morbidity

Worldwide, Canine Distemper Virus (CDV) infection is a highly prevalent disease with high morbidity and mortality. CDV causes a multisystemic disease in a wide range of hosts including 9 families of mammals among them some primates, cetaceans and numerous carnivores. It presents a high tropism for lymphoid, neurological and epithelial tissue, leading to an infection of almost all systems, so the clinical signs observed are very varied. The diagnosis is made based on the clinical presentation of the disease, which considers a variety of signs and must be confirmed by a laboratory diagnostic method. The molecular technique called Reverse Transcription Polymerase Chain Reaction (RT-PCR) has been used to characterize viral strains based on the basis of genetic differences on the hemagglutinin (H) gene of CDV has allowed the identification of 14 circulating lineages in the world. Two lineages, namely the America-1 and the Europe-1/South America-1 have been described in Chile. The goal of this work was to implement a multiplex RT-PCR protocol, which was built on the in silico design of primers based on the H gene nucleotide sequences stored in the Genbank® database. This method was capable of detecting the previously described two circulating genetic lineages of CDV in a differential way providing a supporting diagnostic tool for epidemiological studies in the country. These results suggest that the primers described here are extremely selective for the above-mentioned lineages. In addition, our initial screening indicated that most analyzed clinical samples corresponded to the America-1 lineage, stressing the need for a continuous surveillance in order to properly address the prevalence of both lineages in Chile.

Oral cancer has a tendency to be detected at late stage which is detrimental to the patients because of its high mortality and morbidity rates (survival rate 15-50% [1]). The incidence of oral cancer worldwide is approximately 3% of all malignancies, thus creating a significant worldwide health problem [2].

Diarrheal diseases continue to be the major cause of morbidity and mortality among children under 5 years. This study aimed to isolate, identify and determining the prevalence, antimicrobial susceptibility profile of Shigella sp associated with acute diarrhea among children in Kano, Northern Nigeria. A cross sectional study was conducted among children less than 5 years diagnosed with acute diarrhea and admitted to paediatric ward of Murtala Muhammad Specialist Hospital Kano. Stool samples from a total of 37 (20 male and 17 female) subjects were used to isolate and identified the pathogen. Antimicrobial susceptibility test was conducted using disc diffusion method. The result showed 12 out of 37 samples were positive for Shigella sp which accounted for 32.4%. Higher incidence of Shigella sp was found among subjects of age between 2 – 3 years. The isolates were 100% resistant to Ampicillin. High resistance was also observed in Amoxicillin (83.33%), Chloramphenicol (58.33%) and Tetracycline (25%). The isolates are 100% sensitive to ciprofloxacin, 66.7% to Levofloxacin and Gentamicin each and 58.33% to Erythromycin. Three (3) isolates were resistance to Ampicillin and Amoxicillin, 5 isolates were resistance to Ampicillin, Chloramphenicol and Amoxicillin while 2 isolates were resistance to Ampicillin, Chloramphenicol, Tetracycline and Amoxicillin. It is concluded that Shigella sp is one of the etiological agent of diarrhea in children. Ciprofloxacin, levofloxacin and Gentamicin are drugs of choice for treating diarrhea caused by Shigella sp.

Heftiness, a mind boggling interchange among ecological and hereditary factors and is related with critical horribleness and mortality. Utilization of herbs for the administration of heftiness in the ongoing occasions is pulling in consideration. A web and manual based writing overview was led to survey the measure of data accessible on the natural items for weight administration. Customary writing, PubMed, Scopus, Google researcher databases were screened up to February 2012. The pursuit words were “stoutness”, “home grown medication/items/separates”, “restorative plants”, “customary drug”, “Ayurvedic prescription” without narrowing/constraining looking words or components. Distributions just with edited compositions/full articles and books were inspected in the pursuit. In light of the accessible writing, for huge numbers of the natural and weight reduction items, there is minimal distributed data and there have been no clinical preliminaries or the level of proof is restricted. Our writing study additionally demonstrated that these home grown items fall under an adequate level of proof or with no scientific foundation by any stretch of the imagination, or they have a logical discerning however not to an acknowledgment level. Endeavors were made in the audit to characterize the highlights of conceivable natural weight reduction item. A perfect home grown enemy of stoutness item ought to diminish the weight by 10% over fake treatment of treatment by demonstrating a proof of change of bio markers like blood pres-beyond any doubt, lipids and glycemia with no reactions.

