Journal of Ideas in Health (JIDHealth)
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Gender disparities in lymphocyte counts and cytokine expression in COVID-19
Get PDFBackground: This study seeks to assess gender differences in the severity of COVID-19 infection, which have been noted in different regions during the early stages of the pandemic.
Methods: A cross-sectional study conducted at Baquba Teaching Hospital in Diyala, Iraq, from October 1st to December 31st, 2020, included 132 confirmed COVID-19 patients. These patients underwent a comprehensive set of routine laboratory tests, including complete blood count, blood biochemistry, and D-dimer assessment. Statistical analysis was carried out using SPSS-20, with significance set at p < 0.05.
Results: The study included patients with a mean age of 45.61 (±11.32) years, predominantly male (63.0%), residing in urban areas (57.6%), and presenting with comorbidities (78.8%). All patients exhibited positive results on CT scans (100%) and CRP tests (100%). However, PCR testing confirmed COVID-19 infection in 87.2% of cases, with 12.8% testing negative. Among males, there was a significant increase in IL-6 and IL-10 levels (42.57 ± 7.64 pg/ml and 255.27 ± 21.03 pg/ml) compared to females (16.43 ± 4.19 pg/ml and 187.48 ± 20.35 pg/ml), with p-values <0.001 and 0.003, respectively. Conversely, there was no significant difference in IFN-ɣ levels between males (165.73 ± 16.54 pg/ml) and females (176.12 ± 17.10 pg/ml), with a p-value of 0.105. However, lymphocyte levels were significantly lower in males (4.79 ± 0.85%) compared to females (14.01 ± 1.36%), with a p-value <0.001.
Conclusion: Overall, COVID-19 affects males more severely than females, with males showing weaker immune responses and higher levels of inflammatory cytokines like IL-6 and IL-10. While IFN-ɣ levels do not differ significantly between genders, males have lower lymphocyte counts compared to females
Surgical decision-making: key factors influencing the shift from laparoscopic to open cholecystectomy
Get PDFBackground: Recognizing the preoperatively and intraoperatively factors can aid surgeons in making timely decisions to shift from laparoscopic cholecystectomy (LC) to open cholecystectomy (OC). This study aims to identify the main factors leading to LC conversion to OC among Iraqi patients.
Methods: One-year prospective research was performed using cross-sectional design between 1st April, 2023, and 3oth March, 2024, at Alkalis General Public Hospital and Al Hayat Private Hospital, Diyala, Iraq. Pre and intraoperative data were collected from the planned LC surgeries including demographics, medical history, laboratory and Ultrasound findings. Descriptive and bivariate analysis was carried out to compare variables between patients undergoing LC and those requiring conversion to OC.
Results: Out of 172 LC patients (mean age 48.28±12.62), 52.9% were female, 55.8% obese, 50.6% aged 49+, 23.3% diabetic, and 19.8% had emergency cholecystectomy; 15 (8.7%) required conversion to open surgery. The conversion group was mainly men (66.7% vs. 46.5%, P = 0.001) and older (73.3% vs. 48.4% aged 49+, P = 0.003). Obesity (60.0% vs. 55.4%, P = 0.005) and diabetes (53.3% vs. 20.4%, P < 0.001) were more common. Public hospital referrals were higher (86.7% vs. 52.2%, P < 0.001). Elevated total bilirubin, direct bilirubin, and alkaline phosphatase levels were significant predictors of conversion to OC. Adhesions in Calot\u27s triangle (20.0% vs. 13.4%, P = 0.021) were more common in the conversion group, along with unclear anatomy, thick gallbladder wall, bleeding, stone and bile spillage, and cystic duct injury.
Conclusion: In conclusion, out of 172 LC patients, 15 (8.7%) required conversion to open surgery, predominantly older men with higher obesity, diabetes, and elevated bilirubin and alkaline phosphatase levels, and more adhesions in Calot\u27s triangle
Examining the role of salivary IL-2 and IL-22 in recurrent aphthous stomatitis: a diagnostic approach
Get PDFBackground: Recurrent aphthous stomatitis (RAS) is a prevalent inflammatory condition, that manifests as mouth ulcers. This study aims to evaluate IL-2 and IL-22 levels in saliva samples of individuals with recurrent aphthous stomatitis (RAS) compared to healthy volunteers.
Methods: A case-control study was conducted between April 1st and September 30th, 2023, at the Dental Center of New Baquba, Diyala, Iraq. Saliva samples were collected from 40 patients diagnosed with recurrent aphthous stomatitis and 40 healthy controls. IL-2 and IL-22 levels were assessed in both groups using enzyme-linked immunosorbent assay (ELISA). Statistical analysis, employing paired sample ‘t’ test, was conducted with a significance threshold below.
