Journal of Ideas in Health
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Racial and ethnic disparities in COVID-19 mortality in the United States
Get PDFBackground: Among COVID-19–associated deaths reported in the United States (U.S.), minority communities were disproportionately represented. The objective was to assess differences in mortality by race and ethnicity among patients with coronavirus disease 2019 (COVID-19) in the U.S.
Methods: This is a retrospective case series study with information extracted from the U.S. Centers for Disease Control and Prevention between January 20 and December 29, 2020. Clinical and sociodemographic data were analyzed by race and ethnicity from non-hospitalized and hospitalized patients with COVID-19. Binary logistic models were fitted to evaluate factors associated with COVID-19-related mortality.
Results: A total of 434,076 patients with COVID-19 were characterized; 284,574 cases were Non-Hispanic White, 10,468 cases were Non-Hispanic Asian, and 949,022 cases were Non-Hispanic Black, and 89,407 cases were Hispanic/Latino. For non-hospitalized patients, Hispanic/Latino with pneumonia (OR 3.34, 95%CI: 1.70-6.58) and Non-Hispanic Asian with comorbidities (OR 3.88, 95%CI: 0.99-15.2) had the highest odds for mortality. For hospitalized patients, Non-Hispanic Black with comorbidities (OR 3.02, 95%CI: 2.24-4.08) and Non-Hispanic Asian and Non-Hispanic Black with pneumonia (OR 2.98, 95%CI: 2.09-4.26; and OR 2.97, 95%CI: 2.60-3.38, respectively) had the highest odds for mortality.
Conclusion: Racial/ethnic disparities in mortality persist among patients with COVID-19 in the U.S. These findings support the assertion that racial and ethnic minorities are disproportionately affected by COVID-19 in the U.S
Detection of stem cells in human endometrium: immune-histochemical study
Get PDFIn this work, we recruited CD105 and CD90 markers to identify the endometrial stem cells (EnSCs) in the human uterine endometrium. Fifty endometrial specimens have been extracted from twenty-five deceased women. All specimens have been embedded in paraffin block and prepared for immune-histochemical processing. The expression of CD105 and CD90 was counted per high power field (HPF). Paired sample t-test was used to compare the means between groups and age variables. The Statistical analysis was conducted using “SPSS16 software" The statistical significance was considered at less than 0.05. Results of paired sample t-test showed that the expression count (EC) at the Basalis layer (with CD105) was 5.26 points higher than the Functionalis layer (95% CI [3.43, 7.09]) and the correlation was strongly and positively related (r = 0.829, P < 0.001). The EC at Basalis layer (with CD90) was 4.96 points higher than Functionalis layer (95% CI [3.02, 6.89]) and the correlation was strongly and positively related (r = 0.746, P= < 0.001). The EC at Functionalis layer (with CD105) was 0.9 points higher than the Stroma layer (95% CI [2.27, 4.11]); however, the correlation was weak and positively related (r = 0.429, P = 0.032). The EC at Functionalis layer (with CD90) was 1.4 points higher than the Stroma layer (95% CI [2.1, 4.2]), but the correlation was moderately and positively related r = 0.547, P = 0.005). Findings of an independent-sample t-test showed that the EC of stem cells at the Functionalis, Basalis, and Stroma layers (with CD105 and CD90 markers) was more among patients of reproductive age (<50 years) than patients who were at non-reproductive age (50 years and above), a statistically significant difference [(m = 9.6, 95% CI (5.3, 14.6), t (19.630) = 4.413, P < 0.001)], [(m = 10.2, 95% CI (5.2, 15.2), t (20.714) = 4.202, P < 0.001)] and [(m = 8.4, 95% CI (3.5, 13.4), t (12.313) = 3.523, P = 0.002)], respectively. In conclusion, the EC of the stem cells in the endometrium decreases with age
Human cytomegalovirus and relationship with abortion among Iraqi females: a systematic review
Get PDFBackground: Human cytomegalovirus (HCMV) seroprevalence is a significant health problem, especially among pregnant women in lower socioeconomic societies. This study aims to explore the prevalence of HCMV infections among women in Iraq.
