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Resumen Los trabajadores agrícolas se exponen frecuentemente a los pesticidas, los cuales pueden afectar el sistema cardiovascular. El objetivo de la investigación fue revisar la asociación entre la exposición ocupacional a pesticidas, el desarrollo de enfermedades cardiovasculares y los biomarcadores utilizados en la vigilancia de la salud de los trabajadores. Para ello se realizó una revisión no sistemática de la literatura en tres bases de datos: Pubmed, Embase y Scopus, con ecuaciones de búsqueda elaboradas con los términos "agrochemicals", "myocardial infarction", "occupational exposure" y "farmers", y se incluyeron artículos publicados entre 2007 y 2022. Se encontró que los pesticidas causan elevación de las cifras de presión arterial en trabajadores expuestos y en mujeres embarazadas se relaciona con hipertensión gestacional y preeclampsia. Respecto al infarto agudo de miocardio (IAM), el contacto con los pesticidas clorpirifós, coumafós, carbofurano, pendimetalina, trifluralina y acilalanina aumentan el riesgo de IAM en mujeres, y entre los trabajadores masculinos la exposición a dibromuro de etileno, maneb/mancozeb y dimetil-ditiocarbamato de zinc se asoció con mayor mortalidad. La vigilancia epidemiológica se realiza principalmente con la medición de la actividad de la acetilcolinesterasa eritrocitaria (AChE). Se puede concluir que la exposición a pesticidas puede desencadenar enfermedades cardiovasculares agudas y crónicas, como elevación de las cifras de presión arterial, IAM fatal y no fatal. Los pesticidas dimetil ditiocarbamato de zinc, clorpirifós, coumafós, carbofurano, paratión y malatión son las sustancias que tienen mayor relación con el desarrollo de enfermedad cardiovascular.
Abstract Farmworkers are frequently exposed to pesticides, which can affect the cardiovascular system. The objective of the research was to review the association between occupational exposure to pesticides and the development of cardiovascular diseases, and the biomarkers used in monitoring the health of workers. For this, a non-systematic review of the literature was carried out in three databases: Pubmed, Embase and Scopus, with search equations prepared with the terms "agrochemicals", "myocardial infarction", "occupational exposure" and "farmers". Articles published between 2007 and 2022 were included. Pesticides were found to cause elevated blood pressure levels in exposed workers, and in pregnant women it is related to gestational hypertension and preeclampsia. Regarding acute myocardial infarction (AMI), contact the pesticides chlorpyrifos, coumaphos, carbofuran, pendimethalin, trifluralin, and acylalanine increased the risk of AMI in women, and among male workers exposure to ethylene dibromide, maneb/mancozeb, and zinc dimethyldithiocarbamate was associated with increased mortality. Epidemiological surveillance is mainly carried out by measuring erythrocyte acetylcholinesterase (AChE) activity. It can be concluded that exposure to pesticides can trigger acute and chronic cardiovascular diseases, such as elevated blood pressure, fatal and non-fatal AMI. Zinc dimethyl dithiocarbamate, chlorpyrifos, coumafos, carbofuran, parathion and malathion pesticides are the substances most closely related to the development of cardiovascular disease.
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Introduction: Vitamin D deficiency has been shown to alter insulin synthesis and secretion with additional biological roles to the well-known effects, it has on calcium homeostasis. The mechanism of action of Vitamin D in diabetes is thought to be mediated not only through the regulation of plasma calcium levels, which regulate insulin synthesis and secretion but also through a direct action on pancreatic beta-cell function. Therefore, owing to its increasing relevance, this study has focused on the relationship between vitamin D, milk intake, and sun exposure in well-defined diabetes patients along with controls. : This study was conducted for one yearMethod on five hundred adult diabetes and control cases who participated in the interview and medical examination. The relationship between diabetes, milk intake, and sun exposure with serum 25-hydroxyvitamin D levels was evaluated using regression analysis in the presence of demographic and clinical covariates, such as age, education, employment, and persistent hyperglycemia. The mean age ranges between 51.52�70Results: and 52.24�90 in DM and control groups respectively with male preponderance seen in both groups. The number of patients consuming milk was almost the same (24.11�12) and sun exposure for less than 1 hour was 68% which was similar in both DM and controls. It was observed that several males (72%) were more in the control group were consuming milk >250ml/day as compared to DM patients. Sun exposures between 1-3 hours were also similar in both groups. Mean serum 25 (OH) D levels in diabetic cases (24�82 nmol/L) are significantly lower than controls (41.14�82nmol/L) (p<0.0001). Serum 25(OH)D levels were significantly low in different age groups of DM male and female patients (p<0.001) while no difference was observed in control male and female age groups. There is a specific relationship betweenConclusions: Vitamin D deficiency and DM. But many other lifestyle factors are well known to cause diabetes which may also cause Vitamin D deficiency.
