bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of postural hypotension in primary, community and institutional care: a systematic review and meta-analysis
Authors: McDonagh Sinead T. J. , Mejzner Natasha , Clark Christopher E.
Published: January 2021

Background

Postural hypotension (PH), the reduction in blood pressure when rising from sitting or lying 0to standing, is a risk factor for falls, cognitive decline and mortality. However, it is not often tested for in primary care. PH prevalence varies according to definition, population, care setting and measurement method. The aim of this study was to determine the prevalence of PH across different care settings and disease subgroups.

Methods

Systematic review, meta-analyses and meta-regression. We searched Medline and Embase to October 2019 for studies based in primary, community or institutional care settings reporting PH prevalence. Data and study level demographics were extracted independently by two reviewers. Pooled estimates for mean PH prevalence were compared between care settings and disease subgroups using random effects meta-analyses. Predictors of PH were explored using meta-regression. Quality assessment was undertaken using an adapted Newcastle-Ottawa Scale.

Results

One thousand eight hundred sixteen studies were identified; 61 contributed to analyses. Pooled prevalences for PH using the consensus definition were 17% (95% CI, 14–20%; I2 = 99%) for 34 community cohorts, 19% (15–25%; I2 = 98%) for 23 primary care cohorts and 31% (15–50%; I2 = 0%) for 3 residential care or nursing homes cohorts (P = 0.16 between groups). By condition, prevalences were 20% (16–23%; I2 = 98%) with hypertension (20 cohorts), 21% (16–26%; I2 = 92%) with diabetes (4 cohorts), 25% (18–33%; I2 = 88%) with Parkinson’s disease (7 cohorts) and 29% (25–33%, I2 = 0%) with dementia (3 cohorts), compared to 14% (12–17%, I2 = 99%) without these conditions (P < 0.01 between groups). Multivariable meta-regression modelling identified increasing age and diabetes as predictors of PH (P < 0.01, P = 0.13, respectively; R2 = 36%). PH prevalence was not affected by blood pressure measurement device (P = 0.65) or sitting or supine resting position (P = 0.24), however, when the definition of PH did not fulfil the consensus description, but fell within its parameters, prevalence was underestimated (P = 0.01) irrespective of study quality (P = 0.04).

Conclusions

PH prevalence in populations relevant to primary care is substantial and the definition of PH used is important. Our findings emphasise the importance of considering checking for PH, particularly in vulnerable populations, to enable interventions to manage it. These data should contribute to future guidelines relevant to the detection and treatment of PH.

PROSPERO:CRD42017075423.
Development and psychometric testing of nursing students’ perceptions of clinical stressors scale: an instrument design study
Authors: Rafati Foozieh , Sharif Nia Hamid , Khoshnood Zohreh , Allen Kelly-Ann
Published: January 2021

Background

In clinical environments, nursing students experience a range of stressors that can affect their health, learning, and quality of patient care. This study aimed to develop a Nursing Students’ Perceptions of Clinical Stressors Scale (NSPCSS) and to evaluate its psychometric properties.

Methods

This exploratory, sequential mixed-method study was conducted in 2 phases. In the qualitative (item generation) phase, NSPCSS items were generated using the data collected from semi-structured interviews and a literature review. In the quantitative (psychometric evaluation) phase, face, content, construct, convergent, and discriminant validity and reliability of the scale were tested. To evaluate construct validity, exploratory and confirmatory factor analyses were performed on the data collected from 430 nursing students. Reliability was also assessed through internal consistency and composite reliability.

Results

In this study, 6 factors were extracted from 30 itemes through exploratory factor analysis: (1) instructor’s limited competence in clinical environments, (2) inappropriate clinical environment, (3) inadequate knowledge and skills, (4) inefficient education in clinical planning, (5) instructor’s inappropriate conduct, and (6) concerns about the characteristics of nursing career. These factors accounted for 58.8% of the total variance. The results of the confirmatory factor analysis suggested the goodness-of-fit indices was acceptable. Furthermore, the internal consistency and composite reliability indices of all factors were greater than 0.7.

Conclusions

The NSPCSS is a valid and reliable instrument for assessing clinical stressors among nursing students.
Mental disorder and PTSD in Syria during wartime: a nationwide crisis
Authors: Kakaje Ameer , Al Zohbi Ragheed , Hosam Aldeen Osama , Makki Leen , Alyousbashi Ayham , Alhaffar Mhd Bahaa Aldin
Published: January 2021

Background

Syria has experienced war since 2011, leaving over 80% under the poverty line and millions displaced. War and its retaliations have significantly impacted the mental health of Syrians. This study evaluates the post-traumatic stress disorder (PTSD), and the severity of the mental distress caused by war and other factors such as low social support. This study also evaluates other variables and compares the findings with those of multiple studies on Syria and refugees.

Methods

This is a cross-sectional study that included people who lived in Syria in different governorates. Online surveys were distributed into multiple online groups and included the Kessler 10 (K10) scale which screens for anxiety and depression, the Screen for Posttraumatic Stress Symptoms (SPTSS) tool, the Multidimensional Scale of Perceived Social Support, and questionnaires on demographic and war-related factors.

