scholarly journals Hematological and Biochemical Profile of Patients Infected with Schistosoma mansoni in Comparison with Apparently Healthy Individuals at Sanja Town, Northwest Ethiopia: A Cross-Sectional Study

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Nega Dessie ◽  
Wossenseged Lema ◽  
Mulugeta Aemero
Keyword(s):  
Blood Cell ◽  
Schistosoma Mansoni ◽  
Parasite Density ◽  
Northwest Ethiopia ◽  
Control Group ◽  
Mean Corpuscular Hemoglobin ◽  
Cross Sectional ◽  
Biochemical Profiles ◽  
The Mean ◽  
Apparently Healthy

Background. Schistosomiasis is a parasitic disease that resides in the vascular system of vertebrates, causing a chronic, debilitating disease that affects more than 200 million people and 800,000 deaths per year in over 70 countries. This parasite causes liver dysfunction and disorders normal hematological and biochemical profiles in addition to portal vein hypertension syndrome, ascites, and liver fibrosis. The general objective of the current study is to assess hematological and biochemical profiles of patients infected with Schistosoma mansoni in comparison with apparently healthy individuals (control group) in Sanja town, northwest Ethiopia. Method. A comparative cross-sectional study was conducted from February to April 2019 among microscopically confirmed S. mansoni-infected patients attending Sanja hospital and apparently healthy (control group) from Sanja town community. A total of 220 participants, 110 from the S. mansoni-infected and 110 from the control group, were enrolled using convenient sampling technique. Three grams of stool and six milliliters of blood samples were collected from each study participant. Stool samples were processed using the Kato–Katz technique to determine infection and count parasite density. The blood sample was processed for the analysis of hematological and biochemical profiles using Cell Dyn 1800 (Abbot Hematology, IL, USA) and iChem535 chemistry analyzer, respectively. All data were analyzed using SPSS version 20, and P value less than 0.05 was taken as statistically significant. Results. This study showed that the mean values of serum alanine aminotransferase, aspartate aminotransferase, total protein, total cholesterol, hemoglobin, mean corpuscular hemoglobin concentration, and total white blood cell count were different in the Schistosoma mansoni-positive group as compared with the control group with statistically significant value (P≤0.05). However, the mean values of blood glucose, red blood cell, packed cell volume, and granulocyte count difference were not statistically significant (P≥0.05). The mean value of hemoglobin, red blood cells, blood glucose, mean corpuscular hemoglobin concentration, total protein, total cholesterol, and total white blood cell was significantly dropped in the moderate and heavy S. mansoni parasitic load patients as compared with the control group and light S. mansoni parasite density patients. However, the mean of AST and ALT progressively elevated as the burden of S. mansoni increased. Conclusion. Most hematological and biochemical profiles were significantly lower in the Schistosoma mansoni-positive group as compared with the control group. Most hematological and biochemical profiles decline significantly as the parasite density increased. Hence, with Schistosoma treatment, supportive treatment against hematological and biochemical disorders is recommended.

PERIPHERAL BLOOD CELL CHARACTERISTICS OF LAOTIAN STUDENTS IN HUE

2020 ◽  
pp. 45-49
Author(s):  
Triet Le Phan Minh ◽  
Keopaseuth Phoukhong ◽  
Nghiem Nguyen Dac Duy ◽  
Duong Ha Nu Thuy ◽  
Thu Hoang Thi Anh ◽  
...  
Keyword(s):  
Blood Cell ◽  
Blood Cells ◽  
Blood Count ◽  
Complete Blood Count ◽  
White Blood Cells ◽  
Peripheral Blood Cell ◽  
Mean Corpuscular Hemoglobin ◽  
Cross Sectional ◽  
Significant Difference ◽  
The Mean

