Pulmonary alveolar proteinosis with secondary Aspergillus infection: A case report

Pulmonary alveolar proteinosis (PAP) is a rare disease with mostly due to autoimmune toward granulocyte-macrophage colony-stimulating factor. In some conditions, PAP followed with secondary infection. A 34-year-old woman came with progressive shortness of breath, chronic dry cough, and mild fever. The chest High-Resolution Computed Tomography showed ground-glass opacity with septal reticulation or known as the crazy-paving pattern, and a cavity on the upper lobe of the left lung. The patient underwent bronchoscopy for diagnostic and therapeutic measures and found milky appearance bronchoalveolar lavage fluid (BALF). The serum galactomannan came out positive. Fungal infection detected from the BALF culture, Aspergillus fumigatus, hence fulfilling the diagnosis of PAP with probable invasive pulmonary aspergillosis. The patient showed clinical improvement after undergoing whole lung lavage and given anti-fungal medications.

Prevalence and socio-demographic factors associated with physical inactivity among primary health care users in Tirana, Albania: A cross-sectional study

Introduction: The World Health Organization (WHO) defines physical activity (PA) as any movement of the body produced by skeletal muscle that requires expenditure of energy. The aim of research is to assess the prevalence of and socio-demographic characteristics associated with physical inactivity (PI) among adult primary healthcare (PHC) users in Tirana, the capital of Albania.Methods: This was a cross-sectional study carried out in Tirana from November 2020 to January 2021. During this period 500 consecutively approached individuals aged ≥18 years exiting PHC centers were interviewed face-to-face about the presence of some of the risk factors for non-communicable disease. A structured WHO STEPS questionnaire, an integrated part of which is the instrument required for this study, “Global PA Questionnaire,” was used. In addition to demographic and socioeconomic data, we obtained data on the performance of PA in terms of domains, duration, and intensity. Logistic regression was used to assess socio-demographic factors associated with PI.Results: Prevalence of PI in the study population was 31.6%. Following multivariable adjustment for all covariates, significant positive correlates of PI were female gender, rural residence, retiree status, and unemployment. Conversely, there was an inverse association with moderate level of education.Conclusions: Similar to that of other European populations, the population of Tirana has a high rate of PI showing an upward tendency. The population groups at the highest risk of PI who may be targeted for intervention programs to address this risk factor are women, rural residents, unemployed persons, and retirees.

Effects of axial loaded magnetic resonance imaging of lumbar spine on dural sac and lateral recesses

Introduction: Axial-loaded magnetic resonance imaging (MRI), which can simulate an upright position of the patient may cause a significant reduction of the dural sac cross-sectional area (DCSA) compared with standard MRI, thus providing valuable information in the assessment of the lumbar spinal canal. The purpose of this study was to investigate excessiveness of the change in DCSA and depth of lateral recesses (DLRs) before and after axial-loaded imaging in relation to body mass index (BMI) of the subjects.Methods: Twenty patients were scanned to evaluate DCSA and DLR at three consecutive lumbar spine intervertebral disc levels (L3/4, L4/5, and L5/S1) on conventional-recumbent MRI, and after axial loading were applied.Results: Axial-loaded MRI demonstrates a significant difference of DSCA in comparison to conventional MRI. Furthermore, results show a significant correlation between the DCSA and BMI on level L3/L4, both before and after axial loading MRI. With axial loading, there is a reduction of DSCA of 12.2%, 12.1%, and 2.1% at the levels L3/L4, L4/L5, and L5/S1, respectively. After axial loading has been applied, the depth of the neural foramen has been reduced by an average of 10.1%.Conclusion: Axial-loaded MRI reduces DCSA and DLRs in comparison to standard MRI. Information obtained in this way may be useful to explain the patient’s symptomatology and may provide an additional insight that can influence the treatment decision plan accordingly.

Satisfaction and attitudes of the student population about dental aesthetics

Introduction: Perceptions of the esthetic appearance of teeth vary in different individuals and can affect satisfaction with the dental appearance, attitudes, and the need for appropriate dental treatment. The research aims to examine the factors influencing the satisfaction with the appearance of the dentition and the attitude toward treatments which improve dental esthetics among students of the faculty of dentistry in comparison to the attitudes of students of non-dental faculties.Methods: The research included a total of 358 students of the Faculty of Dentistry and Faculty of Architecture in Sarajevo who voluntarily filled out a questionnaire created for this research. The questionnaire contained questions related to satisfaction with the appearance of teeth in general, tooth color, tooth position, questions related to the previous, and future desired esthetic restorations and treatments.Results: Female subjects expressed statistically significantly greater dissatisfaction with the appearance of the dentition and did or plan to do treatments that could improve dental esthetics compared to male subjects. Students of the Faculty of Dentistry at final years were significantly more satisfied with the general appearance of teeth and tooth color compared to freshmen students of the Faculty of Dentistry and students of the Faculty of Architecture.Conclusion: Satisfaction with dental appearance is a subjective experience that is influenced by various factors, level, and type of education is among them.

