Regular Treatment Research Articles

Urethral length and its relationship with anthropometric parameters in adult male Nigerians

BackgroundThe available literature on urethral length in adult males is limited. To the best of our knowledge, such measurement has never been carried out amongst Nigerian and African men. This study aimed to document average urethral length as well as the relationship between urethral length and age, and anthropometric parameters amongst the Nigerian male adult population to add to the database for urethral length.MethodsIt was a prospective cross-sectional study amongst adult male Nigerians who had an indication for urethral catheterization as part of their regular treatment at the urologic clinics as well as male adult patients who required urethral catheterization in the theatre and the wards for various reasons. All patients had anthropometric parameters measured or calculated. The total usable length (A) of the catheter was measured before catheterization and the unused catheter length (B) was measured after catheterization for each patient. The calculated urethral length (C) was obtained by subtracting B from A. Data were analyzed using SPSS version 26.0. Mean urethral length was determined while the correlation between urethral length and age as well as anthropometric parameters were determined using Pearson Correlation.ResultsA total of 450 adult males were recruited. The mean age of subjects was 63.58 years with a range of 22–91 years. The average total usable and unused catheter lengths were 30.01 and 8.97 cm respectively. The mean urethral length among participants was 21.32 cm (8.4 Inches) with a range of 16.5 to 28 cm (6.5–11.0 Inches). There were no statistically significant correlations between urethral length and age ([r (450) = − 0.029, p = 0.546]) as well as with anthropometric parameters (height: r (450) = − 0.088, p = 0.61; weight: [r (450) = − 0.047, p = 0.324 and BMI: r (450) = − 0.082, p = 0.08) in adult males.ConclusionThis study suggests that there may be racial differences in adult male urethral length but no relationship with age and anthropometric parameters. Further research is needed to explore these findings.

Behavioral guidance for improving dental care in autistic spectrum disorders.

Autism spectrum disorders (ASDs) impair many aspects of everyday life and may prevent access to dental care, often limiting it to emergencies. Impaired oral health has long-lasting negative consequences on health status and on the acquisition of oral habits (e.g., oral respiration and grinding) or competencies (e.g., proper speech production). Children with ASD may be scared in the dental setting, which is rich in sensory stimuli and requires physical contact. Due to their behavioral manifestations, they represent a challenge for dentists and hygienists. We created a dedicated pathway with behavioral support for children with ASD to allow dental care and possibly limit the use of general anesthesia. We evaluated the effects of behavioral support in a quasi-experimental design by comparing two groups of children with ASD. The first group (n = 84) was visited every 2 months for 3 years and received additional support (visual aids, caregiver training, and longer visit duration). A control group, matched for age and sex, was visited at least twice a year or more, if needed, according to standard healthcare guidelines. Compliance with the schedule was high throughout the 3 years. The degree of collaboration significantly improved after 1 year in the supported group, while the control group did not change. At the end of the study, collaboration remained significantly higher than at the beginning in the supported group. Half of dental treatments were possible without general anesthesia in supported children. No adverse effect was apparent on collaboration due to COVID-19 restrictions. Behavioral techniques improved the compliance of ASD children to regular dentistry visits and treatment. Furthermore, oral hygiene at home was similarly improved, addressing oral health from a lifelong perspective.

Clinical characteristics and prognosis of laryngeal tuberculosis combined with respiratory tuberculosis

