Search results for: psychiatric morbidity

Authors: Devasis Ghosh

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The main hindrance to total cure of cancer is a) the failure to control continued production of cancer cells, b) its sustenance and c) its metastasis. This review study has tried to address this issue of total cancer cure in a more innovative way. A 10-pronged “CRAB METHOD”, a novel holistic scientific approach of Cancer treatment has been hypothesized in this paper. Apart from available Chemotherapy, Radiotherapy and Oncosurgery, (which shall not be discussed here), seven other points of interference and treatment has been suggested, i.e. 1. Efficient stress management. 2. Dampening of ATF3 expression. 3. Selective inhibition of Platelet Activity. 4. Modulation of serotonin production, metabolism and 5HT receptor antagonism. 5. Auxin, its anti-proliferative potential and its modulation. 6. Melatonin supplementation because of its oncostatic properties. 7. HDAC Inhibitors especially valproic acid use due to its apoptotic role in many cancers. If all the above stated seven steps are thoroughly taken care of at the time of initial diagnosis of cancer along with the available treatment modalities of Chemotherapy, Radiotherapy and Oncosurgery, then perhaps, the morbidity and mortality rate of cancer may be greatly reduced.

Keywords: ATF3 dampening, auxin modulation, cancer, platelet activation, serotonin, stress, valproic acid

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Authors: Kimton Opiyo, Elliot M. Berry, Patil Karamchand, Barnabas K. Natamba

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Background: Postpartum depression (PPD) is a major psychiatric disorder that affects women soon after birth and in some cases, is a continuation of antenatal depression. Food insecurity (FI) and social support (SS) are known to be associated with major depressive disorder, and vice versa. This study was conducted to examine the interrelationships among FI, SS, and PPD among postpartum women in Gulu, a post-conflict region in Uganda. Methods: Cross-sectional data from postpartum women on depression symptoms, FI and SS were, respectively, obtained using the Center for Epidemiologic Studies-Depression (CES-D) scale, Individually Focused FI Access scale (IFIAS) and Duke-UNC functional social support scale. Standard regression methods were used to assess associations among FI, SS, and PPD. Results: A total of 239 women were studied, and 40% were found to have any PPD, i.e., with depressive symptom scores of ≥ 17. The mean ± standard deviation (SD) for FI score and SS scores were 6.47 ± 5.02 and 19.11 ± 4.23 respectively. In adjusted analyses, PPD symptoms were found to be positively associated with FI (unstandardized beta and standardized beta of 0.703 and 0.432 respectively, standard errors =0.093 and p-value < 0.0001) and negatively associated with SS (unstandardized beta and standardized beta of -0.263 and -0.135 respectively, standard errors = 0.111 and p-value = 0.019). Conclusions: Many women in this post-conflict region reported experiencing PPD. In addition, this data suggest that food security and psychosocial support interventions may help mitigate women’s experience of PPD or its severity.

Keywords: postpartum depression, food insecurity, social support, post-conflict region

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Authors: Mariana Mangas, Yaroslava Martins, Ana Matos Pires

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Introduction: Stigmatization is a common problem to overcome for people suffering from chronic diseases. It usually follows mental disorders and complicates the course of illness and reduces quality of life for people with mental illness. Objective: unsystematic review concerning stigma and mental illness, its impact on psychiatric disease and strategies to eradicate stigma. Methods: A search was conducted on PubMed, using keywords 'stigma' and 'mental illness'. Results and Discussion: Stigma is a psychosocial process that identifies individuals by the negative label of their differences. Stigma often brings a loss of occupational success and social support, reduced functioning and lower quality of life. The sense of stigma is common in individuals with mental illness and has considerable negative repercussions: delays treatment achievement, promotes social isolation, stress and maladaptive coping behaviors and it is associated with higher symptom levels, placing these individuals at higher risk for a poorer outcome and prognoses. Conclusion: Given the interrelation between stigma, symptoms, treatment seeking and disease management, stigma is a key construct in mental illness upon which anti-stigma initiatives may have considerable therapeutic potential. It will take multidisciplinary interventions to overcome mental illness stigma, including changes in social policy, attitudes and practices among mental health professionals, liaison between general public and people with a mental illness under conditions of equity and parity, family support, and easy access to evidence-based treatments.

Keywords: discrimination, stigma, mental illness, quality of life

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Authors: Berit Johannessen

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Introduction: Depression and dementia are the two most common psychiatric disorders of older people. The use of antidepressants does not always have the desired effect and serious side effects are common. Aroma therapists claim that the essential oil of Bergamot has an antidepressant effect. Aromatherapy is defined as holistic or complementary medicine and is rarely used in the Norwegian public health service, but in recent years, there has been an increasing interest in, and use of complementary and alternative therapies (CAM) in the Norwegian population, and aromatherapy is one of the most widely used. Focus for this study: How do nurses experience the use of Bergamot essential oil for patients suffering from dementia and depression? Method: Action research study including 12 patients and 8 nurses. The patients were strategically selected by the nurses and were given Bergamot in a fan diffuser every day for 12 weeks. The patients' mood and behavior patterns were reported daily and the nurse`s experiences were reported weekly. Individual interviews with the nurses were conducted at the end of the project. Results: The nurses reported that bergamot had positive impact on patients mood and wellbeing, and was considered as an effective method for six patients, four had uncertain effect and two had no effect. They also reported less use of medication and that the fan diffusers were easy and pleasant to administer. They found the use of natural remedies as Bergamot inspiring and wanted to learn more about aromatherapy and its use in nursing. Some were disturbed by the smell and some had to deal with critical and negative colleagues. Conclusion: Nurses experienced aromatherapy using bergamot oil in fan diffusers as a simple and useful procedure for patients suffering from dementia and depression. The effects were varying. Further research is needed.