Results: In the case group, the mean age was 53.4 years (SD=1.58), ranging from 26 to 81 years, while in the control group, it was 47.18 years (SD=1.55), ranging from 24 to 78 years. Females predominated in both groups, comprising 62.5% in cases and 52.2% in controls. Most aphthous ulcers (77.5%) were found in the buccal mucosa, with minor aphthous ulcers being the most common (67.5%). Results from paired-samples t-tests revealed significantly higher levels of IL-2 in RAS cases (M=62.090, SD=20.242) compared to controls (M=36.366, SD=14.596), (t(39)=7.101, p < 0.001). Similarly, IL-22 levels were significantly elevated in RAS cases (M=106.537, SD=44.112) compared to controls (M=73.399, SD=32.852), (t(39)=3.553, p=0.001). These results suggest a potential association between RAS and increased IL-2 and IL-22 levels, indicating their involvement in RAS pathophysiology.
Conclusion: In summary, females showed a significant predominance in RAS cases. Significant differences were observed in IL-2 and IL-22 levels between case and control groups
Prevalence and detection of SARS-CoV-2 by RT-PCR: an analytical study
Get PDFBackground: The COVID-19 pandemic has significantly affected the healthcare system. RT-PCR has played a major role in the confirmation of SARS-CoV-2 thus helping in an early diagnosis, clinical interventions and patient isolation. This study was conducted to ascertain the importance of RT-PCR testing among symptomatic and asymptomatic cases in different age groups with association to infection.
Methods: This retrospective cohort study was conducted from August 2020 to August 2021, in the Department of Microbiology, Autonomous State Medical College and Sarojini Naidu Memorial Hospital, Firozabad, Uttar Pradesh, India. Samples were collected from a total of 342, 281 cases which comprised of symptomatic patients (ILI, SARI), asymptomatic contacts, those seeking hospitalization, travelers and were subjected to testing by RT-PCR. The cases were divided into group A of patients presenting with symptoms ≤7 days, group B of patients with signs and symptoms >7 days and group C comprised of asymptomatic cases. The symptoms of patients were associated with the Ct values of the E/N screening gene and the RdRp/ORF1ab confirmatory genes. The Chi-square test was done to test the statistical significance of association of symptomatic patients with the outcome of the test.
Results: The number of positive samples were 4,342 showing a prevalence of 1.3%. The maximum prevalence of infection was found in the age group of 20-29 years followed by the age group 30-39 years (p-value <0.05). The maximum positivity and high viral load were seen in the patients who presented with symptoms ≤7 days with Ct values ≤25.
Conclusion: The maximum infection was found in the young age group. The screening and confirmatory genes could be detected in the samples of asymptomatic cases also which was helpful in isolating them and breaking the chain of further spread of the virus
Insights into substance abuse knowledge and attitudes among high school students in Anbar Province, Iraq
Get PDFBackground: The high prevalence of substance use among children and adolescents has become a major global public health concern. This study aims to explore adolescents\u27 knowledge and attitudes toward substance abuse.
Methods: A cross-sectional study was conducted from January 2nd to February 15th, 2023 in Ramadi City, Anbar Province, Iraq. Students from eight high schools participated, selected through a multistage sampling approach. The bivariate analysis included independent sample t-tests and one-way ANOVA. Furthermore, a multivariable linear regression analysis was employed to predict factors influencing knowledge and attitudes. Statistical analyses were performed using SPSS version 16.
Results: The study included 415 students, with a mean age of 16.7 (±9.3) years, with a majority being male (52.8%). Accuracy rates for knowledge and attitude were 79.6% and 70.2%, respectively. About 79.3% of participants were familiar with terms related to drug abuse in Iraq. Regression analysis showed that higher knowledge scores were linked with male gender and a household income exceeding IQD 600,000 monthly (95% CI:1.311 to 2.923; P <0.001; and 95% CI:1.072 to 2.331; P =0.001), respectively. Attitudes toward drug abuse prevention were influenced by male participants and students with employed fathers (95% CI:1.245 to 4.302; P=0.025; and 95% CI: 2.073 to 6.737; P=0.032), respectively.
Conclusion: In conclusion, most of the students had sufficient knowledge and a constructive attitude toward drug use. Male gender, high income, and employed fathers were the main predictors
Topical corticosteroids in the treatment of acute sunburn: a systematic review
Get PDFBackground: Acute sunburn is a prevalent dermatological issue, particularly affecting individuals with fair skin types I-III. It is characterized by erythema, edema, and discomfort due to ultraviolet (UV) radiation exposure. Topical corticosteroids are commonly used for their anti-inflammatory properties, but their efficacy in sunburn treatment is debated due to limited high-quality evidence from randomized controlled trials (RCTs). This study aims to assess the efficacy of topical corticosteroids in relieving symptoms and inflammation of sunburn.
