South Eastern European Journal of Public Health (SEEJPH - Universität Bielefeld)
Not a member yet
4227 research outputs found
Sort by
Azithromycin Induced Erythema Multiform – A Case Report
Full text linkBackground: Erythema Multiforme (EM) is an acute, immune-mediated skin condition characterized by the sudden onset of distinctive, target-like lesions. While EM can occur due to various causes, including infections and autoimmune disorders, drug-induced EM is a significant and increasingly recognized cause.
Drug-induced EM is a rare condition, with an estimated incidence of 1-5 cases per 100,000 persons per year. However, this condition is likely underreported, and the true incidence may be higher.
Various drugs have been implicated in causing EM, including:
- Antibiotics (e.g., penicillins, sulfonamides)
- Anticonvulsants (e.g., phenytoin, carbamazepine)
- Nonsteroidal anti-inflammatory drugs (NSAIDs) (e.g., ibuprofen, naproxen)
- Antihistamines
- Chemotherapeutic agents
The exact mechanisms of drug-induced EM are not fully understood. However, it is thought that drugs can trigger an immune response, leading to the activation of T cells and the release of cytokines, which cause skin damage and the characteristic target lesions.
Drug-induced EM typically presents with:
- Sudden onset of target-like lesions, often on the palms, soles, and extremities
- Lesions may be accompanied by systemic symptoms, such as fever, fatigue, and arthralgias
- Mucous membrane involvement, including oral and genital ulcers, may occur.
Early recognition of drug-induced EM is crucial to prevent long-term complications, such as scarring, disability, and even mortality. A thorough medical history, physical examination, and laboratory tests are essential for diagnosis.
Discussion: A 48 year old male diagnosed with lower respiratory tract infection was presented with fever , wet cough persisting for the last one week, difficulty in breathing for the last five days followed by poor appetite , fatigue and colour of the sputum was found to be yellow colour since 3 days. His medical consultant suggested to undergo laboratory investigations such as chest x ray , complete blood count. The family history of this patient was found to be father was known case of COPD since 15 years for which he has been receiving Allopathic system of medications since 15 years and mother was known case of hypertension with osteoporosis since 5 years for which she has been receiving Ayurveda system of medicine since 5 years . The family allergic history of this patient reflects nothing significant. The allergic history of this patient reflected that he is allergic to diclofenac sodium and albendazole since one year. His past allergic history revealed that diclofenac sodium had induced angioedema for which he had received for skeletomuscular pain. Patient chest x-ray revealed that he had bilateral lower consolidation to confirm that he was suffering from lower respiratory tract infection. Complete blood count revealed that RBC indices had reflected that he was suffering from normocytic normochromic anemia and leukocytosis. Based on comprehensive medical history of this patient, medical consultant made final diagnosis of this patient has acute bronchitis. His medical consultant ruled out pulmonary tuberculosis, pneumonia based on physical examination findings of this patient. His medical consultant finally prescribed medications Tablet acetaminophen 500mg BD as SoS, Syrup Ambroxyl two teaspoon SoS, and Tablet Azithromycin 500mg OD for five days. Patient fever and cough gradually subsided after receiving symptomatic management for 3 days and after receiving 4th dose of azithromycin on 4th day, patient had developed erythematous rashes on upper and lower trunk within 2 hours of oral administration. Patient immediately noticed skin allergic reactions and approached to his medical consultant, based on physical examination of this patient it was given medical impression as erythema multiform. Patient was prescribed with antihistamines to treat this allergic reaction in according to the severity of symptoms. Patient erythematous rashes gradually subsided after receiving tablet levocetrizine 10mg OD SoS. There are lot of case reports established to ascertain that azithromycin can cause erythema multiform with time temporal relationship to precipitate this skin reaction within span of one to two weeks. The offending drug in this medical case had caused dermatological reaction within one week after oral administration, it had been suspected and suggested to withdraw this offending agent with immediate effect.
Several case reports have documented the association between azithromycin and Erythema Multiforme (EM), with symptoms resolving upon discontinuation of the medication Kaur, S., et al. (2018). A case-control study found that azithromycin was significantly associated with EM, with an odds ratio of 4.3 Mockenhaupt, M., et al. (2019). These findings suggest a causal relationship between azithromycin and EM.
