Hidden Killer Research Articles

ANTIFUNGAL SUSCEPTIBILITY OF OROFUNGAL INFECTIONS AMONG HIV- POSITIVE PATIENTS IN CHUKWUEMEKA ODUMEGWU OJUKWU UNIVERSITY TEACHING HOSPITAL, AWKA ANAMBRA STATE

Fungal diseases are life-threatening and are responsible for a largely silent epidemic, often hidden killers causing substantial morbidity and mortality in susceptible individuals. This study was carried out to determine the prevalence, risk factors and antifungal susceptibility of orofungal infections among HIV positive patients in Chukwuemeka Odumegwu Ojukwu University, Awka. The study was a hospital based cross sectional study carried out between January 2022 and August 2022. A total of 120 patients who gave their consent were used for the study. Oral swab sample of the patients were taken with the aid of sterile swab sticks, and cultured on Sabouraud’s dextrose agar, Chrome agar and blood agar at 37°C incubation. Fungal organisms isolated were characterized accordingly using Gram stain, germ tube tests, sugar fermentation and assimilation tests, and also with fungal atlas for mold identification. ITS region molecular typing was also used to identify the top four most frequently occurring isolates. Structured questionnaires were used to obtain demographic details of the participants and for risk factors evaluation. Isolates were also evaluated for pathogenicity using haemolysis and enzyme assays. Antifungal susceptibility testing of the isolates was conducted using the disc diffusion method. Data obtained were statistically analyzed. The oro-fungi organisms isolated are Candida albicans, Candida glabrata, Candida krusei, Candida tropicalis, Candid neoformans, and Aspergillus fumigatus. Overall prevalence of the isolates in the participants (n=120) showed that C. albicans was the most prevalent isolate with an occurrence of 90% while Cryptococcus neoformans were the least occurring isolates with the occurrence 2.99%. Gender distribution were: COOUTH 71 male (59.17%) 49 female (40.83%), Age range 36-45 years had the highest frequency of 45.83% while age range 56-65 years had the lowest patient frequency of 10.83%. The distribution based on marital status, of which married subjects accounted for 43.33% and single patients were 56.67 % frequency. It was observed that 56.67% of patients that participated in the study had university education as their highest educational level, and they accounted for the most population that took part in the study. A 5.83% frequency that took part in the study had no education and accounted for the least participation frequency in the study. Students had the highest participation frequency of 47.5% while artisans participated the least with a frequency of 7.5%. 6.67% of the participants had Hepatitis B vaccination while 97.5% of the participants were already participating in HAART. The clinical history of examined patients showed that 68.33% had white patches on the tongue which is the highest frequency, followed by bad breath which accounted for 67.17% of the participants. Antifungal exposure profiling of the participants showed that they have significant (p<0.05) exposure to fluconazole while they had least exposure to vericonazole and itraconazole.

The Deepest Extent of Acellular Mucin Pools in Resected Locally Advanced Rectal Cancer With Pathological Complete Response After Preoperative Chemoradiotherapy: A Hidden Killer?

For patients with locally advanced rectal cancer (LARC) with pathological complete response (pCR), the clinical significance of the distribution extent of acellular mucin pools (AMP) distribution remains unclear, so this study was conducted to address key unanswered questions. We performed a retrospective analysis of 317 patients with LARC with pCR after preoperative chemoradiotherapy and total mesorectal resection from January 2011 to June 2020. Based on AMP existence and the deepest tissue layer of distribution, patients were assigned new stages. The patient information was recorded, and the main outcome measures included 5-year disease-free survival (DFS) and 5-year overall survival (OS). A total of 83/317 (26.2%) patients exhibited AMP, and disease recurrence occurred in 46/317 (14.5%) patients. Over the 5-year median follow-up period, the patients with AMP showed 5-year DFS rates (75.9% vs. 88.9%, P =0.004) and 5-year OS rates (85.5% vs. 95.7%, P =0.002) statistically lower than those of patients without AMP. Disease recurrence was seen in 15/54 (27.8%) patients with AMP within the subserosa and/or the serosa, or adipose tissue. Univariate and multivariate analysis showed that the existence of AMP within the subserosa and/or the serosa, or adipose tissue was an independent risk factor for DFS [hazard ratio (HR): 2.344; 95% confidence interval (CI): 1.256-4.376; P =0.007] and OS [HR: 3.374; 95% CI: 1.438-7.917; P =0.005]. The new stages based on the deepest extent of AMP were related to worse DFS ( P =0.004) and OS ( P =0.003) rates among patients with pCR. In conclusion, the presence of AMP might reduce the prognosis of LARC patients with pCR after chemoradiotherapy, especially in patients with AMP in deeper tissue layers. Therefore, the influence of the deepest AMP extent might be worth considering in staging. Moreover, the revised staging of patients with pCR according to the deepest extent of AMP, which is unrelated to the clinical T stage, might facilitate postoperative management.

