Thoybah Yousif Ibrahim Gabralla, Hayat Abdoallah Ahmed Bashir, Omaima Abdalla Hajahmed Mohamed
Background: Vaccination remains the mainstay of strategy for prevention of Coronavirus Disease-2019 (COVID-19). AZD1222 (AstraZeneca vaccine) was distributed in Sudan by the COVID-19 Vaccines Global Access facility in March 2021. It was added to the emergency use list by the WHO in mid-February 2021. However, vaccine safety among patients with autoimmune diseases, such as myasthenia gravis (MG), is yet to be established. MG is a relatively rare illness that could result in life-threatening complications. Myasthenic crisis is considered the most serious complication of MG that can lead to death due to aspiration and respiratory failure. The case: We report the case of a 37-year-old Sudanese female who presented to the emergency room with an exacerbation of her normally well-controlled MG following her second dose of AZD1222 vaccination. She continued to deteriorate and was admitted to the intensive care unit, where she was intubated and placed on a mechanical ventilator. The low-income setting was a major barrier in obtaining intravenous immunoglobulin until the patient died. Our study aims to present an MG case with features of MG exacerbation following administration of a second dose of AZD1222. Conclusion: Little is known about the effect of different COVID-19 vaccines on subgroups of patients with autoimmune diseases like MG. In our case, an exacerbation of MG may have been precipitated by the COVID-19 AstraZeneca vaccine. Therefore, more efforts and experimental studies may be needed, with closer vigilance in MG patients
{"title":"Myasthenia Gravis Exacerbation Following COVID-19 Vaccine: A Case Report","authors":"Thoybah Yousif Ibrahim Gabralla, Hayat Abdoallah Ahmed Bashir, Omaima Abdalla Hajahmed Mohamed","doi":"10.5195/ijms.2023.1455","DOIUrl":"https://doi.org/10.5195/ijms.2023.1455","url":null,"abstract":"Background: Vaccination remains the mainstay of strategy for prevention of Coronavirus Disease-2019 (COVID-19). AZD1222 (AstraZeneca vaccine) was distributed in Sudan by the COVID-19 Vaccines Global Access facility in March 2021. It was added to the emergency use list by the WHO in mid-February 2021. However, vaccine safety among patients with autoimmune diseases, such as myasthenia gravis (MG), is yet to be established. MG is a relatively rare illness that could result in life-threatening complications. Myasthenic crisis is considered the most serious complication of MG that can lead to death due to aspiration and respiratory failure. The case: We report the case of a 37-year-old Sudanese female who presented to the emergency room with an exacerbation of her normally well-controlled MG following her second dose of AZD1222 vaccination. She continued to deteriorate and was admitted to the intensive care unit, where she was intubated and placed on a mechanical ventilator. The low-income setting was a major barrier in obtaining intravenous immunoglobulin until the patient died. Our study aims to present an MG case with features of MG exacerbation following administration of a second dose of AZD1222. Conclusion: Little is known about the effect of different COVID-19 vaccines on subgroups of patients with autoimmune diseases like MG. In our case, an exacerbation of MG may have been precipitated by the COVID-19 AstraZeneca vaccine. Therefore, more efforts and experimental studies may be needed, with closer vigilance in MG patients","PeriodicalId":73459,"journal":{"name":"International journal of medical students","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135733139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alejandro Munoz-Valencia, Francisco J. Bonilla-Escobar, Juan C. Puyana
Background: Hemorrhagic shock is the second leading cause of death for injured people and disproportionately affects low resource economies. The potential role of spatial allocation of blood banks and the unmet transfusion needs of patients are yet to be characterized. We aimed to estimate the effect of the number of blood banks in mortality due to traumatic hemorrhagic shock (THS) in Colombia. Methods: We performed a population-based cross-sectional study using secondary data from the Colombian Government: including annual reports from the Blood Bank Network, mortality, and population estimates for 2015-2016. International Classification of Disease 10th code T79.4 identified THS as the primary cause of death. A city-clustered multivariate negative binomial regression, weighted by violent deaths rate, was used to obtain incidence rate ratios (IRR) of death due to THS with 95% confidence intervals (95%CI). Results: Of the 59,030 violent deaths in Colombia in 2015-2016, 36.76% were due to THS. Only 3.13% of Colombian municipalities had a blood bank. THS incidence decreased as the number of blood banks in a city increased, and the lowest incidence was observed at ten banks (IRR:0.18, 95%CI:0.15-0.22). Receiving medical care in a city with blood banks had a more substantial impact on THS (IRR:0.85; 95%CI:0.76-0.96). Conclusion: The number of blood banks per city was associated with lower incidence of THS deaths. These findings may highlight the inequitable distribution of blood systems and their association with preventable deaths. Further studies with more focused clinical and geographical data might clarify the geographic determinants of blood products’ availability.
