Molecular diagnosis and genetic relationship of foot and mouth disease virus serotype Asia1/Basne/Sul/2015

Foot and Mouth Disease (FMD) is the most economically important viral-induced livestock disease worldwide. From April to May of 2015, tongue epithelial tissue samples were collected from 36 cattle in six villages, which share the border with Iran. Samples were screened using RT-PCR to amplify a conserved region in the VP1 gene, and phylogenetic tree analysis was performed based on the VP1 nucleotide sequence results. Furthermore, the nucleotide sequence was converted to an amino acid sequence in order to detect similarities between the studied samples and those previously published in GenBank (NCBI). Epidemically, based on the amino acid residues, genetic similarity, and amino acid substitutions, the VP1 nucleotide sequences were determined to be close to a novel group, group VII, with 94% identity. The VP1 amino acid sequence analysis revealed a close relationship to the Asia/BAL/PAK/iso-2/2011 isolate (Accession no. JX435109), with 95.7% identity, which is not significantly different. Analysis of the studied samples revealed that the FMDV serotype Asia1 causing the outbreak in the Basne district belonged to group VII, which was introduced from the Balochistan province of Pakistan through illegal movement of animals from this region

The Relationship Between Serum 25 hydroxy Vitamin D Deficiency and Dietary Pattern in Baxshin Hospital, Sulaimani City

Vitamin D is one of the fat-soluble vitamins that have a great role in phosphate and calcium balance and bone structure. To our knowledge, there are limited data on the relation between dietary pattern and serum vitamin d concentration. Therefore, the aim of the current study is find out whether, there are any associations between serum vitamin D and with any specific dietary pattern. A cross sectional study was implemented in Baxshen hospital in order to find the prevalence of vitamin D deficiency and its relation with dietary pattern among healthy participants. 1131 participants were enrolled in the current study male and female with age 18 – 65 years old, living in Sulaimani city and its districts have not used any supplement in the past 6 months before enrolling the study.  Two questionnaires were used for collecting of data, the first one was included demographical data of the participants. Including their age, gender, marital status, educational level, address, and etc. The second one was data on dietary pattern; particularly we focused on some vitamin D dietary sources. A three-day dietary records estimate was taken from the patients and this data were coded and put in dietary software (windiet) and then analyzed. The age of the sample ranged from 18 to 65 years old with the mean of 34.34 years old with a standard deviation of 12.6. One hundred sixty-two (14.3%) of the 1131 participants were female, nine hundred sixty-nine (85.7%) of the participants were male. 65.5 % of them exposure to sun less than 30, 34.5% exposure to sun more than half hour. About 84.6% of participants had severe deficiency of vitamin D and 6.9% of participants had adequate vitamin D. Fish, eggs and yogurt conception was common among those participants whom their serum vitamin D was adequate, in contrary, there were less consumed among those who had vitamin D deficiency.  The percentage of obese (99.8%) was significantly higher than normal weight and overweight among severe deficiency Vitamin D. Furthermore, a highly percentage of adequate was (93.6%) in the normal weight. The mean of vitamin D intake was 761 ± 195.65 IU, in normal weight group, and the mean of vitamin d intake was 125.98 ± 53.15 IU, in obese group. This study has concluded that the reach Dietary sources of vitamin D is not enough to provide the body adequate amount of vitamin D, in addition, Obese and overweight individuals tend to have less serum vitamin D status compared to normal weight individuals and finally recommended daily amount of vitamin d intake should be established for Kurdistan people

Facial deformity correction and genioplasty; a case report and literature review

Introduction: dentofacial deformities are mainly congenital problems that distort the face structure. However, they have many adverse effects on adolescents’ quality of life and self-esteem.Case presentation: We report a case of an 18-year-old female with no family history or previous surgical method. She presented to our hospital with a facial deformity, including a midline shift of 1.5 teeth to the left side and a malalignment of dentation. Orthopantomography (OPG) X-ray and cephalometric X-ray assessed the deformity extent and determined the appropriate surgical procedure. As a result, the patient underwent genioplasty and bimaxillary (BiMax) surgery to correct the problem.Discussion: Facial deformities occur during the normal embryonic phase and develop clearly when the patient reaches puberty due to a growth spurt. Some researchers encourage early correction, while others recommend the surgery only after completing the growth. However, the perfect age for this surgery is 19 years old for boys and 17 for girls after the cessation of facial growth. Therefore, our patient underwent surgery at 18 years old, which is the desirable age.Conclusion: Genioplasty and BiMax are reasonable procedures to treat facial deformities and correct malalign-ment of dentation in an 18-year-old patient without major complications

