Challenges in Disease and Health Research Vol. 7

COPD (Chronic Obstructive Pulmonary Disease) is a chronic progressive inflammatory lung disease, characterized by small airway obstruction and lung alveoli tissue damage.

The mainstays of current treatment of COPD are inhaled bronchodilators and ICS (inhaled Corticosteroids). The key issue in the treatment of COPD is to treat the inflammation. But the inflammation in COPD is partially resistant to Steroid. ICS can only temporarily suppress the inflammation in COPD, but not terminates the inflammation, and therefore there is a need to develop new anti-inflammatory therapies or drugs.

Artemisia Argyi, also called moxa, is a plant. Its leaves have been used to treat various diseases by traditional Chinese herbalists. The dried moxa fluff is made into a stick to heat certain points on patient’s skin to treat various diseases. This therapy is called moxibustion.

Through experiments, the author finds that the mechanism of the moxibustion is that the smoke or tar of the burning moxa has unique anti-inflammatory property, which can treat and cure Steroid resistant chronic non-specific inflammation.

The author develops a new anti-inflammatory therapy by the inhalation of moxa smoke to treat 25 COPD patients. 22 of 25 patients became symptoms free after 1 to 2 months treatment and kept symptoms free after the cessation of treatment without any other treatments.

Currently glucocorticoid steroid is the mainstay of treatment of chronic inflammatory diseases like asthma, COPD, rheumatoid arthritis. But many chronic inflammatory diseases are resistant to glucocorticoid steroid like pulmonary fibrosis, atherosclerosis related diseases, chronic laryngitis and chronic muscle injury. Glucocorticoid steroid has been thoroughly studied and its therapeutic potential has been exhausted, and therefore there is a need to develop new anti-inflammatory drugs or anti-inflammatory therapies. Moxa (Artemisia Argyi) is a plant, its burning smoke or tar has strong anti-inflammatory property. In this article the author wants to introduce a new way (moxa tar) of treating glucocorticoid steroid resistant chronic inflammatory diseases based on some clinical experiments and hypothesis of the author’s personal observation. The purpose of this article is to open up a new field and raise researchers’ attention to this new field for developing new anti-inflammatory drugs or anti-inflammatory therapies. The methods used in this study are Crossover design, i.e. patients serve as their own control, comparing the clinical symptoms and signs before and after moxa tar treatment.

Objective: We aimed to study the kinematic indices of the pelvic floor, anorectal angle and the descent of perinea, and the differing movement, in dyssynergic defecation patients in comparison with healthy controls, based on MR defecography.

Methods: Twenty-two individuals involved with dyssynergic defecation constipation and fourteen healthy asymptomatic subjects fell into this study. In four dynamic pelvic floor MRI indices, namely paradox (unusual change of anorectal angle), perineal descent during straining, perineal ascent, and narrowing of anorectal angle at squeeze, were measured in patients and healthy subjects.

Results: Paradox Index had the highest sensitivity (95.45%) and specificity (92.86%) for detection of dyssynergic defecation, with an R2 value of near 1 (0.902). The sensitivity and specificity of other indices were not high; therefore, no significant improvement could be achieved using other indices along with Paradox Index. Negative Predictive Value (92.85%) and Positive Predictive Value (95.45%) were only high in Paradox Index.

Conclusion: Paradox Index was indicated to be the best finding of MR defecography for identifying dyssynergic defecation patients from healthy controls. Hence, MR defecography could be exploited as an authentic tool to manifest the patients the paradoxical function and the relevant muscles of pelvic floor, which could enhance their imagination of the correct defecation pattern during their treatment.

A program to monitor 4,4’-Methylenebis(2-chloroanilin) (MBOCA) levels in the work environment and to screen for bladder cancer was performed at four MBOCA manufacturing factories in Taiwan. The results of this study have identified a proven bladder carcinoma in MBOCA manufacturing factories. In addition, 1 worker with suspected malignant cells on urine cytology and 1 worker with atypical cytology combined with gross hematuria were identified. The experimental study with mice also showed that MBOCA may be highly toxic and a carcinogen.

Purpose: To compare the effectiveness of a manual, a powered and an ultrasonic toothbrush on reducing dental plaque in dental student population.

Materials and Methods: This study is a comparative cross-over study, 50 students were enrolled in it and all completed it. All the subjects had to be in good condition of general health and had to have complete dentition without malocclusions. They were required to stop oral hygiene for 12 hours and any food or beverage consumption for 4 hours before each of the three appointments during which the plaque index was recorded before and after the brushing with the toothbrush. Tooth assigned that day, the brushing time was 3 min for manual brushing, and 2 min for electric and ultrasonic brushing.

