Category: Nevin Manimala

BMC Public Health. 2022 Nov 4;22(1):2020. doi: 10.1186/s12889-022-14477-y.

ABSTRACT

INTRODUCTION: Globally, the amount of research on the outcomes of pediatric tuberculosis (TB) is disproportionately less than that of adult TB. The diagnosis of paediatric TB is also problematic in developing countries. The aim of this study was to describe the outcomes of pediatric TB in Botswana and to identify the factors associated with unfavorable outcomes.

METHODS: This was a retrospective analysis of pediatric TB outcomes in Botswana, over a 12-year period from January 2008 to December 2019. Treatment success (treatment completion or cured) was considered a favorable outcome, while death, loss to follow-up and treatment failure were considered unfavorable outcomes. Program data from drug-sensitive TB (DS-TB) cases under the age of 15 years were included. Sampling was exhaustive. Binary logistic regression was used to determine the factors associated with unfavorable outcomes during TB treatment. A p value of < 0.05 was considered a statistically significant association between the predictor variables and unfavorable outcomes.

RESULTS: The data of 6,004 paediatric TB cases were extracted from the Botswana National TB Program (BNTP) electronic registry and analyzed. Of these data, 2,948 (49.4%) were of female patients. Of the extracted data, 1,366 (22.8%) were of HIV positive patients and 2,966 (49.4%) were of HIV negative patients. The rest of the data were of patients with unknown HIV status. Pulmonary TB accounted for 4,701 (78.3%) of the cases. Overall, 5,591 (93.1%) of the paediatric TB patient data showed treatment success, 179 (3.0%) were lost to follow-up, 203 (3.4%) records were of patients who died, and 31 (0.5%) were of patients who experienced treatment failure. The factors associated with unfavorable outcomes were positive HIV status (AOR 2.71, 95% CI: 2.09-3.52), unknown HIV status (AOR 2.07, 95% CI: 1.60-2.69) and retreatment category (AOR 1.92, 95% CI: 1.30-2.85). Compared with the 0-4 years age category, the 5-9 years (AOR 0.62, 95% CI: 0.47-0.82) and 10-14 years (AOR 0.76, 95% CI: 0.60-0.98) age categories were less likely to experience the unfavorable outcomes.

CONCLUSION: This study shows a high treatment success rate among paediatric TB cases in Botswana. The government under the National TB Program should maintain and consolidate the gains from this program. Public health interventions should particularly target children with a positive or unknown HIV status, those under 5 years, and those who have been previously treated for TB.

PMID:36333805 | DOI:10.1186/s12889-022-14477-y

BMC Cancer. 2022 Nov 4;22(1):1130. doi: 10.1186/s12885-022-10209-y.

ABSTRACT

BACKGROUND: The aim of this study was to estimate occupational risk variation in the incidence of nasopharyngeal cancer (NPC) in a large population-based cohort of the Nordic Occupational Cancer (NOCCA) study.

METHODS: This study is based on a cohort of almost 15 million persons from Denmark, Finland, Iceland, Norway and Sweden, with 2898 nasopharyngeal cancer cases diagnosed in 1961-2005. The data on occupations were gathered from population censuses and cancer data from the national cancer registries. Standardized incidence ratios (SIR) with 95% confidence intervals (CI) were estimated using the national NPC incidence rates as the reference.

RESULTS: There were 1980 male and 918 female NPC patients. The highest SIRs of NPC were observed among male waiters (SIR 3.69, 95% CI 1.91-6.45) and cooks and stewards (SIR 2.24, 95% CI 1.16-3.91). Among women, launderers had the highest SIR of NPC (2.04, 95% CI 1.02-3.65). Significantly decreased SIRs were found among male farmers (SIR 0.79, 95% CI 0.68-0.92) and male textile workers (SIR 0.49, 95% CI 0.22-0.93).

CONCLUSIONS: This study suggests that NPC may be associated with several work-related exposure agents such as smoking, kitchen air pollution and solvents. In future, occupational exposure-risk relations should be studied to understand more about causality and to assess effective prevention strategies.

PMID:36333796 | DOI:10.1186/s12885-022-10209-y

J Infect Dev Ctries. 2022 Oct 31;16(10):1643-1647. doi: 10.3855/jidc.15840.

