scholarly journals Two cases of imported respiratory diphtheria in Edinburgh, Scotland, October 2019

2020 ◽  
Vol 148 ◽  
Author(s):  
Lucy Li ◽  
Daniella Ross ◽  
Katherine Hill ◽  
Sarah Clifford ◽  
Louise Wellington ◽  
...  
Keyword(s):  
Risk Assessment ◽  
High Risk ◽  
Corynebacterium Diphtheriae ◽  
High Index ◽  
Contact Tracing ◽  
Emerging Infections ◽  
Diphtheria Antitoxin ◽  
History Of ◽  
Risk Areas ◽  
High Index Of Suspicion

Abstract We report two cases of respiratory toxigenic Corynebacterium diphtheriae infection in fully vaccinated UK born adults following travel to Tunisia in October 2019. Both patients were successfully treated with antibiotics and neither received diphtheria antitoxin. Contact tracing was performed following a risk assessment but no additional cases were identified. This report highlights the importance of maintaining a high index of suspicion for re-emerging infections in patients with a history of travel to high-risk areas outside Europe.

scholarly journals Foreign body stone in oesophagus: a unique case

2015 ◽  
Vol 12 (2) ◽  
pp. 140-142 ◽  
Author(s):  
B P Sah ◽  
S T Chettri ◽  
J N. Prasad ◽  
P P Gupta ◽  
S P Shah ◽  
...  
Keyword(s):  
Foreign Body ◽  
High Risk ◽  
Rare Case ◽  
Mentally Retarded ◽  
Risk Groups ◽  
High Index ◽  
Common Occurrence ◽  
Unique Case ◽  
History Of ◽  
High Index Of Suspicion

Foreign body ingestion is a common occurrence in children and in specific high-risk  groups. It is usually diagnosed based on a history of ingestion given by the patient  or an observer. However, children and mentally retarded adults may be unable to  give an accurate history, and a high index of suspicion must be maintained in these  groups. We report a rare case of foreign body stone in an mentally retarded adult  which presented with drooling and impaired feeds, thence enabling for high index  for suspicion.  Health Renaissance 2014;12(2): pp: 140-142

scholarly journals An Alternative Risk Assessment Model of Urban Waterlogging: A Case Study of Ningbo City

2021 ◽  
Vol 13 (2) ◽  
pp. 826
Author(s):  
Meiling Zhou ◽  
Xiuli Feng ◽  
Kaikai Liu ◽  
Chi Zhang ◽  
Lijian Xie ◽  
...  
Keyword(s):  
Risk Assessment ◽  
High Risk ◽  
Assessment Model ◽  
Risk Assessments ◽  
Risk Assessment Model ◽  
Risk Area ◽  
The North ◽  
Coastal Cities ◽  
Risk Areas ◽  
The City

Influenced by climate change, extreme weather events occur frequently, and bring huge impacts to urban areas, including urban waterlogging. Conducting risk assessments of urban waterlogging is a critical step to diagnose problems, improve infrastructure and achieve sustainable development facing extreme weathers. This study takes Ningbo, a typical coastal city in the Yangtze River Delta, as an example to conduct a risk assessment of urban waterlogging with high-resolution remote sensing images and high-precision digital elevation models to further analyze the spatial distribution characteristics of waterlogging risk. Results indicate that waterlogging risk in the city proper of Ningbo is mainly low risk, accounting for 36.9%. The higher-risk and medium-risk areas have the same proportions, accounting for 18.7%. They are followed by the lower-risk and high-risk areas, accounting for 15.5% and 9.6%, respectively. In terms of space, waterlogging risk in the city proper of Ningbo is high in the south and low in the north. The high-risk area is mainly located to the west of Jiangdong district and the middle of Haishu district. The low-risk area is mainly distributed in the north of Jiangbei district. These results are consistent with the historical situation of waterlogging in Ningbo, which prove the effectiveness of the risk assessment model and provide an important reference for the government to prevent and mitigate waterlogging. The optimized risk assessment model is also of importance for waterlogging risk assessments in coastal cities. Based on this model, the waterlogging risk of coastal cities can be quickly assessed, combining with local characteristics, which will help improve the city’s capability of responding to waterlogging disasters and reduce socio-economic loss.

scholarly journals On the Risk Assessment of Terrorist Attacks Coupled with Multi-Source Factors

2018 ◽  
Vol 7 (9) ◽  
pp. 354 ◽  
Author(s):  
Xun Zhang ◽  
Min Jin ◽  
Jingying Fu ◽  
Mengmeng Hao ◽  
Chongchong Yu ◽  
...  
Keyword(s):  
Risk Assessment ◽  
High Risk ◽  
Southeast Asia ◽  
The Philippines ◽  
Assessment Model ◽  
Terrorist Attacks ◽  
Recommendation Algorithm ◽  
Spatial Risk ◽  
Risk Areas ◽  
F Measure

