Do Deeper Levels of Cervical Biopsies Preceded by a Pap Smear Diagnosis of LSIL, ASCUS, or NILM/HPV+ Increase the Yield of Identifying Clinically Significant Lesions?

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S163-S164
Author(s):  
K G Manjee ◽  
W G Watkin
Keyword(s):  
Pap Smear ◽  
Past History ◽  
Prior History ◽  
Cervical Biopsy ◽  
P16 Immunohistochemistry ◽  
Hpv Status ◽  
Significant Difference ◽  
History Of ◽  
Clinically Significant ◽  
Almost All

Abstract Introduction/Objective Cervical biopsy is performed following an abnormal pap smear or positive HPV testing in an attempt to uncover clinically significant lesions [HSIL/invasive carcinoma (HSIL+)]. An excisional procedure is considered if biopsy confirms HSIL+. When preceded by pap smear of LSIL, ASCUS, NILM/HPV+ or persistent HPV, continued surveillance is recommended for biopsies showing no SIL or LSIL. In our laboratory, cervical biopsies are routinely sectioned at 3 levels. Deeper levels are often ordered when initial sections are non-diagnostic. p16 immunohistochemistry, with or without deeper levels, is often ordered to confirm HSIL, or to differentiate HSIL from mimics. In this study, we examine whether and in what clinical situations does obtaining additional levels uncover clinically significant lesions. Methods 430 cervical biopsies between January-May 2018, with recent cytology of LSIL, ASCUS or NILM/HPV+ were identified in the pathology database. HPV status (if known), final biopsy diagnosis and past history of LSIL/HSIL were recorded. For each biopsy, orders for additional levels and/or p16 immunohistochemistry were recorded resulting in 4 categories: C1-no additional levels or p16, C2-deeper only, C3-deeper+p16 and C4-p16 only. Final diagnoses were divided into HSIL+, LSIL and no SIL. Results There was no significant difference in prior history of LSIL/HSIL and HPV status between all categories. Biopsy results were as follows: HSIL+: 11/222 (5%) C1; 1/78 (1%) C2; 7/43 (16%) C3; 15/87 (17%) C4 LSIL: 91/222 (41%) C1; 7/78 (9%) C2; 16/43 (37%) C3; 35/87 (40%) C4 No SIL: 120/222 (54%) C1; 70/78 (90%) C2; 20/43 (46%) C3; 37/87 (42%) C4 The average number of additional levels in C2 and C3 was 3.8 and 1.8, respectively. Conclusion Deeper levels alone did not enhance the detection of HSIL+. Almost all LSIL/HSIL were detected when initial levels were diagnostic or suspicious and supported by p16 immunohistochemistry. 3 levels are adequate to detect clinically significant lesions.

Predictors Factors of Onset de Novo Heart failure after STEMI

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
S Abouradi ◽  
H Choukrani ◽  
A Maaroufi ◽  
A Drighil ◽  
R Habbal
Keyword(s):  
Heart Failure ◽  
De Novo ◽  
Microvascular Disease ◽  
Prior History ◽  
Killip Class ◽  
Funding Sources ◽  
Significant Difference ◽  
Primary Coronary Angioplasty ◽  
History Of ◽  
Predictor Factors

