Spatial distribution of acute cases of Chagas disease reported from 2010 to 2020 in the State of Amazonas / Distribuição espacial dos casos agudos de doença de Chagas notificados de 2010 a 2020 no Estado da Amazônia / Distribución espacial de los casos agudos de enfermedad de Chagas notificados de 2010 a 2020 en el Estado Amazónico

This study aimed to investigate the epidemiology of acute cases of Chagas disease notified in the State of Amazonas between the period from 2010 to 2020. Data were obtained from the portal of the Sistema de Informação de Agravos de Notificação- SINAN, considering the number of cases per municipality of notification. 140 cases of Acute Chagas Disease were notified, distributed in 23 of the 62 municipalities of the State of Amazonas, 82 (59%) were male individuals, with a greater predominance in the age group of 20-39 years old, having 45 (32.1%) cases. As for the race/color variable, the highest number was among brown people with 101 (72.1%) notifications. The oral route prevailed as the main form of disease transmission with 93 (66.4%) records. Infection by the oral route of T. cruzi is the most important route of transmission of CD in the State of Amazonas, the occurrence of transmission is associated in most cases with the consumption of foods such as açaí juice and has been reported frequently over the years between municipalities.

este estudo se propôs a investigar a epidemiologia dos casos agudos de Doença de Chagas notificados no Estado do Amazonas no período de 2010 a 2020. Os dados foram obtidos no portal do Sistema de Informação de Agravos de Notificação - SINAN, considerando o número de casos por município de notificação. Foram notificados 140 casos de Doença de Chagas Aguda, distribuídos em 23 dos 62 municípios do Estado do Amazonas, 82 (59%) eram indivíduos do sexo masculino, com maior predominância na faixa etária de 20-39 anos de idade com 45 (32,1%) casos. Quanto a variável raça/cor, a maior registro foi entre pardos com 101(72,1%) notificações. A via oral, prevaleceu como a principal forma de transmissão da patologia com 93 (66,4%) registros. A infecção pela via oral do T. cruzi, é a mais importante via de transmissão de DC no Estado do Amazonas, a ocorrência da transmissão está associada na maioria das vezes ao consumo de alimentos como o suco de açaí, e tem sido reportada com frequência ao longo dos anos entre os municípios.

Este estudio tuvo como objetivo investigar la epidemiología de los casos agudos de la enfermedad de Chagas notificados en el Estado de Amazonas en el período de 2010 a 2020. Los datos fueron obtenidos del portal del Sistema de Información de Enfermedades de Notificación - SINAN, considerando el número de casos por municipio de notificación. Se notificaron 140 casos de Enfermedad de Chagas Aguda, distribuidos en 23 de los 62 municipios del Estado de Amazonas, 82 (59%) fueron individuos del sexo masculino, con mayor predominio en el grupo etario de 20 a 39 años con 45 (32,1%) casos. En cuanto a la variable raza/color, el mayor número fue entre los morenos con 101 (72,1%) notificaciones. La vía oral predominó como principal vía de transmisión de la enfermedad con 93 (66,4%) registros. La infección por vía oral de T. cruzi es la vía de transmisión más importante de la EC en el Estado de Amazonas, la ocurrencia de la transmisión está mayoritariamente asociada al consumo de alimentos como el jugo de açaí, y ha sido reportada con frecuencia a lo largo de los años entre municipios.

Factores de riesgo relacionados con el síndrome poscovid-19 en pobladores pinareños / Risk factors related to postcovid­19 syndrome in residents from Pinar del Río i: en

Introducción: Las posibilidades de padecer el síndrome poscovid-19 crecen en la medida en que se expande la pandemia. Objetivo: Identificar los factores de riesgo relacionados con el síndrome poscovid-19 en pobladores pinareños. Métodos: Se realizó un estudio de casos y controles, que incluyó a convalecientes de covid-19, atendidos en la consulta multidisciplinaria del Policlínico Luis Augusto Turcios Lima de la provincia de Pinar del Río durante el 2022, quienes fueron incluidos de forma aleatoria en 2 grupos, a razón de 1:2 (100 casos y 200 controles). El análisis estadístico se basó en una estrategia univariada, que consistió en la determinación del odds ratio para cada factor de riesgo, así como en la estimación de los intervalos de confianza al 95 % y la prueba de la Χ2, con un nivel de significación de p<0,05. Resultados: En el estudio predominaron el sexo femenino, la diabetes mellitus, el tratamiento farmacológico, el soporte ventilatorio, la presencia de secuelas establecidas y las complicaciones. Conclusiones: A pesar de identificar los factores de riesgo más frecuentes relacionados con el síndrome poscovid-19, este continúa siendo un desafío para los profesionales de la salud.

