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Quality of Antenatal Care and its Determinants in the Urban-Rural Environment of Kamina, Democratic Republic of the Congo
No full textIntroduction: Every woman should receive quality antenatal care during pregnancy wherever she lives. We carried out this research with the objective of evaluating the quality of antenatal consultations (ANC) in terms of periodicity, screening, and prophylaxis interventions during antenatal consultations in Kamina and to identify the determinants associated with inadequate ANC. Material and methods: This was a descriptive and analytical cross-sectional study carried out in 6 health facilities in Kamina over a period of 17 months with 476 women who had given birth having attended antenatal consultations at least once. A scoring grid of periodicity standards, screening, and prophylactic interventions with a score of 40 was used to qualify the ANC as adequate. Logistic regression was performed to identify the determinants of inadequate ANC. Results: 40.3% of mothers had reached at least 4 antenatal visits (3.4±1.36); 21.2% had started the ANC no later than 16 weeks for an average age of 22.8 weeks ± 6.19. Overall, 72.5% of pregnant women had benefited from ANC qualified as inadequate. After adjustment, the determinants of inadequate ANC were multigestity (aOR=1.86[1.08-3.19]), low level of education of the mother (aOR=3.93; 95% CI=[2, 08-7.42]), and attendance at a first-level health facility (aOR=3.22; 95% CI=[2.06-5.05]. Conclusion: In the majority of cases, the ANC received by pregnant women in Kamina is inadequate. The determinants thus identified should serve the actors to direct the means to improve the quality of antenatal care in Kamina
Review of the Efficiency of Ten Different Commercial Kits for Extracting DNA from Soil Mixed Biological Samples
No full textSoil-mixed bodily fluids are the most common kind of evidence at outdoor crime scenes. This biological evidence contains DNA, which is a key component of forensic science’s ability to prove an accused person’s guilt because it connects the victim and suspect to the crime scene and aids in identifying the offender and victim. The yield of DNA is significantly influenced by factors including temperature, humidity, storage environment, time since deposition, etc. DNA degradation is caused by a variety of microbes, bacteria, humic acid, and other substances present in soil. Nowadays for DNA extraction, a variety of commercial DNA extraction kits was used now. This paper’s objective is to compare the efficiency of ten different commercial kits used to extract mixed DNA samples. It has been observed that samples stored at a low temperature (-20 °C) are the best for soil blood mixture samples. Compared to samples paired with other types of soil (silt, clay, and marshland), sand soil had the largest production of DNA using the QIAmp investigator kit (Qiagen). Blood Miniprep kit extractions were mostly inhibited, the control that amplified confirms that this kit was the worst in terms of DNA extraction potency. The samples with fewer dirt particles had a much greater yield of DNA
Sea Level Rise Impacts in Coastal Areas and Possible Mitigation Engineering Approaches
No full textCoastal areas are subjected to both natural and man-made actions, leading to a deterioration of coastal structures. Climate change has had a heavy impact on these areas in recent years. An important consequence of these actions is sea level rise. This phenomenon is the most important cause of coastal erosion, a serious problem with ecological, economic, and human health consequences. The countermeasures to contrast this phenomenon and the degradation of the entire coastal system, are represented by engineering interventions. These basically consist of approaches for adaptation to sea level rise, namely protection, retreat, and accommodation. Variations and site adaptation of these actions can involve procedures of no intervention; advancement; protection; retreat; accommodation; and ecosystem-based adaptation. While these procedures have provided coastal benefits and protection, in the long run, they may cause further coastal disruption and further aggravate the situation. Such interventions, therefore, require an accurate assessment of the advantages and disadvantages. However, it is certainly necessary to proceed with actions aimed at mitigating climate change, respecting the rules in a sustainable way
Impact of COVID-19 on Laboratory Health Staff in an Indian Tertiary Care Hospital
