Tumor necrosis factor-a (TNF-a) contributes to myocardial infarction (MI) injury. Polymorphism of TNF-a gene promoter region and secretion and release of TNF-a and its transformation by a series of signaling pathways ...Tumor necrosis factor-a (TNF-a) contributes to myocardial infarction (MI) injury. Polymorphism of TNF-a gene promoter region and secretion and release of TNF-a and its transformation by a series of signaling pathways are all changed at different points of pathophysiological process in MI. Researches also investigated TNF-a antagonists and their potential therapeutic role in the setting of MI and heart failure at both molecular and clinical level. This article briefly reviews TNF-a and its mechanism as a mediator in MI. Copyright ? 2015, Chinese Medical Association Production. Production and hosting by Elsevier B.V. on behalf of KeAi Communications Co., Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).展开更多
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and Plasmodium species are the causative agents of coronavirus disease 2019 (COVID-19) and malaria respectively with similar clinical presentations. The obj...Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and Plasmodium species are the causative agents of coronavirus disease 2019 (COVID-19) and malaria respectively with similar clinical presentations. The objective of this study is to determine the burden of co-infection of SARS-CoV-2 and malaria in the general population. Five (5 mLs) of blood samples were collected for SARS-CoV-2 and malaria parasite test. The malaria test was performed using a commercially available one-step malaria antigen Plasmodium falciparum histidine-rich protein 2 (Pf HRP-II) rapid test kit. The results of the study showed that the participants that were coinfected with SARS-CoV-2 IgG and malaria were 13 (2.5%) in Lagos, 1114 (39.1%) in Delta and 49 (2.3%) in Sokoto States. The prevalence of coinfection of SARS-CoV-2 and malaria in urban areas in Lagos, Delta and Sokoto States were 7 (2.2%), 1373 (48.1%), and 5 (0.2%) respectively. In rural areas, the prevalence of coinfection of SARS-CoV-2 and malaria in Lagos, Delta and Sokoto States were 6 (0.3%), 365 (12.8%), and 44 (2.1%) respectively in this study. This suggests that participants in the urban areas were more prone to co-infections than the rural areas in Lagos and Delta states, while it was otherwise in Sokoto State. In conclusion, the co-infection of SARS-CoV-2 and malaria was very high in Delta State compared to the other States. It is important for clinics to screen for both diseases when patients present with symptoms of malaria. This is because the infections have similar symptoms and the public is quick to assume malaria infection without diagnosing for COVID-19 and vice versa.展开更多
BACKGROUND The rising prevalence of carbapenem-resistant Acinetobacter baumannii(CRAB)in neonatal intensive care units(NICUs)represents an escalating challenge in healthcare settings,particularly in managing hospital-...BACKGROUND The rising prevalence of carbapenem-resistant Acinetobacter baumannii(CRAB)in neonatal intensive care units(NICUs)represents an escalating challenge in healthcare settings,particularly in managing hospital-acquired infections(HAIs).Studies across various World Health Organization regions have documented a significant incidence of CRAB-related HAIs,with rates as high as 41.7 cases per 1000 patients in ICUs,accounting for 13.6%of all HAIs.These infections pose a doubled mortality risk compared to infections with carbapenem-susceptible Acinetobacter baumannii.A particularly concerning aspect of CRAB colonization is its asymptomatic nature,enabling its transmission through healthcare workers(HCWs)or the NICU environment to vulnerable neonates with developing immune systems.AIM To explore the prevalence of CRAB colonization in NICUs,focusing on neonates,healthcare workers,and the environmental samples,to enhance epidemiological understanding and inform targeted interventions.METHODS We conducted according to PRISMA 2020 checklist guidelines,a comprehensive literature search across multiple databases including MEDLINE(Ovid),EMBASE(Ovid),Global Health(Ovid),Web of Science,and Global Index Me-dicus.Studies were selected based on predetermined criteria,primarily involving neonates,HCWs,and environmental swabs,using culture or molecular methods to detect CRAB colonization.We excluded studies that did not specifically focus on NICUs,were duplicates,or lacked necessary data.The study selection and quality assessment were conducted independently by two reviewers.Data extraction involved collecting comprehensive details about each study.Our statistical analysis used a random-effects model to calculate the pooled prevalence and confidence intervals,stratifying results by regional location.We assessed study heterogeneity using Cochran's Q statistic and I²statistic,with regression tests employed to evaluate potential publication bias.RESULTS We analyzed 737 records from five databases,ultimately including 13 studies f展开更多
Dengue fever,caused by the dengue virus(DENV),poses a significant public health challenge globally,with Nigeria experiencing sporadic outbreaks.A clear understanding of the dengue burden has not been achieved in Niger...Dengue fever,caused by the dengue virus(DENV),poses a significant public health challenge globally,with Nigeria experiencing sporadic outbreaks.A clear understanding of the dengue burden has not been achieved in Nigeria,just as in other African countries.Understanding the epidemiology and burden of dengue fever is essential for effective prevention and control strategies.This paper examines the recent dengue outbreaks in northern Nigeria,particularly in Sokoto state,and evaluates the recommended Takeda dengue vaccine(TDV)along with future prevention strategies.Despite limited surveillance and underreporting,dengue fever is endemic in Nigeria(with over 5 million cases and 5000 dengue-related deaths in 2023),with recent outbreaks indicating a growing concern.The TDV,a live attenuated tetravalent vaccine,has shown promise in preventing dengue fever,but challenges such as vaccine acceptance and access-ibility need to be addressed.Global urbanization contributes to the disease's spread,which is influenced by factors such as population density,cultural beliefs,water storage practices,hygiene,and water supply accessibility.Future prevention strategies must focus on government intervention,community practices,and innovative vector control measures to mitigate the spread of DENV in Nigeria.This study will serve as a valuable reference for policy-makers,researchers,and clinicians in the management and control of DENV in Nigeria and Africa as a whole.展开更多
Transparency Ecosystemfor Research and Journals inMedicine(TERM)Working Group summarized the essential recommendations that should be considered to review and publish a high-quality guideline.These recommendations fro...Transparency Ecosystemfor Research and Journals inMedicine(TERM)Working Group summarized the essential recommendations that should be considered to review and publish a high-quality guideline.These recommendations fromeditors and reviewers included the 10 components of essential requirements:systematic review of existing relevant guidelines,guideline registration,guideline protocol,stakeholders,conflicts of interest,clinical questions,systematic reviews,recommendation consensus,guideline reporting,and external review.TERMWorking Group abbreviates them as PAGE(essential requirements for Publishing clinical prActice GuidelinEs),recommends guideline authors,editors,and peer reviewers use them for high-quality guidelines.展开更多
