Health Problems Encountered by Short-Term European Volunteers in a Nongovernmental Organization in Cambodia

Short-term volunteers are susceptible to a wide spectrum of morbidities, mostly infectious diseases preventable with general hygiene and preventive measures. This study aimed to identify the health problems encountered by European short-term volunteers collaborating for 1 month with a nongovernmental organization (NGO) in Cambodia and to describe their characteristics. A prospective, descriptive observational study was conducted on short-term volunteers who collaborated with an NGO in Cambodia during August 2018. Informed consent and sociodemographic, clinical, and preventative health-related questionnaire data were provided by 198 volunteers. The health problems encountered were confirmed in a primary care consultation with healthcare professionals. Univariate and bivariate analyses were performed. The median age of the volunteers was 22 years (interquartile range = 21–24), and 64% were women. Some (18.2%) had allergies, 8.6% had preexisting health conditions, and 10.6% were under regular treatment. A total of 77.3% visited a pretravel consultation clinic, 39.9% completed a specific pretravel health course, 21.7% took malaria prophylaxis, 92.4% received hepatitis A vaccination, and 82.3% received typhoid fever vaccination. Medical assistance was sought by 112 (57.3%) of the volunteers. The average number of health problems was 2.5 (standard deviation = 1.5), and the total number of health problems attended by the medical team was 279. The most common health problems were upper respiratory infections (12.2 per 1,000 person-days), wounds (10.8 per 1,000 person-days), and diarrhea (6.3 per 1,000 person-days). Short-term volunteers experienced a high rate of health problems during their stay in Cambodia, but most of the problems were mild and preventable and resolved quickly. Pretravel consultation and specific pretravel health training seemed to increase disease awareness.

An update on long-acting therapies in chronic sight-threatening eye diseases of the posterior segment: AMD, DMO, RVO, uveitis and glaucoma

In the real-world setting, there is suboptimal compliance with treatments that require frequent administration and assessment visits. This undertreatment frequently has negative consequences in eye disease and carries a real risk to vision. For example, patients with glaucoma risk progression of visual loss even with a small number of missed doses, and patients with neovascular age-related degeneration (nAMD) who fail to attend a bi-monthly clinic appointment to receive an intravitreal anti-vascular endothelial growth factor (VEGF) drug injections may lose the initial vision gains in vision. Protracted regular treatment schedules represent a high burden not only for patients and families, but also healthcare professionals, systems, and ultimately society too. There has been a clear need for longer-acting therapies that reduce the frequency, and therefore the burden, of treatment interventions. Several longer-acting interventions for nAMD, diabetic macular oedema, retinal vein occlusion, uveitis and glaucoma have either been developed or are in late-phase development, some of which employ novel mechanisms of actions, and all of which of promise longer (≥3 month) treatment intervals. This review delivers an overview of anti-VEGF agents with longer durations of action, DARPins, bispecific anti-VEGF/Ang2 therapies, anti-PDGF and anti-integrin therapy, Rho-kinase inhibitors, the Port Delivery System, steroids, gene therapy for retina and uveitis, and for glaucoma, ROCK inhibitors, implants and plugs, and SLT laser and MIGS. The review also refers to the potential of artificial intelligence to tailor treatment efficacy with a resulting reduction in treatment burden.

Three-Year Outcomes of Wet Age-Related Macular Degeneration Treatment in Polish Therapeutic Programs

Background and Objectives: Wet age-related macular degeneration (wAMD) is a chronic, progressive disease of the central part of the retina. Standard treatment for wAMD consists of multiple intravitreal injections of anti-vascular endothelial growth factor drugs. The study goal was to evaluate the three-year effectiveness of wAMD treatment with aflibercept and ranibizumab as part of the therapeutic program in routine clinical practice. Materials and Methods: 1430 patients (possessing 1430 wAMD eyes) with median age of 78.0 years (71.0, 83.0) were enrolled in a non-randomized, retrospective, observational, multicenter study; 804 (56.2%) eyes were treatment-naïve. Therapy was carried out in accordance with the guidelines of the treatment program (the fixed or pro re nata regimen). Results: After the first year of treatment, there was a gain of 2.03 (12.15) letters; after the second, 0.94 (13.72) (p ˂ 0.001); and after the third, 0.17 (14.05) (p ˂ 0.001). There was a significant reduction in the central retinal thickness. In the first year, the patients received 7.00 (5.00, 8.00) injections. In the following years, a significantly lower number of injections (4.00 (2.00, 5.00)) was administered. After the first year, there was a significant difference in the distribution of the best corrected visual acuity according to the Early Treatment Diabetic Retinopathy Study protocol, with more frequent values in the ranges > 35 ≤ 70 for this parameter and > 70 letters in the treatment naïve eye subgroup. After the first year, central retinal thickness in treatment-naïve eyes was significantly reduced. Conclusions: Regular treatment of wet age-related macular degeneration as part of the treatment program achieves functional stabilization and significant morphological improvement over a long-term, three-year follow-up, with significantly fewer injections needed after the first year of treatment.

