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100 articles
Cervical Cancer Open Access

Uptake of Cervical Cancer Screening and Its Determinants among Refugee Women in Uganda: Insights from the Uganda Refugee Population-based HIV Impact Assessment

Dec 2025 DOI 10.14302/issn.2997-2108.jcc-25-5518
Steven KikonyogoCorresponding author

Cervical cancer is the fourth most common cancer in women globally, with 660,000 new cases and 350,000 deaths in 2022. The burden is disproportionately high in low- and middle-income countries (LMICs), particularly sub-Saharan Africa. Despite proven interventions like HPV vaccination and screening, uptake remains low. While cervical cancer screening has been studied in the general population, little is known about uptake among refugee women in Uganda, which hosts approximately 1.7 million refugees. This study examines cervical cancer screening uptake and associated factors among refugee women in Uganda. Methods We conducted a cross-sectional secondary analysis of the 2021 Uganda Refugee Population-based HIV Impact Assessment (RUPHIA) survey, focusing on women aged 21–49 in refugee settlements in the West Nile and South-Western regions, which host 90% of Uganda’s refugee population. The primary outcome was self-reported cervical cancer screening status. We used descriptive statistics and logistic regression to identify factors associated with screening uptake. Results Among 731 women, only 72 (9.8%) reported undergoing cervical cancer screening. The mean age of screened women was 37 years (±7), compared to 32 years (±8) for unscreened women. Screening uptake was significantly higher among women aged 31–39 years (AOR = 2.67, 95% CI: 1.32–5.52, p = 0.007), married women (AOR = 12.0, 95% CI: 1.76–163, p = 0.03), and those in polygamous relationships (AOR = 4.76, 95% CI: 1.96–11.1, p < 0.001) Conclusion Cervical cancer screening uptake among refugee women in Uganda is critically low. Integrating culturally sensitive screening programs into refugee health services and addressing socio-economic barriers could improve access and utilization.

Addressing an Overlooked Population: The Role of Discrimination and Violence in Depression Among South Asian Female College Students

Dec 2025 DOI 10.14302/issn.2641-4538.jphi-25-5852
Anirudhan RanjaniCorresponding author

South Asian female college students in the United States face mental health challenges shaped by intersecting experiences of discrimination and violence. This study examined how discrimination and violence contribute to depression in this population. An anonymous, cross-sectional, web-based survey (N=673) was distributed nationally through South Asian organizations, listservs, and social media. Validated measures assessed day-to-day discrimination, college-based discrimination, experiences of violence during college, and depression (PHQ-9). Bivariate analyses and multivariate linear regression examined associations, adjusting for sociodemographic factors. Over half of participants (51.1%) reported college-based discrimination, 66.1% reported experiencing violence during college, and 25.7% met the criteria for depression. In adjusted models, day-to-day discrimination (β=0.261, p<0.001) and college violence (β=0.207, p<0.001) were significant predictors of depression. Bisexual and questioning/unsure students also reported higher depression scores than heterosexual peers. Discrimination and violence are key social determinants of mental health among this population. Findings underscore the need for culturally responsive mental health services, intersectional campus policies, and evidence-based interventions to promote health equity among minority women in higher education.

Biochemical and Hematological Markers of Iron Status of the Populations in the Lekie Division of Cameroon

Apr 2025 DOI 10.14302/issn.2379-7835.ijn-25-5463
Fokou ElieCorresponding author

Iron deficiency is a major public health problem worldwide. It affects a significant proportion of the population, and is responsible for around 50% of anemia cases worldwide. Cameroon in general and Lekie Division in particular, is very highlyaffected by this problem. However, early detection of the problem can prevent the fatalities associated to it. The objective of this study was to provide up-to-date, detailed data on the markers of iron status in these populations, so that treatment can be better targeted. A two-month cross-sectional study was conducted in the Lekie Division in collaboration with local health centres in both urban and rural areas. The study sample consisted of 361 participants of all age groups and sexes. A questionnaire was issued to obtain information of the participants socio-demographic status, then 3 to 5ml of blood were collected and a number of markers of the participants iron status were studied. Of all the hematological markers studied, hemoglobin concentration in the study population was below normal in both men and women. Biochemical markers were good for all socio-demographic parameters. The mean values of biochemical and hematological markers in the population of the Lekie Division were good for all socio-demographic parameters, with the exception of hemoglobin concentration, which remains critical, requiring particular attention in this locality, but above all urgent intervention lest the situation aggravates further.

Ophthalmic Science Open Access

Glaucoma Literacy in a Portuguese Population

Dec 2024 DOI 10.14302/issn.2470-0436.jos-24-5322
Pestana Aguiar CatarinaCorresponding author

Studies show that individuals with limited health literacy skills experience worse health outcomes in a multitude of chronic diseases including glaucoma. These patients have poorer compliance, worse disease understanding and greater disease progression. The main purpose of our study was to evaluate the knowledge about glaucoma basic concepts in patients with this disease. A 24 question survey was given to patients followed by the glaucoma department, by phone or in person. Epidemiological data and personal therapeutic regimens were collected as well as data concerning the pathophysiology, treatment and prognosis of the disease. Survey responses were obtained from 79 patients with a mean age of 72 years old. Most of the patients had a low education level. The majority of patients could not enumerate glaucoma risk factors (74.5%), their glaucoma type (94.9%) or the best glaucoma definition (57%). However, they were able to relate the disease to a high IOP (75.9%) and the possibility of it leading to blindness (96.2%). We believe that patients, when observed in their glaucoma appointments, tend to retain information related to the prognosis and consequences of the disease and not focus on the understanding of its pathophysiology, causes and mechanisms, which may reflect their concern about their own future. However, this may lead to some misconceptions about the definition of glaucoma and specially about what can cause this disease. Some investment should be done to improve health literacy in the glaucoma population, with appropriate language and handed material.

Morphological Variations and Morphometric Analysis of Foramen Ovale in South Indian Population

Mar 2024 DOI 10.14302/issn.2577-2279.ijha-23-4886
Garapati SupriyaCorresponding author

Introduction The foramen ovale is located in the area where intracranial and extracranial structures meet. Procedures involving trigeminal neuralgia and mandibular nerve anaesthesia require an understanding of the foramen ovale's morphometry and anatomy. Our present study was conducted to define mean values and anatomical variations in foramen ovale. Aims 1. To establish the mean length, breadth and the Area of the foramen ovale. 2. And also to study different shapes and special features of the foramen ovale. 3. To compare the values of the present author with the previous studies. Methodology The study was carried out on100 foramen ovale using 50 dry adult human skull bones of unknown sex. Maximum transverse diameter, antero-posterior diameters of the foramen were measured with the help of vernier calipers. and the different shapes of foramen were noted. The data was analysed by using unpaired T test. Results The mean anteroposterior diameter on left side was 6.59±1.37 mm and on right side was 6.99±1.44 mm. The mean transverse diameter on the left is 4.09±0.74 mm and 4.17±0.76 mm on the right side. Incidences of various shapes of the foramen ovale were oval 70%, almond 11%, round 9%, elongated 6%, pear shaped 2 % and irregular 2%. Conclusions The findings from the current study may be useful for understanding the variations of these foramina for interventions in middle cranial fossa.

The Role of Non-Pharmacological Interventions for Disrupted Sleep in the Moderate-Severe Dementia Population: A Systematic Review

Feb 2024 DOI 10.14302/issn.2998-4211.jalr-23-4813
del Carmen Teruel Hernández EstherCorresponding author

This study systematically reviews the literature on non-pharmacological interventions for disrupted sleep-in people meeting established criteria for moderate-severe dementia, and to analyze the methodological quality of the included studies. The PubMed, PEDro, Cochrane, Virtual Health Library, APA PsycInfo databases were searched using a systematic literature review approach to identify various types of non-pharmacological treatments that improve disrupted sleep-in subjects with moderate-severe dementia. In accordance with the inclusion criteria, eight studies were systematically reviewed and analyzed according to the type of non-pharmacological treatment carried out. This systematic review showed that 50% of the studies used bright light therapy, 12.5% ​​the use of manual therapy, and 37.5% sleep hygiene or walking or a combination of these interventions. Based on the results of the present study, although there is some evidence to support these strategies, it is not significantly supported and highlights variation in the way the interventions were delivered. Disrupted sleep is highly prevalent in people with dementia and have a negative impact on the quality of life of the sufferer and the caregiver. Non-pharmacological approaches to its treatment are increasingly popular as an alternative to drugs, whose efficacy and side effects have raised concerns among the population. Currently, there is a need to carry out more future research to establish its effectiveness and to be able to provide clear guidelines at the time of clinical practice.

A Roadmap to Developing a Population-Based Colorectal Cancer Screening Program in Oman

Jan 2024 DOI 10.14302/issn.2641-4538.jphi-23-4856
Rashid AlKalbani SalmaCorresponding author

Colorectal cancer (CRC) is a major public health problem worldwide, as it is the third most common disease and the second leading cause of cancer-related fatalities. In recent years, Oman, like many other countries, has seen an epidemiological shift from communicable diseases to noncommunicable diseases, including colorectal cancer, necessitating comprehensive planning to address the root cause of the problem as well as a comprehensive screening program to detect diseases at an early stage and thus improve health outcomes. Colorectal cancer is the second most frequent cancer in Oman, with the highest mortality rate, inflicting considerable public health and economic consequences; nevertheless, there is no population-based CRC screening programme in place to minimise the disease's incidence, mortality, and severe health outcomes. This review highlights the epidemiology of colorectal cancer in Oman, the Wilson and Junger criteria, operational readiness, and recommendations for implementing a population-based colorectal cancer screening program.

Effect of Ultra-Processed Foods Consumption on Sleep Disturbances Among Brazilian Adults’ Population: A Propensity Score Matching Approach

Dec 2023 DOI 10.14302/issn.2574-4518.jsdr-23-4775
Zanga RosendoCorresponding author

Background Diet, exercise and sleep are three pillars of a healthy life. These lifestyle factors influence one another in complex and dynamic ways. Consistent evidence exists about the bidirectional relationship between sleep patterns and food intake. Objectives We aim to assess the effect of the ultra-processed food(UPF) consumption on sleep disturbances in a sample of the Brazilian adults. Method We analyzed 77,298 persons aged 18 and older from the Brazilian National Health Survey (2019). A Propensity Score Matching (PSM) approach was used to address confounding bias and balance the matched exposed and control groups. The population average treatment effect (PATE) and the population average treatment effect on the treated (PATT) were estimated. Also, the Absolute Risk Increase and the Relative Risk Increase were computed. Results The findings revealed that Brazilian adults who consumed UPF experienced small but statistically significant sleep disturbances compared to non-UPF users. Furthermore, salty UPF showed small but significant worsening of sleep compared to sweet UPF users. Conclusion The consumption of UPF is associated with sleep disturbances in Brazilian adults. The consumption of salty UPF had a more significant effect on sleep disorders than sweet UPF in the overall population. However, among individuals who already consumed sweet or salty UPF, these foods had a more significant effect on sleep disorders. To gain a deeper understanding of the complex relationship between UPF consumption, sleep disorders, and their impact on health and quality of life, further research is needed, including precise measurements and consideration of personality traits using prospective designs.

Human Health Research Open Access

Assessment of Oral Health-Related Quality of Life Among a Sample of Yemeni Population

Mar 2023 DOI 10.14302/issn.2576-9383.jhhr-22-4178
Abdulwahab Al-Shamahy HassanCorresponding author

The study aimed to assess the oral health condition and its impact on the quality of life (QoL) among a sample of Yemeni population. The study including 256 individuals who responded to the Oral Health Impacts Profile (OHIP) through completing a face-to-face survey of the OHIP-14 Arabic version. The data were collected by one dentist trained in the terms of oral health-related quality of life (OHRQoL). The study revealed that the impact of OHRQoL among the study sample was found with a weighted OHIP-14 score of 1.1 (±0.9). Physical pain (3.7±2.3), followed by physical disability (2.4±2.2), and psychological disability (2.1±2.3) were the highest scoring. A significantly higher effect (p < 0.05) was found for the adults (18-44 years old) compared to those elderly individuals (> 64 years). The OHRQoL was better in male than in female and in employees than in both pensioners and un-employees. Females had a significantly higher effect when compared to males in the OHRQoL (p < 0.05). The unemployed subjects were significantly higher than those pensioners and employees in the OHRQoL (p < 0.05). The OHRQoL was also better in subjects with higher income and education than those participants with low. However, there were no significant differences for OHRQoL with respect to the educational level and monthly income of participants (p > 0.05). Conclusion, the quality of life is greatly affected by the oral health conditions of the elderly. This impact of oral health on quality of life has an association with individual and contextual variables.

Characterization of The Oncogeriatric Population Attended at the Arturo López Perez Foundation (Falp) Cancer Institute

Nov 2022 DOI 10.14302/issn.2372-6601.jhor-22-4344
Rocio QuilodranCorresponding author Geriatricians, Arturo Lopez Perez Foundation, Chile

This study characterizes an oncogeriatric cohort at a cancer institute, reporting tumor types, comorbidities, geriatric assessments, and treatment patterns. Findings inform service planning and individualized care for older adults with cancer.

Pandemic Impact on Population Structure

Oct 2022 DOI 10.14302/issn.2692-1537.ijcv-22-4319
V. Ezepchuk YuriiCorresponding author Professor of Biochemistry, Denver, Colorado, USA

The victims of the first wave of the pandemic caused by the coronavirus Covid-19 were tens of millions of people in the population inhabiting the Earth. A previously unknown strain of Covid 19, which has a specific affinity for lung tissue and high contagiousness, has demonstrated a global danger to the life of the population of the entire planet. The pathogenicity of the virus is due to a three-segment structure, in which the RNA-containing segment, which is a pathogenicity factor responsible for specific lesions, most likely has an enzymatic nature.

Expression of Concern: Potential Risks and Unknown Effects of mRNA Vaccines on Population Health (6th Rev). Damages Are Being Materialized

Mar 2022 DOI 10.14302/issn.2692-1537.ijcv-22-4117
Wu JianqingCorresponding author Healthier World (Independent researcher for cause), P. O. Box 689, Beltsville, MD 20704. USA

Several mRNA vaccines are used on the population in the U.S. I started predicting the dangers of mRNA vaccines before March 2021 and update my findings periodically. My prior model study enabled me to identify many flaws in clinical trials, side-effect evaluation methods and mechanism studies, and I also considered consistent failure in predicting drug side effects in the past and systematic failure of FDA in keeping out dangerous drugs from market. I found that the risks of vaccination cannot be determined by experiments alone and must be determined by using a combination of methods. By studying mRNA expression dynamics and kinetics, I predict that vaccination with mRNA vaccines may increase cancer risks, multiple organ failure risks, earlier death risks, genome alteration speeds by one or more mechanisms, alter the normal selection process for viral evolution resulting in more virulent viruses, and aggravate chronic diseases or cause healed diseases to relapse. Two root problems are practical inability to control expression sites and severe adverse reactions from repeated vaccination. Based on mRNA bio-distribution, the mRNA mainly strikes the liver and other vital organs, and poses grave dangers to persons whose vascular functional reserves are relatively small, or whose vascular systems are temporarily burdened by other causes such as viral infections or life activities. If an mRNA vaccine is administered on a pregnant woman by second or booster shots, spike protein synthesis in fetus brain disrupts the highly regulated protein synthesis processes, resulting in potential brain damages. In less than a year, most of my early predicted damages are being materialized or are on the track to hit the population. In this update, I present a benefits-and-risks map to show how the number of deaths caused by mRNA vaccines is grossly underestimated and why claimed benefits like 95% effectiveness rate and 90% death rate reduction are meaningless and misleading.

Clinical Use of Peptide-Based Formula (Peptamen Junior®, Nestle) in the Paediatric Population

Jan 2022 DOI 10.14302/issn.2379-7835.ijn-21-4059
Ford KristynCorresponding author Bachelor of Nutrition and Dietetics, Accredited Practising Dietitian (APD), Department of Nutrition and Dietetics, The Royal Children’s Hospital, Melbourne Australia, Address: 50 Flemington Road, Parkville VIC 3052

Aim There is limited published data describing the characteristics of the paediatric population prescribed semi elemental formulas. This retrospective observational audit aimed to describe the characteristics of the paediatric patients who have been prescribed a hydrolysed whey protein, medium chain triglycerides (MCT) based formula, Peptamen Junior® and the nutritional outcomes. Methods A retrospective observation audit was completed on a cohort of patients that was prescribed a semi elemental formula between 2016 and 2019 from a single tertiary paediatric medical centre. Data variables were collated such as patient characteristics, indications and modalities of administration, duration and tolerance to the formula. Results Data was collated on 375 patients with a median age of 6.2 years. The main underlying medical conditions were haematological/oncology (67%), gastrointestinal disorders (10.7%) and neurological conditions (9.4%). The most common indications for use were chemotherapy related side effects (36.2%), post bone marrow transplant (25.8%) and gastrointestinal symptoms (17.9%). The formula was rarely used as a sole source of nutrition, with 88% patients requiring accompanying forms of nutrition support. The majority of orders prescribed were of standard concentration (80.8%) and tolerance was recorded in 82.8% of patients. Conclusion The semi elemental formula Peptamen Junior® appears to be well tolerated in paediatric patients with a variety of medical conditions that have complex pathologies and may have wider scope of use in a more diverse group of medical conditions than currently indicated.

A Cross Section Survey Assessment Study on the Knowledge and Practice of Periodic Medical Check up among the Saudi population

Oct 2021 DOI 10.14302/issn.2377-2549.jndc-21-3977
Shakeel Iqubal S.M.Corresponding author Department of General Science, Ibn Sina National College for Medical Studies, Al Mahajar Street: 31906, Jeddah 21418, Kingdom of Saudi Arabia

In Saudi Arabia most of the individuals give very little attention to issues like health or no priority to medical checkup. This investigation was carried out to measure knowledge, practice of periodic medical checkup in Kingdom of Saudi Arabia people. A cross-sectional investigation was conducted among 1015 participants. A structured interviewer administered an online questionnaire were distribute by social media and whatsApp. We collected data and analyzed using SPSS version 21. Association between categorical variables were explored using bar chart and tables, Level of significance was set at 5%. The main age of the respondents was 21-30 years, 78.4% were females and 64.2% were married. About 42.1% have ever heard of periodic medical check-up , 57% of those who haven’t ever heard of periodic medical checkup and only 21.9% among those who had ever done it had frequent medical check-up and 78.1% didn’t do it. Attempt is required in ensuring that periodic medical check-up is urged. There is a need to study the factors associated with the uptake of medical check-up among the study population and effort should be made by health agencies to educate traders on the various types of medical check-up, their indications and benefits as well as its practice encouraged

Factors Affecting Atlantic Salmon Populations Adversely; Using the River Dee, Scotland, as an Example

Jul 2021 DOI 10.14302/issn.2643-0282.imsj-21-3899
Hawkins AnthonyCorresponding author Loughine Ltd, Kincraig, Blairs, Aberdeen AB12 5YT, UK.