Results

Our study included 1951 participants, of which, 527 (27.0%) were males and 1538 (78.8%) between the age of 19 and 25. Among participants, 44% had likely severe mental disorder, 27% had both likely severe mental disorder and full PTSD symptoms, 36.9% had full PTSD symptoms, and only 10.8% had neither positive PTSD symptoms nor mental disorder on the K10 scale. Around 23% had low overall support. Half of the responders were internally displaced, and 27.6% were forced to change places of living three times or more due to war. Around 86.6% of the responders believed that the war was the main reason for their mental distress. Those with high SPTSS and K10 scores were found to take more days off from work or school due to negative feelings and having somatic symptoms. Moreover, the number of times changing places of living due to war, educational level, and being distressed by war noise were the most prominent factors for more severe PTSD and mental distress. No differences in PTSD and mental disorder prevalence were noted in participants living in different governorates or among different types of jobs. A strong significant correlation (r = 0.623) was found between SPTSS and K10 scores.

Conclusion

The conflict in Syria has left the population at great risk for mental distress which was higher compared to Syrian refugees elsewhere. Many measures with an emphasis on mental health are needed to help the people against a long-term avoidable suffering.
Association of Vitamin D Concentrations with subjective health complaints in children and adolescents: the CASPIAN-V study
Authors: Namazi Nazli , Qorbani Mostafa , Shafiee Gita , Ahmadian Mohammad Hossein , Motlagh Mohammad Esmaeil , Ebrahimi Mehdi , Asayesh Hamid , Kelishadi Roya , Heshmat Ramin
Published: January 2021

Background

Vitamin D deficiency (VDD) is recognized as a global pandemic. Identification, any association between VDD and subjective health complaints (SHC), can be helpful to realize critical mechanisms and improve psychological and somatic symptoms. Given few studies published on this issue and the importance of its clarification, the main objective of this study was to examine the association between VDD and the SHC in children and adolescents.

Methods

In this national cross-sectional study, 2596 Iranian children and adolescents aged 8–18 years were included. Data on SHC, anthropometric indices, physical activity, and serum levels of vitamin D were collected. Logistic regression models (crude, adjusted) were applied to examine the association between the VDD and the SHC. Statistical analysis was performed using STATA version 11. P-values< 0.05 were considered as statistically significant.

Results

Serum levels of vitamin D in approximately 70% of Iranian children and adolescents were lower than 30 ng/mL. Among the SHC, irritability (40.9%) and feeling anxiety (33.7%) were the most prevalent ones. Multiple complaints in students with the VDD was 2.5 times greater than those with sufficient vitamin D concentrations (p <  0.001). Compared to the reference group, the strongest association was found between vitamin D status and difficulties in getting to sleep (OR: 2.5, 95%CI: 1.18, 3.53, p <  0.001).

Conclusion

VDD was observed in the considerable percentage of the study population. There were no significant differences between the two gender groups. In addition, there were significant associations between vitamin D status and most of the somatic and psychological symptoms, particularly for getting to sleep. It seems national interventional programs for vitamin D supplementation or food fortifications can be helpful.
Effectiveness of oral health education on 8- to 10-year-old school children in rural areas of the Magway Region, Myanmar
Authors: Swe Kyu Kyu , Soe Aung Kyaw , Aung Saw Htun , Soe Htin Zaw
Published: January 2021

Background

Oral diseases are common and widespread around the world. The most common oral diseases are preventable, and early onset is reversible. Myanmar faces many challenges in rendering oral health services, because approximately 70% of the total population resides in rural areas. These relate to the availability and accessibility of oral health services. Therefore, oral health education is one key element to prevent oral diseases and to promote oral health.

Methods

A quasi-experimental study was carried out at Basic Education Middle Schools in rural areas of Magway Township to study the effectiveness of oral health education on the knowledge and behavior of 8- to 10-year-old school children. A total of 220 school children, 110 from intervention schools and 110 from control schools, participated in this study from 2015 to 2017. Data were collected before and after intervention in the two groups by using a self-administered questionnaire. Tooth brushing method data were collected by direct observation with a checklist. Oral health education was provided at eight weekly intervals for 1 year. At one and a half years, third-time data collection was done on the intervention group to assess retention. Chi-square test, two samples t-test and one-way repeated measure ANOVA were used for data analysis. The study was approved by the Institutional Review Board of the University of Public Health in Yangon, Myanmar.

Results

There were significant differences between the two groups in four out of five knowledge questions (p < 0.05) and all behavior questions (p < 0.001) after intervention. A positive effect of oral health education for a period of 45 min at eight weekly intervals for 1 year was found in the intervention group. The intervention had a significant effect on the sustainability of the correct knowledge and behavior of the intervention group although the education session was stopped for 6 months (p < 0.001). Their mean knowledge and behavioral scores at three different points in time were (2.45 ± 1.12 and1.56 ± 0.90) at baseline, (3.79 ± 1.12 and 3.60 ± 1.21) at 1 year after education and (4.07 ± 0.98 and 3.24 ± 1.31) at 6 months after cessation of education, respectively.

Conclusions

Repeated oral health education was effective in promoting and sustaining oral health knowledge and behavior.
Promoting sustainable physical activity among middle-aged Iranian women: a conceptual model-based interventional study
Authors: Shariati Mohammad , Pourrajabali Astaneh Houra , Khedmat Leila , Khatami Farnaz
Published: January 2021

Background

Physical inactivity enhances the risk of adverse health conditions such as non-communicable diseases, morbidity, and mortality among middle- and older-aged population. This study is aimed to design, implement, and evaluate a conceptual model of physical activity (PA) promotion among middle-aged Iranian women (MAIW).

