Morbid Conditions Research Articles

Magnitude and Determinants of Adverse Perinatal Outcomes in Tefera Hailu Memorial Hospital, Sekota Town, Northern Ethiopia.

BackgroundOf 133 million births globally, 3.7 million died in the neonatal period and 3 million are stillborn. The perinatal mortality rate in Ethiopia is 46 per 1000 pregnancies. However, area-specific information is limited in this regard. Therefore, this study aimed to determine the magnitude and determinants of adverse perinatal outcomes in Northern Ethiopia.MethodAn institution-based cross-sectional study was conducted by reviewing the medical records of mothers who gave birth between September 2015 and August 2016. The completeness and consistency of data were checked. Descriptive statistics were computed. A multinomial logistic regression model was fitted to identify determinants of adverse perinatal outcomes. Odds ratio with 95%CI was used and variables that had a P-value of < 0.05 in the final model were considered statistically significant.ResultThe magnitude of adverse perinatal outcomes was 214/799(27.47 %). Out of that, 10.8% had a perinatal mortality outcome, and 16.7% had a perinatal morbidity. Not using modern contraceptives(AOR = 1.7, 95% CI: 1.1-2.7), labor induction or augmentation(AOR = 3.0, 95% CI: 1.2-7.8), obstetric complications(AOR = 2.2, 95% CI: 1.1-4.5), attending antenatal care(AOR = 0.4, 95% CI: 0.2-0.8), primigravida (AOR = 0.5, 95% CI: 0.3-0.9), had no history of medical illness(AOR = 0.5, 95% CI: 0.3-0.8), and urban residency(AOR = 1.9, 95% CI, 1.1-2.9) were the significant determinants of perinatal outcome.ConclusionThe magnitude of adverse perinatal outcomes was considerable and 1 in 5 neonates either had morbidity conditions or died. Improving family planning utilization, ANC, referral linkage, and management of obstetric complications could help to reduce the undesirable consequences of perinatal outcomes.

Morbidity Patterns among Menopausal Women in Rural Uttar Pradesh, India: A Cross-Sectional Study.

ObjectivesThe quality of life declines gradually as women enter menopause, owing to the various problems associated with estrogen deficiency and aging, which adds to their morbidities. This study aimed to investigate the patterns of morbidity among rural menopausal women and compare the morbidity patterns among menopausal transition group and post-menopausal women.MethodsThis community-based cross-sectional study included menopausal women aged 45–55 years from rural areas of the Etawah district, Uttar Pradesh, India. To select blocks and villages of the district, multistage random sampling was performed. According to a pretested, semistructured schedule, data were collected through interviews.ResultsA total of 315 women participated in the study. The most frequent complaints among the participants were of feeling tired and worn out (85.1%) and of muscle and joint pains (67.6%). Poor memory (P = 0.046) and diabetes (P = 0.024) were more common in women who were in the menopause transition phase than in those who were in the postmenopausal phase.ConclusionsThis study showed that majority of the menopausal women suffered from physical problems. Lifestyle modification and awareness programs will be beneficial among women in menopausal transition, to reduce the morbidity later in post-menopausal stage. Behaviour change communication, family and community support are essential in post-menopausal women, to help them cope with various morbid conditions.

ASSESSMENT OF QUALITATIVE CHANGES IN PERIPHERAL BLOOD CELLS IN CHILDREN - RESIDENTS OF RADIOLOGICALLY CONTAMINATED TERRITORIES IN THE LATE PERIOD AFTER THE ChNPP ACCIDENT.