Methods: A systematic review was designed to collect and summarize articles concerning the relationship between HCMV infection and abortion in Iraq. We identified the titles and abstracts of the publications from 2008 to 2022. A pre-defined keyword was recruited to recognize the publications and filter the articles to eliminate duplication and remove irrelevant articles. In the reviewed studies, the HCMV was detected using diagnostic methods such as enzyme-linked immunosorbent assay and immunochromatography (rapid test) or molecular methods such as polymerase chain reaction.
Results: Twenty-four eligible articles have been included in this review sourced data from about 5442 patients covering 15 of 18 provinces in Iraq. The prevalence of HCMV IgG and IgM was (0%-100%) and (0%-93%), respectively. Many factors influenced the varied results, including the design of the study and sociodemographic and clinical aspects.
Conclusion: The high prevalence of HCMV infection indicates a causative relationship with repeated abortion among Iraqi females
Effects of cigarette smoking on the response of hypertensive patients to beta-adrenergic antagonists: a narrative review
Get PDFCigarette smoking is one of the hypertension risk factors which can adversely affect the quality of life. This review aimed to provide a brief overview of the link between smoking and hypertension. At the same time, raising questions about how smoking interacts with beta-adrenergic antagonists that are used as antihypertensive drugs. By searching for relevant studies through multiple search engines, there is inconsistent evidence about the effect of smoking on high blood pressure. Mainly attributed to the availability of numerous confounding factors. However, cigarette smoking cannot be ignored because smoking exerts dual effects on hypertension as a disease and the treatment with antihypertensive drugs, particularly beta-adrenergic antagonists. The potential drug interaction can occur through pharmacokinetics and pharmacodynamics mechanisms resulting in influencing the efficacy of these drugs. It is necessary to have dosage modifications according to the patient\u27s smoking status, whether in hospitals or outpatient clinics
Blood cholinesterase activities and oxidative stress status among farmworkers using pesticides in Duhok, KRG, Iraq
Get PDFBackground: The use of pesticides by farmworkers poses considerable health risks. This study was undertaken to examine plasma and erythrocyte cholinesterase activities, plasma oxidative biomarkers malondialdehyde (MDA), and total antioxidant status (TAS) among farmworkers using different pesticide products in Duhok, northern of Iraq.
Methods: This is a case-control study conducted between November 2021 to July 2022 on 92 male farmworkers who were exposed to pesticides in comparison with 44 non-exposed male subjects (control). The availability and uses of pesticides were obtained from 19 agrochemical shops and the farmworkers exposed to pesticides. Demographic data of pesticide-exposed farmworkers and their practice of pesticide applications were recorded. Plasma and erythrocyte cholinesterase activities and plasma MDA and TAS levels were determined in both groups.
Results: The farmworkers had a significant 10.0% increase in plasma MDA level, with no significant changes in blood cholinesterase activities or the TAS level. Odds and risk ratios of reduced plasma cholinesterase activity (20.0%) suggested an association of health risks in pesticide-exposed farmworkers. Most of the pesticide products (278) in use were insecticides (47.0%), which comprised mainly 26.0% pyrethroids and 3.0-7.0% anticholinesterase insecticides, among others. The majority of the farmworkers (51%) were merely aware of the general target use of the pesticide, and 75% had an exposure history of > 5 years. Pesticide application was mostly (50.0%) manual, and 54.0% used insufficient personal protection equipment; 32.0% ate and drank at work, 48.0% practiced disposal of empty pesticide containers by burning and/or burying them, whereas 25.0% dumped the containers indiscriminately, and 25% disposed them at garbage sites openly.
Conclusion: The farmworkers, with only a marginal increase in oxidative stress biomarker MDA, did not suffer from significant reductions in blood cholinesterase activities, although odds and risk ratios of reduced plasma cholinesterase activity suggested a health risk. Implementation of a national program is needed to measure pre-exposure blood cholinesterase activities in farmworkers
Effect of risk factors on the outcomes of COVID-19-infected intensive care patients: a single-center retrospective study
Get PDFBackground: To date, little attention has been paid to the impact of risk factors on the outcome of patients with coronavirus disease 2019 (COVID-19) hospitalized in the intensive care unit (ICU). This study was performed to examine the effects of risk factors on death among COVID-19 patients hospitalized in the ICU.
