Symptoms Of Respiratory Infection Research Articles

Subjective Smell Disturbances in Children with Sars-Cov-2 or Other Viral Infections do not Correspond with Olfactory Test Results.

Olfactory dysfunction associated with SARS-CoV-2 infection in children has not been verified by a validated olfactory test. We aimed to determine whether these complaints are objectifiable (test-based hyposmia), how often they occur during acute SARS-CoV-2 infection compared to other upper respiratory tract infections (URTI), as well as in children recovered from COVID-19 compared to children with long COVID. Olfactory testing (U-sniff test; hyposmia<8 points) and survey-based symptom assessments were performed in 434 children (5-17 years; 04/2021-06/2022). 186 symptom-free children served as controls. Of the children with symptoms of acute respiratory tract infection, SARS-CoV-2 PCR test results were positive in 45 and negative in 107 children (URTI group). Additionally, 96 children were recruited at least 4 weeks (17.6±15.2 weeks) after COVID-19, of whom 66 had recovered and 30 had developed long COVID. Compared to controls (2.7%), hyposmia frequency was increased in all other groups (11-17%, p<0.05), but no between-group differences were observed. Only 3/41 children with hyposmia reported complaints, whereas 13/16 children with complaints were normosmic, with the largest proportion being in the long-COVID group (23%, p<0.05). Questionnaires are unsuitable for assessing hyposmia frequency in children. Olfactory complaints and hyposmia are not specific for SARS-CoV-2 infection. The number of complaints in the long-COVID group could result from aversive olfactory perception, which is undetectable with the U-sniff test.

Covid-19 Pandemi Sürecinde Sağlıklı Çocuk Takibi ve Kronik Hastalık Kontrollerinin Sürekliliği ve Pandeminin Poliklinik Başvurularına Erken ve Geç Dönemdeki Etkisinin Karşılaştırılması

Aim: Pandemic disrupted health care access in many centers all around the world. CDC recommended that seperating pandemic and non-pandemic hospitals, prioritizing emergency visits, postponing elective operations and, where possible, converting outpatient visits to telehealth calls. In this period, well-child checkups were cancelled and routine childhood vaccination was interrupted. We aimed to evaluate the impact of pandemic on the routine immunization schedule, neonatal screening program, chronic disease follow ups and outpatient clinic visits. &#x0D; Material and Method: In total, 401 children and their parents were included in this study and patient population of interest was children of routine immunization age. Outpatient visit features and compliance with the childhood vaccination and neonatal screening program before and during the pandemic were asked. &#x0D; Results: Compared to 2021, there was a significant increase in both the number of patients with upper respiratory tract infection symptoms and their hospital admissions. While the rates of hospital admissions increased in 2022 in those with diarrhea, almost all of the patients with lower respiratory tract infection symptoms stated that they applied to the hospital in both periods. It was observed that routine vaccination and newborn screening programs were carried out successfully during the pandemic process in Turkey. It was found that chronic disease follow-ups of children were interrupted in 2021. &#x0D; Conclusion: This study has shown how the 3 major components of health system (outpatient clinic visits, well child check-ups and chronic disease follow-ups) were affected at different times of the pandemic in Turkey. Successful management in childhood vaccinations and neonatal screening program should also be ensured in chronic disease follow-up bythe separation of pandemic and non-pandemic hospitals. Showing the strengths and weaknesses of strategies implemented in health system during the pandemic guides the measures to be taken for similar situations that may occur in the future.

Acceptability, cost-effectiveness, and capacity of a facility-based seasonal influenza vaccination among high-risk groups: a study protocol in selected tertiary care hospitals of Bangladesh