BACKGROUND The association between hospitalization for human respiratory syncytial virus(HRSV)bronchiolitis in early childhood and subsequent asthma is well established.The long-term prognosis for non-bronchiolitis lo...BACKGROUND The association between hospitalization for human respiratory syncytial virus(HRSV)bronchiolitis in early childhood and subsequent asthma is well established.The long-term prognosis for non-bronchiolitis lower respiratory tract infections(LRTI)caused by viruses different from HRSV and rhinovirus,on the other hand,has received less interest.AIM To investigate the relationship between infant LRTI and later asthma and examine the influence of confounding factors.METHODS The PubMed and Global Index Medicus bibliographic databases were used to search for articles published up to October 2021 for this systematic review.We included cohort studies comparing the incidence of asthma between patients with and without LRTI at≤2 years regardless of the virus responsible.The meta-analysis was performed using the random effects model.Sources of heterogeneity were assessed by stratified analyses.RESULTS This review included 15 articles(18 unique studies)that met the inclusion criteria.LRTIs at≤2 years were associated with an increased risk of subsequent asthma up to 20 years[odds ratio(OR)=5.0,95%CI:3.3-7.5],with doctor-diagnosed asthma(OR=5.3,95%CI:3.3-8.6),current asthma(OR=5.4,95%CI:2.7-10.6),and current medication for asthma(OR=1.2,95%CI:0.7-3.9).Our overall estimates were not affected by publication bias(P=0.671),but there was significant heterogeneity[I 2=58.8%(30.6-75.5)].Compared to studies with hospitalized controls without LRTI,those with ambulatory controls had a significantly higher strength of association between LRTIs and subsequent asthma.The strength of the association between LRTIs and later asthma varied significantly by country and age at the time of the interview.The sensitivity analyses including only studies with similar proportions of confounding factors(gender,age at LRTI development,age at interview,gestational age,birth weight,weight,height,smoking exposure,crowding,family history of atopy,and family history of asthma)between cases and controls did not alter the overall estimates.CONCLUSI展开更多
Background: Vaginitis is an important public health problem globally. It is associated with gynaecological and obstetric complications. Vulvovaginal candidiasis, bacterial vaginosis and trichomoniasis are ma...Background: Vaginitis is an important public health problem globally. It is associated with gynaecological and obstetric complications. Vulvovaginal candidiasis, bacterial vaginosis and trichomoniasis are mainly responsible for vaginitis. The aim of this study is to determine the occurrence, clinical characteristics and associated risk factors of vulvovaginal candidiasis and bacterial vaginosis among women of reproductive age attending Primary Health Care centres in Lagos Nigeria. Methods:This cross-sectional study recruited 258 women with genital complaints after obtaining their informed written consent between May 2017 and March 2018. Structured questionnaires were administered and high vaginal swabs were collected for laboratory examination. The results were analysed with descriptive statistics, chi-square and simple logistic regression. Results: Out of the 210 (81.4%) of the women with one or more vaginal infections, 105 (50.0%), 26 (12.4%) had bacterial vaginosis, and vulvovaginal candidiasis respectively while 78 (37.1%) had both vulvovaginal candidiasis and bacterial vaginosis. Only 1 (0.5%) participant had trichomoniasis and bacterial vaginosis. History of abortion and age below 25 years were associated with vulvovaginal candidiasis while pregnancy, history of miscarriage, age at first sexual activity and discharge were associated with bacterial vaginosis. Itching was associated with both vulvovaginal candidiasis and bacterial vaginosis. Conclusion: This study revealed vulvovaginal candidiasis and bacterial vaginosis as important cause of genital complaints among reproductive age women in Lagos. Health education, robust diagnosis and early treatment are needed in order to reduce the associated risk factors, disease burden and complications.展开更多
Transparency Ecosystem for Research and Journals in Medicine(TERM)working group summarized the essential recommendations that should be considered to review and publish a high-quality guideline.These recommendations f...Transparency Ecosystem for Research and Journals in Medicine(TERM)working group summarized the essential recommendations that should be considered to review and publish a high-quality guideline.These recommendations from editors and reviewers included 10 components of essential requirements:systematic review of existing relevant guidelines,guideline registration,guideline protocol,stakeholders,conflicts of interest,clinical questions,systematic reviews,recommendation consensus,guideline reporting and external review.TERM working group abbreviates them as PAGE(essential requirements for Publishing clinical prActice GuidelinEs),and recommends guideline authors,editors,and peer reviewers to use them for high-quality guidelines.展开更多
Objective: This study assesses the attitudes and preferences of Chinese clinicians toward their involvement in shared decision making (SDM). Methods: From May 2014 to May 2015, 200 Chinese clinicians from two hospital...Objective: This study assesses the attitudes and preferences of Chinese clinicians toward their involvement in shared decision making (SDM). Methods: From May 2014 to May 2015, 200 Chinese clinicians from two hospitals were enrolled to complete a survey on their attitude towards SDM. We conducted the survey via face-to-face interviews before and after an educational intervention on SDM among young Chinese clinicians. The clinicians were asked to give the extent of agreement to SDM. They also gave the extent of difficulty in using decision aids (DAs) during the SDM process. The variation in the range of responses to each question before and after the SDM intervention was recorded. The frequency of changed responses was analyzed by using JMP 6.0 software. Data were statistically analyzed using Chi-square and Mann—Whitney U tests, as appropriate to the data type. Multiple logistic regressions were used to test for those factors significantly and independently associated with preference for an approach for each scenario. Results: Of the 200 young Chinese clinicians sampled, 59.0% indicated a preference for SDM and a desire to participate in SDM before receiving education or seeing the DA, and this number increased to 69.0% after seeing the DA with the sample video of the SDM process on Statin Choice. However, 28.5% of the respondents still reported that, in their current practice, they make clinical decisions on behalf of their patients. The clinicians who denied a desire to use the DA stated that the main barriers to implement SDM or DA use in China are lack of time and knowledge of SDM.展开更多
BACKGROUND Human immunodeficiency virus(HIV)is a major public health concern,particularly in Africa where HIV rates remain substantial.Pregnant women are at an increased risk of acquiring HIV,which has a significant i...BACKGROUND Human immunodeficiency virus(HIV)is a major public health concern,particularly in Africa where HIV rates remain substantial.Pregnant women are at an increased risk of acquiring HIV,which has a significant impact on both maternal and child health.AIM To review summarizes HIV seroprevalence among pregnant women in Africa.It also identifies regional and clinical characteristics that contribute to study-specific estimates variation.METHODS The study included pregnant women from any African country or region,irrespective of their symptoms,and any study design conducted in any setting.Using electronic literature searches,articles published until February 2023 were reviewed.The quality of the included studies was evaluated.The DerSimonian and Laird random-effects model was applied to determine HIV pooled seroprevalence among pregnant women in Africa.Subgroup and sensitivity analyses were conducted to identify potential sources of heterogeneity.Heterogeneity was assessed with Cochran's Q test and I2 statistics,and publication bias was assessed with Egger's test.RESULTS A total of 248 studies conducted between 1984 and 2020 were included in the quantitative synthesis(meta-analysis).Out of the total studies,146(58.9%)had a low risk of bias and 102(41.1%)had a moderate risk of bias.No HIV-positive pregnant women died in the included studies.The overall HIV seroprevalence in pregnant women was estimated to be 9.3%[95%confidence interval(CI):8.3-10.3].The subgroup analysis showed statistically significant heterogeneity across subgroups(P<0.001),with the highest seroprevalence observed in Southern Africa(29.4%,95%CI:26.5-32.4)and the lowest seroprevalence observed in Northern Africa(0.7%,95%CI:0.3-1.3).CONCLUSION The review found that HIV seroprevalence among pregnant women in African countries remains significant,particularly in Southern African countries.This review can inform the development of targeted public health interventions to address high HIV seroprevalence in pregnant women in African countries.展开更多
