Issues and Development in Health Research Vol. 3

The COVID-19 (coronavirus disease) pandemic, the causative agent of which is the RNA virus SARS-CoV-2, has led to the biggest health crisis in the recent history of the world. The pandemic is not only continually challenging the healthcare system but is also leading to drastic changes in the demographic structure of the population and is causing a considerable loss of human capital. The objective of this article is to take an early look at the demographic aspect of the COVID-19 pandemic and the immense future impacts it can have on demography and human capital formation in the years to come. Pandemics like COVID-19 pose a significant threat to both development and maintenance of human capital and can lead to drastic changes in the population structures and disrupt the demographic transition of populations in different countries worldwide. The observed demographic change along with changes in population age structure (where certain cohorts are more severely affected) brought about by the pandemic have also potentially increased the dependent population whose overall development is hampered due to restrictions imposed on their freedom and lifestyle which can lead to a significant and stringent loss of their capability to productively contribute to a country’s future. The recent mutations reported in 2021 are also leading to the untimely demise of people of the skilled working age groups. The resultant disruption of the process of human capital formation can have severe multi-dimensional and intergenerational implications. As the effects of COVID-19 on demographics and human capital formation can be long lasting, along with development of healthcare facilities, judicious planning in these fields is also of considerable importance.

Celiac disease (CD) is an autoimmune disease characterised by chronic food sensitivity to gluten, as well as diarrhoea and weight loss as typical symptoms. The epidemiology and phenotype of CD are constantly changing, whereas the symptoms exhibited by children with CD are variable and influenced by age. The present study aimed to examine anthropometric marker progressions in 61 Portuguese children with celiac disease at the time of diagnosis and at the time of the study, correlating these differences with gluten-free product intake. Data from 61 celiac disease patients (59.0 percent females) who had been on a gluten-free diet for5.0 ± 4.6 years were analysed. A statistical t-test examination of pBMI at diagnosis and over the study period demonstrated a statistically significant positive increase for both girls and boys (p = 0.008). The discrepancies between ingested and suggested values were measured, revealing that overall energy consumption and carbohydrate consumption had increased. Most children's nutritional status can be restored by following a gluten-free diet; nevertheless, nutritional counselling appears to be necessary to avoid nutrient imbalances and future health problems.

Enduring the test of time, the perilous working condition; and the failure of the ministry of public health and sanitation to acknowledge their existence, street food vendors continue to feed more than a half of the urban populace. Controversial as it may look, whether the street food vendors are illegally into the market system or not, the reality is that the unsuspecting public continues to put itself at risk by consuming food which is not monitored. The street food vendors are the jury and the judges of what is to be sold out or not to be sold to their gullible clients, whose proportion keep on swelling if current trajectory remain the same. It is from this background that the study sought to evaluate sanitary and food handling practices of the street food vendors in Nakuru town. The aim of this paper intents to evaluate sanitary food handling practices among street food vendors in Nakuru County, Kenya. This will bring to light to the unsuspecting general public, especially those who consume street foods on the level of exposure to food borne diseases by virtue of consuming it. The study population was all street food vendors. The target population was all street food vendors who cook and sell cooked foods on the street, while the accessible population was all street food vendors who meet the inclusion criteria within Nakuru central business district. A cross-sectional study design was used. A sample size of 384 was arrived at by use of Fischer’s et al., [1] formula. The study employed cluster sampling design as explained by Mugenda et al., [2] and Kothari [3]. The central business district was then clustered into four quadrants and proportionate sampling was done. A sampling frame of street food vendors was developed from each cluster and randomly sampled to identify the required number of respondents, as elaborated by Ahuja et al., [4]. Both qualitative and quantitative data was collected. Pre-tested and standardized structured questionnaires and observation checklist were used. Data was analyzed using Microsoft-excel and SPSS version 17 and presented descriptively. The findings showed that 318(83%) had a cleaned their workplace, 207(54%) of the vendors handled money and food indiscriminate, 169(44%) had dust bins and 280(73%) of respondents did not have their hair covered. The study recommends the concerned stakeholders to conduct periodic health education and promotion training on sanitary food handling practices among street food vendors.

In this article, the optimization of energy-saving and carbon reducing measures are addressed and discussed. Transportation is one of the most important sources of income and labor for a country's economy. The progressive depletion of fossil fuels and the looming threat of global warming have had an impact on human civilizations and ecosystems in recent years. The primary goal of on-land transportation is to transport people. According to data, the total energy consumption of all passenger cars in Taiwan accounts for 70% of total on-land transport energy consumption and 50% of total energy consumption in the transportation sector.

