Higher Frequency In Cases Research Articles

Glutathione S-transferase polymorphisms (GSTM1/GSTT1) outcomes in clinical profile and treatment responsiveness among Tunisian cohort of Parkinson's disease.

Glutathione S-transferases are involved in the oxidative stress which contributes to the pathogenesis of Parkinson's disease (PD). our aim was to investigate the influence of GSTM1 and GSTT1 polymorphisms on the clinical features and treatments outcomes among PD Tunisian patients. We included 300-PD patients followed in neurology department at Razi-University-hospital. GSTM1 and GSTT1 were screened using PCR methods. Correlation between the clinical phenotype and the genotypes was then assessed after adequate parameters adjustment. Individuals carrying inactive GSTT1/GSTM1 were estimated to have 2.5-fold higher risk of developing PD, p = 0.035. The demographic and clinical baseline analysis of GSTM1 polymorphism revealed significant association between the inactive gene and development of tremor as first symptoms (p = 0.046), further, it was correlated to asymmetric start (p = 0.044). The evaluation of the impact of GSTM1/GSTT1 activity among PD at last follow-up revealed the significant variability of motor impairment among cases carrier of the active genes (p = 0.048). As patients with inactive GSTM1/GSTT1 had higher UPDRS-III score. Additionally, higher frequency of cases with good treatment responsiveness was reported among PD with active GSTM1/GSTT1 (p = 0.038).No motor complications were observed among PD by considering the GSTs genotypes (p > 0.05). Finally, we noted significant impairment of memory among cases with inactivate GSTs (p = 0.04), attention deficit (p = 0.013) and impaired judgement (p = 0.0031). This study represents one of the most comprehensive and extensive investigation to date regarding the influence of GSTT1/GSTM1 genotype among PD patients.We speculate that the impact of GSTT1/GSTM1 on PD progression may occur through a cumulative effect, potentially not manifesting during the initial PD stages. Further studies are necessary to validate our conclusions.

Assessment of interleukin-18 gene polymorphism and serum levels in cutaneous lichen planus

BackgroundLichen planus (LP) is a chronic inflammatory disease with uncertain etiology. Interleukin-18 (IL-18) is an interferon gamma (INFγ) inducing agent. It is a pro-inflammatory cytokine that was found to play a role in the pathogenesis of some autoimmune disorders.Material and methodsThis study included 50 patients with classic cutaneous lichen planus (CLP) and 50 healthy volunteers serving as controls. Venous blood samples were withdrawn from the study subjects under complete aseptic precautions. Blood samples were examined for single nucleotide polymorphisms (SNPs) of IL-18 gene at promoter -137(G/C) and -656 (G/T) using polymerase chain reaction (PCR) and IL-18 level was assessed using enzyme linked immunosorbent assay (ELISA).ResultsThe mean level of IL-18 was significantly higher in CLP patients (31.63 ± 4.90) compared to control subjects (13.95 ± 6.82). Significantly high levels of IL-18 were found among patients with diabetes, hypertension (p < 0.01 in both). HCV positive patients and patients with both OLP and CLP also expressed higher levels of IL-18. Genotypic and allelic distribution at position -137(G/C) showed that the genotype GG was present at significantly higher frequency in cases (58%) compared to controls (28.0%). On the other hand the CC genotype at position -137 was significantly higher in the controls (28%) as compared to CLP cases (6%). Polymorphism of IL-18 at position -656(G/T) showed no significant difference between cases and controls. No significant difference could be detected in IL-18 level between different genotypic variants at position -137(G/C) and -656(G/T).ConclusionIL-18 may play important role in pathogenesis of LP. Elevated IL-18 levels could be part of the pro-inflammatory autoimmune process in LP. The presence of OLP, HCV, diabetes and hypertension is associated with higher production of IL-18. IL-18 promotor region -137(G/C) polymorphism might be a factor that increase the risk of development of lichen planus in Egyptian patients.

Factores de riesgo asociados en el desarrollo de Síndrome de Hellp en gestantes atendidas en el Instituto Nacional Materno PerinataL, Lima, 2018-2021.