BackgroundIn Bangladesh, seasonal influenza imposes considerable disease and economic burden, especially for those at high-risk of severe disease. The most successful approach for influenza prevention is the administration of a vaccine. Many poor and middle-income nations, including Bangladesh, do not have a national strategy or program in place for seasonal influenza vaccines, despite the World Health Organization’s (WHO) advice to prioritize high-risk populations. Additionally, there is a scarcity of substantial data on the cost-effectiveness of seasonal influenza vaccination in these countries. The aim of our study is to determine acceptability, health beliefs, barriers, and intention of receiving influenza vaccine among high-risk populations, assess the cost-effectiveness of implementing a facility-based seasonal influenza vaccination programme, and investigate the required capacity for a potential seasonal influenza vaccination programme.MethodsWe will undertake this study following STROBE guidelines. We will conduct the study in inpatient and outpatient departments of three selected tertiary-level hospitals leveraging the ongoing hospital-based influenza surveillance (HBIS) platform. The study population will include the WHO-defined four high-risk groups excluding healthcare workers: children six months to eight years, pregnant women, elderly ≥ 60 years, and adults with chronic diseases. We will collect quantitative data on participants’ acceptability, health beliefs, barriers, and vaccination intentions using the health belief model (HBM) from patients meeting the criteria for high-risk populations attending two public tertiary-level hospitals. In one of the two public tertiary-level hospitals, we will arrange an influenza vaccination campaign before the influenza season, where the vaccine will be offered free of cost to high-risk patients, and in the second hospital, vaccination will not be offered. Both the vaccinated and unvaccinated participants will then be followed-up once a month for one year to record any influenza-like illness, hospitalization, and death. Additional data for objective two will be collected from patients with symptoms of influenza-like illness (ILI) and severe acute respiratory infection (SARI) at one public and one private hospital to determine both direct and indirect costs associated with influenza illness. We will estimate the required number of influenza vaccines, safe injections, and total storage volume utilizing secondary data. We will use a deterministic Markov decision-analytic model to estimate the cost-effectiveness of facility-based influenza vaccination in Bangladesh.DiscussionThe results of this study will enable the National Immunization Technical Advisory Group and the Ministry of Health & Family Welfare of Bangladesh to decide what steps to take to develop and implement an influenza vaccination strategy targeting high-risk populations.Trial registrationThe Clinicaltrials.gov registration number is NCT05996549. The registration for the protocol version 2.0 took place in August 2023, with the initial participant being enrolled in March 2022.

Anastrozole Protects against Human Coronavirus Infection by Ameliorating the Reactive Oxygen Species-Mediated Inflammatory Response.

The common human coronavirus (HCoV) exhibits mild disease with upper respiratory infection and common cold symptoms. HCoV-OC43, one of the HCoVs, can be used to screen drug candidates against SARS-CoV-2. We determined the antiviral effects of FDA/EMA-approved drug anastrozole (AZ) on two human coronaviruses, HCoV-OC43 and HCoV-229E, using MRC-5 cells in vitro. The AZ exhibited antiviral effects against HCoV-OC43 and HCoV-229E infection. Subsequent studies focused on HCoV-OC43, which is related to the SARS-CoV-2 family. AZ exhibited anti-viral effects and reduced the secretion of inflammatory cytokines, TNF-α, IL-6, and IL-1β. It also inhibited NF-κB translocation to effectively suppress the inflammatory response. AZ reduced intracellular calcium and reactive oxygen species (ROS) levels, including mitochondrial ROS and Ca2+, induced by the virus. AZ inhibited the expression of NLRP3 inflammasome components and cleaved IL-1β, suggesting that it blocks NLRP3 inflammasome activation in HCoV-OC43-infected cells. Moreover, AZ enhanced cell viability and reduced the expression of cleaved gasdermin D (GSDMD), a marker of pyroptosis. Overall, we demonstrated that AZ exhibits antiviral activity against HCoV-OC43 and HCoV-229E. We specifically focused on its efficacy against HCoV-OC43 and showed its potential to reduce inflammation, inhibit NLRP3 inflammasome activation, mitigate mitochondrial dysfunction, and suppress pyroptosis in infected cells.

Pediatric endoscopy in times of pandemic: A nationwide retrospective analysis

BackgroundGastrointestinal endoscopy is a procedure that carries an increased risk of transmission of SARS-CoV-2 infection to medical staff. In patients, COVID-19 is a risk factor for adverse events of medical procedures. This study analyzed the real-life risk of, and factors contributing to, infection transmission to endoscopic personnel, and possible adverse events of the endoscopy procedure and anesthesia in children with COVID-19. MethodsNationwide retrospective analysis of medical records of children with confirmed SARS-CoV-2 infection who underwent gastrointestinal endoscopy in Poland between February 2020 and February 2022. ResultsFifty-eight patients were included in the analysis, 35% of whom had COVID-19 symptoms at the time of endoscopy. The dominant indications for endoscopy were foreign body or corrosive substance ingestion and gastrointestinal bleeding. Nine cases of virus transmission were registered among endoscopic personnel. In all of these cases, the endoscopy team was unaware of the patient's infection (p < 0.01), although symptoms were present in 78% of the children. Lack of use of personal protective equipment was the strongest predictor of SARS-CoV-2 transmission (p < 0.01). The risk of infection was not statistically significantly dependent on the method of anesthesia, intubation or the type of endoscopy. No statistically significant correlation was found between symptomatic infection and adverse events of endoscopy or anesthesia occurrence. There was one reported anesthesia-related adverse event involving extubation difficulties due to worsening respiratory infection symptoms. ConclusionsThe risk of transmitting SARS-CoV-2 to endoscopic personnel during procedures in children is low and depends on compliance with infection prevention and control measures. Performing gastrointestinal endoscopy in children with COVID-19 does not appear to be associated with an increased risk of adverse events.