to establish the relationship between quantitative and qualitative parameters of peripheral blood cells(lymphocytes, neutrophilic granulocytes, monocytes, platelets) depending on the type of somatic diseases andannual internal radiation doses from 137Cs in children - residents of radiologically contaminated territories in thelate period after the Chornobyl Nuclear Power Plant (ChNPP) accident. There were 175 children included in the study comprising residents of radiologically con-taminated territories (n = 79) aged from 4 to 18 years. Annual internal radiation doses in children from 137Cs rangedfrom 0.004 to 0.067 mSv. Certain blood parameters were assessed in a comparative mode in children having got theradiation doses up to 0.01 mSv and higher. The comparison group (n = 96) included children living in settlementsnot attributed to the radiologically contaminated ones. Incidence and type of somatic diseases and its impact onquantitative and qualitative changes in blood parameters (i.e. lymphocyte, neutrophilic granulocyte, monocyte, andplatelet count) were studied. The cell size, state of nucleus, membranes and cytoplasm, signs of proliferative anddegenerative processes were taken into account. Incidence and type of somatic diseases in children did not depend on the annual internal radiation dose.Number of cases of monocytosis was significantly higher among the children exposed to ionizing radiation than inthe comparison group (16.6 % vs. 7.3 %). There were, however, no correlation between these changes and radiationdoses. Number of activated blood monocytes with cytoplasmic basophilia and residues of nucleoli in nuclei washigher in individuals with internal radiation doses > 0.01 mSv. A direct correlation between the qualitative param-eters of monocytes and internal radiation doses was established (rs = 0.60; р < 0.001), as well as a direct correlationof different strength between qualitative parameters of blood cells, indicating their unidirectional pattern depend-ing on the somatic morbid conditions. Regardless of annual internal radiation dose, there was an increase in thenumber of degenerative and aberrant cells vs. the comparison group (р < 0.05), which could be due to the role ofnon-radiation factors. Results of the assessment of quantitative and qualitative parameters of peripheral blood cells reflect-ed the state of morbid conditions in children and are of a diagnostic value. The identified dose-dependent changesin monocyte lineage of hematopoiesis may be the markers of impact of long-term radionuclide incorporation withfood in children living in environmentally unfavorable conditions after the ChNPP accident.

Morbidity and pathological conditions of pregnant women in the Russian Federation

<h3></h3> Состояние здоровья женщины в период беременности оказывает существенное влияние на течение самой беременности, ее исход, на течение родов и послеродового периода, во многом определяет здоровье рожденного ребенка. <h3>ЦЕЛЬ ИССЛЕДОВАНИЯ</h3> Анализ динамики заболеваний и патологических состояний беременных в Российской Федерации за 2014—2018 гг. <h3>МАТЕРИАЛ И МЕТОДЫ</h3> Динамика заболеваемости и диспансерного наблюдения беременных за 2014—2018 гг. анализировалась на основе годовой отчетной формы федерального статистического наблюдения №32 «Сведения о медицинской помощи беременным, роженицам и родильницам», утвержденной Приказом Росстата от 27.11.15 №591 (ред. от 24.12.18) и статистических сборников. <h3>РЕЗУЛЬТАТЫ</h3> В статье изложены результаты анализа динамики и структуры заболеваемости женщин во время беременности в целом по Российской Федерации и отдельно по субъектам за 2014—2018 гг. Рассматривается динамика диспансерного наблюдения беременных в Российской Федерации за 2014—2018 гг. <h3></h3> Анализ заболеваемости беременных в Российской Федерации за 2018 г. выявил выраженную вариабельность заболеваемости в различных субъектах страны. Так, анемия беременных колебалась от 59,7 наблюдения на 100 закончивших беременность в Республике Марий Эл до 17,5 — в Воронежской области. Коэффициент вариабельности показателя (max/min) составлял 3,4. Коэффициент вариабельности болезней мочеполовой системы беременных составил 13,8; сахарного диабета — 80,7; венозных осложнений — 6,5; заболеваний эндокринной системы (МКБ-10 — О99.2, в том числе щитовидной железы), — 16,3; болезней системы кровообращения — 16,2. <h3>ЗАКЛЮЧЕНИЕ</h3> Отмечается положительная тенденция к снижению существовавшей ранее гипертензии, осложняющей беременность, роды и послеродовой период; эклампсии, угрозы преждевременных родов и угрозы прерывания беременности, частоты патологических состояний плода. В то же время наблюдается тенденция к росту заболеваний сахарным диабетом, болезней эндокринной системы (МКБ-10 — О99.2, в том числе щитовидной железы), венозных осложнений, анемии, преэклампсии тяжелой и средней степени тяжести, резус-иммунизации и других форм изоиммунизации, что свидетельствует о необходимости усиления диспансерного наблюдения за беременными с указанными заболеваниями.

