Efficacy of Levamisole with Standard Care Treatment vs Standard Care in Clinical Presentations of Non-Hospitalized Patients with COVID-19: A Randomized Clinical Trial

Introduction: Levamisole (LVM) demonstrated clinical benefit in a trial in patients with mild to moderate coronavirus disease 2019 (COVID-19), but its effect in a larger sample size needs to be confirmed. Methods In this randomized open-label trial, we enrolled non-hospitalized patients with mild to moderate COVID-19 at nine health centers in Tehran province, Iran, in 2021. Patients were randomly assigned to receive a 10-day course of LVM with standard care (n = 185), or standard care (n = 180) in a 1:1 ratio. On days 1 to 10, LVM was administered orally at a dosage of 50 mg. The participants were called and followed on days 1, 3, 5, 7, 9, and 14. The outcomes were general health condition, hospitalization rate, sign and symptoms, and adverse events (AEs). Generalized Estimating Equations model was used for analysis. Results Among 507 randomized patients, 473 started the experiment and received LVM in addition to standard care or received only the standard care (median age, 40 [IQR, 32-50.75] years; 164 [44.9%] women; 9.4% had diabetes, 8.8% hypertension, 1.6% cardiovascular disease), and 346 (98%) completed the trial. Compared to control group, LVM decreased the general health condition of the patients (B=-0.635; CI= -0.041, -0.329; P= 0.000). Patients in the LVM with standard care group had significantly lower odds of developing fever (OR= 0.260; 95% CI= ‎0.11‎‎3‎-0.59‎‎9‎; P = .002), chills (OR= 0.223; 95% CI= ‎‎0.07‎‎6‎-‎0.64‎‎8‎; P = 0.006), fatigue (OR= 0.576; 95% CI= ‎0.34‎‎6‎-‎0.96‎‎0‎‎; P = ‎0.034), and myalgia (OR= 0.54‎‎4‎; 95% CI= ‎0.31‎‎7‎-‎0.93‎‎2‎‎; P =0.027). During the therapy, there was no significant difference in the parameters of dyspnea, cough, diarrhea, nausea, vomiting, sore throat, hyposmia, dysgeusia, and anorexia (P > 0.05). No significant difference was observed in the rate of hospitalization. Although the intervention group had greater AEs than the control group, yet, the difference was not statistically significant. Conclusions LVM has clinical benefit in improving health condition of patients with mild to moderate COVID-19. Further studies are needed to confirm our findings. Trial Registration: Iranian Registry of Clinical Trials: IRCT20201124049480N1; Registration date: 28/03/2021.

The Assessment of General Health Status in Patients with Odonto-Periodontal Pathology and Diabetes Mellitus

The present research attempts to assess the general health status of the studied group of patients by applying the questionnaire method. The research group has been composed of 210 subjects, from both urban and rural areas, having periodontal pathologies and disorders of the glucidic metabolism. In order to obtain information about the general health condition as well as the orodental hygiene, we have applied the questionnaire method, this being well individualized and adapted to be relevant to the present study. It was highlighted that patients with odonto-periodontal pathology and diabetes gave a more affected general health compared to those without diabetes.

Identifying the Dietary Patterns and Chronic Disease’s Effective Factors on the General Health Condition of Tehran’s opposite Gender Adult Twins in 2017