{"title":"The Association of Blood Banks per City with Mortality Due to Traumatic Hemorrhagic Shock in Colombia: A Population-Based Analysis","authors":"Alejandro Munoz-Valencia, Francisco J. Bonilla-Escobar, Juan C. Puyana","doi":"10.5195/ijms.2023.1421","DOIUrl":"https://doi.org/10.5195/ijms.2023.1421","url":null,"abstract":"Background: Hemorrhagic shock is the second leading cause of death for injured people and disproportionately affects low resource economies. The potential role of spatial allocation of blood banks and the unmet transfusion needs of patients are yet to be characterized. We aimed to estimate the effect of the number of blood banks in mortality due to traumatic hemorrhagic shock (THS) in Colombia. Methods: We performed a population-based cross-sectional study using secondary data from the Colombian Government: including annual reports from the Blood Bank Network, mortality, and population estimates for 2015-2016. International Classification of Disease 10th code T79.4 identified THS as the primary cause of death. A city-clustered multivariate negative binomial regression, weighted by violent deaths rate, was used to obtain incidence rate ratios (IRR) of death due to THS with 95% confidence intervals (95%CI). Results: Of the 59,030 violent deaths in Colombia in 2015-2016, 36.76% were due to THS. Only 3.13% of Colombian municipalities had a blood bank. THS incidence decreased as the number of blood banks in a city increased, and the lowest incidence was observed at ten banks (IRR:0.18, 95%CI:0.15-0.22). Receiving medical care in a city with blood banks had a more substantial impact on THS (IRR:0.85; 95%CI:0.76-0.96). Conclusion: The number of blood banks per city was associated with lower incidence of THS deaths. These findings may highlight the inequitable distribution of blood systems and their association with preventable deaths. Further studies with more focused clinical and geographical data might clarify the geographic determinants of blood products’ availability.","PeriodicalId":73459,"journal":{"name":"International journal of medical students","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135821941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Chronic subclinical inflammation indicated by an elevated neutrophil-lymphocyte ratio (NLR) calculated from a complete blood count (CBC) test is reported to be associated with hyperglycaemia, including prediabetes and type 2 diabetes mellitus (T2DM). Current evidence on the association between NLR and glycaemic status is limited and conflicting. AIM: To determine if NLR was higher in those with prediabetes compared to those with normoglycemia, and To compare the NLR among individuals on treatment for T2DM stratified by glycaemic control. Methods: We analysed hospital data of individuals attending a tertiary care hospital in south India between January, 2021 and December, 2021. Individuals had CBC and glycosylated haemoglobin (HbA1c) tests done at the same visit. Hospital records of only those individuals without any clinical features of inflammation at the time of hospital visit were included in this analysis. Normoglycemia and prediabetes were defined as HbA1c < 5.7% and HbA1c ≥5.7 but ≤6.4% respectively, in those without a history of T2DM. Good glycaemic control and poor glycaemic control were defined as HbA1c<7% and HbA1c ≥7 respectively in those on treatment for T2DM.CBC and HbA1c data of 109 individuals each with normoglycemia and prediabetes; and 373 individuals on treatment for T2DM were analysed. After confirming the normality of distribution of NLR, unpaired Student’s ‘t’ test was used: 1. to compare the NLR between those with normoglycemia and prediabetes and 2. to compare NLR among those on treatment for T2DM stratified by glycaemic control. Results: Demographic characteristics including mean age and sex ratio among individuals with and without prediabetes were similar. The Mean (SD) NLR was higher in those with prediabetes compared to those with normoglycemia 1.7(1.0) versus 1.4(0.3); p=0.002. Of the 373 individuals on treatment for T2DM,121(32.4%) had good glycaemic control. There were no differences in demographic characteristics of those with and without good glycaemic control. The mean (SD) NLR between those with and without good glycaemic control, respectively was not different; 1.6(0.1) versus 1.7(0.1); p=0.46. Conclusion: In individuals without any clinical features of inflammation, a higher neutrophil-lymphocyte ratio was associated prediabetes. However, there was no association between neutrophil-lymphocyte ratio and glycaemic control among those on treatment for T2DM.
{"title":"Neutrophil-Lymphocyte Ratio and its Association with Hyperglycaemia: A Cross Sectional Study","authors":"Shailendra Dandge, B. Pooja Shivani","doi":"10.5195/ijms.2022.1800","DOIUrl":"https://doi.org/10.5195/ijms.2022.1800","url":null,"abstract":"Introduction: Chronic subclinical inflammation indicated by an elevated neutrophil-lymphocyte ratio (NLR) calculated from a complete blood count (CBC) test is reported to be associated with hyperglycaemia, including prediabetes and type 2 diabetes mellitus (T2DM). Current evidence on the association between NLR and glycaemic status is limited and conflicting.\u0000 AIM: To determine if NLR was higher in those with prediabetes compared to those with normoglycemia, and To compare the NLR among individuals on treatment for T2DM stratified by glycaemic control.\u0000Methods: We analysed hospital data of individuals attending a tertiary care hospital in south India between January, 2021 and December, 2021. Individuals had CBC and glycosylated haemoglobin (HbA1c) tests done at the same visit. Hospital records of only those individuals without any clinical features of inflammation at the time of hospital visit were included in this analysis. Normoglycemia and prediabetes were defined as HbA1c < 5.7% and HbA1c ≥5.7 but ≤6.4% respectively, in those without a history of T2DM. Good glycaemic control and poor glycaemic control were defined as HbA1c<7% and HbA1c ≥7 respectively in those on treatment for T2DM.CBC and HbA1c data of 109 individuals each with normoglycemia and prediabetes; and 373 individuals on treatment for T2DM were analysed. After confirming the normality of distribution of NLR, unpaired Student’s ‘t’ test was used: 1. to compare the NLR between those with normoglycemia and prediabetes and 2. to compare NLR among those on treatment for T2DM stratified by glycaemic control.\u0000Results: Demographic characteristics including mean age and sex ratio among individuals with and without prediabetes were similar. The Mean (SD) NLR was higher in those with prediabetes compared to those with normoglycemia 1.7(1.0) versus 1.4(0.3); p=0.002. Of the 373 individuals on treatment for T2DM,121(32.4%) had good glycaemic control. There were no differences in demographic characteristics of those with and without good glycaemic control. The mean (SD) NLR between those with and without good glycaemic control, respectively was not different; 1.6(0.1) versus 1.7(0.1); p=0.46.\u0000Conclusion: In individuals without any clinical features of inflammation, a higher neutrophil-lymphocyte ratio was associated prediabetes. However, there was no association between neutrophil-lymphocyte ratio and glycaemic control among those on treatment for T2DM.\u0000 ","PeriodicalId":73459,"journal":{"name":"International journal of medical students","volume":"87 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90316775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Montasir Ahmed A, Swapna R Mondal, Mustaque Ahmed A., Bipin K Shah, P. Oli, P. Kuwar Chhetri
