Difficulty In Breathing Research Articles

Prevalence, duration, and factors influencing post-COVID conditions among patients at several public hospitals, Alexandria governorate, Egypt 2022–2023

BackgroundPost-COVID conditions (PCC), characterized by persistent symptoms following acute infection, represent an emerging chronic illness that potentially affects millions of people worldwide. SARS-CoV-2 infection has resulted in a PCC incidence ranging from 10 to 30 % in non-hospitalized individuals to 50–70 % in hospitalized patients. Most PCC patients experience mild symptoms, while a minority report severe manifestations. We aimed to estimate the prevalence of PCC among COVID-19 patients who attended three public hospitals in Alexandria, Egypt between June 2022 and February 2023, and to investigate its risk factors. MethodsAll COVID-19-confirmed patients aged >18 years attended the selected hospitals, and their household contacts were contacted. Data were collected through telephone interviews using a questionnaire adapted from World Health Organization (WHO) and Penn Medicine tools, covering demographics, COVID-19 history, and PCC symptoms. PCC was defined as symptoms starting three months after the post-acute infection and lasting for at least two months beyond. Statistical analyses employed descriptive statistics, chi-square tests, and a logistic regression model, with a significance level of p < 0.05. ResultsA total of 1546 patients were enrolled. Their mean age was 39.7 ± 15.9 years, 46.0 % were males, and 13.9 % had comorbidities. Of them, 760 patients (49.2 %) reported PCC symptoms including, 52.6 % seen at outpatients, 26.7 % were admitted, and 0.5 % required admission to ICU. PCC symptoms included shortness of breath (94.2 %), mood changes (13.9 %), cough (13.0 %), and fatigue (8.8 %). PCC was associated with older age, hospitalization during acute COVID-19, comorbidities including asthma, hypertension, and diabetes, as well as treatment with different COVID-19 medications. Logistic regression shows that asthma, male gender, and treatment with medicines at the hospital remained significant in the model (ORs: 6.85, 0.36, and 0.88, p < 0.001). ConclusionThis study sheds light on PCC's prevalence and influencing factors following infection in Alexandria, Egypt. Common PCC symptoms included difficulty in breathing, fatigue, and psychological manifestations. The findings emphasize the critical need for early intervention and targeted management strategies, especially for high-risk groups such as asthma patients, to alleviate the long-term health consequences of COVID-19. Study results could guide the prevention of PCC e.g., through vaccination, management of long-term sequelae of PCC e.g., rehabilitation, and psychological support initiatives.

Real-time Monitoring of Carbon Dioxide with IoT ThingSpeak using TiO2 Thick Film Gas Sensor

Carbon dioxide is a colorless, odorless, and non-flammable gas and is claimed to be the fourth most abundant in the earth's atmosphere. Carbon dioxide emission is mainly generated by human and animal exhalation, decomposition of organic matter, and forest fires. Moreover, human activities in the industrial sector emit high levels of carbon dioxide gas, such as through fossil fuel burning, transportation, and deforestation. It is also an asphyxiant and high exposure to it may lead to health effects in humans such as headaches, breathing difficulty, tiredness, coma, and elevated blood pressure. Therefore, in this paper, a carbon dioxide gas sensor with IoT using TiO2 is proposed to observe varying concentrations of carbon dioxide gas at room temperature. Three similar gas sensors were fabricated via screen-printing technology to compare their performance towards carbon dioxide. The hardware development consisted of an Arduino Uno R3 with ESP 8266 Wi-Fi module, wires, LCD display, red and green LEDs, and a 5V power supply. The ThingSpeak application was integrated with the gas sensor and hardware parts to monitor the carbon dioxide concentration in a real-time system. Gas sensor G1 produced the highest response and highest sensitivity with values of 2.120 and 0.245, respectively.

Identifying the predictive value of fractional exhaled nitric oxide (FeNO) for uncontrolled asthma in 3-7-year-old Thai children.

