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Ghana Medical Journal Mar 2024This study aims to examine the frequency of Paratyphi found in blood cultures and evaluate the antibiotic susceptibility pattern of isolates to different antibiotics....
OBJECTIVE
This study aims to examine the frequency of Paratyphi found in blood cultures and evaluate the antibiotic susceptibility pattern of isolates to different antibiotics. Additionally, the study aims to assess the paradigm shift in the trend of enteric fever caused by Typhi (. Typhi) to Paratyphi(. Paratyphi) .
STUDY DESIGN
Retrospective study.
PARTICIPANT
The study enrolled patients aged 12 years and above diagnosed with enteric fever (positive blood culture) and admitted to Peelamedu Samanaidu Govindasamy Naidu (PSG) Hospital.
INTERVENTIONS
The study analyzed demographic and antibiotic susceptibility profiles of isolates collected from 106 enteric fever patients in the hospital between 2010 and 2022. The susceptibility profiles of isolates to multiple antibiotics were assessed.
RESULTS
There were 106 participants, and 95 (89.62%) of them had enteric fever linked to Typhi, while only 11 (10.38%) had enteric fever linked to Paratyphi A. From 2010 to 2022, the study discovered a general decline in the prevalence of enteric fever caused by species. But between 2014 and 2022, the incidence of enteric fever linked to rapidly increased. Azithromycin (100% , n = 106) and ceftriaxone (99% , n = 105) were highly effective against the isolates, whereas nalidixic acid was resisted by 3 isolates (4.72%, n = 3).
CONCLUSION
The study observed a higher incidence of Typhi in comparison to Paratyphi A and a greater susceptibility of males to enteric fever.
FUNDING
None declared.
Topics: Humans; Male; Female; Anti-Bacterial Agents; Typhoid Fever; Retrospective Studies; Salmonella typhi; Microbial Sensitivity Tests; Salmonella paratyphi A; Adult; Adolescent; Child; Middle Aged; Young Adult; Paratyphoid Fever; Incidence; Drug Resistance, Bacterial; Azithromycin; Ceftriaxone; Aged; Prevalence
PubMed: 38957275
DOI: 10.4314/gmj.v58i1.12 -
Ghana Medical Journal Mar 2024To assess the adherence, adverse drug reactions (ADR), and virologic outcomes of dolutegravir-based antiretroviral therapy.
OBJECTIVE
To assess the adherence, adverse drug reactions (ADR), and virologic outcomes of dolutegravir-based antiretroviral therapy.
DESIGN
This was a retrospective chart review.
SETTING
A tertiary health facility-based study in Abakaliki, Nigeria.
PARTICIPANTS
Five hundred and fifteen (515) adult patients on dolutegravir were selected using a Random Number Generator. Demographic and clinical data were extracted from patients' case notes and analysed with IBM-SPSS version-25.
MAIN OUTCOME MEASURES
Adherence to dolutegravir, ADRs, virologic outcome, and change in Body Mass Index (BMI) were estimated.
RESULTS
The mean age of the patients was 45.5±10.8 years; 68.2% of them were females; 97.1% of them had good self-reported adherence. The majority (82.9%) of them reported no ADRs and among those (17.1%) that did, headache (9.7%), body-itching (3.1%), and skin rash (2.7%) dominated. Most achieved viral suppression (94.4%) and did not have detectable viral particles (57.4%). There was a significant increase in the BMI of the patients with a mean weight increase of 0.9kg, a mean BMI increase of 0.3 kg/m, and a 2.6% increase in the prevalence of overweight and obesity.
CONCLUSIONS
Patients on dolutegravir reported low ADRs, good self-reported adherence, and a high viral suppression rate. However, dolutegravir is associated with weight gain. We recommend widespread use and more population-wide studies to elucidate the dolutegravir-associated weight gain.
FUNDING
None declared.
Topics: Humans; Oxazines; Pyridones; Heterocyclic Compounds, 3-Ring; Female; Piperazines; Male; Middle Aged; Retrospective Studies; HIV Infections; Adult; Nigeria; Tertiary Care Centers; Medication Adherence; HIV Integrase Inhibitors; Body Mass Index; Viral Load; Treatment Outcome
PubMed: 38957273
DOI: 10.4314/gmj.v58i1.14 -
Cureus Jun 2024Dementia is an insidious cognitive disorder featuring a decline in cognition that is not well explained by the physiology of aging. Dementia includes a group of...
