Journal of Medicine, Surgery, and Public Health最新文献

Background

Widowhood is a disastrous incident occurring at any stage of life for surviving oneself particularly the older women having critical reflexes on their physical, emotional and as well as socio-economic well-bring. Living alone and being cornered to home may also have serious repercussions on psychological health conditions of geriatric population, a public health concern in recent times.The main essence of this present study was to investigate the impact of widowhood, loneliness and social non-participation on older women depression in Indian context.

Methods

Data for the present study were obtained from the first wave of the Longitudinal Ageing Study in India (LASI), conducted during 2017–2018. A total of 15,559 older adult women were availed for this present study. Descriptive analyses, association studies and finally multinominal logistic regression analyses were performed to fulfill the study objectives.

Result

Currently, 5 % of total study participant’s suffered from depression for most of the times. Findings suggested that widowhood is a catastrophic event giving rise to depression for most of the old women in their later life. With this, living alone in old age period also had a great impact on the prevalence of depression. Preponderance of older women depression is also found among those, not getting involved any social events.

Conclusion

This study suggested that to reduce the prevalence of older women depression, targeted interventions in the form of psychological counseling, screening services and community involvement are very much needed.

Background

Bangladesh is not excluded from the global issue of children being underweight or overweight. This study examined the relationship between underweight, overweight, and sociodemographic variables in children.

Methods

Data from the Multiple Indicator Cluster Survey (MICS) 2019 were used for this study. We employed chi-square and one-way analysis of variance (ANOVA) tests to identify significant variables. Subsequently, we fitted a multilevel mixed-effects logistic regression model and reported odds ratios (OR), confidence intervals (CI), and p-values. STATA version 17 was used for analysis.

Results

The sample size for our study consisted of 10,875 Bangladeshi children under five years of age. From a total of 10,875 children, 20.57% were underweight and 6.80% were overweight. Data were available for 8858 rural and 2017 urban under-five children. The prevalence of underweight was greatly influenced by age, and in rural regions, it consistently increased from 12 months to 59 months. Male children were more likely to be overweight and underweight than female children. Children in the Sylhet division were likelier to be underweight and overweight. Educated mothers reduce the risk of underweight children in urban and rural areas. The richest family children were more likely to be overweight in urban areas. In rural areas, children born with a smaller size were more likely to become underweight and less likely to become overweight.

Conclusions

Our research revealed that the poorest sociodemographic category, the Sylhet division, small newborns, and illiterate mothers were the most vulnerable to child weight problems.

Using Artificial intelligence technologies in cardiology has witnessed rapid advancements across various domains, fostering innovation and reshaping clinical practices. The study aims to provide a comprehensive overview of these AI-driven advancements and their implications for enhancing cardiovascular healthcare. A systematic approach was adopted to conduct an extensive review of scholarly articles and peer-reviewed literature focusing on the application of AI in cardiology. Databases including PubMed/MEDLINE, ScienceDirect, IEEE Xplore, and Web of Science were systematically searched. Articles were screened following a defined selection criteria. These articles' synthesis highlighted AI's diverse applications in cardiology, including but not limited to diagnostic innovations, precision medicine, remote monitoring technologies, drug discovery, and clinical decision support systems. The review shows the significant role of AI in reshaping cardiovascular medicine by revolutionising diagnostics, treatment strategies, and patient care. The diverse applications of AI in cardiology showcased in this study reflect the transformative potential of these technologies. However, challenges such as algorithm accuracy, interoperability, and integration into clinical workflows persist. AI's continued advancements and strategic integration in cardiology promise to deliver more personalised, efficient, and effective cardiovascular care, ultimately improving patient outcomes and shaping the future of cardiology practice.

Background

Tooth decay affects 40–90 % of children in low- and middle-income countries (LMICs), contributing to adverse consequences, including oral pain, difficulty focusing in school, lifelong dental problems, and overall lower quality of life. Few studies have examined the relationship between pocket money given to children, their purchase of sugary snacks and drinks with that money, and the risk for tooth decay.

Methods

This secondary cross-sectional analysis utilized data which were collected in 2014 as part of an oral health promotion program in rural El Salvador. A convenience sample of 279 children and their mothers who participated in the program were recruited to complete an interview with trained community health workers, and children received a dental examination from trained and licensed Salvadoran and U.S. dentists. Only children with teeth (primary, mixed, or permanent dentition) were included in this analysis; as such, children ranged in age from 6 months through 14 years. Descriptive, multivariate logistic regression, and Zero-Inflated Negative Binomial analyses were used to identify associations between pocket money given to children and three oral health outcomes: number of decayed, missing/extracted due to decay, and filled teeth (dmft for primary teeth and DMFT for permanent teeth); presence of deep decay; and occurrence of oral pain.

