World Health Organization Estimates Research Articles

The Influence of Health Innovation Awareness on the Use of Skilled Birth Delivery Services: A Case Study of Kimilili SubCounty, Bungoma County, Kenya

The uptake of skilled birth delivery services (SBDs) is crucial for improving maternal and child health, as it significantly reduces maternal and child mortality rates (MCMR). Maternal morbidity and mortality profoundly impact mothers, babies, families, communities, and society at large. The World Health Organization (WHO) estimates that maternal and child deaths result in an annual loss of USD 15.5 billion in potential productivity globally. In Bungoma County, the rate of SBDs has risen to over 50% in the past eight years, except for 2017 when it dropped to 46% due to a prolonged health workers' strike. However, there has been uncertainty regarding the sustainability of these high SBD rates after the cessation of specific health programs.This study aimed to describe and analyze how awareness of health innovations influences the use of skilled birth delivery services in Kimilili Sub County, Bungoma County. Utilizing a cross-sectional descriptive quantitative analytical design, the study employed both probability and non-probability sampling techniques to select participants. Descriptive statistics, including means and percentages, were used to summarize the data, while multiple regression analysis assessed the relationship among various innovations in increasing skilled birth delivery uptake. Findings indicated that awareness of health innovations, particularly those addressing financial aspects of delivery, significantly influences the uptake of skilled birth delivery (p=0.000). The study concluded that health innovations providing financial support for medical bills and emotional support throughout pregnancy strongly affect skilled delivery rates in Kimilili Sub County.

Functional Language in Children from a Public Cochlear Implant Program in a Developing Country.

Introduction The World Health Organization (WHO) estimates that ∼ 32 million children worldwide are affected by hearing loss (HL). Cochlear implant is the first-line treatment for severe to profound sensorineural HL. It is considered one of the most successful prostheses developed to date. Objective To evaluate the oral language development of pediatric patients with prelingual deafness implanted in a reference hospital for the treatment of HL in southern Brazil. Methods We conducted a retrospective cohort study with a review of medical records of patients undergoing cochlear implant surgery between January 2009 and December 2018. Language development was assessed by reviewing consultations with speech therapy professionals from the cochlear implant group. Results A total of 152 children were included in the study. The mean age at cochlear implant surgery was of 41 months (standard deviation [SD]: ± 15). The patients were divided into six groups considering the type of language most used in their daily lives. We found that 36% of children use oral language as their primary form of communication. In a subanalysis, we observed that patients with developed or developing oral language had undergone cochlear implant surgery earlier than patients using Brazilian Sign Language (Língua Brasileira de Sinais, LIBRAS, in Portuguese) or those without developed language. Conclusion The cochlear implant is a state-of-the-art technology that enables the re-establishment of the sense of hearing and the development of oral language. However, language development is a complex process known to present a critical period to properly occur. We still see many patients receiving late diagnosis and treatment, which implies a delay and, often, the impossibility of developing oral communication. Level of Evidence Level 3 (cohort study).

Rapid survey for assessing effective cataract surgical coverage (eCSC) and effective refractive error coverage (eREC)-Novel indicators of universal eye health.

As per the recent World Health Organization estimates, approximately 2.2 billion people have near and distance vision impairment (VI) globally, and out of this almost 50% is avoidable. The Rapid Assessment of Avoidable Visual Impairment survey was a cross-sectional study conducted in September 2021, using cluster random sampling in 42 clusters with a cluster size of 140, giving a total of 6000 participants. Two teams comprising of trained optometrists and social workers conducted the ocular examination which included unaided, pinhole, and aided visual acuity assessments followed by examination of the anterior segment and lens. Distance visual acuity was measured using simplified tumbling "E" charts of different sizes for VA of 6/12, 6/18, and 6/60. The lens assessment was done in an un-dilated pupil with torch light by the optometrist. Overall, 6520 individuals aged 6 years and above were enumerated, of whom 5440 (83.4%) were examined. The response rate for examination was better among females (93.1%) than males (73.9%), and it decreased from 93.8% in the age group 6-15 years to 77.1% in the 45+ age group. The prevalence of blindness and VI were 0.18% (95% CI: 0.06-0.29) and 4.19% (95%CI: 3.65-4.72), respectively. The major causes of VI in all age groups were uncorrected refractive error (65.4%), cataract (23.7%), cataract surgical complications (2.6%), corneal opacity (0.4%), and other posterior segment diseases (7.5%). The effective cataract surgical coverage (eCSC) was 61.8%, effective refractive error coverage (eREC) for distance vision was 59.8%, and eREC for near vision was 47.0%. The RAAVI methodology is suitable to measure effective coverage in the general population, both for baseline measurement and periodic monitoring. The 2030 targets for the surveyed district are 90% eCSC and 100% eREC. Such exercises need to be conducted in each district of the country to determine the baseline and target values of effective coverage.