INTRODUCTION
Dementia is an insidious cognitive disorder featuring a decline in cognition that is not well explained by the physiology of aging. Dementia includes a group of disorders that are distinguished by a gradual loss of both cognition and the capability to execute day-to-day functions.
MATERIALS AND METHODS
We conducted a cross-sectional study among 384 elderly participants in areas surrounding the All India Institute of Medical Sciences, Bibinagar, Telangana, India. Those with more than 65 years of age were included in the study, and those suffering from serious illnesses were excluded. The Montreal Cognitive Assessment (MOCA) scale, the University of California and Los Angeles (UCLA) Loneliness Scale, and the Patient Health Questionnaire (PHQ-9) were used to assess cognitive status, loneliness, and depression, respectively, among the study participants. Logistic regression was performed to identify factors associated with cognitive impairment (CI), depression, and loneliness.
RESULTS
The average MOCA score of the study participants was 14.9 ± 6.9, with 28.6% of the participants exhibiting severe CI. Nearly half of the participants (49.2%) experienced moderate to high degrees of loneliness, and 39.3% experienced moderate to severe depression. Important factors found to be associated with severe CI were illiteracy (adjusted odds ratio (AOR): 2.85, 95% CI: 1.35-4.45), urban residence (AOR: 0.18, 95% CI: 0.04-0.81), living with a spouse (AOR: 0.23, 95% CI: 0.11-0.78), not consuming alcohol (AOR: 0.35, 95% CI: 0.14-0.87), and depression (AOR: 4.49, 95% CI: 1.37-14.67).
CONCLUSION
CI is a serious public health problem in India. With the increasing proportion of the elderly population in the near future, CI levels will increase, especially in countries like India. Timely interventions such as early identification through community-based screening, the inclusion of a geriatric health component in primary health care, and proper counseling will help address this problem at a grassroots level.
PubMed: 38957261
DOI: 10.7759/cureus.61535 -
Cureus Jun 2024Delirium is a significant public health concern, with tremendous implications for patient outcomes. Intensive care unit (ICU)-related delirium is gaining attention due... (Review)
Review
Delirium is a significant public health concern, with tremendous implications for patient outcomes. Intensive care unit (ICU)-related delirium is gaining attention due to the higher prevalence of delirium in ICU-admitted patients. The most common negative outcomes of ICU delirium include cognitive impairments, functional dependence, high incidence of mortality, extended stay in the ICU, and high costs. So far, no single etiological factor has been identified as the sole cause of delirium. Several functional, neurotransmitter, or injury-causing hypotheses have been proposed for ICU delirium. Several risk factors contribute to the development of delirium in patients admitted to the ICU. These are age, gender, types of sedation, physical restraints, medical and surgical interventions, pain, and extended stay in the ICU. The most commonly used assessment modules for ICU delirium are the PREdiction of DELIRium in ICu patients (PRE-DELIRIC), Early PREdiction model for DELIRium in ICu patients (E-PRE-DELERIC), and Lanzhou Model, Confusion Assessment Method for the Intensive Care Unit (CAM-ICU), Intensive Care Delirium Screening Checklist (ICDSC), and Delirium Rating Scale (DRS). There is no proper treatment for ICU delirium; however, it can be managed through various pharmacological and non-pharmacological interventions. Healthcare providers should receive constant education and training on delirium recognition, prevention, and management to enhance patient care and outcomes in the ICU. Further research is needed on the effective prevention and management of ICU delirium.
PubMed: 38957260
DOI: 10.7759/cureus.61527 -
Cureus Jun 2024Background The escalating global rise in multidrug-resistant gram-negative bacteria presents an increasingly substantial threat to patient safety. Over the past decade,...