Fractional exhaled nitric oxide (FeNO) is the method for monitoring airway inflammation. However, a singular FeNO value cutoff may not adequately represent the control status across different ages and demographics. This study aimed to evaluate the correlation between FeNO values and asthma control levels, identifying an optimal cutoff point for children aged 3 to 7 years. This cross-sectional study was conducted at Naresuan University Hospital from April 1, 2023 to July 31, 2023. Inclusion criteria were asthmatic patients aged 3 to 7 years who were capable of following commands. Exclusion criteria included children who had a coronavirus disease 2019 (COVID-19) infection, those experiencing difficulty breathing, or unable to perform the FeNO measurement. Eligible patients were classified according to their level of asthma control and underwent FeNO testing. Out of 108 participants who successfully completed FeNO measurements, a significant difference in FeNO values was observed across controlled, partially controlled, and uncontrolled asthma groups, with uncontrolled asthma presenting significantly higher values. The optimal FeNO cutoff point for predicting uncontrolled asthma was identified as ≥15 ppb with a sensitivity 46.7%, specificity 86.0%, positive predictive value (PPV) 35.0%, negative predictive value (NPV) 90.9%. This study established a significant correlation between FeNO levels and uncontrolled asthma, FeNO cutoff point ≥15 ppb as the optimal value in predicting uncontrolled asthma in Thai children aged 3-7 years. Factors such as uncontrolled allergic rhinitis, symptoms at onset, smoking exposure, treatment compliance, and inhaled corticosteroid (ICS) usage were associated with FeNO values. The application of FeNO measurement should be integrated with clinical assessments and consideration of these associated factors.

Living with Pompe disease: results from a qualitative interview study with children and adolescents and their caregivers

BackgroundChildren and adolescents with Pompe disease (PD) face chronic and progressive myopathy requiring time-intensive enzyme replacement therapy (ERT). Little is known about their perspectives on the disease and its treatment. This study explored their perceptions of disease symptoms and functioning status, and more subjective feelings about the impacts on their lives as part of developing a disease-specific questionnaire.MethodsEleven pediatric patients aged 8–18 years and 26 caregivers from six children’s hospitals in Germany, Austria, and Switzerland underwent semi-structured interviews. Data were recorded, transcribed using MAXQDA software, and analyzed using qualitative content analysis. A system of meaningful categories was developed.ResultsSixteen main categories were derived across four major thematic areas: perceptions of symptoms and limitations, experiences to do with the biopsychosocial impact of PD, treatment experiences, and general emotional well-being/burden. Participants demonstrated broad heterogeneity in symptom perceptions such as muscle weakness, breathing difficulties, pain, and fatigue. Emotional appraisals of limitations were not directly proportional to their severity, and even comparatively minor impairments were often experienced as highly frustrating, particularly for social reasons. The main psychosocial topics were social exclusion vs. inclusion and experiences to do with having a disease. The main finding regarding treatment was that switching ERT from hospital to home was widely viewed as a huge relief, reducing the impact on daily life and the burden of infusions. Emotional well-being ranged from not burdened to very happy in most children and adolescents, including the most severely affected.ConclusionThis study provided qualitative insights into the perceptions and experiences of pediatric PD patients. Interestingly, biopsychosocial burden was not directly related to disease severity, and tailored psychosocial support could improve health-related quality of life. The present findings ensure the content validity of a novel questionnaire to be tested as a screening tool to identify patients in need of such support.

