Tuberculous pericarditis in adolescents: A case series

Tuberculosis (TB) is one of the major causes of childhood mortality, especially in endemic areas. In 2013, the World Health Organization (WHO) estimated 550,000 new cases and 80,000 deaths due to TB among children. Around 70-80% of the cases were pulmonary TB, while the rest were extra-pulmonary TB.1 Tuberculous pericarditis accounts for only 8% of all TB cases, however, tuberculosis is the main cause of pericarditis in high-TB-burden countries, including Indonesia.2 The mortality rate reached 17-40% and is affected by treatment adequacy.3 Without adequate therapy, the mean life expectancy is 3.7 months, with only 20% surviving to the sixth month.4 A 2004 study reported that successful treatment of TB in children depends on several factors, such as treatment compliance, timing and accuracy of diagnosis, concurrent human immunodeficency virus (HIV) infection and its clinical stage of disease, malnutrition, and drug resistance.5 Adolescents and young adults are at the highest risks of having TB.6 We report here on three cases of tuberculous pericarditis in adolescents and their outcomes following pericardiocentesis and medication.

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Post-Mortem Diagnosis and Autopsy Findings in SARS-CoV-2 Infection: Forensic Case Series

Diagnostics ◽

10.3390/diagnostics10121070 ◽

2020 ◽

Vol 10 (12) ◽

pp. 1070

Author(s):

Arthur-Atilla Keresztesi ◽

Filip Perde ◽

Andreea Ghita-Nanu ◽

Carmen-Corina Radu ◽

Mihai Negrea ◽

...

Keyword(s):

Case Series ◽

Behavioral Disorder ◽

World Health ◽

Violent Death ◽

Post Mortem ◽

Rt Pcr ◽

History Of ◽

The Mean ◽

Novel Coronavirus ◽

Health Organization

Towards the end of 2019, a novel coronavirus was identified as the culprit for a cluster of pneumonia cases in Wuhan, China. Since then, it has rapidly spread worldwide, affecting more than 43 million people, and in March 2020, the World Health Organization (WHO) declared it a pandemic. The purpose of the study is to present the findings of 15 forensic autopsies performed in Romania, on SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) positive subjects, and to present the case of one SARS-CoV-2 infected patient who experienced a violent death, as established during their autopsy. A total of 11 male and 4 female patients were autopsied, and SARS-CoV-2 infection was diagnosed post-mortem in two cases. The most frequent symptoms before death were dry cough, dyspnoea, and fever. Hypertension, ischemic cardiac disease, and a history of stroke were the most frequent associated diseases. The mean duration from the symptoms’ debut to a RT-PCR positive SARS-CoV-2 test was 3.7 days, while the mean survival time from the RT-PCR positive test was 4.2 days. A histological examination was performed in seven cases and revealed, in most of them, hyaline membranes, and mixed inflammatory cell infiltration of the interstitium, alveoli, and perivascular areas. In addition, all of the examined cases developed small vessel thrombosis. A case of violent death was also reported, regarding a 87-year-old male subject who suffered a femur fracture (domestic fall) and was diagnosed with SARS-CoV-2 infection the following day after surgery. After transfer to a COVID-19 (coronavirus disease-19) support hospital, during an episode of behavioral disorder, the patient jumped from the first floor window. Death occurred a few days later, and the cause was established as bronchopneumonia superimposed on SARS-CoV-2 infection. In conclusion, autopsies should be conducted while providing a safe environment for professionals to perform them, because they are crucial procedures that can help gain a better understanding of the role of SARS-CoV-2 infection in thanatogenesis.

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The Historical Development of Burden of Treatment Compliance

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2014.sepoct02 ◽

2014 ◽

Vol 19 (5) ◽

pp. 13-15

Author(s):

Stephen L. Demeter

Keyword(s):

Internal Medicine ◽

Treatment Compliance ◽

World Health ◽

International Classification Of Functioning ◽

Sixth Edition ◽

Burden Of Treatment ◽

Specific Goal ◽

Surrogate Measure ◽

Health Organization

Abstract A long-standing criticism of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) has been the inequity between the internal medicine ratings and the orthopedic ratings; in the comparison, internal medicine ratings appear inflated. A specific goal of the AMA Guides, Sixth Edition, was to diminish, where possible, those disparities. This led to the use of the International Classification of Functioning, Disability, and Health from the World Health Organization in the AMA Guides, Sixth Edition, including the addition of the burden of treatment compliance (BOTC). The BOTC originally was intended to allow rating internal medicine conditions using the types and numbers of medications as a surrogate measure of the severity of a condition when other, more traditional methods, did not exist or were insufficient. Internal medicine relies on step-wise escalation of treatment, and BOTC usefully provides an estimate of impairment based on the need to be compliant with treatment. Simplistically, the need to take more medications may indicate a greater impairment burden. BOTC is introduced in the first chapter of the AMA Guides, Sixth Edition, which clarifies that “BOTC refers to the impairment that results from adhering to a complex regimen of medications, testing, and/or procedures to achieve an objective, measurable, clinical improvement that would not occur, or potentially could be reversed, in the absence of compliance.

