H. Benjelloun — 2024-06-13

We report a case of pleural amoebiasis, diagnosed on the basis of radioclinical findings and positive amoebic serology. Amebic pleuropulmonary disease is the most frequent extra-intestinal expression of amebiasis after liver disease. A 71-year-old male of rural origin, with no recent tuberculosis contagion, who presented purulent pleurisy with a dysenteric syndrome. The patient was treated by antibiotic and pleural decortication under U-VATS. Serological testing and radiological examination will be more useful in the early detection of cases of Entamoeba hystolitica infection. The medical treatement based on a combination of a tissue amoebicide (Metronidazole, etc.) and a contact amoebicide (Hydroxyquinoline, etc.). Surgery may be considered when purulent drainage does not show improvement in the patient's condition.

Achigbu Kingsley I. — 2024-06-13

Drug-induced dystonic reactions are reversible movement and posture disorders that occur after administration of certain drugs. They are characterised by intermittent spasmodic or sustained involuntary contractions of various muscles in the body and are often underdiagnosed or misdiagnosed in clinical practice. These reactions occasionally are life threatening and can be distressing to the patients and their families. In developing countries like Nigeria, parents frequently administer promethazine to their kids to alleviate vomiting. However, it is worthy of note that oral administration of promethazine can cause dystonic reactions.

Herein, we describe the management of a 13-month-old male with promethazine-induced dystonic reactions who was misdiagnosed as severe malaria on presentation. Our aim is to increase awareness of promethazine –induced dystonia among clinicians.

S. N. Jatal — 2024-06-15

Gastrointestinal stromal tumors (GISTs) are mesenchymal tumors that typically occur in the gastrointestinal tract. About 70% of GISTs are benign, while approximately 30% are malignant. GISTs represent less than 0.1% to 3% of all gastrointestinal tumors. These tumors are thought to originate from intestinal cells of Cajal (ICCs) or stem cell-like precursors. ICCs, often referred to as the "pacemaker" cells of the GI autonomic nervous system, regulate GI motility and are found around the myenteric plexus and the muscularis propria throughout the GI tract.

GISTs are composed of different types of cells: approximately 70% are spindle cells, 20% are epithelioid cells, and 10% are mixed cells. Around 85% of GISTs contain mutations in one of two receptor tyrosine kinases (RTKs), KIT or PDGFRA, which play a central role in the pathogenesis of these tumors. Additionally, about 95% of GISTs test positive for the CD117 antigen.

Clinically, GISTs are most commonly found in the stomach (60%), followed by the small intestine (30%), duodenum (5%), rectum (3%), colon (1%), and oesophagus (0.5%). Occurrences in the omentum and mesentery are rare. GISTs affect men and women equally and most commonly occur between the ages of 50 to 70 years. The annual incidence rate is between 6.5 and 14.5 per million people worldwide.

In our study, we report three cases of GISTs located in the duodenum, jejunum, and transverse colon. Diagnosis in these cases was confirmed via CT scan and all cases tested positive for the CD117 antigen.

Rushita D. Nakarani — 2024-06-27

Endobronchial tuberculosis (EBTB) is a rare manifestation of pulmonary tuberculosis characterized by bronchial inflammation, often presenting with tumor-like masses in the airways. Misdiagnosis, particularly as lung cancer or bronchial asthma, is common due to its atypical presentation. We present a case of a 38-year-old female with persistent cough, wheezing, and constitutional symptoms, initially misdiagnosed with community-acquired pneumonia. Despite broad-spectrum antibiotics, there was no improvement. Imaging revealed right upper lobe collapse and a suspicious lesion, prompting a PET-CT scan that indicated a neoplastic or infectious etiology. Bronchoscopy confirmed a friable growth in the right main bronchus, with subsequent biopsy and bronchoalveolar lavage revealing Mycobacterium tuberculosis. Prompt initiation of anti-tuberculosis therapy led to symptom resolution. This case underscores the importance of considering tuberculosis in patients with persistent respiratory symptoms, even without prior TB history.

Hamadoun Traoré — 2024-07-01

Vascular leiomyosarcomas are extremely rare tumours, accounting for less than 1% of all malignant tumours. Venous leiomyosarcomas occur five times more frequently than arterial leiomyosarcomas. These are most often found in the large vessels and less than 50% occur in the peripheral circulation. Median survival has not been quantified. It can be good if radical surgery is performed. Treatment, whatever the stage, requires multidisciplinary management. Surgery with en bloc resection remains the treatment of choice for localised disease; in patients with unresectable locally advanced or metastatic disease, systemic treatment with essentially palliative aims may be proposed. Anthracycline-based treatment is the standard first-line therapy.

We report a case report of a 50-year-old female patient with local, pulmonary and bone relapse of an operated left femoral artery leiomyosarcoma in whom we undertook palliative mono-chemotherapy.

Conclusion: Vascular leiomyosarcomas are extremely rare tumours, accounting for less than 1% of all malignant tumours. Median survival is dramatic for metastatic patients, with a median survival of 8 months, ranging from 5 to 20 months. Surgery remains the standard curative treatment for the localised stage; for stage 4, single chemotherapy is the treatment of choice.

Rushita D. Nakarani — 2024-07-13

Non-resolving or slowly resolving pneumonia presents a significant diagnostic challenge, characterized by persistent radiographic abnormalities despite appropriate antibiotic therapy. This study explores the pivotal role of Fiberoptic Bronchoscopy (FOB) in diagnosing and managing non-resolving pneumonia. Through detailed case presentations, the study illustrates how FOB facilitates precise sampling and identification of underlying causes such as malignancies, infections, and other pulmonary conditions. FOB's ability to provide cytological, microbiological, and pathological insights proves essential in guiding targeted treatment strategies, ultimately improving patient outcomes. The cases discussed underscore the importance of FOB in resolving diagnostic uncertainties, particularly in complex clinical scenarios where standard treatments fail.

Yen Cho Huang — 2024-07-15

Aims: To explore the impact of seroma volume reduction on dosimetry during whole breast radiation therapy (WBRT) and evaluate the significance of adaptive planning.

Presentation of Case: A 71-year-old female with left breast invasive carcinoma underwent lumpectomy and radiotherapy. An initial CT (CT1) six weeks taken post-op showed a seroma cavity, and a second CT (CT2) five weeks later documented a 65% seroma volume reduction (from 217 c.c. to 75 c.c.). Five radiotherapy techniques were evaluated: two-field conventional, three-field conventional, forward IMRT, inverse IMRT, and VMAT. Inverse IMRT and VMAT achieved better high-dose coverage and reproducibility but had larger dose variations. They also showed higher maximum doses and increased hot spot volumes, indicating potential overdosage risks. Conventional techniques provided stable lower-dose coverage but less uniform high-dose distribution compared to IMRT and VMAT.

