Emerging Trends in Disease and Health Research Vol. 9

COVID-19 pandemic, caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was announced, and we had an unpredictable change in the way we were living socially and in our daily routine. The first victim affected by this virus was identified in Wuhan a city in China and Kerala in India. Children and adolescents were also greatly affected by the abrupt withdrawal from school, social life, and outdoor activities. Many of the population faced unexpected variations in their life. The stress they are subjected to directly affected their overall routine life. After the Covid-19 pandemic situation occurred every person in the world should be resolved timely by the government agencies at the Local, National, and International levels. But some dangerous effects are faced by every person in the world which are unforgettable for the entire life. These may be social, psychological, financial, human behavioral, environmental, and health effects. The basic objective of this research article is to critically analyse the impacts of COVID19 on kids, education, medical system and above all psychology of individuals and society as a whole. We pray to the Almighty that these types of pandemics should never be faced by people in the future.

Anti-Müllerian hormone (AMH) levels in the blood and the number of ovarian antral follicles are commonly used to assess ovarian reserve. Because of a low response to ovarian stimulation, women with moderately compromised ovarian reserve (AMH levels between 0.2ng/ml and 1.1ng/ml) have a poor likelihood of conceiving a child through in vitro fertilization (IVF). However, research on forecasting the chances of women with severely low ovarian reserve (AMH \(\leq\)0.2ng/ml) has produced mixed results. Many clinics throughout the world refuse to admit women with very low ovarian reserve (EPOR), claiming that their chances of success are nil. This study found that with customized assisted reproduction enhancement (CARE), this group of women can achieve a relatively high clinical pregnancy rate (23%) and delivery rate (18%). During the pre-stimulation phase, ovarian stimulation, embryological laboratory work, and patient follow-up after embryo transfer, the CARE protocol personalizes the patient's care.

Apparently healthy blood donors might carry double viral co-infections that might be more fatal than viral mono-infection for the donors themselves as well as recipients later on.

The aim of this study is to assess the seroprevalence of double viral co-infections among apparently healthy blood donors in, Jharkhand India.

This is a retrospective study done at Blood Centre, RIMS, Ranchi from 17^th July 2015 to 16^th January 2017 (18 months study). All blood samples were screened for HIV-I and II (4^th generation kit), HBV and HCV (3^rd generation kit) by using chemiluminescence techanique (Manufacturer –Abbott, Model-Architect i 1000SR).

The findings of this study shows that On screening of 41307 blood units, 829 (2.0%) donors were found positive for one of the viral infection (HBV,HCV& HIV). Highest prevalence was for HBV ( 417 donors -1.0%) followed by HCV(324 donors -0.78 %) and HIV (88 donors -0.21 %). 08 (0.019%) donors showed double viral co-infection. 05 (0.012%) donors showed double viral co-infection with HBV and HCV while 03 (0.0072%) donors showed double viral co-infection with HBV and HIV.

Blood donors who appear to be healthy could be carrying life-threatening double virus co-infections.

Background: Incisional hernia is uncommon in pregnancy and is usually treated conservatively. Although there is no optimum strategy for management of incisional hernias in pregnant females, it is apparent that each case must be treated individually.

Objective: To study management of a term pregnancy with incisional hernia.

We report a case of incisional hernia in a term pregnancy of a third gravida, aged 30 years with previous two vaginal deliveries with overlying hyperpigmented lax skin patch. Incisional hernia developed as a result of a previous surgical history of open appendectomy 10 years prior, which had been complicated in the post-operative period, 22 days later, resulting to an emergency laparotomy due to intestinal obstruction. The incisional hernia was repaired with nonabsorbable sutures during the Caesarean section.

Conclusion: Pregnancy with incisional hernia is a rare occurrence. Management is mainly conservative and individualised. Simultaneous hernia repair with caesarean section is safe and generally preferred.