Methods

An interventional study was conducted with 80 women aged between 30 and 59 years in intervention and control groups during 2018–2019. The subjects referred to health centers were selected by the available convenience sampling method. Data collection tools to assess the MAIW' PA level (metabolic equivalent tasks (MET)-min/week) included face-to-face interviews, body mass index (BMI) measurements, the four-question form of PA vital signs in the framework of Iran's Package of Essential Non-communicable (IraPEN) program, and the questionnaire is based on the Health Belief Model (HBM) constructs.

Results

The intervention led to a three-fold increase in the average PA (from 280.63 to 927.70 MET-min/week) of the intervention group. Although no significant difference in the BMI between both groups was found before the intervention, this educational program decreased the mean BMI from 30.36 to 28.83 kg/m2 (p = 0.01). After the intervention, the values of HBM-based perceived sensitivity/severity and self-efficacy were increased from 62.09 to 71.03% and from 27.01 to 83.15%, respectively (p < 0.0001). There were no significant differences in the cue to action and perceived benefits and barriers after the intervention.

Conclusion

The developed model by increasing the motivation of MAIW could remarkably improve the PA level with a decrease in their BMI.

Trial register Iranian Registry of Clinical Trials (IRCT): IRCT20200717048124N1 at 2020-08-05, retrospectively registered.
Inequalities in maternal malnutrition in Ethiopia: evidence from a nationally representative data
Authors: Geda Nigatu Regassa
Published: January 2021

Background

Despite promising progress made in several maternal health indicators, maternal malnutrition (especially undernutrition) remained one of the greatest development challenges for Ethiopia. The main purpose of this study was to examine the disparities in maternal malnutrition and estimate the population level impacts of key risk factors in Ethiopia.

Methods

The analysis was made based on the Ethiopian Demographic and Health Survey (EDHS 2016) data, containing 9949 non-pregnant women. Multiple logistic regression was used to examine the effects of selected explanatory variables on the two nutrition morbidity outcomes (undernutrition and obesity). Two population weighed regression-based measures (the Slope Index of Inequality/SII and Relative Index of Inequality/RII) and Population Attributable Fractions (PAFs) were employed to examine the inequalities in maternal malnutrition.

Results

The prevalence of maternal undernutrition and overweight or obesity were 21% and 6%, respectively. In the multiple logistic regression, four variables appeared to have significant association with both undernutrition and overweight/ obesity, namely age of the women, residence, maternal education, and non-monetary wealth (p < 0.05). Both the absolute and relative measures of inequalities showed remarkable differences in maternal undernutrition, significantly favoring the higher socioeconomic groups (p < 0.05). Further analysis of inequalities, using the Population Attributable Fractions (PAFs), revealed that the combined population level impacts of all the significant risk factors amount 80.38%, from which 25% is attributed to the three socioeconomic variables (non-monetary wealth, maternal education and paternal education).

Conclusion and policy implication

Given the high disparity in both under nutrition and overweight and/or obesity, the study emphasized the need for policy and program efforts to promote parental education in Ethiopia. Strengthening nutrition sensitive mass literacy programs is recommended along with improving women’s employment and rural households’ income for increased access to better diet.
Effectiveness of IT-based interventions on self-management in adult kidney transplant recipients: a systematic review
Authors: Eslami Saeid , Khoshrounejad Farnaz , Golmakani Reza , Taherzadeh Zhila , Tohidinezhad Fariba , Mostafavi Sayyed Mostafa , Ganjali Raheleh
Published: January 2021

Background

Kidney transplant outcomes are broadly associated with transplant recipients’ capacity in following a complex and continuous self-management regimen. Health information technology has the potential to empower patients. This systematic review aimed to determine the impacts of IT-based interventions for self-management in kidney transplant recipients.

Methods

A comprehensive investigation was performed in MEDLINE (via PubMed) and EMBASE (via Scopus) in April 2019. Eligible studies were the randomized controlled trials which aimed to design an automated IT-based intervention. All English papers including adult kidney transplant recipients were included. To assess the clinical trial’s quality, Cochrane Collaboration’s assessment tool was employed. The articles were integrated based on category of outcomes, characteristics of interventions, and their impact. The interventions were classified based on the used IT-based tools, including smart phones, coverage tools, computer systems, and a combination of several tools. The impact of interventions was defined as: (1) positive effect (i.e. statistically significant), and (2) no effect (i.e. not statistically significant).

Results

A total of 2392 articles were retrieved and eight publications were included for full-text analysis. Interventions include those involving the use of computerized systems (3 studies), smart phone application (3 studies), and multiple components (2 studies). The studies evaluated 30 outcomes in total, including 24 care process and 6 clinical outcomes. In 18 (80%) out of 30 outcomes, interventions had a statistically significant positive effect, 66% in process and 33% in clinical outcomes.