A rare case of benign vulvovaginal leiomyoma: Case report and literature review

Introduction: Smooth muscle tumors of the vulva are more difficult to diagnose and are frequently mistaken as Bartholin cysts prior to surgery.Case presentation: A 41-year-old female presented with a left vulvar mass that increased in size compared to the previous year. The patient had normal urination and a regular menstrual cycle. The presentation was not associated with dyspareunia, abnormal bleeding, and signs of infection (e.g., fever, vaginal discharge). The history of any sexually transmitted disease was inconclusive. There was also no family history of malignancy. Physical examination showed a solitary swelling mass, measuring 5 × 2 cm in the left labia majora at the site of the Bartholin gland. The mass was firm in consistency, partially movable, and non-tender with no inguinal lymphadenopathy. Histopathology after surgical removal revealed a benign vulvar leiomyoma.Discussion: Labia majora leiomyoma at the site of the Bartholin gland is rather uncommon. Some cases can develop into atypical leiomyoma or even leiomyosarcoma with local tissue infiltration.Conclusion: If the clinical picture is unusual, it is better to send the patient for ultrasound and MRI to exclude other causes followed by performing wide local surgical excision of the mass to allow proper histopathological and/or immunohistochemistry examination to differentiate between benign and malignant tumors

Abdominal pain from ingested bone misdiagnosed as appendicitis: Report of a rare case and literature review

Bones are potential foreign bodies that could be accidentally ingested, leading to several symptoms varying from asymptomatic to perforation of the gastrointestinal tract. However, these cases are rare but may be misdiagnosed with other common diseases such as appendicitis. We present in this case a 25-year-old male who presented with appendicitis symptoms, after appendectomy the patient had the same complaint, But the colonoscopy demonstrated a meat bone in the terminal ileum and was removed with the same device. Finally, he was discharged from the hospital without complications and after decreasing abdominal pain. According to the literature review, this is one of the rare cases of using colonoscopy to treat bone impaction non-operatively

Diagnostic bias during the COVID-19. A rare case report of salmonella typhi

Introduction: In poor countries, due to the limited resources, mostly they prescribe medications without proper diagnosis. The aim of this report is to show diagnostic bias of COVID-19 case.Case presentation: A 17-year-old male patient was presented to the Hospital with a fever up to 39 °C associated with rigor, sweating, generalized body pain, myalgia, fatigue, loss of appetite, headache, and multiple joint pain with no swelling and redness. The vital signs were steady on physical examination, except temperature which was 39 °C. The chest was clear, and the pulse rate was 90 beats per minute. The heart rate relative bradycardia and lungs were normal. Both a PCR test for COVID-19, and a viral assay ELISA were negative. After further investigations, the culture findings revealed the strong development of Gram-negative coccobacilli (Salmonella serotype Typhi) bacteria under the microscope, which was confirmed by using VITEK 2 to identify it. and treated with ciprofloxacin tab, two times per day for five days and amikacin ampule 500 mg IV every 24 hours for 10 days.Discussion: Fever is a well-known sign of COVID-19 infection which has been observed in 83%–98% of patients with COVID19. As a result, it may be difficult to tell the difference between COVID-19 and other febrile infections, causing delays in diagnosis and treatment and may blind the physician from considering other febrile illnesses.Conclusion: Physicians should construct more comprehensive differential diagnoses for people who experience fever, headache, or myalgia symptoms that are linked to a pandemic. COVID-19

