Elderly Age Group Research Articles

A Study to Evaluate Correlation of C-Reactive Protein and Glycosylated Haemoglobin in Patients of Diabetes Suffering from Acute Coronary Syndrome

Incidence of diabetes is increasing substantially worldwide. Cardiovascular disease is most prevalent cause of mortality and morbidity in diabetic populations. Cardiovascular risk factor including obesity, hypertension, dyslipidemia are common in patients with diabetes mellitus particularly with those of type 2 diabetes. Atherosclerosis has been described as an inflammatory disease. Aim: Study to evaluate correlation of C-Reactive Protein and Glycosylated Haemoglobin in Patients of Diabetes Suffering from Acute Coronary Syndrome. Material and Methods: A descriptive study after satisfying criteria was conducted in 115 patients in medicine department of a medical college and tertiary care hospital over a period of two years that included patients of diabetes suffering from acute coronary syndrome in the age group of 30 to 70 years. Evaluation and correlation was done by clinical profile. Results: Majority of patients were elderly age group of male of 51 to 60 yrs having mean BMI of 24 kg/m2. CRP level of >3 mg/dl was found in 77.39% and majority of patients had HbA1C >7%. CRP and HbA1C were significantly correlated (p<0.05). Majority of patients with elevated CRP were found in with killip class I. But CRP and killip classification were not significantly correlated in our study. Conclusion: Elevated C Reactive Protein and Glycosylated Haemoglobin are better correlated as poor prognostic marker for cardiovascular event in patients of diabetes suffering from acute coronary syndrome.

Epidemiological Profile of Hospitalized Patients with Cystic Fibrosis in Brazil Due to Severe Acute Respiratory Infection during the COVID-19 Pandemic and a Systematic Review of Worldwide COVID-19 in Those with Cystic Fibrosis.

Since the onset of the coronavirus disease, COVID-19 pandemic, concern arose for those who might be at higher risk of a worse COVID-19 prognosis, such as those with cystic fibrosis (CF). In this context, we evaluated the features of hospitalized patients with CF due to severe acute respiratory infection (SARI) in Brazil and we also performed a systematic review including all the studies published from the beginning of the first case of COVID-19 (17 November 2019) to the date of this search (23 May 2022) which included, concomitantly, patients with CF and COVID-19 in the worldwide population. In our Brazilian data, we evaluated the period from December 2019 to March 2022, and we included 33 demographical and clinical patients' features. We classified the patients into groups: (G1) SARI due to another viral infection than severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (23; 5.4%), (G2) SARI due to an unknown etiological agent (286; 67.1%), and (G3) SARI due to SARS-CoV-2 infection (117; 27.5%). The individuals in G3 tended to be older, especially over 50 years old, and presented a higher prevalence of dyspnea, peripheral capillary oxygen saturation (SpO2) <95%, and cardiopathy. The highest prevalence for intensive care unit (ICU) treatment (52; 44.4%) and invasive mechanical ventilation (29; 24.8%) was for patients in G3. Almost half of the patients in G3 died (51; 43.6%); in contrast, none in G1 died. However, we observed 43 (15.0%) deaths in G2. In addition, 12 (4.2%) and one (0.9%) death not associated with SARI occurred, respectively, in the G2 and G3. The patients who died due to SARS-CoV-2 infection had a higher frequency of SpO2 <95% (46; 90.2%), ICU treatment (34; 66.7%), and invasive mechanical ventilation (27; 52.9%) when compared to those who recovered. The systematic review comprised a total of 31 papers published as observational studies. These studies comprised 661,386 patients in total, including children, adults, and elderly age groups. However, only 19,150 (2.9%) patients were diagnosed with CF and, from these patients, 2523 (0.4%) were diagnosed with both CF and COVID-19. It was observed that the most common outcome was the need for hospitalization (n = 322 patients with CF), and the need for oxygen support (n = 139 patients with CF). One hundred patients with CF needed intensive care units, fifty patients needed non-invasive mechanical ventilation support, and only three patients were described as receiving invasive mechanical ventilation support. Deaths were described in 38 patients with CF. Importantly, lung-transplanted patients with CF represented an increased risk of death in one publication; in accordance, another study described that lung transplantation and moderate to severe lung disease were independent risk factors for severe outcomes after SARS-CoV-2 infection. In contrast with the literature, in conclusion, Brazilian patients in G3 presented a severe phenotype, even though most of the other studies did not observe worse outcomes in patients with CF and COVID-19.