Conclusions

IT-based interventions (e.g. mobile health applications, wearable devices, and computer systems) can improve self-management in kidney transplant recipients (including clinical and care process outcomes). However, further evaluation studies are required to quantify the impact of IT-based self-management interventions on short- and long-term clinical outcomes as well as health care costs and patients' quality of life.
Estimating the cost of implementing a facility and community score card for maternal and newborn care service delivery in a rural district in Uganda
Authors: Ssebagereka Anthony , Apolot Rebecca Racheal , Nyachwo Evelyne Baelvina , Ekirapa-Kiracho Elizabeth
Published: January 2021

Introduction

This paper aimed at estimating the resources required to implement a community Score Card by a typical rural district health team in Uganda, as a mechanism for fostering accountability, utilization and quality of maternal and child healthcare service.

Methods

This costing analysis was done from the payer’s perspective using the ingredients approach over five quarterly rounds of scoring between 2017 and 2018. Expenditure data was obtained from project records, entered and analyzed in Microsoft excel. Two scale-up scenarios, scenario one (considered cost inputs by the MakSPH research teams) and scenario two (considering cost inputs based on contextual knowledge from district implementing teams), were simulated to better understand the cost implications of integrating the Community Score Card (CSC) into a district health system.

Results

The total and average cost of implementing CSC for five quarterly rounds over a period of 18 months were USD 59,962 and USD 11,992 per round of scoring, respectively. Considering the six sub-counties (including one Town Council) in Kibuku district that were included in this analysis, the average cost of implementating the CSC in each sub-county was USD 1998 per scoring round. Scaling-up of the intervention across the entire district (included 22 sub-counties) under the first scenario would cost a total of USD 19,003 per scoring round. Under the second scaleup scenario, the cost would be lower at USD 7116. The total annual cost of scaling CSC in the entire district would be USD 76,012 under scenario one compared to USD 28,465 under scenario two. The main cost drivers identified were transportation costs, coordination and supervision costs, and technical support to supplement local implementers.

Conclusion

Our analysis suggests that it is financially feasible to implement and scale-up the CSC initiative, as an accountability tool for enhancing service delivery. However, the CSC design and approach needs to be embedded within local systems and implemented in collaboration with existing stakeholders so as to optimise costs. A comprehensive economic analysis of the costs associated with transportation, involvement of the district teams in coordination, supervision as well as provision of technical support is necessary to determine the cost-effectiveness of the CSC approach.
Validity and reliability of the Self-Care Activities Screening Scale (SASS-14) during COVID-19 lockdown
Authors: Martínez Martín , Luis Elkin O. , Oliveros Edwin Yair , Fernández-Berrocal Pablo , Sarrionandia Ainize , Vidaurreta Marta , Bermejo-Martins Elena
Published: January 2021

Background

In a context where there is no treatment for the current COVID-19 virus, the combination of self-care behaviours together with confinement, are strategies to decrease the risk of contagion and remain healthy. However, there are no self-care measures to screen self-care activities in general population and which, could be briefly in a lockdown situation. This research aims to build and validate a psychometric tool to screen self-care activities in general population.

Methods

Firstly, an exploratory factor analysis was performed in a sample of 226 participants to discover the underlying factorial structure and to reduce the number of items in the original tool into a significant pool of items related to self-care. Later a confirmatory factor analyses were performed in a new sample of 261 participants to test for the fit and goodness of factor solutions. Internal validity, reliability, and convergent validity between its score with perceived stress and psychological well-being measures were examined on this sample.

Results

The exploratory analyses suggested a four-factor solution, corresponding to health consciousness, nutrition and physical activity, sleep, and intra-personal and inter-personal coping skills (14 items). Then, the four-factor structure was confirmed as the best model fit for self-care activities. The tool demonstrated good reliability, predictive validity of individuals’ perception of coping with COVID-19 lockdown, and convergent validity with well-being and perceived stress.

Conclusions

This screening tool could be helpful to address future evaluations and interventions to promote healthy behaviours. Likewise, this tool can be targeted to specific population self-care’s needs during a scalable situation.
Clear cell neuroendocrine tumor in the gallbladder diagnosed as a benign polyp preoperatively: a case report
Authors: Sumiya Ryusuke , Shimizu Atsushi , Nagai Takeshi , Ono Hayato , Kumazawa Keigo , Endo Daisuke , Oide Takashi , Aoyanagi Nobuyoshi
Published: January 2021

Background

Gallbladder neuroendocrine neoplasm is a rare disease that is divided into neuroendocrine tumors (NETs) and neuroendocrine carcinomas (NECs). Clear cell NETs of the gallbladder are extremely rare. We report the case of a patient with polypoid clear cell NET G1 of the gallbladder who underwent laparoscopic cholecystectomy.

Case presentation

A 10-mm pedunculated polyp in the gallbladder neck was detected on a follow-up abdominal ultrasound in a 60-year-old man with chronic hepatitis and hepatitis B without medication. Six months later, an abdominal ultrasound revealed that the tumor had enlarged to 12 mm in size. He was asymptomatic and had no abnormalities in other laboratory examinations, including the tumor markers, carcinoembryonic antigen and CA19-9. Abdominal ultrasound showed a 12-mm polyp in the neck of the gallbladder with perfusion and focal thickening of the gallbladder wall. A gallbladder stone was also seen in the fundus. An enhanced computed tomography scan and magnetic resonance imaging revealed a polypoid lesion and gallbladder stone located at the neck of the gallbladder and the fundus, respectively. Malignancy could not be excluded, and hence, a laparoscopic cholecystectomy was performed. Pathologically, a pedunculated polyp (14 × 11 × 15 mm) was observed in the neck of the gallbladder, and the polypoid lesion comprised nests or trabecular growths of clear NET cells in the lamina propria (ENETS: T1N0M0; AJCC: T1aN0M0). Immunohistochemical staining with synaptophysin, chromogranin A, and CD56 was confined to the tumor. The pathological diagnosis was clear cell NET G1 of the gallbladder. Although clear cell NET is often described as a distinct manifestation of von Hippel-Lindau disease (VHL), the patient had no past medical or family history of VHL. Until his one-and-a-half-year follow-up, the patient was doing well and without any signs of recurrence.