Discussion: The significant reduction in seroma volume affected dosimetry, highlighting the importance of adaptive planning. In this case, daily KV and weekly MV imaging were used for alignment, but CBCT may better monitor seroma changes. Adaptive radiotherapy, repeated CT simulations, and CBCT are essential for effective treatment. Further research should focus on improving treatment precision through advanced imaging and radiotherapy technologies.

Conclusion: This single WBRT case highlights the dosimetric impact of seroma reduction and the importance of imaging and adaptive strategies. Advanced techniques like inverse IMRT and VMAT improve precision but need careful IGRT monitoring. These findings emphasize the need for individualized adaptive planning considerations and further research to optimize protocols for managing seroma volume changes during WBRT.

Amruta Datye — 2024-07-16

TAVR has now been accepted across the globe as a standard treatment in management of severe AS. The procedure got simpler over past two decades with newer and advanced generation valves and deployment techniques. Similarly, with evolved anesthesia techniques, peri-operative optimization and adoption of minimalist approach has considerably reduced the complications, shorten the stay and reduced all-cause morbidity and morbidity.

India has seen surge in patients undergoing TAVR after first procedure in 2011. However, various factors economic, physician learning curve, demography seem to a play role in widespread adoption of this form of treatment.

Leandro Victor Silva Ribeiro — 2024-07-09

Aims: The objective of the study will be to evaluate the presence of sleep disorders, sleep quality and life of women in the menopausal transition and postmenopausal assisted in primary health care (PHC) in Divinópolis/MG.

Study Design: Cross-sectional observational.

Place and Duration of Study: PHC in the municipality of Divinópolis, Minas Gerais, Brazil, between January and December 2023.

Material and Methods: The present study will be carried out by professors and students of the University of the State of Minas Gerais (UEMG), Divinópolis Unit, with women recruited from PHC in the municipality of Divinópolis/MG, after consenting to participate in the study, by signing the Informed Consent Form (ICF). The sample will be consecutive and of convenience and then stratified according to sociodemographic variables, presence or absence of sleep disorders, sleep quality, quality of life and other variables pertinent to the study.

Discussion: Due to the lack of professional performance in primary care for sleep disorders, it is necessary to study the concomitant changes between the menopausal transition and postmenopausal processes. Given the aspects related to these disorders, there is a need for a more in-depth look at the factors that can interfere with sleep quality during this transition.

Conclusion: This study protocol aims to investigate sleep disorders and the quality of sleep and life in women during the menopausal and postmenopausal transition phases. The research seeks to identify data demonstrating the changes that occur during these phases.

Leticia Neves Mode — 2024-07-16

Objective: To evaluate the effect of adding oculomotor exercises to the treatment of Temporomandibular Disorder (TMD) on pain intensity, range of mandibular movement, TMD severity, and ocular convergence insufficiency (CI), immediately, 3 months, and 6 months after treatment.

Study Design: Controlled and randomized clinical trial included blinded evaluators and participants.

Methodology: Individuals aged 18–45 years diagnosed with TMD and convergence insufficiency.

Intervention: Two groups: the experimental group (EG) and the control group (CG) groups will receive 12 treatment sessions. Main outcome measures: pain intensity, range of mandibular movement, convergence insufficiency, and severity of TMD during follow-up immediately after treatment, 3 and 6 months.

Analysis: The statistical analysis will use linear mixed models based on the intention to treat. The significance level will be set at 5%.

Results: This is a preliminary protocol; results will be available once the study is completed. It is expected relevant patient clinical improvement results.

Conclusion: It will be possible to determine the effects of adding oculomotor exercises in the treatment of TMD.

Implications for Practice: If successful, the protocol could be integrated into clinical practice as an adjunct to conventional therapy for TMD, expanding the therapeutic options available to healthcare professionals and patients.

Chu Ka Yin — 2024-07-09

Introduction: The management of chronic respiratory conditions critically relies on Pulmonary Rehabilitation (PR). Traditional PR programs often encounter obstacles in patient engagement and adherence. To overcome these issues, immersive virtual reality (VR) technology is being explored. Immersive VR, experienced through a head-mounted display, provides an interactive simulated environment. Its integration into occupational therapy (OT) PR programs holds the potential to boost the effectiveness of rehabilitation and patient experience.

Objective: This study aimed to probe the effects of VR-based training on PR patients' psychological well-being, training engagement, adherence to breathing control exercises and sense of security. The assessment of these outcomes is intended to ascertain the potential benefits of VR in augmenting PR efficacy.

Methods: A mixed-method, single-group design was adopted, involving a one-week trial with daily half-hour VR sessions. Pre-post assessments, incorporating qualitative and quantitative approaches, were conducted for data collection and analysis. Quantitative measures assessed functional capacity (Barthel Index-Dyspnea; BI-D), psychological well-being (Hospital Anxiety and Depression Scale; HADS) and symptom assessment (Shortness of Breath Questionnaire; SOBQ and Chronic Respiratory Disease Questionnaire; CRQ). Qualitative analysis hinged on semi-structured interviews, with thematic analysis used to discern underlying themes and patterns from participant experiences. The study, conducted from August to November 2023, involved 10 in-patients of the PR program from a rehabilitation hospital, aged 67 to 91, and diagnosed with COPD, COVID-19, and lung cancer.

Results: Quantitative results showed significant improvements across all measures, including BI-D (p<0.001; MD -19.60), HADS-Anxiety (p<0.001; MD -4.60), HADS-Depression (p<0.001; MD-3.90), SOBQ (p=0.002; MD-19.85), CRQ-Dyspnea (p=0.002; MD+1.01), CRQ-Emotion (p=0.004; MD+0.89), CRQ-Management (p=0.010; MD+1.2), and CRQ-Fatigue (p<0.001; MD+1.16). In qualitative analysis, noteworthy enhancements in psychological well-being were reported by all participants. VR resulted in relaxation, stress reduction, and distraction, highlighting a positive mental health impact. The captivating and motivating nature of the simulated environment led to increased engagement and improved breathing exercise compliance. VR also offered a secured platform for practicing breathing control, contributing to an enhanced rehabilitation experience.

Conclusion: Merging VR technology into OT services for PR yields positive results. VR enhances psychological well-being, training engagement, and exercise compliance, while also providing a secure virtual environment. Future research should explore a greater variety of VR training programs to meet a wider range of therapeutic needs.

Ibrahim L. Folorunsho — 2024-07-03

Community-based interventions (CBI) effectively address the negative impact of social and environmental factors on mental well-being by leveraging community resources, strengths, and resilience. Successful examples, such as the Friendship Bench in Zimbabwe and the Community Reinforcement and Family Training (CRAFT) program, demonstrate the importance of community engagement and multi-sector partnerships in creating culturally responsive and sustainable mental health programs.