Introduction: The possibilities to suffer from the postcovid-19 syndrome grow as the pandemic expands. Objective: To identify the risk factors related to the postcovid-19 syndrome in residents from Pinar del Río. Methods: A cases and controls study that included covid-19 convalescents was carried out. They were assisted in the multidisciplinary service of Luis Augusto Turcios Lima Polyclinic of Pinar del Rio province during 2022 that were included in 2 groups at random, at a ratio of 1:2 (100 cases and 200 controls). The statistical analysis was based on an univaried strategy, for which the odds ratio was determined for each risk factor and the confidence intervals were considered at 95 %, as well as the chi-square test, with a significance level of p<0,05. Results: In the study there was a prevalence of the female sex, diabetes mellitus, pharmacological treatment, ventilation support, the presence of established sequels and complications. Conclusions: In spite of identifying the most frequent risk factors related to the postcovid-19 syndrome, it is still a challenge for health professionals.

Transformed Time Series Analysis of First Wave COVID-19: Universal Similarities Found in The Group of Twenty (G20) Countries

As of April 30, 2020, cumulative confirmed coronavirus disease 2019 (COVID-19) cases exceeded 3 million worldwide and 1 million in the US, with an estimated fatality rate of more than 7 percent. Because the occurrence patterns of new confirmed cases and deaths over time are complex and seemingly country-specific, estimating the long-term pandemic spread is challenging. I developed a simple transformation algorithm to investigate the characteristics of the case and death time series per nation and described the universal similarities observed in the transformed time series of 19 nations in the Group of Twenty (G20). A transformation algorithm of the time series data sets was developed with open-source software programs to investigate the universal similarities among the cumulative profiles of confirmed cases and deaths of 19 individual nations in the G20. The algorithm extracted and analyzed statistical information from daily updated COVID-19 pandemic data sets from the European Centre for Disease Prevention and Control (ECDC). Two new parameters for each nation were suggested as factors for time-shifting and time-scaling to define reduced time, which was used to quantify the degree of universal similarities among nations. After the cumulative confirmed case and death profiles of a nation were transformed by using reduced time, most of the 19 nations, with few exceptions, had transformed profiles that closely converged to those of Italy after the onset of cases and deaths. The initial profiles of the cumulative confirmed cases per nation universally showed 3 to 4-week latency periods, during which the total number of cases remained at approximately ten. The latency period of the cumulative number of deaths was approximately half the latency number of cumulative cases, and subsequent uncontrollable increases in human deaths seemed unavoidable because the coronavirus had already widely spread. Immediate governmental actions, including responsive public-health policymaking and enforcement, are observed to be critical to minimize (and possibly stop) further infections and subsequent deaths. In the pandemic spread of infectious viral diseases, such as COVID-19, studied in this work, different nations show dissimilar and seemingly uncorrelated time series profiles of infected cases and deaths. After these statistical phenomena were viewed as identical events occurring at a distinct rate in each country, the reported algorithm of the data transformation using the reduced time revealed a nation-independent, universal profile (especially initial periods of the pandemic spread) from which a nation-specific, predictive estimation could be made and used to assist in immediate public-health policymaking.

Prescription audit in post-operative patients of Dr. B. R. Ambedkar Medical College and Hospital, Bengaluru

