Journal of Clinical Epidemiology & Toxicology
Journal of Clinical Epidemiology & Toxicology is an open access peer-reviewed journal from the publishers of Scientific Research and Community (SRC) which publishes articles in the form of written, video and power-point presentations from the arena of Clinical Epidemiology & Toxicology. The journal focuses to build up accessing the complete content of articles freely from online for reader’s perusal. Article acceptance will be in the form of Research, Review, Case Reports, Analysis, Magazines, Editorials, Opinion, Communications, Mini-Review, Short Communications, Picturized, Book Review, Video Type and Power Point Presentations (PPTS). Articles can be submitted through online from https://www.onlinescientificresearch.com/submit-online or can send through an e-mail with attachment for jcet@onlinescientificresearch.info
Post-Mass Vaccination Epidemiology of Suspected and Laboratory-Confirmed Yellow Fever in Rivers State, Nigeria (2020-2025)
Background: Yellow Fever (YF) is a re-emerging, vaccine-preventable arboviral disease of major public health importance in Nigeria. Rivers State conducted a preventive mass vaccination campaign in early 2020. Sustained surveillance is essential to detect outbreaks and identify residual immunity gaps in the post-campaign period. Objective: To describe the epidemiology of suspected and confirmed Yellow Fever cases in Rivers State from January 2020 to August 2025. Methods: A retrospective descriptive analysis of state-integrated disease surveillance and laboratory data was conducted. Suspected cases were defined using national guidelines. Laboratory confirmation was based on Yellow Fever IgM ELISA at a regional reference laboratory, with confirmatory plaque reduction neutralization testing (PRNT) at a WHO reference laboratory. Demographic, geographic, and vaccination characteristics were analyzed. Results: No suspected cases were reported in 2020. From August 2021 to August 2025, 181 suspected cases were recorded, of which 9 (5.0%) were laboratory confirmed. Confirmed cases occurred in late 2021 and mid-2025. Males accounted for 88.9% of confirmed cases, and 44.4% were infants under one year. None of the confirmed cases had documented YF vaccination. Confirmed infections occurred in only 5 of 23 LGAs, indicating focal transmission. Conclusion: Rivers State experienced sporadic, geographically focal Yellow Fever activity following the 2020 mass vaccination campaign. Confirmed infections occurred exclusively among unvaccinated individuals, highlighting both vaccine effectiveness and persistent immunity gaps. Strengthening routine immunization, targeted supplementary campaigns, and timely laboratory feedback remain essential to prevent future outbreaks.
Copyright (c) 2026 Journal of Clinical Epidemiology & Toxicology
Relationship Between Sleep Quality and Blood Pressure PrePosterior Vitrectomy Patient
Background: Sleep patterns have the highest influence on the incidence of hypertension compared to other variables, namely age and gender. The delay in elective surgery was mostly due to medical factors and mostly due to acute changes in cardiovascular and respiratory functions, abnormal laboratory values and patients refusing surgery. In patients with eye disease, especially in the retina with a Posterior Vitrectomy surgery plan, patients often encounter comorbidities such as hypertension. Incidents of cancellation of elective eye surgery on the day of surgery at the National Eye Center of Cicendo Eye Hospital are also common, especially for reasons of hypertension. Objective: The purpose of this study was to determine the relationship between sleep quality and blood pressure of pre-Posterior Vitrectomy patients at the National Eye Center at Cicendo Eye Hospital, Bandung. Methods: The research method used in this research is analytic observational with cross sectional design. Sampling was carried out at the National Eye Center, Cicendo Eye Hospital, and Bandung. The sampling technique used purposive sampling with a total sample of 114 people. Statistical test with Chi Square Test using SPSS. Result: The results show a p value of 0.003 where the result is smaller than 0.05. From these results, it can be concluded that there is a relationship between the two variables, namely “Sleep Quality” with “Blood Pressure” pre-Posterior Vitrectomy patients at the National Eye Center of Cicendo Eye Hospital Bandung. Conclusion: There is a relationship between sleep quality and blood pressure in pre-posterior vitrectomy patients at the National Eye Centre at Cicendo Eye Hospital, Bandung.