Camilla Castilho Maia — 2024-06-12

In the Amazon region, riverside communities have specific geographical, cultural and social characteristics that challenge health promotion. This is due to the diverse needs and social determinants of these communities, which generally live in rural areas, with a certain degree of isolation and unequal access to health services. It is known that this population faces difficulty or no access to ophthalmological medical care, in addition to the lack of epidemiological studies and the construction of educational technologies aimed at these peoples. This study aims to identify evidence and scientific production on the development of educational technologies aimed at ophthalmology in the context of the lives of riverine patients, by means of an integrative literature review, whose guiding question was: "What current scientific evidence deals with the production of educational technologies in ophthalmology for riverine patients?". Twelve studies were selected, categorised into: benefits of the applicability of ophthalmic technologies in rural populations; benefits of the applicability of ophthalmic technologies in urban populations; pedagogical technologies as a tool for education in ophthalmology and the eye health profile of traditional communities. This review resulted in few findings regarding the main objective of the research. The lack of a descriptor that specifically mentions the riverside population is noteworthy and, as a result, it became unfeasible for the authors to carry out a scientific survey that addressed the triad of the riverside population, educational technologies and ophthalmology. Scientific production on the health of the riverine population in Brazil has increased in recent years, but there are still gaps in relation to medical specialities such as ophthalmology and methods that assess the application of technologies that facilitate the relationship between these specialities and riverine circumstances. As a result, further studies are needed into the health of riverine peoples, especially in the area of ophthalmology. It is necessary to carry out more studies to obtain more information about the modus vivendi of the riverside population. Interpretations of this knowledge can help in the development of public policies that promote socio-environmental sustainability, respecting the right of these populations to remain in their territories with socio-cultural and political autonomy. Additionally, it can be discussed how to develop technological plans for activities that are compatible with riverside culture in order to connect this community to specialized eye health needs.

Mariana Feldner de Britto — 2024-06-18

Background: Sodium-glucose cotransporter 2 (iSGLT2) inhibitors are a class of medications used in the treatment of Heart Failure (HF) to prevent the development and worsening of the disease. Despite the benefits reported in the literature, it is essential to investigate its adverse effects.

Objective: To evaluate the occurrence of hypotension, volume depletion and acute kidney injury in patients with HF with reduced (HFrEF) and preserved (HFpEF) ejection fraction using iSGLT2.

Methodology: Systematic review and meta-analysis previously registered in PROSPERO (CRD42022365684) and carried out in the PubMed, EBSCO and LILACS databases. The risk of bias analysis was performed using the Cochrane risk-of-bias tool for randomized trials. RevMan 3.4.1 was used to perform the data meta-analysis.

Results: Of the 9,474 studies found, ten were included in the review. A risk of hypotension was observed in patients with HF using iSGLT2 (RR: 1.15; 95% CI 1.01 – 1.30; p=0.03; I2= 0%), but there was no risk statistically significant occurrence of volume depletion and acute kidney injury (RR: 1.12; 95% CI 0.95 – 1.33; p=0.17; I2= 0%; RR: 0.85; 95% CI 0 .69 – 1.06; p=0.14;I2= 16%).

Conclusion: In therapy with iSGLT2, an increased risk of adverse events of hypotension was observed, but no increased risk of volume depletion and acute kidney injury was observed. Despite the 15% reduction in relative risk in the outcome of acute kidney injury, the results suggest a renal benefit.

Arhum Mahmood — 2024-06-21

Background: Global trends in cardiovascular death have declined and survival rates have decreased over the last 30 years as a result of advancements in medical and interventional therapy.

Objectives: This systematic evaluation and meta-assessment aim to evaluate the predictive efficacy of superior imaging techniques, in particular, CCTA, in asymptomatic people, aiming to elucidate their potential advantages and disadvantages for screening purposes and offer insights into their suitability for risk stratification and control on this populace, informing future scientific recommendations and practices in cardiovascular screening.

Methods: PubMed and Cochrane Library were searched thoroughly for literature search. Ten articles were extracted to be included in this study.

Results: A total of ten studies were included in this systematic review and meta-analysis. All of the included studies were cohorts either retrospective or prospective cohorts. Meta-analysis was performed for two variables that are Cardiovascular Mortality and MACE. Cardiovascular mortality was shown to be improved with the use of Coronary Computed Tomographic Angiography (CCTA). Only one study reported the quantitative effect of CCTA on MACE.

Conclusion: To conclude, our systematic overview and meta-analysis highlight the tremendous position of CCTA in predicting cardiovascular consequences in asymptomatic individuals, suggesting its potential as a precious danger assessment tool for detecting CAD and enhancing cardiovascular mortality prediction, though similar research is wanted to verify its definitive role in medical practice.

Igor Jordan Barbosa Coutinho — 2024-06-27

Intrastromal ring implantation has been an important therapeutic option for various corneal refractive disorders. In this study, a systematic review of the literature was carried out with the aim of understanding the clinical panorama and changes in endothelial cells following this procedure. It was considered relevant to explore the diversity of perspectives and approaches presented by existing studies, as well as to highlight gaps in knowledge to guide future research. To this end, a comprehensive search strategy in electronic databases was used to identify relevant studies published to date. The inclusion criteria were carefully applied to select articles that specifically addressed the topic in question. A qualitative and quantitative analysis of the data extracted from the included studies was carried out, seeking to identify patterns and trends in the clinical outlook and in the analyses of endothelial cells following intra- stromal ring implantation. The analysis of the included studies revealed a variety of findings related to the clinical panorama after intrastromal ring implantation. A correlation was observed between the clinical effects observed and the changes in endothelial cells, although the long-term stability of these results still requires further investigation. In addition, a relationship was identified between preoperative parameters and post-implant visual acuity, highlighting the importance of carefully evaluating these aspects when selecting candidates for the procedure. From this we can conclude that this systematic review of the literature has provided a comprehensive overview of clinical and endothelial cell analyses following intrastromal ring implantation. The results highlight the complexity of this area of research and point to the ongoing need for research to improve the understanding, application and optimization of already consolidated and innovative therapeutic measures in this field.

Raheel Chaudhry — 2024-06-28

There remains a debate on the effects of alcohol use on cardiovascular health. This systematic review and meta-analysis examined the relationship between this link and blood pressure, lipid profiles, and the frequency of cardiovascular events to shed light on it. A comprehensive search strategy using PRISMA guidelines resulted in nine papers that met the inclusion requirements. Moderate alcohol usage was shown to have a U- or J-shaped connection with cardiovascular events; excessive intake or abstinence was associated with increased risk, but moderate consumption had preventive advantages. Moderate drinkers showed positive changes in their lipid profiles and lowered blood pressure in comparison to heavy or non-drinkers. The wide range of research highlights the need to consider individual characteristics and study techniques. Despite the potential cardiovascular benefits of moderate alcohol use shown by these studies, treatment recommendations should be cautious. To provide personalized recommendations to patients and policymakers, future research should focus on explaining mechanisms, examining modifiers, and assessing the effects of different types of alcohol and drinking habits on cardiovascular health.