Background: Prescribing drugs are an important skill which needs to be continuously assessed and refined accordingly. Many drugs especially antimicrobials and fixed dose combinations that maybe irrational are being prescribed. Hence, this study was undertaken to analyze the rational prescribing guidelines in post-operative patients which will help doctors to update their knowledge and improve their attitude toward selecting cost effective treatment. Aim and Objectives: The aims of this study were as follows: (i) To evaluate prevailing prescription trends and (ii) to evaluate rationality of prescriptions in post-operative cases of surgery, orthopedics, obstetrics, and gynecology (OBG), and Otorhinolaryngology (ORL) departments. Materials and Methods: A prospective observational study was conducted in post-operative wards of departments of surgery, orthopedics, ORL, and OBG of Dr. B. R. Ambedkar Medical College and Hospital, Bengaluru. The study duration was 15 months from December 2018 to March 2020 with a sample size of 2000. Results: In the present study, female preponderance (54.4%) was seen. Majority of the drugs (77.3%) were prescribed under brand name. The most common group of drugs prescribed was non-steroidal anti-inflammatory drugs (135%) and the antibiotic was Cephalosporins (77.5%). As per the World Health Organization (WHO) core prescribing indicators, 6.25 were the average drugs per prescription. Conclusion: According to the WHO core prescribing indicators, polypharmacy was observed and prescribing by generic name was also less. However, there was no irrational use of antibiotics in post-operative cases in our study which reduces the chances of development of antibiotic resistance. Practice of prescribing drugs from the essential drugs list (EDL) was less. The study suggests incorporating educative initiative, development of drug policy, and an EDL-based hospital formulary to ensure rational use of medicines.

Una mirada a las series de casos y sus unidades de análisis

Las series de casos constituyen un tipo particular de estudio de uso muy frecuente en la investigación clínica. En este artículo se pretende resaltar la utilidad y plena vigencia de estos estudios como propuestas de proyectos de terminación de la especialidad, así como abordar sus particularidades más importantes en la delimitación de sus unidades de análisis. Cuando son bien realizadas, estas investigaciones constituyen una excelente fuente de actualización del conocimiento médico y una magnífica oportunidad para que los investigadores jóvenes se entrenen en el campo de la investigación científica.

Case series are a particular type of study that is very frequently used in clinical research. This article intends to highlight the usefulness and full validity of these studies as proposals for completion projects of the specialty, as well as to address their most important particularities in the delimitation of their analysis units. When they are well carried out, these researches constitute an excellent source of updating medical knowledge and a magnificent opportunity for young researchers to train in the scientific research field.

Relationship between Aortic Root Diameter and Type 2 Diabetes in Hypertensive Patients

Background: Diabetes mellitus (DM) involves a series of metabolic conditions associated with hyperglycaemia which is caused by defects in insulin secretion and./or insulin action. The aim of this work was assessment of the relationship between Aortic Root (AOR) diameter and type 2 diabetes mellitus (T2DM) in Hypertension (HTN) cases. Methods: This prospective case control study was carried out on 80 HTN cases. Cases were divided in to three groups: Group A (30 HTN cases) with type 2 DM with good metabolic control (Hb AIC ? 7.0), group B: (30 HTN cases) with type 2 DM with poor metabolic control (Hb AIC > 7.0) and C (Control group) 20 HTN, non-DM subjects of the same age and sex group with no other comorbid conditions. Results: FS had a significant decline in group A (P2 = 0.001) and in group B (P3 <0.001) than C. EF had a significant difference among all groups (P <0.001). Early wave declaration time (DT) had a significant decline in group A (P2 = 0.049) and in group B (P3= 0.023) than C. Tissue doppler early velocity wave had a significant difference among all groups (P = 0.004). Tissue doppler early velocity wave had a significant decline in group A and B than C. (P2 = 0.038. P3 = 0.003). Conclusions: AOR in HTN cases had a significant decline in DM cases compared with non-DM cases. In our results, glycaemic control didn’t play a significant role in aortic root.

Epidemiological characteristics of measles cases with immunization history of MCV in Liaoning in 2014-2021 / 公共卫生与预防医学

Objective To analyze the epidemiological characteristics of measles cases with immunization history of measles-containing vaccine (MCV), and to provide a basis for improving measles prevention and control measures. Methods Data were collected through the measles surveillance system and the immunization program information management system. Data were analyzed by descriptive epidemiological methods. Results A total of 9 164 cases of measles were reported in Liaoning Province during 2014-2021, of which the cases of measles with immunization history of 1 dose MCV accounted for 5.64%, and ≥ 2 doses accounted for 3.60%. There was a statistically significant difference in the immunization proportion among different years (χ2=184.534, P2=109.448, P2=4.147, P<0.05). The onset time of most cases was over 2 weeks after the last dose of MCV vaccination, accounting for 82.06%. The incidence rates of fever, cough, catarrh symptoms, conjunctivitis, lymph node enlargement and articular pain were all significantly lower in the cases with immunization history than those in the patients without a history of MCV immunization (P<0.05). Conclusion The cases with immunization history account for a certain proportion in measles cases, mainly secondary vaccination failure. The incidence rate of fever, cough, catarrhal symptoms, conjunctivitis, Koch's patches, lymphadenopathy, joint pain, and other clinical symptoms in measles patients with a history of MCV immunization is lower than that in patients without immunization history. Inoculation of MCV is of great significance in relieving clinical symptoms. It is necessary to inoculate two doses of MCV in time for measles prevention and control.

