Introduction: The main outcome of efficiently implemented universal test and treat (UTT) program is improved survival. UTT implementation has been ongoing in Cameroon since 2016 but evaluation data are scarce. This st...Introduction: The main outcome of efficiently implemented universal test and treat (UTT) program is improved survival. UTT implementation has been ongoing in Cameroon since 2016 but evaluation data are scarce. This study aims to assess the survival of antiretroviral therapy (ART) patients initiated under UTT in Northwest region of Cameroon. Methods: This retrospective cohort study included HIV-positive patients initiated in 2016 at 27 purposefully selected sites and followed until 2021. Data was anonymously abstracted from ART registers and patients’ charts. Kaplan-Meier survival estimates and Cox model were used to compare the survival of patients initiated under UTT with those initiated otherwise, using stata version 14.0. Results: In total, 2490 HIV-positive patients (median age 42.7 years, 94.7% adults, and 69.0% female) participated in the study. Of 1389 patients with viral load (VL) test results, 55% were initiated on ART late. The VL suppression rate of patients initiated late and those initiated early were similar. During follow-up, 1020 (40.9%) participants censored. The survival curves of patients initiated early on ART and those initiated late were similar during the first 2.5 years of follow-up but significantly (p Conclusions: This study confirms the expected impact of UTT. Programs only need to close existing implementation gaps along the critical pathways (diagnosis and treatment) of UTT, focusing more on males.展开更多
A treat-to-target(T2T)approach applies the principles of early intervention and tight disease control to optimise long-term outcomes in Crohn's disease.The Selecting Therapeutic Targets in Inflammatory Bowel Disea...A treat-to-target(T2T)approach applies the principles of early intervention and tight disease control to optimise long-term outcomes in Crohn's disease.The Selecting Therapeutic Targets in Inflammatory Bowel Disease(STRIDE)-II guidelines specify short,intermediate,and long-term treatment goals,documenting specific treatment targets to be achieved at each of these timepoints.Scheduled appraisal of Crohn’s disease activity against pre-defined treatment targets at these timepoints remains central to determining whether current therapy should be continued or modified.Consensus treatment targets in Crohn’s disease comprise combination clinical and patient-reported outcome remission,in conjunction with biomarker normalisation and endoscopic healing.Although the STRIDE-II guidelines endorse the pursuit of endoscopic healing,clinicians must consider that this may not always be appropriate,acceptable,or achievable in all patients.This underscores the need to engage patients at the outset in an effort to personalise care and individualise treatment targets.The use of non-invasive biomarkers such as faecal calprotectin in conjunction with cross-sectional imaging techniques,particularly intestinal ultrasound,holds great promise;as do emerging treatment targets such as transmural healing.Two randomised clinical trials,namely,CALM and STARDUST,have evaluated the efficacy of a T2T approach in achieving endoscopic endpoints in patients with Crohn’s disease.Findings from these studies reflect that patient subgroups and Crohn’s disease characteristics likely to benefit most from a T2T approach,remain to be clarified.Moreover,outside of clinical trials,data pertaining to the real-world effectiveness of a T2T approach remains scare,highlighting the need for pragmatic real-world studies.Despite the obvious promise of a T2T approach,a lack of guidance to support its integration into real-world clinical practice has the potential to limit its uptake.This highlights the need to describe strategies,processes,and models of care capable of supporting the integration and execution of a T2T approach in real-world clinical practice.Hence,this review seeks to examine the current and emerging literature to provide clinicians with practical guidance on how to incorporate the principles of T2T into routine clinical practice for the management of Crohn’s disease.展开更多
