Malaria helminth co–infections and their contribution for aneamia in febrile patients attending Azzezo health center,Gondar, Northwest Ethiopia: a cross sectional study

ObjectiveTo assess the prevalence of malaria helminth co-infections and their contribution for aneamia in febrile patients attending Azzezo health center, Gondar, Northwest Ethiopia.MethodsA cross section study was conducted among febrile patients attending Azezo health center from February-March 30, 2011. Convenient sampling technique was used to select 384 individuals. Both capillary blood and stool were collected. Giemsa stained thick and thin blood film were prepared for identification of Plasmodium species and stool sample was examined by direct wet mount and formalin-ether concentration technique for detection of intestinal helminthes parasites. Haemoglobin concentration was determined using a portable haemoglobin spectrophotometer, Hemocue Hb 201 analyzer.ResultsOut of 384 febrile patients examined for malaria parasites, 44 (11.5%) individuals were positive for malaria parasites, of which Plasmodium vivax accounted for 75.0% (33), Plasmodium falciparum for 20.5% (9) infectious, whereas two person (4.5%) had mixed species infection. Prevalence of malaria was higher in males (28) when compared with prevalence in females (16). More than half (207, 53.9%) of study participants had one or more infection. Prevalence was slightly higher in females (109, 52.7%) than in males (98, 47.3%). About helminths, Ascaris lumbricoides was the predominant isolate (62.1%) followed by hookworms (18.4%). Only 22 participants were co-infected with malaria parasite and helminths and co-infection with Ascaris lumbricoides was predominant (45.0%). The prevalence of anemia was 10.9% and co-infection with Plasmodium and helminth parasites was significantly associated with (P< 0.000 1) higher aneamia prevalence compared to individuals without any infection.ConclusionsPrevalence of malaria and soil transmitted helminths is high and the disease is still major health problem in the study area. Hence, simultaneous combat against the two parasitic infections is very crucial to improve health of the affected communities in economically developing countries.     

Evaluation of serum 25-hydroxyvitamin D levels in calcific rheumatic mitral stenosis— A cross sectional study

Background and aim of the studyRheumatic mitral stenosis (RMS) is an autoimmune, progressive destructive valve disease occurring as a sequele of streptococcal infection. Epidemiological studies support an association of vitamin D deficiency with initial susceptibility and severity of autoimmune diseases. The aim of the present study was to assess serum level of 25 hydroxyvitamin D in subjects of RMS and assess if any correlation exists with serum levels of vitamin D and severity of disease along with calcification assessed semi-quantitatively by echocardiography by applying Wilkins score.MethodFifty five patients of RMS without any calcification of the valves (Group A) assessed by echocardiography along with fifty five patients of RMS with mild to moderately calcified valves (Group B, Wilkins calcium score 1 or 2) and 55 patients with severely calcified valves (Group C, Wilkins calcium score 3 or 4) were enrolled for the study. All subjects underwent clinical, echocardiographic, and biochemical evaluation. The total Wilkins score, Wilkins calcium score along with serum level of 25 hydroxyvitamin D was evaluated in all the patients.ResultsThe median serum level of 25 hydroxyvitamin D was significantly lower in Group B (20.4 ng/ml, p < 0.001) and group C (11.4 ng/ml, p < 0.001) compared to Group A patients (27.9 ng/ml). Similarly serum level of 25 hydroxyvitamin D in Group C patients were significantly less than Group B patients (p < 0.001). A significant inverse correlation was identified between serum level of 25 hydroxyvitamin D and total Wilkins score (r = −0.65, p < 0.001) as well as Wilkins calcium score (r = −0.69, p < 0.001). But no correlation was identified between 25 hydroxyvitamin D levels and other echocardiographic parameters of RMS.ConclusionOur study showed a significantly lower level of 25 hydroxyvitamin D in subjects of RMS with severely damaged and calcified valves as compared to those with less severely damaged non-calcified valves and it correlated with both Wilkins score and Wilkins calcification score. Thus a link may exist between vitamin D deficiency (an immunomodulator) and severity of autoimmune injury on the valves.     

Characteristics and risk factors for advanced lung cancer with pulmonary embolism: A cross‐sectional,case–control study

Objectives

Pulmonary embolism (PE) is a life-threatening complication that can occur in patients with lung cancer. In this study, we aimed to identify risk factors and examine the clinical characteristics of advanced lung cancer patients with PE.

Methods

We conducted a retrospective review of patients admitted to our two hospitals between January 2020 and June 2022. The case group consisted of patients with lung cancer and PE, and a closely matched control group was included to identify risk factors. Statistical analysis was conducted using R language.