Abstract Funding Acknowledgements Type of funding sources: None. INTRODUCTION STEMI gets complicated very often by a heart failure (HF), which it is important to know associated factors. The aim of this study  was to determinate the predictor factors of onset of de novo HF after STEMI in patients with no prior history of heart failure recorded at baseline. METHODS A retrospective, descriptive study from 1 center in Morocco, including 210 patients hospitalized in a cardiology intensive care unit for STEMI from September 2019 to November 2020. The main outcomes were HF Killip class at hospital presentation and intra-hospital mortality. RESULTS The main age was 59.3 ± 7.02 and Sex ratio: 2, 86. The incidence of de novo HF at admission was higher in women (40, 4% vs. 29.5%, [OR 1, 61; 95%, [CI] 0, 83-3, 11). Forty-nine point eight percent were in Killip≥ 2. The method of early revascularization was Thrombolysis in 82, 3% compared to primary coronary angioplasty without significant difference in onset of the novo HF. There was no association of age, comorbidities, delay to hospital presentation and coronary involvement with incidence of onset of de novo HF.  Women had higher mortality than men with the novo HF (28, 6% vs. 20.5%; OR: 1, 55; 95%). CONCLUSION  Gender has appeared associated to onset of de novo HF after STEMI with a superiority of the female sex after controlling for others factors described in the literature. Anterior studies have related this to the increased prevalence of microvascular disease in women predisposing them to heart failure after STEMI.

Internal Jugular Microembolic Signal Detection in a Patient with Cerebral Sinus Thrombosis Complicated by Pulmonary Embolism

2017 ◽  
Vol 41 (2) ◽  
pp. 74-75
Author(s):  
Laligam Sekhar ◽  
Kyra Becker ◽  
Anne Moore ◽  
Vanessa Tran
Keyword(s):  
Pulmonary Embolism ◽  
Sinus Thrombosis ◽  
Transverse Sinus ◽  
Prior History ◽  
Sagittal Sinus ◽  
Microembolic Signal ◽  
Significant Difference ◽  
History Of ◽  
Blurry Vision ◽  
Clot Burden

A 40-year-old woman with prior history of headaches, left-sided weakness, and diplopia was diagnosed with right sigmoid and transverse sinus thrombosis; increased intracranial pressure and associated cerebral venous infarction that underwent 12 months anticoagulation and then stopped. She has been off anticoagulation for about a year then started not “feeling right,” and was diagnosed with pneumonia and pulmonary embolism. During her course of hospitalization, she presented with progressive headache, possible left-sided weakness, associated blurry vision, nausea, and vomiting. Magnetic resonance venogram (MRV) shows lack of flow-related signals within the left half of the distal superior sagittal sinus, left transverse sinus, and nonocclusive thrombus in the left sigmoid sinus. Mechanical sinus thrombectomy attempted without significant difference in clot burden. A transcranial Doppler (TCD) emboli monitoring exam was ordered and was performed on the bilateral internal jugular for 15 min each. Microembolic signals detected: 52 emboli per hour right internal jugular vein (IJV), and 32 emboli per hour left IJV. She was discharged on methazolamide, furosemide, topiramate, and lifelong warfarin. No major events have been reported since discharge from 2008 to 2016.

scholarly journals The Impact of COVID-19 on Epilepsy Care: A Survey of the American Epilepsy Society Membership

2020 ◽  
Vol 20 (5) ◽  
pp. 316-324
Author(s):  
Dara V. F. Albert ◽  
Rohit R. Das ◽  
Jayant N. Acharya ◽  
Jong Woo Lee ◽  
John R. Pollard ◽  
...  
Keyword(s):  
Elective Surgery ◽  
Clinical Care ◽  
Single Point ◽  
The United States ◽  
Prior History ◽  
Delivery Of Care ◽  
History Of ◽  
Almost All ◽  
The Impact ◽  
New Onset

The COVID-19 pandemic has impacted the delivery of care to people with epilepsy (PWE) in multiple ways including limitations on in-person contact and restrictions on neurophysiological procedures. To better study the effect of the pandemic on PWE, members of the American Epilepsy Society were surveyed between April 30 and June 14, 2020. There were 366 initial responses (9% response rate) and 337 respondents remained for analysis after screening out noncompleters and those not directly involved with clinical care; the majority were physicians from the United States. About a third (30%) of respondents stated that they had patients with COVID-19 and reported no significant change in seizure frequency. Conversely, one-third of respondents reported new onset seizures in patients with COVID-19 who had no prior history of seizures. The majority of respondents felt that there were at least some barriers for PWE in receiving appropriate clinical care, neurophysiologic procedures, and elective surgery. Medication shortages were noted by approximately 30% of respondents, with no clear pattern in types of medication involved. Telehealth was overwhelmingly found to have value. Among the limitation of the survey was that it was administered at a single point in time in a rapidly changing pandemic. The survey showed that almost all respondents were affected by the pandemic in a variety of ways.