Talyta de Alcântara Lima — 2024-07-03

Nowadays, the number of people complaining of back pain is increasing, but this pain is associated with scoliosis. However, scoliosis can be defined as the spine curving sideways, forming an "S" or "C" shape. However, there are several types of scoliosis: congenital, idiopathic, neuromuscular and degenerative. The most common is idiopathic scoliosis, which mostly affects children and adolescents, while congenital scoliosis is present at birth due to malformation of the spine. Neuromuscular scoliosis, on the other hand, affects the individual's neurological or muscular condition, followed by degenerative scoliosis, which develops in adulthood or the elderly and is caused by wear and tear on the spine. The aim of this study is to understand the forms of physiotherapy treatments applied to scoliosis. Subsequently, the physiotherapeutic treatments for this pathology include techniques such as RPG (Global Postural Reeducation), Pilates and waistcoats. RPG is a method that seeks to re-educate posture through stretching and muscle strengthening, while Pilates focuses on strengthening and improving flexibility. In addition, the back brace is used to align the spine during treatment. These treatments are aimed at a wide range of people, from children to teenagers, adults and the elderly, depending on the type and severity of the scoliosis. The benefits include improved posture, pain reduction and muscle strengthening. In conclusion, the results of physiotherapy treatment for scoliosis can vary from person to person, but many patients report a significant improvement in their quality of life, a reduction in the progression of the curvature and pain relief. Finally, treatment should be personalised and monitored by qualified professionals.

Gabriela dos Santos Lopes — 2024-07-05

This article sought to provide a comprehensive and integrated view of the process of musculoskeletal injury and its rehabilitation, highlighting the importance of understanding the different tissues involved, biomechanical aspects and the appropriate choice of therapeutic resources to promote effective and functional recovery of patients. An extensive bibliographic survey was carried out, in which studies whose objectives and content were aligned with the aims of this research were carefully selected. The methodology employed consisted of a wide-ranging review of the specialised literature on the subject in question using the databases of the Latin American and Caribbean Literature in Health Sciences, PublicMedline, Medical Literature Analysis and Retrieval System on Line, Scientific Electronic Library Online, Google Scholar and books. The review provided up-to-date information on the musculoskeletal structures involved in injuries, recovery strategies and available treatments. It highlighted the importance of a multidisciplinary and personalised approach to effective patient recovery, taking into account the particularities of each injury and the need for an individualised rehabilitation plan. It is hoped that this review will contribute to expanding knowledge in this area and help to improve the care provided.

Huseyin Erdem AK — 2024-07-12

Millions of people suffer from lower back pain, which has social, economic, and health consequences. One of the most difficult areas to effectively manage is Chronic Low Back Pain. This systematic review and meta-analysis examine the effectiveness exclusive of surgery, including acupuncture, physiotherapy or medication (NSAIDs), chiropractic procedure, or mental therapy as advised by WHO guidelines. Thirteen studies were reviewed investigating the effect of these treatments on pain relief, functional improvement, and patient satisfaction. Pain scores, functional improvements, and patient satisfaction in the acupuncture group were superior to placebo. Adherence to physiotherapy and patient satisfaction was also good. Substantially less differential added benefits emerged from complementary intervention acupuncture (encircled in red), resulting in moderate to low satisfaction levels compared to medication, especially physiotherapy. Chiropractic effectively decreased LBP and improved function, and participants were generally very satisfied. Mental therapy provided psychological support that alleviated pain intensity and promoted improved physical function, significantly increasing the satisfaction level in these patients as part of their overall pain relief. Nonsurgical treatments, such as acupuncture (Acumoxa), physiotherapy medication, and chiropractic mental therapy, are result-oriented in relieving symptoms of CLBP. Patient satisfaction was highest for acupuncture and medication. Nonetheless, differences in research methodology and population characteristics are likely to make generalizations of what we can learn from the results a more challenging task. Future studies should improve on these limitations and the long-term safety/efficacy of these treatments. Only if alternative treatments like chiropractic and mental therapy, as suggested by WHO, are integrated in management, a line of approach for CLBP will be completed.

Nkechinyere M. Harry — 2024-07-13

Background: Bulimia nervosa (BN) is a severe eating disorder characterized by recurrent episodes of binge eating followed by compensatory behaviors such as self-induced vomiting, misuse of laxatives, fasting, or excessive exercise. Current treatment strategies, including cognitive-behavioral therapy (CBT) and pharmacotherapy, have limitations, with many patients not responding adequately and experiencing high relapse rates. GLP-1 receptor agonists, initially developed for type 2 diabetes mellitus (T2DM) and chronic weight management, have shown potential in regulating appetite and modifying behavior, suggesting a possible role in treating BN.

Objective: This review aims to assess the current evidence regarding the efficacy and safety of GLP-1 receptor agonists, particularly Semaglutide, in the treatment of bulimia nervosa.

Methods: A comprehensive literature search was conducted using PubMed and Google Scholar, focusing on articles published between 2014 and 2024. Studies included were clinical trials, case reports, and reviews addressing the use of GLP-1 receptor agonists in BN. The search terms included "Bulimia Nervosa," "Semaglutide," "GLP-1 receptor agonists," and related terms. After screening and removing duplicates, five relevant articles were included in the qualitative synthesis.

Results: The included studies demonstrated that GLP-1 receptor agonists, such as Semaglutide, liraglutide, and dulaglutide, effectively reduced binge eating episodes and body weight in patients with BN. In a notable case report, a patient with long-standing BN experienced complete resolution of symptoms within two weeks of starting liraglutide, sustained over five years. Retrospective cohort and open-label studies also showed significant reductions in binge eating severity with GLP-1 receptor agonists compared to other anti-obesity medications. Additionally, preclinical studies suggested these agents' potential in modulating appetite and reward pathways in the brain.

Conclusion: The evidence indicates that GLP-1 receptor agonists may be a promising alternative pharmacotherapy for bulimia nervosa, addressing both appetite regulation and behavioral aspects of the disorder. However, the current paucity of large-scale, randomized controlled trials necessitates further research to confirm these findings and establish the efficacy, safety, and optimal dosing of GLP-1 receptor agonists in the treatment of BN. The favorable psychiatric side effect profile and potential for improved patient adherence highlight the need for continued exploration of these agents in clinical practice.

Bruna C. Longo — 2024-06-18

Introduction: Antineoplastic therapy (AT) can cause unwanted effects, including dental alterations. However, many of the studies are case control or cohort studies, use a big number of patients, and may make it difficult to discuss the individual sequels.

Objective: Therefore, this article aims to describe five cases of patients who had done AT in childhood or adolescence and discuss the radiography alterations. The side effects related were agenesis (five patients), root anomalies (two patients) and microdontia (two patients). This individual case analysis enabled to discuss chemotherapeutic agents and radiation parameters individually and the age of dental formation when the patient did the AT.