The origins of arteriosclerosis and, as a result, coronary heart disease, are discussed. It appears absurd to describe the causation of arteriosclerosis solely on the molecular level based on morphological considerations. Cholesterol is a structurally significant component of the human body. The human body regulates it. Long-term statin therapy observations reveal side effects, necessitating a rethinking of this treatment option. A chronic ischemia condition of the arterial artery wall is the cause of arteriosclerosis. Long-term external disturbances such as high blood pressure can lead to insufficient flow and thus successively cause metabolic changes.

Clinical experience, as well as chemical analyses, case observations, and statistics, reveal that statin medication causes significant harm. The necessity of cholesterol metabolism for brain functionality will be the focus. Because the blood-brain barrier doesn't really allow circulating blood to permeate, cells have a sensitive balance of cholesterol metabolism and must govern their needs independently, the importance and consequences of Statin therapy must be reconsidered.

Palliative care is a holistic care concept for people suffering from chronic illness or terminal illness. The care is given right from the time of the first diagnosis of the illness, which instils lots of fear and anxiety in the minds of the parents of the child diagnosed with a serious illness. The main aim is to give multidisciplinary care and alleviate the suffering and render quality of life. Not only the child who is suffering with the disease is taken care of, but the entire family is handled with care and concern. Nursing care and the ethical issues concerned with terminal illness is discussed and the models of holistic care and PCT (Palliative care team) are also described here.

Ebola viral hemorrhagic disease is rare, but is a serious thrombo-hemorrhagic disorder that can occur in Ebola viral sepsis. The demise of the patient occurs due to severe inflammation, multi-organ dysfunction syndrome and hemorrhage associated with a poorly defined coagulopathy. However, recent studies in COVID-19 pandemic have confirmed that viral sepsis including Ebola virus causes endothelial injury via complement activation that promotes inflammation and microthrombogenesis forming microthrombosis that leads to endotheliopathy-associated vascular microthrombotic disease (EA-VMTD). It commonly develops in the liver of Ebola infection (i.e., acute hepatic necrosis) and in the lungs of COVID-19 infection (i.e., acute respiratory distress syndrome). To address clinical and hematological features, a novel pathogenesis based on “two-activation theory of the endothelium” was proposed. Viral sepsis causes microthrombosis via ultra large on Willebrand factor (ULVWF) path of hemostasis in vivo following endothelial release of ULVWF/FVIII and recruitment of platelets. Endothelial injury promotes release of biomolecules from endothelial cells, which provokes various clinical syndromes including severe inflammation, consumptive thrombocytopenia, microangiopathic hemolytic anemia, and multiorgan dysfunction syndrome. In Ebola viral sepsis, activation of inflammatory pathway causes severe inflammation, but activation of microthrombotic pathway produces disseminated VMTD. The pathogenesis of Ebola viral disease is further complicated by hepatic coagulopathy initiated by acute hepatic necrosis, which results in “microthrombo-hemorrhagic syndrome” (erroneously called “disseminated intravascular coagulation” in the past) associated with thrombotic thrombocytopenic purpura (TTP)-like syndrome. The correct diagnostic term for the viral thrombo-hemorrhagic syndrome is “EA-VMTD with hepatic coagulopathy”.

In isolated cases of Crohn's disease, dietary changes have resulted in what biologics and steroids have yet to demonstrate: permanent remissions/cure.  In Crohn’s disease, the induced alterations of gastrointestinal structure and function compromise the quantitative availability of vitamins, minerals and selected amino acids that are essential to optimum function of the immune system. The postulates advanced are 1) that clinical amelioration remissions achieved through dietary manipulation are the consequence of limiting MAP antigen/cytokine interactions at the sites of Mycobacterium avium subspecies paratuberculosis mucosal attachment and ultimately, 2) by dietary restoration and enhancement of host cellular immunity, resulting in the destruction of the MAP-template which drives the dysfunctional pro-inflammatory immune response. The relationship between diet and biologics is examined.