Age-Related Peripheral Vestibular Dysfunction: A Review

Age-related peripheral vestibular dysfunction is usually associated with an imbalance that has a major impact on morbidity, mortality, and health-care resources. Age-related vestibular hypofunction has been shown to correlate with the age-related reduction in the number of vestibular hair cells and neurons. Progressive disequilibrium of aging is a complex and multifactorial condition leading to dizziness and a higher chance of risk of falls. The stability of the posture and gaze during standing and walking is maintained by the processing of vestibular, visual, and somatosensory inputs in the central nervous systems, followed by outputs to the musculoskeletal and visual systems. Every component in this stem deteriorates as the age increases or in the aging process. Vestibular rehabilitation is an effective treatment option for both unilateral and bilateral vestibular dysfunction in the elderly age group. There are different prosthetic devices developed to enhance the postural balance in the older person. Although there is no definitive medical treatment available for age-related peripheral vestibular dysfunction, new medical treatments such as mitochondrial antioxidants or caloric restriction which have been useful for preventing age-related hearing impairment should be investigated in the future for treating age-related peripheral vestibular dysfunction.

Prevalence and Determinants of Long COVID among the COVID-19 Survivors: A Cross-sectional Study from A Rural Area of Maharashtra

Background: Most patients infected with the COVID-19 virus may experience long-term effects from COVID-19 infection, known as post-COVID or long COVID conditions. Long COVID may last for weeks, months or years and may limit ones day to day activities and needs health care. Aim &amp; Objective: To study the prevalence and risk factors of long COVID among the COVID-19 survivors of a rural area of Maharashtra. Methods and Material: A Community-based cross-sectional study was conducted in adult subjects residing in Chanai village from Maharashtra who have had a history of COVID-19 and have passed more than 3 months since the diagnosis from May 2022 to June 2022. The interview of the study participants was conducted with the help of a pre-designed, semi-structured questionnaire for data collection. Statistical Analysis: Data was analyzed using Microsoft Excel 2010, Open EPI-Info version 3.01 updated on 2013/04/06. Data was presented in tables, graphical format, frequencies and percentages and the statistical association was shown using the chi- square test. Results: The majority of participants were males (59%), from 19 to 39 years of age group (57%), having fever as presenting symptom (83%), with mild COVID (13%), and required hospitalization (53%). Long COVID was associated with the elderly age group, male sex (27.1%), severe COVID presentation (88.2%) after 12 weeks, and those required intubation (80%). Conclusion: The prevalence of long COVID was 17.5%. Determinants associated with long COVID were the elderly age group, male sex, severe COVID presentation and who required intubation.

The Burden of Diabetic Foot Ulcers in Urban India

Background: Foot ulcer is the most common cause of hospitalisation among people with diabetes (PWD). The objective of the study is to determine the incidence of diabetic foot ulcers (DFUs) in the urban community in India and its relationship with glycemic level and demographic parameters like age and sex among diabetic patients. Methodology: A retrospective observational study was performed from January 2016 to December 2018 at an urban community set up in Mumbai. The study was conducted in a healthcare setting, providing lifelong contributory healthcare to beneficiaries of an employees’ universal healthcare scheme. PWD from the community was identified using prescriptions of anti-diabetic medications. We identified patients with DFUs from electronic medical records from the hospital information system (HIS). The yearly incidence rate of DFU among PWD was estimated for the study period. The association between glycemic control and the demographic profile of patients with DFU was studied using binary logistic regression. Results: The study documents the average incidence of 66 DFU patients among 10,000 PWD per year in the community. Logistic regression analysis showed higher odds for the elderly age group (OR 2.863) compared to lower age for developing DFU. Similarly, poor control (HbA1c &gt;7%) over glycemic level has a higher chance (OR 1.713) of DFU than that of optimum glycemic control (HbA1c ≤7%). Among the DFU, 15.29% of patients required amputation during the study period. Conclusion: The study documents the community-level incidence of DFUs among patients with diabetes. High glycemic levels and elderly age groups (≥60) are the associated risk factors for DFU.