Conclusion: Erythema multiform usually caused by viral infections such as herpes simplex virus, cytomegalovirus, influenza virus etc and mycoplasma pneumonia, certain medications such as broad spectrum antibiotics, antiepileptic medications etc. . Since this patient had been ruled out with viral infections and pneumonia, it had clearly reflected that azithromycin is offending agent in this case and this patient had been provided with red alert card so that any prescriber prospectively should never prescribe azithromycin and any medicinal product containing azithromycin ingredient
Impact Of C-Reactive Protein/Albumin Ratio on Intra- Hospital Mortality Among Patients with Spontaneous Intracerebral Hemorrhage
Full text linkBackground: Spontaneous intracerebral hemorrhage (ICH) is a severe neurological emergency associated with high morbidity and mortality. Intra-hospital mortality rates remain substantial, and accurate prediction of outcomes is critical for effective management. The C-reactive protein (CRP)/Albumin ratio has been suggested as a prognostic marker in various diseases, but its role in predicting intra-hospital mortality in ICH patients remains underexplored.
Objective: This study aimed to investigate the impact of the CRP/Albumin ratio upon admission on intra-hospital mortality in patients with spontaneous ICH.
Methods: A prospective observational study was conducted over one year at Government Theni Medical College and Hospital. A total of 120 patients diagnosed with spontaneous ICH were included, with 80 survivors and 40 non-survivors. Baseline clinical data, including CRP and albumin levels, comorbidities, and treatment regimens, were collected. Statistical analyses were performed to assess the association between the CRP/Albumin ratio and in-hospital mortality.
Results: The CRP/Albumin ratio was significantly higher in non-survivors compared to survivors (P < 0.001). Elevated CRP levels (P < 0.001) and lower albumin levels (P < 0.001) were also significantly associated with increased mortality. Other factors such as systolic blood pressure (P < 0.001) and premedication (P = 0.005) were also found to influence survival outcomes, while comorbidities like diabetes and smoking status did not show significant effects on mortality.
Conclusion: The CRP/Albumin ratio is a reliable and significant predictor of intra-hospital mortality in patients with spontaneous intracerebral hemorrhage. Monitoring this ratio could aid clinicians in early risk stratification and improve the management of ICH patients. Future studies with larger sample sizes are warranted to further validate these findings and explore additional biomarkers for outcome prediction
Analysis Of Few Physical Characteristics Of College-Level Male Volleyball Players To Predict Their Playing Ability
Full text linkThe study\u27s goal was to predict college-level male volleyball players\u27 playing prowess based on a few physical characteristics. In order to accomplish this, 255 male volleyball players, ages 17 to 25, were chosen at random from different colleges in the Indian state of Karnataka. In this study, predictor variables like physical attributes like speed, agility, flexibility, leg explosive power, muscular endurance, and cardio-respiratory endurance were used to forecast volleyball playing ability. Three certified volleyball coaches evaluated the playing ability, which was defined as the performance factor, subjectively. Pearson product moment correlation coefficients, step-by-step argument methods of multiple regressions to determine which predictor variable, based on each predictor\u27s contribution, had the highest correlation with the criterion variables entered in the equation. The results revealed that the agility, leg explosive power and muscular endurance become the common characteristics which can predict the Volleyball playing ability among college level men players
Correlation Between Risk Factors, Coinfection, and Recurrence of Erythema Nodosum Leprosum (ENL) in Patients with Multibacillary Leprosy
Full text linkObjective: The objective of this study was to determine the correlation between the incidence of co-infection and recurrence of Erythema Nodosum Leprosum (ENL).Methods: A retrospective cross-sectional study was conducted using secondary medical record data from MB leprosy patients with and without ENL recurrence at Dr. Soetomo Academic General Hospital, Surabaya (2020–2024). A non-probability sampling technique was used.Results: Total 95 patients met the inclusion and exclusion criteria. Male 74 patients (77.9%) more than female. The dominant age is <40 years as many as 60 patients (63.2%). Nutritional status was obtained most in the normal category 79 patients (83.2%). Results based on leprosy type the most number was type LL 37 patients (38.9%). The bacterial index was obtained the most with a number of <3 as many as 55 patients (57.9%), and the morphological index 0 in 50 patients (52.6%). The results of the onset of ENL were mostly obtained during MDT treatment, 53 patients (55.8%). Patients with co-infection without recurrence of ENL were 20 patients (43.5%), and patients with co-infection and recurrence of ENL were 26 patients (56.5%). The p value = 0.126, this shows that the incidence of co-infection with and without recurrence ENL is not significantly different, but the results of viral co-infection on ENL recurrence were significant showed p value = 0.030 and r = 0.218.Conclusion: Viral co-infection related recurrent of ENL
A Rare Case of Double Outlet Right Ventricle with Subaortic VSD Complicated by Pneumonia, Renal Failure, and Tracheomalacia in Infancy: A Case Report