PurposeTo investigate the clinical characteristics, diagnosis and prognosis of patients with laryngeal tuberculosis (LTB) combined with respiratory tuberculosis. Materials and methodsA retrospective analysis was conducted on 134 patients who underwent endoscopy and were eventually diagnosed with LTB. The patients' demographic characteristics, clinical manifestations, endoscopic features, auxiliary examination, imaging examination and prognostic characteristics were analyzed. ResultsLTB patients had a median age of 45.5 years (range from 12 to 87 years) and a median course of 3.0 months (range from 0.1 to 72 months). The patients' symptoms mainly presented as hoarseness (97.0 %), abnormal sensation of pharyngeal (49.3 %), cough and sputum (41.0 %), pharyngalgia (39.6 %), dysphagia (10.4 %) and dyspnea (8.2 %). The positive rate of tuberculous symptoms was 25.4 %. Endoscopic features showed that the lesions mainly involved the glottis (87.3 %), presenting as unilateral lesions (66.7 %), near-full-length involvement (88.0 %), with mucosal waves significantly reduced (86.3 %), followed by supraglottis (43.3 %), subglottis (24.6 %) and the pharynx (15.7 %). The lesions may present as granulomatous proliferation (66.4 %), ulceration (65.7 %) or swelling and exudation (51.5 %). A total of 75 patients (56.0 %) were finally diagnosed with combined pulmonary tuberculosis (PTB), with a positive chest X-ray rate of 25.6 % and a positive chest CT rate of 71.2 %. A total of 42 patients who received anti-tuberculosis treatment were followed up, and 73.8 % of patients had significant improvement in symptoms. The morphology of the pharyngeal and laryngeal mucosa returned to basically normal (59.4 %) or scar-like (34.4 %). ConclusionsLTB is usually found in middle-aged men, and patients' symptoms are mainly hoarseness, abnormal sensation of pharyngeal, pharyngalgia, cough and sputum, and can be combined with tuberculous symptoms. These lesions mainly involve multiple subregions, mainly in the glottis, and can be combined with pharyngeal involvement. There were various types of lesions. Half of the patients were complicated with PTB, and chest CT was superior to X-ray in the detection of pulmonary lesions. After regular anti-tuberculosis treatment, the symptoms and morphology of the pharyngeal and laryngeal mucosa of most patients were significantly improved.

A Randomized Controlled Trial Evaluating the Effectiveness of Nanosilver Fluoride in Arresting Dental Caries in School Children.

The study evaluated the effectiveness of nanosilver fluoride (NSF) in arresting dental caries in 4-8-year-old school children. The two-arm, parallel-group randomized controlled trial included a total of 148 children aged 4-8 years with active carious lesions. Children were randomly divided into two groups: group I-NSF (n = 74); and group II-water (placebo and n = 74). Baseline data were recorded using the International Caries Detection and Assessment System (ICDAS) II criteria, and the teeth were treated with either of the solutions. Later, the teeth were evaluated by two blinded examiners for the lesion activity using ICDAS II criteria at 1, 3, and 6-month intervals. The obtained data were analyzed using the Chi-squared test for intergroup comparison and Cochran's Q test for intragroup comparison. Cohen's κ test was used to check the interexaminer and intraexaminer variability. Carious teeth treated with NSF have shown 56.3, 59.2, and 62% arrested carious lesions, whereas the placebo group has shown 0, 2.9, and 4.4% arrested lesions at 1, 3, and 6-month intervals, respectively. NSF showed a high statistically significant difference (p < 0.001) in arresting dental caries compared to the control group at all the time intervals. Nanosilver fluoride (NSF) is found to be effective in arresting dental caries without staining carious lesions. Therefore, it can be used to reduce the bacterial load for caries stabilization in the initial phase of the comprehensive treatment protocol for the management of children with active caries lesions. Most of the decayed teeth in the primary dentition remain untreated either because of inaccessible dental services or the uncooperativeness of children. Hence, there is an absolute need for a cariostatic agent which arrests the progression of caries in a simple and noninvasive manner. The results of this study evidence that NSF effectively arrests dental caries in primary teeth. Hence, this can be a very economical way of arresting caries in the population who don't have access to regular dental treatment. Devi C, Chandrasekhar R, Vinay C, et al. A Randomized Controlled Trial Evaluating the Effectiveness of Nanosilver Fluoride in Arresting Dental Caries in School Children. Int J Clin Pediatr Dent 2023;16(5):667-670.

Treatment effect of respiratory therapy with intermittent hypoxic-hyperoxic training (IHHT) on functional capacity in patients with post COVID19 conditions: a controlled treatment trial

