Recent Updates in Disease and Health Research Vol. 1

Real-world evidence (RWE) is revolutionizing drug safety assessment by drawing insights from diverse data sources that represent real-world clinical practice, healthcare systems, and patient experiences. This paradigm shift challenges the limitations of traditional clinical trials, which occur in controlled environments and may not capture rare adverse events or real-world complexities. RWE harnesses extensive data from sources like electronic health records, claims data, patient registries, social media, and wearable devices, allowing a more authentic perspective on drug safety. The scale and duration of data collection in RWE facilitate the detection of rare adverse events and trends that might be missed in clinical trials. Furthermore, the integration of RWE into drug safety assessment relies on big data and advanced analytics, including machine learning and artificial intelligence. These technologies process vast datasets, identify associations, predict adverse events, and enable real-time monitoring, enhancing drug safety evaluation. In pharmacovigilance and post-market surveillance, RWE complements data from clinical trials, providing comprehensive insights into long-term drug safety and facilitating more efficient adverse event reporting. In the era of precision medicine, RWE helps identify subpopulations vulnerable to adverse events or benefiting more from specific drugs, tailoring treatments to individual patients. However, the use of RWE raises ethical and regulatory challenges related to data privacy, consent, data quality, and bias, necessitating a balance between innovation and patient safety. As RWE continues to expand, it promises to redefine drug safety assessment, benefiting patients, healthcare providers, researchers, and the pharmaceutical industry. Harnessing the potential of RWE is crucial to ensure the development of safe and effective pharmaceuticals in modern healthcare.

This chapter highlights about diagnostic and management of Kimura's disease, an unusual cause of chronic neck lymphadenopathy. Kimura’s disease (KD) is a rare chronic inflammatory disorder of unknown etiology, primarily seen in young Asian males. The disease is characterized by painless subcutaneous swelling in head and neck region, accompanied by regional lymphadenopathy and frequent salivary gland enlargement. Blood and tissue eosinophilia, and elevated immunoglobulin E (IgE) levels, are common associations. This study present a case of 20 year old male who presented with nodular swellings in the bilateral post auricular region. The diagnosis of KD was done based on characteristic histopathologic finding in conjunction with peripheral eosinophilia. A systematic multidisciplinary approach is mandatory to rule out the other common causes of post auricular lymphadenopathy. As a cervicofacial swelling that mimics malignancy, it is of high importance that otorhinolaryngologists be aware of this condition to provide early and appropriate treatment. The diagnosis of KD can be difficult and misleading and patients with this disease are often evaluated using avoidable procedures by just not being aware of KD.

Recent decades have experienced rapid socio-economic, demographic, epidemiological and nutritional transitions resulting in changes in dietary habits, nutritional status, adiposity-related chronic diseases and lifestyle patterns in many developing countries [1-5]. Tribal groups of India in this context present a very disheartening picture. Conventionally, studies related to health issues among tribal populations have shown a high prevalence of undernutrition. However, with the changes in lifestyles, these tribal groups have been inflicted with various cardiovascular and metabolic disorders in different proportions.

Since the total Scheduled Tribe population of India constitutes about 8.6 per cent of the total population of the country [6] and a major numerical chunk, it is worth investigating the changing perspectives of health among the tribes of India in the context of lifestyle diseases in India.

 Precisely for this reason the present paper aims to understand the association of age, sex and Body Mass Index (BMI) with the different metabolic health risk factors using data from six tribes in the Birbhum district of West Bengal and Mayurbhanj district of Odisha, India. Results of the present study indicate that young tribal males are showing an increasing tendency towards growing body weight, against the traditional wisdom, which in turn has been found to be strongly associated with metabolic risk factors. Tribal females are in more danger of developing metabolic risks at lower BMI, irrespective of age, clearly indicating an increasing tendency towards a double burden of disease among the Indian tribal populations. Therefore, the Indication of an increasing tendency towards a double burden of disease among the Indian tribal populations with some risk factors associated with undernutrition and better nutrition needs to be addressed immediately before the situation becomes too alarming.

