Higher Prevalence In Males Research Articles

EPID-08. PATTERN OF EPIDEMIOLOGICAL DISTRIBUTION OF INTRACRANIAL NEOPLASMS IN NIGERIA FROM 1960: A SYSTEMATIC REVIEW AND POOLED ANALYSIS

Abstract BACKGROUND Intracranial neoplasms, encompassing a range of benign and malignant tumors, pose significant health challenges worldwide. This study systematically reviews the epidemiological patterns of intracranial neoplasms in Nigeria from 1960 to the present, providing a comprehensive analysis of their distribution, demographic characteristics, and temporal trends. METHODS A systematic review was conducted following PRISMA guidelines, encompassing studies published from 1960 onwards. Databases including PubMed, Google Scholar, and African Journals Online were searched using relevant keywords. Eligible studies were those that reported on the incidence, prevalence, or demographic details of intracranial neoplasms in Nigeria. RESULTS A total of 45 studies met the inclusion criteria, encompassing 3,517 cases of intracranial neoplasms. The pooled analysis revealed a significant increase in the incidence of intracranial neoplasms over the study period. The pooled prevalence between the year 1960 to presences is 3.22 (95% CI: 1.66 – 5.22), while the pooled 10-yearly incidence was 3.66(95% CI: 1.67 – 6.32), the incidence rose from 2.18% in 1960-1969 to 4.08% in 2000-2009, and eventually to 4.84% in 2010 – 2019. The most common types of intracranial neoplasms identified were gliomas, meningioma pituitary adenomas; meningioma was the leading type found in adults followed by glioma and pituitary adenoma, while in pediatric age group glioma was leading followed by medulloblastoma, and craniopharyngioma. The demographic analysis indicated a higher prevalence in males compared to females with male-to-female ratio of 1.17:1, with the majority of cases occurring in the fourth to sixth decades of life. Geographic distribution showed higher incidence rates in southern Nigeria especially south east and south west compared to Northern Nigeria, potentially reflecting disparities in diagnostic facilities and healthcare access. CONCLUSION This review highlights an increasing trend in the incidence of intracranial neoplasms in Nigeria, with distinct demographic and geographic patterns. The findings underscore the need for improved diagnostic capabilities, enhanced public health strategies, and targeted interventions to address the burden of intracranial neoplasms in Nigeria.

An 8-year review of upper limb congenital differences at a teaching hospital in Jordan: A retrospective study.

To review the types of upper limb congenital differences in patients seen in a tertiary hospital in Jordan and to evaluate the effectiveness of the Oberg-Manske-Tonkin (OMT) system. The medical charts and the X-rays of 222 patients with upper limb congenital differences were reviewed. All these cases were categorized using the OMT classification system. A careful review of the medical charts identified 222 patients with 295 upper extremity anomalies. The prevalence was 45/10000 patients. The mean age of the patients was 6.18±5.5 years, with a higher prevalence in males 54.1%. most cases were malformations 176 (79%) and of these the radial polydactyly was the most common (18.5%). A total of 28 cases of dysplasia were identified. A total of 15 (6.7%) patients were diagnosed with syndromes, of which Poland syndrome showed the highest frequency at 2.3% of the total. The least presentation was for the deformation anomalies (1.4%). The malformation category constituted most of the congenital upper extremity difference in this study. Radial polydactyly was the most common in this category. Considering the regional differences, the need for a well-established healthcare infrastructure is a vital step toward managing and improving the outcomes of these patients.

Gene-echocardiography: unmasking the covert role of fatty acid metabolism gene mutations in adult cardiomyopathy