Health Conditions of Elderly (Secondary Data Analysis of 2021 Social-Economic Survey Data)

In Indonesia during 2019, the elder population reached 13,4% and is predicted to increase gradually from year to year. In general, the elderly age group is a phase in which most individuals have already got a decrement in health condition, both physically and psychologically. The purpose of this study is to give an overview about the health condition of the elderly. This research method is quantitative using descriptive research type. The research design used in this study is a cross-sectional research design. The sampling method for this study is purposive sampling. The population under this study are SUSENAS 2021 Indonesia with a sample of 18.352 resident within the category of elder age group in Indonesia. The research instrument for this paper is the questionnaire result from SUSENAS 2021. The instrument in this study was the results of the 2021 SUSENAS questionnaire. The result of this study shows that 67,4% of elder age group citizens in Indonesia are within the scope of healthy condition. The result of this research test shows that the health condition of the elder age group is affected by age (p=0,000), education (p=0,000), employment (p=0,000), marital status (p=0,000), social activity (p=0,000), health facility services (p=0,000),community activities (p=0,000), and the environmental factor (p=0,000). Meanwhile, gender did not find a related signicant. The conclusion of this study is that in Islam, the elderly have a high position in society, in particular, from the point of view that they are a source of knowledge and experience, as well as information and thoughts. therefore, they must be respected, loved, cared for and given priority to their health, it is essential that they be harmed, neglected, aware of their health, and given proper attention.

Management and Outcome of Intracranial Dural Arteriovenous Fistulas That Have Caused a Hemorrhage in the Posterior Fossa : A Clinical Study.

We evaluated the diagnosis, treatment, and long-term results of patients with dural arteriovenous fistula (dAVF), which is a very rare cause of posterior fossa hemorrhage. This study included 15 patients who underwent endovascular, surgical, combined, or Gamma Knife treatments between 2012 and 2020. Demographics and clinical features, angiographic features, treatment modalities, and outcomes were analyzed. The mean age of the patients was 40 ± 17 (range 17-68), and 68% were men (11/15). Seven of the patients (46.6%) were in the age group of 50 years and older. While the mean Glasgow Coma Scale was 11.5 ± 3.9 (range 4-15), 46.3% presented with headache, and 53.7% had stupor/coma. Four (26.6%) patients had only cerebellar hematoma and headache. All dAVFs had cortical venous drainage. In 11 (73.3%) patients, the fistula was located in the tentorium and was the most common localization. Three (20%) patients had transverse and sigmoid sinus localizations, while one (6.7%) patient had dAVF located in the foramen magnum. Eighteen sessions were performed on the patients during endovascular treatment. Sixteen (88.8%) sessions were performed with the transarterial (TA) route, one (5.5%) session with the transvenous (TV) route, and one (5.5%) session with the TA + TV route. Surgery was performed in two (14.2%) patients. One (7.1%) patient passed away. While there were nine (64.2%) patients with a Rankin score between 0 and 2, the total closure rate was 69.2% in the first year of control angiograms. In the differential diagnosis of posterior fossa hemorrhages, the differential diagnosis of dAVFs, which is a very rare entity, should be considered, even in the middle and elderly age groups, in patients presenting with good clinical status and pure hematoma. The treatment of such patients can be done safely and effectively in a multidisciplinary manner with a good understanding of pathological vascular anatomy and appropriate endovascular treatment approaches.