“Home-based care” refers to the spectrum of services provided in the home to support patients, which includes professional caregiving,  nursing services, home based primary care and hospital at home  to  chronically ill and bed ridden patients of which substantial numbers are bedridden, immobile or suffer from chronic illnesses like dementia,  heart disease, cancer, chronic liver diseases, chronic lung diseases, hypertension, diabetes etc “Home healthcare services are an extension of hospital services into the patient’s house. However, the home care services range from basic support on activities of daily activities like dressing, grooming, ambulation, changing diapers, assisting with the commode  preparing meals  to complex nursing services like Wound dressing, feeding through naso-gastric tube, catheter  change, injection and tracheotomy. The major  goal of home health care services are to help individuals to improve, function and live with greater independence; to promote the patients optimal level of well-being; and to assist the patient to remain at home, avoiding hospitalization or admission to long-term care institutions. The researchers in the present study reviewed about 50 research studies which were undertaken on Elderly population, Nurses, General Duty Assistance and Patients. As the number of older beneficiaries with multiple chronic conditions continues to rise, providing care in the most effective and efficient setting have become even more critical. Therefore the patient preference and satisfaction are increasingly becoming key measures of performance, but on the other hand providing a safe and secure environment to the caregivers(Nurses and GDAS) is the responsibility of patient and their families.

This chapter will discuss bronchopulmonary actinomycosis and our clinical recommendation with the literature review. Actinomycosis is a disease caused by filamentous Gram-positive anaerobic bacteria of the genus Actinomyces. It is a rare and slowly progressive infectious disease affecting various organ systems, including the lung. Given its nonspecific clinical and radiological presentation of pulmonary form, the condition can simulate lung tuberculosis or malignancy. Thus it poses a diagnostic dilemma to the attending physician. Bacteriological culture studies and histological exams are diagnostic pillars that require specific attention to avoid misdiagnosis. It is often a treatable disease condition if diagnosed and treated early on.

The study was carried out in school children from lower middle income class families. Most of children’s parents are daily wage workers, working in handloom industry and construction site. The main purpose of this study was to assess the nutritional status and grade of malnutrition according to World Health Organisation (WHO) growth reference standards and to study morbidity pattern and their socio-demographic profile.

The present descriptive cross sectional Study was carried out among 767 students from class Lower Kindergarten to 7^th standard of Government aided private school. A pre-designed and pre-tested questionnaire was used to interview and examine all the participated students. Data on height, weight and BMI was transformed into WHO 2007 Z score. Grading of malnutrition was carried out using WHO reference tables. Visual acuity was measured using Snellen’s chart. The collected data was analysed using SPSS 15.0. Chi square test of significance was applied. P < 0.05 was considered as statistically significant.

A total of 767 students participated in this study. Boys were 513(66%) and girls were 254(33%). 339(55%) of the children had dental caries (common morbidity), 339(63%) were underweight, 302(39%) had stunting, 272(35%) had thinness and 26(3%) were found to be obese. Two (0.32%) study subjects had heart problems.

The current investigation reveals a morbidity and malnutrition pattern among schoolchildren. For early detection and treatment of common morbidities, a comprehensive periodic health checkup should be performed. More research is needed to determine the impact of health education.

Celiac disease (CD) is a permanent intolerance to gliadin contained in gluten proteins found in wheat, barley, rye, barley and other cereals. Celiac disease is not a disease to Mendelian genetic transmission, but there is a certain degree of genetic disposition in the patient's relatives. An intolerance to gluten determine severe damage to the intestinal mucosa, as villous atrophy. The intolerance to gluten is contrasted by the body with the production of antibodies that, in turn, damage the intestinal mucosa causing a decrease of intestinal absorption. Recently, 39 genomic regions were identified associated with CD and located on chromosome 2; the genes located in this area are physically in contiguity with the HOXD locus present on chromosome 2q31. The Class I homeobox genes (HOX in human), are 39 transcription factors able to control embryonic development and the cell memory program interacting with non coding RNA. I consider the HOX network “The Rosetta stone” of human biology; therefore, does HOX gene network able to control the change of the cell memory program in the CD?