Abstract Introduction COVID-19 can cause long-term lung and systemic damage that will lead to increasing numbers of patients disabled by reduced functional capacity. Intermittent hypoxia-hyperoxia training (IHHT) is a respiratory therapeutic concept which has been suggested to improve exercise performance via controlled hypoxic conditioning. The purpose of the present study is to investigate the therapeutic effect of IHHT on the recovery process during inpatient rehabilitation in post-COVID conditions. Methods A prospective, single-center, randomized controlled trial was conducted in 145 (37 men) patients with post COVID19 conditions aged 27-84 years, who were admitted to a hospitalized rehabilitation program (duration 27±5 days). Patients were 1:1 allocated to the standard rehabilitation program or IHHT on top of standard rehabilitation. The patients in IHHT group attended regular (alternate days) treatments of hypoxia-hyperoxia breathing sessions (10–12% O2 hypoxia breathing followed by 30-35% O2 hyperoxia breathing in 6-8 cycles for a total of 45 min). The primary endpoint of the trial was improvement in walking distance in a six-minute walk test (6MWT) between groups. Further endpoints of functional testing included stair climbing test (SCT), patient global assessment, fatigue assessment scale (FAS) and Quality of life (QoL) assessed by EQ5-D analog scale. Subjective perceived health was assessed by Median Corona Recovery Score (MCRS). Results The IHHT group demonstrated in comparison to controls a significant improved primary endpoint (6MWT difference, IHHT group vs controls: 91.7 vs. 32.5m, P&amp;lt;0.001), improved stair climbing (SCT -1.9 vs. -0.5 sek, P&amp;lt;0.001), improved QoL (EQ5-D analog scale change 31.3 vs. 2.9, P&amp;lt;0.001), improved fatigue (FAS -8.9 vs. 3.6, P&amp;lt;0.001) and improved perceived health (MCRS -10.3 vs. -2, P&amp;lt;0.001, all IHHT group vs. controls). The IHHT group exhibited a significant increase in hemoglobin content and a significant decrease in CRP compared to baseline (P&amp;lt;0.001), whereas these changes were not observed in the control group. Conclusion Respiratory treatment by IHHT in patients with post COVID conditions resulted in improved functional capacity in multiple of functional tests and in improved QoL and perceived health.

Dose-dependent cytotoxicity against lung cancer cells via green synthesized ZnFe2O4/cellulose nanocomposites

Abstract Cancers are complicated sicknesses that happen because of many different things going wrong in cells, and as they get worse, the cells undergo many changes one after another. Nanomedicine is a new way to treat diseases like cancer. Tiny particles called nanoparticles have special properties that can help to treat diseases better than regular treatments. These particles are very small but have a lot of surface area, can carry different drugs, and can be designed to target specific areas. They can move around the body, go into cells, and release drugs slowly. Because of these benefits, nanoparticles could be better for cancer treatment. In this continuous research, we present a simple technique for the quick and single-step synthesis of ZnFe2O4/cellulose nanocomposites, employing the polymer cellulose. This method is not only cost-effective but also environment friendly. Scanning electron microscopy, powder X-ray diffraction, Fourier transform infrared spectroscopy, and the ultraviolet-visible (UV) spectrum were all used to examine the morphological, structural, and electrical properties of ZnFe2O4/cellulose nanocomposites. The nanocomposite derived from UV-DRS exhibits an optical energy bandgap of 1.8 eV. The mechanical strength of the composites gradually increases as ZnFe2O4 is added to the cellulose polymer matrix. These findings propose a straightforward and innovative approach to produce ZnFe2O4/cellulose nanocomposites that can serve as functional biomaterials. In addition, the ZnFe2O4/cellulose nanocomposite exhibits decreased antioxidant activity compared to ascorbic acid. ZnFe2O4/cellulose nanocomposite was found to have an IC50 of 49.64 g·mL−1. With an IC50 value of 55.91 g·mL−1, the synthesized ZnFe2O4/cellulose nanocomposites demonstrate significant cytotoxicity in a dose-dependent manner against the lung cancer cell lines A549. In conclusion, nanocomposites are potential materials for usage in biomedical applications due to their affordable production and mild magnetic sensitivity.

Pre-Emptive Use of Rituximab in Epstein-Barr Virus Reactivation: Incidence, Predictive Factors, Monitoring, and Outcomes.

Post-transplant lymphoproliferative disease (PTLD) is a fatal complication of hematopoietic cell transplantation (HCT) associated with the Epstein-Barr virus (EBV). Multiple factors such as transplant type, graft-versus-host disease (GVHD), human leukocyte antigens (HLA) mismatch, patient age, and T-lymphocyte-depleting treatments increase the risk of PTLD. EBV reactivation in hematopoietic cell transplant recipients is monitored through periodic quantitative polymerase chain reaction (Q-PCR) tests. However, substantial uncertainty persists regarding the clinically significant EBV levels for these patients. Guidelines recommend initiating EBV monitoring no later than four weeks post-HCT and conducting it weekly. Pre-emptive therapies, such as the reduction of immunosuppressive therapy and the administration of rituximab to treat EBV viral loads are also suggested. In this study, we investigated the occurrence of EBV-PTLD in 546 HCT recipients, focusing on the clinical manifestations and risk factors associated with the disease. We managed to identify 67,150 viral genomic copies/mL as the cutoff point for predicting PTLD, with 80% sensitivity and specificity. Among our cohort, only 1% of the patients presented PTLD. Anti-thymocyte globulin (ATG) and GVHD were independently associated with lower survival rates and higher treatment-related mortality. According to our findings, prophylactic measures including regular monitoring, pre-emptive therapy, and supportive treatment against infections can be effective in preventing EBV-related complications. This study also recommends conducting EBV monitoring at regular intervals, initiating pre-emptive therapy when viral load increases, and identifying factors that increase the risk of PTLD. Our study stresses the importance of frequent and careful follow-ups of post-transplant complications and early intervention in order to improve survival rates and reduce mortality.