The stocks of the Atlantic salmon (Salmo salar) in many rivers in North America and Europe have declined in recent years and are experiencing a crisis. Despite their high degree of legal protection, the quality of their aquatic environments within rivers and in the sea, including local coastal waters, appears to be deteriorating. Salmon survival, has declined both within the sea and within rivers. The status of the Atlantic salmon stocks is considered here, together with the adverse effects of different sources, and those steps that may need to be taken to improve the condition of the salmon. This paper is intended to assist management bodies in taking steps to resolve the problems that exist for salmon, both within rivers and in the sea. It makes particular use of information available on the River Dee in Scotland.

Variations in Diameter of the Left Coronary Artery and its Main Branches among Adult Population of Khartoum State, Sudan

Mar 2021 DOI 10.14302/issn.2329-9487.jhc-21-3754
Abdalla AbuzerCorresponding author Department of Anatomy, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia

Themain left coronary artery and its branches have wide variability in its morphology regarding caliber, as seen through angiographic imaging. This study aims to determine the diameters of the left coronary artery and its branches among the Sudanese population & to correlate these diameters and the personal and health data. Angiography of 441 patients of both sexes was used in this study. Personal and health information was obtained from the records. We found that the left coronary artery's diameter was between 2.90- 4.90mm, with an average of 3.96mm. The diameter of the left circumflex artery in the range between 1.70- 4.70mm, with an average of 2.73mm, and that of the anterior descending artery in the range between 1.20- 4.70mm, with an average of 2.78mm. We correlated the diameters of the three arteries and the variables of age, gender, BMI, coronary artery disease, smoking habits, and hypertension. Wefound many correlations to be significant. We concluded that the diameters of the left coronary artery and its branches are affected by age, gender, BMI, coronary artery disease, smoking habits, and hypertension.

Analytical Solutions of the Transmissibility of the SARS-CoV-2 in Three Interactive Populations

Feb 2021 DOI 10.14302/issn.2692-1537.ijcv-21-3732
Isea RaúlCorresponding author Fundación Instituto de Estudios Avanzados, Hoyo de la Puerta, Baruta, Venezuela.

This paper resolves analytically a mathematical model that reproduces the transmission of Covid-19 in three interactive populations, i.e. from the initial source of contagion associated with the bat population, subsequently transmitted to unknown host (usually associate with pangolins). The host were sent and distributed to Seafood Market in Wuhan (defined reservoir), and finally infected to the human population. The model is based on a system of ten differential equations reproducing all the possible infection scenarios among all of them, that is: (1) there is no infection in any of the three populations, (2) only the population of bats is infected, (3) only the pangolins, (4) only the human people. Later, combinations between them, this is: (5) both the bat and pangolin populations, (6) bats and humans, (7) pangolins and humans, and finally, (8) all the previous populations. In each scenario, I deduced the critical points as well as the eigenvalues ​​that indicate the equilibrium conditions. Finally, it is demonstrated the validity of the model with the data corresponding to the second wave of infections in Australia.

Genetic Engineering Open Access

Genetic-Mathematical Modelling of the Populations Interaction

Sep 2020 DOI 10.14302/issn.2694-1198.jge-20-3515
Volobuev A.N.Corresponding author Samara State Medical University. Department of Medical Physics. Samara, Russia

The solution of a genetic-mathematical problem of interaction of the human population cells and virus population to a problem of pandemic COVID-19 is submitted. The mathematical model based on the Hardy - Weinberg law consisting of two interdependent differential equations is used. The equations reflect time dynamics of the human cells and virus populations during their interaction. Solutions of the differential equations are found and results of these solutions are analyzed. The estimation of duration pandemic is received at use of parameters of the human liver cells and a flu virus.

The Prevalence of Osteoporosis in Hiv Infected Patient and its Correlation with Cd4 Count/Clinical Staging in Indian Population

Aug 2020 DOI 10.14302/issn.2324-7339.jcrhap-20-3003
Kant Tiwari SatyaCorresponding author Department of Internal Medicine, All India Institute of Medical Sciences, India

Human immunodeficiency virus (HIV) is a retroviral disease in which the viruses copy their genetic material into the genetic material of the human beings. Infected cells remain infected for the whole of their life. First discovered in the year 1981, Human immunodeficiency virus infections is considered to be a pandemic by the World Health organization.

Educational Needs of Mothers about using Oral Rehydration Salt (ORS) at Home During Acute Diarrhea in Children under 5 at Urmia Population Research Center

Apr 2020 DOI 10.14302/issn.2641-4538.jphi-20-3296
Rezapour BarataliCorresponding author Department of Public Health, Faculty of Health, Assistant Professor, PhD in Health education and promotion, Urmia University of Medical Sciences, Urmia, Iran

Preventable factors such as infectious diseases (pneumonia, diarrhea, and malaria), malnutrition and neonatal complications are still the leading cause of child mortality worldwide 1 In 2013, it is estimated that 6.3 million babies born worldwide died before the age of 5, and approximately 9.2% of these deaths were due to diarrheal diseases 23 in simple, accessible ways, and effective treatment can reduce diarrhea-related mortality and make hospital admissions unnecessary, and the role of mothers is the most important 4. Since the presentation of Oral Rehydration Therapy (ORT) in 1979, mortality has reduced. Diarrhea has had a steady downward trend 5. If mothers who have children under 5 years of age, used correctly ORS, they could easily resolve the problem of dehydration in acute diarrhea 6. Mothers didn’t use correctly ORS because of their Low literacy and lack of knowledge and wrong attitude about ORT7. Some health care workers provide mothers’ required equipments, regardless of their educational needs, and mothers may not use ORS. In this study, health workers identified mothers' educational needs and subsequently they trained them about using ORS at home in acute diarrhea in children under 5 years of age.

Reproductive Parameters of Three Populations of Oreochromis Niloticus (Linnaeus, 1758) in the Sudano-Guinean Altitude Zone of Cameroon

Mar 2020 DOI 10.14302/issn.2691-6622.ijar-20-3257
Nsangou Amidou KpoumieCorresponding author Department of Animal Sciences, University of Dschang, Cameroon

In order to contribute to the improvement of aquaculture production, reproductive parameters of three populations of Oreochromis niloticus of Cameroon were studied between March and May 2019 at the research station of Foumban. At this effect, a total of 81 parents (27 males and 51 females with respective weight 124 ± 6g and 144 ± 5​​g) coming from three hydrogeographicals origins (Niger, Sanaga and IRAD Station) were randomly distributed in triplicate in nine concrete tanks of a m² each with a sex ratio of one male for two females (1♂/2♀). Throughout the test, six females carrying eggs in the oral cavity were collected in each population and 45 days after the start of the trial, all the offspring were collected and the adults sacrificed. At the end of experiment, the IRAD population presented highest significant values (p ≤ 0.05) regardless of the performances considered. The values of the gonado-somatic and the gonado-metric characteristics significantly lower (p ≤ 0.05) were obtained in Niger population (GSR = 0.04 ± 0.02, GSI = 0.05 ± 0.03 and GMR=0.19 ± 0.08;GMI= 0.24±0.07). Considering sex, males presented the lowest significant values (p ≤ 0.05) for all the characteristics studied (GSR = 0.04±0.01, GSI = 0.04±0.01 and GMR= 0.23±0.08;GMI= 0.29±0.09).

Genetic Engineering Open Access

Inbreeding in a Family Tree and in a Population

Mar 2020 DOI 10.14302/issn.2694-1198.jge-20-3206
Volobuev A.N.Corresponding author Samara State Medical University. Department of Medical Physics. Samara, Russia

On the basis of Hardy – Weinberg’s law the problem of inbreeding in a family tree and a population was investigated. With use of an inbreeding factor are received the discrete equation for a family tree and differential equation for a population. The numerical solution of the differential equation for a population was found and analyzed at various values of the inbreeding factor. Migration of inbred population is investigated in view of natural selection. It was shown that velocity of migration falls with increase of the inbreeding factor. Interrelation of the recessive allele frequency at woman for a migrating population with inbreeding factor and standard parameter of selection was found.

Genetic Engineering Open Access

Migration of a Population

Jan 2020 DOI 10.14302/issn.2694-1198.jge-19-3141
Volobuev A.N.Corresponding author Samara State Medical University. Department of Medical Physics. Samara, Russia

On the basis of Hardy – Weinberg law the problem of migration from the genetic point of view is considered. It is proved the linear differential equation of migratory process of a panmictic population. The phase of the solution of this equation is investigated. On the basis of the carried out analysis the dependence of migration velocity of a population on average time of alternation of generations is found. It is shown that migration of primitive people from Africa to Europe needed alternation the several hundred generations. The dependence of migration velocity of a population on the average area developed by a population for year is investigated. Lacks of the carried out analysis owing to absence of the account of natural selection and inbreeding are marked.

D Allele and DD Genotype of I /D Polymorphism in The ACE Gene in Patients with Hypertension, Stroke And Cancer Prostate In Libreville: A Concern Given The High Frequencies of these Signatures in Gabonese Population

Dec 2019 DOI 10.14302/issn.2326-0793.jpgr-19-3114
Ollomo BenjaminCorresponding author Unité Mixte de Recherches (UMR-BIOMED), Faculté de Médecine, B.P 8507 Libreville, Gabon

Background During the last two decades, the polymorphism of Angiotensin-Converting Enzyme (ACE) gene has been extensively studied among different human populations. In humans, several studies have shown the relationship between this polymorphism and the risk of many serious diseases with a heavy burden of health in developing countries. After analyzing the polymorphism in the population, the present study was also concerned with the investigation of an eventual association between hypertension, stroke, cancer prostate and I/D polymorphism of the ACE gene. Materials and Methods Our study population included 163 Baka (pygmy) and 158 Fang (Bantu) from Gabon to evaluate the polymorphism in the country. Concerning the diseases, we included 105 patients and 120 controls for hypertension, 37 patients stroke matched with 50 controls and 97 patients with prostate cancer were recruited. All participants in the study were genotyped for the ACE I/D polymorphism obtained by polymerase chain reaction amplification on genomic DNA. Results Our analysis showed that the ACE D allele DD genotype frequencies were highest of all the data so far in human populations. We obtained a frequency of 0.138 for I allele and 0.862 for D allele among pygmy and the frequencies of 0.313 and 0.687 respectively for the I and D alleles. This difference was significant (p<0.05). In patients, we revealed the predominance of D allele and DD genotype for hypertension (0.27 for I allele and 0.73 for D allele), for stroke (0.15 for I allele and 0.85 for D allele) and 83% of individuals with cancer prostate carry the D allele. D allele and DD genotype are associated with risk to hypertension whereas allele I seem protective at the occurrence of stroke (p<0.05 between healthy and controls). Conclusion We show that the D allele and DD genotype were higher in this population. Also theses two signatures may be associated at genetic risk of hypertension, stroke and prostate cancer in this country deprived of human resources for quality care of many patients.

Monitoring Mast Cell Populations in Waldenström’s Macroglobulinemia: A Xenotransplantation Study

Dec 2019 DOI 10.14302/issn.2372-6601.jhor-19-3092
S. Tsingotjidou AnastasiaCorresponding author Laboratory of Anatomy, Histology and Embryology, Faculty of Veterinary Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, GR-541 24, Greece

Waldenström Macroglobulinemia (WM) is a B-cell lymphoproliferative disorder characterized mainly by uncontrolled accrual of M- immunoglobulin, secreted by malignant lymphoplasmatic cells. Mast cells interacting with malignant B-cells play an important role at the manifestation of the disease. Utilizing a previous xenotransplantation mouse model, this study evaluates long-term implant viability and quantifies distinct bone marrow mast cell populations along with their dynamics in non-WM and WM human bone implants. Non-WM bone implants were obtained from the femoral head of adult humans undergoing hip arthroplasty or hemiarthroplasty, whereas WM human bone implants originated from bone biopsies obtained from the posterior iliac crest of patients with active WM. All bone particles were implanted intramuscularly in twenty-four NOD/SCID mice. Following 3, 4 or 8 months postoperatively, xenografts were removed and studied using special histological techniques to identify mature and immature mast cells. Xenografts survived up to 8 months after implantation presenting normal cytoarchitecture (non-WM) or high-grade neoplastic infiltration and microresorption (WM bone biopsies). Statistical analysis of mast cell populations showed significant elevation regarding time progression and bone marrow microenvironment, thus suggesting the possible influence of malignant cells to the mast cell population in WM. This study presents the extended survival of intramuscular implantation of human adult bone xenografts into NOD/SCID mice and provides additional information on the interaction between mast cells and malignant B-cells.

Genetic Engineering Open Access

Natural Selection in a Population is a Problem of Nonlinear Genetics

Dec 2019 DOI 10.14302/issn.2694-1198.jge-19-3079
Volobuev A.N.Corresponding author Samara State Medical University, Department of Medical Physics, Samara, Russia

The problem of natural selection against recessive homozygotes in a population is investigated. It is shown that natural selection of mutant alleles linked with the Х-chromosome in a population at women is described by the nonlinear differential equation of the third order. The order of the differential equation characterizes a power of selection. It is marked that the high order of the differential equation of natural selection allows level all mutational processes in Earth populations.

An Anatomical Study of the Tibia in the North Indian Population

Oct 2019 DOI 10.14302/issn.2577-2279.ijha-19-3053
A TiwariCorresponding author MBBS II Year, School of Medical Science & Research, Sharda University, Greater Noida.

Introduction The human tibia is a complex anatomical unit and the knowledge of its morphometric values is important in Forensic, Anatomic and Radiological cases in order to identify unknown bodies and stature. Objective It was to analyze the tibia, its morphometry, side difference and to investigate the position of nutrient foramina in tibia. Methods In this study, 60 adult human tibias (30 right and 30 left) were obtained from the Department of Anatomy SMSR SHARDA UNIVERSITY. In the study a total of two parameters i.e. Cross Section Index in the middle and Cnemicus Index of the bones were obtained and evaluated by using two instruments- a Measuring Tape and a Vernier Calipers. All the bones were dry and showed normal anatomical features. Results The mean Cross Section Index in the middle was calculated as 80.42 ± 11.33 on the right side and 78.15± 12.78 on the left side; and the Cnemicus index was 78.40 ± 13.19 on the right side and 70.84 ± 11.38 on the left side Conclusion The two parameters in the North Indian population were compared with other populations. The values were found to be almost comparable however there were subtle differences between different populations. The position of nutrient foramen was also assessed. This knowledge will thus help further researchers and orthopedic surgeons in various procedures like joint replacement therapy, fracture repair, bone grafts and vascularized bone microsurgery as well as in medico‐legal cases.

Genetic Engineering Open Access

Genetic-Mathematical Modelling of Mutational Processes in a Population

Jul 2019 DOI 10.14302/issn.2694-1198.jge-19-2756
Volobuev A.N.Corresponding author Samara State Medical University, Department of Medical Physics, Samara, Russia

Processes of genetic-mathematical modeling of a population development are considered. A basic distinction in the mathematical description of a family tree and a population is shown. In a family tree alternation of generations has discrete character. In a population there is a continuous alternation of generations. The method of the differential equations is applied for the description of a population. It is shown that mutational process in a population can be described with use of a Green’s function. For radiating influence on a population the universal evolutionary law is found.

L162v Polymorphism of Par-Α Gene, A603g Polymorphism of Tissue Factor Gene and Risk of Coronary Heart Disease in Russian Population

Jun 2019 DOI 10.14302/issn.2374-9431.jbd-19-2788
Sergeeva E.G.Corresponding author First Pavlov State Medical University of St. Petersburg

Purpose The goal of this study is to determine the association of L162V polymorphism of PPAR-alpha gene, A603G polymorphism of tissue factor gene and the risk of coronary heart disease development in Russian population.   Materials and Methods A clinical and genetic study of 414 patients with CHD and 220 people of comparable age without CHD which amounted to a control group was performed. L162L and L162V genotypes of L162V polymorphism of PPAR-α gene, A603A, A603G and G603G genotypes of A603G polymorphism of tissue factor gene were determined by polymerase chain reaction followed by restriction analysis. Results A carriage of L162V genotype and V allele of PPAR-α gene was associated with an increase risk of CHD in 2,13 times (L162V genotype) and in 2,21 times (V allele), with an increase in risk of CHD before the age of 45 years in 4,68 times (L162V genotype) and in 3,88 times (V allele). Significantly higher in patients with CHD compared with the general population and in patients with a carriage of G603G genotype and G allele of tissue factor gene was associated with the increase of CHD risk in 2,68 times (G603G genotype) and in 4,37 times (G allele), occurred more frequently in patients with debut of disease at age of 45 years and younger. The level of tissue factor was significantly higher in patients with CHD – carriers G603G genotype compared with carriers A603A genotype (217,9±15,2 pg/ml and 152,6±30,4 pg/ml, respectively, p=0,04). A carriage of the combination of L162V and G603G genotypes was associated with an increased risk of CHD in 3,04 times. Conclusion A carriage of V allele of L162V polymorphism of PPAR-α gene and G allele of A603G polymorphism of tissue factor gene, as well as their pair combination are associated with an increased CHD risk, especially at age 45 years or less.

Correlation of Human Height with Hand Dimensions: A Study in Young Population of Central India

Feb 2019 DOI 10.14302/issn.2577-2279.ijha-19-2609
HS KadlimattiCorresponding author Professor of Anatomy, Department of Anatomy, ESIC Medical College Gulbarga, Karnataka, India

Background and Objective Identification of sex, age, race and stature is the most important aspect of any forensic investigation. There is a strong correlation of stature with hand dimensions and if either of the measurements is known, the other can be calculated. With this objective, the present study was designed to correlate the hand dimensions with stature of an individual and to record the standard deviation in the estimation of stature. Methodology This cross-sectional study was conducted amongst 1000 participants (500 male and 500 female) of ESIC Institute Gulbarga over a period of 14 months. Hand dimensions along with stature and weight were measured. Linear regression coefficient was calculated. Results Mean stature was 161.88 cm. Mean hand length was 18.11 cm on right side and 18.10 cm on left side. Mean hand breadth was 9.91 cm on right side and 9.83 cm on left side. Conclusion Highly significant difference in right and left side mean hand length and breadth measurements was observed. Also observed was a strong positive statistically significant correlation between height and hand dimensions. This data might be useful for forensic, epidemiological and anthropometric studies where stature determination is of utmost importance.

Narcolepsy With or Without Cataplexy In The Pediatric Population: A Systematic Review

Jun 2018 DOI 10.14302/issn.2574-4518.jsdr-18-2071
Sedky KarimCorresponding author Professor of Psychiatry and Medical Student Clerkship Director, CMSRU, Camden, NJ.