Acetaminophen (APAP) (N-acetyl-p-aminophenol) is a chemical molecule used to relieve pain and lower fever in paracetamol medications. The Food and Drug Administration (FDA) advisory group warned in June 2009 about the risk of APAP overdose due to its side effects, which include drug-induced liver disease. In addition, the FDA has begun multicenter non-interventional case-control studies to collect data on APAP toxicity biomarkers in children and adolescents. The National Center for Toxicological Research (NCTR), which is part of the FDA, coordinates the execution of APAP clinical trials in collaboration with other health institutes (hospitals, universities, and clinical centres) around the United States. The goal of these clinical trials is to gather enough data to create a list of biomarkers connected to acetaminophen toxicity that can be matched with specific adduct proteins; this information can then be used to examine and predict future hazards in children who are taking acetaminophen.

Background: The advancement of HIV infection is linked to a great deal of psychological discomfort. The goal of this study was to see if there was a correlation between psychological distress, depression, coping style, and immunological activation in HIV-positive patients.

Objectives: In this study, we analyzed current understandings of depression as well as psychological distress among HIV-infected individuals in West Romania.

Materials and Methods: A total of 110 HIV-positive individuals from Timisoara's Clinic of Infectious Diseases took part in the study. Each patient performed a self-report that included the Beck depression inventory (BDI), the perceived stress scale (PSS), and the brief orienting to the problems experienced (Brief- COPE) scale.CD4 cell counts and viral load were used to track immune activation (VL).

Results: BDI scores indicating moderate depression were found in 26% of the study participants, whereas severe depression was found in 3%. Furthermore, 24.5 percent of the patients had PSS values above 10.Higher levels of depression correlated with lower CD4 cells counts (r = 0.275, p<0.004) and with higher VL (r = 0.211, p < 0.027).  Self-blaming had a negative relationship with CD4, whereas behavioural disengagement had a good relationship with VL.

Conclusion: Increased depression, combined with increased levels of perceived psychological distress, leads to maladaptive coping patterns linked to HIV infection progression.

This chapter reviews initiatives in HIV/AIDS surveillance, as performed by health departments within the United States in collaboration with the Centers for Disease Control and Prevention. The first objective is a historic analysis that emphasizes the expansion of HIV Surveillance Reports, which have served as the main source of information from the Centers for Disease Control and Prevention on the impact of HIV/AIDS over the past four decades in the United States and its eight independent areas. A second objective is a procedural examination of the role of state health departments through active surveillance that contributes to the accuracy and functionality of HIV/AIDS data in HIV Surveillance Reports. The chapter is an expanded, revised version of Bletzer [1].

Background: There is paucity of an optimal method to detect fluid absorption and hemorrhage during urological endoscopic surgery. We designed an endoscopic surgical monitoring system (ESMS) and estimated its performance to establish a practical instrument that can monitor the blood loss and fluid absorption accurately and non-invasively during urological endoscopic surgery.

Methods: Our system employed the strain gauge transducers to detect the inflows and outflows of the irrigating solutions and the photoelectric sensor to determine the hemoglobin concentration of the collected irrigating fluid. The amount of blood lost and the volume of fluid absorbed during endoscopic surgery could be calculated by computer program. The accuracy and validity of this system were validated in simulated experiment and clinical study of 200 patients who underwent transurethral resection of the prostate (TURP).

Results: The relative errors for fluid absorption detection were between 0.07% and 1.00% and the coefficient of variation in serial analysis ranged from 0.78% to 3.86%. Furthermore, the relative errors for blood loss detection were between 0.06% and 1.33% and the coefficient of variation in serial analysis ranged from 0.86% to 3.94%. In clinical study for TURP, the mean fluid absorption was 644 mL and blood loss was 238 mL.

Conclusions: We provide the accuracy and validity of ESMS. It provides an early and real time detection and warning of irrigation fluid absorption and blood loss to make endoscopic surgical procedure safer for the patient.

Infants experience pain similarly and probably more intensely than older children and adults. Pain management in young babies has been largely neglected in more clinical settings, despite subjecting them to painful procedures. Also, invasive procedures has done a lot during neonates and infancy period and it is to believed that the non-pharmacological methods as administration of oral glucose before and during procedures may relieve the infants pain and provide a safe way to analgesia. This review article will help us in assuring the effectiveness of oral glucose on pain response in infants during invasive procedures.

