Knowledge and preventive practices related to Monkey pox among medical doctors in Sokoto metropolis of Sokoto State, Nigeria

Background: For effective control of Monkey pox (Mpox), clinicians need to have adequate knowledge of the disease and adopt appropriate practices to contain it. This study sought to assess the knowledge and practices of medical doctors regarding Monkey pox. Methodology: A descriptive cross-sectional design was utilized for the study and using a two stage sampling method, 210 medical doctors working in Sokoto metropolis were recruited into the study. Aset of structured, pretested and self-administered questionnaire was used to obtain relevant information from the study participants. Data obtained was analyzed using SPSS computer software version 23 with level of statistical significance set at p<0.05 Results: All the respondents were aware of Mpox with more than half (52.3%) having the internet as their commonest source of information. The majority, ((72%) of the clinicians had good knowledge and only years of working experience was significantly associated with knowledge of the disease. Preventive practices were well exhibited by all the respondents with the majority (73%) having appropriate preventive practices. Conclusion and recommendation: This study has demonstrated good knowledge towards Mpox by clinicians in Sokoto metropolis, with a greater majority exhibiting appropriate preventive practices. Sustained awareness and retraining of health care workers in general is necessary to maintain the tempo of high index of suspicion for outbreaks of Mpox and other potential epidemics and also regular use of personal protective equipment

Diversity of sandflies in Vidarbha region of Maharashtra, India, a region endemic to Chandipura virus encephalitis

Background & objectives: Sandflies are implicated as vectors of Chandipura virus (CHPV) (Vesiculovirus: Rhabdoviridae). The virus is prevalent in central India including Vidarbha region of Maharashtra. CHPV causes encephalitis in children below 15 yr of age with case fatality rates ranging from 56 to 78 per cent. The present study was undertaken to determine the sandfly fauna in the CHPV endemic Vidharba region. Methods: A year round survey of sandflies was conducted at 25 sites in three districts of Vidarbha region. Sandflies were collected from their resting sites using handheld aspirators and identified using taxonomical keys. Results: A total of 6568 sandflies were collected during the study. Approximately 99 per cent of the collection belonged to genus Sergentomyia, which was represented by Ser. babu, Ser. bailyi and Ser. punjabensis. Genus Phlebotomus was represented by Ph. argentipes and Ph. papatasi. Ser. babu was the predominant species (70.7%) collected during the study. Ph. argentipes was detected in four villages with 0.89 per cent, whereas Ph. papatasi was detected in only one village with 0.32 per cent of the total collection. CHPV could not be isolated despite processing all the sandflies for virus isolation in cell culture. Interpretation & conclusions: The present study showed influence of higher temperature and relative humidity on sandfly population dynamics. An important observation during the study was the absence or decline in the population of Ph. papatasi and Ph. argentipes in the study area. Surge in Sergentomyia population and their breeding/resting in close vicinity to humans pose a concern as they are known to harbour CHPV and other viruses of public health importance

Screenning of Arrhythmias in Patients Treated for Heart Failure in Parakou in 2017

Introduction: Rhythm disorders (RDs) or arrhythmias are poor prognostic factors during heart failure (HF). Our objective was to study the frequency of rhythm disorders presented by patients treated for HF in Parakou, Benin in 2017. Methods: This was a cross-sectional, descriptive and analytical study. It consisted of a systematic recruitment of all patients admitted for heart failure in the cardiology units of the city of Parakou from March to August 2017. The diagnosis of RDs was made by cardiac auscultation completed by electrocardiographic recording (standard and Holter over 24 hours). The Lown classification was used to describe the severity of ventricular TRs. The threshold for significance was p < 5%. Results: A total of 83 heart failure patients aged 61.47 ± 15.97 years with a sex ratio of 1.08 were selected. Arrhythmia was detected by auscultation in 20.48%; by standard electrocardiogram (ECG) in 25.83% and by Holter ECG in 97.59% of patients. Among the arrhythmias detected by Holter ECG, 81.48% were atrial, including 28.79% of atrial fibrillation. RDs was ventricular in 90.12% of which 47.95% were severe. Left ventricular systolic dysfunction was significantly associated with ventricular arrhythmias. On the other hand, the frequency of ventricular arrhythmias was not associated with the severity of the HF according to the NYHA classification. Conclusion: In Parakou, RDs are frequent in patients with HF. Holter ECG should be included in the follow-up of heart failure patients in order to improve their management.