Study Objectives: Narcolepsy diagnosis has been associated with a long lag time between the onset of the disorder and the diagnosis itself among patients with the disorder. This article reviews the childhood epidemiology of idiopathic narcolepsy, including its prevalence, subtypes, and disease progression. Methods: A literature review was conducted to include both published and unpublished data on pediatric narcolepsy. All English language articles were included through April, 2015. Results: Time from symptom onset to diagnosis for children is approximately three years. The prevalence of cataplexy appears to be lower in children compared to adults, suggesting a later onset of cataplexy. The presence of cataplexy, however, was unrelated to demographic factors and laboratory findings. Conclusion: There is a substantial lag-time between initial symptom presentation and diagnosis in children with narcolepsy. A less quintessential presentation of narcolepsy might occur in children relative to adults, making diagnosis more challenging. Continued improvements in narcolepsy education for both pediatricians and parents might facilitate earlier identification and diagnosis of the disease, thus leading to improved outcome.

Genetic Diversity of Large Japanese Field Mouse Apodemus speciosus Populations and Identification of their Food Plant Resources using DNA Barcoding in an Industrial Green Space

May 2018 DOI 10.14302/issn.2637-6075.jpae-18-2062
Fujii TaichiCorresponding author Graduate School of Bioscience and Biotechnology, Chubu University, 1200 Matsumoto-cho, Kasugai, Aichi, 487-8501, Japan

Estimates of the genetic diversity of Large Japanese field mouse Apodemusspeciosus populations and identification of their plant food resources were conducted in an industrial green space, where were constructed on reclaimed land and belonged to the Aichi Refinery of Idemitsu Kosan Co., Ltd., in Aichi Prefecture, Japan. A total of six mitochondrial D-loop haplotypes were identified in 50 mice. Habitat condition with the highest number of captured individuals had abundant broad-leaved trees and understory vegetation. A minimum spanning network, which did not form a ring-shaped network, revealed that the hereditary population structure was weak. The low genetic diversity observed in the study area was thus attributed to isolation from other populations once the population in the study area by sea and road, which is more than 30 m wide. In order to identify which plant food resources were utilized by mice captured inside the industrial green space, partial chloroplast rbcL sequences were amplified by PCR from DNA extracted from 43 feces samples. Calculations of sample completeness curve revealed that 25 of the taxa identified in this study comprised approximately 90% of the food plant resources in the study area. Of the 21 plant families identified from the obtained rbcL sequences, members of the Rosaceae (28.0%), Fagaceae (17.2%), Lauraceae (14.2%) and Oleaceae (7.7%) were dominant. To ensure the continued survival of A. speciosuspopulation in this industrial green space would be to preferentially conserve plant species that are used as food resources by this species.

Evaluation of Bacterial Population in the Saliva of Drug Addicts

May 2018 DOI 10.14302/issn.2473-1005.jdoi-18-2115
Zahoor MuhammadCorresponding author Department of Chemistry, University of Malakand ChakdaraDir (Lower), Pakistan.

Background: The human mouth harbors over 700 microbial genera. The large number of them is normal bacteria; few of them are opportunistic pathogens. Objective: The study was aimed to evaluate the bacterial population of drug addicted persons and compare it to that of a normal healthy person. Methods: Five different samples of human saliva; alcohol drunken person, oral moist snuff user, cigarette, hashish and shisha smoker were investigated the involvement of bacteria in them. One sample was collected from normal non-addict person. The bacterial population in drug addictive persons were compared that on normal non-addictive person. Results: The bacteria observed were: Gram negative cocci, mono cocci, streptococci, vibrio, gram negative rod, gram positive staphylococcus, gram positive streptococci and gram-positive rod. Conclusion: The order of bacterial population was; alcohol drunken person<oral moist snuff user ˂ cigarette smoker ˂ hashish smoker ˂ shisha smoker˂ normal non addictive person. From the findings in this study it is concluded that all these drugs have some antibacterial activities.

High Rate of Asymptomatic Myocardial Ischemia in HIV Infected Population in Bobo-Dioulasso in Burkina Faso

Nov 2016 DOI 10.14302/issn.2324-7339.jcrhap-16-1271
S. J. B. TougooumaCorresponding author

Introduction The cardiovascular complications have became the 3rd cause of death and the 4th reason for hospitalization of the patients infected by the HIV. The objective of this work was to determine the frequency of asymptomatic myocardial ischemia among patients infected by the HIV receiving antiretroviral therapy. Patients and Methods It was a descriptive cross-sectional study which was conducted in November 2015. The patients infected by HIV1 receiving antiretroviral treatment, with asymptomatic myocardial ischemia were included in the study and they were followed up in the HIV clinic of the in Infectious diseases service of the University Hospital Souro Sanou of Bobo-Dioulasso(CHUSS).. The includes patients benefited from a collection of cardiovascular risk factors, and of two measurements of the blood pressure in a sitting position after 10 minutes of rest and an electrocardiogram 12 derivations after rest. Results A total sample of 123 patients infected by HIV1 was selected, with a median age of 42 years (IQR: 36-50). It was composed of 79% of female. The cardiovascular risk factors found were distributed as follows: HTA (31.7%), obesity (33%), dyslipidemia (10.57%), active smoking (0.8%), diabetes (0.8%). All the known hypertensive cases (5.7%) were insufficiently treated. The median duration of exposure to the antiretroviral therapy was 5.3 years (IIQ: 3-7.7). The disorders of the repolarization were observed in 26 cases (21.13%). They were divided into under epicardic ischemia in 20 cases (16.26%), under endocardic lesion in 2 cases (1.63%) and after-effect of necrosis in 4 cases (3.25%). The Left ventricular hypertrophywas observed in 12 cases (9.76%) and all of them were hypertensive patients. QTc was lengthened among 7 patients (5.69%) independently of the class of antiretroviral therapy administrated. Conclusion In this study about patients infected by HIV1, it emerges that asymptomatic myocardial ischemia is frequent. It would be advisable to reinforce its tracking by using more powerful tests of ischemia, in order to better specify its gravity in this population with an increased cardiovascular risk.  

Marginal Bone Levels and Trabecular Bone Structure: A Longitudinal Population Study of women

Nov 2016 DOI 10.14302/issn.2474-7785.jarh-16-1275
Jonasson GretheCorresponding author Dept. of Behavioral and Community Dentistry, Institute of Odontology at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Bone quality is difficult to assess but the skeletal bone condition is reflected in mandibular trabecular bone, which is well imaged in periapical dental radiographs. The aim of this 12-year prospective cohort study was to test if marginal mandibular bone loss differs in women with varying trabecular bone structure. The sample consisted of 460 women (aged 38, 46, and 54 years) from the prospective population study of women in Gothenburg, Sweden. Marginal bone loss was assessed according to a five-graded scale in two surveys 12 years apart, and the mandibular bone structure was evaluated visually as sparse, mixed, and dense. The results showed that marginal bone loss was significantly correlated to mandibular bone structure (r= 0.20; p<0.001 at baseline, and r= 0.17; p<0.001 after 12 years). Significant differences in marginal bone loss between trabeculation groups were found, with the largest loss in the group with dense trabeculation. Age, smoking, number of missing teeth and trabecular bone structure explained 20-28% of the variation in marginal bone loss. The conclusion was that women with dense trabecular bone in the mandible suffered a stronger periodontal bone destruction when negative events occur, than the women with sparser trabeculation.

Pulmonary Hypertension in an Elderly HIV-infected Veteran Population

May 2016 DOI 10.14302/issn.2324-7339.jcrhap-16-944
P Liappis AngelikeCorresponding author Medical Service, Section of Infectious Diseases, Veterans Affairs Medical Center, Washington DC

Pulmonary hypertension may occur as a co-morbid disease in HIV. We examined the characteristics of our HIV infected veterans with pulmonary hypertension and compared them with a control group of HIV infected patients without pulmonary hypertension. Among our cohort, patients were diagnosed with pulmonary hypertension at a mean age of 49.8 y ± 11.0y. This diagnosis came about 8.1y ± 6.7y after the diagnosis of HIV. Our pulmonary hypertension patients lived for about 3.4 ± 3.0y after their pulmonary hypertension diagnosis. The presence of pulmonary hypertension in HIV infection confers an increased risk of mortality. Mortality in our pulmonary hypertension cohort was 73%.

Apomorphine Subcutaneous Infusion is More Efficient Than foslevodopa/foscarbidopa Subcutaneous Infusion in the Treatment of Advanced Parkison´s Disease for the Spanish National Health System

May 2026 DOI 10.14302/issn.2641-4538.jphi-26-6161
J GonzalezCorresponding author

Objectives Motor fluctuations and non-motor disorders not manageable by first-line treatments in advanced Parkinson's disease require continuous dopaminergic stimulation strategies such as subcutaneous infusions of apomorphine (APO) or foslevodopa/foscarbidopa (FLD/FCD). A Budget Impact Analysis (BIA) was performed to estimate the cost difference between both treatments assuming equivalent clinical efficacy and safety. Material and methods The efficacy results of pivotal clinical trials at 12 and 52 weeks of treatment and the safety profile of APO vs FLD/FCD were compared, based on latest scientific publications and other available clinical data. A comparative BIA was performed, based on estimated annual drug treatment costs at Spanish published prices. Results The efficacy of APO (16 h/day) and FLD/FCD (24 h/day) in reduction of OFF hours (2.47 vs 2.75, 12 weeks; 3.66 vs 3.50, 52 weeks; respectively) and increase of ON hours without disabling dyskinesias (2.77 vs 2.72, 12 weeks; 3.31 vs 3.80, 52 weeks; respectively) could be considered clinically equivalent, as well as their safety profiles. However, a significant discrepancy is observed in the costs of the aforementioned alternatives. Considering published prices and the average dose reported in the literature, in Spain the annual cost of APO would be €13,980 compared to €55,198 for FLD/FCD. Consequently, the financial resources required for the treatment of FLD/FCD would enable the treatment of approximately three to four patients with APO. The BIA indicated the potential for annual savings in more than €2,500 million, considering a total target population of over 60,000 patients per year. Finally, an univariant sensitivity analysis was performed, considering a scenario in which the hospital acquisition cost of FLD/FCD decreased between 20%-30% (€44,159- €38,638/year). In this scenario, the total annual savings range between €1,875-€1,532 million per year. Conclusions Overall APO is more efficient than FLD/FCD, as it provides similar clinical efficacy at a lower treatment cost. The selection of an appropriate treatment option is to be determined by clinical criteria and patient characteristics, but cost evaluation should be considered to select the most cost-effective therapeutic option.

Characterization of People Receiving 2-Drug Regimens (2DR) for HIV Management in Italy

Mar 2026 DOI 10.14302/issn.2994-6743.ijstd-26-6060
Francesco Amadeo PierCorresponding author

Objective To describe the clinical features and real-world treatment of people living with human immunodeficiency virus (PLHIV) using fixed-dose or free combinations of 2-drug regimens (2DR) of antiretroviral therapy (ART). Design Italian retrospective cohort study. Methods Data were extracted from PLHIV who initiated or switched to 2DR: Group 1 (fixed dose), Group 2 (free combination). Results Group 1 was younger and more predominantly male, and had shorter time from AIDS-defining diagnosis to 2DR-ART and from diagnosis to baseline, a lower prevalence of resistance, and fewer comorbidities than Group 2. Median baseline viral load was <50 copies/mL in both groups, but Group 1 had a higher mean due to outliers. The most common ART classes before switching to 2DR were Integrase Strand Transfer Inhibitor (INSTI)-based (48.97%), Non-Nucleoside Reverse Transcriptase Inhibitor (NNRTI)-based (22.73%), and Protease Inhibitor (PI)-based (16.53%). Distribution varied: Group 1: INSTI-based (53.13%), NNRTI-based (24.31%), and PI-based (15.04%); Group 2: INSTI-based (29.41%), PI-based (23.53%), and NNRTI-based (15.29%). After switching, Group 1 was on dolutegravir/lamivudine (79,33%) and dolutegravir/rilpivirine (20,67%); Group 2 mostly on INSTI-PI (52.81%), followed by NNRTI combinations, mainly with doravirine (19.10%). Duration of ART after switching was shorter in Group 1. Conclusion Italian PLHIV on 2DR fixed-dose combinations were younger, virologically suppressed individuals at baseline, with a shorter lead time from diagnosis, lower prevalence of resistance and lower comorbidity rate compared to those on free combinations. These findings underscore an unmet need for 2DR fixed-dose combinations, as the free combinations were predominantly utilized for more challenging populations.

Lineage-Specific Disruption of Hematopoiesis by Oxaliplatin: Mechanisms of Erythropoietin Resistance and Immune Suppression

Feb 2026 DOI 10.14302/issn.2372-6601.jhor-25-5944
Y. Berezin MikhailCorresponding author

Background Oxaliplatin, a widely used chemotherapeutic agent, is associated with hematologic toxicities such as anemia, leukopenia, and thrombocytopenia. Despite their clinical relevance, the molecular mechanisms underlying lineage-specific bone marrow suppression remain poorly understood. Methods We administered oxaliplatin to mice over eight weeks and performed RNA-sequencing (RNA integrity >8) on bone marrow alongside peripheral blood analysis and cytokine profiling. Transcriptomic data were analyzed to identify differentially expressed genes (DEGs) and enriched pathways. For that, we applied a thematic Gene Ontology (thematicGO) enrichment method that groups GO terms into biologically meaningful categories, such as hematopoietic lineage disruption, cell cycle arrest, and cytokine signaling. Results Oxaliplatin induced broad transcriptional suppression of erythropoiesis and lymphopoiesis, with 3,691 DEGs identified (FDR<0.05, |FC|>1.5). Upregulation of Cdkn1a and downregulation of E2f2 suggest G1/S cell cycle arrest, correlating with repression of key erythroid maturation genes (e.g., Spta1, Slc4a1, Alas2) and hemoglobin subunits (Hba-a1/2, Hbb-bs/t). Despite a ~3000-fold increase in renal Epo expression, bone marrow Epor was reduced, indicating erythropoietin resistance. B and T cell markers were also significantly downregulated, signifying a collapse in adaptive immunity. Notably, neutrophil populations were largely spared. Cytokine analysis in plasma revealed a pro-inflammatory shift with elevated TNF-α and reduced TGF-β, potentially exacerbating hematopoietic dysfunction. Conclusions Oxaliplatin induces a lineage-dependent suppression of hematopoiesis, driven by coordinated cell cycle arrest, metabolic stress, and disrupted cytokine signaling. RNA-seq analysis enabled integration of transcriptomic findings into coherent biological themes. These findings provide mechanistic insights into oxaliplatin’s hematologic toxicity linking bone marrow failure (potentially reversible) via interconnected inflammatory and metabolic pathways and may inform therapeutic strategies to minimize or restore myelosuppression in cancer patients.

Core and activating Symptoms of Depression in Chinese Teachers and Comparison between Different Gender and Stage of Teaching: A Network Analysis Approach

Feb 2026 DOI 10.14302/issn.2474-9273.jbtm-25-5885
Jia NingCorresponding author

Background Depression, increasingly recognized as a critical factor impacting mental health, notably affects various populations, including teachers. This study aimed to delineate the specific characteristics of depressive symptom networks among Chinese teachers, identify the core symptoms of depression within this demographic, and examine the variations in depressive symptom networks across different genders and teaching stages. Method The study encompassed 1,670 teachers. Depressive symptoms were assessed using the Self-Rating Depression Scale (SDS). Central symptoms were identified through centrality indices. Network stability was examined via a case-dropping procedure. Directed Acyclic Graphs (DAG) was used to identify the activating symptoms. Results “Personal devaluation” exhibited the highest and most stable centrality values in the network. “Depressed Affect” and “Emptiness of Life” were identified as the activating symptoms in the network. No significant differences were observed in the network structure and global strength of depression between teachers of different genders. However, significant differences in the network’s global strength were found between junior and senior high school teachers. Conclusion “Personal devaluation” emerged as the core depressive symptoms among teachers in China. “Depressed Affect” and “Emptiness of Life” serve as the gateways that activate the entire teacher depression network. Paying close attention to these symptoms could potentially alleviate the experiences of depression in this demographic.

Diabetic Foot and Leg Ulcer & Peri-wound Neuropathy Healing Feasibility Studies

Jan 2026 DOI 10.14302/issn.2640-6403.jtrr-25-5922
Kalmeta MargaretCorresponding author

Diabetic foot and leg ulcers represent a significant global health burden and are frequently associated with peripheral neuropathy, vascular compromise, infection, and high rates of recurrence and amputation. Standard wound care often fails to achieve healing in chronic cases due to unaddressed underlying neuropathic and vascular pathology. This feasibility study evaluated the Hemastyl™ System in patients with long-standing diabetic foot and leg ulcers that had failed standard care and, in many cases, had been diagnosed for amputation. Two prospective feasibility cohorts comprising 39 chronic infected diabetic wounds were treated with the Hemastyl™ System. Outcomes included rapid microbe reduction, high wound closure rates, subjective improvement in neuropathy-related symptoms, and avoidance of amputation in all amputation-diagnosed cases. These findings suggest that targeting neuropathy, vasculature, and microbial burden concurrently may offer a promising approach for healing complex chronic wounds in high-risk populations.

A Decision Tree Ensemble Approach to Diabetes Prediction using the Framingham Heart Dataset, Exploring the Role of AI-Associated Interventions in Reducing Diabetes-Related Adverse Outcomes Between Men and Women

Dec 2025 DOI 10.14302/issn.2641-4538.jphi-25-5886
Y. Talbert PatriciaCorresponding author

Objective Diabetes poses significant public health challenges, with many individuals remaining undiagnosed and at risk of complications. This study aimed to evaluate the performance of decision tree ensemble methods for predicting diabetes onset using the Framingham Heart Study Teaching Dataset and to explore sex-specific risk patterns relevant to AI-driven interventions. Methods We analyzed data from 11,627 participants, incorporating demographics, vital signs, smoking status, medication use, and laboratory measures. Random Forest classifiers were developed to predict diabetes incidence at approximately 6-year (Period 2) and 12-year (Period 3) follow-ups. Class imbalance was addressed using undersampling, oversampling, and the Synthetic Minority Over-sampling Technique (SMOTE). Results The models demonstrated robust performance, achieving an Area Under the Curve (AUC) of 0.856 in Period 2, and moderate predictive ability in Period 3 (AUC = 0.732 in males, 0.786 in females). Key predictors included glucose level, BMI, systolic blood pressure, age, and heart rate. Notably, differences emerged in predictive accuracy between men and women, suggesting potential sex-specific vulnerabilities that merit further study. Conclusion Machine learning approaches, particularly Random Forests, show promise for medium- and long-term diabetes risk prediction, supporting early identification and intervention efforts. Future work should focus on hyperparameter tuning and explainability techniques, such as SHapley Additive exPlanations (SHAP) values, to improve model precision, interpretability, and fairness. Equity-focused strategies remain critical to ensure AI-driven tools benefit diverse populations and do not exacerbate existing disparities in diabetes care.

