Acute Epstein-Barr virus-related myocarditis: life-threatening complication in immunocompetent patient

Acute Epstein-Barr virus (EBV) related myocarditis is an uncommon but potentially life-threatening condition, particularly in immunocompetent individuals. We present a case of a 14-year-old male with no prior medical history who presented with high-grade fever, sore throat, and dyspnea on exertion. Laboratory tests and echocardiography confirmed the diagnosis of myocarditis secondary to EBV infection. The patient required conservative treatment. Follow-up at post-discharge revealed complete recovery, with normal echocardiographic findings and no residual symptoms. This case underscores the importance of early recognition and intervention in EBV-related myocarditis. Despite its rarity, clinicians should consider viral myocarditis in patients with systemic EBV infection and cardiac symptoms. Aggressive supportive care can lead to full recovery, as demonstrated by this case. It can present as a dengue-mimic.

Diagnostic approach and treatment of Zenker's diverticulum

Pharyngoesophageal diverticulum have many subtypes, Zenker's diverticulum being the most common of them. Accounting from 70 to 75% of all esophageal diverticula. The 50% of these occur between the seventh and eighth decade of life. The most common symptom is dysphagia. The predominant symptom of ZD is dysphagia and the most serious is pulmonary aspiration. A 68-year-old female attended a general surgery consultation with progressive dysphagia, weight loss, regurgitation and halitosis. Laboratory studies showed normal, while the upper gastrointestinal series (UGI) showed stasis in the upper part of the esophagus. Digestive panendoscopy revealed Zenker's diverticulum, diverticulectomy and cricopharyngeal myotomy were performed. Zenker's diverticulum is diagnosed through radiological studies and endoscopy. Surgical management is necessary due to the list of complications if left untreated.

Middle cerebral artery stroke in chronic heart failure patient: a case report

Middle cerebral artery (MCA) stroke describes the sudden onset of a focal neurologic deficit resulting from hemorrhagic or ischemic disruption of the MCA's blood supply. Ischemic stroke is frequently divided into several etiological categories, including atherosclerotic, cardio embolic, lacunar, and cryptogenic. Chronic heart failure (CHF) is also common cause of ischemic stroke. A 66-year-old male patient came to the emergency room at Kasih Ibu Gianyar Hospital with complaints of suddenly not being able to talk since 8 hours before entering the hospital. There is weakness on the right side of the upper extremities, and weakness on the right and left lower extremities. The patient has a history of chronic heart failure since 3 years. A thorax X-ray showed atherosclerosis. Computed tomography (CT) scan showed acute thromboembolic ischemic infarction in the left temporoparietal lobe in the left MCA territory. The causal relation between CHF and ischemic stroke represent manifestations of similar underlying risk factors, such as hypertension and diabetes mellitus. The pathophysiological mechanism of chronic heart failure can be at risk of causing a stroke infarction in large blood vessels in the brain such as the MCA, and patient MCA Stroke with CHF has high risk of recurrent stroke.

Morbidity profiling of patients treated at Ayothidoss Pandithar Hospital of the National Institute of Siddha from 2004 to 2023 in Tamil Nadu, India

Background: Understanding the patient flow for health-seeking patterns and utilization of AYUSH care in India has been considered essential for a greater emphasis on mainstreaming and blending into the existing healthcare systems. This study examines the morbidity profiling of patients reporting to Ayothidoss Pandithar Hospital (APH) of the National Institute of Siddha (NIS), Chennai. Methods: The study included new and old/revisit patients who attended the APH, Outpatient Department (OPD), special OPD, and Inpatient Department (IPD) from October 2004 to December 2023. Results: Through OPD and IPD, APH has treated 98,94,373 cases and 7,61,754 cases, respectively. The average number of cases treated per day at OPD was 1484, and 115 in IPD. Men were higher in OPD and IPD. The more common diseases treated during 2012-2023 at OPD were Madhumegam (diabetes mellitus) 13% and Azhal keelvayu (osteoarthritis) 12% whereas, in IPD, it was Thandagavatham (lumbar spondylosis) 9.5% and Pakkavatham (hemiplegia) 9.4%. At APH, 9 X-ray investigations, 44 Varmam therapies, 37 Thokkanam therapies, 497 pathological, 433 biochemical investigations, and 38 microbiological tests were performed each day. Conclusions: This study reveals the scope of the Siddha system of Medicine in managing Musculoskeletal disorders. The patient data generated at APH would enhance the National Health Policy (NHP) objective of strengthening and prioritizing health services' importance, promoting good health, and creating guidelines for high-quality care.

