Impact of asthma on linear growth in preschool children: a cross-sectional study in Iraq

Background: Asthma is a common chronic respiratory condition in children, often emerging during the preschool years. Its long-term effects may extend beyond respiratory health, potentially influencing physical development, including linear growth. This study aims to determine whether a significant association exists between asthma and impaired linear growth of preschool-aged children in Iraq. Methods: A cross-sectional study was conducted between 1st January and 30th June 2024 at Al-Batool Teaching Hospital, pediatric outpatient clinics, Diyala, Iraq. The cohort analyzed data of 90 children aged 1–5 years who has been divided into two groups: asthmatic (n=45) and non-asthmatic controls (n=45). Height-for-age z-scores (HAZ) were used to assess linear growth. Data were collected through caregiver interviews and medical record reviews, including sociodemographic characteristics and clinical information. Chi-square and logistic regression analyses were employed to identify significant associations between asthma and stunting. Results: Among asthmatic children, 42.2% had low HAZ scores compared to 20.0% of non-asthmatic children (p=0.03). Logistic regression showed that asthma was significantly associated with linear growth impairment (OR = 2.8, 95% CI: 1.1–7.2, p=0.028), even after adjusting for confounders such as nutrition and parental education. Conclusion: Asthma in preschool children is significantly associated with impaired linear growth. Early detection, asthma control, and integrated nutrition strategies are crucial to improving both respiratory and growth outcomes. Further longitudinal studies are needed to explore causality and long-term developmental impacts

Frequency domain analysis of heart rate variability in response to cold pressor test in young offspring of hypertensive parents

Background: Cardiovascular reactivity to stress was revealed to be a predictor of future cardiovascular risk. A positive family history of hypertension is an important risk factor for the development of hypertension in the children of hypertensive parents. We applied cold pressor test (CPT) to measure heart rate variability (HRV) with the objective to assess the cardiovascular autonomic response to stress.  Methods: A case-control study was conducted between from December 2022 to November 2023 at the department of Physiology, Government Medical College, Kota in India. A total of 70 Cases and 70 Controls underwent to CPT technique to evaluate the autonomic function to stress. Descriptive and bivariate analysis including Mann-Whitney U-and ANOVA tests were performed. Results: In this study, the mean ± SD values of HRV in control group before CPT was 79 ± 13, during CPT was 81 ± 11 and after CPT was 77 ± 9. The HR in control group was increased during CPT and the level decreased after CPT. The HRV level in control group was statistically significantly different before CPT, during CPT and after CPT, and p= 0.04. Conclusion: The autonomic measurements were found higher in offspring of hypertensive parents (OHTPs) compared to offspring of normotensive parents (ONHTPs). The offspring of hypertensive parents have higher chances of future development of hypertension than the offspring of normotensive parents

Unveiling the facilitators and barriers of adopting healthy diets among Indonesian teenagers during covid-19 pandemic

Background: The COVID-19 pandemic has prompted shifts in dietary habits among Indonesian teenagers, with some embracing healthier choices while others succumb to unhealthy options, especially during confinement. Identifying the factors influencing these dietary changes is essential for crafting effective interventions to promote better nutrition during this challenging time. This study aimed to determine the factors facilitating teenagers\u27 shift to healthy, well-balanced diets.  Methods: A cross-sectional study enrolled 396 teenagers aged 15-17 in Surabaya and Sidoarjo, Indonesia was conducted in the second wave of COVID-19 pandemic. A self-administered questionnaire was distributed using an online survey platform. Nutrition literacy was assessed through health literacy measures related to adolescents\u27 nutrition and diet. Predictors of the outcome were determined by logistic regression analysis. Results: The results showed low economic status, comorbidities, and COVID-19 modules significantly predicted the shift to healthy diets. After adjusted analysis, only low economic levels (OR 0.30, 95% CI [0.13-0.70], p<0.05) and comorbidities (OR 0.33, 95% CI [0.12-0.93], p<0.05) were independent barriers against teenagers shifting to healthy diets, while choosing food without preservatives (OR 2.22, 95% CI [1.18-4.16], p<0.05) and maintaining body weight (OR 3.04, 95% CI [1.79-5.16], p<0.05) independently facilitated it. Conclusion: The strategic actions aimed at improving dietary practices and nutrition literacy in teenagers should be designed to narrow the socioeconomic gap

