Term Deleterious Effects Research Articles

Cardioneural ablation-the first case series without the use of fluoroscopy.

Cardioneural ablation (CNA) and fluoroless ablation (FA) are emerging procedures and movements in contemporary in electrophysiology. Ablation of ganglionated plexus (GP) inputs in the atrium has been successfully targeted as a treatment for symptomatic bradyarrhythmias due to increased parasympathetic tone. As most of these patients are young, avoidance of ionizing radiation is of critical importance to limit potential long term deleterious effects. With widespread use of 3D electroanatomic mapping systems and advanced intracardiac echo (ICE) imaging, fluoroless ablation has become more widely adopted. However, fluoroless CNA has not been widely performed. The objective of this study is to demonstrate that CNA can be done safely and effectively without fluoroscopy. At a single-center, consecutive patients undergoing CNA with a fluoroless approach are described. GP mapping and ablation were performed in both atria. From the right atrium (RA), the right atrium-superior vena cava (RA-SVC GP), the posteromedial ganglionated plexus (PMLGP), which can be accessed from the right atrium-coronary sinus ostium, and the Vein of Marshall GP (VOM-GP) were evaluated. From the left atrium (LA), the superior left atrial ganglionated plexus (LSGP), the left inferior ganglionated plexus (LIGP), the right anterior ganglionated plexus (RAGP), and the right inferior ganglionated plexus (RIGP) were targeted. Over the study period, beginning on January 31, 2021, 30 consecutive subjects (15 females/15 males) aged 42.9 ± 13.6years underwent GP ablation. The average subject had 9.5 (± 9.2) episodes of syncope prior to ablation. The average CHADS2-VA2SC score was zero. The average LVEF was 64.8% (± 4.9). Two of the subjects had concomitant ablations, six failed prior medical therapy, and one had a prior pacemaker placed. All of the procedures were done without fluoroscopy. The average follow-up was 604 (± 366) days. There were 8 patients that did not improve symptomatically postfirst ablation. Four of the eight underwent repeat ablation and have subsequently improved. 26/30 patients symptomatically improved after the 1st or 2nd ablation. There were no complications noted. In comparison to the traditional CNA with fluoroscopy, this proof of concept study reveals fluoroless GP ablation can be performed safely. In addition, the durability and success rate are comparable to other studies of CNA. Given the young age of the cohort and the longitudinal risks of ionizing radiation, fluoroless CNA is a feasible procedure for this patient population.

Derivation of a novel antimicrobial peptide from the Red Sea Brine Pools modified to enhance its anticancer activity against U2OS cells

Cancer associated drug resistance is a major cause for cancer aggravation, particularly as conventional therapies have presented limited efficiency, low specificity, resulting in long term deleterious side effects. Peptide based drugs have emerged as potential alternative cancer treatment tools due to their selectivity, ease of design and synthesis, safety profile, and low cost of manufacturing. In this study, we utilized the Red Sea metagenomics database, generated during AUC/KAUST Red Sea microbiome project, to derive a viable anticancer peptide (ACP). We generated a set of peptide hits from our library that shared similar composition to ACPs. A peptide with a homeodomain was selected, modified to improve its anticancer properties, verified to maintain high anticancer properties, and processed for further in-silico prediction of structure and function. The peptide’s anticancer properties were then assessed in vitro on osteosarcoma U2OS cells, through cytotoxicity assay (MTT assay), scratch-wound healing assay, apoptosis/necrosis detection assay (Annexin/PI assay), RNA expression analysis of Caspase 3, KI67 and Survivin, and protein expression of PARP1. L929 mouse fibroblasts were also assessed for cytotoxicity treatment. In addition, the antimicrobial activity of the peptide was also examined on E coli and S. aureus, as sample representative species of the human bacterial microbiome, by examining viability, disk diffusion, morphological assessment, and hemolytic analysis. We observed a dose dependent cytotoxic response from peptide treatment of U2OS, with a higher tolerance in L929s. Wound closure was debilitated in cells exposed to the peptide, while annexin fluorescent imaging suggested peptide treatment caused apoptosis as a major mode of cell death. Caspase 3 gene expression was not altered, while KI67 and Survivin were both downregulated in peptide treated cells. Additionally, PARP-1 protein analysis showed a decrease in expression with peptide exposure. The peptide exhibited minimal antimicrobial activity on critical human microbiome species E. coli and S. aureus, with a low inhibition rate, maintenance of structural morphology and minimal hemolytic impact. These findings suggest our novel peptide displayed preliminary ACP properties against U2OS cells, through limited specificity, while triggering apoptosis as a primary mode of cell death and while having minimal impact on the microbiological species E. coli and S. aureus.