Co-trimoxazole induced Steven Johnson syndrome in HIV infected patient: things to consider

Co-trimoxazole is a sulfonamide fixed dose combination antibiotic which is effective and widely use in treatment and prevention of opportunistic infections in people living with HIV/AIDS, but can be potentially associated with adverse drug reactions including drug hypersensitivity reactions such as Steven Johnson syndrome. PLWHA individuals have up to a 1000-fold increased risk of drug hypersensitivity reaction compared to the general population, which is associated with drug exposure, immune dysregulation, and concurrent infections. Here we present a case report of a 59-year-old man with HIV who experienced Stevens-Johnson Syndrome after taking co-trimoxazole for 18 days. Therefore, we would like to remind you to be more careful when giving cotrimoxazole to PLWHA because it can take time for a hypersensitivity reaction to occur, also in a few cases, it can occur immediately.

Pineal parenchymal tumour of intermediate differentiation: a rare case report

Pineal parenchymal tumours are erratic, accounting for <1% of all primary central nervous system tumours. It was first categorised by the WHO in 2000 as a pineal parenchymal tumour with an intermediate prognosis between pineocytoma and pineoblastoma. We reported a case of 38-year-old gentle man presented with chief complaints of headache and vomiting since 1 day. MRI brain showed a relatively well defined lesion epicentered at posterior aspect of third ventricle, extending and blocking Aqueduct of Sylvius leading to upstream dilatation of both lateral and third ventricles with periventricular ooze was observed. Excision of lesion was performed, histopathological diagnosis of pineal parenchymal tumours of intermediate differentiation (PPTID) was made, which was further confirmed on IHC. PPTID are enormously erratic tumour, and restricted data are available concerning their pathologic features and biologic behaviours causing interruption in making proper diagnosis and deciding an optimal treatment approach.

Medication error in general medicine department of tertiary care Koshi Zonal hospital in Nepal

Background: Medication errors are the leading cause of patient harm, injuries and even death in hospitalized patients. It endangers patient safety and also increases the cost of treatment leading to enhanced financial burden to the individuals and the community as well. The study was aimed to determine the pattern of occurrence of medication errors. Methods: A cross-sectional study was conducted in 188 hospitalized patients in medical ward at a Zonal Hospital. Medication errors were identified and categorized by reviewing the cardex. The data were analyzed to determine the cause of medication errors including rates of harm to patients. The descriptive statistics frequency and percentage were calculated using Microsoft Excel 2007. The findings were presented as tables and graphs. Results: A total of 985 medication errors were found in 650 (38.3%) drugs prescribed in 177 (94.1%) patients. Approximately 72.9% of the errors reached the patients and 32.39% of the errors were harmful. The most common observed errors were administration errors (41.6%) followed by prescribing errors (36.5%), transcription errors (14.3%) and monitoring errors (7.5%). Omission of prescribing information (63.88%) and wrong dosing schedule (34%) were the most common type of prescribing and transcription errors respectively. Omission of dosages administration (57.32%) to patients was the most common types of administration error. All types of medication errors were highest in the alimentary tract and metabolism class of drugs (32.39%). Conclusions: Medication errors were associated with the majority of hospitalized patients signifying the requirement of immediate preventive strategies and policies to ensure patient safety.