Copyright (c) 2025 Journal of Clinical Epidemiology & Toxicology
Epidemiology: The study of the branch of medicine which deals with the incidence, distribution, and possible control of diseases and other factors relating to health. It has widely become known that most pharmaceutical medicines have many side effects that in time create malfunctions of the body as cellular-neuromuscular-memory fails, and the body deteriorates biochemically
Outcomes of Critically Ill Pregnant Women with COVID-19Pneumonia at Rhuh in Lebanon
Introduction: Since its declaration, the novel COVID-19 has been the center stage of worldwide concern as an international public health emergency due to its immense morbidity and mortality. Pregnant women are considered the most vulnerable population when encountering a SARS-COV2 infection and so extensive studies regarding risk factors, level of severity as well as maternal & neonatal outcomes are crucial to optimize the approach and management of a pregnant infected female. Methods: This is a case-control retrospective study of women with COVID infection (pregnant and non-pregnant) admitted to ICU in Rafik Hariri Hospital between February 2020 and June 2021. Data were collected from digitized records including demographic characteristics, oxygen requirement, vitals, laboratory results, and imaging, management lines, maternal and neonatal outcomes. The latter was analyzed using SPSS Statistics Version 19.0, Armonk, NY: IBM Corp. Results: No significant difference was found concerning the severity of the disease and its course, length of hospital stay, ICU admission, complications during hospitalization, and treatment administration. Non-pregnant women did exhibit more chronic illnesses, mainly HTN and DM, presented with more severe hypoxemia, higher ferritin levels, more lung involvement on CT chest on admission, and were primarily given heparin as anticoagulation. Neonatal death was significant in cases of pregnancy termination with a lack of follow-up after discharge. Conclusion: Pregnant women were hospitalized for less severe indications due to controversy on management and scarcity of evidence. No difference in morbidity and mortality between the two groups and further research is indicated for optimization of treatment and prognosis.
Prevalence of Psychoactive Substance use in the City-Province ofKinshasa / DR Congo
Context and Objective: Psychoactive substance use among young people is a real public health problem in the Democratic Republic of Congo (DRC). The objective of this study was to determine the prevalence of psychoactive substance use in Kinshasa. Materials and Methods: This was a cross-sectional and descriptive study conducted among 9,033 subjects distributed across the twenty-four municipalities of Kinshasa from September 7 to December 7, 2022. The sampling was probabilistic, exhaustive, and convenience. The data were analyzed using Microsoft Excel 2013 software to determine the mean, standard deviation, and confidence interval. The parameters of interest were sociodemographics and the concept of psychoactive substance use. Results: The average age of the study subjects was 31.5 ± 13.9 years. The majority of subjects were under 40 years of age (72.7%), with a sex ratio of 1.28 M/F. More than half had a secondary education (51.1%), a job (68.8%), a single status (63.2%), a low monthly income (74.2%), had an average of five dependents (50.1%), and 35.3% attended Revival churches. Beer was the most commonly consumed psychoactive substance (65.3%). Conclusion: The prevalence of psychoactive substance use in Kinshasa is high. This situation is most prevalent among young, high-school-educated men with informal occupations, single men with an average of five dependents, low monthly income, members of the traditional church, and primarily beer consumers.
Marketing of Dental Hygiene Products and their Use by thePopulation
In the article, maintenance of dental health (SS) is important not only for the normal functioning of the oral cavity and the long-term maintenance of tooth rows, but also for the protection of the health of the body in general, and a sales analysis was given. According to the World Health Organization, among the causes of human diseases, 20% are hereditary factors, 25% are environmental conditions, and 55% are lifestyle-related. An analysis of the sale of toothpaste in the Azerbaijani market was carried out, the results of which show that the sales leaders in the local market are Lacalut, Colgate, Paradontax, Blend-a-med, Sensodyne, Aquafresh. The population survey revealed both opportunities and barriers to the growth of the hygiene products market at the level of the toothpaste segment. The research was conducted in two stages. At the first stage, toothpastes were evaluated according to their composition, abrasive type and pH indicator. In the second stage, a set of international questionnaires was used, 534 questionnaires were distributed in 8 markets, including 4 supermarkets.