Flexible ureterorenoscopy for renal stones in ectopic malrotated pelvic kidneys: a case report on safety and effectiveness

Background: An ectopic pelvic kidney is a rare congenital anomaly with a high incidence of complications such as reflux, the pelviureteric junction (PUJ) obstruction, nephrolithiasis, and even renal failure. We here report a case of retrograde intrarenal surgery (RIRS) for the treatment of right pelvic kidney stones.  Case presentation: A 65-year-old male presented to the urology clinic at Life Hospital, Kalar, Iraq, on September 10, 2024, with complaints of lower abdominal pain, microscopic hematuria, and dysuria. The patient had a medical history of cardiovascular and unhealthy lifestyle-related diseases. Physical examination revealed lower abdominal pain without fever. Serum creatinine was 1.4 mg/dL and HbA1c was 8.7%, with microscopic hematuria and pyuria in urinalysis. Contrast-enhanced CT revealed an ectopic right iliac kidney with moderate hydronephrosis and two renal stones (11 mm and 13 mm). Flexible ureterorenoscopy (fURS) with Holmium: YAG laser stone dusting was performed under spinal anesthesia. The procedure lasted 50 minutes, achieving complete stone clearance. The patient was discharged the same day without complications, and follow-up confirmed successful outcomes. Conclusion: A single-session RIRS has successfully disintegrated the stone. Proper preoperative assessment and selection of the most suitable surgical procedure are critical for successful treatment

Serological insights and clinical patterns of dengue fever in a tertiary care hospital: a survey-based study

Background: Dengue fever, a vector-borne disease caused by the dengue virus (DENV) and transmitted by Aedes mosquitoes, remains a public health concern in India, especially due to its seasonal and geographical variability. The disease manifests with symptoms like fever, myalgia, rashes, leukopenia, and thrombocytopenia, affecting various organs. This study aimed to examine the demographic patterns, clinical presentations, and healthcare-seeking behavior of paediatric dengue patients. Additionally, it analyzed dengue positivity trends from 2021 to 2023. Methods: A descriptive cross-sectional study was conducted from September to December 2021 among suspected dengue paediatric patients admitted to the Paediatrics department of Autonomous State Medical College Firozabad. Diagnostic tests included Dengue rapid NS1, ELISA NS1 Antigen, and IgM ELISA. Data were analyzed to assess clinical symptoms, healthcare access, and yearly dengue trends. Results: A total of 6,445 patients were clinically suspected of dengue at the Paediatrics IPD, Autonomous State Medical College, Firozabad, Uttar Pradesh. Among them, 386 were confirmed dengue-positive by rapid card, NS1 antigen, or IgM ELISA tests. The highest number of suspected cases (43.17%) was observed in school-going children (6–12 years). Males (55.47%) were more affected than females (44.53%), with nearly equal distribution between rural and urban areas. Platelet counts varied widely, with 31.73% having counts between 50,000–100,000. Fever with myalgia (75.65%) was the most common symptom. Dengue positivity fluctuated across years, with the highest rate in 2021 (193/1147 cases), followed by declines in 2022 and 2023. Conclusion: Dengue fever shows a variable trend in incidence, with significant impact from healthcare access and public awareness. Improving awareness and timely diagnosis could help mitigate the severity of cases in future outbreaks

Isolated biliary tract injury: necessity to heighten vigilance following blunt abdominal trauma in children

