Abstract. An outbreak of hepatitis caused by hepatitis E virus (HEV) in Abbottabad, Pakistan was traced to fecal contamination of a water system. Of 109 men hospitalized with hepatitis, 104 (95%) had serologic evidence of acute hepatitis E (IgM antibody to HEV [anti-HEV]), three (3%) probably had acute hepatitis E (high titers of IgG anti-HEV without IgM), and two had acute hepatitis A. Among a subset of 44 men with acute hepatitis E from whom three serum specimens were obtained over a four-month period, the anti-HEV IgG geometric mean titers (GMTs) decreased from 1,519 during the outbreak to 657 at four months. The IgM anti-HEV was detected in 40 (91%) of 44 sera obtained at admission (GMT ס 533 during acute disease), but in only six (14%) four months later. The prevalence of anti-HEV in this population before the outbreak was estimated to be 30%. The presence of IgG anti-HEV appeared to protect against clinical hepatitis or development of serologic evidence of new infection with HEV. This is the second major epidemic of hepatitis E in the Pakistani military confirmed by an anti-HEV enzyme-linked immunosorbent assay (ELISA). Evidence that pre-existing antibody as measured by this ELISA protects against disease is important for assessment of vaccine development.
The science of formulation involving cosmetic ingredients has always been a challenge since the release of active components greatly depends upon the carrier system involved and the selectivity of skin barrier. The principle obstacle of the skin resides in the epidermis and it's hard for many active components to cross it. The formulation related factors like size of particles, viscosity and lipophilicity of the components also play an important role in permeation of the dermal composition. Though widely used; conventional creams and gels still struggle in terms of success. This work focuses on nano based formulation strategies for successful delivery of cosmetic agents. Novel strategies like nanoemulsion, nanogels, liposomes, aquasomes, niosomes, dendrimers and fullerenes have paved way for successful delivery of dermal formulations to desire depths in the skin.
Background. Obstructive sleep apnea (OSA) is associated with coronary artery disease. Intermittent hypoxia associated with OSA increases sympathetic activity and may cause systemic inflammation, which may contribute to atherosclerosis leading to an increase in the size of carotid intima media thickness (CIMT). Methods. PubMed and Cochrane library were reviewed by utilizing different combinations of key words: sleep apnea, carotid disease, intima media thickness, and carotid atherosclerosis. Inclusion criteria were English articles; studies with adult population with OSA and without OSA; CIMT recorded by ultrasound in mean and standard deviation or median with 95% confidence interval; and OSA defined as apnea hypopnea index of ≥5/h. A total of 95 studies were reviewed for inclusion, with 16 studies being pooled for analysis. Results. Ninety-five studies were reviewed, while 16 studies were pooled for analysis; since some studies have more than one data set, there were 25 data sets with 1415 patients being pooled for meta-analysis. All studies used ultrasound to measure CIMT. CIMT standardized difference in means ranged from −0.883 to 8.01. The pooled standardized difference in means was 1.40 (lower limit 0.996 to upper limit 1.803, (P < 0.0001). Conclusion. Patients with OSA appear to have increased CIMT suggestive of an atherosclerotic process.
Fifty-two normally pregnant women underwent echocardiography to examine their pericardium in the first, second and third trimester. Pericardial effusion was noted in 15.3% of the women (n = 8) in the first trimester, 19.2% (n = 10) in the second trimester and 44.2% (n = 23) in the third trimester of pregnancy. Pericardial effusion during pregnancy was found to be completely resolved in all patients who underwent an echocardiogram 6 weeks post delivery (n = 11). There was no statistically significant difference in age, hemoglobin, total protein, albumin/globulin ratio or mean blood pressure during pregnancy between those who developed pericardial effusion and those who did not. The frequency of occurrence of pericardial effusion in primigravidas at 69.2% (9/13) was higher than that in multigravidas, with a ratio of 35.9% (14/39), the difference being statistically significant (p less than 0.025). The frequency of occurrence of pericardial effusion in patients who gained more than 12 kg during pregnancy at 67.7% (11/17) was higher than in patients who gained less than 12 kg, with a ratio of 34.3% (12/35), the difference being statistically significant (p less than 0.025).
, midstream urine specimens were collected during the first antenatal visit of 2,642 pregnant patients. The specimens were obtained for the purpose of microbiological study. Significant bacteriuria was found in 15.8% (N = 419); 188 of the patients were asymptomatic and 231 were symptomatic, yielding an incidence of 7.1% and 8.7%, respectively. Two hundred females with negative urine cultures were selected as a control group, and matched by age, gravidity, and gestational age. The frequency of occurrence of premature birth was found to be higher only in the symptomatic group (P < 0.05), while the frequency of anemia, hypertension, and diabetes was found to be higher in both symptomatic and asymptomatic patients, compared with the control group (P <0.05).H Abduljabbar, RA Moumena, HA Mosli, AS Khan, A Warda, Urinary Tract Infection in Pregnancy. 1991; 11(3): 322-324 Urinary tract infections (UTIs) are second in frequency only to respiratory tract infections in the general practice of medicine [1]. Females are more prone than males to UTIs, and this tendency seems to increase during pregnancy. This increased predisposition to UTIs during pregnancy is partly the result of the pressure of the gravid uterus on the ureters causing stasis of urine flow and is also attributed to the hormonal and immunological changes that occur during normal pregnancy [1].We report on a study carried out at King Abdulaziz University Hospital, Jeddah, that was designed to determine the frequency of significant bacteriuria in healthy pregnant females and its impact on pregnancy. Material and MethodsIn a prospective study conducted over a one-year period from 1987 to 1988, midstream urine samples were collected from 2642 pregnant females who had no apparent underlying medical ailments. All patients were attending the antenatal clinic at King Abdulaziz University Hospital, Jeddah. The urine samples were collected under supervision, using proper aseptic precautions, and were cultured using the Dip Strip technique [2]. Colonies were identified using standard methods [3]. Gram-negative bacilli were identified using the AP120E system.
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