Introduction: Pycnodysostosis derived from the Greek words pycnos-density, dys-defect, ostosis-bone is a rare inherited disorder of the bone with an incidence of 1.7 per million births. It is one of the lysosomal storage disorders with a deficiency of enzyme cathepsin K. Along with a history of repeated fractures of the bones, patients with Pycnodysostosis have a short stature, dolichocephalic skull, obtuse mandibular angle, short terminal phalanx. They also have dental abnormalities such as the delayed eruption of permanent teeth, and double rows of teeth. Mild psychomotor problems were noted in a few individuals. Pycnodysostosis is diagnosed by clinical and radiological features as there is no diagnostic criterion. Skulls show open fontanels, generalized osteosclerosis, loss of the normal angle of the jaw, and hypoplasia of facial bones. Social and occupational support needed to prevent recurrent fractures. Orthopaedic and orthodontic cares are needed. Case: A non-diabetic normotensive male of 63 years presented to the medicine outpatients department (OPD) with complaints of burning type, non-radiating moderate intensity pain in the epigastric region for three months following taking of NSAIDs. He gave a history of fractures of different bones following minimal trauma since his childhood and used to take NSAIDs every now and then. He did take orthopaedic consultation for those fractures but the underlying pathophysiology was not explored. Malunion of long bones resulted in a deformed limb. The rest of his past medical history and family history was unremarkable. On clinical examination, we found the patient had short stature with proportionately short limbs. He had dysmorphic features with a large head, small facial structures, frontal and bilateral parietal bossing. Examination of the oral cavity revealed a narrow high arched palate and hypoplastic, overcrowded teeth. His digits were short and stubby. The lower limbs of the patient have angular deformities that resulted from malunion of bones from previous fracture. Haematological and biochemical investigations were normal. Chest X-ray showed multiple ribs fracture on the right side. The patient's clavicle was normal in X-ray. Both tibia and fibula showed a malunited fracture in diaphysis. Computed tomography (CT) of the skull, as well as 3D reconstruction of CT, found open fontanelles and widening of sutures (Figure). Frontal and parietal bossing was noted. There was hypoplasia of the air sinuses. CT scans showed dysplasia of the bones of the face and hands. Hypoplasia was noted in the terminal phalanx of fingers. An endoscopy of the upper gastrointestinal tract found multiple erosion around the antrum of the stomach. Considering the clinical and radiological feature diagnosis of Pycnodysostosis with NSAIDs-induced antral erosion was made. The patient and his caregivers were briefed about the diagnosis. Consultation from a multidisciplinary team was done concerning his treatment. Conclusion
{"title":"Pycnodysostosis- A Rare Diagnosis Not to Miss","authors":"Montasir Ahmed A, Swapna R Mondal, Mustaque Ahmed A., Bipin K Shah, P. Oli, P. Kuwar Chhetri","doi":"10.5195/ijms.2022.1803","DOIUrl":"https://doi.org/10.5195/ijms.2022.1803","url":null,"abstract":"Introduction: Pycnodysostosis derived from the Greek words pycnos-density, dys-defect, ostosis-bone is a rare inherited disorder of the bone with an incidence of 1.7 per million births. It is one of the lysosomal storage disorders with a deficiency of enzyme cathepsin K. Along with a history of repeated fractures of the bones, patients with Pycnodysostosis have a short stature, dolichocephalic skull, obtuse mandibular angle, short terminal phalanx. They also have dental abnormalities such as the delayed eruption of permanent teeth, and double rows of teeth. Mild psychomotor problems were noted in a few individuals. Pycnodysostosis is diagnosed by clinical and radiological features as there is no diagnostic criterion. Skulls show open fontanels, generalized osteosclerosis, loss of the normal angle of the jaw, and hypoplasia of facial bones. Social and occupational support needed to prevent recurrent fractures. Orthopaedic and orthodontic cares are needed.\u0000Case: A non-diabetic normotensive male of 63 years presented to the medicine outpatients department (OPD) with complaints of burning type, non-radiating moderate intensity pain in the epigastric region for three months following taking of NSAIDs. He gave a history of fractures of different bones following minimal trauma since his childhood and used to take NSAIDs every now and then. He did take orthopaedic consultation for those fractures but the underlying pathophysiology was not explored. Malunion of long bones resulted in a deformed limb. The rest of his past medical history and family history was unremarkable. On clinical examination, we found the patient had short stature with proportionately short limbs. He had dysmorphic features with a large head, small facial structures, frontal and bilateral parietal bossing. Examination of the oral cavity revealed a narrow high arched palate and hypoplastic, overcrowded teeth. His digits were short and stubby. The lower limbs of the patient have angular deformities that resulted from malunion of bones from previous fracture. Haematological and biochemical investigations were normal. Chest X-ray showed multiple ribs fracture on the right side. The patient's clavicle was normal in X-ray. Both tibia and fibula showed a malunited fracture in diaphysis. Computed tomography (CT) of the skull, as well as 3D reconstruction of CT, found open fontanelles and widening of sutures (Figure). Frontal and parietal bossing was noted. There was hypoplasia of the air sinuses. CT scans showed dysplasia of the bones of the face and hands. Hypoplasia was noted in the terminal phalanx of fingers. An endoscopy of the upper gastrointestinal tract found multiple erosion around the antrum of the stomach. Considering the clinical and radiological feature diagnosis of Pycnodysostosis with NSAIDs-induced antral erosion was made. The patient and his caregivers were briefed about the diagnosis. Consultation from a multidisciplinary team was done concerning his treatment.\u0000Conclusion","PeriodicalId":73459,"journal":{"name":"International journal of medical students","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82166415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kankana Karpha, J. Biswas, Siddharth Nath, Arkadeep Dhali
This abstract was published in a different venue and it is not being published in this Supplement to avoid duplicate publications.Link to the publication: https://www.sciencedirect.com/science/article/pii/S2049080122017058?via%3Dihub
{"title":"Factors Affecting Depression and Anxiety in Diabetic Patients: A Prospective Cohort Study from a Tertiary Care Hospital in Eastern India","authors":"Kankana Karpha, J. Biswas, Siddharth Nath, Arkadeep Dhali","doi":"10.5195/ijms.2022.1744","DOIUrl":"https://doi.org/10.5195/ijms.2022.1744","url":null,"abstract":"This abstract was published in a different venue and it is not being published in this Supplement to avoid duplicate publications.Link to the publication: https://www.sciencedirect.com/science/article/pii/S2049080122017058?via%3Dihub","PeriodicalId":73459,"journal":{"name":"International journal of medical students","volume":"145 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90675397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shima Algam Mohamed Musa, Abeer Mamoun Mohamed, Sozan Mudather Osman
Introduction: Psychological distress and suicidal behavior are mental health problems among students and necessitate research to inform strategies for prevention in this population. Although depressive symptoms and suicidal ideation are common in medical students, few programs address this problem, which is needed it to determine the prevalence of psychological distress and suicidal behavior among medical students. Methods: this is a cross sectional faculty-based study . we used Snowballing sampling technique and Kessler 10-item Questionnaire to assess psychological distress. We used SBQ-R (suicidal behavioral questionnaire _Revised) to assess suicidal behavior .The participants were students from 12 medical colleges in Khartoum state, from all academic levels. Results: among 525 undergraduate medical students 136 (25.9%) were males and 389 (74.1%) were females, 23.3% were well, 18.7% had mild mental disorder, 19.2%had moderate mental disorder and 38.8% had severe mental disorder at the last 30 days. The higher of psychological distress was slightly significant among student in preclinical years than clinical years (P=0.08), 72% have poor risk for suicidal ideation and 28% have higher risk of suicidal behavior more significant among students in preclinical years (p= 0.02). Conclusion: Psychological distress and suicidal behavior were more evident in pre-clinical years along with other many factor including, marital status, bad habits, chronic disease, and university type either public or private. We recommend implementing psychological and academic support programs across different undergraduate levels to enhance mental wellbeing, academic performance and prevent suicidal behavior.
