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Feb 2023 DOI 10.14302/issn.2639-3166.jar-22-4403
The major a biotic stresses affecting chickpea production are high and low temperature, drought and salinity. Heat stress is a major a biotic stress factor, constraining chickpea production worldwide. This study was conducted to identifying chickpea genotypes combining heat tolerance and high yield potential and to study correlation among the heat tolerance indices. The genotypes were tested under different field-growing conditions, normal sown (non – heat stress) and late sown (heat stress) at two locations, Merowe and Gezira during winter season 2018/2019. The trials were laid out in alpha lattice design with three replications. Eight heat tolerance indices, which were most frequently used in plant breeding including, geometric mean productivity (GMP), yield index (YI), mean productivity (MP), stress susceptibility index (SSI), stress tolerance index (STI), tolerance index (TOL), sensitivity heat index (SHI) and relative heat index (RHI) were calculated based on seed yield under heat stress (Ys) and non – heat stress (Yp) conditions. Under both environments, the results from combined analysis of variance showed that there were highly significant differences among the genotypes for all traits studies. There were highly significant differences observed among the tested chickpea genotypes response to heat stress. Seed yield in stress (Ys) condition was positive and highly significant correlated with geometric mean productivity, yield index, stress tolerance index and relative heat index. The Ys was negative and highly significant correlated with stress susceptibility index and sensitivity heat index. Seed yield in non-stress (Yp) condition was positive and significant correlated with geometric mean productivity, yield index, stress tolerance index and tolerance index. The results of this research showed that the six indices, GMP, YI, SSI, STI, SHI and RHI can be used as optimal indicators for screening heat tolerant chickpea genotypes. Nine genotypes including four released improved varieties (Shiekh Mohamed, Wad Hamid, Salwa and Hwata) and five genotypes (no. 11, 4, 26, 30 and 34) are most stable chickpea genotypes for heat tolerance and can be further used in breeding program. These genotypes can be used in the chickpea national breeding program to develop varieties with improved heat tolerance in Sudan. Genotype no. 11 (FLIP 08-59 C) was release by Sudan national variety release committee for commercial production under the name Elbarkal in September 2022 to will be grown in Gezira, River Nile and Northern States of Sudan.
May 2022 DOI 10.14302/issn.2379-7835.ijn-22-4149
In Ethiopia stunting, underweight and wasting in school children are very common. The aim of this research was to evaluate the impact of intestinal helminthes and schistosomiasis on malnutrition, anaemia and haematological indices in the school age children of Azezo Elementary School in Gondar town. Kato Katz technique was performed to determine infection and intensity of intestinal helminth infections. AnthroPlus software version 1.04 was used to get malnutrition indices while fully automated haematological analyzers were used to determine haematological and biochemical parameters. A total of 384 school children were recruited in this study. The overall prevalence of helminth infection was 45.8% (178/384) with the leading Ascarislumbericoides infection (20.6%) compared to the second leading Schistosomamansoni (17.4%) and third leading hook worm infections (13.3%). The prevalences of body mass indexes for age Z-scores (BAZ) indices were 9.6% (37) very sever thin, 17.2% (66) sever thin, 38.3% (147) thin, 34.4% (132) normal and 0.5% (2) overweight. On the other hand, the prevalences of height for age Z-scores (HAZ) indices were 12.2% (47) stunt, 87% (334) normal and 0.8% (3) over height. Of the total 384 school age children, 335 (87.2%) had normal blood glucose level (70 – 110 mg/dL) while the remaining 49 (12.8%) school age children were hypoglycemic. The number of the school children with normal total protein level (6.6 – 8 g/dL) was 259 (67.4%) while the remaining 125 (32.6%) school children were hypo-proteinaemic. The prevalence of anemia in the school age children was 33.1% (127). Intestinal helminth infections were statistically significantly associated (p = 0.000) with hypo-proteinaemia, anemia and number of lymphocytes compared with non-infected school children. The likelihood of anemia in intestinal helminth infected school children, when it was compared with uninfected, was 148 times higher for both Ascaris lumbericoides-Schistosoma mansoni co-infection, 38 times for Hookworm, 20 times for Schistosoma mansoni and 3 times for Ascaris lumbericoides mono-infections. Conclusion: Intestinal helminth infections in school age children aggravate malnutrition. Prolonged malnutrition and intestinal helminth infections could result in stunting in school-age children.
Apr 2020 DOI 10.14302/issn.2691-8862.jvat-20-3306
Introduction The Corona virus (CoVID-19) pandemic has hit the most developed countries and has thence spread to inflict other countries around the world. It is the first pandemic that appears in countries not linked to poverty and poor hygiene. Aim To study the relationship between human development and the pattern of the pandemic caused by the CoVID-19 and to identify development indicators that can be useful in monitoring the pandemic. Methods Data collected included confirmed cases of CoVID-19 by country, number of cases that recovered and cases that died and population density per million in this particular country. The data for this information was obtained from the online data on the daily reports on CoVID-19 from the different countries. Data for the Human Development index (HDI) and the ranking for each country were obtained from the most recent United Nations Development of Populations (UNDP) report for 2019. We analyzed data for 166 countries for which the HDI was available for the date of cases reported online on 27th March, 2020 at midnight. Findings There were significant differences by ANOVA for the confirmed cases of CoVID19 cases and total cases per one million population between the countries in the 4 tier group of Human Development. HDI was significantly correlated with confirmed cases, case density and cases that died from CoVID-19 (P<0.01) for all countries but the significance decreased by tier group. Country ranking was inversely correlated with confirmed cases of CoVID-19 (r-0.25 at P=0.001), CoVID-19 cases per million (r-0.4 at P=0.000) and cases that died from CoVID-19 (r-0.2 at P=0.03). Recovery was not inked to HDI or country ranking. The upper HDI tier groups (very high, high and medium) showed significant correlations with total cases per one million population P<0.05, but no correlation was found with confirmed cases or cases that died or recovered from CoVID-19 P>0.05. Conclusions Total cases of CoVID-19 per one million population seems to be a better indicator of the pandemic. The pattern of spread is closely linked to industry.