Genome sequencing is one of the latest technologies to be introduced into medical practices for disease diagnostic and clinical trials for drugs discovery. It is often used in the practices of genomic medicine, to process and analyze genes and markers information to diagnose and treat disease. Specifically, genomic medicine uses DNA and RNA platform sequencing technologies to analyze human genome to detect, mutation, molecular abnormalities with clear clinical significances that may be associated to rare genetic diseases. The Human Genome Sequencing Project, which found around 35,000 genes in sequences of more than 3 billion human DNA and RNA chemical bases, was completed in 2003 with the use of these genomic sequencing platforms (first- and second-generation sequencing technologies). This cleared the door for genomic medicine, allowing researchers to conduct translational genomic clinical trials, which have advanced the clinical trial process in a variety of ways.

Background: Road safety is a shared responsibility. Prompt first aid provision at the place of accidents can reverse unpleasant consequences of victim's health and life. Reducing risk in the world’s road traffic systems requires commitment and informed decision-making by all stakeholders- government, industry, non-governmental organizations and international agencies and the participation of people from all walks of life [1].

Methods: A cross- sectional, community- based, exploratory study was conducted for four months (Jan 2019 to Apr 2019) to assess the knowledge and practices of first aid among drivers and conductors of buses running through Tricity, Chandigarh. In this study, a total of 300 drivers and 300 conductors of buses of CTU, Haryana Roadways, Himachal Roadways and Punjab Roadways were interviewed in order to have a generalized idea about the level of awareness and practices of first aid in real-life circumstances by the government employees of buses.

Results: Five hundred and seventy-five (95.8%) employees were aware of the prominent position of first aid box in buses and 197 (32.8%) employees felt safety of passenger as their foremost duty when bus meets an accident.

Conclusion: The awareness and practices of first aid among drivers/conductors in saving the lives of passengers is seen comparatively more than the other studies conducted previously. But they still require more awareness and better practices to be followed.

Benfotiamine (BFT) supplementation may provide benefits in the prevention of other diabetes-related vascular and neuronal comorbidities. The mechanism of BFT influence on diabetic angio, neuropathies pathogenesis is not well-known. This mini-review was aimed to analyze the latest evidence about the effects of benfotiamine (a lipid-soluble thiamine derivative with higher bioavailability than thiamine) on some metabolic and functional parameters in type 2 diabetes mellitus (T2DM) patients with diabetic angio-, neuropathies. Further investigations aimed to understand the mechanism of action and for confirmation of the beneficial effect of BFT on biochemical parameters, dynamics of independent cardiovascular tests, daily monitoring of electrocardiography, arterial wall stiffness parameters among patients with type 2 diabetes mellitus, diabetic angio-, neuropathies and its associated comorbidities may be needed to validate these clinical findings.

The health service has emerged as a critical one in both its social and economic consequences. The development of this sector thus requires a focus on personnel competence and social health needs. This study aims to achieve these goals through the introduction of case based learning methodology in dealing with protein energy malnutrition related cases. This study aims to quantify improvements in subject knowledge retention as well as attitudes. This study divides students into 2 groups with one receiving traditional lecture based learning and the other being introduced to CBL methodology, results pertaining to the impact of CBL on the latter group are obtained through statistical methods like unpaired t-test and have been presented in tabular form. Overall improvement has been shown in both subject knowledge retention of students and attitudes of both students and teachers towards CBL methodology. This study aims to contribute towards revitalizing the nursing education curriculum in both teaching methodology and in directing greater attention towards social crisis points like Protein energy malnutrition care.

Sarcopenic obesity is a physiological issue caused by ageing that worsens the elderly's quality of life by reducing bodily function, increasing body fat, and decreasing muscle mass. Furthermore, it leads to a variety of social and economic issues, including the progression and contraction of a chronic condition, increased health-care expenses, and a rise in the prevalence or mortality rate. It has an adverse influence on metabolic illness symptoms such as decreased body function and physical strength, blood lipids, and body inflammation and hormones. Exercise therapy is currently recommended as a treatment for elderly health concerns. Regular aerobic exercise is effective in increasing body function and muscle mass, and regular resistance exercise is effective in improving body function and muscle mass. Resistance exercise has recently been highlighted in obese elderly persons in order to improve muscular function and prevent falls. Resistance exercise, on the other hand, has several drawbacks, such as the risk of injury, the inability to exercise in a specific location, and the inability to reduce obesity, so a new exercise approach for the sarcopenic obese elderly should be offered. The circuit exercise with weight bearing offers a lower risk of injury, and it can be done in a group setting without regard to cost or location, and it can be done continuously with interest. Circuit training is also advised for the elderly because it improves body composition and a variety of physical characteristics in a very short period of time. Despite these positive effects, the studies reported so far are limited. Future research is needed to confirm the effects of different intensities, frequency, time, and duration of circuit exercise in sarcopenic obesity elderly. Therefore, this review summarizes recent research evidences suggesting that the improvement of muscle mass and body fat mass via circuit exercise program might be a valuable and viable “sarcopenic obesity therapeutic modality.