Real World Results of Brexucabtagene Autoleucel for Patients with Relapsed/Refractory Mantle Cell Lymphoma - First German/Swiss Analysis

Background: Chimeric antigen receptor T-cells have revolutionized treatment in many B-cell neoplasias. In MCL, brexucabtagene autoleucel (brexu-cel) has been the first product approved based on results of the ZUMA-2 trial for patients failing prior chemoimmunotherapy and BTK-inhibitor. However, in ZUMA-2, strict criteria have been used for patient selection, e.g. no use of intensive bridging/holding treatment was allowed, excluding patients with high treatment needs. In contrast to this, in the real-world scenario patient selection is much more diverse questioning whether the results of controlled trials can be reproduced in the regular treatment landscape. In this intent, we have analyzed the results obtained with brexu-cel as standard-of-care treatment (SOC) of r/r MCL in Germany and Switzerland. Patients/methods: Eligible for this first analysis of an ongoing registry study were all German and Swiss patients with r/r MCL who have been treated with SOC brexu-cel since 09/2020 and were registered with the German Stem Cell Registry (DRST) and the Registry of the European Mantle Cell lymphoma (EMCL), respectively. Of note, some patients have received more than one CAR-T-treatment. Data were analyzed for patient and disease characteristics, prior treatment history, response to treatment, and complications as well as post treatment outcomes. Due to the character of this analysis based on real world data, with heterogeneous surveillance strategies we have used primarily time to next treatment (TTNT) instead of progression-free survival, due to the potential biases for the latter. While still adding patients to the analysis, an additional follow-up data cut is planned 10/2023. Results: 111 patients have been identified: median age at diagnosis was 64.3 years (range 42.3-79.5; 19/99 patients ≥ 70), 18% female (not known (nk) 2.7%); ethnicity 66.7% Caucasian (nk 30.6%). Disease characteristics: 80/88 had stage 3/4 (91%), histology was classical in 34/57 cases (60%) and blastoid in 19/57 (33%), respectively. MIPI score was low 14/53 (26%), intermediate 17 (32%), high 21 (40%). TP53 alteration was present in 13/58 (22%), Ki67-expression was ≤ 30% in 18/50 (36%). TTNT for last treatment preceding CAR-T-treatment was 7.7 months. Overall survival (OS) for the entire patient population from diagnosis was 12.8 years. Preceding CAR-T, median number of treatments was 3 (range 1-9), all patients had prior Rituximab and Ibrutinib, 62 patients (56%) had received autologous stem cell transplantation (SCT) and 11 patients had received an allogeneic SCT. Median age at this time point was 68.1 years (range 49-82y). 50/110 patients were &amp;gt;70 years. Bridging treatment had been used in 88/112 (79%) preceding CAR. Based on investigator evaluation ORR was 86%, best response to CAR-T was CR in 47/76 patients (62%) and PR in 18/76 (24%). Time to death or new treatment after CAR-T was 8 months (mo) for patients ≤ 70y and 12 mo for patients &amp;gt; 70y. There was no difference for the number of prior lines (≤ 3 vs. &amp;gt; 3). The estimated median OS was 1.9 years. 26 patients have received at least 1 additional line of treatment after progression. Safety: Post-CAR CRS was seen in 95/114 (83%), Grade 1/2 77/95 (81%), Grade 3/4 (18%), Grade 5 (1%); ICANS was noted in 57/111 (51%), Grade 1/2 43/57 (75%), all other Grade 3/4. The rate of ICU admissions was 25/106 (24%). However, within 28 days after CAR-T-cell treatment 9/98 (9%) patients have died. Overall, in the post CAR-T-period 20 patients died of reasons other than progression: 4 CAR-related, 11 infections, 5 other/unknown. Discussion: In this real-world analysis, we could demonstrate, despite a more heterogeneous pre-treated patient population, a high overall and complete response rate. Median post CAR-T-cell survival was promising with 1.9 years. While CRS and ICANS risks seem to be comparable to trial data, the high non-relapse mortality (NRM) observed after SOC brexu-cel for r/r MCL is a concern and warrants refinement of anti-infectious surveillance and prophylaxis. Further work focusses on the identification of potential risk factors, e.g. using risk scores such as CAR-HAEMATOTOX, EASIX, and Severe4.

