Determinants of Health Associated with Dengue Incidence in Patients from the Lodana Health Center

Vector-borne diseases constitute a significant public health challenge globally, causing over 700,000 deaths annually. Among them, dengue, transmitted by Aedes mosquitoes, has emerged as a formidable threat, particularly in tropical and subtropical regions. Understanding the biology of the virus, the ecology of mosquito vectors, and the socio-economic factors influencing disease spread is imperative for effective prevention and control strategies. This multidisciplinary challenge necessitates collaboration among scientists, healthcare professionals, governments, and communities. Ecuador, experiencing a surge in dengue cases, particularly in provinces like Manabí, underscores the urgency for tailored interventions. This study aims to analyze the influence of health determinants on dengue incidence at Lodana Health Center, proposing targeted promotional strategies within the healthcare setting. The theoretical framework integrates perspectives from Health Promotion, Critical Epidemiology, and Popular Education, emphasizing community empowerment and participatory approaches to address the complexity of dengue control effectively

Validity and Reliability of MoCA-Ina for Assessing Cognitive Function in Dialysis Patients with Chronic Kidney Disease

BACKGROUND: Montreal Cognitive Assessment (MoCA) is widely used for assessing cognitive function in chronic kidney disease (CKD) patients, but its effectiveness in Indonesian CKD populations remains unclear compared to studies in other regions. OBJECTIVES: To evaluate the reliability and validity of the translated MoCA in assessing cognitive impairment among dialysis patients. METHODS: This cross-sectional study was conducted at the hemodialysis and Continuous Ambulatory Peritoneal Dialysis (CAPD) unit of RSUD Dr. Saiful Anwar in Indonesia from January to February 2024. The study utilized the Indonesian Version of MoCA for cognitive assessment. Reliability and validity of the questionnaire were evaluated using Cronbach\u27s Alpha and Pearson validity test methods. RESULTS: In this study, 43 participants were enrolled, including 21 undergoing hemodialysis and 22 receiving CAPD. MoCA\u27s reliability was confirmed with Cronbach\u27s Alpha values of 0.648 for hemodialysis and 0.737 for CAPD, indicating strong internal consistency. The questionnaire exhibited favorable discriminatory power, with corrected item-total correlation scores exceeding 0.3 for all items in both groups. Validity demonstrated strong construct validity, with critical values surpassing standard references. All statistical significance levels were below 0.05, affirming MoCA\u27s reliability in assessing cognitive function in dialysis patients. CONCLUSION: In conclusion, our study has demonstrated that the translated MoCA is valid and reliable for assessing cognitive function in CKD patients undergoing dialysis

The Outcome of Primary Hyperaldosteronism in Resistant Hypertension with Efficiency Cost in Clinical Practices A Case Report

Aldosterone as a major mineralocorticoid has an important role in regulating circulating volume and potassium homeostasis, especially in the kidney. Manifestation of hypertension and hypokalemia in the young age population must be considered about the role of Aldosterone. This case report will discuss a patient with uncontrolled hypertension with severe hypokalemia who was treated with 3 kinds of antihypertensive drugs but the blood pressure is still high. After performing several diagnostic tests, the Aldosterone level was significantly high and left an adrenal tumor from an abdominal MRI. The patient treated with mineralocorticoid receptor antagonists or Spironolactone 25mg daily and show controlled blood pressure

Bee Sting Rhabdomyolysis: A Clinical Case Study Investigating Elevated Procalcitonin Levels Amidst Biochemical Muscle Injury

Bee stings, although a nuisance, seem easy to deal with, causing only mild symptoms in the majority of people, but severe systemic reactions, like anaphylaxis or rhabdomyolysis, can rarely happen. Here is an unusual case report of a 75-year-old man with over a hundred bee stings, which resulted in elevated creatinine phosphokinase (CPK) levels, acute kidney injury (AKI), and increased markers of inflammation like C-reactive protein (CRP), white cell count and procalcitonin levels (PCT). Here, we highlight particular attention to procalcitonin, a marker sensitively used to differentiate between bacterial infections and other causes of inflammation. It was significantly elevated to 350 times above its normal upper range despite the patient not exhibiting any signs or symptoms of the disease. The patient made a complete recovery with supportive care, and all his biochemical markers of muscle injury and inflammation and AKI improved to baseline. Here, the authors highlight that clinicians should be aware that PCT can be spuriously elevated in rhabdomyolysis and does not automatically equate to a bacterial infection, re-iterating the need for reasonable antimicrobial use in this situation