Conclusion: In these cases, only when the therapy was perform in the age of teeth formation it was consider a direct effect of AT, so the cases presents root malformations, microdontia and premolars agenesis and third molars agenesis. On the other hand, another cases of root malformations, microdontia and third molars agenesis may be an indirect effect of AT or caused by other external factors, because the AT was not performed at the age of formation of these teeth.

Nkechinyere Mary Harry — 2024-06-17

Background: Clozapine is an antipsychotic medication essential for treating treatment-resistant schizophrenia. Its plasma levels are influenced by cytochrome P450 (CYP450) enzymes, particularly CYP1A2. Vaping and traditional smoking may impact clozapine metabolism.

Objective: This study aims to explore how vaping affects the plasma levels of clozapine, focusing on the pharmacokinetic interactions between clozapine and vaping constituents, and the implications for clinical practice.

Methods: A literature review was conducted to examine the interactions between nicotine smoking, CYP450 enzymes, and clozapine metabolism. Additionally, case reports were analyzed to understand the clinical implications for patients on clozapine who switch from smoking to vaping.

Results: Unlike traditional smoking, vaping lacks combustion products like polycyclic aromatic hydrocarbons (PAHs), leading to reduced CYP1A2 induction. Case reports showed that switching from smoking to vaping often results in elevated plasma clozapine levels due to decreased CYP1A2 activity, causing adverse effects from toxicity. However, some vape products containing combustible products like aldehydes and carbonyls can induce CYP450 enzymes, leading to subtherapeutic plasma clozapine level.

Conclusion: Vaping may affect clozapine metabolism primarily through de-induction of CYP1A2 activity in patients who switch from smoking to vaping. Switching from smoking to vaping can reduce CYP1A2 induction, thereby raising the risk of toxicity due to increased serum clozapine levels. Hence, health professionals should carefully monitor plasma clozapine levels in patients who switch from smoking to vaping and adjust dosages as needed to maintain therapeutic efficacy and minimize adverse effects.

Mustafa Moazam — 2024-06-26

This article provides a comprehensive overview of Type 1 Diabetes Mellitus (T1DM), highlighting the autoimmune origins of the illness and its therapeutic options. It discusses the role of insulin in metabolism and highlights the fact that the autoimmune destruction of pancreatic beta cells is the primary characteristic of type 1 diabetes. Environmental triggers such as viral infections, cow's milk proteins, and insufficient vitamin D are studied in addition to genetic factors such as specific alleles associated with the disease's susceptibility. The report discusses the global epidemiology of T1DM and its increasing incidence, emphasizing the need for a comprehensive approach to treatment. Various treatment options are evaluated, emphasizing the need for customized approaches to treat this complex autoimmune disease. These options include gene therapy, insulin treatment, immunomodulatory medications, and vaccination. All things considered, the study adds to our understanding of T1DM and highlights the ongoing need to develop effective treatment modalities.

Ana Flávia César Guimarães — 2024-07-01

Aims: To identify trends and growth in knowledge related to Resin Infiltrants, through a bibliometric review.

Study Design: Bibliometric review.

Methodology: A search was carried out in the Clarivate Analytics Web of Science database, using the terms (infiltrative resin OR resin infiltration) AND (white spot lesions OR white spots OR WSL OR Enamel demineralization OR orthodon* OR defect* OR hypoplas* OR discolor * OR dental fluorosis OR tooth demineralization OR calcification, tooth OR tooth discoloration OR dental enamel). Paired selection of manuscripts was carried out. The initial search identified 599 articles. After comparing titles and abstracts, the 50 most cited manuscripts involving Resinous Infiltrants were listed in order of classification.

Results: The most cited article in the top 50 was Frencken et al. in [1]. The earliest manuscript of this bibliometric analysis was published in 2001 by Robinson et al. in Caries Research and was cited 72 times, while two articles were the most recent, published in 2019 by Urquhart et al. in the Journal of Dental Research, it was cited 112 times and by Coelho Ased et al. in the Journal of Esthetic and Restorative Dentistry, cited 35 times. The citation distribution line shows high peaks in 2010 and 2012. The institutions that stood out the most were Charité Universitat Medizin Berlin, followed by Universitat zu Kiel. The main country was Germany. Among the main journals are the Journal of Dentistry and the publisher Elsevier. In total, 274 keywords were used. The period of 2010 was the period with the greatest concentration of publications and the most productive.

Conclusion: The bibliometric review carried out in this study revealed the growing interest and research around the use of Resinous Infiltrants as an effective and minimally invasive alternative to address white spot lesions and tooth decay.

R. Bharathisuma — 2024-07-13

Root canal treatment is a common procedure in endodontic dentistry treating the teeth with necrosis of the dental pulp caused by carious processes, coronal crack or fracture, or dental trauma. The success of root canal treatment depends on a number of variables related to the preoperative condition of the tooth, as well as the procedure options for endodontic treatment .A successful root canal treatment is defined by the absence of symptoms and observable clinical signs. Single visit root canal treatment used to give more success rate compared to multiple visit treatments. In this paper we aim to treatments based on time, restoration, esthetics, post operative pain, technique and fracture resistance of teeth.

Wang Hsing Han — 2024-06-18

Background: Bacterial contamination at the dental implant abutment interface through microgap may lead to peri-implant tissue infections resulting to marginal bone loss and affecting the long term success of implants.

Aims: The purpose of this In vitro study in vitro was to evaluate the antimicrobial activity of oxygen active gel (BlueM^®) against Porphyromonas gingivalis (Pg) at the implant-abutment interface (IAI) in three different types of implant-prosthetic connections.

Methodology: A total of 45 dental implants with three different types of connections were divided into three groups (n=15/each) according to filling product at the interface: Control (C) - unfilled, BlueM (BM) - oxygen active gel, Chlorexidine (CX) - 2% chlorhexidine gel. They were incubated with a solution containing Pg for 5 days under an aerobic condition. Bacterial contamination at the interface were detected and quantificated by qPCR.

Results: All 45 implants showed contamination at the IAI by Pg after 5 days of incubation, independent of prosthetic connection type. EH type connections showed greater contamination by Pg compared to MT type connections (p=0.0098). No differences were observed among different types of connections in BM and CX groups.

Conclusion: The application of active oxygen gel promoted a reduction in P. gingivalis contamination in EH type connections at the IAI in vitro, but did not eliminate it completely.

Rushita D. Nakarani — 2024-06-21

Aim: This study aimed to investigate the patterns of etiological agents, predisposing factors, radiological presentations, and bacteriological etiologies of Community- Acquired Pneumonia (CAP). The primary objective was to study the prevalence of CAP, while the secondary objective was to explore its association with age, sex, comorbidities, risk factors and causative organisms.

Study Design: Prospective observational study.

Place and Duration of Study: The study was conducted at Ruby Hall Clinic, Pune, from December 1, 2022, to November 30, 2023.