Objective:To explore the effect of the Xian Fang Huo Ming Yin(XFHM)for treating cutaneous infections and promoting wound healing in patients with perianal abscesses.Methods:Sixty-one patients with perianal abscesses w...Objective:To explore the effect of the Xian Fang Huo Ming Yin(XFHM)for treating cutaneous infections and promoting wound healing in patients with perianal abscesses.Methods:Sixty-one patients with perianal abscesses who were admitted to our hospital(Xinghua City People’s Hospital)from May 2022 to May 2023 were selected and randomly divided into two groups,a control group(30 cases)and a study group(31 cases).Both groups received surgical treatment.The control group received conventional treatment and warm water fumigation,sitz bath,and surgical dressing change after surgery,while the research group received XFHM based on the control group.XFHM was taken orally and replaced with warm water for fumigation and sitz bathing.Both groups received treatment for 4 weeks but discontinued sitz bathing after 2 weeks.Various clinical indicators between the two groups were compared.Results:The total clinical effective rate and wound recovery rate of the study group were higher than that of the control group.There were differences in the wound pain scores,surrounding tissue edema,and wound secretions at different time points.Both groups experienced wound pain.The scores of wound pain,surrounding tissue edema,and wound secretions of the study group were lower than those of the control group,7 and 14 days after surgery.The serum interleukin 6(IL-6),tumor necrosis factor-alpha(TNF-α)levels,and pH values of the study group were lower than those of the control group 10 days after surgery(P<0.05).Conclusion:The application of XFHM for treating cutaneous infections and promoting wound healing in patients with perianal abscesses improved the treatment outcome,alleviated clinical symptoms,and promoted healing.展开更多
This paper evaluates the efficacy of two sequential vertical flow filters (VFF), FV1 and FV2, implanted with Typha, in a pilot-scale wastewater treatment system. FV1 comprises three cells (FV1a, FV1b, and FV1c), while...This paper evaluates the efficacy of two sequential vertical flow filters (VFF), FV1 and FV2, implanted with Typha, in a pilot-scale wastewater treatment system. FV1 comprises three cells (FV1a, FV1b, and FV1c), while FV2 consists of two cells (FV2a and FV2b), each designed to reduce various physicochemical and microbiological pollutants from wastewater. Quantitative analyses show significant reductions in electrical conductivity (from 1331 to 1061 μS/cm), biochemical oxygen demand (BOD5 from 655.6 to 2.3 mg/L), chemical oxygen demand (COD from 1240 to 82.2 mg/L), total nitrogen (from 188 to 37.3 mg/L), and phosphates (from 70.9 to 14.6 mg/L). Notably, FV2 outperforms FV1, particularly in decreasing dissolved salts and BOD5 to remarkably low levels. Microbiological assessments reveal a substantial reduction in fecal coliforms, from an initial concentration of 7.5 log CFU/100mL to 3.7 log CFU/100mL, and a complete elimination of helminth eggs, achieving a 100% reduction rate in FV2. The study highlights the impact of design parameters, such as filter material, media depth, and plant species selection, on treatment outcomes. The findings suggest that the judicious choice of these components is critical for optimizing pollutant removal. For instance, different filtration materials show varying efficacies, with silex plus river gravel in FV1c achieving superior pollutant reduction rates. In conclusion, VFFs emerge as a promising solution for wastewater treatment, underscoring the importance of design optimization to enhance system efficiency. Continuous monitoring and adaptation of treatment practices are imperative to ensure water quality, allowing for safe environmental discharge or water reuse. The research advocates for ongoing improvements in wastewater treatment technologies, considering the environmental challenges of the current era. The study concludes with a call for further research to maximize the effectiveness of VFFs in water management.展开更多
