examination was performed and a lateral cephalogram and dental impressions were obtained. Clinical crown height for mandibular anterior teeth and cephalometric variables were measured and compared before and after treatment. A full periodontal evaluation was performed at the follow-up visit. Twenty-one patients enrolled with a mean treatment length of 7.9 ± 3.3 years. For the mandibular anterior teeth, clinical crown height did not change over the evaluated period. At follow-up, all the periodontal assessed variables were within normal limits, with the mean probing depth of 1.4 ± 0.5 mm, recession 0.6 ± 1.1 mm, and clinical attachment loss 0.8 ± 1.0 mm. Compared with baseline, there was a significant proclination of mandibular incisors (mean increase of 5.1 degrees) with the continued use of an oral appliance. Gingival levels were maintained with clinically insignificant changes during the observation period. Inclination of the mandibular incisors increases significantly with the use of an oral appliance in patients with obstructive sleep apnea. Positional changes in these teeth were not associated with any measured evidence of increase in clinical crown height or gingival recession. Heda P, Alalola B, Almeida FR, Kim H, Peres BU, Pliska BT. Long-term periodontal changes associated with oral appliance treatment of obstructive sleep apnea. J Clin Sleep Med. 2021;17(10):2067-2074.

Remodeling of the Posterior Cerebral Artery P1-Segment after Pipeline Flow Diverter Treatment of Posterior Communicating Artery Aneurysms.

Introduction: Flow diverters such as the pipeline embolization device (PED) cause hemodynamic changes of the treated vessel segment. In posterior communicating artery (PcomA), aneurysms’ unique anatomic consideration have to be taken in account due to the connection between the anterior and posterior circulation. We hypothesize that in conjunction with PcomA remodeling, there will also be remodeling of the ipsilateral P1 segment of the posterior cerebral artery (PCA) after PED treatment for PcomA aneurysms. Methods: We retrospectively collected radiological as well as clinical data of PcomA aneurysm patients treated with PED including PcomA and P1 vessel diameters before and after treatment as well as patient and aneurysm characteristics. Results: Overall, 14 PcomA aneurysm patients were included for analysis and PED treatment was performed without complications in all patients. In 10 out of 14 patients (71%), a decrease in PcomA diameter was observed and there was a significant mean decrease of 0.78 mm in PcomA diameter on angiographic last follow-up (LFU) (p = 0.003). In the same patient population (10 out of 14 patients), there was meanwhile a significant mean increase of 0.43 mm in the ipsilateral P1 segment diameter observed (p = 0.015). These vessel remodeling effects were in direct correlation with aneurysm occlusion since all of these patients showed aneurysm occlusion at LFU while 29% showed only partial occlusion without vessel remodeling effects. A decrease in PcomA diameter was directly associated with aneurysm occlusion (p = 0.042). There were no neurologic complications on LFU. Conclusion: In the treatment of PcomA aneurysms with PED, the P1 segment of the PCA increases in diameter while the PcomA diameter decreases. Our results suggest that this remodeling effect is associated with aneurysm occlusion and decrease of PcomA is hemodynamically compensated for by an increase in the ipsilateral P1 diameter.

Patency and Clinico-Haematological Pathologies Sequel to Trypanosoma brucei and Trypanosoma evansi Induced Infections in Yankasa Sheep I