No full textBackground: The COVID-19 pandemic has resulted in significant burdens globally. Healthcare workers (HCWs), at the heart of the unparalleled crisis of COVID-19, face challenges treating patients and doing testing for COVID-19: reducing the spread of infection; developing suitable short-term strategies; and formulating long-term plans. We aimed to assess the psychological impact of COVID-19 on Laboratory health staff. Material and methods: Between February - March 2021, 72 laboratory staff workers of a tertiary care teaching hospital were invited to fill out a questionnaire regarding concerns and worries about the novel coronavirus pandemic, along with a coping scoring system and General health questionnaire level (GHQ-12) survey. Results: Out of 72 laboratory health staff who completed the survey questionnaire, 10 were faculty members, 17 were residents (including senior residents, junior residents, and demonstrators), 39 were lab technicians, followed by 4 were attendants and 2 were data operators. Laboratory staff workers with an age group range from 30 years - 60 years had a higher level of depression symptoms than respondents with 20 years - 29 years of age. Similarly, the symptoms of anxiety were noted to be significantly higher among female respondents and respondents with age >30yrs. The most frequent concern was transmitting the infection to family than to themselves only. A considerable number of laboratory staff workers utilized online psychological resources to deal with their psychological distress.Conclusion: The findings of this survey recognize the various problems faced by laboratory health workers during the period of COVID-19 which affect their working ability. Therefore, in the future, we have to implement such strategies that enhance the performance of laboratory workers, boost their energy level, and encourage them to take care of themselves, in times of such crisis
Calciphylaxis in Hemodialysis
No full textCalciphylaxis (CP) or uremic calcific arterial disease (CUA) is a rare, potentially fatal calcific vasculopathy characterized by calcific and thrombotic occlusion of the vessels of the subcutaneous and dermis leading to extremely painful necrotic lesions. It mainly affects patients with end-stage kidney disease (ESKD) and under long time dialysis. The only therapeutic option is represented by intravenous sodium thiosulfate. Currently, clear guidelines are lacking. We have had a good therapeutic response with doses of sodium thiosulfate in association with multidisciplinary management of the patient (vulnologist, dermatologist, nephrologist, dietitian, and cardiologist). There is limited literature on the use of DOAC therapy as a successful alternative to warfarin in patients on dialysis with calciphylaxis. The left atrial appendage closure could represent an important alternative to dicumarolics in patients with atrial fibrillation with calciphylaxis. A new perspective for the treatment of this disease is SNF472 a selective inhibitor of vascular calcification
Evaluation of Heavy Metals Concentration in Poultry Feed and Poultry Products
No full textThe study was conducted to determine the absorption of essential and non-essential trace minerals from poultry feed to poultry products. Poultry feed, liver, muscles, and egg samples were collected from six poultry farms in Rawalpindi and Islamabad. Mercury, Lead, Cadmium, Chromium, and Iron were analyzed in the samples using Inductively Coupled Plasma Optical Emission Spectrophotometer. Iron, Lead, and Chromium exceeded the permissible limits set by World Health Organization and National Research Council in Poultry feed. Lead was high in the liver, breast muscles, thigh muscles, egg albumen, and egg yolk. Chromium was found in feed, egg yolk, egg albumen, and two (02) of the liver and breast muscle samples. Mercury was not detected in any of the samples. The liver contains significantly higher concentrations of detected heavy metals as compared to thigh and breast muscles and egg yolk contained significantly high concentrations of Iron, Cadmium, and Lead as compared to egg albumen. Standards requirements for feed manufacturers and poultry farmers should be maintained to monitor and mitigate routes of entry of contaminants in the food chain
High-Grade Endometrial Mesenchymal Sarcoma: Current Status and Future Trends
No full textEndometrial Stromal Sarcoma (ESS) is a rare gynecological malignancy originating from endometrial stromal tissue. Representing only a tenth of uterine malignant tumors, ESS is categorized into Low-Grade (LGESS) and High-Grade (HGESS) based on nuclear division. Interestingly, prognostic studies have found no strong correlation between ESS prognosis and nuclear division activity. Undifferentiated Uterine Sarcoma (UUS) represents a spectrum of tumors with varied morphological, clinical, and prognostic features, and lacks a standardized naming convention. In 2014, the World Health Organization grouped ESS into LGESS, HGESS, and UUS based on clinical and pathological attributes. HGESS, despite its rarity, is notorious for its poor prognosis and low survival rate. Its early detection is complicated due to its asymptomatic presentation and ambiguous pathogenesis, leading to debates over treatment approaches. This article delves into the recent research developments concerning HGESS
Pattern of Clinical Presentation and Management of Inflammatory Bowel Disease