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Tomato is one of the most important vegetables affected by various diseases. Owing to its effectiveness and safe in use, azoxystrobin is used in controlling major fungal diseases in tomato. An ethyl acetate method was validated for determining azoxystrobin in tomato using LC-MS/MS. The average recoveries ranged from 79.56% (�28) and 89.28% (�71) %. The dissipation and residue of azoxystrobin in tomato at good agricultural practice conditions were investigated. The dissipation results indicated that the half-life of azoxystrobin in tomato fitted in 1st+1st order was 1.818 and 2.32 at recommended dose double recommended dose respectively. The dissipation rates of azoxystrobin in tomato were almost the same at both doses. Terminal residues in tomato (0.004 mg kg-1) were all below the maximum residue limit (3 mg kg-1 by European Union). The results demonstrated the safety of using azoxystrobin at the recommended dosage to protect tomato from diseases. Moreover, the postharvest intervals estimated will be useful for farmers to ensure their field applications in a judicious manner and, in turn minimizing the residue loads within Maximum residue limit compliance, at harvest.
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Background: Amid the COVID-19 lockdown during the second wave, a crucial investigation into Vitamin D deficiency among undergraduate students gained significance. Recognizing the potential impact on immune health, our objective was to explore serum Vitamin D status and its correlations with gender, diet, body mass index, and sunlight exposure in undergraduate medical students, considering the unique circumstances of restricted outdoor activities during the lockdown. Aims and Objectives: The aim of this study was to assess serum Vitamin D levels in undergraduate medical students during the COVID-19 lockdown. Materials and Methods: The study was conducted from February 2021 to June 2021 at Guntur Medical College, Andhra Pradesh. The cross-sectional study involved 68 undergraduate medical students aged 18–24 years. Ethical clearance was secured. Sociodemographic and anthropometric data were collected through interviews and a Google Forms questionnaire. Biochemical analyses, considering the lockdown’s impact, were performed to categorize Vitamin D status. Results: The study showed a profound impact of the COVID-19 lockdown on Vitamin D status, revealing high prevalence due to restricted sun exposure. Vitamin D deficiency was prevalent, particularly among obese and overweight students. No association between Vitamin D and calcium levels emphasized the need for tailored interventions considering the unique circumstances of lockdown. Parathormone levels were significantly elevated in Vitamin D deficiency. Conclusion: The study revealed a 61.8% prevalence of Vitamin D deficiency, with no statistically significant gender difference. A significant inverse correlation was identified between Vitamin D and parathormone parathyroid hormone levels. A positive correlation was noted between sun exposure duration and Vitamin D levels.
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Pesticide exposure can have long-term effects on human health and the environment. Flower growers are particularly at risk of reproductive health issues and problems with semen quality due to pesticides1-2. Numerous studies have shown that pesticides can signicantly impact male reproductive function and semen quality3-4. Therefore, environmental exposure to pesticides can harm male fertility. Assess the effects of pesticide exposure onObjective: the fertility of ower growers. We conducted a cross-sectional analytical study, comparing 30 owerMaterial and Method: growers exposed to pesticides with a control group of 30 students from the medical school at the Autonomous University of the State of Mexico, who had similar sociodemographic characteristics. We evaluated the WHO seminal parameters and pesticide exposure as the main variables. The mean was utilized to measure central tendency, and the standardStatistical analysis: deviation was used to measure dispersion in descriptive statistics. Bivariate and multivariate analyses were conducted to evaluate the association between the variables, with a signicance level of p > 0.05. Exposure to pesticides can lead toResults: changes in sperm quality among ower growers, affecting concentration, mobility, and morphology. Post sperm capacitation, the exposed group showed lower sperm concentration than the non-exposed group. Raising awareness aboutConclusions: the potential risks associated with increased ower production and the resulting higher pesticide use is crucial, especially in the community of Villa Guerrero. More than 80% of the population in this community is involved in oriculture and uses pesticides year-round without proper protective equipment. Further research is needed to comprehend these pesticides' impact on male fertility fully2-4. By informing the community about these potential risks, individuals can take preventive measures and learn to use pesticides safely and responsibly.5
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Background: Skin is an important barrier of the human body, which offers protection from pathogens, UV radiation, and chemical and mechanical injury. Solar UV radiation is the major cause of extrinsic skin aging and it leads to many acute and chronic cutaneous reactions. Dermoscope is an instrument that helps to visualize the morphological features unseen to the naked eye, using the principle of transillumination and magnification of skin. Aim and Objective: The aim of the study was to study the skin changes associated with sun exposure on the lateral and medial aspects of the forearm using dermoscope. Materials and Methods: A cross-sectional descriptive study of 82 1st-year MBBS students belonging to 18–25 years of age was conducted at Government Medical College, Thrissur, after getting ethics committee approval. Sample size calculated was 76. With the help of a questionnaire, personal details and details related to the sun exposure habits of the subjects were obtained. Dermoscopic photographs of the lateral and medial side of the forearm were taken after informed consent. Results: Chi-square test showed significant changes in pigmentation pattern and hair pattern on the lateral side of the forearm among subjects who had sun exposure for more than half an hour which was not found on the medial side. Conclusion: Photoaged skin appears coarse with uneven pigmentation. Dermoscopy allows the assessment of subtle morphological features of skin aging. Monitoring skin changes due to sun exposure among our population helps in the early identification of abnormal patterns with sun exposure which needs immediate medical attention.
