1976 research outputs found
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Significant reduction of seizure frequency in patients with drug-resistant epilepsy by vagus nerve stimulation: Systematic review and meta-analysis
Full text linkBackground: Epilepsy is a major neurological disorder, typically managed with Anti-Seizure Medication (ASM).
Nevertheless, a substantial 30 % of patients did not respond satisfactorily to ASMs, classifying their condition as
Drug-Resistant Epilepsy (DRE). Vagus Nerve Stimulation (VNS) was recommended as a potential solution. Objective: To evaluate clinical efficacy of VNS on patients with DRE in reduction of seizures through a systematic review and meta-analysis using a random effects model. Methods: A systematic search was done from PubMed, ScienceDirect, Cochrane Library and Google Scholar databases on observational studies and randomized controlled trials (RCTs) for the clinical effectiveness of VNS among DRE patients. A meta-analysis was performed to obtain the pooled estimate of the clinical effectiveness of VNS in terms of seizure reduction and the odds ratio (OR) for patients achieving > 50 % seizure reduction. Heterogeneity was assessed using visual inspection of forest plots and I 2 statistic. Results: A total of 1023 articles were retrieved from the electronic search. After removing duplicates, nonrelevance and non-availability of efficacy data, 28 articles were included in the final analysis. Of these, 9 are RCTs and 19 are observational studies. The pooled estimate of > 50 % seizure reduction was 0.46 (95 % CI:0.40–0.51) and the pooled estimate of the OR comparing > 50 % vs ≤ 50 % seizure reduction was 0.76 (95 % CI: 0.44–1.29). Conclusion: Our meta-analysis showed that 46 % of DRE patients have experienced ≥ 50 % seizure reduction with VNS treatment. It should be considered in patients in whom ASM has failed or who continue to experience seizures after medication
Qualitative Study of Nutritional Support-Related Perceptions and Preferences Among Persons Affected by TB, Family Caregivers, and Healthcare Providers in India
Full text linkEvidence on the implementation aspects of nutritional support interventions for persons with TB in India is limited. This qualitative study employed focus group
discussions with persons with TB (n = 71), their family caregivers (n = 17), and healthcare providers (n = 18). The study was conducted from August 2023 to April 2024 in five states in India. Participants’ knowledge, perceptions, and practices about nutritional intake, experiences, and expectations when accessing nutritional support were explored. Four nutrition-related themes emerged: (a) the experiences and perceptions of persons with tuberculosis and their caregivers, explained by their understanding of the importance of adequate nutrition and TB cures; (b) changes in food practices, explained by protein food adoption, alongside food insecurity experienced by those in poverty; (c) Direct Benefit Transfer (DBT)-related issues, explained by insufficiency and access-related gaps; and (d) preferred choices for nutrition support delivery, explained by less preference towards the involvement of intermediaries and a public distribution system alongside preference for the provision of nutrition through treatment facilities. Our findings underscore the importance of the provision of protein-rich food and an increase in financial support
based on needs assessments. Mitigating the linkage and access gaps in DBT is needed. The delivery of ready-to-consume food through tuberculosis treatment facilities
could be prioritized
Breaking barriers for TB elimination: A novel community-led strategy revolutionizing tuberculosis case finding and treatment support in Senapati District Manipur-A quasi-experimental pre-post study protocol
Full text linkDespite being the world’s highest tuberculosis (TB) burden country, India still misses millions of TB cases annually. To address this issue, the India National Strategic Plan,following WHO strategy, promotes combining active case finding (ACF) with passive case finding (PCF) activities. National TB Elimination Programme (NTEP) began ACF
campaigns thrice a year, targeting vulnerable populations. However, states like Mani�pur faced challenges in implementing and sustaining ACF activities due to resource
constraint
Study on Feto Maternal Outcome in Short Inter Pregnancy Interval
Full text linkPregnancy spacing refers to the practice of maintaining an interval between births of two or more years. Inter pregnancy Interval‐ It is defined as the period between delivery of previous infant and conception
of current pregnancy. (1) WHO has recommended the following to reduce the risk of adverse maternal and perinatal outcomes: After a live birth,the recommended minimum interval before attempting the next pregnancy is at least 24 months. Future research is essential to further
elucidate the optimal IPI for various pregnancy outcomes and to refine current guidelines to enhance maternal and neonatal health. The primary objective of the study is to identify the adverse outcomes of short inter pregnancy interval and educating the mothers regarding the same. This
was a cross‐sectional study conducted in the Department of Obstetrics and Gynecology at Government R.S.R.M Lying‐In Hospital, Government Stanley Medical College, Chennai, from February 2023 to November 2023 (10 months). The case group consisted of 115 women with a short inter pregnancy interval, while the control group comprised 115 women with
a normal inter pregnancy interval. Our findings highlight the importance of targeted interventions and educational programs to promote optimal inter pregnancy intervals (IPI) and enhance maternal and child health outcomes in the region. Further research is necessary to gain a deeper