Safety profile of inactivated COVID-19 vaccine in indonesian adults

BackgroundVaccines are urgently needed to handle the morbidity and mortality of the COVID-19 pandemic in Indonesia. The inactivated vaccine is widely used in Indonesia's national immunization program due to its eligibility of stock, easier to transport, and considered to be more established than newer platforms. In this study, we aimed to evaluate the safety profile of the inactivated vaccine and analyze the safety profile between adults and the elderly. MethodsA prospective analytical study was conducted to evaluate the safety profile of inactivated COVID-19 vaccine among healthy adults aged ≥ 18 years from September 2nd to December 28th, 2021, at ten primary health centers from 5 districts in Jakarta, Indonesia. The participants were instructed to record the symptoms after inactivated COVID-19 vaccine injection in the diary card for 28 days. Chi-square tests were carried out to analyze the relationship between the adverse event following immunization (AEFI) in adults and elderly groups. ResultsFour of 1113 participants were not included in this study due to the lack of follow-up. Out of 1109 participants, there were 1044 adults (18–59 years) and 65 elderly (>59 years). There were no serious AEFI cases reported. Most AEFI cases were mild to moderate and resolved after several days of injection. Local pain, myalgia and fatigue were the most frequent adverse events reported. We found that there was no correlation between the adults and elderly age group with the incidence of AEFI (p = 0.924) for local reactions (p = 0.181) and most of the systemic reactions (p = 0.629). However, there is an increased risk of fever in the elderly group compared to the adult group (OR 4.046, 95 % CI 1.794–9.124, p = 0.003) following immunization. ConclusionsOur study demonstrated that the inactivated COVID-19 vaccine is safe, considering that all symptoms experienced were mild to moderate and resolved entirely.

Comparison of cognitive function tests AD8-INA against MoCA-INA and CDT in the elderly age group at the Uabau Health Center

Background: Dementia is a syndrome of decreased cognitive ability that hinders daily life. Dementia is associated with mortality, especially in patients with major depression, so health services are needed to identify cognitive disorders through pre-elderly and elderly screening. AD8-INA is one of the cognitive screening methods where the questions are directed to patient caregivers that are most practical, concise, and suitable for patients who cannot use their dominant hand, so researchers are interested in studying the sensitivity and specificity of AD8-INA to MoCA-INA and CDT. Methods: A cross-sectional study design was used to observe and analyze cognitive function variables. This study used primary data sources with interviews based on questionnaires on 114 subjects, consisting of pre-elderly and elderly groups who met the eligibility criteria to be included in the study. The MoCA-INA scores were divided into 26 normal and 26 cognitive impairments, the CDT scores 4 normal and 4 cognitive impairments, and the AD8-INA scores 0–1 normal and 2 cognitive impairments. An analysis was carried out to determine the sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, and confidence interval. Results: It was found that the sensitivity of AD8-INA to MoCA-INA was 87.14%, AD8-INA to CDT was 82.14%. In addition, the specificity of AD8-INA to MoCA-INA was 50% and AD8-INA to CDT was 61.11%. Conclusion: AD8-INA has high sensitivity but low specificity. AD8-INA can still be used as an initial screening tool for cognitive function at the Uabau Health Center, but all examination results must be evaluated further.

Cardiorespiratory Fitness Levels in Coronavirus Disease Survivors

Introduction: Covid-19 survivors often complain of fatigue, cough, shortness of breath, fever, dermatitis, headache and so on. This decrease then has an impact on changes in cardiorespiratory fitness. Objective: Determine the level of cardiorespiratory fitness in Covid-19 survivors. Method: This study used a cross sectional design. The population of this study is Covid-19 survivors in Makassar City. Sampling using purposive sampling technique with a sample of 385 people. Data collection was carried out by taking primary data through measuring cardiorespiratory fitness levels using the Six Minute Walk Test (6MWT). Results: A total of 236 people (61.3%) Covid-19 survivors had a low level of cardiorespiratory fitness with an average distance value of 507.6 meters. Conclusion: Respondents who come from the adolescent age group, have a normal BMI, high activity, asymptomatic and mild symptoms, and a phase of chronic Covid-19 infection tend to have a good level of cardiorespiratory fitness. While most respondents from the elderly age group, have obese and obese BMI, work as medical personnel with low physical activity, accompanied by comorbidities and the acute Covid-19 infection phase have a low level of cardiorespiratory fitness.