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Background: Early menarche has emerged as a significant global concern due to its myriad health implications. Divergent findings characterize existing research on its determinants, prompting the necessity for this study to elucidate the discordance among them and to broaden the spectrum of predictors of early menarche. The primary objective of this study is to determine the mean menarcheal age and to study the influence of various factors, including socio-demographic characteristics, body mass index (BMI), and lifestyle habits, on the onset of menarche in our study population. Methodology: This was a questionnaire-based cross-sectional study carried out in the southwestern region of Karnataka between 2016 and 2017. A total of 700 high school girls aged between 14 and 16 years were recruited for the study via a simple random sampling technique. Results: The mean menarcheal age was found to be 12.67 ± 1.19 years, with 33% experiencing it before the age of 12. Factors accelerating menarche included high BMI, excessive exposure to audio-visual media, lack of exercise, non-vegetarian diet, and late sleeping habits, as determined by stepwise logistic regression analysis. Conclusions: Findings emphasize the significance of monitoring menarcheal trends and identifying modifiable factors influencing its onset. There is a need for educational programs focusing on the holistic health of girls.
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Los pesticidas son un grupo de compuestos químicos que tienen diferentes acciones, insecticidas, fungicidas, herbicidas, rodenticidas. Luego de su aplicación el proceso de degradacion es lento. Pueden permanecer en el suelo y en las aguas subterráneas, contaminando el agua. El cambio climático transforma el proceso de degradación de los compuestos químicos, por la alteración de la composición del suelo, produciendo alteraciones en el ecosistema y la biodiversidad.El impacto de los pesticidas sobre la salud humana es un desafío por el gran potencial de daño que tienen. Desde el año 2004, se introduce en Paraguay las semillas geneticamente modificadas, acompañado de un gran incremento de las areas de cultivo y la utilizacion de pesticidas.Con el objetivo de revisar el estado del conocimiento actual sobre los efectos de estas sustancias quimicas, sobre los diferentes organos y sistemas en las poblaciones pediatricas y embarazadas, se realizo una revision descriptiva, abarcando las principales base de datos disponibles.Como objetivo secundario, considerando la extension de areas de cultivo en Paraguay, describir los resutlados de los estudios realizados en el pais. Los resultados de los estudios revisados muestran asociacion entre afectacion de diferentes organos, sistemas, de estas poblaciones y la exposcion ambiental, de las aguas y los alimentos. Algunos de estos resultados se replican en los realizados en las zonas de cultivo del pais.
Pesticides, such as insecticides, fungicides, herbicides, and rodenticides, are a group of chemical compounds that have different actions. After their application, the degradation process is slow. They can remain in the soil and groundwater, contaminating the water. Climate change transforms the process of degradation of chemical compounds, by altering soil composition, producing alterations in the ecosystem and biodiversity. The impact of pesticides on human health is challenging because of the great potential for harm they have. Since 2004, genetically modified seeds have been introduced in Paraguay, accompanied by a great increase in cultivation areas and pesticide use. To review the current state of knowledge about the effects of these chemical substances on the different organs and systems in pediatric and pregnant populations, a descriptive review was carried out, utilizing the main available databases. As a secondary objective, considering the extension of cultivation areas in Paraguay, we also described the results of studies carried out in the country. The results of the reviewed studies show an association between the involvement of different organ systems in these populations and environmental exposure, water, and food. Some of these results are replicated in those carried out in the country's growing areas.
