The Effect of Vaping and Nicotine-containing Liquids to Suppress the Immune System: A Pilot Study

Aims: We present a pilot study to illustrate how the impact of vaping can be quickly and conclusively documented in a large population and appropriate subpopulations. Methods: It has been predicted that with longer duration and higher frequency of vaping, there would be a higher frequency of, a longer duration of, and more severe flu and cold symptoms — indicating a negative impact on the immune system. Studies have linked electronic cigarettes and vaping to respiratory and cardiovascular issues, drastic changes in blood pressure, and the reduced function of tissues and cells in the lungs, but only in small populations, making generalization to the entire population less convincing. A sample of 120, 18–22-year-olds in northern California were asked to complete a 14-question, two-minute, anonymous survey. Those with pre-existing respiratory ailments or a family history of respiratory ailments were excluded from the study along with those who smoke cigarettes or have smoked cigarettes in the past. The survey collected the frequency and time spent vaping and the severity, frequency, and longevity of the flu and cold symptoms. Responses were converted into numerical values and analyzed. Results: Those who vaped more often had more severe flu and cold symptoms (p<0.005). However, no strong trends were present as can be expected from a pilot study. A power analysis based on this pilot data suggests that only 667 subjects would be required to answer the short survey to reach statistical significance. Conclusion: A quick survey was created to show the negative effects of vaping on a general population. Showing effects generalizable to the entire population would require a very reasonably sized sample and could easily allow analysis of subpopulations.

The Effect of Fat Emulsion Intralipid Infusion on Reproductive Outcome for Women with Unexplained First Trimester Habitual Abortion

Objectives: To study the effect of the use of intralipid in management of women suffering from unexplained first trimester habitual abortion. Methods: The study was a prospective cohort study, which conducted in Tanta university Hospital; Egypt. It included 93 women with history of two or more unexplained recurrent abortion in the first trimester. They were divided into three groups: group Ι received only intralipid, group II received low molecular weight heparin (LMWH) and low dose aspirin, and group III served as controls and received only saline as placebo. The patients were followed up until continuation of pregnancy into the second trimester. Occurrence of complication and pregnancy outcomes were evaluated. Results: Ninety three women were included. After treatment, more pregnancy continued into the second trimester, more live births and less numbers of abortions in group A and B in comparison with group C (p=0.008, 0.008 and 0.035) respectively. Maternal and neonatal outcomes were comparable in all studied regimens. Conclusions: Management of women with unexplained first trimester habitual abortion (before 14 weeks) with intralipid or LMWH with small dose of aspirin may increase the proportion of pregnancy continued into the second trimester, more live births and less numbers of abortions. However, LMWH is more superior to the intralipid but with more side effect.

Pattern of ocular Diseases among Children under Five Years of Age in Southeast, Nigeria

Background: Children under 5 years are prone to ocular disorders which could be congenital or acquired. Early recognition of these conditions and timely intervention enhances optimum results. There is paucity of data on the pattern of ocular disorders among these children in Nigeria and this makes it difficult for policy makers to plan health systems that will target this very important group of the population. Aim: To determine the pattern of ocular diseases among children less than 5 years of age in Onitsha, Anambra state Nigeria. Methods: This was a retrospective study of children under 5 years of age that presented to City of Refuge Specialist Eye Clinic Onitsha, Nigeria between January 1st, 2016 to December 31st, 2020. Their case files were retrieved and relevant information extracted. Sociodemographics, month of presentation to the eye clinic and diagnoses were analyzed. Results: A total of 133 children were studied. The patients comprised 85 (63.9%) males and 48 (36.1%) females, with an approximate male to female ratio of 1.8:1. Eye diseases seen were both congenital 32(24.1%) and acquired 101 (75.9%). Of the congenital type, 20 (62.5%) were males, while 12 (37.5%) were females. Most common ocular morbidities recorded were allergic conjunctivitis 41(30.8%) and infective conjunctivitis 34(25.6%). Conclusion: Most of the causes of ocular morbidity in this study were preventable or treatable. Therefore, early detection and management of eye diseases in children will reduce complications in later life.