Background The escalating global rise in multidrug-resistant gram-negative bacteria presents an increasingly substantial threat to patient safety. Over the past decade, carbapenem-resistant Enterobacterales (CRE) have emerged as one of the most critical pathogens in hospital-acquired infections, notably within intensive care units. Colistin has become one of the last-resort antimicrobial agents utilized to combat infections caused by CRE. However, the use of colistin has been accompanied by a notable increase in the prevalence of colistin-resistant bacteria. This study aimed to investigate plasmid-mediated colistin resistance genes ranging from -1 to -8 among members of the Enterobacterales order. Materials and methods This prospective study was conducted in the microbiology laboratory of Afyonkarahisar Health Sciences University Health Research and Practice Center between May 1, 2021 and July 31, 2022. A total of 2,646 Enterobacterales isolates were obtained from all culture-positive clinical samples sent from various clinics. Of these, 79 isolates exhibiting resistance to carbapenem antibiotics were included in the study. Among the 79 isolates, the presence of -1 to -8 genes was investigated in 27 isolates that were shown to be resistant to colistin. The identification of bacteria at the species level and antibiotic susceptibility tests were conducted using the VITEK 2 automated system (bioMérieux, USA). Colistin resistance among Enterobacterales strains exhibiting carbapenem resistance was evaluated using the broth microdilution technique (ComASP™ Colistin, Liofilchem, Italy), in accordance with the manufacturer's instructions. Results In our in vitro investigations, the minimum inhibitory concentration (MIC) values for meropenem were determined to be >8 µg/ml, whereas for colistin, the MIC50 value was >16 µg/ml and the MIC90 value was 8 µg/ml. A total of 27 colistin-resistant strains were identified among the 79 carbapenem-resistant Enterobacterales strains analyzed. The most prevalent agent among colistin-resistant strains was ( ), representing 66.7% of the isolates. This was followed by ( ) with 29.6% and () with 3.7%. The colistin resistance rate among carbapenem-resistant strains was found to be 34.2%, with colistin MIC values in strains tested by the broth microdilution method ranging from 4 to >16 µg/ml concentrations. In polymerase chain reaction (PCR) studies, the -1 gene region was successfully detected by real-time PCR in the positive control isolate. Nevertheless, none of the gene regions from -1 to -8 were identified in our study investigating the presence of plasmid-mediated genes using a multiplex PCR kit. Conclusion Although our study demonstrated the presence of increased colistin resistance rates in carbapenem-resistant Enterobacterales isolates, it resulted in the failure to detect genes from -1 to -8 by the multiplex PCR method. Therefore, it is concluded that the colistin resistance observed in Enterobacteriaceae isolates in our region is not due to the genes screened, but to different resistance development mechanisms.
PubMed: 38957246
DOI: 10.7759/cureus.61538 -
Cureus Jun 2024The prevalence of overweight and obesity among adolescents in Saudi Arabia has been progressively increasing. Obesity is associated with an increased risk of various...
BACKGROUND
The prevalence of overweight and obesity among adolescents in Saudi Arabia has been progressively increasing. Obesity is associated with an increased risk of various morbidities and mortality. Identifying the factors that contribute to obesity in this age group is crucial for implementing targeted prevention measures.
AIM
The aim of this study was to identify risk factors for overweight and obesity among adolescents aged nine to 17 years residing in Tabuk City, Saudi Arabia.
METHODS
A case-control study was conducted during the 2021-2022 academic year at Alabnaa Schools in Tabuk City, Saudi Arabia. The study included overweight/obese individuals (cases, n = 125) and normal-weight individuals (controls, n = 201) who were selected based on their body mass index and classified according to the World Health Organization's reference for defining overweight and obesity in individuals aged five to 19 years. Data were collected from both groups using a self-administered questionnaire.
RESULTS
The study analyzed 125 overweight/obese students and 201 normal-weight students who were matched for sex and age (p > 0.05). Logistic regression analysis identified several risk factors for overweight or obesity among adolescents. A family history of obesity was found to be associated with a 5.735 times increased likelihood of obesity (95% CI: 3.318-9.912, p < 0.001). Another significant contributing risk factor for obesity was frequent consumption of four or more meals per day (adjusted odds ratio: 3.091, 95% CI: 1.094-8.736, p = 0.033). Students who used electronic devices for more than five hours were 2.422 times more likely to exhibit obesity (p = 0.006).