Determinants of post discharge mortality among hospitalized COVID-19 patients.

The post-acute effects of COVID-19 are continually being updated. This investigation was conducted to evaluate the determinants of post discharge mortality in hospitalized COVID-19 patients, especially 18-45 yr of age. A series of three nested case-control analyses was conducted on follow up data collected in the National Clinical Registry for COVID-19 between September 2020 and February 2023 from 31 hospitals. Matching (1:4) was done by the date of hospital admission ±14 days for the following comparisons: (i) case-patients reported as dead vs. controls alive at any contact within one year follow up; (ii) the same in the 18-45 yr age group and (iii) case-patients reported as dead between the first and one year of follow up vs. controls alive at one year post discharge. The one year post discharge mortality was 6.5 per cent (n=942). Age [≤18 yr: adjusted odds ratio (aOR) (95% confidence interval [CI]): 1.7 (1.04, 2.9); 40-59 yr: aOR (95% CI): 2.6 (1.9, 3.6); ≥60 yr: aOR (95% CI): 4.2 (3.1, 5.7)], male gender [aOR (95% CI): 1.3 (1.1, 1.5)], moderate-to-severe COVID-19 [aOR (95% CI): 1.4 (1.2, 1.8)] and comorbidities [aOR (95%CI): 1.8 (1.4, 2.2)] were associated with higher odds of post-discharge one-year mortality, whereas 60 per cent protection was conferred by vaccination before the COVID-19 infection. The history of moderate-to-severe COVID-19 disease [aOR (95% CI): 2.3 (1.4, 3.8)] and any comorbidities [aOR (95% CI): 3 (1.9, 4.8)] were associated with post-discharge mortality in the 18-45-yr age bracket as well. Post COVID condition (PCC) was reported in 17.1 per cent of the participants. Death beyond the first follow up was associated with comorbidities [aOR (95%CI): 9.4 (3.4, 26.1)] and reported PCC [aOR (95% CI): 2.7 (1.2, 6)]. Prior vaccination protects against post discharge mortality till one year in hospitalized COVID-19 patients. PCC may have long term deleterious effects, including mortality, for which further research is warranted.

POS-049 GROWING RELEVANCE OF NOVEL URINARY PYROSEQUENCING TECHNIQUE FOR DIAGNOSIS OF GENITO-URINARY TUBERCULOSIS: A CASE SERIES

Tuberculosis (TB) remains one of the major health challenges in India with more than 2.1 million infected yearly. Genito-urinary TB (GUTB) represents around 27% of all TB cases. Timely diagnosis and treatment is pivotal to avoid the long term deleterious effects of GUTB. While culture and polymerase chain reaction have improved the yield of detection, they have limited sensitivity and specificity especially in paucibacillary infections like GUTB. Moreover, the emerging trend of Multi-drug resistant TB (MDR-TB) poses further challenges.

Correlative study on the effect of toxic paint chemicals on the hepatorenal of paint factory workers in Enugu, Nigeria

