Narra X

Global prevalence of natural disaster-induced acute respiratory infections: A systematic review and meta-analysis of 290,380 participants

2024-12-09T06:05:25+07:00

Acute respiratory infections (ARI) can be caused by the occurrence of natural disasters such as earthquakes, volcanic eruptions, landslides, tsunamis, floods, and droughts. The aim of this study was to determine the global prevalence of acute respiratory infections during post-natural disasters across countries. A systematic review and meta-analysis were conducted in accordance with the PRISMA guidelines. Studies reporting acute respiratory infections prevalence in natural disaster-impacted areas were identified and screened from PubMed, Scopus, Crosreff, Scilit, and medRxiv as of March 16^th, 2024. The meta-analysis was conducted using the Freeman-Tukey double arcsine transformation with a random-effects model. A total of 15 out of 2,052 studies, covering 290,380 subjects, were included in the meta-analysis. The pooled estimate of acute respiratory infection prevalence following natural disasters across multiple countries was 43.0% (95% confidence interval (CI): 31–55%; p-Het<0.01; I²=99.97%). No statistical significance was observed between subgroups, including population density (p=0.281), country income (p=0.583), and types of disasters (p=0.468), suggesting the indiscriminate nature of disaster-induced acute respiratory infections. The highest prevalence was observed in studies from 2015–2019, with a prevalence of 52% (95%CI: 32.7–72.2%; p-Het<0.001; I²=99.97%). In conclusion, the global prevalence of disaster-induced ARI is considered high, reaching 43%, highlighting the need for countermeasures to address these diseases during disasters.

Prognostication of differentiated thyroid cancer recurrence: An explainable machine learning approach

2024-12-28T00:18:37+07:00

Differentiated thyroid cancer (DTC) generally has a favorable prognosis, but recurrence remains a concern for a subset of patients, highlighting the need for accurate predictive tools. While traditional methods, such as the American Thyroid Association (ATA) guidelines, are widely used, they may not fully capture the complex patterns in clinical data. To address this, we developed a machine learning model using LightGBM and enhanced its interpretability with SHAP (SHapley Additive exPlanations). Our model, trained on data from 383 DTC patients, identified response to initial therapy as the most significant predictor of recurrence, alongside age and risk level. The model achieved an accuracy of 93.51%, with precision and sensitivity of 94.23% and 96.08%, respectively, using only five key features selected through Recursive Feature Elimination (RFE). SHAP analysis provided clear insights into how these features influenced predictions, offering a transparent and interpretable approach to risk stratification. These results highlight the potential of explainable machine learning to improve recurrence prediction, support personalized care, and build clinician trust, while laying the groundwork for further validation in diverse populations.

Hypoxic mesenchymal stem cell secretome upregulates IL-10 and STAT3 gene expressions in mice model with polycystic ovary syndrome

2024-12-19T13:46:30+07:00

Polycystic ovary syndrome (PCOS) is a condition characterized by chronic anovulation and hyperandrogenism, which often leads to infertility. It is closely associated with chronic inflammation triggered by glucose and saturated fat, contributing to hyperandrogenism and negatively impacting a patient’s quality of life. Effective therapeutic approaches are essential to address these issues. The secretome of mesenchymal stem cells (MSCs) have demonstrated the ability to suppress pro-inflammatory cytokine secretion and regulate growth factors. The aim of this study was to investigate the effect of hypoxic mesenchymal stem cell secretome (MHSSCs) on the expression of interleukin-10 (IL-10) and signal transducer and activator of transcription 3 (STAT3) genes in a PCOS-induced mouse model. An in vivo experimental study was conducted using a post-test-only control group design. A total of 24 female C57BL/6 mice were divided into four groups: healthy control, negative control (PCOS mice injected with 0.9% NaCl), T1 (PCOS mice administered 200 μL of MHSSCs), and T2 (PCOS mice administered 400 μL of MHSSCs) for 33 days. Gene expression of IL-10 and STAT3 were quantified using quantitative reverse transcription polymerase chain reaction (qRT-PCR), normalized to the expression of the housekeeping β-actin gene. Statistical analysis using one-way ANOVA followed by the least significant difference (LSD) post-hoc test was then performed. The results showed a significant increase in IL-10 expression in the T2 group compared to the negative control group (p<0.001). STAT3 expression was also significantly higher in the T2 group compared to the negative control group (p=0.035). A dose-dependent effect was observed, with the T2 group demonstrating the highest upregulation of both IL-10 and STAT3 expression levels. The study highlights that the administration of MHSSCs effectively increased IL-10 and STAT3 gene expression, suggesting their potential as a therapeutic strategy to alleviate inflammation in PCOS.

Revitalizing the state of primary healthcare towards achieving universal health coverage in conflict affected fragile northeastern Nigeria: Challenges, strategies and way forward

2024-12-19T13:47:34+07:00

The Alma-Ata Declaration of 1978 defined primary healthcare as a critical way to obtain universal healthcare and 'health for all.' In Nigeria, the National Health Policy (NHP) and the subsequent formation of the Primary Health Care System aim to modernize healthcare delivery, at the grassroots level. In recent decades, however, the status of primary healthcare in Nigeria, particularly in the northeastern region, has significantly deteriorated, further posing significant threats to health equity and universal access to healthcare. Armed conflicts, humanitarian crises, insufficient finance, inadequate infrastructure, and labor shortages have negatively impacted the region's primary healthcare facilities. This article discusses the poor state of primary healthcare in northeastern Nigeria and its implications for achieving universal health coverage in the region. In addition, the article elaborates on the historical context, highlights the difficulties and challenges in the development of primary healthcare, and explores potential solutions to improve the system.