Background: Neonatal septicemia is a severe life-threatening bacteremia in which multiplying bacteria release toxins into the blood stream which increases production of cytokines causing clinical manifestations like fever, chills, tissue anoxia, reduced blood pressure, collapse etc. Enterococci are one of the important global pathogens in neonatal septicemia and were considered colonizers in the past. Their gaining resistance has been highlighted mainly to Vancomycin and high level aminoglycosides.

Aim: This study was carried out to emphasize the growing relevance of multi-drug-resistant Enterococci in newborns, which were previously solely non-harmful colonists.

Materials and Methods: It was a retrospective study in which blood culture samples from the neonatal intensive care unit received in the laboratory were considered. Processing of samples and identification of organisms were done as per standard guidelines.

Results: Enterococci accounted for 16% of the isolation rate. 78% of them showed early onset septicemia with male predominance. Vancomycin resistance Enterococci (VRE)was observed in only one isolate (11%) while high level aminoglycoside resistance was observed in 80% of them. Clinical history suggested low birth weight, prematurity, fever, catheterization and raised C- reactive protein levels.

Conclusions: The study shows an upsurge of VRE and highlevel aminoglycoside resistance (HLAR) in neonatal septicemia with the need for periodic training and active surveillance culture program for rapid identification of colonizers as the main cause of bacteremia and increase awareness amongst the health care workers about the rising multi drug resistant infectious incidence of Enterococci.

This chapter highlights about Factors Related to Personal Hygiene of Street Children in the Final Waste Disposal Site in Manggala District, Makassar City, Indonesia. Oral hygiene practices can be linked to personal hygiene practices, including access to water and other sanitation facilities. Street children are a real phenomenon in everyday life that cause complex social and health problems, dirty appearance, come from poor families, slum settlements or even street children do not have a place to live. The number of homeless people, beggars and street children has decreased, there were 990 street children and homeless people with beggars in Makassar City in 2012. There were 798 street children in Makassar City in 2016 who were recorded by Social Service officers from a number of points. Makassar road with various problems. This number includes 257 street children, 249 homeless and beggars, 58 buskers, 41 prostitutes, 5 transgender women, 63 drug users, and 125 mental disorders. The research is an analytic observation using the cross-sectional method. The study was conducted in 21 October, 2019 to 31 December, 2019. The results of the observations of street children were found with traffic light and garbage disposal sites. These places are often found with dirty, dirty appearance, dirty clothes, smelly, unkempt hair, dirty hands, not wearing sandals and sometimes they eat without washing their hands, which can cause health  problems for street children. Based on this background, the researcher is interested in examining the factors related to the personal hygiene of street children in the final waste disposal site in Manggala District, Makassar City. The population was the patients with street children numbered 88 people, a purposive sampling technique was applied through chic square, uji continuity correction and multiple logistic regression analysis. The results showed that the variables age, gender, education and knowledge had a relationship with personal hygiene (p_value<0.035), the R-square value was 0.897, which means that the ability of the independent variable to explain the dependent variable was 89.7% and 10.3% explained by factors other than variables.Knowledge variable has a significant effect on personal hygiene (p_value<0.001), the magnitude of the influence is indicated by the value of Exp (B). 26.6, which means that street children who are knowledgeable are at least 26.6 times less likely to have personal hygiene than street children with good knowledge. Personal hygiene principles should have become a part of everyday life and providing examples of good personal hygiene practices is the best way for parents to teach their children.