Pseudoaneurysms of the ascending aorta are a rare complication of aortic and cardiac surgery. In this article, we present a clinical case of a 56-year-old patient with a fortuitous diagnosis of a pseudoaneurysm of asc...Pseudoaneurysms of the ascending aorta are a rare complication of aortic and cardiac surgery. In this article, we present a clinical case of a 56-year-old patient with a fortuitous diagnosis of a pseudoaneurysm of ascending aorta that was treated by an endovascular stent-graft. We discuss in this article the diagnostic and therapeutic aspect of the case and the place of endovascular treatment for the ascending aorta.展开更多
Inflammation-mediated carcinogenesis develops in the context of chronic inflammation and is a significant cause of cancer within the digestive system.In the chronic inflammation microenvironment,the metabolic activity...Inflammation-mediated carcinogenesis develops in the context of chronic inflammation and is a significant cause of cancer within the digestive system.In the chronic inflammation microenvironment,the metabolic activity of tissue cells undergoes extensive changes,which interfere with the normal function of immune cells.Dysregulation of cell metabolism and immune function has been identified as a key factor contributing to inflammation-mediated carcinogenesis within the major digestive organs,such as the stomach,liver,and colorectum.This metabolic-immune imbalance also corresponds to traditional Chinese medicine(TCM)theories of“yin-yang disharmony”and“disharmony between Ying-nutrients and Wei-defense.”The metabolic-immune imbalance has also been regarded as the key factor supporting“treatment of different diseases with the same method”,in which the same approach is adopted in the treatment of different conditions.In the TCM treatment process,it is necessary to first identify TCM patterns and then apply the corresponding TCM to correct the dysregulated metabolic and immune function,thereby blocking the progression from inflammation to malignancy.Our study findings deepen the TCM understanding of metabolic-immune dysregulation and the relationship between metabolic-immune dysregulation,pattern identification,and treatment method.They also provide new insights for the treatment of inflammation-mediated carcinogenesis in major digestive organs and help us further explore the scientific connotation of the TCM strategy of“treating different diseases with the same method”.展开更多
In Tunisia,water scarcity is only adding pressure on water demand in agriculture.In the context of sustainable development goals,Tunisia has been reusing treated wastewater(TWW)as a renewable and inexpensive source fo...In Tunisia,water scarcity is only adding pressure on water demand in agriculture.In the context of sustainable development goals,Tunisia has been reusing treated wastewater(TWW)as a renewable and inexpensive source for soil fertigation and groundwater(GW)recharge.However,major risks can be expected when the irrigation water is of poor quality.This study aims for evaluating the potential risk of TWW and GW irrigation on soil parameters.Accordingly,we evaluated the suitability of water quality through the analysis of major and minor cations and anions,metallic trace elements(MTEs),and the sodium hazard by using the sodium adsorption ratio(SAR)and the soluble sodium percentage(SSP).The risk of soil sodicity was further assessed by SAR and the exchangeable sodium percentage(ESP).The degree of soil pollution caused by MTEs accumulation was evaluated using geoaccumulation index(Igeo)and pollution load index(PLI).Soil maps were generated using inverse spline interpolation in ArcGIS software.The results show that both water samples(i.e.,TWW and GW)are suitable for soil irrigation in terms of salinity(electrical conductivity<7000μS/cm)and sodicity(SAR<10.00;SSP<60.00%).However,the contents of PO_(4)^(3-),Cu^(2+),and Cd^(2+)exceed the maximum threshold values set by the national and other standards.Concerning the soil samples,the average levels of SAR and ESP are within the standards(SAR<13.00;ESP<15.00%).On the other hand,PLI results reveal moderate pollution in the plot irrigated with TWW and no to moderate pollution in the plot irrigated with GW.Igeo results indicate that Cu^(2+)is the metallic trace element(MTE)with the highest risk of soil pollution in both plots(Igeo>5.00),followed by Ni^(2+)and Pb^(2+).Nevertheless,Cd^(2+)presents the lowest risk of soil pollution(Igeo<0.00).Statistical data indicates that Ca^(2+),Na+,Ni^(2+),and Pb^(2+)are highly distributed in both plots(coefficient of variation>50.0%).This study shows that the use of imagery tools,such as ArcGIS,can provide important information for evaluating the current status of soil fertility or pollution and for better managing soil irrigation with TWW.展开更多
