Risk factors for heat-related illnesses during the Hajj mass gathering: an expert review

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Saber Yezli
Keyword(s):  
Preventive Measures ◽  
Febrile Illness ◽  
Mass Gatherings ◽  
Expert Review ◽  
Hot Environment ◽  
Increased Risk ◽  
Modifiable Factors ◽  
Life Threatening ◽  
Nutrition And Hydration ◽  
And Behavior

Abstract Human exposure to a hot environment may result in various heat-related illnesses (HRIs), which range in severity from mild and moderate forms to life-threatening heatstroke. The Hajj is one of the largest annual mass gatherings globally and has historically been associated with HRIs. Hajj attracts over two million Muslim pilgrims from more than 180 countries to the holy city of Makkah, Kingdom of Saudi Arabia. Several modifiable and non-modifiable factors render Hajj pilgrims at increased risk of developing HRIs during Hajj. These include characteristics of the Hajj, its location, population, and rituals, as well as pilgrims’ knowledge of HRIs and their attitude and behavior. Makkah is characterized by a hot desert climate and fluctuating levels of relative humidity. Pilgrims are very diverse ethnically and geographically, with different adaptations to heat. Significant proportions of the Hajj population are elderly, obese, and with low levels of fitness. In addition, many have underlying health conditions and are on multiple medications that can interfere with thermoregulation. Other factors are inherent in the Hajj and its activities, including crowding, physically demanding outdoor rituals, and a high frequency of infection and febrile illness. Pilgrims generally lack awareness of HRIs, and their uptake of preventive measures is variable. In addition, many engage in hazardous behaviors that increase their risk of HRIs. These include performing rituals during the peak sunshine hours with no sun protection and with suboptimal sleep, nutrition, and hydration, while neglecting treatment for their chronic conditions. HRIs preventive plans for Hajj should incorporate measures to address the aforementioned factors to reduce the burden of these illnesses in future Hajj seasons. Lessons from the Hajj can be used to inform policy making and HRIs preventive measures in the general population worldwide.

scholarly journals Mitigating the Risk of COVID-19 Deaths in Cardiovascular Disease Patients in Africa Resource Poor Communities

2021 ◽  
Vol 8 ◽  
Author(s):  
Ihunanya Chinyere Okpara ◽  
Efosa Kenneth Oghagbon
Keyword(s):  
Cardiovascular Disease ◽  
Preventive Measures ◽  
Policy Makers ◽  
Care Workers ◽  
Increased Risk ◽  
Resource Poor ◽  
Life Threatening ◽  
Novel Coronavirus ◽  
Almost All ◽  
Poor Communities

The novel coronavirus disease 2019 (Covid-19) pandemic has affected millions of patients in almost all countries with over one million cases recorded in Africa where it is a major health challenge. Covid-19 is known to have significant implications for those with pre-existing cardiovascular disease (CVD) and their cardiologists. Patients with pre-existing CVD are at increased risk of morbidity and mortality from Covid-19 due to associated direct and indirect life threatening cardiovascular (CV) complications. Mitigating the risk of such Covid-19 deaths in resource poor communities requires the institution of preventive measures at the primary, secondary and tertiary levels of preventive phenomenon with emphasis at the first two levels. General preventive measures, screening and monitoring of CVD patients for complications and modification of drug treatment and other treatment methods will need to be implemented. Health policy makers and manager should provide required training and retraining of CV health care workers managing Covid-19 patients with CVD, provision of health education, personal protective equipment (PPE), and diagnostic kits.

Safety and Efficacy of Argatroban in the Management of Heparin-Induced Thrombocytopenia

2011 ◽  
Vol 4 ◽  
pp. CMBD.S5118 ◽  
Author(s):  
Bernd Saugel ◽  
Roland M. Schmid ◽  
Wolfgang Huber
Keyword(s):  
Arterial Thrombosis ◽  
Pharmacokinetic Profile ◽  
The United States ◽  
Heparin Therapy ◽  
Direct Thrombin Inhibitor ◽  
Thrombin Inhibitor ◽  
Heparin Induced Thrombocytopenia ◽  
Safety And Efficacy ◽  
Increased Risk ◽  
Life Threatening

Heparin-induced thrombocytopenia (HIT) is a life-threatening adverse reaction to heparin therapy that is characterized by thrombocytopenia and an increased risk of venous and arterial thrombosis. According to guidelines, in patients with strongly suspected or confirmed HIT all sources of heparin have to be discontinued and an alternative, nonheparin anticoagulant for HIT treatment must immediately be started. For both the prophylaxis of thrombembolic events in HIT and the treatment of HIT with thrombosis the direct thrombin inhibitor argatroban is approved in the United States. The objective of this review is to describe the mechanism of action and the pharmacokinetic profile of argatroban, to characterize argatroban regarding its safety and therapeutic efficacy and to discuss its place in therapy in HIT.