Keywords: aromatherapy, bergamot, dementia, depression

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Authors: Saira Baloch, Mohsin Ali Baloch

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Background: Malaria is a potentially life-threatening disease and also a major public health problem in Pakistan. Renal failure is an emerging problem correlated with morbidity and mortality, however can be diagnosed and treated in the early stages. Objectives: To elucidate the biochemical renal parameters in patients with falciparum malaria and comparison with healthy control subjects. Method: 80 patients, who were diagnosed to be affected by falciparum malaria. Detailed history, general physical and systemic examination and necessary pathological, biochemical renal laboratory parameters and investigations were done. Results: Among the 80 patients, 43 were males and 37 were females. All patients were infected with P. falciparum. All patients had increased serum creatinine and urea levels and urine output of less than 400 ml/day were categorized as suffering from renal failure. Conclusion: Patients infected with P. falciparum are at an increased risk of developing renal failure when compared to patients infected with other complications. P. vivax has massive potential to cause life threatening complications and even death. Further research is required to understand the exact pathogenesis of various complications encountered in vivax malaria.

Keywords: falciparum malaria, renal failure, biochemical parameters, pathogenesis

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Authors: Maeah Stephanie A. Macapaz Abadejos

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Covid-19 shook the whole world. Every person on all sides of the world was affected by the pandemic. All the nations and world leaders were searching for a variety of cures and solutions to stop the spread of the virus. In connection with this, this investigative case study aims to show a relationship between COVID-19 vaccinations to the immune system of the seniors and elderly. The seniors and elderly are one of the most vulnerable populations that show high morbidity and mortality in any illnesses and diseases. This study will show lived experiences of the senior’s immune system and health status, how it is being affected by the COVID-19 virus and its vaccines, Risk for COVID-19 Infection, Hospitalization, and Death by Age Group. Participants of this study are from 3 Cebu City Barangays and 2 from Barangays of the Cities of the Cebu Province. To conclude, this study shall serve its purpose of providing clear and concise results in strengthening the evidence of the effects of the COVID-19 virus infection, especially the free vaccinations, on the health and overall well-being of the elderly and seniors.

Keywords: gerontology nursing, vaccination, protection and immunity, seniors and the elderly

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Authors: Vincent Oghenekevbe Olughor, Olusoji Mayowa Ige

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Except for a preexisting liver disease and malnutrition, there are no predilections for low serum albumin (SA) levels in humans. At normal reference levels (4.0-6.0g/dl) SA is a universal marker for mortality and morbidity risks assessments where depletion by 1.0g/dl increases mortality risk by 137% and morbidity by 89%.It has 40 known functions contributing significantly to the sustenance of human life. A depletion in SA to <2.2g/dl, in most clinical settings worldwide, leads to loss of oncotic pressure of blood causing clinical manifestations of bipedal Oedema, in which the patients remain conscious. SA also contributes significantly to buffering of blood to a life-sustaining pH of 7.35-7.45. A drop in blood pH to <6.9 will lead to instant coma and death, which can occur after SA continues to deplete after manifestations of bipedal Oedema. In an intervention study conducted in 2014 following the discovery that “SA is depleted during malaria fever”, a Nutraceutical formulated for use as treatment adjunct to prevent SA depletions during malaria to <2.4g/dl after Efficacy testing was found to be satisfactory. There are five known types of Malaria caused by Apicomplexan parasites, Plasmodium: the most lethal being that caused by Plasmodium falciparum causing malignant tertian malaria, in which the fever was occurring every 48 hours coincides with the dumping of malaria-toxins (Hemozoin) into blood, causing contamination: blood must remain sterile. Other Apicomplexan parasites, Toxoplasma and Cryptosporidium, are opportunistic infections of HIV. Separate studies showed SA depletions in MDRTB (multidrug resistant TB), and MDRTB-HIV patients by the same mechanism discovered with malaria and such depletions will be further complicated whenever Apicomplexan parasitic infections co-exist. Both Apicomplexan parasites and the TB parasite belong to the Obligate-group of Parasites, which are parasites that replicate only inside its host; and most of them have capacities to over-consume host nutrients during parasitaemia. In MDRTB patients the body attempts repeatedly to prevent depletions in SA to critical levels in the presence of adequate nutrients and only for a while in MDRTB-HIV patients. These groups of patients will, therefore, benefit from the already tested Nutraceutical in malaria patients. The Nutraceutical bio-Powder was formulated (to BP 1988 specification) from twelve nature-based food-grade nutrients containing all dedicated nutrients for ensuring improved synthesis of Albumin by the liver. The Nutraceutical was administered daily for 38±2days in 23 children, in a prospective phase-2 clinical trial, and its impact on body weight and core blood parameters were documented at the start and end of efficacy testing period. Sixteen children who did not experience malaria-induced depletions of SA had significant SA increase; seven children who experienced malaria-induced depletions of SA had insignificant SA decrease. The Packed Cell Volume Percentage (PCV %), a measure of the Oxygen carrying capacity of blood and the amount of nutrients the body can absorb, increased in both groups. The total serum proteins (SA+ Globulins) increased or decreased within the continuum of normal. In conclusion, MDRTB and MDRTB-HIV patients will benefit from a variant of this Nutraceutical when used as treatment adjunct.

