Background: Colonoscopy is an invasive procedure used both diagnostically and therapeutically. Direct visualization and real-time image of entire large colon and distal terminal ileum makes it superior. Patients are unable to undergo colonoscopy because of the limitation in the developing country. Moreover, limited studies are available in our country regarding the colonic diseases. Materials and Methods: It was a descriptive cross-sectional study done in Nobel Medical College Teaching Hospital, Biratnagar, Nepal from January 2018 to December 2018. Approval was acquired from Institutional Review Committee. All patients undergoing colonoscopy in the hospital was included. After taking proper consent, bowel preparation, premedications, colonoscopy was performed, findings noted in pro-forma. Results: Of the total 176 patients 119 (67.60%) were male and 57 (32.40%) were female; mean age 46.98 ± 17.13 years. Indication for performing colonoscopy was chronic diarrhea in 58(33.0%), chronic abdominal pain in 47(26.70%). Significant lesion observed in 142 patients (80.68%); colitis with unspecified etiology in 69 (39.20%), ulcerative colitis in 28 (15.90%), crohn’s disease in 13(7.38%).Colitis was more in male 46(66.67%) and involving rectum was common. Pan-ulcerative colitis was common seen in 11patients (39.28%). Conclusion: Chronic diarrhoea and chronic abdominal pain were two common indications. Male patients were in higher prevalence opting for colonoscopy. Colitis of unspecified etiology of rectum and ileo-cecal region was most common finding. Ulcerative colitis involving whole of colon and younger age group was predominantly affected.
Filoviruses (Family Filoviridae genera Ebolavirus and Marburgvirus) are negative-stranded RNA viruses that cause severe health effects in humans and non-human primates, including death. Except in outbreak settings, vaccines and other medical countermeasures against Ebola virus (EBOV) will require testing under the FDA Animal Rule. Multiple vaccine candidates have been evaluated using cynomolgus monkeys (CM) exposed to EBOV Kikwit strain. To the best of our knowledge, however, animal model development data supporting the use of CM in vaccine research have not been submitted to the FDA. This study describes a large CM database (122 CM, 62 female and 60 male, age 2 to 9 years) and demonstrates the consistency of the CM model through time to death models and descriptive statistics. CMs were exposed to EBOV doses of 0.1 to 100,000 PFU in 33 studies conducted at three Animal Biosafety Level 4 facilities, by three exposure routes. Time to death was modeled using Cox proportional hazards models with a frailty term that incorporated study-to-study variability. Despite significant differences attributed to exposure variables, all CMs exposed to the 100 to 1,000 pfu doses commonly used in vaccine studies died or met euthanasia criteria within 21 days of exposure, median 7 days, 93% between 5 and 12 days of exposure. Moderate clinical signs were observed 4 to 5 days after exposure and preceded death or euthanasia by approximately one day. Viremia was detected within a few days of infection. Hematology indices were indicative of viremia and the propensity for hemorrhage with progression of Ebola viremia. Changes associated with coagulation parameters and platelets were consistent with coagulation disruption. Changes in leukocyte profiles were indicative of an acute inflammatory response. Increased liver enzymes were observed shortly after exposure. Taken together, these factors suggest that the cynomolgus monkey is a reliable animal model for human disease.
The purpose of this study is to identify statistically distinguishable trajectories of childhood body mass index (BMI), an important indicator of developmental status of children, and to provide a summary description of demographic characteristics of children based on these distinctive trajectories. Using data from the Healthy Communities Study (HCS), a large longitudinal dataset with oversamples of Hispanic and Black children across 130 communities in the USA, a group-based trajectory analysis approach was used to estimate trajectories of children based on their BMI-z scores. The three most distinguishable BMI trajectory groups identified for the HCS children show no marked increase or decrease in standardized BMI over an age range of 2 to 11. Approximately 28.5% of children were in a trajectory group with consistently obese BMI-z scores for their sex and age. The patterns of BMI trajectory groups identified for boys and girls are similar, but BMI-z scores for boys tend to be slightly higher than those for girls. These BMI trajectories are characterized by racial/ethnic and socioeconomic status disparities. Hispanic and Black children were more likely to be in the obese trajectory group than White children. Children with parents having less education, or children from low family income level, were more likely to be in the obese trajectory group than counterpart children. The findings suggest that BMI disparities exist from the early years of childhood and persist across childhood, with higher BMI associated with Black and Hispanic children as well as those from low socioeconomic status backgrounds.
Background: There is currently a nationwide effort to bring parks and green spaces within a 10-minute walk of the home. We examined the association between park area within 1 km of a child’s residence and self-reported park-specific physical activity (PA) along with accelerometer-derived moderate to vigorous physical activity (MVPA). Methods: A subsample of K through eighth-grade youth (n = 493) from the Healthy Communities Study reported whether they engaged in park-specific PA during the last 24 hours and wore an accelerometer for up to 7 days. Park area was defined as the percentage of park land in a 1 km Euclidean buffer around the participant’s residence, categorized into quintiles. Analysis consisted of logistic and linear regression modeling with interaction effects that controlled for clustering within communities. Results: Regression models estimated greater park-specific PA for participants in the fourth and fifth quintiles of park land. Age, sex, race ethnicity, and family income were unrelated to park-specific PA. Accelerometer analysis indicated that total MVPA was unrelated to park area. Older children (β = −8.73, P < .001) and girls (β = −13.44, P < .001) engaged in less MVPA. Seasonality significantly predicted both park-specific PA and total MVPA. Conclusion: Increasing park area is likely to improve youth PA patterns, lending support for the 10-minute walk initiative.
Background: Alcohol is widely consumed socially accepted recreational beverage, that is toxic and affects directly or indirectly almost every organ. Spectrum of alcoholic liver disease ranges from fatty liver to cirrhosis. One of the complications of the later spectrum is portal hypertension, around 50% develops varices and bleeding depends on the size of the varices. Predicting varices without endoscopic is difficult but few non-invasive parameters are available. Materials and Methods: It was a prospective cross-sectional study done in Nobel Medical College Teaching Hospital, Biratnagar, Nepal from September 2018 to August 2019. Approval was acquired from Institutional Review Committee. Patients with chronic ethanol ingestion and features suggestive of chronic liver disease clinically and investigation wise were enrolled in the study. History, physical examinations along with platelet count, prothrombin time was taken and ultrasonography abdomen and upper gastrointestinal endoscopy was done to see the splenic diameter, and varices. Results: Esophageal varices were present in 53%. Mean platelet count with variceswas 122566 ± 36024.8 /mm3, splenic diameter was 133.1 ± 21.3 mm, prothrombintime (PT) time was 19.3 ± 5.0 sec andratio of platelet per spleen diameter was 930.2 ± 259.4 /mm3/mm.Platelet count < 163500/mm3 has sensitivity and specificity 83.0% and 83.0% respectively. Ratio of platelet per splenic diameter ratio cutoff 1293.7 has 88.7% sensitivity and 85.1% specificity for predicting varices. Conclusion: In chronic alcoholic liver disease patients low platelet count, increased splenicdiameter, low platelet per splenic diameter ratio are useful in predicting presence of esophageal varices.
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