Perceived stress among Sri Lankans during the economic crisis: an online survey

Background: The Sri Lankan population's mental health was undoubtedly significantly impacted by the county’s economic crisis. This study investigated the prevalence of perceived stress and its socio-demographic predictor.  Methods: A web-based cross-sectional survey was undertaken in July-August 2022, using google forms. The respondents were assessed for socio-demographics, and the level of stress experienced over the previous month. Ten-item self-reported perceived stress scale (PSS) was used to assess stress levels analysis. Descriptive statistics and logistic regression analysis were used. Results: A total of 1214 respondents, aged ≥18 years were included in the survey. The majority were females (60%). The mean PSS score of this population was 21.95 ±6.09. More than half of the respondents reported moderate levels of stress (68.5%), while 23% registered high levels. A significant association was demonstrated between stress levels and variables age, gender, and residential area. Respondents below the age of 40 years (OR 1.936, 95% CI, 1.365-2.748, P<0.001) were more likely to report higher odds of having increased PSS scores, while men (OR 0.640, 95% CI, 0.491-0.835, P=0.001), and those without children (OR 0.556, 95% CI, 0.409-0.756, P<0.001) had significantly lower odds of reporting PSS. Conclusion: Respondents experienced moderate to high levels of stress during the financial crisis in Sri Lanka. Higher stress was predicted by younger age, female gender, and having children. The results highlight the urgent need for stress management interventions to boost resilience and improve psychological well-being in this situation.

Bridging the diagnostic gap: liver function tests and IL-6 as potential early predictors of non-alcoholic fatty liver disease in psoriasis

Background: Psoriasis goes beyond skin, intertwining with body systems, notably connecting to nonalcoholic fatty liver disease (NAFLD). This study aims to explore the predictive potential: liver function tests and IL-6 as early markers for non-alcoholic fatty liver disease in psoriasis patients.  Methods: From March to November 2023, a case-control study was performed at the dermatological outpatient clinic of Baquba Teaching Hospital, Iraq. Individuals with confirmed psoriasis and those without underwent comprehensive clinical history and overall health examinations. The diagnosis of non-alcoholic fatty liver disease (NAFLD) was established using the Fatty Liver Index (FLI). Results: Among the 290 participants in this study, 103 with confirmed psoriasis displayed a Fatty Liver Index (FLI) score >60, indicative of non-alcoholic fatty liver disease (NAFLD). The control group, comprising 101 individuals without psoriasis or NAFLD, provided a baseline for comparison. The mean ages were 32.5 ± 16.2 and 31.5 ± 14.3 years for the case and control groups, respectively. Notably, the case group exhibited significantly higher mean ± SD levels of ALT and AST (61 ± 29 vs. 33 ± 17 U/L, p < 0.0001) and (55 ± 27 vs. 25 ± 15 U/L, p < 0.0001), respectively. Moreover, FLI criteria were markedly elevated in the case group (p = 0.0007, p = 0.0005, p < 0.0001, and p < 0.0001, respectively), and IL-6 levels were significantly higher (p = 0.0003). Conclusion: The results proposed that liver function tests and IL-6 could act as early predictors for the detection of non-alcoholic fatty liver disease among individuals grappling with psoriasis

Assessment of anxiolytic-like effects of acute and chronic treatment of flurbiprofen in murine

Background: Non-steroidal anti-inflammatory drugs are commonly used medications with atypical pharmacological effects. This aims to evaluate the anxiolytic-like effects of flurbiprofen in rodent models.  Methods: In vivo experimental try was conducted from October 2022 to January 2023 at the college of veterinary medicine, university of Mosul, Iraq. The effect of flurbiprofen was assessed in mice exposed to the elevated plus maze (EPM), light-dark box test (LDT), and open-field test (OFT). Fifty male mice were divided into two groups of twenty-five, weighing 30–35 g, for acute and chronic treatment. Each group was subdivided into five subgroups: distilled water was administered to the control group; the positive control was injected with 10 mg/kg diazepam; and the flurbiprofen groups were administered orally at 10, 20, and 40 mg/kg. Each subgroup was subjected to EPM, LDT, and OFT one hour after administration. The second group was also subdivided like the first group. It was treated for 15 days constantly and subjected to anxiety tests on the 16th day. Results: Acute treatment with 20 mg/kg flurbiprofen revealed an anxiolytic effect, with increased time spent in the open arm of the EPM test, increased time spent in the LDB test, and increased time spent in the central area in the OFT compared to the control group. Chronic administration of flurbiprofen was ineffective in producing an anxiolytic effect. Conclusion: The low doses of flurbiprofen may eliminate the anxiety effect in experimental mice; however, the anti-anxiety effect does not appear significantly after repeated or chronic administration of flurbiprofen

Detection of SARS-CoV-2 variants among travelers crossing the northern international border checkpoint in Duhok province, Iraq