Calculation of Likelihood Ratios for Incest Cases Using IBD Patterns / 法医学杂志

OBJECTIVES@#To calculate the likelihood ratios of incest cases using identity by descent (IBD) patterns.@*METHODS@#The unique IBD pattern was formed by denoting the alleles from the members in a pedigree with a same digital. The probability of each IBD pattern was obtained by multiplying the prior probability by the frequency of non-IBD alleles. The pedigree likelihoods of incest cases under different hypotheses were obtained by summing all IBD pattern probabilities, and the likelihood ratio(LR) was calculated by comparing the likelihoods of different pedigrees.@*RESULTS@#The IBD patterns and the formulae of calculating LR for father-daughter incest and brother-sister incest were obtained.@*CONCLUSIONS@#The calculations of LR for incest cases were illustrated based on IBD patterns.

Practices of integrating the undergraduate and graduate teaching of Biochemistry and Molecular Biology / 生物工程学报

Biochemistry and Molecular Biology are the cornerstone courses of talent training in the field of life science. Taking these course as an example, this study explored reconstructing the knowledge framework, developing teaching cases, sharing teaching resources, innovating teaching means and establishing ideological education patterns. Supported by the scientific research achievements with discipline characteristics and online teaching platform, this research explored and practiced an integrated curriculum reform mode. This mode is guided by scientific research and education, based on the course development, and driven by communication and cooperation. A shared space of "exchange, practice, openness and informatization" was developed to achieve free and independent integration of undergraduate and graduate teaching motivated by learning knowledge, resulting in an effective student training.

Uterine rupture; An obstetric tragedy still with us. A six year review of cases in a specialist hospital, NorthWest Nigeria

Uterine rupture is a major cause of perinatal and maternal morbidity and mortality, it usually has a devastating outcome if not promptly attended to. The study determined the trends, risk factors, feto-maternal outcomes following uterine rupture as seen at ASYBSH. Method: The study was a retrospective review of cases of uterine rupture managed at the ASYBSH between March 2015 and February 2021. Records of the theatre and labour wards were searched and the folders of patients with uterine rupture were retrieved. Relevant information such as socio-demographic variables, booking status, clinical presentations were retrieved and entered into a structured profoma. Results: Deliveries in the hospital during the period were eleven thousand four hundred and twenty (11,420), out of which one hundred and fifty-six (156) were complicated by uterine rupture giving an overall incidence of 1.36 percent or one in every seventy-four (74) deliveries. Uterine rupture occurred mainly among women of low socio-economic status and high parity. The major predisposing factors were injudicious use of oxytocin (62.8%) prolonged obstructed labour (19.8%), previous caesarean section scar (8.5%), use of misoprostol (5.3%), fundal pressure (2.4%) and unexplained factors (1.2%) Conclusion: Uterine rupture remains a devastating obstetric calamity with a high incidence. Injudicious use of oxytocin, prolonged obstructed labour and previous caesarean section scar were the three leading predisposing factors identified in this study

Spatial epidemiological analysis of severe hand, foot and mouth disease in Guangxi, 2014-2018 / 中国热带医学