APPLICATION OF INTELLECTUAL MONITORING INFORMATION TECHNOLOGY IN DETERMINING THE SEVERITY OF THE CONDITION OF PATIENTS WITH INFLAMMATORY BOWEL DISEASES

The aim: Was to evaluate the effectiveness of the use of information technology of intelligent monitoring in solving the problems of assessing the morbidity of a patient with IBD during treatment. Matherials and methods: 183 patients with IBD were observed. Among them 104(56.8%) patients suffered from Crohn's disease and 79(43.1%) patients had ulcerative colitis. For each patient and each disease, the formation of a list of signs, the extraction of information and knowledge will be carried out according to an individual method. At the lower level, tasks are performed: determination of the list of patient morbidity conditions, the formation of a list of indicators of the patient morbidity conditions, their identification as classes for machine learning models; formation of a list of signs, which identify the state of the patient's morbidity and whose characteristics obtained after results of medical tests. Results: The number of correctly classified points reached 92%. An analysis of the conditions of patients characterized by incorrectly classified points revealed the information content of this fact. In those cases when the classification results did not coincide with the expert assessment of the patient's condition, additional factors were found that influenced his condition and whose characteristics were not taken into account in the structure of classifier models. Conclusions: The results of the testing of classifier models indicate the effectiveness of the use of information technology of intelligent monitoring to assess the condition of patients with IBD.

Oral health of individuals with dementia and Alzheimer's disease: A review.

This paper explores the epidemiological evidence about oral health of individuals with neurodegenerative conditions of Alzheimer's disease (AD) and dementia. PubMed, Web of Science, and Scopus were searched to identify the relevant research papers published during January 2012 to June 2020. All cross-sectional, case–control, and cohort studies reporting oral and dental morbid conditions for status and association with AD and dementia were explored. The explored literature from 22 studies shows that oral health parameters of oral health and levels of oral inflammatory markers were deranged and exaggerated in patients suffering from AD and dementia. Many studies have observed poor oral hygiene as result of lack or irregularity in toothbrushing. Regarding decayed, missing, and filled teeth status in AD/dementia populations, no significant difference is reported. Periodontal diseases have been noted at raised levels in AD and dementia patients and shown progression with aggravation in neurological disorders. Both edentulousness and low chewing efficacies are associated with low cognition. Stomatitis and coated tongue and other oral pathologies are significantly higher in AD patients. AD patients have demonstrated higher bacterial load and inflammation levels than controls, and consequently, inflammatory biomarker levels are also raised. AD patients have reduced salivary secretions and with low buffering capacity. Evidence from the current literature update postulates that individuals suffering from AD and dementia have special oral health-care needs. Appropriate oral health management may thus significantly improve their oral health-related and general quality of life.

Laryngopharyngeal reflux disease, prevalence and clinical characteristics in ENT department of a tertiary hospital Tanzania.

BackgroundLaryngopharyngeal reflux disease (LPRD) is a condition with nonspecific symptoms and most of times patients present late with advanced disease which may predispose to malignancy. The magnitude and clinical characteristics of this condition are not well known among patients attending Otorhinolaryngology services in Tanzania.Materials and methodsThis was a hospital based descriptive cross sectional study, conducted in the wards and clinics of Otorhinolaryngology department of Muhimbili National Hospital. Patients with symptoms of Laryngopharyngeal reflux disease were included in the study. Data was collected using questionnaires and clinical examination forms, were processed and analysed by using SPSS. Results presented in frequency tables, cross tabulations and figures.ResultsThis study recruited 256 participants among them males were 131(51.2%).The mean age was (41.38 ± 13.94) years. Prevalence of Laryngopharyngeal reflux disease was 18.4% without gender predilection. The commonest symptoms were globus sensation, hoarseness of voice and excessive urge to clear the throat with 95.7%, 88.1% and 83.0% respectively while the most observed signs were thick endolaryngeal mucus, Vocal cord oedema and partial ventricular obliteration with 90.9%, 88.6% and 72.7% respectively. Lying down less than two hours after meal and spices foods consumption were the leading risk factors. Hypertension and Diabetes Mellitus type 2 were the most prevalent co morbid conditions associated with Laryngopharyngeal reflux disease.ConclusionThe prevalence of Laryngopharyngeal reflux disease is high among patients attending Otorhinolaryngology services at Muhimbili national hospital. All patients with Laryngopharyngeal reflux disease related symptoms should get thorough evaluation for early diagnosis and treatment.

