Health Sciences

The Clinical Proteomic Tumor Analysis Consortium (CPTAC) initiative has generated extensive multi-omics data resources of deep proteogenomic profiles for multiple cancer types. To enable the broader community of biological and medical researchers to intuitively query, explore, and download data and analysis results from various CPTAC projects, we built a prototype user-friendly web application called “ProTrack” with the CPTAC clear cell renal cell carcinoma (ccRCC) data set (http://ccrcc.cptac-data-view.org). Here we describe the salient features of this application which provides a dynamic, comprehensive, and granular visualization of the rich proteogenomic data.Statement of SignificanceThe CPTAC initiative (https://proteomics.cancer.gov/) has generated multi-omics data for multiple cancer types to understand the proteogenomic aberrations of these malignancies. Collectively this effort has so far produced a large data resource for the research community, including high-throughput p...

Evolution is the natural process that is not limited merely to the biological world but to the social world as well. The standards of living and the expectations change with time. This study was done to generate data that can help doctors and hospital administration to identify and solve problems. It was a cross-sectional study conducted at a major tertiary care hospital of KPK through the month of July 2012. An interviewer based patient satisfaction questionnaire was used to estimate patients' satisfaction by asking questions regarding admission procedure, referral, clinical and lab investigation services, attitude of doctors and nurses, nursing services, cleanliness condition of the wards and overall level of satisfaction. Study included 305 patients, 205 from surgical wards (144 males, 61 females) and 100 from Medical wards (52 males, 48 female). Satisfaction level was high among females than males. Most of the patients having low level of education and unemployed patients we...

Introducción. La bibliometría es la evaluación cuantitativa de la literatura científica que constituye un método objetivo y eficaz para el análisis de la producción y actividad de las comunidades científicas. El uso de datos estadísticos denominados indicadores bibliométricos proporciona información real sobre los procesos de producción científica. Objetivo. Analizar la producción científica de la revista MedUNAB en los últimos 18 años, teniendo en cuenta indicadores bibliométricos y de impacto. Metodología. Estudio bibliométrico analítico de la revista MedUNAB; se incluyeron los artículos publicados en el periodo comprendido entre 1998 y 2016 y se excluyeron las publicaciones de tipo suplemento. La muestra fue de 537 artículos, los datos fueron extraídos de la versión impresa en reserva, se sistematizaron en Microsoft Excel® y, para su análisis, fueron exportados al software STATA 14®. Se realizaron análisis estadísticos descriptivos de variable bibliométricos relacionadas con la g...

Diabetes is now an epidemic affecting both developed as well as developing countries. This study aims at comparing knowledge & practice of foot care and association of demographic factors with it in Indian population of urban and rural settings. The cross-sectional study was conducted in Raigad and Thane district. Self-made Foot care Knowledge questionnaire, Nottingham Assessment of Functional Foot-care Questionnaire (NAFF) were administered. Descriptive analysis was done. Level of knowledge and practice of foot care were calculated as absolute frequencies and were reported as overall percentages. Mann-Whitney Test and Kruskal-Wallis Test were used to find out association between demographic factors with it. Results: Of 100 subjects, 58% in urban and 8% in rural had good knowledge of diabetic foot care. Majority of both 68% of urban and 90% of rural diabetics were not aware how often one should check footwear for damage. 6% of urban 48%rural diabetics had a poor practice score. Majority of diabetics were not aware to inspect feet that include 64% of urban and 82% of rural diabetics. Moreover 4% of urban and 36% of rural diabetics walk outside with bare feet. Socioeconomic and education had an influence in knowledge and foot care practice among rural diabetics. Conclusion: Knowledge and practice of foot care in rural diabetics were less than urban. Education and Socioeconomic status were significantly associated with rural populations. Intensive Foot care educational program need to be adhered to overcome these deficiencies

Teknolojik dönüşüm, iş görme borcunun mekânsal sınırlarını ortadan kaldırırken; "her an ulaşılabilir olma" beklentisi işçinin dinlenme hakkı üzerinde dijital bir baskı oluşturmaktadır. Bu makale, akıllı telefonlar aracılığıyla kurulan dijital denetimin hukuki sınırlarını, 4857 sayılı İş Kanunu ve Yargıtay'ın güncel içtihatları ışığında analiz etmektedir. Özellikle mesai dışı yazışmaların fazla mesai ispatındaki rolü ve işçinin ulaşılamama hakkı, somut vaka analizleri üzerinden detaylandırılmaktadır.

Little is known about how neurology payments vary by service type (i.e., evaluation and management [E/M] vs tests/treatments) and compare to other specialties, yet this information is necessary to help neurology define its position on proposed payment reform. Medicare Provider Utilization and Payment Data from 2012 were used. These data included all direct payments to providers who care for fee-for-service Medicare recipients. Total payment was determined by medical specialty and for various services (e.g., E/M, EEG, electromyography/nerve conduction studies, polysomnography) within neurology. Payment and proportion of services were then calculated across neurologists' payment categories. Neurologists comprised 1.5% (12,317) of individual providers who received Medicare payments and were paid $1.15 billion by Medicare in 2012. Sixty percent ($686 million) of the Medicare payment to neurologists was for E/M, which was a lower proportion than primary providers (approximately 85%) ...

Background Antimicrobial resistance (AMR) represents one of the most crucial threats to public health and modern health care. Previous studies have identified challenges with estimating the magnitude of the problem and its downstream effect on human health and mortality. To our knowledge, this study presents the most comprehensive set of regional and country-level estimates of AMR burden in the WHO European region to date. We estimated deaths and disability-adjusted life-years attributable to and associated with AMR for 23 bacterial pathogens and 88 pathogen-drug combinations for the WHO European region and its countries in 2019. Our methodological approach consisted of five broad components: the number of deaths in which infection had a role, the proportion of infectious deaths attributable to a given infectious syndrome, the proportion of infectious syndrome deaths attributable to a given pathogen, the percentage of a given pathogen resistant to an antimicrobial drug of interest, and the excess risk of mortality (or duration of an infection) associated with this resistance. These components were then used to estimate the disease burden by using two counterfactual scenarios: deaths attributable to AMR (considering an alternative scenario where infections with resistant pathogens are replaced with susceptible ones) and deaths associated with AMR (considering an alternative scenario where drug-resistant infections would not occur at all). Data were solicited from a wide array of international stakeholders; these included research hospitals, surveillance networks, and infection databases maintained by private laboratories and medical technology companies. We generated 95% uncertainty intervals (UIs) for final estimates as the 25th and 975th ordered values across 1000 posterior draws, and models were cross-validated for out-of-sample predictive validity. We estimated 541 000 deaths (95% UI 370 000-763 000) associated with bacterial AMR and 133 000 deaths (90 100-188 000) attributable to bacterial AMR in the whole WHO European region in 2019. The largest fatal burden of AMR in the region came from bloodstream infections, with 195 000 deaths (104 000-333 000) associated with resistance, followed by intra-abdominal infections (127 000 deaths [81 900-185 000]) and respiratory infections (120 000 deaths [94 500-154 000]). Seven leading pathogens were responsible for about 457 000 deaths associated with resistance in 53 countries of this region; these pathogens were, in descending order of mortality, Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterococcus faecium, Streptococcus pneumoniae, and Acinetobacter baumannii. Methicillin-resistant S aureus was shown to be the leading pathogen-drug combination in 27 countries for deaths attributable to AMR, while aminopenicillin-resistant E coli predominated in 47 countries for deaths associated with AMR. Interpretation The high levels of resistance for several important bacterial pathogens and pathogen-drug combinations, together with the high mortality rates associated with these pathogens, show that AMR is a serious threat to public health in the WHO European region. Our regional and cross-country analyses open the door for strategies that can be tailored to leading pathogen-drug combinations and the available resources in a specific location. These results underscore that the most effective way to tackle AMR in this region will require targeted efforts and investments in conjunction with continuous outcome-based research endeavours. Funding Bill & Melinda Gates Foundation, Wellcome Trust, and Department of Health and Social Care using UK aid funding managed by the Fleming Fund.

