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Progressive rubella panencephalitis (PRP) is a rare late complication of rubella that affects mainly teenagers. It is characterized by progressive white matter destruction, gliosis and cerebral atrophy, similar to subacute sclerosing panencephalitis (SSPE) and congenital rubella syndrome. This paper examines the complexity of PRP, its clinical manifestations, pathogenesis, diagnostic criteria, treatment and prophylaxis. PRP should be considered in adolescents with progressive dementia with pyramidal and cerebral dysfunction. With respect to the most affected children, survival and recovery is expected to be poor, with high mortality rates, especially in the first six months of life. The development of progressive spasticity, ataxia, mental deterioration and convulsions in late childhood and early childhood with mothers' rubella or stigmata histories is the subject of research on PRP. Therefore, continued efforts to understand and address PRP are important to improve the quality of diagnosis, treatment and ultimately the quality of life of affected persons.
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Background: Concurrent chemoradiation is one of the major treatments for locally advanced rectal cancer. As radiation therapy suppresses the bone marrow, it is essential to quantify the dose received by the pelvic bone marrow (PBM), which constitutes about 50% of the hematopoietic bone marrow. Methods: A prospective study conducted in 50 patients with locally advanced rectal cancer treated with long course concurrent chemoradiation. All the patients were followed up with weekly complete blood count for assessing hematological toxicities and were graded. PBM was contoured and subdivided into ilium bone marrow (IBM), lower pelvis bone marrow (LPBM) and lumbosacral bone marrow (LSBM). Volumes of bone marrow receiving different doses were quantified. Results: Among the 50 patients, 40 (80%) developed acute bone marrow toxicity, during the course of treatment. Highest grade of bone marrow toxicity developed in 20 (40%) patients which was grade 2. Compared to grade 1, grade 2 neutropenia patients exhibited significantly higher levels of V10 to V40 (p<0.05) in PBM and significantly higher levels of V20 in IBM and LSBM. In LPBM, compared to grade 1 leukopenia and neutropenia, grade 2 leukopenia and neutropenia exhibited significantly higher levels of V10 and V20 (p<0.05). Conclusions: Increased PBM V10 to V40, IBM V20, LSBM V20, LPBM V10 and V20 were significantly related to the higher grades of neutropenia in locally advanced rectal cancer patients undergoing long course concurrent chemoradiation. Increased LPBM V10 and V20 were also significantly related with higher grades of leukopenia.
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Background: The aim of the study was to determine the prevalence and factors associated with asymptomatic bacteriuria among pregnant women. Methods: A cross-sectional study was used to determine the prevalence of uro-pathogens among pregnant women attending Antenatal Clinic at Weija-Gbawe Municipal Hospital. The data was collected between May 2023 and October 2023. The data collection process involved the use of a structured questionnaire, while urine specimens were collected in sterile urine containers and cultured on CLED medium. The bacteria colonies were identified and evaluated for their susceptibility to antibacterial agents. Multiple logistics regression was used to determine the factors associated with bacteriuria among pregnant women. Results: The age range of the participants was 14 years to 45 years with mean age of 30 years (SD±6.5). About 13% of the participants had no formal education. Majority (77.4%) of study participants were obese while only 3.42% had normal weight. Isolates were Escherichia coli (27%), Klebsiella species (23%), Proteus species (18%) and Citrobacter koseri (18%). Gentamicin was sensitive to E. coli and cotrimoxazole was the most resistant antibiotics. Factors such as BMI, educational level, smoking status, recurrent UTI, parity were not found to have statistical influence on prevalence of bacteriuria among pregnant women. Conclusions: The study revealed 15.1% prevalence of ASB among pregnant women with E. coli being the predominate isolates. Gentamicin and cotrimoxazole were the most sensitive and resistant antibiotics respectively. Pregnant women should be advised to adhere to optimal hygiene practices and safe sexual behaviours, with a focus on the role of these practices in preventing uro-pathogen colonization.