Background: Cervical cancer is the fourth most common cancer among women globally, the second most common cancer in Nigeria and the most common cause of cancer-related death in Africa. In 2020, World Health Organizati...Background: Cervical cancer is the fourth most common cancer among women globally, the second most common cancer in Nigeria and the most common cause of cancer-related death in Africa. In 2020, World Health Organization in its updated guidelines recommended cervical cancer screening using HPV DNA, HPV mRNA tests and subsequent treatment as appropriate. However, in resource-poor settings, Visual Inspections with Acetic Acid (VIA), Lugol’s Iodine (VILI) and subsequent treatment of precancerous lesions with thermal ablation remain the practical approaches. Objectives: To determine the prevalence of precancerous cervical lesions and associated risk factors among Women Living with HIV (WLHIV). Methods: A retrospective study on sexually active WLHIV aged 16 - 55 years screened for cervical cancer using VIA and VILI within 16 months period in Faith Alive Hospital Jos. Data were analyzed using IBM-SPSS 26. Sociodemographic characteristics of the study participants and the screening results were presented in frequency tables, and logistic regression was performed to determine risk factors of pre-cancerous lesions. Results: 1113 women were screened for cervical cancer using VIA/VILI. 994 (89.3%) were negative, 101 (9.1%) were positive for precancerous lesions, and 18 (1.6%) were suspicious of cervical cancer. The mean age of clients with pre-cancerous lesions was 41.32 ± 9.89 years. A higher positivity yield (69.4%) was found in ages between 36 and ≥55 years while a less positivity yield (30.6%) was found in age’s ≤ 35 years. History of STI had 1.64 fold risk association with precancerous lesions. Conclusion: Our study demonstrated a high prevalence of precancerous cervical lesions among WLHIV;bimodal age distribution for cancer-suspicious lesions and risk associated with STI. Thus, a “screen-and-treat” approach to cervical cancer prevention by VIA and thermal ablation in resource-poor settings should be undertaken until widespread HPV testing to triage clients is feasible.展开更多
Malaria is still a major public health concern in Cameroon as more than 20 million people are at risk of the disease. Despite the government’s effort to scale up the distribution of long lasting insecticide-treated b...Malaria is still a major public health concern in Cameroon as more than 20 million people are at risk of the disease. Despite the government’s effort to scale up the distribution of long lasting insecticide-treated bed nets (LLINs), full ownership and optimal use is still limited. In 2021, over a million LLINs were made available for distribution in the South West Region. However, the current situation of malaria has not yet been ascertained following the 2021 mass distribution campaign (MDC). Therefore, the aim of this study was to determine LLIN ownership, coverage, usage and the prevalence of malaria following the 2021 MDC in the Tiko Health District (THD), South West Region of Cameroon. A cross-sectional study was carried from May 1 to 27, 2022 in which a multi-stage sampling technique was used to enroll eligible participants. Data were collected from household heads using questionnaires and capillary blood samples collected from consented household members were used to test for malaria. Data were analyzed using SPSS version 25 at 0.05 significance level. From the 150 households surveyed, 96 (64.0%) owned a mosquito net before the recent MDC. There was an overall significant increase (p p = 0.644) in LLINs ownership between areas where door-to-door (79.5%) and fixed “Hit and Run” (75.8%) strategies were used in the distribution of LLINs in THD. The prevalence of malaria was 10.2%. The regular use of LLINs was significantly associated (p = 0.007) with low malaria prevalence. The 2021 MDC had an impact on malaria prevalence in those who properly used them.展开更多