Comparison of etomidate and propofol as an induction agent to study hemodynamic effects and serum cortisol level following endotracheal intubation in hypertensive patients

Background: The present study aimed to compare hemodynamic parameters (heart rate, blood pressure) and adverse effects (injection pain, myoclonus, postoperative nausea/vomiting) between Etomidate and propofol groups. Methods: Patients were divided into two groups: Etomidate Group E and a Propofol Group P. All hemodynamic data were measured during induction, intubation, and post-intubation up to 15 min. Intravenous cortisol levels were measured at baseline, just after induction and at 24 hours after induction. Results: At 3 min and 5 min SBP was decreased by 22.04% and 18.39% in Group P. At 3 min there was fall in DBP by 20.13% in group P whereas there was an increase in group E by 0.13% which is statistically significant (p<0.001). At 1 min, 3 min and 5 min after intubation, fall in the MAP by 26.07%, 21.08% and 18.60% in group P and 0.77%, 0.42% and 1.30% in group E (p value <0.001). Serum cortisol level immediate after surgery was decrease (54%) in Group E (p value <0.001). In Group P, 40% of the patients and in group E 16.66 % of the patients complained of pain on injection (p value 0.046). Conclusions: The cortisol suppression by Etomidate may be beneficial for intubation stress response. Etomidate is better for its hemodynamic stability over propofol.

Potential biomarkers as a predictive factor of response to primary chemotherapy in breast cancer patients

In this study, we identified miRNAs and their potential mRNA targets that are intricately linked to primary chemotherapy response in patients with invasive ductal carcinomas. A cohort of individuals diagnosed with advanced invasive breast ductal carcinoma who underwent primary chemotherapy served as the cornerstone of our study. We conducted a comparative analysis of microRNA expression among patients who either responded or did not respond to primary systemic therapy. To analyze the correlation between the expression of the whole transcriptome and the 24 differentially expressed (DE) miRNAs, we harnessed the extensive repository of The Cancer Genome Atlas (TCGA) database. We mapped molecular mechanisms associated with these miRNAs and their targets from TCGA breast carcinomas. The resultant expression profile of the 24 DE miRNAs emerged as a potent and promising predictive model, offering insights into the intricate dynamics of chemotherapy responsiveness of advanced breast tumors. The discriminative analysis based on the principal component analysis identified the most representative miRNAs across breast cancer samples (miR-210, miR-197, miR-328, miR-519a, and miR-628). Moreover, the consensus clustering generated four possible clusters of TCGA patients. Further studies should be conducted to advance these findings.

Role of homoeopathy of Ayush in dengue fever

In 21st century, dengue came to the limelight. Earlier, it was taught that this is one of the eruptive fevers in human beings where in dengue, the eruption appears typically on the 6th day of the fever. Knowledge and approaches to dengue took a paradigm shift in 21st century. It came to be clubbed under the National Vector Borne Disease Control Program. A mosquito borne single stranded RNA virus is the leading cause of arthropod borne viral diseases like dengue globally. All the types of dengue virus are capable of inducing severe diseases like dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). No one wants to be in DHF or DSS stage as these are mortal stages while other stages are morbid. A vector borne disease (VBD) transmitted by mosquito has no specific cure in modern medicine. To add to that, the issue of platelet transfusion that is made universal because of the inherent panic does more harm than good. It is here that homoeopathy has a role to play therapeutically. The article discusses the disease and the related physiology as well as pathology that goes inside the body during an episode of dengue fever. Along with the diagnosis and management approaches, the article elicits the role of homoeopathy through a suggested treatment protocol. Through the inherent properties of homoeopathy such as cost effectiveness, clinical effectiveness and zero side effects, the article proposes large scale application of homoeopathy at all levels.

A realist review of effective university-based wellness programs on physical activity, occupational balance, and vocal health