COVID-19 diagnostic laboratory strategies: modern technologies and development trends (review of literature).

The COVID-19 pandemic, associated with the new coronavirus SARS-CoV-2, has caused a surge in incidence worldwide, as well as a severe crisis in global health and economy. Therefore, fast and accurate diagnosis of infection is key to timely treatment and elimination of the spread of the virus. Currently, the standard method for detecting coronavirus is reverse transcription polymerase chain reaction (RT-PCR). However, this method requires expensive equipment and trained personnel, which limits the conduct of mass testing and lengthens the time to obtain a research result. Serological tests for antibodies against SARS-CoV-2 and the determination of protective immunity in various populations are used to retrospectively identify patients with asymptomatic and mild forms of infection, monitor the course of infection in hospitalized patients, and also track contacts and epidemiological surveillance. The use of standard methods for diagnosing COVID-19 in conditions of mass morbidity, especially in conditions of insufficient resources and lack of appropriate infrastructure, is associated with a number of limitations. Therefore, the search and development of new, fast, inexpensive, simple, device-free and no less sensitive and specific tests is an urgent task. Therefore, the search and development of new, fast, inexpensive, simple, device-free and no less sensitive and specific tests is an urgent task. The review examines new laboratory technologies for diagnosing a new infection - loop isothermal amplification (LAMP) and immunochromatographic analysis (ICA), which can become a real alternative to the used molecular and enzyme immunoassay methods. The dynamic development of these methods in recent years expands the prospects for their use both for diagnosing COVID-19 and monitoring a pandemic.

Impact of smoking on plasma antioxidant defenses and urinary 8-hydroxy-2-deoxyguanosine in ischemic heart diseases

Background: Oxidative stress is associated with various morbid conditions such as atherosclerosis and coronary artery disease. Cigarette smoking is said to be associated with high oxidative stress levels which may predispose to ischemic heart diseases (IHDs). Urinary 8-hydroxy-2-deoxyguanosine (8-OHdG) has emerged as a biomarker for oxidative stress induced deoxyribonucleic acid (DNA) damage. Aim and Objective: The present study aims at evaluating the plasma markers for oxidative stress and urinary 8-OHdG in smokers suffering from IHD. Materials and Methods: For the present study about 327 male subjects, including 127 healthy subjects and 200 consecutively admitted IHD patients were enrolled and were subsequently divided into two subgroups as smokers and non-smokers consisting of 100 non-smokers and 100 smokers, based on the history of smoking. The healthy control group consisted of 64 smokers and 63 non-smokers. All the subjects were evaluated for plasma malondialdehyde levels, total antioxidant status (TAS), and urinary 8-OHdG. Results: There was increased oxidative stress evident by strong negative correlation between 8-OHdG and TAS was observed in the present study. Conclusion: The urinary 8-OHdG may serve as a sensitive indicator of DNA damage in smokers.

COVID-19: The Patients' Perspectives.

COVID-19: The Patients' Perspectives.