{"title":"Psychological Distress and Suicidal Behavior Among Medical Students at Khartoum State Universities, 2021-2022","authors":"Shima Algam Mohamed Musa, Abeer Mamoun Mohamed, Sozan Mudather Osman","doi":"10.5195/ijms.2022.1786","DOIUrl":"https://doi.org/10.5195/ijms.2022.1786","url":null,"abstract":"Introduction: Psychological distress and suicidal behavior are mental health problems among students and necessitate research to inform strategies for prevention in this population. Although depressive symptoms and suicidal ideation are common in medical students, few programs address this problem, which is needed it to determine the prevalence of psychological distress and suicidal behavior among medical students.\u0000Methods: this is a cross sectional faculty-based study . we used Snowballing sampling technique and Kessler 10-item Questionnaire to assess psychological distress. We used SBQ-R (suicidal behavioral questionnaire _Revised) to assess suicidal behavior .The participants were students from 12 medical colleges in Khartoum state, from all academic levels.\u0000Results: among 525 undergraduate medical students 136 (25.9%) were males and 389 (74.1%) were females, 23.3% were well, 18.7% had mild mental disorder, 19.2%had moderate mental disorder and 38.8% had severe mental disorder at the last 30 days. The higher of psychological distress was slightly significant among student in preclinical years than clinical years (P=0.08), 72% have poor risk for suicidal ideation and 28% have higher risk of suicidal behavior more significant among students in preclinical years (p= 0.02).\u0000Conclusion: Psychological distress and suicidal behavior were more evident in pre-clinical years along with other many factor including, marital status, bad habits, chronic disease, and university type either public or private. We recommend implementing psychological and academic support programs across different undergraduate levels to enhance mental wellbeing, academic performance and prevent suicidal behavior.","PeriodicalId":73459,"journal":{"name":"International journal of medical students","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84252765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Tchoussoknou, D.H Atia, B. F., M. Etoa, V. Djientcheu
Background: Post-traumatic endocrine dysfunction (PTED) is an important and relatively common complication of TBI (traumatic brain injury). It is usually undiagnosed and untreated making it a major cause of poor outcome in TBI patients as it can lead to death, delayed recovery, cognitive impairment, depression, sexual dysfunctions and infertility. Study Design: Analytic cross-sectional study at the Yaounde Central and General Hospitals from January 2022 to April 2022. Objective: The main aim of this study was to evaluate the endocrine dysfunctions and factors associated to their occurrence in patients presenting TBI at the neurosurgical units of the Yaounde Central and General Hospitals. Methods: Patients were enrolled at the neurosurgical units Data was collected with the help of a questionnaire after obtaining their informed consent alongside with blood samples in the morning (between 8AM and 10AM) for screening of anterior hypothalamo-pituitary axis hormones (FSH, LH and TSH) and relative peripheral hormones (cortisol, T4, oestrogene in women and testosterone in men) using fluorescence immunoassay. The study population was made up of all patients diagnosed with TBI during the study period at study sites. Patients taking medications affecting the hypothalamo-pituitary axis were excluded. Variables of interest included socio-demographic variables, clinical variables and paraclinical variables. Data was inserted and analyzed using the software Statistical Package for Social Sciences (SPSS) version 26.0. Association between variables was done using Fisher’s exact test. The association measure used was odd’s ratio (OR) with confidence interval (CI) of 95%. Results: A total of 33 participants were enrolled, out of which 26 responding to our inclusion criteria were retained and 7 excluded because they were on medications affecting the hypothalamo-pituitary axis. The median age of participants was 34 (26.75–41.25) years. There was a predominance of the male population with a sex ratio of 12:1. A total of 17 participants developed PTED (65.38%). The PTED encountered were FSH deficiency (12 patients at 46.1%), LH deficiency (10 patients at 38.4%), morning cortisol deficiency (5 patients at 19.2%), TSH deficiency (7 patients at 26.9%), testosterone deficiency (5 patients at 19.2%) and multiple deficiencies (12 patients at 46.1%). PTED was also found in 6 patients with severe TBI, 6 patients with moderate TBI and 5 patients with mild TBI (35.3%, 35.3% and 29.4%). In ≤7 days from TBI, 11 patients suffered PTED (64.7%) while after 7 days post-TBI, only 6 patients suffered PTED (35.3%). Tiredness was the most frequent symptom observed in 15 patients with PTED (88.2%). No factors associated to the occurrence of PTED were found in this study (p-values were all >0.05). Conclusion: This study suggests that PTED is a common condition amongst sufferers of TBI. PTED occurs in both genders and the most frequent types of anterior pituitary endocrine dysfunctions were
背景:创伤后内分泌功能障碍(PTED)是创伤性脑损伤(TBI)的重要且相对常见的并发症。它通常未被诊断和治疗，使其成为创伤性脑损伤患者预后不良的主要原因，因为它可导致死亡、恢复延迟、认知障碍、抑郁、性功能障碍和不孕。研究设计:2022年1月至2022年4月在雅温得中央医院和综合医院进行的分析横断面研究。目的:本研究的主要目的是评估雅温得中心医院和综合医院神经外科创伤性脑损伤患者的内分泌功能障碍及其发生的相关因素。方法:在神经外科科室招募患者，在获得患者知情同意后，通过问卷收集数据，并于上午(上午8点至10点)采集血液样本，采用荧光免疫分析法筛查下丘脑-垂体前轴激素(FSH、LH和TSH)和相关外周激素(女性皮质醇、T4、雌激素、男性睾酮)。研究人群由研究期间在研究地点诊断为TBI的所有患者组成。排除服用影响下丘脑-垂体轴的药物的患者。感兴趣的变量包括社会人口变量、临床变量和临床变量。使用SPSS 26.0版本的社会科学统计软件包(Statistical Package for Social Sciences)对数据进行插入和分析。变量间的关联使用费雪精确检验。使用的关联度量是奇数比(OR)，置信区间(CI)为95%。结果:共纳入33名受试者，其中26名符合我们的纳入标准，7名因服用影响下丘脑-垂体轴的药物而被排除。参与者的中位年龄为34岁(26.75-41.25)岁。男女性别比为12:1，以男性为主。共有17名参与者发展为PTED(65.38%)。PTED包括FSH缺乏症(12例46.1%)、LH缺乏症(10例38.4%)、早晨皮质醇缺乏症(5例19.2%)、TSH缺乏症(7例26.9%)、睾酮缺乏症(5例19.2%)和多重缺陷(12例46.1%)。重度TBI患者6例，中度TBI患者6例，轻度TBI患者5例，PTED发生率分别为35.3%、35.3%和29.4%。在创伤后≤7天内，有11例患者出现PTED(64.7%)，而在创伤后7天内，只有6例患者出现PTED(35.3%)。疲劳是15例PTED患者最常见的症状(88.2%)。本研究未发现与PTED发生相关的因素(p值均>0.05)。结论:本研究提示PTED是创伤性脑损伤患者的常见病。PTED发生于两性，最常见的垂体前叶内分泌功能障碍类型是性腺功能减退、甲状腺功能减退和促皮质功能不全。大多数PTED患者有相关的ct扫描病变。可能由于样本量小，没有因素与PTED的发生显著相关。