Results

Overall, almost two-thirds of children received daily pocket money with which over 70 % purchased unhealthy snacks/drinks; 83 % of children had tooth decay, with a mean dmft/DMFT of 6.0. After adjusting for covariates, receiving pocket money was associated with 0.18 (95 % CI: 0.05–0.54) times the odds of having zero-dmft/DMFT (i.e., being cavity-free) (p = 0.002). Among children with at least one decayed tooth, receiving pocket money was associated with 1.22 (95 % CI: 1.01–1.53) times the expected dmft/DMFT count (p = 0.04), 3.39 (95 % CI: 1.59–7.22) times the odds of deep decay (p < 0.001), and 2.66 (95 % CI: 1.24–5.70) times the odds of oral pain (p = 0.007) compared to children who did not receive pocket money.

Conclusion

Interventions to reduce the prevalence and severity of tooth decay should include nutrition and oral health education for children and families—including addressing pocket money and healthy vs. unhealthy purchases—in schools, communities, and primary health clinics; school programs to provide healthy foods and beverages for children; and enforcement of policies to prohibit the sale of ultra-processed foods and sugary drinks in and around schools.

Artificial Intelligence (AI) has emerged as a transformative force in various fields, and its application in mental healthcare is no exception. Hence, this review explores the integration of AI into mental healthcare, elucidating current trends, ethical considerations, and future directions in this dynamic field. This review encompassed recent studies, examples of AI applications, and ethical considerations shaping the field. Additionally, regulatory frameworks and trends in research and development were analyzed. We comprehensively searched four databases (PubMed, IEEE Xplore, PsycINFO, and Google Scholar). The inclusion criteria were papers published in peer-reviewed journals, conference proceedings, or reputable online databases, papers that specifically focus on the application of AI in the field of mental healthcare, and review papers that offer a comprehensive overview, analysis, or integration of existing literature published in the English language. Current trends reveal AI's transformative potential, with applications such as the early detection of mental health disorders, personalized treatment plans, and AI-driven virtual therapists. However, these advancements are accompanied by ethical challenges concerning privacy, bias mitigation, and the preservation of the human element in therapy. Future directions emphasize the need for clear regulatory frameworks, transparent validation of AI models, and continuous research and development efforts. Integrating AI into mental healthcare and mental health therapy represents a promising frontier in healthcare. While AI holds the potential to revolutionize mental healthcare, responsible and ethical implementation is essential. By addressing current challenges and shaping future directions thoughtfully, we may effectively utilize the potential of AI to enhance the accessibility, efficacy, and ethicality of mental healthcare, thereby helping both individuals and communities.

Staphylococcus aureus, a prominent human pathogen, exhibits a remarkable ability to interact with host proteins involved in crucial physiological pathways, such as the complement system, coagulation cascade, and fibrinolysis cascade. This paper explores the ability of this notable bacteria to successfully manipulate and evade the host innate system, expatiating on the strategies that enhance its pathogenicity leading to implications on the healthcare system such as the propagation of diverse nosocomial infections. The investigation focuses on key S. aureus proteins, including Coagulase (Coa), von Willebrand factor-binding protein (vWbp), and Staphylokinase (SAK), which play pivotal roles in blood coagulation, fibrinolysis, and evasion of host antibacterial peptides. Notably, these proteins contribute to the formation of fibrin networks, protecting the bacterium from immune clearance and promoting lethal bloodstream infections in murine models. Additionally, the debate surrounding the role of SAK as a critical virulence factor is addressed, emphasizing its impact on biofilm formation, invasion of internal organs, and bacterial loads in sepsis studies. Furthermore, the interaction of S. aureus with matrix metalloproteinases and the secretion of superantigen-like proteins (SSL1 and SSL5) are explored as additional mechanisms employed by the bacterium to impede immune responses. In addressing emerging challenges in innate immunity, the paper discusses the escalating antibiotic resistance in S. aureus, with a specific focus on methicillin-resistant strains (MRSA) and its capacity to instigate healthcare-associated infections as an effect.

