Kefir as a Prevention of Arsenic-mediated Toxicity in Uterine Female Rats

Background: kefir is a fermented milk product that demonstrates numerous health benefits including antioxidant and immunomodulatory. Aim: to study the protective effect kefir on the expression of estrogen receptor alpha (ERα) in endometrial stromal cells and endometrial thickness on female rats that were exposed to arsenic. Methods: twenty-five female Wistar rats (Rattus norvegicus) were divided into five groups (CRL, As, T1, T2, T3). Control group (given a normal diet), As group (given the normal diet and exposed to arsenic trioxide 2 mg/kgBW/day). The T1; T2; T3 were exposed to arsenic trioxide 2 mg/kgBW/day and treated with different doses of kefir (1.25; 2.5; and 5 mL/kgBW/day, respectively) for 35 days. The rats of group As treated with arsenic trioxide only and group CRL served as control with normal feed in water. Cytological samples were taken after 35 days of treatment and examined every day to see the rat oestrus phase, and the proestrus phase of the oestrous cycle was chosen for termination. Uterine tissue fixed in 10% neutral buffered formalin for tissue preparation. ERα expression in endometrial stromal cells was analized using immunohistochemistry method, endometrial thickness was observed using histopathological methods. Results: significant reduction of ERα expression in endometrial stromal cells and endometrial thickness in female rats exposed to arsenic were observed in groups on treated rats (p ≤ 0.000; 0.009, respectively). Conclusion: the administration of kefir in female Wistar rats exposed to arsenic had shown significantly differences on ERα expressions and endometrial thickness. The smallest dose of kefir (1.25 mL/kgBW/day) could increase ERα expression and endometrial thickness in female Wistar rats with arsenic exposure. Therefore kefir has protective effect related to female reproductive system.

Mask Using Practice among Bangladeshi Population During COVID-19 Pandemic: A Video-Based Observational Study

Background: Although the government of Bangladesh made the use of masks mandatory in public settings during COVID-19, individuals have been reluctant to follow. We intended to know how many people used face masks in public settings during COVID-19. Methodology: This study was conducted in several public settings in Shahbag, an urban sub-district of Dhaka; and Sirajdikhan, a rural sub-district of Munshiganj in Bangladesh on November 2020. A total of 4011 people were identified from the video-graphic data captured from 20 public places for monitoring the use of masks. Finding: More than two-thirds of those observed had no face masks or did not utilize them properly. People in urban regions (43%) used mask more in an appropriate manner than those in rural areas (26%). Females wore masks comparatively more than males (53% vs. 35%, p-value <0.001). People used masks more in the morning than in the afternoon (39% vs. 34%, p-value <0.001). People were seen to use a mask more in hospital areas (60%) than in other places. However, in public transportation stands only one-fourth (25%) of the people wore a mask in an appropriate manner. In binary logistic regression male sex, rural area, public places and time of observation (afternoon) were found as risk factors for not wearing a mask. Interpretation: The general population of both rural and urban areas of Bangladesh is reluctant to wear face masks. Along with the ongoing vaccination campaign, people of Bangladesh need to wear masks for the prevention of COVID-19. Funding: This research has been partially supported by Bangabandhu Sheikh Mujib Medical University.

Basic Approach to Prevalence of Iron-Deficiency Anemia among Pregnant Women and Children in South Florida before 2003

Obviously iron deficiency is determined as the most prevalent nutritional problem in the world today. It is provoked by a lack of iron in the diet. In South Florida, since pregnant women tend to neglect prenatal care, the prevalence of anemia primarily occurs during the first and second trimesters of their pregnancy. Accordingly, medical studies show that premature deliveries, low birth weight, birth defects, infant mortality, etc. result from iron deficiency anemia. In this, birth defects are, however, considered as quite associated with folic acid deficiency anemia. That explains why, this paper also deals with the study published by the March of Dimes on folic acid and pregnancy. In addition, the paper approaches qualitatively the socioeconomic and sociocultural aspects of the disease according to eight (8) interviews conducted in Broward and Miami Date counties to highlight the existing preventive programs for vulnerable population such as women, infants and children in South Florida, USA.