Enhancing primary healthcare delivery in Nigeria through the adoption of advanced technologies

2024-12-19T13:48:54+07:00

Enhancing primary healthcare delivery in Nigeria by adopting advanced technologies holds substantial promise for improving healthcare accessibility, quality, and efficiency. Primary healthcare focuses on community-based, essential care that is practical, socially acceptable, and affordable. Despite efforts to improve healthcare delivery, challenges persist, particularly in rural and underserved areas. The aim of this study was to explore the transformative potential of technologies such as telemedicine, electronic health records (EHRs), health information systems (HIS), artificial intelligence (AI), and medical drones in addressing these challenges. Telemedicine facilitates access to healthcare in remote areas by overcoming geographical barriers. EHRs streamline administrative and clinical processes, enhancing patient care and safety. HIS improves data management, patient safety, and provider communication. AI revolutionizes diagnostics, treatment personalization, and operational efficiency. Medical drones offer innovative solutions for delivering medical supplies to remote locations. The paper also addresses the challenges associated with these technologies, including infrastructure limitations, regulatory issues, and data privacy concerns. Recommendations include investing in infrastructure, developing regulatory frameworks, building capacity, fostering public-private partnerships, engaging communities, and implementing robust data security measures. By addressing these recommendations, Nigeria can leverage advanced technologies to enhance healthcare delivery and achieve better health outcomes.

Association of functional levels and serum vitamin D among children with cerebral palsy

2024-12-19T13:31:48+07:00

Children with cerebral palsy are more susceptible to deficiency of vitamin D due to less sunlight exposure, poor dietary intake, and long-term use of anti-epileptic drugs, which disrupt their metabolism, resulting in changes in bone mineral density, osteopenia, and rickets. The aim of this study was to investigate the association between gross motor functional levels and vitamin D status in cerebral palsy children. A cross-sectional study was conducted among cerebral palsy patients aged 2–6 years at Haji Adam Malik Hospital, Medan, Indonesia, from November 2022 to April 2023. The levels of the gross motor function classification system (GMFCS) were classified into two groups: ambulatory (GMFCS I, II, III) and non-ambulatory (GMFCS IV, V). Vitamin D status was classified based on serum 25(OH)D levels as normal (30–100 ng/mL), insufficiency (21–29 ng/mL), and deficiency (<20 ng/mL). A total of 85 children with cerebral palsy were included in this study, categorized as ambulatory (n=28, 32.9%) and non-ambulatory (n=57, 67%). The mean serum vitamin D level was 21.92±9.07 ng/L. As many as 54.1% (n=46) of the total children were categorized as vitamin D deficient, followed by insufficient (n=25, 29.4%) and normal vitamin D level (n=14, 16.5%). Age (p=0.310), sex (p=0.590), nutritional status (p=0.269), and types of cerebral palsy (p=0.271) were not associated with vitamin D status. However, there was a significant association between GMFCS levels and circulating vitamin D levels (p<0.001). In a logistic regression model, children classified as ambulatory were more likely to have better vitamin D status, with odds ratios of 12.30 (95%CI: 3.61–41.90) for deficient versus insufficient and 10.93 (95%CI: 2.67–44.69) for deficient versus normal. In conclusion, there was a significant association between functional levels and vitamin D status among children with cerebral palsy.

Factors associated with feeding problems in children with cerebral palsy: A cross-sectional study from Indonesia

2024-09-03T03:08:53+07:00

Children with cerebral palsy are at high risk for feeding difficulties and malnutrition due to motor impairments and associated conditions. The aim of this study was to evaluate the prevalence and types of feeding problems and their association with malnutrition in children with cerebral palsy. A cross-sectional study was conducted involving 54 children under five years old with cerebral palsy. Participants were classified into spastic cerebral palsy subtypes such as quadriplegic, hemiplegic, diplegic, or triplegic. Feeding problems were categorized as inappropriate feeding practices, reduced food intake, parental misperception, and food preferences using the Pediatric Symptom Checklist-17. Nutritional status was assessed using weight-for-age percentiles based on WHO growth charts. History of constipation and dysphagia were also recorded. Data analysis included Chi-square and Mann-Whitney U tests. Among the participants, 38.9% had hemiplegia, 33.3% diplegia, and 25.9% quadriplegia. Feeding problems were prevalent, with inappropriate feeding practices being the most common (70.4%). Malnutrition was identified in 59.3% of the children. However, no significant associations were observed between CP subtype or demographic variables and the types of feeding problems. Similarly, the type of feeding problem was not significantly associated with malnutrition. Constipation and dysphagia were reported in 31.5% and 37.0% of participants, respectively, and were significantly associated with nutritional status (p<0.001). In conclusion, feeding problems and malnutrition are common in children with cerebral palsy, with inappropriate feeding practices being the most prevalent issue. Although no significant associations were found between CP subtypes or the types of feeding problems and malnutrition, the findings emphasize the multifactorial nature of feeding challenges.