Background@#Wellness programs can be implemented in a university setting and may include varied elements such as physical activity, occupational balance, and vocal health. However, there is limited information that highlights and synthesizes why and how these programs work. Therefore, this study aimed to understand effective programs on physical activity, occupational balance, and vocal health for university constituents in relation to the implementation contexts, mechanisms, and outcomes (CMO).@*Methodology@#Guided by the Health Belief Model in the context of a realist review design, the researchers conducted an iterative search among seven peer-reviewed electronic databases in the health and education fields using a predetermined set of eligibility criteria. @*Results@#The search identified 6564 records, of which programs from 20 records contributed to data synthesis. Nine CMO statements were created, with physical activity programs accounting for most configurations. Key themes identified were tailored and individualized interventions, medium-term incentivization, lifestyle education programs utilizing information and communications technology, interdisciplinary multi-component programs, use of self-monitoring strategies, social support, and shared experiences among employees and students. Analysis of the mechanisms of these effective university programs revealed processes and structures that were consistent with elements of the Health Belief Model.@*Conclusion@#Effective university-based PA programs result from a health-supporting culture among staff and students, utilizing self-based, technological, and social approaches that target and address individual and organizational behaviors in physical activity, occupational balance, and vocal health. This realist review provides practical information that may guide the development of university-based programs and policies targeting these areas of wellness.

Connaissances, attitudes et perceptions de la césarienne chez les gestantes suivies en CPN dans 6 maternités de Kinshasa / NA

Objectifs: Evaluer le niveau de connaissances, décrire les attitudes ainsi que les perceptions des gestantes sur la césarienne. MéthodesIl s'agissait d'une étude descriptive transversale qui s'est déroulée durant la période allant du 01 Février au 30Avril 2023 (soit 3mois) dans les services des consultations prénatales (CPN) des 6 6 structures de la Ville Province de Kinshasa ; les Cliniques Universitaires de Kinshasa (CUK), le Centre Hospitalier Roi Baudoin 1, l'Hôpital Saint Joseph(HSJ), les Maternités de Kintambo, de Binza et de Kingasani. Un total de 481 gestantes était interrogé dans l'ensemble des formations sanitaires sélectionnées. Les données sociodémographiques et celles relatives à la connaissance, attitude et perception sur la césarienne ont été récoltées par interview et analysées à l'aide des statistiques descriptives. L'évaluation de connaissances était faite selon la cotation suivante; moins de 50% de bonnes réponses (MAUVAISES) ;entre 50% et 70% de bonnes réponses (MOYENNES) et plus de 70% de bonnes réponses ( BONNES ). L'échelle de Likert a servi à l'évaluation des attitudes et perceptions sur la césarienne. Résultats Sur les 481 gestantes interviewées, seulement 16,1% avaient un antécédent personnel de Césarienne, l'âge de moyen de gestantes était de 29 ans, mariées pour la plupart (87,9%), employée (56,4%) avec un niveau d'étude secondaire (49,3%) et un niveau socio-économique moyen (53,8%). La source d'information sur cette intervention était diversifiée chez 39,8% de gestantes et les CPN n'ont contribué que dans 22,4%. Le niveau de connaissance était satisfaisant chez 73, 3% de gestantes. L'attitude des gestantes était négative chez 70,1% la perception par contre était positive à 64,4 %. Conclusion: La majorité de gestantes avait un niveau suffisant de connaissances sur la césarienne et une perception positive alors qu'elle garde une attitude négative face à cette intervention.

Objectives: Evaluate the level of knowledge, describe the attitudes and perceptions of pregnant women about cesarean section. Methods This was a cross-sectional descriptive study which took place during the period from February 1 to April 30, 2023 (i.e. 3 months) in the prenatal consultation services (PCS) of the 6 health structures in the City Province of Kinshasa; the University Clinics of Kinshasa (UCK), Roi Baudoin 1 Hospital Center, Saint Joseph Hospital (SJH), Kintambo, Binza and Kingasani maternity wards. A total of 481 pregnant women were interviewed in all the selected health facilities.ResultsAmong the 481 pregnant women interviewed, only 16.1% had a personal history of Caesarean section, the average age of pregnant women was 29 years, most of them married (87.9%), employed (56.4%) with a secondary education level (49.3%) and a socio-economic level. average economic (53.8%). The source of information on this intervention was diversified among 39.8% of pregnant women and antenatal cares only contributed to 22.4%. The level of knowledge was satisfactory in 73.3% of pregnant women. The attitude of the pregnant women was negative at 70.1%, the perception on the other hand was positive at 64.4%.Conclusion:The majority of pregnant women had a sufficient level of knowledge about caesarean section and a positive perception while they maintain a negative attitude towards this intervention