Vaccination is a preventive solution for children to protect them from infectious diseases. Although it is good immunization for children, some parents are reluctant about immunizing their children. The study attempts to identify the socio-cultural determinants of parental refusal for vaccination which may have influenced the uptake of vaccination. This study employed a survey method. A sample of 80 parents including both mothers and fathers who have children between the ages of one to 12 years old were recruited. The participants were selected via the random sampling technique. The questionnaire was distributed through email and on social media. Data were analyzed using SPSS. The results indicate that 58% of parents refused to vaccinate their children. Although parents are aware of the importance of vaccines, they refused to adopt them due to the perception that vaccination is unhygienic in nature and is considered unhealthy for their children. They also believed that other prevent...

Background: Palatal rugae are specialized patterns in keratinized mucosa of the anterior hard palate behind incisive papilla tis are unchangeable in their site and form, all over an individual’s lifespan. Occlusion means “closure” which refers to the interaction among upper and lower teeth. Mal-occlusion is improper alignment of teeth when the upper and lower jaws are closed. Objectives: The objectives of this study is to assessment of palatal rugae arrangement in our population and the determination of rugae pattern in non-treated Class-II and Class-III mal-occlusions when related to Class-I normal mal-occlusions. Methodology: It’s observational and cross-sectional study conducted at Orthodontics department, Lumhs jamshoro and Hyderabad. The sample size of study was 135, the Pre-treatment record of those patients who are receiving orthodontic treatment were enrolled as study participants their maxillary dental cast was assessed for assessment of rugae, Maxillary dental casts were a...

Introduction: Spina bifida is a congenital anomaly characterized by incomplitnes of vertebral arches in the medial line which occurs in 3rd and 4th month of intrauterine life. It is often associated with other congenital malformations, but hydrocephalus and Chiary II malformation are the most frequent. Aim: The aim of this work was to obtain the frequency of surgical cases of spina bifida treated at the Clinic for Neurosurgery, ClinicalCenter University of Sarajevo, Bosnia and Herzegovina.Methods: Retrospective study was carried out on the basis of the clinical records during the period January 2005. to December 2008. Standard methods of descriptive statistics were performed for the data analysis.      Results: A total of 31spina bifida cases were surgically treated in the period from 2005. through 2008. Out of that number 14 (48.2%) were female patients, while 17 (54.8%) were male patients; sex ratio – 1.21:1. The most common type of spina bifida was myelomeningocele, treated in 24...

Background: Chronic obstructive pulmonary disease affects structural and functional domains of the lung with great impact with additively involving and presenting the extra-pulmonary effects which in turn, have an impact on the overall well-being of the affected subjects. Aims: The present study was conducted to assess the health-related quality of life in subjects with COPD. Methods: The present cross-sectional study included 102 subjects with COPD from both genders and ages of more than 45 years where disease severity was assessed using the GOLD system. PFT was done following the guidelines by the ATS and ERS task force standardized lung function testing, whereas, the quality of life was assessed using SGRQ concerning its COPD-specific version. Total scores of SGRQ were compared for different parameters including COPD grades, gender, and age. The collected data were subjected to statistical evaluation.  Results: p-values for impact component scores were 0.06, <0.001, and <0....

Few studies have examined the narrative abilities of gifted children with learning disabilities. This study investigated the ability of eighth-grade gifted children with learning disabilities (gifted/LD) to produce oral and written narratives by comparing their stories to those produced by gifted peers with no learning deficits (nonLD/gifted). It was hypothesized that evidence of difficulty generating the stories relative to the macrostructure (organization of ideas across sentences) and the microstructure (organization of ideas within sentences) would be exhibited by the gifted/LD population. Twenty, 13-year-old eighth-graders served as subjects in the present investigation. All were identified as gifted by their local school system and were enrolled in the gifted program at the time of their participation in the study. Ten of the subjects met criteria for the gifted/LD group and ten met criteria for the nonLD/gifted group. Each subject produced stories under four different conditions, including a spontaneously generated oral story, a spontaneously generated written story, a retold oral story, and a retold written story. The stories produced by the gifted/LD subjects were compared to their gifted peers for differences in thirteen dependent measures of story length, episodic integrity, story grammar components, and sentence complexity. xi Differences in the mean number of occurrences of each of the thirteen variables under both oral and written story generation conditions were found. The results of MANOVAs applied to each condition revealed that only the overall spontaneously generated oral stories told by the gifted/LD subjects reliably differed from those produced by the nonLD/gifted subjects at the p<.05 level of significance. Results of the univariate analyses indicated that these differences were not accounted for by any one element of story macrostructure or microstructure but rather that the stories differed across multiple dimensions, each of which contributed to the overall difference. The significant results of this study suggest that the language of gifted/LD children does differ from that of nonLD/gifted peers when narrative language is examined. Results are discussed relative to the limitations of the study and implications for future research.