目的基于“痰瘀同治”理论,运用痰瘀同调方治疗超重/肥胖糖耐量异常人群,评价痰瘀同调方治疗超重/肥胖糖耐量异常人群的临床有效性及安全性。方法选择超重/肥胖糖耐量异常痰湿瘀滞证患者72例,随机分为对照组与治疗组,各36例,对照组予基...目的基于“痰瘀同治”理论,运用痰瘀同调方治疗超重/肥胖糖耐量异常人群,评价痰瘀同调方治疗超重/肥胖糖耐量异常人群的临床有效性及安全性。方法选择超重/肥胖糖耐量异常痰湿瘀滞证患者72例,随机分为对照组与治疗组,各36例,对照组予基础治疗,治疗组在对照组基础上联合痰瘀同调方治疗。治疗3个月后观察2组体质量指数(BMI)、腰围(WC)、腰臀比(WHR)、空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbAlc)、空腹血清胰岛素(FINS)、稳态模型胰岛素抵抗指数(HOMA-IR)、血脂以及中医痰湿瘀滞症状积分等指标变化,客观评价痰瘀同调方的临床疗效。结果治疗组治疗后BMI、WC、WHR、FPG、2 h PG、HbAlc、FINS、HOMA-IR、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C),均较治疗前有明显改善,且改善程度均优于对照组(P<0.05);治疗组治疗后改善患者形体肥胖、腹部增大、脘腹胀满、倦怠乏力、胸闷、便溏、口淡无味或黏腻等中医症状方面均优于对照组(P<0.05);治疗组中医证候综合疗效总有效率明显高于对照组(P<0.05)。2组研究过程中均未出现不良事件。结论痰瘀同调方干预治疗超重/肥胖糖耐量异常效果明显,安全性良好。展开更多
文摘Introduction: The main outcome of efficiently implemented universal test and treat (UTT) program is improved survival. UTT implementation has been ongoing in Cameroon since 2016 but evaluation data are scarce. This study aims to assess the survival of antiretroviral therapy (ART) patients initiated under UTT in Northwest region of Cameroon. Methods: This retrospective cohort study included HIV-positive patients initiated in 2016 at 27 purposefully selected sites and followed until 2021. Data was anonymously abstracted from ART registers and patients’ charts. Kaplan-Meier survival estimates and Cox model were used to compare the survival of patients initiated under UTT with those initiated otherwise, using stata version 14.0. Results: In total, 2490 HIV-positive patients (median age 42.7 years, 94.7% adults, and 69.0% female) participated in the study. Of 1389 patients with viral load (VL) test results, 55% were initiated on ART late. The VL suppression rate of patients initiated late and those initiated early were similar. During follow-up, 1020 (40.9%) participants censored. The survival curves of patients initiated early on ART and those initiated late were similar during the first 2.5 years of follow-up but significantly (p Conclusions: This study confirms the expected impact of UTT. Programs only need to close existing implementation gaps along the critical pathways (diagnosis and treatment) of UTT, focusing more on males.
文摘A treat-to-target(T2T)approach applies the principles of early intervention and tight disease control to optimise long-term outcomes in Crohn's disease.The Selecting Therapeutic Targets in Inflammatory Bowel Disease(STRIDE)-II guidelines specify short,intermediate,and long-term treatment goals,documenting specific treatment targets to be achieved at each of these timepoints.Scheduled appraisal of Crohn’s disease activity against pre-defined treatment targets at these timepoints remains central to determining whether current therapy should be continued or modified.Consensus treatment targets in Crohn’s disease comprise combination clinical and patient-reported outcome remission,in conjunction with biomarker normalisation and endoscopic healing.Although the STRIDE-II guidelines endorse the pursuit of endoscopic healing,clinicians must consider that this may not always be appropriate,acceptable,or achievable in all patients.This underscores the need to engage patients at the outset in an effort to personalise care and individualise treatment targets.The use of non-invasive biomarkers such as faecal calprotectin in conjunction with cross-sectional imaging techniques,particularly intestinal ultrasound,holds great promise;as do emerging treatment targets such as transmural healing.Two randomised clinical trials,namely,CALM and STARDUST,have evaluated the efficacy of a T2T approach in achieving endoscopic endpoints in patients with Crohn’s disease.Findings from these studies reflect that patient subgroups and Crohn’s disease characteristics likely to benefit most from a T2T approach,remain to be clarified.Moreover,outside of clinical trials,data pertaining to the real-world effectiveness of a T2T approach remains scare,highlighting the need for pragmatic real-world studies.Despite the obvious promise of a T2T approach,a lack of guidance to support its integration into real-world clinical practice has the potential to limit its uptake.This highlights the need to describe strategies,processes,and models of care capable of supporting the integration and execution of a T2T approach in real-world clinical practice.Hence,this review seeks to examine the current and emerging literature to provide clinicians with practical guidance on how to incorporate the principles of T2T into routine clinical practice for the management of Crohn’s disease.