Keywords: antitrypsin-free Nutraceutical, apicomplexan parasites, no predilections for low serum albumin, toxoplasmosis

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Authors: Kamel Abdelaziz Mohamed

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Intoduction:Inadequate knowledge about obstetric admission and infrequent dealing with the obstetric patients in ICU results in high mortality and morbidity. Aim of the work:To evaluate the indications, course, severity of illness, and outcome of obstetric patients admitted to the intensive care unit (ICU). Patients and Methods: We collected baseline data and acute physiology and chronic health evaluation II (APACHE II) scores. ICU mortality was the primary outcome. Results: Seventy obstetric patients were admitted to the ICU over 3 years, 36 of these patients (51.4 %) were admitted during the antepartum period. The primary obstetric indication for ICU admission was pregnancy-induced hypertension (22 patients, 31.4%), followed by sepsis (8 patients, 11.4%) as the leading non-obstetric admission. The mean APACHE II score was 19.6. The predicted mortality rate based on the APACHE II score was 22%, however, only 4 maternal deaths (5.7%) were among the obstetric patients admitted to the ICU. Conclusion: Evaluation of obstetric patients by (APACHE II) scores showed higher predicted mortality rate, however the overall mortality was lower. Regular follow up, together with early detection of complications and prompt ICU admission necessitating proper management by specialized team can improve mortality.

Keywords: obstetric, complication, postpartum, sepsis

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Authors: Masoumeh Kazemi

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Depression is one of the most common mental disorders that damage mental health. In addition to mental distress, mental health damage affects other dimensions of human health, including physical and social health. According to the national study of diseases and injuries in Iran, the third health problem of the country is depression. The purpose of this study was to measure the level of depression in people referred to Karaj psychiatric treatment centers, and to investigate the relationship between depression and drug and alcohol consumption. The statistical population included 5000 people. Morgan table was used to determine the sample size. The research questions sought to identify the relationship between depression and factors such as drug and alcohol use, employment and marital status, and gender. Beck standard questionnaire was used to collect complete information. Cronbach's alpha coefficient was used to confirm the reliability of the questionnaire. To test research hypotheses, non-parametric methods of correlation coefficient, Spearman's rank, Mann-Whitney and Kruskal-Wallis tests were used. The results of using SPSS statistical software showed that there is a direct relationship between depression and drug and alcohol use. Also, the rate of depression was higher in women, widows and unemployed people. Finally, by conducting the present study, it is suggested that people use the following treatments in combination for effective recovery: 1. Cognitive Behavioral Therapy (CBT) 2. Interpersonal Therapy (IPT) 3. Treatment with appropriate medication 4. Special light therapy 5. Electric shock treatment (in acute and exceptional cases) 6. Self-help

Keywords: alcohol, depression, drug, Iran

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Authors: A. M. U. P. Kumari, Vidanapathirana. J., Amarasekara J., Karunanayaka L.

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Leptospirosis is a zoonotic infection with significant morbidity and mortality. As an occupational disease, it has become a global concern due to its disease burden in endemic countries and rural areas. The aim of this study was to assess disease burden in terms of DALYs of leptospirosis. A hospital-based descriptive cross-sectional study was conducted using 450 clinically diagnosed leptospirosis patients admitted to base and above hospitals in Monaragala district, Sri Lanka, using a pretested interviewer administered questionnaire. The patients were followed up till normal day today life after discharge. Estimation of DALYs was done using laboratory confirmed leptospirosis patients. Leptospirosis disease burden in the Monaragala district was 44.9 DALYs per 100,000 population which includes 33.18 YLLs and 10.9 YLDs. The incidence of leptospirosis in the Monaragala district during the study period was 59.8 per 100,000 population, and the case fatality rate (CFR) was 1.5% due to delay in health seeking behaviour; 75% of deaths were among males due to multi organ failure. The disease burden of leptospirosis in the Moneragala district was significantly high, and urgent efforts to control and prevent leptospirosis should be a priority.

Keywords: human leptospirosis, disease burden, disability adjusted life Years, Sri Lanka

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Authors: Poornima Khadanga, Gaurav Pawar, Madhavi Rairikar

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Background: The COVID 19 pandemic, with its unparalleled mental health repercussions, has impacted people globally and has catalyzed a Mental Health pandemic among the youth. The detrimental effects on mental health needs to be pondered at the earliest. Aims: To study the behavioral problems among children and adolescents visiting Psychiatry Outpatient Department Tertiary Health Care during COVID pandemic and its correlation with socio-demographic profiles. Methods: A cross sectional study was conducted by interviewing 120 participants between 4 to 17 years of age and their parents, visiting Psychiatry OPD. Behavioral problems were assessed using the Strength and Difficulties Questionnaire and diagnosed by DSM-5. Statistical analysis was done by SPSS-21. Results: Male participants showed significant association with conduct (t=2.36, p=0.02) and hyperactive problems (t=5.07, p<0.05). Increase in screen time showed a positive correlation with conduct problems (r=0.22. p=0.02). Attention Deficit Hyperkinetic Disorder (18.3%) was the most commonly diagnosed psychiatric illness. Total difficulty score was significantly associated with difficult temperament (F=68.69, p<0.05). Conclusion: The study brings to light the pattern of behavioral problems that emerged during recent times of uncertainties among the young ones, including those with special needs. The increase in disruptive behaviors with increase screen time needs to be addressed at the earliest.