Few studies have examined the narrative abilities of gifted children with learning disabilities. This study investigated the ability of eighth-grade gifted children with learning disabilities (gifted/LD) to produce oral and written narratives by comparing their stories to those produced by gifted peers with no learning deficits (nonLD/gifted). It was hypothesized that evidence of difficulty generating the stories relative to the macrostructure (organization of ideas across sentences) and the microstructure (organization of ideas within sentences) would be exhibited by the gifted/LD population. Twenty, 13-year-old eighth-graders served as subjects in the present investigation. All were identified as gifted by their local school system and were enrolled in the gifted program at the time of their participation in the study. Ten of the subjects met criteria for the gifted/LD group and ten met criteria for the nonLD/gifted group. Each subject produced stories under four different conditions, including a spontaneously generated oral story, a spontaneously generated written story, a retold oral story, and a retold written story. The stories produced by the gifted/LD subjects were compared to their gifted peers for differences in thirteen dependent measures of story length, episodic integrity, story grammar components, and sentence complexity. xi Differences in the mean number of occurrences of each of the thirteen variables under both oral and written story generation conditions were found. The results of MANOVAs applied to each condition revealed that only the overall spontaneously generated oral stories told by the gifted/LD subjects reliably differed from those produced by the nonLD/gifted subjects at the p<.05 level of significance. Results of the univariate analyses indicated that these differences were not accounted for by any one element of story macrostructure or microstructure but rather that the stories differed across multiple dimensions, each of which contributed to the overall difference. The significant results of this study suggest that the language of gifted/LD children does differ from that of nonLD/gifted peers when narrative language is examined. Results are discussed relative to the limitations of the study and implications for future research.

This study examined links between the language bereaved children use to describe the death of their caregiver and children&#39;s psychological/behavioral functioning and coping strategies. Participants included 44 children (54.5% male) aged 7 to 12 (M = 9.05) years who were bereaved by the death of a caregiver. Children were assessed via self- and caregiver-report measures and an in-person interview regarding the loss of their caregiver. Children&#39;s loss narratives gathered through in-person interviews were transcribed and subjected to textual analysis. Linguistic categories included pronouns and verb tense. Drawing from linguistic and self-distancing theories, we hypothesized that children&#39;s use of language reflecting self-distancing (third-person pronouns and past tense) or social connectedness (first-person plural pronouns) would be negatively associated with psychological/behavioral distress and avoidant coping. Similarly, we expected that children&#39;s use of self-focus...

The inclusion of Persistent Complex Bereavement Disorder (PCBD) in the DSM-5 appendix signifies a call for research regarding the distinguishing features and clinical utility of proposed PCBD criteria. Rigorously constructed tools for assessing PCBD are lacking, especially for youth. This study evaluated the validity and clinical utility of the PCBD Checklist, a 39-item measure designed to assess PCBD criteria in youth aged 8 to18 years. Test construction procedures involved: (a) reviewing the literature regarding developmental manifestations of proposed criteria, (b) creating a developmentally informed item pool, (c) surveying an expert panel to evaluate the clarity and developmental appropriateness of candidate items, (d) conducting focus groups to evaluate the comprehensibility and acceptability of items, and (e) evaluating psychometric properties in 367 bereaved youth (M = 13.49, 55.0% female). The panel, clinicians, and youth provided favorable content validity and comprehensib...

To check for the association of genetic polymorphisms related to the methylenetetrahydrofolate reductase (MTHFR) gene namely C677T and A1298C with hypertension in Saudi affected subjects from Qassim region. Participants included 123 Saudi hypertensive cases (83 males and 40 females) in addition to 250 (142 males and 108 females) unrelated healthy controls from the same locality. Their age mean ±SD was 50.93 ± 15.43 years. For all subjects, DNA was extracted followed by real-time PCR amplifications for characterization of genotypes and alleles related to MTHFR C677T and A1298C gene polymorphisms Results: Total cases showed significantly higher carriage rate for the mutant allele 677T compared to controls (40.7% vs. 26%, OR=1.9, 95% CI= 1.2-3.1) with a lower frequency of the wild type 677CC genotype (59.3% vs. 74%, p=0.004). The same was observed among cases-subgroups of hypertension associated with obesity with a notably higher odds ratio (OR=2.6, 95% CI=1.3-5.01, p=0.004). Total cases showed also significantly higher frequency of mutant 1298 C allele carriage rate compared to controls (59.3% vs. 42.4%, OR=1.98, 95% CI= 1.3-3.1) with a lower frequency of the normal AA genotype (40.7% vs. 57.6%, p=0.003). The same was observed among cases-subgroups of hypertension associated with both diabetes and obesity and among cases of hypertension with obesity, also with higher odds ratio (OR=2.6 and 2.2 respectively). This work showed that genetic polymorphisms related to the MTHFR gene are associated with the risk of hypertension particularly when accompanied with obesity and diabetes among Saudi subjects.

The bioavailability of naphthalene present as a component of a complex nonaqueous phase liquid (NAPL) comprised by nine aromatic compounds was investigated. Specifically, the effects of naphthalene mass transfer from the NAPL to the aqueous phase on rates of its microbial degradation were examined. The investigations were conducted using a pure culture, ATCC 17484, and a mixed culture of naphthalene-degrading bacteria, the former having been implicated previously in the direct uptake of sorbed naphthalene. The studies were conducted in mass-transfer-limited, segregated-phase reactors (SPRs) in which both the NAPL and aqueous phases were internally well-mixed. A 30-day active biodegradation period was preceded and followed by a 5-7-day period devoid of bioactivity, during which time the rates and extents of mass transfer of components from the NAPL to the aqueous phase were quantified. The NAPLphase naphthalene mass depletion profiles during biodegradation were compared to those predicted by assuming maximum mass depletion under mass-transfer-limited conditions using both pre-and post-biodegradation dissolution rate and equilibrium parameters. The observed mass depletion rates were high during the initial stages of biodegradation but decreased significantly in later stages. Throughout biodegradation, even in the initial rapid stage, mass depletion rates never exceeded maximum predicted rates based on pre-biodegradation mass transfer parameters. Reduced depletion rates in the later stages appear to relate to mass transfer hindrance caused by formation of biofilms at the NAPL-water interface.

Segala puji dan syukur penulis panjatkan ke hadirat Tuhan Yang Maha Esa yang telah melimpahkan rahmat, dan hidayah-Nya, sehingga penulis dapat menyelesaikan makalah yang berjudul "Metode Pengumpulan Data" sebagai salah satu tugas mata kuliah Metodologi Penelitian yang diampu oleh Bapak Dr. Wirmie Eka Putra, S.E., M.Si., CIQnR., CSRS. Makalah ini disusun dengan tujuan untuk membantu pembaca, khususnya mahasiswa, dalam memahami berbagai aspek penting yang berkaitan dengan metode pengumpulan data dalam penelitian ilmiah. Penulis menyadari bahwa makalah ini masih jauh dari sempurna. Oleh karena itu, penulis sangat mengharapkan kritik dan saran yang membangun dari para pembaca demi perbaikan dan penyempurnaan makalah ini di masa mendatang. Semoga makalah ini dapat memberikan manfaat bagi semua pihak yang membacanya.