Innate immune factor gene expression profiles in patients with atopic dermatitis

Atopic dermatitis is a multifactorial genetically determined inflammatory skin disease characterized by itching, chronically relapsing dermatitis, age-related features of localization and morphology of lesions. The pathogenesis of atopic dermatitis is complex and includes epigenetic alterations, involved in the genomic adaptation, immune response reactions and dysfunction of the epithelial barrier that together trigger the development of atopic dermatitis. The aim of this study is to detect the expression level for IL4, IL13, IL33, TLR2, TLR9 genes in the biological materials of atopic patients.The targeted genes for further expression evaluation were selected according to our previous findings on genome-wide methylation study. We detected the cascades with the differentially methylated genes that are most likely to take place in atopic dermatitis. Thus, we investigated expression levels for the IL4, IL13, IL33, TLR2, TLR9 genes in the skin, peripheral blood mononuclear cells and whole blood cells using RT-PCR on 55 pediatric patients and 26 healthy volunteers, and on 50 adult patients. Statistical analysis was performed with the use of Kruskal-Wallis H test and Mann-Whitney U test. Targeted expression analysis revealed that in the skin samples the expression of TLR9 and IL4 was 12 times significantly lower (p &lt; 0.0001, p &lt; 0.0005) in the lesional skin; and there was a 6-fold decrease in case of TLR2 (p &lt; 0.01). The results for blood mononuclear cells differed and expression levels for most of the assessed targets were significantly higher before treatment. We have also found out that those differences were strongly pronounced especially in an elder age group (12-18 y.o.). Studying the IL33 gene expression in the whole blood samples of adults revealed that its level was significantly higher in case of patients with moderate form of AD. Besides, we concluded that locally in the affected skin inflammatory immune response may dominate; in the mononuclear cells Th2 immune response apparently takes place. New insights on immunological markers and links among them may shed a light on atopic dermatitis pathogenic mechanisms. The detected molecules could play role as potential therapeutic targets and form a management approach for patients with atopic dermatitis.

Особенности ведения периоперационного периода у пациентов с хроническим гепатитом и циррозом печени при выполнении офтальмохирургических операций

Purpose. Study of frequency and structure of hepatitis and cirrhosis among ophthalmic surgical patients. Material and methods. Among 1706 patients, 43 patients with chronic hepatitis and cirrhosis were selected. A clinical assessment of their etiology, severity, and possibility of performing ophthalmic surgery in these patients was carried out. Results. The average age of the selected 43 patients was 64.1 ± 9.7 years, in 72.1 % they conasist in elderly age group. 88.4 % had viral hepatitis (B, C, chronic HBV and HCV coinfection), 9.3 % had a toxic hepatitis, and one patient (2.3 %) had autoimmune hepatitis. Among hepatitis, HCV monoinfection prevailed (55.4 %). The vast majority (97.7 %) had minimal disease activity. Although violations of hemostasis system were detected in 9 patients, signs of significant hypocoagulability were observed in 3 people (6.9 %). After 3-days course of intramuscular injections of vitamin K 2–3 times a day, all 3 patients underwent successful ophthalmic surgery. 97.7 % of patients were admitted to surgery: 39 people. – in planned manner, 3 people – after medical preparation. In one patient with suspected acute viral hepatitis B, planned surgical treatment was postponed. Conclusion. In general structure of ophthalmic surgical patients, the proportion of patients with hepatitis and cirrhosis was 2.5 %. Viral hepatitis B and C prevailed (88.4 %), HCV monoinfection dominated (55.4 %). The vast majority of patients (97.7 %) had minimal hepatitis activity, 6.9 % had signs of significant hypocoagulability, which required their preoperative preparation. Keywords: hepatitis, cirrhosis, ophthalmic surgery

Population-Based Study of Coronary Artery Calcification Using the Automated Analysis of Radiology Reports in Moscow