Analysis of efficacy of intravenous zolendronic acid therapy in osteoporosis with dexa scan

Introduction: Bisphosphonates are one of the commonly used drugs for the treatment and prevention of osteoporosis. Many of the old generation oral bisphosphonates have got lesser affinity to bone mineral matrix and low patient compliance. Newer generation intravenous zolendronic acid has got a better compliance due to once a year dose and it is more effective due to its more affinity towards bone mineral matrix. Hence this study was conducted to evaluate the results of intravenous zolendronic acid in osteoporotic individuals using Dual Energy X ray Absorptiometry. Materials and Methods: The study was conducted in a tertiary centre between January 2012 to January 2016. The sample size was 36. The patient recruitment was done in a consecutive manner. Patients were diagnosed by DEXA scan and Lumbar spine BMD taken as representative and inj. zolendronic acid was given once a year, repeated every year, total for 3 years duration therapy. Student Paired t-test was used to find the statistical significance. Gender, fracture sustained during the study, complication, hypothyroidism and status of improved were expressed as frequency and the percentage. p < 0> Results and Analysis: The mean age of our study population was 67.7 yrs. 12 patients in our study had improvent in BMD (t - score) which was 40% of the whole study group. These 12 patients had an actual percentage rise in BMD by 11.62% on average, detected by DEXA Scan. All these patients were under the age bracket of 65 years. 18 patients did not have any improvement in or worsening of BMD and were above the age bracket of 65 yrs of age. This could be attributed to their medical co - morbid conditions and nutrional status. The incidence of another fracture was 8% among people who had a previous fracture. 10% of the study population had adverse effects like fever and myalgia. There were no other serious adverse effects. Keywords: Osteoporosis, Zolendronic acid, DEXA.

Ensembling Classical Machine Learning and Deep Learning Approaches for Morbidity Identification From Clinical Notes

The past decade has seen an explosion of the amount of digital information generated within the healthcare domain. Digital data exist in the form of images, video, speech, transcripts, electronic health records, clinical records, and free-text. Analysis and interpretation of healthcare data is a daunting task, and it demands a great deal of time, resources, and human effort. In this paper, we focus on the problem of co-morbidity recognition from patient's clinical records. To this aim, we employ both classical machine learning and deep learning approaches. We use word embeddings and bag-of-words representations, coupled with feature selection techniques. The goal of our work is to develop a classification system to identify whether a certain health condition occurs for a patient by studying his/her past clinical records. In more detail, we have used pre-trained word2vec, domain-trained, GloVe, fastText, and universal sentence encoder embeddings to tackle the classification of sixteen morbidity conditions within clinical records. We have compared the outcomes of classical machine learning and deep learning approaches with the employed feature representation methods and feature selection methods. We present a comprehensive discussion of the performances and behaviour of the employed classical machine learning and deep learning approaches. Finally, we have also used ensemble learning techniques over a large number of combinations of classifiers to improve the single model performance. For our experiments, we used the n2c2 natural language processing research dataset, released by Harvard Medical School. The dataset is in the form of clinical notes that contain patient discharge summaries. Given the unbalancedness of the data and their small size, the experimental results indicate the advantage of the ensemble learning technique with respect to single classifier models. In particular, the ensemble learning technique has slightly improved the performances of single classification models but has greatly reduced the variance of predictions stabilizing the accuracies (i.e., the lower standard deviation in comparison with single classifiers). In real-life scenarios, our work can be employed to identify with high accuracy morbidity conditions of patients by feeding our tool with their current clinical notes. Moreover, other domains where classification is a common problem might benefit from our approach as well.

Effectiveness of drug management along with physical and nutritional rehabilitation in children with dyskinetic cerebral palsy

Objective: To assess the improvement in functional activities of children with dyskinetic cerebral palsy after drug management along with physical and nutritional rehabilitation. Design: Observational analytical study. Setting: community based rehabilitation centre & a private medical college at Malappuram, Kerala. Methods: This is a follow up cohort study conducted at the community level. 34 Children with dyskinetic cerebral palsy aged 4-18 years were followed up with medications for dystonia along with physical and nutritional rehabilitation for 9 months. These children were assessed with Barry- Albright dystonia scale prior to medications and at intervals of 3 months prospectively up to 9 months. Results: Over the 9 months prospective study, 34 children were enrolled and started with medications on different occasions. 6 children were excluded (2 of them developed adverse reactions to drugs and 4 were lost to follow up). Out of 28 cases, 21 were males and 7 were females with an average age of 8 years. During the study period, all of them responded well with a significant improvement after 9 months. Conclusion: Optimal drug management of dystonia, physical and nutritional rehabilitation along with management of co morbid conditions are associated with significant improvement in functional abilities of children with dyskinetic cerebral palsy. Keywords: Dyskinetic cerebral palsy, Dystonia, Physiotherapy, Barry-albright dystonia scale.