Introduction: The incidence of multiple births in the world has increased significantly .There are few studies on the nutritional status of twins, to our knowledge, no study has been conducted in this field in Iran. These are among many reasons that make this study, which aims to identify major dietary patterns and Chronic Disease’s Effective Factors on the General Health Condition of Tehran’s Opposite Gender Adult Twins, valuable. Materials and Methods: 128 people (64 pairs) of Opposite Gender Twins participated in this study. After completing the general information questionnaires, International Physical Activity, Semi-quantitative food frequency, and general health, anthropometric indices, and their blood pressure were measured. Dietary patterns were identified by factor analysis. The relationship between dietary patterns and factors affecting chronic diseases with general health was calculated using the logistic regression method. Results: Two western and healthy dietary patterns were identified. There was a significant relationship between the Western dietary pattern and age, gender, and father's education. Twin participants who scored higher in a quarter of the Western dietary pattern were younger than those with lower scores, with men increasing and women decreasing. There was a significant difference in the distribution of healthy dietary pattern with age, economic status, and systolic blood pressure. An increasing relationship was observed in age. The results showed that in first Twins, only Birth Weight, and Physical Activity, whereas, in second Twins besides Birth Weight, gender and Marital status were among the most significant factors in determining the general health of participants. Conclusion: The present study shows that there are two major dietary patterns: healthy and western. The Western dietary pattern has the most variance and this indicates the nutritional transition and prevalence of the Western dietary pattern in Iran. The main finding of this study is the association of birth weight with general health in both twins. Birth weight is directly related to health. Those with low birth weight have more health problems in contrast to those with normal birth weight.

Is There a Link between Suckling and Manipulation Behavior during Rearing in Pigs?

Inadequate possibilities to perform oral manipulation behavior for pigs can lead to misdirection and thus tail biting. Our study aimed to analyze manipulation behaviors of weaner pigs with focus on tail biting and the relationship with agonistic characteristics of the piglets during suckling. We analyzed the individual manipulation behavior of 188 weaner pigs. General health condition and tail lesions were determined weekly. Correlations were estimated between weight at weaning and at the end of rearing period, frequency of manipulative rearing behaviors and Dominance and social tension index based on suckling behavior. Principal component and cluster analyses were performed to identify groups of piglets which showed similar suckling and rearing behaviors. Tail biting increased at the middle and end of rearing with switching roles of biters and victims. Tail lesions were correlated with received tail biting behavior but occurred with a delay of more than a week. The frequency of performed tail biting was correlated with dominance index (rs = −0.256, p < 0.01) and weaning weight (rs = −0.199, p < 0.05). We assume that performed tail biting is more often observed in pigs who show mainly submissive behavior in teat disputes.

Orbital Apex Syndrome due to Orbital Mucormycosis after Teeth Infection: A Successful Case Report

Rhino-orbital-cerebral mucormycosis is a severe and rapidly progressive fungal infection associated with low survival rates. Early diagnosis and proper management are mandatory. We report the case of a 20-year-old female with diabetic ketoacidosis and teeth infection, who presented with sudden orbital apex syndrome. Several surgical procedures were necessary to provide a definite histopathological diagnosis of the fungal infection. Ultimately, given the progressive aggravation of the infection and the ineffectiveness of antifungal and antibiotic agents, an orbital exenteration was performed. A mycobacteriological examination revealed a polymicrobial culture with <i>Mucorales</i>. One year after the initial presentation, the patient is alive and with a good general health condition.

The importance of mucormycosis infections on example of Rhino Orbital Cerebral Mucormycosis

Mucormycosis is an angioinvasive fungal infection, characterized by high morbidity and mortality and is strongly dependent on the patient’s general health condition, initial site of infection, and the time from diagnosis to treatment commencement. It has been reported that the occurrence of mucormycosis has increased rapidly, also among immunocompetent patients. Moreover, the rise in number is expected to continue. Among all clinical manifestations of mucormycosis, the rhino-orbital-cerebral type (ROCM) is the most common. The aim of this article is to increase the awareness of mucoral infections, especially ROCM, and to describe its first symptoms, as proper treatment requires immediate surgical and medical intervention.