Proposal for Educational Intervention in People Living with Type 2 Diabetes Mellitus and in their Family Caregiver

Objective: Design a proposal of educational intervention for both, people who live with Diabetes Mellitus type 2 and their family caregiver. Methodology: Methodology. A case series study was conducted with the participation of 12 people living with type 2 diabetes mellitus and attending a Mutual Help Group in Pachuquilla, Hidalgo. Sociodemographic data, somatometric measurements (weight, height, BMI, waist circumference), blood pressure, and capillary blood samples for glycosylated hemoglobin were collected. Results: The mean age was 64 and range of 39-79 years, O.D. of 12; 67% women; 25% finished secondary school, 50% worked at home, 17% in commerce, 33% unemployed; 58% married, 25% widowed, and 17% divorced and in common law; 33.% with less than 5 years diagnosed, 67% have been diagnosed for more than 5 years; 75% depend economically; 67% have complications, 75% with family support, in diabetes knowledge 33% obtained intermediate score and 67% inadequate score; the weight average was of 77 kg and range of 57-116.5 kg, and O.D. 17 kg; in waist circumference, 100% exceed the recommended limit, in BMI, 50% is classified as overweight and 50% as obese; in blood pressure 50% > 130/80 mmHg and in glycosylated hemoglobin 75% > 7% mg/dl. Conclusion: The currently implemented strategy does not reflect good knowledge and control of the disease. This study invites us to continue with research where an educational intervention is implemented in which family caregivers are included and active participation is encouraged, in addition to implementing the IEP as a theoretical basis for the intervention.

Analysis of the toxicological and pharmacokinetic profile of Kaempferol-3-O-β-D-(6"-E-p-coumaryl) glucopyranoside - Tiliroside: in silico, in vitro and ex vivo assay / Análise do perfil toxicológico e farmacocinético de Kaempferol-3-O-β D-(6"-E-p-cumaril) glucopiranosídeo - Tilirosídeo: ensaio in silico, in vitro e ex vivo

Tiliroside is a glycosidic flavonoid present in many plants species including Helicteres velutina K. Schum (Malvaceae sensu lato), commonly known in Brazil as "pitó". This molecule has been shown to have many biological activities, however no study has been carried out to investigate the toxicity of this substance. The present work aimed to evaluate the possible cellular toxicity in silico, in vitro and ex-vivo of the kaempferol-3-O-β-D-(6”-E-p-coumaroyl) glucopyranoside (tiliroside), through chemical structure analysis, toxicity assessment and predictive bioactive properties, using human samples for in vitro and ex-vivo tests. The in silico analysis suggests that tiliroside exhibited great absorption index when penetrating biological membranes. In addition, it also displayed considerable potential for cellular protection against free radicals, and anticarcinogenic, antioxidant, antineoplastic, anti-inflammatory, anti-hemorrhagic and antithrombotic activities. The assessment of the hemolytic and genotoxic effects of tiliroside showed low hemolysis rates in red blood cells and absence of cellular toxicity in the oral mucosa cells. The data obtained indicate that this molecule could be a promising therapeutic approach as a possible new drug with biotechnological potential.

O tilirosídeo é um flavonóide glicosídico presente em muitas espécies de plantas, incluindo Helicteres velutina K. Schum (Malvaceae sensu lato), conhecida no Brasil como “pitó”. Esta molécula mostrou ter muitas atividades biológicas, porém nenhum estudo foi realizado para investigar a toxicidade dessa substância. O presente trabalho teve como objetivo avaliar a possível toxicidade celular in silico, in vitro e ex-vivo do kaempferol-3-O-β-D- (6 ”-Ep-coumaroil) glucopiranosídeo (tilirosídeo), por meio de análises de estrutura química, toxicidade avaliação e propriedades bioativas preditivas, utilizando amostras humanas para testes in vitro e ex-vivo. A análise in silico sugere que o tilirosídeo exibe bom índice de absorção para penetrar nas membranas biológicas. Além disso, apresentou considerável potencial de proteção celular contra os radicais livres e com atividades anticarcinogênica, antioxidante, antineoplásica, antiinflamatória, anti-hemorrágica e antitrombótica. A avaliação dos efeitos hemolíticos e genotóxicos do tilirosídeo mostrou baixas taxas de hemólise nas hemácias e ausência de toxicidade em células da mucosa oral. Os dados obtidos indicam que esta molécula pode possuir uma abordagem terapêutica promissora como uma possível nova droga com potencial biotecnológico.