Methods: From April 2020 to November 2020, data on 141 COVID-19-infected intensive care patients at 7 Air Force Hospital, Kanpur, were retrospectively retrieved. All analyses were performed using SPSS statistical software (SPSS Inc., Chicago, IL, USA, 15.0). Bivariate and multivariate logistic regression analysis was done to identify independent risk factors. A p-value <0.05 was considered statistically significant.
Results: Most of study population were males (69.5%) with mean age of 59.8 ± 17.5 years. Out of 141 patients, 60 (42.6%) patients had comorbidities and 81 (57.4%) patients had no comorbidities. ICU death rates were 46.1%. Bivariate logistic regression analysis revealed that male sex (OR:0.45;95%CI:0.21-0.94), diabetes mellitus (OR:2.96; 95%CI:1.16-7.54), coronary artery disease (OR:2.48;95%CI:0.83-7.37), chronic kidney disease (OR:0.13,95% CI:0.02-1.12), patients with one (OR:1.25,95%CI:0.54-2.86) or more than two comorbidities (OR:1.95,95%CI:0.81-4.70), and who required high flow oxygen therapy (OR:13.30,95%CI:5.81-30.43), non-invasive (OR: 0.10,95% CI:0.02-0.45) and invasive ventilators (OR:0.04,95%CI:0.02-0.09) all were associated with higher ICU death rates. Multivariable logistic regression found following independent risk factors for death: patients with one comorbidity (OR:0.10;95%CI:0.02-0.66), non-invasive ventilator (OR:0.005;95%CI:0.000-0.091), and invasive ventilator (OR:0.003;95%CI:0.000-0.032).
Conclusion: Identification of risk factors is of utmost importance to reduce death in COVID-19 infected intensive care patients
Prevalence of occult hepatitis B infection in Diyala province, Iraq
Get PDFBackground: Occult HBV infection (OBI) is the absence of hepatitis surface antigens (HBsAg) that is not apparent during detection by serological tests despite the presence of virus DNA. This study aimed to explore the prevalence of OBI infection among various populations in Diyala province, Iraq.
Methods: A prospective cross-sectional study was conducted from 1st January to 30th September, 2021, at Ibn Sina Dialysis Center, Baquba Teaching Hospital, Iraq. Three hundred and sixty participants were equally involved (90 individuals for each) from the dialysis department, the thalassemia department, blood bank donation Centre, and the control group. Study populations were screened for HBV Ag, HBV c IgG, HBV c IgM, abusing the enzyme-linked immunosorbent assay (ELISA) test, and detecting HB core gene. Demographic data of the study group were recorded. Descriptive analysis was done using SPSS Version 25, and the P-value was considered significant wherever it was below 0.05.
Results: The positivity rate of serological markers of OBI among the study population was (6.7%) of the participants were HBs Ag positive. Whereas 22 (6.1%) were anti-HBc IgG positive and 3 (0.8%) were anti-HBc IgM positive. The detection rates of the PCR products of 76 participants after amplification using specific primers for (core-gene) have been presented to the gel electrophoresis, which showed none of the 76 participants were positive for the HBc gene.
Conclusion: The current study showed a medium percentage of anti-HBc IgG in the serum of the study groups without the presence of HBs Ag, which indicates the presence of a previous infection that was resolved or the occurrence of occult hepatitis B infection. The current study results also showed that the serum of any of the study groups was not positive for the core gene, which confirms the possibility of infection with OBI
Artificial intelligence-enabled rapid and symptom-based medication recommendation system (COV-MED) for the COVID-19 patients
Get PDFIn a general COVID-19 population in Cox’s Bazar, Bangladesh, we developed a medication recommendation system based on clinical information from the electronic medical record (EMR). Our goal was also to enable deep learning (DL) strategies to quickly assist physicians and COVID-19 patients by recommending necessary medications. The general demographic data, clinical symptoms, basic clinical tests, and drug information of 8953 patients were used to create a dataset. The learning model in this COVID-MED model was created using Keras (an open-source artificial neural network library) to solve regression problems. In this study, a sequential model was adopted. In order to improve the prediction capability and achieve global minima quickly and smoothly, the COVID-MED model incorporates an adaptive optimizer dubbed Adam. The model calculated a mean absolute error of 0.0037, a mean squared error of 0.000035, and a root mean squared error of 0.0059. The model predicts the output medications, such as injections or other oral medications, with around 99% accuracy. These findings show that medication can be predicted using information from the EMR. Similar models allow for patient-specific decision support to help prevent medication errors in diseases other than COVID-19
Impact of family structure and sociodemographic characteristics on parents headed families in Ramadi City, Iraq
Get PDFBackground: Several factors in the family profile contribute significantly to determining the effective policy when heading the family. This study aims to evaluate the sociodemographic and economic burdens on parents-headed families in Ramadi City, west of Iraq.