Methods: A systematic review was conducted by searching PubMed, Web of Science, ProQuest, Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL) for studies published up to April 30, 2024. Keywords included combinations of terms related to corticosteroids, topical application, and sunburn. Studies were selected based on PRISMA 2020 guidelines, focusing on adult patients treated with topical corticosteroids compared to placebo. Data extraction and quality assessment were independently performed by two researchers using the Cochrane Collaboration’s Risk of Bias tool.
Results: The review included six RCTs with a total of 339 participants, aged 18-68 years, conducted in Europe and the USA. Various topical corticosteroids were studied, including methylprednisolone aceponate, hydrocortisone 17-butyrate, and hydrocortisone-21-acetate. Treatment durations ranged from single applications to twice daily for seven days. The results demonstrated that prolonged treatment with topical corticosteroids significantly reduced sunburn symptoms such as erythema and pain. When applied for seven days, treated areas showed lower sunburn reaction scores and reduced inflammation compared to untreated areas. Early application of corticosteroids, particularly within 6 hours post-exposure, was more effective than later applications. Histological analyses supported these findings, showing improvements in epidermal thickness and reduced dermal inflammation in treated areas.
Conclusion: Topical corticosteroids can effectively alleviate acute sunburn symptoms and aid skin recovery by targeting inflammatory pathways. Their efficacy is enhanced with prolonged and early application. Further research is needed to optimize treatment protocols and assess long-term effects to fully realize the therapeutic potential of corticosteroid therapy in managing acute sunburn
Clinical spectrum of demyelinating disease of central nervous system and frequency of anti AQP4 and anti MOG among them: one-year single-center retrospective study
Get PDFBackground: Inflammatory demyelinating diseases of the central nervous system (CNS) are autoimmune conditions leading to significant neurological disability in adults. Recent classifications include myelin oligodendrocyte glycoprotein antibody associated disease (MOGAD) and neuromyelitis optica spectrum disorder (NMOSD) which pose diagnostic challenges due to overlapping clinical and radiological features. This study aimed to assess the clinical spectrum among adults and children diagnosed with CNS demyelinating diseases and to find the proportion of MOG and/or aquaporin-4 (AQP4) autoantibodies amongst them.
Methods: This single-center, retrospective study examined 20 patients diagnosed with CNS demyelinating disorders between March, 2023 and February, 2024. Data pertaining to demographics, disease types, CSF analysis, MRI findings, treatment modalities, and serological profiles for anti-AQP4 and anti-MOG antibodies were collected from hospital records and evaluated.
Results: Among 20 patients [median age, 34 years (IQR, 18.75); males (n=10) and females (n=10)], acute transverse myelitis (TM) was the most common demyelinating disorder at onset (60%) followed by optic neuritis (ON) (20%). CSF analysis found elevated protein levels in 53% and pleocytosis in 33% of patients. MRI findings revealed longitudinal extensive involvement in 52% of patients, predominantly affecting the cervical and dorsal spine. Serological testing identified 15% positive for anti-AQP4 and 10% for anti-MOG antibodies. MOG+ patients were significantly younger than AQP4+ patients (mean age 16.5 vs. 36.66 years, p=0.016). Both MOG+ patients were male, with 50% presenting with acute TM and 50% with acute disseminated encephalomyelitis. Among AQP4+ patients, the male-to-female ratio was 1:2, with 66.66% presenting with acute TM and 33.33% with ON.
Conclusion: CNS demyelinating disorders primarily affect younger individuals, with TM as the most common initial disorder and extensive spinal involvement in cervical and dorsal regions. Serological testing identified three patients with anti-AQP4 and two with anti-MOG antibodies, providing valuable insights into the clinical spectrum of these disorders through cell-based assays
Seroprevalence and risk factors for brucellosis in cattle and rodents in Kilosa district, Morogoro, Tanzania
Get PDFBackground: Brucellosis is a global zoonosis caused by gram-negative bacteria that affects a diverse array of hosts including humans, domestic animals as well as wild animals such as cattle (B. abortus), goats, and sheep (B. melitensis), pigs (B. suis), and rodents (B. neotomae), and results in financial setbacks in the livestock industry. This study aimed to identify risk factors and estimate the seroprevalence of brucellosis in cattle and rodents in Kilosa district, Tanzania.