Background: To evaluate the complete blood count of Laotian students in Hue city. Materials and method: A cross-sectional study on 400 Lao students who were examinated the complete blood count at Department of Hematology, Hue University of Medicine and Pharmacy from September 2019 to May 2020. Results: 400 Lao students (male/female = 1/1.2), the students who came from Salavan province accounted for the highest percentage (22.25%). The mean of age was 24.78 ± 6.44 (17 - 44). The mean of red blood cells (RBC) was 5.13 ± 0.73 T/L and of hemoglobin in the study group was 129.27 ± 18.58 g/L. The percentage of students with anemia was 13.5% and there were 3 students with severe anemia. The mean of mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) were respectively 81.27 ± 9.32 fL (49.2 - 103.9) and 25.50 ± 3.56 pg (11.8 - 33.2). The mean of white blood cells (WBC) and platelets (PLT) were respectively 7.42 ± 2.29 G/L and 272.33 ± 83.62 G/L. There was a correlation between anemia and age (p < 0.05), mainly in 26 - 40. There was significant difference about RBC and Hb between anemic group and non-anemic group (p < 0.05). Conclusion: It is essential to check the complete blood count of Laotian students to evaluate anemia and screen hemoglobinopathies. Keywords: Laotian students, red blood cell (RBC), white blood cell (WBC), platelet (PLT), hemoglobin (Hb)

scholarly journals COMPARISON OF HEMATO-BIOCHEMICAL PARAMETERS BETWEEN APPARENTLY HEALTHY AND BOVINE TUBERCULOSIS AFFECTED CATTLE IN CHITTAGONG, BANGLADESH

2018 ◽  
Vol 16 (1) ◽  
pp. 53-57
Author(s):  
M. B. Hossain ◽  
M. M. Khan ◽  
M. A. Rumi ◽  
M. Ahammed ◽  
M. S. Bari
Keyword(s):  
Bovine Tuberculosis ◽  
Tuberculin Test ◽  
Cross Sectional Study ◽  
Control Group ◽  
Serum Samples ◽  
Cross Sectional ◽  
Healthy Cattle ◽  
Serum Biochemical ◽  
Biochemical Profiles ◽  
Apparently Healthy

The cross-sectional study was carried out to compare the hematological and serum biochemical profiles between bovine tuberculosis (bTB) affected and apparently healthy cattle during the period from March 2014 to October 2016. A total of 189 blood samples were collected from 93 bTB affected and 96 apparently healthy cattle of 3 Upazilas of Chittagong. The bovine tuberculosis (bTB) was diagnosed primarily by Caudal Fold Tuberculin Tests (CFTT) and confirmed by the Comparative Intradermal Tuberculin Test (CITT). The whole blood was analyzed for hematology, and serum samples were used for biochemical analysis. The study revealed that, the values for TEC, Hb and PCV were higher in infected cohort (based on CFTT) in compare to their counterpart control group. Among these three parameters only PCV values were statistically significant (P ≤ 0.05). Only basophil percentage was significantly (P ≤ 0.05) higher in infected cohort. The values of total protein, albumin, creatinine and SGOT were insignificantly lower and the values of calcium & phosphorus were also insignificantly higher in bTB affected cattle than control group of cattle.

Effect of Medialization of the Trochlear Groove and Lateralization of the Tibial Tubercle on TT-TG Distance: A Cross-sectional Study of Dysplastic and Nondysplastic Knees

2021 ◽  
pp. 036354652098781
Author(s):  
Mathias Paiva ◽  
Lars Blønd ◽  
Per Hölmich ◽  
Kristoffer Weisskirchner Barfod
Keyword(s):  
Trochlear Dysplasia ◽  
Cross Sectional Study ◽  
Magnetic Resonance Images ◽  
Tibial Tubercle ◽  
Control Group ◽  
Trochlear Groove ◽  
Sectional Study ◽  
Cross Sectional ◽  
Mean Values ◽  
The Mean