文摘Objective:To explore the effect of the Xian Fang Huo Ming Yin(XFHM)for treating cutaneous infections and promoting wound healing in patients with perianal abscesses.Methods:Sixty-one patients with perianal abscesses who were admitted to our hospital(Xinghua City People’s Hospital)from May 2022 to May 2023 were selected and randomly divided into two groups,a control group(30 cases)and a study group(31 cases).Both groups received surgical treatment.The control group received conventional treatment and warm water fumigation,sitz bath,and surgical dressing change after surgery,while the research group received XFHM based on the control group.XFHM was taken orally and replaced with warm water for fumigation and sitz bathing.Both groups received treatment for 4 weeks but discontinued sitz bathing after 2 weeks.Various clinical indicators between the two groups were compared.Results:The total clinical effective rate and wound recovery rate of the study group were higher than that of the control group.There were differences in the wound pain scores,surrounding tissue edema,and wound secretions at different time points.Both groups experienced wound pain.The scores of wound pain,surrounding tissue edema,and wound secretions of the study group were lower than those of the control group,7 and 14 days after surgery.The serum interleukin 6(IL-6),tumor necrosis factor-alpha(TNF-α)levels,and pH values of the study group were lower than those of the control group 10 days after surgery(P<0.05).Conclusion:The application of XFHM for treating cutaneous infections and promoting wound healing in patients with perianal abscesses improved the treatment outcome,alleviated clinical symptoms,and promoted healing.
文摘This paper evaluates the efficacy of two sequential vertical flow filters (VFF), FV1 and FV2, implanted with Typha, in a pilot-scale wastewater treatment system. FV1 comprises three cells (FV1a, FV1b, and FV1c), while FV2 consists of two cells (FV2a and FV2b), each designed to reduce various physicochemical and microbiological pollutants from wastewater. Quantitative analyses show significant reductions in electrical conductivity (from 1331 to 1061 μS/cm), biochemical oxygen demand (BOD5 from 655.6 to 2.3 mg/L), chemical oxygen demand (COD from 1240 to 82.2 mg/L), total nitrogen (from 188 to 37.3 mg/L), and phosphates (from 70.9 to 14.6 mg/L). Notably, FV2 outperforms FV1, particularly in decreasing dissolved salts and BOD5 to remarkably low levels. Microbiological assessments reveal a substantial reduction in fecal coliforms, from an initial concentration of 7.5 log CFU/100mL to 3.7 log CFU/100mL, and a complete elimination of helminth eggs, achieving a 100% reduction rate in FV2. The study highlights the impact of design parameters, such as filter material, media depth, and plant species selection, on treatment outcomes. The findings suggest that the judicious choice of these components is critical for optimizing pollutant removal. For instance, different filtration materials show varying efficacies, with silex plus river gravel in FV1c achieving superior pollutant reduction rates. In conclusion, VFFs emerge as a promising solution for wastewater treatment, underscoring the importance of design optimization to enhance system efficiency. Continuous monitoring and adaptation of treatment practices are imperative to ensure water quality, allowing for safe environmental discharge or water reuse. The research advocates for ongoing improvements in wastewater treatment technologies, considering the environmental challenges of the current era. The study concludes with a call for further research to maximize the effectiveness of VFFs in water management.
文摘Pseudoaneurysms of the ascending aorta are a rare complication of aortic and cardiac surgery. In this article, we present a clinical case of a 56-year-old patient with a fortuitous diagnosis of a pseudoaneurysm of ascending aorta that was treated by an endovascular stent-graft. We discuss in this article the diagnostic and therapeutic aspect of the case and the place of endovascular treatment for the ascending aorta.
基金supported by National Natural Science Foundation of China(92059102 and 81630080)the National Key Research and Development Plan of China(2018YFC1704106).
