Journal of Medicine and Life最新文献

Anemia remains a significant public health concern, particularly in developing countries like Sudan, where children are particularly vulnerable to its associated health implications. This study aimed to systematically assess the prevalence of anemia among Sudanese children. We conducted a comprehensive literature search in August 2021 and updated it in December 2022 to identify studies on anemia among Sudanese children. We searched databases including PubMed, Scopus, Science Direct, and Google Scholar. Studies eligible for inclusion in this systematic review and meta-analysis (SRMA) reported data to calculate anemia prevalence in children using WHO criteria. We performed meta-analysis using R software with metaprop and metafor packages. Using a random effects model, we estimated the pooled prevalence of anemia among 8006 Sudanese children to be 53.5% (95% CI, 36.6-70.4%). Subgroup analysis revealed that 62.7% of the children had unclassified anemia, 39.1% had iron deficiency anemia, and 8.7% had sickle cell anemia. Over a 21-year period, childhood anemia in Sudan showed an increasing trend, rising from 40.7% (1999-2009) to 55.1% (2010-2015) and 58.1% (2016-2020). The findings indicate a significantly higher prevalence of anemia among Sudanese children compared to many other countries, highlighting the need for proactive measures to prevent and control anemia in this population.

Developmental dysplasia of the hip (DDH) is the most common musculoskeletal disease in infants, and delayed diagnosis can worsen the prognosis. Clinical evidence increasingly supports universal ultrasound (US) screening over selective US screening. The Graf method remains the most widely accepted US technique. Performing an US screening at one month of age seems appropriate as it allows for some hip maturity and early detection, thereby increasing the chances of a favorable outcome. This paper presents an approach to US findings based on the femoral head coverage method. Considering the long-term cost and psychosocial impact of missed DDH cases, universal ultrasound screening appears to be a cost-effective alternative.

Indoxyl sulfate (IS) is one of the most potent uraemic toxins involved in the progression of chronic kidney disease (CKD) through the induction of inflammation and oxidative stress. This study assessed the potential benefits of reducing IS concentrations through dialysis treatment to improve renal function, inflammation, and oxidative stress. A prospective, observational cohort study of 50 patients with CKD undergoing dialysis treatment was conducted. IS levels, inflammatory markers (IL-6 and hs-CRP), and oxidative status (Cu/Zn-SOD) were measured using immunoenzymatic methods, and the albumin ratio (HNA/HMA) was assessed using high-performance liquid chromatography. Blood samples were collected at baseline and, at 8 weeks and 16 weeks after treatment. At baseline, patients with CKD had elevated levels of IS, renal function indicators, inflammatory markers (IL-6 and CRP), and oxidative markers (Cu/Zn-SOD and albumin ratio HNA/HMA). Dialysis treatment reduced IS levels, and a correlation among IS, renal function, and SOD levels (P < 0.0001) at 8 and 16 weeks was observed. The reduction in IS levels was associated with improved inflammatory marker levels (CRP and IL-6; P < 0.0001) and a significant decrease in the HNA/HMA ratio (P <0.0001) at 8 and 16 weeks. These associations strengthened over time. The results of this study suggest that IS levels may be a therapeutic target for improving outcomes in patients with CKD by improving renal function, inflammation, and oxidative stress. More research is needed to understand how IS contributes to CKD complications.