Conclusion

We report an extremely rare case of gallbladder clear cell NET G1. When NET G1 is incidentally identified in a gallbladder surgical specimen, clinical information and pathological findings should be considered as references.
Prevalence of and reasons for women’s, family members’, and health professionals’ preferences for cesarean section in Iran: a mixed-methods systematic review
Authors: Shirzad Mahboubeh , Shakibazadeh Elham , Hajimiri Khadijeh , Betran Ana Pilar , Jahanfar Shayesteh , Bohren Meghan A. , Opiyo Newton , Long Qian , Kingdon Carol , Colomar Mercedes , Abedini Mehrandokht
Published: January 2021

Background

Cesarean section (CS) rates have been increasing globally. Iran has one of the highest CS rates in the world (47.9%). This review was conducted to assess the prevalence of and reasons for women’s, family members’, and health professionals’ preferences for CS in Iran.

Methods and findings

In this mixed-methods systematic review, we searched MEDLINE/PubMed, Embase, CINAHL, POPLINE, PsycINFO, Global Health Library, Google scholar; as well as Iranian scientific databases including SID, and Magiran from 1 January 1990 to 8th October 2019. Primary quantitative, qualitative, and mixed-methods studies that had been conducted in Iran with Persian or English languages were included. Meta-analysis of quantitative studies was conducted by extracting data from 65 cross-sectional, longitudinal, and baseline measurements of interventional studies. For meta-synthesis, we used 26 qualitative studies with designs such as ethnography, phenomenology, case studies, and grounded theory. The Review Manager Version 5.3 and the Comprehensive Meta-Analysis (CMA) software were used for meta-analysis and meta-regression analysis. Results showed that 5.46% of nulliparous women (95% CI 5.38–5.50%; χ2 = 1117.39; df = 28 [p < 0.00001]; I2 = 97%) preferred a CS mode of delivery. Results of subgroup analysis based on the time of pregnancy showed that proportions of preference for CS reported by women were 5.94% (95% CI 5.86–5.99%) in early and middle pregnancy, and 3.81% (95% CI 3.74–3.83%), in late pregnancy. The heterogeneity was high in this review. Most women were pregnant, regardless of their parity; the risk level of participants were unknown, and some Persian publications were appraised as low in quality. A combined inductive and deductive approach was used to synthesis the qualitative data, and CERQual was used to assess confidence in the findings. Meta-synthesis generated 10 emerging themes and three final themes: ‘Women’s factors’, ‘Health professional factors’, andex ‘Health organization, facility, or system factors’.

Conclusion

Despite low preference for CS among women, CS rates are still so high. This implies the role of factors beyond the individual will. We identified a multiple individual, health facility, and health system factors which affected the preference for CS in Iran. Numerous attempts were made in recent years to design, test and implement interventions to decrease unnecessary CS in Iran, such as mother-friendly hospitals, standard protocols for labor and birth, preparation classes for women, midwives, and gynaecologists, and workshops for specialists and midwives through the “health sector evolution policy”. Although these programs were effective, high rates of CS persist and more efforts are needed to optimize the use of CS.
Indigenous biosystematics of yams (Dioscorea spp.) in Southwest Ethiopia: folk taxonomy, ethnolinguistic analysis, and folk descriptors
Authors: Worojie Tsegaye Babege , Asfaw Bizuayehu Tesfaye , Mengesha Wendawek Abebe
Published: January 2021

Background

In Southwest Ethiopia, various plant species are coexisting in wild and cultivated forms. This provides an ideal setting for studying folk biosystematics of neglected species. One of such species is theDioscoreaspecies, in which we studied to assess the commonly applied folk wisdom of identifying, naming, and classifying yams by Sheko and Bench farmers.

Methods

This study was conducted in Bench-Maji and Sheka Zones using 272 farmers. Data on the lists of local names and system of folk taxonomy; the inherent logic, etymons, and consistency of names; and the folk descriptors and other criteria involved in taxonomy were collected. Data were collected by establishing participatory research appraisal tools, i.e., informant interviews and researcher direct observation.

Results

The result suggests that there exists a well-developed folk taxonomic system in Sheko and Bench. This is evident in the recognition of four distinct folk ranks: sub-variety, variety, supra-variety, and folk generic. Taxa assigned to each ranks have distinct features that mark them as members of a separate categories. Farmers over-differentiate 58 individual taxa at the intraspecific levels. Of these, 37 represented varietal taxa while the rest are sub-varietal taxa. Structurally, over 78% of the varieties are labeled with unitary names while all the sub-varieties consisted of binomial names. Farmers used a total of 26 characters and 74 character states for identifying the different taxa. More than 84% of these refer to aspects of plant characteristics. Tuber characters played a key role in the local identification of varietal and sub-varietal taxa while contexts and gender played a key role in the recognition of supra-variety groups.