Terrorism has wreaked havoc on today’s society and people. The discovery of the regularity of terrorist attacks is of great significance to the global counterterrorism strategy. In this study, we improve the traditional location recommendation algorithm coupled with multi-source factors and spatial characteristics. We used the data of terrorist attacks in Southeast Asia from 1970 to 2016, and comprehensively considered 17 influencing factors, including socioeconomic and natural resource factors. The improved recommendation algorithm is used to build a spatial risk assessment model of terrorist attacks, and the effectiveness is tested. The model trained in this study is tested with precision, recall, and F-Measure. The results show that, when the threshold is 0.4, the precision is as high as 88%, and the F-Measure is the highest. We assess the spatial risk of the terrorist attacks in Southeast Asia through experiments. It can be seen that the southernmost part of the Indochina peninsula and the Philippines are high-risk areas and that the medium-risk and high-risk areas are mainly distributed in the coastal areas. Therefore, future anti-terrorism measures should pay more attention to these areas.

scholarly journals Prediction of the risk of developing diabetes mellitus among Bangladeshi adults by using risk assessment score

2019 ◽  
Vol 10 (1) ◽  
pp. 40-47
Author(s):  
Nazma Akter
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Risk Assessment ◽  
Blood Glucose ◽  
High Risk ◽  
Risk Score ◽  
Diabetes Risk ◽  
High Blood Glucose ◽  
History Of ◽  
Diabetes Risk Score

Background: Diabetes mellitus (DM) is considered as one of the major health problems worldwide. The rising prevalence of type 2 diabetes mellitus (T2DM) in Bangladesh is primarily attributed to rapid urbanization and associated changes in lifestyle, such as sedentary lifestyle, higher calorie food intake and stressful life. Studies support the utilization of riskassessment scoring systems in quantifying individual’s risk for developing T2DM. Thus, a simple risk-assessment scoring system for early screening of T2DM among Bangladeshi adults will be beneficial to identify the high-risk adults and thus taking adequate preventive measures in combating DM.The purpose of the study was to calculate the risk assessment score of developing T2DM within 10 years among Bangladeshi adults. Methods: The cross-sectional observational study was carried out in the outpatient department (OPD) of Medicine, MARKS Medical College & Hospital, a tertiary care hospital in Dhaka, Bangladesh from February 2018 to July 2018 among randomly sampled 205 adult subjects. Subjects undiagnosed with diabetes mellitus and had previous history of high blood glucose during pregnancy or other health examination (i.e. impaired fasting glucose, impaired glucose tolerance or gestational diabetes mellitus) were included. From a review of literature regarding risk factors of developing DM in Bangladesh, the Finnish Diabetes Risk Score (FINDRISC) system was found to be more useful for the Bangladeshi adults. The Finnish Diabetes Risk Score (FINDRISC) questionnaire was used to collect the data including demographic characteristics and different risk factors and to calculate total risk score for predicting the risk of developing T2DM within 10 years. Results: Among 205 subjects, male and female were 57.1% and 42.9% respectively. The Mean (±SD) age of the study subjects was 37.64±1.07 years. In this study, both non-modifiable and modifiable risk factors showed statistically significant association with the FINDRISC among Bangladeshi adults (p<0.05). There was a significant association among FINDRISC with history of previous high blood glucose, and treated hypertensive Bangladeshi adults.33.65% of the Bangladeshi adults had slightly elevated diabetes risk score (DRS). This study predicts that 17.55% of the Bangladeshi adults may have moderate to high risk to develop T2DM within the consecutive 10 years. Conclusion: This study provides a simple, feasible, non-invasive and convenient screening FINDRISC tool that identifies individuals at risk of having T2DM. People with high risk of DM should be referred for early intervention and changes to a healthy lifestyle and primary prevention to prevent or delay the onset of T2DM. Birdem Med J 2020; 10(1): 40-47

scholarly journals Spatial analysis of hepatobiliary abnormalities in a population at high-risk of cholangiocarcinoma in Thailand

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Kavin Thinkhamrop ◽  
Apiporn T. Suwannatrai ◽  
Nittaya Chamadol ◽  
Narong Khuntikeo ◽  
Bandit Thinkhamrop ◽  
...  
Keyword(s):  
Spatial Analysis ◽  
High Risk ◽  
Screening Program ◽  
Care Program ◽  
Population Based ◽  
Northeast Thailand ◽  
Survival Prognosis ◽  
Healthcare Facilities ◽  
History Of ◽  
Risk Areas