Methods: A cross-sectional study was conducted from January 2023 to March 2023, cattle were randomly selected and rodents were trapped using Sherman, wire cages, and havahart traps. Blood samples were collected from the jugular vein and heart of the cattle and rodents, respectively. Sera were harvested from the collected blood and stored at – 20 ºC. All the sera were screened for brucella antibodies using the Rose Bengal Plate Test (RBPT) and confirmed by competitive Enzyme Linked Immuno Sorbent Assay (c-ELISA). The risk factors were captured using a structured questionnaire and analyzed by computing the Chi-square test and generalized linear model.
Results: The seroprevalence of brucellosis was found to be 5.31% in cattle (95% CI: 0.0286-0.089) and 0.72% in rodents (95% CI: 0.0002-0.0397). A significant association was observed between grazing style and brucellosis seropositivity in cattle, with cattle that grazed together with sheep and goats having significantly higher odds of seropositivity (OR=6.5; 95% CI: 1.74-42.17, **p < 0.01).
Conclusion: The detection of Brucella antibodies in both species indicates ongoing transmission and potential risk to public health. Our findings suggest that rodents may serve as reservoirs of brucellosis, contributing to its persistence and spread. Further research is essential to characterize the specific brucella species circulating among cattle and rodents and to understand the dynamics of interspecies transmission
Prevalence and antimicrobial susceptibility characterization of Escherichia coli isolated from the intestines of freshwater fish from the Mindu dam in Morogoro, Tanzania
Get PDFBackground: The Mindu dam, an open system, serves as a microbial reservoir, housing uropathogenic microorganisms like Escherichia coli. Morogoro municipality relies on the dam for water and fish. This study aimed to assess the antimicrobial susceptibility of Escherichia coli isolated from fish and water in Mindu dam.
Methods: In May 2019, a cross-sectional study was conducted in Morogoro municipality. Selected antimicrobials, including ampicillin, tetracycline, cefoxitin, erythromycin, trimethoprim, gentamicin, enrofloxacin, and nalidixic acid, were tested using the disc diffusion method. E. coli ATCC 25922 served as a positive control for quality assurance during bacterial isolation. The potential source of antimicrobial contamination was identified through the multiple antibiotic resistance index.
Results: Out of 148 samples, E. coli was found in 24, none in water. E. coli showed high resistance (≥50.0%) to erythromycin (62.5%), nalidixic acid (79.2%), and ampicillin (75%). Additionally, 58.0% of isolates displayed multi-drug resistance across antimicrobial classes, with a multiple antibiotic resistance index ranging from 0.00 to 0.75.
Conclusion: Antimicrobial-resistant E. coli in the food chain may heighten the spread of complex urinary tract infections in the municipality. It underscores the necessity for robust municipal surveillance of antimicrobial resistance and effective antimicrobial stewardship for enhanced infection prevention and control
Patient satisfaction about the primary health care services in Anbar province, Iraq
Get PDFBackground: Patient satisfaction determines care alignment with expectations, encompassing availability, cost, and environment, crucial for service quality. This study aims to investigate key determinants influencing patient satisfaction with Primary Health Care Centers (PHCC) in Anbar province, Iraq.
Methods: A cross-sectional study was carried from 15th November 2022 till 16th March 2023 across six PHCC using multistage sampling technique. Semi-structured questionnaire was recruited to interview patients. Descriptive and bivariate and multiple logistic regression analyses were conducted to identify significant factors affecting patients’ satisfaction toward PHCC.
Results: A total of 300 patients were included with mean age of 35.7 (+ 4.2), ranged 15-69 years. The PHCC attained an overall satisfaction rate of 64.7%. Patients voiced discontent primarily with waiting times for consultation (67.3%) and appointment scheduling (60.7%). However, 69.3% were content with the proximity to the PHCC. Doctors\u27 conduct was praised by 82.0% of respondents, yet 56.7% noted a lack of health education programs. Management was appreciated by 70.0%, yet laboratory services were received by only 57.7%. Moreover, 75.0% reported essential drug unavailability, and 54.7% mentioned a lack of medical instruments. Factors associated with patients’ satisfaction were aged less than 40 years old (OR = 3.54, 95% CI: 2.44 to 5.21), being male (OR = 3.76, 95% CI: 2.68 to 6.15), unmarried (OR = 4.01, 95% CI: 3.06 to 8.4) and low educated OR = 2.77, 95% CI: 2.76 to 7.57).
Conclusion: Patients\u27 satisfaction with PHCC is notably linked to proximity, respectful doctor behavior, privacy during examinations, and efficient management. Dissatisfaction arises from appointment scheduling, follow-up, and the unavailability of health education, instruments, and drugs