Keywords: behavioral problems, pandemic, screen time, temperament

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Authors: Silvia Carla Da Silva André, Angela Maria Magosso Takayanagui

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Introduction: The Medical Waste (MW) are responsible per 2% of total waste generated for a city and has merited attention due the risks that offers to the public health and environment, representing an important aspect in waste management. In Brazil, the Resolution 306/04 of the National Health Surveillance Agency classifies the MW into 5 groups as follows: Group A (GA) biological, Group B (GB) chemical, Group C (GC) radioactive waste, Group D (GD) common, and Group E (GE) sharps. Objective: This study aimed to determine the amount of waste generated in hospitals of Ribeirão Preto, São Paulo, Brazil. Material and Methods: This is a field research, exploratory, using quantitative variables. The survey was conducted in 11 hospitals in Ribeirão Preto, located in the State of São Paulo, Brazil. It is noted that the study sample included general hospitals, skilled, university, maternity, and psychiatric; public, private, and philanthropic; and large, medium, and small. To quantify the MW, the weighing of the waste was held for six days, following methodology adapted from PAHO. Data were analyzed using descriptive statistics, determining the average global generation of MW and for each group. This research was carried out after approval by the Ethics in Research of the University of São Paulo. Thus, in order to comply with the ethical principles of research, to present the results hospitals were numbered from 1 to 11. Results: The data revealed a greater generation of biological waste among teaching hospitals, which can be justified by the use of materials for the realization of techniques.

Keywords: environmental health, management of medical waste, medical waste, public health

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Authors: Hami Ashraf, Farid Kosari

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Graft-versus-host disease (GvHD) is a common complication of allogeneic hematopoietic stem cell transplantation that can lead to significant morbidity and mortality. Histopathological examination of affected tissues is an essential tool for diagnosing and grading GvHD in animal models, which are used to study disease mechanisms and evaluate new therapies. In this systematic review, we identified and analyzed original research articles in PubMed, Scopus, Web of Science, and Google Scholar that described grading systems for GvHD in animal models based on histopathological features. We found that several grading systems have been developed, which vary in the tissues and criteria they assess, the severity scoring scales they use, and the level of detail they provide. Skin, liver, and gut are the most commonly evaluated tissues, but lung and thymus are also included in some systems. Our analysis highlights the need for standardized criteria and consistent use of grading systems to enable comparisons between studies and facilitate the translation of preclinical findings to clinical practice.

Keywords: graft-versus-host disease, GvHD, animal model, histopathology, grading system

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Authors: Celestina Omoso Isiramen

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The influence of witchcraft belief on disease causation, cure and public health system in Nigeria cannot be underrated. This paper investigated the nexus between witchcraft phenomenon and health-seeking behaviour of HIV sufferers in Edo state, Nigeria. Survey methodology was adopted and stratified random sampling technique was employed in the selection of 600 sample group spread into 200 HIV sufferers, 200 spiritual healers and 200 bio-medics from the three Senatorial districts of the state. Data were collected through the use of structured questionnaire and in-dept interview and analyzed using simple percentage and frequency. Major findings were: belief in witchcraft significantly influenced the people’s perception of HIV causation and wellness and this impacted adversely on public health-care. Poverty, ignorance and dearth of retroviral drugs enhanced the people’s recourse to spiritual healers. Collaboration between spiritual healing techniques and biomedicine was recommended as panacea for curbing HIV/AIDS related morbidity and mortality. It concluded that socio-economic problems must be addressed while the importance of integrating the values of spiritual healing into biomedicine cannot be overstressed.

Keywords: biomedicine, health care, HIV/AIDS, spirituality, witchcraft

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Authors: Benaissa Fatima, Alkama Rezak, Annesi-Maesano Isabella

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To assess the health impact of the air pollution on the population of Béjaia, we carried out a descriptive epidemiologic inquiry near the medical establishments of three areas. From the registers of hospital admissions, we collected data on the hospital mortality and admissions relating to the various cardiorespiratory pathologies generated by this type of pollution. In parallel, data on the automobile fleet of Bejaia and other measurements were exploited to show that the concentrations of the pollutants are strongly correlated with the concentration the urban traffic. This study revealed that the whole of the population is touched, but the sensitivity to pollution can show variations according to the age, the sex and the place of residence. So the under population of the town of Bejaia marked the most raised death and morbidity rates, followed that of Kherrata. Weak rates are recorded for under rural population of Feraoun. This approach enables us to conclude that the population of Béjaia could not escape the urban pollution generated by her old automobile fleet. To install a monitoring and measuring site of the air pollution in this city could provide a beneficial tool to protect its inhabitants by them informing on quality from the air that they breathe and measurements to follow to minimize the impacts on their health and by alerting the authorities during the critical situations.