May 2019 DOI 10.14302/issn.2637-6075.jpae-19-2803
This study evaluated the phytoplankton community of Taylor creek from Polaku to Agbia between November 2013 and July 2014. Sampling was carried out in 12 locations along the stretch of the creek following standard protocol. The phytoplankton enumeration was done and identified accordingly. In all the 12 locations, 100 species of phytoplankton belonging to 14 taxonomic groups including Bacillariophyta (31 species), Chlorophyta (25 species), Pyrrophyta (4 species), Cyanophyta (17 species), Spermatophyta (9 species), Euglenophyta (3 species), Phaeophyta (1 species), Heterokontophyta (2 species), Myxophyta (1 species), Xanthophyta (1 species), Chrysophyta (2 species), Lycopodiophyta (1 species), Cryptophyta (1 species), Dinophyta (2 species). Bacillariophyta, Chlorophyta, Cyanophyta and Spermatophyta with occurrence rate of 36%, 34%, 10% and 10%, respectively were the predominant phytoplankton in the study area occurring in all the locations across the period of the study. The various species have some distinct environmental condition that enable them thrive in their niche, and this determines the structure of the phytoplankton in the study area. The diversity indices provided information about the distribution and health condition of the creek. The study showed significant relationships between Shannon-Wiener, Menhinick, Margalef, equitability and Fisher-alpha indices. The ecosystem showed moderate to heavy pollution based on Shannon Wiener index. There is the need for improved method of waste disposal and other anthropogenic activities being carried in and/ or within the creek.
Jul 2018 DOI 10.14302/issn.2639-3166.jar-18-2083
This study was conducted to determine drought tolerant indices of some sugar beet genotypes under water stress and non-stress conditions. Nine sugar beet (Beta Vulgaris L.) genotypes were tested in a Split-plot experiment based on a randomized complete block design in three replications under three levels of water stress 100%, 75% and 50% from plant requirements at the experimental farm Faculty of Agriculture, Suez Canal University, Ismailia, Egypt during 2015/ 2016 and 2016 / 2017 seasons. Twelve drought tolerance indices were used in this study, stress sensitivity index (SSI), stress tolerance (TOL), mean productivity (MP), geometric mean (GMP), harmonic mean (HM),yield stability index (YSI), yield index (YI), stress tolerance index (STI), sensitivity drought index (SDI), relative drought index (RDI), drought response index (DI) and stress susceptibility percentage index (SSPI). GMP, MP and STI were more informative towards classification of better or superior genotypes with respect to tolerant and sensitive groups. The results showed that the genotypes with high STI, GMP and MP values were suitable for cultivation under drought stress and non-stress environments. Both Yp and Ys of root yield in the control-50% analysis had significantly positive correlated (P value<0.05) with MP, GMP, YI, HM and DI, This indicates that these indices were more effective in identifying high yielding genotypes under drought stress as well as non-stress conditions.Principal components analysis showed that the first two components in the control-50% analysis, genotype Bts 1237 and Temar were identified as the most stable high yielding genotypes in both environments
Aug 2017 DOI 10.14302/issn.3070-2313.jeh-17-1552
Introduction. Obesity often coexists with insulin resistance, which is related to cardiometabolic risk. However, some obese individuals exhibit comparable insulin sensitivity (IS) to that of normal-weight subjects, a state associated with a reduced cardiometabolic risk. We aimed to determine the efficacy of a panel of surrogate markers of insulin sensitivity (IS) for the identification of insulin sensitive obese (ISO) vs. insulin resistant obese (IRO) with similar total fat mass (FM) and body mass index (BMI). Methods. This is a cross-sectional analysis among 144 overweight and obese post-menopausal women. IS was determined by the hyperinsulinemic-euglycemic clamp (HEC) and by surrogate indices such as Matsuda index, the simple index assessing insulin sensitivity using oral glucose tolerance test (SIisOGTT), Abdul-Ghani liver IS index, HOMA-IR and Abdul-Ghani muscle IR index. Results. When using upper and lower quartiles values or the median as cut-off for IS determined by the reference HEC to define ISO vs. IRO, Matsuda index, SIisOGTT and Abdul-Ghani indices classification identified ISO vs. IRO individuals with similar FM and BMI. With HOMA-IR, the two groups were similar for FM and had borderline significant difference in BMI. Using, receiver operating characteristic curves, Matsuda index AUC was similar to that of SIisOGTT and both indices AUCs were significantly higher than Abdul-Ghani indices AUCs. The best cut-off value for the Matsuda index was 2.5 (83.1% specificity, 54.2% sensitivity) and 0.25 for SIisOGTT (64.8% specificity, 70.8% sensitivity). Conclusion. Whole body IS indices, Matsuda and SIisOGTT indices seem to be reliable indices for the identification of ISO vs. IRO individuals.
May 2026 DOI 10.14302/issn.2578-8590.ipj-26-6121
Aims Cardiac autonomic neuropathy is currently an untreatable progressive complication of type 1 diabetes (T1D). Impaired microcirculation is a suspected cause of nerve degeneration in TID. We investigated whether cardiovascular autonomic reflexes often used as indices of nerve functions, are associated with indices of microcirculatory function in young adults with T1D compared with non-diabetic controls. Methods In a cross-sectional study, 15 adults with T1D and 15 age-matched controls (20-40 years) underwent standardized cardiovascular autonomic reflex tests. Continuous recordings of electrocardiogram, cardiac vagal tone, beat-to-beat blood pressure and transcutaneous tissue oxygen (tcpO₂) and carbon dioxide partial pressures (tcpCO2) were done. Results Despite preserved baroreflex, parasympathetic, and sympathetic functions assessed using cardiovascular reflex tests, the individuals with T1D exhibited reduced baseline tcpO2 compared to the controls (37.5±3.75 vs. 49.6 mmHg). During the Valsalva manoeuvre, individuals with T1D exhibited a reduced systolic blood pressure response in phase I (31±10 vs. 43±18 mmHg) and early phase II (-1±15 vs. -18±17 mmHg), and an increased systolic (31±15 vs. 18±14 mmHg) and diastolic (45±11 vs. 33±16 mmHg) response in late phase II compared to controls. The early phase II diastolic response was inversely associated with baseline tcpO2. Conclusion The altered hemodynamic response to the Valsalva manoeuvre is suggestive of possible reduced arterial elasticity, higher vascular resistance, and splanchnic sympatho-vagal imbalance in T1D despite normal autonomic reflex ratios. The concomitant evidence of reduced tissue oxygenation and altered hemodynamics may represent early signs of dysautonomia but require longitudinal validation.