Machine Learning-based Prediction of African Swine Fever (ASF) in Pigs

African Swine Fever (ASF) is a contiguous viral disease of the pig with serious economic threats to the pork industry. Early identification of ASF infection is important to support sustainable developments in the ASF industry. There is also a need for a solution to identify the ASF infection as early as possible based on apparent symptoms of ASF to screen the infected animals, that are not targeted in the existing literature. Many machine learning (ML) solutions have been proposed in recent years for the prediction and identification of human, animal, and plant diseases. To deal with ASF in pigs ML-assisted model is proposed for the early identification of ASF infection without medical diagnosis and expert opinion. The data regarding apparent symptoms are collected from Chinese small pig farms. The loss of appetite, weakness, diarrhea, vomiting, coughing, skin redness, and breathing difficulty levels are taken as major apparent symptoms of ASF infection. Moreover, different ML models are also evaluated for their performance in the prediction of ASF infection based on selected apparent symptoms of ASF infection. In this regard, Support Vector Machine (SVM), K-Nearest Neighbor (k-NN), Decision Tree (DT), Random Forests (RF), and Gaussian Naïve Bayes ML models are evaluated for ASF infection prediction. The implementation of the proposed solution reveals that the GNB model is more accurate as compared to the other evaluated models for the identification of ASF infection from the apparent ASF symptoms in infected pig animals, with 94.31\% accuracy. The proposed solution would be very effective in the early screening of ASF-infected pig animals without medical diagnosis and expert judgment.

Risk factors for death among children with severe malaria, Ivukula sub-county, Namutumba district, Eastern Uganda, september 2021–february 2022

BackgroundIn February 2022, the Ministry of Health received reports of more than 100 child deaths from a ‘strange disease’ in Namutumba District over a period of 6 months from politicians through the media. Preliminary investigations by the district rapid response team confirmed the strange disease to be severe malaria. The scope of severe malaria deaths was investigated, associated factors identified, and recommendations made for control measures to inform early malaria treatment strategies in Namutumba District.MethodsA retrospective study was conducted in March 2022 in the most affected subcounty (Ivukula Subcounty) involving cases and controls. A case was defined as a death with a positive malaria test, fever and any of the following: convulsions, difficulty breathing, yellowing of eyes or palms, tea-coloured urine, anaemia (evidenced by pale eyes or palms, or clinically-identified in medical records), loss of consciousness, or reduced urine output (very little or no urine in a day) in a child ≤ 12 years from September 2021 to February 2022 in Ivukula Subcounty, Namutumba District. Controls were survivors with the same signs and symptoms, recruited in a 2:1 ratio with cases. Cases and controls were actively searched using a door-to-door approach with the help of community health workers. Caretakers were interviewed to obtain data on signs and symptoms, socio-demographic information, health-seeking behaviours and health system risk factors. Drugs and bloodstock status information was obtained from health workers using an interview guide. Factors associated with death were identified using multivariate logistic regression and thematic analysis for qualitative data.ResultsAmong 46 cases, 29 (63%) were < 5 years, and 23 (50%) were female. Death among children with severe malaria was significantly associated with treatment non-completion (aOR = 9.7, 95%CI 1.8–53) and inability to receive blood transfusion for anaemic patients (aOR = 7.1, (95%CI 1.4–36). Healthcare workers reported that inability to reach referral sites due to transport costs, stockouts of anti-malarials and blood products at health facilities, and absence of integrated community case management of childhood illnesses (iCCM) contributed to deaths among children with severe malaria.ConclusionLack of access to anti-malarial treatment and to blood transfusions among anaemic patients due to stockouts were associated with severe malaria deaths among children ≤ 12 years in Ivukula Subcounty. Recommendations made were: accurate quantification of anti-malarials for health facilities, offering transport support to severe patients referred to higher-level facilities, and increasing access to blood products. Activation of iCCM could facilitate public health efforts against severe malaria in the district.