Objective: To determine whether the apolipoprotein E4 (Apo E4) allele may be a genetic risk factor for fibromyalgia syndrome (FMS). Design: A retrospective assessment of associations between Apo E4 genotype and selected environmental exposures among a cohort diagnosed with FMS compared with control subjects. Setting: Marshfield Clinic Research Foundation's Personalized Medicine Research Project (PMRP) biobank. Participants: One hundred fifty-one case subjects with fibromyalgia and 300 age-and gender-matched control subjects. Methods: Fibromyalgia case subjects were identified according to a strict phenotypic definition from among the nearly 20,000 subjects enrolled in the PMRP. Age-and gendermatched control subjects also were identified from the PMRP in a 2:1 control/case ratio. Apo E4 genotype was determined by single nucleotide polymorphism analysis for both case subjects with fibromyalgia and control subjects. Case subjects with fibromyalgia and control subjects were asked to assess their level of function and stress by completing the Short Form-36 and the Perceived Stress Scale. Main Outcome Measures: Statistical associations between the Apo E4 genotype and phenotypic criteria (diagnosis of FMS) as well as historical environmental exposures as documented in the electronic medical record were assessed. Results: Approximately one quarter of both case subjects with fibromyalgia and control subjects were found to carry at least one Apo E4 allele. The odds ratio (OR) for case subjects with fibromyalgia who had ever been in a motor vehicle accident and subsequently had been diagnosed with FMS was increased among those with at least one copy of the Apo E4 allele (OR 7.04) compared with those without an Apo E4 allele (OR 1.90). The presence of an Apo E4 allele did not influence the degree of pain or level of function among those with FMS. Conclusions: These data suggest that specific interactions between genetically susceptible individuals (eg, those with at least one copy of the Apo E4 allele) and the environment (eg, involvement in a motor vehicle accident) may contribute to the risk of being diagnosed with FMS, although Apo E4 allele status does not appear to modulate perceived FMS severity.

Background and Objectives: To assess the knowledge, attitude and practices among Gynecologists' regarding oral health of expectant mothers of Vadodara city, by using self designed, structured, pre-tested close ended questionnaire. Methodology: Total of 130 gynaecologists are included in the study. Ethical approval was obtained by the Ethics committee, Sumandeep Vidyapeeth, Vadodara. Prior to study, questionnaire was pre-tested and validated. Those individuals who participated in the pilot study were not considered for the main study to prevent possible bias. The informed consent was obtained and information sheet was given. The questionnaire was administered on first day of visit and on the next day it was collected back. For statistical analysis SPSS package version 17 and Pearson's Chi Square test was used. The study revealed that majority of gynecologists had good knowledge, attitude and practices regarding oral health of expectant mothers and there is no significant difference in relation with age, sex and years in practice. Majority of gynecologists had good knowledge, attitude and practices but still there is a need for more active participation and involvement of medical specialists like gynecologists and pediatricians, in continuing education programs and forums on dentistry.

Chemical or biological substance designed to kill or retard the growth of pests that damage or interfere with the growth of crops, shrubs, trees, timber and other vegetation desired by humans. Now a day, the utilization of pesticides, fungicides, food, preservatives and cosmetics etc, are continuously increasing day by day which causes physical and mental hazards effect on human being. Pesticide compounds are well absorbed through the mucous membrane of GI tract, respiratory tract and through the skin. Signs & Symptoms of long-term or chronic illness from pesticides are weight loss, constant weakness, numbness in hands or feet, poor balance, skin irritation, loss of vision, very fast or very slow heartbeat, sudden mood changes, confusion, memory loss, and trouble concentrating in general. [1] According to Sushruta, visha which on a constant exposure to a particular time, place and diet as well as constant and regular day-sleep tends to vitiated the dhatus of the body and this poison is consequently known as the dushi visha. As per the definition any substance which has properties of visha and that which is detrimental to the tissue elements on aggravation in favorable condition can be considered as dushi visha. Hence there is need to evaluate, elaborate, and description of long term hazards of chemically composed pesticide in view of Ayurvedic aspect. In first step the chronic pesticide exposed hundred patients has observed for evaluation of dosha, dushya, and srotodusthi. In second step chronic pesticide exposed twenty patients has selected for clinical study among from survived hundred patients.

Buku ajar Etika Profesi dan Hukum Kesehatan disusun sebagai panduan komprehensif untuk memahami prinsip etik, profesionalisme, dan kerangka hukum dalam pelayanan kesehatan. Buku ini mengawali pembahasan dengan konsep dasar moral, etika, dan etik profesi, serta perbedaan antara etika dan hukum dalam praktik kesehatan. Melalui penyajian yang sistematis, pembaca diajak memahami nilai-nilai moral dan prinsip etik yang menjadi landasan perilaku tenaga kesehatan dalam memberikan pelayanan yang bermutu dan berintegritas.

Selanjutnya, buku ini mengulas secara mendalam etika profesi kesehatan, profesionalisme, serta ruang lingkup hukum kesehatan di Indonesia. Pembahasan mencakup peraturan perundang-undangan kesehatan, hak dan kewajiban pasien maupun tenaga kesehatan, dokumentasi medis, hingga aspek hukum dalam perjanjian terapeutik dan malpraktik. Materi juga memperhatikan perkembangan teknologi melalui kajian rekam medis elektronik serta berbagai isu aktual dalam praktik pelayanan kesehatan.

Pada bagian akhir, buku ini membahas berbagai dimensi etik dan hukum dalam situasi khusus, seperti penanganan infeksi emerging dan COVID-19, euthanasia, serta etika dalam penelitian kesehatan. Dengan pendekatan akademik yang jelas dan terstruktur, buku ajar ini diharapkan menjadi referensi penting bagi mahasiswa kesehatan, tenaga kesehatan, dan praktisi yang membutuhkan pemahaman menyeluruh mengenai etika profesi dan hukum kesehatan dalam konteks pelayanan yang profesional, aman, dan bertanggung jawab.

Background: Immunization is the process by which a person’s immune system is fortified and made resistant to an infectious disease/ agent. Immunization saves millions of lives. It is the most important means of preventing childhood morbidity and mortality. This study investigated the knowledge and practice of childhood immunization among men with infants in Enugu Metropolis. Methods: A cross sectional descriptive study using multi stage sampling involving 81 men with infants in Ogbete Main Market Enugu. Data obtained were analyzed using SPSS version 22 adopting descriptive statistics and chi square to test difference and relationship between variables. P-values &lt;0.05 were taken to be level of significance. Results: Findings indicated that median, mean ± standard deviation of the men’s age are 35, 35.8 ± 3.5 respectively. Men’s total knowledge level was significantly associated with their level of education (P&lt;0.05) and their level of practice was significantly associated with ...