Trypanosomosis remains one of the most deadly protozoan diseases that pose a significant impact on livestock health in the tropics. Sixteen (16) rams aged between 24 to 30 months and weighed between 22-25kg were acclimatized under standard animal housing conditions. Twelve (12) of the sheep deemed fit and healthy were randomly divided into four groups (I, II, III, and IV) of three sheep each. Each sheep in groups I and II was inoculated intravenously with 2 mL containing 2 X 106 trypomastigote forms of Trypanosoma brucei and Trypanosoma evansi, respectively. While group III, each sheep received 2 mL containing 2 X 106 mixed inoculums of T. brucei and T. evansi (50% each by volume of the infective inoculums). Sheep in group IV served as the non-infected control. Post-infection animals were monitored for 14 weeks for parasitaemia, clinical signs, and haematological pathologies. The patent infection became evident in groups I, II, and III between 5-21 days post-infection with average patency of 7, 20, and 8.5 days respectively. The infection was characterized by intermittent pyrexia with a significant decrease (p&lt; 0.001) in mean weekly packed cell volume (PCV), haemoglobin concentration (Hb), live weight gain, plasma protein, which significantly decreased (p&lt; 0.001) in all the infected groups. Pearson’s correlation (r) indicates a strong positive correlation (r= 0.991) between parasitaemia and pyrexia, and principal component analysis (PCA) biplot increased the predictabilities of these two indices as the major precursors in the progression of the trypanosomes pathogenesis in sheep.&#x0D; Keywords: Trypanosomosis; Patency; Clinico-haematological pathologies; Trypanosoma brucei; Trypanosoma evansi; Yankasa sheep

Influence of Gender on Some Red Cell Indices, L-Arginine and D-dimer in Malaria Parasite Severity amongst Children Resident in Rivers State, Nigeria

Aim: The aim of the study was to assess the influence of gender on malaria parasite severity in children resident in Rivers State, Nigeria.&#x0D; Study Design: The study was cross-sectional observational study.&#x0D; Place and Duration of Study: University of Port Harcourt Teaching Hospital, Rivers State, Nigeria, between the month of March and August 2020.&#x0D; Methodology: A total of 822 pediatrics (0-16 years), were randomly selected for this study after due parental consent. 5ml of venous blood was collected from each subject: 1ml was dispensed into paediatric EDTA (for haematologic and parasite density) and 4 ml into sodium citrate bottle for L-arginine assay by ELISA-method, while Full blood count was determined using haematological auto-analyser, Mindray BC-6800. Malaria density was determined by microscopic method using thick and thin Giemsa stained blood smears. Level of significance was set at P&lt;0.05.&#x0D; Results: There was a significant decrease (p&lt;.05) in the mean (41.04±3.80%) neutrophil count in female subject with complicated malaria compared with the control (42.81±0.98%) as against a significant decrease in mean (37.71±0.96%) neutrophil count of female subject with uncomplicated malaria. A significant decrease in neutrophil (28.05±3.37%) of male subjects with complicated malaria and uncomplicated malaria (36.10±0.79%) was seen when compared to control (44.32±0.88%). Again, a significant decrease (p&lt;.05) in eosinophil count of female with complicated malaria (3.32±0.74%) was seen when compared with the control subject (3.81±0.19%) and no significant difference was seen in female subjects with uncomplicated malaria (3.62±0.19%) when compared with the control. A significant increase in eosinophil was seen in male subjects with complicated malaria (4.47±0.66%) and uncomplicated malaria (4.52±0.16%) when compared with the control (3.88±0.17%). There was observed a significant difference (p&lt;.001) in the mean L-arginine values of female subjects with complicated (39.22±9.57pg/ml) and uncomplicated (65.13±2.41 pg/ml) malaria compared with the control (42.85±2.48 pg/ml). However, no significant difference was seen in male subjects with complicated (33.21±8.49) and uncomplicated (45.51±2.00 pg/ml) malaria when compared with control (47.97±2.21 pg/ml). Also, a significant difference (p&lt;0.0019) was seen between the mean D2D values of female subjects with complicated (6436.64±568.94 pg/ml) and uncomplicated (2824.55±143.46 pg/ml) malaria among the study subjects as against the control (1866.39±147.35 pg/ml).&#x0D; Conclusion: In conclusion, this study showed a trend between gender and malaria type did not significantly change haematological parameters with the exception of the immune cells such as NEU, LYM, and EOS. However, a significant increase in L-arginine among female subjects was seen indicating a faster rate of malaria clearance.

