Animal Reservoirs for Leptospira spp. In South-East Asia: A Meta-Analysis

Background and Aim: Leptospirosis is a zoonotic disease responsible for high morbidity worldwide. This review is intended to identify other possible animal reservoirs of Leptospira spp. within human surroundings, which may improve the prevention and control of the disease. Methods: A systematic search was performed for the relevant titles, abstracts and keywords in PubMed, Scopus and Google Scholar in March 2018 based on the PICO strategy; which returned 1226 studies. Screening of abstracts had shortlisted 71 studies and data extraction was conducted for 15 studies which had been accepted after review of the full text. Only studies done in South-East Asia were considered. Meta-analysis of the accepted studies was done to compute the composite prevalence of each animal group using random effects model. Results: The articles were analysed from the viewpoint of the study settings and the prevalence of Leptospira spp. in types of animal with the animals being grouped into five major groups, based on taxonomy and likelihood of human contact. It was found that all animal groups have statistically significant value of pooled prevalence, with a range between 8.17% (95% CI: 4.80% - 12.39%) for sheep and goats, to as high as 27.28% (95% CI: 1.24% - 69.69%) for carnivores. The prevalence for other animal groups are 17.95% (95% CI: 7.77% - 31.18%) for rodents, 19.24% (95% CI: 10.65% - 29.65%) for pigs, and 24.90% (95% CI: 15.45% - 35.71%) for ruminants. Conclusion: Meta-analysis showed that other groups of animals, particularly carnivores, pigs, and large ruminants are just as culpable as rodents in being the reservoir for Leptospira spp. These other groups of animals may also play a vital role in the transmission and overall dynamics of human leptospirosis

Differentiated Thyroid Carcinoma: Distant Metastasis as an Unusual Sole Initial Manifestation

Objective:The objective of this study was to identify the characteristic features of patients with distant metastasis as the only manifestation of well-differentiated thyroid cancers and to analyze the treatment outcomesMethods:A retrospective review of all patients with well-differentiated thyroid cancers and distant metastasis as the sole initial presentation was carried out. Data regarding age, gender, tumor histology, site, symptoms, and treatment outcomes were collected.Results:There were 10 patients who presented with distant metastasis as the only presentation. The mean age was 56.1 years. Eight (80%) patients had osseous metastasis, one (10%) had pulmonary and one (10%) had both. Follicular thyroid carcinoma was more common and seen in six (60%) patients. Seven (77.8%) out of nine patients had demised within five years of initial presentation.Conclusion:Distant metastases without a neck lump as the initial presentation of well-differentiated thyroid cancers are extremely rare. No specific guidelines are available to manage such patients due to lack of relevant data in the literature

Konsep terapi Nabi SAW sebagai alternatif dalam menangani penyakit fizikal dan spiritual

Berubat daripada segala penyakit samaada fizikal ataupun spiritu-al merupakan sesuatu perkara yang dituntut oleh Islam. Ia merangkumi pelbagai rawatan menggunakan ubat-ubatan, tanaman herba serta rawa-tan menggunakan doa daripada al-Quran dan al-Sunnah. Namun dalam kehidupan harian, masih ramai yang belum mengenal perubatan yang telah diasaskan Nabi SAW. Kertas kerja ini bertujuan bagi menjelaskan kaedah Rasulullah SAW dalam menangani pesakit. Analisis konten merupakan fokus utama kajian ini. Ianya berkenaan kaedah terapi yang digunakan Rasulullah SAW dalam menangani penyakit. Kaedah pengubatan Rasulullah SAW ini merupakan terapi alamiah menggunakan herba atau bahan semula jadi dan terapi spiritual. Penggunaan doa-doa daripada al-Quran serta ijtihad Baginda SAW merupakan antara asas da-lam rawatan selain penggunaan bahan-bahan yang halal dan tidak terkeluar daripada prinsip syariat. Terapi Nabi juga dilakukan dengan konsep berikhtiar dan bersungguh-sungguh dalam mencari kesembuhan serta menjaga lima perkara asas syariat Islam. Rawatan Islam merupakan antara media dakwah yang sangat memberi kesan baik kepada pesakit dan keluarga pesakit. Konsep terapi Nabi SAW ini diharapkan sebagai antara panduan asas bagi setiap orang Islam dalam menangani penyakit fizikal dan spiritual serta boleh membantu masyarakat yang tertimpa musibah

