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Outbreak of Gastroenteritis Among Riyadh Female Long-Term Elderly Care Facility Residents-Saudi Arabia, January 2023
Khalid Khalfan Alnair,
Shady Kamel,
Abdulaziz S. Almeshal
Issue:
Volume 7, Issue 2, December 2023
Pages:
40-48
Received:
20 June 2023
Accepted:
6 July 2023
Published:
27 July 2023
Abstract: Background: The female long-term elderly care facility in Al-Riyadh is affiliated with the Ministry of Human Resources and Social Development, with a maximum capacity of 60. Between January 29, and February 3rd, 2023, the local public health authorities were notified of a potential gastrointestinal illness (AGE) outbreak involving 15 residents and 4 staff members. Objective: Investigate the outbreak, implemented infection control measures, and infection risk factors in a female (LTCF) in Riyadh. Methods: A laboratory, environmental investigation, and retrospective cohort study were conducted, including 54 residents and descriptive data on 27 employees. The data were collected from clinical histories and through a survey by questionnaire. Results: A total of 19 cases of which 15 (79%) female residents, 3 (16%) staff nurses, and one (5%) female worker at the kitchen had been ill with AGE, corresponding to an overall attack rate of 11% and 28% among the residents. And 3 (16%) being managed as outpatient and 1 (5%) being admitted. No deaths occurred among the affected cases. The Cases ranged from 51-91 years (median: 64 years). The main reported symptoms were vomiting (86.6%), diarrhea (60.0%). Living on the first floor and in unit 3 was associated with a higher risk of developing AGE (RR 3.7, 95% CI 1.2-11.7) and (RR 3.3, 95% CI 1.6 - 7.0) with a P value of 0.01, respectively. Stool analysis and culture for 4 resident cases were negative. Food and water samples were also negative. Conclusion: We concluded that the source of outbreak was not identified as no sample had taken from patients or the prepared food on same day. While it cannot be proven with certainty, this investigation suggests that the outbreak may have originated from food, highlighting the importance of implementing food safety protocols in institutional care facilities. Public health agencies should investigate these outbreaks to uncover any problems with food handling or other possible causes.
Abstract: Background: The female long-term elderly care facility in Al-Riyadh is affiliated with the Ministry of Human Resources and Social Development, with a maximum capacity of 60. Between January 29, and February 3rd, 2023, the local public health authorities were notified of a potential gastrointestinal illness (AGE) outbreak involving 15 residents and ...
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Empirical Research on the Anti-Inflammatory, Antibacterial, and Mucosal Protective Effects of Agarwood Based on the Oral and Intestinal Microenvironment
Yi-Nan Zhang,
Zi-Lin Wang,
Xiang Guo,
Xue-Jing Lin,
Hao-Yi Duan,
Nan Wang,
Shui-Chang Zhang,
Wei-Ru Cheng,
Fan-Di Xu,
Minhaj Ahmad,
Zhu-Ling Guo
Issue:
Volume 7, Issue 2, December 2023
Pages:
49-53
Received:
10 July 2023
Accepted:
1 August 2023
Published:
10 August 2023
Abstract: Objective: To investigate the effects of chemical substances contained in agarwood on the body's inflammatory response, oxidative stress, oral and intestinal micro-ecology, as well as their role in various mucosal diseases, such as recurrent aphthous ulcer (RAU) and inflammatory bowel disease (IBD). Materials and Methods: By reviewing and summarizing literature from the past decade on agarwood and its related chemical components composition, as well as their effects on RAU and IBD, we explore the role of agarwood in the body and its relationship with mucosal-related diseases. Results: The Specific components in agarwood, such as sesquiterpenes, flavonoids, etc., can regulate the body's inflammatory response and oxidative stress levels through various signaling pathways, thereby affecting the mucosal status of the oral and intestinal cavity, such as influencing the expression of tight junction proteins between epithelial cells to restore mucosal barrier permeability. Conclusion: Agarwood can down-regulate the inflammatory response by inhibiting various signaling pathways, mainly NF-κB, reduce oxidative stress by decreasing ROS expression, improve the mucosal barrier in the oral and intestinal cavity, and simultaneously impact the improvement of oral and intestinal micro-ecology. It plays a certain controlling role in mucosal-damaged diseases such as IBD and RAU, laying the foundation for the transformation, development, and upgrading of the agarwood industry.