scholarly journals Supplement Usage Pattern in a Group of COVID- 19 Patients in Tehran

2020 ◽  
Author(s):  
Maryam Bagheri ◽  
Fedyeh Haghollahi ◽  
Mamak Shariat ◽  
Mina Jafarabadi ◽  
Parastoo Aryamloo ◽  
...  
Keyword(s):  
Vitamin D3 ◽  
Past History ◽  
Clinical Signs ◽  
Clinical Findings ◽  
Usage Pattern ◽  
Cross Sectional ◽  
Outpatient Group ◽  
Significant Difference ◽  
Supplement Usage ◽  
History Of

Objective: The coronavirus disease 19 (COVID-19) is a highly transmittable and pathogenic viral infection, causes severe acute respiratory syndrome and was spread throughout the world in early 2020. The effects of vitamin and micronutrient supplements on the prevention and treatment of COVID- 19 seems challenging in scientific considerations. On the other side generally, experts warn against over-consumption of these supplements. Materials and methods: This study aimed to investigate the vitamin and micronutrient supplementation usage pattern in past history of patients with COVID-19 via a cross-sectional inquiry. Totally 510 patients referring to the infectious disease clinic of Imam Khomeini Hospital in Tehran from March 2020 to May 2020 were recruited. The inclusion criterion was suspected patients for COVID-19 based on clinical findings and CT scans of the lung. The infected patients included both inpatients (171) and outpatients (339). Demographic information, clinical signs, and the supplement pattern use were collected through a questionnaire and the data were statistically analyzed. Results: Vitamin D3 intake was reported in 30% (103 patients) of outpatients and 16.5% (28 patients) of hospitalized patients, which is statistically significant (P=0.001). It shows that, the frequency of vitamin D3 consumption in the outpatient group was higher than inpatient group. This significant difference has also been shown in zinc consumption, in 29 patients (9%) outpatients versus 4 patients (2%) inpatients were reported (P=0.007). Multi nominal regression showed that vitamin D3 intake has a supportive effect and reduces the risk of exacerbation and worsening of the disease. (OR=0.291; 95% CI 0.102-.0834, P=0.022). Conclusion: According to the results of the present study and the findings of other studies, considering the supportive effect of vitamin D3 in reducing the severity of infectious diseases; Clinical trials with an appropriate sample size are recommended to investigate the functional role of this vitamin in improving viral diseases of the respiratory tract.

scholarly journals ASXL1/SRSF2 Co-Mutated Acute Myeloid Leukemia (AML): A Rare but Distinct Subpopulation with Dismal Outcomes

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 2598-2598
Author(s):  
Daniel R. Richardson ◽  
David M Swoboda ◽  
Anastasia Ivanova ◽  
Steven M Johnson ◽  
Jonathan Galeotti ◽  
...  
Keyword(s):  
Research Funding ◽  
Multivariable Analysis ◽  
Prior History ◽  
Treatment Intensity ◽  
Cell Transplant ◽  
Myeloid Neoplasm ◽  
Significant Difference ◽  
History Of ◽  
Baseline Characteristics

