Prof. Maged Refaat
Department of Internal Medicine, Allergy and Immunology, Ain Shams University, Egypt.

ISBN 978-81-19761-03-6 (Print)
ISBN 978-81-19761-37-1 (eBook)
DOI: 10.9734/bpi/cidhr/v7

This book covers key areas of disease and health research. The contributions by the authors include gastroenterology, health-care systems, antibiotics, samos syndrome, borderline personality disorder, human immunodeficiency virus, sexually transmissible disease, psychologically disabling illness, neurodevelopmental disease, hyperactivity disorder, oppositional defiant disorder, oedipus complex, attention deficit hyperactivity disorder, emotional dysregulation, non-psychiatric disorders, epithelial-to-mesenchymal transition, human carcinogen, bioaccumulates, cadmium toxicity, onychomcycosis, fungal nail infection, dermatophytes, respiratory pathogens, pneumonia, inflammatory condition, chronic obstructive pulmonary disease, respiratory infection, anxiety spectrum disorder, anger suppression, cytological changes, oral mucosal lesions, ebola virus disease, non-human primates, fatal emerging infection, respectful aternity care, obstetric violence, facility-based deliveries, health education, ecological public health, anthropocene, epidemiology, liver transplant, interleukin-2 receptor, cyclosporine, acute liver failure; hepatic artery thrombosis; hepatopulmonary syndrome. This book contains various materials suitable for students, researchers and academicians in the field of disease and health research.


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The Current Situation of Helicobacter Pylori Infection in Africa

Richard Wismayer

Current Innovations in Disease and Health Research Vol. 7, 29 September 2023, Page 1-11

The aim of this study is to facilitate a working plan for the treatment of H. pylori in Sub-Saharan Africa. Whilst different noninvasive and invasive tests are used for diagnosis there is a need to reach a common guideline in Sub-Saharan Africa for the treatment and diagnosis of H. pylori. The treatment procedure adopted has been demonstrated to determine the efficacy of H. pylori eradication. Treatment failures in Africa are mostly caused by resistance to antibiotics and a lack of healthcare infrastructure.This review describes the challenges in Africa in diagnosing and treating H. pylori infection together with the lack of treatment guidelines and lack of proper protocol for diagnosis. Another issue is a lack of healthcare infrastructure. H. pylori infection is common in Africa, and drug resistance adds to the infection's burden.

The author (CL) discovered the Samos Syndrome when researchers investigated why certain people refuse to take precautionary measures even when aware of pandemic risks. Samos Syndrome suggests that pandemic and primary prevention can only occur if people care about staying healthy and avoiding communicable illnesses. When faced with risky transmissible diseases, individuals either defend themselves or welcome them. This last is what happens in Samos Syndrome. The syndrome is a kind of pathophilia (people attracted by illnesses). As borderline personality disorder, found in Samos Syndrome, becomes more common, so will people who reject primary protection from infectious diseases and health behaviour as their choice. Therefore, we cannot halt pandemic outbursts. Pandemics would sinisterly draw pathophilies and split individuals who wish to avoid sickness from others who would surf the risk caused by pandemics to harm themselves for personal, interpersonal, and psychological reasons.

Reflections on Attention-deficit and Disruptive Behavior Disorders

W. Ver Eecke

Current Innovations in Disease and Health Research Vol. 7, 29 September 2023, Page 22-35

ADHD is a neurodevelopmental disease marked by excessive quantities of impulsivity, hyperactivity, and inattention that are pervasive, problematic in a variety of circumstances, and generally age-inappropriate. Under the umbrella of attention-deficit and disruptive behavior disorders, the authors of the DSM-IV-TR group four disorders (DSM IV, pp. 85–103). "Disruptive behavior disorder not otherwise specified" (Ibid., p. 93) is the fourth group. Thus, the following three options are left: 1) Attention-deficit/hyperactive disorder. 2) Conduct disorder. 3) Oppositional defiant disorder. The diagnostic criteria for ADHD, conduct disorder, and oppositional defiant disorder all include a number of factors pertaining to disobedience to authority. In this article, I will ask if there could be any objective reasons why the children affected by these disorders are compelled or encouraged to avoid or to oppose rules. A more positive way of approaching the problem is to ask if following rules could be made easier or made more meaningful. If so, then it would be possible to formulate helpful approaches to be used by adults having to deal with children affected by those disorders. These helpful approaches could then be used by parents, by therapeutic professionals, and by educators.