Apr 2026 DOI 10.14302/issn.2574-450X.jom-26-6138
Indices, based on data such as height and weight in general and in particularly the body mass index (BMI), are often used to assess overweight. However, there is limited capacity to differentiate the amount of fat mass between individuals. This review refers to an anthropometric model called Dahlmann-Body-Analysis (DBA), which uses simple anthropometric parameters to define a Reference Weight (Ref-Wt). It is based on hand circumference as a proxy for the skeletal frame and, in addition, the circumference of the abdomen as a proxy for central obesity. Processed through a network of algorithms, the DBA model enabled to differentiate the Difference Weight – that means the difference between the Actual Weight and the Reference Weight – into fat mass and skeletal muscle mass. The DBA-model resembles the 2-component model of Albert R. Behnke, which he considered as a living functional construct including essential fat. The DBA-model matches with Behnke`s 2-component model insofar, as the essential fat is replaced by a physiological amount of fat tissue. The review summarizes studies to compare DBA-derived data with Metropolitan Life Insurance tables, evaluates DBA-derived fat tissue mass with bioelectrical impedance analysis (BIA) derived results and analyses the meaning of the DBA model in clinical settings to uncover the underlying mechanisms of metabolic syndrome (MetS) pathogenesis with increasing amounts of fat mass. The model offers the opportunity to calculate changes in fat or muscle tissue in an absolute (kg) or relative (%) amount on individuals. The data suggest that the DBA-model has satisfactory prediction qualities for use as a practical tool in public health care.
Feb 2026 DOI 10.14302/issn.2474-9273.jbtm-25-5885
Background Depression, increasingly recognized as a critical factor impacting mental health, notably affects various populations, including teachers. This study aimed to delineate the specific characteristics of depressive symptom networks among Chinese teachers, identify the core symptoms of depression within this demographic, and examine the variations in depressive symptom networks across different genders and teaching stages. Method The study encompassed 1,670 teachers. Depressive symptoms were assessed using the Self-Rating Depression Scale (SDS). Central symptoms were identified through centrality indices. Network stability was examined via a case-dropping procedure. Directed Acyclic Graphs (DAG) was used to identify the activating symptoms. Results “Personal devaluation” exhibited the highest and most stable centrality values in the network. “Depressed Affect” and “Emptiness of Life” were identified as the activating symptoms in the network. No significant differences were observed in the network structure and global strength of depression between teachers of different genders. However, significant differences in the network’s global strength were found between junior and senior high school teachers. Conclusion “Personal devaluation” emerged as the core depressive symptoms among teachers in China. “Depressed Affect” and “Emptiness of Life” serve as the gateways that activate the entire teacher depression network. Paying close attention to these symptoms could potentially alleviate the experiences of depression in this demographic.
Dec 2025 DOI 10.14302/issn.2768-5209.ijen-25-5762
Sudan's ecological landscape is characterized by various zones, including deserts, semi-deserts, and savannas, which host a diverse array of forests, rangelands, and numerous plant and animal species. However, the sustainable management of these resources is becoming increasingly challenging due to human activities and the impacts of climate change. This article presents the results of a research project focused on monitoring and documenting biodiversity in Sudan's semi-arid regions, particularly emphasizing insect diversity. Insects are vital for maintaining ecosystem health through processes such as nutrient cycling, decomposition, pollination, and acting as natural predators to pests. Field surveys were conducted across three Sudanese states—North Kordofan, Gezira, and Khartoum—to assess the diversity of flora and fauna. Specifically, El Rawakeeb semi-arid land in Khartoum state was investigated, which comprised three sites with varying soil elevations: a hilly site at 420 meters above sea level, a flat site at 416 meters, and a valley site at 411 meters. Researchers utilized direct collection methods and butterfly nets to gather insect specimens, which were subsequently preserved and identified for further analysis. Diversity indices, including Simpson’s Diversity Index, Shannon-Wiener Index, and Margalef Richness Index, were computed to compare the biodiversity of these sites, along with metrics for evenness and species richness. Permanova analysis was carried out for insect variation between the study sites. A total of 1541 insect specimens were gathered from El Rawakeeb, encompassing 34 species distributed across 21 families and 9 orders. The order Lepidoptera exhibited the greatest number of species (35.29%), followed by Coleoptera (20.59%). The orders Neuroptera, Orthoptera and Thysanoptera recorded the fewest species (2.94% each). From the hilly site, 514 insect specimens were collected, representing 9 orders, among which Hymenoptera included 4 species, while Lepidoptera had 3 species, and Odonata, Orthoptera, and Thysanoptera each had 1 species. The highest individual counts were recorded for Copriniklobe (dung beetle), Dacus longistylus (fruit fly), Camponotussp. (carpenter ant), and Anax ephippiger (dragonfly). In a flat site, 484 insect specimens were collected, classified into 15 species, 12 families, and 7 orders. The highest individual counts were noted in four species: Onthophagusnuba (dung beetle), Dacus longistylus (fruit fly), Camponotussp. (carpenter ant), and Anax ephippiger (dragonfly). In a valley site, 543 insect specimens were collected, categorized into 17 species, 16 families, and 9 orders. Insect Diversity in three research sites. Simpson's Diversity Index revealed varying levels of insect diversity across the three sites. The valley site exhibited the highest diversity level with an index score of 0.857, followed by the flat site at 0.826, and the hilly site at 0.819. The Shannon diversity index of 2.22 indicated the highest diversity among the three sites, suggesting a relatively diverse insect community. The relative abundance of insects was greatest in the valley site at 35.24%, followed by the hilly site at 33.35%, and the flat site at 31.41%. The Margalef Richness Index indicated a moderate level of richness in the insects collected from the three locations. Certain insect species were found in some sites but were absent in others. The PERMANOVA revealed notable variations among the three study sites (F = 2.24, p-value = 0.035).
May 2024 DOI 10.14302/issn.2998-4122.jlr-24-4985
Despite a large number of studies examining syntactic features that are predictive of second language (L2) writing quality, assessed by human raters at the university level, few have systematically investigated this link using a large set of indices in the foreign language learning (EFL) classroom context. The current study sought to determine the extent to which a variety of syntactic complexity and sophistication indices are associated with and may predict writing quality by analyzing 30 argumentative essays written by undergraduate EFL students in an Ethiopian university classroom setting. To represent syntactic complexity as a multidimensional construct, we used conventional absolute measures, fine-grained clausal and phrasal indices, and newly proposed sophistication indices related to the use of verb argument constructions (VACs) indexed by TAASSC (Tool for the Automatic Analysis of Syntactic Sophistication and Complexity; 17. Essays were graded, and five separate predicted models of writing quality were created utilizing each complex feature index and all of the measures. Robust predictors of writing quality were identified at both syntactic complexity and sophistication dimensions. Regression analyses showed that the combined model including both fine-grained clausal complexity and VAC-based indices could account for 53.6% of the variance (the largest amount of variance in the study) in writing scores. The finding indicates that the inclusion of diversified adverbial modifiers and nonfinite clauses such as modal auxiliaries controlled by less frequent verbs were predictive of higher-quality writing. These findings shed light on some characteristics of L2 learners' writing growth and enable us to draw pedagogical implications for teaching and assessing writing in the Ethiopian EFL context.