Background: Variants of SARS-CoV-2 have been detected along with the worldwide COVID-19 transmission. Insufficient data exists regarding SARS-CoV-2 variants in Iraq, particularly concerning travelers at Iraqi border crossings. This study aimed to screen SARS-CoV-2 variants among individuals entering Iraq from Turkey through the Ibrahim Khalil international border checkpoint.  Methods: A total of 116 (52 females, 64 males) COVID-19-positive cases from June 6, 2021, to July 30, 2021, were randomly selected from the Ibrahim Al-Khalil border crossing point between Turkey and Iraq. The patients were Iraqis tested positive for COVID-19 through nasopharyngeal and oropharyngeal swab collections. The confirmation of SARS-CoV-2 cases involved RNA extraction and real-time reverse transcription polymerase chain reaction (RT-PCR), following the World Health Organization guidelines. All samples were subjected to variant detection using the reverse transcription RT-PCR method. The RNA was extracted using a Zybio nucleic acid extraction kit and the RT-PCR was conducted using SARS-CoV-2 S-gene mutation detection RT-PCR kit. Results: In the 116 patients, we detected variants B.1.1.7, B.1.617.1.2, B.1.617.1.3, and Omicron sub-lineages (B.1.1.529, BA.1) at frequency rates of 13, 16, 45, and 36 cases, respectively. The highest prevalence rate was the delta variant among the tested subjects (38.8%) followed by the Omicron sub-lineages (B.1.1.529, BA.1) at 31%. Conclusion: This finding, which is the first of its kind at the northern Iraqi border checkpoint, suggests that these two variants could be a source of COVID-19 circulating in the Duhok province in Iraq. Additional studies are warranted across the country’s border entry points

A case report on generalized pemphigus vulgaris treated with rituximaba

Background: Pemphigus vulgaris has an obscure etiology; the presence of autoantibodies is coherent with an autoimmune disease. Rituximab a monoclonal antibody that specifically targets the CD20 antigen of B lymphocytes, has arisen as a novel treatment approach for pemphigus vulgaris.  Case presentation: A 39-year-old male patient presented with a three-month history of mouth ulcers, poor oral hygiene accompanied with heavy tobacco smoking and alcohol consumption. He was diagnosed with pemphigus vulgaris. The disease gradually progressed to involve other body parts. The patient had shown partial improvement after conventional therapy (oral cefuroxime, oral prednisolone with azathioprine) and was later on successfully treated with rituximab. After 90 days of follow-up, no future recurrence was observed. Conclusion: With this case, the authors would like to aware other clinicians of the potential use of rituximab in treating pemphigus vulgaris, especially when the conventional therapy fails

Experimental inoculation of the Botox perineurally of facial nerve and followed by histological assessment for its effect on the zygomatic bone of rabbits

Background: Botox, derived from the toxin produced by Clostridium botulinum, is an attenuated toxin employed as a treatment for cervical dystonia, overactive bladder, strabismus, cerebral palsy, and non-surgical cosmetic procedures. This study aimed to explore the impact of injecting Botox around the facial nerve on the left side of rabbits, specifically focusing on the histological changes in the zygomatic bone.  Methods: Twenty-five adult rabbits of a local breed, weighing 1500-1800 gm and of both sexes, underwent a 15-day acclimation period prior to the experiment. The rabbits were randomly assigned to four groups (1st, 2nd, 3rd, and 4th). A singular intramuscular injection of Botox at a dose of 3.5 U/kg was administered to the left facial muscles. The rabbits in each group were then sacrificed at distinct time points after injection: day 10, day 15, day 30, and day 45. All rabbits survived until the end of the experiment, at which point they were euthanized with chloroform. Post-euthanasia, the rabbits' facial zygomatic bones were dissected and subjected to histological assessment. Results: The results indicated notable changes in the zygomatic bone, including prominent vacuoles within the bony matrix, cracks with cellular debris, limited osteocytes, and collagen bundles resembling woven bone. Additionally, in the day 30 group (T3), irregular bone borders and atrophied osteogenic cells were observed, while the day 45 group (T4) exhibited necrotic areas and bone fragments within the bone matrix. Conclusion: In conclusion, Botox, derived from Clostridium botulinum, serves various medical purposes. The study focused on injecting Botox around rabbits' facial nerves to assess its impact on zygomatic bones histologically. Following a controlled injection and specific time intervals, the examined bone samples exhibited distinct changes, providing insights into Botox's effects on bone morphology