ASSESSMENT OF MAGNITUDE AND RISK CORRELATES OF DEPRESSION & ANXIETY SYMPTOMS AMONG SCHOOL GOING ADOLESCENTS IN MUMBAI SUBURBAN AREA, INDIA

Introduction: In India, Depression & anxiety symptoms are considered Diseases of adulthood. Just like other non-communicable diseases, mental disorders are emerging as Hidden killers, it is important to screen these diseases since adolescence. Objectives: to assess the magnitude of depression & anxiety symptoms and their risk factors. Methods: A cross‑sectional study was conducted among 175 adolescents enrolled in 8th – 10th standards in private school of Mumbai suburban area using the modified PHQ-9 & GAD-7 binary logistic regression was applied to find significant risk correlates. Results:Mean age was 13.95±0.97years and 53.1 % were females. Depression was found in 24 % anxiety symptoms in 23% adolescents. On logistic regression, depression and anxiety symptoms was associated with female gender [OR: 3.072 & OR: 2.925] family members ≤ 5 [OR: 2.182 & OR: 1.502] and not willing to come to school [OR: 6.43 & OR: 5.42]. Conclusion: The level of depression & anxiety symptoms was higher among female gender, having family member ≤ 5 & those who were not willing to come to school. Less fights with parents, no failure in examinations, ability to cope up with academics, having normal sleep pattern, never faced teasing & bullying by fellow students had lower chances of having depression & anxiety symptoms.Anxiety and depression are major public health problems among adolescents. The high burden estimated in our study highlights the need for immediate action to support school going adolescents.

Clinical Symptoms, Endoscopic and Stroboscopic Imaging in Patients with Laryngeal Fungal Infection in Relation to Fungal Identification Result

This paper aims to describe the similarities and differences in fungal laryngitis’ clinical characteristics, endoscopic, and stroboscopic imaging between patients with positive and non-positive fungal identification results. The study enrolled 48 patients diagnosed with fungal laryngitis by the Endoscopy Department in the National ENT Hospital of Vietnam from August 2019 to March 2020. The study results show that the patients in both groups had dysphonia (100%), with insignificant difference in the severity. However, the patients in the Positive group were more likely to go to hospital right in the first month of the symptom (55%), whereas the patients in the Non-positive group usually waited for more than 3 months (57.1%), (p<0.05). In endoscopic imaging, fungal pseudomembrane could be found mainly on the vocal cords in both groups, with instances spreading to the subglottis (15%) and trachea (5%) in the Positive group (p<0.05). The tissue layer of the patients in the Positive group was mostly inflamed, meanwhile the patients in the Non-positive group were more prone to swelling tissue (67.9%), (p<0.05). In stroboscopic imaging, the difference was minimal. The patients in the Positive group were more likely to lose the mucosal wave formation (60%) than in the Non-positive group (46.4%). There were also insignificant differences in the mucosal wave’s characteristics: asymmetry (50% in the Positive group; 66.7% in Non-positive group), diverse periodicity (50% in the Positive group; 33.3% in the Non-positive group). The paper concludes that there were differences between the two groups of patients and the clinical, endoscopic and stroboscopic findings, fungal identification should be further implemented for definitive diagnosis in patients with fungal laryngitis. 
 Keywords
 Fungal laryngitis, dysphonia, endoscopic imaging, stroboscopic imaging, fungal identification.
 References
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SCENARIO OF ASPERGILLUS INDOOR CONTAMINATION IN PAKISTAN (2000- 2020) – A REVIEW