{"title":"Anterior Pituitary Endocrine Dysfunctions in Patients with Traumatic Brain Injury in the Neurosurgical Units of the Yaounde Central and General Hospitals: A Cross-Sectional Study","authors":"A. Tchoussoknou, D.H Atia, B. F., M. Etoa, V. Djientcheu","doi":"10.5195/ijms.2022.1814","DOIUrl":"https://doi.org/10.5195/ijms.2022.1814","url":null,"abstract":"Background: Post-traumatic endocrine dysfunction (PTED) is an important and relatively common complication of TBI (traumatic brain injury). It is usually undiagnosed and untreated making it a major cause of poor outcome in TBI patients as it can lead to death, delayed recovery, cognitive impairment, depression, sexual dysfunctions and infertility.\u0000Study Design: Analytic cross-sectional study at the Yaounde Central and General Hospitals from January 2022 to April 2022.\u0000Objective: The main aim of this study was to evaluate the endocrine dysfunctions and factors associated to their occurrence in patients presenting TBI at the neurosurgical units of the Yaounde Central and General Hospitals.\u0000Methods: Patients were enrolled at the neurosurgical units Data was collected with the help of a questionnaire after obtaining their informed consent alongside with blood samples in the morning (between 8AM and 10AM) for screening of anterior hypothalamo-pituitary axis hormones (FSH, LH and TSH) and relative peripheral hormones (cortisol, T4, oestrogene in women and testosterone in men) using fluorescence immunoassay. The study population was made up of all patients diagnosed with TBI during the study period at study sites. Patients taking medications affecting the hypothalamo-pituitary axis were excluded. Variables of interest included socio-demographic variables, clinical variables and paraclinical variables. Data was inserted and analyzed using the software Statistical Package for Social Sciences (SPSS) version 26.0. Association between variables was done using Fisher’s exact test. The association measure used was odd’s ratio (OR) with confidence interval (CI) of 95%.\u0000Results: A total of 33 participants were enrolled, out of which 26 responding to our inclusion criteria were retained and 7 excluded because they were on medications affecting the hypothalamo-pituitary axis. The median age of participants was 34 (26.75–41.25) years. There was a predominance of the male population with a sex ratio of 12:1. A total of 17 participants developed PTED (65.38%). The PTED encountered were FSH deficiency (12 patients at 46.1%), LH deficiency (10 patients at 38.4%), morning cortisol deficiency (5 patients at 19.2%), TSH deficiency (7 patients at 26.9%), testosterone deficiency (5 patients at 19.2%) and multiple deficiencies (12 patients at 46.1%). PTED was also found in 6 patients with severe TBI, 6 patients with moderate TBI and 5 patients with mild TBI (35.3%, 35.3% and 29.4%). In ≤7 days from TBI, 11 patients suffered PTED (64.7%) while after 7 days post-TBI, only 6 patients suffered PTED (35.3%). Tiredness was the most frequent symptom observed in 15 patients with PTED (88.2%). No factors associated to the occurrence of PTED were found in this study (p-values were all >0.05).\u0000Conclusion: This study suggests that PTED is a common condition amongst sufferers of TBI. PTED occurs in both genders and the most frequent types of anterior pituitary endocrine dysfunctions were","PeriodicalId":73459,"journal":{"name":"International journal of medical students","volume":"231 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76926951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Diabetes is an endocrinopathy and rare in the case of SARS-CoV-2, the virus primarily involves the lungs by its affinity to Angiotensin Converting enzyme(ACE-2) receptors, associated symptoms include Nausea, Vomiting, and Breathlessness. Case Presentation: We present the case of a 41-year-old male with pneumonia-like symptoms and a positive nasal swab RT-PCR test with Imaging studies highly suggestive of CO RADS-5 Progressive stage, the patient was immediately admitted to the Intensive care unit (ICU), and the treatment was started with Medical Oxygen, Intravenous Normal Saline Tablet Doxycycline, and Tablet Ivermectin as per the guidelines, he was admitted for 21 days. After 3 weeks the patient comes for a routine checkup and was found to have an elevated Fasting glucose level of 121 mg/dl (normal reference range 80-100mg/dl) further workup for diabetes revealed that he was a non-diabetic on the previous visit 2 months ago, he also had an increase in weight during this time. With the Body Mass Index(BMI) now being 30.2 from the previous 28.4 (Reference range >30 is obese), the pro-inflammatory cytokines like C-reactive protein were 111.6 (normal 0-6), and elevation in D-Dimer which is a fibrin degradation product was elevated to 1048ng/dl ( normal range 0-500 ng/dl) other measures for the increase in blood sugar also showed elevation as seen in table 1. Discussion: There have been many hypotheses to find a causalrelationship between both Diabetes and COVID-19 like the use of Dexamethasone or that the virus produces proinflammatory cytokines like Interleukin-6(IL-6) that lead to impaired signaling and decreased lipolysis or that there is a direct action on the ACE 2 found in the pancreas by the virus and maybe the least looked upon factor being lockdown leading to sedentary life, no exercises and increase in consumption of fatty foods, whichever may be the case it could very well be a multifactorial cause with many of these ideas involved. Conclusion: In this case, the association may be with decreased physical activity and an increase in Lipolysis or the proinflammatory states as seen by the increase in the C-reactive protein and Interleukin-6 levels.