Recurrent respiratory tract infections in children might be associated with vitamin A status: a case-control study.

Recurrent respiratory tract infections (RRTIs) are common in children and its development might be associated with vitamin A deficiency according to recent research. The aim of this study was to understand the relation between vitamin A status and RRTIs in children, and the relation between dietary intake of vitamin A and RRTIs. 2,592 children aged 0.5-14 years from Heilongjiang province of China participated in the survey. The RRTI group consisted of 1,039 children with RRTIs, while 1,553 healthy children were included in the control group. The levels of serum vitamin A were determined by high performance liquid chromatography (HPLC); dietary information was collected with the Food Frequency Questionnaire (FFQ). Serum vitamin A concentration in the RRTI group was significantly lower than that in the control group (0.27 ± 0.09 mg/L vs. 0.29 ± 0.09 mg/L) (P < 0.01). The levels of vitamin A was obviously associated with the occurrence of RRTIs. The odds ratios (ORs) for vitamin A insufficiency and deficiency were 1.32 (95% CI: 1.09-1.60) and 1.95 (95% CI: 1.50-2.55) respectively; whereas 1.48 (95% CI: 1.13-1.94) and 6.51 (95% CI: 4.18-10.14) respectively, in children with current respiratory tract infection (RTI) symptoms. Even an insufficient intake of animal liver was associated with lower RRTIs [OR: 0.45 (95% CI: 0.38-0.53)], while only an excessive intake of meat had the same effect [OR: 0.85 (95% CI: 0.68-1.06)]. Low serum vitamin A concentration was associated with high incidence of RRTIs in children in northeast China; low serum vitamin A concentrations and the current RTI symptoms were associated with the development of RRTIs; and low intakes of vitamin A-rich foods were also associated with the development of RRTIs.

The role of nutritional support with probiotics in outpatients with symptomatic acute respiratory tract infections: a multicenter, randomized, double-blind, placebo-controlled dietary study

BackgroundA number of laboratory data and clinical studies have shown that probiotic bacteria may be beneficial in respiratory viral diseases. We investigated the role of probiotics in coronavirus disease-19 (COVID -19), post-disease symptoms, and humoral immune responses to viral antigens.MethodsThis was a randomized, double-blind, placebo-controlled, prospective, multicenter study. We included symptomatic patients aged 18–65 years without risk of severe disease, and positive antigen/PCR test for SARS-CoV-2. Patients received (Bifidobacterium (B.) lactis BI040, B. longum BL020, Lactobacillus (L) rhamnosus LR110, L. casei LC130, L. acidophilus LA120, 5 billion CFU total) or placebo 1 capsule a day for 28 days and recorded symptoms. Three months later patients completed Post-COVID-19 Questionnaire (PCQ-19). On days 0–5 and 28–35, blood was sampled for IgG to nucleocapsid protein (NCP) and receptor binding domain (RBD)/spike 1 (S1) protein. The primary outcome measure was a patient global symptom score on day 10 of observation. The difference between groups was assessed using the Mann–Whitney U test.ResultsSeventy-three patients were assessed for clinical endpoints and 44 patients were evaluated for antibody production. At day 10, the median global symptom score (interquartile range) was lower in the probiotic group (0.0 (0.0–2.0) vs. 2.0 (1.0–5.0), P < 0.05). The probiotic group had a shorter duration of fatigue and anxiety after COVID -19 (P < 0.05) and a greater change in IgG concentration on RBD/S1 (225.9 vs. 105.6 binding antibody units/mL, P < 0.05).ConclusionsUse of probiotics alleviates acute and post-disease symptoms, and improves humoral immune response to viral antigens.Trial registrationRegistered at clinicaltrials.gov as NCT04907877, June 1, 2021.

