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Tanzania is allocated in the Eastern part of Africa and it is one among the seven countries that form East African Community (EAC). According to the recent 2022 National Census, Tanzania has a population of 61,741,120 of which 30,053,130 are men and 31,687,990 are women. Currently, the country is implementing Development Vision 2025 which identifies enabling environment essential for the nation to flourish economically, politically and socially. 

Infections are common complications among patients on chronic hemodialysis. Hemodialysis patients with a catheter have a 2- to 3-fold increased risk of hospitalization for infection and death compared with patients with an arteriovenous fistula or graft [1]. 

Introduction: This paper presents the first application of forensic entomology in a murder investigation in Nigeria involving the remains of a 54-years victim, on January 9th, 2019 in a shaded wooded area in advanced decomposition, with no clear indication of the time of death. Objectives: To estimate the minimum post-mortem interval of a 54-year-old corpse recovered in the advanced decomposition stage using the blowfly Chrysomya megacephala and the Advance-Degree-day (ADD) method.Results: An autopsy report revealed multiple wounds to the forehead including a bullet hole. Dead embalmed dead maggots recovered from the body were identified as C. megacephala, and an accumulated degree-day model was used to estimate the minimum post-mortem interval. The findings revealed that the recovered larvae were still within the third-instar stage and had accumulated thermal energy between 58 hours (= 1.6 days, equivalent to 38.7 ADD) and 102 hours (= 2.8 days, equivalent to 68.0 ADD), suggesting that the body may have been exposed to insect activity between January 1st and 9th January 2019 after expanding the range to cater for some uncertainties. Conclusion: In this Nigerian murder case, forensic entomology used the calliphorid species C. megacephala to estimate the minPMI to be between 2 and 9 days before the body was discovered, which translates to 1st - 9th January 2019 after consideration of some uncertainties and limitations. This confirmed the crucial role that insects play in providing valuable evidence to complement forensic pathological findings in homicides when conventional methods failed. Notwithstanding difficulties with employing insect evidence in forensic investigations in Nigeria, the application of this modern forensic technique has the potential to aid in the resolution of many unsolved murder cases and expedite the delivery of justice. The ability of law enforcement agencies in Nigeria to use the potential of insects in criminal investigations can be improved through collaborations and training with professionals from diverse professions.

In addition to conventional cyclones, direct-flow cyclones are often used in industry to separate dust and gas systems, despite the fact that in some cases they are inferior to other types of cyclones in their characteristics. 

Oxidative stress has been implicated in Alzheimer’s and many other diseases and more recently, it has been linked to various COVID-19-related symptoms. Many diseases do not develop immediately as a result of the accumulated causes or injury, but rather, as a result of prolonged exposure to elevated oxidative stress, which disrupts the body’s natural homeostatic functions.

Cancer prognosis reflects a complex biological process measured by multiple types of omics data. Deep learning frameworks have been proposed to integrate multi-omics data and predict patient outcomes in different cancer types, potentially revolutionizing cancer prognosis with superior performance. This minireview summarizes the advances in the strategies for multi-omics data integration and the performance of different deep learning models in prognosis prediction of diverse cancer types using multi-omics data published in the past 18 months. The challenges and limitations of deep learning models for predicting cancer outcomes based on multi-omics data are discussed.

Background: It is unknown what effect the menstrual cycle can have on the susceptibility to trauma following sexual assault. Objectives: To compare the incidence of genital injuries following sexual assault in women with relationship to the three phases of the menstrual cycleMethods: The design was a retrospective, cohort analysis set in a community-based nurse examiner program over a five-year study period. Sexual assault victims were between the ages of 13 - 40 years and agreed to a forensic examination. The menstrual cycle was divided into three phases: follicular, luteal and menses phase. The primary outcomes were the frequency and type of genital injuries documented in relation to the different phases of the menstrual cycle.Results: Case files of 1376 cases of sexual assault were reviewed; 682 (49.6%) met the inclusion criteria. A total of 220 victims (32.3%) were in the follicular phase, 361 (52.9%) were in the luteal phase and 101 (14.8%) were in the menses phase. The three groups were comparable in terms of demographics, assault characteristics, and overall frequency of non-genital injuries. Assault victims in the follicular phase of the menstrual cycle had significantly more documented genital injuries (72.3%; 95% CI 66.4 - 78.2) compared to the luteal phase (64.0%; 95% CI 59.0 - 68.9) and the menses phase (58.4%; 95% CI 48.8 - 68.0). Conclusion: Forensic examiners documented more genital injuries in the follicular phase of the menstrual cycle. Sex hormones may have confounding effects through influences on vaginal epithelial and mucosal integrity.