Methods: A prospective cross-sectional household-based survey was conducted from 1st to 28th February 2019 among Iraqi people residents in Ramadi city, Anbar province. A multistage sampling technique was recruited to identify the eligible sample. A semi-structured questionnaire was used to interview (face-to-face) the respondents. Data from 267 households have undergone univariate and bivariate analyses. Multiple logistic regression, odds ratio (OR), and confidence intervals (CIs) were estimated to explore the predicting variables. The statistically significant is considered at less than 0.05.
Results: The mean age of respondents was 43.88 (± 12.1) years (range: 25 to 69 years). Out of the total surveyed people, 52.8% were young (less than 44 years), male-headed families (59.6%), low educated level (65.5%), unemployed (52.4%), married (67.4%) and headed big families of seven members and above (43.1%). History of chronic diseases and smoking habits was positive among 46.4% and 45.7% of respondents, respectively. Findings of the binary logistic regressions showed that history of smoking (OR = 7.201, 95% CI: 3.254 to15.936), families of 7 members and above (OR = 6.239, 95% CI: 2.938 to 13.250), unhappy (OR = 5.237, 95% CI: 2.140 to 12.818), aged 44 years and above (OR = 3.518, 95% CI: 1.581 to 7.829), being single (unmarried, divorced, widow) (OR = 2.697, 95% CI: 1.230 to 5.914), and had a monthly income of less than USD400 (OR = 2.333, 95% CI: 1.112 to 4.859) are significantly associated with female-headed family.
Conclusion: Priority must be given to some elements such as genetic, physical differences, biopsychosocial factors, and the economic situation when discussing parents\u27 behavior in heading the family
Knowledge, attitude and practice towards COVID-19 among healthcare workers in Iraq
Get PDFBackground: In the absence of effective treatment, coronavirus disease (Covid-19) poses severe risks to public health. This study aimed to explore the knowledge, attitude, and practice towards the COVID-19 pandemic among healthcare workers.
Methods: An online approach was adopted to conduct a cross-sectional study from 1st to 31st October 2020 among Iraqi healthcare workers in Anbar Province, west of Iraq. A semi-structured and self-administered questionnaire was recruited to collect the data. The study tool contains four parts sociodemographic, knowledge, attitude, and practice assessment. Multiple Linear regression was performed to test the association between the dependent and the independent variables. SPSS version 16 was used to analyze the data, and the statistical significance level was considered at less than 0.05 p-values.
Results: A total of 209 health workers were included in this study. Most of the respondents (54.5%) were Doctors (Physician, dentist, and pharmacist), males (60.8%), married (74.2%), aged less than 45 years (53.1%), urban region (64.6%), with a monthly income of USD 400 and above (61.7%) and 75.1% of them perceived their health good. The mean knowledge, attitude, and practice level of participants were 14.43 (± 2.01), 27.68 (± 2.74), and 4.33 (± 0.97), respectively. In the regression analysis, doctors (P-value = 0.000) aged 45 years and above (P-value=0.008) and urban residents (P-value=0.007) were significantly associated with upper knowledge scores. Female gender (P-value =0.022) was significantly related to positive attitude scores. While married (P-value = 0.038), those with experience of 10 years and above (P-value=0.041) showed better practice.
Conclusion: The level of knowledge, attitudes, and practices of healthcare workers in Anbar Province was adequate. However, with the expected new waves of pandemics, the policy of continuous training to update healthcare workers is inevitable to control and prevention of COVID-19