Oral glutamine dipeptide or oral glutamine free amino acid reduces burned injury progression in rats / O dipeptídeo de glutamina oral ou aminoácido livre de glutamina oral reduz a progressão da lesão por queimadura em ratos

Abstract This study was carried out to evaluate the effect of Glutamine, as a dipeptide or a free amino acid form, on the progression of burn injuries in rats. Thirty male Wistar rats were burned with a comb metal plate heated in boiling water (98 °C) for three minutes, creating four rectangular full-thickness burn areas separated by three unburned interspaces (zone of stasis) in both dorsum sides. The animals were randomized into three groups (n=10): saline solution (G1-Control) and treated groups that orally received Glutamine as dipeptide (G2-Dip) or free amino acid (G3-FreeAA). Two and seven days after burn injury, lesions were photographed for unburned interspaces necrosis evolution assessment. Seven days after injury, glutathione seric was measured and histopathological analysis was performed. By photographs, there was a significant reduction in necrosis progression in G3-Free-AA between days two and seven. Histopathological analysis at day 7 showed a significantly higher stasis zone without necrosis and a higher number of fibroblasts in G2-Dip and G3-FreeAA compared with G1-Control. Also, glutathione serum dosage was higher in G2-Dip. The plasmatic glutathione levels were higher in the G2-Dip than the G1-Control, and there was a trend to higher levels in G3-FreeAA. The reduction in histological lesions, greater production of fibroblasts, and greater amounts of glutathione may have benefited the evolution of burn necrosis, which showed greater preservation of interspaces.

Resumo Este estudo foi realizado para avaliar o efeito da Glutamina, como um dipeptídeo ou forma de aminoácido livre, na progressão de queimaduras em ratos. Trinta ratos Wistar machos foram queimados com um pente de metal aquecido em água fervente (98 °C) por três minutos, criando quatro áreas retangulares queimadas separadas por três interesespaços não queimados (zona de estase) em ambos os lados do dorso. Os animais foram randomizados em três grupos (n = 10): solução salina (G1-Controle) e grupos tratados que receberam glutamina via oral como dipeptídeo (G2-Dip) ou aminoácido livre (G3-FreeAA). Dois e sete dias após a queimadura, as lesões foram fotografadas para avaliação da evolução da necrose entre os espaços não queimados. Sete dias após a lesão, foi dosada a glutationa sérica e realizada análise histopatológica. Pelas fotografias, houve uma redução significativa na progressão da necrose no G3-Free-AA entre os dias dois e sete. A análise histopatológica no dia 7 mostrou uma zona de estase significativamente maior sem necrose e número mais elevado de fibroblastos em G2-Dip e G3-FreeAA em comparação com G1-Controle. Os níveis plasmáticos de glutationa foram maiores no G2-Dip em relação ao G1-Controle, e houve tendência a níveis mais elevados no G3-FreeAA. A redução das lesões histológicas, maior produção de fibroblastos, maior quantidade de glutationa podem ter beneficiado a evolução da necrose da queimadura, que mostrou maior preservação dos interespaços.

Oral glutamine dipeptide or oral glutamine free amino acid reduces burned injury progression in rats

Abstract This study was carried out to evaluate the effect of Glutamine, as a dipeptide or a free amino acid form, on the progression of burn injuries in rats. Thirty male Wistar rats were burned with a comb metal plate heated in boiling water (98 °C) for three minutes, creating four rectangular full-thickness burn areas separated by three unburned interspaces (zone of stasis) in both dorsum sides. The animals were randomized into three groups (n=10): saline solution (G1-Control) and treated groups that orally received Glutamine as dipeptide (G2-Dip) or free amino acid (G3-FreeAA). Two and seven days after burn injury, lesions were photographed for unburned interspaces necrosis evolution assessment. Seven days after injury, glutathione seric was measured and histopathological analysis was performed. By photographs, there was a significant reduction in necrosis progression in G3-Free-AA between days two and seven. Histopathological analysis at day 7 showed a significantly higher stasis zone without necrosis and a higher number of fibroblasts in G2-Dip and G3-FreeAA compared with G1-Control. Also, glutathione serum dosage was higher in G2-Dip. The plasmatic glutathione levels were higher in the G2-Dip than the G1-Control, and there was a trend to higher levels in G3-FreeAA. The reduction in histological lesions, greater production of fibroblasts, and greater amounts of glutathione may have benefited the evolution of burn necrosis, which showed greater preservation of interspaces.

