ABSTRACT
Background: Rabies which is 100 fetal but preventable is caused by bite of rabid animals particularly dogs. Animal bites cases are major public health problem in India and also in the UT of Jammu & Kashmir. Objective(s): To study the trend and seasonal Variation of animal bite cases attending the Anti Rabies clinic (from 2009 to 2022), run by Department of Community Medicine, Government Medical College Srinagar at SMHS Hospital. Material(s) and Method(s): The retrospective Cross sectional study conducted at Anti-Rabies Clinic of SMHS Hospital, a tertiary care associated Hospital of Government Medical College Srinagar. Data was collected from the record of Animal bite register at Anti rabies clinic after proper permission from the incharge of the clinic. Data was entered and analyzed on Excel soft ware. Result(s): More than 70,000 number of animal bites cases were reported at the Anti-Rabies clinic from the year 2009 to 2022. there has been a rise of cases from the year 2009 to 2018 with a slight decrease in the year 2019-20. About 97% of all animal bites were dog bites. Majority of the cases (>60%) were category of three (3) exposure. One year analysis for seasonal variation shows that incidence was more in March and May-June. Conclusion(s): the present study showed that animal bites cases were rising with little decrease in the year 2019-20 as may be due to lesser animal human interaction due to Covid-19 restrictions. Keeping in view the present trend it is expected that the Animal bite cases will show rising trend in coming years. Multidisciplinary approach is advocated to control the increasing trend.
ABSTRACT
Immunity plays a fundamental role in the maintenance and protection of the human body from infectious and pathogenic microorganisms. It requires regular intake of nutrients for proper functioning of the immune system. Due to an unbalanced lifestyle and consumption of ready-to-eat foods, immunity is being affected negatively. Inflammation and immunity are influenced by diet and nutrition. Simple sugars, trans fats, refined carbs, and processed meat, among other meals, may induce inflammation while simultaneously counteracting the anti-inflammatory benefits of omega-3 fatty acids. As a result, unhealthy food intake may enhance systemic inflammation in individuals, boosting the generation of IL-6. Dietary nutrition is a well-known aspect of immune system maintenance, with the significance of micronutrients prominently featured in a variety of scientific literary works. Currently, global population is susceptible viral infection such as COVID-19. This viral strain is directly attacking the immunity of the individual and bringing it at risk. When a patient's immune system isn't operating correctly, COVID-19 is thought to raise the harshness of the infection or make it more vulnerable to contagious diseases. This review paper will help in understanding the immune responses mechanism along with diet balance and maintaining the sufficiency of vitamins and minerals to fight against COVID-19 infection.Copyright © 2023 The Author(s)
ABSTRACT
This study evaluates the portfolio diversification potential of different classes of assets-equity, cryptocurrency and precious metals-using total, asymmetric and frequency-based spillover transmission framework. The VARbased generalized variance decomposition method is used to analyse the daily prices of S&P 500, bitcoin, gold, silver and platinum between April 2011 through January 2021. The results of aggregate spillover support bitcoin as a potential diversifier due to its isolation from other sets of assets. The decomposition of overall spillover into downside and upside spillover reveals a higher downside connectedness than the upside, suggesting an asymmetric interdependence amongst these markets. Moreover, the frequency based aggregate spillovers suggest the connectedness is driven mostly by the shorter time-horizons. The study provides important policy implications for market participants with distinct investment objectives.