Bioaerosols in indoor environment include substantial portion of fungi which are considered as “hidden killers”. Pakistan like other countries, also bears the atrocities of fungi and their mycotoxins and suffers more due to its favourable climate, weak economy and unawareness. Genus Aspergillus of Fungi is quite important and is predominant in indoor environment, along with Penicillium. There are not adequate research studies on the indoor micro-floral composition, however, the available data shows that numerous Aspergillus species are found inside the buildings whether they be houses, hospitals, laboratories, cafeteria or slaughterhouses. The mycotoxins produced by Aspergillus species include aflatoxins, fumonisins, citrinin, ochratoxins and cyclopiazonic acid. They are mainly carcinogenic and cause various diseases like aflatoxicosis, pentaketide nephrotoxin, and necrosis. To avoid such issues, fungal growth should be avoided by controlling temperature and humidity. In addition, fungicides, ultraviolet radiation or essential oils can be used against fungi. The condition of the buildings can also be adjusted to minimize fungal growth like building material, ventilation system, wall paint and hygiene. The database of the country is not satisfactory with insignificant laws and regulation. To estimate the potential risks of Aspergillus species and their mycotoxins, regular monitoring is required at all levels. It will also help to devise solutions related to health and environment related problems.

Social isolation and loneliness: a hidden killer

Isolation and loneliness are risk factors for poor health, and are increasingly affecting younger men. GPs can play an important role in recognising and addressing the problems using the tools and services being developed to help tackle the issues.

THE EFFICACY OF DASHMOOLADI CHURNA IN ESSENTIAL HYPERTENSION: A CASE STUDY

Ayurveda is one of the most ancient medical sciences of the world. It describes the basic and applied aspects of life process, health, disease and its management with the sound base of principles and approaches.
 21st century is a world of industrialization & fast life which has created various life style disorders. Hypertension is one of life threatening gift of today’s life, which is psychosomatic, hereditary and occurring as a result of aging. It is also called as a silent or hidden killer because most of sufferers (85%) are asymptomatic and as per available reports, in more than 94% cases of hypertension under lying cause is not found. Such patients are said to have Essential Hypertension (EHT). Hypertension is one of the leading causes of the Global burden of disease.
 60 Years male patient suffering from Anidra, Shirashoola, Bhrama, Daurbalya, Klama, Krodhaprachurya since last two months. He came to our hospital for Ayurvedic treatment. With our unique herbal combination of drug, his all symptoms got controlled.
 This is one single study on Dashmooladi churna to evaluate the efficiency on Essential hypertension.

Emergency medical service providers' knowledge and perception of sepsis at Makkah Saudi Red Crescent Authority

Background: Sepsis is a life-threatening condition existing worldwide and is frequently known as the “hidden killer” because it is a time-sensitive illness, like myocardial infarction and cardiac arrest; therefore, prehospital providers must have adequate knowledge about it. Aim: The aim was to measure the knowledge and perception of sepsis among emergency medical service (EMS) providers to assure better patient prognosis. Methodology: A cross-sectional paper-based questionnaire survey comprising 15 questions, divided into three sections, was conducted at Makkah Saudi Red Crescent Authority to evaluate their knowledge related to the signs and symptoms of sepsis in particular and management and perception of sepsis in general. The responses received were categorized according to the specialties considering P

The Hidden Killer: Towards Regulating Railyard Diesel Particulate Matter Emissions in Oregon

The Hidden Killer: Towards Regulating Railyard Diesel Particulate Matter Emissions in Oregon