Abstract: Objective: To investigate the effects of chemical substances contained in agarwood on the body's inflammatory response, oxidative stress, oral and intestinal micro-ecology, as well as their role in various mucosal diseases, such as recurrent aphthous ulcer (RAU) and inflammatory bowel disease (IBD). Materials and Methods: By reviewing and summarizi...
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Endoscopic Management of Colonic Perforation Due to Biliary Stent Migration
Issue:
Volume 7, Issue 2, December 2023
Pages:
54-56
Received:
31 July 2023
Accepted:
21 August 2023
Published:
31 August 2023
Abstract: Biliary stenting is an indispensable procedure in malignant and benign obstructions. Stent migration is seen in approximately 5-10% of patients with biliary stent placement. Duodenal, ileal, jejunal and colon perforation due to biliary stent migration has been reported in less than 1% of cases. In this case, a 70-year-old female patient who had a biliary stent implanted 7 months ago due to choledocholithiasis was admitted with the complaint of abdominal pain. Computed tomography showed a plastic biliary stent with one end perforating the lumen of the sigmoid colon and the other end perforating the colon wall and peritoneal cavity. The patient was successfully removed endoscopically due to the absence of abscess and peritonitis clinic. Biliary stenting is an indispensable procedure in malignant and benign obstructions. Stent migration is seen in approximately 5-10% of biliary stent patients. Duodenal, ileal, jejunal and colonic perforation due to biliary stent migration tubules in less than 1% of cases. In this case, a 70-year-old female patient who had a biliary stent inserted 7 months ago due to choledocholithiasis applied with the complaint of abdominal pain. Computed tomography showed a plastic biliary stent with one end in the lumen of the sigmoid colon and the other end perforating the colon wall and peritoneal wall. Due to the absence of abscess and peritonitis clinic on computed tomography, it was decided to plan an endoscopic procedure for the patient. In rectosigmoidoscopy, a plastic stent perforating the sigmoid colon wall and one end in the peritoneum was observed. The stent was removed with foreign body forceps. The perforation area formed by the stent was closed with a hemoclip. It should not be forgotten that stent migration and related perforation may occur in abdominal pain in patients with a history of biliary stent. Perforation cases without abscess and peritonitis clinic should be evaluated in terms of endoscopic treatments, as in our case.
Abstract: Biliary stenting is an indispensable procedure in malignant and benign obstructions. Stent migration is seen in approximately 5-10% of patients with biliary stent placement. Duodenal, ileal, jejunal and colon perforation due to biliary stent migration has been reported in less than 1% of cases. In this case, a 70-year-old female patient who had a b...