Length-weight relationships of fish from sandy beaches / Relação peso-comprimento de 16 espécies de peixes que ocorrem perto de praias arenosas ao longo da bacia do baixo rio Negro na Amazônia brasileira

This study estimated the length–weight relationships of 16 fish species occurring close to the shores of sandy beaches along the lower Negro River basin, Brazilian Amazon. The specimens were captured for one day each month, in October to November 2016, early in the morning and early evening, using trawl net (20 m length and 3.5 m height, 5 mm mesh between opposite knots). Measurements were taken for standard length (SL – 0.1 cm precision) and total weight (TW – 0.01 g precision). The parameters a and b of the equation WT = a.LTb were estimated. The a values ranged from 0.0018 to 0.0226 and b values ranged from 2.5271 to 3.3244. This study also provides new data on of maximum lengths for six species, Amazonsprattus scintilla, Brycon pesu, Moenkhausia megalops, Pachyurus paucirastrus, Reganella depressa and Trachydoras microstomus, and new reports of the LWRs parameters of 15 fish species.

Este estudo estimou as relações comprimento-peso de 16 espécies de peixes que ocorrem às margens de praias arenosas ao longo da bacia do baixo Rio Negro, Amazônia brasileira. As espécies foram capturadas durante um dia de cada mês, de outubro a novembro de 2016, no início da manhã e no início da noite, usando rede de cerco (20 m de comprimento e 3,5 m de altura, 5 malha mm entre nós opostos). As medidas foram feitas para comprimento padrão (SL - precisão de 0,1 cm) e peso total (TW - precisão de 0,01 g). Os parâmetros a e b da equação WT = a.LTb foram estimados. Os valores de a variaram de 0,0018 a 0,0226 e os valores de b variaram de 2,5271 a 3,3244. Este estudo também fornece novos dados sobre comprimentos máximos para seis espécies, Amazonsprattus scintilla, Brycon pesu, Moenkhausia megalops, Pachyurus paucirastrus, Reganella depressa e Trachydoras microstomus, e novos reportes dos parâmetros da LWRs de 15 espécies de peixes.

Analysis of the toxicological and pharmacokinetic profile of Kaempferol-3-O--D-(6-E-p-coumaryl) glucopyranoside - Tiliroside: in silico, in vitro and ex vivo assay

Abstract Tiliroside is a glycosidic flavonoid present in many plants species including Helicteres velutina K. Schum (Malvaceae sensu lato), commonly known in Brazil as pitó. This molecule has been shown to have many biological activities, however no study has been carried out to investigate the toxicity of this substance. The present work aimed to evaluate the possible cellular toxicity in silico, in vitro and ex-vivo of the kaempferol-3-O--D-(6-E-p-coumaroyl) glucopyranoside (tiliroside), through chemical structure analysis, toxicity assessment and predictive bioactive properties, using human samples for in vitro and ex-vivo tests. The in silico analysis suggests that tiliroside exhibited great absorption index when penetrating biological membranes. In addition, it also displayed considerable potential for cellular protection against free radicals, and anticarcinogenic, antioxidant, antineoplastic, anti-inflammatory, anti-hemorrhagic and antithrombotic activities. The assessment of the hemolytic and genotoxic effects of tiliroside showed low hemolysis rates in red blood cells and absence of cellular toxicity in the oral mucosa cells. The data obtained indicate that this molecule could be a promising therapeutic approach as a possible new drug with biotechnological potential.

Resumo O tilirosídeo é um flavonóide glicosídico presente em muitas espécies de plantas, incluindo Helicteres velutina K. Schum (Malvaceae sensu lato), conhecida no Brasil como pitó. Esta molécula mostrou ter muitas atividades biológicas, porém nenhum estudo foi realizado para investigar a toxicidade dessa substância. O presente trabalho teve como objetivo avaliar a possível toxicidade celular in silico, in vitro e ex-vivo do kaempferol-3-O--D- (6 -Ep-coumaroil) glucopiranosídeo (tilirosídeo), por meio de análises de estrutura química, toxicidade avaliação e propriedades bioativas preditivas, utilizando amostras humanas para testes in vitro e ex-vivo. A análise in silico sugere que o tilirosídeo exibe bom índice de absorção para penetrar nas membranas biológicas. Além disso, apresentou considerável potencial de proteção celular contra os radicais livres e com atividades anticarcinogênica, antioxidante, antineoplásica, antiinflamatória, anti-hemorrágica e antitrombótica. A avaliação dos efeitos hemolíticos e genotóxicos do tilirosídeo mostrou baixas taxas de hemólise nas hemácias e ausência de toxicidade em células da mucosa oral. Os dados obtidos indicam que esta molécula pode possuir uma abordagem terapêutica promissora como uma possível nova droga com potencial biotecnológico.