CONCLUSIONS
Certain factors may increase the risk of overweight or obesity in adolescents aged nine to 17 years. These factors include frequent eating, prolonged use of electronic devices, family history of obesity, and the misconception that obesity is not an illness. Tailored school health programs are needed to improve students' healthy lifestyles and eating behaviors, minimize sedentary entertainment and use of electronic devices, and engage children in physical activity.
PubMed: 38957243
DOI: 10.7759/cureus.61533 -
Frontiers in Public Health 2024Carpal tunnel syndrome is characterized by symptoms such as pain, numbness, or tingling on the anterior surface of the index, middle, or radial half of the ring finger,...
BACKGROUND
Carpal tunnel syndrome is characterized by symptoms such as pain, numbness, or tingling on the anterior surface of the index, middle, or radial half of the ring finger, which is frequently associated with weakness of hand grip, and nocturnal pain and/or numbness resulting from compression of the median nerve at the carpal tunnel between the carpal bones and the transverse ligament. The construction industry involves many activities aside from the building process, such as landscaping, painting, electrical supply, plastering, paving, and telecommunications. Performing such tasks involves repetition of wrist flexion and extension, forceful grip with the hand, and/or vibrations of the hand and arm. This study aimed to assess the prevalence of carpal tunnel syndrome and its associated risk factors among construction workers.
METHOD
An institutional-based cross-sectional study design was conducted among six construction sectors in Gondar from April to July 2021. An interviewer-administered questionnaire was prepared from the literature with a Katz hand diagram, and a physical examination and a special test (carpal compression test, Phalen's, and Tinel's test) were carried out for those participants who reported pain during the interview. Binary logistic regression was conducted with SPSS 25 to identify the associated risk factors for carpal tunnel syndrome. The strength of the association was detected by the adjusted odds ratio.
RESULT
A total of 333 study participants aged 18-70 years were included in this study. Among the participants, 11.7% (AOR: 95%CI: 8.1-15.3) had carpal tunnel syndrome. Age, cigarette smoking, work experience, and working with finger-pressing tools were risk factors significantly associated with carpal tunnel syndrome among construction workers with a -value of <0.05.
CONCLUSION
The magnitude of carpal tunnel syndrome was 11.7% among construction workers. Being of older age, having more experience, cigarette smoking, and working with finger-pressing tools were risk factors significantly associated with carpal tunnel syndrome among construction workers. Employers should implement work safety education programs that raise awareness about the risks of cigarette smoking and encourage employers and supervisors to seek early medical intervention and treatment for carpal tunnel syndrome before it becomes a chronic problem.
Topics: Humans; Carpal Tunnel Syndrome; Ethiopia; Adult; Male; Construction Industry; Risk Factors; Cross-Sectional Studies; Middle Aged; Occupational Diseases; Prevalence; Surveys and Questionnaires; Female; Young Adult
PubMed: 38957208
DOI: 10.3389/fpubh.2024.1365124 -
Cureus Nov 2023Neurosyphilis, a rare manifestation of spreading into the central nervous system, is a critical differential diagnosis due to its potentially severe neurologic...
Neurosyphilis, a rare manifestation of spreading into the central nervous system, is a critical differential diagnosis due to its potentially severe neurologic effects if left untreated. We present a case of a 37-year-old woman who complained of bilateral vision loss and headaches originally concerning for idiopathic intracranial hypertension and uncontrolled diabetes. Comprehensive evaluations eventually led to a neurosyphilis diagnosis. Ophthalmologic examination revealed multifactorial visual symptoms with diabetic retinopathy contributing alongside neurosyphilis. Treatment was started promptly at the time of diagnosis and resulted in improvement in visual symptoms. This case emphasizes the importance of syphilis screening in appropriate age ranges, even in low-prevalence areas. Recognition of neurosyphilis as a potential diagnosis can impact patient outcomes and highlights the need for continued vigilance to identify the disease.
PubMed: 38957199
DOI: 10.7759/cureus.49299 -
Scandinavian Cardiovascular Journal :... Jun 2024Electrocardiogram (ECG) and measurement of plasma brain natriuretic peptides (BNP) are established markers of right ventricular dysfunction (RVD) in the setting of acute...