Aortic valve replacement is a routine procedure with acceptable risk. In some cases, mortality is high, contraindicating the procedure. The minimally invasive transcatheter aortic valve implantation seems to be an alternative, reducing morbidity and mortality. In this procedure, a bioprosthetic valve is introduced through a catheter and fixed within the injured native aortic valve. Even though the technique is considered comparatively safe, the risks of complications exist and they that have been established by individuals after the technique, for example new-onset permanent left bundle branch block (LBBB) and the need for permanent cardiac pacing implantation. A systematic review of literature of PUBMED was carried out using “10 years” and “free full texts” as filters, containing the terms “TAVI,” “pacing,” and “complications,” finding a total of eight articles. Other databases, such as SCIELO, Google Scholar and MEDLINE were used to give background, consistency, and profundity to the text. The implantation of aortic valve prosthesis per catheter seems to be a valid modality for high–surgical risk patients with aortic stenosis. The results of this series of patients suggest that the need for a definitive pacemaker after endovascular treatment is not inexorable and is not easily predicted by the risk factors described so far. TAVI is the procedure of choice considered feasible and safe. Since the site of implantation of the valve prosthesis is close to septal cardiac structures with important function, conduction disorders are frequent, requiring cautious surveillance for at least seven days after the procedure. A lack of consensus and large variability in the management of conduction disturbances post-TAVR exists. Future studies need to validate the proposed algorithm and determine the role of EP studies, ambulatory continuous ECG monitoring, and prophylactic pacemaker in the management of conduction disturbance in post-TAVR patients.

Cancer turns from a terminal illness to more of a chronic illness. This perspective has broadened the scope of care from treating the disease alone to managing cancer-related symptoms including mental disorders. Among the nosological forms of comorbid mental pathology in cancer patients, affective disorders (depression and anxiety) predominate. While there is no evidence to support a causal role for depression in cancer, it may impact the course of the disease and a person's ability to participate in treatment. Depressive syndromes are highly correlated with a reduced quality of life, increased difficulty managing the course of disease, and earlier admission to inpatient or hospice care.  

The most common form of depressive symptomatology in people with cancer is an adjustment disorder with depressed mood, sometimes referred to as reactive depression which may be under-recognized and undertreated. More severe symptoms of depression are of clinical concern because of their association with marked distress, more prolonged hospital stays, physical disorders, poorer treatment compliance and adherence to therapy, disability, increased desire for hastened death and completed suicide. Suicidal statements may range from an off-hand comment resulting from frustration or disgust with a treatment course to a reflection of significant despair and an emergent situation.

The diagnosis of depression is difficult due to the problems inherent in distinguishing biological or physical symptoms from symptoms of illness or toxic side effects of treatment. A critical part of cancer care is the recognition of the levels of depression present and determination of the appropriate level of intervention, ranging from brief counseling or support groups to medication and/or psychotherapy. At least one half of all people diagnosed with cancer will successfully adapt. Pharmacotherapy for depression in patients with advanced cancer should be guided by a focus on symptom reduction, irrespective of whether the patient meets the diagnostic criteria for major depression. The optimal antidepressant for specific patients can be determined by each patient’s depressive symptom profile and potential dual benefit for depression and cancer-related symptoms such as anorexia, insomnia, fatigue, neuropathic pain and hot flashes. Because of both their adverse effect profiles and risk for lethality in overdose, tricyclic/heterocyclic antidepressants, monoamine oxidase inhibitors and reversible inhibitors of monoamine oxidase A are rarely used in patients with cancer. Timely and precise diagnosis and appropriate treatment of depression is required in an effort not only to increase quality of life but also to reduce adverse effects on cancer course, length of hospital stay, treatment adherence and efficacy and possibly prognosis and survival.