ABSTRACT Objectives: To determine the risk factors associated with the development of Hellp Syndrome (HS) in pregnant women attended at the Instituto Nacional Materno Perinatal, 2018-2021. Materials and methods: The study is a retrospective cross-sectional analysis using a case-control design. Twenty-five hundred medical records were collected and 196 cases and controls with Hellp syndrome (HS) were selected following eligibility criteria. A data collection form including variables and study dimensions was used. For the analysis, SPSS software was used, applying frequency techniques and Pearson's Chi-square tests to evaluate associations. Results: In cases of Hellp syndrome (HS), higher frequencies were observed in single and cohabiting women, representing 16.8% (p = 0.583); with primary education level in 20.4% (p = 0.195). Regarding age, 12.2% of SH cases were women between 30 and 32 years of age (p = 0.640). A higher proportion of cases were found with a history of arterial hypertension, with 29.1% (OR: 1.230), and in those with malnutrition, with 27.6% (OR: 1.780). There was no significant association with parity, but a higher frequency of cases was observed in nulliparous women, with 17.9% (OR: 1.538), and in pregnant women with a gestational age of 40 weeks, with 6.1%. Conclusions: Malnutrition is the statistically significant risk factor associated with the development of SH.

The Epidemiologic and Clinical Characteristics of the 2023 Dengue Outbreak in Bangladesh.

The ongoing 2023 dengue outbreak is the worst ever case reported in Bangladesh. There is a lack of epidemiological studies on the outbreak. A 2-tailed t test was performed. Multivariable logistic regression analysis was conducted. We found about 277 801 cases and 1393 deaths from the 2023 dengue outbreak. About 52% of the cases were from outside of Dhaka. The male:female ratio was about 3:2. The highest frequency of cases was found among people aged 19-29 years (28.7%, 79 673 of 277 801; P = .001). The overall case fatality rate (CFR) was 0.5%. The highest CFR was found among children aged 0-10 years (12%). Fever (99%) was the most prevalent, followed by joint pain (86%). We found significantly higher odds of fatalities (adjusted odds ratio [aOR], 4.21; 95% CI, 3.93-4.74; P = .05), cases (aOR, 3.85; 95% CI, 3.25-4.12; P = .001) and hospitalizations (aOR, 3.26; 95% CI, 3.11-4.04; P = .006) during the 2023 outbreak compared with previous outbreaks during 2008-2022. This is one of the early reports of epidemiological and clinical characteristics of ongoing dengue outbreak.

Recurrence of Pulmonary Tuberculosis Associated with Comorbidities - Current Interdisciplinary Problem

Introduction. The recurrence of pulmonary tuberculosis remains a significant public health problem in many countries of the world, despite the remarkable progress in the treatment and rehabilitation of patients with new cases of tuberculosis. It is demonstrated that the high incidence of recurrence of pulmonary tuberculosis is conditioned by the influence of some factors combination. Currently, the comorbidities, which impose the risk of disease recurrence directly or indirectly, are of a major importance. Thus, it is important to study the clinical and epidemiological characteristics of pulmonary tuberculosis recurrence associated with the comorbidities. Materials and methods. There were studied 715 patients with pulmonary tuberculosis recurrence, including 503 patients with comorbidities, as well as statistical reporting data for the Right Bank region of the Dniester River and ATU (Autonomous Territorial Unit) of Gagauzia, Republic of Moldova during 2019-2021. Results. The obtained results demonstrate that in phthisiopulmonology the presence of comorbidities constitutes a significant and important medico-social problem. In the structure of relapses associated with comorbidities, it was noted the predominance of extensive infiltrative processes, high frequency of cases with destruction in the lung tissue and bacillary cases. The need to review and improve the general antituberculosis measures accepted both in the work of phthisiopneumologists and primary care specialists is argued in order to improve the prognosis of TB treatment associated with comorbidities. Conclusion. The recurrence of pulmonary tuberculosis associated with comorbidities requires an integrated multidisciplinary approach.

Evaluation of epidemiological, clinical, laboratory and treatment characteristics of Crimen Congo hemorrhagic fever patients: Results of a 10-year analysis.