Abstract Background Although the role of fatty acid metabolic deficiencies in cardiomyopathy is established, the precise identity of causative genes and their respective phenotypes in adult cardiomyopathy remains unclear. Methods We implemented a combination of echocardiography and whole exome sequencing in clinically diagnosed cardiomyopathy patients to uncover this relationship. This involved recording cardiac phenotypes, identifying genes associated with disrupted fatty acid metabolism, and subsequently followed up with these patients. Results Out of 802 cardiomyopathy patients, 27 exhibited mutations in genes tied to fatty acid metabolism. Specifically, 16 patients demonstrated a hypertrophic cardiomyopathy (HCM) phenotype, and 11 showed a dilated cardiomyopathy (DCM) phenotype. The implicated genes were SLC22A5 (n=7), ACADVL (n=6), ACADS (n=4), ACADM (n=3), SLC25A20 (n=3), ACADL (n=2), HADH (n=1), and AGK (n=1), with a higher prevalence in males. Among these, the SLC22A5 mutation was predominant and correlated with HCM phenotype. Notably, compound mutations were frequently observed (16/27), leading to earlier disease onset and diminished aortic sinus dimension. Further investigation showed that smaller aortic sinus dimensions resulted from abnormal left ventricular myocardial work. HCM phenotype mutation carriers showed more consistent left ventricular hypertrophy and a higher probability of right ventricular hypertrophy, while DCM phenotype mutation carriers exhibited impaired contractile function across all left ventricle segments. After a 24-month follow-up, the DCM phenotype group demonstrated higher cardiovascular risk, including two fatalities. Conclusion Our investigation highlights the significant prevalence of mutations related to abnormal fatty acid metabolism in adult cardiomyopathy patients, underscoring the utility of a gene-echocardiography approach for diagnosis.

TÉCNICAS FISIOTERAPÊUTICAS NOS DIFERENTES NÍVEIS DE GRAVIDADE DA BRONQUIOLITE

Acute viral bronchiolitis (AVB) is the main respiratory infection in children under two years, responsible for the highest number of hospital admissions in this age group in the winter period. It presents different levels of severity, with treatment varying according to the severity of each frame, however, there is still no consensus on the performance of physiotherapy. Objective: To identify and relate the physiotherapeutic techniques used in the different levels of AVB severity. Method: A prospective, observational, cross-sectional study conducted in a public hospital of medium complexity in the metropolitan region of the south of the country. Neonatal characteristics of the child and the physiotherapeutic techniques performed were associated with the severity level of respiratory dysfunction. Results: The sample consisted of 31 infants, with a higher prevalence of males (64.5%) and moderate severity of AVB (51.4%), according to the instrument adopted for evaluation (Wood-Downes scale modified by Ferrés). Increased expiratory flow, associated with thoracic compression and decompression maneuvers, were the most used physiotherapeutic techniques (35.5%). There was no statistically significant difference in the association between bronchiolitis conduct and severity, possibly because the sample did not include serious cases. However, the relationship between initial pulmonary auscultation and techniques used (p=0.04) was observed. Conclusion: The choice of the physiotherapeutic techniques adopted was based on the findings of the initial pulmonary auscultation and not only on the characteristics of the disease. Despite consistency in intervention, as advocated in international consensus and recommendations, conventional techniques without scientific evidence were also used.

The effect of bipolar effective disorder and low socio-economic status on juvenile delinquents in Pakistan

Bipolar disorder remains a significant taboo in Pakistan, particularly among juvenile delinquents, leading to their social segregation. The prevalence of this mood disorder in Pakistani youth is concerning, largely due to limited awareness and inadequate mental health resources for children and adolescents. Economic instability, family conflict, and lack of access to care contribute to chronic stress, delaying the diagnosis and treatment of bipolar disorder. This study aimed to explore the relationship between socio-economic status and bipolar disorder in juvenile offenders, focusing on the role of social support. We included 220 children, aged 12 to 18, diagnosed with severe bipolar disorder. Most lived with both biological parents, while some were in single-parent households due to separation or loss. Our findings indicated that low socio-economic status significantly impacts mental health and personality development. Factors such as financial instability, inadequate housing, and lack of access to quality healthcare increase feelings of inferiority, leading to higher rates of bipolar disorder. Notably, 88.4% of participants exhibited extreme symptoms, with a higher prevalence in males (55%) than females (29%). The delinquency rate was significant, with 56% of boys and 32% of girls involved in criminal activities. These results suggest a strong correlation between low socio-economic status and the severity of bipolar disorder in juvenile delinquents. Many young individuals resort to crime due to unmet basic needs, reinforcing the idea that socio-economic challenges directly influence mental health outcomes. Overall, these findings underscore the urgent need for improved mental health care and support for vulnerable youth in Pakistan.