Zoological Research Open Access

Assessing the Impact of Environmental Factors on Andipalayam Lake's Insect Biodiversity

Dec 2025 DOI 10.14302/issn.2694-2275.jzr-25-5595
S GopalakrishnanCorresponding author

Andipalayam Lake, a freshwater body located in Tiruppur, Tamil Nadu, plays a significant role in sustaining the local ecosystem, particularly through its diverse insect populations. This study aims to document and analyze the insect biodiversity present in and around Andipalayam Lake, focusing on the ecological roles these species play in maintaining the lake’s health. Insects are key components of aquatic ecosystems, contributing to processes such as pollination and nutrient cycling and serving as prey for higher trophic levels. Despite their ecological importance, studies on the insect biodiversity of Andipalayam Lake have been limited, prompting the need for an extensive survey. This research employed a combination of sweep nets, pitfall traps, and light traps to collect insect species over a year, covering various seasons to capture population dynamics and seasonal variations. Water quality parameters, such as temperature, pH, and dissolved oxygen, were monitored to assess their influence on insect diversity. The study identified over 38 species of insects from diverse orders, including Odonata (dragonflies), Diptera (flies), Coleoptera (beetles), and Hemiptera (true bugs). Seasonal variations were observed, with higher species richness during the monsoon period due to increased vegetation and moisture levels. The most abundant species were found to belong to Diptera and Coleoptera, indicating their adaptability to fluctuating water levels. Environmental factors such as pollution from nearby agricultural runoff and urban development were found to negatively affect insect diversity, with a notable decline in sensitive species during periods of increased contamination.

Model Based Research Open Access

Mathematical Modelling of Typhoid Fever Transmission Dynamics and Intervention Impact in Harare, Zimbabwe (2018–2020)

Dec 2025 DOI 10.14302/issn.2643-2811.jmbr-25-5731
Mukeredzi InnocentCorresponding author

Background Typhoid fever remains a significant public health issue in Harare City, Zimbabwe, exacerbated by recurrent outbreaks between 2018 and 2020. Key challenges, including inadequate water supply and sanitation infrastructure, high population density, and limited healthcare access, have intensified the disease burden. Understanding the key transmission drivers and assessing the impact of various interventions are essential for informing policy and health strategies. Objectives This study aimed to: 1: To predict future trends in typhoid fever cases Harare City typhoid hot areas. 2: To develop a mathematical model to simulate the spread of typhoid fever incidence under different intervention scenarios and recommend evidence-based strategies for reducing the disease burden in Harare City. Methods A dynamic compartmental SIR-based model, adapted from the Pitzer Vaccine Effectiveness (VE) framework, was employed to simulate disease transmission. This model accounted for both short-cycle (human-to-human) and long-cycle (environmental) transmission pathways. Data from Harare City (2018–2020) were used for model calibration and forecasting, and sensitivity analysis was performed to assess the impact of different intervention levels. Findings The model identified inadequate sanitation, contaminated water sources, and low health- seeking behaviors as primary drivers of typhoid transmission. In the absence of interventions, the model projected a sustained high rate of transmission. However, treatment and WASH interventions could reduce the disease burden by 50–60%, while combined strategies incorporating vaccination and education led to an 80% reduction in cases. Sensitivity analysis indicated that treatment and WASH interventions were particularly impactful at moderate coverage levels. Conclusion Mathematical modeling effectively demonstrated the multifactorial drivers of typhoid fever transmission in Harare. Integrated interventions that combine WASH, vaccination, treatment, and education present the most promising approach for long-term control of the disease. The findings offer a solid, data-driven foundation for public health decision-making and resource allocation.

Recruitment Strategies and Challenges in a Pilot HIV Prevention Study among Cisgender Black Women in Houston, Texas

Dec 2025 DOI 10.14302/issn.2324-7339.jcrhap-25-5715
Couture LucyCorresponding author

Recruitment for research studies focused on communicable diseases such as HIV (Human Immunodeficiency Virus) has historically been challenging, particularly among populations who have been underrepresented in media messaging, yet maintain a significant vulnerability to new HIV cases, like Black women. This study examines the recruitment strategies utilized in Aim 2 of pilot study at the University of Texas Health Science Center (UTHealth) in Houston, Texas that was funded by the Ujima Mentoring Program to develop, implement, and evaluate a video log (vlog)-based intervention. The overarching goal of the pilot study was to promote the uptake of pre-exposure prophylaxis (PrEP) among cisgender Black women in Harris County, Texas. Aim 2 involved the creation of a culturally relevant vlog for use in Aim 3, which sought to educate and motivate participants to consider PrEP as an HIV prevention strategy. With the growing role of digital platforms in public health outreach, social media was employed alongside traditional recruitment methods such as flyers and word-of-mouth referrals. Despite an expanded online reach, engagement remained low, and participation rates did not increase proportionally to the number of individuals who viewed recruitment materials. The reluctance to participate was largely attributed to stigma surrounding HIV and concerns about being publicly associated with an HIV prevention study based on participants feedback to the research team. Even the availability of research incentives to encourage participation did not significantly improve recruitment accrual goals, particularly among healthcare providers who experienced limitations with eligibility due to institutional policies. This study underscores the need to better understand the social and cultural barriers that prevent Black women and healthcare providers from engaging in HIV prevention research. While digital recruitment strategies can enhance visibility to a larger audience, they must be supported with trust-building efforts, community partnerships, and culturally competent messaging to encourage meaningful participation. These findings point to the critical need for multi-faceted recruitment strategies that go beyond social media campaigns and actively build trust within communities, ensuring that HIV prevention research and interventions are both accessible and culturally resonant.

Potential use of Ginger (Zinger officinale Rose) Extracts as Biopesticide against Myzuspersicae Sulzer (Hemiptera, Aphididae) on Pepper Crops

Dec 2025 DOI 10.14302/issn.2768-5209.ijen-25-5602
Lassaad MdellelCorresponding author

Chemical insecticides have been the primary method used by farmers to control pests. However, their negative environmental impacts, harmful effects on beneficial insects and human health, and prohibition in organic farming systems have driven the search for natural alternatives with insecticidal properties. These alternatives provide a safer and more sustainable way to control insect pests. Medicinal plants and their constituents play an important role in pest management. For example, ginger (Zingiber officinale) extracts contain bioactive compounds with insecticidal activities. The objective of this work was to track the population of the green peach aphid (Myzuspersicae) on pepper crops in a greenhouse, identify the active ingredients in ginger extracts, and evaluate the insecticidal effects of three concentrations of ginger-derived aqueous and essential oil extracts against M. persicae on pepper plants under laboratory and greenhouse conditions. The results demonstrate that M. persicae grows rapidly on pepper crops under greenhouse conditions, reaching high densities on leaves. The ginger extract contains two active ingredients with insecticidal effects against this pest. The significant reduction in aphid (M. persicae) populations indicates that Z. officinale aqueous extract (150 mL/L) and essential oil (2 mL/L) have strong potential for the biological control of this pest under greenhouse conditions. Thus, the use of ginger plant extract emerges as a promising alternative for reducing M. persicae infestations on pepper plants.  

Efficacy of Neemraj and Beauvitech on Abundance and Distribution of Arthropod Pests in Soil and Hydroponically Grown Strawberry

Dec 2025 DOI 10.14302/issn.2768-5209.ijen-24-5325
G.W MbauCorresponding author

Strawberry is a commercially important crop which has gained global significance in terms of production and consumption. The strawberry farmers have been faced with economic losses due to attack from arthropod and phytophagus pests. To overcome this challenge, management of pests is important with reduced impact on beneficial organisms and the environment. Use of non-chemical approaches as an alternative to insecticide driven management is highly gaining popularity. Identification of the non-chemical production for management of strawberry pest such as entomopathogenic fungi and botanicals is critical. The need for compatibility of entomopathogenic fungi in crop production techniques with other insecticides to enhance efficacy is required. The interaction between these control agents could be synergistic, additive or even antagonistic. Synergistic interactions usually lead to enhanced effectiveness of the microbial control agents while reducing the adverse effects of the pesticides in combination. In this review a description of the compatibility of entomopathogenic fungus Beauvaria bassiana and botanical neem in strawberry pest management is given. The experiment involved five treatments: Neemraj, Beauvitech, Neemraj and Beauvitech, Ampligo and control. These treatments were allocated in a completely Randomized design in two separate greenhouse setups one with soil and other with pumice. The treatments were replicated four times. The data was subjected to analysis of variance (ANOVA) using the general linear model (GLM) procedure of the statistical analysis system (SAS) program, version 9.1. Tukey’s (HSD) test at P≤ 0.05 was used to separate significant means. The combination of Neemraj and Beauvitech was most effective in the management of pests in both hydroponics and soil grown media. Pest populations were reduced significantly as follows; thrips, Frankliniella spp 2.1, red spider mites Tetranychus species 11.5, tarnished plant bug Lygus species 3.0, there was 0% cricket Gryllus species damage and 0 number strawberry weevil in hydroponics cultures while in soil culture pest mean populations were: thrips 5.6, spider mites Tetranychus species 18.2, strawberry weevil (Otiorhynchus species) 7.0, tarnished plant bug 3.0 and there was 13.8% cricket Gryllus species damage on strawberry plants.

Insect-Based Foods: A Comprehensive Review on Nutritional Benefits and Environmental Sustainability

Dec 2025 DOI 10.14302/issn.2768-5209.ijen-25-5732
S Isaac AnvyCorresponding author

The growing population demands and environmental concerns associated with traditional protein sources have prompted the exploration of alternative and sustainable food sources. The purpose of this comprehensive review is to highlight the nutritional benefits and sustainability of insect-based foods as a promising solution. Global population growth necessitates innovative approaches to meet the demand for nutritious and sustainable protein sources. There are numerous challenges associated with traditional livestock farming, including land use inefficiency, high water usage, and greenhouse gas emissions. As a result, edible insects have emerged as a viable alternative, providing proteins (35-77% of dry matter), healthy fats (10-50%), essential amino acids, and micronutrients such as iron (up to 31mg/100g) and zinc (up to 20mg/100g), vitamins, and minerals. In contrast to livestock, which requires 22,000-43,000 liters of water to produce 1 kg of beef, insect farming consumes significantly less water and land resources. Insects have the potential to address nutritional deficiencies and strengthen food security as they are recognized for sustainable production. The study thoroughly investigates the literature addressing environmental and sustainability concerns associated with edible insect farming, using a rigorous bibliometric and scientometric analysis via Vos viewer. With the help of Vos Viewer, it was possible to identify the geographical distribution of countries that contributed to the field of edible insects and their acceptance, as well as the top ten documents in this field with the most citations and mostly used keywords in this field of research. Future research and implementation strategies will be able to benefit global food security and environmental conservation through these alternative protein sources.

Systematic Review on Peri-Operative Intravenous Fluid: ‘Restrictive vs Liberal’ Fluid use on Major Abdominal Surgical Patients

Dec 2025
Waine ArnoldCorresponding author

Background Intravenous Fluids use during surgery is a common practice for many reasons. However recent evaluation of perioperative abdominal surgery patients have poised many issues. Mostly on the type of fluid and quantity of volume usage on major abdominal surgery. Many studies into this aspect of perioperative fluid usage have been done, and volume definition have been accrued either restrictive (Maintenance fluid of less than 1.75 Liters) or liberal or standard (Maintenance fluid between 1.75 Liters to 2.75 Liters) usage. The outcome was assessed to ascertain the best patient recovery without complications from the two fluid regime. Result/Discussion After PRISMA exclusion criteria, there were eight randomized control studies assessed to provide a summary, comparing all the studies using either restrictive fluid or liberal fluids used in major abdominal surgery. Post operative complications and the length of hospital stay were assessed as the major outcomes end points and the cumulative result favored those with restrictive fluid usage. Conclusion Although the restrictive use of fluids in abdominal surgery is favored from the measured outcomes, there are inherent cofounders and heterogenicity in the eight studies that require more detail studies involving multiple study centers and population.

Water Open Access

Water Quality Analysis on Public and Household Water Sources – A Case Study of Sunyani-West District, Fiapre

Dec 2025 DOI 10.14302/issn.2769-2264.jw-24-4937
Otchere BernardCorresponding author

Access to potable and quality water in most rural communities is low such that over 2.2 billion people worldwide are negatively affected. The increasing population in Fiapre and the inconsistent water supply by the Ghana Water Company Limited (GWCL) have forced most residents to resort to alternative groundwater sources such as boreholes, wells, etc. Yet, many residents use these sources of water unaware of the quality of the water and its potential health implications. This study assessed drinking water quality in Fiapre by calculating its Weight Average Water Quality Index (WAWQI) and investigating potential risk factors associated with contamination through a cross-sectional study and laboratory analysis of various physicochemical and microbiological water quality parameters. WAWQI was used to compute parameters using 10 factors including pH, electrical conductivity, temperature, TDS, phosphate, chloride, total hardness, nitrate, alkalinity, and faecal coliform. The findings revealed that the pH level of water, phosphate concentration, and fecal coliform count surpassed the recommended thresholds set by the World Health Organization (WHO) for safe drinking water. Although levels of electrical conductivity, TDS, nitrate, total hardness, and chlorine kept changing from one water source to another, the difference was not significant apart from phosphate and fecal coliform which shows a significant difference between the sachet water sources and other water sources (P<0.05). The study outcomes demonstrated that the overall water quality is predominantly categorized as good to fairly good, with the highest Water Quality Index (WQI) value reaching 87.84% and the lowest recorded at 54.81%. Therefore, to improve the water quality in the municipality, local management agencies should pay attention to the microbiological quality of the water sources. The study recommends regular handwashing practices, hygienic surroundings of the water source, and drinking water treatment to reduce the possible risk factors associated with the contamination of the water sources.

Model Based Research Open Access

A New Model of Body Composition Detects Association Between Severe Obesity and Increase in Skeletal Muscle Mass

Sep 2025 DOI 10.14302/issn.2643-2811.jmbr-25-5688
Dahlmann NicolausCorresponding author

Obesity is associated with functional limitations in muscle performance. The true effect of obesity on skeletal muscle mass, including any interactions with aging effects, remains to be elucidated. The present study investigated the impact of obesity on the stimulation of muscle growth, based on a new model of body composition. A dataset of 44 men and 64 women was analysed. Body weight (Wt), body height (Ht), hand circumference (HdC) and waist circumference (WC) were measured. Processed by the Dahlmann-Body-Analysis (DBA) system, a new model of body composition, the increase of skeletal muscle mass (ΔSMM) compared to the individual reference weight was calculated. Muscle mass data derived by the DBA model are compared with DXA-derived predictive equations of studies representing different countries and ethnicities estimating the appendicular skeletal muscle mass. Means of these groups are tested by ANOVA. Age ranged from 18 to 72 years. All subjects had a BMI ≥ 29.7 (kg/m²). The mean values of ΔSMM as an estimate of muscle mass gain calculated by the DBA-system were 11.8 ±3.6 kg for men and 8.9 ±2.6 kg for women, respectively, demonstrating a linear, significantly rising relationship with BMI (ß > 0, p<0.001). The study population did not show a decrease in muscle mass with age in either men or women up to an age of 65 years. The results suggest that the present model has satisfactory prediction qualities to detect an increase in skeletal muscle mass associated with a growing burden of body fat.

Osteoarthritis Depressive, Loneliness and Social Isolation in Later Life and the Robotic Companion

Aug 2025 DOI 10.14302/issn.2474-7785.jarh-25-5659
Marks RayCorresponding author

Background Older adults with disabling osteoarthritis may be severely impacted by negative emotions and pain, especially if they feel isolated. Review Aims 1) To summarize the research base concerning the presence of depression in older adults suffering from osteoarthritis; 2) To examine the degree to which mitigating loneliness is desirable in this regard and may be helped by one of the many emergent robotic social devices offering companionship; and 3) To provide directives for professionals who work or are likely to work with this population in the future. Methods Reviewed were current publications detailing some aspect of osteoarthritis in the older adult, depression, emergent loneliness and social isolation, and the role and impact of robotic personal ‘friends’ in this realm. Results Collectively, these data reveal efforts to reduce and mitigate different degrees of depression in older adult osteoarthritis cases are needed and that social robots may help quell isolation. Implication Those older adults with osteoarthritis suffering from depression and emergent loneliness and social isolation may benefit from robotic human or pet like contacts and interactions regardless of cause and overall health status, but the key is still loneliness prevention.

Burden of Unintentional Childhood Injuries in Pre-School Children (2-6yrs) and Knowledge of Primary Caregivers on Early Management: A Descriptive Observational Study in Urban Slums of Bhubaneswar, Odisha

Dec 2024 DOI 10.14302/issn.2641-4538.jphi-24-5358
Kar SonaliCorresponding author

Background Injuries, particularly unintentional ones, are a neglected public health concern and are preventable or avoidable. Children in urban slums are especially vulnerable due to hazardous living conditions, inadequate supervision, and lack of safe sojourns or play areas. Since these injuries result in seeming spontaneous recovery, appropriate care being initiated by the primary care giver is questionable. Objective To assess the burden of unintentional injuries of unintentional injuries in pre-school going children aged 2-6 years in urban slums of Bhubaneswar, Odisha. To compare the knowledge of the 1st level care post-injury among the primary care givers against standardized prescribed care. Methods A cross-sectional descriptive observational study was conducted for over 2 years in urban slums under the Bhubaneswar Municipal Corporation (BMC), the capital city of Odisha. A total of 285 children aged 2-6 years, whose mothers consented to participate, were included in the study. Data regarding the type of injury and its management, as well as, associated socio-demographic factors, were collected using a pre-designed, pre-tested questionnaire. Descriptive statistics was used to derive the burden of unintentional injuries in children. The knowledge of the 1st level of care to be given after the common injuries was assessed among all the primary caregivers to detect the treatment and care gap. Results The majority of primary respondents were mothers aged 21-30 years (82.1%), The frequency of an episode of unintentional injury (occurrence in last 3 months) in the study population was found to be 58%. The most common type of injury reported was skin lacerations or tears, common site being in the upper and lower limbs. Males were more affected as compared to females (54.64 %) The reporting of unintentional injuries among the children was found to have significant association with the occupation of the father. Fathers who were unemployed or working as unskilled labor, their child’s probability of reporting an unintentional injury was found to be high, with p value coming to be statistically significant. Conclusion The study highlights the complex interplay of sociodemographic factors influencing unintentional injuries among children in urban slums and the need to create awareness among the primary caregivers, about the immediate management, so that chronic complications may be averted. It is difficult to avert injury as this age group is agile and nowadays supervision is challenging. Still, the knowledge of management would not just empower the caregiver, but also the growing child, who can attend to their younger siblings or themselves, whenever they get injured next. Further research with larger sample sizes is warranted to validate these findings and develop effective prevention strategies.

