scholarly journals Risk factors for the progression of trachomatous scarring in a cohort of women in a trachoma low endemic district in Tanzania

2021 ◽  
Vol 15 (11) ◽  
pp. e0009914
Author(s):  
Meraf A. Wolle ◽  
Beatriz E. Muñoz ◽  
Fahd Naufal ◽  
Michael Saheb Kashaf ◽  
Harran Mkocha ◽  
...  
Keyword(s):  
Public Health Problem ◽  
Progression Rate ◽  
Poverty Index ◽  
Severity Scale ◽  
Active Trachoma ◽  
Rate Of Development ◽  
Endemic District ◽  
Chronic Conjunctivitis ◽  
Trachomatous Trichiasis

Background Trachoma, a chronic conjunctivitis caused by Chlamydia trachomatis, is the leading infectious cause of blindness worldwide. Trachoma has been targeted for elimination as a public health problem which includes reducing trachomatous inflammation—follicular prevalence in children and reducing trachomatous trichiasis prevalence in adults. The rate of development of trachomatous trichiasis, the potentially blinding late-stage trachoma sequelae, depends on the rate of trachomatous scarring development and progression. Few studies to date have evaluated the progression of trachomatous scarring in communities that have recently transitioned to a low trachomatous inflammation—follicular prevalence. Methodology/Principal findings Women aged 15 and older were randomly selected from households in 48 communities within Kongwa district, Tanzania and followed over 3.5 years for this longitudinal study. Trachomatous inflammation—follicular prevalence was 5% at baseline and at follow-up in children aged 1–9 in Kongwa, Tanzania. 1018 women aged 15 and older had trachomatous scarring at baseline and were at risk for trachomatous scarring progression; 691 (68%) completed follow-up assessments. Photographs of the upper tarsal conjunctiva were obtained at baseline and follow-up and graded for trachomatous scarring using a previously published four-step severity scale. The overall cumulative 3.5-year progression rate of scarring was 35.3% (95% CI 31.6–39.1). The odds of TS progression increased with an increase in age in women younger than 50, (OR 1.03, 95% CI 1.01–1.05, p = 0.005) as well as an increase in the household poverty index (OR 1.29, 95% CI 1.13–1.48, p = 0.0002). Conclusions/Significance The 3.5-year progression of scarring among women in Kongwa, a formerly hyperendemic now turned hypoendemic district in central Tanzania, was high despite a low active trachoma prevalence. This suggests that the drivers of scarring progression are likely not related to on-going trachoma transmission in this district.

C-reactive protein as a marker of progression of carotid atherosclerosis in subjects with type 2 diabetes mellitus

VASA ◽  
2017 ◽  
Vol 46 (3) ◽  
pp. 187-192 ◽  
Author(s):  
Aleš Pleskovič ◽  
Marija Šantl Letonja ◽  
Andreja Cokan Vujkovac ◽  
Jovana Nikolajević Starčević ◽  
Katarina Gazdikova ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Carotid Atherosclerosis ◽  
Inflammatory Marker ◽  
Progression Rate ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Hs Crp ◽  
Unstable Plaques

Abstract. Background: This prospective study was designed to evaluate the effect of inflammatory markers on the presence and progression of subclinical markers of carotid atherosclerosis in a 3.8-year follow-up period in patients with type 2 diabetes mellitus (T2DM). Patients and methods: A total of 595 subjects with T2DM were enrolled. Subclinical markers of carotid atherosclerosis (carotid intima media thickness (CIMT), plaque thickness, and plaques presence) were assessed with ultrasound at the time of recruitment and again after 3.8 years. Subjects with T2DM were divided into 2 groups according to the plasma high sensitive C-reactive protein (hs-CRP) levels (subjects with hs-CRP ≥ 2 mg/L and subjects with hs-CRP below 2 mg/L). Results: Subjects with T2DM and hs-CRP levels ≥ 2 mg/L had higher CIMT in comparison with subjects with T2DM and hs-CRP levels below 2 mg/L, and higher incidence of plaques/unstable plaques in comparison with subjects with T2DM and hs-CRP levels below 2 mg/L. Multivariate logistic regression analysis found the association between the HDL cholesterol level and presence of plaques, whereas the inflammatory marker hs-CRP was not associated with subclinical markers of progression of carotid atherosclerosis. Multiple linear regression analysis found the association between the hs-CRP levels and either CIMT progression rate or a change in the number of sites with plaques in a 3.8-year follow-up. Conclusions: We demonstrated an association between the inflammatory marker hs-CRP and either CIMT or incidence of plaques/unstable plaques at the time of recruitment in Caucasians with T2DM. Moreover, we found the association between hs-CRP levels and either CIMT progression rate or a change in the number of sites with plaques in a 3.8-year follow-up in subjects with T2DM.