Background: Tibial tubercle–trochlear groove (TT-TG) distance is often used as a measure of lateralization of the TT and is important for surgical planning. Purpose: To investigate if increased TT-TG distance measured on axial magnetic resonance images is due to lateralization of the TT or medialization of the TG. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 84 knees (28 normal [NK], 28 with trochlear dysplasia [TD], and 28 with patellar dislocation without TD [PD]) were examined. The medial border of the posterior cruciate ligament (PCL) was chosen as the central anatomic landmark. The distance from the TT to PCL (TT-PCL) was measured to examine the lateralization of the TT. The distance from the TG to the PCL (TG-PCL) was measured to examine the medialization of the TG. Between-group differences were investigated by use of 1-way analysis of variance. Results: The mean values for TT-TG distance were 8.7 ± 3.6 mm for NK, 12.1 ± 6.0 mm for PD, and 16.7 ± 4.3 mm in the TD group ( P < .01). The mean values for TT-PCL distance were 18.5 ± 3.6 mm for NK, 18.5 ± 4.5 mm for PD, and 21.2 ± 4.2 mm in the TD group ( P = .03). The mean values for TG-PCL distance were 9.6 ± 3.0 mm for NK, 7.1 ± 3.4 mm for PD, and 5.1 ± 3.3 mm in the dysplastic group ( P < .01). Conclusion: The present results indicate that increased TT-TG distance is due to medialization of the TG and not lateralization of the TT. Knees with TD had increased TT-TG distance compared with the knees of the control group and the knees with PD. The TT-PCL distance did not differ significantly between groups, whereas the TG-PCL distance declined with increased TT-TG.

scholarly journals Atrophy patterns in isolated subscapularis lesions

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Gernot Seppel ◽  
Andreas Voss ◽  
Daniel J. H. Henderson ◽  
Simone Waldt ◽  
Bernhard Haller ◽  
...  
Keyword(s):  
Muscle Atrophy ◽  
Area Ratio ◽  
Cross Sectional Area ◽  
Control Group ◽  
Sectional Area ◽  
Cross Sectional ◽  
Subscapularis Muscle ◽  
Mri Scans ◽  
The Mean ◽  
The Cross

Abstract Background While supraspinatus atrophy can be described according to the system of Zanetti or Thomazeau there is still a lack of characterization of isolated subscapularis muscle atrophy. The aim of this study was to describe patterns of muscle atrophy following repair of isolated subscapularis (SSC) tendon. Methods Forty-nine control shoulder MRI scans, without rotator cuff pathology, atrophy or fatty infiltration, were prospectively evaluated and subscapularis diameters as well as cross sectional areas (complete and upper half) were assessed in a standardized oblique sagittal plane. Calculation of the ratio between the upper half of the cross sectional area (CSA) and the total CSA was performed. Eleven MRI scans of patients with subscapularis atrophy following isolated subscapularis tendon tears were analysed and cross sectional area ratio (upper half /total) determined. To guarantee reliable measurement of the CSA and its ratio, bony landmarks were also defined. All parameters were statistically compared for inter-rater reliability, reproducibility and capacity to quantify subscapularis atrophy. Results The mean age in the control group was 49.7 years (± 15.0). The mean cross sectional area (CSA) was 2367.0 mm2 (± 741.4) for the complete subscapularis muscle and 1048.2 mm2 (± 313.3) for the upper half, giving a mean ratio of 0.446 (± 0.046). In the subscapularis repair group the mean age was 56.7 years (± 9.3). With a mean cross sectional area of 1554.7 mm2 (± 419.9) for the complete and of 422.9 mm2 (± 173.6) for the upper half of the subscapularis muscle, giving a mean CSA ratio of 0.269 (± 0.065) which was seen to be significantly lower than that of the control group (p < 0.05). Conclusion Analysis of typical atrophy patterns of the subscapularis muscle demonstrates that the CSA ratio represents a reliable and reproducible assessment tool in quantifying subscapularis atrophy. We propose the classification of subscapularis atrophy as Stage I (mild atrophy) in case of reduction of the cross sectional area ratio < 0.4, Stage II (moderate atrophy) in case of < 0.35 and Stage III (severe atrophy) if < 0.3.

Toxicopathological effects of lambda-cyhalothrin in female rabbits (Oryctolagus cuniculus)

2010 ◽  
Vol 30 (7) ◽  
pp. 591-602 ◽  
Author(s):  
Abdul Basir ◽  
Ahrar Khan ◽  
Riaz Mustafa ◽  
Muhammad Zargham Khan ◽  
Farzana Rizvi ◽  
...  
Keyword(s):  
Blood Cell ◽  
Oryctolagus Cuniculus ◽  
Hemoglobin Concentration ◽  
Control Group ◽  
Mean Corpuscular Hemoglobin ◽  
Dependent Manner ◽  
Cell Counts ◽  
Lambda Cyhalothrin ◽  
Group A ◽  
Dose Dependent