ABSTRACT

INTRODUCTION: Pneumocystis jirovecii pneumonia (PJP) is a lung mycosis commonly found in immunocompromised patients (e.g., HIV patients); however, its role in solid cancer remains unclear. This study aims to identify Pneumocystis jirovecii colonization among naïve non-small-cell lung cancer (NSCLC) through bronchoalveolar lavage (BAL) and explore its correlation with clinical parameters.

METHODOLOGY: This cross-sectional study recruited newly diagnosed naïve NSCLC patients who had not been given systemic treatments. We tested BAL from patients for P. jirovecii colonization with nested PCR targeting the mtLSU rRNA gene. Demographic and clinical characteristics were obtained from medical records, and the correlation between P. jirovecii colonization and clinicopathological data were analyzed. Kaplan-Meier analyses were done to evaluate survival.

RESULTS: Among 56 newly diagnosed, naïve NSCLC patients enrolled, the prevalence of P. jirovecii colonization was 17.9% (10 subjects). There was no statistically significant difference in demographic and clinical characteristics between the P. jirovecii colonization group versus no colonization (p value > 0.05). The overall survival duration for both groups demonstrated no significant difference.

CONCLUSIONS: This study demonstrated a relatively high prevalence of P. jirovecii colonization among BAL samples of naïve Indonesian NSCLC patients. Further study is needed to delineate its implications for the potential transmission source, lung cancer pathogenesis, and prognosis.

PMID:36332219 | DOI:10.3855/jidc.15840

J Infect Dev Ctries. 2022 Oct 31;16(10):1630-1636. doi: 10.3855/jidc.16851.

ABSTRACT

INTRODUCTION: The most common infection in cholestatic infants is caused by human cytomegalovirus (HCMV). The aims were to detect the presentation of HCMV in cholestatic infants and to evaluate the concordance, sensitivity, and specificity between serology and polymerase chain reaction (PCR) of HCMV from liver biopsy and urine specimens.

METHODOLOGY: A descriptive observational study with a cross-sectional approach was conducted on 35 cholestatic infants with ethical approval. Specimens were liver biopsy, urine, and anti-HCMV serology. Liver and urine specimens were performed to nested PCR, followed by statistical analysis.

RESULTS: PCR from the liver biopsy and urine specimen were positive in 74.3% and 85.7%, respectively. There was no concordance between IgM with the liver PCR, but there was a concordance between IgM with the urine PCR and between IgG with the liver and urine PCR. The sensitivity and specificity of IgM with the liver PCR were 46 % and 56%, respectively, with a diagnostic accuracy of 49%. While IgG sensitivity was 96% with a diagnostic accuracy of 80%. IgG sensitivity and IgM specificity compared with the urine PCR were 93% and 100%, respectively, with a diagnostic accuracy of more than 60%.

CONCLUSIONS: It demonstrates a high prevalence of HCMV DNA in urine and liver biopsy from cholestatic infants. HCMV PCR assay is more sensitive and specific than the anti-HCMV IgM, but IgG has high sensitivity and accuracy diagnostic. Therefore, serological examination is an option for diagnosing HCMV infection in cholestatic infants in developing countries with no PCR facilities.

PMID:36332217 | DOI:10.3855/jidc.16851

J Infect Dev Ctries. 2022 Oct 31;16(10):1623-1629. doi: 10.3855/jidc.15151.

ABSTRACT

INTRODUCTION: Parents’ knowledge and attitudes regarding influenza vaccine significantly determine whether or not their children will receive the vaccine. The objective of the present study was to evaluate the knowledge, attitude and practice among Saudi parents towards vaccinating their children against influenza.

METHODOLOGY: A descriptive cross-sectional study was conducted in multiple regions of Riyadh. We used a convenience sampling technique to enroll study subjects. Individuals who were Saudi nationals, with at least one child between 6 months and 14 years of age were included.