Abstract Cholangiocarcinoma (CCA) is a serious health challenge with low survival prognosis. The liver fluke, Opisthorchis viverrini, plays a role in the aetiology of CCA, through hepatobiliary abnormalities: liver mass (LM), bile duct dilation, and periductal fibrosis (PDF). A population-based CCA screening program, the Cholangiocarcinoma Screening and Care Program, operates in Northeast Thailand. Hepatobiliary abnormalities were identified through ultrasonography. A multivariate zero-inflated, Poisson regression model measured associations between hepatobiliary abnormalities and covariates including age, sex, distance to water resource, and history of O. viverrini infection. Geographic distribution was described using Bayesian spatial analysis methods. Hepatobiliary abnormality prevalence was 38.7%; highest in males aged > 60 years (39.8%). PDF was most prevalent (20.1% of males). The Standardized Morbidity Ratio (SMR) for hepatobiliary abnormalities was highest in the lower and upper parts of the Northeast region. Hepatobiliary abnormalities specifically associated with CCA were also more common in males and those aged over 60 years and distributed along the Chi, Mun, and Songkram Rivers. Our findings demonstrated a high risk of hepatobiliary disorders in Northeast Thailand, likely associated with infection caused by O. viverrini. Screening for CCA and improvement of healthcare facilities to provide better treatment for CCA patients should be prioritized in these high-risk areas.

scholarly journals Ecological risk assessment of geohazards in Natural World Heritage Sites: an empirical analysis of Bogda, Tianshan

2019 ◽  
Vol 11 (1) ◽  
pp. 327-340 ◽  
Author(s):  
Qin Liu ◽  
Zhaoping Yang ◽  
Hui Shi ◽  
Zhi Wang
Keyword(s):  
Risk Assessment ◽  
High Risk ◽  
Ecological Risk ◽  
Ecological Risk Assessment ◽  
World Heritage ◽  
Natural World ◽  
Low Risk ◽  
World Heritage Site ◽  
Heritage Site ◽  
Risk Areas

Abstract Ecological risk assessment plays an important role in avoiding disasters and reducing losses. Natural world heritage site is the most precious natural assets on earth, yet few studies have assessed ecological risks from the perspective of world heritage conservation and management. A methodology for considering ecological threats and vulnerabilities and focusing on heritage value was introduced and discussed for the Bogda component of the Xinjiang Tianshan Natural World Heritage Site. Three important results are presented. (1) Criteria layers and ecological risk showed obvious spatial heterogeneity. Extremely high-risk and high-risk areas, accounting for 13.60% and 32.56%, respectively, were mainly gathered at Tianchi Lake and Bogda Glacier, whereas the extremely low-risk and low-risk areas, covering 1.33% and 17.51% of the site,were mainly distributed to the north and scattered around in the southwest montane region. (2) The level of risk was positively correlated with the type of risk, and as the level of risk increases, the types of risk increase. Only two risk types were observed in the extremely low-risk areas, whereas six risk types were observed in the high-risk areas and eight risk types were observed in the extremely high-risk areas. (3) From the perspective of risk probability and ecological damage, four risk management categories were proposed, and correlative strategies were proposed to reduce the possibility of ecological risk and to sustain or enhance heritage value.

scholarly journals Scrotal Ulcer is a Rare Presentationof TB Epididymis in Young Male

2021 ◽  
pp. 146-149
Author(s):  
Rekadi Srinivasa Rao ◽  
Senthil Kumar ◽  
R. Anantharamakrishnan ◽  
P. Varadaraju
Keyword(s):  
Case Report ◽  
Early Diagnosis ◽  
Clinical Presentation ◽  
Young Male ◽  
High Index ◽  
History Of ◽  
Scrotal Swelling ◽  
High Index Of Suspicion

Introduction: Scrotal tuberculosis (TB) is rare and may present as painful scrotal swelling with ulceration and discharging sinus. Case Report: A 28 years male with 2 months history of swelling and pain over left scrotum. Developed ulcer over the scrotal region with multiple sinus associated with pus discharge. Conclusion: The clinical presentation of TB scrotal ulcer can be atypical and a high index of suspicion is required for early diagnosis. Diagnosis is by using ultrasonography, microbiology, and biopsy. Treatment requires prolonged ATT for 6 months.

scholarly journals Measles outbreak in Gothenburg urban area, Sweden, 2017 to 2018: low viral load in breakthrough infections

2019 ◽  
Vol 24 (17) ◽  
Author(s):  
Nicklas Sundell ◽  
Leif Dotevall ◽  
Martina Sansone ◽  
Maria Andersson ◽  
Magnus Lindh ◽  
...  
Keyword(s):  
Viral Load ◽  
High Risk ◽  
Medical Records ◽  
Clinical Symptoms ◽  
Previous History ◽  
Contact Tracing ◽  
Measles Outbreak ◽  
History Of ◽  
Measles Vaccination