Decoding Urinary Stones: Compositional Insights and Recurrence Patterns from a Tertiary Care Hospital in Eastern India.

Background and objective Urinary stones are a prevalent medical condition entailing significant health burdens and substantial financial ramifications. Its global prevalence is expected to rise notably, particularly in low-middle-income nations. Understanding the spectrum of diverse urinary stone types is crucial for effective management and prevention. This study aims to elucidate the demographic profiles, clinical types, and recurrence of urinary stone cases at a tertiary care hospital in Eastern India. Methods and materials The clinical data from the electronic medical record of 1,231 patients with urolithiasis who underwent surgery in a tertiary care center in eastern India from January 2015 to November 2022 were retrospectively analyzed. Patient data, including demographic information, clinical records, dietary habits, water intake, and stone recurrence history, were collected. A thorough statistical analysis was conducted to elucidate the associations between patient characteristics, urinary stone composition, and recurrence. Results Among the 1,231 participants, the majority of cases (343 (27.9%)) were in the 31-40 age group, with a higher prevalence in males (876 (71.2%)) than in females (355 (28.8%)). Flank pain or abdominal pain (593 (48.1%)) was the primary complaint, followed by nausea/vomiting (227 (18.5%)). Most stones (922 (74.9%)) were located in the kidney, and calcium oxalate was the predominant stone component (773 (62.8%)). The highest stone recurrence rates were in patients aged between 21-30 years (21 (36.8%)) and 31-40 years (16 (28.0%)). A low non-vegetarian diet and adequate hydration may reduce the likelihood of stone recurrences. Conclusion This study provides insights into the compositional analysis of urinary stones in the eastern Indian population, addressing the causes of their recurrence and management strategies, which are crucial for prevention and effective management. The findings indicate that the early middle-aged group exhibited the highest incidence of urinary stones. We also observed that strict adherence to a low animal protein, along with proper hydration and lifestyle changes, significantly reduced urinary stone recurrence.

Insights Into the Epidemiological, Clinical, Histopathological, and Dermoscopic Aspects of Chronic Plaque Psoriasis.

Background Psoriasis is a persistent inflammatory condition of the skin marked by clearly demarcated red plaques adorned with silvery scales. It impacts individuals across different age ranges and presents with unique clinical, histological, and dermoscopic characteristics. This research seeks to offer an extensive assessment of the demographic, clinical, histological, and dermoscopic attributes of chronic plaque psoriasis (CPP). Methodology A total of 60 patients with CPP were included in this study. Data were collected on demographic characteristics, disease duration, clinical features, histopathological findings, and dermoscopic patterns. Statistical analysis was performed using IBM SPSS Statistics for Windows, Version 20 (Released 2011; IBM Corp., Armonk, New York), employing descriptive statistics to summarize demographic and clinical characteristicsand histopathological and dermoscopic findings. Results The study included 60 patients with CPP, predominantly aged 41-50 years (n=18, 30%), with a higher prevalence in males (n=35, 58.3%). Plaque psoriasis was the most common type observed (75%), with lesions primarily located on the scalp (n=30, 50%) and elbows (n=25, 41.7%), consistent with typical psoriasis distribution patterns. Histopathological analysis revealed acanthosis in 55 patients (91.7%) and parakeratosis in 50 patients (83.3%), indicating thickened epidermis and retention of nuclei in the stratum corneum, which are characteristic of psoriasis. Additionally, Munro's microabscesses were found in 30 patients (50%) and spongiform pustules in 10 patients (16.7%), supporting the diagnosis through classic markers. Dermoscopic evaluations identified red dots or globules in 55 patients (91.7%) and white scales in 50 patients (83.3%), essential for differentiating psoriasis from other skin conditions. Further dermoscopic findings included micro-erosions in 25 patients (41.7%), hemorrhagic spots in 15 patients (25%), and yellowish scales in 20 patients (33.3%), reflecting disease activity and inflammation. Conclusion This study underscores the importance of a multifaceted approach in diagnosing and managing CPP. The prevalence of psoriasis in middle-aged males and the common clinical presentation on the scalp and elbows are consistent with previous studies. Histopathological and dermoscopic features provide critical diagnostic support and can guide effective treatment strategies. Continued research is essential to enhance understanding and management of this prevalent dermatological condition.

Cleft lip/palate patients’ oral health status: an epidemiological study at a Brazilian pediatric hospital

Cleft lip/palate is a congenital maxillofacial malformation which results from genetic and environmental factors. In Brazil, the prevalence is 1 in every 673 live births. Several alterations result from oral clefts and affects function, aesthetics, and social life. Due to morphofunctional changes, these patients are more susceptible to disorders of the oral cavity. This study aimed to conduct an epidemiological study about alterations of the stomatognathic complex in cleft lip/palate patients at Albert Sabin Pediatric Hospital in Fortaleza, Ceará, Brazil. Files containing medical records, imaging exams and dental models of 64 patients from 2005 to 2017 were analyzed. There was a higher prevalence of males, patients from the countryside and the left unilateral transforaminal cleft subtype. 85.9% of the patients had undergone cheiloplasty and palatoplasty. About 74% of patients had dental agenesis, 71.9% developed the precanine tooth, 26.6% presented dental shape anomalies and 65.6% presented maxillary atresia. The mean DMFT index (decayed, missing, and filled teeth) of the patients was 3.51. These results corroborate and add valuable information to the available literature on cleft lip/palate patients. Our results demonstrate that cleft patients present dental and skeletal alteration that need specialized treatment.

Antipsychotics and chronic dystonia at a Botulinum Toxin clinic.

Chronic dystonia, characterised by sustained muscle contractions and abnormal postures, poses clinical challenges, especially when associated with antipsychotic medication use. To delineate the demographic and clinical profiles of adults with dystonia and examine the association with antipsychotic medication. Botulinum Toxin Clinic at Tygerberg Hospital, Cape Town, South Africa. We conducted a retrospective cohort study of adult patients seen at the Botulinum Toxin Clinic between January 2018 and June 2022. Of the 119 patients studied, those assessed with antipsychotic-induced dystonia (32.69%) presented at a younger age (p < 0.001), were more likely female (p = 0.04), received higher average dose of Botulinum toxin (p < 0.001), and incurred a higher estimated Botulinum toxin treatment cost (p = 0.01) compared to those with primary dystonia. Logistic regression identified age and Botulinum toxin dose as factors associated with psychotropic-related dystonia (p = 0.005 and p = 0.012, respectively). Clinical and demographic factors are associated with dystonia in adults taking antipsychotic medication. These patients generally manifested symptoms at an earlier age, had a higher male prevalence, and required prolonged treatment with Botulinum toxin, leading to increased costs. In those assessed with antipsychotic-induced dystonia, a comorbid diagnosis of a mood disorder was more common than that of a psychotic disorder. By identifying the demographic and clinical profile of individuals with dystonia because of antipsychotic medication, this study provides a basis for preventative strategies and enhanced patient care.

Epidemiological Aspects and Pattern of Intoxication among Elderly in Khorasan-Razavi; Northeast of Iran.

This study aimed to assess the risk factors and clinical-epidemiological patterns of acute poisoning among elderly individuals to guide prevention strategies. The epidemiological, clinical data, manner and cause of poisoning, and outcome of the registered elder cases (≥ 60 years old) in the clinical toxicology department of Imam Reza Hospital of Mashhad University of Medical Silences (CTD-IRH-MUMS) were investigated for nine months. The sex and age distribution of the patients were compared with the general population of Khorasan-Razavi using direct standardization. Among the 3064 cases registered at the hospital, 124 elderly patients were included in the study. The majority (71.8%) were male, with a mean age of 69.47. Male gender was found to be a significant risk factor for poisoning among elderly individuals compared to the general population (OR = 2.62) (1.55-4.42) (p-value < 0.001), however, it was not significant for age. Substance dependency, particularly on opiates, was common among the patients (56.5%), with a higher prevalence in males. Substance overdose (35.4%) and suicide (23.3%) were the most common methods of poisoning, with varying frequencies between genders (p-value = 0.002). Male gender was identified as a risk factor for opiate intoxication (OR = 4.68, CI = 1.70-11.83, p-value < 0.05) but not for suicide attempts. The average hospital stay duration was similar between male and female patients. The mean length of hospital stay was 3.53 ± 4.02 days (median = 3.0, range = 0.5-26 days) and was similar in both sexes. In conclusion,male gender and opiate dependency were highlighted as key factors in the poisoning of elderly individuals. These findings emphasize the importance of addressing these factors in preventive measures.

Clinical Features of Behçet’s Disease Uveitis

Abstract: Behçet’s disease (BD) is a chronic, multisystemic vasculitis first described by Professor Hulusi Behçet in 1937. It is characterized by recurrent inflammatory attacks affecting multiple organs, with uveitis being a significant and severe complication that can lead to blindness. BD typically emerges between the ages of 20 and 30 years, with a higher prevalence in males and rare occurrences in children. The prevalence and severity of BD and its ocular symptoms tend to diminish with age. In Turkey, BD is a leading cause of noninfectious uveitis, and its prevalence varies across different regions. Ocular involvement, seen in up to 90% of BD patients, often appears 2–4 years after disease onset and may be the initial sign in 10%–20% of cases. BD uveitis is characterized by recurrent nongranulomatous panuveitis and retinal vasculitis, typically affecting both eyes. Diagnostic tools such as fluorescein angiography (FA), optical coherence tomography (OCT), and laser flare photometry (LFP) are essential for monitoring disease activity and guiding treatment. FA is crucial for identifying occlusive and leaky vasculitis, while OCT helps in detecting macular complications and visualizing retinal infiltrates and their sequelae. LFP quantitatively evaluates intraocular inflammation. Recognizing the ocular manifestations of BD early is vital for accurate diagnosis and effective management. This review highlights the clinical features, diagnostic tools, and importance of early diagnosis in managing BD uveitis.

Impact of the American Society of Anesthesiologists (ASA) classification on hip fracture surgery outcomes: insights from a retrospective analysis

BackgroundThe American Society of Anesthesiologists (ASA) classification is the most used system to assess patient health status before surgery, ranging from I to V levels. This study aims to explore the impact of different ASA risk classes (ASA II [mild risk] and ASA III [severe risk]) on clinical outcomes following hip fracture surgery, including all-cause mortality and postoperative complications.MethodsA retrospective analysis from 2019 to 2021 across three Jordanian centers was conducted. The study included patients aged 65 and above who underwent hip fracture repair surgeries. Preoperative measures, intraoperative management protocols, and postoperative care were collected. Clinical data were extracted from electronic medical records, including demographics, fracture type, intraoperative data, and postoperative outcomes.ResultsThe analysis included 1033 patients, with 501 (48.5%) in the mild anesthetic risk group (ASA I-II) and 532 (51.5%) in the severe anesthetic risk group (ASA III-V). The mean age was 73 years, with a higher prevalence of males in the severe risk group. Patients in the severe risk group had more comorbidities, higher ICU admissions (15.23% vs. 6.18%), longer hospital stays (median 7 vs. 6 days), and higher rates of postoperative thromboembolic complications (3.39% vs. 1.39%) compared to the mild risk group. Additionally, the severe risk group showed higher mortality rates both in-hospital mortality (3.38% vs. 1.39%) and all-cause mortality (16.92% vs. 10.36%). Multivariate analysis identified higher ASA score as independent risk factors for increased all-cause mortality (HR = 1.64 95%CI 1.51–2.34) and thromboembolic complications (OR = 2.85 95%CI 1.16-7). Length of hospital stay was significantly associated with higher ASA score (OR = 1.04 95%CI 0.96–1.11).ConclusionThe study underscores the significant impact of anesthetic risk on the outcomes of hip fracture surgeries. Patients with higher ASA scores associated with severe systemic diseases may have at increased risk of adverse outcomes.