Prevalence of intestinal parasites in HIV/AIDS-infected patients with correlation to CD4+ T-cell count at hospital in Eastern India.

In developing nations, one of the most common reasons for death and illness is due to infections that are brought on by intestinal parasites. People who have HIV are more likely to contract parasites that are either well-established intestinal pathogens, like Entamoeba histolytica, Giardia lamblia and Strongyloidesstercoralis, or an opportunistic pathogen like Cryptosporidium, Isospora, Cyclospora and Microsporidia. Higher prevalence of intestinal parasitic infections occurs in patients with low CD4+ cell counts. Hence, this study had been performed to know the correlation of intestinal parasitic infection in HIV/AIDS patients with reference to CD4+ cell count. The study comprised 1477 HIV-positive patients who were treated at ART Centre of Rajendra Institute of Medical Sciences (RIMS), Ranchi. All participants provided verbal informed consent before specimens were collected. Blood and stool sample were used for the identification of parasite and CD4+ T-Cell count. In patients living with HIV, the prevalence of intestinal parasite infection was 12.59 per cent. In a manner parallel, the prevalence of parasitic infections was found to be 10.29% among male HIV-positive patients and 2.31% among female HIV-positive patients. This study has shed light that low CD4+ T-cell count appears to be a factor for intestinal parasitic infections and development of diarrhoea. Regular screening and treatment of intestinal parasitic infections is very important in overall improvement in quality of life of HIV/AIDS patients. Nevertheless, sanitary hygiene practices and deworming are needed to enhance the control of infection in the affected areas.

Evaluation of ALBA device for upper extremity motor function in adults with subacute and chronic acquired brain injury: a randomised controlled trial protocol in a tertiary clinic of the metropolitan region of Chile

IntroductionStroke is a significant worldwide cause of death and a prevalent contributor to long-term disability among adults. Survivors commonly encounter a wide array of motor, sensory and cognitive impairments. Rehabilitation...

Multimodal treatment, including extracorporeal shock wave therapy, for refractory chronic tension-type headache: a case report

BackgroundFew reports have described multidisciplinary treatment, including extracorporeal shock wave therapy, for patients with refractory chronic tension-type headache. In this study, we conducted multidisciplinary treatment for a patient with chronic tension-type headache who suffered from chronic headache refractory to treatment.Case presentationThe patient was a 45-year-old Japanese male suffering from 20 years of headache. As his headache had worsened recently, he visited a local clinic. With the diagnosis of suspected tension-type headache, its treatment was unsuccessful and he was referred to our hospital. The neurology department confirmed the tension-type headache and prescribed another medication, but he showed no improvement. Then, the patient was referred to the rehabilitation medicine department for consultation. At the initial visit, we identified multiple myofascial trigger points in his bilateral posterior neck and upper back regions. At the initial visit, he was prescribed 10 mL of 1% lidocaine injected into the muscles in these areas. In addition, he received 2000 extracorporeal shock wave therapy into bilateral trapezius muscles, and was instructed to take oral Kakkonto extract granules, benfotiamine, pyridoxine hydrochloride, and cyanocobalamin. Cervical muscle and shoulder girdle stretches and exercises were also recommended. At follow-up treatment visits, we used extracorporeal shock wave therapy to bilateral trapezius muscles, which led to immediate pain relief. After 11 weeks, he was not taking any medication and his headache was subjectively improved and his medical treatment ended.ConclusionA patient with chronic tension-type headache refractory to regular treatment was successfully treated with a multimodal approach including extracorporeal shock wave therapy in addition to standard treatment. For patients with tension-type headache accompanied by myofascial trigger points, it may be recommended to promptly consider aggressive multimodal treatment that includes extracorporeal shock wave therapy.