Objective: Some chemical components of paint have been classified as toxigenic and carcinogenic to human health. The liver and kidney function markers have been found useful in assessing toxic effect of substances. This study assessed the liver and kidney function parameters of paint factory workers in Enugu, Nigeria. Methods: One hundred and forty apparently healthy men, aged (21-40 years), were recruited for this cross-sectional study. Eighty paint factory workers (PFW) as test subjects and sixty non-paint factory workers (NPFW) as controls. Blood samples were collected from participants for the determination of serum electrolytes, urea, creatinine, alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), conjugated and total bilirubin using standard methods. Data were analysed using SPSS computer software version 22. Results: The results showed that mean serum level of AST, ALP, Sodium and Chloride were significantly higher in PFW compared to NPFW (P< 0.05). Workers use of personal protective equipment were hand gloves (20%), goggles (7.5%), safety boots (52.5%), dust masks (20%), factory gown (36.25%). Self-reported occupational health problems amongst the PFW was also evaluated, and headache had the highest percentage (68.75%), followed by eye irritation (60%), skin irritation (56.25%), dizziness (23.75%), sleep disorder (20%), anxiety (12.5%), memory loss (0%). Conclusion: This study shows that occupational exposure of humans to volatile organic compounds and heavy metals in paints may have long term deleterious effects on liver, kidney or brain function in paint factory workers.

MO018CARDIOVASCULAR EFFECTS OF UNILATERAL NEPHRECTOMY IN LIVING KIDNEY DONORS AT FIVE YEARS

Abstract Background and Aims Chronic kidney disease (CKD) is a highly prevalent risk factor for cardiovascular disease with an inverse relationship between estimated glomerular filtration rate (eGFR) and increases in all-cause and cardiovascular mortality. Living kidney donation provides a model to study the cardiovascular effects of a reduced kidney function in previously healthy subjects without comorbidities. We report follow up results in a group of kidney donors and healthy controls who underwent cardiovascular assessment at baseline, 12 months and 5 years after nephrectomy in the CRIB-DONOR studies (NCT01028703, NCT02973607). Method A longitudinal blinded end point study of kidney donors (n=50) and healthy controls (n=45) followed up between May 2017 to May 2019. Participants underwent a cardiac MRI (3.0 Tesla) for assessment of left ventricular (LV) size, mass, systolic function (ejection fraction and 3-dimensional feature tracking) and aortic distensibility. Clinical assessment included; office and 24-hr ambulatory blood pressure measures, measurement of arterial stiffness (SphygmoCor) and blood and urine analysis. Results Mean follow up time was 5.7 ± 0.7 yrs. Mean eGFR in donors was 95 ± 15 ml/min/1.73m2 prior to donation, 65 ±13ml/min/1.73m2 at 12 months and 67 ± 14 ml/min/1.73m2 at 5 years. This compared with an annual decline in eGFR of -1ml/min/1.73m2 in healthy controls. Despite a rise in LV mass at 12 months in the original study, by 5 years, LV mass in donors was no different to controls (113 ± 31g vs. 115 ± 30g, p=0.707). There was also no significant difference in LV volumes or LV geometry. At 5 years, 3D global longitudinal strain (donors -16.2 ± 2.5% vs. controls -14.9 ± 2.1%, p=0.007) and 3D global circumferential strain (donors -19.0 ± 2.5% vs. controls -17.7 ± 2.2%, p=0.004) were marginally greater in donors than controls. Markers of vascular stiffness (pulse wave velocity and augmentation index) were increased in donors compared to controls at 12 months but at 5 years they were not significantly different. No changes in office or ambulatory blood pressure were observed at any time point in donors or controls. At 5 years, uric acid was significantly greater in donors than controls (335 ± 83 µmol/L vs. 276 ± 7, p=<0.001) and had increased after the 12 month time point despite an improvement in eGFR. At 12 months the prevalence of a detectable troponin and levels of fibroblast growth factor-23 were greater in donors compared to controls, but this effect was lost at 5 years Conclusion The reduction in eGFR associated with nephrectomy in living kidney donors in the absence of intrinsic renal disease or comorbidity does not lead to adverse changes in cardiovascular structure and function at 5 years. This study offers reassurance to living kidney donors and the transplant community but should prompt further work into the causes of cardiovascular disease in CKD as we have found no medium term deleterious cardiovascular effects of an isolated reduction in eGFR.