Length-weight relationships of fish from sandy beaches

Abstract This study estimated the lengthweight relationships of 16 fish species occurring close to the shores of sandy beaches along the lower Negro River basin, Brazilian Amazon. The specimens were captured for one day each month, in October to November 2016, early in the morning and early evening, using trawl net (20 m taken for standard length (SL 0.1 cm precision) and total weight (TW 0.01 g precision). The parameters a and b of the equation WT = a.LTb were estimated. The a values ranged from 0.0018 to 0.0226 and b values ranged from 2.5271 to 3.3244. This study also provides new data on of maximum lengths for six species, Amazonsprattus scintilla, Brycon pesu, Moenkhausia megalops, Pachyurus paucirastrus, Reganella depressa and Trachydoras microstomus, and new reports of the LWRs parameters of 15 fish species.

Resumo Este estudo estimou as relações comprimento-peso de 16 espécies de peixes que ocorrem às margens de praias arenosas ao longo da bacia do baixo Rio Negro, Amazônia brasileira. As espécies foram capturadas durante um dia de cada mês, de outubro a novembro de 2016, no início da manhã e no início da noite, usando rede de cerco (20 m de comprimento e 3,5 m de altura, 5 malha mm entre nós opostos). As medidas foram feitas para comprimento padrão (SL - precisão de 0,1 cm) e peso total (TW - precisão de 0,01 g). Os parâmetros a e b da equação WT = a.LTb foram estimados. Os valores de a variaram de 0,0018 a 0,0226 e os valores de b variaram de 2,5271 a 3,3244. Este estudo também fornece novos dados sobre comprimentos máximos para seis espécies, Amazonsprattus scintilla, Brycon pesu, Moenkhausia megalops, Pachyurus paucirastrus, Reganella depressa e Trachydoras microstomus, e novos reportes dos parâmetros da LWRs de 15 espécies de peixes.

Analysis of the toxicological and pharmacokinetic profile of Kaempferol-3-O-ß-D-(6"-E-p-coumaryl) glucopyranoside - Tiliroside: in silico, in vitro and ex vivo assay / Análise do perfil toxicológico e farmacocinético de Kaempferol-3-O-ß-D- (6 "-E-p-cumaril) glucopiranosídeo - Tilirosídeo: ensaio in silico, in vitro e ex vivo

Abstract Tiliroside is a glycosidic flavonoid present in many plants species including Helicteres velutina K. Schum (Malvaceae sensu lato), commonly known in Brazil as "pitó". This molecule has been shown to have many biological activities, however no study has been carried out to investigate the toxicity of this substance. The present work aimed to evaluate the possible cellular toxicity in silico, in vitro and ex-vivo of the kaempferol-3-O-β-D-(6"-E-p-coumaroyl) glucopyranoside (tiliroside), through chemical structure analysis, toxicity assessment and predictive bioactive properties, using human samples for in vitro and ex-vivo tests. The in silico analysis suggests that tiliroside exhibited great absorption index when penetrating biological membranes. In addition, it also displayed considerable potential for cellular protection against free radicals, and anticarcinogenic, antioxidant, antineoplastic, anti-inflammatory, anti-hemorrhagic and antithrombotic activities. The assessment of the hemolytic and genotoxic effects of tiliroside showed low hemolysis rates in red blood cells and absence of cellular toxicity in the oral mucosa cells. The data obtained indicate that this molecule could be a promising therapeutic approach as a possible new drug with biotechnological potential.

Resumo O tilirosídeo é um flavonóide glicosídico presente em muitas espécies de plantas, incluindo Helicteres velutina K. Schum (Malvaceae sensu lato), conhecida no Brasil como "pitó". Esta molécula mostrou ter muitas atividades biológicas, porém nenhum estudo foi realizado para investigar a toxicidade dessa substância. O presente trabalho teve como objetivo avaliar a possível toxicidade celular in silico, in vitro e ex-vivo do kaempferol-3-O-β-D- (6 "-Ep-coumaroil) glucopiranosídeo (tilirosídeo), por meio de análises de estrutura química, toxicidade avaliação e propriedades bioativas preditivas, utilizando amostras humanas para testes in vitro e ex-vivo. A análise in silico sugere que o tilirosídeo exibe bom índice de absorção para penetrar nas membranas biológicas. Além disso, apresentou considerável potencial de proteção celular contra os radicais livres e com atividades anticarcinogênica, antioxidante, antineoplásica, antiinflamatória, anti-hemorrágica e antitrombótica. A avaliação dos efeitos hemolíticos e genotóxicos do tilirosídeo mostrou baixas taxas de hemólise nas hemácias e ausência de toxicidade em células da mucosa oral. Os dados obtidos indicam que esta molécula pode possuir uma abordagem terapêutica promissora como uma possível nova droga com potencial biotecnológico.

