Bibliometric analysis on infective endocarditis

Introduction: Although infective endocarditis (IE) is rare disease, this disease has importance due to its high morbidity and mortality rates. The exact incidence is not known as it is not a reportable disease. Unlike developed countries, the disease affects the young more than the elderly in developing countries. Most of the time, the diagnosis cannot be made at the first examination and the disease is often overlooked. In order to reduce the mortality and morbidity of this disease, it is important to quickly recognize the disease by following current diagnosis and treatment methods, to identify the causative agent and to treat accordingly. Both the epidemiology and the management of IE are changing due to medical advances. This situation may also be reflected in scientific publications. We aimed to analyze the global researches on IE. Material and methods: The Scopus database was searched for bibliometric analysis without selecting document type. Data were retrieved for the time period January 1, 1940 and Semptember 26, 2021, containing the keywords " Infective’’ and’’endocarditis " in their title. Results: 7911 publications were included in the study. The first publication was made in the year 1891. Most of the publications were research articles [n=5784 (73.11%)] and were from the United States of America (USA) [n =1622 (20.50%)]. Japan, France, United Kingdom and Spain were also in the top 5 publishing countries on IE. Conclusions: Infective endocarditis is still an important reason of mortality, and there are many unanswered questions about the managament and preventation of this disease. This situation reflected the scientific publications. Since this is a global problem, not just some developed countries involved in the IE research, also more countries should be encouraged to participate the studies on IE.

Public opinion and practice towards COVID-19 pandemic in Libya

Introduction: World Health Organization declared COVID-19 as a pandemic, and like any global health crisis at its beginning, need a commitment to take the necessary precautions due to its spread among people before and during the presence of vaccine or drug. This study aims to assess public opinion and practice of Libyan community in the context of the COVID-19 pandemic. Materials and methods: A cross-sectional online study was conducted among Libyans between Sep. 15th, and Oct. 29th, 2020 using a developed-design questionnaire consisting of 23 questions assessing the aim of the study. 2305, who agreed to participate, was involved in the present study. Results: The response rate of Libyan regions, the west, east, middle and south areas, was 80.0%, 8.7%, 10.0 % and 1.3%, respectively. The majority were female (63.1%), with mostly in the 20-50 years’ age group (86.6%). The high level of education was university graduate (71.3%). The opinion average rate of participants was 33.2 % disagree and 26.4 % strongly disagree towards ban measures issued by authorities. Findings reveal good practice of applying preventive measures (always, an average rate of 35.1%). The relationship between opinion score and the participant’s demographic data show highly significant difference with the educational level (P = 0.002), but no differences found with residence (P = 0.183), with age (P = 0.212), and with gender (P = 0.313). With regard to the practice score, a significant difference was existed with gender (P = 0.029), age (P = 0.000), level of education (P = 0.013) and residence (P = 0.000). Conclusions: Libyan people has an acceptable level of awareness and opinion in applying the necessary precautionary measures towards COVID-19 pandemic, where prevention practices are influenced by level of education, residence, age and gender.

The impact and effectiveness of new coronavirus vaccine on disease outcome worldwide

Introduction: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is spreading rapidly around the world caused serious respiratory disease leading to death, therefore vaccine is the effective way to control this pandemic. Scientists tried to produce safe and effective SARS-CoV-2 vaccines in record time and vaccination program started in December 2020. The aim of this study to determine the impact of SARS-CoV-2 vaccine on COVID-19 disease. Materials and methods: The COVID-19 cases data of post-vaccination and pre-vaccination were collected from Worldmeter website, and the percentage of vaccinated people data obtained from Statistics and Research Coronavirus Vaccinations. The statistical analyses performed with SPSS software version 16.0. Results: The results showed countries with higher percentage of full dose vaccinated people correlated strongly with decrease of death and the severity of the disease among their infected population. This study showed that different vaccine mechanism against SARS-CoV-2 virus of more than 23.5% of vaccination people with full dose vaccine is effective to decrease death and serious symptoms of COVID-19 disease and increasing the recovery rate. Conclusions: Different mechanism type of full dose vaccine against SARS-CoV-2 is effective to decrease death and serious symptoms of COVID-19 disease with increasing recovery rate. It was difficult to assess the effect of single dose alone, therefore more studies are recommended to assess the effect of single dose vaccine with COVID-19 disease outcome and to determine if the vaccine will accelerate the period of recovery rate and reduce the infectious period time in each country.