Brain metabolic correlates of apathy in amyotrophic lateral sclerosis: An 18F-FDG-positron emission tomography stud.

The aim of this study was to evaluate brain metabolic correlates of apathy in amyotrophic lateral sclerosis (ALS). A total of 165 ALS patients underwent 18 F-2-fluoro-2-deoxy-D-glucose positron emission tomography (18 F-FDG-PET) and Frontal Systems Behaviour Scale (FrSBe) evaluation. FrSBe provides "before" and "after" apathy subscores, referring to premorbid and morbid conditions. "After" apathy subscore and "before-after" gap, i.e. the difference between "before" and "after" subscores, were regressed against whole-brain metabolism. Among patients with a pathological "after" apathy subscore (i.e., ≥65), we compared patients with "before" apathy subscores ≥65 and <65, and patients with "before-after" gaps of <22 and ≥22. In the whole sample, the "after" apathy subscore negatively correlated with metabolism in the dorsolateral prefrontal cortex (DLPFC), dorsomedial prefrontal cortex (DMPFC), ventrolateral prefrontal cortex (VLPFC), premotor cortex (PMC) and anterior cingulate cortex (ACC), and insula bilaterally. A positive correlation was found in the cerebellum and pons. The "before-after" gap negatively correlated with metabolism in bilateral DLPFC, DMPFC and PMC, and left VLPFC and ACC, and positively correlated with cerebellar and pontine clusters. Among patients with an "after" apathy subscore ≥65, we found no difference between those with "before" apathy subscores ≥65 and <65. Patients with a "before-after" gap ≥22, compared to patients with a gap <22, showed relative hypometabolism in bilateral DLPFC and DMPFC, and left ACC and PMC, and relative cerebellar and pontine hypermetabolism. No studies on brain 18 F-2-fluoro-2-deoxy-D-glucose positron emission tomography correlates of apathy have been performed in ALS. We found that FrSBe "after" apathy subscore correlated with metabolic changes in brain regions known as neuroanatomical correlates of apathy. Furthermore, our findings support the relevance of the gap between premorbid and morbid conditions to detect behavioural changes due to the neurodegenerative process underlying ALS.

Acute kidney injury with cardiorenal syndrome; experience from a tertiary care renal unit in Pakistan

Introduction: Acute kidney injury (AKI) is a commonly recognized clinical problem after many morbid conditions related to heart like congenital heart disease surgery, acute or chronic congestive heart failure, acute myocardial infarction, infective endocarditis or cardiomyopathies. Cardio-renal syndrome (CRS) includes a spectrum of disorders involving both the heart and kidneys simultaneously; here acute or chronic dysfunction in one organ may induce acute or chronic dysfunction in the other. Objectives: To report here, case series of patients with AKI developing in association with CRS. We aim to report different causes of CRS and outcome of patients in this group of patients. Patients and Methods: Subjects for the study reported here comprised a cohort of 34 patients coming to this institution with AKI in association of CRS. AKI was defined according to KDIGO guidelines and CRS based on consensus conference of ADQI in 2012. Type 1or type2 CRS are included in the study. All patients had normal size kidneys on ultrasonography. Results: Thirty-four patients with AKI and CRS were brought to this institute from January 1990 to December 2014; this was contributing 1% to medical causes of total AKI. Among these 25 were males and 9 females; mean age of these patients was 54.06±14.106 years. Causes of CRS were acute myocardial infarction (ST elevated), congestive cardiac failure, infective endocarditis and dilated cardiomyopathy. More than two third of patients were either oliguric or anuric on presentation. Fluid replacement and/or inotropic support required in 79%. Renal replacement therapy in form of hemodialysis was conducted in 64.7% and intermittent peritoneal dialysis in one patient. Complete renal recovery was observed in 19 (56%) patients, while 12 (35%) died during acute phase of illness. CKD-V developed in one patient, 2 patients lost long term follow up, but became dialysis free and renal functions were in improving trends, they were labeled as partial recovery. Secondary insults like hypotension, aggressive diuresis, and volume loss from gastro-intestinal tract or infection were evaluated for any co-relation with outcome but statistically no significant difference was found. Conclusion: CRS can be severe life-threatening condition especially when patients present with circulatory collapse. Diuretics must be used cautiously in patients with congestive cardiac failure. Infective endocarditis with acute right heart failure can lead to CRS.