Background: Advances in the understanding of the genetic determinants of AML and the widespread use of next-generation sequencing (NGS) have led to the refinement of prognostically distinct molecular subgroups. Mutations in ASXL1 and SRSF2, which are common in myelodysplastic syndrome (MDS) and myeloproliferative neoplasms (MPNs), rarely co-occur in patients (pts) with AML. The largest reported cohort (n=15) of ASXL1/SRSF2 co-mutated AML had no long-term survivors (Papaemmanuil et al. NEJM 2016). It remains unknown how clinical factors such as prior history of a myeloid neoplasm or intensity of treatment influence outcomes. We sought to assess the clinical characteristics and analyze outcomes in a larger cohort of pts with ASXL1/SRSF2 co-mutated AML. We hypothesized that this profile may be a genomic footprint of prior myeloid neoplasia. Methods: We conducted a multi-institutional retrospective analysis of newly diagnosed adult AML pts with both ASXL1 and SRSF2 mutations at the University of North Carolina and at Moffitt Cancer Center from 2011-2018. NGS was performed on DNA using the Illumina TruSight Myeloid 54-gene sequencing panel. The primary endpoint was overall survival (OS) defined as time from diagnosis of AML to death. Pts were stratified by secondary AML (s-AML), defined as having a documented history of MDS/MPN. Secondary outcomes included rates of complete remission (CR) and CR with incomplete hematologic recovery (CRi). Multivariable analysis was performed with baseline characteristics. Results: Forty-six pts were identified and included. The median age of pts was 72 years (range 42 - 85). Sixty-seven percent (28/42) had normal cytogenetics; 88% (37/42) were intermediate risk cytogenetics by current ELN guidelines. Sixty-one percent (n=28) were classified as having s-AML. One pt had therapy-related AML without preexisting MDS/MPN and was therefore not included in s-AML. The Figure illustrates co-existing mutations and individual responses to upfront therapy stratified by s-AML and non-s-AML. The median number of mutations was 5 (range 2 - 7). The most common co-occurring mutations were TET2 (52%), RUNX1 (35%), IDH2 (15%), and STAG2 (15%). Median OS was 7.0 months (m) (CI 5.3, 15.4). Median OS for pts with s-AML (n=28) and non-s-AML (n=18) was 6.1 and 15.4 m (p=0.05), respectively. There was no significant difference in median OS between s-AML and non-s-AML on multivariable analysis (hazard ratio (HR) = 2.56, p=0.07). Median OS did not differ by age (Age <65 years v. older, p=0.54), total # of mutations (≥ 5 v. less, p=0.73), or etiology of s-AML (MDS v. MPN, p=0.66). Twenty-two (47%) pts received upfront intensive induction chemotherapy (IC), 17 (37%) received hypomethylating agents (HMAs), and 7 pts (15%) received no AML-directed chemotherapy. Median OS did not significantly differ between pts receiving upfront IC and HMAs (15.3 v. 7.04 m, p=0.21). Among non-s-AML pts, median OS was longer in those receiving IC (n=10) versus HMAs (n=7) (15.4 v. 3.5 m, p=0.01). Among all pts receiving IC, median OS was longer in non-s-AML pts (n=10) versus s-AML pts (n=12) (15.4 v. 5.9 m, p=0.01). Median OS did not differ by treatment intensity for s-AML pts (IC v. HMA: 5.9 v. 9.9 m, p=0.38). Six pts underwent allogeneic hematopoietic cell transplant (HCT) with a median OS NR (median follow-up 15.6 m). Overall rate of CR/CRi was 35% and was similar between pts receiving IC and HMAs (45% v. 21%, p=0.29). Among pts with non-s-AML, CR/CRi rates with IC and HMAs were 70% and 29%, respectively (p=0.11). Among pts with s-AML, CR/CRi rates with IC and HMAs were 42% and 20%, respectively (p=0.38). On multivariable analysis of baseline characteristics, only ECOG performance status (PS) was significantly associated with OS (HR 2.25, p=0.01). ECOG PS remained significant (HR 2.65, p=0.03) after adjusting for HCT and treatment intensity. Conclusions: ASXL1/SRSF2 co-mutated AML represents a rare but distinct genotype with most pts having pre-existing myeloid neoplasms and associated co-mutations commonly seen in MDS/MPNs. OS is dismal regardless of age, number of mutations, treatment intensity, or prior history of myeloid neoplasm. HCT may mitigate these poor outcomes and lead to long-term survival. This represents the largest reported cohort to date of pts with ASXL1/SRSF2 co-mutated AML. Further study is warranted to inform risk stratification and prognosis of pts with ASXL1/SRSF2-mutated AML. Disclosures Foster: Bellicum Pharmaceuticals, Inc: Research Funding; Daiichi Sankyo: Consultancy; MacroGenics: Research Funding; Celgene: Research Funding. Coombs:Octopharma: Honoraria; Pharmacyclics: Honoraria; Medscape: Honoraria; Abbvie: Consultancy; Loxo: Honoraria; Cowen & Co.: Consultancy; Dedham Group: Consultancy; H3 Biomedicine: Honoraria; Covance: Consultancy. Sallman:Celyad: Membership on an entity's Board of Directors or advisory committees. Zeidner:Agios: Honoraria; Celgene: Consultancy, Honoraria, Research Funding; Daiichi Sankyo: Honoraria; Tolero: Honoraria, Research Funding; Pfizer: Honoraria; AsystBio Laboratories: Consultancy; Merck: Research Funding; Takeda: Research Funding; AbbVie: Honoraria.