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Background: The economic status of women is now accepted as an indicator of a society’s development in Bangladesh. Women workers like the majority in the informal sector have been exposed to rigorous work, discipline, fixed working hours, specific production norms etc. The aim of the study was to perform cross-sectional study was conducted to assess nutritional status of female garment workers in Chattogram, Bangladesh. Methods: The study was conducted with the help of a semi-structured questionnaire to collect data from the respondents by face-to-face interview. Informed written consent was obtained from the respondents. A checklist containing height and weight (measured using measuring tape and digital weight machine respectively) of the respondents included in the questionnaire. Results: According to the study, gastrointestinal problem was reported by 49.7% and the rest reported problem were respiratory problem (35.3%), skin problem (27.3%), urinary problem (18%), eye problem (15%). Age, marital status, number of children, family member, monthly income, job section, working hours and overtime were significantly associated with various types of health problem. Respondents were categorized into underweight (?18.5 kg/m2), normal (18.6-24.9 kg/m2) and overweight and above (?25.0 kg/m2) using BMI. Prevalence of underweight, normal and overweight and above were 3.3%, 61.3% and 35.3% respectively. Conclusions: Female worker’s age, marital status, number of children, monthly income, job duration, job section and overtime showed significant association with their nutritional status (BMI). Findings of this study may play an important role to develop a policy and in commercial sector of our country to reduce health problem of the female garment workers for better productive and healthy lifestyle.
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Pancreatic hydatidosis is a rare infection with a frequency of less than one percent. Most of the abdominal hydatid cysts occur in liver. The purpose of this study was to present our experience of few rare cases of isolated pancreatic hydatid cyst, its presentation and management. Five pancreatic hydatidosis patients admitted in Gandhi Medical College, Secunderabad between 2021 to 2023 were reviewed. Demographic characteristics, clinical findings, and laboratory data were collected. Commonest symptom was pain in left upper quadrant followed by jaundice. The preoperative diagnosis was established in 3 patients by combination of ultrasonography, computed tomography, endoscopic ultrasonography and serological tests. Surgical treatment was done in three cases and two were medically treated. None of them had recurrence during a follow-up of 1 year. Pancreatic hydatid cyst even if rare should be considered in any pancreatic cystic mass in endemic countries like India.
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Mental health, commonly known as behavioral health, is the psychological, emotional, and social well-being of an individual. It mostly affects a person’s ideas, emotions, behaviors, and relationships with other people. The idea that social media use and mental health are inextricably related appears to be the most intricate and varied. The effect of social media on mental health is a complicated topic with many moving parts. According to a countrywide survey carried out in India, as of 2023, approximately 67.5% of adults in the country utilize at least one social networking site; this percentage may be steadily increasing over time. Despite its numerous benefits, social media has also been connected to problems in society and poor mental health outcomes. People need to be aware of the potential risks of social media like disinformation, addiction, cyberbullying, data security and privacy concerns, and its possible effects on mental health. This review offers a thorough analysis of social media’s effects on mental health, and it demonstrates how crucial it is to develop a thoughtful and balanced relationship with our digital life to ensure that the advantages of connection do not come at the expense of our mental health.
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Background: A good dietary practices are for plays a crucial role in influencing recovery from tuberculosis and it is a modifiable risk factor. Adequate nutrition is needed for faster recovery along with proper drug absorption and other thermodynamics of drugs besides adherence to drug treatment. It helps in better weight gain besides others benefits. So, the government of India started Nikshay Poshan Yojana (NPY) and providing monetary aid in form of Direct Benefit Transfer since March 2018 for patients. As there are very few studies which have tried to analyze and explore the effect of direct monetary benefits in many schemes. Aim and objectives of current study was to assess monetary support indicators and its utilization among TB patients. Methods: A cross-sectional study was conducted where the patients were taken using sequential sampling from Designated Microscopic Centers from January 2020 to December 2021. Data was analyzed using SPSS 20.0 and results were presented in tabular form. Results: Approximately 63.9% patients received Direct Benefit Transfer money. Approximately 69.5% of those who received money used it. However, no significant association ascertained between DBT money used and under-nutrition. Conclusions: Knowledge about TB and DBT should be provided through already existing ICT tool. Purpose of DBT money should be stressed at initiation of treatment to eliminate TB by 2025 as envisioned under National TB elimination program.