The appropriateness of opioid therapy for patients with Chronic Non-Malignant Pain (CNCP) has been questioned by a variety of researchers and policy makers [1-3]. One comprehensive review concluded that the benefits of such therapy for pain relief and functional improvement are modest at best and that opioid therapy is associated with significant harms including various symptoms (e.g., headache, nausea, sedation), development of opioid use disorder, fractures and death from overdose [3].

Neck exploration for primary HPT is the standard operation in which 4 parathyroid glands are identified and one abnormal parathyroid gland is removed. This is recommended for all patients with primary HPT. We hypothesized that most patients with primary HPT have a single abnormal parathyroid gland (adenoma) and parathyroid imaging studies will identify it and support a focused minimally invasive parathyroidectomy (MIP). This can be combined with ioPTH monitoring making bilateral exploration unnecessary. This paper reports a 93.4% success rate in 249 consecutive prospective patients with primary HPT over a 15-year period with a short operating time and few complications. The findings suggest that this alternate surgical MIP approach should be the procedure of choice for HPT patients.

Introduction: The spread of SARS-CoV-2 cases grew exponentially. In Mexico, it focused mainly on containing the disease and adopting activities and actions to mitigate it. Hospital reconversion was a fundamental strategy in the management of care for patients with COVID-19.Objective: To know the clinical characteristics of patients admitted with respiratory disease and probable COVID-19 in the Zacatecas General Hospital “Luz González Cosío” México.Material and methods: Descriptive, cross-sectional, and analytical study, at the General Hospital, from March 2019 to September 2021; using data from the Respiratory Disease Surveillance System. Data from patients admitted with a diagnosis of some pathology of respiratory disease and probable COVID-19 were analyzed.Results: We included 2,678 diagnosed with respiratory disease and a mean age; of 47.6 ± 21.6 gender distribution was almost equal; women 1,344 (51.0%). positive result to COVID-19 by PCR; 1,654 negatives; 900 and 124 without result. 193 (7.0%) required mechanical ventilation. The presence of comorbidities was evaluated; type 2 diabetes mellitus, systemic arterial hypertension, obesity, alone and together. Also the association of the age factor, as well as the lethality index; was 531 (19.6%).Discussion: What has been published in other studies about comorbidities and their influence on the severity of COVID-19 is confirmed, disagreeing on the case fatality rate; 20.7% against what was reported; 17.6% in other countries for COVID-19 hospitalized. An age variable was used as a risk factor with a cut-off point > 45 years; (FRE), obtaining; RR 3.42 (95% CI 2.79 to 4.19) and an odds ratio of 4.015 in binary logistic regression analysis. Reported male mortality (OR = 1.45; 95% CI: 1.41–1.51) according to our OR results; 1,45.Conclusion: The present study shows how certain chronic diseases influenced respiratory disease to present a serious state, regardless of the positive or negative result of COVID-19.

Aminonitriles are pharmacological-interest bioactive due to their promising antimicrobial and antitumor activity. Since cytotoxicity tests are inherent to the new drug development process, this work aimed to verify reports in the scientific literature on the cytotoxic effects of aminonitriles. The method adopted was an integrative review of works published in the last 10 years in the PubMed, Embase, Web of Science, and Virtual Health Library (VHL) databases. Three articles that matched the selection and eligibility criteria were included in this review. A total of 33 aminonitriles were used in the cytotoxicity experiments, and of the nine molecules based on pyridine, two exerted moderate cytotoxic activity, of the twelve synthesized from benzimidazole, none showed cytotoxic activity, and of the twelve derived from renieramycins, all showed considerable cytotoxic activities. The studies used in this research evaluated the cytotoxic effects of aminonitriles with evident anticancer and antimicrobial activity. The importance of evaluating the cytotoxicity of aminonitriles is emphasized, as well as the need for investigative research that explores other evaluation methods in pre-clinical tests that may corroborate the existing findings, with a view to the development of therapies against emerging health problems.

Portal vein thrombosis (PVT) is a rare condition that may congest bowel venous drainage and cause mesenteric ischemia. In acute settings, gastrointestinal bleeding (GIB) is rare, and acute abdominal pain is the most common clinical presentation. A 24-year-old man who presented with acute abdominal pain and a single episode of hematemesis is reported. Workups revealed evidence of thrombosis in the portal vein, but upper endoscopy was incapable to detect the source of the bleeding. We discuss the possible scenarios for the GIB in this case and review similar reports in the literature.