scholarly journals Obesity and risk of ovarian cancer subtypes: evidence from the Ovarian Cancer Association Consortium

2013 ◽  
Vol 20 (2) ◽  
pp. 251-262 ◽  
Author(s):  
Catherine M Olsen ◽  
Christina M Nagle ◽  
David C Whiteman ◽  
Roberta Ness ◽  
Celeste Leigh Pearce ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Menopausal Status ◽  
Low Grade ◽  
Ovarian Cancer Risk ◽  
Histological Subtypes ◽  
Increased Risk ◽  
Modifiable Factors ◽  
Menopausal Women ◽  
Increase Risk ◽  
Post Menopausal

Whilst previous studies have reported that higher BMI increases a woman's risk of developing ovarian cancer, associations for the different histological subtypes have not been well defined. As the prevalence of obesity has increased dramatically, and classification of ovarian histology has improved in the last decade, we sought to examine the association in a pooled analysis of recent studies participating in the Ovarian Cancer Association Consortium. We evaluated the association between BMI (recent, maximum and in young adulthood) and ovarian cancer risk using original data from 15 case–control studies (13 548 cases and 17 913 controls). We combined study-specific adjusted odds ratios (ORs) using a random-effects model. We further examined the associations by histological subtype, menopausal status and post-menopausal hormone use. High BMI (all time-points) was associated with increased risk. This was most pronounced for borderline serous (recent BMI: pooled OR=1.24 per 5 kg/m2; 95% CI 1.18–1.30), invasive endometrioid (1.17; 1.11–1.23) and invasive mucinous (1.19; 1.06–1.32) tumours. There was no association with serous invasive cancer overall (0.98; 0.94–1.02), but increased risks for low-grade serous invasive tumours (1.13, 1.03–1.25) and in pre-menopausal women (1.11; 1.04–1.18). Among post-menopausal women, the associations did not differ between hormone replacement therapy users and non-users. Whilst obesity appears to increase risk of the less common histological subtypes of ovarian cancer, it does not increase risk of high-grade invasive serous cancers, and reducing BMI is therefore unlikely to prevent the majority of ovarian cancer deaths. Other modifiable factors must be identified to control this disease.

An Analytical Study Carried Out to Identify Symptoms of Occupational Lung Diseases and Preventive Measures among Workers Involved in Marble Industries in Rajsamand District of Rajasthan

2021 ◽  
Vol 8 (02) ◽  
pp. 53-57
Author(s):  
Kalika Gupta ◽  
Mitin Parmar ◽  
Pranav Bhavsar ◽  
Milan Chaudhary
Keyword(s):  
Lung Disease ◽  
Lung Diseases ◽  
Preventive Measures ◽  
Educational Interventions ◽  
Protective Measure ◽  
Work Place ◽  
Cross Sectional ◽  
Safety Measures ◽  
Increased Risk ◽  
Occupational Lung Diseases

BACKGROUND Occupational lung diseases are diseases affecting the respiratory system, including occupational asthma, black lung disease and many more. Workers exposed to marble dust stand an increased risk of suffering from asthma symptoms, chronic bronchitis, nasal inflammation and impairment of lung functions. The recognition of occupational causes can be made difficult by years of latency between exposure in the workplace and the occurrence of disease. Through this study, authors have established the importance of early identification of symptoms of occupational lung diseases and the importance of preventive measures that can be applied to reduce incidence of such diseases. METHODS This was a cross sectional community-based study conducted on 340 marble mining or cutting workers of Rajnagar [Morwar], Rajsamand district of Rajasthan, for a duration of three months. Workers were clinically examined and asked about environmental conditions and use of preventive measures through a questionnaire designed by the investigators and with the help of pamphlets and videos, educational interventions were provided. RESULTS Almost 90 % of the workers didn’t use protective measure like mask or shield. Among the 10 % workers who were using safety measures, 60 % were using face mask and 20 % were using apron at the work place. After the educational intervention given by investigators, around 63 % had started using various safety measures. CONCLUSIONS Early interventions after development of symptoms are important as they can decrease chances of further worsening of the condition. Health education, periodic health check-ups and use of protective measures are the essence in preventing occupational lung diseases. KEYWORDS Occupational Lung Disease, Cough, Marble Workers, Silicosis

Cancer and COVID-19: A proposed mechanism with therapeutic interventions.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 3135-3135
Author(s):  
Yan Leyfman ◽  
Nancy Emmanuel ◽  
Aleksey Tentler ◽  
Jared Cappelli ◽  
Timothy K Erick ◽  
...  
Keyword(s):  
Respiratory Illness ◽  
Organ Damage ◽  
Multiple Organ ◽  
Therapeutic Interventions ◽  
Actual Number ◽  
Data Registry ◽  
Number Of Patients ◽  
Increased Risk ◽  
Life Threatening ◽  
Active Cancer