Background: Community-acquired pneumonia (CAP) Considered as one of the main causes of morbidity and mortality, particularly in the elderly. Diagnosis relies on clinical, radiological, and microbiological assessments. The study aims to provide insight into the clinical and microbiological profiles of CAP in a developing country setting.

Methodology: 72 patients aged over 12 years, presenting with clinical and radiological evidence of CAP, were enrolled. Standard investigations included complete blood count, biochemistry, sputum Gram stain and culture, blood culture, BioFire FilmArray Pneumonia Panel, chest X-ray, and CT scan. The BioFire Panel was used selectively due to cost considerations. Data analysis employed statistical methods such as the Chi-Square test, Mean, Standard Deviation, Fischer Exact test, and Odds Ratio.

Results: The mean age of the patients was 59.93 years, with a male predominance (61%). Fever, dyspnea, and cough were the predominant symptoms. Common comorbidities included hypertension, diabetes, and chronic lung diseases. Microbiological analysis revealed diverse pathogens, with gram-positive cocci in 17% and gram-negative bacilli in 11% of cases. Sputum culture and BioFire Panel identified various bacterial and viral pathogens. Prior antibiotic use significantly affected sputum culture results but not BioFire test outcomes.

Conclusion: CAP in the studied cohort presented with diverse clinical and microbiological profiles. The BioFire Panel demonstrated higher sensitivity and a broader pathogen detection range compared to conventional methods. The findings emphasize the need for precise diagnostic tools and tailored treatment strategies to manage CAP effectively.

Diogo, MLG — 2024-06-21

Aims: This study aims to assess the efficacy of red, blue, and combined red-blue light therapy versus 20% salicylic acid peel in treating Grades 2 and 3 inflammatory acne.

Study Design: Cases studies.

Place and Duration of Study: Universidade Nove de Julho, Universidade Adventista de São Paulo, São Paulo Brazil. Between March 2022 from April 2024.

Introduction: Acne is an inflammatory disorder that occurs in the pilosebaceous follicles and deeply affects the self-esteem and quality of life of individuals. Conventional treatments usually produce side effects and promote antibiotic resistance. Light therapy has emerged as a promising modality in clinical and scientific realms for acne management. This study aims to evaluate the effectiveness of red, blue and combined red-blue light therapy versus 20% salicylic acid peeling in the treatment of inflammatory acne grade 2 and 3.

Methodology: We divided 20 participants into four groups who used a mask of LEDs. Group 1 used a mask with blue light (470nm), group 2 used a mask with red light (660nm), group 3 used a mask with red (660nm) and blue (470nm) lights combined in the same device. The groups that used the LED masks received the treatment 3 times a week for 30 days, totaling 12 sessions. Group 4 was submitted to two sessions of salicylic acid peeling at 20%, every 15 days.

Results: Blue light (group 1) showed an improvement of 28.40% in the general skin condition. Group 4 of salicylic acid peeling had an improvement of 28.37%. The combined red and blue light group had an improvement of 26.43%, while the red light showed an improvement of 10.97%.

Conclusion: Based on the series of cases presented, all groups showed improvement, but blue light showed higher results than red light and salicylic acid. However, studies with a larger number of participants should be performed and the ideal parameters for Led use in inflammatory acne should be discussed.

Bede C Azudialu — 2024-06-24

Background: Diabetes is a chronic disease that occurs when the pancreas does not produce enough insulin, no insulin or when the body cannot effectively use the insulin it produces. The majority of people with diabetes have type 2 diabetes (T2DM). According to the International Diabetes Federation “diabetes is one of the largest global health emergencies of the 21st century”. The World Health Organization (WHO) ranked depression as the fourth most common disease in 2019. The connection between depression and type 2 diabetes was recognized as early as in the 17th century. Today, depression and type 2 diabetes have become a great global challenge.

Objective: To determine the prevalence of depression among adult males with type 2 DM attending General Outpatient Clinic of Federal Medical Center, Keffi Nigeria.

Methodology: The study design was hospital- based cross-sectional descriptive study on adult male diabetic patients on follow up at the GOPC of FMC Keffi.

Systematic random sampling method was used to select participants into the study. A total of 209 participants were recruited into this study, after obtaining informed consent from them. Data collected from the study participants included socio-demographic data, depression was assessed using the Hamilton Depression Rating Scale (HDRS, Biochemical Measurement (fasting blood sugar) was taken using the glucometer kits- (ACCU-CHEK Active).

Results: The age range of the study population is between 40 and 75 years with majority within 50-59 years (35.5%). A total of 101 (48.3%) of the study participants were identified by the Hamilton’s depression rating scale to be depressed, while 108 (51.7%) had no depression. Among the participants, the risk of developing depression was significantly(p=0.001) found with being divorced or unmarried and unemployment, poor glycaemic control, ingestion of alcohol, cigarette smoking, increase duration of diabetes and presence of erectile dysfunction.

Conclusion: In this study, the prevalence of depression was 48.3%. Depression is a highly prevalent health problem that is both under-diagnosed and under treated and affects the quality of life of a large number of men with type 2 diabetes mellitus. There is need to screen all diabetics for depression at any clinic visit in view of the observed high prevalence.

Chowdhury Md Navim Kabir — 2024-06-26

Epigastric discomfort with/without chest pain is a common scenario in emergency/outdoor patient department. Patients having mild to moderate epigastric discomfort without retrosternal chest pain showing maiden ECG abnormalities like ST segment elevation/ depression. That’s why importance of ECG have been proven undoubtedly as life saving emergency investigation. 35 male and 28 female patient with age group of 32-67 years of old participated in this cross sectional study. Average age of male patients was 43+_ 2 and 49+_2 in female years.23 male and 19 female had history of repeated epigastric discomfort which was subsided by injectable Esomeprazole, anti emetics. Rest of patients have minor discomfort which was subsided by oral anti ulcerants. 10 male and 11 female patients who came in emergency & OPD department for relieving epigastric discomfort without having chest pain. 7 male patients having ST segment elevation /depression and followed by Troponin- I (according to post ECG advice for confirmed heart attack) in 2 male patients.5 females diagnosed as MI after getting ECG followed by Troponin-I result. Emergency and OPD should have ECG facility for it's specificity in early MI diagnosis. This early diagnosis can reduce cardiac mortality in middle ages to elderly patients in grass root level.

Hamza Hafiani — 2024-06-27

Introduction: Delays in non-traumatic emergency abdominal surgeries can significantly impact patient outcomes. Identifying the factors contributing to these delays is crucial for improving surgical efficiency and patient care. This study aims to prospectively analyze the determinants of delays in non-traumatic emergency abdominal surgeries and their effects on clinical outcomes.

Methods: A prospective observational study was conducted on patients requiring non-traumatic emergency abdominal surgery over a one-year period. Data were collected on demographic variables, clinical characteristics, and time intervals from hospital admission to surgery. Factors such as diagnostic procedures, availability of surgical staff, operating room logistics, and preoperative optimization were analyzed. Statistical analysis was performed to identify significant predictors of surgical delays.