Profile and Trends of Community Morbidity in Mali from January 2018 to December 2019: A Cross-Sectional Study

Abstract: The global burden of disease is dominated by non-communicable diseases, but for African and developing countries, infectious diseases and febrile syndromes are the most frequent. At the community level, the actual disease burden remains understudied. Aims: Our study aimed to determine the profile and trends of morbidity diagnosed at the community level and to determine the most frequent reasons for consultation in routine consultation. Methods: we conducted a cross-sectional and retrospective study on data from the CSCom consultation register in Nyamina. The data was collected using epi info 7 software and analyzed with R version 4 software. Results: at the end of our study, we recorded 8778 patients in routine consultation for 55.2% of women. Malaria was the most prevalent diagnosis with 68% followed by ARI 8%. While 75% of malaria cases occurred before the age of 20, non-communicable diseases such as hypertension were more common among the elderly. Conclusion: the morbidity profile was globally more dominated by communicable diseases, in particular malaria and ARI

Interesting Case of Acute Lung Oedema Complication of Dengue Hemorrhagic Fever-Hypercoagulability: Interesting Case of Acute Lung Oedema Complication of Dengue Hemorrhagic Fever-Hypercoagulability

  A B S T R A C T   Background: Diagnosis and management of dengue hemorrhagic fever (DHF) can be challenging with confounding complications. Important confounding factors are conditions that alter hematologic parameters and prognosis of infection. We report a case of a patient with a positive DHF IgG result and hypercoagulation leading to Acute Lung Oedema (ALO), a serious condition with risk of respiratory failure leading to death. This is the first case to highlight the unique set of diagnostic and therapeutic challenges of DHF in this context.   Case Presentation: A twenty-seven-year-old man presented with suspected DHF with thrombocytopenia and hypoalbumin. Pharmacologic and fluid therapy were optimal. However, the patient suddenly developed dyspnea leading to respiratory failure and had to be admitted to the intensive care unit. The patient also had severe infection as evidenced by D-dimer > 5,000 ng/ml and pulmonary edema, one of which was due to pulmonary embolism.  This requires appropriate and rapid treatment, considering the patient is in critical condition.   Conclusion: This patient faced two diagnostic challenges: the diagnosis of dengue fever with positive DHF IgG but with different clinical manifestations and the diagnosis of hypercoagulation related to pulmonary embolism. There were two therapeutic difficulties: that of balancing the risks and benefits of administering anticoagulants and steroids in a pulmonary embolism patient with DHF. As decisions in such cases are patient-specific, sharing individual experiences will help guide future therapeutic management decisions.   Keywords:  Acute Lung Oedema (ALO), Dengue Hemorrhagic Fever (DHF), Hypercoagulatio

Semen Analysis in Type 2 Diabetes Mellitus Patients with Infertility: Semen Analysis in Type 2 Diabetes Mellitus Patients with Infertility

Background: According to World Health Organization (WHO), the condition of infertility is related with inability to get conceived even after regular unprotected active sexual intercourse for one year. Nowadays, the prevalence of infertility is increasing day by day. Among couples who are desperate for pregnancy, about to 15% have complaints related to infertility. Aim: The present study is aimed to analyze and compare different semen parameters among diabetic infertile males and non-diabetic fertile males. Methods: This cross-section study done at Dr.Patnam Mahender Reddy Institute of Medical Sciences, Chevella and included 100 diabetic infertile and 100 fertile males. Subjects are selected as per inclusion and exclusion criteria. After 2 to 7 days of sexual abstinence, the semen samples were obtained by masturbation. Semen samples were then observed for microscopic and macroscopic examination as per WHO instructions. Blood sample was collected from a cubital vein, and serum was obtained. The results obtained were entered in tabular form with relevant heading of each parameter. The obtained data is analyzed IBM SPSS Statistics version 20. Results: It has been observed that there was a significant decrease of sperm concentration, sperm motility, sperm count, semen volume and sperm morphology in diabetic infertile group when compared to non-diabetic fertile group with significant increase in semen liquefaction time and appearance of abnormal sperms. Conclusion:  Levels of Liquefaction time, abnormal appearance, viscosity and abnormal morphology were found to increased and sperm motility, concentration, count were observed to be decreased in the study group on comparison control group