Palateless Complete Denture:A Minimally Invasive Approach to Preventive Case

Background: Tooth loss due to caries and various other consequences, can cause simple loss of function to long term deleterious effects on the remaining residual bone, oral proprioception, temporomandibular joints and facial appearance. Case Description: A 33 year old female patient with Kennedy’s class I edentulism in both the arches with just three teeth remaining in maxilla has been treated with attachment retained maxillary palateless overdenture and mandibular removable partial denture. The maxillary teeth 11 21 23 were endodontically treated and a short coping with rhein 83 attachment were cemented and a maxillary overdenture over this was fabricated. This was opposed by mandibular partial denture. This case report attempts to prevent the remaining teeth in the oral cavity and gives a cost effective treatment option to the patient considering her financial status. Conclusion: This case report emphasizes the use of preventive prosthodontics helping enhance the quality of life of patient

Acute uterine effects and long-term reproductive alterations in postnatally exposed female rats to a mixture of commercial formulations of endosulfan and glyphosate

Endosulfan and glyphosate are widely used pesticides and have been associated to reproductive disorders. We examine the acute and long-term effects of postnatal exposure to commercial formulations of endosulfan (EF), glyphosate (glyphosate-based herbicide, GBH) and a mixture of both pesticides (MIX). After birth, female pups of Wistar rats received saline solution (CONTROL), EF (600 μg/kg of b.w/day), GBH (2 mg/kg of b.w/day) or a mixture (at the same doses) from postnatal day (PND) 1 to PND7. The uterine histology and expression of Hoxa10, estrogen (ERα) and progesterone (PR) receptors were evaluated on PND8. Reproductive performance was evaluated on gestational day 19. GBH and MIX rats showed an increment of 1) the incidence of luminal epithelial hyperplasia, 2) PR and Hoxa10 expression. EF modified ERα and Hoxa10 expression. During adulthood, MIX and GBH rats showed higher post-implantation losses while EF alone produced an increase of pre-implantation losses. We showed that the co-administration of both pesticides produced acute uterine effects and long–term deleterious reproductive effects that were similar to those induced by GBH alone. We consider important to highlight the necessity to evaluate the commercial pesticide mixture as a more representative model of human exposure to a high number of pesticides.

A two-hit story: Seizures and genetic mutation interaction sets phenotype severity in SCN1A epilepsies

SCN1A (NaV1.1 sodium channel) mutations cause Dravet syndrome (DS) and GEFS+ (which is in general milder), and are risk factors in other epilepsies. Phenotypic variability limits precision medicine in epilepsy, and it is important to identify factors that set phenotype severity and their mechanisms. It is not yet clear whether SCN1A mutations are necessary for the development of severe phenotypes or just for promoting seizures. A relevant example is the pleiotropic R1648H mutation that can cause either mild GEFS+ or severe DS.We used a R1648H knock-in mouse model (Scn1aRH/+) with mild/asymptomatic phenotype to dissociate the effects of seizures and of the mutation per se. The induction of short repeated seizures, at the age of disease onset for Scn1a mouse models (P21), had no effect in WT mice, but transformed the mild/asymptomatic phenotype of Scn1aRH/+ mice into a severe DS-like phenotype, including frequent spontaneous seizures and cognitive/behavioral deficits. In these mice, we found no major modifications in cytoarchitecture or neuronal death, but increased excitability of hippocampal granule cells, consistent with a pathological remodeling.Therefore, we demonstrate for our model that an SCN1A mutation is a prerequisite for a long term deleterious effect of seizures on the brain, indicating a clear interaction between seizures and the mutation for the development of a severe phenotype generated by pathological remodeling. Applied to humans, this result suggests that genetic alterations, even if mild per se, may increase the risk of second hits to develop severe phenotypes.