RESULTS: Over half of the Saudi parents (53.8%) scored well on influenza and vaccine knowledge, while most of them (92.0%) showed positive attitude towards vaccination. Most of the children (87.9%) were immunized with national vaccination program and 63.6% of the parents were aware of the availability of seasonal influenza vaccines in primary healthcare centres (PHCs) and hospitals. However, only 28% of the parents and 18% of their children received the seasonal influenza vaccine between 2019 and 2020. High education level, high monthly household income and being part of a medical profession were statistically significant (p < 0.05) determinants of good knowledge. Similarly, male gender, younger parent, low monthly income, working in a medical profession and parents with one child aged between 6 months and 14 years were significant predictors (p < 0.05) of positive attitude.

CONCLUSIONS: Compliance of Saudi parents towards influenza vaccination is fairly poor despite positive attitude. Stringent efforts are needed to encourage the parents to actively ensure annual influenza immunization of their children.

PMID:36332216 | DOI:10.3855/jidc.15151

J Infect Dev Ctries. 2022 Oct 31;16(10):1564-1569. doi: 10.3855/jidc.14341.

ABSTRACT

INTRODUCTION: This study aims to research the effects of hematological and inflammatory parameters on the prognosis of COVID-19 disease and hospitalization duration.

METHODOLOGY: One hundred and eighty-six patients with COVID-19 and a control group consisting of 187 healthy individuals were included in the study. Hematological variables and inflammatory parameters of the patients were recorded on the first and the fifth days of hospitalization.

RESULTS: White blood cell count, lymphocyte count, and platelet count were statistically lower, and mean platelet volume (MPV), neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR) levels were higher in the patient group compared to the control group. It was observed that the neutrophil count and MPV level were lower, and the platelet count and ferritin level were statistically higher on the fifth day of follow-up compared to the admission day. In contrast, there was a significantly positive correlation between the duration of hospitalization and the fifth day D-dimer (r = 0.546, p < 0.001) and ferritin (r = 0.568, p < 0.001); in addition, there was a negative correlation between the duration of hospitalization and admission day lymphocyte count and the fifth-day lymphocyte count.

CONCLUSIONS: Increased levels of ferritin and D-dimer, and decreased count of lymphocytes are among the important factors affecting the duration of hospitalization for COVID-19 patients. Furthermore, we think that neutrophil count and MPV levels are low, and platelet count and ferritin levels are high during the disease. Therefore, these parameters can be used as prognostic indicators of the disease.

PMID:36332208 | DOI:10.3855/jidc.14341

J Infect Dev Ctries. 2022 Oct 31;16(10):1542-1554. doi: 10.3855/jidc.16884.

ABSTRACT

INTRODUCTION: There is lack of universal agreement on the management of COVID-19. Intravenous high dose vitamin C (HDVC), remdesivir (RDV), and favipiravir (FPV) have been suggested as part of the treatment regimens and only RDV is approved by the Food and Drug Administration (FDA) so far. There is no study in Lebanon that addresses the descriptive cohort of HDVC and antiviral therapy amongst COVID-19 inpatients. Our goal was to highlight such a cohort.

METHODOLOGY: A retrospective electronic chart review of COVID-19 inpatients was done over a period of 10 months (August 2020 to April 2021). Comparative data analysis was performed between HDVC and non-HDVC (NHDVC) groups, and RDV and FPV groups.

RESULTS: Among HDVC patients, 70.1% (p = 0.035) and 67.2% (p = 0.008) had dyspnea and desaturation respectively. Patients on HDVC were less likely to remain in hospital for more than 20 days (p = 0.003). HDVC patients were more likely to be on oxygen therapy with 74.7% (p = 0.002). RDV patients were more likely to be on other COVID-19-related medications during hospitalization including the use of tofacitinib, baricitinib, tocilizumab, and anticoagulation as recommended in the guidelines. Statistical significance was noted for the status on discharge as 90.1% of the patients that received RDV were discharged after clinical improvement, compared to the 74.2% of the FPV patients.

CONCLUSIONS: Further research is needed to establish local guidelines for the treatment of COVID-19. A significant role of HDVC and FPV might resurface if randomized control trials are conducted.

PMID:36332206 | DOI:10.3855/jidc.16884

J Asthma. 2022 Nov 4:1-17. doi: 10.1080/02770903.2022.2144354. Online ahead of print.