Ethical Challenges in Conducting Clinical Trials for New ChemicalEntities
Over the past three decades the quest for the testing of new chemical entities for emerging and old diseases without therapeutic drugs has increased. The uses of randomized controlled trials (RCTs) have become more popular over clinical judgment, case reports, and observational studies and became the gold evidential standard in medicine. In addition, RCTs has become the main component of the regulatory process whereby a new therapeutic can gain access to the drug market. Currently, clinical trials for new drugs are large and a tightly regulated enterprises that have to comply with ethical requirements while maintaining high regulatory standards, a balance that becomes increasingly challenging as the research questions become more sophisticated. In this chapter, some of the most important ethical issues involving RCTs, with emphasis on the most recent debates and the context of oncological research in particular have been discussed.
Assessment of Lethal Dose and Lethal Time of Diazinon in SwissAlbino Mice
Approximately two thirds of deaths and millions of nonfatal cases are attributed to organophosphorus pesticides (OPP) annually. Diazinon, a prominent member of the OP pesticides, was introduced for both agriculture and public health usages during. For several decades, the compound was among the top pesticides in use in many countries, including Libya. The toxicity of this compound is based on its ability to inhibiting the acetylcholinesterase enzyme (AchE), which is vitally important for normal nerve impulse transmission. This study evaluated the acute toxicity of diazinon through acute exposure testing on female Swiss albino mice. In the acute toxicity test, 72 mice were subcutaneously injected with doses of diazinon ranging from 320 to 480 μL/ kg. Mortality and symptoms were recorded over four days, with the median lethal dose found to be 403.5 μL/kg. Based on the findings, the present study suggests that stringent controls and surveillance must be placed on diazinon and similar chemicals.
Impact of Lebanon’s Economic Crisis on Food Poisoning: A Studyof Demographic Disparities, Knowledge, Attitude and Practice inNorth Lebanon Community
The ongoing economic crisis in Lebanon has significantly impacted public health, particularly in relation to food safety and foodborne illnesses. This crosssectional study aims to assess the knowledge, attitudes, and practices (KAP) concerning food poisoning among the North Lebanon community during the crisis. Data were collected from 349 participants aged 18 and above through a structured online questionnaire from March to May 2023. The findings revealed a decline in food safety awareness since the crisis, with only 26.6% of participants reporting being well-informed, compared to 73.4% prior to the crisis. Social media emerged as the primary source of food safety information (75.6%), while healthcare workers were underutilized (16.9%). Dairy products (12.6%) and poultry (11.7%) were identified as the leading causes of food poisoning, particularly from collective catering sources (83.7%). Participants expressed growing concerns over food quality in restaurants (80.5%) and new food brands entering the market (36.1%). Despite heightened public awareness, gaps in food hygiene practices persist, underscoring the need for enhanced food safety education and regulatory oversight. These results highlight the urgent necessity for public health interventions to address food safety risks exacerbated by the ongoing economic challenges in Lebanon.
The Commercialization of Cuban Medical Services in PrimaryHealth Care
Introduction: The activity of the health sector and its exports require a comprehensive and systemic approach. Cuba has resources that affect the growth of health tourism. Marketing the services that are carried out every day in Primary Health Care is not integrated into the work system of its professionals. Objective: Implement a strategy for the commercialization of Cuban Medical Services from Primary Health Care. Methods: An intervention study with a single study group was carried out between July 2022 and June 2023, in the municipality of Trinidad, Sancti Spíritus province. 90 participants were included. Qualitative and quantitative research techniques and procedures were integrated. The feasibility test was applied to reach a consensus among the specialists consulted. Results: the female sex predominated. Before applying the strategy, the level of information was 100% inadequate, and then it went to a 98.88% adequate level of information. The applied strategy solves the essential problems of the investigation. The opinion of the specialists was in favor of the applicability of the strategy. Conclusions: The strategy introduced positive modifications in the knowledge of those included in the study. It was considered very appropriate by the specialists consulted, so its application is viable.