This chapter provides an overview of stress and mental health problems, including depression, anxiety, and suicidality, among students in Japan during the coronavirus disease 2019 (COVID-19) pandemic by searching databases and reviewing studies of this topic. The COVID-19 pandemic has substantially impacted the mental health of students worldwide, disrupted routine education, and caused psychological distress, leading to an increase in the number of suicides in this population. In addition to the fear of infection, the lack of awareness related to COVID-19 preventive measures and the limited communication with others caused by self-isolation and restrictions on movement and activities have negatively affected the mental health of students. The COVID-19 pandemic has led to the emergence of reports of its negative impact on mental health worldwide. These repercussions are predicted to be strong among students, as this population is vulnerable to emotional stress because of the psychological challenges associated with the transition to adulthood. However, the data regarding the effects of the COVID-19 pandemic on the mental health of students are insufficient. This chapter provides insights into the stress that developed among students during the COVID-19 pandemic, and its findings can be used to effectively identify and support students who may struggle during future pandemics and crises. In particular, educators may use the results of this study to prevent negative effects on mental health and promote the future academic achievements, general well-being, efficacy, and empowerment of students in this new-normal post-COVID-19 pandemic era.

Background: Malaria is a major public health problem in our countries where its distribution is similar to sickle cell disease. According to the latest world report on malaria, there are 249 million cases in 2022 with 608,000 deaths.

Children under 5 years old represent approximately 78% of all malaria deaths in WHO Africa Region where we find 94% of all malaria cases and 95% of deaths [16=1].

The relationship between sickle cell disease and malaria is the subject of much controversy. However, there is a lack of data on our services. Our objective was to study the epidemiological, diagnostic and evolutionary characteristics of malaria in children with sickle cell disease followed in a specialized setting.

Patients and Methods: We conducted a retrospective, descriptive, and analytical study of children with sickle cell disease (SCD) who presented with malaria and were followed at the Ambulatory Care Unit for Sickle Cell Children and Adolescents (USAD) at the Albert Royer National Children’s Hospital in Dakar, Senegal, West Africa from January 1st, 2017, to December 31st, 2019. We included all the following pediatric patients, less than 16 years, with sickle cell disease who presented at least one episode of malaria, confirmed by a positive thick drop, during these 3 years. We did not include patients with incomplete records or those older than 16 years. The clinical and biological signs, and the follow-up was collected and analyzed with Excel package 2019.

Results: Of 3773 patients followed for sickle cell disease, 21 had presented malaria. The frequency was 0.5% or 7 cases/year. However, we exploited the data of 14 of them. The sex ratio was 6 boys for a girl and the mean age at admission was 7.3 years. The highest number of malaria cases was observed in 2018 and the peak frequency was observed in November with 8 cases (57.1%). Fever was the most frequent symptom, observed in 10 patients (71.4%). All patients were SS homozygous, with a mean baseline hemoglobin level of 7.5g/dl. All patients had a positive thick blood smear and Plasmodium falciparum was the only species found in the blood smear, with a mean parasite density of 1693 parasites/ml of blood. All patients had anemia, with a mean hemoglobin level of 7.74 g/dl. Twelve patients (85.7%) were hospitalized and had all received inject- able artesunate followed by oral Artemisinin Combination Therapy (ACT). Long-lasting insecticidal nets were used in 9 patients (69.2%). The evolution was favorable in all patients, and any death was reported.

Conclusion: The patients who presented the association of malaria and sickle cell disease were all SS homozygotes. However, malaria must be considered as serious in this chronic anemic setting. That’s why it is important to improve prophylaxis. Therefore, it is important to make different strategies to reduce the global burden.

Background: Within the landscape of rising skin disorders, a substantial portion is rooted in autoimmune etiology, often showcasing manifestations of systemic pathologies. This chapter explores the intricate association between autoimmune thyroid disorders and Vitiligo, a skin condition marked by progressive melanocyte loss.  Emphasis is placed on elucidating the prevalence of thyroid autoantibodies in vitiligo patients, specifically Anti-thyroid peroxidase (anti-TPO Ab) and antithyroglobulin (anti-TG Ab) Antibodies.  

Research Methodology: A comprehensive hospital-based case-control study encompassing 60 participants was conducted to unravel the complex relationship between thyroid autoimmunity and dermatological disorders, such as psoriasis, melasma, atopic dermatitis, and Vitiligo.  Noteworthy findings indicate a robust association between autoimmune thyroid disorders and Vitiligo, with elevated thyroid Antibody levels observed in vitiligo cases compared to controls. 