Investigation of the Prevalence of Digestive System Parasites in Chickens in the Kirikkale Region

Objective: In this study, it was aimed to investigate the prevalence of digestive system parasites in free-range chickens in Kırıkkale region. &#x0D; Material-Method: One hundred (100) faecal samples were taken by visiting the poultry houses where domestic chicken breeding was carried out. Care was taken to ensure that the faecal samples were fresh and not in contact with soil. Each faecal sample was separately placed in plastic containers with lids and delivered to Kırıkkale University, Faculty of Veterinary Medicine, Department of Parasitology, Routine and Epidemiology laboratory under appropriate conditions. The samples were analysed on the same day by native-lugol and Fülleborn flotation technique and the faecal samples which were positive for Eimeria oocyst were sporulated in potassium dichromate for species identification. &#x0D; Result: Sixty-three of the faecal samples (63%) were found to be infected with one or more parasite eggs/oocysts. Eggs/oocysts of one, two and three different parasite species were detected in 42.9%, 39.7% and 11.1% of the faecal samples, respectively. In this study; Eimeria spp. 13%, Ascaridia spp. 6%, Capillaria spp. 12%, Eimeria spp.+Trichostrongylus tenuis, 3%, Eimeria spp. + Ascaridia spp. 3%, Ascaridia spp. + Capillaria spp. 11%, Ascaridia spp. + Capillaria spp. + Eimeria spp. 3%, Capillaria spp, 4%, Eimeria spp. + Ascaridia spp. + Heterakis spp. 1%, Ascaridia spp. + Capillaria spp. + Trichostrongylus spp, + Trichostrongylus tenuis, 1%, Capillaria spp. + Ascaridia spp. + Heterakis spp. 2%, Ascaridia spp. + Heterakis spp. 2% and Trichostrongylus tenuis 1%. Eimeria spp. oocysts were morphologically identified as E. tenella, E. necatrix, E. brunetti, E. mitis and E. maxima. &#x0D; Conclusion: As a result, it is thought that the parasite rate is high due to the fact that the sampled chickens are free-ranging in the natural environment, parasites are more common during the infective periods of parasites or parasite control and treatment are not performed regularly. In order to reduce the presence of parasite infections that cause yield losses, it is recommended that the animals should have access to clean feed and water sources and regular parasitic control and treatment should be carried out.

Sexualised drug use among gay and bisexual men in New Zealand: Findings from a national cross-sectional study.

New Zealand has a unique illicit drug market, gay cultures and drug use patterns. Minimal attention has been given to how drug use shapes sexual practice, especially in the era of biomedical HIV prevention among gay and bisexual men (GBM). An online cross-sectional study of GBM ('Flux NZ') adapted from an Australian study was undertaken to explore connections between drug use, sexual practice, health and community. We describe drug use patterns, then identify three discrete groups determined by intensity of recent (past 6 months) sexual practice: no recent sex, recent sex and recent sexualised drug use. We examine factors associated with these groups and identify factors independently predicting sexualised drug use. Of 739 participants, almost a third had engaged in group sex (29%), 17.5% were taking pre-exposure prophylaxis (PrEP), 6.5% were HIV positive. Overall, 59.5% had recently used illicit drugs (16.9% methylenedioxymethamphetamine, 6% methamphetamine, 3.3% gamma-hydroxybutyrate acid, 1.4% ketamine). Sexualised drug use was common (35.7%). Those engaged in sexualised drug use were connected to gay community and had a high uptake of biomedical HIV prevention. Independent predictors of sexualised drug use included being sexually adventurous, knowing their HIV status, having more than 10 recent sexual partners, engaging in group sex and sex at a sex-on-site venue. Many GBM engaging in sexualised drug use manage HIV transmission risks through regular testing, PrEP and HIV treatment. HIV prevention efforts should target GBM with less intensive sexual behaviour but who may be at comparatively higher risk of HIV transmission.

Iron Overload In Beta Thalassemia Major And Intermedia Patients In West Bengal

Iron overload is a significant concern in beta-thalassemia major and intermedia patients. These conditions lead to reduced production of hemoglobin, necessitating frequent blood transfusions. As a result, excess iron accumulates in the body, primarily in vital organs like the heart and liver. This can cause serious complications, including heart failure and liver damage. To manage iron overload, patients often require chelation therapy, which involves the use of medications to remove excess iron from the body. Regular monitoring and treatment are essential to mitigate the long-term consequences of iron overload in these individuals. This is a study to create awareness about the consequences of iron overload in the patients of West Bengal.