Prevention of mother-to-child transmission(PMTCT)of HIV with highly active antiretroviral therapy(HARRT)allows the HIV^+pregnant mothers to have vaginal delivery and breastfeed.Here we investigated the maternal plasma...Prevention of mother-to-child transmission(PMTCT)of HIV with highly active antiretroviral therapy(HARRT)allows the HIV^+pregnant mothers to have vaginal delivery and breastfeed.Here we investigated the maternal plasma immunoglobulin,cytokine secretion and the outcome of the exposed infants among the HIV^+HAART treated pregnan women in Nigeria.In this study,different plasma immunoglobulins and cytokines were measured in the HIV^+HAART treated pregnant mothers.Pooled culture supernatants of B and T lymphocytes showed lower levels of IFN-γ,IL-10 and IL-4.There were lower IFN-γand IL-10 secretions at 1st trimester;however,IL-10 continued to be lower throughout 2nd and 3rd trimesters.TNF-αsecretion significantly decreased as pregnancy progressed to term.There were high plasma IgG and low IgM in the HIV^+HAART treated pregnant women.Plasma IgG was high during 1st and 3rd trimesters.After one year of follow up,all the exposed children were seronegative for HIV-1 and HIV-2.Vaginal delivery and breastfeeding among HIV^+HAART treated mothers have shown to be safe.The use of HAART by the infected mothers and the use of septrin and niverapin by the exposed infants prevented mother to-child transmission of HIV.展开更多
Background:To understand the relationship between myocardial contractility and ex-ternal stimuli,detecting ex vivo myocardial contractility is necessary.Methods:We elaborated a method for contractility detection of is...Background:To understand the relationship between myocardial contractility and ex-ternal stimuli,detecting ex vivo myocardial contractility is necessary.Methods:We elaborated a method for contractility detection of isolated C57 mouse papillary muscle using Myostation-Intact system under different frequencies,volt-ages,and calcium concentrations.Results:The results indicated that the basal contractility of the papillary muscle was 0.27±0.03 mN at 10 V,500-ms pulse duration,and 1 Hz.From 0.1 to 1.0 Hz,con-tractility decreased with an increase in frequency(0.45±0.11-0.10±0.02 mN).The voltage-initiated muscle contractility varied from 3 to 6 V,and the contractility gradu-ally increased as the voltage increased from 6 to 10 V(0.14±0.02-0.28±0.03 mN).Moreover,the muscle contractility increased when the calcium concentration was increased from 1.5 to 3 mM(0.45±0.17-1.11±0.05 mN);however,the contractility stopped increasing even when the concentration was increased to 7.5 mM(1.02±0.23 mN).Conclusions:Our method guaranteed the survivability of papillary muscle ex vivo and provided instructions for Myostation-Intact users for isolated muscle contractility investigations.展开更多
<strong>Background: </strong>Urinary tract infections (UTIs) in women with bacterial vaginosis (BV) continue to pose tremendous health concerns and require appropriate use of antibiotics for effective case...<strong>Background: </strong>Urinary tract infections (UTIs) in women with bacterial vaginosis (BV) continue to pose tremendous health concerns and require appropriate use of antibiotics for effective case management. This study determined the prevalence, etiology and antibiotic resistance profile of uropathogenic bacteria isolated from sexually active women with BV in Lagos Nigeria. <strong>Method:</strong> A total of 258 sexually active women presenting with gynaecological complaints at the maternal and child unit of twenty Primary Health Care Centres in Lagos Nigeria from May 2017 to March 2018 were consecutively enrolled with consent. Bacterial vaginosis was diagnosed based on Amsel criteria. Midstream urine samples were collected aseptically, analyzed for bacterial pathogens and antibiotic susceptibility using standard microbiological methods. <strong>Results:</strong> BV was diagnosed in 184 (71.3%) with 69.2% also having UTI. Ninety four (36.4%) had UTI predominantly caused by Gram negative bacteria (96.8%). The organisms isolated were <em>Escherichia coli</em> 79 (84.0%), <em>Klebsiella pneumoniae</em> 5 (5.3%), <em>Pseudomonas aeruginosa</em> 4 (4.3%), <em>Proteus mirabilis</em> 3 (3.2%) and <em>Staphylococcus saprophyticus</em> 3 (3.2%). The pathogens elicited high resistance (66.7% - 100%) to tetracycline, amoxicillin-clavulanic acid, nitrofurantoin and cephalosporins, and moderate resistance (50%) to ofloxacin by <em>P. aeruginosa</em> strains. The isolates were susceptible (100%) to piperacillin-tazobactam and meropenem. Multi-drug resistance (MDR) was observed among 97.8% of the bacteria isolated. <strong>Conclusion: </strong>Findings from this study indicate high occurrence of UTI caused by MDR pathogens among sexually active women with BV with emerging evidence of poor clinical utility of nitrofurantoin and other commonly used first-line antibiotics against UTI. Further studies on non-bacterial aetiology of BV, molecular characterization of <em>S. saprophyticus</em> and Gram Negative Bacteria UTI 展开更多
BACKGROUND The hepatitis B virus(HBV)infection is a global public health concern that affects about 2 billion people and causes 1 million people deaths yearly.HBV is a bloodborne disease and healthcare workers(HCWs)ar...BACKGROUND The hepatitis B virus(HBV)infection is a global public health concern that affects about 2 billion people and causes 1 million people deaths yearly.HBV is a bloodborne disease and healthcare workers(HCWs)are a high-risk group because of occupational hazard to patients’blood.Different regions of the world show a highly variable proportion of HCWs infected and/or immunized against HBV.Global data on serologic markers of HBV infection and immunization in HCWs are very important to improve strategies for HBV control.AIM To determine the worldwide prevalence of HBV serological markers among HCWs.METHODS In this systematic review and meta–analyses,we searched PubMed and Excerpta Medica Database(Embase)to identify studies published between 1970 and 2019 on the prevalence of HBV serological markers in HCWs worldwide.We also manually searched for references of relevant articles.Four independent investigators selected studies and included those on the prevalence of each of the HBV serological markers including hepatitis B surface antigen(HBsAg),hepatitis e antigen(HBeAg),immunoglobulin M anti-HBc,and anti-HBs.Methodological quality of eligible studies was assessed and random-effect model meta-analysis resulted in the pooled prevalence of HBV serological markers HBV infection in HCWs.Heterogeneity(I²)was assessed using theχ²test on Cochran’s Q statistic and H parameters.Heterogeneity’sources were explored through subgroup and metaregression analyses.This study is registered with PROSPERO,number CRD42019137144.RESULTS We reviewed 14059 references,out of which 227 studies corresponding to 448 prevalence data among HCWs(224936 HCWs recruited from 1964 to 2019 in 71 countries)were included in this meta-analysis.The pooled seroprevalences of current HBsAg,current HBeAg,and acute HBV infection among HCWs were 2.3%[95% confidence interval(CI):1.9-2.7],0.2%(95%CI:0.0-1.7),and 5.3%(95%CI:1.4-11.2),respectively.The pooled seroprevalences of total immunity against HBV and immunity acquired by natural HBV infectio展开更多