Cutaneous and systemic sarcoidosis case report Sarcoidosis is an inflammatory disease that affects multiple organs in the body, but mostly the lungs and lymph glands. In people with sarcoidosis, abnormal masses or nodules (called granulomas) consisting of inflamed tissues form in certain organs of the body. These granulomas may alter the normal structure and possibly the function of the affected organ(s). Objective: To identify systemic and cutaneous disease in human body with bone marrow proliferation. Patients and Methods: 54 years old man patient complained of fever and night sweats. He was missed diagnosed in Cairo by oncologist as diffuse large B cell lymphoma patient since 2007 due to involvement liver and lymph nodes and he received treatment with Gemser drug and he complete remission from liver damage. At 2015 complained of night sweats; fever and loss of weight and high coup and rheumatic pain miss diagnosed as tuberculosis T B in Jordan and he received treatment for one year without improvement. I received the patient in 2018 started appeared erythematous papule nodular skin eruptions in his body I revised all his previous investigations. CBC, Bone marrow biopsy and aspiration, liver biopsy, hilar lymph node biopsy skin biopsy, immunohistochemical cytology zeal Nelson stain-vet, PCR-VE, tuberculin test -vet ACE angiotensin converting enzyme and liver function test were diagnostic plain chest or-ay, ultrasound for liver. Results: The clinical data and investigations showed the patient had non Caseating necrosis inflammatory granuloma in his thoracic lymph nodes and liver and skin most probably systemic and cutaneous sarcoidosis. Conclusion: Arcoidosis is unknown etiology disease and treated with methotrexate and prednisolone orally with monitoring follow up
Preclinical Developmental Toxicity Evaluation of the Aqueous andEthanolic Extracts of Ageratum Conyzoides (Asteraceae) in WistarRat Models
Introduction: Ageratum conyzoides L. (Family Asteraceae) is an annual herb with a long history of traditional medicinal use in the tropical and sub-tropical region of the world. Its use in pregnancy necessitates a study. Therefore, this study aimed at evaluating A. conyzoides for potential developmental toxicity in female Wistar rats. Methodology: The pregnant rats were treated with 0 mg/kg (only distilled water) or 500 mg/kg of aqueous and ethanolic extracts of the leaves, flowers, stems and combined aerial parts of A. conyzoides. The extracts of the aerial parts of A. conyzoides were administered orally throughout the period of organogenesis of females (5th to the 15th day of gestation). The dams were sacrificed on day 23 or allowed to deliver and wean. Maternal signs of toxicity were monitored throughout the gestational period. The duration of pregnancy, number and weight of neonates, live births and number of dead fetuses were determined immediately after parturition. Each litter was followed up for a period of 28 days post-partum and different parameters related to their growth were recorded. Results: The flower aqueous extract administration to dams induced prolonged labor which lasted 5 to 6 hours. Also, the administration of the aqueous extract of the whole aerial part of A. conyzoides to the dams led to the delivery of no pups. In the treatment (500 mg/kg) groups, no gross abnormalities were observed during offspring examination. The follow-up of the offspring for a duration of 28 days post-partum revealed a significant increase in the weight of the pups from dams delivered by compared to the control group receiving only distilled water. Conclusion: This study has shown that, the administration of the aqueous extract of the combined aerial part of A. conyzoides interrupts pregnancies when administered to dams from the 5th to the 15th day of gestation. In addition, the administration of the flower aqueous extract of A. conyzoides to pregnant rats induces prolonged labor. Also, A. conyzoides extracts do not adversely affect offspring growth following exposure during pregnancy
Ethical Issues in Advertising Weight Loss Drugs to Patients: ASynthetic Experiment Using LLMs (Large Language Models) toSuggest How Education Might Help People to Address the Issues
Using LLMs (large language models), the paper shows how to approach the ethical issues involved in the increasingly popular strategy of advertising prescriptiononly weight loss drugs directly to consumers. The paper shows the background, the issues, the benefits of creating “stories” to give the topic a deeper sense of reality. The paper finishes by using LLMs to synthesize and then prescribe ten different aspects of a course devoted to critical thinking about the topic.