Clinical Review and Management of Oral Potentially Malignant Disorders with Epithelial Dysplasia

Background: Oral potentially malignant disorders (OPMDs) comprise any disorders, tumors, in addition to any microscopic alterations that have a risk of malignant development of cancers of the mouth. When epithelial dysplasia is detected in an oral lesion, it is termed as a precancerous lesion. Finding: Several changes in the color or thickness of normal oral mucosa might be detected during the clinical diagnosis of the oral lesions. Leukoplakia of the oral cavity is a clinical name for one of the most predominant OPMDs of the oral mucosa. When comparing oral examination with naked eyes to planning to apply staining with special stain or using an image of optical fluorescence, the incidence of patients with oral epithelial dysplasia may rise, as well as the clearing of the lesion boundary. Increased size of more than 2cm2, the presence of colored regions with a red hue, the presence of lichenoid process characteristics, and severe epithelial dysplasia are all considered risk factors. One-third of premalignant lesions may progress to cancer, whereas the other two-thirds may stay stable or regress without progressing to malignancy. Conclusion: It is critical to research the patients' unique characteristics, which include psychological, genetic, dietary, and dental problems. When epithelial dysplasia is present in an oral lesion, it is termed a precancerous lesion. Oral potential malignant diseases with epithelial dysplasia may or may not develop into carcinoma and may or may not be recurrent.

Measuring Air Quality Over Denpasar City Indonesia in 2021

The imbalance number of rapid vehicles with transportation facilities has become the problem. In Denpasar, Indonesia, the congestion during peak hours happens so often. Based on the department of transportation in Denpasar, Indonesia, the number of vehicle ownership in Bali is 4.1 million in condition with a ratio of one resident to one vehicle with the current population of Bali Province approximately 4.2 million. Our study aim to measure the air chemical parameters of CO, O3, SO2, NO2 and the physical parameters of the noise level. The research population is the atmosphere environment in the Denpasar City area. The research sample points were taken in the city center and the outskirts of Denpasar, with a total of 27 sample points. We employed impinge to get the airborne chemical gases and it is all analyzed with a spectrophotometer. We used a sound level meter to measure the ambient noise level. The data analysis was performed with free sample t test. The average ambient air chemistry obtained CO 517.34 µgr/Nm3, O3 0.17 µgr/Nm3, SO2 61.46 µgr/Nm3 and NO2 2.51 µgr/Nm3 and an average noise level 67.66 dBA. The number has found below the requirements Environmental Quality Standards and Environmental Damage Standard Criteria by Bali Governor. There is a difference in the mean parameters of CO, SO2, NO2 and ambient noise level in the downtown area. The average CO is 757.15 µgr/Nm3, SO2 67.60 µgr/Nm3, NO2 3.77 µgr/Nm3 and the noise level is 68.53 dBA with Denpasar outskirts mean CO 217.57 µgr/Nm3, SO2 53.79 µgr/Nm3, NO2 0.95 µgr/Nm3 and noise level 66.57 dBA. There is no difference in the average ambient O3 in the city center area with an average of 0.22 µgr/Nm3 with the outskirts of Denpasar an average of 0.11 µgr/Nm3.

Anesthetic Management in Patient with Suspected Brain Abscess, Atrium Septal Defect, and Eisenmenger Syndrome

Introduction: Patients with congenital heart disease especially with systemic shunting between systemic and pulmonary circulation often develop pulmonary hypertension and left-to-right shunt (Eisenmenger syndrome) if left untreated. These patients are at risk of developing spontaneous brain abscess due to brain infarction caused by polycythemia, impaired immune function, and loss of lung phagocytosis. Such patients were often admitted to the emergency room with signs of increased intracranial pressure (ICP), and needed specific consideration during surgery. Case: a 31-year old female diagnosed with intracranial space occupying lesion (SOL) due to suspected brain abscess with concurrent heart defects (atrial septal defect / ASD and Eisenmenger syndrome) was consulted to the operating theatre for emergency burrhole aspiration. The surgery was performed for an hour and the postoperatively the patient was admitted to the intensive care unit (ICU). Conclusion: perioperative management of patients with brain abscess and concurrent ASD and Eisenmenger syndrome consists of preoperative management, methods of anesthesia, monitoring, and interventions to prevent the worsening of left-to-right shunt and increasing intracranial pressure. These managements consist of optimal pain management, perioperative oxygen therapy, and prevention of precipitating factor that increases left-to-right shunting.

Perioperative Anesthetic Management in Preterm 12 Days Infants with Giant Meningoencephalocele at Mid Occipital and Secondary Trigonocephaly