Assessment of Nutritional Status of Chronic Renal Failure Patients on Hemodialysis in Damanhour National Medical Institute in El-Beheira Governorate, Egypt

Background: Nutritional problems are of the most important risk factors of increasing mortality rates in chronic renal failure patients on hemodialysis and morbidity occurring from malnutrition significantly severely affects their quality of life. Aim: To assess the nutritional status of chronic renal failure patients on hemodialysis (HD) attending HD unit in Damanhur National Medical Institute. Methods: A cross-sectional study was carried out in the hemodialysis unit on 174 patients. Data collection was done via a specially designed questionnaire containing; socio-demographic and clinical data, anthropometric measurements, biochemical measurements, 24-hour recall list and questions for assessment of nutritional knowledge. Malnutrition inflammation score (MIS) was used for assessment of the nutritional status. Results: 65.5% of the patients were mildly malnourished, 24.7% were moderately malnourished and only 9.8% were normal and the level of malnutrition was significantly affected by duration of renal disease and hemodialysis duration. 44.3 % of patients had poor nutritional knowledge level, and only 4% had good nutritional knowledge and the nutritional knowledge level had a significant association with level of malnutrition. 96% did not attend any nutritional health education sessions, but they were willing to attend these sessions. Conclusions: Malnutrition was highly prevalent among the studied patients. There was a statistically significant relationship between levels of malnutrition (MN) and the level of nutritional knowledge of hemodialysis patients.

Serum Leptin and Earlier Stages of Nephropathy among Type 2 Diabetic Subjects in a Bangladeshi population

Objective: To evaluate the relationship of Serum Leptin and Early Nephropathy among uncontrolled type 2 Diabetes Mellitus patients of Bangladesh Institute of Research and Rehabilitation in Diabetes Endocrinology and Metabolism (BIRDEM), Dhaka and Endocrinology department of Sylhet MAG Osmani Medical College (SOMC) & Hospital Sylhet, Bangladesh. Methods: This study was carried out from January 2013 to December 2015 among 100 type 2 diabetic patients from the outpatient department (OPD) BIRDEM and SOMC hospital. Results: 16 out of 30 controls and 65 out of 100 people with diabetes have a family history of diabetes. Early retinopathy and neuropathy were observed in 45.5% and 36.5% diabetic subjects. Mean±SD of serum urea in control subjects was 28.65±6.27; in diabetic subjects was 30.21±7.67. Serum creatinine in controls was 1.12±0.24, in diabetic subjects was 1.13±0.25. Serum leptin levels in control subjects {1.65 (0.05-8.66)} was lower than diabetic counterpart {1.21 (0.11-13.3)}. Leptin levels in male controls {(1.29 (0.05-2.49)} was significantly (P 0.000) lower than the female controls {4.03 (0.05-8.66)}. Conclusion: It was evident that there was very little or no association between serum leptin level and the indices of renal function. No changes of circulating serum Leptin concentration in the earlier stages of Diabetic Nephropathy were found.

Presentation of Small Bowel Volvulus in East Africa

Introduction: A benign gastrointestinal surgical condition involving torsion of part or all of a segment of small bowel on its mesenteric axis is small bowel volvulus (SBV). The clinical presentation is similar to acute mesenteric ischaemia and hence a preoperative clinical diagnosis is difficult to obtain. In developing countries, as a presenting surgical cause of small bowel obstruction it has contributed to a significant burden. The aim of this case report was to discuss a typical case of small bowel volvulus in a developing country and highlight the importance of resuscitation and early surgical intervention. Presentation of case: A 35 year old lady admitted to hospital with a 3 day history of colicky central abdominal pain. She reported a long period of fasting and sudden ingestion of food. On physical examination her abdomen was moderately distended with minimal tenderness. Laboratory investigations were normal and a plain abdominal X-ray revealed features suggestive of small bowel obstruction. After resuscitation the patient was taken for a laparotomy where evidence of SBV was found. An omental band adhesion was divided, the volvulus untwisted and the small bowel was all viable. The patient made an uneventful postoperative recovery. Discussion: The incidence of SBV is higher in Africa, Asia and the Middle East compared to the Western world. Secondary SBV is more commonly found in older age groups however primary SBV is more common in children. The most common complaints of SBV includes abdominal pain, abdominal distention and vomiting. The mortality rate due to SBV has been found to be decreasing with early diagnosis due to abdominal CT scanning. This reduction in mortality is due to a reduction in the incidence of gangrene of the SBV. Conclusions: Due to the high mortality and variable presentation, surgeons must consider small bowel volvulus a probably diagnosis in a patient with abdominal pain and features of small bowel obstruction. Early surgical intervention is necessary to reduce the morbidity and mortality from SBV.

Knowledge, Attitude and Practices of the General Population towards COVID-19 Vaccinations: A Cross-sectional Study