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Background: Gastritis is the syndrome associated with the inflammation of the stomach epithelium. Age, dietary pattern, health issues, level of stress, the existence of any other gastrointestinal symptoms, smoking, use of alcohol, and use of over-the-counter medication were considered extraneous variables. The purpose of this study was to determine the lifestyle characteristics that predispose to gastritis among the international students of Grodno State Medical University, Belarus and the results were closely and meticulously analyzed. Methods: A descriptive survey strategy was used to evaluate the variables associated with gastritis. A simple random approach was chosen for this research. Data was collected with the help of a questionnaire in the format of an online Google form and recorded. Responses from 211 respondents mostly aged 18 to 29 years old were collected. The survey focused on gastritis and its connection to lifestyle factors like smoking, stress, and eating patterns. Results: The frequency value for the consumption of processed food was the highest above all with regards to dietary habits in this study followed by consumption of fibrous food, having carbonated drinks, frequency of having coffee/tea per day, and general stress level with their daily workload as well as evidently due to consumption of spicy food. Conclusions: This study demonstrates that the incidence of gastritis among the respondents was multifactorial.
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Pheochromocytoma with reported incidence of 2-8 per million, is a rare and special tumor with its own unique clinical and pathological features, originating from the amazingly intelligent neuroendocrine cells of chromaffin cells of the adrenal medulla. It may behave as 慻reat masquerader� and be sweet and predictable as a child, while at times act as a 憈reacherous murderer� crashing and tearing everything in its path with fierce rage, the main cornerstone of the disease being surgical excision. Here, we report a rare case of middle aged female presenting with hypertensive crisis which necessitates intensive care unit (ICU) management where she responded well to anti-hypertensives and radiological investigations were suggestive of bilateral pheochromocytoma. The course of treatment consisted of array of investigations to ascertain the diagnosis before embarking on bilateral adrenalectomy keeping in mind the consequences of absence of adrenal and subsequent possibility of Nelsons syndrome, which we were able to treat successfully. Here we want to highlight the consideration of bilateral adrenal tumors as a differential diagnosis for suprarenal growths, subsequent surgical course and post-operative medical treatment highlighting the importance of mineralocorticoids and glucocorticoids for day to day functioning.
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Isaacs� syndrome (IS) is a rare condition which is characterized by peripheral nerve hyperexcitability which is due to continuous motor activity. The exact etiology for this condition is unknown yet there are several etiopathologies like autoimmune, genetic, or hereditary which can be an etiology for the IS. In our case report the likely etiology is autoimmune. Its clinical feature includes fasciculation, myokymia, and hyperhidrosis. To confirm the diagnosis mostly imaging methods of examination are performed like MRI, ultrasound, and EMG. In our patient MRI and EMG examination was performed. There are no particular therapeutic treatments that can help in this condition only symptomatic treatment can be delivered. Plasma exchange has a promising outcome for a momentary. In our case report, we propose the possible etiology of the condition.
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Sepsis is a condition that occurs when the body's response to infection becomes unbalanced and potentially life-threatening. In this study, there is a focus on understanding and addressing sepsis. This detailed review explores how sepsis is defined in its prevalence in populations and how it is present clinically. The development of sepsis involves a series of events triggered by infections resulting in inflammation and dysfunction in organs. The symptoms of sepsis can range from signs like fever and changes in state to more severe complications such as septic shock. Early recognition of these symptoms using criteria like Systemic inflammatory response syndrome (SIRS) is crucial for intervention, which can greatly impact patient outcomes. Various diagnostic markers, imaging techniques and a deeper understanding of the pathophysiology behind sepsis have contributed to identification and targeted treatment approaches. Managing sepsis involves a combination of therapy, support for blood circulation, respiratory interventions and careful use of agents that modulate the system. It's important to emphasize the efforts among healthcare professionals from disciplines when it comes to managing sepsis effectively. Providing follow up care is essential for survivors as they may experience long term consequences such as sepsis syndrome. Due to its impact on health ongoing research is necessary to explore therapeutic options and refine existing strategies for managing sepsis effectively. The field continues to evolve with advancements, in precision medicine host directed therapies and interdisciplinary collaboration playing roles. This review seeks to grasp the concept of sepsis, providing insights into its various aspects, including the difficulties, in diagnosis and the ever-evolving treatment strategies.