Genetics of Hypertension: From Monogenic Analysis to GETomics.

Arterial hypertension is the most frequent cardiovascular risk factor all over the world, and it is one of the leading drivers of the risk of cardiovascular events and death. It is a complex trait influenced by heritable and environmental factors. To date, the World Health Organization estimates that 1.28 billion adults aged 30-79 years worldwide have arterial hypertension (defined by European guidelines as office systolic blood pressure ≥ 140 mmHg or office diastolic blood pressure ≥ 90 mmHg), and 7.1 million die from this disease. The molecular genetic basis of primary arterial hypertension is the subject of intense research and has recently yielded remarkable progress. In this review, we will discuss the genetics of arterial hypertension. Recent studies have identified over 900 independent loci associated with blood pressure regulation across the genome. Comprehending these mechanisms not only could shed light on the pathogenesis of the disease but also hold the potential for assessing the risk of developing arterial hypertension in the future. In addition, these findings may pave the way for novel drug development and personalized therapeutic strategies.

A CROSS-SECTIONAL STUDY ON MALIGNANT TERTIAN MALARIA AMONG CHILDREN BELOW FIVE YEARS ATTENDING THE OUTPATIENT DEPARTMENT LABORATORY AT JINJA REGIONAL REFERRAL HOSPITAL.

Background: World Health Organisation estimates that 229 million new cases of Malignant Tertian Malaria in 2019 in the world. 3.3 billion people in tropical regions and Uganda there is still a high mortality rate, especially in children below five years. Purpose of the study: The study was to determine the prevalence of Malignant Tertian Malaria among children below five years at Jinja Regional Referral Hospital. Methodology: A descriptive cross-sectional study was used and data was obtained from 146 respondents using an interviewer-administered questionnaire diagnosed, described, analyzed, and presented information on tables and figures using Microsoft Excel. Results: The prevalence of MTM was 48.6% among children below five years. The most common socio-economic factor was household structure with a prevalence of 56.33% and 43.66% for respondents who were staying in completed houses and those whose houses were not in good condition respectively. The knowledge of caretakers about MTM was inadequate most caretakers knew about MTM with a prevalence of 63.38%. Conclusion: Although interventions for the management of MTM were in place, a prevalence of 48.6% was still high and demands for additional efforts from the health workers and the Ministry of Health to lower the heavy disease burden. Recommendation: The health workers should offer health education about MTM to the patients attending the hospital and emphasis on early diagnosis and treatment of MTM infections should be prioritized.

Isolation and Purification Glycyrrhizic acid and Determination of the Biological Activate Against Microbial Pathogens

Background: The World Health Organization estimates that 80% of the world's population uses plant extracts or their active components in traditional therapies. Recently, there has been a lot of interest in the quest for new antioxidant and antibacterial plant-based medications. Additionally, Glycyrrhiza glabra is a popular food flavoring and sweetening ingredient.Methods: This work was to isolate and purify licorice root's glycyrrhizin acid (GA) and investigate its antimicrobial properties against S. aureus and K. pneumoniae were isolated from urine , blood, wounds, ear water, sewage, soil, and water, totaling 12 isolates of each kind, Analytical method for the measurement of Glycyrrhizic acid from the root extract that has been suitably supported by a mass spectroscopic analysis.Results: The result showed the effects of GA with different concentrations on S. aureus and. K. pneumoniae. Obviously, the MIC range value was in concentration between 18.75 to 37.5 % for S. aureus isolates, and 4.68 to 75 for K. pneumoniae isolates. The result indicated that GA reduced the metabolic activity of cells in biofilm on S. aureus and K. pneumoniae with an inhibition percentageConclusion: GA may have an effect on cell membrane permeability, biofilm formation, and efflux activity, which inhibits bacterial growth.Keywords: Glycyrrhizin acid; Staphylococcus aureus; Klebsiella pneumoniae; Antibiotic; Biofilm