Crimean-Congo hemorrhagic fever (CCHF) is a viral zoonosis transmitted by ticks and may have an acute and severe course with fever, bleeding, muscle aches, headache, diarrhea, weakness, and similar non-specific symptoms. This study aimed to determine the distribution of CCHF cases in Amasya province, which is endemic for this disease, according to districts, epidemiological, clinical, laboratory, and treatment characteristics. The characteristics of 88 CCHF cases over 18 who were admitted to our clinic and treated between January 2013 and January 2023 were evaluated retrospectively. Demographic data such as age, gender, occupation, district of residence, history of tick contact, the incubation period of the disease, period of development of the disease (months, years), length of hospital stay, symptoms, physical examination and laboratory findings, blood product replacement therapies applied, recovery and mortality status of the patients were reached by scanning the patient files. The mean age (±standard deviation) of 88 cases was 48±18 years, and 53 (60.2%) were male. Of the patients, 68 (77.3%) were engaged in farming and animal husbandry, and 79 (89.7%) lived in villages and hamlets. Tasova district had the highest frequency of cases, with 29 (32.9%) patients. June was the most common month for the disease, with 31 (35.2%) cases. The most common symptom on admission was fatigue, with a rate of 93%. Other symptoms included myalgia and arthralgia (83.2%), fever (65%), headache (64.4%), nausea-vomiting (43.5%), conjunctival hyperemia (35.2%), and diarrhea (21.7%). In clinical follow-up, bleeding was missed in 15 (17.04%) patients. On admission to the hospital, there were elevated levels of thrombocytopenia (92%), leukopenia (84.1%), aspartate aminotransferase and alanine aminotransferase (86.3%), creatinine phosphokinase (71.6%), and lactate dehydrogenase (76.1%). None of the patients were given ribavirin treatment. Our mortality rate was 3.40% with three patients. Amasya is an endemic area for CCHF with all its districts. In our province's spring and summer months, tick contact history and the farming-livestock profession should be questioned in patients with fever complaints in clinic admissions, especially emergency services. In the case of the detection of thrombocytopenia in these patients, CCHF should be kept in mind.

Identification of a shared, common haplotype segregating with an SGCB c.544 T > G mutation in Indian patients affected with sarcoglycanopathy

Sarcoglycanopathy is the most frequent form of autosomal recessive limb-girdle muscular dystrophies caused by mutations in SGCB gene encoding beta-sarcoglycan proteins. In this study, we describe a shared, common haplotype co-segregating in 14 sarcoglycanopathy cases from 13 unrelated families from south Indian region with the likely pathogenic homozygous mutation c.544 T > G (p.Thr182Pro) in SGCB. Haplotype was reconstructed based on 10 polymorphic markers surrounding the c.544 T > G mutation in the cases and related family members as well as 150 unrelated controls from Indian populations using PLINK1.9. We identified haplotype H1 = G, A, G, T, G, G, A, C, T, G, T at a significantly higher frequency in cases compared to related controls and unrelated control Indian population. Upon segregation analysis within the family pedigrees, H1 is observed to co-segregate with c.544 T > G in a homozygous state in all the pedigrees of cases except one indicating a probable event of founder effect. Furthermore, Identical-by-descent and inbreeding coefficient analysis revealed relatedness among 33 new pairs of seemingly unrelated individuals from sarcoglycanopathy cohort and a higher proportion of homozygous markers, thereby indicating common ancestry. Since all these patients are from the south Indian region, we suggest this region to be a primary target of mutation screening in patients diagnosed with sarcoglycanopathy.

Association of TP53 rs1042522 G > C, MDM2 rs2279744 T > G, and miR-34b/c rs4938723 T > C polymorphisms with aneuploidy pregnancy susceptibility

BackgroundAneuploidy pregnancy is a severe major birth defect and causes about 50% spontaneous miscarriages with unknown etiology. To date, only a few epidemiological studies with small sample sizes have investigated the risk factors for aneuploidy pregnancy. TP53, MDM2, and miR-34b/c genes are implicated in tumorigenesis with aneuploidy, yet the function of their polymorphisms in aneuploidy pregnancy susceptibility needs to be clarified.ObjectiveTo elucidate the association of TP53 rs1042522 G > C, MDM2 rs2279744 309 T > G, and miR-34b/c rs4938723 T > C specific polymorphisms with aneuploidy pregnancy.MethodsIn the retrospective case-control study, 330 aneuploidies pregnancy women and 813 normal pregnancy controls were recruited between January 2018 and April 2022 at the First People’s Hospital of Yunnan Province, Kunming, China. Three functional polymorphisms, the TP53 rs1042522 G > C (Arg72Pro), MDM2 rs2279744 309 T > G, and miR-34b/c rs4938723 T > C, were genotyped using the snapshot method.ResultsThe frequency distribution of three genotypic variants was not different between case and control pregnant women and was similar to with Hardy-Weinberg Equilibrium (HWE). However, in the younger subgroup (less than 35 years old), a significant difference was detected in allele and recessive model (p = 0.01). In the advanced age subgroup (more than or equal to 35 years old), G of MDM2 rs2279744 T > G revealed a significantly higher frequency in cases than controls (p = 0.045), and miR-34b/c rs4938723 T > C revealed a significant difference under the dominant model (p = 0.03), but no significant differences were observed in other models and in both younger and older subgroup (p > 0.05, respectively). These results suggest that individual polymorphisms were not associated with aneuploidy pregnancy, combined with age, they may serve as a risk factor for aneuploidy pregnancy.ConclusionCombination of TP53 rs1042522 G > C, MDM2 rs2279744 T > G, and miR-34b/c rs4938723 T > C polymorphisms with maternal age may be related to aneuploidy pregnancy susceptibility. These findings might elaborate on the genetic etiology of aneuploidy pregnancy.

The Impact of A Successful Pterygium Excision on Corneal Astigmatism and Topography

Objective: To determine the impact of successful excision of pterygium on corneal astigmatism and topography.&#x0D; Study Design: Quasi-experimental study.&#x0D; Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi Pakistan, from Feb 2021 to Jul 2021.&#x0D; Methodology: All 52 patients of pterygium who underwent surgical excision of the pterygium during the study period were included. The size of pterygium was measured in millimeters. Pre-operative automated keratometry and corneal topography was done, and changes in astigmatism, surface asymmetry index, surface regularity index, uncorrected visual acuity and best corrected visual acuity were measured postoperatively on the 7th day. Paired sample t-test was applied between pre- and post-operative astigmatism, surface asymmetry index, surface regularity index, uncorrected visual acuity and best corrected visual acuity.&#x0D; Results: The mean age of participants was 42.02±13.3 years, with 22(42.3%) females and 30(57.7%) males. The male to female ratio is 1.36:1. The highest frequency of cases was noted in the age group, 31-50 years (42%), followed by 18-20 years (21%). Pterygium size was 2.25 to 4.10 mm, with a mean of 3.16±0.54mm. Pain and photophobia were noted in 5 cases. Pre- and postoperative comparison of astigmatism and corneal topography revealed a significant reduction in Surface Asymmetry Index and Surface Regularity Index values (p-value&lt;0.001). Uncorrected Visual Acuity (p=0.002) and Best Corrected Visual Acuity also improved significantly after surgery (p=0.006).&#x0D; Conclusions: This study concluded that pterygium excision brings a significant decrease in astigmatism and reversible corneal topography changes.

Different Translocations of Multiple Myeloma on Fluorescent In Situ Hybridization (FISH) with Clinical Correlation.

To evaluate the association of chromosomal translocations in multiple myeloma (MM) detected by Fluorescent In Situ Hybridization (FISH) and its clinical characteristics. Cross-sectional study. Place and Duration of the Study: Department of Haematology, Armed Forces Institute of Pathology (AFIP), Rawalpindi, Pakistan, from February to August 2022. A total of 40 cases of MM were included. All cases were diagnosed using international myeloma working group (IMWG) criteria. Clinical presentations like bone pain, backache, fatigue, pallor, and weight loss were noted. The workup for myeloma-defining events was done. FISH analysis was done for t (4;14), t (11,14), t (14;16), t (14;20), and del 17p. Data were analysed using the chi-square test. A p-value ≤0.05 was considered statistically significant. Out of 40 patients, 8 (20%) were females and 32 (80%) were males. The highest frequency of cases were noted among males in the age group >60 years and females in the age group 40-60 years. FISH for t (4;14) was positive in 22 (55%) patients, for t (11;14) was positive in 4 (10%) patients, for t (14;16) was positive in 3 (7.5%) patients, and for t (14;20) was positive in 3 (7.5%) patients, while for del17p was positive in 8 (20%) patients. Cases with t (4;14), t (11;14), and t (14;20) had bone pain, fatigue, and backache as the most common presentations. Among the various parameters studied, lytic lesions, beta-2 microglobulin, spike protein, deranged haemoglobin, TLC, ESR, albumin, and creatinine were significant risk factors in patients who were tested positive for various mutations. The FISH technique has brought an immense uprising in the genetic analysis of MM. Among translocations, t (4;14) and del17p are associated with poor clinical outcomes and prognosis. If the diagnosis of MM is delayed, then an increase in morbidity and mortality can occur. Multiple myeloma, FISH, Translocations.

Pathway Alterations in Stage II/III Primary Melanoma.

Genomic classification of melanoma has thus far focused on the mutational status of BRAF, NRAS, and NF1. The clinical utility of this classification remains limited, and the landscape of alterations in other oncogenic signaling pathways is underexplored. Using primary samples from the InterMEL study, a retrospective cohort of cases with specimens collected from an international consortium with participating institutions throughout the United States and Australia, with oversampling of cases who ultimately died of melanoma, we examined mutual exclusivity and co-occurrence of genomic alterations in 495 stage II/III primary melanomas across 11 cancer pathways. Somatic mutation and copy number alterations were analyzed from next-generation sequencing using a clinical sequencing panel. Mutations in the RTK-RAS pathway were observed in 81% of cases. Other frequently occurring pathways were TP53 (31%), Cell Cycle (30%), and PI3K (18%). These frequencies are generally lower than was observed in The Cancer Genome Atlas, where the specimens analyzed were predominantly obtained from metastases. Overall, 81% of the cases had at least one targetable mutation. The RTK-RAS pathway was the only pathway that demonstrated strong and statistically significant mutual exclusivity. However, this strong mutual exclusivity signal was evident only for the three common genes in the pathway (BRAF, NRAS, and NF1). Analysis of co-occurrence of different pathways exhibited no positive significant trends. However, interestingly, a high frequency of cases with none of these pathways represented was observed, 8.4% of cases versus 4.0% expected (P < .001). A higher frequency of RTK-RAS singletons (with no other pathway alteration) was observed compared with The Cancer Genome Atlas. Clonality analyses suggest strongly that both the cell cycle and RTK-RAS pathways represent early events in melanogenesis. Our results confirm the dominance of mutations in the RTK-RAS pathway. The presence of many mutations in several well-known, actionable pathways suggests potential avenues for targeted therapy in these early-stage cases.

Risk Factors for Obstetric Emergencies With Referral Implementation at the Palembang Health Center

Obstetric emergencies are potentially life-threatening conditions that can occur in pregnant women and even during delivery. The main causes of obstetric emergencies (APGO, AGO and AGDO) are due to bleeding during childbirth, septic infection, hypertension, preeclampsia or eclampsia, and dystocia. One of the effective management efforts in obstetric emergencies is the implementation of appropriate and planned referrals that can save mothers and newborns. The purpose of this study was to determine the risk factors for obstetric emergencies with referrals at the Palembang Health Center. Methods: Quantitative research using a cross sectional approach. The population is all pregnant women who carry out examinations at the Palembang Health Center with a total sample of 128 pregnant women. The results showed that the highest frequency of cases in the APGO risk factor group was pregnant women aged ≥ 35 years (35.9%), in the AGO group it was serotonin (43%), in the AGDO group it was severe preeclampsia/eclampsia (13.3%) , the highest scoring group was High Risk Pregnancy (KRT) (11.7%) and the most referral criteria were planned referrals (91.4%). In conclusion, there was no significant difference in the risk factors for obstetric emergencies in the APGO variable p=0.727 and AGO p=0.328 between planned referrals and late referrals (p&gt;0.05), but there were significant differences in the risk factors for obstetric emergencies in the AGDO variable between planned referrals and referrals late p=0.011 (p&lt;0.05)

Scabies in the Philippines: A Secondary Analysis of Local Patient Registries.