Adverse Pulmonary Responses to Aspirin and Acetaminophen in Chronic Childhood Asthma

PEDIATRICS ◽  
1983 ◽  
Vol 71 (3) ◽  
pp. 313-318
Author(s):  
Thomas J. Fischer ◽  
Timothy D. Guilfoile ◽  
Hemant H. Kesarwala ◽  
John G. Winant ◽  
Gregory L. Kearns ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Flow Rate ◽  
Past History ◽  
Forced Expiratory Volume ◽  
Base Line ◽  
Double Blind ◽  
Asthmatic Children ◽  
Significant Difference ◽  
History Of ◽  
Expiratory Flow

Because aspirin (ASA) is often reported to have an adverse effect on pulmonary function in children with chronic asthma, acetaminophen is commonly used as an ASA substitute in these children. To study acetaminophen effects on pulmonary functions, double-blind, oral challenges of ASA (600 mg), acetaminophen (600 mg), or lactose were administered on separate days to 25 chronic asthmatics, ten boys and 15 girls, ranging in age from 8 to 18 years (mean age ± 1 SD: 12.5 ± 2.8 years). No patient had a past history of adverse reactions to either drug. Forced expiratory volume in 1 second (FEV1), peak expiratory flow rate (PEFR), maximal mid-expiratory flow rate (FEF25-75), forced vital capacity (FVC), maximal voluntary ventilation (MVV), and flow volume curves were measured at base line and ½, 1, 2, 3, and 4 hours after ingestion of drug or placebo. Persistent decreases from base line FEV1 (&gt; 20%) or FEF25-75 (&gt; 30%) occurred in four ASA- and two acetaminophen-challenged patients. One ASA-sensitive patient was placebo intolerant; another reacted to acetaminophen. The acetaminophen responses were of less intensity than the ASA responses. Analysis of group mean pulmonary function responses to ASA, acetaminophen, and lactose showed no significant difference among the three agents at any time. Aspirin should be used cautiously in asthmatic children. Acetaminophen appears to be an adequate, although not completely, innocuous ASA substitute.

Suicide in probation: Towards the ideation-to-action model

2021 ◽  
pp. 026455052110415
Author(s):  
Charlie Brooker ◽  
Karen Tocque ◽  
Georgia West ◽  
Alice Norman-Taylor ◽  
James Fowler
Keyword(s):  
Suicide Ideation ◽  
Suicide Attempts ◽  
Psychological Treatment ◽  
Secondary Analysis ◽  
Control Group ◽  
Significant Difference ◽  
Action Model ◽  
History Of ◽  
Clinically Significant ◽  
A Prospective Study