Conclusions

This study documented a great wealth of knowledge on indigenous biosystematics of yams, constitutes an essential step towards setting development priorities aimed at in situ conservation. The study clearly demonstrated the value of folk biosystematics for assessing the actual extent and spatial dynamics of yam diversity in traditional farming.
Unusual sites of bone involvement in Langerhans cell histiocytosis: a systematic review of the literature
Authors: Reisi Nahid , Raeissi Pouran , Harati Khalilabad Touraj , Moafi Alireza
Published: January 2021

Background

Langerhans cell histiocytosis (LCH) is a rare disease that originates from the uncontrolled proliferation and accumulation of bone marrow-derived immature myeloid dendritic cells. Dendritic cells are a type of histiocyte that play an important role in the human immune system and are found in the bone, skin, stomach, eyes, intestines, and lungs.

Objective

This systematic review aimed to collect and report published case reports of rare bone disease caused by LCH to avoid misdiagnoses or delays in diagnosis.

Methods

We systematically searched Scopus, PubMed, Embase, and Web of Sciences from August 1, 2000 to December 31, 2019. Studies reporting cases of LCH with rare bone involvement were included.

Results

We identified 60 articles including 64 cases. Of the identified cases, 31 (48.4%) involved children, and 33 (51.6%) involved adults. Additionally, 46.9% (30 individuals) were from Asian countries. The mean age of the children was 7.6 ± 4.3 years and that of the adults was 36 ± 12 years. The findings indicated that unifocal bone involvements were the most prevalent form of the disease (68.7%), and, overall, the skull and chest wall were the most commonly affected bones in both adults and children. The spine and long bones were the second most commonly affected bones in children, and the spine and jaw were the second most commonly affected bones in adults. Pain and swelling were the most frequent presenting signs among the investigated cases, and loss of consciousness, myelopathy, nerve palsy, visual loss, torticollis and clicking sounds were rare signs. Osteolytic lesions were the most frequent radiologic feature (62.5%), and intracranial hemorrhage, fluid–fluid level, dura and intracranial extension and pathologic fractures were rare radiological features. Total excision, curettage and observation in the unifocal group of patients and systemic chemotherapy in the other groups (i.e., multifocal and multisystem) were the most frequent management approaches. The recovery rates of the unifocal and multifocal groups were 77.3% and 81.8%, respectively, while that of the multisystem group was 55.5%. The rates of recurrence and mortality in the multisystem group were 11% and were higher than those in the other groups.

Conclusions

LCH is a rare disease that can affect any organ in the human body. However, bone is the most commonly involved organ, and rare bone involvements may be the first or only symptom of the disease due to the rarity of such lesions; a lack of familiarity with them may result in misdiagnosis or delayed diagnosis.
Sensitive universal detection of blood parasites by selective pathogen-DNA enrichment and deep amplicon sequencing
Authors: Flaherty Briana R. , Barratt Joel , Lane Meredith , Talundzic Eldin , Bradbury Richard S.
Published: January 2021

Background

Targeted amplicon deep sequencing (TADS) has enabled characterization of diverse bacterial communities, yet the application of TADS to communities of parasites has been relatively slow to advance. The greatest obstacle to this has been the genetic diversity of parasitic agents, which include helminths, protozoa, arthropods, and some acanthocephalans. Meanwhile, universal amplification of conserved loci from all parasites without amplifying host DNA has proven challenging. Pan-eukaryotic PCRs preferentially amplify the more abundant host DNA, obscuring parasite-derived reads following TADS. Flaherty et al. (2018) described a pan-parasitic TADS method involving amplification of eukaryotic 18S rDNA regions possessing restriction sites only in vertebrates. Using this method, host DNA in total DNA extracts could be selectively digested prior to PCR using restriction enzymes, thereby increasing the number of parasite-derived reads obtained following NGS. This approach showed promise though was only as sensitive as conventional PCR.

Results

Here, we expand on this work by designing a second set of pan-eukaryotic primers flanking the priming sites already described, enabling nested PCR amplification of the established 18S rDNA target. This nested approach facilitated introduction of a second restriction digestion between the first and second PCR, reducing the proportional mass of amplifiable host-derived DNA while increasing the number of PCR amplification cycles. We applied this method to blood specimens containing Babesia, Plasmodium, various kinetoplastids, and filarial nematodes and confirmed its limit of detection (LOD) to be approximately 10-fold lower than previously described, falling within the range of most qPCR methods.