understanding of the underlying causes and to identify additional risk factor
Computational drug repurposing reveals potential alanine racemase inhibitors for combating drug-resistant tuberculosis
No full textThe management of tuberculosis (TB) poses a significant challenge, particularly in low- to middle-income regions, due to its high mortality rate and severity. Given the paramount importance of maintaining the structural integrity of the bacterial cell wall, alanine racemase emerges as a critical therapeutic target due to its key role in the peptidoglycan pathway and its unique absence in humans. However, the imperative to discover novel inhibitors targeting this pathway is underscored by the rise of drug-resistant TB strains. In this study, we employed a computational drug repurposing approach to predict potential alanine racemase inhibitors by screening FDA-listed drugs cataloged in DrugBank 5.1.9. Additionally, docking studies used cycloserine, a known alanine racemase inhibitor, as a reference compound. The prioritization of a potent inhibitor relied on multiple criteria, including binding affinity, intermolecular interaction patterns, MMGBSA analysis, ΔG calculations, ADMET properties, and molecular dynamics simulations to evaluate the protein-drug complex stability. Our comprehensive analysis identified three compounds (DB00712, DB09064, and DB05015) as potential hits, successfully passing all prioritization processes. However, DB09064 exhibited the most promising attributes among these candidates, demonstrating enhanced complex stability, binding affinity (-8.5 kcal/mol), and significant intermolecular interactions. Furthermore, its interaction pattern and Protein-Drug complex Root Mean Square Deviation (RMSD) trajectory closely resembled cycloserine, indicating its potential in targeting alanine racemase. Therefore, DB09064 (Ciprofibrate) is predicted as a highly potential hit. With further lead optimization and experimental validation to mitigate off-target effects, it could emerge as a novel alanine racemase inhibitor, offering potential implications for combating drug-resistant TB
Tuberculosis in the elderly population: Findings from a State-level TB prevalence survey (2022) from India
Full text linkPopulation-based data on tuberculosis (TB) epidemiology are sparsely available from India. A large-scale cross-sectional TB survey was conducted among individuals aged 15 yr and above across Tamil Nadu in India by the State government. Advanced age is one of the major risk factor for TB, so this study undertook a sub-analysis of the data on elderly population from the original TB survey sample
Burden of 375 diseases and injuries, risk-attributable burden of 88 risk factors, and healthy life expectancy in 204 countries and territories, including 660 subnational locations, 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023
No full textFor more than three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has provided a framework to quantify health loss due to diseases, injuries, and associated risk factors. This paper presents GBD 2023 findings on disease and injury burden and risk-attributable health loss, offering a global audit of the state of world health to inform public health priorities. This work captures the evolving landscape of health metrics across age groups, sexes, and locations, while reflecting on the remaining post-COVID-19 challenges to achieving our collective global health ambitions
Global burden of 292 causes of death in 204 countries and territories and 660 subnational locations, 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023
No full textTimely and comprehensive analyses of causes of death stratified by age, sex, and location are essential for shaping effective health policies aimed at reducing global mortality. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 provides cause-specific mortality estimates measured in counts, rates, and years of life lost (YLLs). GBD 2023 aimed to enhance our understanding of the relationship between age and cause of death by quantifying the probability of dying before age 70 years (70q0) and the mean age at death by cause and sex. This study enables comparisons of the impact of causes of death over time, offering a deeper understanding of how these causes affect global populations
Evaluating the cost-effectiveness of Cy-Tb for LTBI in India: a comprehensive economic modelling analysis
No full textLatent tuberculosis infection (LTBI) remains a significant challenge, as there is no gold standard diagnostic test. Current methods used for identifying LTBI are the interferon- γ release assay (IGRA), which is based on a blood test, and the tuberculin skin test (TST), which has low sensitivity. Both these tests are inad- equate, primarily because they have limitations with the low bacterial burden characteristic of LTBI. This high- lights the need for the development and adoption of more specific and accurate diagnostic tests to effectively identify LTBI. Herein we estimate the cost-effectiveness of the Cy-Tb test as compared with the TST for LTBI diagnosis
Altered serum mineral concentrations among pulmonary tuberculosis and its association with Vitamin D, adipokines and inflammatory cytokines
No full textTuberculosis (TB), being the second most killer among infectious diseases remains a major health challenge in many developing countries. Most cases of active TB are due to reactivation of Latent TB Infection (LTBI). Existing evidence suggests that malnutrition can contribute to TB reactivation, by modulating the immune response, along with other factors such as chronic diseases such as Diabetes, HIV, smoking, alcohol use, and aging. Therefore, in
order to study the relationship between malnutrition and TB, we analysed the plasma levels of minerals and other inflammatory mediators among PTB, LTBI+ and LTBI− groups