Background: The problem of drug-resistant Mycobacterium tuberculosis (M.tb) is alarming and therefore there is an immediate need for alternative or complementary drugs. This could be achieved by repurposing existing FDA-approved drugs. In this study, the anti-tuberculosis activity of microbial siderophores was evaluated against drug-resistant M.tb isolates. The cell cytotoxicity of the siderophores was also evaluated on mammalian cell lines.

Methods: Drug susceptibility testing to assess the anti-tubercular effect of the siderophores was done using the Mycobacteria Growth Indicator Tube method. Mammalian cell cytotoxic effects of the siderophores was evaluated by the MTT assay.

Results: The siderophores assessed were found to be effective individually and in the presence of primary or secondary anti-TB drugs routinely prescribed, but that are not effective on drug-resistant M.tb isolates. Interestingly, the MIC of a siderophore decreased when assessed along with anti-tubercle drugs. No significant cell cytotoxicity was observed.

Conclusion: Siderophores are safe and may be useful additions to the anti-TB drug regimen aiding in conquering drug-resistant tuberculosis.

In 2009, Kenya's Ministry of Health reformed the health sector with the purpose of promoting and improving citizens' health. It founded the Hospital Management Services Fund, which will be managed at the facility level by the Hospital Management Committees (HMCs). Since the HMCs were established at the county level following the devolution of health care in 2016, no review of their performance has been conducted in Busia County. The main goals of devolution include among others to promote social and economic development as well as the provision of proximate, easily accessible services throughout Kenya. We evaluated the HMCs' selection criteria, orientation, induction, and performance in Busia, as well as their implications for Kenya and other African contexts. Through Focus Group Discussions and key informant interviews, data was obtained from all HMC members in six level 4 and one level 5 hospitals. Documents collected both at the facility and county levels were analysed and used appropriately. The National Guidelines were not fully followed by all seven hospitals examined. Three hospitals (43%) nominated individuals with educational levels below the needed O level certification. Another 33% (43%) violated Kenya's 2010 Constitution by discriminating against people with disabilities and minorities. The study reveals widespread commissions and omissions in the recruitment process, which caused anxiety and frustration among HMC members, staff, and the hospitals' catchment populations. Finally, because the nominated HMC members have not been gazetted, appointed, orientated, and facilitated, they lack the legal authority to assume their tasks and obligations.

Antibodies in the immune system have been conditioned to recognize pathogens with similar appearances as a result of previous infection or vaccination. With the COVID-19 pandemic, the level of protection of convalescents' antibodies against reinfections is unknown. However, there is immunological evidence that antibodies protect against severity. Antibody levels are said to be a reasonable substitute for immune protection. The duration of these convalescent antibodies in the body is still being studied. The purpose of this study was to look into cases of COVID-19 reinfection in people who had recovered from an initial COVID-19 infection.

A case series of people in Rivers State between March 2020 and June 2021 who had a second positive COVID-19 PCR test result. With a median age of 46 (36-49) years and four males and one female, five individuals with COVID-19 retest positives were identified. Diabetes, hypertension, and the human immunodeficiency virus (HIV) were discovered to be comorbid in four of the cases. The two incidents were separated by 96 (37–196) days on average. The convalescent patients experienced COVID-19 symptoms in both the first and second episodes, with the exception of one asymptomatic case in the second episode.This study demonstrates the potential for COVID-19 reinfection. This outcome may be related to the persistence of circulating antibodies and the presence of other chronic diseases such as HIV and diabetes in the individual. While further research is advised, it is recommended that all eligible individuals, including COVID-19 convalescents with comorbidities, be fully immunized. Continued adherence to non-pharmaceutical interventions will increase the likelihood of pandemic safety.