@#Abstract: Objective　To explore the spatial epidemiological characteristics of severe cases hand, foot and mouth disease (HFMD) in Guangxi, China, from 2014 to 2018, and to provide a basis for identifying the high-risk regions as well as the prevention and control of severe cases of HFMD in Guangxi. Methods　Spatial-temporal scanning analysis, global and local spatial autocorrelation analysis were used to analyze the spatial clustering of HFMD. The trend surface analysis was used to evaluate the spatial distribution trend of HFMD. Results　From 2014 to 2018, the incidence and severe case fatality rates of HFMD were 3.89/100 000 and 4.23%, respectively. Monte Carlo scanning analysis showed that the first cluster region was Cenxi City, the second cluster was mainly concentrated in northwest of Guangxi, and the aggregation time was mainly concentrated in April to May and August to October. The global spatial autocorrelation analysis showed that the severe HFMD was significant clustering distribution, and the Moran's I coefficients of the sever cases, severe morbidity and severe case fatality rate were 0.088, 0.118, 0.197, respectively (P<0.05). Local spatial autocorrelation analysis showed that hotspots of severe HFMD cases were concentrated in the southern Guangxi, mainly in Lingshan County. Anselin local Moran's I clustering and outlier analysis indicated that 5 high-high (H-H) clustering regions for fatality were Lingshan, Pubei, Zhongshan, Zhaoping and Pinggui County. There were 6 high-high (H-H) clustering regions for severe incidence rate, namely Lingshan, Qinnan, Lingyun, Youjiang, Bama Yao Autonomous and Pinggui County, and 1 high-low (H-L) clustering region, Cenxi County. The trend surface analysis showed that the overall number of severe cases of death decreased from east or west to the middle, and increased from north to middle, and then decreased to south. Conclusions　Severe HFMD cases in Guangxi have obvious spatial-temporal clustering, and the hop spots are mainly concentrated in southern Guangxi. The prevention and control of HFMD in areas with high incidence of severe cases should be strengthened to reduce the burden of HFMD cases.

Epidemiological characteristics of influenza in Mianyang, Sichuan, 2019-2021 / 中国热带医学

@#Objective To understand the epidemiological and etiological characteristics of influenza in Mianyang City from 2019 to 2021, so as to provide a basis for the prevention and control of influenza. Methods Influenza surveillance data in Mianyang City from 2019 to 2021 were collected and analyzed statistically. Results A total of 55 970 cases of influenza were reported in Mianyang City from 2019 to 2021, with an average annual incidence of 388.08/100 000. A total of 103 723 cases of influenza -like illness cases (ILI) were reported, with an average annual ILI% of 3.58%. The incidence, ILI% , and positive detection rates of influenza were all far higher than those in the corresponding period in 2019. The classification of the population is mainly composed of students under the age of 15. The top three reported cases were Fucheng District (20 118, 35.94%), Youxian District (6 394, 11.42%) and Jiangyou District (5 800, 10.36%). 10 126 samples of ILI were received and detected, with a positive rate of 19.53%, the positive rate of ILI samples was mainly students under 15 years old. The dominant strains of influenza viruses showed an alternating trend over the years, and A (H3) was the predominant type in 2019. Except for 2 A (H9) strains detected in 2021, the rest were all BV strains. Due to the impact of COVID-19 in 2020, the positive detection rate was low throughout the year. 43 outbreaks of ILI were reported, which were mainly occurred in winter, and most of them were in primary schools. Conclusion From 2019 to 2021, the characteristics of cases, ILI, pathogen surveillance and outbreak events of influenza in Mianyang City are basically the same, with students under 15 years of age and schools remaining the key population and sites of concern. the importance of non-pharmaceutical interventions for influenza prevention and control is further evidenced by the low incidence of influenza during the COVID-19 pandemic.

Investigation of viral etiology with sever acute respiratory infection of hospitalized patients in Guangdong Province from 2019 to 2021 / 公共卫生与预防医学

Objective To investigate the infection status and epidemiological characteristics of viral pathogens in hospitalized patients with severe acute respiratory infection (SARI) in Guangdong Province from 2019 to 2021, so as to provide reference for clinical diagnosis and prevention. Methods The respiratory tract samples of SARI patients collected from 2019 to 2021 were detected and analyzed for respiratory syncytial virus (RSV), adenovirus (ADV), human rhinovirus/enterovirus (HRV/EV), human metapneumonic virus (HMPV) and other common respiratory viruses using Luminex respiratory multi-pathogen detection technology. Results A total of 1 948 influenza-negative cases were collected, of which 24.28 % were positive detection of virus infection. HRV/EV was the highest (10.32%), followed by RSV (4.31%). The detection rates were statistically significantly different among different age groups (χ2=176.186，P2=0.042，P>0.05). The detection peaks of RSV were mainly concentrated in summer and autumn, while HMPV was prevalent in winter, and HRV/EV and ADV had no obvious seasonality. Mixed infection was found in 39 samples, and the mixed infection rate was 2.00%. In the mixed infection cases, HPIV and HRV/EV combined infection was the most common. Conclusion HRV/EV, RSV, HMPV and ADV are predominant viral pathogens in SARI influenza-negative hospitalized cases in Guangdong Province from 2019 to 2021. It is recommended to strengthen the surveillance of SARI cases in children under 5 years old.