Herpes Simplex Keratitis after PRK

Background: Herpes simplex virus (HSV) is a double stranded DNA virus that infects much of the world’s population. The World Health Organization estimates 67% of people under the age of 50 have HSV-1 and 11% of people under the age of 50 have HSV-2. While most systemic infections remain inactive and do not cause symptoms, the activation and appearance of ocular HSV can be a destructive and vision-threatening issue. HSV keratitis can be epithelial, stromal or a combination. Patients who have recently undergone photorefractive keratectomy (PRK) have a higher risk of HSV keratitis. Because of this, HSV keratitis should be considered in any PRK post-op patient that presents with unusual signs and symptoms such as decreased vision, increased IOPs, ocular pain, photophobia, iritis and corneal haze. When diagnosed in a timely manner, the prognosis is generally favorable. Current treatments for HSV keratitis include antiviral coverage as well as immunosuppression with topical steroids. Case Report: This case involves a patient that developed HSV keratitis while on topical steroid therapy following PRK. The weeks following the initial presentation were spent battling corneal haze, iritis, pain, increased IOPs and decreased visual acuity. After close monitoring and treatment changes based on each clinical presentation, the patient recovered with good vision and minimal corneal scarring. The findings and recommended treatment options are discussed. Conclusion: HSV affects much of the world’s population. Reactivation of the latent virus can lead to vision threatening corneal disease. HSV is capable of causing inflammation and pathology throughout most of the anterior segment of the eye, and therefore should be considered when managing any new or recalcitrant anterior pathology. Although the diagnosis is usually clinical, laboratory testing can be used to confirm a diagnosis. Treatment aims to decrease the viral load and to limit stromal scarring.

Herpes Simplex Keratitis after PRK

Background: Herpes simplex virus (HSV) is a double stranded DNA virus that infects much of the world’s population. The World Health Organization estimates 67% of people under the age of 50 have HSV-1 and 11% of people under the age of 50 have HSV-2. While most systemic infections remain inactive and do not cause symptoms, the activation and appearance of ocular HSV can be a destructive and vision-threatening issue. HSV keratitis can be epithelial, stromal or a combination. Patients who have recently undergone photorefractive keratectomy (PRK) have a higher risk of HSV keratitis. Because of this, HSV keratitis should be considered in any PRK post-op patient that presents with unusual signs and symptoms such as decreased vision, increased IOPs, ocular pain, photophobia, iritis and corneal haze. When diagnosed in a timely manner, the prognosis is generally favorable. Current treatments for HSV keratitis include antiviral coverage as well as immunosuppression with topical steroids. Case Report: This case involves a patient that developed HSV keratitis while on topical steroid therapy following PRK. The weeks following the initial presentation were spent battling corneal haze, iritis, pain, increased IOPs and decreased visual acuity. After close monitoring and treatment changes based on each clinical presentation, the patient recovered with good vision and minimal corneal scarring. The findings and recommended treatment options are discussed. Conclusion: HSV affects much of the world’s population. Reactivation of the latent virus can lead to vision threatening corneal disease. HSV is capable of causing inflammation and pathology throughout most of the anterior segment of the eye, and therefore should be considered when managing any new or recalcitrant anterior pathology. Although the diagnosis is usually clinical, laboratory testing can be used to confirm a diagnosis. Treatment aims to decrease the viral load and to limit stromal scarring.

Insights into the Shifting Dynamics of Climate Change and Human Health in N.E. India: A Rapid Review

Climate change is the greatest existential challenge to planetary and human health and is dictated by a shift in the Earth’s weather and air conditions owing to anthropogenic activity. The interactions between climate change and health outcomes are diverse and complex and include several exposure pathways that might promote the development of non-communicable diseases such as cardiovascular disease, diabetes, etc. The World Health Organization estimates that the warming and precipitation trends due to anthropogenic climate change of the past 30 years already claim over 150,000 lives annually. Climate change and human health are interconnected through a direct and indirect pathway. The increase in high temperatures due to climate change has a tremendous impact on human hydration levels and can cause heat stress in diabetics with cardiovascular complications leading to strokes. It is difficult to disregard the harmful impact of heat waves on the geriatric population all over the world, due to varied physiological conditions related to socioeconomic level. Exposure to high temperature prompts significant stress and strain on the thermoregulatory responses to heat stress in CVD. Studies reported that environmental effects from climate change have negative impacts on metabolic control, glucometer availability, insulin pumps, and medication gradually threatening the health, well-being, economy, and environment of the world. Reviewing the interconnections between the expanding climatic variability in climate change and human health it seems the growing risk factors are enormous and have tremendously fueled global health disparities.