Apr 2024 DOI 10.14302/issn.2574-4526.jddd-24-4996
The General Accounting Office released a study in August 1992 of twenty-nine sampled prescription drugs that reported an average increase in the price of approximately 138 percent between 1985 and 1991 (GAO 1992, 4, Table 1) Those and other published price indexes are increasingly being used in the public policy arena to focus the debate on the potential regulation of pharmaceutical prices and the coverage of health insurance. In an industry where products are multidimensional and the rate of technological progress is brisk, misinterpretation of unadjusted indices of drug prices can easily arise. This can lead to erroneous conclusions regarding appropriate policies for the pharmaceutical industry. Researchers have addressed numerous general theoretical issues concerning the construction and interpretation of price indices 1. Two issues of particular interest for pharmaceutical markets are the new goods problem, which deals with the introduction of generic drugs into a drug price index, and the quality problem, which recognizes that newer versions of drugs with the same basic Chemical action may be superior in certain dimensions to drugs already on the market. Specific to pharmaceutical markets, 2 have also argued that the sampling procedure used by the Bureau of Labor Statistics to calculate pharmaceutical price indices is flawed. Each of those problems deserves careful analysis. This study focuses on the issue of product quality measurement and quality change.
Mar 2024 DOI 10.14302/issn.2640-690X.jfm-24-5016
Background Antibiotics are the most prescribed medications worldwide. Global consumption rose by 65% in 76 low and middle-income countries between the years 2000 and 2015. According to the World Health Organization, improper administration of antibiotics occurs in over 60% of people with upper respiratory tract infections. Inadvertent antibiotic use has been identified as a contributor to antimicrobial resistance. Outpatient antibiotic use accounts for around 80-90% of all antibiotic use in patients. Clinical officers are non-physician healthcare workers who have received less training, have a more restricted scope of practice than physicians. Clinical officers are key service providers in this country especially at the primary healthcare level. Objective The study assessed the factors that influence antibiotic prescribing for upper respiratory tract infections by clinical officers. Method A prospective study was carried out at 20 public hospitals in Kiambu County, on 36 clinical officers and 600 patient prescriptions. The parameters measured were patient factors, prescriber factors, institutional factors and how they affected the antibiotic prescribing practices by either being rational or irrational. Rational prescribing was identified as prescribing the right drug, at the right frequency, in the right duration, right dose for the right indication. Prescriptions were considered irrational if they did not satisfy any of the rational indices. Data was collected via a questionnaire from the clinical officers while WHO prescription checklist was used to collect data from patient encounters. Data was analyzed using Statistical Package for Social Sciences version 22.0 (SPSS v22.0) with P-value, Confidence Interval and Odds Ratio. Results A total of 600 patient encounters were recorded and 79.8% of the 479 encounters had an antibiotic prescription for URTI, 91% of the antibiotics prescribed were the right dose, 98% had the right frequency, 75% had the right duration, and only 23% had the right indication. Patients above 65 years were more likely to receive an antibiotic prescription OR 3.98 CI 0.91,17.41 P=0.17 compared to children under 12 years old. Males were more likely to receive an antibiotic, but this was not significant OR 1.06 CI 0.70, 1.59 P=0.79. A total of 28 (4.6%) patients had fever, and all received antibiotics. A total of 36 clinical officers were sampled and only 5 (13.8%) were found to have rational prescriptions (P=0.63), prescriber age (P=0.92), prescriber level of education (P=0.99) and prescriber work experience (P=0.22) were not associated with antibiotic prescription. As per institutional factors, availability of antibiotics (P=0.026) and availability of prescription guidelines (P=0.012) were associated with rational prescription of antibiotics. Conclusion The study indicated that there was a high antibiotic prescription rate deviating from the WHO standard. It demonstrated that most antibiotic prescriptions were irrational.
Oct 2022 DOI 10.14302/issn.2576-9359.jot-22-4303
Background Doppler ultrasonography can evaluate vascular and renal parenchymal disorders. In this study, color Doppler patterns in transplanted kidneys were compared with histological diagnosis to develop diagnostic models for transplanted kidney failure. Method 45 kidney transplant patients participated in this prospective study (16 suffered acute tubular necrosis (ATN), and 29 had transplant rejection). All patients had color-Doppler ultrasonography to measure kidney parameters and Doppler indices. Serum creatinine levels also assessed the transplanted kidney's function. Result Ultrasound showed a significant difference between the two groups in iliac and interlobar PSV. The ROC analysis showed a high diagnostic value of the iliac artery PSV, in distinguishing ATN from kidney transplant rejection. Serum creatinine level correlated directly with transplanted kidney volume, renal cortical thickness, and transplanted kidney length, and inversely with interlobar artery PSV and EDV. In graft rejection patients, the only significant inverse correlation was found between serum creatinine level and PSV of the iliac artery and EDV of the intrelobar artery. Discussion and conclusion The iliac artery PSV can differentiate between ATN and rejection after renal transplantation. Evaluation of renal metric parameters along with PSV and EDV of the interlobar artery (in patients with ATN) and iliac artery and interlobar artery (in transplant rejection) help determine renal dysfunction.
Mar 2021 DOI 10.14302/issn.2577-2279.ijha-21-3746
Background The neonatal morbidity and mortality is very high in the Sudan, the umbilical cord association and contribution to this is planned to be answered. Therefore the present study was designed to provide some information on the morphological variations of human umbilical cord via gross anatomical assessment and their correlation with foetal factors such as foetal weight and length. Methods A prospective hospital - based study conducted in Wad Madani Maternity Teaching Hospital Department of Obstetrics and Gynecology between July 2014 and March 2018 Results The mean diameter of the 371 umbilical cords was 2.1±0.24cm. Length was 53.8±3.8 cm length ranging from 48 – 62 cm and 10 (2.7%) of 371 umbilical cords were uncoiled. of which, 1 (0.3%) cords were with absent Wharton’s Jelly. The mean neonatal indices were 2.95 kg, 33.19 cm and 44.42 cm for weight, head circumference and length respectively. There was just significant strong positive correlation between umbilical cord length and length of neonates. Also Umbilical cord diameter had a positive correlation with length of neonates and negative correlation with weight of neonates and APGAR Score. Conclusion The present study suggests that ‘normal’ cord length should be between 40 cm and 70 cm in length. Umbilical cord diameter had a positive correlation with fetal length and negative correlation with fetal weight and APGAR score. The diameter range of 1-2 cm suggests that a normal cord must not exceed 2 cm in diameter. However the umbilical cord index had negative correlation with length of neonates.