Respiratory Diseases Open Access

Profile of Patients Who Died During One Year in the Pneumophthisiology Department of the Hospital National Ignace Deen CHU in Conakry

Dec 2024 DOI 10.14302/issn.2642-9241.jrd-24-5320
Djelo Diallo BoubacarCorresponding author

Introduction Mortality is one of the most important demographic phenomena in public health, and its rate is the primary indicator of a population's state of health. The aim of this study was to describe the profile of patients in the pneumo-phthisiology department of the Hospital National Ignace Deen CHU in Conakry. Methodology This was a retrospective descriptive study lasting one year, from 01 January to 31 December 2023, on 176 records of hospitalized patients who died in the pneumophthisiology department of the Ignace Deen National Hospital. Results A total of 1043 patients were hospitalized during our study period, 176 of whom died, giving a mortality rate of 16.87%. The mean age of the deceased patients was 49.57±18.8 years, with a male predominance (sex ratio=1.93). Clinical signs on admission were dominated by dyspnoea (70.45%) and chest pain (61.36%). Tuberculosis was the most common diagnosis with a frequency of 42.61%, followed by TB/HIV co-infection with a frequency of 22.16%. The average length of hospitalization was 8.79 days. Probable cause of death was dominated by respiratory distress (54.44%) and decompensated anaemia (32.95%). Conclusion Mortality in the pneumo-phthisiology department of the Ignace Deen National Hospital remains high. Anemia and respiratory distress were the most common diagnoses of severity, hence the need to improve management of these probable causes of death.

Assessing the risk of Obstructive Sleep Apnea in Type 2 Diabetes Mellitus patients in India

Nov 2024 DOI 10.14302/issn.2574-4518.jsdr-24-5271
Kovila RajivCorresponding author

Background/Aim Obstructive Sleep Apnea (OSA) is a prevalent disorder characterized by recurrent respiratory disturbances during sleep. Patients with Type 2 Diabetes Mellitus (T2DM) and obesity exhibit a substantial susceptibility to OSA (23%–86%). People with OSA have a high risk of several comorbidities like insulin resistance, cardiovascular disease, depressed mood and hypertension. Thus, the objective was to comprehensively evaluate the risk of OSA among T2DM patients in India. Materials and Methods A cross-sectional survey was conducted across four cities in India involving 2,000 T2DM patients. The survey gathered data on patient demographics, clinical endpoints, and estimated the risk of OSA using an app which included the STOP BANG questionnaire. Multivariate logistic regression analysis was used to evaluate the association between OSA risk and key variables such as age, gender, BMI, and HbA1c. Result Overall, 63.9% of T2DM patients were identified as high risk and 27.3% were at intermediate risk for OSA development. Results of the multivariate logistic regression demonstrated that patients with high BMI ≥35 had significantly greater odds (OR: 5.70; p<0.00) of developing OSA; males had 2.75 times higher odds (p<0.00) and patients with HbA1c value >8% had higher odds (OR: 1.22; p<0.00) of developing OSA. Conclusion OSA risk and prevalence are significantly higher in T2DM patients than in the general population with a notable escalation in patients who are overweight/obese, older, and have prolonged diabetes duration. Early screening using digitalization with a highly sensitive, cost-efficient, and valid tool like STOP-BANG followed by appropriate intervention for OSA can not only reduce the eventual economic burden but can improve patient outcomes.

Creation of Music-Induced Analgesia in Chronic Pain Patients through Endogenous Opioid Production: A Narrative Review

Oct 2024 DOI 10.14302/issn.2688-5328.ijp-24-5319
Puri NivritiCorresponding author

Chronic pain affects over 30% of the global population, and reliance on external drugs for treatment has led to major issues, including the present opioid epidemic. A healthier option is necessary, which is why music therapy’s analgesic effects have been extensively studied within the last 20 years. Not only is music relatively harmless but given that chronic pain patients require repeated treatment, musical intervention is far more accessible and economical. While the mechanisms underlying music-induced analgesia are relatively unclear, the production of endogenous opioids while listening to music through both the descending pain modulatory circuit and the limbic system, is postulated to play this role. This review describes the brain regions and pathways by which music may trigger the release of endogenous opioids such as enkephalins, endorphins, and dynorphins. More importantly, it discusses the cellular mechanisms through which these neuropeptides are thought to mediate pleasure-induced analgesia in chronic pain patients.

Immunization Open Access

Predictors of COVID-19 Vaccine Hesitancy in North-Central Nigeria

Sep 2024 DOI 10.14302/issn.2577-137X.ji-24-5207
Olutola AyodotunCorresponding author

COVID-19 vaccine hesitancy has emerged as a major challenge to global efforts to control the pandemic, particularly in Nigeria, where hesitancy to other effective vaccines such as polio and measles has been widely reported. Several individual, societal, and structural factors contribute to this behaviour and prevent the effectiveness of COVID-19 prevention efforts. Objectives This study sought to identify the predictors of COVID-19 vaccine hesitancy in the seven states of North-Central, Nigeria. Methods A population-based cross-sectional online survey was conducted among residents using a semi-structured questionnaire adapted from the WHO SAGE vaccine hesitancy scale and distributed via social media networks over 8-weeks. Results A total of 1,429 responses met the inclusion criteria and were analysed. Among the respondents, 60.7% were males, 47.5% were between the ages of 26 and 45, and 80.1% had postsecondary education. A total of 421 respondents (29.5%) were hesitant and unwilling to receive the vaccine. The reasons for hesitancy were concerns about side effects (37.1%), doubt about the existence of COVID-19 (11.0%), and the perception of time required to receive the vaccine (9.6%). Post-secondary education (AOR: 0.49, 0.36-0.66) and people of the Islamic faith (AOR: 0.68, 0.52-0.90) were found to be associated with lower levels of hesitancy. Conclusion The study found that vaccine hesitancy is a complex problem that is linked with multiple social determinants of health as lower educational attainment, lower income and Christian faith were found to be predictors of vaccine hesitancy. Confidence, Complacency and Convenience factors were expressed by respondents as concerns about side effects, doubt about the existence of COVID-19 and time required to receive the vaccines were the most prominent reasons for unwillingness to receive the vaccine. In order to protect the public health of communities, targeted interventions are required to increase vaccine acceptance by cultivating trust in vaccines, disseminating accurate information, and engaging with community stakeholders including religious groups.

Exercises Pursued by Older Adults with Osteoarthritis and Their Structural Impacts are Hard to Uncover; a Scoping Review of Selected 1970-2024 Studies

Sep 2024 DOI 10.14302/issn.2474-7785.jarh-24-5282
Marks RayCorresponding author

Persons with osteoarthritis often have signs of reduced muscle strength. Some studies suggest that this strength could be improved with exercise. However, does this form of therapy improve the disease status as assessed by improvements in cartilage viability, a hallmark of the disease? This brief describes the possible usage of exercises in general, plus those known to improve strength and function, and reduce pain and whether structural impacts that favor or impede disease regression have been observed in this context among the older osteoarthritis adult population. Since exercise may also do harm, rather than good in osteoarthritis management if excessive, contra indicated, or suboptimal, what is the consensus in this regard in 2024?

Understanding Inherited Bleeding Disorders: Genetic Mutations in Blood Coagulation Factors and Regulatory Proteins

Aug 2024 DOI 10.14302/issn.2372-6601.jhor-24-5108
Zakaria Baniamer AnsamCorresponding author

Hereditary thrombotic diseases, or inherited bleeding disorders, are a group of genetic conditions that disrupt normal blood coagulation. These diseases result from mutations in genes encoding blood coagulation factors or other regulatory proteins, impairing the body's ability to regulate bleeding and clotting. The most common inherited clotting disorders are hemophilia A and B, which are associated with deficiencies in clotting factors VIII and IX, respectively. Von Willebrand disease (VWD) is another prevalent disorder characterized by a deficiency or dysfunction of the Von Willebrand factor, a protein essential for coagulation. Additionally, the Factor V Leiden mutation is linked to an increased risk of blood clots. The prevalence of inherited coagulation disorders varies significantly by region and subpopulation. It is estimated that 5,000 to 10,000 male newborns are born with hemophilia A or B each year. Von Willebrand disease is much more common, affecting about 1% of the global population. The Factor V Leiden mutation is found in significant percentages of certain populations, with 3–8% of Caucasians being carriers. While antithrombin deficiency is more common in some areas, the incidence of other inherited clotting disorders, such as Factor XI, protein C and S deficiencies, and VWD, varies widely worldwide. This study discusses the incidence of inherited clotting disorders and their impact on affected individuals and their families. It also covers new advancements in disease management, alternative therapy approaches, and contemporary diagnostic techniques, aiming to improve diagnoses, treatments, and outcomes for patients with hereditary clotting disorders.

A Cross Sectional Analysis of Frailty and Markers of Frailty in Young People Living with HIV/AIDS

Jul 2024 DOI 10.14302/issn.2641-4538.jphi-24-5017
V K SashindranCorresponding author

Background Frailty is an ageing-associated state linked to poor prognostic outcomes. Chronic inflammation due to HIV-infection, AIDS-related infections. and the adverse effects of antiretroviral therapy (ART) all contribute to frailty in people living with HIV/AIDS (PLHA). Frailty has been comprehensively studied in populations comprising predominantly of Caucasian PLHA. However, there remains a dearth of such data in Indian populations, especially in younger PLHA. Methodology This cross-sectional study aimed to estimate the prevalence of frailty in PLHA (18 - 50 years) who had been on ART for 24-60 months and identify markers linked to frailty. Frailty was assessed in 152 subjects using the Fried frailty-index. Parameters measured included the mid-upper arm and calf circumferences, pain-severity (using the Brief Pain Inventory), highly-sensitivity C-reactive protein, d-dimer, and interleukin-6. Results The prevalence of frailty and pre-frailty were 6.58% and 23.02%, respectively. Reduced grip strength and self-reported exhaustion were associated with frailty (15.79% and 13.16%, respectively). Low calf-circumference and mid-upper arm circumference were not significantly associated with frailty/pre-frailty. The prevalence of pain was 21.7% and both pain severity and pain interference were significantly associated with frailty/pre-frailty. CD-4 counts at the time of assessment showed an inverse association with frailty. Elevated C-reactive protein (CRP of 0.04 associated with 0.49 probability of frailty (95% CI 0.40 – 0.59), CRP of 0.12 associated with 0.63 probability of frailty (95% CI 0.47 – 0.76)). D-dimer levels were not significantly associated with frailty /pre-frailty. Conclusion In this first-of-its-kind study on frailty in young PLHA (mean age 37 years) from the Indian sub-continent, the prevalence of frailty and pre-frailty was 6.58% and 23.02%, respectively. Multivariate analysis showed a strong association of frailty with pain severity, CD4 count at time of assessment, hs-CRP levels and duration of ART.

Effects of a Novelty Virtual Interactive Brain Atlas on Student Perception of Neuroanatomy

Jul 2024 DOI 10.14302/issn.2577-2279.ijha-24-5150
H.C DaviesCorresponding author

The instructional techniques in neuroanatomy laboratories continue to evolve to incorporate online interactive resources to improve student experience and outcomes. This study aims to design an “all in one”Virtual Interactive Brain Atlas (VIBA) that provides students with an educational resource that will improve their knowledge of neuroanatomy while in the brain lab and provide them with lab resources they can self-study and self-test. Coronal, midsagittal, whole brain, and horizontal brain slices were used to create detailed descriptions, interactive features, and quiz assessments to create VIBA. Upper level undergraduate and optometry students taking a neuroanatomy one-semester course were provided with VIBA for use during the semester. A paper survey was distributed after completing the course to determine student perception. No significant difference was indicated between the student groups regarding their self-reported understanding prior to the brain lab (p= 0.194) and after the brain lab (p= 0.308). There was a significant difference between the student populations when stating that they strongly agreed that the online brain atlas improved their understanding of neuroanatomy (p= 0.032) and that the VIBA tool was easy to navigate (p=0.048). There was a significant difference between the two student groups that strongly agreed that the online brain atlas quality was sufficient (p= 0.015). This online interactive brain atlas was created in a time-efficient manner from readily available models and was well received by experienced neuroanatomy faculty and students.

Osteoarthritis in Older Adults: Is More Emphasis on Managing and Mitigating its Stressful Ramifications, and Enhancing Coping, and Self Efficacy Cognitions Indicated?

Jun 2024 DOI 10.14302/issn.2474-7785.jarh-24-5141
Marks RayCorresponding author

Efforts to mitigate or prevent painful disabling osteoarthritis have been pursued for more than a century with limited success. This current overview briefly summarizes how selected beliefs and behaviors, including coping and stress management approaches are potential mediators or moderators of osteoarthritis pain and its overall common adverse prognosis and outcome. Published data housed predominantly in PUBMED, PUBMED CENTRAL, SCIENCE DIRECT, and GOOGLE SCHOLAR sites and pertaining to selected aspects of the literature of current interest, cumulative results reported as of May 30, 2024, show a modest to strong rationale exists for considering the abovementioned factors in efforts to reduce pain and enable daily functions. Accordingly this line of research should be continued, and translated clinically without undue delay, especially in the face of increases in the aging population and osteoarthritis prevalence and undue suffering.

Precision Agriculture Open Access

Sesame (Sesamum indicum L.) seeds and di ammonium phosphate (dap) potential for controlling Striga seed germination, sorghum growth and grain yield

Apr 2024 DOI 10.14302/issn.2998-1506.jpa-22-4349
Abdou Ousseini ArdalyCorresponding author

Sorghum is important staple food for feeding humans and animals in sub-Saharan African country. Nowadays, with the advent of climate change couple to the population growth, the crop is faced to new challenges wish are gradually affecting the productivity. In Niger, a dry land country where farmers are growing sorghum at a small scale for family subsistence, the crop is confronted to biotic and abioticonstraints including nutrient deficiency in the soil. Among those constraint, Striga is the one that causes huge damage to sorghum cultivation through yield reduction. In addition, nutrient depletion in the soil are causing weed progresses in farmer’s field at a large scale. In fact, to overcome Striga problem several control methods have been successfully tested, but some of them are efficient but not accessible to farmers. It is important to control the weed by using effective and accessible way for smallholder farme in Niger. The main objective of this study was to assess the effectiveness of different doses of sesame (0, 0.5 and 1.5 g) and DAP (0, 2 and 5 g) on Striga impact and sorghum grain yield. Two (2) grammes micro dosing utilization of DAP shows good result in Striga plant emergency and distribution along sorghum field. Concerning the three doses of sesame seed involve in this experiment, the micro dosing two (1.5 g) positively affect Striga effect. The combination sesame seed and DAP can significantly reduce Striga impact on sorghum cultivation and increased sorghum grain yield.

Syphilis and Beyond: A Comprehensive Analysis of Associated Infections and Comorbidities in a Five-Year Retrospective Study in the United Arab Emirates (2018-2022)

Apr 2024 DOI 10.14302/issn.2994-6743.ijstd-24-5006
Khatoon Hossein Mehdi Poor NargisCorresponding author

Objectives This study explores the clinical characteristics, associated infections, and management outcomes of syphilis within a specific population over the years 2018 to 2022. With a focus on the frequency, clinical manifestations, and co-infections of syphilis, the research addresses a critical gap in understanding the nuanced dynamics of this sexually transmitted infection and its impact on public health. Methods The study employs a retrospective analysis of data collected from 2018 to 2022, utilizing three key serological tests (Syphilis AB, RPR/VDRL, and TPHA) to characterize syphilis infections within the population. Clinical manifestations and associated infections, including HIV, HBV, HCV, Chlamydia, Gonorrhea, and HPV, are systematically assessed. Treatment rates and re-infection patterns are also analyzed, providing a comprehensive overview of syphilis epidemiology within the studied timeframe. Results The frequency of syphilis, particularly indicated by the Syphilis AB test, exhibited a marked increase in 2020, reaching 96%, suggesting a heightened frequency within the population. RPR/VDRL test results demonstrated consistent frequency, emphasizing the persistent presence of active syphilis infections. Clinical manifestations, such as chancre, skin rashes, alopecia syphilitica, and lymphadenopathy, displayed dynamic patterns over the study years. Co-infection rates varied, with fluctuations observed in HIV, Chlamydia, Gonorrhea, and HPV, while HBV and HCV showed infrequent but stable frequency. The management of syphilis cases demonstrated commendable treatment rates, but an increase in re-infection rates in 2021 highlights the need for continued vigilance. Conclusion This study provides a comprehensive evaluation of syphilis epidemiology, clinical characteristics, and associated infections within the studied population. The results offer valuable insights into the dynamic nature of syphilis and its co-infections, informing public health initiatives and interventions. The findings contribute to our understanding of the epidemiological landscape and underscore the importance of sustained efforts in both prevention and treatment to curb the transmission of syphilis and its associated infections. The study, however, calls for continued vigilance and research to address the evolving trends and challenges in syphilis management within the specified population.

Cervical Cancer Open Access

Cervical Cancer with The Active And Stable PI3K/MTOR/AKT Pathway In Azerbaijan Patients

Mar 2024 DOI 10.14302/issn.2997-2108.jcc-23-4838
S. Mardanova KonulCorresponding author

Among the reproductive cancers cervical cancer has special place, because the second most frequent cause of cancer-related death among women worldwide. The studies suggested that the PI3K/mTOR/AKT signaling pathway is associated with certain reproductive tumors. A lot of research is ongoing for understanding this pathway evidence of its role in promoting tumorigenesis and recent progress in the development of therapeutic agents that targeted PI3K/AKT. In this a single-arm study included 34 Azerbaijan population woman with HPV-negative cervical tumors. The core genes of PAM signaling pathway were analyzed using RT-PCR method. Our preliminary results suggested that tumorgenesis of HPV-negative cervical cancer patients approximately 25% associated with dysregulation of PAM signaling pathway reason which are core genes alteration. The overall survival times in the PAM-active and PAM-stable patients were not significantly varies. However, the main factor for overall survival times were treatment strategy: both PAM-active and PAM-stable patients who received radiation therapy alone had a shorter overall survival than patients who received radiation plus chemotherapy. The patients with alteration of ATK1 and mTOR genes in PAM signaling pathway had poor prognosis then patients with PIK3CA and PTEN mutation

Wildlife Open Access

White Eared Kob (Kobuskobleucotis, Lichtenstein and Peters, 1854,) in Ethiopia; Migration Status, Potential Anthropogenic Threats and Conservation Directives from an Ecotourism Perspectives

Feb 2024 DOI 10.14302/issn.2997-2248.jwl-23-4791
Sahile AtinafaCorresponding author

The Trans boundary protection of migratory species is a common argument for international cooperation. Ecotourism supports these activities through long-term commitment from international conservation organizations, all interest groups and various political entities. However, due to anthropogenic influences and inadequate understanding of species ecology, sustainable conservation of migratory species is often challenging. Therefore, this review article evaluates the migration status, potential anthropogenic threats, and conservation directives from the perspective of ecotourism of the white-eared kob (Kobuskobleucotis, Lichtenstein and Peters, 1854). Ethiopia. Kobus kobleucotis migrate through the Boma-Gambella border ecosystems of Ethiopia and South Sudan at certain times of the year. This migration is anonymous and requires an understanding of the overall ecology of the species. Currently, the white-eared Kob population exceeds half a million, making it the second largest migration in Africa, after the wildebeest migration in the Serengeti, Tanzania. Kobs occur in groups of five to forty depending on sex and age and are nocturnal but inactive on the hottest days. Rich grasslands and permanent water sources are the preferred habitats for the species. However, the decline in grassland potential, frequent hunting, expanding settlements, changes in land use and land cover are potential threats to the white-eared kob in Gambella National Parks. Therefore, understanding the total ecological, anthropogenic and behavioral variables that influence the movement and status of the species is the ultimate parameter for conservation activity. Furthermore, entire migration corridors require sustainable management by balancing stakeholder interests and rural community development through nature-based tourism. It is also noted that solid economic and environmental incentives through nature-based tourism require adequate protection in Gambella and the surrounding regions.