We report here the results of a prospective analysis of the pattern of antibiotics use over a one month period(May 2009)at two teaching hospitals in Sanandaj,western part of Iran.Data on antibiotic usage were obtained...We report here the results of a prospective analysis of the pattern of antibiotics use over a one month period(May 2009)at two teaching hospitals in Sanandaj,western part of Iran.Data on antibiotic usage were obtained from the pharmacy services.Data was coded,computed and analyzed using SPSS version 11.5.A total of 1336 and 556 patients from Beasat and Tohid hospital respectively received antibiotic.Male patients represented 758(41.5 %)and females 1080(58.5 %)of the total number of patients evaluated by physicians at the two hospitals during the one month period.Usage of antibiotics varied from hospital to hospital;Beasat hospital had the highest usage.The ward-wise distribution of antibiotic use showed that the prevalence of prescribing was highest in the post partum ward(66.58%).Similarly,among Tohid hospital wards,men surgical ward and women surgical ward prescribed antibiotics significantly more than all other wards.The route of administration of antibiotics was parentrally for 85.5% and 88.2% at Beasat anf Tohid hospitals respectively.The distribution of use of individual antibiotics showed that cepfzoline was the most frequently prescribed antibiotics used at both the hospitals.Delivery(childbirth)and pneumonia were the most frequent diagnosed pattern for which an antibiotic was prescribed at Beasat and Tohid hospital respectively.In conclusion our study suggests that there is considerable scope for improving prescribing pattern among the practitioners and minimizing the use of antibiotics.The improvement would be facilitated by providing feedback,prescriber education and hospital formulary.展开更多
Hemichorea with corresponding putamenal T1 hyper-intensity and T2 hypointensity on MR imaging has occasionally been reported in diabetes mellitus with nonketotic hyperglycemia. However, the signal intensity in pu-tame...Hemichorea with corresponding putamenal T1 hyper-intensity and T2 hypointensity on MR imaging has occasionally been reported in diabetes mellitus with nonketotic hyperglycemia. However, the signal intensity in pu-tamenal and cerebellum lesion on MR imaging, which is believed to be pathogenetically related to hemichorea, is rarely documented in diabetes mellitus with nonketotic hyperglycemia. We describe a 57-year-old man with nonketotic hyperglycemic hemichorea on his right arm and legs, whose signal intensity in putamenal and cerebellum lesion was demonstrated by MR imaging.展开更多
<strong>Introduction: </strong><span style="font-family:""><span style="font-family:Verdana;">Fetal heart rate monitoring during labor is used to study fetal well-being...<strong>Introduction: </strong><span style="font-family:""><span style="font-family:Verdana;">Fetal heart rate monitoring during labor is used to study fetal well-being and predict neonatal acidosis of newborn. Fetal heart rate monitoring is analyzed by the obstetrical team and categorized according to the FIGO guidelines. An important limitation of this diagnostic tool is an inter- and intra-observer variability, leading to subjective cardiotocography interpretation and classification. Our objective was to study the association between the categories of fetal heart rate analysis (according to FIGO classification) and neonatal acidosis of full-term newborns. </span><b><span style="font-family:Verdana;">Study design:</span></b><span style="font-family:Verdana;"> This is a multicenter retrospective cohort study conducted between 2014 and 2018 in the Grand-Est region. We searched and included retrospectively children hospitalized in a pediatric intensive care unit in one of the participating hospitals with an ICD-10 coding type “P91.6” corresponding to “Hypoxic Ischemic Encephalopathy”. Maternal, pregnancy, delivery, and newborn characteristics were collected and compared by univariate logistic regression with multiple imputation. Odds Ratio and 95% confidence intervals (CI) were calculated using the model and presented. Multiple imputation with m = 100 imputations was tested, using Rubin rules to combine the results. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">55 patients were included in the study. Fetal heart rate tracings classified in Category 3 as “pathological” according to FIGO guidelines were significantly associated with an increased risk of severe neonatal acidosis. Late decelerations and bradycardia during labor were associated with severe neonatal acidosis. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Severe neonatal acidosis may be suspected by interpretation of fetal heart rate展开更多
AIM: To investigate the patient characteristics, relationship between the Logistic EuroSCORE (LES) and the observed outcomes in octogenarians who underwent surgical aortic valve replacement (AVR). METHODS: Two hundred...AIM: To investigate the patient characteristics, relationship between the Logistic EuroSCORE (LES) and the observed outcomes in octogenarians who underwent surgical aortic valve replacement (AVR). METHODS: Two hundred and seventy three octogenarians underwent AVR between 1996 and 2008 at Bristol Royal Inf irmary. Demographics, acute outcomes,length of hospital stay and mortality were obtained. The LES was calculated to characterize the predicted operative risk. Two groups were def ined: LES ≥ 15 (n = 80) and LES < 15 (n = 193). RESULTS: In patients with LES ≥ 15, 30 d mortality was 14% (95% CI: 7%-23%) compared with 4% (95% CI: 2%-8%) in the LES < 15 group (P < 0.007). Despite the increase in number of operations from 1996 to 2008, the average LES did not change. Only 5% of patients had prior bypass surgery. The LES identifi ed a low risk quartile of patients with a very low mortality (4%, n = 8, P < 0.007) at 30 d. The overall surgical results for octogenarians were excellent. The low risk group had an excellent outcome and the high risk group had a poor outcome after surgical AVR. CONCLUSION: It may be better treated with transcatheter aortic valve implantation.展开更多
The physical and mental development of pupils could be arrested by inadequate food intake and infection with immediate and long term consequences. This has implications on decreased school performances, lower intellig...The physical and mental development of pupils could be arrested by inadequate food intake and infection with immediate and long term consequences. This has implications on decreased school performances, lower intelligent quotient levels, poor psychosocial development, and decreased cognitive functions. This study assessed the growth and body fat distribution among pupils aged 5 - 19 years. A cross-sectional study was conducted among pupils from five primary schools in different communities around Kainji Dam. This assessment was based on a comparison with reference standards set by the World Health Organization to determine their deviations. A qualified registered nurse carried out physical measurements to obtain age, height, and body weight using electronic weighing scale and stadiometer. Data were analyzed using Anthroplusv1.0.4 software. The overall prevalence of stunting was 21.5% with 8% being severely stunted. The prevalence of thinness was 35.2% with 11.2% being wasted while the overall prevalence of underweight was not calculated for children > 10 years old. The prevalence of underweight for 5 - 10 years old children was 16.9% with 2.4% being severely underweight. The curves for both male and female children deviated from normal distribution. Females have higher percentage of stunting than males. This study revealed a high prevalence of thinness and stunting which is the consequence of poor nutrition arising from multifaceted and interrelated circumstances such as poor feeding, eating practices and repeated infection. Intervention such as Home Grown School Feeding Programme of the Government is a right step in improving the nutritional status of pupils in rural communities.展开更多