Affective temperament, attachment style and life events related to abandonment in an Italian sample with somatic symptoms

ObjectiveThis study investigates the psychological factors influencing somatic symptoms following the end of a romantic relationship. We hypothesize that affective temperaments may predict attachment styles and depressive rumination components in individuals who have experienced abandonment. Furthermore, we postulate that gender differences exist in the variables under investigation. MethodsThe administered tests included: Temperament Evaluation of Memphis, Pisa, Paris and San Diego Questionnaire (TEMPS-A), Attachment Style Questionnaire (ASQ) and Ruminative Response Scale (RRS). The differences between the groups were assessed using Student's t-test for independent samples. In addition, regression analysis, in which the RRS (Brooding, Reflection and Depression) and ASQ (Confidence, Discomfort with Closeness, Need for Approval, Preoccupation with Relationships, and Relationships as Secondary) variables were considered dependent variables and all the TEMPS-A factors were included in the equation. ResultsSubjects at the end of a love affair presented the following psychosomatic symptoms: difficulty breathing, chest pain, feeling faint, sweating, dizziness, fatigue, palpitations, air hunger, difficulty sleeping, and swollen legs and ankles. The Anxious and Hyperthymic temperaments were negative predictors of the ruminative depressive dimension, and of “Confidence” and “Discomfort with Closeness” in the ASQ. The Cyclothymic and Anxious temperaments were predictors of “Discomfort with Closeness”, “Need for Approval”, “Preoccupation with Relationships”, and “Relationships as Secondary”. ConclusionAffective temperaments play a crucial role in determining how an individual deals abandonment in a romantic relationship, significantly influencing attachment styles and the tendency towards depressive rumination.

Isolated congenital cleft mitral valve: a rare cause of mitral regurgitation presented as poor weight gain in children

The anterior mitral leaflet cleft is very rare congenital lesion often encountered in association with other congenital heart defects. The isolated anterior leaflet cleft is a rare anomaly and is usually the cause of mitral valve regurgitation which is correctable. Children with poor feeding exhibit weight loss, growth retardation and sometimes heart failure. Clinically echocardiography is the first investigation of choice for evaluation of mitral valve disease providing useful information about valve anatomy and hemodynamic parameters. A case of 6-month-old male child with chief complaint of poor feeding and difficulty in breathing especially in early morning is being presented in this case report. A pan-systolic murmur of grade 4/6 heard on apex and back side of chest wall. Echocardiography revealed an isolated anterior mitral leaflet cleft producing moderate-severe mitral regurgitation. Isolated cleft of mitral valve is a very rare defect that has to be identified and diagnosed. All children presented with poor weight gain or failure to thrive should be screened with TTE to rule out congenital heart diseases.

A unique and rare presentation of Henoch-Schonlein purpura: a case report

Henoch-Schönlein purpura (HSP), or IgA vasculitis, is a common small vessel vasculitis in children, typically presenting with palpable purpura, abdominal pain, arthritis, and renal involvement. However, atypical presentations can delay diagnosis and management. A 12-year-old girl presented with multiple episodes of loose stools and abdominal pain. The initial diagnosis focused on acute gastroenteritis, and she was treated symptomatically. Subsequently, she developed urticarial rashes with breathing difficulty, complicating the diagnosis. Despite symptomatic treatment, she experienced severe abdominal pain, hematemesis and melena. Further investigations revealed antral gastritis, duodenitis, and cystitis. On the 14th day of admission, the patient developed characteristic palpable purpura on the lower limbs. Skin biopsy confirmed leukocytoclastic vasculitis with IgA deposits, consistent with HSP. The patient recovered with supportive care and remained symptom-free on follow-up. This case underscores the importance of considering HSP in pediatric patients with atypical presentations, such as gastrointestinal symptoms and urticaria without initial purpura. Early recognition and appropriate management are essential to prevent complications and ensure favourable outcomes. The variability in HSP presentations necessitates a high index of suspicion for timely diagnosis and treatment.

Trends in Injectable Biomaterials for Vocal Fold Regeneration and Long-Term Augmentation.