Objectives: Natural disasters confront individuals, communities and governments with the challenge of rebuilding and addressing psychosocial sequelae. With the increasing number of natural disasters it is timely to evaluate the efficacy of interventions and strategies to address the mental health needs of individuals and the community. Method: An evaluation of literature related to the psychological impact of natural disasters, treatment efficacy and government strategies to confront the social and psychological impact of natural disasters for the period 1983-2016 was undertaken. Results: Epidemiological studies following natural disasters despite the use of differing psychological measures demonstrate significant psychological morbidity - anxiety (7-42%), complicated grief (28-41%), depression (6.5-38%), post-traumatic stress disorder (11-89%) and substance misuse (1.3-24%). Intervention studies post-disaster demonstrate efficacy variability. Conclusions: The increase in the number and impact of meteorological and hydrological events since the 1980s and the psychological, social and economic consequences of these events has resulted in the development and implementation of government policies to confront the immediate and long-term adverse outcomes. The focus is typically on resources and infrastructure redevelopment with less focus on social and mental health interventions with long-term evaluation of interventions uncommon. The consequence of natural disasters emphasizes the importance developing strategies to ensure effective evaluated psychosocial interventions are available across at-risk communities.

Introduction: Obesity defined as increased fatty mass is progressively rising in recently, even though its affects begins to all systems in childhood and adolescence periods, the most important morbidity and mortality reason of obesity is its effects on the cardiovascular system. Researches point out endothelial dysfunction and atherosclerosis as the reason of the cardiovascular system disease in obesity. The studies conducted on childhood period related to this subject are highly limited and the results of these are also controversial. Therefore in our study the effects of obesity on endothelial functions in children and adolescents was assessed by flow mediated dilation (FMD) method. In addition to that, effects of epidemiological, biochemical, hormonal and clinical features of cases to FMD were investigated. Material and method: A total number of 104 cases were cover in this study. Obese group (group 1) was consisted of 59 children whose body mass index (BMI) was ≥ 95th percentile and mean age was 12 ± 2.8 years old. The control group (group 2) consisted of 45 children whose body mass index (BMI) was between 25th -84th percentil and mean age was 11.4 ± 2.9 years old. The detailed history, epidemiological data and physical examination were performed. The population classified three groups according to sport activities. 97th percentile and higher values were accepted as morbid obesity. The blood pressure was measured with a mercury sphygmomanometer with utilizing the proper size cuff in compliance with the criterion used by the “National High Blood Pressure Education Program Working Group”. The complete blood count and biochemistry tests (renal and liver function tests, electrolytes, lipids, hsCRP) of the cases were analysed with biochemistry Roche Cobas Integra 800 and hormon assays of the cases (thyroid function tests, diurnal cortisol, ACTH, 17 OHP, prolactin, DHEA-S) were analysed by ECLIA method on Roche Elecsys 2010 device in the laboratory of our hospital. IR-HOMA values > 2.5 in prepuberal and > 4 in pubertal were defined as the insulin resistance. Bone ages of cases were evaluated with left hand wrist X-ray by using Greulich and Pyle Bone Age Atlas. flow mediated dilation (FMD) was used to assess the endothelial functions of all cases. The brachial artery was evaluated with SPG 12 MHz surface probes by using GE voluson ultrasound system in this method. FMD was expresses as percent (%) increase according to the basal vein dimension. 7% mean value was taken as the limit in the comparisons. Results: The ratio of male and female was 20/39 in group 1 and 14/31 in group 2. 32.3% of the cases in group 1 and 47.6% of the cases in group 2 were prepubertal. The waist and hip circumferences ratio of the group 1 (0.86 ± 0.05) was significantly higher than group 2 (0.80 ± 0.07). While there was no difference between groups 1 and 2 in terms of the birth weight, using duration period of vitamin D and beginning time to additional nutrition, breastfeeding duration of group 1 (10.6 ± 7.8 months) was significantly shorter than group 2 (14 ± 7.4 months). BMIs of the mothers in group 1 were statistically higher than the mothers in group 2 (27.5 ± 4.8 kg/m² and 24.3 ± 3.2 kg/m² respectively. The mean of IR-HOMA was 4 ± 2.9 in group 1 and 1.9 ± 0.8 in group 2 and there was the insulin resistance in 51% of the obese cases. The dyslipidemia was diagnosed in 38.5% of the cases in group 1. The systolic and diastolic blood pressures in group 1 (117 ± 12.2 mmHg and 73.7 ± 9.4 mmHg respectively) were significantly higher than in group 2 (107.5 ± 9.1 mmHg and 68.2 ± 7.1 mmHg respectively). Hypertension was determined in 25% of the cases included in group 1. The minimum values of FMD in groups 1 and 2 were 1.01% and 3.1% respectively. The maximum values of FMD in groups 1 and 2 were 9.7% and 15% respectively. The mean values of FMD was %5 ± 2.3 in group 1 and %8.1 ± 3.5 in group 2. Compared with group 2, group 1 demonstrated significantly impaired FMD. There was no association between FMD and the birth weight, breastfeeding duration, physical exercises in two groups. A negative correlation was found between FMD and BMI (p < 0.01, r = -0.402). The correlation was determined between FMD and BMI of the mother (p = 0.017, r = -0.305) and the presence of obese individuals in the family (p = 0.021, r =-0.413). It was found that a significant negative correlation between FMD and waist-hip circumference ratio (p = 0.003, r = -0.421). When each groups were assessed in terms of biochemical and hormonal characteristics, there was low negative correlation between FMD and uric acid level and strong negative correlation between FMD and ALT level were determined in group 1. Conclusion: In our study showed that the obesity begins in the childhood period may cause to the endothelial dysfunction. For this reason, according to our opinion, recognition prior indicators of endothelial dysfunction in early time may be helpful both to take the precautions required and to prevent cardiovascular complications in childhood and influences to the adult period. The rising sizes of the waist and hip circumferences, positive family history for obesity and obesity of the parents were determined as the most important parameters negative affecting FMD. Unlike the literature, the association between endothelial dysfunction and GGT level the indicator of the hepatosteatosis in obese children was also found as well as FMD and ALT have also a close association independent from BMI in this study. Thus, a different point of view was formed since ALT may possibly have a predictor value in the assessment of the endothelial functions and it is also found as a highlighted risk factors for the endothelial dysfunction in this study. Because of this reason, it can be recommended that when the liver function tests carry out in obese children it does not show only hepatosteatosis but also can be used as an early indicator of the cardiovascular complications of obesity. Another important subject to be emphasize that the ALT level in the childhood period may be an early cardiovascular risk indicator in both obese and nonobese children.