THE RELATIONSHIP TYPE OF PERSONALITY WITH HYPERTENSION DEGREES ON HYPERTENSION PATIENS OF WOMEN 30 – 50 YEARS IN PUSKESMAS PAJANG SURAKARTA

Background:Hypertension is a cardiovascular disease commonly called the silentkiller because hypertension is a hidden killer. Several factors that affect theoccurrence of hypertension are factors that can be changed and can not bechanged. In addition, hypertension can also be caused by tension, anxiety, socialstatus and personality type. Purpose: This study aims to determine the relationshipof personality type to the incidence of hypertension. The type of this research isdescriptive correlation with cross sectional design. Research Methods:Thisresearch was conducted at Puskesmas Pajang Surakarta on October 2017-March2018. The type of this research is descriptive correlation with cross sectionaldesign. Samples were 30 respondents of hypertension patients). Samplingtechnique using accidental sampling. The data were collected by usingquestionnaires. Data analysis used univariate and bivariate analysis using chisquaretest. Results: this research took 30-50 years old female respondents that is30 respondents with hypertension of degree1 as much as 9 people 30.0%, degree2as many as 5 people 16.7%, degree3 16 people 53.3% and there are 22 people73.3% with personality type A and 8 people 26.7% personality type B. Bivariateanalysis shows that there is a relationship of personality type with the incidenceof hypertension with value (p = 0.000, 0.000). Conclusion: There is a relationshipbetween personality type A and B with degree of hypertension where personalitytype A is more likely to have hypertension than personality type B.

Diabetes research.

I began watching the BBC's Panorama documentary Diabetes: The Hidden Killer but got frustrated and had to turn it off. I have had type 1 diabetes for 28 years and am shocked at the resources thrown at people with type 2, which can easily be prevented. This funding would be better used on research into type 1 diabetes and its treatment.

Response to Discussions of “Transferred Potential—A Hidden Killer of Many Linemen”

Response to Discussions of “Transferred Potential—A Hidden Killer of Many Linemen”

Discussion of “Transferred Potential—A Hidden Killer of Many Linemen”

Proper grounding during maintenance of circuits that could accidentally become live is a key factor in maximizing safety for maintenance personnel. It is critically important that practices employed in any specific situation be evaluated routinely to ensure they truly are optimal mitigating solutions for the possible hazards that may be encountered. The research and evaluation provided by the authors seem to indicate that practices that may be appropriate in some parts of the world under one set of conditions seem to not be optimal for the conditions under which work is performed where the authors acquired their data.

Discussion of “Transferred Potential—A Hidden Killer of Many Linemen”

Summary form only given. The following discussion relates to the above paper [1]. Grounding is one of the most misunderstood aspects of electrical power systems, and the transferred earth potentials component of power system grounding is even less understood. I read this paper with great interest and wish to commend the authors for tackling the subject-particularly as it relates to worker safety within their country, especially since it is counter to existing practices. Having been in 30 different countries and observing installations worldwide, it is very apparent to me that safety grounding is commonly misunderstood worldwide. The reference to investigating other accidents that had been “closed” without finding the cause speaks to this point. The authors correctly identified the transferred earth potential and that it was the greater risk (I called it “transfer by grounded conductors” in reference [5] of [1]). This speaks to the need for using insulated boom trucks, always using insulated gloves, bonding the metal poles below their feet to the temporary ground, and working through practices that involve the equipotential bonding mentioned. Further details addressing wood and cement poles are a logical extension of their work. It is my hope that the authors can leverage their work with this paper to educate and affect real change in safety practices within India and elsewhere.

Why OSA may be Regarded as the Real Hidden Killer in Diabetes

Obstructive Sleep Apnea Syndrome (OSAS) is a common and usually overlooked phenomenon causing a deep reduction in oxygen delivery to the body tissues and a serious disruption of the sleep pattern. Furthermore there are scattered reports in the medical literature pointing to a role of this respiratory disturbance on sudden death. We hypothesize that the phenomenon may have a role in the vascular damage and the high cardiovascular death rate of diabetes interacting at least at three consecutive steps.