The aim of this study was to investigate effects of lambda-cyhalothrin (LCT) on clinical, hematological, biochemical and pathological alterations in rabbits (Oryctolagus cuniculus). New Zealand white female rabbits (n = 24) of 4-5 months age having 997.92 ± 32.83 g weight were divided into four equal groups. Group A (control) received normal saline intraperitoneally (ip). Animals in groups B, C and D were treated with LCT 1.0, 4.0 and 8.0 mg/kg bw ip. Each group received seven consecutive doses at an interval of 48 hours. Blood and serum samples were collected at an interval of 96 hours. Blood analysis revealed a significant (p < 0.05) decrease in red blood cell and white blood cell counts, hemoglobin concentration and lymphocytes, while mean corpuscular hemoglobin concentration, mean corpuscular volume, neutrophils, monocytes and eosinophils were increased. Serum biochemical analysis revealed significant (p < 0.05) decrease in serum total proteins and serum albumin, while an increase was seen in serum alanine aminotransferase and aspartate aminotransferase activities compared with the control group. Serum globulin values varied non-significantly in all treatment groups as compared to control group. A dose-dependent increase in the incidence of micronucleated polychromatic erythrocyte was observed. All gross and histopathological lesions observed in LCT-treated rabbits were dose-dependent. Liver of the treated rabbits exhibited extensive perihepatitis, hyperplasia of bile duct, necrosis, hemorrhages and congestion. In lungs, there were hemorrhages, thickened alveolar walls, congestion, emphysema, collapsed alveoli and accumulation of extensive inflammatory cells. Kidneys were congested and hemorrhagic whereas renal parenchyma and stroma were normal. Microscopically, heart showed congestion of blood vessels and nuclear pyknosis, myodegeneration. It was concluded from the study that LCT produced toxicopathological alterations in rabbits in a dose-dependent manner. On the basis of the results, it can be suggested that overdosing of LCT be avoided while treating animals for ectoparasites.

scholarly journals EFFECTS OF PHYSICAL TRAINING ON THE MYOCARDIUM OF FEMALE LDL KNOCKOUT OVARIECTOMIZED MICE

2017 ◽  
Vol 23 (6) ◽  
pp. 441-445
Author(s):  
Ledimar Brianezi ◽  
Mara Rubia Marques ◽  
Clever Gomes Cardoso ◽  
Maria Luiza de Jesus Miranda ◽  
Fernando Luiz Affonso Fonseca ◽  
...  
Keyword(s):  
Physical Training ◽  
Volume Density ◽  
Collagen Fibers ◽  
Nuclear Volume ◽  
Control Group ◽  
Cross Sectional ◽  
Training Time ◽  
Aerobic Activity ◽  
Ovariectomized Mice ◽  
The Mean

ABSTRACT Introduction: The emergence of coronary heart disease increases with menopause, physical inactivity and with dyslipidemia. It is known that physical training promotes the improvement of cardiovascular functions. Objective: The purpose of this study was to investigate the effects of aerobic physical training on the left ventricle in female LDL knockout ovariectomized mice. Methods: Thirty animals were divided into 6 groups (n=5), namely, sedentary non-ovariectomized control; sedentary ovariectomized control; trained ovariectomized control; sedentary non-ovariectomized; sedentary ovariectomized; and trained ovariectomized. We analyzed the mean nuclear volume parameters, the cross sectional area of the myocytes, the apparent density of the capillaries, interstitium, myocytes and collagen fibers. Results: The results show that for the density of the number of nuclei, the physical activity decreased to values close to the ovariectomized control group. Regarding the mean nuclear volume and the average area of myocytes, training and ovariectomy promoted the elevation of these values but hypercholesterolemia was lower. the volume density of myocytes, hypercholesterolemia showed an increase of these values as well as the training. There was no change in the volumetric density of the capillaries and the density of collagen fibers. The training caused the decrease in the density of the interstitial volume, and the hypercholesterolemia changed to a smaller one than the control group. Conclusion: We concluded that the moderate aerobic activity or the training time used in our study were not sufficient to generate significant alterations in the hypercholesterolemic group.