Analysis of influenza surveillance results in Jingzhou， Hubei Province from 2016 to 2021 / 上海预防医学

ObjectiveTo understand the epidemiological characteristics of influenza in Jingzhou from 2016 to 2021， so as to provide scientific evidence for the formulation of influenza prevention and control policies in this region， and effectively protect people's health. MethodsData of influenza-like illness （ILI） and pathogen surveillance in Jingzhou during 2016‒2021 were collected and statistically analyzed. ResultsA total of 46 272 ILI cases were reported from two hospitals in Jingzhou City from 2016 to 2021. The difference in the constituent ratio of ILI was statistically significant among different age groups （P<0.05）. A total of 12 812 specimens were collected from two hospitals for influenza surveillance. A total of 1 513 cases were RNA positive，and the positive rate of influenza virus nucleic acid detection was 11.81％. The RNA positive specimens were mainly B （Victoria）， accounting for 39.33％. There were statistically significant differences in the positive rate of influenza virus nucleic acids and different types of influenza virus nucleic acids among different years （P<0.05）. ConclusionThe influenza epidemic in Jingzhou peaks in winter and spring， and the new A （H1），A （H3）， B （Victoria） and B （Yamagata） types alternate and mixed epidemics dominate.

Characteristics of detection methods for 250 newly diagnosed leprosy cases in Hunan Province from 2013 to 2022 / 中国热带医学

@#Abstract：Objective To investigate the detection methods of newly discovered leprosy cases in Hunan Province in 2013-2022, and analyze the trend of changes, and provide scientific basis for the prevention and treatment of leprosy. Methods The detailed information of newly diagnosed leprosy cases in Hunan Province from 2013 to 2022 was collected through the Leprosy Management Information System (LEPMIS), and the descriptive epidemiological method was used to analyze the detection methods of newly discovered leprosy cases. Results From 2013 to 2022, a total of 250 newly diagnosed leprosy cases were detected in Hunan Province, including 143 cases (57.20%) were found in outpatient clinics, 33 cases (13.20%) were found in clue investigations, 27 cases (10.80%) were notifiable-reported, 23 cases (9.20%) were self-reported, 11 cases (4.40%) were found in other ways (e.g., group survey), 9 cases (3.60%) were found in contact examinations, 2 cases (0.80%) were found in census, and 2 cases (0.80%) were found in epidemic point inspection. From 2013 to 2022, the number of cases detected in outpatient clinics showed an upward trend (rs=0.515), while the cases detected in clue investigation (rs=-0.873), notifiable-reported (rs=-0.127), self-reported (rs=-0.301), contact examination (rs=-0.363), census (rs=-0.701) and epidemic point inspection (rs=-0.701) showed a downward trend. The majority of leprosy cases with different demography characteristics and clinical characteristics were found through outpatient clinics, except that the majority of leprosy cases in children were found by contact examination (66.76%). Of 165 male cases, 92 cases (55.76%) were found in outpatient clinics and 51 out of 85 female cases (60.00%) were found in outpatient clinics. Among age groups, 113 out of 187 cases aged 15 to 60 (60.43%) and 30 out of 60 cases aged over 60 (50.00%) were found in outpatient clinics. Among patients with differentoccupations, 112 out of 208 cases of farmers (53.85%) and 31 out of 42 cases of other occupations (73.81%) were found inoutpatient clinics. Among cases with different types of leprosy, 111 out of 185 cases of multibacillary leprosy (60.00%) and 32 out of 65 cases of paucibacillary leprosy (49.23%) were found in outpatient clinics. Among cases with different numbers of skin lesions, 4 out of 8 cases of skin lesion-free leprosy (50.00%), 3 out of 9 cases of single skin lesion leprosy (33.33%), and 136 out of 233 cases of multiple skin lesions leprosy (58.37%) were found in outpatient clinics. Of 72 cases without nerve damage, 48 cases (66.67%) were found in outpatient clinics. Of 27 cases with single nerve damage, 17 cases (62.96%) were found in outpatient clinics. Of 151 cases with multiple nerve damage, 78 cases (51.66%) were found in outpatient clinics. Among patients with different levels of malformation, 58 out of 102 cases with no malformation (56.86%), 28 out of 45 cases with Grade malformation (62.22%), 35 out of 68 cases with Grade Ⅱmalformation (51.47%), and 22 out of 35 cases with other types of malformation (62.86%) were found in outpatient clinics. Conclusions Outpatient clinics is the main way to detect newlydiagnosed leprosy cases under the low prevalence of leprosy in Hunan Province, and it is an important strategy to move the early detection of leprosy cases to comprehensive medical institutions in the future.