Introduction: A meningoencephalocele is herniation of neural element along with meninges through a congenital defect in cranium. The incidence of encephalocele is approximately 1/5000 live births; occipital encephalocele is more common in females than males. It is called as giant meningoencephalocele when the head is smaller than the meningoencephalocele. These giant meningoencephaloceles harbor a large amount of cerebrospinal fluid (CSF) and brain tissue, so there occur various surgical challenges and anesthetic challenges in positioning and intubation. Case: A 12 days neonate was consulted to the neurosurgery department with complaints of large swelling over the back of head and difficulty in feeding. She was diagnosed with ventriculomegaly and meningoencephalocele since 32-33 pregnancy. The swelling was small at the time of birth, but it gradually increased in size. The child was born by section caesarean because of fetal distress and meningoenchepalocele. The neonate current weight was 3.195 grams with Post Conceptional Age (PCA) 35-36 weeks. On examination, the patient large spherical swelling was present over occipital region and there was no head control. The patient was active, conscious with no impression of focal neurological deficit. Systemic examination was unremarkable. The head circumference was 30 cm and circumference of occipital swelling was 40 cm. Potential problems in this patient include preoperative preparation and optimization of general condition, difficulty in positioning the patient, difficult airway (intubation), periodic apnea and potential hemodynamic disturbances and a sudden decrease in intracranial pressure during cele resection. Conclusion: Perioperative management in this case started from preoperative to postoperative evaluation. Preoperative preparation in anticipation of airway difficulties and communication with the operator is very important. Appropriate anesthetic techniques should aim to maintain stable hemodynamics and oxygenation and prevent a sudden increase or decrease in intracranial pressure.

Ultrasound Guided Brachiocephalic Vein Cannulation using Supraclavicular Approach

The need of central vein cannulation has been increased since the increased case of critical patients and patients underwent high-risk patients. Supraclavicular approach of central vein cannulation is an alternative approach to central vein cannulation due to fewer anatomical variance, good longitudinal vein view, better visualization of needle during procedure, clear demarcation of landmarks, larger target area, better patient comfort, and fewer complications. This case study presents an ultrasound guided central vein cannulation using supraclavicular approach in 30 year old male patient diagnosed with septic shock, anemia, trombcytopenia, and electrolyte imbalance post laparotomy. The indication of central vein cannulation in the patient was to deliver volume resuscitation, to provide emergency vein access, to provide nutritional support, to deliver chemically caustic agents, and central vein pressure monitoring.

COVID-19 Testing: Perceived Barriers Among the Urban Slum Dwellers of Dhaka, Bangladesh

Background: Urban slum dwellers are unduly affected by COVID-19, and low testing rates among them are worsening their situation. This study aimed to explore the perceived barriers to COVID-19 testing in the slums, which is crucial to its surveillance, tracking, and allocating resources to combat the pandemic. Methods: A quantitative study with a cross-sectional design was conducted among 149 urban slum dwellers (≥11 years of age), who had previously experienced COVID-19 like symptoms. They were identified from an existing slum cohort at Bauniabadh, Dhaka. Information related to their testing status and perceived barriers was acquired by a telephone survey from October to November 2020. Results: The mean age of the respondents was 34.4±15.6 years, and 58.4% of them were female. Fever (79.2%) and cough (74.5%) were the most common symptoms mentioned. Only 6.7% of the respondents had undergone COVID-19 testing. Fast relief (within 1-3 days) from symptoms (87.6%) was the most prevailing barrier to testing, seen across all age and education groups. Negative advocacy regarding the testing from family and friends (46.7%), participants uncertainty about the guidelines, site, cost, and schedule of testing (15.3%), and a general belief that ‘COVID-19 is not a disease of slum people instead, it is an affliction of the rich folk’ (20.4%), were the other cited barriers. Conclusions: The COVID-19 testing rate remained very low among the urban slum dwellers. To remove the barriers to testing, tailored behavioral change communication and augmenting the resources for testing are necessary to curb the spread in the slums.

The Wellness Program for Physical Fitness and Decreasing Metabolic Syndrome Risk Factors

Indonesia is currently facing a double burden of disease. The high rate of communicable diseases has been followed by high rates of non-communicable diseases (NCD) such as hypertension, heart disease, cancer and diabetes mellitus. This study aims to produce a holistic approach model in the form of a Wellness Program in an effort to improve physical fitness and decrease of metabolic syndrome for civil servants. This study was designed with an experimental design. Subjects were members of civil servants in Klungkung Regency, Indonesia who have one or more of syndrome metabolic risk. Subjects were divided into two groups, namely the treatment group and the control group. The treatment group is a group that is given a wellness program model in the form of physical exercise according to the rules of frequency, intensity and duration, balanced nutrition education and smoking behavior control. The results show a significant increase in nutritional knowledge (p<0.05), the implementation of physical activity rules with a frequency of 3-5 x/week in 78%, duration 20-60 minutes in 76% of light-moderate exercise, decreased smoking habit significantly p=0.042 (p<0.05), increased physical fitness with VO2max value 29.28 + 7.68 (treatment group) vs 24.28 + 5.91 (control group) with p<0, 05, decreasing of blood sugar was 118.08 + 35.81 mg/dl (treatment group ) vs. 124 + 42.22 mg/dl with p value = 0.001 (p <0.05) with t- independent test. Meanwhile, the risk factor variables for the metabolic syndrome (obesity, cholesterol and blood pressure) showed a decrease but were not significantly different.