Spleen: an organ of multiple shapes

Introduction: The spleen is located in the upper part of the abdominal cavity. As an organ, the spleen can have various shapes and size. Material and methods: The human spleen was studied in 273 cadavers (154 men and 119 women) who did not have diseases of the spleen. The shape of the spleen was analyzed based on splenic index, Michels classification. Results: The most common shape of the spleen in men is the elongated one. It was encountered in 79 (51.3%) cases out of 154. In women, the most common shape was the intermediate. It was encountered in 51 (42.9%) of the 119 cases. Based on Michels classification the clinoid (wedge) shape was encountered in 102 (37.74%) cases, triangular in 59 (21.83%) and tetrahedral in 30 (11.1%). In 30.26% the shape of the spleen couldn’t be classified according to Michels classification. In 21 cases (7.77%) the spleen had a flat shape; in 27 (9.99%) – dome-shaped; in 1 case (0,37%) – Z-shape; in 18 (6.66%) – round shape; in 6 (2.22%) – irregular shape; in 2 (0.66%) - shape with a node in the hilum; in 1 (0,37%) – rhomboid shape, in 2 (0,74%) – bilobed shape and in 4 cases (1,48%) – lobular shape. The splenic fissures located on the upper edge of the organ were found in 81 (29.91%) cases, and also on the lower edge - in 41 (14.02%) cases. In 13 (4.67%) cases fissures were encountered on both sides. In 148 (51.4%) cases the spleen had no fissures on its surface. Conclusions: The spleen has various shapes beyond the classical wedge, triangular and tetrahedral. All of these shapes do not represent a pathological finding but in certain situation may require further analysis and interpretation depending on the imaging technique and experience of the physician.

Predicting of poor outcomes in COVID-19 patients: Experience from an Argentinean hospital

Introduction: The pressure over health systems caused by the COVID-19 pandemic brought about the need to develop tools that would allow for the identification of those patients that require immediate attention. Our objective was to identify clinical and biochemical predictors of poor outcomes (PO) in a cohort of patients hospitalized due to COVID-19 in an Argentinean public hospital. Methods: Prospective cohort study conducted from March 3rd, 2020 to February 16th, 2021 in a tertiary care center in Santa Fe, Argentina. Clinical and biochemical characteristics of patients with COVID-19 pneumonia admitted consecutively were analyzed in order to identify predictors of a composite of poor outcomes (PO) -all-cause mortality and/or need for invasive mechanical ventilation. Results: 421 patients were included. The mean age was 56.13 ± 15.05 years. 57.0% were males. 79.7% presented at least one comorbidity. 27.7% (n=116) presented PO. In the multivariate analysis, a higher 4C-score and a higher LDH, as well as a lower SatO2/FiO2, were associated with a higher risk of PO. No variable reached an AUC of 0.800 in the ROC analysis. 4C-score presented a numerically higher AUC (0.766 IC 95% 0.715-0.817). Conclusions: Each point that the 4C-score increases, the risk of PO rises by 28%. Also, for every 100-units increase in LDH or 50-units decrease in SatO2/FiO2 at admission, there is a 20% increased risk of PO.

Effectiveness of the Family and Friends CPR course in learning cardiopulmonary resuscitation in relatives of patients with high cardiovascular risk or who have suffered a cardiovascular event