Sacroileitis Developing in Irregularly Treated Brusellosis

Brucellosis; Fever, also known as corrugated fever, is a zoonotic disease charactarized by chills and muscle aches. It can be seen endemic in many countries including our country. Consumption of unpasteurized dairy products is the most common mode of transmission. Diagnosis is made by culture of the organism and increase in antibody titer in serum samples. Complications affecting many systems, mostly osteoarticular, are seen in the disease. In our case, a case of sacroileitis developed as a result of irregular treatment in a patient who was engaged in animal husbandry and was diagnosed with brucellosis is presented. In our case, it was started that osteoarticular involvement could develop under treatment and the importance of regular treatment at correct doses was emphasized.

Healthcare utilization during the COVID-19 pandemic: changes, potential causes. A Swiss cohort study

Abstract Background The COVID-19 pandemic led to a decrease in the provision and use of healthcare. Few studies reported reasons for these changes. We aimed to (i) describe the frequency of changes in healthcare utilization in those requiring ongoing treatment, and possible reasons thereof, and (ii) assess characteristics associated with change, during the second wave of the pandemic. Methods Participants from the Corona Immunitas e-cohort study (age ≥20 years) completed monthly questionnaires between September 2020 and February 2021. We used descriptive and bivariate statistics, to compare participants reporting a change in healthcare utilization with those who reported no change. We used negative binomial regression to explore characteristics associated with the number of changes. Results In total, 3190 adults from nine research sites participated in this study. One-fifth (N = 658, 21%) reported the need for regular treatment. About 14% of them reported a change in healthcare utilization, defined as events in which participants reported that they changed their ongoing treatment, irrespective of the reason. Reported reasons for change were medication changes and side-effects, specifically for hypertension, or pulmonary embolism treatment. Females were more likely to report changes in healthcare utilization (Incidence Rate Ratio (IRR)=1.69, p = 0.030), and those with hypertension were least likely to report changes (IRR=0.45, p = 0.092). Conclusions Among those who needed regular treatment, few reported changes in healthcare utilization. The importance of continuity of care for females and chronic diseases other than hypertension must be emphasized. This calls for tailored measures considering gender disparities. Key messages • Changes in healthcare utilization were more pronounced in women than men during the Covid-19 pandemic. • Tailored disease surveillance is necessary considering gender disparities and chronic diseases other than hypertension.

Predicting the risk of acute respiratory failure among asthma patients-the A2-BEST2 risk score: a retrospective study.

Acute respiratory failure (ARF) is a common complication of bronchial asthma (BA). ARF onset increases the risk of patient death. This study aims to develop a predictive model for ARF in BA patients during hospitalization. This was a retrospective cohort study carried out at two large tertiary hospitals. Three models were developed using three different ways: (1) the statistics-driven model, (2) the clinical knowledge-driven model, and (3) the decision tree model. The simplest and most efficient model was obtained by comparing their predictive power, stability, and practicability. This study included 398 patients, with 298 constituting the modeling group and 100 constituting the validation group. Models A, B, and C yielded seven, seven, and eleven predictors, respectively. Finally, we chose the clinical knowledge-driven model, whose C-statistics and Brier scores were 0.862 (0.820-0.904) and 0.1320, respectively. The Hosmer-Lemeshow test revealed that this model had good calibration. The clinical knowledge-driven model demonstrated satisfactory C-statistics during external and internal validation, with values of 0.890 (0.815-0.965) and 0.854 (0.820-0.900), respectively. A risk score for ARF incidence was created: The A2-BEST2 Risk Score (A2 (area of pulmonary infection, albumin), BMI, Economic condition, Smoking, and T2(hormone initiation Time and long-term regular medication Treatment)). ARF incidence increased gradually from 1.37% (The A2-BEST2 Risk Score ≤ 4) to 90.32% (A2-BEST2 Risk Score ≥ 11.5). We constructed a predictive model of seven predictors to predict ARF in BA patients. This predictor's model is simple, practical, and supported by existing clinical knowledge.