Conclusions

The assay detects and differentiates the major malaria parasites of humans, along with several other clinically important blood parasites. This represents an important step towards a TADS-based universal parasite diagnostic (UPDx) test with a sufficient LOD for routine applications.
Network machine learning maps phytochemically rich “Hyperfoods” to fight COVID-19
Authors: Laponogov Ivan , Gonzalez Guadalupe , Shepherd Madelen , Qureshi Ahad , Veselkov Dennis , Charkoftaki Georgia , Vasiliou Vasilis , Youssef Jozef , Mirnezami Reza , Bronstein Michael , Veselkov Kirill
Published: January 2021

In this paper, we introduce a network machine learning method to identify potential bioactive anti-COVID-19 molecules in foods based on their capacity to target the SARS-CoV-2-host gene-gene (protein-protein) interactome. Our analyses were performed using a supercomputing DreamLab App platform, harnessing the idle computational power of thousands of smartphones. Machine learning models were initially calibrated by demonstrating that the proposed method can predict anti-COVID-19 candidates among experimental and clinically approved drugs (5658 in total) targeting COVID-19 interactomics with the balanced classification accuracy of 80–85% in 5-fold cross-validated settings. This identified the most promising drug candidates that can be potentially “repurposed” against COVID-19 including common drugs used to combat cardiovascular and metabolic disorders, such as simvastatin, atorvastatin and metformin. A database of 7694 bioactive food-based molecules was run through the calibrated machine learning algorithm, which identified 52 biologically active molecules, from varied chemical classes, including flavonoids, terpenoids, coumarins and indoles predicted to target SARS-CoV-2-host interactome networks. This in turn was used to construct a “food map” with the theoretical anti-COVID-19 potential of each ingredient estimated based on the diversity and relative levels of candidate compounds with antiviral properties. We expect this in silico predicted food map to play an important role in future clinical studies of precision nutrition interventions against COVID-19 and other viral diseases.
Green biomimetic synthesis of Ag–TiO2 nanocomposite using Origanum majorana leaf extract under sonication and their biological activities
Authors: Bhardwaj Diksha , Singh Ruby
Published: January 2021

Background

Studies of plant extract-mediated synthesis of nanoparticles is extensively explored and studied in recent time due to eco-friendly, cost-effectiveness and minimal use of toxic chemicals for synthesis. In this study, the synthesis of Ag–TiO2nanocomposites (NCs) was carried out usingOriganum majoranaleaf extract under ultrasound irradiation.Origanum majoranaleaf extract plays an important role as reducing and capping agent in synthesis of Ag–TiO2nanocomposites (NCs). The antimicrobial activities of synthesised Ag–TiO2NCs have been studied against Gram-positive and Gram-negative bacteria. In addition to this, the antioxidant activity of green Ag–TiO2NCs was also evaluated on the basis of free radical scavenging activity against 1,1-diphenyl-2-picrylhydrazyl (DPPH), 2,2′-azino-bis(3-ethylbenzthiazoline-6-sulfonic acid (ABTS), and hydrogen peroxide free radicals.

Results

Green-synthesised Ag–TiO2NCs were successfully characterised on the basis of UV–Vis spectrophotometer, Fourier transform infrared (FT-IR) spectroscopy, X-ray diffraction analysis (XRD), scanning electron microscopy energy-dispersive X-ray spectroscopy (SEM–EDS) and transmission electron microscopy (TEM). The results revealed the spherical shape of nanocomposite with an average size 25–50 nm. The synthesised Ag–TiO2NCs have showed significant antimicrobial activity againstEscherichia coli,Bacillus subtilisandAspergillus nigerin comparison to TiO2nanoparticles (NPs). The antioxidant evaluation of biomimetic synthesised Ag–TiO2NCs also exhibited strong activity than TiO2NPs and comparable to standard.

Conclusion

Green-synthesized Ag–TiO2NCs provide a promising approach that can satisfy the requirement of large-scale industrial production bearing the advantage of low cost, eco-friendly and reproducible.
Surgical site infection and its association with rupture of membrane following cesarean section in Africa: a systematic review and meta-analysis of published studies
Authors: Mekonnen Alemayehu Gonie , Mittiku Yohannes Moges
Published: January 2021

Introduction

Surgical site infection occurs within 30 days after a surgical procedure and involves the skin, subcutaneous tissue, and soft tissue. Surgical site infection following cesarean section is a common postoperative complication and is associated with maternal morbidity and mortality in resource-limited settings. Even though the proportion of surgical site infection and some risk factors were reported by kinds of literature, varying results were stated across studies. There is also limited knowledge on the association between postpartum surgical site infection and the rupture of membrane. Hence, this systematic review and meta-analysis was designed to estimate the pooled proportion of surgical site infection and its association with rupture of membrane following cesarean section in Africa.

Methods

Studies published from January 01, 2000 to January 30, 2020 were searched from MEDLINE via PubMed, Scopus, Medscape, Web-science and CINAHL databases to search relevant published articles. We also performed a manual search of reference lists of key articles to retrieve additional relevant articles. Initially, 559 records were identified and 15 studies included in the analysis. The statistical analysis was performed using STATA 11. Heterogeneity between-study was explored by forest plot and inconsistency index (I2). The publication bias was checked by a funnel plot and Egger’s test. Pooled estimates of proportion and odds ratio were calculated by a random-effects model with a 95% confidence interval (CI).

Results

The overall pooled proportion of surgical site infection following cesarean section was 10.21% (I2 = 86.8,p < 0.000; 95% CI = 8.36, 12.06). The odds of developing surgical site infection among women who had the rupture of membrane before delivery were nearly 6 times higher than those who had not a rupture of the membrane (AOR = 5.65, 95% CI: 3.95–8.07).