{"title":"Rare Manifestation of Diabetes Mellitus in COVID-19 Patient: A Case Report","authors":"Kahan Mehta, S. Mehta","doi":"10.5195/ijms.2022.1743","DOIUrl":"https://doi.org/10.5195/ijms.2022.1743","url":null,"abstract":"Introduction: Diabetes is an endocrinopathy and rare in the case of SARS-CoV-2, the virus primarily involves the lungs by its affinity to Angiotensin Converting enzyme(ACE-2) receptors, associated symptoms include Nausea, Vomiting, and Breathlessness.\u0000Case Presentation: We present the case of a 41-year-old male with pneumonia-like symptoms and a positive nasal swab RT-PCR test with Imaging studies highly suggestive of CO RADS-5 Progressive stage, the patient was immediately admitted to the Intensive care unit (ICU), and the treatment was started with Medical Oxygen, Intravenous Normal Saline Tablet Doxycycline, and Tablet Ivermectin as per the guidelines, he was admitted for 21 days. After 3 weeks the patient comes for a routine checkup and was found to have an elevated Fasting glucose level of 121 mg/dl (normal reference range 80-100mg/dl) further workup for diabetes revealed that he was a non-diabetic on the previous visit 2 months ago, he also had an increase in weight during this time. With the Body Mass Index(BMI) now being 30.2 from the previous 28.4 (Reference range >30 is obese), the pro-inflammatory cytokines like C-reactive protein were 111.6 (normal 0-6), and elevation in D-Dimer which is a fibrin degradation product was elevated to 1048ng/dl ( normal range 0-500 ng/dl) other measures for the increase in blood sugar also showed elevation as seen in table 1.\u0000Discussion: There have been many hypotheses to find a causalrelationship between both Diabetes and COVID-19 like the use of Dexamethasone or that the virus produces proinflammatory cytokines like Interleukin-6(IL-6) that lead to impaired signaling and decreased lipolysis or that there is a direct action on the ACE 2 found in the pancreas by the virus and maybe the least looked upon factor being lockdown leading to sedentary life, no exercises and increase in consumption of fatty foods, whichever may be the case it could very well be a multifactorial cause with many of these ideas involved.\u0000Conclusion: In this case, the association may be with decreased physical activity and an increase in Lipolysis or the proinflammatory states as seen by the increase in the C-reactive protein and Interleukin-6 levels.","PeriodicalId":73459,"journal":{"name":"International journal of medical students","volume":"57 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78774144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maria Camila Cortes Montoya, Humberto Alejandro Nati Castillo, Jessica Triviño, Ana Sofia Orozco Cano, Simon Gonzalez Naranjo, Juan Felipe Caicedo Olaya, Juan Francisco Amaya Amezquita, Karen Sofía Ayala Girón, Laura Losada, Davidshon Montes, Yimmi Pinto Valencia, Marcela Fama, N. Cabeza, F. Lora, Jorge Gomez
Background: In Colombia, the studies about the etiology of acute diarrhea disease (ADD) in children by using standard stool culture techniques methods and DNA detection tools for intestinal virus show that viral origin was the most frequent, however still between 16 to 45% of the cases of unknown etiology. Specific staining techniques or high sensitivity molecular methods for the intestinal coccidia Cryptosporidium sp and Cyclospora sp have been not applied in the Colombian studies, for this reason, the current situation of these intestinal coccidia in Colombia as cause of diarrhea is unknown. Objective: To estimate the frequency of Cryptosporidium sp. and Cyclospora sp. and to analyze the association between infection and clinical manifestations on children with acute diarrhea consulting the pediatrics emergency service of a third level Hospital. Methods: An observational descriptive study was performed in 150 children that consulted the emergency service at the Hospital San Juan de Dios in Armenia, Colombia, in the period between April 1st and May 31st of 2022. We applied questionnaires and collected primary data from clinical records of children, as well as stool samples of each child after receiving informed consent from the parents and/or legal guardian of the minors. To identify the pathogenic intestinal coccidia (Cryptosporidium sp. and Cyclospora sp.), we used stool fresh preparations with 1% iodine and stained by a modified Ziehl Nielsen coloration protocol (Kinyoun stain). Samples were examined by expert microbiologists on a light microscope with a 40x objective. Prevalence and odds ratios were estimated. For statistical analysis differences in proportions among groups were compared via the X2 test and Fisher exact test. For non-parametric data, differences of means between two groups were analyzed through a Kruskall-Wallis test. Differences of medians were analyzed via Kruskal-Wallis test for non-parametric variables and analysis of variance (ANOVA) for parametric variables; statistical significance was considered when p ≤ 0.05. Statistical calculations were made by using software factors in Epi Info 7.2 Epi-Info version 3.5.1 (CDC, Atlanta). Results: The prevalence of infection in the children that went to the urgency service was of 19,7% by Cryptosporidium sp. and 10,9% by Cyclospora sp. The 59,2% of children with cryptosporidiosis and 66,6% of children with cyclosporidiosis were hospitalized. There was a statistically significant association between the presence of parasite in stools and fever in cyclosporidiosis (93,3% of children with cyclosporidiosis vs. 56% by other causes, OR 10,7 IC95% 1,3-84; p= 0,004). Conclusions: The study results indicate the need to use specific diagnostic techniques to identify Cryptosporidium sp and Cyclospora sp in children with diarrhea, because they are frequent and are treatable with specific antiparasitic medication. We recommend that its search should be done systematically.