Background: Although patients with acute headache frequently present in emergency department, the causes and predictors of short-term outcome in patients with acute headache in general neurology have not been adequate...Background: Although patients with acute headache frequently present in emergency department, the causes and predictors of short-term outcome in patients with acute headache in general neurology have not been adequately investigated. Methods: We prospectively reviewed the medical records of 130 hospitalized acute headache pa-tients in general neurology of China. Their initial CT scan was assessed, as was their lumbar puncture (LP) examination if performed. Results: The main cause of acute headache was acute secondary headache (80.8%), which was mainly attributable to acute cerebrovascular events (72.4%) followed by intracranial infection (19.0%). Among the 10.8% of patients who died during hospitalization most (85.7%) had subarachnoid hemorrhage (SAH). Significant predictors of survival were severe headache versus thunderclap headache, meningismus, de-layed loss of consciousness, and hypertension (all p < 0.05). Multiple logistic regression analyses showed significant differences in severe headache or thunderclap headache (OR, 0.255;95%CI, 0.066 - 0.990;p = 0.048) and delayed loss of consciousness (OR, 0.060;95%CI, 0.016 - 0.224, p = 0.000) between patients who died and those who survived. Conclusions: The main underlying cause of hospitalized acute headache was acute cerebrovascular events. Severe headache and delayed loss of consciousness are predictors for poor outcome of acute headache.展开更多
基金the National Natural Science Foundation of China
文摘Tumor necrosis factor-a (TNF-a) contributes to myocardial infarction (MI) injury. Polymorphism of TNF-a gene promoter region and secretion and release of TNF-a and its transformation by a series of signaling pathways are all changed at different points of pathophysiological process in MI. Researches also investigated TNF-a antagonists and their potential therapeutic role in the setting of MI and heart failure at both molecular and clinical level. This article briefly reviews TNF-a and its mechanism as a mediator in MI. Copyright ? 2015, Chinese Medical Association Production. Production and hosting by Elsevier B.V. on behalf of KeAi Communications Co., Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
文摘Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and Plasmodium species are the causative agents of coronavirus disease 2019 (COVID-19) and malaria respectively with similar clinical presentations. The objective of this study is to determine the burden of co-infection of SARS-CoV-2 and malaria in the general population. Five (5 mLs) of blood samples were collected for SARS-CoV-2 and malaria parasite test. The malaria test was performed using a commercially available one-step malaria antigen Plasmodium falciparum histidine-rich protein 2 (Pf HRP-II) rapid test kit. The results of the study showed that the participants that were coinfected with SARS-CoV-2 IgG and malaria were 13 (2.5%) in Lagos, 1114 (39.1%) in Delta and 49 (2.3%) in Sokoto States. The prevalence of coinfection of SARS-CoV-2 and malaria in urban areas in Lagos, Delta and Sokoto States were 7 (2.2%), 1373 (48.1%), and 5 (0.2%) respectively. In rural areas, the prevalence of coinfection of SARS-CoV-2 and malaria in Lagos, Delta and Sokoto States were 6 (0.3%), 365 (12.8%), and 44 (2.1%) respectively in this study. This suggests that participants in the urban areas were more prone to co-infections than the rural areas in Lagos and Delta states, while it was otherwise in Sokoto State. In conclusion, the co-infection of SARS-CoV-2 and malaria was very high in Delta State compared to the other States. It is important for clinics to screen for both diseases when patients present with symptoms of malaria. This is because the infections have similar symptoms and the public is quick to assume malaria infection without diagnosing for COVID-19 and vice versa.
文摘BACKGROUND The rising prevalence of carbapenem-resistant Acinetobacter baumannii(CRAB)in neonatal intensive care units(NICUs)represents an escalating challenge in healthcare settings,particularly in managing hospital-acquired infections(HAIs).Studies across various World Health Organization regions have documented a significant incidence of CRAB-related HAIs,with rates as high as 41.7 cases per 1000 patients in ICUs,accounting for 13.6%of all HAIs.These infections pose a doubled mortality risk compared to infections with carbapenem-susceptible Acinetobacter baumannii.A particularly concerning aspect of CRAB colonization is its asymptomatic nature,enabling its transmission through healthcare workers(HCWs)or the NICU environment to vulnerable neonates with developing immune systems.AIM To explore the prevalence of CRAB colonization in NICUs,focusing on neonates,healthcare workers,and the environmental samples,to enhance epidemiological understanding and inform targeted interventions.METHODS We conducted according to PRISMA 2020 checklist guidelines,a comprehensive literature search across multiple databases including MEDLINE(Ovid),EMBASE(Ovid),Global Health(Ovid),Web of Science,and Global Index Me-dicus.Studies were selected based on predetermined criteria,primarily involving neonates,HCWs,and environmental swabs,using culture or molecular methods to detect CRAB colonization.We excluded studies that did not specifically focus on NICUs,were duplicates,or lacked necessary data.The study selection and quality assessment were conducted independently by two reviewers.Data extraction involved collecting comprehensive details about each study.Our statistical analysis used a random-effects model to calculate the pooled prevalence and confidence intervals,stratifying results by regional location.We assessed study heterogeneity using Cochran's Q statistic and I²statistic,with regression tests employed to evaluate potential publication bias.RESULTS We analyzed 737 records from five databases,ultimately including 13 studies f
文摘Dengue fever,caused by the dengue virus(DENV),poses a significant public health challenge globally,with Nigeria experiencing sporadic outbreaks.A clear understanding of the dengue burden has not been achieved in Nigeria,just as in other African countries.Understanding the epidemiology and burden of dengue fever is essential for effective prevention and control strategies.This paper examines the recent dengue outbreaks in northern Nigeria,particularly in Sokoto state,and evaluates the recommended Takeda dengue vaccine(TDV)along with future prevention strategies.Despite limited surveillance and underreporting,dengue fever is endemic in Nigeria(with over 5 million cases and 5000 dengue-related deaths in 2023),with recent outbreaks indicating a growing concern.The TDV,a live attenuated tetravalent vaccine,has shown promise in preventing dengue fever,but challenges such as vaccine acceptance and access-ibility need to be addressed.Global urbanization contributes to the disease's spread,which is influenced by factors such as population density,cultural beliefs,water storage practices,hygiene,and water supply accessibility.Future prevention strategies must focus on government intervention,community practices,and innovative vector control measures to mitigate the spread of DENV in Nigeria.This study will serve as a valuable reference for policy-makers,researchers,and clinicians in the management and control of DENV in Nigeria and Africa as a whole.
基金supported by the Foundation of Chinese Medical Association Publishing House.
文摘Transparency Ecosystemfor Research and Journals inMedicine(TERM)Working Group summarized the essential recommendations that should be considered to review and publish a high-quality guideline.These recommendations fromeditors and reviewers included the 10 components of essential requirements:systematic review of existing relevant guidelines,guideline registration,guideline protocol,stakeholders,conflicts of interest,clinical questions,systematic reviews,recommendation consensus,guideline reporting,and external review.TERMWorking Group abbreviates them as PAGE(essential requirements for Publishing clinical prActice GuidelinEs),recommends guideline authors,editors,and peer reviewers use them for high-quality guidelines.