Jul 2020 DOI 10.14302/issn.2379-7835.ijn-20-3463
Background Evidence suggests that low birth weight (LBW) is associated with increased cardiovascular and metabolic risk in adulthood, including increased arterial stiffness, a marker of early vascular aging (EVA) assessable by pulse wave velocity (PWV), obesity and glucose homeostasis abnormalities. The present study aimed to explore the late impact of LBW on PWV and cardiometabolic phenotypes among young adult Cameroonians. Methods The study evaluated 120 subjects (mean age: 26 ± 5 years; 54% male sex) at the Cameroon Heart Institute, Douala, Cameroon, between January and June 2018. Birth weight (BW) and gestational age, sociodemographic, anthropometrics and fasting capillary blood glucose were recorded in all participants. Blood pressure (BP) and PWV were measured using an automatic oscillometric device (Mobil-O-Graph®). Multiple-adjusted linear regression was used to determine predictive factors for PWV. For assessment of potential impact of BW on EVA, PWV was adjusted for age, sex, body mass index (BMI) and mean arterial pressure (MAP). Results 28 participants (23.3%) of the study sample had LBW (<3000g). There was no gender difference between LBW or normal birth weight patients (NBW; controls). Age- and MAP-adjusted PWV (aPWV) were higher in women with LBW compared to NBW (5.6 m/s and 5.3 m/s respectively, P = 0.038). In men, aPWV was similar in LBW and NBW. In this study population, aPWV was higher (on average +15 cm/s) in LBW than in controls, although the difference was not statistically significant (P=0.083). Multivariate regression analysis showed age, male sex, BMI and MAP were independent determinants of PWV, but not LBW. Compared to NBW controls, the prevalence of overweight/obesity, impaired glucose homeostasis and diabetes was higher in LBW: 42.9% vs 37%; 10.7% vs 3.3%, and 3.6 % vs 1.1%, respectively. Moreover, compared with controls, LBW individuals who were overweight/obese in adulthood had a much higher mean fasting capillary glucose (1.54 ±0.17 g/l vs 0.87 ±0.11 g/l in NBW, p=0.003). Conclusion This study suggests that although LBW is associated with increased aortic stiffness in young adulthood, mainly in women, the association was predominantly driven by aging, MAP, BMI and male sex. In adulthood, LBW subjects exhibited higher obesity indices and altered glucose homeostasis.
May 2020 DOI 10.14302/issn.2328-0182.japst-20-3347
The study evaluated the impact of co-infection of malaria parasitaemia, and HIV positive indices on the CD4 cell count of 120 HIV infected subjects, who were already diagnosed and visiting Braithwaite Memorial Specialist Hospital Port Harcourt for routine Medical check-up. Also, a control group of 40 HIV negative were included as part of the study control group. The subjects were between the age ranges of ≤10–79 years respectively. A double check laboratory assay was conducted to detect the presence of antibody to HIV as confirmed using immunocomb 11 and Determine for HIV status. A thick Blood film stained with field stain (A and B) was used to detect the presence of malaria parasite in the subject’s blood. Furthermore, CD4 cell count was assayed using Partec cyflow counter (Partec, Germany). Excel and Graphpad statistical software were used for analysis of the data generated. The result among the HIV positive subjects and control subjects revealed that the highest positive for malaria infection was observed among ≤10 years age group as 2 (100%) and 11 (84.61%) respectively. In the HIV positive subjects, the distribution of malaria infection among sex revealed a high rate in male 42(77.78%) than in female 44 (66.67%). Similarly, the control recorded a high rate of malaria infection in male 11 (57.89%) than in female 7 (33.33%). However, 86 (71.67%) had malaria and HIV co-infection while 34 (65%) had only HIV mono infection. The positive HIV subjects who had CD4 cells count below 200 cells/mm3 were 15%, above 200-499cells/mm3 were 58.3% while 500 cells/mm3 and above had normal CD4 cells counts for 26%. Nonetheless, for the control subjects, no CD4 cells count of below 200cells/ mm was observed, 2.5% fell within the moderate category while 75% had normal CD4 cells count. Statistical analysis using ANOVA and t-test showed that there is significant difference between CD4 of seropositive and seronegative subjects infected with or without malaria (p=0.00). In addition, a t-test further demonstrated Comparison of Mean CD4 Cell Count among HIV and Malaria Infected and Non-Infected Subjects. MP/HIV Co-Infection and Mono Infection with No Infection showed strong mean difference (p=0.00) in the various CD4 counts while HIV Mono-Infection and others only had a non significant (p=0.44) mean difference between HIV Mono-Infection and No HIV or Malaria Infection. A robust and effective malaria and HIV control management programme should be strongly underpinned; so as to improve the quality of life of patients and HIV patients should be encouraged to live a healthy life style, through the provision of antiretroviral drugs and regular health education engagement, even as the provision of antimalarial treated net would be helpful to the subjects.
Apr 2020 DOI 10.14302/issn.2379-7835.ijn-20-3279
Aim This cross-sectional study assessed the nutritional status of ethnic reproductive women aged between 15-40 years, comprising 85 lactating women (LW) and 86 non-pregnant-non-lactating women (NPNLW) who lived in various parts of three hilly districts (Bandarban, Khagrachari and Rangamati) of the Chittagong Hill Tracts (CHTs) of Bangladesh. Materials and Method Research tool was pretested semi-structured questionnaire for this observational study. Anthropometric indices like weight, height and mid-upper-arm-circumference (MUAC) were used in assessing the nutritional status. Results Most (44.4%) of the ethnic women were Marma, followed by Chakma (39.8%), Bam (8.2%) and Tripura (5.8%). No significant (P>0.05) differences were observed in socio-economic variables between LW and NPNLW. Overall, mean age of the women was 28 (±7.2) years; mean family income was 18,822.2 (±3091) BDT and majority (86%-87%) were reported to be food secured throughout the year. Mean Dietary calorie (2631±798 kcal) intake of both groups were up to the mark according to the recommended dietary allowances (RDAs) and most (80.3%-86%) of them also possessed good nutritional knowledge. However, no significant (P>0.05) differences were observed in dietary calorie intake and nutritional knowledge score between two groups of women. Overall, most (68.4%) of the women had normal body max index (BMI kg/m2), 11.7% were found to be undernourished or thin and 19.9% were overweight. It was noticed that better nutritional status of LW and NPNLW were significantly associated with literacy (P<0.05), occupancy in household chores (P<0.05), better income (P<0.05), food security (P<0.05), recommended calorie intake level (P<0.05) and better nutritional knowledge score (P<0.05). Conclusion This study showed that vast majority of the ethnic reproductive women of CHTs are in better nutritional status with normal BMI (kg/m2) and daily calorie intake according to RDA. Most of them were food secured and their nutritional knowledge score was also up to the mark. Better socio-economic condition, nutritional knowledge and accurate calorie intake play a vital role in achieving healthy nutritional status of the two women groups of CHTs.