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Abstract Background: Despite overwhelming evidence supporting the efficacy and effectiveness of Pre-Exposure Prophylaxis (PrEP) in HIV prevention, its adoption has been marginal. In Colombia, more information about eligibility, awareness, and intentions to use PrEP in target populations and how these relate to social determinants is needed. Aim: To assess PrEP awareness, the motivational cascade, and the social conditions related to the cascade. Methods: A cross-sectional study in a non-probabilistic sample was conducted between April 2020 and February 2021 among 552 Men with Sex with Men (MSM) and 158 Transgender Women (TGW). We used the Poisson regression to explore the associations between PrEP eligibility, awareness, and elements of the motivational PrEP cascade (willingness, intention, and self-perceived need to take) and their sociodemographic characteristics. Results: 51.2 % of the participants were aware of PrEP, 58.7 % were willing to use it, 45 % were self-perceived as PrEP candidates, and 56.2 % intended to take it.TGW were less likely to be aware but more willing to use PrEP than the sample of MSM interviewed face-to-face. Low education was related to low PrEP awareness and low income to low willingness to start PrEP. Conclusions: These results support the pertinence of the cascade concept to describe the stage of the target population regarding eligibility and motivation to take it. To accelerate PrEP implementation, efforts are needed to increase awareness among MSM and TGW with focalized strategies for those with low socioeconomic status.
Resumen Introducción: A pesar de la enorme evidencia que apoya la eficacia y efectividad de la Profilaxis Pre-exposición (PrEP) para el VIH, su adopción continúa siendo marginal. En Colombia, poco se sabe sobre los determinantes sociales y su efecto en la elegibilidad, familiaridad e intención de uso de la PrEP en poblaciones de interés. Objetivo: Evaluar la familiaridad con la PrEP, la cascada motivacional de la PrEP y las condiciones sociales como determinantes de esta cascada. Métodos: Entre abril 2020 y febrero 2021 se realizó un estudio transversal en una muestra no probabilística de 552 Hombres que tienen Sexo con Hombres (HSH) y 158 Mujeres Transgénero (MTG). Usando la regresión de Poisson, se exploraron las asociaciones entre elegibilidad, familiaridad y elementos de la cascada motivacional de PrEP (voluntad, intención y necesidad autopercibida de tomarla) con las características sociodemográficas. Resultados: El 51,2 % sabían de la PrEP, el 58,7 % estaban dispuestos a utilizarla, el 45 % se percibían como candidatos a PrEP, y 56,2 % tenían intención de tomarla. Una baja escolaridad se relacionó con una baja familiaridad con la PrEP y los bajos ingresos con menor intención de uso. Las MTG estaban menos enteradas sobre la PrEP, pero estaban más dispuestas a usarla que los HSH que fueron entrevistados en persona. Conclusión: Los resultados apoyan la pertinencia del concepto de la cascada de PrEP para describir el estado de elegibilidad y motivación para tomarla. Para acelerar la implementación de la PrEP, se debe incrementar su conocimiento entre HSH y MTG con estrategias focalizadas en poblaciones menos escolarizadas.
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Background: Hypocalcaemia is a biochemical abnormality commonly seen in paediatric population with a multi-factorial etiology having varied presentation ranging from acute emergency to chronic diagnostic dilemma. We studied the clinical profile of infants and children presenting with hypocalcaemia from 0 to 12 years of age. Methods: Clinical features, risk factors, precipitating factors, feeding/dietary practices of all children (0-12 years) visiting our tertiary care centre, from January 2019 to March 2020, diagnosed with hypocalcaemia were recorded and a correlation with serum calcium levels was studied. Results: Out of 92 patients having hypocalcaemia majority 57 (62%) were males. Majority of participants belonged to age group of 6 months-2 years i.e. 40 (43.48%). The commonest presentation was convulsions present in 39 (42.39%) participants affecting more children less than 2 years of age; whereas majority of children above 2 years of age presented with growth impairment. Risk factors identified were perinatal risk factors, faulty feeding practices in infants, inadequate dietary calcium intake in children, inadequate sun exposure. Amongst the biochemical factors precipitating hypocalcaemia, alkalosis showed significant association (p value 0.016) with degree of hypocalcaemia; most common etiology was vitamin D deficiency and nutritional rickets. Conclusions: Hypocalcemia plays vital role in infants and growing children because of its various implications on growth and development. Exposure to sunlight, vitamin D and calcium supplementation during pregnancy and lactation and infancy with good dietary calcium intake for children during their growth spurts can prevent complications. Health education and awareness of common risk factors for hypocalcaemia can prove helpful.
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Background: Traditional Indian medical education limits first-year MBBS students to classroom settings, delaying clinical exposure until the second year. Early clinical exposure (ECE) aims to integrate basic sciences with clinical practice, enhancing student understanding and interest through direct patient interaction. Aim was to assess first-year MBBS students' perceptions of ECE. Objectives were to introduce clinical settings to first-year students, and to explore students' experiences and attitudes towards ECE.Methods: The study was conducted at Dr. Panjabrao Deshmukh Memorial Medical College, Amravati, involving 100 first-year MBBS students. Ethical clearance and permissions were obtained. Students participated in bedside teaching in small groups over four weeks, focusing on clinical conditions and diagnostics. Observations in the radiology department included first-trimester ultrasounds with patient interaction. A qualitative approach using focus group discussions and a post-test questionnaire was employed.Results: Learning and knowledge: 81% found ECE helpful, interest in topic: 75% reported increased interest, motivation: 84% felt motivated to learn more, correlation with clinical features: 60% found it helpful, ward rounds: 89% valued participation, knowledge sharing: 87% appreciated discussion opportunities, and overall utility: 79% recognized ECE's utility. Feedback indicated significant enhancements in learning, interest, and motivation, despite some neutral or negative responses.Conclusions: ECE is a vital teaching tool that improves first-year MBBS students' understanding, motivation, and professional skills. Despite logistical challenges, its overall positive impact on medical education justifies its implementation.
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Background: Infertility affects approximately 8-10% of couples worldwide. Sperm deoxyribonucleic acid (DNA) fragmentation index (DFI) has emerged as a significant factor in infertility research, highlighting its importance in understanding reproductive health.Methods: This prospective clinical study aimed to assess the impact of Dfrag� tablets, a unique nutraceutical combination containing vitamin D3 (600 IU), selenomethionine (40 mcg), coenzyme Q10 (100 mg), and astaxanthin (8 mg), on high sperm DFI over a 3-month period. The study utilized the sperm chromatin dispersion test (SCD) to measure DFI and examined semen parameters before and after the intervention.Results: Dfrag� tablets were found to significantly improve semen volume, total sperm count, sperm concentration, and progressive motility within the 3-month treatment period. The study reported an average reduction of 36% in DNA fragmentation levels post-treatment with Dfrag� tablets. However, no significant changes were observed in total motility or sperm morphology.Conclusions: This study demonstrates the potential of Dfrag� tablets in reducing sperm DNA fragmentation and improving key semen parameters associated with fertility.
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Background: Dental fluorosis is a significant public health problem in India as drinking water with high fluoride is widespread throughout the country. Although dentists are key players in the prevention and management of the condition, little is known about their knowledge, attitudes and practices (KAP) related to fluorosis. Methods: A cross-sectional study on an Indian dentist population was conducted. A 13-question survey was completed by participants in January 2023 - April 2023 using simple random sampling. The questionnaire included some demographic data and information on the source of knowledge and risk factors of fluorosis, related diseases, proper diagnostic measures and treatment and the point of view concerning prophylaxis. Data analysis was done using SPSS Version 23. Results: Nearly half were aware of drinking water as a key source of fluoride, however all had gaps in knowledge regarding additional sources and adequate level of fluoride. Most of dentists wanted bleaching and veneers; preferences varied while attitudes towards prevention were positive, the study found a gap in applying sections of the essential knowledge and identified that competence in fluorosis management should be improved with educational interventions. Conclusions: Knowledge and practices regarding fluorosis are variable among Indian dentists, with significant gaps in understanding of this condition and its diagnosis. There is a need for educational programs, interdisciplinary work and public awareness in these areas to improve management of fluorosis and oral health. Integration of the subject of fluorosis in the undergraduate courses are recommended to fill the gaps of knowledge and competence in health professionals.
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The positive aspect of technological innovation makes life easier; it may also involve components that impair the quality of life via certain negative effects. Cell phone towers emit high-frequency radio waves, which are a significant environmental pollutant and a serious problem today. The thermogenic effect is primarily linked to the intensity of electromagnetic fields (EMF), measured by the specific absorption rate (SAR). This review work compiled both field and laboratory studies carried out on various parameters such as growth, behaviour, reproduction and development, cancers in human beings, etc. Information on various studies published on the effects of EM radiations and methods employed during EMR studies is enlisted herein. The studies showing the impact on dosimetry, co-exposure, epidemiology, haematology, endocrinology, molecular structure, wildlife, and ecology were considered. Lack of standardization and inconsistent results hindered the ability to generalize the findings.