A Comprehensive Study of Respiratory Pathogen Shifts in Response to the COVID-19 Pandemic: Insights from a Tertiary Level Hospital in Bangladesh

Introduction: Respiratory tract infections (RTIs) are a global health concern, with lower respiratory infections (LRIs) causing millions of deaths annually. The COVID-19 pandemic, caused by SARS-CoV-2, led to unprecedented public health measures, including lockdowns and vaccination campaigns, which have influenced the landscape of respiratory infections. This study aims to investigate the impact of COVID-19, its mitigation strategies and vaccination status on the prevalence and distribution of bacterial pathogens causing RTIs in a Bangladeshi hospital. Methods: Respiratory samples were collected from 100 patients with RTI symptoms in a teaching hospital in Bangladesh from December 2022 to May 2023. Bacterial cultures were performed, and antibiotic susceptibility testing was conducted. Patient data, including age, gender, comorbidities, and vaccination status, were analyzed statistically. Results: Among the participants, 96% exhibited bacterial growth in respiratory samples. Klebsiella pneumoniae was the most prevalent pathogen (63.2%), followed by Streptococcus spp. (12.2%) and Staphylococcus aureus (10.2%). The prevalence of these pathogens varied by age groups, with Klebsiella pneumoniae being prominent in the 50-69 age range. COVID-19 vaccination status significantly influenced the distribution of bacterial species, with fully vaccinated individuals having higher rates of certain infections, such as Klebsiella pneumoniae and Streptococcus spp. Comorbidities were also associated with variations in bacterial infections. Discussion: This study reveals a high prevalence of bacterial pathogens in post-COVID-19 RTIs, with Klebsiella pneumoniae being the predominant species. The findings suggest that COVID-19 vaccination status plays a crucial role in shaping the spectrum of bacterial infections, with fully vaccinated individuals showing a higher prevalence of specific pathogens. Comorbidities also influence the type and frequency of bacterial infections. These results align with previous studies and underscore the need for continued monitoring and research in the ever-evolving landscape of infectious diseases. Conclusion: The COVID-19 pandemic has brought significant changes to the patterns of respiratory infections. Understanding the impact of COVID-19 and vaccination status on respiratory pathogens is vital for healthcare providers and policymakers. This study emphasizes the importance of ongoing research and vigilance in addressing the evolving challenges of infectious diseases in the post-COVID-19 era. It highlights the interconnectedness of vaccination, immunity, and susceptibility to bacterial infections, providing critical insights for public health strategies.

The shifting landscape of private healthcare providers before and during the COVID-19 pandemic: Lessons to strengthen the private sectors engagement for future pandemic and tuberculosis care.

COVID-19 pandemic changed many aspects of healthcare services and deliveries, including among private healthcare providers (i.e., private healthcare facilities [HCFs] and private practitioners [PPs]). We aimed to compare the spatial distribution of private providers and describe changes in characteristics and services offered during and before the COVID-19 pandemic, and explore the tuberculosis (TB) and COVID-19-related services offered by the private sector in Bandung, Indonesia. A cross-sectional study with historical comparison was conducted in 36 randomly selected community health centers areas (locally referred to as Puskesmas) in Bandung, Indonesia, during the COVID-19 pandemic from 5th April 2021 - 27th December 2021. Data pertaining to before the COVID-19 pandemic was abstracted from a similar survey conducted in 2017 (i.e., INSTEP study). We obtained latitude and longitude coordinates of private healthcare providers and then compared the geographical spread with data collected for INSTEP study. We also compared characteristics of, and services provided by private healthcare providers interviewed during the COVID-19 pandemic with those previously interviewed for INSTEP study. Differences were summarized using descriptive and bivariate analyses. From April-December 2021, we surveyed 367 private HCFs and interviewed 637 PPs. Compared to INSTEP study data, the number of operating HCFs was reduced by 3% during the COVID-19 pandemic (401 vs. 412 before COVID-19), although we observed increases in laboratory service (37.8% increase), x-ray service (66.7% increase), and pharmacy (18.1% increase). Among a subset of private HCFs managing patients with respiratory tract infection symptoms, a quarter (60/235, 25.3%) indicated that they had to close their facilities in response to the emerging situation during the COVID-19 pandemic. For PPs, the number of practicing PPs was reduced by 7% during the COVID-19 pandemic (872 vs. 936 before COVID-19). Interestingly, the number of practicing PPs encountering patients with TB disease increased during the COVID-19 pandemic (42.9% vs. 35.7% before COVID-19, p = 0.008). This study confirmed that the COVID-19 pandemic adversely impacted health care service deliveries in private sectors, largely marked by closures and shortened business hours. However, the increased service capacities (laboratory and pharmacy), as well as significant increase in the number of patients cared for TB disease by PPs during the COVID-19 pandemic, made a more compelling case to further the implementation of public-private mix model for TB care in Indonesia.

Association of symptomatic upper respiratory tract infections with the alteration of the oropharyngeal microbiome in a cohort of school children in Côte d'Ivoire.