Feb 2020 DOI 10.14302/issn.2577-2279.ijha-20-3178
Background In recent years great attention has been focused on the structural and histological structures of the placenta and the umbilical cord due to their vital roles in fetal development and neonatal survival. While extensive studies have been documented in this area in the developed world, there is very little published information about the morphological variations that occur in human placenta in Sudan. Therefore, this study was designed to evaluate the structural variations in placental indices and its relation to neonatal outcome. Methods A prospective hospital - based study conducted in Wad Madani Maternity Teaching Hospital Department of Obstetrics and Gynecology between July 2014 and March 2018. Results Mean placental indices for weight, diameter and thickness were 515.51 g, 18.80 cm and 2.43 cm respectively. The mean neonatal indices were 2.95 kg, 33.19 cm and 44.42 cm for weight, head circumference and length respectively. Neonatal weight correlated significantly with placental weight, neonatal length and neonatal head circumference (P < 0.000). On the contrary, neonatal weight had no significant correlation with placental thickness and diameter Conclusion In this study, there was a strong relationship between the placenta and the fetus suggesting that the well-being of the fetus is highly dependent on the placenta since it serves as a link between the mother and the fetus.
Dec 2019 DOI 10.14302/issn.2574-4488.jna-19-3112
Introduction Increased oxidative stress and blunted anti-oxidant mechanisms are important problems in hemodialysis (HD) patients. Reactive oxygen species (ROS) act directly on proteins, leading to the formation of oxidized amino acids. Advanced oxidation protein products (AOPP) are among these substances. Many oxidant substances increase the level of AOPP. Iron is an element with strong oxidant capacity, especially when used intravenously. It is thought that iron treatment further increases the oxidative stress in HD patients. We aimed to investigate the relationship between AOPP and inflammatory status in HD patients. Materials and Methods Patients who were on maintenance HD program without additional co-morbidities and no history of use of intravenous iron within the last two weeks were recruited in the study. The blood samples taken just before the dialysis session were analyzed for AOPP, serum iron, total iron binding capacity (TIBC), ferritin, C-reactive protein (CRP), ß2-microglobulin, fibrinogen, interleukin (IL)-1, IL-6 and tumor necrosis factor-α levels besides routine biochemical measurements and complete blood count. Results The number of patients included in the study was 102 (n: 53 female, %52.0) and the mean age was 47.6±13.9 years. The mean transferrin saturation was 25.4%. AOPP levels, iron use in patients was higher compared to patients who do not use (respectively 2.58±0.19 mmol/l and 2.50 ±0.16mmol/l, p = 0.046). We did not detect statistically significant correlation of AOPP levels with iron parameters and other inflammatory markers. Conclusion The present study showed that intravenous iron therapy does not increase oxidative stress. Although serum AOPP level was higher in patients on intravenous iron treatment, it was not correlated with iron indices and inflammatory markers. So, intravenous iron may exert its oxidant effect free from serum iron indices.
Sep 2019 DOI 10.14302/issn.2574-450X.jom-19-3000
Background Polycystic ovarian syndrome (PCOS) is increasingly being diagnosed and treated with sometimes variable lifestyle advice and pharmacological interventions. Obesity is considered as the sole culprit and variable definitions in clinics compound the understanding of pathogenic heterogeneity of this syndrome. We evaluated the differences between various simple to calculate anthropometric indices along with some anthropometric-biochemical equations in subjects with or without PCOS. Objective To compare traditional measures like waist to hip and height ratio (WHpR and WHtR), BMI, newer markers depicting central obesity like Abdominal Volume index(AVI), Body roundness index (BRI), A Body Shape index (ABSI), Conicity index (C-index) along with biochemical-anthropometric equations like lipid Accumulation Products (LAP), Visceral Adiposity Index (VAI) and Chinese Visceral Adiposity Index (CVAI) for diagnosing PCOS as per the Rotterdam criteria Design Cross-sectional analysis Place & Study Duration Naval hospital, Islamabad from Jan- 2018 to July- 2019 Subjects and Methods From our finally evaluated 333 female subjects we initially compared the differences for the presence of hirsutism as per modified Ferrimen Gallwey scores and biochemical hyperandrogenism by measuring free androgen index (Total testosterone/SHBG x 1000. We evaluated waist circumference, BMI, WHpR, WHtR,AVI, BRI, ABSI, C-index along with biochemical-anthropometric equations like LAP, VAI and CVAI for differences in subjects diagnosed to have PCOS by Rotterdam criteria or ultrasonography alone. Results Differences in hirsutism as defined by modified FG score between subjects defined to have PCOS or otherwise as per Rotterdam defined criteria were as [(PCOS=169, Mean=17.33 + 9.05) (No PCOS=164, Mean=8.21 + 5.74), p< 0.001] and ultrasound [(PCOS=87, Mean=16.95 + 9.57) (No PCOS=246, Mean=11.38 + 8.51), p< 0.001]. Similarly, the differences in FAI between subjects defined to have PCOS or otherwise as per Rotterdam criteria and ultrasound were as [(PCOS=169, Mean=6.41 + 4.88) (No PCOS=164, Mean=2.77 + 1.79), p< 0.001] and [(PCOS=87, Mean=5.75 + 5.01) (No PCOS=246, Mean=4.22 + 3.68), p= 0.011]. Anthropometric measures and anthropometric-mathematical equations were raised in non-PCOS subjects than PCOS subjects. Lean-PCOS demonstrated lower degree of hirsutism and biochemical hyperandrogenism in comparison to obese-PCOS. Conclusion Hirsutism and free androgen indices were raised in PCOS females. Anthropometric based measurements were not different in PCOS cases and non-PCOS females. Lean-PCOS demonstrated lower degree of hirsutism and biochemical hyperandrogenism in comparison to obese-PCOS.