Effects of adjuvant ozone autohemotherapy combined with routine treatment on clinical and paraclinical features of mechanically ventilated COVID-19 patients in the intensive care unit: a pilot randomized controlled trial

Until the availability of an effective and practical vaccine, there is a serious need to recognize alternative treatments for coronavirus disease 2019 (COVID-19). This study aimed to determine whether major ozonated autohemotherapy (MOAH) can improve the clinical and paraclinical parameters in critically-ill patients with COVID-19 requiring mechanical ventilation. In this controlled trial, we enrolled 40 critically ill COVID-19 patients receiving invasive mechanical ventilation. The enrolled patients were then randomized into the MOAH and control groups. The patients in the MOAH group received MOAH three times per week (10 times in total) in addition to routine treatment and standard critical supportive care. Patients in the control group were only given regular treatment and standard critical supportive care. The patients in the MOAH group had more days of breathing with no aid than those in the control group. Moreover, the length of stay in the intensive-care unit was significantly lower in the MOAH group than in the control group. MOAH resulted in higher ventilation-free days and less intensive-care unit stay compared with the control treatment. In COVID-19 patients undergoing mechanical ventilation, MOAH with routine treatment resulted in more ventilator-free days and less intensive-care unit stay compared with the standard therapy.

Effect Of 12 Weeks Yoga Training And 12 Weeks Detraining on Blood Pressure Subjects with Hypertension

Background: Hypertension, an early predictor of cardiovascular disease can be prevented by healthy lifestyle modification. Stress-induced disorders such as hypertension can be effectively managed with the holistic science of yoga. Objective: In hypertensive individuals who are receiving routine treatment, we investigated the effects of yoga training for 12 weeks and compare as well as analyze these parameters at the end of yoga training (12th week) and after 12 weeks of follow-up with hypertensive on regular treatment (non-yoga group). Materials and methods: The study involved randomly assigned 124 hypertensive subjects to either experimental or control groups where N=65, and the yoga groups where n=61 between age of 25 to 45 years were included. In both the yoga group and the control group, heart rates (HR), Systolic Blood Pressures (SBP), Diastolic Blood Pressures (DBP), Pulse Pressures (PP), Mean Arterial Pressures (MAPs), and mean arterial pressure products were recorded before, after, and during the study period. Results: The means of RPP, HR, PP, SBP, MAP and DBP of pre-post, and follow-up values of the control group were compared by RM ANOVA and also there was no significant difference were found that exists among the groups. The mean values in the test group of post-training and follow-up show a significant decrease when compared with pre-training values. There are a significant decrease in test group follow-up values and post-training compared with follow-up values of control group and post-training respectively. In test group follow-up values the significant increase is found when compared with the test group post-training. Conclusion: Yoga reduced HR, SBP, DBP, PP, MAP, and RPP in essential hypertension under resting conditions. Reduced Sympathetic Activity, Enhanced Vagal Modulation and the increased sensitivity of baroreflex might be responsible for the harmonization of autonomic cardiovascular rhythms. Detraining from yoga, on the other hand, did not result in an increase in blood pressure. In conclusion, the present study shows that regular practice in yoga is helpful in reducing the hypertension, and that deep rest keeps the body healthy.

Pharmacological treatment of asthma in Sweden from 2005 to 2015

Objective Despite access to effective therapies many asthma patients still do not have well-controlled disease. This is possibly related to underuse of inhaled corticosteroids (ICS) and overuse of short-acting β2-agonists (SABA). Our aim was to investigate longitudinal trends and associated factors in asthma treatment. Methods Two separate cohorts of adults with physician-diagnosed asthma were randomly selected from 14 hospitals and 56 primary health centers in Sweden in 2005 (n = 1182) and 2015 (n = 1225). Information about symptoms, maintenance treatment, and use of rescue medication was collected by questionnaires. Associations between treatment and sex, age, smoking, education, body mass index (BMI), physical activity, allergic asthma, and symptom control were analyzed using Pearson’s chi2-test. Odds ratios (ORs) were calculated using logistic regression. Results Maintenance treatment with ICS together with long-acting β2-agonists (LABA) and/or montelukast increased from 39.2% to 44.2% (p = 0.012). The use of ICS + LABA as-needed increased (11.1–18.9%, p < 0.001), while SABA use decreased (46.4– 41.8%, p = 0.023). Regular treatment with ICS did not change notably (54.2–57.2%, p = 0.14). Older age, former smoking, and poor symptom control were related to treatment with ICS + LABA/montelukast. In 2015, 22.7% reported daily use of SABA. A higher step of maintenance treatment, older age, obesity, shorter education, current smoking, allergic asthma, low or very high physical activity, and a history of exacerbations were associated with daily SABA use. Conclusions The use of ICS + LABA both for maintenance treatment and symptom relief has increased over time. Despite this, the problem of low use of ICS and high use of SABA remains.