The oropharyngeal microbiome plays an important role in protection against infectious agents when in balance. Despite use of vaccines and antibiotic therapy to prevent respiratory tract infections, they remain one of the major causes of mortality and morbidity in Low- and middle-income countries. Hence the need to explore other approaches to prevention by identifying microbial biomarkers that could be leveraged to modify the microbiota in order to enhance protection against pathogenic bacteria. The aim of this study was to analyze the oropharyngeal microbiome (OPM) of schoolchildren in Côte d'Ivoire presenting symptoms of upper respiratory tract infections (URTI) for better prevention strategy. Primary schools' children in Korhogo (n = 37) and Abidjan (n = 39) were followed for six months with monthly oropharyngeal sampling. Clinical diagnostic of URT infection was performed and nucleic acid extracted from oropharyngeal swabs were used for 16S rRNA metagenomic analysis and RT-PCR. The clinical examination of children's throat in Abidjan and Korhogo identified respectively 17 (43.59%) and 15 (40.54%) participants with visible symptoms of URTIs, with 26 episodes of infection in Abidjan and 24 in Korhogo. Carriage of Haemophilus influenzae (12%), Streptococcus pneumoniae (6%) and SARS-CoV-2 (6%) was confirmed by PCR. A significant difference in alpha diversity was found between children colonized by S. pneumoniae and those that were not (p = 0.022). There was also a significant difference in alpha diversity between children colonised with H. influenzae and those who were not (p = 0.017). No significant difference was found for SARS-CoV-2. Sphingomonas, Ralstonia and Rothia were significantly enriched in non-carriers of S. pneumoniae; Actinobacillus was significantly enriched in non-carriers of H. influenzae; Actinobacillus and Porphyromonas were significantly enriched in non-carriers of SARS-CoV-2 (p < 0.001). Nearly 40% of children showed clinical symptoms of infection not related to geographical location. The OPM showed an imbalance during H. influenzae and S. pneumoniae carriage. This study provides a baseline understanding of microbiome markers in URTIs in children for future research, to develop targeted interventions aimed at restoring the microbial balance and reducing the symptoms associated with RTIs.

Итоги открытого многоцентрового неинтервенционного наблюдательного проспективного исследования влияния на качество жизни препарата Кипферон®, применяемого у детей 0–7 лет с острыми респираторными вирусными инфекциями в условиях рутинной амбулаторно- поликлинической практики

Objective. To evaluate the dynamics of the quality of life of children aged 0 to 7 years with acute respiratory viral infections (ARVI) of mild and moderate severity when adding the drug Kipferon® (a mixture of normal human immunoglobulin and recombinant interferon α-2b) to standard therapy, as well as to determine the effect of this drug on the infectious morbidity of patients during 3 months following the course of treatment. Patients and Methods. A multicenter observational clinical study conducted at 19 clinical centers in Russia in routine outpatient and polyclinic practice included 855 children aged 0 to 7 years; the mean age was 3.5 ± 1.7 years. There were 460 (53.8%) boys and 395 (46.2%) girls. There were 89 children aged 0 to 1 year; older children were 766. Patients were divided into 2 groups: the main group (n = 656), children from which received Kipferon® (rectal suppositories, according to the instructions for use) for 7 days in addition to standard symptomatic therapy, and the control group (n = 199). The children were examined on admission, on the 3–5th and 6-8th day from the beginning of treatment; 1 and 3 months after the end of the course of therapy. The severity of the main clinical symptoms was evaluated using a 10-point system. The legal representatives of all patients signed informed consent. Statistical analysis of the results was performed using the methods of descriptive and variation statistics, Student and Mann–Whitney criteria; differences were considered reliable at p &lt; 0.05. Results. The initial general level of discomfort, as well as the degree of severity of 11 main symptoms of acute respiratory infection were comparable in both groups and significantly improved by the end of the treatment course. On the 3-5th day from the beginning of treatment in patients receiving Kipferon® preparation, statistically significant (p &lt; 0.05) improvement in all leading manifestations of ARVI was revealed, while in the control group improvement was registered only in 8 symptoms out of 11. In infants of the main group by the 3–5th day of treatment, difficulties in feeding and falling asleep significantly (p &lt; 0.05) decreased; older patients significantly better ate and slept, and were more physically active. Bacterial complications of ARVI in the main group developed 2 times less frequently: 36 (5.7%) cases vs. 20 (10.3%); the differences are reliable (p = 0.026) according to the χ2 criterion. Repeated acute respiratory viral infections during 3 months of follow-up were significantly (p &lt; 0.05) more frequent in children who did not receive Kipferon® (47.5% vs. 20.3%). No serious adverse events were detected during the use of Kipferon® preparation. Adverse events were recorded in 2 patients, none of them was classified as related to the use of the study drug; serious adverse events were absent during the entire observation period. Conclusion. The efficacy and safety of the immunomodulating drug Kipferon® allows us to recommend it as an important addition to symptomatic agents in the treatment of acute respiratory infections in pediatrics. Key words: children, interferons, Kipferon®, acute respiratory viral infections