Hidden Killers: Human Fungal Infections

Although fungal infections contribute substantially to human morbidity and mortality, the impact of these diseases on human health is not widely appreciated. Moreover, despite the urgent need for efficient diagnostic tests and safe and effective new drugs and vaccines, research into the pathophysiology of human fungal infections lags behind that of diseases caused by other pathogens. In this Review, we highlight the importance of fungi as human pathogens and discuss the challenges we face in combating the devastating invasive infections caused by these microorganisms, in particular in immunocompromised individuals.

Self-Neglect: A Hidden Killer

Self-Neglect (SN) can be defined as: This definition is holistic and captures the intentional and choice factors as well as socio-cultural influence of the behaviour and the potential negative impact of SN for the individual, their family and community. A key component of assessment by professionals is the individual’s decision making capacity and ability to understand the consequences of their actions. Occasionally, distorted images and headlines appear in the media such as “A Systems Failure: Pensioner found dead due to Self-Neglect”. There is a general outcry of public rage but the media are not interested in understanding why the vulnerable but competent adult who was self-neglecting is not rescued. A social media heading like this is a nightmare for professionals and services. A range of interrelated factors contribute to health inequalities of older people such as socio-economic and material factors, psychosocial factors and lifestyle factors. Many of these are risk ...

Earthquakes from the ocean: Danger zones

Some of the most powerful earthquakes emanate from remote ocean-floor faults. Geophysicists are now laying networks of sensors to keep tabs on these hidden killers.

Lupin allergy: a hidden killer in the home

This review addresses the problem of lupin sensitization in the home environment. We summarize the data currently available on allergy to lupin, which has become, in recent years, a hidden killer in our homes. Since 2006, when lupin was included in European regulations as a food whose presence must be declared, the situation may have changed. Nevertheless, we must take into account the possibility of undeclared allergenic ingredients or the presence of 'hidden' allergens, given that contamination during food production processes may be a great risk for sensitized individuals. Furthermore, the United States, Japan, Australia and New Zealand still do not include lupin among the ingredients that must be listed on foodstuff labelling. Our responsibility is to educate the public so that they are aware of the danger and look for lupin in the labels of products that run the risk of containing it. Lupin allergy can manifest itself in isolation or in parallel to peanut allergy. Identification of the proteins causing possible cross-reactivity is complicated, and new structural studies are needed. To date, it has not been possible to clearly identify the allergens responsible for isolated lupin sensitization in relation to parallel and/or cross-sensitization between lupin and peanut. Most of the allergenic proteins of lupin are α- and β-conglutins, with a lesser presence of γ- and δ-conglutins. A β-conglutin corresponding to Lup an 1, with a sequence similar to Ara h 1, has been identified as a major allergen of lupin in patients with allergy following lupin ingestion.

Lupin allergy: a hidden killer at home, a menace at work; occupational disease due to lupin allergy

The products of the flowering plant, lupin, are increasingly used as a human food product, particularly in baking. Occupational sensitization to lupin with occupational rhinitis, conjunctivitis and asthma was first described in 2001, and confirmed in a larger cross-sectional study in a food processing company in 2006. Sensitization by inhalation may result in occupational asthma, work-exacerbated asthma, occupational rhinitis and conjunctivitis. The incidence of occupational sensitization may be as high as 29%. The relationship with exposure intensity is as yet unclear, and requires further clarification. Although there is little information from long-term studies, these diseases are likely to improve after cessation of exposure. Cross-sensitization to other legumes, particularly peanuts, has been shown by skin prick testing, with potential for serious anaphylactic reactions. This review summarizes the available literature on occupational sensitization to lupin products. It is one of two reviews, one covering the problem of lupin allergy in the home, while the present article deals with lupin sensitization in the workplace. Increased awareness is needed of this occupational hazard to avoid future cases of occupational disease and their accompanying morbidity and potential mortality.