Status of Histopathology Services In Ethiopia

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S120-S120
Author(s):  
G O Yeabyo
Keyword(s):  
Addis Ababa ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Status ◽  
Prevention Of Cancer ◽  
Great Public Health ◽  
Cancer Diseases

Abstract Introduction/Objective Cancer is one of a great public health problem in developing countries like Ethiopia and scarcity of histopathology laboratory is another burden for diagnosis and follow up of cancer diseases. The main purpose of this study is to evaluate the accessibility of histopathology services in Ethiopia. Methods Cross sectional study design were used to analyze the status of histopathology services in Ethiopia. Results There are 13 histopathology laboratories in the nation and a survey was conducted at these institutions. Out of these 13 Histopathology services seven are located in the capital, Addis Ababa and six found out of the capital located in four different regions. About 40,239,100 habitants have no histopathology service around their catchment area. Conclusion There are very limited histopathology laboratories, as a result diagnosis and prevention of cancer diseases are inadequate throughout the country.

Fatigue in Patients With Multiple System Atrophy

Neurology ◽  
2021 ◽  
Vol 98 (1) ◽  
pp. e73-e82
Author(s):  
Lingyu Zhang ◽  
Bei Cao ◽  
Yanbing Hou ◽  
Xiaojing Gu ◽  
Qian-Qian Wei ◽  
...  
Keyword(s):  
Multiple System Atrophy ◽  
Regression Model ◽  
Rating Scale ◽  
Early Stage ◽  
Progression Rate ◽  
Nonmotor Symptoms ◽  
Binary Logistic Regression Model ◽  
Neurofilament Light Chain ◽  
Neurofilament Light

Background and ObjectivesNonmotor symptoms are common in patients with multiple system atrophy (MSA), but there is limited knowledge regarding fatigue in MSA. This study aimed to investigate the frequency and evolution of fatigue and the factors related to fatigue and its progression in patients with MSA at an early stage.MethodsPatients with probable MSA were comprehensively evaluated at both baseline and the 1-year follow-up, including their motor and nonmotor symptoms. Fatigue and anxiety were assessed using the Fatigue Severity Scale (FSS) and Hamilton Anxiety Rating Scale (HARS), respectively. Orthostatic hypotension (OH) was defined as a decrease in the systolic or diastolic blood pressure by at least 30 and 15 mm Hg, respectively. The binary logistic regression model and linear regression model were used to analyze the factors related to fatigue and its progression, respectively.ResultsThis study enrolled 146 patients with MSA. The frequency of fatigue was 60.3%, 55.1%, and 64.9% in MSA, MSA with predominant parkinsonism (MSA-P), and MSA with predominant cerebellar ataxia (MSA-C), respectively. The frequency of fatigue and the FSS score in patients with MSA increased from baseline to the 1-year follow-up (p < 0.05). Young age (odds ratio [OR] 0.939, 95% confidence interval [CI] 0.894–0.987), OH (OR 2.806, 95% CI 1.253–6.286), and high HARS score (OR 1.014, 95% CI 1.035–1.177) were associated with fatigue in MSA. OH was associated with fatigue in MSA-P (OR 3.391, 95% CI 1.066–10.788), while high HARS score was associated with fatigue in MSA-C (OR 1.159, 95% CI 1.043–1.287). In addition, only low FSS scores at baseline were associated with the annual progression rate of FSS scores in MSA, MSA-P, and MSA-C (p < 0.05). Neurofilament light chain, α-synuclein, glial fibrillary acidic protein, brain-derived neurotrophic factor, and triggering receptor expressed on myeloid cell-2 were not significantly associated with fatigue and its progression in MSA.DiscussionFatigue was prevalent in early-stage MSA, and it increased and remained persistent over time. This study demonstrated that OH and anxiety were associated with fatigue in patients with MSA.