背景:在哥伦比亚，使用标准粪便培养技术方法和肠道病毒DNA检测工具对儿童急性腹泻病(ADD)的病因进行了研究，结果表明，病毒来源是最常见的，但仍有16%至45%的病例病因不明。肠道球虫隐孢子虫(Cryptosporidium sp)和环孢子虫(Cyclospora sp)的特异性染色技术或高灵敏度分子方法尚未在哥伦比亚的研究中应用，因此这些肠道球虫在哥伦比亚引起腹泻的情况尚不清楚。目的:了解某三级医院儿科急诊科患儿急性腹泻隐孢子虫和环孢子虫感染频次，分析感染与临床表现的关系。方法:对2022年4月1日至5月31日在哥伦比亚亚美尼亚圣胡安德迪奥斯医院就诊的150名儿童进行观察性描述性研究。我们采用问卷调查的方式，从儿童的临床记录中收集原始数据，并在征得未成年人的父母和/或法定监护人的知情同意后收集每个儿童的粪便样本。为了鉴定致病性肠道球虫(隐孢子虫和环孢子虫)，我们使用含有1%碘的新鲜粪便制剂，并用改良的Ziehl - Nielsen染色法(Kinyoun染色法)进行染色。样品由专业微生物学家在40倍物镜的光学显微镜上检查。估计患病率和优势比。统计分析采用X2检验和Fisher精确检验比较各组间比例差异。对于非参数数据，通过Kruskall-Wallis检验分析两组间均值的差异。对非参数变量采用Kruskal-Wallis检验，对参数变量采用方差分析(ANOVA)分析中位数差异;p≤0.05认为差异有统计学意义。采用Epi Info 7.2 Epi-Info version 3.5.1 (CDC, Atlanta)软件因子进行统计计算。结果:急诊就诊患儿隐孢子虫和环孢子虫感染率分别为19.7%和10.9%，隐孢子虫病患儿和环孢子虫病患儿住院率分别为59.2%和66.6%。环孢子虫病患儿粪便中寄生虫的存在与发热之间存在统计学意义上的关联(93.3%的环孢子虫病患儿与56%的其他原因的环孢子虫病患儿相比，OR 10,7 IC95% 1,3-84;p = 0004)。结论:本研究结果提示，由于隐孢子虫和环孢子虫在儿童腹泻中较为常见，且可通过特异性抗寄生虫药物治疗，因此需要采用特异性诊断技术对其进行鉴别。我们建议对其进行有系统的研究。
{"title":"Prevalence of Intestinal Coccidia: First Description of Cyclosporidiosis Associated with Diarrhea in Children in Colombia","authors":"Maria Camila Cortes Montoya, Humberto Alejandro Nati Castillo, Jessica Triviño, Ana Sofia Orozco Cano, Simon Gonzalez Naranjo, Juan Felipe Caicedo Olaya, Juan Francisco Amaya Amezquita, Karen Sofía Ayala Girón, Laura Losada, Davidshon Montes, Yimmi Pinto Valencia, Marcela Fama, N. Cabeza, F. Lora, Jorge Gomez","doi":"10.5195/ijms.2022.1794","DOIUrl":"https://doi.org/10.5195/ijms.2022.1794","url":null,"abstract":"Background: In Colombia, the studies about the etiology of acute diarrhea disease (ADD) in children by using standard stool culture techniques methods and DNA detection tools for intestinal virus show that viral origin was the most frequent, however still between 16 to 45% of the cases of unknown etiology. Specific staining techniques or high sensitivity molecular methods for the intestinal coccidia Cryptosporidium sp and Cyclospora sp have been not applied in the Colombian studies, for this reason, the current situation of these intestinal coccidia in Colombia as cause of diarrhea is unknown. \u0000Objective: To estimate the frequency of Cryptosporidium sp. and Cyclospora sp. and to analyze the association between infection and clinical manifestations on children with acute diarrhea consulting the pediatrics emergency service of a third level Hospital.\u0000Methods: An observational descriptive study was performed in 150 children that consulted the emergency service at the Hospital San Juan de Dios in Armenia, Colombia, in the period between April 1st and May 31st of 2022. We applied questionnaires and collected primary data from clinical records of children, as well as stool samples of each child after receiving informed consent from the parents and/or legal guardian of the minors. To identify the pathogenic intestinal coccidia (Cryptosporidium sp. and Cyclospora sp.), we used stool fresh preparations with 1% iodine and stained by a modified Ziehl Nielsen coloration protocol (Kinyoun stain). Samples were examined by expert microbiologists on a light microscope with a 40x objective. Prevalence and odds ratios were estimated. For statistical analysis differences in proportions among groups were compared via the X2 test and Fisher exact test. For non-parametric data, differences of means between two groups were analyzed through a Kruskall-Wallis test. Differences of medians were analyzed via Kruskal-Wallis test for non-parametric variables and analysis of variance (ANOVA) for parametric variables; statistical significance was considered when p ≤ 0.05. Statistical calculations were made by using software factors in Epi Info 7.2 Epi-Info version 3.5.1 (CDC, Atlanta). \u0000Results: The prevalence of infection in the children that went to the urgency service was of 19,7% by Cryptosporidium sp. and 10,9% by Cyclospora sp. The 59,2% of children with cryptosporidiosis and 66,6% of children with cyclosporidiosis were hospitalized. There was a statistically significant association between the presence of parasite in stools and fever in cyclosporidiosis (93,3% of children with cyclosporidiosis vs. 56% by other causes, OR 10,7 IC95% 1,3-84; p= 0,004). \u0000Conclusions: The study results indicate the need to use specific diagnostic techniques to identify Cryptosporidium sp and Cyclospora sp in children with diarrhea, because they are frequent and are treatable with specific antiparasitic medication. We recommend that its search should be done systematically.","PeriodicalId":73459,"journal":{"name":"International journal of medical students","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90044394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Many patients recovered from Covid-19 without requiring any critical treatment, vulnerable populations such as older people, especially those with comorbidities, are more likely to develop a severe infection and face higher mortality rates. Background: Why are older Adults are Higher Risk? The majority of older adults have comorbid conditions, which are associated with a higher risk for COVID-19. Many live in residential care homes, which have seen the highest number of COVID-19 cases due to tightly shared living spaces. With weakened immune systems, older adults living in poverty face additional challenges in protecting themselves from the virus, as it is difficult for them to comply with public health measures such as social distancing. 