Background: Bile duct injury after blunt abdominal trauma is a rare entity in the pediatric population. Its occurrence has been highly linked to the primary injuries of the liver or duodenum as explained by their anatomical affiliation.  Case presentation: Here we present a case of a 4-year-old female brought in with a history of generalized abdominal pain that was associated with distension and absolute constipation. This was preceded by a blunt abdominal traumatic incident four days prior. On examination, she was ill-looking, tachypneic, and had a grossly distended abdomen with a positive Blumberg\u27s sign. After the baseline laboratory and radiographic investigations, she was taken for exploration where Bile peritonitis was found secondarily to a perforated common bile duct (CBD). All other visceral structures and organs were fine; a meticulous primary closure of the 2 by 1 cm defect was done as superimposed by an omental patch. She fared well post-operatively and was discharged on the seventh day. Conclusion: Though rare, biliary tract injury should always be considered among the differential diagnoses in blunt abdominal trauma, as its early diagnosis precipitates early intervention which will in turn positively affect the patient\u27s outcome

Navigating the complexities of anesthetic management in a preterm neonate with double outlet right ventricle posted for noncardiac surgery

Background: Double outlet right ventricle (DORV) is an uncommon congenital heart defect characterized by the simultaneous emergence of both the aorta and pulmonary artery from the right ventricle. This condition is frequently linked with other congenital anomalies, such as imperforate anus, which presents considerable challenges for anesthesiologists. This case report outlines the effective anesthetic management of a preterm neonate diagnosed with DORV and imperforate anus, who was scheduled for an urgent sigmoid colostomy.  Case presentation: A 6-day-old preterm female weighing 2.2 kg, exhibited DORV along with a subaortic ventricular septal defect, mild pulmonary stenosis, adequate biventricular function, and moderate pulmonary hypertension. Additionally, she presented with an imperforate anus accompanied by a recto-vaginal fistula. The preoperative assessment involved echocardiography, electrocardiography, and various laboratory tests. The pediatric cardiologist advised that the patient\u27s oxygen saturation should be maintained within the range of 80-85% throughout the emergency colostomy procedure. Anesthetic management involved premedication with glycopyrrolate, ondansetron, fentanyl, and dexamethasone. The patient was induced with sevoflurane and intubated with a 2 mm endotracheal tube. Anesthesia was maintained with a mixture of air and oxygen, sevoflurane, and atracurium. Hypothermia was prevented using a warmer, and fluid management was guided by the patient\u27s hemodynamic parameters. After the 1-hour surgery, the patient was transferred to the neonatal intensive care unit, where she was initially supported with synchronized intermittent mandatory ventilation and later extubated Conclusion: The effective anesthetic management of this preterm neonate with DORV and imperforate anus necessitated a comprehensive understanding of the associated cardiac and anorectal anomalies, meticulous preoperative planning, and a collaborative multidisciplinary approach to perioperative care. The anesthesiologist was instrumental in ensuring the patient\u27s safety and enhancing the surgical conditions throughout the emergency colostomy procedure

Serological similarity of Leptospira serovars in livestock and livestock keepers in Ngorongoro conservation area, Tanzania

Background: Leptospirosis is a bacterial zoonotic disease affecting mammals including wildlife, livestock, and humans, with higher prevalence recorded in pastoral communities where close contact between animals and humans increases the risk of transmission. This study aimed to determine the seroprevalence of Leptospira serovars among livestock and livestock keepers in four selected villages of the Ngorongoro Conservation Area (NCA), during the wet season. Methods: A cross-sectional study was conducted from February to April 2022 in four villages within NCA. The convenience sampling technique was recruited to collect blood samples from 141 livestock (96 cattle, 25 sheep, and 20 goats) and 154 livestock keepers. Sera were analyzed using the Microscopic Agglutination Test (MAT) to diagnose individuals infected by Leptospira serovars. Data were analyzed using SPSS v26 with descriptive and inferential statistics including Chi-square, Kruskal-Wallis, and logistic regression. Results: The overall seroprevalence was 10.64% in livestock and 5.19% in livestock keepers. Cattle had the highest positivity (11.46%) among animals. Hebdomadis was the most frequently detected serovar in livestock, while Grippotyphosa predominated in humans. Oloirobi village recorded the highest human seroprevalence (3.25%) with a statistically significant difference compared to Endulen (p=0.007). Analysis of logistic regression showed no significant associations between seropositivity and sex or age of livestock keepers. Conclusion: The presence of Leptospira antibodies in both livestock and humans indicates ongoing exposure in the NCA. These findings underscore the need for targeted interventions including livestock vaccination programs, improved animal husbandry practices, and increased public health education for livestock keepers to reduce transmission risks and protect both animal and human health