Length-weight relationships of fish from sandy beaches / Relação peso-comprimento de 16 espécies de peixes que ocorrem perto de praias arenosas ao longo da bacia do baixo rio Negro na Amazônia brasileira

Abstract This study estimated the length-weight relationships of 16 fish species occurring close to the shores of sandy beaches along the lower Negro River basin, Brazilian Amazon. The specimens were captured for one day each month, in October to November 2016, early in the morning and early evening, using trawl net (20 m taken for standard length (SL - 0.1 cm precision) and total weight (TW - 0.01 g precision). The parameters a and b of the equation WT = a.LTb were estimated. The a values ranged from 0.0018 to 0.0226 and b values ranged from 2.5271 to 3.3244. This study also provides new data on of maximum lengths for six species, Amazonsprattus scintilla, Brycon pesu, Moenkhausia megalops, Pachyurus paucirastrus, Reganella depressa and Trachydoras microstomus, and new reports of the LWRs parameters of 15 fish species.

Resumo Este estudo estimou as relações comprimento-peso de 16 espécies de peixes que ocorrem às margens de praias arenosas ao longo da bacia do baixo Rio Negro, Amazônia brasileira. As espécies foram capturadas durante um dia de cada mês, de outubro a novembro de 2016, no início da manhã e no início da noite, usando rede de cerco (20 m de comprimento e 3,5 m de altura, 5 malha mm entre nós opostos). As medidas foram feitas para comprimento padrão (SL - precisão de 0,1 cm) e peso total (TW - precisão de 0,01 g). Os parâmetros a e b da equação WT = a.LTb foram estimados. Os valores de a variaram de 0,0018 a 0,0226 e os valores de b variaram de 2,5271 a 3,3244. Este estudo também fornece novos dados sobre comprimentos máximos para seis espécies, Amazonsprattus scintilla, Brycon pesu, Moenkhausia megalops, Pachyurus paucirastrus, Reganella depressa e Trachydoras microstomus, e novos reportes dos parâmetros da LWRs de 15 espécies de peixes.

Exploration of esophagojejunostomy after totally laparoscopic total gastrectomy / 中华胃肠外科杂志

The advantages of lymph node dissection through total laparoscopic total gastrectomy (TLTG) seem to be more and more accepted by the academic community. However, reconstruction of digestive tract is challenging and remains a focus of debate and research. Which way is better for esophagojejunostomy, circular stapler or linear stapler,remains to be answered. The authors believe that, under the conditions of existing anastomosis instruments, using of linear stapler for esophagojejunal side-to-side anastomosis may be the most common choice, but it must be used with strict indications, because there are still many problems to be solved. It is believed that with the breakthrough in the development of the circular stapler suitable for esophagojejunostomy in TLTG, the application of circular stapler for digestive tract reconstruction will become the mainstream again in future. Thus, the current routine clinical practice of TLTG should be cautious and the surgical indications should be strictly evaluated.

Philippine guidelines on periodic health examination: Pediatric immunization

Executive Summary@#This Clinical Practice Guideline for the Periodic Health Examination (Pediatric Immunization) is an output from the joint undertaking of the Department of Health and National Institutes of Health-Institute of Clinical Epidemiology. This clinical practice guideline is a systematic synthesis of scientific evidence on immunization for the prevention of human papilloma virus (HPV) infection, influenza, typhoid fever, Japanese encephalitis, poliomyelitis, meningococcal infection, and Hepatitis A in the pediatric population. The CPG provides nine (9) recommendations on prioritized questions regarding the relevant vaccines for preventing these seven (7) diseases. Recommendations are based on the appraisal of the best available evidence on each of the eight identified clinical questions. The CPG is intended to be used by general practitioners and specialists in the primary care setting, policy makers, employers and administrators, allied health practitioners and even patients. The guideline development process followed the widely accepted Grading of Recommendations, Assessment, Development, and Evaluation or the GRADE approach including GRADE Adolopment, a systematic process of adapting evidence summaries and the GRADE Evidence to Decision (EtD) framework. 1,2 It includes 1) identification of critical questions and critical outcomes, 2) retrieval of current evidence, 3) assessment and synthesis of the evidence base for these critical questions, 4) formulation of draft recommendations, 5) convening of a multi-sectoral stakeholder panel to discuss values and preferences and assess the strength of the recommendations, and 6) planning for dissemination, implementation, impact evaluation and updating. The recommendations in this CPG shall hold and will be updated after 3 years or when new evidence arise.