Malgré l'augmentation des conflits armés et des changements qui les caractérisent, les enjeux éthiques auxquels font face les médecins militaires sont très peu traités dans la littérature en bioéthique. Les médecins militaires sont des membres du corps militaire, même s'ils sont non combattants, et ils jouent un rôle de soignant tout en pouvant être appelés à agir comme aide humanitaire. Certains auteurs se sont même interrogés sur la compatibilité morale d'être à la fois médecin et soldat. Les conflits éthiques soulevés dans la littérature sur les médecins militaires peuvent être organisés autour de trois perspectives : 1) les problèmes moraux en médecine militaire seraient particuliers compte tenu des difficultés à respecter les principes bioéthiques traditionnels; 2) les codes d'éthique médicaux et les lois internationales seraient trop restrictifs ou inadéquats pour le contexte militaire; et 3) les médecins sont des acteurs sociaux qui devraient être pacifistes, défenseurs des droits de la personne, politiquement neutres ou promoteurs de la paix. Une revue des divers dilemmes rencontrés par les médecins militaires identifiés dans la littérature nous montre que ces perspectives se situent à des niveaux d'analyse différents (micro, méso, macro), que les contextes et les acteurs impliqués sont souvent différents et que les dilemmes vont bien au-delà des enjeux liés strictement à l'intérêt du patient. Tout comme la profession médicale en général, la médecine militaire est complexe et soulève des points de vue divergeant quant au rôle et aux obligations du médecin. Une plus grande clarté des concepts employés dans les discussions autour de l'éthique médicale militaire apparaît donc nécessaire.

Background Antimicrobial resistance (AMR) represents one of the most crucial threats to public health and modern health care. Previous studies have identified challenges with estimating the magnitude of the problem and its downstream effect on human health and mortality. To our knowledge, this study presents the most comprehensive set of regional and country-level estimates of AMR burden in the WHO European region to date. We estimated deaths and disability-adjusted life-years attributable to and associated with AMR for 23 bacterial pathogens and 88 pathogen-drug combinations for the WHO European region and its countries in 2019. Our methodological approach consisted of five broad components: the number of deaths in which infection had a role, the proportion of infectious deaths attributable to a given infectious syndrome, the proportion of infectious syndrome deaths attributable to a given pathogen, the percentage of a given pathogen resistant to an antimicrobial drug of interest, and the excess risk of mortality (or duration of an infection) associated with this resistance. These components were then used to estimate the disease burden by using two counterfactual scenarios: deaths attributable to AMR (considering an alternative scenario where infections with resistant pathogens are replaced with susceptible ones) and deaths associated with AMR (considering an alternative scenario where drug-resistant infections would not occur at all). Data were solicited from a wide array of international stakeholders; these included research hospitals, surveillance networks, and infection databases maintained by private laboratories and medical technology companies. We generated 95% uncertainty intervals (UIs) for final estimates as the 25th and 975th ordered values across 1000 posterior draws, and models were cross-validated for out-of-sample predictive validity. We estimated 541 000 deaths (95% UI 370 000-763 000) associated with bacterial AMR and 133 000 deaths (90 100-188 000) attributable to bacterial AMR in the whole WHO European region in 2019. The largest fatal burden of AMR in the region came from bloodstream infections, with 195 000 deaths (104 000-333 000) associated with resistance, followed by intra-abdominal infections (127 000 deaths [81 900-185 000]) and respiratory infections (120 000 deaths [94 500-154 000]). Seven leading pathogens were responsible for about 457 000 deaths associated with resistance in 53 countries of this region; these pathogens were, in descending order of mortality, Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterococcus faecium, Streptococcus pneumoniae, and Acinetobacter baumannii. Methicillin-resistant S aureus was shown to be the leading pathogen-drug combination in 27 countries for deaths attributable to AMR, while aminopenicillin-resistant E coli predominated in 47 countries for deaths associated with AMR. Interpretation The high levels of resistance for several important bacterial pathogens and pathogen-drug combinations, together with the high mortality rates associated with these pathogens, show that AMR is a serious threat to public health in the WHO European region. Our regional and cross-country analyses open the door for strategies that can be tailored to leading pathogen-drug combinations and the available resources in a specific location. These results underscore that the most effective way to tackle AMR in this region will require targeted efforts and investments in conjunction with continuous outcome-based research endeavours. Funding Bill & Melinda Gates Foundation, Wellcome Trust, and Department of Health and Social Care using UK aid funding managed by the Fleming Fund.

Background: There exist several models for assessment of risk of cardiovascular disease (CVD), including different criteria for diagnosis of obesity, of which a major disparity is 'definition of waist circumference'. Case reports and comparative reviews are hereby presented to exemplify that one cap 'model' does not fit all. Cases: First case illustrates how very slim person with BMI of 17 may possess cardiovascular risk ≥22.7% compared to an obese individual who has a BMI of 39 with CVD risk ≤8.0%. Second case review illustrates how the same BMI and lipid models vary in outcomes depending on gender. Third case report shows how different 'definitions of waist circumference' impacts on identification of obesity, which in turn affect decision about metabolic syndrome. The needs for paradigm shift and 5-step framework are briefly highlighted.

Povzetek: Duhovnost, esenca holistične oskrbe stanovalcev domov za starejše, se izraža v oskrbi hudo bolnih ali umirajočih. Ne glede na njen pomen so duhovnost in z njo povezane potrebe ter stiske pogosto prezrte. Duhovna oskrba lahko dopolni nezadovoljivo oskrbo in tako izboljša kakovost življenja stanovalcev ter preprečuje izgorelost zaposlenih. Takšno oskrbo pa lahko zagotovi le osebje, ki svojo vlogo razume. Odgovori na zastavljeno raziskovalno vprašanje: »Kakšna je percepcija duhovnosti in duhovne oskrbe pri zaposlenih v slovenskih domovih za starejše?« so potrdili vpliv dojemanja duhovnosti na percepcijo duhovne oskrbe. Podatki so bili zbrani na vzorcu 20 domov za starejše; izvedena je bila eksploratorna faktorska analiza, ki je bila dodatno preverjena s konfirmatorno faktorsko analizo. Standardizirani regresijski koeficient pri neodvisni spremenljivki zaznavanje eksistencialne komponente duhovnosti 0,854 je s p < 0,001 statistično značilno različen od nič. Pri spremenljivki nereligiozna komponenta duhovnosti je vrednost standardiziranega regresijskega koeficienta -0,025 in nima značilnega vpliva (p = 0,53) na duhovno oskrbo.

Introduction: Nursing students frequently experience academic stress as a result of their demanding coursework, clinical obligations, and performance standards. Stress has a detrimental effect on sleep quality, which can result in poor mental and physical health. Methodology: A quantitative cross-sectional study was conducted among 100 undergraduate nursing students in selected colleges of Jaipur using a structured questionnaire including Academic Stress Scale and Pittsburgh Sleep Quality Index (PSQI). Convenience sampling technique was used. Data were analyzed using descriptive and inferential statistics Results: According to the results, 64% of students had moderate stress, 22% experienced high stress, and 14% experienced low stress. Seventy percent of students had poor quality sleep. Academic stress and sleep quality were shown to be significantly correlated (p < 0.05). Conclusion: Nursing students' sleep quality is greatly impacted by academic stress. Stress reduction and better sleep hygiene require interventions.