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Retinotomy and retinectomy for anterior inferior proliferative vitreoretinopathy: Can visual outcome be improved?

European Journal of Ophthalmology ◽

10.1177/11206721211012848 ◽

2021 ◽

pp. 112067212110128

Author(s):

Mumin Hocaoglu ◽

Murat Karacorlu ◽

M. Giray Ersoz ◽

Isil Sayman Muslubas ◽

Serra Arf

Keyword(s):

Proliferative Vitreoretinopathy ◽

Rhegmatogenous Retinal Detachment ◽

Silicone Oil ◽

Clinical Stage ◽

Case Series ◽

Visual Outcome ◽

Attachment Rate ◽

Good Visual Outcome ◽

The Mean

Purpose: To describe the treatment outcomes and prognostic factors of retinotomy/retinectomy for rhegmatogenous retinal detachment (RD) complicated anterior inferior proliferative vitreoretinopathy (PVR). Methods: Retrospective, nonrandomized, single-center case series. The outcomes of 126 cases of retinotomy/retinectomy for RD complicated by advanced (Grade C) anterior inferior PVR managed consistently by one surgeon during a 15-year period were evaluated. Results: Forty-two eyes (33%) had primary RDs and 84 (67%) had recurrent RDs. The extent of retinotomy/retinectomy varied: 90° in 21 eyes (17%), >90° to <180° in 49 eyes (39%), and ⩾180° to ⩽240° in 56 eyes (44%). The retinotomy/retinectomy location was peripheral in 58 eyes (46%) and equatorial in 68 eyes (54%). The mean follow-up period was 43 ± 42 months. The silicone oil (SO) was removed from 98% of the eyes. The single-operation success rate after the primary retinectomy was 87%, and the final attachment rate was 94%. Visual acuity improved from 20/630 to 20/160 ( p < 0.001). Vision ⩾20/200 was achieved in 101 eyes (80%). Good visual outcome was correlated positively with preoperative VA ( p = 0.02), previous vitrectomy with gas tamponade ( p = 0.007), and was negatively correlated with number of previous RD operations ( p = 0.01), larger extent of RD ( p = 0.02) and more extensive retinotomy/retinectomy ( p = 0.04). Conclusions: An appropriate and timely intervention, including vitrectomy alone, inferior relaxing retinotomy/retinectomy and standard SO tamponade provide satisfactory outcomes for RDs complicated by PVR. Lesser extension of grade C PVR at baseline, such as PVR limited to one quadrant should encourage vitreoretinal specialists to consider retinotomy/retinectomy at a milder clinical stage of PVR development.

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Vaccination Coverage for Routine Vaccines and Herd Immunity Levels against Measles and Pertussis in the World in 2019

Vaccines ◽

10.3390/vaccines9030256 ◽

2021 ◽

Vol 9 (3) ◽

pp. 256

Author(s):

Pedro Plans-Rubió

Keyword(s):

Vaccination Coverage ◽

Action Plan ◽

Herd Immunity ◽

World Health ◽

Immunization Programs ◽

National Immunization ◽

The World ◽

Measles Vaccination ◽

The Mean ◽

Health Organization

In 2012, the World Health Organization (WHO) established the Global Vaccine Action Plan with the objective to promote essential vaccinations in all countries and achieve at least 90% vaccination coverage for all routine vaccines by 2020. The study assessed the mean percentages of vaccination coverage in 2019 for 13 routine vaccines, vaccination coverage variation from 2015 to 2019, and herd immunity levels against measles and pertussis in 2019 in countries and regions of WHO. In 2019, the mean percentages of vaccination coverage were lower than 90% for 10 (78.9%) routine vaccines. The mean percentages of vaccination coverage also decreased from 2015 to 2019 for six (46.2%) routine vaccines. The prevalence of individuals with vaccine-induced measles immunity in the target measles vaccination population was 88.1%, and the prevalence of individuals with vaccine-induced pertussis immunity in the target pertussis vaccination population was 81.1%. Herd immunity against measles viruses with Ro = 18 was established in 63 (32.5%) countries but not established in any region. Herd immunity against pertussis agents was not established in any country and in any region of WHO. National immunization programs must be improved to achieve ≥90% vaccination coverage in all countries and regions. Likewise, it is necessary to achieve ≥95% vaccination coverage with two doses of measles vaccines and three doses of pertussis vaccines in all countries and regions.