Keywords: air, urban pollution, health, impacts

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Authors: Anisa Suraya Ab Razak, Izza Hayat

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Introduction: The diagnosis and management of severe hyponatremia in neuropsychiatric patients present a significant challenge to physicians. Several factors contribute, including diagnostic shadowing and attributing abnormal behavior to intellectual disability or psychiatric conditions. Hyponatraemia is the commonest electrolyte abnormality in the inpatient population, ranging from mild/asymptomatic, moderate to severe levels with life-threatening symptoms such as seizures, coma and death. There are several documented fatal case reports in the literature of severe hyponatremia secondary to psychogenic polydipsia, often diagnosed only in autopsy. This paper presents a case study of acute severe hyponatremia in a neuropsychiatric patient with early diagnosis and admission to intensive care. Case study: A 21-year old Caucasian male with known epilepsy and learning disability was admitted from residential living with generalized tonic-clonic self-terminating seizures after refusing medications for several weeks. Evidence of superficial head injury was detected on physical examination. His laboratory data demonstrated mild hyponatremia (125 mmol/L). Computed tomography imaging of his brain demonstrated no acute bleed or space-occupying lesion. He exhibited abnormal behavior - restlessness, drinking water from bathroom taps, inability to engage, paranoia, and hypersexuality. No collateral history was available to establish his baseline behavior. He was loaded with intravenous sodium valproate and leveritircaetam. Three hours later, he developed vomiting and a generalized tonic-clonic seizure lasting forty seconds. He remained drowsy for several hours and regained minimal recovery of consciousness. A repeat set of blood tests demonstrated profound hyponatremia (117 mmol/L). Outcomes: He was referred to intensive care for peripheral intravenous infusion of 2.7% sodium chloride solution with two-hourly laboratory monitoring of sodium concentration. Laboratory monitoring identified dangerously rapid correction of serum sodium concentration, and hypertonic saline was switched to a 5% dextrose solution to reduce the risk of acute large-volume fluid shifts from the cerebral intracellular compartment to the extracellular compartment. He underwent urethral catheterization and produced 8 liters of urine over 24 hours. Serum sodium concentration remained stable after 24 hours of correction fluids. His GCS recovered to baseline after 48 hours with improvement in behavior -he engaged with healthcare professionals, understood the importance of taking medications, admitted to illicit drug use and drinking massive amounts of water. He was transferred from high-dependency care to ward level and was initiated on multiple trials of anti-epileptics before achieving seizure-free days two weeks after resolution of acute hyponatremia. Conclusion: Psychogenic polydipsia is often found in young patients with intellectual disability or psychiatric disorders. Patients drink large volumes of water daily ranging from ten to forty liters, resulting in acute severe hyponatremia with mortality rates as high as 20%. Poor outcomes are due to challenges faced by physicians in making an early diagnosis and treating acute hyponatremia safely. A low index of suspicion of water intoxication is required in this population, including patients with known epilepsy. Monitoring urine output proved to be clinically effective in aiding diagnosis. Early referral and admission to intensive care should be considered for safe correction of sodium concentration while minimizing risk of fatal complications e.g. central pontine myelinolysis.

Keywords: epilepsy, psychogenic polydipsia, seizure, severe hyponatremia

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Authors: Babak Rezavand

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Pneumocystis carinii pneumonia (PCP) is one of the main causes of morbidity and mortality among immunocompromised and HIV-positive patients and remained one of the most important common opportunistic infections in these individuals in the world. Pneumocystis infection has been reported in many mammals. The aim of this study was to determine the Pneumocystis infection in wild rats as natural reservoirs of this organism in Tehran city, Iran. Fifty three rats (Rattus rattus) were live trapped in different areas of Tehran city, Iran. After isolation of their lung tissues and homogenization in sterile conditions, DNA was extracted. DNAs from all of the Pneumocystis species were amplified by pAZ102-H and pAZ102-E primers, and Nested PCR was performed using pAZ102-X and pAZ102-W primers from the initial PCR product for all the species of Pneumocystis. Amplification of the genome revealed the presence of Pneumocystis in the lungs of 17 rats (32%) through a PCR product with a bandwidth of 346 bp. In the Nested PCR amplification, from the PCR product of 53 rats, 64.2% of the samples were positive with a bandwidth of 261bp. Pneumocystis SPP infestation is highly prevalent among wild rats in Tehran city, indicating the existence of infection in the natural ecosystem of these rodents. As a host, rat plays an important role in the transmission of the microorganism in the world.

Keywords: pneumocystis SPP, rattus rattus, nested PCR, Tehran

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Authors: Rubab Z. Kahlon, Ibtisam Butt, Isma Younis, Aamer G. Mufti

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Worldwide lung cancer 1.61 million cases were seen in both genders. Lung carcinoma is the major cause of both morbidity and mortality in the world. Purpose of the present study was to describe the spatio- temporal trends of lung cancer in both genders. A retrospective study was conducted. Total 1498 patients of lung carcinoma were examined. Only lung cancer patients from all over the Punjab were included in the present study. MS Excel 2010 was used for data tabulation and calculation while the Arc GIS version 9.3 was used for geographical representation of the data. 1498 cases of Lung cancer were found from 2008-2012. The number of male patients was 1236 and female was 262. Majority of the patients were from Lahore districts with 807 patients. Lung cancer was more prevalent in male as compared to female in our region. Increase in the prevalence of lung cancer was prominently seen in the most populated and industrial areas of the Punjab province. Time trend of five years showed fluctuation in the lung cancer incidence during the study period.