Determinants of Exclusive Breastfeeding Among Mothers of Infants Less Than Six Months of Age in Mogadishu: A Facility-Based Cross-Sectional Study

Jan 2024 DOI 10.14302/issn.2691-5014.jphn-23-4865
Abdullahi Dahie HassanCorresponding author

Background Breastfeeding is a vital practice for infant health and well-being, with exclusive breastfeeding (EBF) during the first six months being particularly crucial. Despite its benefits, EBF is sub-optimally practiced in many low-to-middle income countries. This study focuses on Somalia, a country with historical political instability and poor health indicators, aiming to identify the prevalence and determinants of exclusive breastfeeding among women with infants under six months attending SOS Mother and Child Hospital in Mogadishu. Methods A hospital-based cross-sectional design was used, and data were collected through a structured questionnaire. The study sample consisted of 345 mothers, selected using a systematic sampling technique. Descriptive, bivariate, and multivariate analyses were conducted to assess breastfeeding practices and determine factors influencing exclusive breastfeeding prevalence. Result The study found that the prevalence of exclusive breastfeeding among the study population in Somalia was 44%, influenced by factors such as maternal education, employment, and utilization of antenatal and postnatal care services. Male infants and younger infants had higher odds of being exclusively breastfed. Conclusion and recommendations The study emphasizes the importance of promoting exclusive breastfeeding as the optimal feeding practice for infants in Somalia, highlighting the need for comprehensive health education during antenatal care visits and postnatal counseling. It recommends the development of supportive policies, such as maternity leave and workplace accommodations, along with community-based initiatives and support groups to facilitate and encourage exclusive breastfeeding practices.

Respiratory Diseases Open Access

Spirometric profile of people living with HIV on antiretroviral drugs in Abidjan

Jan 2024 DOI 10.14302/issn.2642-9241.jrd-23-4809
Kadiatou SamakeCorresponding author

Introduction People living with HIV (PLHIV) are susceptible to developing non- communicable chronic respiratory diseases. Our objective was to study the spirometric profile of this population. Material and methods This was a descriptive and analytical cross-sectional retro-prospective study conducted from March 15 to June 15, 2022 and relating to the analysis of the medical files of asymptomatic and eligible for spirometry PLHIV, aged 18 years and above. They were received in the voluntary counselling and testing (VCT) centres of one of the two pulmonology departments in Abidjan. Results The study involved 54 subjects including 22 men (40.7%) and 32 women (59.3%) with an average age of 48.9 years. The majority of patients were non-smokers (81.4%) and the main history was pulmonary tuberculosis (35.2%). Only 29.6% had chronic respiratory symptoms and 42.6% had a normal BMI. The frequency of spirometric abnormalities was 57.4%. These spirometric abnormalities included 40.7% peripheral obstructive pattern; 9.3% restrictive pattern; 3.7% asthma and 3.7% COPD. A more than 10 years duration of HIV infection (p=0.001 OR= 0.2 (0.1 – 0.7)) and a duration of ART of at least 10 years (p=0.001 OR= 0, 2 (0.1 – 0.7)) were significantly associated with the existence of ventilatory abnormalities. Conclusion The high frequency of ventilatory anomalies in PLHIV independently of the existence of chronic respiratory signs leads us to propose spirometry in the follow-up assessment of PLHIV while paying particular attention to those on ARVs for more than 10 years.

Understanding Reasons for Lack of Effectiveness of National TB Program in Peru: Qualitative Analysis of MDRTB Control

Jan 2024
Manga SeleneCorresponding author

Drug-resistant tuberculosis (DR-TB) is the most urgent public health problem to solve in Peru, according to the Ministry of Health 1. In the WHO Global TB Report 2021, Peru has the highest burden of DR-TB in the Americas (Table 1), with 38% of TB cases either RR or MDR. In addition, the Ministry reports an estimated prevalence rate of DR-TB of 5.7% in new cases and 24.2% in previously treated cases. A total of 2493 new cases of DR-TB were reported in 2022, with 18.5% treatment dropout in 2019 believed to have increased by at least 52% in 2022 1. The post-pandemic context has created additional challenges for the control of DR-TB in Peru. A complex multiplicity of factors connects this disease to groups with high vulnerability, such as populations in extreme poverty and overcrowding or deprived of freedom; those who have immune system disorders, such as HIV and diabetes; and isolated indigenous populations.

Duffy Red Cell Antigen Phenotype among Indigenous Pregnant Women attending Antenatal Clinic at Federal Teaching Hospital Gombe, Gombe State, North Eastern Nigeria

Dec 2023 DOI 10.14302/issn.3070-1937.ijbt-23-4714
M. Gaji AhmedCorresponding author

Background and Objectives Duffy (FY) blood group system is implicated in transfusion incompatibilities and haemolytic disease of the foetus and newborn (HDFN). The primary objective was to determine the Duffy phenotype among indigenous pregnant women in Gombe, Gombe State, Nigeria. Materials and Methods This was a Cross sectional study where simple random sampling was employed on consented participants. Two hundred and fifty nine pregnant women attending antenatal clinic at Federal Teaching Hospital Gombe were randomly recruited into the study. About 3mls of blood was taken, and Duffy antigen typed by standard tube technique (LORNE LABORATORY UK). Results Among the Indigenous tribe, the percentage of Fy(a+b+) was seen in 2.2% of Fulani and 3.4% of Tangale, Fy(a+b-) phenotype was seen in 4.3% of Tangale, 6.8% of Fulani,9.5% of Tera, 10.3% of Hausa and 10.5% of Waja. Fy(a-b+) phenotype was seen in 5.3% of Waja, 7.6% of Fulani,8.7% of Tangale, 9.5% of Tera and 12.5% of Bolawa. Fy(a-b-) phenotype was seen in 2.4% of Tula,6.4% of Bolawa,7.3% of Waja, 7.8% of Tera, 17.8% of Tangale, 11.8% of Hausa and 46.5% of Fulani. About 84.6% of the study population had the null Duffy phenotype. Conclusion The research showed the phenotypic distribution of Duffy blood group among the study participants with relatively high percentage of null Duffy phenotype hence possible risk of alloimmunisation.

Veterinary Healthcare Open Access

Camel Brucellosis in Ethiopia: Seroprevalence and Associated Risk Factor

Oct 2023 DOI 10.14302/issn.2575-1212.jvhc-23-4532
Abda Neja SultanCorresponding author

Camels are a significant source of income for nomadic populations in many developing countries, including Ethiopia. Camels are well adapted to dry and semi-dry regions, providing income, food security, and transportation. However, camel production and productivity are constrained by infectious diseases, such as brucellosis, which is a highly infectious bacterial disease that affects camels and humans worldwide. Brucellosis causes significant economic losses due to abortion, low herd fertility, and decreased milk production. In Ethiopia, the prevalence of camel brucellosis varies depending on factors related to the host, agent, climate, and management system, with a reported prevalence ranging from 0.5% to 11.9%. Accurate diagnosis of camel Brucellosis is essential for herd-based screening of animals. Although culturing the pathogen is the preferred method for diagnosis, serological tests such as Rose-Bengal plate test (RBPT), Enzyme-linked immunosorbent assay (ELISA), and Complement fixation test (CFT) and polymerase chain reaction (PCR) assays have been developed. Implementing effective diagnosis and surveillance systems to control the spread of brucellosis in animals and humans is very important, on top of awareness campaigns, vaccination programs, and suitable laboratory establishment recommended. Continued research is essential to maintain the health and productivity of camel populations, particularly in pastoral areas where camels play a significant role in the livelihood of communities. Therefore, the present paper views the seropositive prevalence and potential risk factors associated with camel brucellosis in Ethiopia.

Farming Open Access

Application of Permaculture Practices to Improve Sustainable Agriculture in the Maltese Islands

Sep 2023 DOI 10.14302/issn.3070-2232.jf-23-4696
Baron ByronCorresponding author

Small island states, such as Malta face numerous, unique challenges in relation to agricultural sustainability, with solutions amenable to larger states being unfit given the particular characteristics of the island. These include the poor soil conditions, the limited water resources, the aging farmer population, farming being mainly part-time, and most farmers having no formal training. Currently farmers practice intensive agriculture to achieve higher crop productivity at lower production costs by relying heavily on agri-chemicals and over-extracting groundwater. This destroys the Maltese natural environment and urges for the development and implementation of sustainable agriculture practices, whereby traditional farming is supplemented with sustainable alternatives such that local agriculture remains productive in the long-term while safeguarding the local environment. Here we outline some of the critical issues that urgently need to be addressed and potential ways forward in relation to soil, water and biodiversity, implementing permaculture principles in small-scale, practical actions in order to improve the sustainability of local agricultural through a combination of scientific evidence, agricultural technology and traditional practices.

The Effectiveness of Treating Anxiety with Reiki

Sep 2023 DOI 10.14302/issn2474-9273.jbtm-23-4712
Erika HumphreysCorresponding author

The effectiveness of treating anxiety with Reiki is explored within ten quantitative studies. Methodology utilized for a critical appraisal and systematic review of the literature is explained with inclusion and exclusion criteria. Theoretical framework for the project is grounded in the work of Hildegard Peplau, whose nursing theory based on the therapeutic use of self is foundational for Reiki implementation. A thorough critique of the literature is conducted for key components of robustness and believability. This critique is conducted using a structured guide addressing synthesized strengths and weaknesses of the body of literature. A synthesis of the literature explores the findings of the studies. This synthesis reports on Reiki’s effectiveness in treating anxiety within a variety of patient settings and populations, its effect on subscales of anxiety, physiological manifestations of anxiety and pain associated with anxiety. Cultural considerations effecting Reiki’s potential effectiveness are discussed. Gaps in the literature are examined, including the studies’ narrow sample population, lack of participant exclusionary factors for controlled outcome data, and the lack of studies across time. Implications for future research are discussed with recommendations for expanded research that includes a broader variety of settings, age groups, and patient diagnoses, including anxiety disorders, for research data that is transferable. Implications for further practice for the advanced practice registered nurse (APRN) are explored, with the potential benefits for both providers and patients, including improved patient satisfaction and expansion of provider treatment modalities.

Osteoarthritis and Depression Update: 2023-Can the Stress and Coping Model Help?

Aug 2023 DOI 10.14302/issn.2474-7785.jarh-23-4730
Marks RayCorresponding author

Background Osteoarthritis and depression are both key barriers to healthy aging and greatly heighten the risk for many negative health issues that seriously impact life quality. When combined what are the implications? Aim This mini review examines 2023 data pertaining to osteoarthritis and depression and older adults and a possible theoretical framework of stress that may direct our approaches in the future. Methods and Procedures Articles published between January 1 and August 15 2023 that addressed the current topic of interest and that were extracted from PUBMED, PubMed Central, Science Direct, and Google Scholar were carefully read and their key points arepresented in narrative form. Results As in the past, very few tangible theory-based prospective analyses that employ valid measures of depression and examine any association of any form of osteoarthritis longitudinally and in a consistent manner prevail. Several reports use the same or similar large cohort to draw upon, and find various degrees of clinical implications, but this may not embrace the need for more inclusivity, sampling strategies, control and diversity issues, as well as embracing the role of cognitions positive and negative. Conclusion Without efforts to develop sound research designs of diverse and carefully differentiated osteoarthritis substantive samples it is impossible to delineate the origin or implications of the osteoarthritis-depression linkage reported currently or arrive at a deep understanding of its relevance, to life quality and public health costs. What is needed to protect against or minimize either or both these clinically related disabling correlates in the aged population warrants timely study.

Obesity Management Open Access

Improving Effective Screening and Management of Obesity in an Urgent Care Clinic

Jul 2023 DOI 10.14302/issn.2574-450X.jom-23-4654
Hodges StephanieCorresponding author

Background Nearly 40% of the adult population in the United States are considered obese by current standards, which equates to approximately 93 million people. Obesity is a chronic disease that is linked to more than 40 other diseases, including hypertension, heart disease, stroke, diabetes, and at least 13 distinct types of cancers. The direct and indirect costs of obesity have been estimated at up to $210 billion annually. Local Problem In Cumberland County, North Carolina, 34% of the adult population was considered obese. The aim of this quality improvement study was to increase effective care (screening, patient engagement, and referral to treatment) in adult patients with a BMI greater than 30 kg/m2 to 75% within 90 days. Methods A rapid cycle plan-do-study-act framework was used to evaluate four focus areas concurrently over 8 weeks with a small test of change completed in each 2-week cycle. Interventions An expanded screening with a checklist, shared decision-making tools (SDMTs), and a referral to treatment checklist were implemented. Activities from the team engagement plan were initiated. Results The effective care of patients increased by 42 percentage points while engaging both the patients and the staff. Conclusions Utilizing standardized communication, SDMTs, checklists, and management plans improved effective care while motivating and enabling patients to take control of their care and make sustainable lifestyle changes that enhance overall health.

Model Based Research Open Access

A General Approach to Modeling Covid-19

Jul 2023 DOI 10.14302/issn.2643-2811.jmbr-23-4556
Isea RaulCorresponding author

The present work shows that it is possible to analytically solve a general model to explain the transmission dynamics of SARS-CoV-2. First, the within-host model is described, and later a between-host model, where the coupling between them is the viral load of SARS-CoV-2. The within-host model describes the equations involved in the life cycle of SARS-CoV-2, and also the immune response; while that the between-Host model analyzes the dynamics of virus spread from the original source of contagion associated with bats, subsequently transmitted to a host, and then reaching the reservoir (Huanan Seafood Wholesale Market in Wuhan ), until finally infecting the human population.

Zoological Research Open Access

Distribution and Conservation Challenges of Diurnal Large Mammals in Bayo Community Managed Forest, Salamago Woreda, South Omo Zone, Southern Ethiopia

Jun 2023 DOI 10.14302/issn.2694-2275.jzr-23-4483
Tamirat HaileCorresponding author

An ecological study on diurnal mammals was carried out in Bayo Community Managed Forest located in Salamago Woreda, South Omo Zone. The objective of the study was to investigate the distribution and conservation challenges of diurnal large mammals in the study area. Based on the habitat type and topography of the study area, total of 11 transect, i.e 7 in forestland, and 4 in Wooded Grassland were laid to collect the data. Besides direct methods, indirect methods such as faecal droppings, fresh tracks, carcass or shell count, den (burrow), hair, and digging were used. Questionnaire and focus group discussions were also used to assess anthropogenic threats in the study area. Data were analyzed using descriptive statistics, SPSS and QGIS software. A total of 20 species of diurnal large mammals belonging to six orders and eight families were identified. The species identified were Cercopithecus pygerythrus, Cercopithecus aethiops, Papio anubis, Erytherocebus patas, Cercopitheus neglectus, Colobus guereza, Equus quagga, Traglaphus strepsiceros, Traglaphus imberbis, Traglaphus scriptus, Medagua guentheri, Sylvicapra grimma, Kobus ellipsiprymnus defessa, Syncerrus caffer, Potamochoerus larvatus, Phacochoerus africanus, Hylochoerus meinertzhageni, Hystrix cristata, Orycteropus afer, and Phataginus temminckii smutus. Seasonal variation in the between habitat types (χ2 = 4.849, df= 1, p<0.05). Totally, 685 and 600 mammals were counted during wet and dry seasons, respectively. On habitat basis, 683 and 602 animals were recorded in forestland and wooded grassland habitats, respectively. Major threats in the study area include poaching, fire, grazing, fuelwood extraction, population growth, habitat modification, overharvesting of resources and invasive species. About 98.44% of respondents had a positive attitude towards Bayo Community Managed Forest. The interference of local community has had the impact on mammal’s species. Habitat based mammals’ management involving participation of Woreda and Zonal Government is recommended for sustainable. The local government should promote the study area and provide appropriate support for its conservation.

Effect of Protein and Energy-Dense Nutritional Supplement with Immunonutrients on Cachexia in Cancer Patients: An Open-Label, Single-Arm Study Among Indian Patients

Jun 2023 DOI 10.14302/issn.2379-7835.ijn-23-4587
Bhoite RachanaCorresponding author

Background Cachexia is highly prevalent in cancer patients and is responsible for as much as 20% of all cancer deaths. Nevertheless, there is little emphasis on cachexia in routine clinical practice. This study looks at the efficacy and tolerability of a protein and energy-dense nutritional supplement with immunonutrients on cachexia in cancer patients. Methods This was a three-month, prospective, open-label study of patients undergoing radiotherapy and/or chemotherapy for head and neck or gastrointestinal or lung cancer. Efficacy endpoints were mean change in muscle strength, acute phase proteins (albumin and pre-albumin), C-reactive protein (CRP) levels, weight, Glasgow prognostic score (GPS), and nutritional status at the end of the study period. Results The study population consists of 47 (79.66%) males and 12 (20.34%) females with a mean age of 47.98 ± 12.16 years. The mean change in muscle strength, albumin, pre-albumin, CRP levels, and weight for the overall study population was 0.17 ± 12.09 kg (P=0.9145), -0.05 ± 0.53 g/dl, (P=0.5888), -0.01 ± 0.09 g/dl (P=0.2951), 0.50 ± 37.41 mg/dl (P=0.9258), -0.59 ± 3.70 kg (P=0.2265), respectively. At the end of the study period, there was a significant improvement in the nutritional status concerning total calories, protein, and fat intake. Conclusion Protein and energy-dense nutritional supplement with immunonutrients might help in the improvement of muscle strength, GPS, and dietary intake. The addition of the supplement to the diet regime of patients with cancer cachexia increases their daily consumption of proteins which might translate to multimodal clinical benefits.