Blood pressure profile in freshly detected alcohol dependence syndrome patients

Background: Alcohol consumption and raised Blood pressure (BP) are among the top five risk factors responsible for the growing global non-communicable diseases (NCD) burden. The present study was undertaken to study the relation between alcohol dependence syndrome (ADS) and hypertension and the effect of reduction in alcohol consumption on BP.Methods: A prospective observational study was conducted at a tertiary care hospital over a period of 02 years from 08 Oct 2016 to 02 Oct 2018. A total of fifty freshly diagnosed ADS patients with BP in the pre- hypertensive or hypertensive range after the withdrawal subsided, were recruited into the study. The study group was subjected to repeated BP measurements, serum Gamma glutamyl transferase (GGT) measurements and status of alcohol consumption at 03, 06, 09 and 12 monthly intervals. The data was analyzed with ANOVA, Post-hoc Bonferroni and Pearson’s correlation tests.Results: There was a statistically significant mean decrease in systolic and diastolic blood pressure from the baseline till 03 months and between 03 months and 06 months of follow-up. The correlation between GGT levels and systolic and diastolic BP at different time intervals showed that there was a statistically non-significant weak positive correlation at baseline (r value=0.125) (p value= 0.38). During follow-up period there was a negative correlation between GGT and systolic BP at 12 months (r value= -0.40), which was statistically significant. The correlation between alcohol consumption and BP at different time intervals showed a moderate positive correlation at baseline with systolic BP(r value= 0.478), which was statistically significant.Conclusions: This study evaluated changes in blood pressure occurring during Alcohol dependence syndrome treatment. Observed decreases in systolic and diastolic blood pressure were substantially accounted for by reductions in alcohol consumption and occurred largely in the first 03 months of treatment. There was no significant fall in systolic blood pressure between 06 months and 01-year duration of follow-up.

The biomechanical role of the lacertus fibrosus of the biceps brachii Muscle

The lacertus fibrosus (LF) is involved in various surgeries. However, the biomechanical contribution of the LF remains unclear. The aim of this study was to determine the role of the lacertus fibrosus on the elbow and forearm kinematics and on the biceps brachii muscle lever arms. This biomechanical study was performed on seven fresh-frozen upper limbs of cadavers. Elbow flexion, forearm supination, and biceps brachii muscle lever arms were analyzed in the intact conditions (I) and after superficial (R) and deep part (R2) of the lacertus fibrosus release, respectively. Elbow flexion shows a significant difference (p < 0.0001) between I, R, R2. Abduction/adduction shows a significant difference between I-R (p < 0.0001) and I-R2 (p < 0.0001). Supination does not show a significant difference in mean maximum amplitude, but between 40 and 70%, there are significant differences. There is a significant mean decrease of lever arm in flexion (28%) and supination (50%) after superficial and deep part of the lacertus fibrosus release. The results of this study show that the lacertus fibrosus increases the lever arm during flexion and supination. It limits the flexion and abduction of the elbow and supination of the forearm. Lacertus fibrosus maintains the rhythmicity between the elbow flexion and supination of the forearm. Basic science study, biomechanics.

Use of wearable sensors to assess compliance of asthmatic children in response to lockdown measures for the COVID-19 epidemic

Between March and April 2020, Cyprus and Greece health authorities enforced three escalated levels of public health interventions to control the COVID-19 pandemic. We quantified compliance of 108 asthmatic schoolchildren (53 from Cyprus, 55 from Greece, mean age 9.7 years) from both countries to intervention levels, using wearable sensors to continuously track personal location and physical activity. Changes in ‘fraction time spent at home’ and ‘total steps/day’ were assessed with a mixed-effects model adjusting for confounders. We observed significant mean increases in ‘fraction time spent at home’ in Cyprus and Greece, during each intervention level by 41.4% and 14.3% (level 1), 48.7% and 23.1% (level 2) and 45.2% and 32.0% (level 3), respectively. Physical activity in Cyprus and Greece demonstrated significant mean decreases by − 2,531 and − 1,191 (level 1), − 3,638 and − 2,337 (level 2) and − 3,644 and − 1,961 (level 3) total steps/day, respectively. Significant independent effects of weekends and age were found on ‘fraction time spent at home’. Similarly, weekends, age, humidity and gender had an independent effect on physical activity. We suggest that wearable technology provides objective, continuous, real-time location and activity data making possible to inform in a timely manner public health officials on compliance to various tiers of public health interventions during a pandemic.