Resumo Este estudo foi realizado para avaliar o efeito da Glutamina, como um dipeptídeo ou forma de aminoácido livre, na progressão de queimaduras em ratos. Trinta ratos Wistar machos foram queimados com um pente de metal aquecido em água fervente (98 °C) por três minutos, criando quatro áreas retangulares queimadas separadas por três interesespaços não queimados (zona de estase) em ambos os lados do dorso. Os animais foram randomizados em três grupos (n = 10): solução salina (G1-Controle) e grupos tratados que receberam glutamina via oral como dipeptídeo (G2-Dip) ou aminoácido livre (G3-FreeAA). Dois e sete dias após a queimadura, as lesões foram fotografadas para avaliação da evolução da necrose entre os espaços não queimados. Sete dias após a lesão, foi dosada a glutationa sérica e realizada análise histopatológica. Pelas fotografias, houve uma redução significativa na progressão da necrose no G3-Free-AA entre os dias dois e sete. A análise histopatológica no dia 7 mostrou uma zona de estase significativamente maior sem necrose e número mais elevado de fibroblastos em G2-Dip e G3-FreeAA em comparação com G1-Controle. Os níveis plasmáticos de glutationa foram maiores no G2-Dip em relação ao G1-Controle, e houve tendência a níveis mais elevados no G3-FreeAA. A redução das lesões histológicas, maior produção de fibroblastos, maior quantidade de glutationa podem ter beneficiado a evolução da necrose da queimadura, que mostrou maior preservação dos interespaços.

Torsemida em Comparação com Furosemida no Tratamento da Insuficiência Cardíaca: Uma Revisão Sistemática e Metanálise de Ensaios Clínicos Randomizados / Torsemide versus Furosemide in the Treatment of Heart Failure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Resumo A furosemida é o diurético mais utilizado para o tratamento de sintomas de sobrecarga de volume em pacientes com insuficiência cardíaca. Dados recentes sugerem que a torsemida pode ser superior à furosemida neste contexto. No entanto, ainda não é claro se isso se traduz em melhores resultados clínicos nesta população. Avaliar se a torsemida é superior à furosemida no contexto da insuficiência cardíaca. Realizamos uma revisão sistemática e metanálise de estudos clínicos randomizados (ECRs) comparando a eficácia da torsemida em comparação com a furosemida em pacientes com insuficiência cardíaca. PubMed, Embase e Web of Science foram as bases de dados pesquisadas em busca de estudos elegíveis. Os desfechos de interesse foram internações por todas as causas, internações por insuficiência cardíaca (IIC), internações por todas as causas cardiovasculares, mortalidade por todas as causas, e melhoria de classe da NYHA. Parâmetros ecocardiográficos também foram avaliados. Foi aplicado um modelo de efeitos aleatórios para calcular as razões de risco (RR) e as diferenças médias (DM) com intervalos de confiança (IC) de 95% e nível de significância de 0,05. Foram incluídos 12 ECRs, envolvendo 4.115 pacientes. A torsemida reduziu significativamente a IIC (RR de 0,60; IC de 95%, 0,43-0,83; p=0,002; I2=0%), internação por causas cardiovasculares (RR de 0,72; IC de 95%, 0,60-0,88; p=0,0009; I2=0%), e melhora da fração de ejeção do ventrículo esquerdo (FEVE) (DM de 4,51%; IC de 95%, 2,94 a 6,07; p<0,0001; I2=0%) em comparação com a furosemida. Não houve diferença significativa no número de internações por todas as causas (RR de 0,93; IC de 95%, 0,86-1,00; p=0,04; I2=0%), mortalidade por todas as causas (RR de 0,98; IC de 95%, 0,87-1,10; p=0,73; I2=0%), melhora da classe NYHA (RR de 1,25; IC de 95%, 0,92-1,68; p=0,15; I2=0%), ou mudança de classe NYHA (DM de -0,04; IC de 95%, -0,24 a 0,16; p=0,70; I2=15%) entre os grupos. A torsemida reduziu significativamente as internações por insuficiência cardíaca e causas cardiovasculares, melhorando também a FEVE.