Mixed brain abscess due to Streptococcus and Tuberculosis in a pregnant woman with favorable evolution. A case report

2020 ◽  
pp. 1-3
Keyword(s):  
Brain Abscess ◽  
Public Health Problem ◽  
Elective Cesarean Section ◽  
Histopathological Study ◽  
Global Public Health ◽  
Mother And Child ◽  
Elective Cesarean ◽  
Causes Of Mortality ◽  
Abscess Wall

Tuberculosis is a global public health problem and is among the top ten causes of mortality in the world. We present the unusual case of a 37-year-old woman, referred for fever, progressive headache, nausea, vomiting and change in mental status. Brain imaging studies. showed a left frontal brain abscess with subfalcin herniation. As an urgent procedure, surgical drainage of the brain abscess was performed, and in the culture of pus there was growth of an anaerobic Streptococcus. The histopathological study of the abscess wall showed data on tuberculosis. The patient was pregnant at surgery, for about five weeks and received anti-tuberculous medications with close maternal fetal follow-up. Pregnancy came to term and was resolved by an elective cesarean section, both mother and child had a favorable evolution.

scholarly journals Evaluation of coverage of mass drug administration programme conducted in Nalgonda district of Telangana state

2018 ◽  
Vol 5 (12) ◽  
pp. 5178
Author(s):  
Praveena Ganapa ◽  
Kishore Y. Jothula ◽  
Vishweswara Rao Guthi ◽  
P. Abhishek ◽  
V. Jyothi ◽  
...  
Keyword(s):  
Lymphatic Filariasis ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Compliance Rate ◽  
Public Health Problem ◽  
Control Programme ◽  
Major Public Health Problem ◽  
Endemic District ◽  
Study Population ◽  
Coverage Rates

Background: Lymphatic filariasis has been a major public health problem in India. Government of India during 2004 initiated Mass Drug Administration (MDA) with annual single dose of DEC tablets to all the population living at the risk of filariasis. Nalgonda is endemic district where MDA programme is undertaken every year to eliminate lymphatic filariasis. The present study was undertaken to evaluate the coverage and compliance rates of the MDA programme conducted during January 2018.Methods: The guidelines of National Vector Borne Disease Control Programme (NVBDCP) were used to select a total of 129 households from four clusters (three rural and one urban). Each household was visited by a team and data was recorded on pre-structured questionnaire available in operational guidelines manual of NVBDCP. Data analyzed by SPSS version 22.Results: Total of 129 households were included in the study, Among the 523 study population, only 494 were eligible population to receive MDA. Current study shows that coverage rate was 79.84% and compliance rate was 84.6%. Fear of side effects was most common reason for noncompliance.Conclusions: Efforts should be made to improve coverage rates by involving more human resources, supervision and incentives. Though compliance rates were higher than required there is need to maintain these rates by IEC activities and community participation. 

scholarly journals Justification and active guideline implementation for spine radiography referrals in primary care

2016 ◽  
Vol 58 (5) ◽  
pp. 586-592 ◽  
Author(s):  
Pirita Tahvonen ◽  
Heljä Oikarinen ◽  
Jaakko Niinimäki ◽  
Esa Liukkonen ◽  
Seija Mattila ◽  
...  
Keyword(s):  
Primary Care ◽  
Lumbar Spine ◽  
Guideline Implementation ◽  
Public Health Problem ◽  
Further Education ◽  
Major Public Health Problem ◽  
Spine Radiography ◽  
Cervical Spine Radiography ◽  
Active Implementation

Background Spinal disorders are a major public health problem. Appropriate diagnostic imaging is an essential part in the management of back complaints. Nevertheless, inappropriate imaging increases population collective dose and health costs without improving outcome. Purpose To determine the effects of active implementation of referral guidelines on the number and justification of spine radiography in primary care in one city. Material and Methods Specified guidelines for spine radiography were distributed to referring practitioners altogether three times during the study period. Educational lectures were provided before the guidelines were taken into use. The guidelines were also made available via the intranet. The number of spine radiography referrals during similar 6-month periods in the year preceding the interventions and the following 2 years was analyzed. Justification of 448 spine radiographs was assessed similarly. Results After interventions, the total number of spine radiography examinations decreased by 48% (P < 0.001) and that of cervical spine radiography by 46% ( P < 0.001), thoracic spine by 53% ( P < 0.001), and lumbar spine by 47% ( P < 0.001). The results persisted after 1-year follow-up. Before interventions, 24% of the cervical, 46% of the thoracic, and 32% of the lumbar spine radiography referrals were justified. After interventions, only justification of lumbar spine radiography improved significantly, 64% being justified ( P = 0.005). Conclusion Spine radiography in primary care can be reduced significantly by active referral guideline implementation. The proportion of inappropriate radiography was unexpectedly high. Thus, further education and studies concerning the appropriate use of spinal radiography seems to be needed.