Introduction: Problems of prevention, diagnosis and treatment of diseases of the circulatory system remain highly relevant. One of the effective preventive measures is early identification of risk factors, including coronary calcium. Recent achievements in the field of computer vision have made it possible to conduct opportunistic coronary calcium screening. Objective: To study the prevalence of coronary artery calcification as a risk factor for cardiovascular diseases in the population of Moscow based on the results of an automated analysis of radiology findings. Materials and methods: In July 2021 – December 2022, we conducted a retrospective descriptive epidemiological study, within which we analyzed chest CT images of 165,234 patients (71,635 males and 93,599 females) for coronary artery calcification and calcium scoring using AI services in an automated mode. Results: Coronary calcium was detected in 61.4 % of the examined. The proportion of men was 68.9 %, women – 55.7 % (р &lt; 0.001). The calcium score ranged from 1 to 60,306 units (mean = 558.2). The average growth rate of the calcium score for the whole population was 170.75, the average growth rate was 168.13, and the average increase rate was 68.13 units during study period. In 47.6 % of men and 36.5 % of women with coronary calcium, the calcium score was clinically significant, i.e. ≥ 300 (p &lt; 0.001). Most people with coronary calcium at a clinically significant level belonged to elderly and senile age groups (42.0 % each). Conclusions: The prevalence of coronary calcium in the population of Moscow was 8.03 per 1,000 people. In men, coronary calcium (including that at a clinically significant level) was statistically more frequent while the average calcium score in them was significantly higher than in women of most age groups. The mean calcium score demonstrated a constant increase with age.

Chasing SARS-CoV-2 XBB.1.16 Recombinant Lineage in India and the Clinical Profile of XBB.1.16 Cases in Maharashtra, India.

Background SARS-CoV-2 has evolved rapidly, resulting in the emergence of lineages with a competitive advantage over one another. Co-infections with different SARS-CoV-2 lineages can give rise to recombinant lineages. To date, the XBB lineage is the most widespread recombinant lineage worldwide, with the recently named XBB.1.16 lineage causing a surge in the number of COVID-19 cases in India. Methodology The present study involved retrieval of SARS-CoV-2 genome sequences from India (between December 1, 2022 and April 8, 2023) through GISAID; sequences were curated, followed by lineage and phylogenetic analysis. Demographic and clinical data from Maharashtra, India were collected telephonically, recorded in Microsoft® Excel, and analyzed using IBM® SPSS statistics, version 29.0.0.0 (241). Results A total of 2,944 sequences were downloaded from the GISAID database, of which 2,856 were included in the study following data curation. The sequences from India were dominated by the XBB.1.16* lineage (36.17%) followed by XBB.2.3* (12.11%) and XBB.1.5* (10.36%). Of the 2,856 cases, 693 were from Maharashtra; 386 of these were included in the clinical study. The clinical features of COVID-19 cases with XBB.1.16* infection (XBB.1.16* cases, 276 in number) showed that 92% of those had a symptomatic disease, with fever (67%), cough (42%), rhinorrhea (33.7%), body ache (14.5%) and fatigue (14.1%) being the most common symptoms. The presence of comorbidity was found in 17.7% of the XBB.1.16* cases. Among the XBB.1.16* cases, 91.7% were vaccinated with at least one dose of vaccine against COVID-19. While 74.3% of XBB.1.16* cases were home-isolated; 25.7% needed hospitalization/institutional quarantine, of these, 33.8% needed oxygen therapy. Out of 276 XBB.1.16* cases, seven (2.5%) cases succumbed to the disease. The majority of XBB.1.16* cases who died belonged to an elderly age group (60 years and above), had underlying comorbid condition/s, and needed supplemental oxygen therapy. The clinical features of COVID-19 cases infected with other co-circulating Omicron variants were similar to XBB.1.16* cases. Conclusion The study reveals that XBB.1.16* lineage has become the most predominant SARS-CoV-2 lineage in India. The study also shows that the clinical features and outcome of XBB.1.16* cases were similar to those of other co-circulating Omicron lineage infected cases in Maharashtra, India.

Correlation of the Role of Drug Swallowing Supervisor (PMO) and Drug Side Effects with Medication Compliance in Elderly Pulmonary TB Patients

The 2019 World Health Organization notes that tuberculosis is a disease that is still a global concern. Indonesia has the 3rd highest number of cases after India and China. The target rate for medication adherence in Berau Regency, which is included in the elderly age group, has not been achieved due to the lack of PMO support and the side effects of the drugs experienced. The type of research used is analytical research which is carried out only through observation, without any intervention on the research subject. Statistical test results showed that there was no significant relationship between drug side effects and medication adherence with a pvalue of 0.273 &gt; 0.05.

Innovation in Acute Ischemic Stroke Patients over 80 y/o-A Retrospective Monocentric Study on Mechanical Thrombectomy of Consecutive Patients: Is Age an Adequate Selection Criterion?