Clinical features of unrecognized congenital adrenal hyperplasia due to 17α-hydroxylase deficiency since adolescence: A case report / Journal of the ASEAN Federation of Endocrine Societies

@#The majority of patients with congenital adrenal hyperplasia (CAH) present with a deficiency of 21-hydroxylase or 11-beta-hydroxylase, which account for 90% and 7% of cases, respectively. However, CAH due to 17α-hydroxylase deficiency (17OHD) is an extremely rare form of CAH (<1% of all CAH cases) that leads to a deficiency of cortisol and sex steroids, along with features of aldosterone excess. This is a case of a 51-year-old single female who was referred to us for the evaluation of new-onset hypertension and hypokalaemia of one-year duration. She was born out of a second-degree consanguineous marriage and reared as a female. She was diagnosed to have testicular feminization syndrome when she presented with a history of primary amenorrhea, absence of secondary sexual characteristics, and bilateral labial swellings at pubertal age. Subsequently, she underwent gonadectomy at the age of 16. Due to the presence of hypertension, metabolic alkalosis and bilaterally enlarged adrenals on CT scan, 46, XY disorders of sexual development (DSD) was considered. A karyotype confirmed the presence of 46, XY chromosomal sex, and genetic analysis revealed a mutation in the CYP17A1 gene, thus confirming the diagnosis of 17a-hydroxylase deficiency.

Discussion on countermeasures of medical research integrity governance: Analysis of medical research integrity cases based on the notification of ministry of science and technology / 中华医学科研管理杂志

Objective:To study the characteristics and patterns of medical research integrity cases reported by the Ministry of Science and Technology, and to explore the countermeasures to strengthen the management of medical research integrity.Methods:20 batches of 555 cases of scientific research integrity cases publicly reported by the Ministry of Science and Technology of the People's Republic of China from June 2021 to May 2022 were taken as the research objects, and the papers involved, regional distribution, scientific research dishonesty and disciplinary measures were classified and analyzed.Results:Data falsification was the most common problem of scientific research dishonesty, accounting for 47.39%. Shandong Province was the province with the most reported cases, accounting for 50.81%. 27.67% of the corresponding authors received 5 disciplinary measures, and 26.28% of the first authors received 6 disciplinary measures. Among the disciplinary measures, the proportion of suspension of applications for various scientific research projects was the highest, with 87.60% of corresponding authors and 91.42% of first authors receiving this punishment. The corresponing authors with 5 years suspension accounted for 49.24% of all years, and the first authors accounted for 57.48%.Conclusions:To promote the integrity governance of medical research, we should strengthen the supervision of medical journals, promote regional exchanges, encourage active error correction, and improve the construction of scientific research integrity database.

HIF – 1? as a marker of risk assessment for malignant transformation in oral submucous fibrosis: An immunohistochemical study

Background: Oral submucous fibrosis (OSMF) is a potentially malignant disorder associated with habit of chewing betel quid containing arecanut. Morphological features of OSMF especially fibrosis suggests a possibility of the hypoxic environment in diseased tissues. The adaptation of cells to hypoxia appears to be mediated via hypoxia inducible factor-1? (HIF-1?) which is also said to be associated with malignant transformation of epithelial cells in various other carcinomas like prostate and cervical carcinoma. Therefore, the main objective of this study was to investigate the role of HIF-1? in progression and malignant transformation of OSMF. Materials and Methods: The study group consisted of histo-pathologically diagnosed 30 cases of oral submucous fibrosis and 10 cases of OSCC were taken as control. The immunohistochemistry was carried out on neutral buffered formalin-fixed paraffin-embedded tissue sections by using the monoclonal antibody of HIF-1?. Statistical analysis was done using SPSS software version 2.0. Results: A gradual and significant rise in the expression of HIF-1? was observed in various grades of OSMF and OSCC cases. HIF 1? expression was increased in cases showing hylanization and constricted blood vessels. A cut off value of 39.6% of HIF-1? positive cells was determined statistically to categorize the cases into high risk and low risk group for malignant transformation. Conclusion: Overexpression of HIF-1? may contribute to the progression and malignant transformation of OSMF. Cases expressing more than 40% of HIF-1? positive cells are at a greater risk for malignant transformation.