scholarly journals Association between endometriosis, headache, and migraine

2019 ◽  
Vol 11 (1) ◽  
pp. 19-24 ◽  
Author(s):  
Burcin Karamustafaoglu Balci ◽  
Zehra Kabakci ◽  
Damla Y Guzey ◽  
Bartu Avci ◽  
Murathan Guler ◽  
...  
Keyword(s):  
Nervous System ◽  
Autonomic Nervous System ◽  
Medical Records ◽  
Cross Sectional Study ◽  
Control Group ◽  
Cross Sectional ◽  
Autonomic Nervous ◽  
Screening Questions ◽  
The Mean ◽  
Id Migraine

Introduction: Available data suggest that there is an association between endometriosis and a group of disorders including autonomic nervous system irregularities. A deeper understanding of relationship between endometriosis and autonomic nervous system is needed as it may lead to novel discoveries on the causes or consequences of endometriosis. In this study, we analyzed the prevalence of migraine in patients with endometriosis. Methods: In this cross-sectional study, medical records of women were reviewed through January 2013 to December 2017. Women with laparoscopically proven endometriosis (n = 185) were compared with those without endometriosis (n = 168). The 3-item screening questions (ID Migraine™) test was used to screen migraine. Data were analyzed using SPSS v25 (IBM Corporation). The χ2 test was used for analyzing the nominal parameters and group comparisons. Pearson χ2 was used to study the association between endometriosis and migraine. Results: The mean age was 31.86 ± 4.49 years of the endometriosis group and 28.95 ± 5.11 years of the controls (p = 0.408). The two pre-screening questions of ID Migraine test were answered positively by 86 patients of the endometriosis group (75.4%) and by 53 patients of the control group (54.6%) (p = 0.001). Of these patients, 51 (44.7% of endometriosis group) and 26 (26.8% of control group) were diagnosed as having migraine using 3-item Migraine questionnaire (p = 0.007). Conclusion: This study showed that the prevalence of migraine was significantly higher in patients with endometriosis. Because there is a strong correlation, patients with endometriosis should be screened for headache and migraine to increase the benefits of care.

scholarly journals Patients with Achilles Tendon Rupture Have a Degenerated Contralateral Achilles Tendon: An Elastography Study

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Qianru Li ◽  
Qi Zhang ◽  
Yehua Cai ◽  
Yinghui Hua
Keyword(s):  
Achilles Tendon ◽  
Axial Strain ◽  
Achilles Tendon Rupture ◽  
Cross Sectional Area ◽  
Control Group ◽  
Computer Assisted ◽  
Study Group ◽  
Sectional Area ◽  
Cross Sectional ◽  
The Mean

Purpose. To evaluate differences of Achilles tendon (AT) hardness and morphology between asymptomatic tendons in patients with acute AT ruptures on the contralateral side and asymptomatic tendons in healthy people by using computer-assisted quantification on axial-strain sonoelastography (ASE). Methods. The study consisted of 33 asymptomatic tendons in 33 patients (study group) and 34 tendons in 19 healthy volunteers (control group). All the tendons were examined by both ASE and conventional ultrasound. Computer-assisted quantification on ASE was applied to extract hardness variables, including the mean (Hmean), 20th percentile (H20), median (H50) and skewness (Hsk) of the hardness within tendon, and the ratio of the mean hardness within tendon to that outside tendon (Hratio) and three morphological variables: the thickness (THK), cross-sectional area, and eccentricity (ECC) of tendons. Results. The Hmean, Hsk, H20, H50, and Hratio in the proximal third of the tendon body in study group were significantly smaller than those in control group (Hmean: 0.43±0.09 vs 0.50±0.07, p=0.001; Hsk: -0.53±0.51 vs -1.09±0.51, p<0.001; H20: 0.31±0.10 vs 0.40±0.10, p=0.001; H50: 0.45±0.10 vs 0.53±0.08, p<0.001; Hratio: 1.01±0.25 vs 1.20±0.23, p=0.003). The THK and cross-sectional area of tendons in the study group were larger than those in the control group (p<0.05). Conclusions. As a quantitative objective method, the computer-assisted ASE reveals that the asymptomatic ATs contralateral to acute rupture are softer than those of healthy control group at the proximal third and the asymptomatic tendons in people with rupture history are thicker, larger, and rounder than those of normal volunteers especially at the middle and distal thirds of AT body.