Nursing students' attitudes about their profession

Introduction: Positive attitudes toward the nursing profession among nursing students improve the sustainability of the profession. Studying the attitudes of nursing students toward nursing is of great importance, as it can indicate their remaining in the profession. This study aimed to determine the attitudes of nursing students toward the nursing profession.Methods: This was a cross-sectional, descriptive, analytical study. The research was conducted at the Faculty of Health Studies at the University of Sarajevo from May to June 2019. The study involved a convenience sample of 107 currently enrolled Bachelor of Nursing students from the 1st to the 4th (and final) year of full-time study and part-time students in the Baccalaureate of Nursing Care program at the University of Sarajevo. The students voluntarily and anonymously completed a questionnaire consisting of demographic information and the Nursing Image Questionnaire.Results: Overall, 107 students participated in the research. Their mean age was 23 years old (standard deviation, 5 years). Spearman’s correlation factor shows a statistically significant correlation between the scores and the mode of studying (full-time or part-time) (rho = −0.200*, p = 0.039) and whether respondents working in the profession or not (rho = 0.249*, p = 0.010).Conclusion: The attitudes of future Bachelor of Nursing toward the nursing profession were very positive. Full-time students had more positive attitudes toward the profession, compared with part-time students, although the difference was not statistically significant.

Does mother scented simulated hand promote comfort, reduce pain, and distress among mechanically ventilated preterm neonates during invasive procedures?

Introduction: Breakthrough technologies in the neonatal intensive care unit (NICU) revolutionized neonates’ quality of care. Mother scented simulated hand (MSSH) is an ergonomically designed supportive hand that uses the power of touch to simulate the feeling of being held and cuddled. This study aimed to determine the effect of MSSH on promoting comfort among mechanically ventilated preterm neonates during invasive procedures.Methods: A quasi-experimental, pre-posttest two groups study was carried out in NICU in Smouha, Alexandria. A sample of 62 mechanically ventilated neonates was randomly assigned to two equal groups; the study group wrapped with a warm MSSH during the invasive procedures while the control group received standard care of NICU. Two observers independently rated the neonates’ level of comfort, distress, and pain during endotracheal suctioning (ETS) and heel prick using COMFORTneo scale.Results: It is revealed that the mechanically ventilated neonates had a significantly higher comfort level with MSSH than the standard care during and after both ETS and heal break (p < 0.001 for each). The neonates had significantly lower distress and pain scores when encircled by MSSH during invasive procedures than standard care (p < 0.001 for NRS distress and p < 0.001 for NRS distress).Conclusion: Wrapping the preterm neonates with a warm MSSH promotes comfort and reduces their pain and distress during invasive procedures, especially when their mothers are not physically available.

The effect of Benson relaxation technique on fatigue of patients diagnosed with multiple sclerosis

Introduction: The previous studies showed that fatigue is a very common symptom in patients diagnosed with multiple sclerosis (MS) and has the greatest effect on their activities of daily living. Benson relaxation technique (BRT) is one of the most relaxation techniques used to decrease fatigue, improve emotional status and quality of life in patients with several chronic diseases. This study aimed to investigate the effect of BRT on fatigue level of patients diagnosed with MS in Jordan.Methods: This is a quasi-experimental repeated measure study. It involved six neurological clinics in the Ministry of Health and five neurological clinics at private hospitals. In this study, 95 patients returned the completed questionnaire and attended BRT.Results: The mean age of the patients was 33 years. Females accounted for 60% of the patients and almost half of the patients were single. All patients reported having a university degree and three-quarters of the patients were employed. Almost, two-thirds of the patients reported having not more than 1 time of relapse in the past 2 years. The majority of them reported <3 years from the confirmed diagnosis. Findings showed a statistical significant reduction in the overall level of fatigue including physical, cognitive, and psychosocial fatigue of patients with MS after BRT (p < 0.001).Conclusions: Results suggested that this technique is a very effective strategy for reducing fatigue in patients with MS. Therefore, in addition to prescribing medication, it is recommended that this method be applied in the care of patients diagnosed with MS.