Introduction: Early, high-quality cardiopulmonary resuscitation (CPR) increases survival rates in cardiac arrest. Although most cases occur at home and are witnessed, CPR is performed in few of these cases. For this reason, teaching CPR is especially important in relatives of patients with high cardiovascular risk. Therefore, the aim of this study was to demonstrate the effectiveness of the Family and Friends CPR course in the theoretical and practical learning of cardiopulmonary resuscitation in relatives of patients with high cardiovascular risk or who have suffered a cardiovascular event. Materials and methods: We carried out an analytical, quasi-experimental, prospective, before-and-after study. We selected 20 participants during outpatient consultation at the Cardiology Department of the Cayetano Heredia Hospital in Lima, Peru. A theoretical knowledge questionnaire and an adult CPR checklist were used to assess the level of theoretical and practical knowledge, respectively. The theoretical knowledge was measured at three points in time (before, immediately after and one month after the intervention) and the practical skills at two points in time (immediately after and a month after the intervention). Results: The level of theoretical knowledge was low (8.64 ± 2.47) before the intervention, achieving a good level of knowledge immediately after (17.33 ± 2.02) and one month later (16.5 ± 1.91). Furthermore, the medians of the level of practical knowledge were 15 immediately after and one month later, showing that they maintained a good level of practical knowledge. Conclusions: The Family and Friends CPR course was effective in the theoretical and practical learning of CPR in the studied population, and was sustained one month after the intervention.

Factors related to the exclusive breastfeeding in the working area of PHC Poasia, Kendari City

Introduction: Inadequate exclusive breastfeeding is responsible for more than 236,000 child deaths each year and significantly increases the risk of death in infancy and childhood. While the COVID-19 Pandemic continues, this should not be a barrier for breastfeeding mothers to breastfeed their babies. This study aims to analyze the factors related to exclusive breastfeeding during the COVID-19 pandemic in the working area of the Poasia Health Center, Kendari City. Methods: This cross-sectional study involves 100 participants in the working area of the Poasia Public Health Center, Kendari City. The dependent variable in this study was exclusive breastfeeding during the COVID-19 pandemic, while the independent variables were age, employment status, education level, parity, family support, and support from health workers. Data analysis was carried out in stages, including univariate, bivariate, and multivariate analysis. Results: The results showed a relationship between parity (p-value = 0.006), family support (p-value = 0.001), and support from health workers (p-value = 0.003) with exclusive breastfeeding in the working area of the Poasia Health Center, Kendari City. At the same time, age (p-value = 0.524), status, occupation (p-value = 0.452), and education level (p-value = 0.708) are not related. The results of multivariate analysis using logistic regression showed that family support was most associated with exclusive breastfeeding (Exponent (B) = 8.549). Conclusions: The lower the mother's parity, the more likely she is to give exclusive breastfeeding. Good and maximal family and staff support will stimulate the mother to give exclusive breastfeeding.

Risk Factors for Ectopic Pregnancy: A Case-Control Study in Tertiary Care Hospitals of Jammu and Kashmir

Introduction: An ectopic pregnancy occurs when a fertilized egg attaches somewhere outside the uterus.There are many risk factors for ectopic pregnancy. This study will help us to prepare a list of risk factors associated with ectopic pregnancy in our state. In addition, it will help implement a risk-reduction counseling program before conception, which will help us screen high-risk patients and reduce and manage ectopic pregnancy. Materials and methods: The present study was conducted in our department for two years, from August 2018 to July 2019. Cases included all patients with ectopic pregnancy admitted in labor. A total of 192 cases were taken, out of which 8 cases refused to participate in the study, so 184 patients were included in the study. Results: Patients with previous ectopic pregnancy have 6.34 times increased risk of a repeat ectopic pregnancy (odds ratio 6.34, confidence interval 1.40-28.77), and this association was highly significant (p = 0.006). The risk of ectopic pregnancy is 3.02 times increased (odds ratio 3.10; 95% confidence interval, 1.16-7.84) if the patient once had the pelvic inflammatory disease and is statistically significant (p = 0.01). The study also revealed that 17 (10.3%) patients with ectopic pregnancy had a history of tubal ligation or some other tubal surgery done in the past compared to 3 (2.2%) patients among controls, and this finding is statistically highly significant (p = 0.001). Conclusions: In the present study, we found that the main risk factors for incidence of ectopic pregnancy are prior ectopic pregnancy, prior tubal ligation, and prior pelvic/abdominal surgery. In addition, ectopic pregnancy was positively related to the previous history of ectopic pregnancy, abortion, cesarean section, and infertility. These findings can be helpful for early diagnosis of ectopic pregnancy to pursue proper medical therapy instead of unnecessarily surgical treatment.