Human vocal folds (VF), a pair of small, soft tissues in the larynx, have a layered mucosal structure with unique mechanical strength to support high-level tissue deformation by phonation. Severe pathological changes to VF have causes including surgery, trauma, age-related atrophy, and radiation, and lead to partial or complete communication loss and difficulty in breathing and swallowing. VF glottal insufficiency requires injectable VF biomaterials such as hyaluronan, calcium hydroxyapatite, and autologous fat to augment VF functions. Although these biomaterials provide an effective short-term solution, significant variations in patient response and requirements of repeat reinjection remain notable challenges in clinical practice. Tissue engineering strategies have been actively explored in the search of an injectable biomaterial that possesses the capacity to match native tissue's material properties while promoting permanent tissue regeneration. This review aims to assess the current status of biomaterial development in VF tissue engineering. The focus will be on examining state-of-the-art techniques including modification with bioactive molecules, cell encapsulation, composite materials, as well as, in situ crosslinking with click chemistry. We will discuss potential opportunities that can further leverage these engineering techniques in the advancement of VF injectable biomaterials.

Are There Benefits to Breastfeeding for Long Durations That Continue after Breastfeeding Has Stopped? An Analysis of Acute Respiratory Illness in Nigerian Children.

Background: While an abundance of evidence exists regarding infectious outcomes in children as they relate to the short-term benefits of breastfeeding, there is limited evidence related to similar impacts beyond one year and after breastfeeding has stopped. Specifically, little is known about the long-term benefits of breastfeeding for acute health outcomes after infancy, particularly in Nigeria. Methods: The Nigeria Demographic and Health Survey data was used in this study. We utilized data (n = 5391) on children who had stopped breastfeeding for at least 12 months before the survey. Breastfeeding duration was categorized into 1-6 months, 7-12 months, 13-18 months, 18-24 months, and > 24 months. Any recent incident of acute respiratory illness in children was operationalized using the responses to related questions (recent incidents of fever, cough, running nose, and short, rapid, or difficulty breathing in children). Adjusted logistic regression was used to estimate odds ratios, and statistical significance was determined at p ≤ 0.05. Results: Post-infancy and after breastfeeding had stopped, the odds of recent acute respiratory illness were significantly less (AOR = 0.37, 95% CI [0.15-0.79], p = 0.04) in children breastfed for 19-24 months compared to those breastfed for 1-6 months. No significant association was found between the other durations and ARI post-infancy (p > 0.05). Conclusions: These findings indicate that breastfeeding for up to 24 months has a long-term protective effect from an acute health condition that contributes to the high under-five mortality rates recorded for decades in Nigeria specifically, and more broadly, in sub-Saharan Africa.

Retrospective analysis of the upper airway anatomy and Sella turcica morphology across different skeletal malocclusions: a computerized technique

ObjectiveThis study aimed to investigate the normal volumetric space and variations in the measurements of different landmarks in adults with different skeletal relations of the maxilla and the mandible based on CBCT data. The study also analyses these landmarks to locate any correlations.BackgroundNumerous studies in orthodontics have found a relationship between orthodontic treatment and changes in the anatomy and function of the airway. Severe changes in airway morphology can cause breathing difficulties, lower quality of life, and even result in life-threatening conditions such as obstructive sleep apnoea. Consequently, orthodontic diagnosis and treatment planning require a thorough understanding of the airway space and its function.MethodsThe present retrospective study was conducted using CBCT records of 120 adult patients, containing 40 samples of each skeletal class (20 males and 20 females). The boundaries were defined for the 3 major regions: the nasopharynx, the oropharynx, and the hypopharynx. Various measurements were recorded across these regions, as well as selective cephalometric landmarks. The obtained data was used to calculate average and standard deviation, while regression analysis was used to evaluate correlations and t-test was used to test statistical significance of gender differences.ResultsThe results demonstrate that skeletal Class III individuals exhibit a reduced airway volume in the nasopharynx compared to other groups, whereas skeletal Class II individuals displayed a diminished airway volume in the hypopharynx. A strong correlation was observed for Sella turcica parameters. There were no significant differences in skeletal parameters across genders. Nasopharynx cavity volume demonstrated significant differences between skeletal Class I–Class III as well as between skeletal Class II–Class III. Hypopharynx cavity volume also demonstrated significant differences between skeletal Class I–Class II and between skeletal Class II–Class III.ConclusionThe major findings are the presence of a reduced nasopharyngeal volume in skeletal Class III malocclusions while skeletal Class II individuals displayed a diminished hypopharyngeal volume, making these critical areas to consider during the diagnostic and orthodontic treatment planning stages. This study also revealed a consistent correlation between Sella turcica parameters across various facial skeletal profiles, with skeletal Class II patients exhibiting a distinct pattern and skeletal Class I and Class III demonstrating an average relationship.