Clinical aspects of human Bocavirus 1 in a sample of Egyptian infants with acute lower respiratory tract infection: A pilot study

Background/aim The recent advance in molecular technology permitted a comprehensive range of novel viral etiological causes to be detected in respiratory tract specimens. The human Bocavirus 1 (HBoV1) as a virus of the Parvoviridae family recently was defined as a human pathogen mainly linked to acute respiratory infection in children. Our aim was to identify the rate and seasonal variation of Bocavirus 1 infection and their correlation with the different clinical presentations in Egyptian infants less than 2 years old with acute lower respiratory tract infection. Patients and methods This study enrolled 100 infants aged from 4 weeks to 2 years presenting with symptoms of acute respiratory infection from Materia Hospital and Alzahraa University Hospital. Full medical history, general and local examination of the chest focusing on respiratory rate and plain chest radiograph were collected from each infant. In addition, pharyngeal swabs were collected from participated infants and were subjected to DNA extraction followed by PCR using different viral protein-targeted primer sets. Results Bronchopneumonia was the prominent diagnosis in the enrolled infants (38%) followed by bronchiolitis (34%) and bronchitis (28%) subsequently. The presence of HBoV1 among studied patients was 8% and the peak of the infection was in January (37.5%) followed by April (25%) and July (25%). Most of patients with HBoV1 positive were presented with respiratory distress and refusal of feeding. Seven percent of all patients were presented with diarrhea. Conclusions HBoV1 infection may be considered as a risk factor for lower respiratory tract infections in Egyptian children less than 2 years old.

Symptoms of depression among outpatients with suspected COVID-19 in metropolitan Local Government Areas of Kaduna State, Nigeria.

The novel SARS-CoV-2 virus that causes Coronavirus disease (COVID-19) has redefined global health and response to Acute Respiratory Infection (ARI). The outbreak of a cluster of influenza-like illnesses in Wuhan, China, has morphed into a pandemic in the last quarter of 2019, stretching from South East Asia to Europe, The Americas, Africa, and the Australian subcontinent. We evaluated the prevalence of depression among outpatients diagnosed with ARI. We utilized a cross-sectional, observational design and investigated the prevalence of symptoms of depression among outpatients with ARI and described the characteristics of outpatients with ARI in Kaduna State. The prevalence of symptoms of depression was 19.6% for respondents with symptoms of ARI and 14.4% for those without symptoms of ARI. On no risk of depression, we had a higher proportion of the respondents without symptoms of ARI (86%) than those with symptoms of depression (80%) (M = 318.4, SD = 29.62 case, and M = 344.0, SD = 14.2 control, r = 0.88, CI = 13.5 to 6.5, P = 0.000952). Likewise, in the category with mild risk of depression, respondents without symptoms of ARI were fewer (10%) than those with symptoms of depression (15%) (M = 58.4, SD = 26.0 case, and M = 42.1, SD = 12.7 control, r = 0.86, CI = 11.8 to 5.8, P = 0.0136. There was no significant difference between respondents with symptoms of ARI and without symptoms of ARI in the categories of moderate (M = 13.6, SD = 5.1 case, and M = 11.6, SD = 4.6 control, r = 0.87, CI = 2.3 to 2.1, P = 0.178) and high (M = 5.6, SD = 2.5 case, and M = 4.4, SD = 3.2 control, r = 0.61, CI = 1.2 to 1.5, P = 0.174) risk of depression. Symptoms of depression were commoner among respondents who presented with symptoms of Acute Respiratory Infection (ARI) at the Outpatient Department (OPD). However, further explanatory research is needed to establish causality.

Clinical Manifestations of Wegener Granulomatosis in Iranian Ethnicities Using the K-Means Algorithm: A Descriptive Study.