Nanodentistry is the application of nanotechnology in dentistry. The arrival of 21^st century, suddenly focused on dentistry a new paradigm regarding expected standard for state-of the- art-patient care. Over last few years truly remarkable progress has been made in such diverse areas as proteomics, gene therapy, vaccine development, stem cells, tissue engineering nanotechnology and drug development through combinatorial chemistry.

Although much of this progress has been at the preclinical, translational research stage and some notable advances have already entered the clinic. Nanodentistry is the future of dentistry in which every procedure will be performed using equipment and devices based on nanotechnology. All diagnoses and treatments will be given using nanoscale-structured materials and nanorobots. These materials and devices will have the ability to accurately diagnose a problem and provide solution in the shortest possible time and precisely.

Nanotechnology makes it possible to construct materials which have longer life and very close to nature. Nanoproducts made for various dental procedures has more hardness, elasticity and strength with increased shelf life than the ones which were used in conventional practice. Furthermore, they will have better appearance in terms of color, texture and esthetic appeal.

To date, little is known on the prevalence, incidence, and characteristics, in patients with tuberous sclerosis complex.

Tuberous sclerosis complex is a genetic multisystem disorder. It is an autosomal disorder affecting multiple organs. It is characterised by the growth of multiple hamartomas in several organs such as brain, kidney, skin, uterus and liver. It is caused by mutation of either TSC1 or TSC2 gene encoding hamartin and tuberin respectively. The diagnosis of TSC is established using diagnostic criteria based on clinical and imaging findings. Routine screening and surveillance of patients with TSC is needed to determine the presence and extent of organ involvement, especially the brain, kidneys, and lungs, and identify the development of associated complications. As the treatment is organ specific, imaging plays a crucial role in the management of patients with TSC.

We report a case of 50 years old female with tuberous sclerosis complex who presented with facial angiofibromas, angiomyolipomas of bilateral kidney, subependymal nodules and subependymal giant cell astrocytoma. The aim of the study is to present clinical and radiological features in a patient who exhibited multiple hamartomas of various organ system.

Active lifestyles meeting or exceeding 150 minutes/week of PA are associated with risk reductions in multiple chronic health conditions. However, sedentary work-related environmental conditions are linked with a decline of physical activity (PA) in the United States and abroad. University staff may uniquely experience work-related challenges that could inhibit achievement of recommended daily levels of PA, yet few studies on this exist. OBJECTIVE: To evaluate self-report PA among employees at a private university and assess alignment with global and national goals for PA to reduce the burden of non-communicable diseases. METHODS: Eligible survey respondents (N = 253) were women (n = 173, 39.3 ± 13.4 years of age, 164.4 ± 8.1 cm in height, 69.7 ± 16.4 kg in weight, and 25.9 ± 6.6 kg/m² body mass index [BMI] ) and men (n = 82, 41.5 ± 12.9 years of age, 178.33 ± 8.1 cm in height, 85.8 ± 14.4 kg in weight, and 27.03 ± 4.6 kg/m² BMI of) employed as staff at Biola University. Participants completed the International Physical Activity Questionnaire (IPAQ), using the Survey Monkey^® platform. Occupations were categorized by type (administration, staff, and facilities). Activity specific (leisure, household, occupational, and transport) weekly minutes and metabolic equivalent (MET) minutes per week were calculated and then summed to get grand total minutes of weekly PA and grand total MET minutes of PA per week. Total walking PA, moderate PA, and vigorous PA minutes per week and MET minutes per week were tabulated and analyzed. RESULTS: Men were significantly (P < .05) more physically active per week in total PA MET minutes per week, workplace PA in MET minutes per week, and minutes per week than women. A stepwise decrease between PA and increases in educational attainment was observed, yet was statistically insignificant. Facilities personnel were significantly (P < .05) more active than both administration and staff. Staff and administration had similar activity levels. The percentage of employees completing a total of at least 150 minutes of PA per week was 82.4% of the sample. CONCLUSION: A large majority of university employees exceeded the ACSM minimum weekly recommendations for PA. However, activity levels varied significantly between sex and job type.

Squamous cell carcinoma (SCC) has many histologic variants, such as clear cell SCC, signet ring SCC, basaloid SCC, desmoplastic SCC, verrucous and pigmented SCC, among others. Pigmented SCC is a rare histopathological variant with oral mucosa being common site of origin.