Spontaneous Subgaleal Hemorrhage in a Child with Autism

May 2023 DOI 10.14302/issn.2691-5014.jphn-23-4555
Kathryn DohertyCorresponding author

Severe ascorbic acid (Vitamin C) deficiency, commonly known as “scurvy,” continues to be a problem in malnourished populations across the world but is relatively rare in the United States. Early features of this condition include general weakness, fatigue, and aching limbs. An extremely rare and late feature of this condition is subgaleal hemorrhage. Scurvy has such a low prevalence in First World countries that it is often misdiagnosed or not diagnosed at all. The subject in this case report presented acutely and is one of few to involve a subgaleal hemorrhage to be documented in medical literature to date. Laboratory studies and clinical improvement through treatment established the diagnosis. Ascorbic acid deficiency should be considered when evaluating children with poor nutrition despite socioeconomic status, living conditions, or access to health care. This case also reminds us that neurodivergent children are a vulnerable population and more research will need to be conducted to determine just how detrimental the pandemic has been to patients with ongoing problems who were lost to follow up.

Attitude of Nursing Students towards LGBTIQ Individual and its Associated Factors in Kathmandu Metropolitan City

Apr 2023 DOI 10.14302/issn.2641-4538.jphi-23-4412
Bist AmritCorresponding author

Background People may have both negative and positive attitudes about other people, their way of living and those attitudes can be influenced by various factors. LGBTIQ individuals are facing various difficulties and barriers to run their daily life due to different attitudes of people. Attitudes may be different from person to person influenced by their knowledge, acceptance behaviour and understanding. By finding out the associated factors that influences the attitude of people we can change people’s view towards LGBTIQ individuals. Each and every person deserves to be treated equally regardless of their gender, sexual orientation, and preferences. Methods This was a cross-sectional study in which the sample size was 423 and the study population was nursing students. A simple random sampling method was used to select sample for the study. Self-administered questionnaire was used to collect data. The collected data was entered in EPI 3.1 and analyzed using SPSS 25. A descriptive statistic was used to find out the frequency and percentage and analysis (chi-square) was used to find out the association between the dependent and independent variables. A p-value of <0.05 was considered statistically significant. Results Results showed that 87.2% have positive attitudes towards LGBTIQ individuals, and the majority (56.6%) have knowledge about homosexuality. Similarly, more than two-thirds (82.7%) of respondents were not homophobic, and 50.4% showed positive stereotypes about LGBTIQ individuals. Religion (p=0.030), caste (p=0.001) and Family type (p=0.016) were statistically significant with regard to the attitudes of students towards LGBTIQ. Conclusion The majority of students had positive attitudes towards LGBTIQ individuals and few had negative attitudes. Almost half of the respondents had adequate knowledge about homosexuality. The majority of students were not homophobic and few were homophobic. Half had positive stereotypes and about other half had negative stereotypes.

Can Vitamin D Positively Impact Sarcopenia Severity Among Older Adults with Hand Osteoarthritis: A Review of the Evidence

Apr 2023 DOI 10.14302/issn.2474-7785.jarh-23-4550
Marks RayCorresponding author

Aim This review examines the research base concerning hand osteoarthritis and changes in muscle mass and quality known as sarcopenia and the possible use of vitamin-D supplementation for reducing this potentially adverse functionally disabling state. Methods Publications detailing a possible link between hand osteoarthritis manifestations and sarcopenia, plus those discussing vitamin D as a possible intervention strategy for minimizing sarcopenia in the older adult were systematically sought and reviewed. Results Collectively, data reveal hand osteoarthritis in the older population is common, and is possibly affected by age as well as disease associated muscle mass declines. Vitamin D, a powerful steroid required by the body to foster many life affirming physiological functions may help reduce the degree of any prevailing sarcopenia and thereby some degree of hand osteoarthritis disability. Conclusions Older individuals with hand osteoarthritis, as well as healthy older adults at risk for sarcopenia are likely to benefit physically from efforts to clarify the extent of this association and if indicated, to examine and intervene thoughtfully to maximize muscle composition as well as safe vitamin D levels where subnormal. Researchers can make highly notable impacts in multiple spheres in this regard and are encouraged to do so.

Prevention and Safety Training to Improve Community Health

Mar 2023 DOI 10.14302/issn.2690-0904.ijoe-21-3884
Keshaverz VajiheCorresponding author

Background and Purpose Public health problems are caused by the emergence of environmental pollution and infectious diseases, which have caused concern around the world. The public health threat affects the relationship between people. Population growth and associated pressures increase difficulties associated with effective means of maintaining public health. The diseases transmitted from human and livestock communication, water pollution, air pollution, and environmental pollutants urge us to find new solutions to address these problems. Understanding the environmental and environmental health is a prerequisite for protecting public health. In Iran, like other countries in the world, the issue of environmental protection and its compliance with the first program of economic, social and cultural development of the Islamic Republic has begun and expanded in the future. In this regard, new perspectives are being introduced that will bring about dramatic changes at various levels of planning, processes and specialized sectors such as civil, industrial and educational sectors. The training of engineers in this regard can play a very important role in refining the attitudes of young engineers and using these bases in their specialized activities. One of the important tasks of universities is to provide a suitable platform for such training. In this regard, it is essential that the major industrial universities of the country develop various programs in this field. Materials and Methods The present study is a review of the type of validity that is performed through search of authoritative scientific databases such as PubMed and Scopus, Google scholar, PubMed using the key words of building safety and health, HSE, and prevention methods are the latest information. Results Implementing the principles of HSE in various construction, industrial and other projects requires time, because any change that is considered in the system requires a change of attitude, which in turn requires time to adapt and adapt to the new conditions. The conditions for the projects in this research are their current conditions, and the next research, after a while, can determine the percentage of project progress in terms of HSE. Conclusion In order to comply with the principle of HSE cases, there is a need for training. These trainings should be executed at different levels and levels of contracting and monitoring so that the level of awareness of the risks involved in the development of civil operations between the personnel reaches a common frontier.

Safety of BBIBP-CorV (Sinopharm) COVID-19 Vaccination in People With Multiple Sclerosis: A Report From Iran

Mar 2023 DOI 10.14302/issn.2690-4837.ijip-22-4342
Massood Nabavi SeyedCorresponding author

Introduction Vaccination against SARS CoV-2 started on March 2020 in Iran and people with multiple sclerosis (pwMS) have a priority to be vaccinated in line of other high-risk population. Up to now, BBIBP-CorV (Sinopharm) is the main vaccine which have been used in Iranian population, and in high risk population such as pwMS. Method In this survey, the safety and possible side effects of this vaccine after the first or/and second doses in 520 pwMS have been assessed from July to August 2021. MS Patients who have received one or two doses of Sinopharm vaccine were evaluated. Results Around 44% of pwMS who received Sinopharm reported few minor side effects, whereas its side effect have been reported in 60% of patients who received the second dose. All side effects have begun within the first 24 hours and subsided between 48-96 hours afterward. No serious side effects or mortality have been reported. There was no correlation between the side effects and age, the disability status, and the type of first or second line DMDs (disease modifying drugs). Only some side effects were significantly higher in the progressive form of the disease. Conclusion MS patients can receive Sinopharm vaccine safely and the minor side effects should not scare them.

Diseases Open Access

Prevalence of Typhoid and Paratyphoid fever in a tertiary care hospital of Kathmandu valley

Feb 2023 DOI 10.14302/issn.2997-1977.jd-22-4378
Gautam KirtikaCorresponding author

Typhoid or enteric fever is caused by Salmonella serotype typhi and paratyphi. It is one of the major public health problem in developing countries including Nepal. In recent years, increased urbanization and growing population within Kathmandu valley, attributed mainly to improper sanitary condition and fecal contamination of drinking water. These all factors contributes to a very high prevalence of typhoid fever through out the country. Methods This study was laboratory based study carried out six month period from march 2017 to August 2017 at microbiology lab in Nepal Medical college. Results and conclusion In the present study, the prevalence of enteric fever is mainly caused by Salmonella. Typhi than Salmonella Paratyphi A was observed.

Improved Latrine Coverage and Associated Factors Among Rural Community in Gicumbi Gistrict, Rwanda

Oct 2022 DOI 10.14302/issn.2641-4538.jphi-22-4326
Rutayisire ErigeneCorresponding author Department of public Health, Mount Kenya University Rwanda Kigali Rwanda

This study aimed at determining improved latrine coverage and associated factors among rural community in Gicumbi district. A cross-sectional study was employed using mixed methods with quantitative and qualitative data collection approaches. The quantitative approach of data collection method was conducted and then qualitative approach followed. A structured questionnaire was used to collect quantitative data and Focus Group Discussions (FGDs) was conducted to collect the qualitative data. The study population consists of household heads or their representatives and key informants from the study area of Gicumbi district. For quantitative the total sample size was 236 households while for qualitative data, a total of three FGDs with eight (8) participants was conducted among twenty four (24) rural community members of Gicumbi district. Raw data from the questionnaire were entered into EPI data and transported into SPSS version 22 for analysis. Descriptive statistics was used to tabulate and describe the data. The strengths of the associations were determined with multiple logistic regressions. The results shows that 69.1% of respondents were male, 30.1% were farmers, 16.9% had formal employment while 57.2% completed secondary education. The prevalence of improved latrine in Gicumbi District was 65.3%. Tertiary education was also 4.3 times more likely to have improved compared to those who did not have formal education (AOR=4.3CI: 95%: 1.027-7.032. P=0.005). Respondents with average monthly income Between 50,000 and 100,000 Rwfs are 2.7 times more likely to have improved latrine (AOR=2.7 CI at 95%:1.009-4.120, P=0.022).

Socio-Demographic Factors Responsible for Uptake of Intermittent Preventive Treatment and Health Seeking Behaviours for Malaria in Pregnancy among Women of Reproductive Ages in Nigeria

Oct 2022 DOI 10.14302/issn.2641-4538.jphi-22-4329
Adejoh Attah TimothyCorresponding author National Space Research and Development Agency, Obasanjo Space Centre, Umaru Musa Ydar'adua express way, P.M.B. 437, Lugbe, Abuja

Introduction Malaria in pregnancy is a serious public health concern that could result in detrimental health outcomes for pregnant women and their foetuses. In Nigeria, there is still a significant risk of the disease epidemic and adverse effects especially in pregnancy. The aim of this study is to assess the socio-demographic factors associated with Intermittent Preventive Treatment and health seeking behaviours for malaria in pregnancy among women of reproductive ages in Nigeria Methods Using the National Demographic Survey (NDHS) 2018 data, a cross sectional study was conducted to assess socio-demographic factors associated with Intermittent Preventive Treatment (IPT) for Malaria among Nigerian women of reproductive ages. Result Majority were between ages 30-39 years (39.5%), married/cohabiting (91.8%), Muslims (59.5%), from the north (68.9%), uneducated ( 49.9%), poor (47.5%), and grand parous (65.7%). 63.4% of the women had taken fansidar for malaria in pregnancy while only 6.1% had received healthcare for malaria from informal sources. Except for marital status, all socio-demographic variables (regions, highest educational level, wealth index, age group, religion and parity) were significantly associated with intake of IPT. Additionally, region, education, wealth index, age group, marital status and religion were associated with health seeking behaviour for malaria in pregnancy (P<.05). After control for other variables, wealth index, highest educational level, married/cohabiting marital status and religion was significantly associated with intake of IPT while region, primary and secondary education, poorer and richest wealth index, widowed/separation influenced health seeking for malaria in pregnancy (P<.05). Conclusion The National Malaria Elimination programme should evaluate existing policies that develop interventions that are centred on high risk population in order to prevent malaria in pregnancy while improving health seeking behaviours of women of reproductive ages.

A Clinical, Electrocardiographic and Echocardiographic Comparison of Patients with Single Vs Multivessel Disease Presenting with Acute Coronary Syndromes

Sep 2022 DOI 10.14302/issn.2329-9487.jhc-22-4252
Kumari Nuthalapat RamaCorresponding author Additional Professor of Cardiology, Department of Cardiology, Nizams institute of medical sciences, Panjagutta, Hyderabad, Telangana state, India

Background Prevalence of coronary artery disease is between 7-13 percent in urban and 2-7 % in rural India1. The alarm in rise in the prevalence of coronary risk factors like diabetes, hypertension, dyslipidemia, smoking, central obesity and physical inactivity2. The correlation between these risk factors and the severity of coronary atherosclerosis, assessed by angiography which may be either single or multivessel is less consistent with studies reporting conflicting results 3,4. Therefore our study aims to understand the proper correlation between risk factors and severity of coronary artery disease in an Indian population Methods This study was conducted in the department of cardiology, NIMS hospital Hyderabad which receives patients from the urban as well as rural areas of Telangana. the patients admitted in the department of cardiology, NIMS hospital Hyderabad that presented with acute coronary syndromes and diagnosed to have coronary artery disease (single vessel/multivessel disease) on coronary angiography taken for study. Sample Size is 150 Results Among the 150 subjects, males were 111(74%) and females were 39(26%). Mean age of the study population is 55.2 ± 11.4. Among SVD group 73.65% were males &26.3% were females. Among MVD group 76.2% were males & 23.7% were females. Mean age for SVD was 53±14.4 years, while mean age foe MVD was 58.6±14.5 years. For ACS mean age of presentation for females is 60.7±11.4 and for males mean age of presentation is 55.1±12.6. MVD (57.2%) were more common among smokers than SVD. In <45 years age group SVD (69.2%) were more common than MVD (30.8%). In 45- 70 years age group and >70 years age group MVD were more common than SVD with 69.6% and 66.6% respectively, which is statistically significant. MVD (60%) were more common among hypertensives than SVD. Among non-hypertensives MVD (41.8%) was less common than SVD (58.2%) MVD was common among all age groups, which is statistically signicant. Among STEMI group SVD (58.3%) was more common than MVD (41.7%). Among NSTEMI group MVD (62%) was more common than SVD (38%).Correlation between groups was statistically significant. Among SVD study group, LVEF was commonly between 30-45% & very few with LVEF <30% MVD was associated with more severe LV dysfunction as compared to SVD in acute MI. The difference in ejection fraction between the two groups was statistically significant P value=0.0002. In hospital MACE Among SVD there was 1 MI (due to stent thrombosis) who had to TVR (primary PCI) & rest were asymptomatic and discharged in normal state MVD there were in hospital deaths (due to refractory cardiogenic shock) rest were asymptomatic and were discharged in normal state. This difference between the two groups was statistically insignificant. Conclusion Multivessel disease in ACS were seen more commonly among elderly as compared to young subjects where single vessel disease were more common. Females especially elderly more commonly have multivessel disease. Mean age for multivessel disease was higher than single vessel disease. Among <45 years age group, SVD was more prevalent among smokers, obese and physically active. Multi vessel disease is more prevalent among patients with risk factors like diabetes, hypertension, dyslipidemia and physically inactive. Subjects with family history of premature CAD presented early and correlated well with prevalence of SVD.NSTEMI presented more with multi vessel disease. In echocardiographic wall motion analysis, a depressed regional segment of infarcted area with remote hyperkinesis predicted SVD where as remote area hypokinesis predicts more multivessel disease. In hospital outcomes were seen among multi vessel disease as compared to single vessel disease although not statistically significant.

COVID-19 and Hip Osteoarthritis Disability-Linkages and Emerging Practice Implications

Aug 2022 DOI 10.14302/issn.2474-7785.jarh-22-4271
Marks RayCorresponding author Department of Health and Behavior Studies, Columbia University, Teachers College New York, USA.

Older adults suffering from chronically painful disabling osteoarthritis of one or more joints such as the hip joint continue to experience multiple health issues, commonly progressive debility, and excess disability. This mini review strove to examine current perspectives in the realm of hip joint osteoarthritis, a widespread disabling disease affecting many older adults in the face of the possible repercussions of the multiple COVID-19 restrictions in response to the SARS-CoV-2 pandemic that emerged in late 2019, along with the persistence of multiple evolving COVID-19 variants that remain lethal to many older adults, especially among the older chronically impaired population. Using multiple data bases, results reveal that very little progress has been made in recent times to mitigate hip osteoarthritis, along with very few innovative treatment approaches when severe, other than surgery and medication. Moreover, a multitude of non-pharmacologic approaches have not reduced numbers of cases requiring surgery to any extent, even when employed. In addition, outcomes of hip joint replacement surgery, and other treatments for ameliorating unrelenting pain remain largely suboptimal, especially where those undergoing surgery may now be more impaired than in pre pandemic times, and where high rates of opioid related deaths prevail in this regard. As such, it is concluded that whether in the community or being treated in hospital, exposure to COVID-19 remains risky especially in cases who are now weaker and frail, plus suffering from excess chronic disease manifestations, thus warranting more attention and protection of this high risk group, plus insightful preventive efforts to avert multiple interacting COVID-19 effects in the realm of osteoarthritis suffering, especially where patients are willing to risk infection by undergoing surgery.

Predictors of Adherence to Pre-Exposure Prophylaxis among Female Sex Workers in South-Western Nigeria

Jul 2022 DOI 10.14302/issn.2324-7339.jcrhap-22-4204
Samson Jegede OluwatosinCorresponding author LAUTECH Teaching Hospital, Ogbomoso, Nigeria

Introduction Pre-exposure prophylaxis (PrEP) is an element of the biomedical interventions of Human Immunodeficiency virus (HIV) prevention. The level of protection is strongly correlated to PrEP drug adherence. In Nigeria, the prevalence of HIV among female sex workers (FSW) is 15.5%. The 2020 integrated biological and behavioral surveillance survey did not report on PrEP adherence among FSW. This study therefore assessed the level of adherence to PrEP and its predictors among FSW in South-Western Nigeria. Methodology This cross-sectional analytical study was conducted in 2021. Study population were brothel-based FSW at Gambari Ogbomoso and Lagos, Nigeria. A total of 156 FSW participated in the study. Data was collected using interviewer-administered semi-structured questionnaire and analyzed using IBM SPSS Version 25. Results One hundred and forty-nine properly completed questionnaires were analyzed. Ninety-nine respondents (66.4%) have been working for more than 5years as a FSW and 65(43.6%) had initiation of sex work before 18 years of age. Respondents’ sexual behavior showed that 55 (36.9%) of total respondents had consistent use of condom. One hundred and thirty-four respondents (89.9%) had good knowledge of PrEP, 97 (65.1%) had good attitude towards PrEP while 111 (74.5%) had good perception of risk of HIV infection. One hundred and thirty-two (88.6%) reported to be taking PrEP and 119 (79.9%) had good adherence to PrEP. Predictors of adherence to PrEP were educational status, age of commencement of sex work and monthly income. It was found that educated sex workers were 2.67 times more likely to adhere to PrEP (OR=2.67, 95% CI=1.280-5.591, p=0.019). Those who commenced sex work after clocking 18 years of age were 75% times less likely to adhere to PrEP (OR=0.251, 95% CI=0.106-0.597, p=0.001) while those with average monthly income more than #10,000 were 1.65 times more likely to adhere to PrEP (OR=1.65, 95% CI=0.674-4.042, p=0.0275. Discussion and Recommendation The level of adherence to PrEP is considerably high and underscores a positive effect of the efforts of the Government of Nigeria in controlling HIV as a threat by 2030. Further studies would be useful to understand the behavioral factors associated with low adherence to PrEP among FSW who have spent more than 5 years in sex work.