Jun 2019 DOI 10.14302/issn.2766-869X.jfd-19-2718
We analyze the effects of the ethnomycological knowledge depending on the age range of its users and how far their homes are from the forest areas. As a study model, the traditional mycological knowledge of San Pedro Tlalcuapan SPT, in Central Mexico was used. During 2017, 135 semi-structured interviews were conducted with people of three age ranges and living in three areas of the community located at different distances from the forest. Data was analyzed using descriptive statistics and analyses of non-metric multidimensional scaling, which were then applied to calculate two indices. The effect of age and origin of the individuals on bio-cultural relevance was assessed using multiple linear regression models.Fifty species of edible wild mushrooms were registered, those mentioned most often were of the Russuladelica complex., Amanita basii and Boletus aff. edulis. Ninety-five percent of the people interviewed consumed wild mushrooms on average two times a week, while 57% collected them. Wild mushrooms are mainly recognized for their food and ecological importance. Ordination and regression analyses show that people closest to the forest, as well as older people, are able to identify more of the wild mushrooms and have greater bio-cultural mushroom awareness. Results show that there is a risk that traditional knowledge about wild mushrooms will disappear, since it is only popular in a part of the community and only at some age ranges, indicating that there is a disconnect in the transfer of knowledge.
Apr 2019 DOI 10.14302/issn.2639-3166.jar-19-2735
An integral and efficient management of water for irrigation requires the adoption of new technologies to respond to the challenges imposed by the agricultural sector, in particular to stabilize production through the adequate use of water resources. In this sense, it is vital to characterize and know the amount of area which is under irrigation in such agricultural systems. In this paper we show the use of satellite information data in a GIS environment with the objective of characterizing the productive areas under irrigation in Cruz del Eje, Córdoba, Argentina in 3 types: A) irrigation region B) irrigable area and C) actually irrigated area. Multitemporal image indices and segmentation were used for this characterization and then maps of these 3 types of agricultural land cover were generated. Additionally, we present simple satellite images processing and classification procedures to increase the knowledge about the land cover over this irrigated area. Finally, we discuss how this geographically explicit information generated could be useful for the decision-making process on current irrigated areas and on the potential of productive systems through community irrigation systems.
Feb 2019 DOI 10.14302/issn.2470-5020.jnrt-18-2554
Background Controversy exists about definition of agitation and especially about inclusion of aggression as a part of agitation in people with dementia. Methods Papers describing neurobiological indices related to behavioral symptoms of dementia were reviewed. Papers comparing indices in persons exhibiting aggression and persons exhibiting agitation were selected for this review. Results The survey found seven papers which compared neuroanatomical indices and three papers which compared neurochemical indices. The neuroanatomical indices differentiating agitation and aggression included changes in brain perfusion, sizes of brain areas, distribution of neurofibrillary tangles, and white matter changes. The neurochemical indices differentiating agitation and aggression included relationships with neurotransmitter variables and the cell count in the locus coeruleus. Conclusion Despite the small number of papers and some methodological problems, the presented information clearly indicates that aggression and agitation are two distinct unrelated syndromes in persons with dementia.
Feb 2019 DOI 10.14302/issn.2641-9467.jgrc-19-2619
The Andean region is the centre of origin and domestication of at least 9 species of native root and tuber crops in addition to several species of native potatoes. Within this group, Mauka – also known as Miso or Taso ‒ (Mirabilis expansa Ruíz & Pav.) Standl. ‒ Nyctaginaceae) is one of the least well known, despite having much potential. It is cultivated at high altitudes (2300 to 3500 m a.s.l.) in Ecuador, Peru and Bolivia and is thought to be of pre-Inca origin. Mauka is characterized by its high nutritional value due to substantial levels of protein, calcium and phosphorus, as well as secondary metabolites with nutraceutical properties of varied application. It also has good potential as a forage plant. Based on ethnobotanical knowledge and scientific investigations, this review presents advances in the agronomic understanding of Mauka since its discovery five decades ago in several isolated rural Bolivian communities. The information presented covers both Andean and non-Andean countries. It includes results from journals on natural resources, botany, agronomy, and the congress minutes from botanical, agronomic and phytogenetic resources conferences. Theses on Mauka specifically and on phytogenetic resources in general were also reviewed. Books and manuals were reviewed in the libraries of the International Potato Center, INIAP-Ecuador, INIA-Peru and universities. The plant is described with emphasis on its agronomic traits and according to its propagation forms (seed or vegetative); in terms of its agroecology, phenology, growth dynamics and their indices, crop management, harvest and post-harvest processes. It is concluded that important advances in the understanding of the agronomy of Mauka have been accomplished. Furthermore, the review highlights aspects requiring further research, in order to develop improved production technologies to ensure its future use and conservation.
Nov 2018 DOI 10.14302/issn.2474-3585.jpmc-18-2345
Background: lifestyle modification is known as the cornerstone for prevention and treatment of chronic diseases. To promote individual’s lifestyle, the first step is to measure their lifestyle by a valid and reliable tool. The aim of present study was to evaluate psychometric properties of the Persian version of Healthy Lifestyle and Personal Control Questionnaire (HLPCQ). Method: A crosssectional study carried out on 300 medical students in Kerman University of Medical Sciences, Iran. Data collected using a questionnaire contained demographic data and Persian version of HLPCQ. The reliability of the questionnaire determined using Cronbach’s alpha and intra class correlation coefficient (ICC). The construct validity of the questionnaire evaluated by exploratory and confirmatory factor analysis. Data were analyzed by SPSS version 19 and Lisrel 8.8. Results: Internal consistency of HLPCQ was 0.78 using Cronbach’s alpha and 0.80 by ICC. In confirmatory factor analysis, the scale had acceptable goodness of fit indices. Conclusions: The Persian version of HLPCQ had excellent psychometric properties and can be used in in primary health care settings.
Aug 2018 DOI 10.14302/issn.2575-1212.jvhc-18-2167
A cohort of Pony Club horses was observed for 13 months with data collected from owner-kept diaries and monthly property visits. All horses studied had access to pasture for all or part of the day. Whilst paddock size was seldom limiting, pasture degradation was evident and observed pasture mass and composition varied greatly. Horses’ body weight indices and body condition scores also varied greatly, closely matching seasonal variations in pasture mass. Increments in bodyweight varied in a non-linear fashion with body condition score. Most horses experienced additional year-round hand-fed supplementation and half of the study horses recorded body condition scores greater than 3.5 out of 5. This suggests that the owners of Pony Club horses did not rely on pasture as the sole source of nutrition, even though, based on estimated energy demands, well-managed pasture can meet the energy requirements of Pony Club horses. Furthermore, the fact that owners appeared not to make horse feeding decisions based on body condition score resulting in obesity, raises health and welfare concerns in this cohort of horses. The inappropriate feeding of supplements observed during times of high pasture growth was a concern. Whilst the ideal pasture for Pony Club horses has not been described, it is likely to differ to those considered ideal for broodmares and other livestock because of these unique health risks associated with high levels of non-structural carbohydrate content in improved pasture species. This study highlights the need to educate owners about recognising unhealthy body conditions of horses and better managing pastures and pasture access to reduce the risk of obesity related disorders, whilst at the same time reducing pasture degradation and supplemental feed costs
May 2018 DOI 10.14302/issn.2643-6655.jcap-18-2086
In 1979, a study conducted by Ehrhardt et al. retrospectively examined childhood behavioral patterns of 30 adults; 15 identified as lesbian women and 15 identified as transmen. All 30 adults had been assigned female at birth, and, as children, all were regarded as “tomboys.” The study found several key factors that distinguished the two cohorts. The goal of this study was to replicate and extend the 1979 study, utilizing a larger sample size and including a reference group of heterosexual women. Given the major social, technological, medical, and legal paradigm shifts that have occurred over the past four decades, we sought to determine if the previous findings still differentiate the cohorts. In light of the exponential rise in the number of gender diverse and dysphoric youth who request treatment, providing optimal, affirmative care and education is paramount, especially since many of these young people seek social and/or medical transition. Exploration of the early behavioral indices of the diverse trajectories may help to inform best practices for optimal care for these young people and their families.