Keywords: districts, gender, lung cancer trends, Punjab province of Pakistan

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Authors: Waqas Mehdi, Muhammad Umar Hassan, Khadeeja Mustafa

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Objective: Post-concussion syndrome (PCS) is a medical term used to point out the complicated combination of physical, emotional, cognitive and behavioral signs and symptoms associated with Mild Traumatic Brain Injury(mTBI). This study was conducted to assess the improvement or debilitating effect of behavioral therapy in addition to the conventional treatment and to document these results for increasing the efficiency of treatment provided to such cases. Method: This was primarily an interventional prospective cohort study which was conducted in the Department of Neurosurgery, Mayo Hospital Lahore. The sample size was 200 patients who were randomly distributed into two groups. The interventional group with Cognitive behavioral therapy was added in addition to the conventional treatment regimen and the Control group receiving only conventional treatment. Results were noted initially as well as after two weeks of the follow-up period. Data were subsequently analyzed by Statistical Package for Social Sciences (SPSS) software and associations worked out. Result and conclusion: Among the patients that were given therapy sessions along with conventional medicine, there was a significant improvement in the symptoms and their overall quality of life. It is also important to notice that the time period taken for these effects to wane is cut down by psychiatric solutions too. So we can conclude that CBT sessions not only speed up recovery in patients with post-concussion syndrome they also aid in the efficiency improvement in functional capability and quality of life.

Keywords: neurosurgery, CBT, PCS, mTBI

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Authors: Alami Ilyass, Kharchoufa Loubna, Alachouri Mostafa

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Cardiovascular disease (CDV) remains the major cause of morbidity; mortality and disability throughout the world. The ethnopharmcological and ethnobotanical studies are the paramount importance to set a high value on phytogenetic resources and to address health problems of some communities; especially poor peoples. Our work presents an analysis of published data from studies, that have been undertaken, in Morocco, by different seeker teams in separately areas during the last decades. Objectives: Evaluate and identify medicinal plants used for cardiovascular treatment by Moroccan people. Methodology: All these studies have the same approaches ; they were conducted by interviewing people suffering from diabetes. We use Factorial Analysis (FA) and principal Components analysis (PCA) to analyse the aggregated data from the different studies. Results: globally; 95 plants species were listed; all these plant were used empirically by Moroccan society for treating cardiovascular problems. These plants were divided in to 42 families and 87 genus. The lamiaceae; asteraceae; Apiaceae and poaceae are the botanical families with high number of plant species. Coclusion: Traditional medecine has been widely used for treatment of cardiovascular problems and it has been recognized as an interesting alternative to conventional medicine.

Keywords: cardiovascular, ethnobotanical, medicinal plants, Morocco

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Authors: Hendra Wibowo, Suprayitno Wardoyo, Dhama Shinta

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Introduction: Pediatric pulmonary tuberculosis (TB) incidence was increasing, with many undetected cases. In complicated TB, treatment should consist of returning pulmonary function, preventing further complications, and eliminating bacteria. Complicated TB management was still controversial, and surgery was one of the treatments that should be evaluated in accordance with its role in the treatment of complicated TB. Method: This study was an evidence-based case report. The database used for the literature search were Cochrane, Medline, Proquest, and ScienceDirect. Keywords for the search were ‘primary pulmonary tuberculosis’, ‘surgery’, ‘lung resection’, and ‘children’. Inclusion criteria were studies in English or Indonesian, with children under 18 years old as subject, and full-text articles available. The assessment was done according to Oxford Centre for evidence-based medicine 2011. Results: Six cohort studies were analyzed. Surgery was indicated for patients with complicated TB that were unresponsive towards treatment. It should be noted that the experiments were done before the standard WHO antituberculosis therapy was applied; thus, the result may be different from the current application. Conclusion: Currently, there was no guideline on pulmonary resection. However, surgery yielded better mortality and morbidity in children with complicated pulmonary TB.

Keywords: pediatric, pulmonary, surgery, therapy, tuberculosis

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Authors: Olivier Mulisya, Guelord Barasima, Henry Mark Lugobe, Philémon Matumo, Bienfait Mumbere Vahwere, Hilaire Mutuka, Zawadi Léocadie, Wesley Lumika

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Abdominal pregnancy is defined as pregnancy anywhere within the peritoneal cavity, exclusive of tubal, ovarian, or broad ligament locations. It is a rare form of ectopic pregnancy with high morbidity and mortality for both the mother and the fetus. Diagnosis can be frequently missed in most poor-resource settings because of poor antenatal coverage, low socioeconomic status in most of the patients as well as lack of adequate medical resources. Clinical diagnosis can be very difficult and an ultrasound scan is very helpful during the early stages of gestation but can also be disappointing in the later stages. We report a case of a 25-year-old woman with severe abdominal pain not amended with any medication. A clinical picture of shock lead to an emergency laparotomy which confirmed the diagnosis of abdominal pregnancy. The ministry of health in developing countries should make an effort to make routine early ultrasounds accessible to pregnant women, and obstetricians should keep in mind the possibility of ectopic pregnancy, irrespective of the gestational age.