Efficacy of Rasayan in the Prevention of Communicable diseases (Janapadhodhwamsa)

Ayurved is a holistic science which mainly emphasizes on the preventive aspect of diseases and ill- health. The concept of communicable disease is mentioned under the concept of “Janapadhodhwamsa”. Rasayan therapy plays a very key role in the prevention of communicable diseases. An attempt has been made to establish a co- relation between the Ayurvedic concept and the current most prevelant communicable diseases and their categorization under the pranavaha srotas, Annavaha srotas, Udakvaha srotas, Rasa and Raktavaha srotas. In the present scenario, increased urbanization and modified lifestyle has led to derangement of agni. This deranged agni has led to compromised immunity, which itself serves as a cause and provoking factor for many infectious diseases. In today’s context, the whole world is facing the communicable and infectious pandemic, termed Covid-19. No any specific treatment modality is been established till date. In the view of lack of any treatment modality and vaccine availability, focus is been given on enhancing the immunity and maintaining good health status is been laid .By maintaining good immunity and health, we can protect ourselves from this infectious disease and also prognosis of the patients will also be good, who are with co- morbid conditions. Thus now emphasis is laid to improve the immunity by techniques such as Rasayan Chikitsa.

Risk factors of morbidity among construction workers: a review

Construction industry is the second largest employer of workers the world over and is second only to the number of workers in the agricultural sector. Since construction industry and workers come under the un-organized sector, they are not benefitted by any of the advantages enjoyed by the workers in the organised sector. Most of the workers belong to the poor socioeconomic background and illiterates who are hired by the agents based on the construction manpower needs on a daily wages manner. Migrant workers from poorer and under developed areas of the country are increasingly being exploited for this purpose. The rigorous and strenuous construction work and their temporary and shabby living conditions make them vulnerable for several types of diseases and ill health, for which they may not get adequate and timely medical care and support. Workplace safety and workers safety are often compromised. They constantly face physical, chemical and biological risk factors. Risk factors and risk behaviour like smoking, tobacco use, alcoholism and even substance abuse among the construction workers contribute to their high morbidity and even mortality. This review article focuses on the various risk factors and the risk behaviours, which the construction workers are exposed and are prone to develop, leading to different types of morbid conditions at the work place as well as in their places of living.

Comparison of before and after COVID-19 urology practices of a pandemic hospital.

The aim of this study is to compare the effects of COVID-19 on urology practice using pre- and post-pandemic data of a pandemic hospital. March 11 is considered as the beginning of COVID-19 and, changes in the number of the outpatient clinic examinations, non-surgical procedures, and surgery in the 8-week period before and during the pandemic were evaluated by weeks. Age, gender, and comorbid diseases of the operated patients were compared statistically. The symptoms, complaints, mortality, and morbidity conditions of the patients were recorded by contacting them. Descriptive data and chi-square test were used. The number of COVID-19 cases has been reported as 8,916 for the hospital, 88,412 for the city and 150,593 for the country. The mean age of the operated patients before and after 11 March was 51 and 47, and comorbidities were 79 and 40, respectively, and there was no statistically significant difference(p<0.05). The number of patients examined was 2,309 and 868, the number of operated patients 173 and 94, the number of patients undergoing non-surgical procedures were 371 and 174, respectively. The names and numbers of surgical and non-surgical procedures are listed according to European Association of Urology (EAU) priority classification. In follow-up, no complication because of COVID-19 was observed in any patient. Our study showed that, although the numbers have decreased, similar operations can be performed in daily urology practice without any contamination and mortality during the pandemic compared to the prepandemic period, by taking precautions and following the algorithms.