Osteoarthritis Depression Impacts and Possible Solutions Among Older Adults: Year 2021-2022 in Review

Jun 2022 DOI 10.14302/issn.2474-7785.jarh-22-4229
Marks RayCorresponding author Department of Health and Behavior Studies, Columbia University, Teachers College New York, USA.

Background Osteoarthritis, a serious joint disease, said to represent a generally declining state of wellbeing and function among many older adults has been shown to be affected to a considerable degree by various negative beliefs and inactions rather than degradation alone. Aim This review examines the case of depression as this pertains to the older adult with osteoarthritis of one or more joints. Specifically, the most up to date information on this topic was sought, as care improvements over the past decade have not shown any impactful population wide results. Method Reviewed were relevant 2021-2022 research and review articles specifically pertaining to what is being observed currently by researchers as far as osteoarthritis-depression linkages goes, as these may reveal opportunities for more profound research, and practice-based endeavors. Results In line with 60 years of prior research, it appears a clinically important role for depression in some osteoarthritis cases cannot be ruled out. It further appears that if detected and addressed early on, many older adults suffering from osteoarthritis may yet be enabled to lead a quality life, rather than a distressing and excessively impaired state of being. Those older osteoarthritis cases requiring surgery who suffer from concomitant depressive symptoms are likely to be disadvantaged in the absence of efforts to treat and identify this psychosocial disease correlate. Conclusion Providers and researchers are encouraged to pursue this line of inquiry and begin to map clinical osteoarthritis measures with those that can track cognitive patterns, musculoskeletal, features and inflammatory reactions along with valid depression indicators among carefully selected osteoarthritis sub groups.

Tay-Sachs Disease: From Molecular Characterization to Ethical Quandaries and the Possibility of Genetic Medicine

Jun 2022 DOI 10.14302/issn.2470-5020.jnrt-22-4217
O. Henderson JeffreyCorresponding author Department of Science and Mathematics, Judson University, Elgin, IL 60123, USA

Tay-Sachs disease (TSD) is a rare neurodegenerative disorder caused by mutations in the HEXA gene, which encodes the ɑ subunit of the enzyme β-hexosaminidase A. Lacking this key enzyme in GM2 ganglioside catabolism, individuals who are homozygous for HEXA mutations suffer from abnormal accumulation of GM2 ganglioside in brain and nerve cells, ultimately resulting in the progressive deterioration of the central nervous system. TSD is one of three disorders characterized by β-hexosaminidase deficiency; Sandhoff disease (SD) and the AB variant arise by mutations in the HEXB and GM2A genes respectively, which disrupt other points of GM2 ganglioside degradation. Characterized by developmental delay and stagnation, muscular weakness, coordination deficits, seizures, and eventual hearing and vision loss, these three disorders are clinically indistinguishable and occur in three forms defined by age of onset. While there is a much higher incidence of TSD in the Ashkenazi Jewish population, community carrier screening and counseling initiatives have reduced disease prevalence to about the equivalent of non-Jewish populations; however, such efforts have raised ethical concerns in the Jewish community that are increasingly relevant in light of scientific and medical advancements. Currently, treatments for TSD and its related disorders focus on symptom management, with gene therapies and the application of modified CRISPR-Cas-9 technology being explored.

Respiratory Diseases Open Access

Microalbuminuria and the Presence of Hypoxemia in Patients with Chronic Obstructive Pulmonary Disease

Jun 2022 DOI 10.14302/issn.2642-9241.jrd-22-4181
K. Al Miraj A.Corresponding author Research Assistant, Dept of Vascular Surgery, BSM Medical University Dhaka, Bangladesh

Introduction Worldwide, the Chronic Obstructive Pulmonary Disease (COPD) is a major public health concern; On the basis of epidemiologic data, by 2020, COPD will be the third leading cause of death worldwide. Objective To assess the frequency of Microalbuminuria and the presence of Hypoxemia in patients with COPD. Materials and Methods Study Design Cross-sectional observational study. Place of Study Department of Medicine & Respiratory Medicine in Dhaka Medical College Hospital (DMCH). Study Period Six months after approval of the protocol Study Population Patient suffering from COPD and admitted in Department of Medicine & Respiratory medicine, DMCH, Dhaka, Bangladesh. Total 100 samples were included in this study. COPD usually presents with a history of chronic cough with sputum production or exertional breathlessness which may be associated with relevant clinical findings and a post-bronchodilator FEV1/FVC less than 0.7. In most cases it is associated with smoking Results Total 100 patients of COPD were included in the study. Mean age was 58.16±5.4 years ranging from 50 to 74 years. Out of 100 patients, majority (42%) were from age group 55 to 60 years. Among all, 82% patients were male and 18% were female, of 100 patients, majority (30%) were day laborer. Only 2% were unemployed. The percentage of housewives was 18%. Other 34% were businessman and service holders. COPD severity was assessed using GOLD guideline. Out of 100 COPD patients, 38% had severe COPD (GOLD stage III). 16 % patients were in mild (Stage I) and 32% patients were in moderate stage (Stage II). The condition was very severe for 14% patients (Stage IV). Of 100 COPD patients, 30% had microalbuminuria. Among 100 COPD patients, chance of microalbuminuria increases among COPD patients with the increase of age significantly. There is smoking history of 36 pack year for COPD patients with microalbuminuria. Of 100 patients 26% were hypoxemic. The average forced expiratory volume (FEV1%) was 37.40 with standard deviation 14.48 for patients with microalbuminuria. The PaO2 and PaCO2 is 63.06 with standard deviation 7.09 and 46.09 with standard deviation 2.43 for COPD patients with microalbuminuria respectively. All of these characteristics are significant with p-value 0.00. However, the body mass index (BMI), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were not found significant. The patients who had PaO2 less than 70 mmHg were considered hypoxemic. The patients who had microalbuminuria among them 87% were hypoxemic. Only 13% patients were free from hypoxemia who had microalbuminuria. Patients without microalbuminuria had no history of hypoxemia. There is significant relation exists between hypoxemia and the presence of microalbuminuria (p<0.5). Conclusion In this study, about one-fourth of the patients have hypoxemia and more than one fourth of the patients have microalbuminuria. Stage III was more frequent among the study population but there was no association between severity grading and presence of microalbuminuria. However, significant relation is found between co-existence of both microalbuminuria and hypoxemia in COPD patients.

Fragiles but Resilient. The Key Strategies to Cope with Pandemic in Persons with Multiple Sclerosis. A Controlled Web Survey

Jun 2022 DOI 10.14302/issn.2470-5020.jnrt-22-4106
Sgoifo AnnalisaCorresponding author ASST Grande Ospedale Metropolitano Niguarda, Department of Neurosciences, Division of Neurology, Piazza Ospedale Maggiore, 3 - Milano, 20162, IT

Background SARS-CoV-2 pandemic represented an unexpected psychological stress, being a major threat to health and limiting daily’s life, especially for the fragile population. How could the people with (pw) Multiple Sclerosis (MS) cope with this emergency? Objective To observe the pwMS’s psychological reaction in comparison with non affected persons and to evaluate the impact of lifestyle changes on psychological symptoms, due to the pandemic. Methods The study was observational, retrospective, controlled, focused on good clinical practice and conducted at Niguarda Hospital. PwMS and controls filled a web survey containing anamnestic data, habits, depression and anxiety self-questionnaires. The primary outcome was the pwMS’s psychological anxiety and depression score compared with controls. Results On April, 10 2020, 88/165 pwMS and 187 controls joined the study. Unexpectedly, no significant differences between groups were observed for depression mean score: 6.6(5.2) in pwMS and 6.2(4.8) in controls and for anxiety: 5.9(4.8) and 5.0(4.2). PwMS focused on health concern more often than controls, but they respected the restrictions more easily and benefited from practical activities more than controls. Conclusion PwMS showed a proper psychological resilience in comparison with controls. These findings might guide the clinical interviews and suggest both the areas to be supported and the strengths to be promoted in pwMS.

Prevalence of Covid 19 in Students Attended Al-Dora Family Medical Center for Covid 19 Test

May 2022 DOI 10.14302/issn.2692-1537.ijcv-22-4174
Jaafar Kadhim Al-Ameri RawaCorresponding author Family Medicine Specialist, AlMustansiriyah University, Iraq

Introduction: Covid 19 pandemic affected all aspect of life, particularly schools attending. Students replaced their presentational lessons by on line distance learn. Ministry of health decisions varied between complete electronic study and attendance several days per week depending on the number of cases of the whole population. In Iraq, total cases till 15 of September, 2021, reached 1.963,264 and total death 21,631. Highest percent of confirmed cases in age group (30-39) years; 24.7%, while in children aged (0-9) years only 1.6%, and in older age group (10-19) years; 7.5%. Cases of covid19 at lower percent in small children and in school age children and tend to increase with age as it reached to 22.6% in age group (20-29). Objectives: Prevalence of covid 19 in students attending AL-dora medical center lab. Comparisons in number of cases of students before and after the school lock –down. Methods: It is a cross sectional study, included the records of schools health unit and lab records of VTM nasal or pharyngeal swab and rapid test in Al-Dora family health center from 1/10/2020 to 15/7/2021. Results: The study included 1711 students, the mean age group was 15.7 (± 4.9) years. The study showed the prevalence of covid19 in students attained the lab was 23.4%, highest percent was in age group >18 years and the lowest percent was in age group 6-12 years. The percent of vaccinated students in academic year 2020/2021 was 0.3 %( 3/1000). There is no significance difference in age group 6-12 years and age group >18 years before closing schools and colleges and after closing while age group 13-18 years showed a significant increase in positive cases after closing schools as cases increase from 18.1% to 25.9% after closing schools. Positive cases showed no significance difference with sex before and after closing. Discussions: The educational path of students in different age groups had broken down. Fear of parents could be justified but it could be exaggerated. School closures were applied almost around the world trying to decrease the potential spread of disease despite early studies suggested this would have less impact than most other non-pharmacological interventions.

Osteoarthritis and Neuromuscular Deficits: Can a Causative Role be Discounted- Key 2017-2022 Observations

May 2022 DOI 10.14302/issn.2474-7785.jarh-22-4191
Marks RayCorresponding author Department of Health and Behavior Studies, Columbia University, Teachers College New York, USA.

Background The origin of osteoarthritis, the most common disabling disorder of older adults remains uncertain. Aim This mini review examines the possible role played by various neuromuscular deficits in the osteoarthritis etiopathogenic process. Methods and Procedures Articles that haveaddressed the current topic of interest and were located in the PUBMED,Google Scholar, and Web of Science electronic data bases as of 2017-2022 were carefully sought and examined. Results Various neuromuscular mechanisms may have a bearing on the development and progression of osteoarthritis, but the data are largely unrelated and observational in nature. Conclusion More research to examine this issue is sorely needed and could have considerable merit in light of the growing populations of older adults at risk for disabling osteoarthritis in the face of few intervention options to help them to achieve an optimal functional level.

Human Health Research Open Access

HIV and Homosexuality: In the Light of Therapeutic Interventions

May 2022 DOI 10.14302/issn.2576-9383.jhhr-21-3994
Yadav RavinderCorresponding author Medical Social Welfare Officer Department of Medical Record Government Medical College and Hospital, Sector-32, Chandigarh, India

In this article the author reviews research on high risk factor of Human Immunodeficiency Virus in homosexuals and how lack of awareness & unprotected anal sex contribute substantially to new infections among this population. current HIV prevention efforts by providing insight into the patterns of Indian MSM behavior and sexual partnerships, and the specific cultural, social inequality, the gaps and lack of knowledge and psychological context in which HIV risk is occurring. And the need to develop effective awareness programs for well-functioning prevention of HIV and considerable understanding of the logistical and socio-cultural barriers MSM experience while accessing HIV prevention services. And in last will put light on therapeutic interventions for Human Immunodeficiency Virus, behavioral interventions that are socially and culturally appropriate for the population or community being prioritized and addressing multilevel psychosocial factors, including skills building and strategies to foster self-acceptance and increased social support for MSM. At the same time, prevention messages need to be designed and adapted to the knowledge level and culture of people.

Analysis of Risk of Death due to COVID-19 in Cameroon

Mar 2022 DOI 10.14302/issn.2692-1537.ijcv-22-4115
Whegang Youdom SolangeCorresponding author The University of Dschang Taskforce for the Elimination of COVID-19 (UNITED#COVID-19) .

Background Cameroon is battling against the novel coronavirus (COVID-19) pandemic. Although several control measures have been implemented, the epidemic continues to progress. This paper analyses the evolution of the pandemic in Cameroon and attempts to provide insight on the evolution of COVID-19 within the country’s population. Methods A susceptible-infected-recovered-dead (SIRD)-like model coupled with a discrete time-dependent Markov chain was applied to predict COVID-19 distribution and assess the risk of death. Two main assumptions were examined in a 10-state and 3-state Markov chain: i) a recovered person can get infected again; ii) the person will remain recovered. The COVID-19 data collected in Cameroon during the period of March 6 to July 30, 2020 were used in the analysis. Results COVID-19 epidemic showed several peaks. The reproductive number was 3.08 between May 18 and May 31; 2.75 between June 1 and June 25, and 2.84 between June 16 and June 24. The number of infected individuals ranged from 17632 to 26424 (June 1 to June 15), and 28100 to 36628 (June 16 to June 24). The month of January 2021 was estimated as the last epidemic peak. Under the assumption that a recovered person will get infected again with probability 0.15, 50000 iterations of the Markov chain (10 and 3- state) demonstrated that the death state was the most probable state. The estimated lethality rate was 0.44, 95%CI=0.10%-0.79%. Mean lethality rate assuming ii) was 0.10. Computation of transition probabilities from reported data revealed a significant increase in the number of active cases throughout July and August, 2020, with a mean lethality rate of 3% by September 2020. Conclusion Multiple approaches to data analysis is a fundamental step for managing and controlling COVID-19 in Cameroon. The rate of transmission of COVID-19 is growing fast because of insufficient implementation of public health measures. While the epidemic is spreading, assessment of major factors that contribute to COVID-19-associated mortality may provide the country’s public health system with strategies to reduce the burden of the disease. The model outputs present the threatening nature of the disease and its consequences. Considering the model outputs and taking concrete actions may enhance the implementation of current public health intervention strategies in Cameroon. Strict application of preventive measures, such as wearing masks and social distancing, could be reinforced before and after the opening of learning institutions (schools and universities) in the 2020/2021 calendar year and next.

Covid-19 Pandemic and Persons with Disabilities: Impacts and Risk Factors, Lessons for Future Interventions

Mar 2022 DOI 10.14302/issn.2692-1537.ijcv-21-3757
Muhammed YahyaCorresponding author Department of Sociology, School of Arts and Sciences, University of The Gambia. Banjul, The Gambia, West Africa

Background The pandemic has disrupted the lives of many globally including persons with disabilities. These disruptions are universal. However, the vulnerable communities are more affected. Purpose The study examines impacts on persons with disabilities to share knowledge and inform interventions that ensure persons with disabilities are supported. Methodology The study is a systematic literature review using different search engines to search for scholarly articles all over the globe. Results Persons with disabilities have been negatively impacted in numerous ways: lack of access to healthcare services, inadequate rehabilitation services, increased human rights violation, stigmatization and discrimination, increased risk of dying, being subjected to violence, losing financial income, lack of access to education and treatment, increased in neglect and traumatization, poverty, lack of access to food, decreased in community support; and worse of all, in comparison with the overall population, the death of persons with disabilities during the Covid-19 is higher. These impacts were precipitated by inaccessible built environment and sense of touching, lack of disability sensitive policies, increased prevalence of risk factors, difficulties in adhering to WHO recommendations, pervasiveness of underlying health conditions, lack of disability-friendly information and inclusive intervention, national budget cuts; and poorly funded institutions. Conclusion Persons with disabilities have been negatively impacted due to many risk factors peculiar to them.

Dolutegravir: Pharmacokinetics and Pregnancy Profile

Mar 2022
Bereda GudisaCorresponding author Department of Pharmacy, Negelle Health Science College, Guji, Ethiopia

Dolutegravir suppresses this integration enzyme, so human immune virus can’t create every greater copies of itself, thus ‘’integrase inhibitor.’’ Dolutegravir is hastily absorbed pursuing oral administration. The median maximum plasma concentration is reached 1.5–2.5 hours after oral uptake with a mean half-life of 12–15 hours, rendering feasible for once-daily dosing without the need for pharmacological boosting. The terminal half-life is about 14 hours. The apparent oral clearance is about 1 liter/hour. Fifty three percent of the total oral dose of dolutegravir is excreted unchanged in the feces, thirty two percent through urine as glucuronide (eighteen percent) or alkylated product (three point five percent), and other organic conjugated products sequencing from phase II liver metabolisms. Dolutegravir’s categorized as pregnancy category B (no confirmation of pitfall in humans) means either animal-reproduction inquests have not substantiated a fetal peril but there are no restrained inquests in pregnant women or animal-reproduction inquests have reveal an adverse effect (distinctive than a de-escalate in fertility) that was not inveterate in restrained inquests in women in the first trimester (and there is no confirmation of a pitfall in later trimesters) or there is survey in animal that revealed the medication is safe in pregnant animal, but there is no fetal pitfall confirmation in pregnant women.Antiviral Pregnancy Registry (APR) revealed that as of January 2017, pregnancy outcomes and birth defects were analyzed from 142 pregnancies with reported exposure to DTG during pregnancy. There were 128 live births reported (3 terminations, 11 miscarriages, no stillbirths). Only 4 (3.0%) reported birth defects, which is similar to the expected rate of birth defects in the general population. European Pregnancy and Paediatric HIV Cohort Collaboration (EPPIC) displayed that as of July 2017, 101 pregnancies with exposure to DTG had been identified with 84 birth outcomes. Rates of preterm delivery and “small for gestational age” were identical to outcomes reported from women on alternative regimens (standard of care in the United Kingdom of Great Britain and Northern Ireland).

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