An Overview of Pharmacovigilance Practice and Management inSub-Saharan African Countries
Most sub-Sahara African countries faced with prolonged resource deficiencies suffers specific constraints in establishing a functional and operationally-free pharmacovigilance systems platforms which should guide and in facilitate the generation of vital data to reinforce health information policies and practices. Despite the commendable efforts invested by the different stake holders within such countries to harmonize pharmacovigilance guidelines and regulations, lack of integration and the dependence on pharmacovigilance systems remain major constrains. Other identified difficulties are those associated with the problem of translating data reporting tools into multiple communicable languages, and the inadequacy of the healthcare experts who translates with the patient’s population, the pressure imposed by the short consultation time between a patient and a health practitioner. To add to this, there exist issues of community concern like the increasing use of herbal traditional products with anecdotal therapeutic evidence, low quality, self-medication practices, counterfeit and roadside drugs use, substandard medications that are readily accessible to the population. Some prolonged problems are associated with social and political instability, territorial conflicts, little or no access to drug utilization data, which makes it difficult to reliably estimate the true risks of medication use. Pharmacovigilance activities are still at its infancy due to poor and less trained health personnel, lack of budget allocation for health vigilance from the State financial attributions. In addition to the limited investment in pharmacovigilance activities, there is little collaboration between public health programmes and National Medicines Regulatory Authorities (NMRA), especially during mass drug administration for neglected tropical diseases and mass vaccinations. Frequent spontaneous report in SSA is low and this can hinder robust signal detection analyses. This paper attempts to identify the challenges of the practice of pharmacovigilance in sub-Saharan African countries and its implication in health vigilance in the community. In this paper, we review the specific challenges and areas of progress in pharmacovigilance in SSA.
Assumptions for Structure Equation Modeling (SEM), Normalityof Data Distribution Analysis & Model Fit Measures
Structure Equation Modeling (SEM) is a well-known research technique. Before proceed further in data analysis, the researcher describes the fundamentals of Structure Equation Modeling (SEM), as well as its modeling criteria, assumptions, and concepts. The researcher uses Structure Equation Modeling (SEM) to make assumptions about normality, missing data, and sampling errors measurement. In evaluating the model’s fit with the data, Confirmatory Factor Analysis (CFA) starts with a model that anticipates the existence of a predetermined number of latent factors as well as the indicator variables that each factor will load on. Firstly, Normality Test. The “Skewness and Kurtosis” scores of the assessment model, Confirmatory Factor Analysis (CFA), range from -2 to +2. Independent Variables adopted are Self-Efficacy (SE), Perceived Benefits (PB), Behavioural Beliefs (BB), Mediating Variable is Consumer Innovativeness (CI), and Dependent Variable is Health Protective Behaviours (HPB). This study used a total sample size of 400 respondents of private healthcare customers, indicating that the data was normally distributed and satisfied Structure Equation Modeling (SEM)’s normality predictions. Secondly, missing data check. Missing data would jeopardise the statistical analysis in later part and the result might not be able to represent the idea from population. As a result, those questionnaires with more than 30% missing value would b eliminated and excluded from analysis to prevent such phenomena happened. Thirdly, measurement and sampling errors. Minimising sampling error was done by using suitable sample size. A widely used minimum sample size estimation method in PLS-SEM is the “10-times rule” method, which builds on the assumption that the sample size should be greater than 10 times the maximum number of inner or outer model links pointing at any latent variable in the model. Lastly, model fit measures. The study model meets all of the fit indices in general [1].
Adverse Events Following Immunization with Covid-19 Vaccines:Results from the State Registry and Surveillance System in RiversState, Nigeria
Introduction: The manufacture of COVID-19 vaccines was a response to the COVID-19 public health emergency. Four of the WHO approved COVID-19 vaccines were available and administered in Nigeria. Side effects may manifest physically post-vaccination and are part of a normal immune response; they are usually mild and fleeting. Common side effects of the COVID-19 vaccines include fever, pain at the injection site, headache, and fatigue; allergic reactions may also occur. Some severe side effects also reported include myocarditis and Bell’s palsy. This study aimed to describe the adverse events occurring after COVID-19 vaccination, as reported by the Adverse Event Following Immunization (AEFI) surveillance system in Rivers State. Methods: A retrospective study describing all reported cases of adverse events post-COVID-19 vaccination in Rivers State. Data were collated from the Rivers State registry and AEFI surveillance system between March 18, 2021, and January 31, 2022. AEFI severity was classified as mild, moderate, and serious. The outcomes of interest were categorised as recovered, death, and disability. Results: The total number vaccinated in Rivers State as of 31 January 2022, was 548,383 and total persons reporting an AEFI was 1042. There were ten hospitalisations, and zero deaths recorded. Fever was the most reported adverse event –57% of the cohort; and the Oxford-AstraZeneca vaccine was administered to 78.3% of the reporting population. The reporting rate for total doses received was nineteen cases per 10,000 doses administered; and the reporting rate for serious reactions was 18 cases per 1,000,000 doses administered. The proportion between males and females reporting an AEFI was significantly different. Conclusion: The COVID-19 vaccines were safe in the study population as there were no major safety concerns identified and the benefits inherently outweighed the risk.