Assessment of Cardiovascular Risk and Factors among Post COVID-19 Patients with Type 2 Diabetes Mellitus and Dyslipidaemia

Background: The current study aims to assess the impact of structured patient education on cardiovascular complications in post-covid patients with type-2 diabetes mellitus and dyslipidaemia. Objectives: To assess the prevalence of cardiovascular risk among type-2 diabetes mellitus with dyslipidaemia in post-covid patients. to analyse the cardiovascular risk correlated with diabetes and lipid profile. to assess the impact of patient education on cardiovascular risk complications. Method: A total of 300 patients were screened and of them, 205 were enrolled in the study based on the inclusion and exclusion criteria. Patient education was given to selected patients using structured patient leaflets and oral education after baseline. They are followed up after 2 months. Cardiovascular risk was assessed by ASCVD and Framingham risk assessment score. Results: The study analysed that there was a high prevalence in males, the age group 51-70 years, non-alcoholic, and non-smokers. At the baseline, most patients were at high risk. On comparing the baseline with the review, a 49.3% difference was seen in the high-risk category. Conclusion: The study revealed that age, gender, low density lipoprotein, total cholesterol, and random blood sugar were the important cardiovascular risk factors. The implementation of pharmacist care in collaboration with physicians and nurses may reduce cardiovascular risk complications and help in better medication management.

Hubungan Kebiasaan Merokok dengan Penyakit ISPA pada Pasien di Puskesmas Mandai Kabupaten Maros

This study aims to analyze the relationship between smoking habits and the incidence of Acute Respiratory Tract Infection (ARI) in patients at Puskesmas Mandai, Maros Regency. Using quantitative methods with a correlation analytic approach and cross-sectional design, data were collected from 105 respondents from September to October 2022. The results showed that most ARI patients were children under 10 years old (51.4%), with a higher prevalence in males (58.1%). In terms of smoking status, all secondary smokers (50.5%) and the majority of tertiary smokers (37.1%) experienced ARI, while only 7.6% of primary smokers experienced ARI. Statistical analysis showed a significant association between smoking and ARI incidence (p-value less than 0.05). This finding confirms that smoking, especially in the family environment, contributes significantly to the increased incidence of ARI. It is recommended that Puskesmas Mandai conduct socialization about the dangers of smoking and further research with more respondents for more specific and comprehensive results.

Prevalence of Irritable Bowel Syndrome (IBS) in the Arab World: A Systematic Review.

Irritable Bowel Syndrome (IBS) is a common functional pathology of the gastrointestinal tract (GIT) across the globe. The prevalence rate of IBS varies across the regions. In the present systematic review, we aim to investigate the prevalence of IBS in Arab countries in recent years. To identify relevant studies, a comprehensive search was undertaken in various databases including CINAHL (Cumulated Index to Nursing and Allied Health Literature) Ultimate, Scopus, PubMed, and Web of Science. Furthermore, Google Scholar was also explored to identify relevant studies. The inclusion criteria included studies that assessed IBS in the Arab world and were published in the English language. Fifty-two cross-sectional studies from seven countries, encompassing 51,683 participants, were included. The majority of the included studies were conducted in Saudi Arabia (n=40), followed by Jordan (n=4) and Egypt (n=3). The highest prevalence rates were reported by studies from Saudi Arabia, Lebanon, and Jordan. Low prevalence rates (<20%) were noted in 19 studies included in this systematic review. Female predominance in IBS prevalence was observed in most studies, while only two studies indicated higher prevalence in males. Key risk factors included family history, anxiety, depression, gastroesophageal reflux disease, low income, diabetes, low water intake, workload, occupation, food allergy, smoking, age, chronic diseases, and stress. IBS prevalence in the Arab world varies significantly. Female predominance was seen in the present systematic review as well.

Comparative Analysis of Heart Failure with Preserved Vs Reduced Ejection Fraction: Patient Characteristics, Outcomes, Mortality Prediction, and Machine Learning Model Development in the JoHFR.

Heart failure (HF) is a global health challenge affecting millions, with significant variations in patient characteristics and outcomes based on ejection fraction. This study aimed to differentiate between HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF) with respect to patient characteristics, risk factors, comorbidities, and clinical outcomes, incorporating advanced machine learning models for mortality prediction. The study included 1861 HF patients from 21 centers in Jordan, categorized into HFrEF (EF <40%) and HFpEF (EF ≥ 50%) groups. Data were collected from 2021 to 2023, and machine learning models were employed for mortality prediction. Among the participants, 29.7% had HFpEF and 70.3% HFrEF. Significant differences were noted in demographics and comorbidities, with a higher prevalence of males, younger age, smoking, and familial history of premature ASCVD in the HFrEF group. HFpEF patients were typically older, with higher rates of diabetes, hypertension, and obesity. Machine learning analysis, mainly using the Random Forest Classifier, demonstrated significant predictive capability for mortality with an accuracy of 0.9002 and an AUC of 0.7556. Other models, including Logistic Regression, SVM, and XGBoost, also showed promising results. Length of hospital stay, need for mechanical ventilation, and number of hospital admissions were the top predictors of mortality in our study. The study underscores the heterogeneity in patient profiles between HFrEF and HFpEF. Integrating machine learning models offers valuable insights into mortality risk prediction in HF patients, highlighting the potential of advanced analytics in improving patient care and outcomes.

Molecular Characterization of Agents of Cutaneous Leishmaniasis in Dutsin-Ma Local Government Area of Katsina State, Northwestern, Nigeria

Study’s Novelty/Excerpt This study identified Leishmania major as the predominant species causing cutaneous leishmaniasis (CL) in Dutsin-ma LGA, Katsina state, Nigeria, using molecular characterization techniques such as ITS rDNA gene amplification and RFLP analysis. The findings revealed that 85.7% of individuals with suspected CL lesions were confirmed to have Leishmania infections, with a higher prevalence in males (71.4%) and farmers (71.46%). These results highlight the endemic nature of CL in this region, emphasizing the need for targeted public health interventions and awareness programs to control the spread of this neglected tropical disease. Full Abstract Leishmaniasis is one of man's neglected tropical diseases (NTD), caused by a protozoan parasite of the Leishmania genus. The dixenous life cycle of Leishmania species consists of the vertebrate and vector stages resulting in the differentiation of metabolic processes, morphological forms, and remodelling of genes in the parasite. To identify the species of Leishmania responsible for cutaneous leishmaniasis (CL) in Dutsin-ma LGA of Katsina state, Nigeria, a purposive sampling technique was employed. Samples were collected from individuals with suspected CL lesions and subjected to molecular characterization to confirm the Leishmania species. Questionnaires were also used to gather socio-demographic and behavioral data. Molecular characterization involved amplifying the ITS rDNA genes and applying the restriction fragment length polymorphism (RFLP) technique. The results revealed that 85.7% of the individuals screened had lesions associated with Leishmania infection, with a higher prevalence in males (71.4%) compared to females (14.3%). Among the infected individuals, 71.46% were farmers, and one was a student. The lesions were predominantly found on the legs (57.1%) and hand/arm (28.6%), with no lesions detected on other body parts. The ITS rDNA genes were successfully amplified from six patients, confirming Leishmania major as the predominant species causing CL through RFLP analysis. In conclusion, CL caused by L. major is endemic in Dutsin-ma LGA, Katsina state, in the Northwestern zone of Nigeria

Prevalence of Diabetic Retinopathy among Self-reported Newly Diagnosed Diabetics

Introduction: Diabetic Retinopathy (DR) poses a significant threat to individuals with diabetes, leading to visual impairment and blindness if not promptly addressed. This study focuses on the prevalence of diabetic retinopathy among self-reported newly diagnosed diabetics. Material method: This is a prospective study on 200 self-reported newly diagnosed diabetics from April 2022 to May 2023. Patient data, including complaints, diabetes duration, family history, hypertension, and therapy details, were comprehensively analyzed. Complete Ocular examinations including best-corrected visual acuity, intraocular pressure, slit lamp examination, fundus examinations, and Fundus fluorescein angiography were done. Diabetic Retinopathy was graded using a modified ETDRS grading system. Laboratory investigations included complete blood count, fasting and postprandial blood sugar, lipid profile, renal function test, and Hb1AC levels, providing a thorough assessment of patients’ ocular and systemic health. Result: Out of the 200 diabetics, 43.5% had diabetic retinopathy, with a slightly higher prevalence in males (44.64%) compared to females. The age group 50 - 59 had the highest prevalence (74.19%), and Hindus, Muslims, and other communities showed comparable percentages. Family history and hypertension were significant factors, with 88% of those with a family history developing retinopathy. NPDR was predominant (87.35%), while 12.64% had PDR. Clinically Significant Macular Edema (CSME) was present in 59.77%, with 80.76% of these cases having concomitant hypertension. Conclusion: The study emphasizes the imperative for early detection and comprehensive management of diabetic retinopathy among newly diagnosed diabetics. Age, gender, family history, and hypertension emerge as crucial determinants, advocating for integrated care and targeted screening programs to safeguard vision.