Abstract Furosemide is the most used diuretic for volume overload symptoms in patients with heart failure (HF). Recent data suggested that torsemide may be superior to furosemide in this setting. However, whether this translates into better clinical outcomes in this population remains unclear. To assess whether torsemide is superior to furosemide in the setting of HF. We performed a systematic review and meta-analysis of RCTs comparing the efficacy of torsemide versus furosemide in patients with HF. PubMed, Embase, and Web of Science were searched for eligible trials. Outcomes of interest were all-cause hospitalizations, hospitalizations for HF (HHF), hospitalizations for all cardiovascular causes, all-cause mortality, and NYHA class improvement. Echocardiographic parameters were also assessed. We applied a random-effects model to calculate risk ratios (RR) and mean differences (MD) with 95% confidence intervals (CI) and a 0.05 level of significance. 12 RCTs were included, comprising 4,115 patients. Torsemide significantly reduced HHF (RR 0.60; 95% CI, 0.43-0.83; p=0.002; I2=0%), hospitalization for cardiovascular causes (RR 0.72; 95% CI, 0.60-0.88; p=0.0009; I2=0%), and improved LVEF (MD 4.51%; 95% CI, 2.94 to 6.07; p<0.0001; I2=0%) compared with furosemide. There was no significant difference in all-cause hospitalizations (RR 0.93; 95% CI, 0.86-1.00; p=0.04; I2=0%), all-cause mortality (RR 0.98; 95% CI, 0.87-1.10; p=0.73; I2=0%), NYHA class improvement (RR 1.25; 95% CI, 0.92-1.68; p=0.15; I2=0%), or NYHA class change (MD -0.04; 95% CI, -0.24 to 0.16; p=0.70; I2=15%) between groups. Torsemide significantly reduced hospitalizations for HF and cardiovascular causes, also improving LVEF.

The use of gut microbiota probiotics in the management of atopic dermatitis in children: systematic review

Atopic dermatitis (AD) is one of the most common inflammatory skin diseases, affecting more than 20% of the population at some time in their lives. Currently, corticosteroids are generally used for the treatment of AD, although these drugs have the potential to cause more serious side effects. Objective of the study was to find out the role of probiotics in the management of atopic dermatitis in children through a review of previous research. A PubMed search was carried out with the keywords 'atopic dermatitis' and 'probiotic' from databases for the last 10 years (2014-2023). Researchers present the results in narrative form and in table form. A total of 10 articles were included in this study. The research comes from several different countries with the research time being from 2017 to 2022. Each study describes the author, year of study, total sample, type of probiotic, duration of treatment, results and side effects. Giving probiotics to pediatric patients with atopic dermatitis has an impact on reducing SCORAD in evaluation after 2-3 months (8-12 weeks). No significant side effects were found in the included studies.

Effectiveness of two different campaigning methods in reaching the public: conventional pamphlet campaign versus social media campaign: a pilot study

Cost effective campaigning method to attract people to an awareness program need to be identified. Conventional pamphlet campaign remain popular despite the expanding range of social media campaign that have potential to reach large number of people at low cost. Two different methods of awareness campaigns were used to attract people to an awareness program. The conventional pamphlet was distributed manually and social media campaign was done in Facebook as a paid promoted post. The budget was fixed to Rs.1200/-for each group. People with interest are invited to scan the provided QR code which directs to an electronic form (e-form). The number of sign up were estimated in each method. A total of 17 people signed up to participate in awareness program. Of which conventional pamphlets campaign showed 6 sign up and social media campaign showed 11 sign-ups. The cost per sign up for conventional pamphlet campaign and social media campaign are Rs.109.09 and Rs.200 respectively. The social media campaign was the cost-effective method and reached larger number of sign-ups when compared to conventional pamphlet campaign. Overall, our results demonstrate that social media campaigning is the cost-effective method in attracting people than conventional pamphlets campaigning.