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The use of vitreous renal chemistries in the discrimination of postmortem fresh water drowning

Toxicology Research and Application ◽

10.1177/2397847321997523 ◽

2021 ◽

Vol 5 ◽

pp. 239784732199752

Author(s):

Eni-yimini Solomon Agoro ◽

Charles German Ikimi ◽

Tommy Edidiong

Keyword(s):

Fresh Water ◽

Biochemical Parameters ◽

World Health ◽

The World ◽

Diacetyl Monoxime ◽

Water Pond ◽

The Mean ◽

Health Organization ◽

Post Hoc ◽

Cover Up

Background: The World Health Organization (WHO) has estimated drowning as the leading cause of unintentional death in the world, with 372,000 deaths reported annually. Not all drowning are unintentional; some could be disguised to cover up an act of heinous criminality. This study was aimed at using some vitreous renal function biochemical parameters as a discriminant of postmortem fresh water drowning. Twelve albino rabbits constituted the sample size as validated by Mead’s formula. The study was divided into three groups; the control, postmortem-drowned and truly drowned as mimicked using an artificial fresh water pond. Vitreous humours were extracted using Coe method. The vitreous renal chemistries were analysed using diacetyl monoxime, Jaffe’s test, uricase and ion-selective electrode (ISE) methods respectively. Result: The mean of vitreous creatinine, urea, uric acid, Na+, K+, Cl−, Ca2+, glucose and CO2 of the control, postmortem-drowned and truly drowned groups were compared using One-way Anova (post-hoc-LSD) with the aid of SPSS Inc., Chicago, IL, USA; Version 18–21 package. The findings revealed a significant increase in concentrations of vitreous creatinine, glucose, Ca2+ and K+ of the drowned death group, whereas vitreous concentrations of CO2 and urea significantly decreased when compared to the controls and/or postmortem-drowned death. Conclusion: The study has shown that some of the studied vitreous biochemical parameters could be used as an ancillary tool in discriminating death due to fresh water drowning from that of disguised or postmortem-drowned death.

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Dental caries in 6-12-year-old indigenous and non-indigenous schoolchildren in the Amazon basin of Ecuador

Brazilian Dental Journal ◽

10.1590/s0103-64402008000100015 ◽

2008 ◽

Vol 19 (1) ◽

pp. 83-86 ◽

Cited By ~ 14

Author(s):

Widman Medina ◽

Anna-Karin Hurtig ◽

Miguel San Sebastián ◽

Edy Quizhpe ◽

Cristian Romero

Keyword(s):

Amazon Basin ◽

Ethnic Origin ◽

World Health ◽

Caries Experience ◽

Cross Sectional ◽

Health Response ◽

Indigenous Children ◽

Prevention And Health Promotion ◽

The Mean ◽

Health Organization

The purpose of this study was to evaluate the caries experience among 6-12-year-old indigenous (Naporunas) and non-indigenous (recent settlers of mixed ethnic origin) schoolchildren, living in the Amazon basin of Ecuador. Cross-sectional data were obtained from 1,449 clinical exams according to the World Health Organization criteria. Nine (7.6%) indigenous and 3 (4.5%) non-indigenous children had no caries experience in their primary dentition at the age of 6. The mean dmft value (SD) among indigenous and non-indigenous children aged 6 was 6.40 (3.36) and 8.36 (3.93), respectively. Sixty-four (54.2%) indigenous and 29 (43.3%) non-indigenous children had no caries experience in their permanent first molars at the age of 6. Only 7 (6.26%) indigenous and 2 (2.60%) non-indigenous children were caries-free at the age of 12. The mean DMFT values (SD) for 12-year-olds were 4.47 (2.85) among indigenous and 5.25 (2.89) among non-indigenous children. Fillings were almost non existent. Caries rates were high among both groups, with untreated carious lesions predominating in all ages. The data of indigenous children suggest adoption of a non-traditional diet. An appropriate oral health response based primarily on prevention and health promotion is needed.