Introduction Wegener granulomatosis (WG) appears with clinical symptoms, including recurrent respiratory infection, renal manifestations, and nonspecific systemic symptoms. Objective To study the clinical manifestations of WG in Iranian ethnicities, and data on 164 patients were recorded from 2013 to 2018. Methods The data included demographics, symptoms, and the Birmingham Vasculitis Activity Score (BVAS). The symptoms involved the following sites: the nose, sinus, glottis, ears, lungs, kidneys, eyes, central nervous system, mucous membranes, skin, heart, stomach, intestine, as well as general symptoms. The clinical manifestations of nine ethnicities were analyzed. Results In total, 48% of the patients were male and 51% were female, with a median age of 51 years. The BVAS was of 15.4, the sites most involved were the sinus ( n = 155), nose ( n = 126), lungs ( n = 125), and ears ( n = 107). Gastrointestinal ( n = 14) and cardiac ( n = 7) involvement were less common. Among the patients, 48.17% were Persian, 13.41% were Azari, 11.17% were Gilaki, 11.17% were Kurd, and 10.9% were Lor. Conclusion Our findings indicated that the sinus, nose, lungs, and ears were the sites most involved, and gastrointestinal and cardiac involvement were less common. In the present study, involvement of the upper and lower respiratory tract was higher than that reported in Western and Asian case series. Moreover, we report for the first time that, in all patients with ear involvement, the left ear was the first to be affected. The clinical manifestations among Iranian ethnicities were not different, and the Gilaki ethnicity had the highest BVAS, mostly because the weather was humid; therefore, in Iran, in areas with humidity, the rate of the disease was higher.

Investigating neighbourhood environmental risk factors associated with childhood acute respiratory infection symptoms in Ethiopia mixed effect and multilevel logistic regression analysis based on EDHS 2016.

Acute respiratory infection is an infectious illness caused by acute viral or bacterial infection. According to a 2018 WHO report, exposures to indoor and ambient air environmental pollution were contributing factors to a higher risk of respiratory problems following 7 million deaths of children under five globally. Housing conditions such as wall material, roof type, kitchen location, sanitation condition, and cooking fuel type are household-level predictors of acute respiratory disease among children under five years of age. This research used EDHS-2016 secondary data, which are nationally representative. The data collection period was from January 18, 2016, to June 27, 2016. Among the 16,650 total surveys, 10,006 households that had children below 5 years of age. The outcome variable for this study was acute respiratory infection symptoms. Analyses were performed using STATA Version 17.1. The data were weighted before performing analysis to reinstate the representativeness of the sample. In the bivariable analysis, a p value <0.2 was used to screen for multivariable. Multicollinearity was checked using the variance inflation factor. Then, a multilevel multivariable regression model was used in this study for the analysis of acute respiratory infection symptoms and possible predictor variables. Variables with a p value <0.05 in multivariable regression analysis were considered statistically significant predictors. Most (95.00%) households commonly used solid fuel for cooking, and household main construction materials: 81.44 and 91.03% of floors and walls of households were constructed with unprocessed natural materials, respectively. The prevalence of acute respiratory infection symptoms among children under five years of age was 7.955% (7.397, 8.551%). The findings indicated that acute respiratory infection symptoms among children under five years of age were significantly linked with the age of the children, diarrhea status, residence, region, fuel type, stool disposal, wall material, and floor material. Interventions should target modifiable factors such as proper stool disposal of the youngest child, informing the health effects of poor housing conditions such as improving wall and floor construction material to reduce acute respiratory infection symptoms among children under five years of age.

How predictive of SARS-CoV-2 infection are clinical characteristics at presentation among individuals with COVID-like symptoms treated at the Mexican Institute of Social Security.

The COVID-19 pandemic has progressed rapidly, with the emergence of new virus variants that pose challenges in treating infected individuals. In Mexico, four epidemic waves have been recorded with varying disease severity. To understand the heterogeneity in clinical presentation over time and the sensitivity and specificity of signs and symptoms in identifying COVID-19 cases, an analysis of the changes in the clinical presentation of the disease was conducted. To analyze the changes in the clinical presentation of COVID-19 among 3.38 million individuals tested for SARS-CoV-2 at the Mexican Social Security Institute (IMSS) from March 2020 to October 2021 and evaluate the predictivity of signs and symptoms in identifying COVID-19 cases. A retrospective analysis of clinical presentation patterns of COVID-19 among individuals treated at IMSS was performed, contrasting the signs and symptoms among SARS-CoV-2-positive individuals with those who tested negative for the virus but had respiratory infection symptoms. The sensitivity and specificity of each sign and symptom in identifying SARS-CoV-2 infection were estimated. The set of signs and symptoms reported for COVID-19-suspected patients treated at IMSS were not highly specific for SARS-CoV-2 positivity. The signs and symptoms exhibited variability based on age and epidemic wave. The area under the receiver operating characteristic (ROC) curve was 0.62 when grouping the five main symptoms (headache, dyspnea, fever, arthralgia, and cough). Most of the individual symptoms had ROC values close to 0.5 (16 out of 22 between 0.48 and 0.52), indicating non-specificity. The results highlight the difficulty in making a clinical diagnosis of COVID-19 due to the lack of specificity of signs and symptoms. The variability of clinical presentation over time and among age groups highlights the need for further research to differentiate whether the changes are due to changes in the virus, who is becoming infected, or the population, particularly with respect to prior infection and vaccination status.