A study on prevalence and socio demographic factors associated with overweight and obesity among high school children of Raichur city

Background: Overweight/obesity among children is an emerging public health problem in our country. Overweight/obesity is a form of development-driven malnutrition that is emerging among all ages and socio-economic groups. Childhood overweight/obesity is a risk factor for later adult diseases and is associated with impaired health during childhood itself which may continue untreated for many years. The belief that overweight/obesity was the problem of developed countries alone is no longer true. India is one of the developing countries showing emerging and rising trends of overweight/obesity. Methods: A cross sectional study was undertaken in high schools of Raichur city. Data was collected by interviewing 1900 study subjects using pre-tested semi-structured questionnaire and by physical examination. The data was analyzed using percentages, proportions, odds ratio and Chi-square test with the help of Epi Info 7 software. Results: Prevalence of overweight and obesity among high school children of Raichur city was found to be 4.57% and 5.11% respectively. Significant association of overweight/obesity was found with gender, age, religion, socio-economic status, parent’s education, type of diet and physical exercise. Conclusions: Considering association of overweight/obesity with various risk factors, preventive measures like lifestyle modifications, changes in dietary pattern and regular exercise should be promoted in these age group children.

‘G’ followed by ‘H’-gout follows homoeopathy

Currently in modern medicine, it is seen that taking a uric acid reducing drug during an attack of gout actually prolongs the pain and discomfort. So, the learning is that one need not worry about high uric acid levels during an acute flair of gout. What actually someone needs is an anti-inflammatory that reduces the inflammation caused by the crystals of uric acid that build up in the joints when someone has gout. This anti-inflammatory drug is ‘colchicine’. Homoeopathy has been using the drug ‘colchicum autumnale’ for last 233 years since its discovery in 1790 by Dr. Samuel Hahnemann (1755-1843). It also uses its active principle ‘colchicine’ for the last 233 years. It is quite striking to see that the modern medicine is realizing the importance of ‘colchicine’ currently. The same ‘colchicine’ was advised to be used as an anti-inflammatory to reduce the markers like C-reactive protein, LDH, D-dimer and homocysteine. During the COVID-19 peak, again the homoeopathic Colchicine came to the rescue. The current article examines the use of homoeopathy in gout and uric acid problems and again at a larger issue with the protein metabolism and the kidney heath. Integration of homoeopathy at large scale will help the nation to protect its members from protein metabolism disorders, kidney health and gout as well.

Caregivers’ knowledge and attitude scale towards drug: development and validation

Background: Drug abuse is a prevalent issue in society, often used to reduce stress and improve mental health. It is often seen as a personal disorder, causing harm to users and their loved ones. In today’s globalized world, society strives for better care, emphasizing the importance of solving problems and emphasizing the role of caregivers in supporting drug addicts. Methods: A standardized knowledge and attitude scale was developed to assess 60 caregivers of drug addicts in Kolkata, India. The scale was self-administered and tested at 21-day intervals. The Pearson’s correlation coefficient method was applied for questionnaire validity. The scale was used to eliminate poor items and ensure reliability. Results: The tool primarily consists of twenty-two (22) knowledge and twenty-two (22) attitude items towards drug. Following item analysis, four (4) distracting items from the knowledge scale are dropped in accordance with the difficulty index and discrimination index. The discrimination indices from the attitude scale were used to eliminate 1 distracting item. As a result, 18 items for the knowledge scale and 21 items for the attitude scale were retained. The knowledge and attitude tools’ final form has found high significant correlation. Conclusions: The study explained how to create a standardized scale with good items and significant reliability to evaluate knowledge and attitude towards drug addicts.