Suicide in probation services is far higher than the general population. This paper presents secondary analysis of data previously used to evaluate the outcome of delivering psychological treatment to probationers in London. A sample of probation service users who screened positive for clinically significant symptoms of distress and were subsequently assessed and offered treatment ( n = 274) were allocated retrospectively to one of three groups: those with a history of suicidal ideations but no suicide attempts (ideation group), those with a history of a suicidal act (attempt group) or a control group where suicide was not evident (no history group). Results indicate no significant difference between the ideation and the attempt groups, but significant differences between these and the no history group. The findings are discussed within the context of the suicide ideation-to-action models that have been debated in other offender settings. We conclude that a more nuanced understanding of suicidal acts and suicide attempts is required in probation services including a prospective study that tests the ideation-to-action model.

Breakthrough Fungal Infections after Allogeneic Hematopoietic Stem Cell Transplantation in Patients on Prophylactic Voriconazole.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 2849-2849 ◽  
Author(s):  
Steve Trifilio ◽  
Seema Singhal ◽  
Stephanie Williams ◽  
Jane Winter ◽  
Martin Tallman ◽  
...  
Keyword(s):  
Fungal Infections ◽  
Past History ◽  
Therapeutic Drug ◽  
Prior History ◽  
Pharmacokinetic Data ◽  
Therapeutic Success ◽  
Hematopoietic Stem ◽  
Exact Test ◽  
History Of ◽  
Anti Fungal

Abstract Voriconazole is a triazole anti-fungal agent with excellent activity against Aspergillus spp. We use liquid itraconazole 200 mg PO twice daily from day 0 to a month beyond discontinuation of all immunosuppression as standard anti-fungal prophylaxis after allogeneic HSCT in patients with no prior history of aspergillosis. This is changed to PO voriconazole 200 mg twice daily if corticosteroid therapy is started for GVHD. Voriconazole is continued even after steroid therapy is discontinued. Patients with a past history of aspergillosis get voriconazole from day 0. 71 allograft recipients who received voriconazole, and in whom complete clinical, microbiologic, and pharmacokinetic data were available were studied to determine the efficacy of voriconazole in preventing invasive fungal infections (IFI). 17 patients had not received itraconazole previously. The remainder had received itraconazole for 1–161 days (median 14). The length of voriconazole therapy was 6–956 days (median 133). The total number of patient-days on voriconazole was 13805 (~38 years). A total of 10 IFIs were seen in patients on voriconazole: Candida glabrata (n=5), Candida krusei (n=1), Cunninghamella (n=1), Rhizopus (n=2), and Mucor (n=1). The figure below shows the actuarial probability of IFI − 18% at 1 year. Figure 1 Figure 1. It is noteworthy that while 4 cases of zygomycosis were seen, no case of Aspergillus infection was seen. The figure below shows the actuarial probability of zygomycosis − 7% at 1 year. Zygomycetes are generally not susceptible to voriconazole, and thus breakthrough infections are not surprising. However, C. glabrata and C. krusei are often susceptible to voriconazole with MICs of <2 μ g/mL (Spellberg et al. Clin Infect Dis2006;42:244–251). In that context, it is interesting that plasma steady-state trough voriconazole levels around the time the infection occurred were <0.2, <0.2, 0.33, 0.55, 0.63, and 1.78 μ g/mL in the 6 candidiasis cases. Excluding the 4 zygomycosis cases, all 6 candidiasis cases were seen amongst the 43 patients with voriconazole levels of ≤ 2 μ g/mL and none amongst the 24 with levels of >2 μ g/mL (P=0.061; Fisher’s exact test). This observation is in keeping with a recent report that showed correlation between voriconazole levels and therapeutic success in aspergillosis (Smith et al. Antimicrob Agents Chemother2006;50:1570–1572). We conclude that (1) voriconazole is extremely effective at preventing aspergillus infections, (2) zygomycosis is a concern in voriconazole-treated patients although the incidence appears low, and (3) therapeutic drug monitoring with dose adjustment may be indicated in patients on voriconazole to avoid breakthrough infections with fungi that are otherwise susceptible to the drug. Figure 2 Figure 2.