Jan 2018 DOI 10.14302/issn.2474-3585.jpmc-17-1836
Objective: Demographic analysis of intrauterine deaths in North-Eastern Hungary with national and international comparison. Materials and Methods: The authors collected data from the National Bureau of Statistics’ 1996-2014 database to assess frequency, gestational age, maternal age and education for six counties of the region. 722 individual cases were analyzed. A regional survey was initiated to collect more detailed data on living environment in the region between 2010 and 2014 through community midwifery services records. Results: Data over 20 years showed most intrauterine deaths (Perinatal mortality, Late fetal death, Stillbirth] occurred between 24th and 36th weeks of which 35% occurred in the North-Eastern region of Hungary. The causes of intrauterine deaths were placental abruption, cord accident, placental insufficiency, malformations and intrauterine infection. Detailed analysis regarding attendance at either the Obstetricians or the community midwifery services, the patient’s medical history and the patients’ compliance were reported, compliance in 1% completely lacked. Gravidity and multiparity were associated risk factors. A significant proportion was associated with teenage pregnancy, low maternal education, smoking risks, unemployment, dependence on social support, unhygienic environment and smaller accommodations. Lack of cooperation during antenatal care was significant. Conclusion: Frequency and distribution of intrauterine deaths in North-Eastern Hungary show a similar picture as those of socio-economic indices. The unfavorable trend came to an end in 2015, however the national statistics did not show any improvement. The solution to the problem seems to be independent of the service provision, therefore, socio-economic development of affected counties is warranted, and financial incentives and/or government aid provided during pregnancy may improve future perinatal outcomes.
Feb 2017 DOI 10.14302/issn.2476-1710.jdt-16-1346
Theaim of study is to evaluate antidepressant-like activity of the new peptidergic neuroprotectoracetyl-(D-Lys)-Lys-Arg-Arg-amide, homologous of ACTH15-18 primary amino acids sequence, that demonstrates nootropic and neuroprotective properties. Using Porsolt swimming test (PST) efficacy of tetrapeptide neuroprotector KK-1 at a single dose of 0.02 mg/kg was investigated on 16 white random bred male rats (body mass equaled 180-220 grams). Imipramine (15 mg/kg i.p.) was used as a reference drug. Then depression was induced in these rats by reserpine (4 mg/kg, i.p.). The KK-1 (intranasally, i.n.) and imipramine were administered once a day during 3 days until the reserpine-induced depression was reproduced. The indices of rats behavior under the conditions of open-field test (OFT) and PST were evaluated. The influence of both drugs on specific reserpine-induced depressions symptoms (hypothermia and blepharoptosis) was also registered. The results were processed statistically. The tetrapeptide neuroprotector KK-1 reduced immobilization time of rats at PST (statistically significant differences compared with control group), exceeding efficacy of reference drug imipramine. Normalizing of locomotor and exploratory activity in the OFT, decreasing indices of rats helplessness behavior in PST by tetrapeptide neuroprotector KK-1 demonstrates its antagonism with depressive action of reserpine. The tetrapeptide KK-1 showed antidepressant-like action both in intact rats and in rats with the model of reserpine-induced depression. It reduced specific symptoms of depression – hypothermia and blepharoptosis, exceeding the activity of reference drug imipramine.
Jan 2016 DOI 10.14302/issn.2381-862X.jwrh-15-801
Objectives: To measure the horizontal inequity in the uptake of hospital delivery and quantify the contribution of various social determinants of health (SDH) to such inequity in China from 1993-2008 Methods: With four national representative surveys in China conducted in 1993, 1998, 2003 and 2008, we measured horizontal inequity in the uptake of hospital delivery using indirect standardized concentration indices (CIs). By decomposing Cis into components, we explored the contributions of income, health insurance, education, living conditions to such inequities. Oaxaca type decomposition was further used to explain the role for each SDH on the changes of inequities between 1993 and 2008. Results: We found that horizontal inequity in the coverage of hospital delivery approached equal line in the urban areas and shrank by 90% in rural China in 1993-2008. The data also showed that dramatic socio-economic achievement was made across the 16 years, including education, income, health insurance and living conditions, which contributed substantially to the reduction of the inequities in the uptake of hospital delivery. Income’s contribution was mainly made by its protection effect, while health insurance’s role was mainly played by its equal distributions in the rural areas. Conclusions: The horizontal inequity in the uptake of hospital births vanished in urban China and decreased in the rural. The leading contributors to such inequity were income, health insurance, living conditions and education. Decomposition analysis suggests that more investments are warranted for financial risk protection and targeted demand side subsidies may make a difference.
Jan 2015 DOI 10.14302/issn.2372-6601.jhor-14-381
Haemorrhage is common to both dengue fever (DF) and dengue haemorrhagic fever (DHF). Thrombocytopaenia is exceedingly common, while prolonged partial thromboplastin time and reduced fibrinogen concentration are the other abnormal haemostatic indices evident from early in the disease course. These haematological abnormalities correlate better with the timing and severity of plasma leakage rather than the clinical haemorrhagic manifestations. Blood products including prophylactic platelet transfusions are hardly required in the management of DHF. Judicious fluid therapy is the most effective intervention to prevent complications and bleeding in DHF. Concealed haemorrhage is an important complication requiring early recognition and blood transfusions to improve outcomes. Understanding the pathogenesis of coagulopathy and the significance of altered haemostatic indices, and its co-relation to disease severity and phase of DHF, is essential for appropriate interventions particularly when DHF co-exists in patients on mandatory anticoagulation for prosthetic heart valves and atrial fibrillation.