Priapism is a prolonged erection, usually painful, that occurs in the absence of sexual desire or stimulation, is not relieved by masturbation or intercourse and is the consequence of a mismatch in the regulatory mechanisms that initiate penile erection and those that allow its detumescence. One of the main causes of low-flow priapism is the use of drugs with an α-adrenergic antagonist effect, among which antipsychotic drugs stand out. Our objective is to present a clinical case and review the literature on the use of antipsychotics in medicine, psychiatry and other specialties and their relationship with the dose of the psychoactive drug in the onset of priapism. We present a 23-year-old male patient, single, with a significant history of mild Autism, for which he has received regular treatment with 6 mg daily of risperidone. He started experiencing priapism spontaneously for the last 4 days until a family member took him to the Emergency Room – intense, persistent and painful penile erection. Given the failure of the initial medical treatment for priapism, it was decided to perform multiple distal cavernous-cancellous shunts with improvement after 72 hours and discharge of the patient. We understand that there is a high affinity of antipsychotics for the α 1-adrenergic receptor, risperidone has an α 1 antagonist capacity. In fact, the third cause of priapism cases induced by atypical antipsychotics is secondary to risperidone, including recent cases associated with its parenteral depot presentation RisperdalConsta®.

Introduction: Severe cases of COVID-19 presented a high incidence of multi-organ dysfunction syndrome (MODS) during their evolution. This was attributed to a theoretical cytokine storm, where microcirculatory disorders would play a fundamental role, causing these patients to present a sepsis-like pattern as observed in sublingual microcirculation studies. The evidence in this regard is controversial. The Peripheral Perfusion Index is a reliable method to continuously and non-invasively assess the microcirculatory bed, which assesses the pulsatile (PPI) component of the plethysmographic pulse curve.Methods: We conducted a prospective observational study to evaluate the behavior of the PPI in patients with severe respiratory failure due to SARS-CoV-2 and its association with SDOM.Results: We evaluated 60 patients with APACHE II 14.6 ± 4.4 and SOFA 4.7 ± 2.1. 55% of the patients presented SDOM. Perfusion monitoring showed IP values of 5.32 ± 1.87 that were associated with normal lactate levels of 1.49 mmol/L (min 0.89/ max 2.20 mmol/L). The PPI values between the living and the dead did not show a significant difference (p = 0.854) or the presence of SDOM.The PPI values between the patients who presented renal failure, hemodynamics, or perfusion disorders were determined by the presence of hyperlactatemia, and for those who did not present these characteristics, no statistical difference was found; neither when stratified by PaFiO2 ratio. Mortality was 55%.Conclusion: In our series of patients with severe pneumonia due to COVID-19, we found high PPI values, which would correspond to a pattern of capillary recruitment, and the associated organ injury could not be substantiated by this phenomenon.

Reproductive health care disparity is a significant public health issue that affects many populations. This disparity stems from various factors, including race, ethnicity, socioeconomic status, geographic location, and education level. Such inequality results in adverse health outcomes such as unintended pregnancy, infertility and sexually transmitted infections among certain populations. Therefore, addressing reproductive health care disparities requires increasing access to affordable and comprehensive reproductive health services, promoting culturally competent care, improving access to family planning services and addressing barriers to care. Furthermore, promoting comprehensive sexuality education and addressing the root causes of inequality are also crucial in eliminating reproductive health care disparities. By addressing these disparities, we can ensure that all individuals have equal access to quality reproductive health care and services, leading to improved health outcomes for everyone.

The nanometer-scale spatial organization of immune receptors plays a role in cell activation and suppression. While the connection between this spatial organization and cell signaling events is emerging from cell culture experiments, how these results translate to more physiologically relevant settings like the tumor microenvironment remains poorly understood due to the challenges of high-resolution imaging in vivo. Here we perform super-resolution immunofluorescence microscopy of human melanoma tissue sections to examine the spatial organization of the immune checkpoint inhibitor programmed cell death 1 (PD-1). We show that PD-1 exhibits a variety of organizations ranging from nanometer-scale clusters to more uniform membrane labeling. Our results demonstrate the capability of super-resolution imaging to examine the spatial organization of immune checkpoint markers in the tumor microenvironment, suggesting a future direction for both clinical and immunology research.