2021 clinical practice guidelines in the evaluation and management of pediatric community-acquired pneumonia

Preface@#The Clinical Practice Guidelines (CPG) for the Diagnosis and Management of Pediatric Community-Acquired Pneumonia (PCAP) was initiated by the Philippine Academy of Pediatric Pulmonologists, Inc. (PAPP) and the Pediatric Infectious Disease Society of the Philippines (PIDSP), in cooperation with Philippine Pediatric Society, Inc. (PPS) way back in 2004. Several CPG updates were then undertaken by the PAPP PCAP CPG Task Force from 2008 to 2016. Clinically-relevant research questions were answered with recent and current recommendations based on evidence from local and international data. The 2021 PCAP CPG initiative was envisioned in March 2018 upon the recommendations of the 2018 PAPP Board for the purpose of updating the evidence in the PCAP CPG 2016 clinical questions. This led to the collaboration of PAPP and PIDSP to develop this CPG. Individual members were identified from each society as content experts to form the Steering Committee along with a clinical epidemiologist and technical writer as review experts. The committee identified the scope and target end user of the CPG as well as additional clinical questions to be included in the 2021 update aside from the questions on the previous CPGs. Selected members from the two societies formed the Technical Working Group (TWG) who did the literature search, appraisal of evidences, and formulation of recommendations. These recommendations were then presented to the stakeholders who became part of the consensus panel. There was no identified conflict of interest among the CPG developers, TWG members and stakeholders. A survey to determine potential competing interests were conducted during the development of this CPG. This initiative was fully funded by the PAPP and PIDSP societies. The 2021 PCAP CPG significantly differs from the previous CPGs in several aspects. First, the current guideline is a consensus between two pediatric societies. Second, much of the literature review has been centered on meta-analyses or systematic reviews instead of individual studies. Finally, appraisal of published literature was based on Grading of Recommendations, Assessment, Development and Evaluation (GRADE) criteria. Such methodological differences may provide difficulties in defining evolution of care through the years. As identified in the previous CPG updates, there is lack of local data hence most of the evidences gathered came from international studies. The applicability of such data to the local setting needs to be critically assessed for its value and relevance. Corollary to this, several gaps in knowledge are identified and these may serve as a guide for future research.

Philippine pediatric COVID-19 living clinical practice guidelines as of March 2022

Executive Summary@#The Coronavirus disease 2019 (COVID-19) pandemic has triggered a global crisis and has affected millions of people worldwide. With the evolution of the different variants of concern, the incidence of COVID- 19 in the pediatric population has risen. The Surveillance and Analysis of COVID-19 in Children Nationwide (SALVACION) Registry, developed by the Pediatric Infectious Disease Society of the Philippines (PIDSP) and the Philippine Pediatric Society (PPS), has reported 3,221 cases as of March 31, 2022, with 90.4% requiring hospitalization and 36.2% with moderate to critical disease severity. Given the magnitude of the impact of COVID-19, with most of the clinical recommendations available designed towards adult patients, there was an urgent need for clinicians, public health officials and the government to also prioritize evidence-based clinical practice guidelines for the pediatric population. Hence, the development of the Philippine Pediatric COVID-19 Living Clinical Practice Guidelines was conceptualized. This independent project, funded and supported by the PPS and PIDSP, aimed to formulate up-to-date, evidence-based recommendations on the treatment, diagnosis, infection prevention and control of COVID-19 in children. Following the standard CPG development process outlined in the DOH Manual for CPG Development and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology, 15 evidence summaries and 24 recommendations were generated by 12 consensus panelists representing their specific health organizations and institutions.