Keywords: abdominal pregnancy, live new bron, ultrasound imaging, abdominal pain

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Authors: Zhenfeng Xie

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Acute gastroenteritis (AGE) is a common cause of morbidity and mortality in infants and young children worldwide, especially in developing countries. Enterovirus(EVs) have been identified in patients with AGE in many countries around the world, and some studies have revealed that EV infection is associated with gastrointestinal symptoms and plays a role in AGE. As a potential causative pathogen of AGE in humans, continuous detection and identification of EVs in pediatric patients with AGE is needed. In this study, we aimed to investigate the prevalence, seasonal distribution, and molecular characteristics of EVs circulating in pediatric patients with AGE in Thailand from 2019 to 2022. A total of 1422 stool specimens were collected for this study. RT-PCR amplification of the 5'UTR was used to screen for EV positive samples. EV genotyping was determined based on nucleotide sequence and phylogenetic analysis of the VP1 sequences. EV prevalence in pediatric AGE patients was 8.3% (118 out of 1,422). Among these, 35.6% of EV infection cases were caused by species A, followed by species C and B (33.1% and 30.5%, respectively). A total of 26 EV genotypes were identified in this study. Poliovirus 3 and coxsackievirus A2 were the predominant genotypes detected(14% and 13%, respectively). EV was detected all year round with higher prevalence between July and December. In summary, this study reports EV's prevalence and genotype diversity in pediatric patients with AGE in Thailand during 2019-2022.

Keywords: enterovirus, epidemiology, acute gastroenteritis, genotype

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Authors: N. David, H. O. Gao

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Air pollution is a serious environmental threat on a global scale and can cause harm to human health, morbidity and premature mortality. Reliable monitoring and control systems are therefore necessary to develop coping skills against the hazards associated with this phenomenon. However, existing environmental monitoring means often do not provide a sufficient response due to practical and technical limitations. Commercial microwave links that form the infrastructure for transmitting data between cell phone towers can be harnessed to map rain at high tempo-spatial resolution. Rainfall causes a decrease in the signal strength received by these wireless communication links allowing it to be used as a built-in sensor network to map the phenomenon. In this study, we point to the potential that lies in this system to indirectly monitor areas where air pollution is reduced. The relationship between pollutant wash-off and rainfall provides an opportunity to acquire important spatial information about air quality using existing cell-phone tower signals. Since the density of microwave communication networks is high relative to any dedicated sensor arrays, it could be possible to rely on this available observation tool for studying precipitation scavenging on air pollutants, for model needs and more.

Keywords: air pollution, commercial microwave links, rainfall, washout

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Authors: Basuki Supartono

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Introduction: Diabetic wound risks limb amputation, and the healing remains challenging. Chronic Hyperglycemia caused the insufficient inflammatory response and impaired ability of the cells to regenerate. Tissue Engineering Technique is mandatory. Methods: Tissue engineering (TE)-based therapy Utilizing mononuclear cells, plasma rich platelets, and collagen applied on the damaged tissue Results: TE technique resulting in acceptable outcomes. The wound healed completely in 2 months. No adverse effects. No allergic reaction. No morbidity and mortality Discussion: TE-based therapy utilizing mononuclear cells, plasma rich platelets, and collagen are safe and comfortable to fix damaged tissues. These components stop the chronic inflammatory process and increase cells' ability for regeneration and restoration of damaged tissues. Both of these allow the wound to regenerate and heal. Conclusion: TE-based therapy is safe and effectively treats unhealed diabetic lesion.

Keywords: diabetic foot lesion, tissue engineering technique, wound healing, stemcells

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Authors: Frank Boris Feutmba Keutchou, Saurelle Fabienne Bieghan Same, Verelle Elsa Fogang Pokam, Charles Ursula Metapi Meikeu, Angel Marilyne Messop Nzomo, Ousman Tamgue

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Infectious diseases are one of the most important causes of morbidity and mortality worldwide. These diseases are caused by micro-pathogenic organisms, such as bacteria, viruses, parasites, and fungi. Heritable changes in gene expression that do not involve changes to the underlying DNA sequence are referred to as epigenetics. Emerging evidence suggests that epigenetic mechanisms are important in the emergence and progression of infectious diseases. Pathogens can manipulate host epigenetic machinery to promote their own replication and evade immune responses. The Human Genome Project has provided new opportunities for developing better tools for the diagnosis and identification of target genes. Several epigenetic modifications, such as DNA methylation, histone modifications, and non-coding RNA expression, have been shown to influence infectious disease outcomes. Understanding the epigenetic mechanisms underlying infectious diseases may result in the progression of new therapeutic approaches focusing on host-pathogen interactions. The goal of this study is to show how different infectious agents interact with host cells after infection.