OBJECTIVES
Electrocardiogram (ECG) and measurement of plasma brain natriuretic peptides (BNP) are established markers of right ventricular dysfunction (RVD) in the setting of acute pulmonary embolism (PE) but their value at long-term follow-up is largely unknown. The purpose of this prospective study was to determine the prevalence of ECG abnormalities, describe levels of N-terminal proBNP (NT-proBNP), and establish their association with dyspnea at long-term follow-up after PE.
DESIGN
All Swedish patients diagnosed with acute PE in 2005 ( = 5793) were identified through the Swedish National Patient Registry. Surviving patients in 2007 ( = 3510) were invited to participate. Of these, 2105 subjects responded to a questionnaire about dyspnea and comorbidities. Subjects with dyspnea or risk factors for development of chronic thromboembolic pulmonary hypertension were included in the study in a secondary step, which involved collection of blood samples and ECG registration.
RESULTS
Altogether 49.3% had a completely normal ECG. The remaining participants had a variety of abnormalities, 7.2% had atrial fibrillation/flutter (AF). ECG with any sign of RVD was found in 7.2% of subjects. Right bundle branch block was the most common RVD sign with a prevalence of 6.4%. An abnormal ECG was associated with dyspnea. AF was associated with dyspnea, whereas ECG signs of RVD were not. 61.2% of subjects had NT-proBNP levels above clinical cut-off (>125 ng/L). The degree of dyspnea did not associate independently with NT-proBNP levels.
CONCLUSIONS
We conclude that the value of ECG and NT-proBNP in long term follow-up after PE lies mostly in differential diagnostics.
Topics: Humans; Pulmonary Embolism; Peptide Fragments; Male; Female; Natriuretic Peptide, Brain; Electrocardiography; Sweden; Biomarkers; Aged; Prospective Studies; Dyspnea; Middle Aged; Registries; Time Factors; Predictive Value of Tests; Prevalence; Ventricular Dysfunction, Right; Risk Factors; Aged, 80 and over; Prognosis; Ventricular Function, Right; Bundle-Branch Block
PubMed: 38957080
DOI: 10.1080/14017431.2024.2373090 -
Scandinavian Cardiovascular Journal :... Dec 2024. The prevalence of patients with prior stroke is increasing globally. Accordingly, there is a need for up-to-date evidence of patient-related prognostic factors for...
. The prevalence of patients with prior stroke is increasing globally. Accordingly, there is a need for up-to-date evidence of patient-related prognostic factors for stroke recurrence, post stroke myocardial infarction (MI) and death based on long-term follow-up of stroke survivors. For this purpose, the RIALTO study was established in 2004. A prospective cohort study in which patients diagnosed with ischemic stroke (IS) or transient ischemic attack (TIA) in three Copenhagen hospitals were included. Data were collected from medical records and by structured interview. Data on first stroke recurrence, first MI and all-cause death were extracted from the Danish National Patient Registry and the Danish Civil Registration System. . We included 1215 patients discharged after IS or TIA who were followed up by register data from April 2004 to end of 2018 giving a median follow-up of 3.5-6.9 years depending on the outcome. At the end of follow-up 406 (33%) patients had been admitted with a recurrent stroke, 100 (8%) had a MI and 822 (68%) had died. Long-term prognostic predictors included body mass index, diabetes, antihypertensive and lipid lowering treatment, smoking, a sedentary lifestyle as well as poor self-rated health and psychosocial problems. . Long-term risk of recurrent stroke and MI remain high in patients discharged with IS or TIA despite substantial improvements in tertiary preventive care in recent decades. Continued attention to the patient risk profile among patients surviving the early phase of stroke, including comorbidities, lifestyle, and psychosocial challenges, is warranted.
Topics: Humans; Male; Female; Ischemic Attack, Transient; Aged; Myocardial Infarction; Denmark; Risk Factors; Recurrence; Time Factors; Middle Aged; Prospective Studies; Risk Assessment; Ischemic Stroke; Registries; Patient Discharge; Prognosis; Aged, 80 and over; Cause of Death
PubMed: 38957077
DOI: 10.1080/14017431.2024.2373085