文摘Inflammation-mediated carcinogenesis develops in the context of chronic inflammation and is a significant cause of cancer within the digestive system.In the chronic inflammation microenvironment,the metabolic activity of tissue cells undergoes extensive changes,which interfere with the normal function of immune cells.Dysregulation of cell metabolism and immune function has been identified as a key factor contributing to inflammation-mediated carcinogenesis within the major digestive organs,such as the stomach,liver,and colorectum.This metabolic-immune imbalance also corresponds to traditional Chinese medicine(TCM)theories of“yin-yang disharmony”and“disharmony between Ying-nutrients and Wei-defense.”The metabolic-immune imbalance has also been regarded as the key factor supporting“treatment of different diseases with the same method”,in which the same approach is adopted in the treatment of different conditions.In the TCM treatment process,it is necessary to first identify TCM patterns and then apply the corresponding TCM to correct the dysregulated metabolic and immune function,thereby blocking the progression from inflammation to malignancy.Our study findings deepen the TCM understanding of metabolic-immune dysregulation and the relationship between metabolic-immune dysregulation,pattern identification,and treatment method.They also provide new insights for the treatment of inflammation-mediated carcinogenesis in major digestive organs and help us further explore the scientific connotation of the TCM strategy of“treating different diseases with the same method”.
文摘In Tunisia,water scarcity is only adding pressure on water demand in agriculture.In the context of sustainable development goals,Tunisia has been reusing treated wastewater(TWW)as a renewable and inexpensive source for soil fertigation and groundwater(GW)recharge.However,major risks can be expected when the irrigation water is of poor quality.This study aims for evaluating the potential risk of TWW and GW irrigation on soil parameters.Accordingly,we evaluated the suitability of water quality through the analysis of major and minor cations and anions,metallic trace elements(MTEs),and the sodium hazard by using the sodium adsorption ratio(SAR)and the soluble sodium percentage(SSP).The risk of soil sodicity was further assessed by SAR and the exchangeable sodium percentage(ESP).The degree of soil pollution caused by MTEs accumulation was evaluated using geoaccumulation index(Igeo)and pollution load index(PLI).Soil maps were generated using inverse spline interpolation in ArcGIS software.The results show that both water samples(i.e.,TWW and GW)are suitable for soil irrigation in terms of salinity(electrical conductivity<7000μS/cm)and sodicity(SAR<10.00;SSP<60.00%).However,the contents of PO_(4)^(3-),Cu^(2+),and Cd^(2+)exceed the maximum threshold values set by the national and other standards.Concerning the soil samples,the average levels of SAR and ESP are within the standards(SAR<13.00;ESP<15.00%).On the other hand,PLI results reveal moderate pollution in the plot irrigated with TWW and no to moderate pollution in the plot irrigated with GW.Igeo results indicate that Cu^(2+)is the metallic trace element(MTE)with the highest risk of soil pollution in both plots(Igeo>5.00),followed by Ni^(2+)and Pb^(2+).Nevertheless,Cd^(2+)presents the lowest risk of soil pollution(Igeo<0.00).Statistical data indicates that Ca^(2+),Na+,Ni^(2+),and Pb^(2+)are highly distributed in both plots(coefficient of variation>50.0%).This study shows that the use of imagery tools,such as ArcGIS,can provide important information for evaluating the current status of soil fertility or pollution and for better managing soil irrigation with TWW.