Although it is clear that stroke is a time-dependent and age-associated disease, we still need more evidence regarding the efficacy and outcomes in elderly patients who were excluded from the first trials of mechanical thrombectomy. The aim of this study is to highlight patient characteristics, the timing of medical attention and therapy, successful recanalization, and functional outcomes in patients over 80 y/o who underwent mechanical thrombectomy at the Ospedale Maggiore della Carità di Novara (Hub) since endovascular stroke treatment was first started here. all 122 consecutive patients over 80 y/o at admission who underwent mechanical thrombectomy between 2017 and 2022 at our Hub center were retrospectively included in our database. A good functional outcome in these elderly patients was considered as the 90 days modified Rankin Scale (mRS) ≤ 3 and/or a decrease in functional status as ∆mRS ≤ 1 in order to interpret the results for patients with intact intellect and basal mRS > 3. Successful recanalization as a score of TICI ≥ 2b (Thrombolysis in Cerebral Infarction) was analyzed as a secondary outcome. Good functional outcome (mRS ≤ 3 and/or ∆mRS ≤ 1) was observed in 45.90% (56/122). The rate of successful recanalization (TICI ≥ 2b) was 65.57% (80/122). Our data confirm that a good outcome in the elderly age group has a correlation with age; being younger, with a milder NIHSS (National Institutes of Health Stroke Scale) at the onset and with a lower pre-morbid mRS is statistically associated with a better outcome. However, age should not be a criterion to exclude older patients from mechanical thrombectomy. Decision-making should take into consideration the pre-morbid mRS and the severity of the stroke on the NIHSS scale, especially in the age group over 85 y/o.

Clinical Presentation of Heart Failure Patients Admitted in Colonel Maleque Medical College, Manikganj

Background: Heart failure is a complex syndrome that arises from abnormalities in the structure and/or function of the heart, whether inherited or acquired. This increase in prevalence and incidence is due to a variety of factors, including the aging of the population, improved survival rates from other cardiovascular diseases, and changes in lifestyle and risk factors such as obesity and diabetes. Heart failure patients have various presentations and different etiologies. This study aimed to see the different clinical presentations of hospitalized heart failure patients. Methods: This study was done to see Clinical Presentation of Heart Failure Patients admitted in Colonel Maleque Medical College, Manikganj and Maikganj Sadar Hospital. Total 3650 patients were enrolled for this study during the period of April 2018 to March 2023. Results: Most of the patients (60%) were of 51-70 years age group. 70 % (2555) patients were male. 99 % patients presented with SOB, 95 % patients had basal creps, 70% had orthopnoea, 49% had Paroxysmal Nocturnal Dyspoea (PND), 40% had leg edema and 25% had raised JVP. Average heart rate was 84 beats/min, average systolic B.P. was 128 mm Hg and average diastolic B.P. was 76 mm Hg. 49% population had hypertension, 39% patients had diabetes and 28% had concomitant respiratory illness. Average EF was 37 %. Ischemic Cardiomyopathy was the commonest (40%) cause of heart failure, acute coronary syndrome was the second leading (30%) cause, valvular heart disease and hypertension is the third common cause. Conclusion: Most of the heart failure patients are elderly age group. Most of the patients presented with shortness of breath and bilateral basal creps. Most patients had co-morbid other illness that influences the natural course of heart failure patients. Most common causes are ischemic cardiomyopathy, a sequel of ischemic insult of the heart. J Medicine 2023; Vol. 34, No. 2(1) Supplement: 219

Literature Review: Hubungan Mencuci Tangan dan Konsumsi Makanan Dengan Kasus Diare Pada Anak Sekolah di Indonesia

One of the main causes of mortality in children, as well as an important factor leading to malnutrition is Diarrhea. The prevalence of diarrhea among the 5-14 age group ranks highest after the toddler and elderly age groups. In 2018, the number of diarrhea cases among all age groups served by healthcare facilities increased by 229,734 cases from the previous year of 2017. Children who have persistent diarrhea may experience subpar results in terms of their growth and development.. The purpose of this study is to ascertain the connection between handwashing practices and dietary habits and the prevalence of diarrhea in school-aged children.. The research method used is a Literature Review, by searching for research articles sourced from the electronic database Google Scholar using keywords such as diarrhea, handwashing habits, food consumption, and students. From the analysis of 5 articles, it was found that the habit of washing hands with soap and maintaining nail hygiene can prevent the occurrence of diarrhea in children. A good food consumption pattern also has a lower risk of experiencing diarrhea. Age differences in children are also related to the incidence of diarrhea, where younger children are more susceptible to experiencing diarrhea.