Az elhízás kezelése és megelőzése: táplálkozás, testmozgás, orvosi lehetőségek

Összefoglaló. Az elhízás és következményes megbetegedései fontos népegészségügyi problémát jelentenek hazánkban is. Kezelése komoly szakmai kihívás, ugyanakkor prevenciója eredményesebb lehet. Az elhízott betegekkel leggyakrabban találkozó háziorvosok, más szakorvosok és egészségügyi szakemberek részéről nagy igény van egy viszonylag rövid, áttekinthető, naprakész gyakorlatias útmutatóra. A különböző orvosszakmai társaságokban tevékenykedő, évtizedes szakmai tapasztalatokkal rendelkező szerzők összefoglalják tudományosan megalapozott, bizonyítékokon alapuló ismereteiket. Az elhízás kezelését lépcsőzetesen célszerű megkezdeni, előtte felmérve a beteg motivációját, általános állapotát, lehetőségeit. A szerzők leírják az energiaszükséglet meghatározásával, az étrenddel és a fizikai aktivitás megtervezésével kapcsolatos alapvető szempontokat. Felsorolják a hazánkban elérhető gyógyszereket és metabolikus sebészeti beavatkozásokat, az életmódi támogatás igényét. Az elhízás megelőzésében az élet első 1000 napjának táplálkozása, a későbbiekben a szülői minta a meghatározó. Sok kihasználatlan lehetősége van a háziorvosok, a lakóközösségek, az állami szervek koordinált együttműködésének, helyi kezdeményezéseknek. Az elhízás betegségként való meghatározása egyaránt igényel egészségpolitikai és kormányzati támogatást, az elhízottak ellátására szakosodott multidiszciplináris centrumok számának és kompetenciájának növelését. Orv Hetil. 2021; 162(9): 323–335. Summary. Obesity and related morbidities have a high public health impact in Hungary. The treatment is a challenge, but prevention seems more effective. General practitioners, other specialists and health care professionals who are treating obese persons require short, summarized, updated and practical guideline. Hungarian medical professionals of different scientific societies, having decennial practices, are summarizing their evidence-based knowledge. Obesity management requires step by step approach, evaluating previously the general health condition, motivation and options of the patients. The measurement of energy requirement, planning of diet and physical activities, available surgical methods and medications are described in detail with life style and mental support needed. The most important period in the prevention of obesity is the first 1000 days from conception. Other significant factors are the life style habits of the parents. Proper obesity prevention requires better coordination of primary health care, community and governmental activities. Obesity should be defined as morbidity, therefore stronger governmental support and more health-policy initiatives are needed, beside increasing number and developing of multidisciplinary centres. Orv Hetil. 2021; 162(9): 323–335.

Analysis of Unmet Healthcare Needs in Ireland: A Data Mining Approach

This study explores data form the Survey of Income and Living Condition (SILC), related to factors contributing to unmet healthcare needs in Ireland. We analysed predisposing, enabling and needs factors by building predictive models and measured the predictor importance by sensitivity analysis. Results show that critical factors for meeting the healthcare needs include financial status, degree of urbanization, indicators of social exclusion and deprivations, and self-perceived general health condition. Identifying and quantifying those factors form raw data may facilitate decision making in the domain.

Environmental changes and general health condition

Background: The environment directly affects health status and plays a major role in quality of life, years of healthy life lived, and health disparities. Humans impact the physical environment in many ways, like over population, pollution, burning fossil fuels, and deforestation. The study was conducted to assess environmental changes and the general health condition. Methods: It was a cross-sectional study. To assess environmental changes and general health condition of dental second year student and data were collected by checklist. Respondents were selected purposively. Data were collected on 8th September 2019 at Marks medical college dental unit. Samples were second year dental students, who were presented in class on that date. Results: Distribution of the respondents according to sex, 64.5% were female and 35.5% male. Majority of the student (51.6%) were come from outside of the Dhaka. 45.2% respondents were lived in Dhaka by born. 80.6% respondents lived with their family. It was alarming that 83.9% respondents never did physical exercise and only 16.1% did sometimes physical exercise. 61.3% respondent admired that they have hair loss, 16.1% has no problems in skin but others has problems. 51 .6% has dust, 1 2.9% has food allergy. 6.5 % has frequently exposure of diarrhea diseases. Often 67.7% has been suffered by headache. Reason of seasonal changes 29% respondents suffered by itching. 77.4% and 83 .9% respondents were affected by anxiety and depression. 77.4% respondent has knowledge about weather change in our country as well as whole world. Conclusion: General health condition maybe changed for multiple causes. Environment is one of the strong factors. The relation between environmental temperature and health has been known for a very long time. JOPSOM 2020; 39(1): 73-77