Background: Successful orthodontic therapy has always depended upon on intraoral anchorage with a great resistance to displacement. Osseointegrated implants are considered reliable sources of anchorage for orthodontists hence; the present study was undertaken for assessing the outcome of orthodontic Mini dental implants. Materials & methods: A total of 100 patients were enrolled. In all the involved patients, one or more self-drilling mini-screws were inserted. Orthodontic mini-implants were considered successful when they proved a perfect skeletal anchorage during the entire treatment period (independent from the period&#39;s length) without sign of mobility. All the results were recorded and analysed using SPSS software. Results: Success was observed in 85 percent of the cases. Failure was seen in 15 percent of the cases. Among the failure cases, inflammation was the cause in 10 percent of the cases while screw fracture was seen in 5 percent of the cases. Conclusion: Under the  ha...

Assessment of histological stage is an integral part of disease management in patients infected with the hepatitis C virus (HCV). The aim of this study was to develop a model incorporating objective clinical and laboratory parameters to estimate the probability of severe fibrosis (i.e., Ishak fibrosis > 3) in previously untreated African American (AA) and Caucasian American (CA) patients with HCV genotype 1. The Ishak fibrosis scores of 205 CA and 194 AA patients enrolled in the Viral Resistance to Antiviral Therapy of Chronic Hepatitis C study (Virahep-C) were modeled using simple and multiple logistic regression. The model was then validated in an independent cohort of 461 previously untreated patients with HCV. The distribution of fibrosis scores was similar in the AA and CA patients as was the proportion of patients with severe fibrosis (35% vs. 39%, P ‫؍‬ .47). After accounting for the number of portal areas in the biopsy, patient age, serum aspartate aminotransferase, alkaline phosphatase, and platelet count were independently associated with severe fibrosis in the overall cohort, and the relationship with fibrosis was similar in both the AA and CA subgroups. The area under the receiver operating characteristic curve (AUROC) of the Virahep-C model (0.837) was significantly better than in other published models (P ‫؍‬ .0003). The AUROC of the Virahep-C model was 0.851 in the validation population. In conclusion, a model consisting of widely available clinical and laboratory features predicted severe hepatic fibrosis equally well in AA and CA patients with HCV genotype 1 and was superior to other published models. The excellent performance of the Virahep-C model in an external validation cohort suggests the findings are replicable and potentially generalizable. (HEPATOLOGY 2006; 44:925-935.

In patients with chronic hepatitis C virus (HCV) infection, steatosis and fibrosis have been shown to be inversely associated with total cholesterol (TC) and lowdensity lipoprotein cholesterol. Steatosis and fibrosis have also been found to be associated with triglyceride (TG) levels; though, the direction of the relationship is inconsistent across studies. The objective of this study was to assess whether viral level and histological factors are associated with the serum lipid profile in a treatment-naı ¨ve cohort with chronic HCV genotype 1 infection. Participants were from the prospective Study of Viral Resistance to Antiviral Therapy (Virahep-C). Fasting lipid profiles were analysed for 160 African Americans and 170 Caucasian Americans. Linear regression was used to evaluate associations of each lipid with viral load and liver disease. TG levels were significantly and directly associated with HCV levels (P = 0.0034) and steatosis (P < 0.0001). Other lipid parameters were significantly lower in those with fibrosis [HDLc (P = 0.001) and TC levels (P = 0.004)] than in those without fibrosis. In patients with HCV genotype 1 infection, more severe liver disease was associated with lower lipid levels, with the exception of TG levels that were directly related to steatosis. The direct relationship between viral load and TG levels is consistent with proposed the mechanisms of very low density lipoprotein/HCV particle secretion. In contrast, the direct relationship between TG level and steatosis is inconsistent with posited mechanisms of HCV-induced steatosis, a possible reflection of HCV genotype 1 infection and a metabolic aetiology of steatosis.

Assessment of histological stage is an integral part of disease management in patients infected with the hepatitis C virus (HCV). The aim of this study was to develop a model incorporating objective clinical and laboratory parameters to estimate the probability of severe fibrosis (i.e., Ishak fibrosis > 3) in previously untreated African American (AA) and Caucasian American (CA) patients with HCV genotype 1. The Ishak fibrosis scores of 205 CA and 194 AA patients enrolled in the Viral Resistance to Antiviral Therapy of Chronic Hepatitis C study (Virahep-C) were modeled using simple and multiple logistic regression. The model was then validated in an independent cohort of 461 previously untreated patients with HCV. The distribution of fibrosis scores was similar in the AA and CA patients as was the proportion of patients with severe fibrosis (35% vs. 39%, P ‫؍‬ .47). After accounting for the number of portal areas in the biopsy, patient age, serum aspartate aminotransferase, alkaline phosphatase, and platelet count were independently associated with severe fibrosis in the overall cohort, and the relationship with fibrosis was similar in both the AA and CA subgroups. The area under the receiver operating characteristic curve (AUROC) of the Virahep-C model (0.837) was significantly better than in other published models (P ‫؍‬ .0003). The AUROC of the Virahep-C model was 0.851 in the validation population. In conclusion, a model consisting of widely available clinical and laboratory features predicted severe hepatic fibrosis equally well in AA and CA patients with HCV genotype 1 and was superior to other published models. The excellent performance of the Virahep-C model in an external validation cohort suggests the findings are replicable and potentially generalizable. (HEPATOLOGY 2006; 44:925-935.

In patients with chronic hepatitis C virus (HCV) infection, steatosis and fibrosis have been shown to be inversely associated with total cholesterol (TC) and lowdensity lipoprotein cholesterol. Steatosis and fibrosis have also been found to be associated with triglyceride (TG) levels; though, the direction of the relationship is inconsistent across studies. The objective of this study was to assess whether viral level and histological factors are associated with the serum lipid profile in a treatment-naı ¨ve cohort with chronic HCV genotype 1 infection. Participants were from the prospective Study of Viral Resistance to Antiviral Therapy (Virahep-C). Fasting lipid profiles were analysed for 160 African Americans and 170 Caucasian Americans. Linear regression was used to evaluate associations of each lipid with viral load and liver disease. TG levels were significantly and directly associated with HCV levels (P = 0.0034) and steatosis (P < 0.0001). Other lipid parameters were significantly lower in those with fibrosis [HDLc (P = 0.001) and TC levels (P = 0.004)] than in those without fibrosis. In patients with HCV genotype 1 infection, more severe liver disease was associated with lower lipid levels, with the exception of TG levels that were directly related to steatosis. The direct relationship between viral load and TG levels is consistent with proposed the mechanisms of very low density lipoprotein/HCV particle secretion. In contrast, the direct relationship between TG level and steatosis is inconsistent with posited mechanisms of HCV-induced steatosis, a possible reflection of HCV genotype 1 infection and a metabolic aetiology of steatosis.