Results

A total of 4957 patients were reviewed, and 162 patients (comprising 54 cases and 108 controls) were included in this study. The prevalence of lung cancer with PE in the study population was 1.08%. The majority of patients were male, and the most common histological subtype was adenocarcinoma (67%), followed by squamous cell carcinoma, small cell carcinoma, and poorly differentiated non-small cell lung cancer. The majority of patients had a high performance status (PS) score, with 50% experiencing respiratory failure (mainly hypoxia) and 33% with deep vein thrombosis (DVT). Forty-eight percent of patients were diagnosed with concurrent PE. Further analysis showed that PE was an independent predictor of poor survival, and a PS score of >1 was an independent risk factor for PE in patients with lung cancer.

Conclusion

Our study provides valuable insights into the epidemiology and prognosis of PE in lung cancer patients and suggests that a poor ECOG PS, which has not been previously reported, is an independent risk factor for PE.     

Diagnostic yield of endoscopy in irritable bowel syndrome: A nationwide prevalence study 1987–2016

Introduction: Symptoms of irritable bowel syndrome (IBS) are common reasons for endoscopic procedures. We examined the yield of colonoscopy and upper endoscopy in IBS for several organic diseases.Methods: Matched population-based prevalence study in Sweden. We identified 21,944 participants diagnosed with IBS from 1987 to 2016 undergoing colonoscopy with a biopsy from all of Sweden's 28 pathology departments within 6 months of diagnosis. We compared prevalence of histopathology-proven diagnoses of inflammatory bowel disease (IBD), colorectal cancer, precancerous polyps, and microscopic colitis between patients recently diagnosed with IBS and matched controls without IBS (n = 81,101) undergoing colonoscopy. We also compared prevalence of celiac disease between patients diagnosed with IBS (n = 9,965) and matched controls (n = 45,584) undergoing upper endoscopy with biopsy. IBS patients were also compared to their siblings. Conditioned logistic regression estimated adjusted odds ratios (aORs).Results: Biopsy-proven IBD was seen in 1.6% of IBS and in 5.9% of controls (aOR=0.21; 95%CI=0.19–0.24). The prevalence of precancerous polyps was 4.1% vs. 13.0% (aOR=0.28; 95%CI=0.26–0.30), colorectal cancer 0.8% vs. 6.3% (aOR=0.17; 95%CI=0.14–0.20) and celiac disease 1.9% vs. 3.4% (aOR=0.54; 95%CI=0.47–0.63). Conversely, the prevalence of microscopic colitis was 2.9% vs. 1.7% (aOR=1.77; 95%CI=1.61–1.95), with higher prevalence in older patients and patients with IBS with diarrhea. Yield of colonoscopy for precancerous polyps, colorectal cancer, and microscopic colitis increased by age. Our findings were consistent using unaffected siblings as the comparator group.Discussion: The diagnostic yield of upper endoscopy and colonoscopy for organic disease is low in patients with a first-time diagnosis of IBS, though increases with age.     

Application of protection motivation theory in epidemic prevention in patients with respiratory diseases under the COVID‐19 pandemic: A cross‐sectional study

Objective

This study aimed to investigate the effects of nursing intervention based on protection motivation theory (PMT) on patients with respiratory diseases in the context of the Coronavirus Disease 2019 (COVID-19) pandemic.

Methods

A total of 74 patients with respiratory diseases who were hospitalized from June 2020 to February 2021 were enrolled and stratified into a control group (n = 37) and an experimental group (n = 37) according to a stratified random sampling method. The control group adopted a routine nursing intervention program of the respiratory department, whereas the experimental group received a PMT-based nursing intervention program on the basis of the control group. Chronic Disease Self-Management Study Measures (CDSMS) and Self-Efficacy for Managing Chronic Diseases 6-item Scale (SECD6) were used to evaluate the effect of PMT intervention before intervention, after 1 week, and after 4 weeks of intervention. The levels of forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC and peak expiratory flow (PEF) were measured to evaluate pulmonary function.

Results

Before the intervention, there were no significant differences in the scores of CDSMS and SECD6 scales and liver function indexes between the two groups (p > 0.05). After 1 and 4 weeks of intervention, the scores of CDSMS and SECD6 scales of the experimental group were significantly higher than those of the control group (p < 0.0001). The indexes of pulmonary function of the experimental group were improved, but there was no significant difference compared with the control group (p > 0.05).

Conclusion

Nursing intervention based on PMT contributes to the improvement of self-management behaviors and self-efficacy, which is conducive to the prognoses of patients.     