Results: Out of 217 patients, 40% experienced significant delays (>6 hours) from admission to surgery. Key factors contributing to delays included prolonged diagnostic workup (35%), limited operating room availability (25%), and preoperative medical optimization (20%). Delays were associated with increased postoperative complications (15% in delayed group vs. 8% in non-delayed group, p<0.05) and extended hospital stay (mean of 7 days in delayed group vs. 4 days in non-delayed group, p<0.05).

Discussion: The study highlights that diagnostic delays and operating room logistics are major contributors to surgical postponements. Addressing these issues through streamlined diagnostic protocols and improved operating room management can potentially reduce delays. Enhanced preoperative planning and resource allocation are also essential to mitigate the impact of delays on patient outcomes.

Conclusion:Delays in non-traumatic emergency abdominal surgeries are influenced by multiple factors, including diagnostic processes, operating room availability, and preoperative medical optimization. Reducing these delays through targeted interventions can improve patient outcomes and optimize surgical care.

Larissa de Menezes Jiquiriçá — 2024-06-28

Background and Aim: Falls are one of the leading causes of disability and mortality among the elderly. Risk factors for falls are multifactorial, and classified into intrinsic and extrinsic factors. The aim of this research is to investigate, using already available general public health data, the epidemiological aspects of fall-related hospitalizations among elderly individuals admitted to the Northwest mesoregion of the state of Rio de Janeiro, to establish the groundwork for future studies with specific evaluation methodologies the development of more appropriate Public Health policies.

Methods: The research was based on the data obtained from the Hospital Information System (DataSUS) and the 2022 census from the Brazilian Institute of Geography and Statistics (IBGE), assessing hospitalizations due to falls among individuals aged 60 and over in the Mesoregion of the Northwest of Rio de Janeiro between 2014 and 2023. The data were compiled for analysis of demographic distribution, fall incidence, gender distribution, and mortality rate.

Results: Significant variations in hospitalization rates were observed. Disparities in incidence rates were attributed to different degrees of exposure to risks considered as extrinsic factors predisposing to falls. The distribution of incidences by gender and age groups reflected trends observed in similar research, with women and individuals over 80 years old disproportionately requiring hospitalization. The mortality rate among elderly hospitalized for falls was 3.5%, lower than the national average.

Conclusion: The epidemiological analysis highlights the need for more effective Public Health interventions in Miracema and Itaocara. While some municipalities have succeeded in preventing falls among the elderly, others still face challenges. Sharing experiences among Municipal Health Departments, resource cooperation, joint planning of regional actions, and collaborative governance are recommended strategies to mitigate this serious Public Health issue.

Clement Odion — 2024-07-05

Background: Acute appendicitis is a common surgical condition of the abdomen. However, diagnostic difficulties may arise, resulting in high rate of negative appendicectomies.

This study aimed to assess the role of C-reactive protein (CRP) in improving the accuracy of diagnosis of acute appendicitis and thus reducing the rate of negative appendicectomies.

Materials and Method: The study was a cross-sectional, hospital-based study carried out on 66 patients who had appendicectomy following a clinical diagnosis of acute appendicitis. Samples for CRP were collected from all recruited patients preoperatively. Following appendicectomy, the appendix was sent for histology. A proforma was used to collect data. All the statistical analyses were performed using IBM statistics package for social sciences (SPSS) version 21. At 95% confidence level, p-values less than 0.05 were considered significant.

Results: Thirteen (13) of the appendices removed had normal histopathologic examination, giving a negative appendicectomy rate of 19.7%. The diagnostic accuracy, sensitivity, specificity and positive predictive value for preoperative CRP were 80%, 79%, 85% and 95% respectively.

Conclusion: An elevated level of CRP is a useful aid for the diagnosis of acute appendicitis. Deferring surgery in patients with normal CRP would likely decrease the incidence of negative appendicectomies.

Qazi Shafayetul Islam — 2024-07-09

Aims: The COVID-19 pandemic lockdown has led to a rise in the number of gender-based violence (GBV) cases within families. This increase is mainly due to patriarchal influence, prolonged stay at home, social isolation, and financial abuse. Women and girls, in particular, have been adversely affected by this phenomenon, experiencing significant mental health impacts. A study conducted in Toronto explored the various types and causes of violence against South Asian Bangladeshi women and girls and how it affects their mental health, too.

Methodology: Bangladeshi-Canadian Community Services (BCS), an ethnic organization conducted a study on gender-based violence (GBV) from Sep to Dec 2021. Two extensive Zoom group discussions involved 55 females and six males, including social workers (n=9), community leaders/workers (n=17), community youth ambassadors (n=9), and community members (n=26, among them n=11 were victims). Audio recordings were transcribed and translated into English, then thematically coded to identify forms of GBV and provide narratives based on participants' experiences.

Results: South Asian Bangladeshi women and girls have been subjected to various forms of violence by their husbands or male family members, such as physical, psychological/emotional, verbal, and financial violence. Physical violence includes shaking their wives' hands and necks and pushing wives and girls. Psychological, verbal, and financial violence includes scolding, threatening, demoralizing, blaming, belittling, coercing, stealing money, and committing financial fraud. The causes of violence against women during the lockdown are related to the loss of husbands' jobs and idleness, the tendency to establish male power over women out of fear of losing patriarchal control during a crisis, husbands' mental turmoil due to the lockdown and financial crisis, women's protest against extramarital relationships, fear of contracting viruses, taking advantage of women's vulnerability, and greediness towards wives' money. As a result of this violence, many victims have reported experiencing anxiety, mental trauma, frustration, distress, depression, and discrimination. Victims of violence have faced many obstacles in accessing appropriate providers, such as language barriers and threats from their husbands.

Conclusions: The COVID-19 pandemic has disproportionately affected South Asian Bangladeshi women and girls who are experiencing gender-based violence. To address this issue, policymakers, governments, and ethnic organizations must collaborate to create comprehensive plans that aim to eliminate gender-based violence, as well as associated cultural problems and stigma. Community organizations can provide resources and support for victims, working with families and husbands to create a safer environment for those affected.

Charles Cruz e Silva — 2024-07-09

Aims: to analyze results of partial or total colectomies conducted in colorectal cancer (CRC) patients at a private hospital in Belém, Pará, Brazil.

Study Design: The study was cross-sectional, retrospective and descriptive. Place and duration of the study: the study analyzed medical records of CRC patients subjected to either partial or total colectomy at a hospital in Belém between 2018 and 2022.

Methods: The research abided by ethical norms including the Norms for Research Involving Humans of the Health National Center. The target population was composed of CRC patients of both sexes. The definitive International Classification Diseases (ICD) C18 and C19 and the following keywords “colorectal cancer”, “colon cancer”, “partial colectomy” and “total colectomy” were used to search the medical records. The analyzed variables were: epidemiologic factors, pre-operative variables, peri-operative and post-operative variables, bleeding, oncological factors, presence of compromised lymph nodes, and early and late complications.