Background: Cricket bowlers often have to perform overhead throwing due to which in the dominant arm, compared with the nondominant arm the magnitude of glenohumeral internal rotation is decreased and magnitude of external rotation is increased. Glenohumeral internal rotation deficits (GIRD) are deficits of internal rotation and total arc of motion in the dominant side which is common in overhead athletes including cricket bowlers. Hence the aim of the study was to compare the effectiveness of muscle energy technique vs mulligan in patients with glenohumeral internal rotation deficit. Methodology: 30 patients were included in the study which was divided into two groups; Group A with 15 patients and Group B with 15 patients.30 cricket bowlers with presence of glenohumeral internal rotation deficit were selected. Before application of muscle energy technique and mulligan active shoulder range of motion using full scale goniometer was taken. Treatment was given for 4 weeks, 6 sessions ...

Overview: Despite the availability of highly sophisticated dental equipment, several ergonomic risk factors such as repetitive tasks and non-neutral physical postures do contribute greatly to work-related musculoskeletal disorders in dental surgeons. The current study was carried out to analyze the correlation between ergonomic risk factors and work-related musculoskeletal disorders in terms of perception of pain and stiffness experienced by dental surgeons. Materials and Methods: One hundred and thirty dental surgeons with one year of work experience and having moderate to severe pain on the Numeric Pain Rating Scale were asked to participate in the pre-test. Both male and female dental surgeons were equally distributed and they were in the age group of 20-35 years. After explaining the purpose of the study, an informed written consent was obtained from the participants on voluntary basis. After a six week ergonomic awareness training program, the correlation between ergonomic risk...

Objective: Osteoporosis is the most common type of bone disorder characterized by low bone mineral density (BMD). It is a multifactorial disease and caused by the interaction of environmental and genetic factors. It has been reported that mutations in the vitamin D receptor (VDR) gene highly affect the metabolism of minerals, which reduces bone density. Therefore, this study aimed to determine the association of VDR gene polymorphisms TaqI (rs731236) and ApaI (rs7975232) with osteoporosis risk in the Saudi population. Methods: This case-control study involved 73 individuals with osteoporosis and 73 healthy controls in Jeddah, KSA. DNA extracted from peripheral blood was used to determine the genotypes and allele frequencies of VDR variants by polymerase chain reaction-restriction fragment length polymorphisms. Osteoporosis was confirmed by measuring BMD using dual-energy X-ray absorptiometry. The results were interpreted using the Hardy-Weinberg equilibrium assumption with P < 0.05 considered as significant. Results: A significant increase in the genotype frequencies of the ApaI (Aa) and (aa) was observed among osteoporotic patients compared to controls (P = 0.002 and P < 0.0001, respectively). Only the homozygous (tt) genotype of TaqI was significantly higher in those with osteoporosis than in the controls (P = 0.001). The minor "a" allele of ApaI and the "t" allele of TaqI were significantly more common in the patients as compared to controls (P < 0.0001 and P = 0.01, respectively). Conclusion: VDR polymorphisms ApaI and TaqI were found to be significantly determinant risk factors for osteoporosis progression in the Saudi population.

low fatigue (FIS<40) were the classifications of patients. Out of five groups, the group-V (HCC) had higher incidence (68.8%) of high fatigue patients. Additionally, FSS and FIS mean score was significantly higher than other groups. The longest fatigue duration (45±96 months) was observed in group-III (Child class C cirrhosis group) followed by HCC group (40±32 months) with no statistically significant. Conclusion: The present study found that fatigue is a common symptom in liver cirrhosis patients. Assessment of healthrelated QoL is therefore crucial in the treatment of cirrhotic patients. In cirrhotic people, fatigue may be reduced if anemia is treated but not the liver profile. Female and HCC patients reported significantly higher fatigue indices.

aimed to assess changes of those indicators across Central Eastern Europe and Central Asia (CEECA) over the last three decades to capture how care has developed during that historical period. Methods: We retrospectively obtained data on numbers of psychiatric beds and prison populations from 30 countries in CEECA between 1990 and 2019. We calculated the median of the percent changes between the first and last available data points for all CEECA and for groups of countries based on former political alliances and income levels. Findings: Primary national data were retrieved from 25 out of 30 countries. Data from international registries were used for the remaining five countries. For all of CEECA, the median decrease of the general psychiatric bed rates was 338% between 1990 and 2019. Median increases were observed for forensic psychiatric beds (247%), residential facility beds (120%), and for prison populations (360%). Greater reductions of rates of psychiatric beds were observed in countries with lower per capita income as well as in countries that were formerly part of the Soviet Union. Seventeen out of 30 countries showed inverse trends for general psychiatric beds and prison populations over time, indicating a possible shift of institutionalisation towards correctional settings. Interpretation: Most countries had decreased rates of general psychiatric beds, while there was an increase of forensic capacities. There was an increase in incarceration rates in a majority of countries. The large variation of changes underlines the need for policies that are informed by data and by comparisons across countries.

Objective: the study seeks to determine the relationships between neuroticism and extroversion, on the one side, and the perception of various dimensions of social stigma, on the other, in psychiatric in-patients with depressive disorders, such as depressive episodes, or mood and anxiety disorders with the presence of depressive symptoms. Material and methods: A total of 72 patients were examined in the study. twenty four of them (f/M -12/12; age range 42-65 years) were used for assessing the reliability of a depression stigma questionnaire (dSQ) created specifically for this study. the remaining 48 patients (f/M -31/17; age range 17-74 years) were then surveyed with the dSQ and other psychometric tools employed in the study. Self-reported data on the self-stigma, perceived stigma, public (mirrored) stigma, secrecy, treatment stigma, and the levels of neuroticism, extroversion, and depression were collected. Results: the study demonstrates that treatment stigma and secrecy were the most frequent aspects of stigma experienced by the patients. Secrecy correlated negatively with age and positively with the education level. there were correlations between neuroticism and four of the stigma dimensions: treatment stigma, secrecy, perceived stigma, and self-stigma. extroversion, in turn, correlated with perceived stigma, public stigma, and self-stigma. Conclusions: the study confirms the relevance of personality resources in the perception and coping with stigma and points to secrecy as a major underlying factor in these processes. in light of the present findings, stigma experienced by the patient is not only related to the external indicators of social stigmatization and the state of depression, but also to the personal features of an individual.