A study of antibody response to Covid-19 infection

: The Coronavirus disease 2019 is a disease caused by the etiological agent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It was a newly identified β-coronavirus that had spread rapidly around the world, resulting in a very high number of infections and deaths, threatening public security, and placing a heavy burden on global healthcare systems and economy. The present study was done to study antibody response in COVID-19 infection.: The study was carried out in the Department of Respiratory Medicine, R.D. Gardi Medical College, Ujjain, India after approval by ethics committee. The post COVID-19 cases attending respiratory medicine OPD were included in the study.: The present study was conducted in 122 patients. The mean age of the patients was 51.20±14.21 years, median age was 54.5 years, the minimum age was 14 years and the maximum age was 80 years, the most number of COVID-19 infection cases was in the elderly age group of more than 50 years. The severity of disease was seen in those above 50 years of age (57.3%) with p&amp;#62;0.05. Among the severe cases mean age of the cases was 49±17 years, in moderate cases mean age 52±14 and among mild group of cases mean age was 51±15 years.In the present study there were 73.8% males and females were 26.2% Among COVID-19 cases who reported in the OPD the maximum that is 86 (&amp;#62;70%) patients had moderately severe disease, while severe cases were only about 14 %. Mild cases were 15.6%.In the present study RT-PCR were negative in 36(29.5%) as against 86 (70.5%) were confirmed cases of COVID-19 and among positive cases 40 % cases became negative between 6-10 daysAmong severe disease cases mean SARS COV2 antibody 650.06±240.47 was significantly higher as compare to moderate cases 461.49±331.41 and mild cases 404.11±240.47.: India has the world’s largest vaccination program. COVID-19 antibodies estimation are important tests carried out to determine the response of the body against COVID-19 infection.Our results show a significant association between SARS COV2 antibody and the severity of disease.

Evaluation of Antibiotics Used for Lower Respiratory Tract Infections in a Tertiary Care Hospital

Objective: The main objective of the study was to evaluate patterns of antibiotics prescribed for Lower respiratory tract infections (LRTIs) in a tertiary care hospital. Methodology: A prospective observational study was conducted in the pulmonology and general medicine departments of a tertiary care hospital. The data was collected from the in- patient department after considering inclusion and exclusion criteria for a period of 6 months. Antibiotics prescribed were compared with the guidelines mentioned in the European respiratory society guidelines (ERS), Indian respiratory guidelines, IDSA guidelines, and NICE guidelines to determine the appropriateness of therapy. Statistical tools like Chi-square test were applied to the data by using SPSS software. Result: A total of 284 patients diagnosed with various LRTIs, male 55% patients predominated over female patients of 45%. The majority of the patients were under age group of 61-70 years (24%), literates (71.84%), and symptoms of SOB (88.73%), Cough (69.01%), generalized weakness/body pains (54.92%), fever (50.70%), wheeze (11.26%) and chest pain (9.85%). Among all cases of LRTI, most of the patients 56.4% were diagnosed with viral pneumonia (COVID-19). Higher number of patients was treated with beta-lactam antibiotics. Inj.Piperacillin/tazobactum (38%), Tab.Cefpodoxime proxetil/Clavulanic acid (41%), Inj.Cefaperazone/Sulbactum (35%) and Inj.Amoxicillin/Clavulanic acid (23%) were frequently used. Conclusion: Lower respiratory tract infections are mostly seen in males, elder age groups and in literate patients. Present study showed that the antibiotics were used taking into consideration various clinical and diagnostic evidences like radiology, bio-markers, patient condition and severity of the disease. However the establishment of antibiotic stewardship program is necessary to ensure safe and appropriate use of antibiotics and to prevent antibiotic resistance in patients.