Clinical practice guidelines on leptospirosis in children 2019

Executive Summary@#Leptospirosis is a disease prevalent mostly in tropical and subtropical countries. Its potential to be a concerning problem emerges with the onset of the rainy season, as flooding and heavy rainfall facilitate disease epidemics. Among those at risk of contracting the disease are field workers, veterinarians, sewer workers, military personnel and those who swim or wade in contaminated waters. In the absence of an existing evidence-based guideline for the pediatric age group, this first edition hopes to standardize approach to diagnosis, antibiotic management, and prevention of leptospirosis. The intended users are primary care physicians, family medicine physicians, pediatricians, and other healthcare workers involved in the management of leptospirosis in children. Ten priority questions were identified by a group of experts composed of an oversight committee, a guideline writing panel, and a technical review committee. The GRADE methodology was used to determine the quality of evidence of each recommendation. The draft recommendations (summarized below) were finalized after these were presented to and voted on by a panel of stakeholders.

Use of contraceptive methods in rural areas in Cote d'Ivoire: a cross-sectional study

Patients and methods: This cross-sectional survey took place in May, 2018 in Kodjokro, a village in the south-east of Côte d'Ivoire. The study population consisted of women of reproductive age, from 15 to 49 years old. A questionnaire was used to collect data on socio-demographic, gyneco-obstetrical characteristics, knowledge and attitudes and he use of contraceptive methods. The chi-square test was used to measure the associations between the use of contraceptive methods and each of the characteristics studied

Paraplejia funcional que imita una mielopatía aguda durante el embarazo: reporte de un caso

Introducción: Los trastornos funcionales son un reto clínico en la atención de pacientes con déficits neurológicos. Pueden generar manifestaciones clínicas típicas y gran discapacidad. Para su diagnóstico se requiere de una alta sospecha inicial asociado a una batería de examen físico completa. Hallazgos clínicos: Presentamos el caso de una paciente indígena embarazada de 19 años, con pérdida de la fuerza en sus extremidades inferiores, un nivel sensitivo y pérdida del control de los esfínteres. Luego de una evolución estacionaria con estudios imagenológicos e infectocontagiosos dentro de la normalidad. Se sospechó el diagnóstico de un trastorno neurológico funcional por lo que se realizó la prueba del Spinal Injuries Center (SIC) el cual fue positivo. Tratamiento y evolución: Realizamos una intervención multidisciplinar, incluyendo el servicio de rehabilitación, neurología, psiquiatría y psicología. Se utilizaron intervenciones con movimientos articulares, fortalecimiento muscular, estimulación eléctrica y psicoterapia. Posteriormente se obtuvo la recuperación completa de la paciente antes del alta hospitalaria, con la exigencia de seguimiento ambulatorio, además de una inserción satisfactoria en las actividades sociales y familiares. Conclusiones: Este caso refleja la importancia de un análisis neurológico detallado, el conocimiento de diferentes herramientas de semiología y el reto diagnóstico de los trastornos funcionales en neurológicos. La intervención de un equipo multidisciplinar favorece abordajes multidimensionales y resultados clínicos favorables.

Introduction: Functional disorders pose a clinical challenge in the care of patients with neurological deficits. They can generate typical clinical manifestations and great disability. Diagnosis requires a high initial suspicion together with comprehensive physical examination. Clinical Findings: We present the case of a 19-year-old pregnant indigenous patient, with loss of strength in her lower extremities, with a sensitive level and loss of sphincter control. After a stationary evolution with imaging and infectious studies within normal limits, a diagnosis of a functional neurological disorder was suspected; thus, the Spinal Injuries Center (SIC) test was performed, showing positive results. Treatment and evolution: A multidisciplinary intervention was carried out, including the neurology, psychiatry and psychology rehabilitation. Interventions amied towards joint movements, muscle strengthening, electrical stimulation and psychotherapy were used. Eventually, the patient's complete recovery was achieved before hospital discharge, in addition to a satisfactory integration into social and family activities, with a outpatient follow-up requirement. Conclusions: This case reflects the importance of a detailed neurological analysis, knowledge of different semiology tools and the diagnostic challenge of functional neurological disorders. The intervention of a multidisciplinary team favors multidimensional approaches and favorable clinical results.