Rising trend of cardiovascular risk factors between 1991–1994 and 2010–2012: A repeat cross sectional survey in urban and rural Vellore

BackgroundRepeat cross sectional surveys document the trend of prevalence rates for non-communicable diseases and their risk factors. In this study, we compare the prevalence rates for risk factors for cardiovascular disease in urban and rural Vellore between 1991–1994 and 2010–2012.MethodsCross sectional survey was carried out in 1991–1994 in a rural block in Vellore district and in Vellore town, to study the prevalence of cardiovascular risk factors among adults aged 30–60 years. A repeat survey was done in 2010–2012 using the WHO STEPS method. In both surveys, socio-demographic and behavioral history, physical measurements, biochemical measurements, and medical history were obtained. Age adjusted rates were used to compare the rates in the two surveys.ResultsIn the rural areas, there was a three times increase in diabetes and body mass index (BMI) ≥25 kg/m² (overweight/obese) with a doubling of the prevalence of hypertension. In urban areas there was a tripling of diabetes, doubling of proportion with BMI ≥ 25 kg/m² and 50% increase in prevalence of hypertension. While the proportion of male current smokers reduced by 50% in both rural and urban Vellore, lifetime abstainers to alcohol decreased in the rural area from 46.8% to 37.5% (p < 0.001).ConclusionsThere has been an alarming rise in diabetes, hypertension, and overweight/obese with an even greater increase in rural areas. Alcohol use is increasing while smoking is on the decline. Primary prevention programs are required urgently to stem the rising incidence of non-communicable diseases in India.     

Target organ associations in Turkish patients with Behçet's disease: a cross sectional study by exploratory factor analysis

OBJECTIVE: To look for target organ associations in Turkish patients with Beh?et's disease (BD). METHODS: We studied target organ associations in 272 consecutive patients with BD. The occurrence of any of the clinical manifestations related to BD within the previous 3 months was sought by history questionnaire completed by a rheumatologist and by physical examination. Factor analysis was used to analyze the data. RESULTS: Four factors were identified by factor analysis of variables oral and genital ulcers, erythema nodosum, papulopustular skin lesions, uveitis, superficial and deep vein thrombosis, joint, arterial, neurological, and gastrointestinal involvement; the 4 identified factors explained 69% of the original information of the matrix. There was an association between oral ulcers, genital ulcers, and erythema nodosum (Factor 1); and between superficial and deep vein thrombosis (Factor 2). Uveitis was identified as a distinct feature, and was negatively associated with erythema nodosum (Factor 3) only among the females. There was also an association between papulopustular skin lesions and joint involvement (Factor 4). Factors 2 and 3 had higher scores in males (p = 0.001 and p = 0.009, respectively) versus females. CONCLUSION: We studied clinical features of BD in Turkish patients. The 4 factors we identified by factor analysis differ from a previous study from Israel, probably due to different methodologies used in the 2 studies. One factor described in our study, the association between papulopustular lesions and arthritis, supports findings of our recent study. A recognized association between superficial and deep vein thrombosis was also confirmed.     

Relationship of health literacy and adherence to oral anticoagulation therapy in patients with atrial fibrillation: a cross‐sectional study

Journal of Thrombosis and Thrombolysis - Oral anticoagulant therapy (OAT) has increased substantially due to the aging population and prevalence rise of atrial fibrillation (AF). Medication...     

Risk factors for foot ulcers—A cross sectional survey from a primary care setting in Brazil

AimsTo identify the prevalence of higher risk of foot ulceration and associated factors among patients with diabetes mellitus (DM) at primary health care services.MethodsIndividuals with DM, registered at primary health care services in a municipality in southern Brazil, were interviewed and underwent foot examinations. Their risk of ulceration was classified in accordance with the recommendations of the International Working Group on the Diabetic Foot. Poisson bivariate and multivariate analyses were performed and adjusted prevalence ratios (PR) and 95% confidence intervals (CI) were calculated.ResultsThe prevalence of higher risk of foot ulceration among the 337 interviewees was 27.9% (95% CI 23.1–32.9). The following factors were associated with this risk: having been diagnosed with DM for more than 10 years (Adjusted-PR 1.669; 95% CI 1.175–2.373; p = 0.004); having had previous diagnoses of acute myocardial infarction (Adjusted-PR 1.873; 95% CI 1.330–2.638; p < 0.001) and stroke (Adjusted-PR 1.684; 95% CI 1.089–2.604; p = 0.019); presenting interdigital mycosis (Adjusted-PR 1.539; 95% CI 1.030–2.300; p = 0.035) and calluses (Adjusted-PR 1.654; 95% CI 1.117–2.451; p = 0.012).ConclusionsThe prevalence of higher risk of ulceration was high, which reinforces the importance of continued education for health care professionals in order to prevent complications in the feet of these patients.     

