Knowledge Regarding HIV/AIDS among Nepalese Army

Introduction: A global pandemic threat HIV/AIDS is also matter of concern of developing countries like Nepal where the first case was identified in July 1988 and later became epidemic and then concentrated epidemic among risk group for HIV. Several studies reflected HIV is associated to many factors, Literacy and Socio-economic conditions being at the highest rank. Members of Nepal army are generally with less educational background and few with higher educational status are at higher post. Thus knowledge regarding HIV/AIDS among this group need to be assessed. Aims: The overall objective of our study was to assess knowledge regarding HIV/AIDS among Nepal army in Banke district. Methods: A Cross-sectional descriptive study with population size of 146 Army was performed which covered the entire population of Shree Shreemehar Army Camp in Banke, starting from 18th June to 27th August, 2018. A pre-tested questionnaire containing structural, semi-structural and open ended questions were made as data collection tool. All the soldiers in Army camp were interviewed after receiving consent as an ethical clearance. Results: All 146 Army of our study were aware about HIV/AIDS mainly via mass media (83.56%). 33 respondents still didn’t know about availability of its treatment. Misconception about its complete cure and vaccination was seen in 12 and 39 respondents respectively. 58 respondents were found knowing about the free health services by government. 141 respondents knew certain things about prevention. 28 respondents admitted of having multiple sex partners and only 24 among them used preventive measure. Conclusion: Though all the respondents of our study had known about HIV/AIDS still they had misconception regarding its treatment and prevention. Many respondents do not even know about the free health services of government. Few of them still don’t use preventive measure.

Development and Evaluation of a Molecular Hepatitis A Virus Assay for Serum and Stool Specimens

Hepatitis A virus (HAV) is an emerging public health concern and there is an urgent need for ways to rapidly identify cases so that outbreaks can be managed effectively. Conventional testing for HAV relies on anti-HAV IgM seropositivity. However, studies estimate that 10–30% of patients may not be diagnosed by serology. Molecular assays that can directly detect viral nucleic acids have the potential to improve diagnosis, which is key to prevent the spread of infections. In this study, we developed a real-time PCR (RT-PCR) assay to detect HAV RNA for the identification of acute HAV infection. Primers were designed to target the conserved 5′-untranslated region (5′-UTR) of HAV, and the assay was optimized on both the Qiagen Rotor-Gene and the BD MAX. We successfully detected HAV from patient serum and stool samples with moderate differences in sensitivity and specificity depending on the platform used. Our results highlight the clinical utility of using a molecular assay to detect HAV from various specimen types that can be implemented in hospitals to assist with diagnostics, treatment and prevention.

Infraorbital Hyaluronic Acid Filler: Common Aesthetic Side Effects with Treatment and Prevention Options

Background Infraorbital hollows can give a fatigued or aged appearance which can be treated by volumizing the segmented transition from the tear trough to the cheek with hyaluronic acid filler. Due to thin skin and the complex anatomy of the infraorbital area, both short- and long-term side effects from this treatment are very common. While some patients are clear surgical candidates vs. filler candidates, in real-world practice, many, if not most patients are on a continuum where either procedure is appropriate, and the treatment decision is individualized based on each person’s risk vs. benefit profile. Objectives Common aesthetic side effects from hyaluronic acid filler treatment in the infraorbital area will be reviewed, including their etiology, prevention, detection, and treatment. Method The authors’ experience from injecting the infraorbital areas of more than 800 patients in private clinical practice and observations from both short and long-term follow ups over eight years is leveraged to provide detailed guidance. Results Recommendations on injection techniques, patient selection, and patient education are presented along with algorithms for the prevention and management of bruising, short- and long-term swelling, bumps, and blue discoloration (which is usually secondary to swelling from the filler rather than just the filler alone placed or migrating too superficially). Conclusion For nearly all patients, complete dissolution of filler with hyaluronidase is not required to address the issue, and the guidelines provided here will assist clinicians in management of side effects to increase patient satisfaction with their treatment and aesthetic outcome.