Scabies is the second most common cause of disability among skin diseases in the Philippines as of 2019. There is no large nationwide study describing the epidemiologic profile of scabies in the country. This study aimed to describe the demographic, seasonal, and geographic profile of scabies in the Philippines. We compared secondary data of two local patient registries (Philippine Dermatological Society, PDS, 2010 to 2021; and Philippine Pediatric Society, PPS, 2009 to 2021) for reported cases of scabies in the Philippines. We reported the frequency and percentage distribution according to age, sex, month, year, and type of diagnosis, and region. The median annual frequency of scabies cases (mostly outpatient) for PDS (from year 2010) was 4087 (range ([QR], 342-6422 [3271.5]), while it was 183 (range [IQR], 64-234 [96.5]) (all inpatient) for PPS (from year 2009). There was a reduction to one-third (PDS) and one-fourth (PPS) of pre-pandemic numbers during the pandemic years (2020-2021). The peak months for scabies cases were the cooler months: January (median, 12.1% of annual cases; range [IQR], 2.6%-31.4% [3.6%]) to February (median, 10.0% of annual cases; range [IQR], 1.5%-27.8% [2.5%]) based on PDS data, and November (median, 10.0% of annual cases; range [IQR], 0.0%-24.3% [7.0%]) to January (median, 9.0% of annual cases; range [IQR], 0.0%-24.3% [6.6%]) for PPS data. Overall, for PDS, age 1-4 years is the most affected age group (median, PDS, 17.5% of annual cases; range [IQR], 11.9%-25.4% [8.1%]), while it was the less than 1-year-olds (median annual cases, 48.9%; range [IQR], 29.1%-67.3% [13.20%]) among PPS pediatric population aged 0 to 18 years. Males (median, 53.9% of annual cases; range [IQR], 45.0%-67.2% [8.8%]) were more affected than females in PPS. While for PDS during earlier years (prior to 2015), males (median, 51.6% of annual cases from 2010 to 2014; range [IQR], 47.4%-52.9% [0.2%]) were more affected than females. However, males became less affected than females with median, 44.7% of annual cases from 2015 onwards (range [IQR], 43.4%-46.5% [1.2%]). NCR was the region with the highest frequency of cases in PPS (median, 52.6% of annual cases; range [IQR], 22.7%-75.0% [20.4%]). The 2nd most affected regions were Central/Eastern Visayas (34.2%, 2009-2013; range [IQR], 17.9%-54.1% [5.3%]), Bicol region (12%; 2014 to 2018; range [IQR], 17.9%-54.1% [7.4%]), Central Luzon (18%; 2019), Central/Eastern Visayas (29%, 2020), and Northern/Central Mindanao (17%, 2021). Scabies was commonly seen in the younger age group, slightly more in females in the PDS, while slightly more among males in the PPS, in the cooler months of the year, and in the urbanized NCR.

American tegumentary leishmaniasis in the population of the city of Rio Branco, Acre, Brazil: a 2007–2015 time series analysis

American tegumentary leishmaniasis (ATL) is a public health problem in the State of Acre. This study analyses the incidence of all forms of ATL time series in the human population from 2007 to 2015. This time series ecological study investigated the incidence of all forms of ATL in the city of Rio Branco, Acre, Brazil. Data on the number of cases of all forms of ATL diagnosed from 2007 to 2015 were collected from the secondary Health Surveillance Board database, Rio Branco City Health Department. Prais–Winsten regression was used to analyze the trends in ATL incidence. Subsequently, the annual percent change (APC) was estimated. The incidence of disease remained stationary during the studied period, except in the age group from 15 to 19 years old with an increase in the annual variation percentage (APC: 6,48%; IC95%: 1,67; 11,53) and a decline between 20 and 34 years old (APC: -15,41%; IC95%: -18,57; -12,13) and 35 and 49 years old (APC: -8,52%; IC95%: -14,63; -1,97). There was a higher frequency of cases between 2007 and 2015 in the cutaneous form, entry of new cases, evolution to cure, and diagnosis by clinical-laboratory procedures. In conclusion, there was a high disease incidence during the studied period. Additionally, an increase in the ATL incidence in the younger age group and a decrease in the ATL incidence in the middle age groups were observed. KEY WORDS: Cutaneous leishmaniasis; time series study; incidence.

The Clinical Profile of Children With Hepatitis A Infection: An Observational Hospital-Based Study.

Introduction: Hepatitis A is a frequent form of hepatitis, especially in children. The changing epidemiology of the disease signifies the need for descriptive data concerning the clinical presentation and outcome of hepatitis A in children. The present study describes the clinical and biochemical profile of children with hepatitis A infection from a tertiary care center in the Aurangabad district of Maharashtra in Western India.Methods: One hundred patients between one and 18 years of age, presenting with symptoms/signs such as nausea, anorexia, vomiting, jaundice, abdominal pain, tender hepatomegaly, bleeding manifestations, or encephalopathy, were enrolled for the study. Serologically confirmed cases by detecting immunoglobulin M (IgM) antibodies against hepatitis A virus (HAV) were enrolled in the study. A detailed case proforma noted the clinical features and details such as age, gender, area, water supply, socioeconomic status, season, and biochemical parameters.Results: Most patients (45%) were among the age group of one to five years. Fever was reported in 96 (96%) patients, abdominal pain in 78 (78%) patients, dark-colored urine in 65 (65%) patients, vomiting in 47 (47%) patients, and anorexia in 63 (63%) patients. Icterus was found in 80 (80%) patients and hepatomegaly in 74 (74%) patients. In 61 (61%) patients, serum total bilirubin level on the first day was 1-4 mg/dL. Sixty-five (65%) patients were using tap water as the water source, and the maximum number of patients (43%) came in August. Most patients belonged to the class IV group (61%) as per the modified Kuppuswamy classification.Conclusions: Most patients were 10 years or below, presenting predominantly with fever, abdominal pain, dark-colored urine, vomiting, and anorexia. Icterus and hepatomegaly were found in three-fourths or more of the patients. Around monsoon (June to September), there was the highest frequency of cases, and the socioeconomic status of most of the patients was within lower or upper-lower categories.

Obstructive Sleep Apnea and Hearing Loss: Is There Any Correlation?

Introduction Obstructive sleep apnea (OSA) is a breathing disorder related to sleep that has a negative effect on the behavior and health of people around the globe. Chronic hypoxemia and variations in the concentration of oxygen in the blood noticed in OSA individuals may have adverse effects on the process of auditory transduction and transmission. Objective To assess the effect of OSA on hearing and to find out the parameters that have more influence on hearing recorded during polysomnography of patients with OSA. Methods The present is a hospital-based, observational, analytical, cross-sectional study conducted over a period of one year. After application of the exclusion criteria, the patients were then submitted to the application of the Berlin questionnaire, as well as polysomnography, impedance, and pure tone audiometry (PTA). Results A total of 58 individuals were studied. Age, gender, and height were comparable among cases and controls, while weight, body mass index (BMI), and neck circumference were significantly higher in cases in comparison to controls. The mean PTA was significantly higher at 10 kHz or higher frequencies in cases in comparison to controls. Conclusion We observed that there is evidence that the auditory mechanism is affected in OSA patients. We recommend early auditory screening of OSA patients for timely diagnosis and to raise awareness about its prevention.

Genetic variations in ATM and H2AX loci contribute to risk of hematological abnormalities in individuals exposed to BTEX chemicals.

BackgroundLoci controlling DNA double‐strand breaks (DSBs) repair play an important role in defending against the harmful health effects of benzene, toluene, ethylbenzene, and xylene (BTEX), but their gene variants may alter their repair capacity. The aim of the current study was to determine the relationship of functional polymorphisms ATM‐rs228589 A>T, WRN‐rs1800392 G>T and H2AX‐rs7759 A>G in DBS repair loci with the abnormal hematological indices in workers who exposed to BTEXs.MethodsWe included 141 cases with one or more abnormal hematological parameters, who had been occupationally exposed to BTEX chemicals and 152 controls with a similar exposure condition but without any abnormal hematological parameters. Atmospheric concentrations of BTEXs were measured and whole blood samples were taken from the participants to determine hematologic parameters and SNP genotyping.ResultsResults showed that T allele of ATM‐rs228589 and G allele of H2AX‐rs7759 had a higher frequency in cases than controls (p = 0.012 and p = 0.001, respectively). Also, AT and TT genotypes of ATM‐rs228589 and AG and GG genotypes of H2AX‐rs7759 were higher in cases compared to controls. The AT and TT genotypes of ATM‐rs228589 have significant associations with a risk of hematological abnormalities in the codominant (AT vs. AA, p = 0.018), dominant (AT + TT vs. AA, p = 0.010) and overdominant (AT vs. AA + TT, p = 0.037) models. The GG and AG genotypes of H2AX‐rs7759 were in relation with increased risk of abnormal hematological indices under codominant (GA vs. AA, p = 0.009 & GG vs. AA, p = 0.005), dominant (AG + GG vs. AA, p = 0.001), and recessive (GG vs. AA + AG, p = 0.025) models.ConclusionsThese observations may help to understand the mechanisms of BTEX hematotoxicity and identify useful biomarkers of risk assessment for workers exposed to BTEX.