Frequency and risk factors of cigarette smoking among male medical students of Bacha Khan Medical College, Mardan

Tobacco consumption is a major global health issue that contributes significantly to morbidity and mortality rates. The World Health Organization (WHO) estimates that over five million deaths occur each year due to tobacco use, projected to rise to 8 million by 2030. Furthermore, current research reveals that 47% of males and 12% of females worldwide smoke. Of particular concern is cigarette and tobacco use among medical students, given their role in crafting public health policy and guiding society's tobacco prevention measures. Studies show that smoking rates among medical students in developing countries are between 16-21%, with multi-country surveys in countries like Malaysia, India, Pakistan, Nepal and Bangladesh indicating rates between 6.7% and 17.8%. For example, a study conducted on medical students in Damascus University Faculty of Medicine revealed a 10.9% prevalence of cigarette smoking, 23.5% for water pipe, and 7.3% for both, with higher rates reported among final-year students. Likewise, a study of Rawalpindi Medical College students found that 24% had smoked at least once, with greater prevalence among hostellites rather than day scholar students.

Behavioral prevention of HBV transmission in urban communities toward global elimination of hepatitis in 2030: a systematic review

Hepatitis B is a serious threat to public health on a global scale. The Hepatitis B virus (HBV), which spreads both vertically and horizontally, is easily contracted by anyone. In 2020, the World Health Organization estimates that 257 million people worldwide have hepatitis B, and 900,000 people die from it each year. According to the World Health Organization (2021), there are approximately 39.4 million people in Southeast Asia living with chronic hepatitis B mortality, with 410,000 deaths caused by the disease. HBV can spread through injections, horizontal transmission, blood transfusions, and organ transplants. Cochrane, Science Direct, PubMed, Elsevier, Sage, Willey, DOAJ, and Google Scholar database sources were used to search for supported research on how to prevent hepatitis virus transmission in urban communities. 15 publications address the primary and secondary prevention of hepatitis B transmission in urban settings. Prevention keeps a person in good health and prevents them from progressing to a later, worse stage. Given that the hepatitis B virus can infect anyone, regardless of age, and that it affects people's health worldwide, as well as their families, communities, and families within them. In order to eradicate the hepatitis B virus, society must be aware of the importance of implementing preventive measures on a continuous and long-term basis through health advocacy activities, hepatitis B virus screening campaigns, health education, counseling, hepatitis B vaccination with community-based activities, and secondary prevention through combination therapy treatment in post-liver transplant patients.

Awareness of psychiatrists regarding physician suicide and prevention in developed and less developed countries

IntroductionThe World Health Organization estimates that more than 700,000 people worldwide die by suicide every year. Suicide is a complex issue, and occupation can be considered one of the risk factors. Data from the USA indicates that the suicide rate among doctors is higher compared to the general population. Among different specialties, general practitioners face the highest risk, followed by internal medicine, and then psychiatry. Apart from Anglo-Saxon countries, available data regarding physician suicide is limited; in some countries, the topic is considered taboo.ObjectivesThe goal of this pilot study was to explore whether psychiatrists in different countries have access to suicide databases that include occupational information and to determine what prevention strategies and interventions are currently in use.MethodsWe distributed a short questionnaire to a group of psychiatrists (n=25) to assess the existing methods in their respective countries for collecting suicide data and implementing suicide prevention measures. The survey included both developed and less developed countries. Out of the 20 participating countries, 12 returned our questionnaire by the deadline. The final participating countries were Croatia, Czech Republic, Ethiopia, France, Germany, Hungary, Kazakhstan, Mexico, Qatar, Serbia, Sweden, and the UK.ResultsBased on our colleagues’ reports, none of the responding countries have publicly available data on the number of physicians who committed suicide in the last three years. The risk of suicide and substance abuse among doctors is not systematically assessed or published in any of the participating countries. Kazakhstan is the only country where burnout, anxiety, and depression among doctors are regularly assessed. Ethiopia is the only participating country without a hotline for individuals in a suicide crisis. Mexico, Qatar, and Kazakhstan are the only countries with dedicated hotlines for health workers. Regarding preventive strategies, colleagues from Hungary, Serbia, Sweden, and Ethiopia did not report any strategies specifically aimed at preventing physician suicides. Germany and the UK were the two countries with more than one prevention strategy, both providing a free toolkit to identify and support at-risk populations. There are significant differences in the amount of mental health support that doctors receive in each country.ConclusionsPsychiatrists are not aware of physician suicide data and the utilization of preventive strategies vary widely among the participating countries. There is no standard practice for screening doctors for suicide risk, burnout, anxiety, depression, substance abuse, or adequate data collection on suicide. Based on these findings, it would be necessary to include more countries in the sample and conduct a more detailed examination of the issue in the future.Disclosure of InterestNone Declared