Full text linkIntroduction: Double Outlet Right Ventricle (DORV) with Subaortic VSD is a high-risk congenital heart disease that potentially leads to direct complications due to its anatomical abnormalities or prolonged treatment in the intensive care unit. Congestive heart failure (CHF) with pulmonary oedema, recurrent pneumonia, and acute kidney injury (AKI) are some of the complications that can occur. Objectives: This study aimed to report a 9-month-old infant who was admitted to the ICU with DORV and Subaortic VSD complicated with CHF, AKI, and pneumonia. Case Report: The patient received prolonged treatment in the ICU with suboptimum conservative treatment due to congenital heart defects and required palliative surgery, namely pulmonary artery banding. Handling complex cases of the infant with congenital heart defects and their complications requires a multidisciplinary approach. Collaboration among healthcare providers can effectively support patients with similar conditions
Interdisciplinary management care for older person; A Scoping Review of Randomized Control Trial Study
Full text linkIntroduction: The decrease of function capacity elderly and various comorbidities in older person related with elderly quality of life. Interdisciplinary is an approach to solve health problem involving various professions, however, limited interdisciplinary evidence review related to the life quality of older person. Objective: identified types of interdisciplinary intervention for older person. Method: Scoping review study with four databases, including Medline, EBSCOhost, PubMed, Science Direct. The assessment of the article quality was conducted using Joanna Briggs Institute. Results: The search results contained 976 studies, with 194 duplicates, and 782 were selected according to the literature study problem. Forty-six articles were completely scanned; from the total number screened, there were 10 articles that fulfilled the criteria to be reviewed. Two main themes were found 1) The type of interventions for elderly’s quality of life; a) Homebased geriatric interdisciplinary rehabilitation, b) interdisciplinary interprofessional collaboration, c) Multidisciplinary integrated care, d) Home visit. 2) Obstacles in implementing an interdisciplinary approach; a) Patient awareness and the function of family members, b) Health factors of the elderly people. Conclusion: Interdisciplinary approaches have positive impact for older person with various health problems. Interdisciplinary approach recommended in performing care to the elderly with their various health problems, however specific elderly health problem with types of the intervention are recommended for future work
Formulation, Optimization, and Evaluation of Nigella sativa Nanoemulsion for Diabetes Mellitus
Full text linkBackground: Therapeutic potential of polyherbal formulations is often limited by poor solubility and bioavailability. This study aimed to develop and optimize a Polyherbal Nanoemulsion using the spontaneous emulsification method to enhance drug encapsulation and improve release characteristics.Methods: Box-Behnken Design (BBD) was employed to optimize critical formulation parameters, including Black Seed Oil concentration, Smix ratio, and aqueous phase volume. The nanoemulsion was characterized for particle size, encapsulation efficiency, and in vitro drug release, In vitro anti-diabetic activity was evaluated using α-amylase and α-glucosidase inhibition assays to compare the efficacy of the nanoemulsion with a standard drug (Acarbose). ANOVA and response surface analysis were conducted to assess the impact of formulation variables. Predicted and experimental values were compared to validate the optimization model.Results: Optimized formulation exhibited an encapsulation efficiency of 93.83 ± 1.4, particle size of 183.14 ± 0.8 nm, and cumulative drug release of 79.76 ± 1.7 closely matching the predicted values (176.5 nm, 92.9%, and 77.8%, respectively). Encapsulation efficiency ranged between 83.9%–93.2%, while particle size varied from 176–224 nm. In vitro release studies confirmed an improved drug release profile, with 3D surface response and ANOVA analysis highlighting the significant influence of formulation factors on nanoemulsion properties. In vitro anti-diabetic studies showed that the Polyherbal Nanoemulsion exhibited α-amylase inhibition of 72.5 ± 2.1% and α-glucosidase inhibition of 68.9 ± 1.8%, demonstrating comparable efficacy to Acarbose (80.2 ± 1.5% and 76.4 ± 1.2%, respectively).Conclusion: Polyherbal Nanoemulsion demonstrated enhanced encapsulation efficiency and improved drug release compared to conventional formulations. The strong correlation between predicted and experimental values validates the optimization approach, indicating that this nanoemulsion system is a promising strategy for improving the bioavailability of polyherbal formulations
Surgical Strategies of Vaginoplasty for Vaginal Agenesis Patients with or without Functional Uterus: A Case Series