ABSTRACT

Objectives: Childhood asthma is one of the most common non-communicable diseases in the world. Several perinatal and postnatal factors have been associated with increased risk of developing childhood asthma. The present study aims to assess whether childhood overweight and obesity and abnormal birth anthropometric measures affect the risk of developing childhood asthma in pre-school age. Methods: In the present study, 5215 pre-school children at the age of 2-5 years were enrolled after applying several inclusion and exclusion criteria and they examined whether they present asthma symptoms. Non-adjusted and adjusted statistical analysis was performed to assess whether perinatal and postnatal factors increase the risk of developing childhood asthma. Results: A prevalence of 4,5% of childhood asthma was recorded. Among children diagnosed with asthma, 19,4% were affected by overweight and 13,9% were obese. Childhood overweight/obesity was indepedently associated with a 76% higher risk of childhood asthma than normal weight. Abnormal birth anthropometric measures, i.e. birth weight, length and head circumference, were independently associated with higher odds (87%, 29% and 23%, respectively) of childhood asthma than normal ranges. Conclusion: This is a cross-sectional, nationally representative study which supported evidence that childhood overweight/obesity and abnormal birth anthropometric measures may independently increase the risk of childhood asthma in pre-school age. Emergent health policies and strategies are recommended to promote healthy lifestyle, preventing childhood obesity at the early stages of life.

PMID:36332163 | DOI:10.1080/02770903.2022.2144354

Anal Chem. 2022 Nov 4. doi: 10.1021/acs.analchem.2c02332. Online ahead of print.

ABSTRACT

Estimation of the stoichiometric ratio of a supramolecular aggregate formed by different compounds is very important in elucidating the structure and function of the aggregate. Many spectroscopic methods used to estimate the stoichiometric ratios of coordination complexes become invalid when characteristic peaks of the aggregate overlap with peaks of compounds that form the aggregate. Previously, we combined the asynchronous orthogonal sample design with Job’s method to address the abovementioned problem. However, the interference of noise may lead to incorrect results. Herein, a new method has been developed. In the generation of corresponding Job’s curve, the intensity of a cross peak at a single apex is replaced by the volume of the cross peak. Since most noise is canceled in the calculation of the volume of the cross peak, resultant Job’s curve is robust to noise. Moreover, the Jonckheere-Terpstra statistical test, a famous nonparametric method to detect whether the data has an upward or downward trend, could further reduce the risk of yielding incorrect results caused by noise. We have applied this approach to two real-world examples (resveratrol/β-Cyclodextrin (β-CD) and N, N-diethyl-N‘-benzoylthiourea (DEBT)/Cu²⁺) with satisfactory results. The method described in this paper provides a robust way to measure the stoichiometric ratio in supramolecular systems.

PMID:36332132 | DOI:10.1021/acs.analchem.2c02332

Birth. 2022 Nov 4. doi: 10.1111/birt.12687. Online ahead of print.

ABSTRACT

BACKGROUNDS: Outpatient induction of labor (IOL) is an alternative choice offered to pregnant women requiring cervical ripening. Outpatient IOL can provide solutions in terms of women empowerment, but most importantly promotes as normal labor as possible, within the medical context of the IOL. The objectives of this systematic review were to assess safety and effectiveness of cervical ripening performed with a slow-release dinoprostone vaginal insert in term pregnancies in two settings: the outpatient (home) versus the inpatient (hospital).

METHODS: The electronic databases Cinahl, Embase, Medline and Maternity and Infant Care were searched to detect studies that met the inclusion criteria. Both reviewers collected the data and assessed the quality of the studies and assessed the pooled odds ratio using a 95% confidence interval and a random-effects model. Primary outcomes were linked to maternal and neonatal morbidity. Secondary outcomes were related to birth outcomes.

RESULTS: No statistical difference was seen between the outpatient and inpatient setting in terms of maternal complications, neonatal morbidity, cesarean section, and labor onset <24 h. Women in the outpatient setting were significantly less likely to experience uterine hyperstimulation, and they were also significantly more likely to require oxytocin to augment or induce their labor than the women in the inpatient setting. Women in the outpatient setting were more satisfied with the cervical ripening experience.

CONCLUSIONS: Cervical ripening with a slow-release dinoprostone vaginal insert in term pregnancies in the outpatient setting appears as safe as the inpatient setting in terms of maternal, neonatal, and birth outcomes.

PMID:36332128 | DOI:10.1111/birt.12687