Dyspeptic Symptoms In Type 2 Diabetes Patients

Background: Nearly half of the patients with diabetes experience diabetic gastroparesis. Some diabetic patients present with complaints of epigastric pain, vomiting, nausea, or postprandial fullness, however only a few have severe symptoms. Objective: To determine the frequency of dyspepsia among T2DM patients. Methods: This cross-sectional study was performed in Ziauddin Hospital Kemari Branch, Karachi, Pakistan after acquiring ethical approval from the hospital ethics committee. Short-Form Leeds Dyspepsia Questionnaire (SF-LDQ) was used to identify the presence of dyspepsia. Based on the sum of the frequency of symptoms, a cut-off value of 4 and above was used for the presence of dyspepsia. Results: A total of 368 patients were included in the study with a median age of 68.6 ± 14.2 years. The majority were females (62.8%). The mean duration of diabetes was 15 ± 10.4 years. The frequency of indigestion, heartburn, regurgitation, and nausea was 35.3%, 30.7%, 31.5%, and 11.4% respectively. Out of 368, 168 (45.7%) patients were found to have dyspepsia. The risk of dyspepsia was significantly lower among younger age, male gender, and patients having controlled glycemic status, patients doing physical activity twice a week, taking all three meals on time, and always having their breakfast early. The odds of having dyspepsia were higher among those who are currently and formerly addicted to alcohol, current and former smokers, having comorbidity, consuming <8 glasses of water per day, and those who were always or sometimes sleeping within two hours of having dinner. Conclusion: This study analyzed that dyspeptic symptoms including indigestion, heartburn, and regurgitation were common in T2DM patients, and about half of these patients had dyspepsia which was common among patients with poor glycemic control and those with unhealthy lifestyles

Morphological Identification and Resistance Profile of Antibiotic and Heavy Metals-Resistant Bacteria in Hospital Sewage of Peshawar

Background: Increased resistance of microorganisms to commonly prescribed antibiotics has emerged as a significant hurdle in contemporary medical practice. The World Health Organization (WHO) has declared antibiotic resistance as a " major threat to public health.". In the present study, bacterial isolates were selected based on high antibiotic and heavy metal tolerance from a water sample taken from hospital sewage.Methods: Antibiotic-resistant bacteria were isolated through the disk diffusion method. Gram staining was done for morphological identification. For molecular identification, the 16s rDNA PCR amplification was done with universal primers. Results: The strain BC1 was found resistant to ampicillin (10μg/ml), and cefixime (5μg/ml). While, susceptible to kanamycin (30μg/ml), azithromycin (15μg/ml) and intermediate in response to amoxicillin (30μg/ml). The strain BC2 was resistant to ampicillin (10μg/ml), cefixime (5μg/ml) and kanamycin (30μg/ml). While, Susceptible to amoxicillin (30μg/ml), and intermediate in response to azithromycin (15μg/ml). The strains were also found resistant to heavy metals.Conclusion: The recent investigation on bacterial strains from hospital effluent found interesting candidates for understanding the AMR bacteria and developing novel active biomolecules to combat the antibiotics problem. The isolated strains could be a source of novel resistant genes however; a comprehensive molecular analysis is needed for advanced studies

Animal Reservoirs for Leptospira spp. in South-East Asia: A Meta-Analysis

Background and Aim: Leptospirosis is a zoonotic disease responsible for high morbidity worldwide. This review is intended to identify other possible animal reservoirs of Leptospira spp. within human surroundings, which may improve the prevention and control of the disease. Methods: A systematic search was performed for the relevant titles, abstracts and keywords in PubMed, Scopus and Google Scholar in March 2018 based on the PICO strategy; which returned 1226 studies. Screening of abstracts had shortlisted 71 studies and data extraction was conducted for 15 studies which had been accepted after review of the full text. Only studies done in South-East Asia were considered. Meta-analysis of the accepted studies was done to compute the composite prevalence of each animal group using random effects model. Results: The articles were analysed from the viewpoint of the study settings and the prevalence of Leptospira spp. in types of animal with the animals being grouped into five major groups, based on taxonomy and likelihood of human contact. It was found that all animal groups have statistically significant value of pooled prevalence, with a range between 8.17% (95% CI: 4.80% - 12.39%) for sheep and goats, to as high as 27.28% (95% CI: 1.24% - 69.69%) for carnivores. The prevalence for other animal groups are 17.95% (95% CI: 7.77% - 31.18%) for rodents, 19.24% (95% CI: 10.65% - 29.65%) for pigs, and 24.90% (95% CI: 15.45% - 35.71%) for ruminants. Conclusion: Meta-analysis showed that other groups of animals, particularly carnivores, pigs, and large ruminants are just as culpable as rodents in being the reservoir for Leptospira spp. These other groups of animals may also play a vital role in the transmission and overall dynamics of human leptospirosis