The Role of Cadmium Induced EGFR/STAT5 Pathway Activation in Epithelial to Mesenchymal Transition

Aikaterini Stavrou , Angelica Ortiz, Max Costa

Current Innovations in Disease and Health Research Vol. 7, 29 September 2023, Page 36-66

Cadmium (Cd) is a toxic and carcinogenic heavy metal found in cigarette smoke, air and drinking water, due to agricultural and industrial activities, posing a health risk to the general population. Prolonged, low-dose Cd exposure via inhalation or ingestion induces lung and kidney cancers in both humans and animal models. While exposure to high-dose Cd is cytotoxic and is correlated with the occupational setting, low-dose Cd exposure is carcinogenic and predominantly correlated with the general population. Even though Cd is categorized as a group 1 “human carcinogen” by IARC, the mechanism by which Cd-exposed cells overcome calcium chelation and induce malignant transformation remains unclear. This study examines the mechanism by which cells exposed to low doses of Cd survive the loss of E-cadherin cell-cell adhesion and induce epithelial-to-mesenchymal transition (EMT). Two epithelial cell lines, BEAS-2B and HEK293, were exposed to 0.4 µM and 1.6 µM of Cadmium chloride hemipentahydrate (CdCl2.2.5H2O) for 24 hours (h) and 9 weeks (wks). The chosen doses are environmentally relevant to levels of Cd found in food and cigarettes. A dose-dependent decrease in E-cadherin and an increase in N-cadherin protein expression was observed in cells treated with low-dose Cd. Moreover, Cd treated cells exhibited a faster proliferation rate when compared with control cells. This observation led to the examination of the EGFR/STAT5 pathway activation, which has also been observed to be activated in studies done in cancer cells. Our results showed a dose-dependent and time-dependent increase in both total EGFR and phosphorylated EGFR (p-EGFR) protein. Similar results were observed with STAT5 and phosphorylated STAT5 (pSTAT5) protein in both short-term and long-term exposures, however the 0.4 µM dose had the highest expression at 24 h. EGFR/STAT5 inducible genes were also upregulated in Cd-treated cells in just 24 h. These data demonstrate that epithelial cells can overcome Cd-mediated toxicity by activating the EGFR/STAT5 pathway to induce cell survival and proliferation, leading to EMT.

Finding and Fighting the Fungi in the Nails

Anita Nair , Anil Gaikwad , Ajit Damle , Vaibhav Rajhans , Shahriar Roushani

Current Innovations in Disease and Health Research Vol. 7, 29 September 2023, Page 67-97

Background: Fungal infections of nails, one of the important skin appendages, can lead to chronicity. This study was conducted to formulate baseline data for various fungal etiological agents, its clinical correlation and to understand the risk factors associated to onychomycosis.

Materials and Methods: 113 clinically suspected cases of onychomycosis were subjected to mycological studies. Diagnosis was confirmed with help of microscopy and culture. 

Result: Overall isolation rate of onychomycosis in suspected cases was 75%.

Total direct microscopy positivity was 70% and total culture positivity was 52%. Most common age group affected was 21-40 years (53.9%). Males (60.1%) were more affected than females (39.8%). Majority of suspected patients were farmers (24.7%), followed by students (19.4%). Housewives contributed to 16.8% of cases. Disease was limited to fingers in 78.7% cases, followed by toes which amounted to 18.5% of the cases. 2.6% had both, fingers as well as toes affected. Distal Lateral Subungual Onychomycosis was the most prevalent clinical pattern found in 68.1% participants. This was followed by Proximal subungual Onychomycosis, Total Onychomycosis, Candidial onychomycosis, Superficial White Onychomycosis in 9.7%, 7.9%, 7% and 7% participants respectively. None of the participants were having endonyx. Risk factors such as trauma, use of occlusive footwear, diabetes were observed to be an important contributing factor. Positive family history was given by 2.6% cases. Most common organism turned out to be T.mentagrophytes followed by T.rubrum. Thus, dermatophytes were the leading causative agent with 86.4% of the total agents isolated. Nondermatophytes contributed to 3.3% and yeasts accounted for 10.1% cases.

Conclusion: The results show that relying only on the clinical manifestation in the diagnosis of onychomycosis is often misleading. The present study tries to highlight the need for microbiological confirmation in case of onychomycosis.