Rabbitry and Emerging Rabbit Haemorrhagic Disease Virus in Nigeria: A Concern for Food Safety and Security

For many decades, small-scale livestock, including rabbit production, has been a veritable pro-poor poverty alleviation venture in Africa. With the rising population and increasing demand for food, the need to introduce and expand small-scale rabbit farms for long-term sustainability cannot be overemphasized. While increasing the production and commercialization of domestic rabbit production is desirable, the intensification of livestock also comes with some animal health problems. One of these is the emergence of Rabbit Haemorrhagic Disease (RHD) caused by Rabbit Haemorrhagic Disease Virus (RHDV). The virus causes sudden death in rabbits, and does not yet pose any public health risk. Symptoms of RHD may include: loss of appetite, lethargy, high fever, seizures, jaundice, bleeding from natural orifices, difficulty in breathing and sudden death. The first known outbreak of RHD in Nigeria was reported in September 2020 at rabbit farms in Kwara and Oyo States,in Nigeria. Despite several intervention strategies, the disease has continued to spread across the country. In this review, we search literature on the current state and knowledge of RHD as it affects rabbits and the economic impact on livelihood and animal health implication of this emerging viral disease on rabbit farms in Nigeria.

A - 146 Psychiatric Drugs Can Precipitate Neuropsychological Predicates of Homicide

Abstract Objective A man inexplicably killed his beloved wife. He had no history of violence, was a prominent member of the community, and gave no indications of the impending horrific act. He had been recently commenced treatment with psychiatric drugs, and his condition deteriorated, culminating in homicide. After his incarceration, he stopped taking psychiatric drugs and his mental health improved. Many practitioners are not aware that psychiatric drugs can create a risk for violence - or precursors of violence - such as anger, hostility, and agitation. This risk is often described on the product label. Method The subject was an intensive care nurse who became exhausted and despondent serving long hours during the Covid epidemic, when many of his patients were put on ventilators and died. He had suffered panic attacks from his difficulty breathing through the respiratory masks. He temporarily left employment and sought psychiatric assistance for his professional “burn-out” condition. After three doses of venlafaxine, he reported side effects including increased anxiety, blood pressure and heart rate. He was then prescribed escitalopram without tapering of the venlafaxine. As his anxiety progressed, he was prescribed escitalopram once daily and buspirone three times daily, yet he continued to deteriorate until the homicide. Results Expert genetic analysis found susceptibility to the psychiatric drugs prescribed. The neuropsychological evaluation, months post-homicide, found excellent neuropsychological function, although psychomotor and processing speed was deficit. Personality testing found no disorders, with a profile inconsistent with violent behavior. Conclusions Prescribers need to monitor patients carefully for potentially adverse and violent outcomes of treatment.

