RELATIONSHIP BETWEEN DISABILITY AND RADIOGRAPHIC FINDINGS OF LUMBAR DISK DEGENERATION IN SAMPLE OF IRAQI PATIENTS WITH MECHANICAL LOW BACKACHE

Objectives: Disability related to chronic low back pain (LBP) is a complex and multidimensional phenomenon all over the world. The prevalence of backache in middle age and elderly is up to 84%. This study aims to evaluate the associations of X-ray features of lumbar disk degeneration with severity of disability among patients with mechanical LBP. Methods: A cross-sectional study was conducted on a total of 300 patients with chronic mechanical LBP. Severity of disability was measured using Modified Oswestry Disability Index and intensity of backache was assessed using numeric rating scale (0–10). X-ray features of lumbar disc degeneration according to Lane classification and spondylolisthesis were assessed in lateral recumbent lumbar X-rays. Results: The mean age of our sample was 52.45±7.87 and 71.7% of involved patients were women. Most patients were recorded as overweight or obese. The findings of disk space narrowing were mild in 65.7%, moderate in 28.7%, and severe in 5.6%, where the presence of osteophytes were small in 76.9%, moderate in 20.5%, and large in 2.6%. Regarding disability, two-third of cases were focused on minimal disability, followed by moderate, severe, and crippled as (26%), (6%), and (2%), respectively. There was highly significant association between women and pain radiation to legs (p=0.004). Obesity and overweight had meaningless effects on all markers. Conclusions: The severity of disability was significantly more in women, high intensity of lower back pain, presence of pain radiating to legs, moderate/severe disk space narrowing on X-ray, and disk degenerative disease score on X-ray, while age, presence of osteophytes and spondylolisthesis, body mass index, and pain duration were not associated with severity of disability

ASSOCIATION OF ANTI-CYCLIC CITRULLINATED PEPTIDE ANTIBODY IN A SAMPLE OF ADULT PATIENTS WITH PSORIASIS AND PSORIATIC ARTHROPATHY

Objective: Psoriatic arthritis (PsA) is a chronic inflammatory arthropathy commonly associated with psoriasis, a large number of patients with PsA that has persistent inflammation may develop progressive joint damage and disability and have reduced life expectancy. This study aims to determine the associations of anti-cyclic citrullinated peptide (CCP) antibodies in adult patients with psoriasis and PsA.Methods: A case–control study was conducted at Baghdad teaching hospital, Units of Rheumatology and Dermatology, during the period from December 2016 to April 2017 including three groups; 40 patients with psoriasis, 40 patients with PsA fulfilling the CASPAR classification criteria, and 40 healthy control persons.Results: Two patients with psoriasis (5%) and 10 patients with PsA (25%) were seropositive for anti-CCP antibodies (ACPA). Healthy controls were negative for anti-CCPA. Regarding ACPA positivity, a significant difference was found between those three studied groups (p<0.001) and there was a significant difference between positive and negative ACPA in PsA patients regarding disease activity score (p=0.044).Conclusion: Positive ACPA were found more significant with PsA than in patients with psoriasis as well as associated with higher disease activity

The effect of Pomegranate Peels Aqueous Extract against Streptococcus Mutans and the Adherence to tooth surface in Comparison to Chlorhexidine Gluconate (in Vitro Study)

For centuries, nature has been an enormous source of agents of medical importance and this study was conducted to evaluate the antibacterial activity of aqueous extract of pomegranate peels against Streptococcus mutans by using agar diffusion technique and the adherence to tooth surface in comparison to chlorhexidine gluconate in vitro was also studied. This study revealed that pomegranate peels exhibit good antibacterial activity and this activity was found to be increased as the concentration of extract increased and the result also showed that the pomegranate peels aqueous extract was effective in inhibiting the adherence of Streptococcus mutans to tooth surface Keywords: pomegranate peels, streptococcus mutans, adherenc

The Effect of Solvent-Modification on the Physicochemical Properties of ZnO Nanoparticles Synthesized by Sol-Gel Method

This study investigated the solvent effect on the synthesis of Zinc Oxide (ZnO) nanoparticle using sol-gel method. Zinc acetate dihydrate and oxalic acid were used as a chemical precursor for the synthesis of the ZnO nanoparticle considering the effects of various solvents. The effect of using water, propanol, or ethanol as solvent during the synthesis were examined. The resultant gel in the aqueous and organic moderate solvent was thermally cracked into ZnO nanoparticles at 450 °C under atmospheric pressure. The results showed that the solvent type has a significant effect on the morphology and particles size of the ZnO nanoparticles synthesized. Atomic Force Microscopy (AFM) was used to investigate the microstructure of the nanoparticles. The crystalline and chemical structure of the prepared ZnO nanoparticle were studied by X-ray diffraction (XRD) and Fourier Transform Infrared spectroscopy (FTIR). The average diameter of nano-size particles obtained for ethanol, propanol and water are 79.55 nm, 83.86 nm and 85.59 nm, respectively. ZnO particles showed higher degree of crystalline in water compared to other solvents under current investigation. Copyright © 2021 by Authors, Published by BCREC Group. This is an open access article under the CC BY-SA License (https://creativecommons.org/licenses/by-sa/4.0).

Forkhead box P3 gene expression and chromosomal analysis in a sample of Iraqi patients with multiple sclerosis

Background: Multiple Sclerosis disease is a demyelination process which interferes with the neuronal signal transmission, thus leading to different cognitive and physical dysfunctions like optic neuritis, motor, sensory and coordination problems. Recently many researches have been directed toward studying the relation between some genes and multiple sclerosis. Among the important genes to be studied in multiple sclerosis is the forkhead box P3 gene expression. Objectives: The aims of the present work were to study the expression of forkhead box P3 gene by real time polymerase chain reaction, and to perform chromosomal analysis on the multiple sclerosis patients peripheral blood lymphocytes. Patients and methods: A case-control study was performed using real time polymerase chain reaction technique to measure the relative expression of forkhead box P3 gene in peripheral blood leukocytes of 25 newly diagnosed untreated multiple sclerosis patients and comparing them with that of 25 apparently healthy controls, in addition to performing chromosomal analysis on multiple sclerosis patients peripheral blood lymphocytes. Results: Significant down-regulation in forkhead box P3 gene was detected in multiple sclerosis patients in comparison to controls. Chromosomal analysis that was performed for multiple sclerosis patients revealed normal results. Conclusion: Multiple sclerosis is associated with significant change in forkhead box P3 gene expression that can be measured by real time polymerase chain reaction technique. Furthermore, multiple sclerosis is not associated with gross chromosomal abnormalities

Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and developm nt investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens

Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose: Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods: Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results: The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion: We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake