Mild Category Research Articles

Patriarki dan Kesehatan pada Ibu yang Memiliki Balita

Patriarchy is a social system that places men as the main power holders and domination in various roles in society and households. Patriarchy requires wives or mothers to be responsible for domestic affairs and taking care of children. Mothers are one of the groups that are vulnerable to mental health problems, especially depression. The purpose of this study was to determine the relationship between patriarchy and the mental health of mothers who have toddlers, especially in terms of depression as measured by DASS 42. This research method is a quantitative study with a cross-sectional research design. The research sample used a total sampling of 37 mothers who have toddlers in Rawa Bangun Village, Rengat District, Indragiri Hulu Regency, Riau Province. The results of the DASS 42 measurement on the aspect of depression showed that the majority of mothers of toddlers were in the normal range, namely 19 people (51.4%), mild category 8 people (21.6%), moderate 8 people (21.6%), severe 1 person (2.7%) and in the very severe range 1 person (2.7%). The one way ANOVA test showed a p-value of 0.853, which means there is no relationship between patriarchy and the mental health of mothers with toddlers in terms of depression.

P0319 The Fuction of Serological Biomarkers in Assessing Endoscopic Activity in Inflammatory Bowel Disease

Abstract Background Identifying IBD and evaluating disease activity depend critically on endoscopy. But it is expensive and intrusive, which emphasizes the need for more easily available and non-invasive biomarkers to help in IBD diagnosis and assessment. This work seeks to investigate their correlation with endoscopic activity and assess the diagnostic relevance in IBD. Methods Between January 2022 and September 2024, we registered 365 UC patients, 319 CD patients and 100 control patients at the First Affiliated Hospital of Zhengzhou University. The subsequent biomarkers were examined:WBC, Hb, PLT, N, L, HCT, EOS, ALB, GLB, CRP, ESR, ALB/GLB (AGR), CRP/ALB (CAR), CRP/L (CLR), PLT/ALB (PAR), PLT/L(PLR), N/L (NLR). MES, SES-CD were respectively utilized to evaluate endoscopic activity in UC and CD. Mild endoscopic activity was characterized by MES=1 or SES-CD=3-6, moderate activity by MES=2 or SES-CD=7-15, and severe activity by MES=3 or SES-CD≥16. Biomarker comparions were conducted among UC, CD, and control groups, and between biomarkers and endoscopic activity were examined. Results 1. While Hb, HCT, L, ALB, and AGR were significantly lower (P<0.05) in both UC and CD groups compared with controls, N, PLT, GLB, CRP, ESR, CAR, CLR, PLR, PAR, and NLR were significantly raised (P<0.001). EOS levels in UC group averaged 0.19×109/L while in CD group they averaged 0.14×109/L, with this difference reaching statistical significance (P<0.01). 2. Whereas WBC, PLT, N, CRP, ESR, GLB, CAR, CLR, PLR, PAR, and NLR were significantly increased (P<0.01), Hb, HCT, ALB, and AGR were significantly lowered in those with moderate to severe disease compared to mild group. Significant variations in N, CRP, ESR, ALR, GLB, AGR, CAR, CLR, and PAR were noted among mild, moderate, and severe disease categories for CD patients (P<0.05). 3. ESR (OR=1.09, P=0.0015), CAR (OR=381.71, P=0.0018) and PAR (OR=1.27, P=0.0072) were independent risk factors for UC endoscopic activity. The AUC of their combination (0.87; 95%CI 0.82-0.92) surpassed the individual values of ESR(0.81; 95%CI 0.75-0.87), CAR(0.84; 95%CI 0.79-0.89), and PAR(0.81; 95%CI 0.76-0.87). AGR (OR=0.05, P<0.001) and CAR (OR=1.72, P=0.0117) were independent risk factors for endoscopic activity in CD. The AUC for the combination (0.81; 95%CI 0.75-0.86) was also higher than only AGR (0.80; 95%CI 0.74-0.85) or CAR (0.74; 95%CI 0.68-0.80). Conclusion IBD endoscopic activity was substantially correlated with biomarkers WBC, Hb, HCT, PLT, N, CRP, ESR, ALB, GLB, AGR, CAR, CLR, PLR, PAR, and NLR. While a lower AGR and a higher CAR may indicate more severe endoscopic activity in CD patients, elevated ESR, CAR, and PAR may point to more severe endoscopic activity in UC patients. Their amalgamation can enhance diagnostic efficacy.

Post-COVID-19 laryngo-tracheal sequelae: a comprehensive study at a tertiary care centre

BackgroundThe laryngo-tracheal framework is a complex structure responsible for several functions, including phonation, airway formation for breathing, and preventing aspiration. These functions rely on precise neurological and structural coordination. The COVID-19 pandemic primarily affected the lungs and upper respiratory tract, and the patients were classified into mild, moderate, and severe categories to determine appropriate management strategies, including home isolation and hospital admission. Mild cases typically underwent home isolation, while moderate-to-severe cases required hospitalization. Moderate cases often necessitated oxygen supplementation through various means such as oxygen masks, non-rebreather masks, and high-flow nasal cannula, while severe cases required mechanical support and emergency procedures like intubation, continuous positive airway pressure, and tracheostomy. These interventions, along with other factors like viral neuritis and comorbid illnesses, result in various laryngo-tracheal sequelae; in this study, we have tried to look for the laryngo-tracheal sequelae in post-COVID-19 patients.MethodsA sample of 348 patients who were diagnosed with COVID-19 using reverse transcription polymerase chain reaction were identified retrospectively, and their demographics, comorbidities, intubation/tracheostomy, and management data were collected; then all the patients were subjected to video-laryngoscopy, and findings were noted and analysed.Type of studyRetrospective cross-sectional observational study.ObjectivesPrimary objective of the study was to assess the rates of laryngo-tracheal sequelae occurring in post-COVID-19 patients.Secondary objective was to assess the role of various factors along with COVID-19 that have led to the sequelae.ResultsThe study population included 348 participants, with an age distribution ranging from 21 to over 60 years.Post-COVID-19 symptoms were seen in 22.7% of all the patients included out of which hoarseness of voice 32.9%, difficulty in breathing 24.05%, and other related symptoms such as cough 18.98%, foreign body sensation 8.8%, throat irritation 7.5%, throat pain 5.06%, throat dryness 1.2%, and difficulty in swallowing 1.2% of the patients.Majority of our patients had history of hospital admission which was predominant (87.1%) over home isolation (10.3%). Most common comorbidity was diabetes mellitus (DM) (62.4%) along with hypertension.The various findings were noted in 10.1% of total patients included in the study including vocal cord polyps 19.9%, vocal cord paresis 19.9%, vocal cord granulomas 8.5%, vocal nodule 5.7%, and chronic congestion of laryngeal inlet 17.1% of the patients.Significant associations were observed between sequelae and factors such as hospital admission, intubation and tracheostomy, duration of O2 support, and diabetes mellitus.ConclusionsLaryngo-tracheal sequelae are commonly present and are persistent for months after recovery from COVID-19 in hospitalized and intubated/tracheostomized patients due to various factors related to the disease and its treatment.

Association between burnout and quality of care in primary care

To assess the influence of burnout in family physicians on their score on the EQA index. Observational study. SITE: Study conducted in the primary care centers of the Terrassa Health Consortium, in Vallès Occidental, Catalonia. Primary care physicians with a basic care unit were included. Of the 107 family doctors working in the 8 primary care centers of the Terrassa Health Consortium, 73 professionals participated. A self-administered survey was carried out with demographic and occupational elements such as age, gender, length of service at the work center, the MBI and the last self-reported EQA value belonging to the year 2023. Sociodemographic variables were analysed; years of experience and clinical variables such as the EQA, the Maslach test and its dimensions emotional exhaustion, depersonalisation and personal fulfilment. The Maslach Burnout Inventory test was administered. The level of statistical significance considered was 5%. Seventy-threefamily doctors took the Maslach test, 54 (74%) had burnout, of which 21.9% (16) were severe. A statistically significant relationship was found between burnout and EQA (P=.023) and between emotional exhaustion and EQA (P=.013) in the mild and severe categories (P=.003). Family physicians with burnout have a lower EQA value, which is not associated with age, sex or years of experience, but with the emotional exhaustion suffered.

The first assessment of Angiotensin-Converting Enzyme 1 (ACE1) D/I polymorphism and demographic factors in association with COVID-19 outcomes in the Moroccan Population.

SARS-CoV-2 responsible for the COVID-19 pandemic, infiltrates the human body by binding to the ACE2 receptor in the respiratory system cell membranes, leading to severe lung tissue damage. An analog of ACE2, ACE1, has gained attention due to its well-known Deletion/Insertion (D/I) polymorphism, which seems to be associated with COVID-19 outcomes. This study aims to reveal the allelic and genotypic frequencies of the rs4646994 polymorphism in the Moroccan population and investigate the association between COVID-19 outcomes and both genotypic and demographic data. We screened 162 Moroccan COVID-19 patients for the ACE1 gene D/I polymorphism using PCR amplification of the ACE1 polymorphic region within intron 16. Statistical analysis of the relationship between COVID-19 outcomes and each of the genetic and demographic data was performed using R software. The D allele was present in 74% of subjects. Homozygous (II) and heterozygous (DI) genotypes for the Insertion allele were present in 41.4% and 5.6% of patients, respectively. The median age in the COVID-19 'critical symptoms' category was significantly higher and gradually decreased with less severe symptoms. Similarly, males were significantly overrepresented in the 'critical symptoms' category, while females predominated in the 'mild symptoms' category. The present study reports the prevalence of ACE1 D/I alleles for the first time in the Moroccan population and confirms the strong association of severe COVID-19 outcomes with male sex and older age. Moreover, this work is the first to explore the relationship between ACE1 D/I polymorphism and COVID-19 clinical outcomes in North African adults. The lack of a significant association may be due to cohort size or population-specific factors. A comprehensive investigation in a larger North African cohort is highly recommended.

Penerapan Dan Efektifitas Senam Dismenore (Menstruasi) Terhadap Antisipasi Munculnya Nyeri Haid Pada Remaja Putri Di SMP Negeri Kota Bogor

Menstruation is a physiological change in a woman's body that occurs periodically and is influenced by reproductive hormones, this usually occurs every month between adolescence and menopause. The purpose of the study was to determine changes in the pain scale in adolescent girls who experience dysmenorrhea before and after the implementation of dysmenorrhea exercises. This research method uses a descriptive case study by observing female adolescent respondents at SMP Negeri Kota Bogor who were given the implementation of dysmenorrhea exercises which were carried out for 3 meetings in 1 week with a time of ± 30 minutes each meeting. The results showed that after the implementation of dysmenorrhea exercises there was a decrease in the pain scale, before the gymnastics the pain scale was in the moderate pain category, after the dysmenorrhea exercises were carried out it was included in the mild pain category. The conclusion of the study stated that this dysmenorrhea exercise can reduce the pain scale in adolescent girls who experience dysmenorrhea.

Prediction of In-Hospital Mortality after Emergency Laparotomy Using Glasgow Coma Scale, ASA Physical Status Classification, and P-POSSUM Score.

To determine the importance of the Glasgow Coma scale (GCS), ASA physical status classification system, and P-POSSUM score in predicting mortality among patients undergoing emergency laparotomies. An analytical study. Place and Duration of the Study: Department of General Surgery, Sheikh Khalifa Bin Zayed Al-Nahyan Hospital Muzaffarabad, Pakistan, from October 2020 to January 2022. All emergency laparotomies performed during the above-mentioned period were included consecutively, excluding trauma laparotomies, re-do laparotomies after elective surgery, appendectomies, cholecystectomies, pancreatectomies, organ transplantation surgeries, and laparotomies due to gynaecological or vascular causes such as ruptured abdominal aortic aneurysm. The GCS scores were broken down into mild (14-15), moderate (9-13), and severe (3-8) categories. The ASA scoring was classified into five classes, i.e., Classes I to V. The P-POSSUM scores were assessed for each of the following five groups: (≤10, 11-20, 21-30, 31-40, and ≥41). Out of 50 patients (mean age: 47 ± 19 years), there were 39 (78%) males and 11 (22%) females. The median values for GCS and P-POSSUM scores were 15 and 11.1, respectively. According to the ASA, most patients (21, 42%) fit into Class II. Twelve (24%) patients died, while 38 (76%) survived. The mortality rate increased with an increasing P-POSSUM score, a lowering GCS score, and a higher class of ASA (all p <0.001). The ROC curve analysis showed that P-POSSUM had the best performance at 0.987, followed by ASA (0.951) and GCS (0.411). The ASA Physical Status Classification System and P-POSSUM scoring were significantly predictive of mortality after an emergency laparotomy. ASA Physical Status Classification System, Emergency laparotomy, Glasgow coma scale, Mortality, Outcome, P-POSSUM.

D-Dimer Level on Admission as an Outcome Predictor of COVID-19 Patients in Tertiary Care Hospitals in Bangladesh

Background: Worldwide, along with clinical scenario and imaging techniques, biochemical markers have been used in management of Coronavirus Disease-2019 (COVID-19). Different haematological, biochemical and immunological markers are being used to identify high risk group of patients early for prompt initiation of treatment. Coagulopathy is a mainstay of COVID-19 disease pathogenesis and D-dimer is one of the markers elevated markedly earlier, even when there is no significant clinical symptom of severity and imaging changes. However, there is no conclusive data regarding this issue in our country. Objective: This study aimed to evaluate the association of on admission D-dimer level with in-hospital outcome. Methodology: This prospective observational study was conducted in Bangabandhu Sheikh Mujib Medical University and Dhaka Medical College Hospital from June 2020 to May 2021. Ethical clearance was obtained from institutional review board (IRB) of BSMMU. Total 186 COVID-19 admitted patients were enrolled in accordance with inclusion &amp; exclusion criteria. A detailed history and thorough clinical examination were carried out in each patient. D–dimer level was detected by standard procedure on the first day of admission by SYSMEX CS-1600 analyser. Clinical and laboratory information were recorded with a semi-structured questionnaire. Severity of COVID-19 patients was categorized according to WHO classification. After collection of all the required data, analysis was done by SPSS 24.0. Results: Mean age of all patients was 58.60±12.30 years (range: 22-90 years) wherein maximum belonged to 51-70 years of age (62.3%) and male gender (71.5%). Maximum study patients were diabetic (57%) and hypertensive (57%) for average duration more than 10 years. Most of the study patients (71%) were in severe category of COVID-19, followed by moderate (25.8%), mild (2.7%) and critical (0.5%) category. Median D-dimer of all patients was 0.96 µg/mL. On admission D-dimer level was significantly higher among severe/critical COVID-19 patients compared to mild/moderate (1.11 vs 0.54µg/mL, p &lt;0.05). Twenty-eight (28) days mortality rate of admitted COVID-19 patients was 18.3%. Receiver operator curve analysis found highly significant cut-off value for D-dimer (1.62 µg/mL) with 70.6% sensitivity and 78.3% specificity in predicting 28-days hospital mortality of COVID-19 patients (AUC= 0.839, p value &lt;0.001). Besides, patients with D-dimer ≥1.62 µg/mL had significantly higher NLR (8.6 vs 4.6), CRP (107 vs 57mg/L) and serum LDH (512 vs 370 IU/L) level compared to patients with D-dimer &lt;1.62 µg/mL. Conclusion: On admission D-dimer was significantly associated with severity as well as 28-days mortality of COVID-19. Keyword: COVID-19, Corona virus, D-dimer.

Analyzing the Impact of Binaural Beats on Anxiety Levels by a New Method Based on Denoised Harmonic Subtraction and Transient Temporal Feature Extraction.

Anxiety is a widespread mental health issue, and binaural beats have been explored as a potential non-invasive treatment. EEG data reveal changes in neural oscillation and connectivity linked to anxiety reduction; however, harmonics introduced during signal acquisition and processing often distort these findings. Existing methods struggle to effectively reduce harmonics and capture the fine-grained temporal dynamics of EEG signals, leading to inaccurate feature extraction. Hence, a novel Denoised Harmonic Subtraction and Transient Temporal Feature Extraction is proposed to improve the analysis of the impact of binaural beats on anxiety levels. Initially, a novel Wiener Fused Convo Filter is introduced to capture spatial features and eliminate linear noise in EEG signals. Next, an Intrinsic Harmonic Subtraction Network is employed, utilizing the Attentive Weighted Least Mean Square (AW-LMS) algorithm to capture nonlinear summation and resonant coupling effects, effectively eliminating the misinterpretation of brain rhythms. To address the challenge of fine-grained temporal dynamics, an Embedded Transfo XL Recurrent Network is introduced to detect and extract relevant parameters associated with transient events in EEG data. Finally, EEG data undergo harmonic reduction and temporal feature extraction before classification with a cross-correlated Markov Deep Q-Network (DQN). This facilitates anxiety level classification into normal, mild, moderate, and severe categories. The model demonstrated a high accuracy of 95.6%, precision of 90%, sensitivity of 93.2%, and specificity of 96% in classifying anxiety levels, outperforming previous models. This integrated approach enhances EEG signal processing, enabling reliable anxiety classification and offering valuable insights for therapeutic interventions.