基金Supported by the European Union (EDCTP2 Programme),No. TMA2019PF-2705
文摘BACKGROUND The association between hospitalization for human respiratory syncytial virus(HRSV)bronchiolitis in early childhood and subsequent asthma is well established.The long-term prognosis for non-bronchiolitis lower respiratory tract infections(LRTI)caused by viruses different from HRSV and rhinovirus,on the other hand,has received less interest.AIM To investigate the relationship between infant LRTI and later asthma and examine the influence of confounding factors.METHODS The PubMed and Global Index Medicus bibliographic databases were used to search for articles published up to October 2021 for this systematic review.We included cohort studies comparing the incidence of asthma between patients with and without LRTI at≤2 years regardless of the virus responsible.The meta-analysis was performed using the random effects model.Sources of heterogeneity were assessed by stratified analyses.RESULTS This review included 15 articles(18 unique studies)that met the inclusion criteria.LRTIs at≤2 years were associated with an increased risk of subsequent asthma up to 20 years[odds ratio(OR)=5.0,95%CI:3.3-7.5],with doctor-diagnosed asthma(OR=5.3,95%CI:3.3-8.6),current asthma(OR=5.4,95%CI:2.7-10.6),and current medication for asthma(OR=1.2,95%CI:0.7-3.9).Our overall estimates were not affected by publication bias(P=0.671),but there was significant heterogeneity[I 2=58.8%(30.6-75.5)].Compared to studies with hospitalized controls without LRTI,those with ambulatory controls had a significantly higher strength of association between LRTIs and subsequent asthma.The strength of the association between LRTIs and later asthma varied significantly by country and age at the time of the interview.The sensitivity analyses including only studies with similar proportions of confounding factors(gender,age at LRTI development,age at interview,gestational age,birth weight,weight,height,smoking exposure,crowding,family history of atopy,and family history of asthma)between cases and controls did not alter the overall estimates.CONCLUSI
文摘Background: Vaginitis is an important public health problem globally. It is associated with gynaecological and obstetric complications. Vulvovaginal candidiasis, bacterial vaginosis and trichomoniasis are mainly responsible for vaginitis. The aim of this study is to determine the occurrence, clinical characteristics and associated risk factors of vulvovaginal candidiasis and bacterial vaginosis among women of reproductive age attending Primary Health Care centres in Lagos Nigeria. Methods:This cross-sectional study recruited 258 women with genital complaints after obtaining their informed written consent between May 2017 and March 2018. Structured questionnaires were administered and high vaginal swabs were collected for laboratory examination. The results were analysed with descriptive statistics, chi-square and simple logistic regression. Results: Out of the 210 (81.4%) of the women with one or more vaginal infections, 105 (50.0%), 26 (12.4%) had bacterial vaginosis, and vulvovaginal candidiasis respectively while 78 (37.1%) had both vulvovaginal candidiasis and bacterial vaginosis. Only 1 (0.5%) participant had trichomoniasis and bacterial vaginosis. History of abortion and age below 25 years were associated with vulvovaginal candidiasis while pregnancy, history of miscarriage, age at first sexual activity and discharge were associated with bacterial vaginosis. Itching was associated with both vulvovaginal candidiasis and bacterial vaginosis. Conclusion: This study revealed vulvovaginal candidiasis and bacterial vaginosis as important cause of genital complaints among reproductive age women in Lagos. Health education, robust diagnosis and early treatment are needed in order to reduce the associated risk factors, disease burden and complications.
基金supported by the Foundation of Chinese Medical Association Publishing House.
文摘Transparency Ecosystem for Research and Journals in Medicine(TERM)working group summarized the essential recommendations that should be considered to review and publish a high-quality guideline.These recommendations from editors and reviewers included 10 components of essential requirements:systematic review of existing relevant guidelines,guideline registration,guideline protocol,stakeholders,conflicts of interest,clinical questions,systematic reviews,recommendation consensus,guideline reporting and external review.TERM working group abbreviates them as PAGE(essential requirements for Publishing clinical prActice GuidelinEs),and recommends guideline authors,editors,and peer reviewers to use them for high-quality guidelines.
文摘Objective: This study assesses the attitudes and preferences of Chinese clinicians toward their involvement in shared decision making (SDM). Methods: From May 2014 to May 2015, 200 Chinese clinicians from two hospitals were enrolled to complete a survey on their attitude towards SDM. We conducted the survey via face-to-face interviews before and after an educational intervention on SDM among young Chinese clinicians. The clinicians were asked to give the extent of agreement to SDM. They also gave the extent of difficulty in using decision aids (DAs) during the SDM process. The variation in the range of responses to each question before and after the SDM intervention was recorded. The frequency of changed responses was analyzed by using JMP 6.0 software. Data were statistically analyzed using Chi-square and Mann—Whitney U tests, as appropriate to the data type. Multiple logistic regressions were used to test for those factors significantly and independently associated with preference for an approach for each scenario. Results: Of the 200 young Chinese clinicians sampled, 59.0% indicated a preference for SDM and a desire to participate in SDM before receiving education or seeing the DA, and this number increased to 69.0% after seeing the DA with the sample video of the SDM process on Statin Choice. However, 28.5% of the respondents still reported that, in their current practice, they make clinical decisions on behalf of their patients. The clinicians who denied a desire to use the DA stated that the main barriers to implement SDM or DA use in China are lack of time and knowledge of SDM.
文摘BACKGROUND Human immunodeficiency virus(HIV)is a major public health concern,particularly in Africa where HIV rates remain substantial.Pregnant women are at an increased risk of acquiring HIV,which has a significant impact on both maternal and child health.AIM To review summarizes HIV seroprevalence among pregnant women in Africa.It also identifies regional and clinical characteristics that contribute to study-specific estimates variation.METHODS The study included pregnant women from any African country or region,irrespective of their symptoms,and any study design conducted in any setting.Using electronic literature searches,articles published until February 2023 were reviewed.The quality of the included studies was evaluated.The DerSimonian and Laird random-effects model was applied to determine HIV pooled seroprevalence among pregnant women in Africa.Subgroup and sensitivity analyses were conducted to identify potential sources of heterogeneity.Heterogeneity was assessed with Cochran's Q test and I2 statistics,and publication bias was assessed with Egger's test.RESULTS A total of 248 studies conducted between 1984 and 2020 were included in the quantitative synthesis(meta-analysis).Out of the total studies,146(58.9%)had a low risk of bias and 102(41.1%)had a moderate risk of bias.No HIV-positive pregnant women died in the included studies.The overall HIV seroprevalence in pregnant women was estimated to be 9.3%[95%confidence interval(CI):8.3-10.3].The subgroup analysis showed statistically significant heterogeneity across subgroups(P<0.001),with the highest seroprevalence observed in Southern Africa(29.4%,95%CI:26.5-32.4)and the lowest seroprevalence observed in Northern Africa(0.7%,95%CI:0.3-1.3).CONCLUSION The review found that HIV seroprevalence among pregnant women in African countries remains significant,particularly in Southern African countries.This review can inform the development of targeted public health interventions to address high HIV seroprevalence in pregnant women in African countries.