Results: All toothbrushes significantly reduced plaque index after brushing (p <10⁶). The ultrasonic toothbrush was significantly more effective than the manual toothbrush in removing the plaque (P = 0.0003). While the comparison between the electric toothbrush with oscillation-rotation action and the manual toothbrush was statistically insignificant (P = 0.0982), so as the comparison between rotary and ultrasonic electric rotary toothbrushes (p = 0.0922).

Conclusion: The three toothbrushes managed to reduce the amount of plaque after brushing. The ultrasonic toothbrush is significantly better than the manual toothbrush in removing the plaque.

Levels of five heavy metals namely, cadmium, cobalt, iron, lead, and zinc were determined in tissues (roots, leaves and stems) of Azadirachta indica collected at different spots in Akungba-Akoko, (Nigeria).  Transfer coefficients of the elements into the plant tissues were also determined with a view to quantifying the differences in bioavailability to the plant species. The tissues were acid-digested and analyzed by flame atomic absorption spectrophotometry. The levels (ppm) of heavy metals recorded in the roots, leaves and stems of the plant respectively ranged: Cd (0.14 – 0.34, 0.09 – 0.20, 0.09 – 0.33); Co (4.01 – 5.48, 3.22 – 5.14, 3.84 – 5.40); Fe (82.27 – 137.98, 49.20 – 160.10, 58.33 – 116.62); Pb (0.50 – 0.57, 0.33 – 0.97, 0.28 – 0.48) and Zn (52.07 – 149.94, 52.01 – 113.73, 49.58 – 127.05). Fe has highest concentration while Cd has lowest concentration in all tissues analyzed. The stems of the plant showed least bioaccumulation of most metals studied and hence most suitable for medicinal purpose. The order of bioaccumulation by the leaves, stem barks, and roots of Azadirachta indica followed the sequence Pb < Cd < Zn < Fe < Co. Since metal uptake from plants is a major component of human exposure via the food chain, vegetative parts of Azadirachta indica used for therapeutic purposes should be collected far away from highways to reduce or possibly eliminate health hazards associated with the ingestion of heavy metals.

Objective: The purpose of this study was  to determine the bacteriological aetiology and incidence of Urinary Tract Infections (UTIs) and antibacterial susceptibility patterns among pregnant women attending antenatal clinics at the Federal Medical Centre in Bida, Niger-State, using the gold standard of culture.

Study Design: Data were obtained from the Medical Microbiology Department Registry from pregnant women who attended routine antenatal clinics between January 2010 and December 2012.A total of 1242 pregnant women aged 15 to 54 years old had mid-stream urine samples taken.

At the first antenatal appointment, samples were collected inside sterile disposable universal bottles from pregnant women suspected of having UTIs. SPSS version 16.0 was used to code, compute, and analyse the data, and p values of 0.05 were considered statistically significant.

Results: Out of 1242 pregnant women between the ages of 15 and 54 in this study, our research found that the incidence of UTI was 46.1 percent, which was statistically significant (p = 0.046, with a mean age of 30.92 years and a standard deviation of 5.46). The most common uropathogen (60%) was Escherichia coli, followed by Staphylococcus aureus (28.3%). Escherichia coli was susceptible to Nitrofurantoin and Gentamycin (61.4%) and (51.5%) respectfully.

Conclusion: The incidence of urinary tract infection in this study was 46.1% uropathogen, which is cause for concern among the general public. As a result, pregnant women should be screened for symptomatic or asymptomatic UTIs at antenatal clinics on a regular basis.

Background: Several international studies have documented a connection between nurses’ working environment and burnout. However, there are a paucity of studies have been conducted to date regarding perioperative nurses burnout and the characteristics of their working environments in Spain.

Objective: To analyse the influence of organizational factors of the perioperative nurse`s work environment on the three-burnout dimensions: emotional exhaustion, depersonalisation, and personal accomplishment.

Methods: We conducted a cross-sectional, quantitative, prospective study with 130 surgical nurses in a tertiary hospital in Spain using a self report questionnaire to data collect a socio-demographic, the Maslach Burnout Inventory, and the Practice Environment Scale of the Nursing Work Index. Analysis: A univariate and a bivariate analysis between organisational factors, explanatory variables and burnout dimensions were performed and, finally, a multivariate regression was used to ascertain the effect of the NWI-PES factors on burnout.

Results: The degree of general burnout was moderate-high. This study showed emotional exhaustion in 43% (56) of nurses, depersonalization in 21% (28), and reduced personal accomplisment in 53 % (69). The work environment was considered unfavourable as only one factor of five was favourable (Nursing foundations of quality care). Multiple regression analyses showed three organizational factors were associated with all three dimensions of burnout: “Nurse manager ability, leadership, and support of nurses”; “Staffing and resources adequacy”; and “Nursing foundations of quality care”.

Conclusions: Burnout prevalence in perioperative nurses is high-moderate and affects about one-third of the sample in each of the 3 burnout subscales — Emotional Exhaustion is the most affected subscale, followed by Depersonalization and Personal Accomplishment.