Results: After searching the hospital records, it was found that 414 patients were hospitalized with CRC between 2018 and 2022. Of these, 288 were not considered for the study due to the exclusion criteria and, therefore, 122 patients were included in the research. Fistulas were the most common early complication and recurrence the most common late complication with significant association to the presence of positive lymph nodes to pathological staging (p=0.025). Early deaths were most recurrent in stage IV (p=0.003). No statistical relevance was found between the type of colectomy and the presence of early (p=0.906) and late (p=0.237) complications. As for surgeries, conventional surgeries were related to higher rates of complications and prolonged admission.

Conclusion: Negative outcomes for CRC patients are related to pathological staging and patients with positive lymph nodes presented the worst results. In addition, robotic surgery and laparoscopy were related to faster recovery and lessened early complications.

Sayed Halaly — 2024-07-09

Background: Since the middle of April 2023, Sudan has experienced a large armed conflict, which resulted in millions of its people leaving their homes, being internally displaced persons (IDPs) inside the country and externally displaced to neighboring countries. A lot of them were exposed to different kinds of trauma, violence, and injuries, making them more vulnerable to psychological disorders, particularly post-traumatic stress disorder (PTSD). This study aimed to estimate the prevalence of PTSD and determine the associated risk factors among IDPs in Abo Hamad Town, Nahr Neel State, Sudan in December 2023. To our knowledge, few studies explored PTSD among IDPs in Sudan.

Materials and Methods: This is a cross-sectional community-based household study in Abo Hamad Town, Nahr Neel State, Sudan. A total of 118 adult IDPs were interviewed. A pre-tested and structured questionnaire assessed the participants' socio-demographic, clinical, and psychosocial characteristics and substance and displacement–related factors. The Short Post-traumatic Stress Disorder Rating Interview (SPRINT) scale was used to examine PTSD among them. Data were collected during two weeks by a well-trained team supervised by a consultant psychiatrist. Data were analysed using the SPSS version 22. Descriptive results were displayed using frequency tables. Bivariate and multivariate logistic regression was used to identify the association between the outcome and independent variables. A p-value equal or less than 0.05 was considered statistically significant at 95% CI.

Results: The study comprised 118 participants, 72.9% female and 27.1% male. The mean age was 29.94 years (SD+11.84). Most were educated; 57.6% were university graduates, and 22% had secondary education. Married individuals accounted for 46.6% of the sample, while 45.0% were single. More than half (53.4%) of the participants were unemployed. Over two-thirds (67.8%) had been displaced for over four months. A lack of social support was reported by half (50.9%) of the participants. While 16.9% had a chronic medical condition, 5.1% were identified as having a mental illness. The prevalence of PTSD among Internally displaced persons was found to be 70.3%, and a quarter (27.1%) had severe symptoms. The most frequent event was the participant located in an area prone to shooting, which was reported by 90.7% of respondents, followed by property destruction, difficulty lodging, forced detachment from family, and abnormal death of a family member or friend, reported by 53.4%, 50.8%, 37.3%, and 34.7% respectively. Experiencing multiple events was common, and more than half (52.5%) of the participants experienced four or more traumatic events. Related factors with significant association with PTSD were female gender, torture, witnessing the murder of a stranger, and multiple traumatic events experienced by the respondent.

Conclusion: This study showed an alarming high prevalence of PTSD among IDPs in an urban setting. Factors found to be significantly associated with PTSD were being female, experiencing torture, witnessing the murder of a stranger and exposure to multiple traumatic events. Further studies are required to investigate PTSD in IDPs, and psychological support services are of paramount importance to manage PTSD and reduce the suffering of IDPs.

Chiegboka S. Frances — 2024-07-15

Background: Co-morbidities in Lassa fever refers to the presence of other underlying medical conditions or diseases in individuals infected with the virus. These co-morbidities can significantly affect the progression and outcome of Lassa fever, making it a complex and challenging infectious disease to control.

Objective: To determine the effects of Co-morbidities on Lassa fever and it's management between 2019-2023 in a Lassa Fever Research Institute in Nigeria.

Methodology: This study was conducted at the Lassa Fever Research Institute at Irrua Specialist Teaching Hospital (ISTH) in Edo State, Nigeria. It engaged a retrospective cross-sectional design and employed a systematic sampling technique. Data analysis was done using IBM SPSS version 21.0 software for descriptive statistics. Associations were tested using the Chi-square test, with a significance level set at p<0.05.

Results: The study found that Lassa fever had no specificity for age as it affected individuals across a wide age range (18-78 years), with the highest incidence in the 47-57 year age group. Hypertension was the most common comorbid condition (30%), followed by peptic ulcer disease (20%). Ribavirin was the main stay of treatment used. The analysis showed no significant relationship between comorbidities and mortality, as the majority of cases (85%) had outstanding outcomes. However, there was a significant relationship (p=0.04) between the level of education and outcomes, with most individuals having a tertiary education and experiencing positive outcomes.

Conclusion: According to this study, it was discovered that there were no significant relationship between co morbidities and mortality as majority of the cases reviewed were seen to have good outcomes with the aid of the current treatment (ribavirin).

Seema Charitha Cheemala — 2024-06-15

The human gastrointestinal (GI) tract harbors a diverse and dynamic community of microorganisms known as the gut microbiome, which plays a fundamental role in maintaining gastrointestinal (GI) and cardiovascular health. It explores the intricate interplay between the gut microbiota, GI health, and cardiovascular diseases (CVDs). It discusses the essential roles of the gut microbiome in energy metabolism, nutrient absorption, immune regulation, and gut barrier integrity. Dysbiosis, characterized by an imbalance in gut microbiota composition, has been linked to various GI conditions, including inflammatory bowel diseases (IBD) and irritable bowel syndrome (IBS), as well as CVDs such as hypertension, atherosclerosis, and heart failure. Therapeutic strategies targeting the gut microbiome, including probiotics, prebiotics, fecal microbiota transplantation (FMT), and precision nutrition, offer promising avenues for managing GI and cardiovascular diseases. Recent research has brought attention to the significance of gut microbiota in CVDs, highlighting sex-specific variations, microbial metabolites' impact, and potential therapeutic interventions. Challenges in microbiome research, such as sample size limitations and methodological variability, are addressed, along with opportunities for innovation, including multi-omics integration and personalized medicine guided by microbiome data. By addressing these challenges and leveraging opportunities, gut microbiome research can revolutionize healthcare, ushering in a new era of personalized and microbiome-informed medicine. This comprehensive analysis offers valuable perspectives into the intricate relationship between gut microbiota, GI health, and cardiovascular diseases, paving the way for future research and clinical applications in this burgeoning field.