文摘Prevention of mother-to-child transmission(PMTCT)of HIV with highly active antiretroviral therapy(HARRT)allows the HIV^+pregnant mothers to have vaginal delivery and breastfeed.Here we investigated the maternal plasma immunoglobulin,cytokine secretion and the outcome of the exposed infants among the HIV^+HAART treated pregnan women in Nigeria.In this study,different plasma immunoglobulins and cytokines were measured in the HIV^+HAART treated pregnant mothers.Pooled culture supernatants of B and T lymphocytes showed lower levels of IFN-γ,IL-10 and IL-4.There were lower IFN-γand IL-10 secretions at 1st trimester;however,IL-10 continued to be lower throughout 2nd and 3rd trimesters.TNF-αsecretion significantly decreased as pregnancy progressed to term.There were high plasma IgG and low IgM in the HIV^+HAART treated pregnant women.Plasma IgG was high during 1st and 3rd trimesters.After one year of follow up,all the exposed children were seronegative for HIV-1 and HIV-2.Vaginal delivery and breastfeeding among HIV^+HAART treated mothers have shown to be safe.The use of HAART by the infected mothers and the use of septrin and niverapin by the exposed infants prevented mother to-child transmission of HIV.
基金Specialized Project of Fuwai Hospital,Grant/Award Number:2022-FWTS07Shenzhen Sanming Project of Medicine,Grant/Award Number:2016-SZZF02+1 种基金National Natural Science Foundation of China,Grant/Award Number:81900343CAMS Innovation Fund for Medical Sciences,Grant/Award Number:CIFMS,2021-I2M-C&T-A-011。
文摘Background:To understand the relationship between myocardial contractility and ex-ternal stimuli,detecting ex vivo myocardial contractility is necessary.Methods:We elaborated a method for contractility detection of isolated C57 mouse papillary muscle using Myostation-Intact system under different frequencies,volt-ages,and calcium concentrations.Results:The results indicated that the basal contractility of the papillary muscle was 0.27±0.03 mN at 10 V,500-ms pulse duration,and 1 Hz.From 0.1 to 1.0 Hz,con-tractility decreased with an increase in frequency(0.45±0.11-0.10±0.02 mN).The voltage-initiated muscle contractility varied from 3 to 6 V,and the contractility gradu-ally increased as the voltage increased from 6 to 10 V(0.14±0.02-0.28±0.03 mN).Moreover,the muscle contractility increased when the calcium concentration was increased from 1.5 to 3 mM(0.45±0.17-1.11±0.05 mN);however,the contractility stopped increasing even when the concentration was increased to 7.5 mM(1.02±0.23 mN).Conclusions:Our method guaranteed the survivability of papillary muscle ex vivo and provided instructions for Myostation-Intact users for isolated muscle contractility investigations.
文摘<strong>Background: </strong>Urinary tract infections (UTIs) in women with bacterial vaginosis (BV) continue to pose tremendous health concerns and require appropriate use of antibiotics for effective case management. This study determined the prevalence, etiology and antibiotic resistance profile of uropathogenic bacteria isolated from sexually active women with BV in Lagos Nigeria. <strong>Method:</strong> A total of 258 sexually active women presenting with gynaecological complaints at the maternal and child unit of twenty Primary Health Care Centres in Lagos Nigeria from May 2017 to March 2018 were consecutively enrolled with consent. Bacterial vaginosis was diagnosed based on Amsel criteria. Midstream urine samples were collected aseptically, analyzed for bacterial pathogens and antibiotic susceptibility using standard microbiological methods. <strong>Results:</strong> BV was diagnosed in 184 (71.3%) with 69.2% also having UTI. Ninety four (36.4%) had UTI predominantly caused by Gram negative bacteria (96.8%). The organisms isolated were <em>Escherichia coli</em> 79 (84.0%), <em>Klebsiella pneumoniae</em> 5 (5.3%), <em>Pseudomonas aeruginosa</em> 4 (4.3%), <em>Proteus mirabilis</em> 3 (3.2%) and <em>Staphylococcus saprophyticus</em> 3 (3.2%). The pathogens elicited high resistance (66.7% - 100%) to tetracycline, amoxicillin-clavulanic acid, nitrofurantoin and cephalosporins, and moderate resistance (50%) to ofloxacin by <em>P. aeruginosa</em> strains. The isolates were susceptible (100%) to piperacillin-tazobactam and meropenem. Multi-drug resistance (MDR) was observed among 97.8% of the bacteria isolated. <strong>Conclusion: </strong>Findings from this study indicate high occurrence of UTI caused by MDR pathogens among sexually active women with BV with emerging evidence of poor clinical utility of nitrofurantoin and other commonly used first-line antibiotics against UTI. Further studies on non-bacterial aetiology of BV, molecular characterization of <em>S. saprophyticus</em> and Gram Negative Bacteria UTI
基金Supported by AREF/EDCTP,No.VARIAFRICA-TMA2019PF-2705.
文摘BACKGROUND The hepatitis B virus(HBV)infection is a global public health concern that affects about 2 billion people and causes 1 million people deaths yearly.HBV is a bloodborne disease and healthcare workers(HCWs)are a high-risk group because of occupational hazard to patients’blood.Different regions of the world show a highly variable proportion of HCWs infected and/or immunized against HBV.Global data on serologic markers of HBV infection and immunization in HCWs are very important to improve strategies for HBV control.AIM To determine the worldwide prevalence of HBV serological markers among HCWs.METHODS In this systematic review and meta–analyses,we searched PubMed and Excerpta Medica Database(Embase)to identify studies published between 1970 and 2019 on the prevalence of HBV serological markers in HCWs worldwide.We also manually searched for references of relevant articles.Four independent investigators selected studies and included those on the prevalence of each of the HBV serological markers including hepatitis B surface antigen(HBsAg),hepatitis e antigen(HBeAg),immunoglobulin M anti-HBc,and anti-HBs.Methodological quality of eligible studies was assessed and random-effect model meta-analysis resulted in the pooled prevalence of HBV serological markers HBV infection in HCWs.Heterogeneity(I²)was assessed using theχ²test on Cochran’s Q statistic and H parameters.Heterogeneity’sources were explored through subgroup and metaregression analyses.This study is registered with PROSPERO,number CRD42019137144.RESULTS We reviewed 14059 references,out of which 227 studies corresponding to 448 prevalence data among HCWs(224936 HCWs recruited from 1964 to 2019 in 71 countries)were included in this meta-analysis.The pooled seroprevalences of current HBsAg,current HBeAg,and acute HBV infection among HCWs were 2.3%[95% confidence interval(CI):1.9-2.7],0.2%(95%CI:0.0-1.7),and 5.3%(95%CI:1.4-11.2),respectively.The pooled seroprevalences of total immunity against HBV and immunity acquired by natural HBV infectio
文摘We report here the results of a prospective analysis of the pattern of antibiotics use over a one month period(May 2009)at two teaching hospitals in Sanandaj,western part of Iran.Data on antibiotic usage were obtained from the pharmacy services.Data was coded,computed and analyzed using SPSS version 11.5.A total of 1336 and 556 patients from Beasat and Tohid hospital respectively received antibiotic.Male patients represented 758(41.5 %)and females 1080(58.5 %)of the total number of patients evaluated by physicians at the two hospitals during the one month period.Usage of antibiotics varied from hospital to hospital;Beasat hospital had the highest usage.The ward-wise distribution of antibiotic use showed that the prevalence of prescribing was highest in the post partum ward(66.58%).Similarly,among Tohid hospital wards,men surgical ward and women surgical ward prescribed antibiotics significantly more than all other wards.The route of administration of antibiotics was parentrally for 85.5% and 88.2% at Beasat anf Tohid hospitals respectively.The distribution of use of individual antibiotics showed that cepfzoline was the most frequently prescribed antibiotics used at both the hospitals.Delivery(childbirth)and pneumonia were the most frequent diagnosed pattern for which an antibiotic was prescribed at Beasat and Tohid hospital respectively.In conclusion our study suggests that there is considerable scope for improving prescribing pattern among the practitioners and minimizing the use of antibiotics.The improvement would be facilitated by providing feedback,prescriber education and hospital formulary.