Maternal mental health is a serious issue that affects both mothers and infants, necessitating increased knowledge and awareness among healthcare providers. This study assessed the effect of an educational intervention on maternity nurses' knowledge and attitudes towards postpartum depression (PPD) using a quasi-experimental pre/post-one-group design. The sample consisted of 120 maternity nurses recruited conveniently from different maternity departments at the Ministry of National Guard hospital. The study used two valid and reliable instruments: The Postpartum Depression Literacy Scale (PODLIS) by Mirsalimi et al. (2020) and the Attitudes Scale adapted from Kang et al. (2019). The participants, predominantly aged 30-39 with at least a bachelor's degree and holding SN1 nurse status, were mainly from Malaysia. The intervention significantly increased PPD knowledge in all domains, with the greatest improvement in risk factors and causes (10.09%). Positive associations existed between the pre-intervention attitude scale and professional help, recognition facilitation, and overall PPD knowledge (P < 0.05). Post-intervention, attitudes correlated positively with understanding risk factors and causes and facilitating recognition (P < 0.05). There were significant variations in the change of overall PPD knowledge based on the participants' nationality (P < 0.05), and attending a PPD workshop significantly affected the change of attitude (P < 0.05). The study concluded the beneficial effects of the educational intervention on both knowledge and attitudes regarding PPD among maternity nurses. Customized educational programs are essential for preparing healthcare professionals with the necessary competencies and comprehension to deal with PPD effectively.

Diabetes is considered one of the most prevalent endocrine metabolic diseases. Monitoring hypoglycemia unawareness is an important component of routine diabetes care and can identify patients at increased risk of a severe hypoglycaemic event. This study aimed to evaluate the frequency of hypoglycemia unawareness and identify the factors contributing to its occurrence. A sample of 390 patients diagnosed with type 1 and type 2 diabetes was interviewed in an endocrine and diabetes center in Al-Ahsa city. Sociodemographic data, risk factors, and Clarke scores were used to evaluate the impairment of hypoglycemia awareness. Reduced awareness of hypoglycemia was found in 93 patients (23.8%). There were no statistically significant differences in the age of the patients, mean age of diagnosis, or cumulative glucose level between patients with awareness and those with reduced awareness (P > 0.05). Patients with type 2 diabetes mellitus (T2DM) showed significantly reduced awareness compared to type 1 diabetes (T1DM) (P = 0.038). Additionally, there were no statistically significant differences in hypoglycemia awareness between patients who underwent nephropathy screening and those who did not (P = 0.523). In conclusion, our study revealed reduced hypoglycemia awareness in 93 patients. However, there was no statistically significant difference related to various factors, including age and cumulative glucose levels. Patients with T2DM showed significantly lower hypoglycaemic awareness compared to patients with T1DM. Further research is needed to evaluate other factors of hypoglycemia unawareness.

Brucellosis, a chronic zoonotic disease with a significant global burden, particularly in endemic areas, can also present as neurobrucellosis, a rare complication. We report a case of polyradiculoneuropathy in a pediatric patient resulting from this uncommon presentation. A 5-year-old girl presented with progressive asymmetric lower limb weakness for two weeks that progressed to a loss of ambulation in four weeks. She also had flu-like symptoms and persistent high-grade fever. Her history was notable for ingesting raw milk before the onset of fever. Initial examination revealed meningismus signs and fever. She had bilateral weak hip flexion graded 4/5 on the Medical Research Council (MRC) scale, weak right and left knee flexion (3/5 and 4/5, respectively), and weak right ankle dorsiflexion (4/5). She also had diminished reflexes throughout. The patient exhibited a clinical picture resembling Guillain-Barré Syndrome (GBS) after admission as her weakness progressed. Cerebrospinal fluid (CSF) analysis revealed no cell counts, elevated protein levels (1545 mg/dL), and normal glucose levels (3.34 mmol/L). Blood and CSF cultures were negative, but the serum antibody titer was elevated at 1:1280 against Brucella melitensis and Brucella abortus species. Lumbosacral MRI showed diffuse enhancement of the lower nerve roots. A nerve conduction study (NCS) demonstrated axonal and demyelinating polyradiculoneuropathy. The patient regained her strength three months after presentation, following a course of antibiotics. When evaluating patients with atypical manifestations resembling GBS, brucellosis should be considered an important differential diagnosis in endemic areas.

Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by recurring periods of inflammation and remission, primarily affecting the colon. The concept of medication-related burden, which refers to the adverse effects experienced by patients due to conventional medical treatments, is relatively new in the field. This study aimed to measure medication-related burden among patients with ulcerative colitis in Iraq. The study was conducted at the Gastroenterology and Hepatology Teaching Hospital, Medical City, Baghdad, Iraq, from December 2022 to May 2023. We used the Arabic version of the Living with Medicines Questionnaire version 3 (LMQ-3) to explore medication-related burdens experienced by patients with UC. Eighty-six patients with ulcerative colitis were included. The mean of the total medication-related burden score was 107.5 ± 20.7. The findings showed that 45.3% of patients with UC had a moderate degree of medication-related burden, followed by minimum burden (44.2%), high burden (5.8%), and no burden (4.7%). The lowest median burden scores emerged in five domains: interactions with healthcare professionals, practical difficulties with medication use, medication side effects, medication effectiveness, and the impact on daily life. Conversely, the highest-burden scores were noted in the cost, concerns about medication use, and autonomy to vary the regimen domains. In multivariate analysis, none of the patient-related variables was independently correlated with the total medication-related burden score. A large proportion of the patients with UC who participated in the current study reported varying degrees of medication-related burden, with the majority having a minimum to moderate medication-related burden.

The liver is a critical organ in the human body and is frequently exposed to numerous exogenous toxic substances, including silver nanoparticles (AgNPs). This study aimed to examine the anti-inflammatory, anti-angiogenic, and hepatoprotective effects of Withania somnifera (W. somnifera) extract on AgNP-induced liver toxicity in Swiss mice. Fifty mice were divided into five groups. Group I (negative control) consisted of ten mice. Group II received oral W. somnifera extracts (80 mg/kg/bw) for 14 days. Group III was injected intraperitoneally (i.p.) with AgNPs at a daily dose of 35 mg/kg/bw for 3 days. Group IV received i.p. AgNPs for 3 days, followed by saline for 14 days. Group V received i.p. AgNPs for 3 days, followed by oral W. somnifera (80 mg/kg/bw) for 14 days. Liver function tests, pro and anti-inflammatory cytokines, antioxidant activities, protein carbonyl (PC) levels, liver histopathological analysis, immunohistochemical expressions of transcription factor (NF-κB), and vascular endothelial growth factor (VEGF) were examined. Group III had elevated levels of liver function, a significant increase of pro and anti-inflammatory cytokines, antioxidant activity, and PC levels. Histological observations revealed congested sinusoids filled with red blood cells (RBCs) and hepatocyte necrosis. Also, positive expressions of NF-κB and VEGF were detected compared with Group I. However, the administration of W. somnifera to Group V revealed significant changes with evident improvements in liver function biomarkers, pro and anti-inflammatory cytokines, antioxidant activities, oxidative stress markers (PC), and histopathological and immunohistochemical parameters compared to Group III. The results revealed that W. somnifera has promising and potential hepatoprotective, anti-inflammatory, and anti-angiogenic effects against liver toxicity. Further detailed studies are recommended to explore the potential of W. somnifera as a treatment for human liver ailments.

Influenza affects millions globally each year, often causing severe complications, hospitalizations, and deaths, particularly among the elderly. As the global population ages, infections will pose a growing health risk. Annual vaccination remains the most effective way to prevent influenza and its complications. After the age of 65, people suffering from chronic diseases become the majority of this population category. All the data support that most of the population over 65 years old, whose immune system goes through immunosenescence, presents multimorbidity, requiring age-appropriate anti-influenza protection. The immune response to the traditional influenza vaccine has been proven to be lower in the elderly, highlighting the need for a more immunogenic vaccine specifically tailored to the elderly population group. Therefore, high-dose (HD) influenza vaccines have demonstrated their safety and are more effective in preventing influenza and its associated complications compared to standard-dose (SD) vaccines in the elderly in the context of immunosenescence. These recommendations focus on the safety, effectiveness, and efficacy of HD influenza vaccines, adapted to the elderly and available on the Romanian market, to increase the vaccination rate and, thus, protect against influenza infection and its complications. Therefore, strategies such as increased accessibility and free immunizations, as well as ensuring that flu vaccines for the elderly are prescribed without restrictions based on the number of comorbidities, should be used.