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Introduction: Globally, disparities exist in healthcare quality, accessibility and regulation (Das, & Gertler, 2007). Consequently, few countries have governing bodies overlooking healthcare-professional (HCP) practice (Epstein, & Bing, 2011). Research has suggested that HCP regulation depended on nations' human development index (HDI), gross domestic product (GDP), and safety (Ozturk, & Topcu, 2014). IPC enables partnership working between HCPs to ensure patient-centred care (Gregory, & Austin, 2016). This study thematically analysed pharmacy professional standards' documents of various countries and investigated whether nations' developmental parameters influenced pharmacy regulation. Objectives * To compare global pharmacy professional standards on IPC. * To synthesise a thematic framework to evaluate literature on IPC. * To iInvestigate the relationship between HDI, GDP, global peace index (GPI), and pharmacy regulation. Method(s): A group (N = 8) of countries were studied based on 2018 HDI classification;(N = 4) 'very high' (Australia, Hong Kong, Canada, United Kingdom) and (N = 4) 'low' (Solomon Islands, Haiti, Yemen, South Sudan). Pharmacy professional standards' documents were screened to extract IPC-related themes via a constant comparative method. This facilitated thematic framework synthesis;'pharmacists' attitudes' and 'patient outcomes' were measures of IPC. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), (N = 17) peer-reviewed journal articles from 2010-2019 studying pharmacists in sample countries were selected. Key terms searched on Medline/PubMed databases were: 'IPC', 'pharmacist' and 'professional standards'. Literature was then reviewed with reference to the thematic framework and development metrics (HDI/GDP/GPI). This study did not require ethics approval. Result(s): Of the countries (N = 8) studied, only HDI-classified 'very high' had professional standards' documents, frequently incorporating IPC. Key themes were: 'shared decision-making', 'continuity-of-care', and 'effective communication'. Seven studies referred to these themes and confirmed IPC benefits: fewer medication-related errors4. The number of IPC standards and HDI-rank for 'very high' countries, except Hong Kong, were positively correlated, suggesting possible economic impact on pharmacy sector progress. Two studies found cultural influences on Hong Kong pharmacists' attitudes as contributory to a hierarchical than IPC-approach to healthcare provision5. HDI and GPI had a strong negative correlation (r = -0.83), potentially explaining low pharmacist density and GDP healthcare expenditure in HDI-classified low. Conclusion(s): Results denote that IPC improved patient safety (Gregory, & Austin, 2016). Global differences existed in pharmacists' attitudes and IPC training. These correlated with growing gaps in HDI and GPI between HDI-classified 'very high' and 'low' countries. Qualitative analysis highlighted the need for elaboration of 'continuity-of-care' and inclusion of 'understanding roles/responsibilities of team members' in the United Kingdom's professional standards set by the General Pharmaceutical Council. Future work could study 2021/inequality-adjusted HDI data, 'high'/'medium' HDI countries to improve validity alongside COVID19 impact on GDP and pharmacy practice.
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Background: Genetic testing allows for enhanced prognostication and early intervention in patients with high risk of developing cancer. Genetic testing often reveals variants of uncertain significance (VUS), for which association with disease risk is unclear. The ambiguity of this finding creates a dilemma for patients and providers and has been associated with significant communication error and distress. In this retrospective observational study, we seek to characterize the indications, outcomes, and trends in patients undergoing genetic testing in a community hospital in Cambridge, MA. As our study spanned the beginning of the COVID-19 pandemic, we also assessed its impact on care accessibility. Methods: We included patients undergoing genetic testing at our hospital between December 2019 and October 2020 (n=371). Medical charts were abstracted to identify patient characteristics, family history, indication for genetic testing, genetic findings, and subsequent management. Results: Our population had a mean age of 48 years (SD=15), was predominantly female (88.1%), and had a high proportion of Ashkenazi Jewish descent (15.3%). The vast majority (351, 94.6%) had a family history of cancer, while 123 (33.2%) had a personal history of cancer, most commonly breast (n=89). The most common indications for genetic testing were Hereditary Breast and Ovarian Cancer (HBOC in 280, 75%), Lynch Syndrome (LS in 22, 5.9%), and Familial Adenomatous Polyposis (FAP in 7, 2%). Of patients who met HBOC, LS, or FAP criteria for genetic testing, pathogenic mutations were identified in 9.5% and VUS in 28.6%. Out of total 35 (9.4%) pathogenic mutations found in our entire study population, the most common were in BRCA (9, 25.7%), MUTYH (5, 14.2%), and Lynch genes (3, 8.6%). Out of 103 patients with VUS (27.8%), the most common sites were APC (14) and MSH3 (9). We found no significant trend in genetic counseling consultations over our 11 months study period despite the COVID-19 pandemic (R = 0.006). Conclusions: Among patients who met criteria for genetic cancer screening at a community hospital, 9.5% were found to have a pathogenic mutation while 28.6% were found to have VUS. These numbers are comparable to previously published estimates. Despite advances in our understanding of genetic colon and gynecological cancers, the majority of patients presenting for genetic cancer counseling continue to do so due to breast cancer concerns. Lastly, we noted high efficacy in our conversion of in-person genetics consultations to telemedicine during the COVID-19 pandemic, suggesting telemedicine is a robust format for genetic counselling. Mutations (N): BRCA1 (3), BRCA2 (6);MUTHY (5);MSH2 (2), MSH6 (1);ATM (2), and one each in PALB2, RAD50, RAD51C, RAD51D, Tp53, CDKN2A, APC, F2, SDHA, SDHB, VHL. FANCL, NTHL1.