Isthmin 2 (ISM2) is a protein that is almost exclusively expressed in the human placenta. There has been no previous study that looked into this protein in preeclampsia or choriocarcinoma. A prospective, cross-sectional study of women with preeclampsia, gestational hypertension, and normotensive pregnancy was carried out. We measured serum concentrations of ISM2 protein and performed immunohistochemistry in placenta tissues. In addition, we compared ISM2 immunohistochemistry in choriocarcinoma samples to lung, prostate, colon, stomach, and breast cancer tissues. A total of 81 individuals were enrolled in the study, 30 of whom had preeclampsia, 21 of whom had gestational hypertension, and 30 of whom were healthy controls. When compared to the control group, the ISM2 protein was shown to be lower in preeclampsia patients (P ¼ 0.036). Immunohistochemistry validated these findings. The ISM2 protein was also shown to be overexpressed in choriocarcinoma. Our findings imply that ISM2 has an angiogenic function. Its lower serum level in our preeclampsia patients could imply that it is implicated in the disease's aetiology; on the other hand, its high expression in choriocarcinoma suggests that ISM2 may be involved in the angiogenesis of this and other malignancies.

Hospital infection control program with stable structure should be present in all institutions that provide health care in order to create a managed environment. Infection control is the discipline which is concerned with preventing health care associated infection; it is a vital; though often non-supported and not recognized as a part of the organization of the healthcare. Health care associated infections are drawing increasing attention from patients, insurers, governments and regulatory bodies. This is not only because of the magnitude of the problem in terms of the associated morbidity, mortality and cost of treatment, but also due to the growing recognition that most of these are preventable. Hospital Infection control is very essential for the safety and wellbeing of patients, hospital staffs and visitors of the hospital. Hospital administrators should strive to create an organizational atmosphere in which adherence to recommended Hospital infection control practices is considered an integral part of providing high-quality care. For such an approach to be successful, hospitals must provide visible support and sufficient resources in the form of continuous education and training programs.

Migraine is a common, debilitating disorder that imposes a large personal burden on sufferers and high economic costs on society. Sufferers have a significant level of migraine-related disability in all aspects of their daily lives, including employment, household work, and non-work activities. Since there is a wide range of disorders that cause headaches, a systematic approach to classification and diagnosis is an essential prelude to clinical management and to useful research. The Electroencephalogram (EEG) is frequently used in the examination of patients with migraine nowadays. High voltage abnormal slow-wave activity is seen in some patients with migraine. Several types of abnormal EEG were reported in basilar migraine including 1) an excess beta activity in the ictal phase in children 2) predominant delta activity during the attack of headache and normal EEG during attack 3) slowing in the posterior region or slowing with spikes and sharp wave complexes 54-56 and 4) unusual association of acute confusional state with FIRDA (frontal intermittent rhythmic delta activity) during the attack of migraine.

Warty dyskeratoma is a rare epidermal tumour that mostly affects middle-aged and older people. It appears as a papule or nodule and usually affects the head and neck region. For the past 15 years, a 65-year-old woman has complained of nodular swelling across her right face with itching. The removed mass's histopathology exhibited hyperkeratotic, parakeratotic, and acanthotic epidermis with massive, numerous invaginations, lacunae, and villi development. Dyskeratotic acantholytic cells are prevalent in the stratum corneum and higher malpighi layer. According to the research, these changes are most commonly observed in single hair follicle. In our patient, there was no evidence of recurrence after excisional biopsy. We present a unique example of warty dyskeratoma involving several neighbouring hair follicles.  

Type 2 diabetes is rising at an alarming rate in Papua New Guinea and the country has no policy to address this epidemic. Evidence available in the primary prevention of type 2 diabetes is not widely known to be applied in a fractured healthcare system among the high-risk population.

The objective of this literature review is to assess all available evidence in the primary prevention of type 2 diabetes mellitus and to suggest the integration and the application of the relevant evidence in the Papua New Guinean response to the type 2 diabetes epidemic under a clear policy.

A literature review was conducted to analyze the available evidence in the primary prevention of type 2 diabetes in the pre-diabetic population. The findings demonstrated that the primary prevention researches on lifestyle change, and the use of metformin among the prediabetes individuals have reduced the occurrence of overt type 2 diabetes. It is, therefore, possible to use these evidences to address the type 2 diabetes epidemic in Papua New Guinea, to be driven by a non -communicable disease policy.