Respiratory Pathogens: A Comparison between Pre- and Post-pandemic Situation of COVID-19

Ki Yeon Kim , Jae Soo Kim , Young Ki Lee , Ga Yeon Kim , Bo Kyeung Jung

Current Innovations in Disease and Health Research Vol. 7, 29 September 2023, Page 98-111

This investigation aims to determine how respiratory pathogens changed both before and after the COVID-19 epidemic, a kind of viral pneumonia for which a pandemic was proclaimed (March 2020). Pneumonia is an infection that affects one or both lungs. It causes the air sacs, or alveoli, of the lungs to fill up with fluid or pus. Bacteria, viruses, or fungi may cause pneumonia. To determine the relationship between personal cleanliness and the prevention of infection by respiratory pathogens, the data were broken down by gender and age. A retrospective analysis was performed on 39,814 sputum, bronchial aspirate, and transtracheal aspirate samples obtained from 15,398 patients visiting a university hospital, located in Chungcheongnam-do, South Korea, between January 2018 and December 2021. From 4,454 patients whose samples were culture positive for bacteria, 6,389 strains were isolated and further cultured. The outpatients with respiratory pathogens had a mean age of 66.2 years, and when the results of the culture tests were compared by gender, it was found that males made up 64.9% (2,892/4,454) and females made up 35.1% (1,562 out of 4,454). The number of outpatients who requested respiratory microbial cultures following the start of the pandemic was decreased by 20.7% compared to the pre-COVID-19 pandemic period, and the number of outpatients who had a positive culture result was decreased by 23.0%. Following the pandemic, the number of respiratory samples obtained decreased by 6.7% while the sample positive rate decreased by 18.3%. When compared to pre-COVID-19 levels, the isolated microbial strains showed a significant reduction for the Acinetobacter baumannii complex (43.1%), Streptococcus pneumoniae (60.5%), Haemophilus influenzae (67.2%), and Moraxella catarrhalis (78.1%). According to the distribution of respiratory microbial strains by age group, patients above the age of 70 had the highest prevalence of isolated bacteria. The improvements in personal hygiene due to the COVID-19 pandemic exerted a substantial influence on the pattern of change in other common respiratory microorganisms, which highlights the importance of personal hygiene management in the prevention of respiratory infections.

Clinical Presence of Anger in Anxiety Spectrum Disorders: A Narrative Literature Review

Divya Utreja , Riddhi Pitroda

Current Innovations in Disease and Health Research Vol. 7, 29 September 2023, Page 112-120

This chapter aims to inform the readers about the current understanding of anger in relation to anxiety among individuals with anxiety spectrum disorders. This narrative literature review throws light on the relationship between anger and anxiety among individuals with anxiety spectrum disorders, the inclusion of anger in the classificatory systems, whether this population is more likely to experience and express or suppress their anger, and whether trait anger can assist in predicting the later development of an anxiety disorder. The authors’ clinical observations and future directions are also discussed.

Determination of Cytological and P53 Expression Effects after Waterpipe Using

Faris M. Elmahdi , Lina A. Salim

Current Innovations in Disease and Health Research Vol. 7, 29 September 2023, Page 121-133

The goal of this investigation was to look into the cytological alterations and p53 expression in oral mucosa among waterpipe users in the Kingdom of Saudi Arabia (KSA). Waterpipe smoking is a popular activity among young adults worldwide and has been linked to various health problems. Tobacco is one of the most important risk factors for premature death globally. More than 60 toxic chemicals in tobacco can invade the body’s various systems. Oral squamous cell carcinoma (OSCC) is a pathological type of oral cancer, accounting for over 90% of oral cancers. A vast quantity of scientific, clinical and epidemiological data shows that tobacco is associated with the development of oral squamous cell carcinoma, and its carcinogenic pathways may be complicated. A cross-sectional study was conducted during January to October 2022 in KSA. Two oral mucosa samples were collected from 500 volunteers, of which 300 were waterpipe users and 200 were non-users. Samples were stained using the Papanicolaou staining procedure and immunocytochemical method to show the cytological changes and expression of P53. The Papanicolaou staining outcomes revealed four different results: inflammation, infection, atypia and keratinization. Cytological inflammation was identified in 77/300 (25.6%) waterpipe smokers, which was higher than in non-users (12/200, 6%). Conversely, cytological infection and atypia were observed more commonly in waterpipe smokers than in controls (9% vs. 4.5% and 4.3% vs. 0.5%, respectively), while keratinization was only detected in waterpipe users (3.6%) compared to non-users. Additionally, waterpipe users exhibited higher p53 protein expression compared to non-users. These findings imply that usage of a waterpipe causes specific alterations in the oral mucosa, including elevated p53 expression in abnormal and keratinizing cells. The possible prognosis of oral mucosal lesions that may be malignant, however, may not be determined solely by the presence or lack of p53 staining.