Stigmatization towards cancer among university students in Malaysia

Introduction: Stigmatization towards cancer is a barrier to early cancer screening and treatment. This study was conducted to determine the level of cancer stigma among Malaysian university students in Malaysia with different sociodemographic backgrounds.Methods: This cross-sectional study recruited 400 students (mean age, SD = 22.22 ± 1.67 years) from a selected university in Malaysia. Data were collected from October 2019 to February 2020 through an online survey. The Cancer Stigma Scale (CASS) was used in assessing the levels of cancer stigma among university students with different courses and social backgrounds. The CASS was used in assessing multiple aspects of cancer stigma, including severity, personal responsibility, awkwardness, avoidance, policy opposition, and financial discrimination.Results: Data were analyzed using SPSS (version 23). Results showed that the stigmatization level toward cancer among university students varied across the six subscales. Items regarding the severity of a cancer diagnosis showed the highest level of agreement (32–52%; M = 3.05, SD = 0.96), whereas the item ‘avoiding someone with cancer’ showed the lowest agreement, 7–10% (Mean = 1.85, SD = 0.97). Stigma was significantly higher in young students, males, non-health science students, students in the junior year level, students without family histories of cancer, and the low-income group (p < 0.05).Conclusion: These findings may provide a benchmark of stigmatization level among university students in Malaysia and may be a valuable basis for delivering information and education on cancer screening and treatment.

Evaluation of serum levels of malondialdehyde and endogenous non-enzymatic antioxidants in relation to colorectal cancer stage and intestinal wall infiltration

Introduction: Oxidative stress and lipid peroxidation are pointed as possible factors in the development of colorectal cancer (CRC). The aim of this study was to assess the serum malondialdehyde (MDA) and non-enzymatic antioxidants concentration (albumin, bilirubin, uric acid, and ferritin) and their relation with the stage and histopathologic size (pT) of CRC. Methods: One hundred and twenty patients with clinically and histopathologically confirmed CRC and the need for surgical treatment were included in a cross-sectional study. All patients were divided into groups according to the disease stage and depth of tumor invasion. The control group included 30 subjects with no signs of malignant and inflammatory bowel disease. The patients and controls did not receive vitamin supplementation. Peripheral venous blood was sampled before the surgical treatment of CRC patients and on the day of the examination of control subjects for determination of serum MDA and the concentration of the non-enzymatic antioxidants. Results: The serum levels of MDA were progressively increased in CRC patients with the highest level in the fourth stage of disease and pT4 group. Ferritin levels increased significantly with the CRC stage and decreased with the depth of bowel wall invasion. Serum albumin concentration significantly decreased with increasing stage and increasing depth of tumor invasion of the intestinal wall, while serum bilirubin level showed no change compared to the control group. Serum uric acid concentration was significantly higher in CRC patients, but no difference was observed with CRC progression. It was confirmed that serum albumin significantly negatively correlated with the CRC stage (rho = −0.649, p < 0.001), while serum MDA significantly positively correlated with the CRC stage (rho = 0.750, p < 0.001). Conclusion: These results indicate that serum MDA concentrations are related to the progression of CRC, to which the imbalance in non-enzymatic antioxidants also contributes.

Short-term effects of carrying a school bag on the distribution of force and plantar pressure during walking of children of different levels of physical activity

Introduction: Carrying a school bag is a dominant activity that a child performs during daily productive activities. The aim of the research is to examine how carrying a school bag of different weights affects the distribution of force and plantar pressure during normal walking on the flat terrain of children of varying levels of physical activity.Methods: The pilot study included 124 students aged 11-12 from Banja Luka. According to the protocol, each group of respondents was treated with an intervention-customized school bag and a comparator-school bag that the child only opted for. For the research, the Physical Activity Questionnaire for Older Children, measurement of anthropometric parameters, school bag weight, and Zebris tape (Zebris Medical GmbH, Germany) were used for gait analysis.Results: Inactive children achieved the lowest and active children’s highest walking speed during normal walking without a bag, with their customized school bag. When carrying a custom school bag: The highest maximum force is projected on the left heel 330.72 N in inactive children, and the lowest 265.93 N in moderately active children, the highest maximum pressure on the left heel is registered in inactive children, 27.60 N/cm2, and the lowest 21.85 N/cm2 in moderately active children. The maximum force-time of % of standing time on the left foot in the middle part lasted the longest in inactive children, and the shortest active children carried their school bag 40.31% and a custom school bag 39.76%.Conclusion: High physical activity and individual adjustment to distribute the burden well allow the child to adequately respond to the loads carried by the weight of the school bag.