Attitudes, Beliefs, and Behaviors of Topical Antibiotic Prescribing among Primary Care Providers in Saudi Arabia: A Cross-Sectional Study.

The World Health Organization (WHO) estimates that 20-50% of antibiotics are misused in society. In addition to the development of antimicrobial resistance, topical antibiotics have been associated with adverse effects such as allergic contact dermatitis (ACD) and inadequate wound healing. This study investigated the appropriateness of topical antibiotic prescriptions among primary care providers in Saudi Arabia. A cross-sectional survey was conducted among Saudi Arabian primary care providers (physicians (general, family, and internal medicine)) employed in governmental and non-governmental healthcare facilities (primary care centers and outpatient clinics). In total, 222 participants were included in the analysis. A total of 73% agreed that inappropriate topical antibiotic use puts patients at risk, and 43% reported antibiotic resistance in daily practice. Many respondents lacked knowledge of the proper indications for topical antibiotics, and 66.2% attributed this to a lack of updated knowledge, while 45% blamed inadequate supervision. Antibiotic prescription patterns deviated from the standards recommended by WHO. This calls for continuous review at all levels of healthcare, providing more physician education and ensuring that antibiotic therapy guidelines are easily accessible and effectively used to avoid the negative consequences of inappropriate antibiotic prescription.

Correlation between Maternal Culture and Knowledge Towards Complementary Feeding for Breast Milk in Pampang Village, Kayong District

Nutritional problems are one of the main causes of high morbidity and mortality rates in children. The World Health Organization (WHO) estimates that about 54% of infant and child deaths are caused by malnutrition. Nutritional problems in Indonesia result in more than 80% of child deaths. The purpose of this study was to determine the correlation between maternal culture and knowledge with complementary feeding for breast milk. Crossectional research method with quantitative method with a population of 147 mothers. The sample of this study was 30 mothers who had infant in Pampang village, Kayong District 2023 with proportional sampling techniques. The data analysis method uses a chi-square test with SPSS. The results showed that there was a significant correlation between culture and complementary feeding with a p-value = 0.031 and a significant correlation between maternal knowledge and complementary feeding with p-value of 0.026. Keywords: breast milk, culture, complementary feeding, knowledge