No full textBackground: Inflammatory bowel disease (IBD) is characterized by non-specific chronic relapsing inflammation of the gastrointestinal tract and extra-intestinal manifestations. It includes Crohn’s disease (CD) ulcerative colitis (UC) and unclassified colitis.Objective: To assess the clinical presentations and management of inflammatory bowel disease in Sudanese patients.Methodology: Prospective, cross-section hospital-based study was conducted at Soba University Hospital (SUH) and Ibn Sina Hospital, in a period from December 2016 to March 2017. Data was entered and analyzed with SPSS, an interview questionnaire containing demographic, clinical, type of IBD, treatment, and complications.Results: A total of 64 IBD patients were included, 50% were diagnosed with UC, 28.1% with CD and 21.9% unclassified type. The most frequent age in UC patients was 41 – 50 years 34.4%, in CD was 31- 40 years 38.9% and for the unclassified type was 51 – 70 years 57.2%. The female was higher in CD while males were higher in Ulcerative colitis disease, symptoms were diarrhea, rectal bleeding, abdominal pain, rectal pain, tenesmus and fatigue. Study participants received 5 amino salicylic acid, and steroids, especially in the oral formulation. Minimal usage of topical forms, azathioprine, and biological agents. Conclusion: The study concluded UC is more common than CD. This should be taken into account as an important update for internal medicine professionals to adjust their expectations and lines of diagnosis, and management. The emergence of the unclassified type in Sudan requires good communication between the pathologists and the physicians and MDT meetings in every patient with suspicion of IBD
Synergistic Approach: Photobiomodulation, Neuromodulation, and Drug Therapy in Neuropsychiatry. A Promising Strategy to Enhance PBM Adoption and Neurotherapy Efficacy
No full textPhotobiomodulation (PBM) is an effective method for treating neuropsychiatric diseases, yet its universal acceptance and utilization remain constrained. In this Letter to the Editor/Expert Opinion, we address the challenges confronting PBM researchers and pioneers, striving to establish universal confidence in its exclusive application for neuropsychiatric patient care. Despite encouraging animal experiments and selecting positive human clinical trial outcomes, PBM’s widespread acceptance of PBM is hindered by factors including limited clinical studies and clashes with established therapies, such as drug therapy and psychotherapy.To overcome these obstacles and broaden PBM’s adoption and application of PBM in neuropsychiatry, we propose a combinatorial therapy approach. By integrating PBM with interventions such as Cognitive Behavioral Therapy (CBT) or drug therapy, a cumulative effect can be attained, benefiting both patients and therapists. Patients gain access to diverse treatment options and experience synergistic effects of combined therapies, thereby enhancing outcomes. Therapists benefit from expanded intervention choices and improved quality of patient care.This study introduces a novel strategy of amalgamating PBM with recognized interventions, such as CBT and drug therapy, to address existing challenges. This combined approach offers a practical solution to augment PBM acceptance and usage in the realm of neuropsychiatry.To endorse this strategy, a shift in the research direction is imperative. Future studies should investigate the amalgamated use of PBM with other neurointerventions, such as CBT or drug therapy. Robust clinical trials contrasting groups like “PBM + CBT” and “PBM (sham) + rTMS” are vital to persuade clinicians and patients toward embracing combined PBM therapies.Although PBM’s eventual autonomy as a neuropsychiatric treatment is an overarching goal, the present combination therapy approach proves practical, inevitable, and mutually beneficial. By bridging conventional therapies with PBM, this strategy may facilitate wider acceptance and utilization in neuropsychiatry
Bispectral Index Monitoring: Ability to Detect Deep Sedation during Endoscopy
No full textBackground: Clinical practice guidelines recommend monitoring the depth of anesthesia during endoscopic examination of the gastrointestinal tract using sedation scales, despite their subjective nature, while the use of the bispectral index, an objective measure, during sedation, remains controversial. The main objective of this study was to assess the ability of bispectral index monitoring to characterize the depth of anesthesia during endoscopy.Methods: We conducted a cross-sectional study to assess the performance of the bispectral index using data from a multicentre clinical trial with 180 patients undergoing scheduled colonoscopies. Sedation was monitored using the bispectral index and Ramsay Sedation Scale. Data on sedation were recorded at five-time points (t1 to t5) during the colonoscopy.Results: Bispectral values were significantly associated with Ramsay scores (rho, -0.73; p < 0.0001). In regression analysis, each unit increase in bispectral value was associated with a reduction in the risk of a high Ramsay score (> 3) at all points (OR 0.922; 95% CI: 0.865–0.979; p < 0.0001 at t1). Receiver operating characteristic curve analysis found areas under the curve of 0.8272 for a bispectral index cut-off for deep sedation of 69.76 (sensitivity, 95.35%; negative predictive value, 97.53%) when reaching the colic flexure (t2) and 0.8399 for a cut-off of 69.29 (sensitivity, 96.15%; negative predictive value, 98.81%) at the end of the colonoscopy (t5).Conclusion: Bispectral index monitoring enables objective real-time reliable assessment of sedation. It enables easy continuous monitoring with a very good performance for detecting deep sedation and correlates with a clinical scale routinely used in endoscopic procedures