VITAMIN D AND DEPRESSION IN OLDER ADULTS: LESSONS LEARNED FROM OBSERVATIONAL AND CLINICAL STUDIES

Depression is a mental disorder triggered by the interaction of social, psychological, and biological factors that have an important impact on an individual’s life. Despite being a well-studied disease with several established forms of treatment, its prevalence is increasing, especially among older adults. New forms of treatment and prevention are encouraged, and some researchers have been discussing the effects of vitamin D (VitD) on depression; however, the exact mechanism by which VitD exerts its effects is not yet conclusive. In this study, we aimed to discuss the possible mechanisms underlying the association between VitD and depression in older adults. Therefore, we conducted a systematic search of databases for indexed articles published until April 30, 2021. The primary focus was on both observational studies documenting the association between VitD and depression/depressive symptoms, and clinical trials documenting the effects of VitD supplementation on depression/depressive symptoms, especially in older adults. Based on pre-clinical, clinical, and observational studies, it is suggested that the maintenance of adequate VitD concentrations is an important issue, especially in older adults, which are a risk population for both VitD deficiency and depression. Nevertheless, it is necessary to carry out more studies using longitudinal approaches in low- and middle-income countries to develop a strong source of evidence to formulate guidelines and interventions.

Review of the Chemical Composition, Pharmacological Effects, Pharmacokinetics, and Quality Control of Boswellia carterii

Objective. This review aimed to systematically summarize studies that investigated the bioactivities of compounds and extracts from Boswellia. Methods. A literature review on the pharmacological properties and phytochemicals of B. carterii was performed. The information was retrieved from secondary databases such as PubMed, Chemical Abstracts Services (SciFinder), Google Scholar, and ScienceDirect. Results. The various Boswellia extracts and compounds demonstrated pharmacological properties, such as anti-inflammatory, antitumour, and antioxidant activities. B. carterii exhibited a positive effect on the treatment and prevention of many ageing diseases, such as diabetes, cancer, cardiovascular disease, and neurodegenerative diseases. Conclusion. Here, we highlight the pharmacological properties and phytochemicals of B. carterii and propose further evidence-based research on plant-derived remedies and compounds.

Drug-Induced Atrial Fibrillation / Atrial Flutter

Drug-induced atrial fibrillation / flutter (DIAF) is a serious and potentially life-threatening complication of pharmacotherapy. Purpose of the work: systematization and analysis of scientific literature data on drugs, the use of which can cause the development of DIAF, as well as on epidemiology, pathophysiological mechanisms, risk factors, clinical picture, diagnosis and differential diagnosis, treatment and prevention of DIAF. Analysis of the literature has shown that many groups of drugs can cause the development of DIAF, with a greater frequency while taking anticancer drugs, drugs for the treatment of the cardiovascular, bronchopulmonary and central nervous systems. The mechanisms and main risk factors for the development of DIAF have not been finally established and are known only for certain drugs, therefore, this section requires further study. The main symptoms of DIAF are due to the severity of tachycardia and their influence on the parameters of central hemodynamics. For diagnosis, it is necessary to conduct an electrocardiogram (ECG) and Holter monitoring of an ECG and echocardiography. Differential diagnosis should be made with AF, which may be caused by other causes, as well as other rhythm and conduction disturbances. Successful treatment of DIAF is based on the principle of rapid recognition and immediate discontinuation of drugs (if possible), the use of which potentially caused the development of adverse drug reactions (ADR). The choice of management strategy: heart rate control or rhythm control, as well as the method of achievement (medication or non-medication), depends on the specific clinical situation. For the prevention of DIAF, it is necessary to instruct patients about possible symptoms and recommend self-monitoring of the pulse. It is important for practitioners to be wary of the risk of DIAF due to the variety of drugs that can potentially cause this ADR.

Causes of post treatment apical periodontitis

Endodontic treatment approaches aim to achieve proper treatment and prevention of apical periodontitis to enhance the oral health status and enhance the prognosis of affected teeth. However, many complications can develop secondary to endodontic treatment. The management of post-treatment apical periodontitis might be challenging to clinicians, and the prognosis is usually lower than that of primary apical periodontitis. Therefore, identifying the potential etiology and intervening against them might be ideal for these cases. The present literature review discusses the commonest causes reported in the literature to predispose to the development of post-treatment apical periodontitis. Most of the various investigations in the literature indicate that post-treatment apical periodontitis is usually caused by either extraradicular or intraradicular infections, like primary apical periodontitis. However, it should be noted that some studies also reported that technical or procedural errors might predispose to the pathogenesis of the condition. However, it has been reported that the presence of associated bacterial infection conditions this.