Liver Transplantation and Drug Monitoring

Vinodhini V. M. , Aishwarya S. K. , Renuka P. , Arul Senghor , B. Gayathri

Current Innovations in Disease and Health Research Vol. 7, 29 September 2023, Page 134-148

The liver is the most commonly transplanted major organ after the kidney. The first human liver transplant (LT) was attempted by Thomas Starzl in 1963 in Denver. The pre-LT laboratory testing is important to avoid rejection and post LT complication. Liver allograft rejection should be considered if liver biochemistry deteriorates post liver transplant. Most LT recipients require lifelong immunosuppression to maintain graft health. Where, chronic use of immunosuppressants is associated with significant side effects. Therefore, parameters like CBC, Creatinine/calculated GFR, ALT and/or AST and Albumin to be monitored regularly. Therapeutic monitoring generally involves only markers of pharmacokinetics. But new approaches are being developed for identifying the influence of pharmacogenetic and pharmacodynamic variables so as to provide for a more personalized treatment regimen.

In claiming that the foresight of the latest transition in this 21st Century has now emerged, as the eco-environmental and climate mediated health risks have increasingly become a priority for sustainable health implications. This chapter specifically urges universities to take the lead in curriculum reform by incorporating these epistemology competencies through transformative health education agenda. In order to support sustainable health developments in transition across intergenerations, it is pivotal for universities acting proactively as capacity building blocks for training all healthcare professionals with the necessary essentialities for a transformative health education agenda. According to Omran’s three key stages of epidemiologic transition as in the Age of (i) Pestilence and hunger, (ii) Preceding Pandemics, (iii) Degenerative and Man-Made Diseases, plus with the later fourth stage of (iv) Delayed Degenerative Diseases as postulated by Olshansky and Ault, all of which shows progressive shifts in disease patterns described as in these typical and successive stages are by no means easy. Especially nowadays under these large-scale changes of global environmental degradation and climate crisis in the Anthropocene that in fact is predominantly affecting global public health. Henceforth, Li has postulated the latest or successively the fifth stage of epidemiologic transition should be in the Age of Environmental and Climate Mediated Health Risks. For this reason, the current 'Bio-medical' model of disease-oriented only emphasizes from the past four epidemiological stages appears to be insufficient under these existential unprecedented phenomena with actual and potential catastrophic and highly complex dynamics of direct and indirect effects on widely diverse health impacts in this new epoch. Planetary health is now scientifically supported as the ultimate ecological determinant that influences sustainable development in health, thus the establishment of health education on ecological public health is crucial to the global public health in transition under this new epoch of the Anthropocene.

Respectful Care as a Human Right: Key Components of Implementing “Respectful Maternity Care”

Nongmeikapam Monika , Nirmali Gogoi

Current Innovations in Disease and Health Research Vol. 7, 29 September 2023, Page 170-181

Over the past few decades the concept of “respectful maternity care” has evolved and expanded to have amore holistic approach. Respectful maternity care is a critical but often neglected area of quality healthcare. It is not only a crucial component ofquality of care but it is also ahuman right. World Health Organization recommendation states that: Respectful maternity care – which refers to care organized for and provided to all women in a manner that maintains their dignity, privacy and confidentiality, ensures freedom from harm and mistreatment, and enables informed choice and continuous support during labor and childbirth – is recommended.Over 90 global organizations, including the International Federation of Gynecology and Obstetrics (FIGO) and the International Confederation of Midwives (ICM), have endorsed a statement from WHO calling on governments, healthcare institutions and healthcare providers to prevent and eliminate disrespect and abuse during facility-based childbirth. In this chapter, we review the evidence of respectful maternity care and discuss about the significant considerations for professional practice for health care providers.

The necessity to evaluate security threats on the national mining subsector, which produces and possesses vital mining infrastructures, arises in the context of the potential occurrence of energy blackout situations, which raises significant questions of national interest and has ramifications for Europe and NATO. Critical mining infrastructures must be extensively analyzed in terms of ensuring and increasing energy and national security in order to avert possible national crises since they may be exposed to internal and/or foreign attacks. The shortage of coal or the power generated by it may severely harm industry, the economy, and state structures, which are virtually exclusively dependent on electricity, according to the authors, who feel that addressing the national mining subsector is a purely national security problem. The best outcomes and results came from early identification and intervention. The Luwero epidemic, in which just one case was noticed, represented the optimum situation. Rural epidemics were simpler to control. Following its introduction into the Masindi region, the community-imposed quarantine stopped the ebola virus's spread. Only one case spread to the general community, and the outbreak was contained to the extended family of the index patient. However, the outbreak's invasion of the slum portions of the town accelerated the infection's spread throughout the Gulu municipality. In order to assist early case discovery and isolations as well as contact tracing and public education, community mobilization and leadership were essential. Survival was increased by palliative care. It is important to underline that the focus should be on treatment rather than isolation, since this improved public trust and health-seeking behavior. The most effective scenario for epidemic control was early discovery and intervention. Leadership and community mobilization were essential for epidemic containment. Supporting and enhancing the national initiatives need international partnership.