Full text linkBackground: Vaginal agenesis, a key feature of conditions such as Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome and androgen insensitivity syndrome (AIS), poses significant challenges to physical and psychological health. Surgical intervention is often required to create a functional vaginal canal, particularly in patients desiring sexual functionality or alleviation of associated symptoms. The presence of a functional uterus adds complexity to surgical planning due to potential menstruation and fertility considerations. This case series explores various surgical techniques, their indications, and outcomes in patients with or without a functional uterus.Aim and Objective: To evaluate the surgical strategies and outcomes of vaginoplasty in patients with vaginal agenesis, focusing on differences in approaches for those with and without a functional uterus.Material and Methods: This retrospective case series analyzed 25 patients undergoing vaginoplasty at a tertiary care center over a 1-year period. Techniques included non-graft methods (Vecchietti procedure, perineal dissection), graft-based methods (split-thickness skin grafts, intestinal grafts), and hybrid approaches. Patients were grouped by the presence or absence of a functional uterus, with assessments of surgical success, complications, and patient-reported outcomes.Results: The study population had a mean age of 21.4 years, with 60% diagnosed with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. Non-graft techniques achieved high success rates (87.5%-100%) with minimal complications. Graft-based techniques provided excellent functional outcomes, particularly intestinal grafts, but were associated with mucus discharge in some cases. Patients with a functional uterus (24%) required additional menstrual management strategies; 1 case of hematometra was resolved successfully. Overall, 92% of patients reported high satisfaction with vaginal functionality, and 85% experienced significant psychosexual health improvement.Conclusion: Vaginoplasty strategies should be tailored to individual patient anatomy and goals. Both non-graft and graft-based techniques offer high success rates with acceptable complication profiles. Multidisciplinary care is essential, particularly for patients with a functional uterus, to optimize outcomes and address complex needs
Examination of the Anxiety Levels of the Participants of the Turkish Boxing Championships About Catching COVID-19 After COVID-19: The Role of Demographic Factors
Full text linkPurpose: The main purpose of this study is to determine the anxiety levels of athletes participating in the Turkish Boxing Championship after the COVID-19 pandemic and to examine how these anxiety levels are related to demographic factors such as gender, age, national athlete status and boxing duration. The pandemic period has had various psychological effects on athletes, and it has been observed that anxiety levels are particularly high. This study will attempt to better understand these anxiety levels and to reveal how demographic factors shape anxiety.
Method: The research was carried out by adopting a quantitative pattern. The study was conducted with 89 athletes randomly selected from among the athletes participating in the 2024 Turkish Boxing Championship. The participants included 52 male and 37 female athletes, and a questionnaire was administered to each participant to measure their anxiety about contracting COVID-19. The questionnaire collected demographic factors such as age, gender, national athlete status, and boxing duration, along with anxiety levels about COVID-19. The data were analyzed using descriptive statistics and ANOVA tests.
Findings: Research findings have shown that anxiety about COVID-19 varies significantly across age groups. In particular, a significant increase in anxiety levels was observed in athletes aged 14-17 compared to other age groups. However, it was found that factors such as gender, national athlete status, and boxing duration did not create a significant difference in anxiety levels. This finding shows that the effect of age on COVID-19 anxiety is more pronounced and that athletes in this age group experienced more anxiety during the pandemic.
Conclusion: The study reveals that anxiety about catching COVID-19 varies depending on age and that athletes, especially in the younger age group, experience this anxiety more intensely. No significant effect of other demographic factors (gender, national athlete status, duration of boxing) on anxiety was found. This result emphasizes that the pandemic has specific effects on athletes for different age groups and the need for age-specific customized interventions in anxiety management. It also points to the importance of developing psychological support and anxiety management programs for athletes in the field of sports psychology
Impact of Covid-19 on the UK Stock Market
Full text linkThe COVID-19 pandemic caused unprecedented disruptions to global financial markets, significantly impacting stock indices and sectoral performance. This study analyses the FTSE 350 index during Lockdown 1.0 in the UK, focusing on market volatility, sectoral disparities, and public sentiment dynamics. The research tests three key hypotheses H1 (COVID-19 case growth is negatively correlated with FTSE 350 performance), H2 (Defensive sectors (Pharma, Utilities) demonstrate greater resilience compared to economically sensitive sectors (Travel, Retail)) and H3 (Investor sentiment, as measured by Google Trends, significantly predicts market movements). The findings confirm a strong negative correlation between rising COVID-19 cases and FTSE 350 performance, with a lagged effect of two to three weeks, suggesting delayed market reactions. Sectoral analysis reveals Travel, Retail, and Banks suffered severe declines, while Pharma and Utilities remained stable, validating the resilience of defensive sectors. Sentiment analysis highlights that search trends for terms like "unemployment" and "recession" were leading indicators of market movements, particularly for vulnerable industries.Additionally, while the FTSE 350 generally adhered to the Efficient Market Hypothesis (EMH), a “stickiness” effect was observed, where daily COVID-19 case announcements influenced market behaviour for up to a week. These insights underscore the importance of targeted financial support for vulnerable sectors, strategic investments in essential industries, and leveraging sentiment analysis for risk management. This study provides a framework for navigating future crises and enhancing economic resilience