Animal Model of Severe Fever With Thrombocytopenia Syndrome Virus Infection

Severe fever with thrombocytopenia syndrome (SFTS), an emerging life-threatening infectious disease caused by SFTS bunyavirus (SFTSV; genus Bandavirus, family Phenuiviridae, order Bunyavirales), has been a significant medical problem. Currently, there are no licensed vaccines or specific therapeutic agents available and the viral pathogenesis remains largely unclear. Developing appropriate animal models capable of recapitulating SFTSV infection in humans is crucial for both the study of the viral pathogenic processes and the development of treatment and prevention strategies. Here, we review the current progress in animal models for SFTSV infection by summarizing susceptibility of various potential animal models to SFTSV challenge and the clinical manifestations and histopathological changes in these models. Together with exemplification of studies on SFTSV molecular mechanisms, vaccine candidates, and antiviral drugs, in which animal infection models are utilized, the strengths and limitations of the existing SFTSV animal models and some important directions for future research are also discussed. Further exploration and optimization of SFTSV animal models and the corresponding experimental methods will be undoubtedly valuable for elucidating the viral infection and pathogenesis and evaluating vaccines and antiviral therapies.

Bronchiolitis diagnosis, treatment, and prevention in children: an evidence-based clinical practice guideline adapted for the use in Egypt based on the ‘Adapted ADAPTE’ Methodology

Background The presented evidence-based clinical practice guideline (CPG) is proposed as a National CPG using an evidence-based and formal CPG adaptation methodology. The purpose of this study was to adapt the international CPGs’ recommendations for children with bronchiolitis to suit the healthcare system in the Egyptian context. This CPG, ‘diagnosis, treatment, and prevention of Bronchiolitis’, applies to children from 1 through 23 months of age. Other exclusions are noted. The quality of evidence, benefit-harm relationship, and strength of recommendations are indicated. This study is part of a larger collaborative initiative with the faculty staff of pediatric departments of 15 Egyptian universities and a national research center to formulate a national Committee (EPG) that aims to define the topics of, assign authors to, and assist in the adaptation of pediatric evidence-based CPGs according to a national strategic plan. The committee is guided by a formal CPG adaptation methodology: the ‘Adapted ADAPTE’. Results The Bronchiolitis Guideline Adaptation Group (BGAG) reviewed the results of the AGREE II assessment and decided to adapt mainly the Australasian (PREDICT) CPG and for the questions not answered in PREDICT we adapted the relevant recommendations from the American Academy of Pediatrics (AAP) CPG. Seven implementation tools were included: a care pathway for assessment of severity, a clinical algorithm for treatment of acute bronchiolitis in the emergency room, a separate flowchart for assessing babies with bronchiolitis, a power point slide presentation lecture for treatment of acute bronchiolitis, patient information in Arabic, a clinical score (Modified Tal Score) for prediction of bronchiolitis severity, and the criteria for admission and discharge in the hospital. A comprehensive set of multifaceted CPG implementation strategies was provided for the clinicians, patients, nurses, and other relevant stakeholders contextualized to the national settings Conclusion Our experience with this adaptation methodology provides useful insight into its utilization on a national level in Egypt. The BGAG recommended the next review of this adapted CPG to be after 3 years from its publication (i.e., 2022) after checking for updates in the original CPG.

Brucellosis relapse causing thoracic aortic ulcers and aneurysm formation: a case report

Background Brucellosis is an infectious disease caused by Brucella spp, which can involve the cardiovascular, digestive, and respiratory systems. Cardiovascular involvement is a rare occurrence, it has an extremely high mortality rate. Case presentation A 67-year-old Chinese man presented with thoracic aortic multiple ulcers and partial aneurysm formation that caused symptoms of left waist and left buttock pain. The man was admitted to our hospital due to abdominal aorta pseudoaneurysms 5 years ago. The diagnosis was made by thoracic computed tomography angiography (CTA), previous history, and positive culture of Brucella, and the patient was successfully treated by thoracic aortic covered stent-graft implantation and specific medical treatment. Conclusions People who have a history of contact with cattle and sheep, should beware of the possibility of Brucella infection. If chest and abdominal pain occur, timely medical treatment is recommended, aortic aneurysm, the disease with a high risk of death, can be identified or excluded by CTA. Early treatment and prevention of disease progression are more beneficial to patients.