Ruptured abdominal aortic aneurysm (rAAA) carries high morbidity and mortality. Advances in endovascular techniques in the last two decades allow for minimally invasive approach for repair of these aneurysms. A succinct but comprehensive pre-operative is essential for delivery of a safe anesthetic for the patient with rAAA. Placement of proximal occlusion balloon in the descending aorta using the rapid control technique can be life-saving. Endovascular aortic repair (EVAR) can be performed under monitored anesthesia care using local anesthetic and IV sedation, and with fewer invasive lines. However, rapid conversion to general endotracheal anesthesia should be expected. Anesthesiologists should be familiar with the hemodynamic management of rAAA and be ready to provide resuscitation to correct for anemia, coagulopathy, and acidemia. In addition, the anesthesiologist should be aware of the common complications related to EVAR, including abdominal compartment syndrome, distal ischemia, and local vessel injury.

According to recent guidelines, endovascular angioplasty is the standard treatment for TASC A and B primary aorto-iliac occlusive (AIOD) disease, and the first-line approach for TASC C lesions [1,2]. Extended TASC D occlusive disease is usually treated by open surgery yielding excellent patency rates at a cost of a higher mortality (2%-4%) and a severe morbidity (up to 10%) [3]. However, several studies have reported promising results after endovascular treatment of extensive AIOD and full reconstruction of the aortic bifurcation [4,5]. In a recent meta-analysis, Jongkind et al., concluded that endovascular treatment of extensive AIOD can be performed successfully by experienced interventionists in selected patients [6]. Although primary patency rates seem to be lower than those reported for surgical revascularization, reinterventions can often be performed percutaneously yielding a secondary patency comparable to surgical repair.

Allogeneic hematopoietic stem cell transplant (alloHSCT) is a curative treatment for many hematologic malignancies. Unfortunately, about 30-50% of all recipients undergoing alloHSCT develop acute graft-versus-host-disease (aGVHD), which is associated with high morbidity and mortality [1,2]. Treatment of aGVHD involves the use of immune suppressive drugs such as high dose of steroids that leads to further immunosuppression and risk for opportunistic infections. Often patients are refractory to steroids therapy making the prognosis dismal. Thus, it is critical to identify robust biomarkers to detect aGVHD before onset of clinical symptoms so that therapeutic strategies can be implemented that may result in better treatment responses and less toxicity. 