The role of magnesium supplement in laryngopharyngeal reflux disease

<p class="abstract"><strong>Background:</strong> Laryngopharyngeal reflux disease (LPRD) is one of the most prevalent upper gastrointestinal disorder encountered in clinical practice and its optimal treatment is not standardized. The role of magnesium in the human body functions is often underestimated. Since magnesium (Mg) plays a major role in the regulation of smooth muscle contractionby relaxing the pyloric sphincter and enhancing gastric emptying, thereby decreasing the pressure on the LES, it was hypothesized that adding magnesium supplements along with the regular treatment for LPRD, can improve LPRD symptoms. Magnesium has a neutralizing action on the gastric acid and therefore, it may be pertinent to achieve optimal Mg intakes in patients with LPRD.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study done over a period of 1 year conducted in a tertiary care hospital in central India in patients presenting with LPRD of the age group 18-65 years. </p><p class="abstract"><strong>Results:</strong> The study patients were divided into two groups-one treated with esmoprazole 40 mg capsules and alginate syrup and the other with esmoprazole capsules, alginate syrup and magnesium glycinate (250 mg) supplement. Both the groups showed appreciable improvement in their mean reflux symptom index (RSI) and reflux finding score (RFS) at 1 month and 3 months follow-up. Females showed a higher preponderance than males in the disease, symptoms and the mean RSI and RFS score.</p><p class="abstract"><strong>Conclusions:</strong> Addition of magnesium supplements along with the regular treatment for LPRD, can improve LPRD symptoms and should be considered in the treatment protocol of LPRD.</p>

Approximating the asymptomatic infectious cases of the COVID-19 disease in Algeria and India using a mathematical model

In this research, we are interested in discussing the evolution of the COVID-19 infection cases and predicting the spread of COVID-19 disease in Algeria and India. To this aim, we will approximate the transmission rate in terms of the measures taken by the governments. The least square method is used with an accuracy of 95% for fitting the artificial solution with the real data declared by WHO for the purpose of approximating the density of asymptomatic individuals for COVID-19 disease. As a result, we obtained the different values of the basic reproduction number (BRN) corresponding to each measure taken by the governments. Moreover, we estimate the number of asymptomatic infected persons at the epidemic peak for each country. Further, we will determine the needed ICU beds (intense medical carte beds) and regular treatment beds. Also, we provide the outcome of governmental strategies in reducing the spread of disease. Combining all these components, we offer some suggestions about the necessity of using the recently discovered vaccines as Pfizer/Bioentec and Moderna for limiting the spread of the COVID-19 disease in the studied countries.

First experiences with 177Lu-PSMA-617 therapy for recurrent or metastatic salivary gland cancer

Background Advanced salivary gland cancers become difficult to treat when they are technically irresectable and radiotherapy limits are exceeded. There is also an unmet need to improve palliative systemic therapy. Salivary glands depict the Prostate-Specific Membrane Antigen (PSMA) on 68Ga-PSMA-PET/CT, a transmembrane protein that is targeted for diagnosis and treatment of advanced prostate cancer. Some salivary gland carcinomas also express PSMA. Methods This study aimed to retrospectively evaluate the effectiveness of 177Lu-PSMA-617 therapy for recurrent or metastatic salivary gland cancers, as a last resort treatment. Patients with serious tumour-related discomfort for whom no regular option was available were selected and critically re-assessed by the tumour board. Radionuclide therapy eligibility was confirmed when tumour targeting was greater than liver SUVmax on 68Ga-PSMA-PET/CT. The protocol aimed at four cycles of 6.0–7.4 GBq 177Lu-PSMA-617 every 6–8 weeks. Clinical response was evaluated by questionnaires and radiological response by 68Ga-PSMA-PET/CT. Results Six patients were treated with 177Lu-PSMA: four adenoid cystic carcinomas, one adenocarcinoma NOS and one acinic cell carcinoma. In two patients, radiological response was observed, showing either stable disease or a partial response, and four patients reported immediate relief of tumour-related symptoms. Most reported side effects were grade 1–2 fatigue, nausea, bone pain and xerostomia. Four patients prematurely discontinued therapy: three due to disease progression and one due to demotivating (grade 1) side-effects. Conclusions Palliative 177Lu-PSMA therapy for salivary gland cancer may lead to rapid relief of tumour-associated discomfort and may even induce disease stabilization. It is safe, relatively well tolerated and can be considered when regular treatment options fail.