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Background: Changes in the liver function test may serve as an early marker for timely diagnosis and identification of patients who may develop severe dengue. The purpose of this study was to examine the link between dengue fever severity and liver function test. Methods: This prospective observational study was conducted in the Department of General Medicine, Madhesh Institute of health sciences, provincial hospital, Janakpurdham in which we included dengue positive patients (aged 18 years or more) based on NS1 antigen or high titer on IgM/IgG testing from July 2023 till August 2023. We excluded patients with diseases like malaria, cirrhosis of liver, enteric fever, viral hepatitis or any other disease or taking any medication which can derange LFT. Results: We included 96 patients fulfilling the study criteria. Of these, 71% had DF, 22% had DHF and 7% had DSS. Among liver enzymes, mean AST of the patients was significantly higher in DSS group of patients (775.19�.65 U/l), as compared to those in the DF and DHF group of patients, p value <0.01. Similarly, mean ALT of the patients was significantly higher in DSS group of patients (387.8�.6 U/l), as compared to those in the DF and DHF group of patients, p value<0.01. On the contrary, mean alkaline phosphatase levels were similar between the three patient groups. Conclusions: Based on the results our study, we conclude that raised AST and ALT levels were significantly associated with severity of DSS and DHF. Patients with dengue infection should have a baseline liver function test and subsequent LFT monitoring to detect early hepatic impairment.
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Background:Human immunodeficiency virus/ Acquired immunodeficiency syndrome (HIV/AIDS), has remained a disease of public health concern, with the largest burden being found in sub Saharan Africa. The advent of anti-retroviral therapy (ART) has significantly reduced the mortality of the disease, thereby transforming it to a chronic disorder, with significant co-morbid psychiatric sequalae.Objectives:To determine the prevalence and pattern of psychiatric morbidity among PLWHAattending Aminu Kano Teaching Hospital, Kano.Materials and methods:This was a cross sectional study of adult patients with HIV/AIDS attending outpatient clinic at the S.S. Wali Virology Centre of Aminu Kano Teaching Hospital who gave informed consent. Systematic random sampling technique was used.Patients aged 18years and above who had been on ARVdrugs for at least one year were included, while those who had a medical emergency and needed immediate attention were excluded.Socio demographic characteristics were obtained using a socio-demographic questionnaire and psychiatric morbidity was assessed with the MINI International Neuropsychiatry Interview.Results:Atotal of 420 participants were recruited in the study with a male to female ratio of 1:1.5 and mean age of 40.4±10.0 years. The prevalence of a psychiatric disorder was 22.1% out of whom 5.0% had more than one psychiatric diagnosis. Major depression was the most common (11%) psychiatric disorder. Generalized Anxiety disorder, substance abuse, post-traumatic stress disorder and alcohol abuse accounted for 7.6%, 5.5%, 2.4% and 1.7% of psychiatric disorders respectively.Conclusion:Psychiatric disorders are common in PLWHA, with major depression being the commonest.
Subject(s)
HIV Infections , Acquired Immunodeficiency SyndromeABSTRACT
Il s'agit d'un patient de 25 ans reçu pour hématochézie de grande abondance et douleurs abdominales après utilisation par voie orale et rectale d'un purgatif à base de graines de Jatropha curcas ou pignon d'Inde appelée en bambara (langue locale du Mali) « Bagani ¼ et de Scoparia dulcis appelée en bambara « timitimini ¼. La coloscopie réalisée a permis de retrouver une nécrose du colon descendant. Le patient est décédé dans un tableau de choc septique par perforation colique.