DIGITAL IMPRESSION VERSUS CONVENTIONAL IMPRESSION FROM THE POINT OF VIEW OF DENTIST PREFERENCES

Nowadays digital impression represents a new breakthrough for dental offices, since more and more dentists use dental scanners. From the point of view of the dentist's preferences, there are not many studies regarding the use of the digital impression in comparison with the conventional impression. (1) Background: The aim of this study was to make a comparison between the digital impression and the classic impression and highlight the advantages and disadvantages of using the two methods, both in terms of the patient and the dentist; (2) Methods: To fulfill the objectives of this study, the Google Forms Platform was used to distribute a questionnaire regarding digital impression and classic impression. The questionnaire included 14 questions with the possibility of choosing only one answer and was addressed to dentists. (3) Results: 42 responses were recorded to the 14 questions contained in the questionnaire; (4) Conclusions: Intraoral scanning dental impression compared to traditional impression has less effect on patient gag effect, breathing difficulties, stress and anxiety, and results in better patient perception and comfort.

Effects of Heart Rate Variability (HRV) Biofeedback in Pulmonary Indicators and HRV Indices Among Patients with Chronic Obstructive Pulmonary Disease.

Patients with chronic obstructive pulmonary disease (COPD) exhibit reduced cardiac autonomic activity, linked to poor prognosis and exercise intolerance. While heart rate variability biofeedback (HRVB) can enhance cardiac autonomic activity in various diseases, its use in patients with COPD is limited. This study explored the impact of the HRVB on cardiac autonomic activity and pulmonary indicators in patients with COPD. Fifty-three patients with COPD were assigned to either the HRVB (n = 26) or the control group (n = 27), with both groups receiving standard medical care. The HRVB group also underwent one-hour HRVB sessions weekly for six weeks. All participants had pre- and post-test measurements, including the Six-Minute Walking Test (6MWT), lead II electrocardiogram (ECG) recording, Modified Medical Research Council Dyspnea Scale (mMRC), body mass index, airflow obstruction, dyspnea, and exercise capacity (BODE) index. ECG data were analyzed for heart rate variability (HRV) as an index of cardiac autonomic activity. A two-way mixed analysis of variances demonstrated significant interaction effects of Group × Time in pulmonary indicators and HRV indices. The HRVB group exhibited significant post-test improvements, with decreased mMRC and BODE scores and increased 6MWT distance and HRV indices, compared to pre-test results. The 6MWT distance significantly increased and mMRC significantly decreased at post-test in the HRVB group compared with the control group. This study confirmed the efficacy of HRVB as an adjunct therapy in patients with COPD, showing improvements in exercise capacity, breathing difficulties, and cardiac autonomic activity.

Environmental Impact of Heavy Metals on Health in Soils Polluted with Medical Waste in Baiji City

Due to the environmental concerns of improper medical waste management inside and outside hospitals and health institutions, this issue is one of the most important environmental studies topics. Four places in Baiji City in Iraq were selected as study areas: Al-Hajjaj Health Center, Al-Boutama Health Center, Al-Zuwai Health Center, and Baiji General Hospital. This study investigates the environmental health risks of incineration treating hospital waste and health centers. According to the data obtained from practical and laboratory studies, Baiji General Hospital had the highest concentrations of the five toxic heavy metals tested, i.e., lead, cadmium, chromium, zinc, and nickel. These values peaked at 98.36, 59.54, 58.74, 79.52, and 13.32 mg/l for Pb+2, Cd+2, Cr+3, Ni+2, and Zn+2, respectively. Exceeding the measured values of toxic metal elements within internationally permissible limits increases the concentration of these toxic metals, posing greater health risks to the population. This process appears clearly and significantly if medical waste is burned in random locations, producing toxic fumes and gases that can cause diseases dangerous to health when inhaled; therefore, there must be mechanisms and scientific management to control the combustion process in private health incinerators. The survey results showed that the indiscriminate burning of medical waste in surveyed areas leads to diseases and can pose a tangible and immediate threat to human life, such as high blood pressure, eye irritations, suffocation of patients with difficulty and shortness of breath, and asthma, especially the elderly and newborns. Original overshooting of the measured values of toxic metal elements within the internationally permissible limits can increase the concentration of these toxic metals, posing more significant health risks to the population.