3135 Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel betacoronavirus that causes the respiratory illness coronavirus disease 2019 (COVID-19). COVID-19 ranges in severity from an asymptomatic viral infection to life-threatening cases of pneumonia, acute respiratory distress syndrome (ARDS), multi-organ damage and sepsis. Cancer patients are at an increased risk of severe SARS-CoV-2 infection due to their immunocompromised status. We propose a mechanism by which SARS-CoV-2 infection causes multiple organ damage through IL-6-mediated inflammation and hypoxia-induced cellular metabolic alterations leading to cell death. Hypoxia is also induced by malignancy due to alterations in metabolism, resulting in greater IL-6 secretion. Methods: To highlight the possible effect of active cancer on the likelihood of hypoxia in COVID-19, we analyzed the correlation between cancer status and the severity of COVID-19 from the COVID-19 and Cancer Consortium data registry. For cancer status, we looked at progressive cancer and remission of cancer only -- those being the two extremes of presence and absence of uncontrolled cancer. Similar to prior studies, the severity of COVID-19 was used as an indication of hypoxia. Results: We observed a 24% positive deviation between expected and actual number of patients with actively progressing cancer who had hypoxic COVID-19 (moderate to severe), and a 26.9% negative deviation between expected and actual number of patients with active cancer who had no hypoxia with COVID-19 (p<0.0001). Conversely, for patients with cancer in remission, there was only a +5.8% and -5.1% deviation between expected and actual number of patients who did not have hypoxia and who had hypoxia, respectively. Conclusions: These results suggest that in the presence of poorly controlled malignancy, there is an increased likelihood of hypoxia in patients with COVID-19, thereby exacerbating downstream cytokine release syndrome and contributing to prolonged systemic inflammatory injury. Appreciating this pathway, future therapies can be developed to target the pathogenesis of both diseases and prevent progression, as seen with mesenchymal stem cells, which demonstrated a 91% overall survival and 100% survival in patients younger than 85 years old at one month after a single treatment.[Table: see text]

scholarly journals Intensive care unit professionals' knowledge and behavior related to the adoption of contact precautions

2009 ◽  
Vol 17 (5) ◽  
pp. 625-631 ◽  
Author(s):  
Adriana Cristina de Oliveira ◽  
Clareci Silva Cardoso ◽  
Daniela Mascarenhas
Keyword(s):  
Intensive Care ◽  
Preventive Measures ◽  
Cross Sectional Study ◽  
Control Measures ◽  
Cross Sectional ◽  
Appropriate Behavior ◽  
Contact Precautions ◽  
And Behavior ◽  
Nursing Professionals ◽  
Structured Questionnaire

This study aimed to assess the knowledge and behavior of professionals working in Intensive Care Units (ICU) related to the adoption of contact precautions for the control of hospital infections (HI). This cross-sectional study used a semi-structured questionnaire to collect data. Descriptive and multivariate analyses were carried out, including logistic regression and decision tree using CHAID algorithm. A total of 102 professionals participated in the study, of whom 36.3% presented appropriate knowledge and 51% appropriate behavior in relation to HI control measures. Nursing professionals had almost four times more chance (OR = 3.58, CI 1.48-8.68) of presenting appropriate behavior than the remaining professionals. The multivariate analysis did not reveal variables associated with knowledge. No statistically significant association was found between knowledge and behavior (p = 0.196). These results suggest the need to implement educational activities so as to permit a balance between theory and professionals' practice concerning HI preventive measures, aiming to improve knowledge and behavior.

scholarly journals COVID-19 Infection with Refractory Diabetic Ketoacidosis- A case Report

2021 ◽  
Vol 7 (2) ◽  
pp. 54-56
Author(s):  
Reshmi Mishra ◽  
◽  
Jyoti Ranjan Behera ◽  
P. Ramkumar ◽  
Mukesh Kumar Jain ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Metabolic Acidosis ◽  
Diabetic Ketoacidosis ◽  
Vital Organ ◽  
Increased Risk ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
New Onset

Diabetic ketoacidosis is an acute life-threatening complication of type 1 diabetes. Sometimes it is the first presentation in an undiagnosed child. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) and diabetes mellitus are very much interrelated as diabetes mellitus is associated with an increased risk of severe COVID19 at the same time, many cases of new-onset diabetes had been diagnosed. Hyperglycemia, metabolic acidosis, and ketonemia are classical presentations. It is essential to correct the acidosis and fluid correction and insulin therapy in these patients, leading to vital organ dysfunction. In refractory metabolic acidosis, renal replacement therapy may help

scholarly journals Mobility And Behavior Influences On Import Malaria In The Kecamatan Watulimo Kabupaten Trenggalek