Neurotoxicity in acute and repeated organophosphate exposure

The term organophosphate (OP) refers to a diverse group of chemicals that are found in hundreds of products worldwide. As pesticides, their most common use, OPs are clearly beneficial for agricultural productivity and the control of deadly vector-borne illnesses. However, as a consequence of their widespread use, OPs are now among the most common synthetic chemicals detected in the environment as well as in animal and human tissues. This is an increasing environmental concern because many OPs are highly toxic and both accidental and intentional exposures to OPs resulting in deleterious health effects have been documented for decades. Some of these deleterious health effects include a variety of long-term neurological and psychiatric disturbances including impairments in attention, memory, and other domains of cognition. Moreover, some chronic illnesses that manifest these symptoms such as Gulf War Illness and Aerotoxic Syndrome have (at least in part) been attributed to OP exposure. In addition to acute acetylcholinesterase inhibition, OPs may affect a number of additional targets that lead to oxidative stress, axonal transport deficits, neuroinflammation, and autoimmunity. Some of these targets could be exploited for therapeutic purposes. The purpose of this review is thus to: 1) describe the important uses of organophosphate (OP)-based compounds worldwide, 2) provide an overview of the various risks and toxicology associated with OP exposure, particularly long-term neurologic and psychiatric symptoms, 3) discuss mechanisms of OP toxicity beyond cholinesterase inhibition, 4) review potential therapeutic strategies to reverse the acute toxicity and long term deleterious effects of OPs.

P165 Treatment of post-transplant denovo HLA donor specific antibodies in kidney transplant recipient in the absence of rejection

Background Development of denovo DSA is associated with poor allograft outcomes. Despite strong evidence of long term deleterious effect of DSA in the absence AMR, active treatment for DSA is still debatable. Case Study We periodically screen kidney transplant patient for denovo DSA. Patients with increasing DSA’s undergo kidney biopsy; if C4d is negative patients are offered intravenous immunoglobulin (IVIG) 1 gram/kg every 2 weeks for 3 months. Results Six patient developed DSA (florescence intensity-MFI) at a median of 108 days. Patients had a median serum creatinine of 2 mg/dL at time of DSA detection. Most patients received thymoglobulin induction. Post IVIG treatment median serum creatinine was 1.25 mg/dL. Download : Download high-res image (455KB) Download : Download full-size image One patient developed thromboembolic complication. With IVIG significant drop in DSA was observed in patient A, with complete disappearance in 3 patients (B, E, and F). We observed improvement in renal function. Conclusion From our case series it appears that treatment of DSA in the absence of rejection is achievable in some patients and may translate into better kidney allograft function. However long-term prospective studies are warranted to address and better understand this phenomenon.

Preventing Perioperative Acute Kidney Injury

Peri-operative acute kidney injury (AKI) is a feared consequence of surgery and is associated with considerable morbidity and mortality. It has both short and long term deleterious effects. The term AKI is used to describe a rapid deterioration (hours to days) of renal function. The patho-physiology of peri-operative AKI is complex and involves both ischemia and inflammation as causative factors. Recently, several definition systems for AKI were proposed, incorporating both small changes of serum creatinine and urinary output reduction as diagnostic criteria. Urine output does not predict postoperative AKI.[1,2] Despite the continued effort to standardize the definition of AKI using S.Cr, these methods have several flaws. The increase In S.Cr is late in the course of AKI such that by the time the diagnosis is made using standard laboratory methods the disease is well established. In addition, S.Cr can be influenced by volume overload, nutrition, steroids, and muscle trauma.

Effect of 24% Oral Sucrose in Pain Reduction during Venipuncture in Neonates

Neonates frequently undergo various painful procedures without analgesia and routinely experienced pain in the Neonatal Intensive Care Unit. The issue of pain management among new born has been largely neglected and commonly overlooked in most of the clinical settings can lead to long term adverse consequences and deleterious effect. Administrating sucrose before painful procedure like venipuncture can relief pain in new born. The present study was carried out in (NICU) of IMS and SUM Hospital, Bhubaneswar with the purpose to determine the effect of 24% oral sucrose administration on pain reduction during venipuncture. 30 neonates undergoing venipuncture were selected through purposive sampling. The pain level was assessed by using Neonatal Infant Pain Scale (NIPS) with routine care during venipuncture and then same neonates were administered 24% sucrose solution orally just 2 minutes before undergoing venipuncture second time. A highly significant reduction of pain during venipuncture in experimental group was observed at (p<0.001, t=9.38).

Effects of a tumor necrosis factor-alpha inhibitor (etanercept) on the sciatic nerve in a hypoxic ischemia-induced neonatal rat model.