Analysis of the chronic hepatitis B morbidity in conditions of mass vaccination in the Republic of Moldova

The purpose of the study is to analyze the dynamics of the chronic hepatitis B morbidity under the condition of mass vaccination in the Republic of Moldova during 2000–2019. Materials and methods . Statistical data provided by the National Agency of Public Health of the Republic of Moldova on acute and chronic hepatitis B for 2000–2019 were analyzed. The analysis was performed by using epidemiological, descriptive-evaluative, analytical and statistical research methods. Results and discussion . Еpidemiological study over a 20-year period (2000–2019) revealed that the introduction of immunization against viral hepatitis B has made a great contribution to the reduction of acute viral hepatitis B . At this stage, the incidence of HBV in the Republic of Moldova has significantly decreased from 76.,6 in 1989 to 0,17 per 100 thousands population in 2019. The incidence of chronic viral hepatitis B, is increasing from 23,32 in 2000 to 59,24 per 100 thou -sands population in 2019. A pronounced tendency of incidence decreasing in acute viral hepatitis B is recorded in both children and adults. The incidence of chronic viral hepatitis B in children shows a pronounced decreasing as well, compared to adults, who had an increasing incidence of from 26,85 in 2000 to 72,87 per 100 thousands population in 2019. The data obtained as a result of interviewing patients, revealed that patients with chronic viral hepatitis B constitute 50,22±1,91%, P &lt; 0,001. The average age of patients with chronic viral hepatitis B was 54,05±10,53 years (X2=8,45, P=0,036). The female constitute 51,25±2,67%, P &lt; 0,001, and the male – 48,75±2,74%, P &lt; 0,001. Patients with high risk of infection were those exposed to intramuscular injections [OR=1,07; 95%, Cl: 0,79–1,45, P=0,62], sharing sharp objects [OR=1,06; 95%, Cl: 0,86–1,31, P=0,53], sharing scissors [OR=1,04; 95%, Cl: 0,85–1,28, P=0,66] and blood transfusion [OR=1,01; 95%, Cl: 0,78–1,32, P=0,89].

Safety of e-bikes compared to conventional bicycles: What role does cyclists’ health condition play?

IntroductionThe rising use of e-bikes (EBs) presents an opportunity to increase active transportation but may compromise road safety due to increased travel speed and weight compared to conventional bicycle (CBs). Evidence comparing the safety of EBs and CBs is limited while the influence of cyclists’ health status has been neglected. MethodsThis cross-sectional case-control study compared EB and CB users in the Netherlands. Data were gathered 1) through a survey among crash casualties treated at emergency departments aged >16 (N = 2383) and 2) control group data were collected among cyclists without any known crash experience, randomly drawn from a panel of the Dutch population (N = 1860). Using logistic regressions, we assessed the likelihood of crashes and crash severity while adjusting for bicycle use and health status. ResultsEB users had poorer health than CB users, but they were not more likely to be involved in a crash or to sustain more severe injuries. However, older female cyclists did have an elevated risk on EBs and sustained more severe injuries. Health-related factors such as the presence of morbid conditions, medication use, and the body mass index were neither associated with crash likelihood nor associated with injury severity and accordingly did not explain the findings for older females. However, balance and coordination problems, and the use of anti-epileptic drugs were associated with crashes. ConclusionOur findings provide support that EB users have a poorer health status than CB users, while general health status is unrelated to the likelihood and severity of bicycle crashes. EBs enable more vulnerable groups to cycle or keep cycling but, after controlling for bicycle use, EB users are not more likely to be involved in a crash or to sustain severe injuries. As older females run a higher risk on an EB and are more likely to fall while (dis)mounting, we recommend to promote EBs enabling safer (dis)mounting such as by reduced saddle height.