Portable electrochemical biosensors based on microcontrollers for detection of viruses: a review

With the rise of zoonotic diseases in recent years, there is an urgent need for improved and more accessible screening and diagnostic methods to mitigate future outbreaks. The recent COVID-19 pandemic revealed an over-reliance on RT-PCR, a slow, costly and lab-based method for diagnostics. To better manage the pandemic, a high-throughput, rapid point-of-care device is needed for early detection and isolation of patients. Electrochemical biosensors offer a promising solution, as they can be used to perform on-site tests without the need for centralized labs, producing high-throughput and accurate measurements compared to rapid test kits. In this work, we detail important considerations for the use of electrochemical biosensors for the detection of respiratory viruses. Methods of enhancing signal outputs via amplification of the analyte, biorecognition of elements and modification of the transducer are also explained. The use of portable potentiostats and microfluidics chambers that create a miniature lab are also discussed in detail as an alternative to centralized laboratory settings. The state-of-the-art usage of portable potentiostats for detection of viruses is also elaborated and categorized according to detection technique: amperometry, voltammetry and electrochemical impedance spectroscopy. In terms of integration with microfluidics, RT-LAMP is identified as the preferred method for DNA amplification virus detection. RT-LAMP methods have shorter turnaround times compared to RT-PCR and do not require thermal cycling. Current applications of RT-LAMP for virus detection are also elaborated upon

A Fiber Bragg Grating—Bimetal Temperature Sensor for Solar Panel Inverters

This paper reports the design, characterization and implementation of a Fiber Bragg Grating (FBG)-based temperature sensor for an Insulted-Gate Bipolar Transistor (IGBT) in a solar panel inverter. The FBG is bonded to the higher Coefficient of Thermal Expansion (CTE) side of a bimetallic strip to increase its sensitivity. Characterization results show a linear relationship between increasing temperature and the wavelength shift. It is found that the sensitivity of the sensor can be categorized into three characterization temperature regions between 26 °C and 90 °C. The region from 41 °C to 90 °C shows the highest sensitivity, with a value of 14 pm/°C. A new empirical model that considers both temperature and strain effects has been developed for the sensor. Finally, the FBG-bimetal temperature sensor is placed in a solar panel inverter and results confirm that it can be used for real-time monitoring of the IGBT temperature

Green synthesis of lead oxide nanoparticles for photo-electrocatalytic and antimicrobial applications

Synthesis of nanoparticles (NPs) for many different uses requires the development of environmentally friendly synthesis protocols. In this article, we present a simple and environmentally friendly method to synthesize lead oxide (PbO) NPs from the plant material of the Mangifera indica. Analytical techniques such as spectroscopy, X-ray diffraction, and microscopy were used to characterize the synthesized PbO NPs, and their photo-electrocatalytic and antifungal properties were also evaluated. H2O2 was used to investigate the efficacy of removing methylene blue dye. At a range of pH values, H2O2 was used to study the role of hydroxyl radicals in the breakdown of methylene blue dye. Methylene blue dyes are more easily eliminated due to increased generation of the *OH radical during removal. Dye degradation was also significantly affected by the aqueous medium’s pH. Additionally, the electrocatalytic properties of the PbO NPs adapted electrode were studied in CH3COONa aqueous solution using cyclic voltammetry. Excellent electrocatalytic properties of the PbO NPs are shown by the unity of the anodic and cathodic peaks of the modified electrode in comparison to the stranded electrode. Aspergillus flavus, Aspergillus niger, and Candida glabrata were some fungi tested with the PbO NPs. Against A. flavus (40%) and A. niger (50%), and C. glabrata (75%), the PbO NPs display an excellent inhibition zone. Finally, PbO NPs were used in antioxidant studies with the powerful antioxidant 2, 2 diphenyl-1-picrylhydrazyl (DPPH). This study presents a simple and environmentally friendly method for synthesizing PbO NPs with multiple uses, including photo-electrocatalytic and antimicrobial activity

Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods: The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk–outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. Findings: Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7–9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4–9·2]), smoking (5·7% [4·7–6·8]), low birthweight and short gestation (5·6% [4·8–6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8–6·0]). For younger demographics (ie, those aged 0–4 years and 5–14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9–27·7]) and environmental and occupational risks (decrease of 22·0% [15·5–28·8]), coupled with a 49·4% (42·3–56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9–21·7] for high BMI and 7·9% [3·3–12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6–1·9) for high BMI and 1·3% (1·1–1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4–78·8) for child growth failure and 66·3% (60·2–72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). Interpretation: Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions