Prevalencia y análisis clinicopatológico de pacientes con mutación en el gen PIK3CA con cáncer de mama avanzado Rh+/Her2- en el Instituto Oncológico Nacional De Panamá

Antecedentes: La vía de señalización de la fosfoisitol 3-quinasa (PI3K), que promueve el crecimiento y el metabolismo de las células cancerosas, es la vía mutada con mayor frecuencia en el cáncer de mama y es asociada con quimio resistencia y mal pronóstico. En este estudio presentamos el primer análisis en población panameña y de la región, con ataciones precisas de la mutación PIK3CA, las características clinicopatológicas y pronóstico. Métodos: Estudio exploratorio, donde se recolectaron prospectivamente tumores de 74 pacientes con cáncer de mama metastásico RH+/Her2- del Instituto Oncológico Nacional entre 2022 y 2023. Se realizó un ensayo de PCR en tiempo real para análisis de mutación en ADN extraído del material tumoral fijado en formalina e incluido en parafina para detectar mutaciones en los exones 1, 4, 7, 9 y 20 del gen PIK3CA. Resultados: La mediana de edad de las pacientes estudiadas fue 59 años. La mutación en PIK3CA se encontró en 33.8% (25/74) de pacientes con cáncer de mama, entre ellas 44% fueron mutaciones en el exón 20, 38% en el exón 9, 13% en el exón 4 y 5% en el exón 1. Se observó una correlación significativa entre la mutación y el  tener historia de cáncer en la familia (p= 0.005), y en pacientes postmepáusicas (P = 0.045).  encontramos asociación entre la mutación y el tipo histológico, grado, tamaño tumoral ni estatus axilar al momento del diagnóstico. La mediana de supervivencia libre de progresión  se alcanzó en ambos grupos y tampoco demostró una diferencia significativa. Conclusión: La prevalencia de la mutación es relativamente alta comparada con escenarios internacionales, puede ofrecer una ventaja para elegir las mejores opciones de tratamiento por lo que debe evaluarse de forma rutinaria durante las intervenciones clínicas. (provisto por Infomedic International)

Background: The phosphoisitol 3-kinase (PI3K) signaling pathway, which promotes cancer cell growth and metabolism, is the most frequently mutated pathway in breast cancer and is associated with chemoresistance and poor progsis. In this study we present the first analysis in Panamanian and regional population, with precise antations of the PIK3CA mutation, clinicopathological characteristics and progsis. Methods: Exploratory study, where tumors were prospectively collected from 74 patients with RH+/Her2- metastatic breast cancer from the Instituto Oncológico Nacional between 2022 and 2023. A real-time PCR assay for mutation analysis was performed on DNA extracted from formalin-fixed, paraffin-embedded tumor material to detect mutations in exons 1, 4, 7, 9 and 20 of the PIK3CA gene. Results: The median age of the patients studied was 59 years. The mutation in PIK3CA was found in 33.8% (25/74) of patients with breast cancer, among them 44% were mutations in exon 20, 38% in exon 9, 13% in exon 4 and 5% in exon 1. A significant correlation was observed between the mutation and having  history of cancer in the family (P = 0.005), and in postmepausal patients (P = 0.045). We found  association between the mutation and histologic type, grade, tumor size or axillary status at diagsis. Median progression-free survival was t reached in both groups and did t show a significant difference. Conclusion: The prevalence of the mutation is relatively high compared to international settings, it may offer an advantage in choosing the best treatment options and should be routinely evaluated during clinical interventions. (provided by Infomedic International)

Caracterización de la conducta suicida en población general de la Región de Coquimbo (Chile) entre 2018 y 2020 / Characterization of suicidal behavior in Coquimbo, Chile, between 2018 and 2020

Introducción La conducta suicida es un problema de salud pública mundial. La Organización Mundial de la Salud estimó en 700 000 los fallecimientos por suicidio para el año 2021. Objetivo El propósito fue estimar la prevalencia de la conducta suicida y describir sus factores relacionados en la Región de Coquimbo, Chile, entre los años 2018 y 2020. Métodos Se analizaron 2190 notificaciones por intentos suicidas del sistema de vigilancia epidemiológica regional, que correspondieron a 1781 personas; junto con 217 informes de personas fallecidas por suicidio del Servicio Médico Legal. Resultados La tasa global de suicidio para la región en el período fue de 9,79 fallecimientos por 100 000 habitantes. Se estandarizaron las tasas del año 2018 según la información disponible, con método directo para la tasa regional (9,55 por 100 000 habitantes) e indirecto para las comunas. Las comunas rurales presentaron mayores tasas que las urbanas. Las mujeres mostraron mayor riesgo de intentos (: 1,28; intervalo de confianza 95%: de 1,23 a 1,33) y menor riesgo de suicidio (0,086; de 0,06 a 0,13) que los hombres. Las personas jóvenes presentaron mayor riesgo de intentos y menor riesgo de suicidio, comparado con personas mayores. Destaca el aumento de la tasa de suicidio en personas mayores (de 70 a 79 años) durante el año 2020. El nivel educacional básico es una variable de riesgo para suicidio (2,21; de 1,15 a 4,23), comparado con educación universitaria. Los intentos de suicidio previos y patología psiquiátrica son factores de riesgo. Conclusiones La prevalencia de suicidio y los factores relacionados son similares a lo reportado en otros estudios e informes nacionales, destacando la ruralidad y mayor riesgo en varones de edad adulta avanzada. A diferencia de los suicidios, los intentos son más frecuentes en mujeres y personas jóvenes. Antecedentes de problemas de salud mental, intentos previos y violencia en la familia son factores de riesgo para ambas conductas. Conocer el comportamiento de la conducta suicida en la población es fundamental para su prevención.

Introduction Suicidal behavior is a public health problem worldwide. The World Health Organization estimated 700 000 deaths for the year 2021. Objective This study aimed to estimate the prevalence of suicidal behavior and describe its related factors in the Coquimbo Region, Chile, between 2018 and 2020. Methods 2190 suicide attempt notifications from the regional epidemiological surveillance system were analyzed, corresponding to 1781 people, along with 217 reports from the Forensic Medical Service of people who died by suicide. Results The overall suicide rate for the region during that period was 9.79 deaths per 100 000 inhabitants. The 2018 rates were standardized according to available information, with direct methods for the regional rate (9.55 per 100 000 inhabitants) and indirect methods for the communes. Rural communes presented higher rates than urban ones. Women showed a higher risk of attempts (OR 1.28; 95% CI 1.23 to 1.33) and a lower risk of suicide compared to men (0.086; 0.06 to 0.13). Young people had a higher risk of suicide attempts and a lower risk of suicide compared to older people. The increased suicide rates in older people (70 to 79 years) during 2020 are noteworthy. Basic education level is a risk variable for suicide (2.21; from 1.15 to 4.23), compared to having higher education. Previous suicide attempts and psychiatric pathology are risk factors. Conclusions Suicide prevalence and related factors are similar to those reported in other studies and national reports, highlighting rurality and higher risk in older male adults. In contrast to suicides, attempts are more frequent in women and young people. A history of mental health problems, previous attempts, and family violence are risk factors for both outcomes. Knowing the patterns of suicidal behavior in the population is fundamental for its prevention.