Pengaruh Kombinasi Aromaterapi Lemon Dan Akupresur Terhadap Penurunan Mual dan Muntah Pada Ibu Hamil Trimester I di Praktek Mandiri Bidan Suryati Kabupaten Jayapura

Nausea and vomiting are common symptoms experienced by pregnant women, especially in the first trimester, and can interfere with the quality of life and well-being of the mother. Although this condition is often considered normal, excessive nausea and vomiting can lead to dehydration, electrolyte imbalance, and weight loss, which is a risk to the health of the mother and fetus. The combination of lemon aromatherapy and acupressure has long been known as a non-invasive method that can help reduce nausea and vomiting. The purpose of the study was to evaluate the effect of the combination of lemon aromatherapy and acupressure on the reduction of nausea and vomiting in pregnant women in the first trimester at the Suryati Midwifery Independent Practice, Jayapura Regency. The results showed that before the intervention was given, the majority of respondents in the intervention and control groups experienced nausea and vomiting in the moderate and severe categories. After the intervention for 7 days with a frequency of 3 times a day, the intervention group experienced a significant decrease in the rate of nausea and vomiting, switching to the moderate and mild categories. In contrast, the control group that did not receive the intervention showed no significant change, with the majority remaining in the category of moderate and severe nausea and vomiting. Statistical analysis showed that there was a significant difference in the intervention group with a p-value of 0.001 (p &lt; 0.05), while there was no significant difference in the control group (p-value 0.564). These findings confirm the effectiveness of the combination of lemon aromatherapy and acupressure as a safe and effective alternative in reducing nausea and vomiting in pregnant women in the first trimester.

The Relationship Between Anxiety and Eating Patterns Among Clinical Clerkship Students at Prima Indonesia University

Medical students often experience higher levels of stress compared to students in other faculties. They have high expectations from family and society towards them, which is one of the causes of this stress. They also need to understand actual medical practice and read many books every day. So, the researcher conducted a cross-sectional analytic observational approach with 64 respondents, which aimed to understand the relationship between anxiety and diet in clinical clerkship students at UNPRI. This research study will investigate the relationship between diet and anxiety disorders in clinical clerkship students at UNPRI. The main anxiety disorder is General Anxiety Disorder-7 (GAD-7). This study is an analytic observational study with a cross-sectional approach. This result is relevant considering the majority of respondents, 53.1%, were in the mild anxiety category, while 40.6% had moderate anxiety, and 6.3% suffered from severe anxiety. The dietary patterns to be studied are the frequency of food consumed and the method to record the regulated meals. From the study, it was found that there was a significant relationship between anxiety and diet found through bivariate analysis with the Spearman correlation test. The correlation coefficient (r) was 0.681, and the significance value (p) was 0.000. This indicates a positive correlation where higher anxiety is associated with greater disordered eating.

Towards a voice-based severity scale for Parkinson’s disease monitoring

Abstract The unified Parkinson’s disease rating scale, used to monitor the disease progression, is based on visual assessments of motor symptoms. Vocal manifestations of Parkinson’s disease differ from the motor ones, specifically in their rate of change with disease severity. As such, a different scale is needed to provide the voice measures of the disease severity. This study employed a dataset of voice-quality features from repeated recordings of Parkinson’s disease patients. The changes of all voice features across the categories were evaluated using one-way analysis-of-variance and support vector regression. Significant changes and marked non-linearly increasing or decreasing trends were shown for all features, for the three-categories scale. Significant changes and trends were obtained in the 12-categories scale, but only for the mild category and the severe category range of scores. The findings imply a potential for voice-based monitoring for the early and late severity stages of Parkinson’s disease that could be continuously used by patients and provide timely warnings of deterioration.

Bleeding Symptoms in Pediatric Patients with Congenital FVII Deficiency and Correlation to Thrombin Generation Assay Parameters: A Single-Center Retrospective Analysis.