This 25-year-old patient was presented with profuse hematochezia and abdominal pain following oral and rectal use of a purgative based on Jatropha curcas or "pignon d'Inde" seeds, known in Bambara (the local language of Mali) as "Bagani", and Scoparia dulcis, known in Bambara as "timitimini". Colonoscopy revealed necrosis of the descending colon. The patient died of septic shock due to colonic perforation
Subject(s)
Proctocolitis , Abdominal Pain , Gastrointestinal Hemorrhage , CatharticsABSTRACT
Background: Dengue fever is a viral disease transmitted by mosquitoes and affects millions of people worldwide. It can also be transmitted through blood transfusions, particularly during peak transmission periods. Methods: This was a cross sectional study which was conducted over a two-month period (June 2022 to July 2022) at a tertiary hospital blood bank. A total of 180 nonrepetitive serum samples were collected from voluntary blood donors and analyzed using the dengue NS-1 Ag Microlisa ELISA kit. Results: Among the 180 samples two samples tested positive for the dengue virus NS-1 antigen using the NS-1 antigen capture ELISA, indicating a prevalence of acute dengue virus infection among blood donors during the peak transmission period of 1.2% (2/180). Conclusions: The use of NS-1 antigen testing was shown to be useful for dengue virus detection. Routine screening of blood donors for dengue virus is not universally implemented in many countries, partly due to the lack of sensitive and specific screening tests. However, the use of serological tests, such as ELISA for dengue antibodies or NS-1 antigen, can effectively detect dengue virus in blood donors. Interventions made during peak transmission periods can help in curtailing the spread of dengue infections.
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Renal vein thrombosis (RVT) is a rare clinical diagnosis which is the presence of thrombus in the major renal veins or its tributaries. Major causes include nephrotic syndrome, trauma, malignancy, hypercoagulable states. Presentation could be unilateral or bilateral flank pain and/or haematuria. Symptoms could be confused with nephrolithiasis. A normal ultrasonography (USG) in the initial stage could delay the diagnosis and hence propensity for dreaded complications such as loss of renal function and pulmonary embolism. Anticoagulation is the mainstay of therapy for RVT. Review of the literature reveals that thrombolytic therapy can also be used in patients with the most severe disease. Here we present a case of a young male, who initially suspected to have acute pyelonephritis, turned out to have extensive Iliocaval and unilateral RVT secondary to factor V leiden mutation who underwent catheter directed thrombolysis and mechanical thrombectomy.
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A Field experiment was conducted during Rabi 2022-23 at Agricultural and Horticultural Research Station, Kathalagere, KSNUAHS, Shivamogga, to study the effect of crop specific blended fertilizers on the growth and yield of maize. The experiment was laid out in Randomized Complete Block Design with ten treatments replicated thrice. Nutrient composition of blended fertilizer used for basal application was 16:18:11:4:1 N:P2O5:K2O:S:Zn and for top dress was 27: 0:13 N:P2O5:K2O. The treatments T1, T2, T3 consisted of application of basal blended fertilizer @ 312.5, 412.5 and 515 kg ha-1, respectively and top dress blended fertilizer @ 237.5, 312.5 and 390 kg ha-1, respectively. Basal blended fertilizer @ 412.5 kg ha-1 + top dress of urea at 30 and 45 DAS (T4), Package of practice (PoP) through straight fertilizer (T5), PoP through complex fertilizer (T6), recommended dose through Urea, DAP, MOP and ZnSO4 + top dress of nano urea @ 0.4% at 30 and 45 DAS (T7), physical blending of Urea, SSP, MOP and ZnSO4 (16:18:11:4:1 N:P:K:S:Zn) for basal and Urea and MOP (27:0:13 N:P:K) for top dress (T8), farmers' practice (T9) and absolute control (T10). Among all treatments, the application of basal blended fertilizer @ 515 kg ha-1 + Top dress of blended fertilizer @ 390 kg ha-1 recorded the maximum plant height (222.4 cm), number of leaves (10.3 plant-1), total dry matter accumulation (285.86 g plant-1), cob length (21.31 cm), cob girth (18.31 cm), number of kernels per cob (516.57) and test weight (24.22 g) at harvest as compared to PoP through straight and complex fertilizer and absolute control. The same treatment recorded significantly higher kernel and straw yield (69.51 and 89.36 q ha-1, respectively) in comparison to other treatments but it was on par with T2, T5 and T6. The treatment T3 recorded 27.8 % higher yield compared to T9. In study area the application of basal blended fertilizer @ 515 kg ha-1 + Top dress of blended fertilizer @ 390 kg ha-1 is recommended to achieve higher growth and yield of maize.