Comparison of the timed inspiratory effort index with the T-piece trial as a decision-making tool for extubation: a randomized controlled non-inferiority trial

The "timed inspiratory effort" (TIE) index, a new predictor of weaning outcome, normalizes the maximal inspiratory pressure with the time required to reach this value up to 60 s, incorporating the time domain into the assessment of inspiratory muscle function. The objective of this study was to determine whether the TIE predicts successful extubation at a similar rate as the T-piece trial with less time required. A non-inferiority randomized controlled trial was performed with ICU subjects eligible for weaning. The participants were allocated to the TIE or the T-piece groups. The primary outcome was successful weaning, and the main secondary outcome was ICU mortality. Eighty participants of each group were included in the final analysis. Time from the start of a successful test to effective extubation was significantly lower in the TIE group than in the T-piece group, 15 (10 to 24) vs 55 (40 to 75) min, P<0.001. In the Kaplan-Meier analysis, no significant differences were found in successful weaning (79.5 vs 82.5%, P=0.268) or survival rate (62.9 vs 53.8%, P=0.210) between the TIE and T-piece groups at the 30th day. In this preliminary study, the TIE index was not inferior to the T-piece trial as a decision-making tool for extubation and allowed a reduction in the decision time.

Antidiabetic and Toxicity Studies of the Extract of Four Nigerian Medicinal Plants

Aims: To evaluate the anti-hyperglycaemic efficacy and safety of the methanol extract of the combination of Senecio biafrae leaf, Xylopia aethiopica fruit, Carica papaya seed and Spondias mombin stem bark mixed together in ratio 1:1:1:1 Study Design: Extract of medicinal plants was assayed using glucose and streptozotocin-induced herperglycaemic rats model. Place and Duration of Study: Department of Pharmacognosy, Obafemi Awolowo University, IleIfe, Nigeria, between May, 2019 and January, 2022. Methodology: The extract of the combined plant parts was tested for toxicity in rats while its effects on glucose level, blood and biochemical components were also assessed. Its in-vitro anti-hyperglycaemic activity was assayed in ?-amylase and ?-glucosidase inhibitory models while its in-vivo effects were tested in glucose and streptozotocin-induced hyperglycaemic rats. The antioxidant activity of the extract was also carried out. Results: The extract did not show any adverse effects on blood sugar levels, haematological and biochemical parameters in normal rats in sub acute toxicity tests. The extract gave comparable (p > 0.05) ?-amylase and ?-glucosidase inhibitory effects to acarbose. In glucose-induced hyperglycaemic rats, its 100 mg/kg was the most effective dose with 19, 40, 43, and 57% activity that was significantly higher (p < 0.05) than the 10, 18, 24, and 40% activity given by glibenclamide (5 mg/kg) at the same time points. In streptozotocin-induced diabetic assay, its 50 mg/kg showed 31, 85, 85 and 82 % effects on days 4, 7, 10 and 14, respectively that was significantly higher than its 100 mg/kg and glibenclamide on days 7 and 10. The extract also elicited high free radical scavenging effects in all the antioxidant assays. Conclusion: The extract of the combination of four Nigerian antidiabetic plants mixed together in equal ratio gave significantly better antidiabetic activity at low doses than the individual plants without toxic effects.

Analysis of the Hive Yield of Three Species of Bees for Honey Production in Eastern Honduras

Objectives: The analysis of the performance of honey production hives of three species of honeybees was carried out. Study Design: Three harvests per year of honey per hive of each species the first was on March-April, the second was on June-July, and the third was on November -December, with a sampling of ten hives per species, data were evaluated by ANOVA analysis, and Duncan mean separation test developed by SAS/STAT program. Place and Duration of the Study: This research was developed in the department of Para韘o, municipality of Danl�, Honduras, Central America, in Cerro El 羐uila, latitude 13�'59" N, and longitude 86�'59" W, the sampling was carried out in 2020. Methodology: The qualitative variables were evaluated for each species by In Situ observation that characterized the honeycombs of the three species, and the data were subjected to an analysis of variance and Duncan's mean separation, where the dependent variable is the average yield of Kg of honey/hive. Results: According to the ANOVA, there are significant differences in: the harvest of the three species of bees (p<0.0001), for the three annual harvests (p=0.0024), and by hives (p<0.0001) and in the analysis of separation of means the three averages of honey yield observed are not homogeneous (P>0.05), the Apis mellifera produces 63.1 kg/hive-year, the Tetragonisca angustula obtained an average of 0.679 kg / hive-year, and Melipona beecheii obtained 13.19 kg/hive-year. Conclusion: In the three species is observed that they have differences in the structures of the construction of their hives, their entrance, the construction of their cells, production and storage of honey and pollen, birth of queens, and method of defense; and when evaluating the average annual yield by species, by harvest, and by hives, is found that the three variables evaluated of bees are different averages of honey production.