Introduction: Infection and the accompanying inflammation of the upper and lower respiratory tract, influenza and COVID-19, are among the deadliest diseases in human life in the world. Due to the high emergence of bacterial resistance to antibiotics, we strive to find alternatives to contribute to the treatment by using a new formulation of a mixture of six essential oils in the form of a drop called Respira drops for a therapeutic approach to the upper or lower parts of the respiratory system infection, either by inhalation or sniffing, or by touching it with the body in the form of a skin patch on the head, neck, or chest. The present study suggested that natural essential oils may act as a prophylactic and therapeutic agent in respiratory tract hypoxia, inflammation, and bacterial and viral infection (influenza and COVID-19).Case presentation: A 62-year-old Yemeni man was suffering from acute pneumonia and had used antibiotics his condition improved, but he was suffering from difficulty breathing and stayed on the use of oxygen at home for more than three months, and his SpO2 ranged between 75 to 85 and he also suffered from an abdominal hernia, and he went for a procedure Surgery, and when the SpO2 was measured at 86, the surgery was not completed as a result, so he used Respira drops by inhalation and by steam for twenty-four hours and the next day he went to the hospital and the SpO2 was measured 96 and the operation was performed and he continued using Respira for two weeks three times per day and his condition improved completely.Conclusion: The present case study shows the excellent therapeutic response for Respira drops as inhalation and smiling three times per day increased SpO2 levels which reflect the anti-inflammatory, antimicrobial and anti-viral effects (influenza and COVID-19).

Originating from China in 2019, the novel Coronavirus Disease 2019 (COVID-19) pandemic had badly affected most of the world causing immense morbidity and mortality. The disease in moderate to severe cases was characterized by intense inflammation leading to ARDS and hypercoagulable states leading to thrombo-embolism and mortality.Aim: This study aimed to explore the association of inflammatory biomarkers with COVID-19 disease severity in our hospital which became a dedicated COVID hospital during the pandemic.

Background: Since 2019, remote patient monitoring (RPM) for patients with chronic heart failure (CHF) has been supported by the European Society of Cardiology. However, real-world data on the use of such solutions has been limited and not primarily based on patient-reported outcomes. The aim of this study was to describe the Satelia® Cardio solution in France within the French ETAPES funding program and assess the security and performance of its clinical algorithm.Methods: A retrospective observational study was conducted on CHF patients monitored by RPM through Satelia® Cardio. From September 1, 2018, to June 30, 2020, patients were included if they had completed over six months of follow-up. The risk of a possible CHF decompensation was categorized by the system in three levels: green, orange and red. The algorithm security and performance were assessed through the negative predictive value (NPV) of the prediction of hospitalization of a patient within seven days.Results: In total, 331 patients were included in this study with 36,682 patient self-administered questionnaires answered. Patients were mostly males (70.4%) and had a mean age of 68.1 years. The mean left ventricular ejection fraction (LVEF) was 35.4% (± 12.3) and 73.3% of patients had a LVEF ≤ 40%. The questionnaire response rate was 90.9%. A green status was generated for 95.3% of answers. There were 4.5% (n = 1,499) orange alerts and 0.2% (n = 74) red alerts. Overall, 92.1% of patients had at least one CHF related hospitalization and 31.7% (n = 105) of these cases were non-scheduled. The NPV at seven days was 99.43%.Conclusion: Satelia® Cardio is a feasible, relevant and reliable solution to safely monitor the cohorts of patients with CHF, reassuring cardiologists about patient stability.

Introduction: Patients with aortic stenosis often develop hypertrophy and fibrosis, regardless of symptoms. Cardiac Magnetic Resonance (CMR) represents the gold standard for the evaluation of fibrosis despite numerous limitations: cost, availability, atrial fibrillation, claustrophobia, kidney failure or inability to apnea.Purpose: The aim is to validate the role of echocardiographic parameters, such as Global Longitudinal Strain (GLS), as early markers of fibrosis. Clinical and laboratory data, particularly B-type Natriuretic Peptide (BNP), were also analyzed.Material and methods: In our study we recruited 33 patients with severe aortic stenosis, correlating echocardiographic values of GLS with the qualitative analysis of Late Gadolinium Enhancement (LGE) and the quantitative analysis of T1 mapping of CMR.Results: 70% of patients with an alteration of GLS had LGE+. Univariate logistic regression shows that the factors associated with the presence of LGE on CMR are hypertension (p = 0.043), GLS (p = 0.032), and elevated BNP values (p = 0.021); for GLS, Odds Ratio (OR) is 5 so the chance of finding fibrosis on CMR increases 5 times in presence of an altered GLS. The multivariate analysis confirms the association with impaired GLS values (p = 0.033) and hypertension (p = 0.025), but not with elevated Pro-BNP values.Conclusion: In patients with severe aortic stenosis, the association between GLS, LGE, and T1 mapping can help identify earlier those patients with structural changes caused by the disease, who could benefit from early intervention. It remains to be established how the presence of these alterations has a role in determining the intervention time and the outcome of these patients.