Clinical and demographic characteristics of human bocavirus-1 infection among patients with symptoms of acute respiratory tract infection during the COVID-19 pandemic in the Central province of Sri Lanka

NA

Effects of maternal and child factors on the immunological composition of human milk

Introduction and objective: The relationship between the bioactive components of milk and maternal and child health is not well elucidated yet. The aim of this study was to determine whether maternal factors (diseases and drugs used during pregnancy, method of delivery, age) and child characteristics (age, length and body weight at birth) affect breast milk composition (leukocytes, stem cells, and epithelial cells). Materials and methods: Twenty-three breastfeeding mothers of infants aged 1–6 months were recruited for the study. All the mothers and children were healthy, with no symptoms of respiratory tract infection. Samples of breast milk (20 mL) were collected. Each sample was assessed for its cellular composition (epithelial cells, mesenchymal stem cells, leukocytes). Only a few studies available in the literature have evaluated both immune cells (leukocytes) and cells of non-immune origin (mesenchymal and epithelial cells) in human milk. In this regard, our analysis is innovative. Results: Women receiving pharmacotherapy during pregnancy had a significantly higher percentage of eosinophils in their breast milk compared to women who did not receive any medication when pregnant. The cellular composition of milk correlated inversely with the age of the mother and child. The more advanced the mother’s age, the lower the number of monocytes in the milk. On the other hand, the older the child, the lower CD4 lymphocyte count in milk. Conclusions: The study suggests that the cellular composition of breast milk is influenced not only by the characteristics related to the mother but also by child-depended factors. Research in this area needs to be continued.

Evaluation of antimicrobial activity of a herbal mixture

Due to adverse effects of using allopathic medicines, the use and search for pharmaceuticals made from plants has increased recently. A mixture of herbal extracts known as “Chukku Kashaya” is widely used as home remedy in Kerala for respiratory disorders. Additionally, it relieves cold and fever symptoms. The present investigation focused on evaluating the antimicrobial activity of methanolic extracts obtained by soxhlet extraction of leaves of Ocimum tenuiflorum and Plectranthus amboinicus and fruits of Piper nigrum and rhizome of Zingiber officinalae and their combination in equal ratios and their activity was determined using agar well diffusion method against Staphylococcus aureus (gram positive), Klebsiella pneumoniae (gram negative), and Pseudomonas aeruginosae (gram negative). Streptomycin was used as positive control. Zingiber officinalae showed maximum zone of inhibition against all the bacteria and herbal mixture showed moderate zone of inhibition. The mixture was more active than Ocimum tenuiflorum , Piper nigrum and Plectranthus amboinicus. Staphylococcus aureus was shown to be the most sensitive to all the extracts and herbal mixtures, whereas Klebsiella pneumoniae showed the least activity. Though Z.officinalae has higher antimicrobial activity, there is limited literature support to prove its activity against fever, cold and other symptoms of respiratory tract infections. Z.officinalae is mainly used for GI related disorders. This herbal blend is more efficient because it includes of O.tenuiflorum : having antipyretic, analgesic and voice improving activity ; P.amboinicus: providing relief from cough, asthma, bronchitis and other symptoms of respiratory tract infections; P. nigrum which can improve appetite and digestion .

Household heating fuels impact on Acute Respiratory Infection (ARI) symptoms among children in Punjab, Pakistan

Exposure to household air pollution (HAP) accounted for the loss of 86 million healthy lives in 2019, with almost half of all deaths due to lower respiratory infection among children under 5 years of age. Similarly, the situation in Punjab – Pakistan’s largest province – is also not promising. This study was conducted to examine household energy consumption and respiratory symptoms among children under the age of five in rural and urban areas of Punjab. Using data from the Multiple Indicator Cluster Survey (MICS) 2017-18, logistic regression models were applied to the data of a sample of 35,000 children under the age of five living in households with polluting heating fuels. A hypothesis was formulated to investigate the relationship between polluting heating activities and respiratory infections among children under five. Those Children who live in households having traditional space heaters without chimneys are 50% more likely to have symptoms of Acute Respiratory Infection (ARI) compared to those whose households have chimneys with traditional space heaters. When households utilize polluting heating fuel, the likelihood of children experiencing rapid, shortness of breath increases by 49%, and the likelihood of children displaying ARI symptoms characterized by coughing rises by approximately 30%. This study proposed a complete banning of polluting heating activities and replacing it with cleaner ones using financial incentives. It is pertinent to raise awareness campaigns majorly focusing on the guidelines to adopt better heat output with less harmful emissions.