Objective: To investigate the occurrence of depressive and anxiety disorders in patients remitted for endovascular treatment of renal artery stenosis (RAS), and whether symptoms of depression and anxiety can be reduced after the treatment of RAS with percutaneous transluminal renal angioplasty (PTRA).Methods Patients: Selected for renal angiography with pressure measurement in the renal arteries due to suspected RAS were invited to participate in the study. 37 patients agreed to answer a questionnaire. Eighteen patients also agreed to a clinical psychiatric examination including the International Neuropsychiatric Interview (M.I.N.I. 6.0) to be diagnosed according to the DSM-IV. Results: Twenty-one of the 37 patients completing the questionnaire were found to have a pressure gradient of ≥ 10 mmHg at angiography, indicating significant stenosis. Ten of the 18 examined patients met the criteria for current DSM-IV anxiety diagnosis and two patients had a current depression. Three of the 18 examined patients had previously made a suicide attempt. Conclusion: The results of this study suggest that patients with suspected RAS have a high psychiatric comorbidity, as 56% of the patients undergoing psychiatric examination met the DSM-IV criteria for a current anxiety disorder.

Over the past 20 years, there has been a surge of clinical investigations and useful trials on heart failure (HF) with preserved ejection fraction (HFpEF). HFpEF represents the largest phenotype of HF, a public health concern for its link with high mortality and rates of morbidity.

Oral Cancer (OC) or squamous cell carcinoma of the oral cavity accounts for approximately 3% of all cancers worldwide, with increased incidence in developing countries. The use of tobacco is directly associated with approximately 80% of oral cancers, especially in older men over 40 years of age. As nearly one-third of the Indian population over 15 years consume smokeless tobacco in one or the other forms, a recent increase has been observed in OC incidence among women and young adults. Lately, the sexual behaviors of young & homosexuals have resulted in the emergence of oropharyngeal cancers due to infection with HPV 16. About 60% of oral cancer cases in India have a five-year survival rate, and this can be improved to 70% to 90% by mere early detection in stages I and II and with various treatment modalities. Despite the well-known benefits of oral cancer screening for the whole population in developing countries remains controversial. It is imperative to address the cultural barriers and societal norms, which limit the acceptability and participation in screening programs in India and many developing countries. This unique challenge of increasing OC morbidity in India and developing countries requires horizontal integration of the health systems with new services focused on cancer control, which gives the best chance for long-term survival, improved outcomes, and affordable care!This article is based on the author’s experience of overseeing 1 case of early detection and 2 cases of delayed diagnosis, outcomes and relevant literature review, and current guidelines for the management of OC.

Anxiety is also a very common disorder, both in patients and their family members. Anxiety and stress can compromise the quality of life of cancer patients and their families. Feelings of anxiety and anguish can occur at various times of the disease path: during screening, waiting for test results, at diagnosis, during treatment or at the next stage due to concern about relapses. Anxiety and distress can affect the patient’s ability to cope with diagnosis or treatment, frequently causing reduced adherence to follow-up visits and examinations, indirectly increasing the risk of failure to detect a relapse, or a delay in treatment; and anxiety can increase the perception of pain, affect sleep, and accentuate nausea due to adjuvant therapies. Failure to identify and treat anxiety and depression in the context of cancer increases the risk of poor quality of life and potentially results in increased disease-related morbidity and mortality [1]. From all this we deduce the need and importance of dedicated psychological and psychiatric support for these patients within the Breast Unit. The fact that the psycho-oncologist who is dedicated to the care of patients with breast cancer must be an integrated figure in the multidisciplinary team of the Senological Center and not an external consultant is enshrined in the same European Directives that concern the legislation concerning the requirements that a Breast Unit must have in order to be considered a Full Breast Unit (Wilson AMR, et al. 2013).One of the most complex situations you find yourself dealing with is communication with the patient. This communication is particularly complex in two fragile subpopulations that are represented by women. [Menditto L. T (Tirannie) Cancer of the Breast. Am J Psychol & Brain Stud, 2023; 1(1):26-30].