scholarly journals First Report of Cattle Tick Rhipicephalus (Boophilus) annulatus in Egypt Resistant to Ivermectin

Insects ◽  
2019 ◽  
Vol 10 (11) ◽  
pp. 404 ◽  
Author(s):  
Saeed El-Ashram ◽  
Shawky M. Aboelhadid ◽  
Asmaa A. Kamel ◽  
Lilian N. Mahrous ◽  
Magdy M. Fahmy
Keyword(s):  
Immersion Test ◽  
Tick Control ◽  
Cattle Tick ◽  
First Report ◽  
Significant Difference ◽  
History Of ◽  
Rhipicephalus Annulatus ◽  
Almost All ◽  
Lower Slope ◽  
Egg Fertility

Tick control is mainly dependent on the application of acaricides, but resistance has developed to almost all classes of acaricides, including macrolactones. Therefore, we aimed to investigate ivermectin resistance among tick populations in middle Egypt. The larval immersion test was conducted using a commercial formulation of ivermectin (1%). Different concentrations of the immersion solution (0.0000625% (625 × 10−7%), 0.000125% (125 × 10−6%), 0.0005% (5 × 10−4%), 0.001% (1 × 10−3%), 0.0025% (2.5 × 10−3%), 0.005% (5 × 10−3), and 0.01% (1 × 10−2%)) were prepared by diluting a commercial ivermectin (1%) with distilled water containing 1% (v/v) ethanol and 2% (v/v) TritonX-100. Field populations of Rhipicephalus annulatus were collected from five different localities in Beni-Suef province, Egypt. Adult engorged female ticks were collected and assessed for oviposition and egg fertility. Eggs were collected, and hatched larvae were then used in the experiment. Application of acaricides was conducted on 10-day-old larvae. There was a significant difference in the LC50 (50% lethal concentration) among the examined localities on the log dose-response plot, where, the LC50 of tick populations from two localities (Emin elaros and Aldiabia) was higher than the other localities (Alhalabia, Alkom, and Beshnna). Besides, tick populations from Emin elaros and Aldiabia showed higher LC90 values with lower slope values compared to those from Alhalabia, Alkom, and Beshnna. According to these values (LC50, LC90, and slope values), as well as a history of acaricide failure to ticks in these areas, R. annulatus developed resistance to ivermectin. This study documents the first report of field populations of R. annulatus resistant to ivermectin in Egypt.

scholarly journals Awareness regarding pulmonary tuberculosis among the middle aged adults of the selected community

2018 ◽  
Vol 8 (4) ◽  
pp. 27-33
Author(s):  
Nisha Khatri ◽  
Babita Thapa
Keyword(s):  
Infectious Disease ◽  
Pulmonary Tuberculosis ◽  
Past History ◽  
Positive Family History ◽  
Signs And Symptoms ◽  
Structured Interview ◽  
History Of ◽  
Community People ◽  
Almost All ◽  
Middle Aged Adults

Tuberculosis is a highly contagious infectious disease worldwide. Tuberculosis causes ill-health among millions of people each year and ranks as the second leading cause of death from an infectious disease worldwide. A descriptive exploratory study design was conducted among 106 middle adulthood Community people of Saptakoshi Municipality of Saptari District, between 2074/06/3 to 2074/06/1 using non-probability purposive sampling method, and data was collected using semi-structured interview schedule. More than half of the respondents (62.3%) were of the age group 40-49 years, nearly half (50.9%) were Female. Near about one fifth (19%) of the respondents had positive family history of tuberculosis. Majority of the respondents (98.1%) stated cause of tuberculosis as bacteria. Almost all the respondents were aware about the signs and symptoms of tuberculosis. Only 12.3% of the respondents were aware about DOTS Programme. A significant association (p=0.037) was revealed between level of awareness and Past history of previous exposure to Pulmonary Tuberculosis

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