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Background: Chronic obstructive pulmonary disease is a progressive and persistent inflammatory condition associated with significant morbidity and mortality. Increased oxidative stress amongst others, plays an important role in the pathogenesis of this disease. The objective of the present study was to conduct a preliminary yet comprehensive examination of metal exposure specifically copper and zinc levels and their association with overall oxidative stress in COPD. Methods: A cross sectional study was carried out in a tertiary care hospital in South India. Two groups were included in the study. One group with 20 COPD patients and the other group of 20 healthy controls. Plasma samples were obtained from both the groups and serum levels of copper and zinc were studied by atomic absorption spectrometry. Cu/Zn ratio obtained from the results was further correlated with oxidative stress index calculated from total oxidant status and total antioxidant status in COPD with respect to controls. Results: The copper levels were significantly higher and the zinc levels lower in the COPD group as compared to the control group. The copper/zinc ratio was higher in COPD as compared to control population. The correlation between Cu/Zn ratio and oxidative stress index showed a positive correlation with a regression coefficient of 0.7. Conclusions: The study throws light on the trace element imbalance in COPD and how these could induce oxidative stress, contributing to persistent inflammation in COPD. In the clinical perspective, monitoring Cu/Zn ratio in COPD patients may lead to better risk mitigation and thereby better therapeutic management of the disease.
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Background: The purpose of this study was to assess factors associated with human immunodeficiency virus (HIV) pre-exposure prophylaxis uptake and retention among sex workers in Nakuru town, Kenya. The theory of planned behavior and the acquired immunodeficiency syndrome (AIDS) risk reduction model served as the study's theoretical framework. Methods: A cross-sectional research design was adopted for this study. The study targeted all the sex workers in Nakuru town who were 18 years old and above. A random sampling technique was used to get the hotspots where the sex workers were to be found. Snow balling sampling technique was then adopted to identify and recruit the study participants. Using primary sources. The quantitative data was obtained from the respondents using a questionnaire. Quantitative data was analyzed using descriptive and inferential statistics (regression analysis). The findings presented in table and graphical formats. Results: The analysis using multiple linear regression indicated that there was a collective significant effect between the awareness, health system factors, socio economic individual factors and use of pre-exposure prophylaxis (PrEP) among sex workers. A further analysis showed that, put together, the four predictor variables explained 35.7% of variation on PrEP uptake and retention. Conclusions: The study concluded that while use and none use PrEP can be explained by the four factors evaluated in this study, there are a lot of other factors that influence utilization of PrEP.
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Rabies is a zoonotic illness with a high mortality rate that attacks mammals' central nervous systems. It is a viral illness that may be avoided with immunization. Up to 99% of the human rabies transmissions occur in dogs, making them the primary cause of rabies mortality in humans. It is a case-report of rabies death in a 55-years old male, a prisoner from Phulbani Jail (Kandhamal), who was presented to MKCG Medical College and Hospital casualty with with chief complaints of difficulty in breathing and difficulty in drinking water since last night on 17 July 2023, at 11:19 pm. The patient had a history of dog bite exposure four years ago, for which he had not received any post-exposure prophylaxis. The patient was identified as having a likely case of rabies based on his previous history of animal bite and clinical manifestations. Patient was declared dead on 18 July 2023 at 10:30 am. Rabies diagnosis was confirmed by pathological examination of brain sample which showed presence of Negri bodies. This case-report focuses on the importance of proper medical history information including any animal bite exposure especially for convicts before admitting in prison so as to avoid later morbidity and its legal consequences. Such kind of incident also shows that there is lack of awareness regarding rabies in community. In this instance, mortality may have been prevented if the patient had finished the anti-rabies vaccine regimen and made it to a higher center in time for immunoglobulin. Increasing rabies vaccination awareness among the general public can help reduce rabies-related deaths.