Mental Health and Suicide Decriminalization: Connecting the Dots

Suicide is a current public health crisis as every year, more than 800,000 individuals die by suicide worldwide. According to World Health Organization (WHO) estimates, 77% of these deaths occur in low- and middle-income countries (LMICs). In context of mental illness only, the reported percentage of completed suicides varies from 60% to 98% of all suicides.2,3 Many of the remaining episodes have to do with interpersonal or financial issues, and the crises that follow. Nonetheless, prejudice, violence, and armed conflicts can be some of the other reasons.3 At the start of the twenty-first century, depression accounted for thirty percent of deaths worldwide from unnatural causes. Substance-use disorders came in second with eighteen percent, schizophrenia with fourteen percent, and personality disorders with thirteen percent.2 In June 2022, twenty nations had suicide attempts criminalized and subject to penalties.4 One prominent defense of criminalization of suicide was that it deters people from trying to die by suicide and thus may be a successful suicide prevention strategy but according to the literature, this idea is at best false and at worst deceptive. According to a recent study, there is no conclusive evidence that nations with criminalized suicide have lower suicide rates than the worldwide average.4.In fact, the suicide rates in five of the seven nations where it is illegal were higher than the global average.4 A recent ecological study of 171 countries has shown that suicide laws are linked to increased national suicide rates particularly among women in non-Muslim nations with low Human Development Index scores.5 Women may be more susceptible to suicidal thoughts due to the patriarchal culture's lack of support and the laws that criminalize suicide. This clearly shows that there is no positive benefit of criminalizing suicide while on the other hand research has shown that suicide rates are decreased by laws that restrict access to fatal suicide methods (pesticides, weapons, and so forth).6 While many countries do not prosecute people who attempt suicide rigorously ,7criminalization of suicide discourages people from seeking help, stigmatizes those who try suicide, and makes it difficult to accurately quantify suicide rates due to misclassification of the event because of law. The care process for people who attempt suicide is complicated by the criminalization of suicide attempts.8 Treatment can be considerably delayed by the criminal justice system.

Evaluation of novel compounds as anti-bacterial or anti-virulence agents.

Antimicrobial resistance is a global threat, leading to an alarming increase in the prevalence of bacterial infections that can no longer be treated with available antibiotics. The World Health Organization estimates that by 2050 up to 10 million deaths per year could be associated with antimicrobial resistance, which would equal the annual number of cancer deaths worldwide. To overcome this emerging crisis, novel anti-bacterial compounds are urgently needed. There are two possible approaches in the fight against bacterial infections: a) targeting structures within bacterial cells, similar to existing antibiotics; and/or b) targeting virulence factors rather than bacterial growth. Here, for the first time, we provide a comprehensive overview of the key steps in the evaluation of potential new anti-bacterial and/or anti-virulence compounds. The methods described in this review include: a) in silico methods for the evaluation of novel compounds; b) anti-bacterial assays (MIC, MBC, Time-kill); b) anti-virulence assays (anti-biofilm, anti-quorum sensing, anti-adhesion); and c) evaluation of safety aspects (cytotoxicity assay and Ames test). Overall, we provide a detailed description of the methods that are an essential tool for chemists, computational chemists, microbiologists, and toxicologists in the evaluation of potential novel antimicrobial compounds. These methods are cost-effective and have high predictive value. They are widely used in preclinical studies to identify new molecular candidates, for further investigation in animal and human trials.

PENGISIAN SIGN IN DALAM MENINGKATKAN KEPATUHAN SAFE SURGERY DI RUMAH SAKIT PKU MUHAMMADIYAH YOGYAKARTA II

Background: Complications and deaths due to surgery become one of the global health problems. World Health Organization estimates that at least half a million deaths due to preventable surgical. An effort to improve the quality of surgical services including the Surgical Safety Checklist to use made by World Health Organization. Compliance to use this surgery checklist which is can increase the number of safe surgery,reduce the wrong site surgery and nearmiss.
 Method: This research is a qualitative action research design. The study population was all the doctors and nurse anesthetist. Number of samples 6 people. The data is collected by observation sheet Surgical Safety Checklist: Sign In RS PKU Muhammadiyah Yogyakarta Unit II for 3 cycles of observation.
 Result and Discussion: The results of observations on the first to the third cycle shows that all disobeying nurse anesthetist (100%) the Surgical Safety Checklist to fill: Sign In. The results of the response every cycle and a structured interview with the anesthesiologist showed that nurses are still confused how to use the checklist, the checklist has not been a necessity, the culture of patient safety is still minimal, lack quality of human resources, lack of supervision and lack of socialization mechanisms Surgical Safety Checklist noncompliance that influence nurses Sign In to to fill.
 Conclusion: Completing Sign In in the installation of surgery center in PKU Muhammadiyah Yogyakarta Unit II Hospital is noncompliance, because they still haven’t got the identity bracelet mounted on a patient who will be operating and marking the location of a rare surgery. Advice to hospital are to create a Standard Operating Procedure (SOP), SOP socialize regularly, make in-house training, increase the commitment of doctors and nurses, create a surveillance system, create a system of reward and punishment.