Inherited factor VII deficiency is the most common rare bleeding disorder, affecting about 1/500,000 individuals without gender predilection. Most of the patients with FVII 20-50% are asymptomatic, but post-traumatic or post-surgical bleeding may often occur since there is not an exact correlation between FVII plasma levels and the bleeding phenotype. We enrolled 19 children and adolescents with FVII levels of 20-35% and 33 controls. Laboratory data collected included thrombin generation, prothrombin time, activated partial thromboplastin time, fibrinogen, and FVII levels. In our study, we found a statistical difference in the lag time ratio (p < 0.01) and tt-peak ratio (p < 0.05) between patients and controls but no difference in the other parameters, such as the endogenous thrombin potential (ETP). However, when we categorized patients, regardless of their bleeding scores, as presenting symptoms and having no symptoms, both the lag time ratio (p = 0.01) and tt-peak ratio (p < 0.05) were significantly different, and the vel. index % showed increased levels in patients without symptoms (p < 0.05). This study shows that thrombin generation may be a useful tool in assessing the risk of bleeding symptoms in children with an FVII deficiency categorized in the mild category (20-35%), although we cannot predict the severity of the bleeding.

The Effect Red Betel Leaves (Piper Crocatum) On Pregnancy Gingivitis

Gingivitis is a periodontal disease that easily occurs in pregnant women, such as inflammation of the gums (3). The decrease in pH in the mouth, the influence of the hormones estrogen and progesterone during pregnancy causes gum inflammation (4), so safe therapy is needed such as boiled water from red betel leaves which can improve the oral hygiene status of gingivitis sufferers (11) and the inhibitory power of red betel leaf extract is very potently inhibits microorganisms that cause periodontal disease (12). The aim of this study was to determine whether there is an effect of boiled water from red betel leaves (piper crocatum) on pregnancy gingivitis. The method used in this research is quasi experimental with a pretest-posttest with control group design. The sample studied was 60 pregnant women, consisting of 30 pregnant women in the treatment group and 30 pregnant women in the control group. Data analysis used the Independent T-test. The results of the case group research in the pretest were 15 people (50%) of pregnant women with gingivitis and 13 people (43.6%) in the moderate category, 6 people (20%) in the post test results after intervention without gingivitis and 21 people (70%) in the mild category. ), while in the control group in the pretest, 19 people (63.3%) had mild category of pregnant women with gingivitis, 9 people (30%) in the moderate category, 17 people (56.7%) in the post test after intervention in the mild category, moderate category 11 people (36.7%), as well as the influence of boiled water from red betel leaves (piper crocatum) on pregnancy gingivitis (pvalue 0.000 &lt; 0.05). The conclusion is that boiled water from red betel leaves can reduce gingivitis so it can be used as a safe medicine to reduce gingivitis in pregnant women while maintaining oral and dental hygiene.

Study of the Correlation between the Extent and Clinical Severity, and the Histopathological Characteristics of Geographic Tongue.

Geographic tongue is an oral lesion with an unknown etiology. Recently, the Geographic Tongue Area and Severity Index (GTASI) has been proposed to assess the area and severity of geographic tongue, aiming to measure the clinical severity of the condition. However, this index does not account for the histopathology, which vary based on the clinical stage of the lesion and the biopsy area. The present study aimed to evaluate the correlation between GTASI score and its histopathological features. This cross-sectional observational study included 40 participants diagnosed with GT confirmed both clinically and histopathologically. Considering GT severity, a vast majority 60% of cases were classified as mild, with females' predominance in both mild and severe categories. The average age of participants was 56 years for mild and severe cases and 47 years for moderate ones. The prevalent histopathological features of geographic tongue included parakeratosis, acanthosis, spongiosis, basal layer hyperplasia, mono- and polymorphonuclear exocytosis, suprapapillary hypotrophy, claviform epithelial ridges, fusion of epithelial ridges, conjunctival papillary edema, and chronic subepithelial infiltration, with no significant differences taking into consideration clinical severity level. Papillary vascular ectasia, Munro microabscesses, Kogoj pustules, and dense connective tissue were more prevalent in with more severe cases of GT. Mild inflammatory infiltrate intensity was predominant in persons with mild GT, while moderate infiltrate intensity was found predominantly in moderate cases of GT. The clinical severity level of GT closely corresponds with its histopathological characteristics.

Patterns of C1-Inhibitor Plasma Levels and Kinin-Kallikrein System Activation in Relation to COVID-19 Severity.