Neonatal hypoxic-ischemic (HI) injury has been considered to have acute and long term deleterious effects on many tissues, including the peripheral nerve. In this study, the effects of atumor necrosis factor-alpha (TNF-a) inhibitor (etanercept) on peripheral nerve damage and the ultrastructure of the sciatic nerve and gastrocnemius muscle in rats exposed to HI during the neonatal period were examined. In this study, 45 seven-day-old rats were used and they were divided into three groups. The right carotid arteries of the rats in the saline and etanercept groups were ligated and put in ahypoxia chamber containing 8% oxygen for two hours. Just after hypoxia, the etanercept group was given 10mg/kg etanercept, but the saline group had only saline intraperitoneally. The sham group rats' carotid arteries were not ligated or put in hypoxia. The amplitude, area and latency of sciatic nerve compound motor action potential (CMAP), which mainly reflects axonopathy and myelinopathy, were measured using standard techniques in the seventeenth week following the HI.Sciatic nerve and gastrocnemius muscle were evaluated with atransmission electron microscope, and grading for myelin sheath damage was done to all groups. Neuropathy was seen in rats after HI.While treatment with etanercept showed aprotective effect for the axons of sciatic nerve, demyelination could not be recovered with etanercept. This study is the first in literature to show apartial interruption of the signal through the peripheral nerve fibers caused by axonal and myelin dysfunction continuation in rats exposed to HI after birth, in the 17th week.

The effect of tumor necrosis factor-α inhibitor soon after hypoxia-ischemia on heart in neonatal rats

AimsPerinatal hypoxic-ischemic insult has acute and long term deleterious effects on many organs including heart. Although tumor necrosis factor alpha (TNF-α) has been reported to increase soon after hypoxia, the inhibition of this mediator has not been documented. The aim of this study was to investigate the effects of a TNF-α inhibitor (etanercept) on contractility and ultrastructure of rat heart muscles exposed to hypoxia-ischemia during neonatal period. Main methodsForty-five seven-day old rats divided into three groups were included in this study. The right carotid arteries of Saline and Etanercept groups of rats were ligated and kept in a hypoxia chamber containing 8% oxygen for 2h. Immediately after hypoxia, while Etanercept group was administered 10mg/kg etanercept, Saline group had only saline intraperitoneally. The carotid arteries of rats in Sham group were located without ligation and hypoxia. Mechanical activity of heart was recorded and tissue samples were examined by electron microscopy in the sixteenth week following the hypoxia-ischemia. Key findingsWhile atrial contractile force in Etanercept group was similar to Sham group, there was significant decrease in Saline group (p<0.001). However, there was only non-significant decrease in ventricular contractility of Saline group comparing to Sham group (p>0.05). After hypoxia-ischemia, ultrastructural degenerative changes and mitochondrial damage in atriums of Etanercept group were significantly less severe than Saline group. SignificanceThis study demonstrated that neonatal hypoxia-ischemia caused long term cardiac dysfunction and ultrastructural degenerative changes in the heart of rats. TNF-α inhibitor administration soon after hypoxia-ischemia may have heart protective effect.

Sunlight decreased genotoxicity of azadirachtin on root tip cells of Allium cepa and Eucrosia bicolor

Utilization of neem plant ( Azadirachta indica A. Juss) extract for pest control in agriculture has raised concerns over contamination by the residues to the environment. Such residues, particularly azadirachtin (Aza), may cause deleterious effect to non-target organisms. This investigation was conducted to find out if Aza could be inactivated through exposures to sunlight. Activity of Aza was assessed as its ability to cause cytotoxic and genotoxic effects in the forms of nuclei abnormality and chromosome aberration as measured by mitotic index (MI) and mitotic aberration (MA). Varying concentrations of Aza were tested on Allium cepa and Eucrosia bicolor. It was found that the MI of all root tip meristematic cells of A. cepa and E. bicolor treated with 0.00005%, 0.00010%, 0.00015%, and 0.00020% (w/v) Aza-containing neem extract for 24 h, were significantly lower than the controls. Complementary to the lower levels of MI, the Aza-treated groups showed higher MA levels in all cases investigated. Furthermore, the decreasing levels of MI and the increasing levels of MA related well with the increasing concentration of Aza. Microscopic examination of root tip meristematic cells revealed that the anomaly found most often were mitotic disturbances and chromosomal bridges. Exposures of 0.00020% (w/v) Aza to sunlight for 3 days and 7 days decreased Aza ability to induce cytotoxicity and genotoxicity, both in terms of MI and MA, to root tip meristematic cells in A. cepa and E. bicolor. Photodegradation of Aza upon exposure to direct sunlight was confirmed by HPLC. The study implicates that Aza would unlikely cause long term deleterious effects to the environment since it would be inactivated by sunlight.