The Lipid Accumulation Product Index (LAP) and the Cardiometabolic Index (CMI) Are Useful for Predicting the Presence and Severity of Metabolic Syndrome in Adult Patients with Obesity.

Background: The concomitant occurrence of obesity and metabolic syndrome (MetS) causes a significant worsening of a patient's clinical condition. Indexes that employ anthropometric measurements alone or associated with blood parameters have been investigated for their ability to identify MetS. This study aimed to evaluate the diagnostic accuracy of three of these indexes, the body adiposity index (BAI), the lipid accumulation product index (LAP), and the cardiometabolic index (CMI), in a cohort of 1912 adult subjects with obesity. Methods and Results: MetS was found in 62.3% of the enrolled subjects, with a higher prevalence in males (72.5%) than females (60.9%). Receiver operating characteristic (ROC) analysis was used to define which index performed better. The BAI was found to be the lowest-performing index, with an ROC area of 0.50, a sensitivity of 30.31%, a specificity of 74.48%, and a likelihood ratio of 1.19. On the contrary, the LAP and the CMI showed a comparable ROC area of 0.82. The LAP had a sensitivity of 63.06%, a specificity of 86.55%, and a likelihood ratio of 4.69, while the CMI had a sensitivity of 67.59%, specificity of 81.55%, and a likelihood ratio of 3.66. The analysis was also performed in the group divided into males and females, with overlapping results. Conclusions: The LAP and the CMI performed better than the BAI in detecting MetS both in the general population with obesity and in the male/female subgroups. In the future, it will be important to validate these useful diagnostic tools in order to employ them in clinical practices.

Cardiac resynchronization therapy in inotrope-dependent heart failure: a meta-analysis.

The viability of cardiac resynchronization therapy (CRT) in inotrope-dependent heart failure (HF) has been a matter of debate. We searched Medline, EMBASE, Scopus, and the Cochrane Library until 31 December 2022. Studies were included if (i) HF patients required inotropic support at CRT implantation; (ii) patients were ≥18years old; and (iii) they provided a clear definition of 'inotrope dependence' or 'inability to wean'. A meta-analysis was performed in R (Version 3.5.1). Nineteen studies comprising 386 inotrope-dependent HF patients who received CRT (mean age 64.4years, 76.9% male) were included. A large majority survived until discharge at 91.1% [95% confidence interval (CI): 81.2% to 97.6%], 89.3% were weaned off inotropes (95% CI: 77.6% to 97.0%), and mean discharge time post-CRT was 7.8days (95% CI: 3.9 to 11.7). After 1year of follow-up, 69.7% survived (95% CI: 58.4% to 79.8%). During follow-up, the mean number of HF hospitalizations was reduced by 1.87 (95% CI: 1.04 to 2.70, P<0.00001). Post-CRT mean QRS duration was reduced by 29.0ms (95% CI: -41.3 to 16.7, P<0.00001), and mean left ventricular ejection fraction increased by 4.8% (95% CI: 3.1% to 6.6%, P<0.00001). The mean New York Heart Association (NYHA) class post-CRT was 2.7 (95% CI: 2.5 to 3.0), with a pronounced reduction of individuals in NYHA IV (risk ratio=0.27, 95% CI: 0.18 to 0.41, P<0.00001). On univariate analysis, there was a higher prevalence of males (85.7% vs. 40%), a history of left bundle branch block (71.4% vs. 30%), and more pronounced left ventricular end-diastolic dilation (274.3±7.2 vs. 225.9±6.1mL). CRT appears to be a viable option for inotrope-dependent HF, with some of these patients seeming more likely to respond.