In this study three organizational factors played a significant role in predicting burnout among perioperative nurses. We recommend hospital management implement policies to improve these organizational factors. Addition to interventions in the work environment, which has an important influence on burnout: Promoting positive leadership styles, providing necessary resources, and creating a positive climate in the work environment could increase psychosocial wellbeing and decrease burnout among perioperative nurses.

Carbohydrates are the most abundant biomolecules on Earth. They are important for muscle contraction during prolonged exercise performing at moderate intensity and short duration exercise performed at high-intensity [1,2]. There is a considerable amount of studies related to the ergogenic effects of nutritional resources in sport performance [3]. Carbohydrates are important for muscle contraction during performance of prolonged exercise at moderate intensity and high-intensity exercise with short duration. Based on this evidence, this article aims to review the physiological and biochemical concepts and definitions of carbohydrates; searches for a relation between the consumption of carbohydrates and daily studies; and mainly analyzes the relations between consumption of carbohydrates and physical performance, analogously before, during and after the competition. To conduct the study was first done a widespread research looking for articles and scientific studies, and after that the research was filtered using up-to-date articles. The power of an athlete directly influences his physical performance [4]. In the pre-competition stage stored glycogen increases and prevents from depletion [5]. Supplementation during competition aims to replenish lost fluids and carbohydrates [6]. After a competition it is necessary to rehydrate, fill glycogen stores and recreate an electrolyte balance [3]. Literature reviews are important connectors that have been studied….. where the science must advance. More research should be done to get to know the ideal carbohydrate intake appropriate for each sport.

E-cigarettes and related vapor products (e-cigs) are here to stay They have tipped from a fad to a permanent part of the tobacco product scene. They now constitute a fifteen-year-old multibillion dollar industry in the United States. They offer personal and public health benefits far exceeding theoretically plausible harms. The current FDA “deeming” regulations threaten to eliminate more than 99% of e-cig brands by imposing requirements so costly that few can afford to apply. Sensible federal regulation of all tobacco-related products would allow low-risk products while protecting the public against poor quality products and predatory marketing. Instead, the current FDA regulatory process protects cigarettes from competition from e-cigs and other low-risk alternatives and threatens to drive teens and dedicated e-cig users back to cigarettes or to hazardous contraband and home-made products. Alternatives to the current regulations are proposed.

I first visited the issue of e-cigarette tipping points three and a half years ago, in August of 2017. [1] In this paper I revisit this issue, [2] with an eye to what, if anything, had changed since that time.  The 2017 paper was written shortly after e-cigarettes appeared to have passed two major tipping points.  The first had to do with popularity, with an estimated 10% of the American adult population using or having used e-cigarette products [3]. The second had to do with a perception safety and public health benefit [4]. At the time, I noted that the American Food and Drug Administration (FDA) was projecting a harshly negative view of the safety of e-cigarettes, and, at that time, was only grudgingly acknowledging that there might be personal and public health benefits. Since then, sentiment in the FDA and in the larger American tobacco control community has turned so far against e-cigarettes that each product is now threatened with forced removal from the market unless the manufacturer can promptly submit a “viable” Pre-Market Tobacco Application (PMTA). As previously noted [1], such an application is a physical impossibility for 99% or more of e-cigarette manufacturers because of the cost of the studies required to prepare the application. This essay will address how and why we find ourselves facing the demise of most of the e-cigarette industry in the United States, and what, if anything, should be done about it.

The Nigerian rural people demonstrate undesirable health-seeking behavior because of their cosmological and nosological notions which ascribe etiology of diseases and ill-health to entities far beyond the realm of the stethoscope. A comprehensive healthcare system in Nigeria has to focus more on the 65% of rural people who are the poorest of the poor.  The present review is therefore solicited to enhance the health status of rural dwellers by providing potentially useful guidance that will enhance the knowledge of healthcare professionals with respect to the peculiar health-seeking behavior of rural dwellers so as to promote good patient-physician interaction and to provide empirical basis for rational health policy formulation. A manual literature and internet (Google, Medline, Embase, HINARI and Cochrane data bases) search showed that in a pluralistic medical milieu in which the rural dwellers find themselves, the decision to seek healthcare, where to do this and the form of care perceived as appropriate are all influenced by a multiplicity of factors relating to the person, the facility and the socio-cultural environment. Primarily, religious beliefs, use of Traditional African Medicine (TAM) and patients’ perception of reality influence health-seeking behavior. In order to adequately and successfully manage the Nigerian rural patients, the healthcare provider must pay attention to patients’ impression of illness and underpinning health beliefs during consultation, in therapeutics and in handling evolving complications of TAM and ethical dilemmas. Improvement of rural infrastructure and behavioral health promotion campaigns among the rural people together with rational health policy formulation and regulation of TAM practice, are imperative.