Aims: This study aims to evaluate the knowledge, attitude, and practices of the general population towards coronavirus vaccinations in Pakistan. Study Design: A cross-sectional study. Place and Duration of Study: Sample: Department of Dental Surgery, Altamash Institute of Dental Medicine, Pakistan, between March 2021 and June 2021. Methodology: A cross-sectional study was carried out among 500 individuals who were above 18 years of age. A well-constructed questionnaire consisting of 4 parts (Demographics, Knowledge, Attitude, and Practices) was constructed containing informed consent and distributed online. Spearman correlation test was used to analyse knowledge, attitude, and practices towards coronavirus vaccinations. Results: A total of 500 responses were collected from the participants. Most of the participants had adequate knowledge regarding the availability of the vaccines. About 116 (23.2%) participants had contracted the virus. The majority of 308 (61.7%) participants agreed on vaccines to be effective against the virus. Most of the 401 (80.4%) participants were willing to get themselves vaccinated when their turn comes. 265 out of 500 (53.1%) people have been vaccinated against coronavirus. The minority of people assumed a chip inside the vaccine and religious factors as reasons not to get vaccinated. Those residing in urban locations and with increasing age had better knowledge and attitudes towards vaccinations. Conclusion: To control and contain the ongoing pandemic, vaccination against the coronavirus is a must. There is still scope in evaluating and improving the general population’s knowledge regarding the vaccination programs especially in the rural areas where resources and socioeconomic status is weaker.

Thyroid Disorders and Diabetes Mellitus: Prevalence and Assosciation

Background: Diabetes mellitus and thyroid dysfunction are closely related. Numerous studies have reported an increased prevalence of thyroid disorders in diabetic patients, especially in type 1 diabetes mellitus. Objectives: Therefore, the purpose of this review is to discuss the numerous underlying mechanisms behind the relationship between diabetes mellitus and thyroid dysfunction in order to demonstrate that the correlation between these two prevalent conditions is unlikely to be a coincidental finding. Review: Diabetes and Thyroid disorders are characterized by endocrine system dysfunction. Thyroid hormones influence glucose metabolism in different ways, for example, they increase absorption of glucose from the gut, increase GLUT-2 level, regulate energy balance, and cause increased lipolysis which ultimately raises glucose levels in the body. Furthermore, thyroid hormones interact with adiponectin, leptin, ghrelin, to affect glucose metabolism. Additionally, studies suggest that hyperthyroidism impairs diabetic glycemic control, whereas hypothyroidism increases the risk of hypoglycemia, further complicating diabetes management. Conclusion: This paper emphasizes thyroid abnormalities, if left untreated, can raise the risk of several diabetes complications including retinopathy, neuropathy, and nephropathy, and can worsen diabetic symptoms. As a result, treating subclinical hypothyroidism or hypothyroidism in diabetic individuals can be advantageous. Therefore, a systematic method for early thyroid testing in diabetic patients to avoid severe complications is highly recommended.

Mycology of Otomycosis in Port Harcourt

Tropical climate favors the growth of fungal infection in the ear resulting in otomycosis. This study is aimed at determining the predisposing factors, symptoms, prevalence and demographic data of patients diagnosed with otomycosis. This is a 1 year prospective hospital based study, between June 2017 to June 2018 at University of Port Harcourt Teaching Hospital (UPTH), Rivers State, Nigeria. Clinical features, predisposing factors and examination findings were noted on the administered questionnaire. Patients were examined and specimen collected for microscopy, culture, sensitivity and mycological studies. Our results show isolated fungi were present in 34 out of 120 ear swabs of patients and in 5 out of 120 ear swabs from the control group. The prevalence of otomycosis was 2.7%, while the ear symptom with the highest frequency was itching (86.7%) and debris in ear canal (67.6%). Patients with positive growth constitute 53% females and 47% males. Age groups 10-29 and 40-49 years had the highest and lowest number of infected patients, respectively. Candida was the commonest organism isolated accounting for 61.8% followed by Aspergillus spp. (23.5%) and Penicillium (8.8%).

Comparative Study between Adductor Canal Block, Femoral Nerve Block and Epidural Analgesia for Management of Post-Operative Pain in Total Knee Replacement

Background: Total knee arthroplasty (TKA) is a common surgery that is associated with moderate to severe pain. Early ambulation and physical therapy are essential for functional recovery and long-term functional outcome after TKA as well as for reducing the immobility related complications. Hence, optimal pain relief while maintaining the motor function remains the mainstay in postoperative pain management after TKA. ‎Patients and Methods: This prospective randomized controlled open-labelled study was carried out at Tanta University Hospital, Orthopedic Surgery Department from January 2020 to February 2021. Results: Heart rate was significantly increased at 12 and 18 hours postoperatively in group I and II compared to group III and there was insignificant change between group I and group II. Mean arterial blood pressure was significantly increased at 12 and 18 hours postoperatively in group I and II compared to group III and was insignificant change between group I and group II.NRS was significantly increased at 12 and 18 hours postoperatively in group I and II compared to group III and was insignificant change between group I and group II. Patient satisfaction was significantly higher in group III compared to group I and group II on the second postoperative day. Conclusion: Adductor canal nerve block provide better postoperative pain relieve with lower NRS after TKA than femoral and epidural blocks. It provides more stability of hemodynamic parameter and longer time for the 1st time of analgesic request. Also, total consumption of morphine in 1st postoperative day is lower than femoral and epidural blocks.