文摘Hemichorea with corresponding putamenal T1 hyper-intensity and T2 hypointensity on MR imaging has occasionally been reported in diabetes mellitus with nonketotic hyperglycemia. However, the signal intensity in pu-tamenal and cerebellum lesion on MR imaging, which is believed to be pathogenetically related to hemichorea, is rarely documented in diabetes mellitus with nonketotic hyperglycemia. We describe a 57-year-old man with nonketotic hyperglycemic hemichorea on his right arm and legs, whose signal intensity in putamenal and cerebellum lesion was demonstrated by MR imaging.
文摘<strong>Introduction: </strong><span style="font-family:""><span style="font-family:Verdana;">Fetal heart rate monitoring during labor is used to study fetal well-being and predict neonatal acidosis of newborn. Fetal heart rate monitoring is analyzed by the obstetrical team and categorized according to the FIGO guidelines. An important limitation of this diagnostic tool is an inter- and intra-observer variability, leading to subjective cardiotocography interpretation and classification. Our objective was to study the association between the categories of fetal heart rate analysis (according to FIGO classification) and neonatal acidosis of full-term newborns. </span><b><span style="font-family:Verdana;">Study design:</span></b><span style="font-family:Verdana;"> This is a multicenter retrospective cohort study conducted between 2014 and 2018 in the Grand-Est region. We searched and included retrospectively children hospitalized in a pediatric intensive care unit in one of the participating hospitals with an ICD-10 coding type “P91.6” corresponding to “Hypoxic Ischemic Encephalopathy”. Maternal, pregnancy, delivery, and newborn characteristics were collected and compared by univariate logistic regression with multiple imputation. Odds Ratio and 95% confidence intervals (CI) were calculated using the model and presented. Multiple imputation with m = 100 imputations was tested, using Rubin rules to combine the results. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">55 patients were included in the study. Fetal heart rate tracings classified in Category 3 as “pathological” according to FIGO guidelines were significantly associated with an increased risk of severe neonatal acidosis. Late decelerations and bradycardia during labor were associated with severe neonatal acidosis. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Severe neonatal acidosis may be suspected by interpretation of fetal heart rate
文摘AIM: To investigate the patient characteristics, relationship between the Logistic EuroSCORE (LES) and the observed outcomes in octogenarians who underwent surgical aortic valve replacement (AVR). METHODS: Two hundred and seventy three octogenarians underwent AVR between 1996 and 2008 at Bristol Royal Inf irmary. Demographics, acute outcomes,length of hospital stay and mortality were obtained. The LES was calculated to characterize the predicted operative risk. Two groups were def ined: LES ≥ 15 (n = 80) and LES < 15 (n = 193). RESULTS: In patients with LES ≥ 15, 30 d mortality was 14% (95% CI: 7%-23%) compared with 4% (95% CI: 2%-8%) in the LES < 15 group (P < 0.007). Despite the increase in number of operations from 1996 to 2008, the average LES did not change. Only 5% of patients had prior bypass surgery. The LES identifi ed a low risk quartile of patients with a very low mortality (4%, n = 8, P < 0.007) at 30 d. The overall surgical results for octogenarians were excellent. The low risk group had an excellent outcome and the high risk group had a poor outcome after surgical AVR. CONCLUSION: It may be better treated with transcatheter aortic valve implantation.
文摘The physical and mental development of pupils could be arrested by inadequate food intake and infection with immediate and long term consequences. This has implications on decreased school performances, lower intelligent quotient levels, poor psychosocial development, and decreased cognitive functions. This study assessed the growth and body fat distribution among pupils aged 5 - 19 years. A cross-sectional study was conducted among pupils from five primary schools in different communities around Kainji Dam. This assessment was based on a comparison with reference standards set by the World Health Organization to determine their deviations. A qualified registered nurse carried out physical measurements to obtain age, height, and body weight using electronic weighing scale and stadiometer. Data were analyzed using Anthroplusv1.0.4 software. The overall prevalence of stunting was 21.5% with 8% being severely stunted. The prevalence of thinness was 35.2% with 11.2% being wasted while the overall prevalence of underweight was not calculated for children > 10 years old. The prevalence of underweight for 5 - 10 years old children was 16.9% with 2.4% being severely underweight. The curves for both male and female children deviated from normal distribution. Females have higher percentage of stunting than males. This study revealed a high prevalence of thinness and stunting which is the consequence of poor nutrition arising from multifaceted and interrelated circumstances such as poor feeding, eating practices and repeated infection. Intervention such as Home Grown School Feeding Programme of the Government is a right step in improving the nutritional status of pupils in rural communities.
文摘Background: Although patients with acute headache frequently present in emergency department, the causes and predictors of short-term outcome in patients with acute headache in general neurology have not been adequately investigated. Methods: We prospectively reviewed the medical records of 130 hospitalized acute headache pa-tients in general neurology of China. Their initial CT scan was assessed, as was their lumbar puncture (LP) examination if performed. Results: The main cause of acute headache was acute secondary headache (80.8%), which was mainly attributable to acute cerebrovascular events (72.4%) followed by intracranial infection (19.0%). Among the 10.8% of patients who died during hospitalization most (85.7%) had subarachnoid hemorrhage (SAH). Significant predictors of survival were severe headache versus thunderclap headache, meningismus, de-layed loss of consciousness, and hypertension (all p < 0.05). Multiple logistic regression analyses showed significant differences in severe headache or thunderclap headache (OR, 0.255;95%CI, 0.066 - 0.990;p = 0.048) and delayed loss of consciousness (OR, 0.060;95%CI, 0.016 - 0.224, p = 0.000) between patients who died and those who survived. Conclusions: The main underlying cause of hospitalized acute headache was acute cerebrovascular events. Severe headache and delayed loss of consciousness are predictors for poor outcome of acute headache.