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Clinical Outcome of Patients with COVID Transaminitis Given Essential Phospholipids in a Tertiary Medical Center: A Retrospective Cohort Study
Daniel Frederick Cruz Ulep,
Adolf Lim-Teodoro,
Emmanuel Monsayac
Issue:
Volume 7, Issue 2, December 2023
Pages:
57-63
Received:
13 August 2023
Accepted:
29 August 2023
Published:
6 September 2023
Abstract: Background: The COVID-19 pandemic has been a global public health challenge since the initial emergence of the novel coronavirus. COVID-19 infections can cause multi-systemic effects, including gastrointestinal symptoms such as abdominal pain, loose bowel movement, and increased liver enzymes, leading to transaminitis. The use of essential phospholipids, with its anti-inflammatory, antioxidant, antifibrinogenic, antiapoptotic, membrane-protective, and lipid-regulating effects, may be a viable treatment option for COVID-19-induced transaminitis. Methods: This retrospective cohort study aims to evaluate the clinical outcomes of administering essential phospholipids to adult Filipino patients with COVID-19 Transaminitis admitted in a tertiary medical center from July 2021 to February 2022. A total of 238 COVID-19 patients admitted met the inclusion criteria. The primary treatment arm consists of 156 patients who received essential phospholipids during admission, while the control arm consists of the remaining 82 patients who did not receive essential phospholipids. The study's statistical analysis utilized Wilcoxon Signed Rank Test, Mann-Whitney U Test, and Chi-square test. The computed minimum sample size is 109 based on a confidence value of 95%, a margin of error of 5, 50% population proportion, and a population size of 150. Results: The study shows that the prevalence of COVID-19 Transaminitis is 70%. There is also a significant decrease from baseline to repeat serum AST and ALT levels for patients who took essential phospholipids. Although not statistically significant, there is a trend toward a decrease in mortality rate from those patients who took essential phospholipids compared to those who did not (16% vs. 24% respectively). There was also higher mortality rate for those patients with COVID-19 transaminitis (21%), from those who did not have COVID-19 transaminitis (16%), however, the study did not reach the level of significance. There is a significant difference in the number of COVID-19 critical patients with transaminitis compared to those who did not have transaminitis (51% vs 33%). Conclusion: The prevalence of transaminitis in COVID-19 infection is high. essential phospholipids may hold promise as an effective treatment option for COVID-19 transaminitis. The presence of transaminitis in COVID-19 patients appears to have a significant impact on the severity of the disease or the course of treatment.
Abstract: Background: The COVID-19 pandemic has been a global public health challenge since the initial emergence of the novel coronavirus. COVID-19 infections can cause multi-systemic effects, including gastrointestinal symptoms such as abdominal pain, loose bowel movement, and increased liver enzymes, leading to transaminitis. The use of essential phosphol...
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Review Article
Recurrent Diarrhoeal Disease is a Major Cause of Childhood Malnutrition and Necessity of Contravention of the Vicious Cycle of Diarrhoea Related Malnutrition in Bangladesh
Mohammed Istiaque Hossain*,
Mohammad Delwar Hossain,
Susanta Kumar Ghosh,
Khadija Rahman,
Mohammad Monir Hossain,
Afsana Khanom,
Riffat Mohiuddin,
Tasnim Ahmed
Issue:
Volume 7, Issue 2, December 2023
Pages:
64-76
Received:
24 September 2023
Accepted:
13 October 2023
Published:
24 November 2023
Abstract: In children, diarrheal illness and its sequelae continue to be a leading cause of morbidity and death, particularly in impoverished nations like Bangladesh. Globally, diarrheal illnesses pose a severe threat to public health, particularly because they are the second-leading cause of mortality in children (behind respiratory illnesses). About 63% of the worldwide burden of childhood diarrhea affects children under the age of five. The etiology of many disorders must be accurately and quickly detected, but standard procedures are typically unsuccessful in doing so, in addition to being time- and labor-intensive. Up to 40% of cases of diarrhoea, on average, have an unknown etiological cause. This study highlights the promise of the metagenomics technology as a diagnostic method for enteric diseases and provides an overview of current trends in the epidemiology and management of diarrhea. Increased frequency, increased volume, and altered stoma consistency are all signs of diarrhea. Environments in the industrialized and underdeveloped worlds have different pathogens. The most significant aetiological factor associated with severe dehydrating diarrhea is rotavirus diarrhea. In order to target the right treatment, it is crucial to identify the specific microbiological cause of diarrhoea. However, the World Health Organization (WHO)'s recommendations for broader preventive measures highlight the key causes of the enormous disease burden in developing nations. Worldwide, acute diarrheal illness in children under the age of five continues to be a leading cause of morbidity and death. Children are more likely to experience severe infectious diarrhea in environments with low sanitation and hygiene, limited water supply, and a lack of resources. A complete history and physical examination, as well as assessments of the child's nutritional and hydration status as well as a thorough clinical evaluation for any complications or accompanying diseases, are all necessary for the care of a kid who presents with severe diarrhea. In Bangladesh, the use of zinc supplements, reduced-osmolarity oral rehydration solution (ORS), and rotavirus vaccination are recent advancements in the management of severe diarrheal illness.