Preventive Denture Therapy For Geriatric Patients

Tooth loss carries a number of consequences, from simple loss of function to long term deleterious effects on the remaining residual bone, oral proprioception, temporomandibular joints and facial appearance. Over-denture therapy envisages preventive prosthodontic concept since it attempts to conserve the remaining few natural teeth. The rationale of the treatment approach using tooth supported over-dentures in two elderly patients is discussed.

Determinants of weight gain in young women: A review of the literature

Introduction: Young adult women are gaining weight at a higher rate than women in other age groups. Given the long term deleterious health effects of being overweight or obese, it is important to know the determinants of this weight gain. No previous review has focused on the determinants of weight gain in young women specifically.

Hypoglycaemia and improved testicular parameters in Sesamum radiatum treated normo-glycaemic adult male Sprague Dawley rats

The development of a new dietary adjunct with a novel natural antioxidant impact on diabetes mellitus with prevention of its long term deleterious effect on the male fertility in general has been increasingly expressed in recent time. Hence, we aim to evaluate the effects of aqueous extract of Sesame radiatum leaves on adult male Sprague Dawley rats’ testis using unbiased stereological, biochemical and hormonal studies. Thirty adult male rats were divided into three groups of 10 rats each. The treated groups; 1 and 2 received 28.0 and 14 mg/kg bwt of aqueous extract of sesame leaves via oral garvage, respectively, while the control group received equal volume of 0.9% (w/v) normal saline per day for 6 weeks. Serum follicle-stimulating hormone (FSH), testosterone and blood glucose were assayed. In addition five microns of uniformly random transverse sections of processed testicular tissues were equally analyzed using an un-biased stereological study. The result showed that the mean percentage volume fractions (Vf) of epithelial cells and lumen of the testis were 76% (P 0.05) higher than the control in a dose related manner. Serum testosterone and FSH were significantly higher and lower, respectively, in the high dose sesame when compared to control. Sesame leaves intake improved glucose profile and testicular parameters in a dose related manner via possible improved insulin activity on the cells with a stimulatory impact on sperm production. This also confirmed its folkloric claims.

Mid-term results following surgical treatment of congenital cardiac malformations in adults

The long term consequences of untreated of residual or recurrent lesions pose unique challenges in the growing population of adults with congenitally malformed hearts. In our unit, 335 patients aged from 18 to 72 years, with a mean age of 35 plus or minus 14 years, presented for correction of congenital cardiac disease from September, 1997, through December, 2006. Of the group, 42 (12.5%) had undergone one or more prior surgical procedures, 3 were admitted as emergencies, and a further 10 (3%) had suffered prior cardiac related complications. Symptoms had been noted by 181 patients (54%), and 42 (12.5%) had an established arrhythmia. Chromosomal anomalies were identified in 13 (3.8%), and diagnostic catheterisation was required in 201 (60%) patients. Of the overall group, 2 patients died early (0.6%). Complications occurred in 61 patients (18%), including atrial fibrillation, pneumothorax, postoperative haemorrhage, pericardial or pleural effusions requiring drainage, stroke, complete heart block, endocarditis, wound dehiscence, and peripheral neuropathy. The median length of stay in the intensive care unit and hospital were 2 and 7 days, respectively. Death occurred later in 2 further patients (0.6%), due to atrial fibrillation and pulmonary hypertension. At mean follow-up of 63 plus or minus 30 months, the majority of the remaining patients are well with resolution or significant improvement in their symptoms. Despite the long term deleterious effects of untreated, residual or recurrent congenital cardiac lesions in adults, therefore, we conclude that surgical correction can be achieved with low mortality and acceptable morbidity. Most significant complications are related to arrhythmias.