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PRESENCE AND LEVELS OF CONCENTRATION OF POLYCYCLIC AROMATIC HYDROCARBONS (PAHS) IN SMOKED FISH, HIDES AND SKIN OF SLAUGHTER CATTLE AND GOATS IN AWKA URBAN, NIGERIA

International Journal of Current Pharmaceutical Research ◽

10.22159/ijpps.2019v11i2.33014 ◽

2019 ◽

pp. 14-17

Author(s):

IKECHUKWU OFOMATA ◽

LYNDA ONYINYE OBODOECHI ◽

REGINALD IKECHUKWU OBIDIKE ◽

JOHN ANAELOM NWANTA

Keyword(s):

World Health ◽

Fish Tissues ◽

Anambra State ◽

Smoked Fish ◽

Permissible Level ◽

Flame Ionization ◽

Slaughter Cattle ◽

Polycyclic Aromatic ◽

The Mean ◽

Health Organization

Objective: This study evaluated the presence and concentration of PAHs in singed and unsinged hides and skin of slaughter cattle and goats and smoked and non-smoked fish in Awka urban area of Anambra State, Nigeria. Methods: Sixty samples of singed and unsinged hides and skin for were collected from Kwata slaughterhouse in Awka town where fish tissues were also collected from fish smoking spots in Awka urban. The samples were examined for the presence PAHs such as: benzo[a]pyrene; benzo[a]anthracene; benzo[k]flouranthene and indeno[1-2-3cd]pyrene using gas chromatography equipped with flame ionization detector. Results: The result showed that the mean concentrations (µg/kg) of benzo[a]pyrene and indeno [1-2-3cd]pyrene in unsinged cattle hides were 7.89±7.77 and 2.25±0.97 respectively. The mean concentrations upon singeing were of 15.81±14.93 and 3.55±2.89. The mean concentrations (µg/kg) of benzo[a]pyrene; benzo[k]flouranthene and indeno[1-2-3cd]pyrene in unsigned goat skins were 6.52±10.77; 6.58±5.93 and 3.48±0.00 respectively. When the goatskin was singed, the mean concentrations were 17.50±26.03; 10.84±11.19 and 8.79±11.77. The mean concentrations (µg/kg) of benzo[a]pyrene; benzo[k]flouranthene and indeno[1-2-3cd]pyrene in non-smoked fish were 8.65±9.67; 2.11±2.10 and 54.76±60.35 respectively. When the fish were smoked, the mean concentrations of 26.42±40.21; 6.64±11.11 and 599.36±1395.61 were recorded respectively. In all species of animals sampled, no trace of benzo[a]anthracene was detected. Conclusion: The mean concentrations of all carcinogenic PAHs detected in this work were below the maximum permissible level set by World Health Organization (WHO) and European Commission (30µg/kg) with the exception of indeno[1-2-3cd]pyrene in smoked and non-smoked fish, which was far above the permissible level.

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Assessment of quality of life in type 2 diabetes mellitus patients using World Health Organization quality of life-BREF questionnaire and appraisal of diabetes scale - a cross-sectional study

Italian Journal of Medicine ◽

10.4081/itjm.2021.1444 ◽

2021 ◽

Vol 15 (3) ◽

Author(s):

Supriya Patil ◽

Yamini Patil ◽

Sanjay Kumar Patil

Keyword(s):

Quality Of Life ◽

Cross Sectional Study ◽

World Health ◽

Diabetic Patients ◽

Sectional Study ◽

Cross Sectional ◽

The Mean ◽

Health Organization

Diabetes is a chronic metabolic disorder that disturbs the quality of life (QOL) of patients. Therefore, evaluation of diabetes- related QOL could be a key outcome measure for its management. This study assessed the QOL in type 2 diabetes mellitus (T2DM) patients using the World Health Organization (WHO) quality of life (QOL)˗BREF questionnaire and disease-specific appraisal of diabetes scale (ADS). In this cross-sectional study, 520 T2DM patients were included. Patients’ demographic data, clinical information was collected through interviews, and the WHOQOL-BREF instrument and ADS were used for the QOL of patients. Statistical analysis was performed by using R software (Version 3.6.0). The mean ADS scores were lower in controlled diabetic subjects (18.50±3.08) and higher in uncontrolled diabetic subjects (19.29±2.73) (P<0.05). For WHOQOL-BREF, the mean scores for all the domains (overall general health, physical, psychological, social, and environmental) were significantly higher in controlled diabetic subjects (P<0.001). In addition, the age, duration of diabetes, associated comorbidities, treatment, and HbA1c level of patients showed a highly significant correlation with WHOQOL-BREF (P<0.001). Diabetic patients had poor-to-average QOL. Therefore, public health measures and education of diabetic patients are essential to create more awareness for improving the QOL of T2DM.