scholarly journals Pattern ERG as a predictor in ocular hypertensive

2016 ◽  
Vol 15 (2) ◽  
Author(s):  
Paaraj Dave ◽  
Jitendra Jethani
Keyword(s):  
Amplitude Ratio ◽  
Corneal Thickness ◽  
Visual Fields ◽  
Cross Sectional Study ◽  
Control Group ◽  
Study Group ◽  
Pattern Erg ◽  
Check Size ◽  
Cross Sectional ◽  
The Mean

Purpose: To report the repeatability of Pattern Electrotretinogram (PERG) and its findings in ocular hypertension (OHT) and normal eyes.Methods: A cross-sectional study where PERG responses were compared between the study group comprising of 80 eyes of 80 patients with intraocular pressure (IOP)>21 mmHg and the control group with 80 eyes of 80 normal individuals (IOP≤21mmHg). The optic disc and the visual fields were normal with a visual acuity of ≥ 0.8 in both groups. PERG was recorded twice for each individual in the control group by a single operator on 2 consecutive days to assess the repeatability.Results: The mean age in the study and control groups was 50.05±10.03 and 54.8±7.66 years(p=0.44) respectively. The mean IOP was 26.55±3.9 mmHg for the study group as opposed to 14.45±2.9 mmHg for the controls (p<0.001). The central corneal thickness and the cup-disc ratio was similar between the groups (p>.05). The P50-N95 amplitude (p=0.01) and the P50 latency (p<0.001) was statistically significantly different between both the groups. The intra-class correlation coefficient (ICC) showed poor agreement for all parameters except for N35-P50 0.8 to 16 degree check size amplitude ratio (PERG ratio).Conclusion:  Increase in P50 latency emerges as a new candidate for early glaucoma indicator in addition to reduction in P50-N95 amplitude. PERG parameters suffer from high test-retest variability. Deterioration in PERG recordings should be interpreted with caution. The variability is lesser for the PERG ratio which maybe more meaningful while monitoring for change over time.

scholarly journals Prevalence, Intensity, and Associated Factors of Schistosoma mansoni among School Children in Northwest Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Ayalew Jejaw Zeleke ◽  
Ayenew Addisu ◽  
Yalewayker Tegegne
Keyword(s):  
Risk Factors ◽  
Schistosoma Mansoni ◽  
Grade Level ◽  
Neglected Tropical Diseases ◽  
Multivariate Logistic Regression Analysis ◽  
Sampling Technique ◽  
Northwest Ethiopia ◽  
Moderate Intensity ◽  
Cross Sectional ◽  
Study Participants

Background. Schistosomiasis is one of the Neglected Tropical Diseases in Ethiopia, and its burden may show variations from time to time across different regions. Thus, this study was aimed at determining the prevalence, intensity, and associated risk factors of Schistosoma mansoni (S. mansoni) among schoolchildren in Northwest Ethiopia. Methods. A school-based cross-sectional study was conducted. A multistage sampling technique was used to select the study participants. Stool specimens were collected and examined using two-slide Kato-Katz method. Data were analyzed using SPSS version 20 software. Multivariate logistic regression analysis was used to identify risk factors. p values less than 0.05 were taken as statistically significant. Result. A total of 786 schoolchildren were participated in this study. The prevalence of S. mansoni was 33.5%. The mean egg count of the parasite among the infected study participants was 523.665 eggs per gram (epg) of stool. Thirty-seven, 42, and 21 percent of the study participant’s infection were due to light, moderate, and heavy infection intensities, respectively. Age of 8-11 years old ( AOR = 1,687 , 95 % CI = 1.163 , 2.892 ), 5th-8th grade level ( AOR = 2.280 , 95 % CI = 1.348 , 3.856 ), residing in Chuahit District ( AOR = 95.559 , 95 % CI = 12.945 , 705.419 ), and using untreated water for domestic supply ( AOR = 1.724 , 95 % CI = 1.457 , 2.148 ) were found to be risk factors for S. mansoni infection. Conclusion. High prevalence of S. mansoni and relatively higher proportion of moderate intensity of infection in this study imply that schistosomiasis is still one of the major public health problems in Northwest Ethiopia. It is also highlighted that study sites, provision of water supply, age, and grade level of the schoolchildren were identified as a risk factors for the disease.

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