Global, regional, and national burden of meningitis and its aetiologies, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background Although meningitis is largely preventable, it still causes hundreds of thousands of deaths globally each year. WHO set ambitious goals to reduce meningitis cases by 2030, and assessing trends in the global meningitis burden can help track progress and identify gaps in achieving these goals. Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we aimed to assess incident cases and deaths due to acute infectious meningitis by aetiology and age from 1990 to 2019, for 204 countries and territories. Methods We modelled meningitis mortality using vital registration, verbal autopsy, sample-based vital registration, and mortality surveillance data. Meningitis morbidity was modelled with a Bayesian compartmental model, using data from the published literature identified by a systematic review, as well as surveillance data, inpatient hospital admissions, health insurance claims, and cause-specific meningitis mortality estimates. For aetiology estimation, data from multiple causes of death, vital registration, hospital discharge, microbial laboratory, and literature studies were analysed by use of a network analysis model to estimate the proportion of meningitis deaths and cases attributable to the following aetiologies: Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae, group B Streptococcus, Escherichia coli, Klebsiella pneumoniae, Listeria monocytogenes, Staphylococcus aureus, viruses, and a residual other pathogen category. Findings In 2019, there were an estimated 236 000 deaths (95% uncertainty interval [UI] 204 000–277 000) and 2·51 million (2·11–2·99) incident cases due to meningitis globally. The burden was greatest in children younger than 5 years, with 112 000 deaths (87 400–145 000) and 1·28 million incident cases (0·947–1·71) in 2019. Age-standardised mortality rates decreased from 7·5 (6·6–8·4) per 100 000 population in 1990 to 3·3 (2·8–3·9) per 100 000 population in 2019. The highest proportion of total all-age meningitis deaths in 2019 was attributable to S pneumoniae (18·1% [17·1–19·2]), followed by N meningitidis (13·6% [12·7–14·4]) and K pneumoniae (12·2% [10·2–14·3]). Between 1990 and 2019, H influenzae showed the largest reduction in the number of deaths among children younger than 5 years (76·5% [69·5–81·8]), followed by N meningitidis (72·3% [64·4–78·5]) and viruses (58·2% [47·1–67·3]). Interpretation Substantial progress has been made in reducing meningitis mortality over the past three decades. However, more meningitis-related deaths might be prevented by quickly scaling up immunisation and expanding access to health services. Further reduction in the global meningitis burden should be possible through low-cost multivalent vaccines, increased access to accurate and rapid diagnostic assays, enhanced surveillance, and early treatment.publishedVersio

Awareness and preparedness of healthcare workers against the first wave of the COVID-19 pandemic: A cross-sectional survey across 57 countries.

BACKGROUND: Since the COVID-19 pandemic began, there have been concerns related to the preparedness of healthcare workers (HCWs). This study aimed to describe the level of awareness and preparedness of hospital HCWs at the time of the first wave. METHODS: This multinational, multicenter, cross-sectional survey was conducted among hospital HCWs from February to May 2020. We used a hierarchical logistic regression multivariate analysis to adjust the influence of variables based on awareness and preparedness. We then used association rule mining to identify relationships between HCW confidence in handling suspected COVID-19 patients and prior COVID-19 case-management training. RESULTS: We surveyed 24,653 HCWs from 371 hospitals across 57 countries and received 17,302 responses from 70.2% HCWs overall. The median COVID-19 preparedness score was 11.0 (interquartile range [IQR] = 6.0-14.0) and the median awareness score was 29.6 (IQR = 26.6-32.6). HCWs at COVID-19 designated facilities with previous outbreak experience, or HCWs who were trained for dealing with the SARS-CoV-2 outbreak, had significantly higher levels of preparedness and awareness (p<0.001). Association rule mining suggests that nurses and doctors who had a 'great-extent-of-confidence' in handling suspected COVID-19 patients had participated in COVID-19 training courses. Male participants (mean difference = 0.34; 95% CI = 0.22, 0.46; p<0.001) and nurses (mean difference = 0.67; 95% CI = 0.53, 0.81; p<0.001) had higher preparedness scores compared to women participants and doctors. INTERPRETATION: There was an unsurprising high level of awareness and preparedness among HCWs who participated in COVID-19 training courses. However, disparity existed along the lines of gender and type of HCW. It is unknown whether the difference in COVID-19 preparedness that we detected early in the pandemic may have translated into disproportionate SARS-CoV-2 burden of disease by gender or HCW type