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Magnesium Sulphate For Tetanus, review of two cases

Medicinus ◽

10.19166/med.v7i4.2386 ◽

2020 ◽

Vol 7 (4) ◽

pp. 112

Author(s):

Tirta Darmawan Susanto

Keyword(s):

Intensive Care ◽

Autonomic Dysfunction ◽

Magnesium Sulphate ◽

Case Series ◽

Clinical Findings ◽

Muscle Spasm ◽

World Health ◽

Control Muscle ◽

Hospitalization Period ◽

Health Organization

<div class="WordSection1">Introduction: Tetanus is critically ill disease with long term hospitalization period. It need to be carefully monitored, usually in intensive care unit and involves critical care physicians. Benzodiazepine is preferred by World Health Organization (WHO) for muscle spasm control in tetanus, but it will be less costly if magnesium sulphate can be used alone to control spasm and autonomic dysfunction in tetanus. We report a series of 2 tetanus cases that were treated using magnesium sulphate to provide a brief clinical description about the use of magnesium sulphate in tetanus. We also give a brief review on epidemiology, pathophysiology, clinical findings, diagnosis, and treatment of tetanus to provide implications for intensive care physicians. Methods : Case series reportResults : Two patients with tetanus was given magnesium sulphate infusion to control muscle spasm and autonomic dysfunction with good results as expected. Both of them were survive and discharged home in healthy condition.Conclusions :Magnesium sulphate can also be used to control muscle spasm and autonomic dysfunction although WHO recommend benzodiazepines for controlling muscle spasm. Intensive care physicians should have enough knowledge about tetanus and how it should be managed adequately to ensure survival from tetanus.</div>

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Therapeutic Effectiveness and Safety of Repurposing Drugs for the Treatment of COVID-19: Position Standing in 2021

Frontiers in Pharmacology ◽

10.3389/fphar.2021.659577 ◽

2021 ◽

Vol 12 ◽

Author(s):

Safaet Alam ◽

Taslima Binte Kamal ◽

Md. Moklesur Rahman Sarker ◽

Jin-Rong Zhou ◽

S. M. Abdur Rahman ◽

...

Keyword(s):

Clinical Trials ◽

Case Series ◽

Basic Knowledge ◽

World Health ◽

Current Status ◽

Drug Candidates ◽

Health Organization ◽

Meta Analyses

COVID-19, transmitted by SARS-CoV-2, is one of the most serious pandemic situations in the history of mankind, and has already infected a huge population across the globe. This horrendously contagious viral outbreak was first identified in China and within a very short time it affected the world's health, transport, economic, and academic sectors. Despite the recent approval of a few anti-COVID-19 vaccines, their unavailability and insufficiency along with the lack of other potential therapeutic options are continuing to worsen the situation, with valuable lives continuing to be lost. In this situation, researchers across the globe are focusing on repurposing prospective drugs and prophylaxis such as favipiravir, remdesivir, chloroquine, hydroxychloroquine, ivermectin, lopinavir-ritonavir, azithromycin, doxycycline, ACEIs/ARBs, rivaroxaban, and protease inhibitors, which were preliminarily based on in vitro and in vivo pharmacological and toxicological study reports followed by clinical applications. Based on available preliminary data derived from limited clinical trials, the US National Institute of Health (NIH) and USFDA also recommended a few drugs to be repurposed i.e., hydroxychloroquine, remdesivir, and favipiravir. However, World Health Organization later recommended against the use of chloroquine, hydroxychloroquine, remdesivir, and lopinavir/ritonavir in the treatment of COVID-19 infections. Combining basic knowledge of viral pathogenesis and pharmacodynamics of drug molecules as well as in silico approaches, many drug candidates have been investigated in clinical trials, some of which have been proven to be partially effective against COVID-19, and many of the other drugs are currently under extensive screening. The repurposing of prospective drug candidates from different stages of evaluation can be a handy wellspring in COVID-19 management and treatment along with approved anti-COVID-19 vaccines. This review article combined the information from completed clinical trials, case series, cohort studies, meta-analyses, and retrospective studies to focus on the current status of repurposing drugs in 2021.

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