Sjögren's syndrome (SS) is a chronic autoimmune condition characterized by lymphoplasmacytic infiltration into salivary and lacrimal glands, leading to sicca syndrome and systemic symptoms. While pulmonary, musculoskeletal, dermatological, and renal manifestations are well-documented, reports of central nervous system (CNS) involvement, particularly stroke, remain rare. We present a case report of a 30-year-old female whose initial manifestation of vasculitis associated with Sjögren's syndrome was an ischemic stroke. Laboratory findings revealed a positive ANA profile and radiological investigations showed an infarct in the right middle cerebral artery (MCA). The patient was then managed using steroids, antiplatelets, hydroxychloroquine, and physiotherapy. Although small-vessel vasculitis is commonly implicated in CNS involvement, major cerebral vessel involvement in Sjögren's syndrome is infrequently reported, with only three cases documented in the literature. This case highlights the importance of recognizing stroke as a potential manifestation of Sjögren-related vasculitis and expands the understanding of CNS complications in this autoimmune disorder. Increased awareness of this rare presentation may aid in prompt diagnosis and appropriate management of vasculitic complications in Sjögren's syndrome patients. Further research is needed to elucidate the underlying mechanisms and explore optimal treatment strategies for this subset of patients.

Various regions of the cerebral cortex, such as the prefrontal cortex, parahippocampal gyrus, insular cortex, temporal cortex, and anterior cingulate cortex, play critical roles in emotion regulation and executive/cognitive control. Given these regions' involvement, it is hypothesized that average cortical thickness might play a role in mediating the socioeconomic gradient observed in substance use behaviors. However, the mechanisms through which average cortical thickness influences the differential impact of socioeconomic factors, such as parental education, on the initiation of tobacco and marijuana use among youths from diverse backgrounds remain unclear. Recent studies indicate that the effects of socioeconomic factors on substance use and brain development are racialized, often showing weaker associations in racialized populations due to social stratification and racism. Our aim was to examine whether average cortical thickness mediates the racialized effects of parental education as a major socioeconomic determinant on the initiation of tobacco and marijuana use among youth. This longitudinal study, spanning 36 months, utilizes data from the Adolescent Brain Cognitive Development (ABCD) study, which included 10,777 pre-adolescents aged 9–10 years. From this, 8263 (76.67%) were White youth and 2514 (23.33%) were Black. Structural equation modeling was employed to assess the mediating role of average cortical thickness in the relationship between parental education (social determinant), race, and the initiation of tobacco and marijuana use, while considering covariates such as sex and age. Socioeconomic factors were predictive of future substance use. However, the association between these socioeconomic factors and substance use was found to be weaker among Black youths compared to White youths. Average cortical thickness partially mediated the influence of the racialized socioeconomic gradient on substance use, indicating both direct and indirect effects. Average cortical thickness acts as a partial mediator in the racialized impact of socioeconomic determinants on the initiation of adolescent substance use, underscoring the intricate relationship between neurodevelopmental and social factors in influencing substance use behaviors. This observation supports a biopsychosocial model that incorporates the effects of racism, aligning with the theory of minorities’ diminished returns.

Cholesterol crystal embolism (CCE) has emerged as a significant factor in cardiovascular pathology, often overlooked in clinical diagnosis. Its role in eliciting immune responses and contributing to various cardiovascular diseases underscores its clinical importance. This review article delves into the complex interplay between CCE, the immune system, and atherosclerotic cardiovascular diseases. CCE, primarily arising from ruptured atherosclerotic plaques, can significantly impact cardiovascular health. It triggers an immune response by activating the NLRP3 inflammasome, leading to the secretion of proinflammatory cytokines, which exacerbate vascular inflammation and atherogenesis. The review highlights the role of CCE in various cardiovascular manifestations, including atheromatous disease progression and plaque rupture, with a particular focus on the clinical presentations, differential diagnoses, and impact on organs like the heart, kidneys, and peripheral vasculature. Additionally, it addresses the diagnostic challenges and the criteria for identifying CCE, emphasizing the role of imaging and biopsy. Therapeutic approaches, including the use of statins and anti-inflammatory medications, are discussed, along with management strategies for complications. The review concludes with an overview of the prognostic factors, mortality rates, and quality of life considerations for patients with CCE, providing insights into the importance of early detection and comprehensive management.

Haemophagocytic lymphohistiocytosis (HLH) is an uncommon serious hematological disorder marked by tissue destruction and extreme inflammation brought on by abnormal immune system activation. It can manifest as primary (hereditary) in infants/young children or secondary, often associated with infections, malignancy, and autoimmune disorders. We present a case of HLH secondary to lymphoma in an elderly patient, highlighting the diagnostic challenges and clinical complexities encountered in this age group. Our 85-year-old male patient presented with persistent fever, generalized weakness, and abnormal laboratory findings, including pancytopenia and markedly elevated ferritin levels. Despite extensive investigations, including imaging studies and bone marrow biopsy, the diagnosis was challenging due to overlapping clinical features. The patient's clinical course was further complicated by COVID-19 infection, necessitating a palliative care approach. This case underscores the importance of early recognition and multidisciplinary management in optimizing outcomes for HLH, especially in elderly patients with comorbidities.