Key Results: The prevalence of autoimmune thyroid disease in vitiligo patients surpasses that of the general population, underscoring the imperative for systematic screening and heightened awareness.  In-depth biochemical analyses unveil significant disparities in thyroid hormone profiles and Antibody levels between vitiligo cases and controls, hinting at a potential role of thyroid dysfunction in the etiopathogenesis of Vitiligo. 

Conclusion and Implications: This chapter contributes substantively to the burgeoning body of evidence supporting the nexus between autoimmune thyroid disorders and Vitiligo.  Exploring underlying mechanisms and shared genetic factors is a foundation for informed clinical practices.  The insights from this study pave the way for enhanced patient care and the development of tailored treatment strategies for those navigating the complexities of coexisting autoimmune conditions.  The imperative of early detection and management of thyroid autoimmunity in vitiligo patients is emphasized, offering practical guidance to healthcare professionals engaged in the nuanced care of individuals grappling with autoimmune skin disorders.

Desmoplastic infantile ganglioglioma (DIG) is a rare glioneuronal tumor characterized by prominent collagen-rich stroma, spindle cell glial component, and small ganglion cells (WHO grade I). The tumor is more frequently identified in the supratentorial region of patients aged less than 1 year with clinical features of macrocephaly or seizures. DIGs are solid-cystic tumors with sharp demarcation from the brain and/or attached to the dura and are associated with a favorable prognosis after complete surgical resection. In this article, we report a case of DIG in a 4-year-old girl presenting with headache, absence seizures, and decreased muscle tone. No clinical signs of recurrence were observed during 8 months of follow-up.

Inflammatory bowel disease (IBD) is a chronic inflammatory disorder and one of the most common inflammatory diseases of the gastrointestinal (GI) tract in young adults. It is now equally prevalent in Western countries as well as in Asian countries. Immune dysregulation in the GI tract incited by various pathogenic stimuli has also gained great attention from researchers in the field of IBD. Recently, there has been an increasing IBD burden in low- to middle-income countries as opposed to the earlier notion of this being a disease of affluence. It occurs due to a variety of factors, namely, local immune alteration, disruption, and inflammation of the mucosa, environmental factors, microbial commensals, and pathogen-induced genetic predisposition or genetic alteration in protective factors, etc. IBD majorly includes two forms of disease, namely, Crohn’s disease (CD) and ulcerative colitis (UC). UC presents as mucosal inflammation, particularly involving the colon, while CD manifests as patchy inflammation within the proximal colon, mainly the ileum.

So far, an exact etiopathogenesis of IBD is yet to be completely elucidated. Several recent research have emphasized the role of altered innate and humoral immunity in its causation, many of them based on animal models of IBD. Due to the poor understanding of its etiopathogenesis, IBD is still a challenge for the treating clinicians leading to persistent and recurrent disease in many cases.

Immune dysregulation in the GI tract incited by various pathogenic stimuli has gained great attention from researchers in the field of IBD. This review focuses on highlighting the role of various T cell subsets, their interplay, and associated  cytokines involved in the pathogenesis of IBD along with a short description of genetic as well as other immunological factors. This will help to assess the Th lineage-specific transcription factors (TFs) and associated cytokines involved in the etiopathogenesis of IBD. A better understanding of the pathogenic factors and subsequent randomized controlled trials targeting these factors is prudent for better therapeutic approaches for IBD. Immune dysregulation and its clear understanding will help to address this prevalent disease more precisely.

This chapter defines heat gain and heat loss during metabolism and physical activity. The metabolic heat generated by a person increases as a function of the physical work performed. Metabolic heat can be estimated based on actual measurement of oxygen consumption of a worker, or estimated using detailed calculations and tabulations. Metabolism, physical activity, digestion, and environmental elements including high outside temperature, humidity, sun radiation, lack of shade, physical activity, clothing, indoor climate, and urban heat island effect all contribute to heat gain. Convection, radiation, evaporation, respiration, and conduction are the ways in which heat is lost.