Abstract: In children, diarrheal illness and its sequelae continue to be a leading cause of morbidity and death, particularly in impoverished nations like Bangladesh. Globally, diarrheal illnesses pose a severe threat to public health, particularly because they are the second-leading cause of mortality in children (behind respiratory illnesses). About 63% of...
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Research Article
Anthropometric and Biochemical Findings in Non-Alcoholic Fatty Liver Disease with or Without Diabetes
Md. Mawla Ali Sheikh*,
Md. Anisur Rahman,
Tareq Mahmud Bhuiyan,
Md. Golam Azam
Issue:
Volume 7, Issue 2, December 2023
Pages:
77-86
Received:
1 October 2023
Accepted:
30 October 2023
Published:
22 December 2023
Abstract: Background: Non-alcoholic fatty liver disease (NAFLD) has emerged as a prevalent cause of chronic liver diseases globally in the past decade, posing significant risks to liver health, cardiovascular well-being, and even warranting consideration for liver transplantation. There is limited research on the clinical, anthropometric, biochemical, and metabolic characteristics of NAFLD patients, both with and without diabetes, in Bangladesh. Aim of the study: This study aimed to assess the prevalence of diabetes and non-diabetes among a group of NAFLD patients and to investigate the anthropometric, biochemical, and metabolic profiles of NAFLD patients with diabetes compared to those without diabetes. Methods: This prospective observational study was conducted at the Department of Gastrointestinal Hepatobiliary & Pancreatic Disorder (GHPD), BIRDEM General Hospital, Dhaka, from April 2014 to April 2015. A total of 111 individuals with ultrasonographically diagnosed NAFLD were included in the study. Participants underwent assessments for various parameters, including anthropometric measurements, biochemical assays (including blood glucose levels, liver function tests, lipid profiles, and HOMA-IR), and the presence of diabetes or metabolic syndrome (as defined by IDF criteria). The patients were categorized and analyzed based on the presence or absence of diabetes. Statistical analysis was performed using SPSS version 16.0. Results: Among the 111 NAFLD patients, 71 (63.96%) were diagnosed with diabetes, while 40 (36.04%) did not have diabetes. In comparison to those without diabetes, NAFLD patients with diabetes tended to be older (47.15±10.26 vs. 43.35±10.7 years) and included a higher proportion of females (61.98% vs. 57.50%). They also had a significantly higher prevalence of hypertension (77.47% vs. 40.0%; p<0.001), dyslipidemia (64.79% vs. 40.0%; p=0.01), and metabolic syndrome (74.64% vs. 30.0%; p<0.001). Diabetic NAFLD patients had a higher mean body mass index (BMI) compared to non-diabetic NAFLD patients (27.09±3.98 vs. 25.18±3.58 kg/m2; p=0.01). Most patients, both with diabetes (87.32%) and without diabetes (80%), had central obesity. Additionally, diabetic NAFLD patients exhibited higher waist circumference, hip circumference, waist-to-hip ratio, waist-to-height ratio, systolic blood pressure, and diastolic blood pressure when compared to non-diabetic NAFLD patients. Serum levels of ALT, AST, GGT, and ALP were significantly elevated in the diabetic group. While triglyceride levels, total cholesterol, LDL-cholesterol, and fasting insulin levels were also higher in diabetic NAFLD patients, these differences were not statistically significant. However, insulin resistance, as measured by HOMA-IR, was significantly higher in diabetic NAFLD patients. Conclusion: NAFLD patients with diabetes exhibit greater metabolic risk factors, including higher BMI, central obesity, hypertension, elevated triglyceride levels, and increased insulin resistance, all of which may contribute to the progression of non-alcoholic steatohepatitis (NASH) and advanced fibrosis. Notably, a substantial proportion of NAFLD patients without diabetes also display metabolic risk factors, highlighting the importance of recognizing NAFLD in individuals without diabetes.
Abstract: Background: Non-alcoholic fatty liver disease (NAFLD) has emerged as a prevalent cause of chronic liver diseases globally in the past decade, posing significant risks to liver health, cardiovascular well-being, and even warranting consideration for liver transplantation. There is limited research on the clinical, anthropometric, biochemical, and me...
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