Sociodemographic characteristics of professional categories most affected by COVID-19 in Mozambique, from March to July 2020

the risk of a worker becoming ill due to coronavirus disease 2019 (COVID-19) is related to occupational exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Due to the need to restore work activities in Mozambique, the study was conducted with the aim of identifying the occupational categories most affected by COVID-19 in the former in the period from March to July 2020. this is a cross-sectional descriptive study, in which data from professions of confirmed cases of COVID-19 from 22 March to 29 July 2020 in Mozambique were analyzed. The professionals' data were reported daily by the National Institute of Health (NIH) and merged into a single database and exported to Excel, the latter categorized according to standard operating procedure (SOP) and descriptive statistics performed for its analysis. in the period under analysis, 1,127 professionals were diagnosed with COVID-19, divided into 11 categories. Nampula province had the highest frequency of cases with 25.00% (277). The highest frequency of cases was registered in the domestic professional category, which had 16.77% (189/1,127) with the female sex being more frequent, 79.37% (150/189); and defense and security had 14.20% (160/1,127) of cases and male gender with 91.25% (146/160); Health workers had 13.04% (147/1,127), and the maximum number of COVID-19 cases was recorded in June with 58.50% (86/147). the professional categories most affected by COVID-19 in the period under review correspond to those groups that carry out activities requiring a physical presence at the workplace and from this; it is recommended that professionals reinforce preventive measures.

Spatial distribution and incidence of HIV/AIDS cases in Santa Cruz do Sul, state of Rio Grande do Sul, 2001 to 2020.

to describe the spatial distribution, treatment status and characteristics of cases of people infected with the human immunodeficiency virus HIV in Santa Cruz do Sul, RS, 2001 to 2020. descriptive study with data from individuals undergoing treatment for HIV/AIDS, in Santa Cruz do Sul, diagnosed from January 2001 to October 2020. 708 (94.4%) cases were analyzed, of these (58.2%) were male, with a mean age of 39 years, the maximum incidence rate was in 2019 (59.4/100,000 inhabitants), there was a high frequency of cases in the south and central region of the city, 92.9% of these individuals were still in active treatment and the dropout rate was 7.1% in the period. a higher incidence of HIV was observed in adult male, from the central and southern regions of the city, with a treatment rate close to the goals of the World Health Organization and a low dropout rate.

Success Rate of Repeat Endoscopic Third Ventriculostomy Procedure According to the Ventriculostomy Orifice Closure Patterns: A Single Institutional Series of 74 Patients.

To analyze the success rates of repeat endoscopic third ventriculostomy (re-ETV) procedure according to ventriculostomy orifice closure types in patients who have undergone a second neuroendoscopic surgery for non-communicating hydrocephalus. The study included 74 patients who underwent re-ETV procedure due to dysfunctional ventriculostomy orifice. Ventriculostomy closure patterns are classified into three types: Type-1 is defined as the complete closure of the orifice with non-transparent gliosis or scar tissue. Type-2 represents the closure or narrowing of the orifice by newly formed translucent membranes. Type-3 pattern is defined as the blockage of CSF flow due to newly formed reactive membranes in the basal cisterns, with an intact ventriculostomy orifice. The frequency of the ventriculostomy closure patterns was found as follows. Type-1: 17 cases (22.97%); Type-2: 30 cases (40.54%); and Type-3: 27 cases (36.48%). The success rate of the re-ETV procedure according to closure types was 23.52% in Type-1 cases, 46.66% in Type-2 cases, and 37.03% in Type-3 cases. A significantly higher rate of Type-1 closure pattern was observed in the myelomeningocele associated hydrocephalus cases (p < 0.01). In cases where ETV failure occurs, an endoscopic exploration with reopening of the ventriculostomy orifice is a preferable treatment option. Therefore, identifying patients who may benefit from the re-ETV procedure is essential. Type-1 closure pattern was observed to have a higher frequency in cases where hydrocephalus was associated with myelomeningocele, and the success rate of re-ETV seems to be lower in those cases.