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Resumen Este artículo tiene como objetivo discutir las concepciones de los Hombres Gay, Hombres Bisexuales y una Mujer Transgénero que usan o quieren usar profilaxis previa a la exposición por el virus de la inmunodeficiencia humana oral (PrEP) sobre nuevas vías de administración. Fueron entrevistados 17 usuarios del BCN Checkpoint. Las entrevistas fueron grabadas en audio, sometidas a análisis categorial temático teniendo en cuenta la perspectiva praxeográfica. Todos están adaptados al uso de la PrEP diaria y a demanda. En relación con las nuevas vías de administración (PrEP inyección intramuscular cada dos meses; pastilla mensual; inyección subcutánea cada seis meses) todos son muy receptivos a esas posibilidades, pero les falta información sobre las especificidades de cada una de ellas y una evaluación específica de sus necesidades. Tanto la satisfacción con el uso de PrEP oral, como las expectativas sobre las nuevas vías de administración son positivas. Sin embargo, lo más importante para los/a entrevistados/a es la garantía de que tendrán seguimiento para continuar cuidando de la salud afectivo-sexual, lo que no depende del tipo de vía de administración.
Abstract This article aims to discuss the expectations of Homosexual Men, Bisexual Men and a Transgender Woman, who use or want to use an oral pre-exposure prophylaxis (PrEP) for the human immunodeficiency virus (HIV) about PrEP modalities. Sixteen PrEP users, who are followed up in the BCN Checkpoint, were interviewed,. The interviews were audio-recorded, subjected to thematic categorical analysis within the theoretical framework from the praxiographic perspective. They are all adapted to the use of daily oral and event-based PrEP. In relation to the new PrEP modalities (monthly pill; intramuscular injection every two months; subcutaneous injection every six months), they are all very receptive to these possibilities, but they lack information on the specificities of each and specific assessment of their needs. Comments about the use of oral PrEP are positive, and expectations regarding the new PrEP modalities are visibly high. However, the most important thing for the interviewees is the guarantee that they will have follow-up appointments to continue taking care of their affective-sexual health, which is not dependent on the type of PrEP modalities.
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ABSTRACT The goal of this study was to estimate the prevalence of environmental and occupational exposure to pesticides according to sociodemographic factors among cancer patients. It is a cross-sectional study with cancer patients in the state of Mato Grosso. The prevalence of environmental and occupational exposure to pesticides was calculated as to the variables gender, age, macro-region, and education. Pesticide use per agricultural crops in liters was estimated, and a thematic map was constructed following the macro-region of the agricultural economy. Of the 998 patients, most were female (54.9%), aged between 50 and 69 years old (50.1%), had less than eight years of schooling (60.7%), and resided in the South-Central macro-region (55.4%). Regarding environmental and occupational exposure, 53.1% of the patients live or have lived in a municipality with agricultural plantations; 17.4% lived near crops; 43.4% worked in agriculture, livestock, or extractivism; and 22.9% worked or work directly with pesticides. Environmental and occupational exposure was higher in males, in the older age groups, schooling from 0 to 4 years, and in the macro-regions with higher pesticide use. The study concluded that environmental and occupational exposure among cancer patients is associated to sociodemographic characteristics and macro-regions of the agricultural economy.
RESUMO O objetivo deste estudo foi estimar a prevalência de exposição ambiental e ocupacional aos agrotóxicos conforme fatores sociodemográficos entre pacientes com câncer. Trata-se de um estudo observacional de delineamento transversal com pacientes com câncer do estado de Mato Grosso. Foi calculada a prevalência de exposição ambiental e ocupacional aos agrotóxicos conforme as variáveis sexo, faixa etária, região e escolaridade. Foram estimados o uso de agrotóxicos por culturas agrícolas em litros e construído mapa temático segundo a macrorregião de economia agropecuária. Dos 998 pacientes, a maioria era do sexo feminino (54,9%), tinha entre 50 e 69 anos (50,1%), possuía menos de oito anos de escolaridade (60,7%) e residiam na macrorregião Centro-Sul (55,4%). Em relação à exposição ambiental e ocupacional, 53,1% dos pacientes moram ou moraram em município com plantação agrícola, 17,4% residiam próximo à lavoura, 43,4% trabalharam na agricultura, pecuária ou extrativismo e 22,9% trabalharam ou trabalham diretamente com agrotóxicos. A exposição ambiental e ocupacional foi maior no sexo masculino, nas faixas etárias mais elevadas, escolaridade de 0 a 4 anos e nas macrorregiões de maior uso de agrotóxicos. Conclui-se que a exposição ambiental e ocupacional entre pacientes com câncer se associou as características sociodemográficas e macrorregiões de economia agropecuária.
ABSTRACT
Background and Objectives: Rabies is an anthropozoonosis of global relevance and high lethality that requires qualified care and attention to the aggressor species. The objective was to describe the sociodemographic profile and causality of human anti-rabies care services reported between the years 2007 and 2022 in the city of Ponta Grossa, state of Paraná. Method: Descriptive and quantitative epidemiological study carried out from the notification forms of human anti-rabies care in the city of Ponta Grossa, Paraná, between January 2007 and December 2022. Data were collected from the Notifiable Diseases Information System (SINAN) and tabulated in the Excel program. The main variables addressed were: sociodemographic factors, date of care, type of exposure, and species of the animal involved. Data were analyzed from absolute and relative frequency. The project follows the ethical standards of the National Health Council. Results: The sample included 16,668 cases. The sociodemographic profile of users who sought anti-rabies care was made up of 51.93% male, 92.98% were White and 4.55% Brown race, 15.77% were aged between 20 and 29 years, 13.16% between 30 and 39 years old. As for causality, 90,35% of notifications were due to bites, of which 95.60% were caused by canines and 3,81% by felines. Conclusion: Despite the predominance of reports resulting from accidents involving bites, it is necessary to raise awareness among health professionals and the population regarding the epidemiological importance of other types of potential exposure to the rabies virus.(AU)
Justificativa e Objetivos: Antropozoonose de relevância global, a raiva apresenta alta letalidade e requer atendimento qualificado, assim como atenção às espécies agressoras. Assim, o objetivo foi descrever o perfil sociodemográfico e a causalidade de atendimentos antirrábicos humanos pós-exposição notificados entre 2007 e 2022 no município de Ponta Grossa, Paraná. Método: Estudo epidemiológico descritivo e quantitativo realizado com dados secundários obtidos das fichas de notificação de atendimento antirrábico humano no município de Ponta Grossa, Paraná, entre janeiro de 2007 e dezembro de 2022. Os dados foram coletados do sistema de informação de Agravos de Notificação (SINAN) e tabulados no programa Excel. As variáveis analisadas foram: fatores sociodemográficos, data de atendimento, tipo de exposição e espécie do animal envolvido. Os dados foram analisados a partir de frequência absoluta e relativa. Resultados: A amostra foi composta por 16.668 casos. O perfil sociodemográfico dos usuários que buscaram atendimento antirrábico foi dividido em 51,93% do sexo masculino, 92,98% brancos e 4,55% pardos, 15,77% com idade entre 20 e 29 anos. Quanto à causalidade, 90,35% das notificações decorreram de mordeduras, e 95,60% destas foram causadas pela espécie canina e 4,43% pela felina. Conclusão: Apesar do predomínio de notificações decorrentes de acidentes envolvendo mordeduras, é necessário sensibilizar os profissionais da saúde e a população sobre a importância epidemiológica dos outros tipos de potenciais exposições ao vírus da raiva.(AU)
Justificación y Objetivos: Antropozoonosis de relevancia mundial, la rabia tiene una alta letalidad y requiere cuidados calificados, así como atención a la especie agresora. Así, el objetivo fue describir el perfil sociodemográfico y la causalidad de las visitas antirrábicas humanas notificadas entre los años 2007 y 2022 en el municipio de Ponta Grossa, Paraná. Métodos: Estudio epidemiológico descriptivo y cuantitativo realizado a partir de los formularios de notificación de atención antirrábica humana en el municipio de Ponta Grossa, Paraná, entre enero de 2007 y diciembre de 2022. Los datos fueron recolectados por el Sistema de Información de Enfermedades de Declaración Obligatoria (SINAN) y tabulados en el programa Excel. Las principales variables abordadas fueron: factores sociodemográficos, fecha de atención, tipo de exposición y especie de animal involucrada. Los datos se analizaron a partir de la frecuencia absoluta y relativa. El proyecto sigue las normas éticas del Consejo Nacional de Salud. Resultados: La muestra incluyó 16.668 casos. El perfil sociodemográfico de los usuarios que buscaron atención antirrábica estuvo conformado por 51,93% hombres, 92,98% eran blancos y 4,55% mestizos, 15,77% con edad entre 20 y 29 años, 13,16% entre 30 y 39 años. Cuánto a la causalidad, 90,35% de las notificaciones se debieron a mordeduras, de las cuales 95,60% fueron causados por caninos y el 3.81% por felinos. Conclusiones: A pesar del predominio de las notificaciones resultantes de accidentes con mordeduras, es necesario concientizar a los profesionales de la salud y la población sobre la importancia epidemiológica de otros tipos de exposición potencial al virus de la rabia.(AU)