Background: Cervical Cancer poses a significant global health challenge, especially in lowresource settings. It is a significant health problem worldwide, with over half a million new cases diagnosed each year, accounting for approximately 6.6% of all gynecological Cancer cases and over 300,000 deaths each year. In Zambia, it is the leading cause of mortality and morbidity among women. The number of cases has increased by approximately 40%. This study explored the lived experiences of Cervical Cancer patients undergoing chemotherapy at the Cancer Diseases Hospital in Lusaka, Zambia, focusing on their subjective experiences. By examining their journeys through chemotherapy, the study aimed to highlight the subtle complexities in which treatment impacts patients’ lives and well-being.  Methods and procedures: Employing a qualitative descriptive phenomenological study design, in-depth interviews were conducted with 10 participants with diverse demographics. The sample size was determined by data saturation and saturation was reached at 10. Ethical protocols were ensured, and Study approval was obtained from UNZABREC and the National Health Research Authority. Thematic analysis was conducted on audio-recorded interviews with cervical cancer patients, ensuring confidentiality and accuracy while discerning significant patterns and themes in their narratives. Results/findings: Emotional experiences ranged from anxiety to gratitude. Psychological challenges encompassed coping mechanisms, stress management, emotional adjustments, and treatment-related fears. Socially, community support, workplace accommodations, and healthcare provider roles were key. Physical experiences revealed side effects managed through coping strategies. Financial challenges significantly impacted individuals and families.  Conclusions and recommendations: The study revealed that cervical cancer patients undergoing chemotherapy face complex challenges spanning emotional, psychological, social, physical, and financial domains, underscoring the imperative for comprehensive patient-centered care. Recommendations suggest focusing on financial aid for cancer patients and tackling treatment expenses and insurance issues. The Cancer Diseases Hospital should establish multidisciplinary teams for holistic care, and enhance patient education efforts. Nurses should adopt strategies integrating cultural competence and patient-centered care to address diverse challenges during chemotherapy. These aim to enhance the well-being and care quality of Cervical Cancer patients.

Ureteral double-J stents are a commonly used device in urological practice to allow urinary drainage, avoid ureteral obstruction processes, and protect the upper urinary tract after surgical procedures. However, long indwelling time may give rise to numerous complications, such as infection, migration, and fragmentation of the stent, especially encrustation. Encrustation of stents is a well-known complication that has been closely related to the time active of the stent and can cause significant morbidity if not timely addressed. In severe cases, abundant mineral deposition can result in the development of large calculi encasing the stent and rarely progress to staghorn stones. These cases may pose challenges in terms of the extraction of the stent and may result in complex endourological intervention. The encrustation likelihood is substantially higher if stents are left forgotten or remain in place longer than the advised period. Most patients with heavily encrusted stents have symptoms including flank pain, urinary tract infection, hematuria, or obstructive uropathy, but can present without any symptoms, and this can delay the diagnosis.

Spinal muscular atrophy (SMA) is a devastating autosomal recessive neuromuscular disorder characterized by progressive muscle weakness, atrophy, and respiratory failure due to selective degeneration of lower motor neurons arising from homozygous deletion of exon 7 (95%) or mutation in the SMN 1 gene (5%),with severity correlating with SMN2 copy number—from fatal Type1 to milder Type 4—affecting 1:6,000–10,000 births worldwide and burdening India with 1,500–2,000 annual cases amid diagnostic delays. Although the backup SMN2 gene compensates a bit for SMN deficiency, a critical C→T transition in exon 7 leads to exon skipping and production of a truncated, unstable and nonfunctional SMN protein. Recent advances in disease-modifying therapies-including antisense oligonucleotides, small-molecule splicing modifiers, and gene replacement-have significantly improved clinical outcomes; however, they do not restore endogenous SMN expression in all tissues and often require repeated administration. Despite these medications like Spinraza injections, Zolgensma gene therapy, Evrysdi pills that increase SMN protein, the condition still has got significant morbidity: Type 1 babies frequently die before the age of two, 60–95% develop scoliosis, which makes spinal injections uncomfortable and dangerous, and lifetime expenses for each patient surpass $2 million. What if we could edit the nucleotide base of SMN2(T6C) using ABE10 to make it emulate like SMN1 gene to restore stable functional SMN protein that would be the permanent cure for SMA. This cutting edge molecular tool “AI-based Adenine Base Editors” would facilitate an endogenous regulation, laying the groundwork for precision medicine in rare disease management.