文摘Background: Cervical cancer is the fourth most common cancer among women globally, the second most common cancer in Nigeria and the most common cause of cancer-related death in Africa. In 2020, World Health Organization in its updated guidelines recommended cervical cancer screening using HPV DNA, HPV mRNA tests and subsequent treatment as appropriate. However, in resource-poor settings, Visual Inspections with Acetic Acid (VIA), Lugol’s Iodine (VILI) and subsequent treatment of precancerous lesions with thermal ablation remain the practical approaches. Objectives: To determine the prevalence of precancerous cervical lesions and associated risk factors among Women Living with HIV (WLHIV). Methods: A retrospective study on sexually active WLHIV aged 16 - 55 years screened for cervical cancer using VIA and VILI within 16 months period in Faith Alive Hospital Jos. Data were analyzed using IBM-SPSS 26. Sociodemographic characteristics of the study participants and the screening results were presented in frequency tables, and logistic regression was performed to determine risk factors of pre-cancerous lesions. Results: 1113 women were screened for cervical cancer using VIA/VILI. 994 (89.3%) were negative, 101 (9.1%) were positive for precancerous lesions, and 18 (1.6%) were suspicious of cervical cancer. The mean age of clients with pre-cancerous lesions was 41.32 ± 9.89 years. A higher positivity yield (69.4%) was found in ages between 36 and ≥55 years while a less positivity yield (30.6%) was found in age’s ≤ 35 years. History of STI had 1.64 fold risk association with precancerous lesions. Conclusion: Our study demonstrated a high prevalence of precancerous cervical lesions among WLHIV;bimodal age distribution for cancer-suspicious lesions and risk associated with STI. Thus, a “screen-and-treat” approach to cervical cancer prevention by VIA and thermal ablation in resource-poor settings should be undertaken until widespread HPV testing to triage clients is feasible.
文摘Malaria is still a major public health concern in Cameroon as more than 20 million people are at risk of the disease. Despite the government’s effort to scale up the distribution of long lasting insecticide-treated bed nets (LLINs), full ownership and optimal use is still limited. In 2021, over a million LLINs were made available for distribution in the South West Region. However, the current situation of malaria has not yet been ascertained following the 2021 mass distribution campaign (MDC). Therefore, the aim of this study was to determine LLIN ownership, coverage, usage and the prevalence of malaria following the 2021 MDC in the Tiko Health District (THD), South West Region of Cameroon. A cross-sectional study was carried from May 1 to 27, 2022 in which a multi-stage sampling technique was used to enroll eligible participants. Data were collected from household heads using questionnaires and capillary blood samples collected from consented household members were used to test for malaria. Data were analyzed using SPSS version 25 at 0.05 significance level. From the 150 households surveyed, 96 (64.0%) owned a mosquito net before the recent MDC. There was an overall significant increase (p p = 0.644) in LLINs ownership between areas where door-to-door (79.5%) and fixed “Hit and Run” (75.8%) strategies were used in the distribution of LLINs in THD. The prevalence of malaria was 10.2%. The regular use of LLINs was significantly associated (p = 0.007) with low malaria prevalence. The 2021 MDC had an impact on malaria prevalence in those who properly used them.
文摘目的基于“痰瘀同治”理论,运用痰瘀同调方治疗超重/肥胖糖耐量异常人群,评价痰瘀同调方治疗超重/肥胖糖耐量异常人群的临床有效性及安全性。方法选择超重/肥胖糖耐量异常痰湿瘀滞证患者72例,随机分为对照组与治疗组,各36例,对照组予基础治疗,治疗组在对照组基础上联合痰瘀同调方治疗。治疗3个月后观察2组体质量指数(BMI)、腰围(WC)、腰臀比(WHR)、空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbAlc)、空腹血清胰岛素(FINS)、稳态模型胰岛素抵抗指数(HOMA-IR)、血脂以及中医痰湿瘀滞症状积分等指标变化,客观评价痰瘀同调方的临床疗效。结果治疗组治疗后BMI、WC、WHR、FPG、2 h PG、HbAlc、FINS、HOMA-IR、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C),均较治疗前有明显改善,且改善程度均优于对照组(P<0.05);治疗组治疗后改善患者形体肥胖、腹部增大、脘腹胀满、倦怠乏力、胸闷、便溏、口淡无味或黏腻等中医症状方面均优于对照组(P<0.05);治疗组中医证候综合疗效总有效率明显高于对照组(P<0.05)。2组研究过程中均未出现不良事件。结论痰瘀同调方干预治疗超重/肥胖糖耐量异常效果明显,安全性良好。