2019 ◽  
Vol 11 (2) ◽  
pp. 91
Author(s):  
Asep Prastiawan
Keyword(s):  
High Frequency ◽  
Mosquito Net ◽  
Duration Of Stay ◽  
Mobility Factor ◽  
Increased Risk ◽  
Knowledge And Practice ◽  
Endemic Areas ◽  
And Behavior ◽  
The Village ◽  
Control Study

Malaria is becoming the most widely distributed disease in the world. There were 212 million cases of malaria and 429,000 of them died in the year 2015. Enviromental, behavior, knowledge and health care factors play an important role in the incidence of malaria in endemic areas. The purpose of this study was analyze the influence of mobility and behavioral factors on malaria import incidence in the Kecamatan Watulimo, Kabupaten Trenggalek. This research was an observational, used case control study design. The research samples were 42 people. Data were statistics analyzed using logistic regression test. The results of this research were influence between high frequency of mobility (p=0.023; OR=16.670), duration of stay in endemic areas for a bit (p=0.014; OR=35.940), less knowledge (p=0.022; OR=11.946), and less practice (p=0.010; OR=25.534) against malaria import incidence in the Kecamatan Watulimo, Kabupaten Trenggalek. But there was not influence attitude (p=0.470) against malaria import incidence in the Kecamatan Watulimo, Kabupaten Trenggalek. The high frequency of mobility factor ≥ 3 times and duration of stay in endemic areas for a bit 1-2 months, behavior factor less knowledge and practice can lead to increased risk of malaria import incidence in the Kecamatan Watulimo, Kabupaten Trenggalek. We recommended to increased the community knowledge and practice on malaria and its prevention with counseling. Increased JMD empowerment, revitalization of Posmaldes, provision of chemoprophylaxis malaria and insecticide mosquito net at the village level.

scholarly journals Legal Status of Persons Serving Sentences in the event of Health Emergency

2021 ◽  
Vol 16 (3) ◽  
pp. 143-151
Author(s):  
A. Yu. Alekseev
Keyword(s):  
Legal Status ◽  
Preventive Measures ◽  
Healthcare Sector ◽  
Correctional Facilities ◽  
Legal Regime ◽  
Foreign Countries ◽  
Increased Risk ◽  
Coronavirus Infection ◽  
Legal Restrictions ◽  
Subjective Rights

The paper discusses the preventive measures carried out in the penitentiary institutions of foreign countries, preventing the penetration and spread of coronavirus infection. Persons serving sentences in places of detention are at increased risk of infection in the event of an outbreak of the disease. Their situation requires separate consideration in planning and responding to crises. Measures to ensure social distancing are implemented through a special legal regime, the introduction of which limits the subjective rights of convicts. The introduced legal restrictions in some states provoked the emergence of criminal emergencies, which required the optimization of criminal and penal legal relations. Due to the emergency in the healthcare sector, it seems possible to use such institutions of criminal law as release from serving a sentence, deferment from serving a sentence, replacing the unserved part of a sentence with a milder type of punishment as an exceptional measure, and developing alternative ways to maintain socially useful ties. These methods include: increasing the duration of calls in correctional facilities, conducting visits through video conferencing, organizing a prompt exchange of information on the health status of relatives and convicts using a hotline, and using secure mobile devices.

scholarly journals Non-traumatic Tension Gastrothorax: A Potential Mimicker of Tension Pneumothorax

2021 ◽  
Vol 15 (8) ◽  
pp. 1-7
Author(s):  
Jonathan D. Pierce ◽  
Neal R. Shah ◽  
Ata A. Rahnemai-Azar ◽  
Amit Gupta
Keyword(s):  
Clinical Presentation ◽  
Tension Pneumothorax ◽  
Accurate Diagnosis ◽  
Imaging Features ◽  
Elderly Female ◽  
Hemodynamic Compromise ◽  
Mediastinal Shift ◽  
Increased Risk ◽  
Life Threatening ◽  
Tension Gastrothorax

Tension gastrothorax is a rare, life-threatening clinical condition caused by intrathoracic herniation of the stomach through a diaphragmatic defect which becomes increasingly distended over time. If not recognized promptly, this can rapidly progress to respiratory distress, mediastinal shift, and hemodynamic compromise. Initial clinical presentation and imaging findings closely mirror those of tension pneumothorax, confounding diagnosis and potentially leading to unnecessary interventions with increased risk of morbidity and mortality. Here, we present a case of an elderly female who presented with a non-traumatic tension gastrothorax and a review of key imaging features and strategies to aid in recognition and accurate diagnosis of this emergent clinical entity.

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