A new virus disease spread last December in Wuhan city in China for uncertain reasons and it was named by the World Health Organization (WHO) as COVID-19.  The Coronavirus disease (COVID-19) has had an incredible influence in the last few years. It causes thousands of deaths around the world. This makes a rapid research movement to deal with this new virus. As a computer science, much technical research has been done to tackle it by using image processing algorithms. This study was conducted by experimenting on the recent dataset, the Kaggle dataset of COVID-19 X-ray images, and used the ResNet50 deep learning network with 5 and 10-fold cross-validation. This study introduces a method based on deep learning networks to classify COVID-19 based on X-ray images. This result is encouraging to rely on to classify the infected people from the normal. The experiment results show that 5 folds give more effective results than 10 folds with an accuracy rate of 97.28%. Henceforth, deep learning can offer significant results in recognizing the virus in its earliest stages. Future studies can be conducted on different architectures of deep learning using different datasets which helps to recognize the infected people in earlier stages and save their lives.

Aims and Objectives: This study promotes mental health multivitamin supplementation as an alternate treatment.

Methodology: The complementary therapy of multivitamin supplementation is designed using introspection and Google Scholar.

Research and Results: This chapter examines diet, multivitamins, and mental health using introspection and Google Scholar. It shows how nutritional deficits influence the CNS, genetics, stress, and neurodegeneration. The chapter emphasizes cell, oxidative stress, and sirtuin signaling balance. The study shows that various vitamins influence neurotransmitter pathways together, emphasizing their importance in brain function. The brain-gut axis, which has nutritional implications, highlights the gut microbiome's significance in mental health. The chapter also discusses evidence-based therapy combinations such as nutritional psychiatry integration, multivitamin supplementation as an adjunct therapy, lifestyle changes, and tailored nutritional therapies for certain illnesses. This comprehensive study prepares for mental health research and evidence-based therapies.

Conclusion: Psychiatric problems can be healed with multivitamins.

Potable water, good sanitary conditions, good hygienic practices are essential for the survival and development of children.

Objective: The study aimed to determine the demographic and socioeconomic effect of water; sanitation and hygiene (WASH) in the occurrence of diarrheal disease among paediatric age group, Aba Abia State.

Methods: The study adopted a descriptive cross-sectional survey design to assess the environmental sanitation in the selected study areas. The survey was designed with the use of questionnaire which was administered to a sample size of 360 participants. The collected data was entered into computer Software called Statistical Package for Social Sciences (SPSS) Version 20.0 and analyzed using descriptive statistical analysis.

Results: The results were displayed in frequency tables and charts. The relation between variables were determined with Pearson Chi-Square test and the findings showed that 267(74.2%) of the participants reported they have had 1-5 times episodes of diarrhea per year and the episode of diarrhea was more common among male children with 204(56.7%) compared to female with 156(43.3%). Also, 204(56.7%) of the participants agreed that they have available water supply and the major source of water supply was borehole with 227(63.1%). In terms of water treatment, 255(70.8%) reported they don’t boil water before use; 100(27.7%) don’t wash hands after defecation, 225(62.5%) don’t wash hands after touching pet animals and only 32(8.8%) reported they don’t wash fruits/vegetables before eating or cooking. From the findings, 175(48.6%) heard about WASH and 264(73.3%) have the knowledge of treating children with diarrhea at health centre.

Conclusion:  In conclusion, the findings showed that water, sanitation and hygiene (WASH) had impact in the occurrence of diarrhea disease among paediatric age group in relation to demographic and socioeconomic factors. Again, the available and functional sanitary facilities do not meet the required standards set by the Ministry of Health, EHORECON and WHO guidelines. Therefore, there should be organized workshops; seminars and conferences periodically on the importance of water, sanitation and hygiene (WASH) practices in all local Governments in Abia State and beyond.