Immunological Aspects of Depressive Disorder - The Review

Abstract Depression represents a mood disorder and is considered to be one of the most common mental disorders in general. World Health Organization estimates that depression will be the leading cause of disability-adjusted life years, until 2030. Depression is a complex heterogeneous disorder where immune system and its regulation play an important role. Innate and adaptive immunity mechanisms are included, along with processes of immune activation and suppression. The expression of humoral factors of innate immunity, especially pro-inflammatory cytokines, is increased, whereas the intensity of cellular immune mechanisms, primarily T cells and NK cells, are impaired. The influence of pro- inflammatory cytokines on depression is reflected in their effect on certain enzymes and ensuing reduction of neurotransmitters serotonin and dopamine. They also affect the neuroendocrine function in central nervous system, resulting in increase of cortisol levels and inactivation of glucocorticoid receptors in the periphery, which leads to neurodegeneration and decrease in neurotransmitter production. Certain cytokines affect neuroplasticity through the decreasing of concentration of neurotrophic brain factor and induction of brain cell apoptosis. The results are often contradictory talking about mechanisms of adaptive immunity. On one hand, an increased activity of Tlymphocytes is observed, while on the other, there are evidence of spontaneous apoptosis and impaired function of these cellsin depression. In addition, neuroprotective role of autoreactive and regulatory T cells in prevention of depression has also been demonstrated. The aim of this paper is to analyze the current knowledge on the role of immune mechanisms in the pathogenesis of depression.

Hepatitis E Virus (HEV) Infection Among Immunocompromised Individuals: A Brief Narrative Review.

Hepatitis E virus (HEV) is a single-stranded positive-sense RNA virus that belongs to Hepeviridae family. HEV is the most common cause of acute viral hepatitis worldwide. According to the World Health Organization (WHO), there are estimated 20 million HEV infections worldwide every year, leading to estimated 3.3 million symptomatic cases of HEV infection. The WHO estimates that HEV infection caused approximately 44,000 deaths in 2015, which represents 3.3% of mortality rates due to viral hepatitis. In low-income (LI) countries and lower-middle-income (LMI) countries, HEV is a waterborne infection induced by HEV genotype (gt) 1 and HEV gt 2 that cause large outbreaks and affect young individuals with a high mortality rate in pregnant women from South Asian countries and patients with liver diseases. HEV gt 3, HEV gt 4, and HEV gt 7 are responsible for sporadic infections with zoonotic transmission mainly through the consumption of raw or undercooked meat from different animals. Acute HEV infection is relatively asymptomatic or mild clinical form, in rare cases the disease can be moderate/severe clinical forms and result in fulminant hepatitis or acute liver failure (ALF). Furthermore, HEV infection is associated with extrahepatic manifestations, including renal and neurological clinical signs and symptoms. Pregnant women, infants, older people, immunocompromised individuals, patients with comorbidities, and workers who come into close contact with HEV-infected animals are recognized as major risk groups for severe clinical form of HEV infection and fatal outcome. Chronic HEV infection can occur in immunocompromised individuals with the possibility of progression to cirrhosis.

A Single Case Study in Management of Pakshaghat with Ayurveda

In the Sharira, Vata is seen as the controller of all things. Vatavyadhi is the term for the influence of vitiated vata on the Dusyas, which permeate the whole body or a portion of it and give rise to various sorts of illness. One of the significant illnesses that fits this description is pakshaghata, also referred to as hemiplegia. One Vataj Nanatmaja Vyadhi who is regarded as a Mahavatavyadhi is Pakshaghata. There is a correlation between pakshaghata and hemiplegia, a condition caused by a cerebrovascular accident or stroke. Hemiplegia, which results in both mental and physical instability. In the world’s population, there are around 9 instances per 1000 people. A stroke is described as an abrupt onset of vascular mechanism-related neurologic impairment. 15% are initial hemorrhages, and 85% are ischemic. The World Health Organization estimates that 15 million stroke victims globally experience a stroke each year, of whom 5 million die and another 5 million become permanently incapacitated. According to current scientific theory, brain injuries that are too severe for treatment to reverse can result in lifelong neurological impairment. As a result, the prognosis for the illness is dismal, leaving the crippled individual dependent. The current research aims to provide baseline data for student physicians to cope with this terrible condition by identifying the etiopathogenesis, clinical aspects, and therapy of the disease from Ayurvedic classics.