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Background: Diabetes is one of the most common chronic conditions in the world. The worldwide prevalence of diabetes mellitus (DM) has risen dramatically over the past two decades because of increasing obesity and reduced activity levels. The purpose of this study was to show the association between depression and diabetes. Methods: It was a cross-study. The study included 240 patients who were chosen randomly with no gender bias. A convenient subject of 240 diabetic patients was interviewed. Results: Out of the total 240 diabetic patients, included in this study, the majority of patients, 52.63% in the age group of 60 years had depression with a Hamilton score of >19 while 47.37% of patients in the age of 40 to 50 years had Hamilton score of >19. 84.21% of males had depression with a Hamilton score >19 as compared to females who had a Hamilton score of 15.79%. The patients within the age group of 40-59 have 2.5 times more risk of having depression as compared to the age group of 20 to 39 and patients in the age group >60 years have 4.23 times higher risk of depression as compared to patients in the age group of 20 to 39 years. The association between gender and depression shows that males have a higher rate of depression (78.17%) as compared to females (21.81%) with an odd's ratio of 3.0. Conclusions: Our study showed a high prevalence of depression and anxiety in male patients and the elderly age group. Planning and implementation of screening for mental health issues in the elderly population diagnosed with a lifestyle disease-such as type 2 diabetes mellitus-with existing comorbidities should be recognized as one of the most important goals of the public health system. It seems necessary to involve medical teams in the screening process to verify the symptoms, promptly establish the diagnosis, and initiate the appropriate depression treatment. In diabetic patients, depression remains underdiagnosed and an important aspect of the diabetic specialists would be the awareness of this quite common co-morbidity.
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Background: This study aimed to assess the effect of enhanced vegetation index, proximity to national borders, proximity to protected areas, and water on malaria morbidity in Sub-Saharan Africa. Methods: Data were pooled from the Demographic and Health Surveys (DHS) conducted in 32 Sub-Saharan African countries spanning 2000 to 2020. Women's standard weights were denormalized and bivariate analyses were conducted to identify potential confounders. Two models were fitted; model 1 involved primary exposure variables and model 2 involved primary exposure variables adjusted for significant confounders. The final interpretation of the results was based on model 2. Results: The prevalence of malaria cases was 23.1%, The risk of children suffering malaria in households that belong to the 3rd quantile of the vegetation index is 27% less compared to children that belong to the households in the 1st quantile of the vegetation index [aOR=0.73, 95%CI: 0.55-0.99; p-value<0.05]. Children belonging to households in the 4th quantile of proximity to water have a 33% higher risk of suffering from malaria compared to households that are closer to water [aOR=1.33, 95%CI:1.08-1.63; p-value<0.01]. Conclusions: Environmental factors have been found to influence malaria morbidity among children in SSA. Intervention should be targeted at households especially those that are closer to water with more children under five to ensure full access and use of ITNs among all children under five as part of the overall goal of achieving the health-related SDGs.
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Background: Pregnancy induced hypertension known as preeclampsia is considered to be the second cause of death next to anaemia. There are significant sources of maternal and foetal mortality and morbidity. Antihypertensive medication reduces the progression of the course of hypertensive disorders. However, its effect on the outcomes of pregnancy may include development of preeclampsia, preterm delivery, foetal /neonatal demise, IUGR, low birth weight. Whether such associations are casual or confounded is unknown. Hence, we intended to study the rationale use of drugs in pregnancy induced hypertensive patients. Methods: Patients diagnosed with hypertensive disorders in pregnancy were recruited. Pregnant women in the age group of 18-45 years who consented to participate were included. Non pregnant women and women with PCOD, depression and on any medications were excluded. Details on drug treatment, type of drugs, combination, dose, dosage and duration were noted. Results: 105 patients were enrolled. 51% belonged to 18-25 years. 98% mothers received monotherapy and 2% received dual therapy. Labetalol was the most commonly prescribed drug. 50% of the patients received a combination of Nifedipine and Methyldopa while another 50% received Nifedipine with Labetalol. The outcome of new born babies born in mothers receiving antihypertensive drugs had complications of low birth weight and malformations. The dose of the medications prescribed was well within the range. Conclusions: Proper counselling to the patients regarding life style management, regular follow ups and monitoring of blood pressure is important to understand, resolve the burden and complication.