Conclusions

The proportion of surgical site infections following the cesarean section is relatively high. Women who had rupture of the membrane before delivery were more likely to develop surgical site infections following the cesarean section. Due attention should be given to the provision of prophylactic antibiotics that can reduce surgical site infection after cesarean delivery.
Effects of some bioinsecticides on the tomato leaf miner, Tuta absoluta (Meyrick, 1917) (Lepidoptera: Gelechiidae)
Authors: Erol Alime Bayindir , Erdoğan Oktay , Karaca İsmail
Published: January 2021

Background

In this study, commercial bioinsecticides including entomopathogenic fungi, Beauveria bassiana, Metarhizium anisopliae, and Verticillium lecanii, and Spinetoram active ingredient insecticide were evaluated against the tomato leaf miner, Tuta absoluta (Meyrick, 1917) (Lepidoptera: Gelechiidae) larvae.

Main body

The active ingredients were prepared at the recommended concentrations under laboratory conditions and applied to the 2nd instar larvae of T. absoluta by spraying with a hand sprayer. On the 1st, 3rd, 5th, and 7th days of the application, evaluations were made by counting survived individuals. The findings showed that the highest mortality rates were detected in the case of Spinetoram with 56, 60, 88, and 100% on all counting days of the experiments, respectively. The highest mortality rate among bioinsecticides was recorded for M. anisopliae, with 87% mortality on the 7th day of application.

Short conclusion

As a result, Spinetoram was found the most effective insecticide when applied to T. absoluta, followed by M. anisopliae.
Comparative study of fungal stability between Metarhizium strains after successive subculture
Authors: Hussien Rana H. M. , Ezzat Said M. , El Sheikh Ali A. , Taylor James W. D. , Butt Tariq M.
Published: January 2021

Background

Metarhiziumspecies are considered one of the most outstanding powerful biological control agents that have been commercialized as biopesticides against various agricultural pests. Fungal stability with successive in vitro cultivation is a desirable trait for a large-scale production of fungal biopesticide.

Main body

The new Egyptian strainMetarhizium anisopliaeAUMC 3262 exhibited auspicious results when compared toMetarhizium brunneumARSEF 4556 andM. brunneumV275 based on the variations of fungal characteristics, and essential quality control parameters (radial growth rate, conidial yield, viability, and virulence) after repeated in vitro subculturing. Changes in morphological characteristics were noted at both AUMC 3262 and ARSEF 4556. Following the 5th subculture, decreased conidial yield was noted, though radial growth remained stable, confirming that there is a non-positive correlation between conidial yield and radial growth rate for these species. In contrast, V275 showed a high morphological stability, conidial yield, and radial growth rate after repeated subculture. The three tested strains manifested high viability up to 100% and displayed the same pattern of Pr1 production. A slight variation was recorded in the median lethal time (LT50) values against the great wax moth,Galleria mellonella(L.), larvae between different subcultures of the testedMetarhiziumstrains.

Conclusion

The new Egyptian strain AUMC 3262 showed a high stability with a slight difference in some parameters after the successive subculture compared to both ARSEF4556 and V275.
Etiologies and outcome of lower gastrointestinal bleeding in patients presenting to a tertiary care Children’s Hospital
Authors: Talib Muhammad Abu , Aziz Muhammad Tariq , Suleman Hassan , Khosa Ghazi Khan , Joya Saima Jabeen , Hussain Ibrar
Published: January 2021

Objective: To determine etiology and outcome of children with lower gastrointestinal bleeding (LGIB).

Methods: This was a prospective study conducted at the Department of Pediatric Gastroenterology and Hepatology, Children’s Hospital and The Institute of Child’s Heath, Multan, Pakistan, from July 2019 to March 2020. A total of 148 cases presented with bleeding per rectum and underwent colonoscopy, were included. Children of both genders and aged three month to 15 years were included. Detailed history, clinical examination, laboratory studies, colonoscopy and histopathology were done in all cases. Study information like demographics, complaints, general clinical examination, colonoscopy and histopathological findings were recorded.

Results: Overall, mean age was noted to be 7.20±1.83 years. Abdominal pain was reported in 41 (27.7%), diarrhea 36 (24.3%), fever 12 (8.1%) and constipation in 4 (2.7%). Pallor was noted among 68 (45.9%), weight loss 39 (26.3%) and tachycardia 31 (20.9%). Colonoscopy revealed juvenile colonic / rectal polyps, infectious colitis and solitary rectal ulcer (SRU) as the most common etiologies found among 58 (39.2%), 20 (13.5%) and 19 (12.8%) cases respectively. Juvenile polyps and non-specific colitis were the commonest histopathological findings seen in 55 (37.2%) and 20 (13.5%) cases respectively. Colonoscopic polypectomy was used to remove all juvenile polyps.

Conclusion: LGIB is presentation of various underlying causes. Children with LGIB commonly present with abdominal pain. Juvenile polyps were the most frequent cause of LGIB among children flowed by non-specific colitis. Most of the children having LGIB were diagnosed and treated successfully, few are in remission and very few were found resistant to treatment.

doi: https://doi.org/10.12669/pjms.37.2.2676

How to cite this:Talib MA, Aziz MT, Suleman H, Khosa GK, Joya SJ, Hussain I. Etiologies and outcome of lower gastrointestinal bleeding in patients presenting to a tertiary care Children’s Hospital. Pak J Med Sci. 2021;37(2):556-560. doi: https://doi.org/10.12669/pjms.37.2.2676

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