Although more than four years have passed since the pandemic began, SARS-CoV-2 continues to be of concern. Therefore, research into the underlying mechanisms that contribute to the development of the disease, especially in more severe forms, remains a priority. Sustained activation of the complement (CS), contact (CAS), and fibrinolytic and kinin-kallikrein systems (KKS) has been shown to play a central role in the pathogenesis of the disease. Since the C1 esterase inhibitor (C1-INH) is a potent inhibitor of all these systems, its role in the disease has been investigated, but some issues remained unresolved. We evaluated the impact of C1-INH and KKS on disease progression in a cohort of 45 COVID-19 patients divided into groups according to disease severity. We measured plasma levels of total and functional C1-INH and its complexes with kallikrein (PKa), reflecting KKS activation and kallikrein spontaneous activity. We observed increased total and functional plasma concentrations of C1-INH in COVID-19 patients. A direct correlation (positive Spearman's r) was observed between C1-INH levels, especially functional C1-INH, and the severity of the disease. Moreover, a significant reduction in the ratio of functional over total C1-INH was evident in patients exhibiting mild to intermediate clinical severity but not in critically ill patients. Accordingly, activation of the KKS, assessed as an increase in PKa:C1-INH complexes, was explicitly observed in the mild categories. Our study's findings on the consumption of C1-INH and the activation of the KKS in the less severe stages of COVID-19 but not in the critical stage suggest a potential role for C1-INH in containing disease severity. These results underscore the importance of C1-INH in the early phases of the disease and its potential implications in COVID-19 progression and/or long-term effects.

COVID-19 inflammatory signature in a Mozambican cohort: unchanged red blood series and reduced levels of IL-6 and other proinflammatory cytokines

SummaryBackgroundAlterations in haematological, biochemical parameters and cytokine levels, were reported in patients with COVID-19, however, there is an underrepresentation of the African population, which could provide evidence for understanding SARS-CoV-2 pathogenesis and useful tools for clinical management of cases. In this study, we aimed to determine the haematological, biochemical and cytokine profile in Mozambican individuals with SARS-CoV-2.MethodsA cohort of 85 Mozambican individuals with RT-PCR SARS-CoV-2 results, was stratified into negative, asymptomatic, mild, moderate, and severe categories. Haematological, biochemical and cytokines measurement were performed on samples from the study participants. Principal component analysis (PCA) was performed to identify similar patterns among the study cases. Comparisons between groups were performed using the Kruskal-Wallis test. Receiver operating characteristic (ROC) and area under the curve (AUC) analysis were conducted to evaluate the ability of these parameters to distinguish severe from non-severe cases of SARS-CoV-2 infection.ResultsSARS-CoV-2 infection was associated with a significant (p < 0.05) decrease in peripheral blood absolute counts of total lymphocytes and eosinophils, below the reference values along with no abnormal change (p > 0.05) in red blood cell count, haemoglobin, platelets and other red series parameters. At the serum level, SARS-CoV-2 infection was associated with an increase in serum levels of C-reactive protein (C-RP) and glucose above the reference values and to a significant reduction a significant (p < 0.05) reduction in levels of interferon-gamma (INF-γ), Tumour Necrosis Factor alfa (TNF-α) and the interleukin 1 beta (IL-1β) and IL-6 in severe cases, when compared to negative cases. Haematological, biochemical and cytokine profiles segregate severe from non-severe cases of COVID-19 with an excellent performance of C-RP (AUC = 0.95; p < 0.001) and good performance of lymphocytes (AUC = 0.88; p < 0.001) and IL-15 (AUC = 0.86; p < 0.001).ConclusionThe lack of variation in red and platelet series, coupled with a decrease in the levels of classical pro-inflammatory in severe cases, deviates from what has been reported in other contexts suggesting, that there may be peculiarities in COVID-19 manifestation within the context of this study population. Furthermore, these results identify parameters with potential for clinical management of COVID-19 and therefore good resource allocation, particularly for severe cases.