U n i fes p), o aumento oco r reu ent re 1994 e 2004, passando de 4 para mais de 9 denúncias diárias; em 2005, a média de queixas cresceu ainda mais: 12 por dia. Com base em tais dados, em seu trabalho Boyaciyan mostra que pouco mais de 16% das quase 24 mil denúncias registradas culminou em processo legal e, dessas, 12% eram ligadas às áreas de ginecologia e obstetrícia. Entre as causas para esse crescimento, o pesquisador enumera algumas questões conjunturais da prática e da formação médica, assim como um maior acesso à informação por parte dos pacientes, o que os têm tornados mais questionadores e conscientes de seus direitos.

Periodontitis is a chronic inflammatory disease that causes destruction of tooth-supporting tissues. Interlukin-20 (IL-20) is a proinflammatory cytokine of the IL-10 family that is involved in some diseases; rheumatoid arthritis, psoriasis, and atherosclerosis. The purpose of this study was to evaluate the levels of IL-20 in gingival crevicular fluid (GCF) and serum of both chronic periodontitis patients and periodontal healthy subjects. Thirty systemically male subjects were categorized into group 1 (healthy) and group 2 (chronic periodontitis patients). The patients were clinically evaluated by; plaque index (PI), bleeding index (BI), probing pocket depth (PD) and clinical attachment loss (CAL). GCF and serum samples were obtained from all individuals to measure IL-20 levels by using of enzyme-linked immunosorbent assay (ELISA) technique. The levels of IL-20 in GCF were significantly higher in chronic periodontitis patients compared to healthy subjects (P ≤ 0.05). In addition, the...

This study aimed to assess the level of knowledge and attitudes toward dengue fever among nurses and primary healthcare workers in Tabriz, Iran, and to identify factors associated with these outcomes. Methods: A cross-sectional analytical study was conducted from March to June 2025. Participants included 556 healthcare workers (345 nurses and 211 primary healthcare providers) from hospitals and primary care centers in Tabriz. Stratified random sampling was used for nurses and census sampling for primary healthcare providers. Data were collected using a validated 50-item questionnaire. Knowledge (score range 0-40) and attitude (score range 0-8) were assessed, with scores ≥ 60% considered adequate or positive. Data were analyzed using descriptive statistics, independent t-tests, ANOVA, Pearson correlation, and multivariable general linear modeling. Results: A total of 556 healthcare workers participated, including 345 nurses and 211 primary healthcare providers. Overall, 67.9% of participants demonstrated adequate knowledge and 79.4% showed positive attitudes toward dengue fever based on study-defined thresholds. Knowledge and attitude scores were significantly lower among nurses compared with primary healthcare providers. Multivariable analysis indicated that occupation was the strongest predictor of knowledge, while attitudes were independently associated with occupation, gender, work experience, and knowledge level. Although most participants correctly identified mosquito-borne transmission, substantial misconceptions persisted regarding person-to-person transmission and pharmacological management. Conclussion: Healthcare workers in Tabriz demonstrated generally acceptable knowledge and positive attitudes toward dengue fever; however, important gaps were identified, particularly among nurses and in specific domains such as transmission pathways and clinical management. The observed associations between knowledge and attitudes highlight the need for targeted educational interventions tailored to professional roles. While improved knowledge may support preparedness, further studies incorporating direct assessment of clinical practices are required to determine its impact on real-world dengue prevention and management.

CD14 is a co-receptor for bacterial lipolysaccharide (LPS) detection. It is found on myelomonocytic cells such as monocytes, macrophages, and Langerhans cells, CD14 expression in bladder cells is necessary for cytokine secretion and increased tumor growth. The goal of this study was to use immunohistochemistry (IHC) to assess CD14 expression in patients with transitional cell carcinoma of the urinary bladder in order to see if there was a link between CD14 marker expression in bladder cancer and cystitis. The immunoexpression of CD14 in paraffin sections from 30 bladder biopsy samples was separated into three groups: cystitis, low grade bladder cancer (L.G), and high grade bladder cancer (H.G), and studied using immunohistochemical assays (IHC). For bladder cancer (L.G & H.G), the percentage of samples that gave positive results for IHC/CD14 expression was 70% and 80%, respectively, compared to 30% for cystitis. The incidence of study samples appear in both sexes.

Acinetobacter baumannii is one of the ESKAPE pathogens which are the leading cause of nosocomial infections throughout the world. The aim of this study is to detect the role of Some Proteins in Resistance of Acinetobacter baumannii to imipenem. The research included the collection of 100 different clinical specimens of( urine, burns, and wounds) isolated from patients in Al-Diwaniyah Teaching Hospital for the period from September to December 2021. 20 isolates out of 100 isolates belonging to A.baumannii  were obtained. The samples were collected from different clinical specimens distributed as follows:7(35%) Swabs of burns,8(40%) swabs of wounds, and 5(25%)from urine, an examination was conducted for (8)Antibiotics by ( Antibiotic Susceptibility Test-AST ) on 20  isolates. The results showed that all isolates are resistant to antibiotics except for imipenem showed a sensitivity of 20% and resistance of 80% to imipenem. The results of the Minimum Inhibitory Concentration level of im...

The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a rules-based synthesis of the available evidence on levels and trends in health outcomes, a diverse set of risk factors, and health system responses. GBD 2019 covered 204 countries and territories, as well as first administrative level disaggregations for 22 countries, from 1990 to 2019. Because GBD is highly standardised and comprehensive, spanning both fatal and non-fatal outcomes, and uses a mutually exclusive and collectively exhaustive list of hierarchical disease and injury causes, the study provides a powerful basis for detailed and broad insights on global health trends and emerging challenges. GBD 2019 incorporates data from 281 586 sources and provides more than 3•5 billion estimates of health outcome and health system measures of interest for global, national, and subnational policy dialogue. All GBD estimates are publicly available and adhere to the Guidelines on Accurate and Transparent Health Estimate Reporting. From this vast amount of information, five key insights that are important for health, social, and economic development strategies have been distilled. These insights are subject to the many limitations outlined in each of the component GBD capstone papers.

BackgroundThe epidemiological transition of non-communicable diseases replacing infectious diseases as the main contributors to disease burden has been well documented in global health literature. Less focus, however, has been given to the relationship between sociodemographic changes and injury. The aim of this study was to examine the association between disability-adjusted life years (DALYs) from injury for 195 countries and territories at different levels along the development spectrum between 1990 and 2017 based on the Global Burden of Disease (GBD) 2017 estimates.MethodsInjury mortality was estimated using the GBD mortality database, corrections for garbage coding and CODEm—the cause of death ensemble modelling tool. Morbidity estimation was based on surveys and inpatient and outpatient data sets for 30 cause-of-injury with 47 nature-of-injury categories each. The Socio-demographic Index (SDI) is a composite indicator that includes lagged income per capita, average educational...

This publication is part of the FNIGC Research Series, a series of special reports focused on issues facing First Nations reserve and Northern communities which leverage data from the FNIGC' s national survey initiatives. The FNIGC Research Series is available online at the FNIGC' s website www.fnigc.ca.