Prevalência de anomalias dentárias e outros achados orais em radiografias panorâmicas de brasileiros com fissura labiopalatal: um estudo retrospectivo / Prevalence of dental anomalies and other oral findings on panoramic radiographs of Brazilian with cleft lip and palate: a retrospective study

Objetivo: avaliar a prevalência de anomalias dentárias (AD) e outros achados orais em radiografias panorâmicas de pacientes com fissuras labiopalatais (FLP) nascidos no Nordeste brasileiro. Métodos: a amostra foi composta por 69 pacientes com fissuras labiopalatais unilateral (FLPu) (n = 51) e bilateral (FLPb) (n = 18), não sindrômicos, de ambos os sexos, idade de 6 a 17 anos, nascidos no Nordeste brasileiro. Foram analisados prontuários e radiografias panorâmicas de pacientes atendidos de janeiro/2020 a julho/2022. Os dados categóricos foram expressos em forma de frequência absoluta e percentual e comparados por teste exato de Fisher ou qui-quadrado de Pearson (SPSS, p < 0,05). Resultados: entre os achados orais, destacaram-se as anomalias de número e as ausências dentárias por trauma, cárie ou doença periodontal. As AD foram identificadas em 34 pacientes (49,3%). As anomalias de número apresentaram maior prevalência, com diferença estatística significativa para pacientes FLPb do sexo masculino (p = 0,047). A agenesia foi a AD mais frequente (n = 24; 34,8%). As ausências dentárias por trauma, cárie ou doença periodontal foram observadas em 44 pacientes (n = 63,8%), com uma diferença estatística significativa entre os grupos FLPu e FLPb (p = 0,018). Conclusões: as AD e as ausências dentárias por trauma, cárie ou doença periodontal apresentaram uma alta prevalência entre pacientes brasileiros com FLP e devem ser consideradas durante o planejamento ortodôntico-cirúrgico desses indivíduos.

Aim: this study aimed to assess the prevalence of dental anomalies (DA) and other oral findings in panoramic radiographs of patients with cleft lip and palate (CLP) born in the Northeast region of Brazil. Methods: the sample consisted of 69 patients with unilateral cleft lip and palate (UCLP) (n = 51) and bilateral cleft lip and palate (BCLP) (n = 18), non-syndromic, of both genders, aged 6 to 17 years, born in the Brazilian Northeast. Patient records and panoramic radiographs from those treated between January 2020 and July 2022 were analyzed. Categorical data were expressed as absolute frequency and percentage and compared using Fisher's exact test or Pearson's chi-square test (SPSS, p < 0.05). Results: among oral findings, anomalies in number and tooth absences due to trauma, caries, or periodontal disease stood out. DAs were identified in 34 patients (49.3%). Anomalies in number showed higher prevalence, with a statistically significant difference for male BCLP patients (p = 0.047). Agenesis was the most frequent DA (n = 24; 34.8%). Tooth absences due to trauma, caries, or periodontal disease were observed in 44 patients (63.8%), with a statistically significant difference between the UCLP and BCLP groups (p = 0.018). Conclusions: DAs and tooth absences due to trauma, caries, or periodontal disease showed a high prevalence among Brazilian patients with CLP and should be considered during the orthodontic-surgical planning for these individuals.

Epidemiología de la apendicitis aguda en Colombia: Un análisis de las bases de datos administrativas del Ministerio de Salud / Epidemiology of acute appendicitis in Colombia: An Analysis of the Ministry of Health administrative databases

Introducción. La apendicitis aguda es una afección común, con un pico de incidencia entre los 10 y 20 años. La cirugía es el tratamiento preferido y la apendicectomía por laparotomía sigue siendo el estándar, aunque el abordaje laparoscópico ha mostrado menos complicaciones. El objetivo de este artículo fue caracterizar tanto la enfermedad como el tratamiento quirúrgico en Colombia, usando datos de bases oficiales. Métodos. Se accedió a la base de datos del Sistema Integrado de Información para la Protección Social (SISPRO) del Ministerio de Salud de Colombia en febrero de 2023. Se recogieron datos de los pacientes con diagnóstico de apendicitis y con procedimiento de apendicectomía entre 2017 y 2021, y se analizaron por edad, sexo y ubicación geográfica. Resultados. Entre 2017 y 2021 se diagnosticaron 345.618 casos de apendicitis (51,8 % mujeres), con pico de incidencia a los 15-20 años. Se realizaron 248.133 apendicectomías, el 16,7 % por laparoscopia. Los hospitales con más procedimientos reportados estaban en Bogotá, Yopal, Popayán y Florencia. La mortalidad fue de 0,56 % en hombres y 0,51 % en mujeres. Conclusión. La apendicitis es común, con pico a los 10-19 años. Las mujeres tienen mayor probabilidad de apendicectomía, debido a otras afecciones ginecológicas. El acceso a la apendicectomía disminuye la mortalidad; en estos pacientes, el 16 % fue laparoscópica, lo que sugiere que se necesita más entrenamiento y acceso a esta técnica. Este estudio aporta a la comprensión de la epidemiología de la apendicitis y apendicectomías en Colombia.

Introduction. Acute appendicitis is a common condition, with a peak incidence between 10 and 20 years of age. Surgery is the preferred treatment and laparotomy appendectomy remains the standard, although the laparoscopic approach has shown fewer complications. The objective of this article was to characterize both the disease and the surgical treatment in Colombia, using data from official databases. Methods. The Integrated Information System for Social Protection (SISPRO) database of the Ministry of Health was accessed in February 2023. Data with diagnosis of apendicitis and with appendectomy between 2017 and 2021 were collected. Analysis was done by age, gender, and geographic location. Results. Between 2017 and 2021, 345,618 cases of appendicitis were diagnosed (51.8% females), with peak incidence at 15-20 years of age. A total of 248,133 appendectomies were performed, 16.7% by laparoscopy. The hospitals with most reported procedures were located in Bogotá, Yopal, Popayán, and Florencia. Mortality was 0.56% in men and 0.51% in women. Conclusion. Appendicitis is common, peaking at ages 10-19. Women are more likely undergo appendectomy due to other gynecological conditions. Access to appendectomy improves mortality. In these patients, 16% were laparoscopic, suggesting that more training and access to this technique is needed. This study contributes to the understanding of the epidemiology of appendicitis and appendectomies in Colombia.

Cáncer incidental de vesícula: incidencia y factores asociados en pacientes de una institución de la ciudad de Medellín / Incidental gallbladder cancer: Incidence and associated factors in patients from an institution in the city of Medellín

Introducción. El cáncer de vesícula biliar es una de las neoplasias más frecuentes de la vía biliar y la mayoría de los casos se diagnostican de forma incidental o en estadios avanzados. En Colombia existen pocas publicaciones acerca de la prevalencia y características clínicas de pacientes con cáncer insospechado de vesícula biliar. El objetivo de este trabajo fue actualizar la información existente. Métodos. Estudio de tipo transversal basado en registros médicos. Como variable de resultado se definió el hallazgo incidental de patología maligna reportado por un patólogo y el subtipo histológico. Se midieron variables demográficas, clínicas y quirúrgicas. Se calcularon OR con sus respectivos intervalos de confianza (IC95%). Resultados. De los 2630 casos analizados, en cuatro se hizo diagnóstico de cáncer incidental de vesícula, con una prevalencia del 0,15 %. Se encontraron como características asociadas al cáncer incidental de vesícula, la edad, el antecedente de cáncer y la presencia de pólipos. Conclusiones. Esta es una patología poco frecuente en la población evaluada, lo que permite afirmar que no es necesario realizar estudios prequirúrgicos más amplios de forma rutinaria, a menos que el paciente presente alguno de los factores asociados.

Introduction. Gallbladder cancer is one of the most common neoplasms of the bile duct and most cases are diagnosed incidentally or in advanced stages. In Colombia, there are few publications about the prevalence and clinical characteristics of patients with unsuspected gallbladder cancer. The objective of this work was to update the existing information. Methods. Cross-sectional study based on medical records. The incidental finding of malignant pathology reported and the histological subtype were defined as the outcome variable. Demographic, clinical and surgical variables were measured. ORs were calculated with their respective 95% CI. Results. Of the 2630 cases analyzed, four were diagnosed with incidental gallbladder cancer, with a prevalence of 0.15%. Characteristics associated with incidental gallbladder cancer were age, history of cancer and the presence of polyps. Conclusions. This is a rare pathology in the population evaluated, which allows us to recommend that it is not necessary to routinely perform more extensive presurgical studies, unless the patient presents any of the associated factors.

Efecto del confinamiento por COVID-19 en la prevalencia de la enfermedad hepática esteatósica asociada a disfunción metabólica / Effect of COVID-19 lockdown on the prevalence of metabolic dysfunction-associated steatotic liver disease

Introducción. La enfermedad hepática esteatósica asociada a disfunción metabólica (MASLD) es una condición clínica frecuente, relacionada con el sobrepeso, la dislipidemia y la diabetes. Como estos factores de riesgo están a su vez asociados al sedentarismo y la ganancia de peso, se esperaría un impacto como resultado del confinamiento por COVID-19 en la prevalencia de dicha condición. Metodología. Estudio longitudinal retrospectivo en un panel de datos de 132 pacientes de 2017 a 2022, en donde fueron incluidos pacientes con una ecografía hepática y una valoración médica y paraclínica 1,5 años antes y después del periodo de confinamiento (25 de marzo de 2020 a 28 de febrero de 2021). El desenlace primario fue un cambio significativo en la prevalencia de la MASLD, y se utilizó un modelo exploratorio de regresión logística de efectos fijos con panel de datos para hallar los predictores de cambio. Resultados. En un total de 132 pacientes analizados, la prevalencia global de la MASLD antes (31 %; IC95%: 23-39) y después (35,6 %; IC95%: 27,4-43,8) del confinamiento por COVID-19 no cambió significativamente, sin embargo, en las mujeres sí hubo un aumento significativo (RR: 4; IC95%: 1,0004-16). Se encontró una marcada diferencia de prevalencia entre sexos (17 % en mujeres y 46 % en hombres; p=0,001). El confinamiento se asoció a incrementos en la masa corporal (diferencia: +1 kg; IC95%: 0,1-1,9), el colesterol LDL (diferencia: +9,7 mg/dL; IC95%: 4,9-14,4) y al diagnóstico de prediabetes (RR: 2,1; IC95%: 1,4-3,1). La MASLD se asoció positivamente a la preferencia nutricional por la comida rápida (p=0,047). Solo el índice de masa corporal resultó predictor independiente de MASLD (RR: 1,49; IC95%: 1,07-1,93). Conclusión. La prevalencia global de la MASLD no varió después del confinamiento por COVID-19, pero sí se incrementó en mujeres, y algunos de sus factores de riesgo también aumentaron significativamente. Se encontró equivalencia numérica entre la MASLD y la definición previa de la enfermedad. Se requiere un estudio local más grande para desarrollar y validar un mejor modelo predictor del cambio de la MASLD a través del tiempo.

Introduction. Metabolic dysfunction-associated steatotic liver disease (MASLD) is a common clinical condition, related to overweight, dyslipidemia and diabetes. As these risk factors are in turn associated with sedentary lifestyle and weight gain, an impact as a result of the COVID-19 confinement on the prevalence of MASLD would be expected. Methodology. Retrospective longitudinal study in a data panel of 132 patients from 2017 to 2022. Patients with a liver ultrasound and a medical and paraclinical assessment 1.5 years before and after the confinement period (March 25, 2020 to February 28, 2021) were included. The primary outcome was a significant change in the prevalence of MASLD, and an exploratory fixed-effects logistic regression model with panel data was used to find predictors of change. Results. In a total of 132 patients analyzed, the overall prevalence of MASLD before (31%, 95%CI: 23-39) and after (35.6%, 95%CI: 27.4-43.8) confinement by COVID-19 did not change significantly, however, in women there was a significant increase (RR: 4, 95%CI: 1.0004-16). A marked difference in prevalence was found between sexes (17% in women and 46% in men; p=0.001). Confinement was associated with increases in body mass (difference: +1 kg, 95%CI: 0.1-1.9), LDL cholesterol (difference: +9.7 mg/dL, 95%CI: 4.9-14.4) and the diagnosis of prediabetes (RR: 2.1, 95%CI: 1.4-3.1). MASLD was positively associated with nutritional preference for fast food (p=0.047). Only body mass index was an independent predictor of MASLD (RR: 1.49, 95%CI: 1.07-1.93). Conclusion. The overall prevalence of MASLD did not change after the COVID-19 lockdown, but it did increase in women, and some of its risk factors also increased significantly. Numerical equivalence was found between MASLD and the previous definition of the disease. A larger local study is required to develop and validate a better predictor model of MASLD change over time.

Dementia prevalence among hospitalized older patients: a multicenter study in Iran / Prevalência de demência entre pacientes idosos hospitalizados: um estudo multicêntrico no Irã

ABSTRACT Dementia poses a significant societal and health challenge in the 21st century, with many hospitalized patients experiencing dementia without a documented diagnosis. Objective: To evaluate the prevalence of dementia and its associated risk factors among older patients admitted to hospitals. Methods: The study included older patients (≥ 60 years) admitted to medical departments of a general hospital in three major Iranian cities. Researchers utilized the Activities of Daily Living-Instrumental Activities of Daily Living (ADL-IADL) scale, the Geriatric Depression Scale (GDS), the Mini-Cog test, the 4 A's test (4AT), and the Abbreviated Mental Test Score (AMTS). Among the 420 recruited older inpatients, 228 (54.3%) were female. Results: The mean age of participants was 71.39 years (standard deviation ±7.95), with 30.7% diagnosed with major neurocognitive disorder (dementia). The likelihood of dementia exhibited statistically significant correlations with gender, age, number of children, and occupation. Conclusions: Screening older individuals for cognitive impairment upon hospital admission holds the potential to prevent adverse outcomes and enhance the quality of treatment for patients concurrently dealing with dementia.

RESUMO A demência representa um grande desafio social e de saúde no século 21, com muitos pacientes hospitalizados sofrendo de demência sem um diagnóstico documentado. Objetivo: Avaliar a prevalência de demência e seus fatores de risco associados entre pacientes idosos hospitalizados. Métodos: O estudo incluiu pacientes idosos (≥ 60 anos) internados em um hospital geral em três grandes cidades iranianas. Os pesquisadores utilizaram a escala de Atividades da Vida Diária-Atividades Instrumentais da Vida Diária (Activities of Daily Living-Instrumental Activities of Daily Living - ADL-IADL), a Escala de Depressão Geriátrica, o teste Mini-Cog, o teste dos 4 As (4AT) e o Pontuação do Teste Mental Abreviado (Abbreviated Mental Test Score - AMTS). Dos 420 idosos selecionados, 228 (54,3%) eram do sexo feminino. Resultados: A média de idade dos participantes foi de 71,39 anos (desvio padrão ±7,95), sendo 30,7% diagnosticados com transtorno neurocognitivo maior (demência). A probabilidade de demência apresentou correlações estatisticamente significativas com sexo, idade, número de filhos e ocupação. Conclusões: A triagem de idosos para comprometimento cognitivo na admissão hospitalar tem o potencial de prevenir resultados adversos e melhorar a qualidade do tratamento para pacientes que lidam simultaneamente com demência.

Temporal and spatial analysis of over 7,000 measles cases outbreak from 2018 to 2019 in the Brazilian Amazon

ABSTRACT Objective: This study aimed to present a temporal and spatial analysis of the 2018 measles outbreak in Brazil, particularly in the metropolitan city of Manaus in the Amazon region, and further introduce a new tool for spatial analysis. Methods: We analyzed the geographical data of the residences of over 7,000 individuals with measles in Manaus during 2018 and 2019. Spatial and temporal analyses were conducted to characterize various aspects of the outbreak, including the onset and prevalence of symptoms, demographics, and vaccination status. A visualization tool was also constructed to display the geographical and temporal distribution of the reported measles cases. Results: Approximately 95% of the included participants had not received vaccination within the past decade. Heterogeneity was observed across all facets of the outbreak, including variations in the incubation period and symptom presentation. Age distribution exhibited two peaks, occurring at one year and 18 years of age, and the potential implications of this distribution on predictive analysis were discussed. Additionally, spatial analysis revealed that areas with the highest case densities tended to have the lowest standard of living. Conclusion: Understanding the spatial and temporal spread of measles outbreaks provides insights for decision-making regarding measures to mitigate future epidemics.

Determinants of continued breastfeeding in children aged 12-23 months in three regions of Haiti / Determinantes de la continuación de la lactancia materna en la población infantil de entre 12 y 23 meses en tres regiones de Haití / Determinantes do aleitamento materno continuado em crianças de 12 a 23 meses de idade em três regiões do Haiti

ABSTRACT Objectives To identify the prevalence and determinants of continued breastfeeding in Haitian children aged 12-23 months. Methods Three cross-sectional surveys were conducted yearly during the summers of 2017 to 2019 as part of a 4-year (2016-2020) multisectoral maternal and infant health initiative in the regions of Les Cayes, Jérémie, and Anse d'Hainault in Haiti. A total of 455 children 12-23 months of age and their mothers participated in the study. A child was considered to be continuing breastfeeding if the mother reported giving breast milk in the 24-hour dietary recall. Unadjusted and adjusted prevalence ratios were estimated, and associations were assessed between continued breastfeeding and explanatory factors related to sociodemographic characteristics, household food security, maternal nutrition, and breastfeeding knowledge and practices. Results The prevalence of continued breastfeeding was 45.8%. Continued breastfeeding was significantly more prevalent among younger children, children who did not have a younger sibling, children whose mother was not pregnant, those living in the Jérémie region, children who had been exclusively breastfed for less than 1 month, and children whose mother knew the World Health Organization's recommendation for continued breastfeeding up to 2 years or beyond. Conclusions The study results highlight the need for geographically equitable access to tailored and adequate health services and education that support breastfeeding in a way that is compatible with the local context.

RESUMEN Objetivos. Determinar la prevalencia y los determinantes asociados a la continuación de la lactancia materna en la población infantil haitiana de entre 12 y 23 meses. Métodos. Durante los veranos del 2017 al 2019 se llevaron a cabo tres encuestas transversales anuales como parte de una iniciativa multisectorial de salud materna e infantil de 4 años (2016 a 2020) en las regiones de Les Cayes, Jérémie y Anse d'Hainault de Haití. En el estudio participaron 455 menores de edades comprendidas entre 12 y 23 meses y sus madres. Se consideró que un menor continuaba con la lactancia materna si, en la evaluación de la alimentación basada en el recuerdo de 24 horas, la madre declaraba la toma de leche materna. Se calcularon los cocientes de prevalencia ajustados y sin ajustar y se evaluó la asociación entre la continuación de la lactancia materna y posibles factores explicativos relacionados con las características sociodemográficas, la seguridad alimentaria de la familia, la nutrición materna y los conocimientos y prácticas en materia lactancia materna. Resultados. La prevalencia de la continuación de la lactancia materna fue del 45,8%. Esta prevalencia fue significativamente mayor cuando se trataba de lactantes de menor edad, cuando no había hermanos menores, cuando la madre no estaba embarazada, en los residentes en la región de Jérémie, cuando había habido una alimentación exclusiva con leche materna durante menos de un mes y cuando la madre conocía la recomendación de la Organización Mundial de la Salud de continuar con la lactancia materna hasta los dos años o más. Conclusiones. Los resultados del estudio ponen de relieve la necesidad de disponer de un acceso geográfico equitativo a unos servicios de salud y una educación que respalden la lactancia materna de una manera compatible con el contexto local.

RESUMO Objetivos Identificar a prevalência e os determinantes do aleitamento materno continuado em crianças haitianas de 12 a 23 meses de idade. Métodos Três pesquisas transversais foram realizadas anualmente nos verões de 2017 a 2019 como parte de uma iniciativa multissetorial de saúde materno-infantil de quatro anos (2016-2020) nas regiões de Les Cayes, Jérémie e Anse d'Hainault no Haiti. Um total de 455 crianças de 12 a 23 meses de idade e suas mães participaram do estudo. Considerou-se que a criança continuava sendo amamentada se a mãe relatasse ter dado leite materno no recordatório alimentar de 24 horas. Foram estimadas as taxas de prevalência não ajustadas e ajustadas e foram avaliadas as associações entre o aleitamento materno continuado e os fatores explicativos relacionados às características sociodemográficas, à segurança alimentar da família, à nutrição materna e aos conhecimentos e práticas de aleitamento materno. Resultados A prevalência de aleitamento materno continuado foi de 45,8%. O aleitamento materno continuado foi significativamente mais prevalente entre crianças mais novas, crianças que não tinham irmão mais novo, crianças cuja mãe não estava grávida, residentes da região de Jérémie, crianças que haviam sido exclusivamente amamentadas por menos de um mês e crianças cuja mãe conhecia a recomendação da Organização Mundial da Saúde de manter o aleitamento materno por 2 anos ou mais. Conclusões Os resultados do estudo destacam a necessidade de acesso geograficamente equitativo a educação e serviços de saúde adaptados e adequados para apoiar o aleitamento materno de forma compatível com o contexto local.

Prevalence of trachoma in indigenous and non-indigenous areas, Northeastern Brazil, 2019-2021 / Prevalencia del tracoma en zonas de población indígena y no indígena del nordeste de Brasil, 2019-2021 / Prevalência de tracoma em áreas indígenas e não indígenas, Nordeste do Brasil, 2019-2021

ABSTRACT Objective. To estimate the prevalence of trachoma in indigenous and non-indigenous populations in selected areas of the state of Maranhão, in northeastern Brazil. Methods. This was a population-based survey with probabilistic sampling. For the diagnosis of trachoma, external ocular examination was performed using head magnifying loupes, at 2.5X magnification. The prevalence of trachomatous inflammation - follicular (TF) in children aged 1-9 years and the prevalence of trachomatous trichiasis (TT) in the population aged ≥15 years were estimated. Relative frequencies of sociodemographic and environmental characteristics were obtained. Results. The study included 7 971 individuals, 3 429 from non-indigenous populations and 4 542 from indigenous populations. The prevalence of TF in non-indigenous and indigenous populations was 0.1% and 2.9%, respectively, and the prevalence of TT among indigenous populations was 0.1%. Conclusions. The prevalence of TF and TT in the two evaluation units in the state of Maranhão were within the limits recommended for the elimination of trachoma as a public health problem. However, the prevalence of TF was higher in the indigenous evaluation unit, indicating a greater vulnerability of this population to the disease. The prevalence of TF of below 5.0% implies a reduction in transmission, which may have resulted from improved socioeconomic conditions and/or the implementation of the World Health Organization SAFE strategy.

RESUMEN Objetivo. Estimar la prevalencia del tracoma en poblaciones indígenas y no indígenas en determinadas zonas del estado de Maranhão, en el nordeste de Brasil. Métodos. Se trató de una encuesta de ámbito poblacional con muestreo probabilístico. Para el diagnóstico del tracoma, se realizó un examen ocular externo con una lupa frontal de 2,5X aumentos. Se estimó la prevalencia de la inflamación tracomatosa folicular (TF) en la población infantil de 1 a 9 años y la prevalencia de la triquiasis tracomatosa (TT) en la población de 15 años o más. Se obtuvieron las frecuencias relativas de las características sociodemográficas y ambientales. Resultados. En el estudio participaron 7 971 personas, 3 429 de poblaciones no indígenas y 4 542 de poblaciones indígenas. La prevalencia de la TF en las poblaciones no indígenas e indígenas fue de 0,1% y 2,9%, respectivamente, en tanto que la de la TT en las poblaciones indígenas fue de 0,1%. Conclusiones. La prevalencia de la TF y la TT en las dos unidades de evaluación del estado de Maranhão estuvo dentro de los límites recomendados para la eliminación del tracoma como problema de salud pública. Sin embargo, la prevalencia de la TF fue mayor en la unidad de evaluación indígena, lo que indica una mayor vulnerabilidad de esta población a la enfermedad. La prevalencia de la TF inferior al 5,0% implica una reducción de la transmisión, que puede haber sido consecuencia tanto de la mejora de las condiciones socioeconómicas como de la aplicación de la estrategia SAFE de la Organización Mundial de la Salud.

RESUMO Objetivo. Estimar a prevalência do tracoma em populações indígenas e não indígenas em áreas selecionadas do estado do Maranhão, na região Nordeste do Brasil. Métodos. Inquérito de base populacional com amostragem probabilística. Para o diagnóstico de tracoma, foi realizado exame ocular externo com o auxílio de lupas binoculares com ampliação de 2,5×. Foram estimadas a prevalência de inflamação tracomatosa folicular (TF) em crianças de 1 a 9 anos de idade e a prevalência de triquíase tracomatosa (TT) na população com idade ≥15 anos. Foram obtidas as frequências relativas das características sociodemográficas e ambientais. Resultados. O estudo incluiu 7 971 indivíduos (3 429 de populações não indígenas e 4 542 de populações indígenas). A prevalência de TF nas populações não indígenas e indígenas foi de 0,1% e 2,9%, respectivamente, e a prevalência de TT entre as populações indígenas foi de 0,1%. Conclusões. A prevalência de TF e TT nas duas unidades de avaliação no estado do Maranhão ficou dentro dos limites recomendados para a eliminação do tracoma como problema de saúde pública. No entanto, a prevalência de TF foi maior na unidade de avaliação indígena, indicando uma maior vulnerabilidade dessa população à doença. A prevalência de TF abaixo de 5,0% implica uma redução na transmissão, que pode ter sido resultado de melhores condições socioeconômicas e da implementação da estratégia SAFE da Organização Mundial da Saúde.

Lernaeid parasites prevalence in commercial freshwater fish species at various fish farms in Pakistan

Abstract Reports abound on Lernaea parasitizing the brood stock, fingerlings, and marketable-sized culturable freshwater fish species in various parts of the world. We investigated seven small-scale aquaculture farms and how the prevailing Lernaea is impacting them. Randomly seven fish farms were selected to determine the prevalence percentage of lernaeid ectoparasites. Relevant information of the fishponds to estimate the various aspects such as effects of water source and quality, feed, stocking density, treatment used, and weight and length of fish, concerned with Lernaea infestation and prevalence was gathered. The results indicated that Catla catla (F. Hamilton, 1822) showed highest prevalence (41.7%) among the seven fish species, whereas Oreochromis niloticus showed zero. Other five fish species Ctenopharyngodon idella, Cirrhinus cirrhosis, Cyprinus carpio, Labeo rohita and Hypophthalmichthys molitrix showed 13.2%, 8.1%, 7.7%, 7.4%, 0.9% prevalence, respectively. In Royal Fish Farm 84.3% lernaeid infestation was observed, while no parasite was observed in the Vicents Chunnian fish farm. The water source, quality, feed, fertilizers, stocking density, water temperature, and potential treatment options displayed varying tendencies among fish farms and prevalence. Depending on the weight and length, the highest prevalence (56.7%, and 66.7%) was observed in 3501-4000 g and 81-90 cm groups. The infestation rate varied in various fish body parts with the dorsal fin the most vulnerable organ and showed 2.3% overall prevalence (while 18.4% contribution within total 12.6% infestation). Out of 147 infected fish samples, 45 were extensively contaminated by Lernaea spread. In conclusion, our findings confirm that Lernaea could pose a considerable threat to marketable fish, and various treatment options should be educated to the farmers to help mitigate the spread and potential losses. Furthermore, Catla catla is more vulnerable to Lernaea infestation (41.7%), so are the fish species being cultured at higher stocking densities.

Resumo Abundam os relatórios sobre Lernaea parasitando o estoque de cria, alevinos e espécies de peixes de água doce cultiváveis de tamanho comercial em várias partes do mundo. Investigamos sete fazendas de aquicultura de pequena escala e de que maneira a Lernaea predominante está impactando-as. Aleatoriamente, sete fazendas de peixes foram selecionadas para determinar a porcentagem de prevalência de ectoparasitas de Lernaea. Foram recolhidas informações relevantes sobre os viveiros de peixes para estimar os vários aspectos, tais como efeitos da fonte e qualidade da água, alimentação, densidade de povoamento, tratamento utilizado e peso e comprimento dos peixes, relacionados com a infestação e prevalência de Lernaea. Os resultados indicaram que Catla catla (F. Hamilton, 1822) apresentou maior prevalência (41,7%) entre as sete espécies de peixes, enquanto Oreochromis niloticus apresentou zero. Outras cinco espécies de peixes Ctenopharyngodon idella, Cirrhinus cirrhosis, Cyprinus carpio, Labeo rohita e Hypophthalmichthys molitrix apresentaram 13,2%, 8,1%, 7,7%, 7,4%, 0,9% de prevalência, respectivamente. Em Royal Fish Farm, 84,3% de infestação de Lernaea foi observada, enquanto não se observou nenhum parasita na fazenda de peixes Chunnian de Vicent. A fonte de água, qualidade, ração, fertilizantes, densidade de estocagem, temperatura da água e opções de tratamento potenciais exibiram tendências variadas entre as fazendas de peixes e prevalência. Dependendo do peso e comprimento, a maior prevalência (56,7% e 66,7%) foi observada nos grupos de 3501-4000 g e 81-90 cm. A taxa de infestação variou em várias partes do corpo dos peixes, sendo a nadadeira dorsal o órgão mais vulnerável e apresentou 2,3% de prevalência geral (enquanto 18,4% de contribuição dentro do total de 12,6% de infestação). Das 147 amostras de peixes infectados, 45 estavam amplamente contaminadas pela propagação de Lernaea. Em conclusão, nossos resultados confirmam que Lernaea pode representar uma ameaça considerável para peixes comercializáveis, e várias opções de tratamento devem ser educadas para os agricultores para ajudar a mitigar a propagação e as perdas potenciais. Além disso, Catla catla é mais vulnerável à infestação por Lernaea (41,7%), assim como as espécies de peixes sendo cultivadas em densidades de estocagem mais altas.

Percentage Incidences of Bacteria in Mahseer (Tor putitora), Silver carp (Hypophthalmichthys molitrix) Fish Collected from Hatcheries and Local Markets of District Malakand and Peshawar of Khyber Pakhtunkhwa, Pakistan

Abstract Fish is the main source of animal protein for human diet. The aim of this study was to find out prevalence of pathogenic bacteria of two selected economically important fish of Pakistan namely Mahseer (Tor putitora) and Silver carp (Hypophthalmichthys molitrix). Live fish samples from hatcheries and dead fish samples from different markets of study area were randomly collected. The fish samples were analyzed for isolation, identification and prevalence of bacteria. The isolated bacteria from study fish were identified through biochemical test and about 10 species of pathogenic bacteria were identified including the pathogenic bacteria to human and fish namely, Pseudomonas aeruginosa, Escherichia coli, Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus iniae, Serratia spp. Citrobacter spp. Stenotrophomonas spp. Bacillus spp. and Salmonella spp. The bacterial percentage frequency of occurrence in Silver carp and Mahseer fish showed Pseudomonas aeruginosa 21.42%, Staphylococcus epidermidis 17.85%, Escherichia coli 11.90%, Staphylococcus aureus 9.52%, Citrobacter spp. 9.52%, Serratia spp. 8.33%, Streptococcus iniae 7.14%, Stenotrophomonas spp. 5.95%, Bacillus spp. 4.76% and Salmonella spp. 3.57%. The study revealed that Fish samples of Mahseer and Silver carp that were collected from markets have found more isolates (10 bacterial species) than did the fresh fish pond samples (03 bacterial species) of hatcheries. The occurrence of pathogenic bacteria in study fish showed risk factor for public health consumers.

Resumo O peixe é a principal fonte de proteína animal para a alimentação humana. O objetivo deste estudo foi descobrir a prevalência de bactérias patogênicas de dois peixes economicamente importantes selecionados do Paquistão, nomeadamente Mahseer (Tor putitora) e carpa prateada (Hypophthalmichthys molitrix). Amostras de peixes vivos de incubatórios e amostras de peixes mortos de diferentes mercados da área de estudo foram coletadas aleatoriamente. As amostras de peixes foram analisadas quanto ao isolamento, identificação e prevalência de bactérias. As bactérias isoladas dos peixes do estudo foram identificadas através de testes bioquímicos e cerca de 10 espécies de bactérias patogênicas foram identificadas incluindo as bactérias patogênicas para humanos e peixes, nomeadamente, Pseudomonas aeruginosa, Escherichia coli, Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus iniae, Serratia spp. Citrobacter spp. Stenotrophomonas spp. Bacillus spp. e Salmonella spp. A porcentagem de freqüência de ocorrência bacteriana em carpa prateada e peixes Mahseer mostrou Pseudomonas aeruginosa 21,42%, Staphylococcus epidermidis 17,85%, Escherichia coli 11,90%, Staphylococcus aureus 9,52%, Citrobacter spp. 9,52%, Serratia spp. 8,33%, Streptococcus iniae 7,14%, Stenotrophomonas spp. 5,95%, Bacillus spp. 4,76% e Salmonella spp. 3,57%. O estudo revelou que as amostras de peixes de Mahseer e carpa prateada coletadas nos mercados encontraram mais isolados (10 espécies bacterianas) do que as amostras de peixes frescos (03 espécies bacterianas) de incubatórios. A ocorrência de bactérias patogênicas nos peixes do estudo apresentou fator de risco para consumidores de saúde pública.

Prevalence of Anemia in Patients with Diabetes Mellitus: A Systematic Review and Meta-Analysis / 生物医学与环境科学（英文）

OBJECTIVE@#Anemia is a common public health concern in patients with type 2 diabetes worldwide. This study aimed to identify the prevalence of anemia among patients with diabetes.@*METHODS@#Electronic databases, including PubMed, Scopus, Web of Sciences, and Google Scholar, were searched systematically for studies published between 2010 and 2021. After removing duplicates and inappropriate reports, the remaining manuscripts were reviewed and appraised using theNewcastle-Ottawa Scale (NOS) tool. A random-effects model was used to calculate the pooled estimates of the extracted data using Stata version 17. Heterogeneity of the studies was assessed using the Q statistic.@*RESULTS@#A total of 51 articles containing information on 26,485 patients with diabetes were included in this study. The articles were mainly from Asia (58.82%) and Africa (35.29%). The overall prevalence of anemia was 35.45% (95% CI: 30.30-40.76), with no evidence of heterogeneity by sex. Among the two continents with the highest number of studies, the prevalence of anemia in patients with diabetes was significantly higher in Asia [40.02; 95% CI: 32.72-47.54] compared to Africa [28.46; 95% CI: 21.90-35.50] ( P for heterogeneity = 0.029). Moreover, there has been an increasing trend in the prevalence of anemia in patients with diabetes over time, from [15.28; 95% CI: 9.83-22.21] in 2012 to [40.70; 95% CI: 10.21-75.93] in 2022.@*CONCLUSION@#Globally, approximately 4 in 10 patients with diabetes suffer from anemia. Therefore, routine anemia screening and control programs every 3 months might be useful in improving the quality of life of these patients.

Status and trend of refractive disorder burden in China based on a global perspective / 公共卫生与预防医学

Objective Based on the global burden of disease (GBD) study data, to analyze the current situation and changing trend of refractive disorders in China by comparing Japan, India, the United States, the United Kingdom and the world. Methods The prevalence, years lived with disability (YLD) rate of refractive disorders from 1990 to 2019 were obtained from the global health exchange (GHDx）database. The disease burden and change trend of refractive disorders were analyzed using Joinpoint and other software. Results In 2019, the number of refractive disorders in China exceeded 27 million, with the prevalence and YLD rate were 19.18‰ and 89.40/100,000 respectively. From 1990 to 2019, the prevalence and YLD rate of refractive disorders showed an increasing trend globally (except India), with the largest increase in China (up by 53.21% and 53.96% respectively). The age standardized YLD rates in China, Japan, the United States, and the United Kingdom were all lower than the global average level, but China's age standardized YLD rates were higher than the developed countries (Japan, the United States, and the United Kingdom). Conclusion From 1990 to 2019, there was a certain gap between China and developed countries in the control of refractive disorders. Therefore, it is necessary to understand the disease status from a global perspective in order to better prevent and control refractive disorders in the future.

Trends in prevalence and disability-adjusted life years of cataract in China from 1990 to 2019 / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To assess the evolving burden of cataracts in China from 1990 to 2019.METHODS: Data on disease burden related to cataracts in China were retrieved from the Global Burden of Disease(GBD)2019 study based on large public databases. Utilizing data from the GBD 2019 study, we extracted information on cataract-related disease burden in China from extensive public databases. Analysis of prevalence and disability-adjusted life years(DALYs)associated with cataracts in China was conducted based on GBD 2019 findings. The variable characteristics of age-standardized prevalence rates(ASPR)and age-standardized DALYs rates(ASDR)in China and its neighboring countries were also explored.RESULTS: Between 1990 and 2019, the number of prevalent cases of blindness and vision loss caused by cataracts in China increased by 223.54%, and the corresponding DALYs raised by 142.14%. Over the past 30 years, females exhibited higher age-standardized prevalence and DALYs rates compared to males. Meanwhile, individuals aged 65 to 84 years were found to be more susceptible to cataracts than other age groups. Compared with neighboring countries, China ranked from the 9th position in 1990(867.09, 95%UI: 761.36 to 975.42, per 100 000 population)to the 11th in 2019(991.56, 95%UI: 861.52 to 1131.04, per 100 000 population)in ASPR, while from the 9th in 1990(65.85, 95%UI: 46.39 to 89.41, per 100 000 population)to the 10th position in 2019(59.16, 95%UI: 41.70 to 80.15, per 100 000 population)in ASDR. However, on a global scale, China maintained relatively low ASDR and ASPR for cataracts in 2019.CONCLUSION: The study highlights a substantial rise in the prevalence and DALYs associated with blindness and vision loss due to cataracts from 1990 to 2019 in China, and underscores the urgent need for increased early screening of cataracts, particularly among the elderly and females.

Diabetic foot disease and its associated factors in Hanzhong in 2016 - 2022 / 公共卫生与预防医学

Objective To study the status of diabetic foot and its related factors in Hanzhong area in recent years, and to provide a scientific basis for the prevention and management of diabetic foot complicated by type 2 diabetes. Methods A stratified sampling method was used to select 528 patients with type 2 diabetes among permanent residents in Hanzhong from April 2016 to April 2022. Relevant medical history and laboratory examination data were collected, and the incidence of diabetic foot was calculated. The influence of related factors on the risk of diabetic foot was analyzed by regression model. Results Among 528 subjects in this study, the disease course and body type of T2DM showed that male patients had significantly longer disease, and the proportion of overweight and obesity was higher, P2=27.516，P<0.05）. The proportion of male patients complicated with diabetic foot was higher than that of female patients (P<0.05). At the same time, the incidence of Wagner Grade I was higher in males than in females (P<0.05). The effects of potential factors on the risk of diabetic foot were discussed by gender. Univariate analysis and multivariate logistic regression analysis indicated that the risk factors of diabetic foot in male T2DM patients included: Increased course of disease, increased age, poor blood glucose control, increased total cholesterol level, increased BMI level and increased platelet to lymphocyte ratio . Potential risk factors in women include increased course of disease, age, poor blood sugar control (increased glycosylated hemoglobin levels) and increased platelet to lymphocyte ratios in all cases（P<0.05）. Conclusion The current prevalence rate of type 2 diabetes patients complicated with diabetes foot in Hanzhong area is 16.29%, which is still high , and the prevalence rate of men is significantly higher than that of women. Older age, long duration of T2DM, poor blood glucose control, increased total cholesterol level, increased blood uric acid level, decreased urine pH value, and increased platelet lymphocyte ratio are potential risk factors for diabetes foot. Male patients should also pay attention to the occurrence of overweight and obesity tendency to reduce the risk of diabetes foot.