Performance of Soluble CD28 and CTLA4 as a Potential Marker of Immunosenescence

Background: Immunosenescence is a condition of decreased function of the immune system that is generally found in elderly individuals. Several costimulatory molecules, such as CD28 and CTLA-4 have been investigated for their essential role in the immune aging process. Aim: This study aimed to determine the role of the soluble costimulatory molecules in immunosenescence. Methods: This study was observational research with cross-sectional approach. Samples were tested using ELISA and flow cytometry examination. Statistical analysis was conducted using independent T-test or Kruskal-Wallis comparison test. Correlation between each biomarker was determined with Pearson or Spearman correlation test. Diagnostic performances of each biomarked were assessed using ROC curve. Results: This study involved 52 subjects, of which 20 were young individuals aged between 20 to 28 years and 32 were elderly individuals aged between 60 to 85 years.  In this study we found that CD4CD28+ and CD8CD28+ T cells were lower in elderly group (p<0.001), while CD4CD57+ and CD8CD57+ T cells were higher in elderly group (p<0.001). sCD28 and sCTLA-4 were significantly higher (p 0.039 and p 0.025 respectively) in old individuals than in young individuals. CD8CD28+ and sCD28 exhibit a significant negative moderate correlation (p=0.007, r= -0.368) meanwhile sctla4 has no correlation with surface immunosenescence markers. Based on the results of roc analysis, sCTLA-4 was the best predictor to determine immunosenescence with area under curve of 0.7. The cut-off value for sCTLA-4 to determine immunosenescence is 26.5 ng/ml with sensitivity and specificity 58.6% and 63.2% respectively. Conclusion: sCTLA-4 as a soluble costimulatory molecule can be developed as promising predictive biomarkers of immunosenescence, which could be detected more quickly and efficiently using elisa as an alternative to flowcytometry

Cardiovascular Health and Risk Factors Among Adult Study Participants: Insights from Sociodemographic Characteristics and Health Behaviors

Background: Cardiovascular diseasesconstitute a significant global health challenge, necessitating a comprehensive understanding of their risk factors. This study explores the interplay between sociodemographic characteristics, health behaviors, and cardiovascular health among adult participants. Aim: The study aims to assess the cardiovascular health status and risk factors in adults, considering sociodemographic characteristics and health behaviors. Methods: In the Inter-University Consortium for Political and Social Research Study (ICPSR146521), data that had been gathered prospectively were used to assess the prevalence of metabolic syndrome, its risk factors, and the linked lifestyle in adult Myanmar inhabitants. Results: The study found that age was significantly associated with cardiovascular health, with an increase in age correlating with elevated risk. While gender was not a significant predictor, marital status and occupation played roles in shaping cardiovascular health outcomes. Smoking and sedentary lifestyles were identified as substantial risk factors, while physical exercise and healthier dietary habits demonstrated protective effects. Regression analysis further underscored the influence of BMI, age, and total cholesterol on cardiovascular health. Conclusion: This study provides critical insights into the complex interplay between sociodemographic characteristics, health behaviors, and cardiovascular health among adults. The findings emphasize the significance of age, smoking, physical activity, and dietary choices in shaping cardiovascular risk. Tailored interventions and public health strategies that consider these factors can enhance cardiovascular diseases prevention and management efforts, ultimately contributing to a reduction in the global burden of cardiovascular diseases