Keywords: epigenetic, infectious disease, micro-pathogenic organism, phenotype

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Authors: Feyza Gökce, Jochen Gensichen, Antonius Schneider, Karolina de Valerio, Gabriele Pitschel-Walz

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People with depressive symptoms often first consult a General Practitioner (GP) before making use of other treatment options. The present study shows the adaptation and evaluation of a psychoeducational program for patients with depressive symptoms that are treated by GPs in Bavaria, Germany. The adaptation of an existing psychoeducational program, that is used in inpatient psychiatric settings, was performed in exchange with experts (psychotherapists, general practitioners, and a patient representative). As a result, a program consisting of 4 psychoeducational sessions was developed, which is carried out in individual settings in GP practices by the practitioners themselves. This program will be compared to treatment as usual that patients with depression receive by GPs. Data is collected at 3 measurement points (baseline, 3-months-follow-up, 6-months-follow-up) using different questionnaires (BDI-II, D-Lit-R German, FERUS, PAM13-D, PHQ-9, GAD-7, PHQ-15, PC-PTSD-5). In addition to the change in depressive symptoms, changes in depression knowledge, self-efficacy, and patient activation will be analyzed, and the feasibility of the program and the subjective benefit for GPs and patients will be assessed. By now, 84 patients have been recruited by 20 cluster-randomized GP practices, with 73.5% of the participants being female and 26.5% being males. The average age was M= 50.1 (SD= 14.67) years. The change in depression symptoms over the 3-month period will be compared between the two study conditions by using a linear mixed model by the end of data collection (December 2023). The subjective benefit for the patients and GPs will be assessed via feedback questionnaires. Results will be presentable by the beginning of 2024 and will provide indications for further development and barriers to the implementation of such a program for GP practices.

Keywords: depression, general practice, psychoeducation, primary care

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Authors: Dhruv J. Limaye, Hanga Galfalvy, Cheick A. Sissoko, Yung-yu Huang, Chunanning Tang, Ying Liu, Shu-Chi Hsiung, Andrew J. Dwork, Gorazd B. Rosoklija, Victoria Arango, Lewis Brown, J. John Mann, Maura Boldrini

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Memory and emotion require hippocampal cell viability and connectivity and are disrupted in major depressive disorder (MDD). Applying shotgun proteomics and stereological quantification of neural progenitor cells (NPCs), intermediate neural progenitors (INPs), and mature granule neurons (GNs), to postmortem human hippocampus, identified differentially expressed proteins (DEPs), and fewer NPCs, INPs and GNs, in untreated MDD (uMDD) compared with non-psychiatric controls (CTRL) and antidepressant-treated MDD (MDDT). DEPs lower in uMDD vs. CTRL promote mitosis, differentiation, and prevent apoptosis. DEPs higher in uMDD vs. CTRL inhibit the cell cycle, and regulate cell adhesion, neurite outgrowth, and DNA repair. DEPs lower in MDDT vs. uMDD block cell proliferation. We observe group-specific correlations between numbers of NPCs, INPs, and GNs and an abundance of proteins regulating mitosis, differentiation, and apoptosis. Altered protein expression underlies hippocampus cellular and volume loss in uMDD, supports a trophic effect of antidepressants, and offers new treatment targets.

Keywords: proteomics, hippocampus, depression, mitosis, migration, differentiation, mitochondria, apoptosis, antidepressants, human brain

Procedia PDF Downloads 100

Authors: Milind Bharambe, Chander Shekhar

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India is a vast country with its 1.21 billion population at the dawn of new decade, which accounts for one sixth of the global human capital in the world today. It is well known that health expenditure in India is dominated by private spending. This is an unfortunate consequence of India’s development because of large positive externality associated with health spending, which make health a merit good. This paper has used data from NSSO and Indian Government’s spending on health as reported by Ministry of Health and Family Welfare. Understanding of the dynamism of age-structure of the population would greatly optimize the expenditure on health care services. A country with good public health indicators is bound to possess good human capital which is an asset to the economic growth and indicator of development status of country. The paper tries to present the linkages between the health expenditure incurred by different states at various levels of demographic transition levels and the efficiency in utilization of health expenditure. It also looks into the way in which allocative efficiency health services can be improved. Paper tries to explore the per capita spending on health and how the demographic transition taking place in different states of India affect the required quantity and quality of health services.

Keywords: age structure, demographic transition, health expenditure, morbidity

Procedia PDF Downloads 403

Authors: Hind O. Osman, Tilal Elsaman, Bashir A. Yousef, Esraa Elhadi, Aimun A. E. Ahmed, Eyman Mohamed Eltayib, Malik Suliman Mohamed, Magdi Awadalla Mohamed

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Epilepsy is the most common neurological condition and cause of substantial morbidity and mortality. In the present study, the molecular hybridization tool was adopted to obtain six Schiff bases of isatin and adamantane-1-carbohydrazide (18–23). Then, their anticonvulsant activity was evaluated using a pentylenetetrazole- (PTZ-) induced seizure model using phenobarbitone as a positive control. Our findings showed that compounds 18–23 provided significant protection against PTZ-induced seizure, and maximum activities were associated with compound 23. Moreover, all investigated compounds increased the latency of induced convulsion and reduced the duration of epilepsy, with compound 23 being the best. Interestingly, most of the synthesized molecules showed a reduction in neurological symptoms and severity of the seizure. Molecular docking studies suggest GABA-A receptor as a potential target, and in silico ADME screening revealed that the pharmaceutical properties of compound 23 are within the specified limit. Thus, compound 23 was identified as a promising candidate that warrants further drug discovery processes.

Keywords: isatin and adamantane, anticonvulsant activity, PTZ-induced seizure, molecular docking

Procedia PDF Downloads 207