Assessing the effectiveness of spinal compared to general anesthesia in scheduled minimally invasive lumbar spine surgeries in a tertiary care hospital in Gujarat, India

Background: Minimally invasive spine surgery (MIS) is increasingly preferred over traditional open surgery due to its advantages. Anesthesia choice plays a key role in surgical outcomes. This study compares spinal anesthesia (SA) and general anesthesia (GA) in patients undergoing scheduled MIS for lumbar spine conditions. Methods: This prospective randomized study was conducted in Parul Sevashram Hospital, Parul University, Vadodara, Gujarat, between May 2024 and October 2024. The study included 34 ASA-1 and ASA-2 patients scheduled for one—or two-level MIS, divided into two groups: Group G (GA) and Group S (SA). Preoperative evaluation included demographics, lab tests, and imaging. Intraoperative monitoring covered heart rate, mean arterial pressure, and oxygen saturation. Postoperative assessments included blood loss, satisfaction scores, and complications. Results: Spinal anesthesia (SA) showed better hemodynamic stability, reduced blood loss (67.5±19.8 ml in Group S vs 73.2±14.9 ml in Group G), and higher satisfaction scores. Surgery duration was shorter in the SA group (89.9±8.2 min in Group S vs 94±7.2 min in Group G), with fewer complications. PACU stay was significantly lower in Group S (134±17.2 min) compared to Group G (175±20.4 min). Postoperative analgesic requirement (Inj Butorphanol) was also less in Group S (5 mg vs 14 mg IV). Conclusion: Spinal anesthesia is a safe and effective alternative to general anesthesia for MIS, offering better patient outcomes and satisfaction. This study supports the broader use of spinal anesthesia in suitable candidates to improve perioperative care

Non-medical pathways to cardiovascular health: a discourse analysis of dietary and lifestyle interventions in the United States

Background: Cardiovascular diseases (CVD) are a leading cause of morbidity and mortality in the United States. While conventional medical treatments dominate cardiovascular care, non-medical pathways, such as plant-based dietary patterns and lifestyle modifications, have gained recognition for their potential to complement traditional approaches. Methods: A qualitative discourse analysis was conducted on peer-reviewed articles published between 2013 and 2023. A systematic search across databases identified 10 studies that met inclusion criteria, focusing on non-medical interventions for reducing CVD risk in U.S.-based populations. Data extraction and thematic synthesis highlighted key patterns related to dietary and lifestyle interventions, cost implications, physiological outcomes, and implementation barriers. Results: Five key themes emerged from the analysis: (1) Plant-based dietary patterns, including vegetarian and vegan diets, consistently improved blood pressure and lipid profiles. (2) Lifestyle modifications, such as increased physical activity and stress management, enhanced cardiovascular health when integrated into primary care frameworks. (3) Non-medical interventions demonstrated significant improvements in physiological outcomes, including reductions in systolic and diastolic blood pressure. (4) These interventions were cost-effective and scalable, making them viable options for diverse populations. (5) Barriers to implementation included cultural and socioeconomic factors, as well as challenges in sustaining long-term adherence. Conclusion: Non-medical pathways, particularly plant-based dietary patterns and lifestyle modifications, play a critical role in mitigating cardiovascular disease risks. These approaches not only address key physiological risk factors but also provide cost-effective, accessible, and scalable solutions for diverse populations. Overcoming barriers to implementation through tailored interventions and community-based strategies is essential to ensure their success. Integrating these non-medical pathways into healthcare frameworks could significantly reduce the burden of CVD and promote equitable health outcomes