A massive benign prostate delivered intact: a case report

Background: Benign prostatic enlargement (BPH) is an age-related condition. Males above the age of 40 years commonly experience lower urinary tract symptoms (LUTS) related to the progressively growing prostate. BPH is coined by a deterioration in the quality of the patient`s life. Medicines along with advanced surgical procedures may not be suitable for treating oversized prostate glands. Case presentation: A 84-years-old man presented to the urology clinic with severe LUTS that are getting worse over 2 years. He was never catheterized. Medicinal treatments failed to alleviate the symptoms. He has no past medical or surgical history of significance. Prostate ultrasonography revealed a huge prostate of 340cc. He underwent open prostatectomy and enjoyed an uneventful post-operative hospital stay. Histology showed a benign nodular prostatic hyperplasia. Conclusion: This case presents one of the largest prostates reported in the literature

Exploring the determinant of flu vaccine hesitancy among Turkish population: a cross-sectional study

Background: Although influenza is a contagious and widespread viral disease, its impact on public health is controlled by vaccination programs. However, anti-vaccination sentiment is also increasing in society. This study aims to explore the factors influencing influenza vaccine hesitancy. Methods: Between November 2020 and January 2021, a cross-sectional observational survey was carried out in Turkey. To investigate the extent of vaccine hesitancy among individuals, an online questionnaire was created using Google Forms. Data were collected using an exponential non-discriminative snowball sampling technique. Besides internal consistency reliability, chi-square was performed. Statistical significance was defined as p < 0.05. Results: This research encompassed a cohort of 172 respondents, with an average age of 53.5±14.3 years within the total sample. Most participants (126, 73.25%) were above 45. The participant group was predominantly female (93, 54.1%), and most had achieved a high school or university education (117, 66.2%). Out of the participants, 123 individuals (71.5%) reported having a chronic ailment. Among the 172 participants, 118 (68.6%) exhibited no reluctance to receive the influenza vaccine, while 54 (31.4%) expressed vaccine hesitancy. There was a notable statistically significant distinction in the level of knowledge regarding influenza vaccines (p<0.001, χ²= 20.482). Conclusion: Lack of information, perceived harms, lack of trust in pharmaceutical companies, and experiences are among the most important determinants of anti-vaccination. Pharmacists may have a potential role in the leading part of the healthcare team in the fight against anti-vaccination in the community

Zoonoses awareness and health perception in livestock farmers: Example of a city in Western Türkiye

Background: Zoonotic diseases are on the increase globally. Relevant disease awareness practices regarding public knowledge are useful for disease control. This study aimed to evaluate the relationship between individuals' perception of health and awareness of zoonotic diseases. Methods: A cross-sectional study was conducted among farmers in the villages of Kutahya province, located in the west of Türkiye, between February and March 2022. A questionnaire involving questions about the sociodemographic characteristics of the participants in the first part and information about the transmission route of zoonotic diseases and the Health Perception Scale (HPS) in the second part was used in this study. Mann Whitney U and Kruskal Wallis-H Test was performed to compare group medians. P<0.05 was considered statistically significant. Results: The mean age of the participants was 44.10±10.73. The mean score of the individuals obtained from the HPS was 46.62±4.58. The health perception of the participants was found to be moderate. There was a negative correlation between the control center and precision sub-dimensions and age (respectively r: -0.260, p<0.001; r: -0.320, p<0.001). A positive correlation was found between the importance of health and self-awareness and age (respectively r:0.248, p<0.001; r:0.279, p<0.001). Those who knew that zoonoses could be transmitted from sheep, cattle, and humans had higher HPS scores than those who did not know (respectively p:0.003; p:0.001; p:0.007). Conclusion: Increasing health perception in livestock farmers may effectively prevent zoonotic diseases

The prevalence of depression and anxiety in nurses caring for covid-19 patients in Saudi Arabia: a single center experience

Background: Healthcare workers in direct contact with confirmed COVID-19 patients often face a negative impact on psychological health. This study aims to examine the prevalence of anxiety and depression among nurses caring for COVID-19 patients.  Methods: A cross-sectional survey was conducted during the COVID-19 pandemic from January 2022 to April 2022 at King Faisal Specialist Hospital and Research Center in Riyadh, Saudi Arabia. The prevalence of depression and anxiety was assessed using the Patient Health Questionnaire (PHQ-9), and the Generalized Anxiety Disorder-7 (GAD-7) questionnaire. Kruskal–Wallis’s test was used to compare the total scores of the PHQ-9 and GAD-7 with respect to demographic characteristics. P<0.05 was considered statistically significant. Results: A total of 123 nurses were included in the study. Most of them were females (69.92%), aged 30–39 years (45.53%), had a bachelor's degree in nursing (75.61%), and had more than ten years of experience (3830.89%). The depression and anxiety prevalence in the study was 78.1% and 72.4%, respectively. Nurses aged 30–39 years were significantly associated with depressive symptoms.  Female nurses showed significantly higher scores for depression and anxiety than males 74.42% and 67.45%, respectively. Conclusion: The findings suggest that nurses are at risk for developing depression and anxiety. Therefore, regular mental health screening is necessary for nurses, particularly during a pandemic