The prevalence of colorectal neoplasia in patients with end-stage renal disease: a case–control study

BACKGROUND AND PURPOSE: The scarcity of organs for transplantation has led to aggressive pretransplant evaluations. Many younger kidney transplant patients with end-stage renal disease, who would be ordinarily at average risk for colorectal cancer, undergo screening colonoscopy as part of this evaluation. The purpose of this study was to determine the prevalence of colorectal neoplasia in patients with end-stage renal disease who are potential transplant candidates. MATERIALS AND METHODS: We performed a retrospective chart review analysis on 57 kidney transplant candidates who underwent pretransplant screening colonoscopy between August 1999 and December 2004. The control group was comprised of 60 age- and gender-matched subjects without end-stage renal disease who underwent routine screening colonoscopy. RESULTS: The prevalence of polyps in end-stage renal disease patients was 37 vs 22% in the control group (p = 0.07, not significant). None of the risk factors studied were found to predict the presence of polyps in the study group. CONCLUSION: These results suggest that screening guidelines for colorectal cancer for the general population should be adequate for potential kidney transplant recipients.     

A register-based study: adverse events in colonoscopies performed in Sweden 2001–2013

Objectives: The rates for colonoscopy-associated adverse events vary considerably worldwide. In Sweden, the figures are known to a limited extent. We assessed the frequency of severe colonoscopy-related adverse events and the impacts of different risk factors, including the use of general anaesthesia.

Material and methods: This is a retrospective population-based cohort study of the colonoscopies performed during the years 2001–2013 on adults identified in the Swedish health registers. The rates for bleeding, perforation, splenic injury and 30-day mortality were calculated. Covariates for risks were assessed in a multivariate Poisson regression model.

Results: There were 593,315 colonoscopies performed on the 426,560 individuals included in the study. The rates for colonoscopy-related bleeding and perforation were 0.17% and 0.11%, respectively. When polypectomy was performed, the rates were 0.53% for bleeding and 0.25% for perforation. There were 31 splenic injuries (1:20,000 colonoscopies) reported. The crude 30-day death rate for colonoscopy was 0.68%. Of those diagnosed with bleeding or perforation, 5.6% and 6.1% were dead within 30 days, respectively. The multivariate RR for perforation when general anaesthesia was employed was 2.65 (p?<?.001; 95%CI 1.71–4.12).

Conclusions: The perforation rate seemed to be relatively high in an international perspective. General anaesthesia was associated with a significantly higher risk for perforation. Splenic injuries were more frequent than expected.     

Neurocognitive testing in late-onset Tay–Sachs disease: A pilot study

Summary Objectives  To test neurocognitive function in patients with late-onset Tay–Sachs disease (LOTS) using a computerized system to assess whether cognition is a clinically relevant outcome measure of possible therapeutic intervention in LOTS. Methods  Ten adults with Tay–Sachs disease were administered at least one battery of the Mindstreams Neurotrax system for evaluation of cognitive function. Six sub-scores and a Global Cognitive Score (GCS) were tabulated. A disease specific severity score was also devised with six domains. Results  Despite identical genotypes, all patients but the two oldest had ≥3/6 sub-scores one standard deviation below normal mean (100); verbal and executive functions were most affected. The severity score measured other functions. Conclusions  Because of provocative findings on re-testing in patients exposed to miglustat, and despite the very small cohort, cognitive function may be an appropriate and clinically relevant outcome measure for future therapeutic interventions in LOTS. Competing Interests: A private grant to one of us (D.E.) for LOTS-related research provided funds for transportation of patients to Jerusalem and paid for Neurotrax testing. G.M.D. and E.S. are paid employees of the Neurotrax Corporation. DE, AZ, IKL and RN had no associations during the period covered in this report such as consultancies, stock ownership, or other equity interests or patent licensing arrangements that may have posed a conflict of interest.     

Tuberculosis at Raffic Hariri University Hospital (RHUH) during 10 years period 2005–2015, cross sectional,observational study

Aim

Tuberculosis is a contagious disease caused by Mycobacterium tuberculosis. It represents, according to WHO, one of the most leading causes of death worldwide.¹

Serum level of zinc in asthmatic patients: A case–control study

BackgroundHypozincemia could lead to a variety of defects in growth and the immune system, while it seems to be associated with increased rate of asthmatic attacks in children.MethodsThis study was performed to assess the serum zinc level in 100 paediatric asthmatic patients in comparison with a control group.ResultsMean serum level of zinc in the asthmatic patients was 70.5 ± 22.6 μg/dL, which was significantly lower than 80.9 ± 16.9 μg/dL in the control group (p < 0.001). Forty-two asthmatic patients (42%) had hypozincemia, while this rate was 12% in healthy children (p < 0.001). There was a significant association between the zinc level and severity of asthma (p < 0.001). However, no significant association was detected between the serum level of zinc and other factors, including control and treatment of the disease.ConclusionsAs for high rate of hypozincemia in the asthmatic children, evaluation of serum zinc level in asthmatic children could be suggested, while zinc substitution in the diet of those with hypozincemia could be recommended.