Interdialytic Weight Gain and Nutritional Status are Associated with Quality of Life Among Hemodialysis Patients in Dr. Mohammad Hoesin General Hospital Palembang

Hemodialysis patients experience changes in all aspects of their life, particularly due to fluid and dietary restrictions. Excessive interdialytic weight gain and malnutrition are common problems that negatively impact the increase of morbidity and mortality in these patients, as well as a decrease in their quality of life. This research aims to determine the relationship between interdialytic weight gain and nutritional status with the quality of life of chronic kidney disease patients undergoing hemodialysis at Dr. Mohammad Hoesin General Hospital Palembang. 102 patients were involved in this cross-sectional study, and they were taken by purposive sampling. IDWG data was collected using The Interdialytic Weight Gain (IDWG) observation sheet, nutritional status was identified using the Dialysis Malnutrition Score (DMS), and quality of life was assessed using The Kidney Disease Quality of Life Short Form-36 (KDQOL-36TM). The data analysis used in this study is Fisher Exact test. Based on The Fisher Exact test, there is a relationship between IDWG and quality of life (p=0.048). The results of statistical analysis also showed a relationship between nutritional status and quality of life (p=0.047). Most patients had IDWG in the mild category, good nutritional status, and poor quality of life based on KDQOL-36TM. This study concludes a relationship between interdialytic weight gain and nutritional status with the quality of life of patients undergoing hemodialysis. It is recommended that health workers in hemodialysis units monitor interdialysis weight gain regularly and conduct routine nutritional screenings to prevent a decrease in quality of life.

Deep learning prediction of curve severity from rasterstereographic back images in adolescent idiopathic scoliosis.

Radiation-free systems based on dorsal surface topography can potentially represent an alternative to radiographic examination for early screening of scoliosis, based on the ability of recognizing the presence of deformity or classifying its severity. This study aims to assess the effectiveness of a deep learning model based on convolutional neural networks in directly predicting the Cobb angle from rasterstereographic images of the back surface in subjects with adolescent idiopathic scoliosis. Two datasets, comprising a total of 900 individuals, were utilized for model training (720 samples) and testing (180). Rasterstereographic scans were performed using the Formetric4D device. The true Cobb angle was obtained from radiographic examination. The best model configuration was identified by comparing different network architectures and hyperparameters through cross-validation in the training set. The performance of the developed model in predicting the Cobb angle was assessed on the test set. The accuracy in classifying scoliosis severity (non-scoliotic, mild, and moderate category) based on Cobb angle was evaluated as well. The mean absolute error in predicting the Cobb angle was 6.1° ± 5.0°. Moderate correlation (r = 0.68) and a root-mean-square error of 8° between the predicted and true values was reported. The overall accuracy in classifying scoliosis severity was 59%. Despite some improvement over previous approaches that relied on spine shape reconstruction, the performance of the present fully automatic application is below that of radiographic evaluation performed by human operators. The study confirms that rasterstereography cannot be considered a valid non-invasive alternative to radiographic examination for clinical purposes.

Exploring the Relationship Between Visceral Fat and Coronary Artery Calcification Risk Using Metabolic Score for Visceral Fat (METS-VF).

Metabolic Score for Visceral Fat (METS-VF) is a novel indicator for estimating intra-abdominal fat, yet its connection with coronary artery calcification (CAC) remains uncharted. Our research aims to explore the novel METS-VF indicator's link to CAC while comparing its performance against relevant anthropometric indices. This study enrolled participants who underwent health checkups and computed tomography scans for categorizing severity of CAC using the coronary artery calcium score. The METS-VF was calculated and compared with anthropometric indices in estimating the presence of CAC and different CAC severity using receiver operating characteristic curves. Overall, 1217 participants (mean age 50.7 ± 9.9, 53.8% male) were included. METS-VF (odds ratio [OR], 1.506; 95% confidence interval [CI], 1.181-1.921; p = 0.001) was positively associated with the presence of CAC, even after accounting for cardiometabolic factors. Notably, METS-VF was positively associated with mild (OR, 1.450; 95% CI, 1.115-1.886; p = 0.006), moderate (OR, 1.865; 95% CI, 1.137-3.062; p = 0.014), and severe (OR, 2.316; 95% CI, 1.090-4.923; p = 0.029) CAC. Moreover, METS-VF yielded the highest area under curve (AUC) value in the estimation of the CAC presence (AUC = 0.710), mild (AUC = 0.682), moderate (AUC = 0.757), and severe (AUC = 0.807) CAC when compared with body mass index, waist circumference, visceral adiposity index, triglyceride-glucose index, and metabolic score for insulin resistance. The optimal METS-VF cut-off value was 6.4 for predicting CAC. METS-VF emerged as a strong independent marker for detecting CAC presence across mild, moderate, and severe CAC categories, outperforming major anthropometric indices in accurately estimating the presence of CAC and different severity of CAC.