E-Ophthalmology in the Diagnosis and Follow-Up of Chronic Glaucoma

2013 ◽  
pp. 88-108 ◽  
Author(s):  
Jose Andonegui ◽  
Aitor Eguzkiza ◽  
Mikel Auzmendi ◽  
Luis Serrano ◽  
Ane Zurutuza ◽  
...  
Keyword(s):  
Public Health ◽  
Intraocular Pressure ◽  
Visual Fields ◽  
Public Health Problem ◽  
Current Status ◽  
Future Trends ◽  
Important Public Health Problem ◽  
Important Public Health ◽  
Chronic Glaucoma

e-Ophthalmology is the use of information and telecommunications technologies to provide or support a group of activities related to ophthalmic care. Chronic glaucoma is an ocular disease characterized by optic neuropathy that leads to progressive loss of the visual fields and often is associated with elevated intraocular pressure levels. Glaucoma is an important public health problem because it is one of the main causes of blindness worldwide and generates an important demand for ophthalmologic consultations. The aim of this chapter is to discuss the application e-Ophthalmology-based models in the diagnosis and follow-up of chronic glaucoma. The authors describe the current status of the use of e-Ophthalmology-based models in the screening and follow-up of chronic glaucoma, the main advantages of these models, the technologic requirements for their implementation, and future trends in this field.

Food Insecurity and Mortality in American Adults: Results From the NHANES-Linked Mortality Study

2020 ◽  
pp. 152483992094592 ◽  
Author(s):  
Srikanta Banerjee ◽  
Tim Radak ◽  
Jagdish Khubchandani ◽  
Patrick Dunn
Keyword(s):  
Health Risk ◽  
Food Insecurity ◽  
Public Health Problem ◽  
The United States ◽  
Mortality Data ◽  
Long Term Outcomes ◽  
Interdisciplinary Approaches ◽  
The Impact

Food insecurity is a significant public health problem in the United States leading to substantial social, economic, and health care–related burdens. While studies continue to estimate the prevalence of food insecurity, the long-term outcomes are not extensively explored. The purpose of this study was to assess the impact of food insecurity on mortality. We analyzed data on adults (≥ 20 years) from the 1999–2010 National Health and Nutrition Examination Survey, with mortality data obtained through 2015. Among the total study participants (n = 25,247), 17.6% reported food insecurity. Food-insecure individuals were more likely to be younger in age, minorities, poorer, with lesser education, obese, smokers, and with diabetes compared to food-secure counterparts. During a 10.2-year follow-up, among the food insecure, 821 individuals died (11%). The hazard ratio (HR) for mortality among the food insecure compared with the food secure, with adjustment for age and gender only, was 1.58; 95% confidence interval [CI: 1.25, 2.01]. The adjusted HRs for all-cause mortality, HR = 1.46, CI [1.23, 1.72], p < .001, and cardiovascular mortality, HR = 1.75, CI [1.19, 2.57], p < .01, were statistically significantly higher among food-insecure individuals, after adjustment for multiple demographic and health risk factors. Individuals who are food-insecure have a significantly higher probability of death from any cause or cardiovascular disease in long-term follow-up. Comprehensive and interdisciplinary approaches to reducing food insecurity–related disparities and health risks should be implemented. Including food insecurity in health risk assessments and addressing food insecurity as a determinant of long-term outcomes may contribute to lower premature death rates.

Psychomotor Development of the Danzig Quintuplets in Their First Year of Life. A Psychological Evaluation

1972 ◽  
Vol 22 (S1) ◽  
pp. 186-188
Author(s):  
M. Bogdanowicz
Keyword(s):  
Physical Appearance ◽  
Psychological Evaluation ◽  
Body Posture ◽  
Psychomotor Development ◽  
First Year ◽  
Intelligence Scale ◽  
Rate Of Development ◽  
Personality Features ◽  
First Year Of Life

A psychological follow-up, based on the Brunet-Lézine Scale, showed a constant progress in the development of the quintuplets, the pace being quite proper from the 5th month on.The children differed from each other: the best pace of psychomotor development was observed in Adam and Ewa, the worst in Piotr.In all children, control of body posture showed the highest rate of development, exceeding the presumed norms. Some delay was observed in speech. The results of the examinations made by the Psyche-Cattell Intelligence Scale agree with those obtained by the Brunet-Lézine Scale.Besides the differences in physical appearance, the children showed differences in personality features.

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