EVALUATION OF DEVELOPMENT LEVEL OF INTEGRATED NON-COMMUNICABLE DISEASES GUIDANCE POST IN MOJOGENENG VILLAGE, JATIREJO HEALTH CENTER, MOJOKERTO REGENCY

Introduction: PTM is one of the most common causes of death in Indonesia. Based on a preliminary study of data from the Jatirejo Public Health Center in 2018, 2743 families with hypertension were found while those receiving routine treatment were 884 families. In Mojogeneng village, 163 families suffer from hypertension, but only 64 families receive regular treatment. Based on these problems, it can be said that the implementation of the PTM Posbindu in Mojogeneng Village has not run optimally, therefore it is necessary to carry out an evaluation that aims to see the level of development of the PTM Posbindu through 12 indicators according to the UKBM technical guidelines.Methods: Using a qualitative study conducted in Mojokerto Regency by involving related parties. The technique used is interview, Focus Group Discussion/FGD, observation and document review. The secondary data of the research was obtained from the results of the PTM Posbindu activities which were discussed in accordance with the research variables.Results: Variable developmental level of PTM Posbindu, Related to the implementation of activities carried out every month, 25% target obesity coverage, 35% target blood glucose, 25% target blood cholesterol, PTM counseling is carried out 3 or 4 times a year, counseling on all PTM problems, physical activity once a week 30% target, participants aged >55 years 70%, 45-55 years 55%, 35-44 years 30%, 25-35 years 15%, implementing activities 90% from the community, health financing 80% from the community , 75% independent participants, and Partnership 3 to 4 times a year.Discussion: Evaluation of the developmental level of PTM Posbindu consists of 12 indicators, the first indicator is independent category, second pratama, third middle, fourth pratama, fifth middle, sixth independent, seventh middle, eighth >55 years old and 44-55 full moon, 35-44 years old and 25-34 middle years, ninth and tenth full moons, eleventh full moons, and twelfth full moons.

Tocilizumab in HIV patient with severe COVID-19: case report

Background A 73-year-old male patient who had a history of Human Immunodeficiency Virus (HIV) infection for over 20 years was diagnosed with SARS-CoV-2 infection. Case presentation The patient was admitted to the Intensive Care Unit (ICU), where he remained for 25 days, due to a severe condition. Intubation, hemodialysis, and tracheostomy were necessary to maintain homeostasis. In addition to regular treatment with etravirine, dolutegravir, darunavir, and ritonavir for highly active antiretroviral therapy, the patient received tocilizumab, which showed a great recovery in the patient’s condition. Conclusion The patient had several risk factors, such as male gender, age > 70 years, and arterial hypertension. The use of tocilizumab was of great importance in the patient’s recovery since the drug increased his immune response, which is deficient, due to HIV infection.

Knowledge And Attitude On Mental Illness Among People Of A Selected Community Of Biratnagar

Introduction: Mental disorders are widely recognized as a major contributor to the global burden of disease. Mental illness often generates misunderstanding, prejudice, confusion and fear; therefore it should be a concern for all of us, rather than only for those who suffer from a mental disorder. Aim of this study is to assess the knowledge and attitude on mental illness among people of a selected community. Material And Method: Descriptive cross-sectional research design was used to assess knowledge and attitude in selected community of Biratnagar. Sample size was 92. Non-probability purposive sampling technique was used to collect data through face to face interview using Semi-structured questionnaire. Data entry and analysis was done on SPSS version 16. Descriptive statistics was calculated. Results: Finding of the study shows 88% views mental illness as a medical condition. All respondents identified that mentally ill people cannot held his/her responsibility and are prone to violent. Mental illness perceived as treatable by 66.7% with regular treatment and follow-up and 20.7% preferred treatment with traditional healer. Findings of the study showed adequate level of knowledge among 97.8% respondents. Conclusion: The finding of the study suggests level of knowledge was adequate among respondents whereas most of them had negative attitude towards mental illness. The level of negative attitude suggests the strong emphasis on public education towards mental illness.