32.5% of individuals in the lowest income quartile were hospitalized due to COVID19, compared to only 11.4% of individuals from the highest income quartile. Methods: The data was retrieved from the Canadian MIS Database (CMDB) and the discharge abstract database (DAD). The CMDB contains financial and statistical operations information on public hospitals and regional health authorities across Canada. Case selection is based on COVID-19 diagnosis codes available in the International Statistical Classification of Diseases and Related Health Problems. Results: Elderly faced higher rates of hospitalization during the pandemic. The average length of hospital stay was also higher for older adults—hospitalizations of individuals under age 65 without comorbidity 41,707 with comorbidity 12,372. Hospitalizations of individuals 65 and older without comorbidity were 22,221 with comorbidity 24,731. Higher Hospitalization rates and issues of inequality in the healthcare system globally. As the pandemic progressed, hospitalization increased in number significantly. The average length of stay for individuals younger than age 65 without comorbidity is 7.7 days compared to 17.0 days in patients with comorbidity. The average full length of stay for individuals 65 and older without comorbidity was 13.2 days, While in patients with comorbidity 19.2 days. Older adults had higher in-facility death rates due to COVID-19 hospitalization. The in-facility death rate of individuals younger than 65 without comorbidity is 2.5%, With comorbidity at 12.9%. In-facility death rate of individuals 65 and older without comorbidity is 14.4%, with comorbidity at 23.2%. Conclusion: By analyzing and comparing various hospitalization rates for Canada, the precise data indicate that older adults have been disproportionately impacted by COVID-19. It is now important to determine the underlying structural issues that have caused this inequality to prioritize healthy aging.
{"title":"Exploring the Disproportionate Impact of COVID-19 in Older Adults in Canada","authors":"Mujabad Shah, Karan Gupta, Yamini Sharma, Vineeta Singh, Carla Emilia Ibarra, Kajan Kugathasan","doi":"10.5195/ijms.2022.1850","DOIUrl":"https://doi.org/10.5195/ijms.2022.1850","url":null,"abstract":"Introduction: Many patients recovered from Covid-19 without requiring any critical treatment, vulnerable populations such as older people, especially those with comorbidities, are more likely to develop a severe infection and face higher mortality rates.\u0000Background: Why are older Adults are Higher Risk? The majority of older adults have comorbid conditions, which are associated with a higher risk for COVID-19. Many live in residential care homes, which have seen the highest number of COVID-19 cases due to tightly shared living spaces. With weakened immune systems, older adults living in poverty face additional challenges in protecting themselves from the virus, as it is difficult for them to comply with public health measures such as social distancing. 32.5% of individuals in the lowest income quartile were hospitalized due to COVID19, compared to only 11.4% of individuals from the highest income quartile.\u0000Methods: The data was retrieved from the Canadian MIS Database (CMDB) and the discharge abstract database (DAD). The CMDB contains financial and statistical operations information on public hospitals and regional health authorities across Canada. Case selection is based on COVID-19 diagnosis codes available in the International Statistical Classification of Diseases and Related Health Problems.\u0000Results: Elderly faced higher rates of hospitalization during the pandemic. The average length of hospital stay was also higher for older adults—hospitalizations of individuals under age 65 without comorbidity 41,707 with comorbidity 12,372. Hospitalizations of individuals 65 and older without comorbidity were 22,221 with comorbidity 24,731. Higher Hospitalization rates and issues of inequality in the healthcare system globally. As the pandemic progressed, hospitalization increased in number significantly. The average length of stay for individuals younger than age 65 without comorbidity is 7.7 days compared to 17.0 days in patients with comorbidity. The average full length of stay for individuals 65 and older without comorbidity was 13.2 days, While in patients with comorbidity 19.2 days. Older adults had higher in-facility death rates due to COVID-19 hospitalization. The in-facility death rate of individuals younger than 65 without comorbidity is 2.5%, With comorbidity at 12.9%. In-facility death rate of individuals 65 and older without comorbidity is 14.4%, with comorbidity at 23.2%.\u0000Conclusion: By analyzing and comparing various hospitalization rates for Canada, the precise data indicate that older adults have been disproportionately impacted by COVID-19. It is now important to determine the underlying structural issues that have caused this inequality to prioritize healthy aging.","PeriodicalId":73459,"journal":{"name":"International journal of medical students","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87775852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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