Outbreak investigation of a campus bacterial dysentery by water source pollution in Lhasa City / 中国学校卫生

Objective@#To investigate risk factors and the nature of the outbreak of bacillary dysentery in Lhasa City, so as to customize targeted prevention and control measures.@*Methods@#Using on site epidemiological investigation, the suspected, probable and confirmed cases of bacillary dysentery in one school and one kindergarten in Lhasa City from June 26 to July 1, 2022 were collected, and additional cases were identified through interview from school staffs and family members, reviewing morning examination records and tracking records of school illness related absence. A case control study was conducted to investigate suspicious meals and drinking raw water, and polymerase chain reaction (PCR) was performed to detect Shigella line nucleic acid fragment in the patients feces, anal swabs, retained food, and terminal water.@*Results@#A total of 55 cases were found in two schools, with the prevalence rate of 15.41% in total and 16.71% in students ( n =53), 7.5% in staff ( n =2). The epidemic curve was suggestive of a point source exposure. The prevalence rate among students who walk to school and students who live in the school showed no difference (16.10%，17.09%)( χ 2=0.05, P >0.05), and the prevalence rate was higher among elementary school students than kindergarten students (19.83%，6.67%)( χ 2=7.13, P <0.05). Case control comparisons showed a direct association between drinking raw water and morbidity in the case and control groups during June 24-26 ( OR=4.01, 95%CI =1.75-9.19, P < 0.05). A total of 23 fecal Shigella nucleic acid positives were detected from the two schools, two from the end water in front of the cafeteria door, and two from sludge in the sewage pipe around the wellhead.@*Conclusions@#The outbreak of bacillary dysentery is caused by the contamination of the pipe network water. Health administrative departments should improve the supervision and management of drinking water health safety, and schools should strengthen the management of water supply facilities for effectively prevent of waterborne infectious disease outbreaks.

Prevalence and molecular detection of human Cryptosporidium infections: a review / 中国血吸虫病防治杂志

Cryptosporidium is an important intestinal parasite that is mainly transmitted through the fecal-oral route. Human infection may occur following ingestion of water and food contaminated by Cryptosporidium oocysts, and children and immunocompromised individuals are at a high risk of infections. The main symptoms of Cryptosporidium infections include diarrhea, vomiting, malnutrition, and even death. Because of high sensitivity and rapid procedures, molecular tests are helpful for the diagnosis of cryptosporidiosis and may reduce the public health risk of cryptosporidiosis. This review summarizes the advances in the latest prevalence and molecular detection of human Cryptosporidium infections during recent years.

Prevalence of Chronic Non-Communicable Respiratory Diseases in Mosul City

@#Introduction: Chronic non-communicable respiratory diseases (CNCRDs) encompass a group of conditions affecting the airways and lung structures, including Chronic Obstructive Pulmonary Disease (COPD), emphysema, allergic rhinitis, asthma, pulmonary arterial hypertension, and cystic fibrosis. CNCRDs pose a significant global health challenge, resulting in approximately four million deaths annually. This study aimed to identify the prevalence and risk factors associated with CNCRDs and measure trends in the prevalence of these risk factors over time. Methods: A cross-sectional epidemiological study was conducted using data collected from primary health centers on both sides of Mosul City. The study period extended from January 1 to July 31, 2022, with information obtained from (40) primary health centers, consisting of (20) centers on the right side and (20) centers on the left side of Mosul. Results: In 2021, the City of Mosul recorded a total of 13,005 registered cases, with 5,598 cases being attributed to asthma (43%), and 7,347 cases being associated with COPD (57%). Bronchial asthma constituted 43% of cases, with 5598 patients, and the highest incidence occurred in the age group between 20-44 years. Conclusion: The prevalence of bronchial asthma and COPD among patients with CNCRDs in Mosul is alarmingly high. It emphasizes the importance of implementing preventive policies and strategies targeting modifiable risk factors for these respiratory conditions.

Percentage Incidences of Bacteria in Mahseer (Tor putitora), Silver carp (Hypophthalmichthys molitrix) Fish Collected from Hatcheries and Local Markets of District Malakand and Peshawar of Khyber Pakhtunkhwa, Pakistan / Incidências percentuais de bactérias em Mahseer (Tor putitora), carpa-prateada (Hypophthalmichthys molitrix), peixes coletados em incubatórios e mercados locais do distrito de Malakand e Peshawar de Khyber Pakhtunkhwa, Paquistão

Abstract Fish is the main source of animal protein for human diet. The aim of this study was to find out prevalence of pathogenic bacteria of two selected economically important fish of Pakistan namely Mahseer (Tor putitora) and Silver carp (Hypophthalmichthys molitrix). Live fish samples from hatcheries and dead fish samples from different markets of study area were randomly collected. The fish samples were analyzed for isolation, identification and prevalence of bacteria. The isolated bacteria from study fish were identified through biochemical test and about 10 species of pathogenic bacteria were identified including the pathogenic bacteria to human and fish namely, Pseudomonas aeruginosa, Escherichia coli, Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus iniae, Serratia spp. Citrobacter spp. Stenotrophomonas spp. Bacillus spp. and Salmonella spp. The bacterial percentage frequency of occurrence in Silver carp and Mahseer fish showed Pseudomonas aeruginosa 21.42%, Staphylococcus epidermidis 17.85%, Escherichia coli 11.90%, Staphylococcus aureus 9.52%, Citrobacter spp. 9.52%, Serratia spp. 8.33%, Streptococcus iniae 7.14%, Stenotrophomonas spp. 5.95%, Bacillus spp. 4.76% and Salmonella spp. 3.57%. The study revealed that Fish samples of Mahseer and Silver carp that were collected from markets have found more isolates (10 bacterial species) than did the fresh fish pond samples (03 bacterial species) of hatcheries. The occurrence of pathogenic bacteria in study fish showed risk factor for public health consumers.

Resumo O peixe é a principal fonte de proteína animal para a alimentação humana. O objetivo deste estudo foi descobrir a prevalência de bactérias patogênicas de dois peixes economicamente importantes selecionados do Paquistão, nomeadamente Mahseer (Tor putitora) e carpa prateada (Hypophthalmichthys molitrix). Amostras de peixes vivos de incubatórios e amostras de peixes mortos de diferentes mercados da área de estudo foram coletadas aleatoriamente. As amostras de peixes foram analisadas quanto ao isolamento, identificação e prevalência de bactérias. As bactérias isoladas dos peixes do estudo foram identificadas através de testes bioquímicos e cerca de 10 espécies de bactérias patogênicas foram identificadas incluindo as bactérias patogênicas para humanos e peixes, nomeadamente, Pseudomonas aeruginosa, Escherichia coli, Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus iniae, Serratia spp. Citrobacter spp. Stenotrophomonas spp. Bacillus spp. e Salmonella spp. A porcentagem de freqüência de ocorrência bacteriana em carpa prateada e peixes Mahseer mostrou Pseudomonas aeruginosa 21,42%, Staphylococcus epidermidis 17,85%, Escherichia coli 11,90%, Staphylococcus aureus 9,52%, Citrobacter spp. 9,52%, Serratia spp. 8,33%, Streptococcus iniae 7,14%, Stenotrophomonas spp. 5,95%, Bacillus spp. 4,76% e Salmonella spp. 3,57%. O estudo revelou que as amostras de peixes de Mahseer e carpa prateada coletadas nos mercados encontraram mais isolados (10 espécies bacterianas) do que as amostras de peixes frescos (03 espécies bacterianas) de incubatórios. A ocorrência de bactérias patogênicas nos peixes do estudo apresentou fator de risco para consumidores de saúde pública.