Clinical phenotype and molecular genetic analysis of seven children with CHARGE syndrome

To explore the clinical phenotype and genetic etiology for seven children with CHARGE syndrome (CS). Clinical data of seven children with CS diagnosed between March 2020 and December 2022 at the Children's Hospital Affiliated to Zhengzhou University were analyzed. Genomic DNA was extracted from peripheral blood samples from the children and their parents, and subjected to whole exome sequencing. Candidate variants were verified by Sanger sequencing and pathogenicity analysis. The ages of the children had ranged from 1 day after birth to 12 years old, and all of them had shown growth retardation. The reasons for their admission had included postnatal breathing, swallowing and feeding difficulties in five cases. One child was found to have abnormal external genitalia in conjunct with hearing impairment, whilst another child had shown no secondary sexual characteristics during puberty. All of the children were found to harbor CHD7 gene variants, which included 3 nonsense variants, 2 frameshifting variants and 2 missense variants, i.e., c.6292C>T (p.R2098*), c.2754G>A (p.W918*), c.469C>T (p.R157*), c.3308T>A (p.V1103D), c.7111delC (p.Q2371Kfs), c.6023delA (p.D2008Vfs) and c.3565C>T (p.R1189C). All of the variants were de novo in origin. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the c.3308T>A (p.V1103D) and c.3565C>T (p.R1189C) variants were rated as likely pathogenic (PS2+PM2_Supporting+PP3), whilst the remainders were rated as pathogenic (PVS1+PS2+PM2_Supporting). There is strong clinical and genetic heterogeneity in CS. Early genetic testing may facilitate accurate diagnosis. The detection of novel variants has expanded the phenotypic spectrum of CS and the mutational spectrum of the CHD7 gene.

Efektivitas Pelaksanaan Vaksin Polio dalam Meningkatkan Kesadaran Masyarakat Desa Sialang indah Terhadap Pentingnya Imunisasi di Desa Sialang Indah Kecamatan Pangkalan Kuras, Kabupaten Pelalawan

Real Work Lecture (KKN) is a form of community service activity by students with a cross-scientific and sectoral approach at a certain time and area. The implementation of KKN activities usually lasts between one to two months and takes place in villagelevel areas. The Directorate General of Higher Education in Indonesia has requires every university to carry out KKN as an intracurricular activity that combines the tri dharma of higher education, namely: education, research, and community service. We observed how the effectiveness of polio vaccine implementation in increasing community awareness of the importance of immunization in Sialang Indah Village, Pangkalan Kuras Sub-district, Pelalawan Regency. The virus will damage the nervous system of the sufferer's body so that there can be a risk of paralysis, difficulty breathing, or even death. The polio virus often affects toddlers or children under 5 years old, especially if they have not had the polio vaccination. However, it is not impossible that polio can also be experienced by adults.

Association between the C-reactive protein to albumin ratio with asthma and mortality in adult: a population-based study

Asthma is a prevalent chronic disease characterized by airflow obstruction, causing breathing difficulties and wheezing. This study investigates the association between the C-reactive protein to albumin ratio (CAR) and asthma prevalence, as well as all-cause and respiratory mortality among asthma patients, using data from the 2001–2018 National Health and Nutrition Examination Survey. We included participants aged 20 years and older with complete CAR data, excluding those who were pregnant or lost to follow-up. The analysis employed weighted logistic regression and Cox proportional hazards models with stepwise adjustment, restricted cubic spline analysis for nonlinear relationships, and time-dependent ROC curves for predictive accuracy. Results showed that the highest CAR quartile significantly increased the risk of asthma (OR 1.56, 95% CI 1.38–1.78), all-cause mortality (HR 2.20, 95% CI 1.67–2.89), and respiratory mortality (HR 2.56, 95% CI 1.30–5.38). The impact of CAR on all-cause mortality was particularly significant in hypertensive patients. These findings highlight CAR’s potential as a valuable biomarker for predicting asthma prevalence and mortality, underscoring its role in asthma management and prognostication.