In an outbreak of measles in Gothenburg, Sweden, breakthrough infections (i.e. infections in individuals with a history of vaccination) were common. The objective of this study was to compare measles RNA levels between naïve (i.e. primary) and breakthrough infections. We also propose a fast provisional classification of breakthrough infections. Medical records were reviewed and real-time PCR-positive samples genotyped. Cases were classified as naïve, breakthrough or vaccine infections. We compared clinical symptoms and measles RNA cycle threshold (Ct) values between breakthrough and naïve infections. Sixteen of 28 confirmed cases of measles in this outbreak were breakthrough infections. A fast provisional classification, based on previous history of measles vaccination and detectable levels of measles IgG in acute serum, correctly identified 14 of the 16 breakthrough infections, confirmed by IgG avidity testing. Measles viral load was significantly lower in nasopharyngeal samples from individuals with breakthrough compared with naïve infections (median Ct-values: 32 and 19, respectively, p < 0.0001). No onward transmission from breakthrough infections was identified. Our results indicate that a high risk of onward transmission is limited to naïve infections. We propose a fast provisional classification of breakthrough measles that can guide contact tracing in outbreak settings.

scholarly journals Diagnostic Accuracy of Different Screening Tools for Identifying Osteoporosis Risk Among Post-Menopausal Filipino Women Aged 45–65 Years

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A244-A244
Author(s):  
Justiene Mia Klarisse Alcantara Danga ◽  
Steven Johnson Lim ◽  
Jacquelyn Sulit ◽  
Elizabeth P Pacheco
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
High Risk ◽  
Diagnostic Accuracy ◽  
Screening Tools ◽  
Clinical Risk Factors ◽  
T Score ◽  
Filipino Women ◽  
History Of ◽  
Osteoporosis Risk

Abstract Early screening of osteoporosis decreases fracture risk. Several identified clinical risk factors led to the development of screening tools to estimate osteoporosis risk. Bone Mineral Densitometry (BMD) as a diagnostic tool for screening is not practical because of high cost and poor availability. The extensively studied osteoporosis screening tools are: Simple Calculated Osteoporosis Risk Estimation (SCORE), the Osteoporosis Risk Assessment Instrument (ORAI), the Age Bulk One or Never Estrogen (ABONE), body weight (WEIGHT), and the Osteoporosis Risk Index (OSIRIS). These tools were developed and validated in Caucasians. Validation of these tools for specific populations is necessary because of the observed variations in BMD across geographic and ethnic groups. To date, the utility of these screening tools in the Philippines is unknown. We conducted a cross-sectional analysis of all patients who underwent BMD screening for osteoporosis in a tertiary hospital from January 2015 to September 2020. The study participants were postmenopausal Filipino women aged 45 to 65 years. The subjects had no history of osteopenia, osteoporosis, hip or spine fractures, use of osteoporosis medications, renal insufficiency, bilateral oophorectomy, hysterectomy, or early menopause. We identified demographic and clinical risk factors. These risk factors were used to calculate the risk score of five osteoporosis risk assessment tools: ORAI, ABONE, WEIGHT, OSTA, and ORISIS. Using the DEXA T-score as an external criterion, the sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios, and diagnostic accuracy for each tool were calculated. Included were 1869 subjects with a mean age of 57.9 + 4.3 years old. Osteoporosis, with a T-score of &lt;-2.5 at the lumbar or femoral neck area, was seen in 665 (35.58%). Risk factors such as weight, height, BMI, menopausal years, history of previous fractures, and intake of oral calcium supplements correlated significantly with a higher risk (OR=1.025, 95%CI: 0.974–1.079; OR=1.059, 95%CI: 0.84–1.338; OR=1.063, 95%CI: 0.817–1.383; OR=1.74, 95%CI: 1.198–2.528; and OR=1.088, 95%CI: 0.869–1.319), of having osteoporosis in the said population. ORAI and WEIGHT have the highest probability of identifying patients with a sensitivity of 88.42% and 91.28%, and accuracy of 85.71% and 87.98%. Both performed equally in screening for osteoporosis in this setting. However, ABONE, OSTA, and ORISIS underestimated the number of high-risk osteoporosis patients, because of their low sensitivity and diagnostic accuracy. Both ORAI and WEIGHT are simple and easy to calculate and can serve as an initial screening tool to identify Filipino postmenopausal women who are at high risk for osteoporosis. A prospective study with a correlation of fracture occurrences may provide evidence for the value of these tools as a screening test.

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