Simulate the Dynamic Interactions Across Nutritional Supplements,the Polybiome, and the Biochemical Approach Dependent onPatient-Derived Gastrointestinal Knowledge
Dietary and lifestyle planning decisions, dysbiosis in the composition of the microbial community and the production of bioactive metabolites by the gastrointestinal microbiota are all factors that have a significant influence on the mucosal integrity of the intestines and the progression of diseases like colon cancer. Even though intestinal microorganisms or its metabolites that generate play key roles in a wide range of biochemical processes, scientific exploration into the connections between dietary supplements and the composition of the host’s intestinal microbiota has been limited so far. Therefore, colonic patients derived from gastrointestinal tissues have made it possible to design in mammalian cells environments with an adequate and appropriate level of intelligence to simulate both functional and pathophysiological nutrition, gut microbiome and host interactions, which is an opportunity that has never before been available. Colon patient reactions to intestinal microbiota biochemical processes and gut bacteria may give new insights into how these metabolites may mitigate or trigger illnesses. This would be a big step forward in our understanding of how the composition of the gut microbiota is influenced by nutrition, both in the host and in the host’s environment.
The Impact of Weaning from Breastfeeding on Physiological andBehavioral Development in a Rat Model
Background: Weaning of mammalian progeny is associated with a change in body shape and physical characteristics. It programs growth, body composition, and the tempo of physiological and behavioral development and maturation, as well as litter size and parity and, thereby, reproductive strategy. Methods: To evaluate the impact of weaning from breastfeeding on physiological and behavioral development we use two kinds of tests: 1. Open field test - an experimental test that helps assess motor movement and anxiety versus curiosity in rodents. 2. Object recognition test that tests the ability to identify new objects compared to old ones and in our case tested this memory in the short term. Results: Early weaning showed significantly better motor movement, better curiosity and memory, and less anxiety than late-weaning animals. Conclusions: Animals that are weaned early show better cognitive and behavioral processes on a level of curiosity and mobility with better memory and are less anxious compared to animals that are weaned latez
“COVID-19 – POST-COVID SYNDROME” Pandemic:Complex Treatment with Medical Leeches, IncludingDetoxification. Confirmation of the Validity of The THEORY“HOMOTOXICOLOGY” OF H. - H. RECKEVEG
Treatment of the disease “COVID-19 - POST-COVID SYNDROME” requires the mandatory inclusion of detoxification methods in the technology of treatment and rehabilitation. The paper reflects the experience of using medical leeches in the context of the author’s “System Method of Leeching” in cases where intoxication was dominant in the “Clinical Image of the Disease”. The mechanism of action of medical leeches, which were successfully used in case of intoxication of patients with different pathologies, including “COVID-19 - POSTCOVID SYNDROME”, is considered.
The Disease “COVID-19 - POSTCOVID SYNDROME
Social Support and Prevention of the Vulnerability Psychosocial inBigger Caretakers of Adults with Insanity
Background: One of the illnesses that more deterioration functional and bigger stress provides to the caretaker is the insanity. Objective: To propose a program of social support for the prevention of the vulnerability psychosocial in bigger caretakers of adults with insanity residents in Santa Clara. The investigation embraced one period from January 2020 to January 2022 in a mental center health “Chiqui Gómez”. Method: Was carried out a study decriptive, restrospective, for sampling intentional non probabilistic composed by 11 bigger caretakers of adults. It gathers it of the data was carried out through the empiric method the questionnaire and for the analysis of the data the statistical calculation was used. Results: It allowed the introduction of improvements in their design toward bigger caretakers of adults with insanity. Conclusions: It contributed to the establishment of a logical and coherent articulation among the specific objectives and the projects psychosocial that compose the program.
Antioxidant Property of Total Saponins and Tannins of Dialiumguineense Stem Bark in Rats Hearts Exposed to CCl4
The aim of this study was to investigate the antioxidant property of total saponins and tannins of Dialium guineense stem bark in rats hearts exposed to carbon tetrachloride (CCl4). A total of twenty-five (25) adult male Wistar rats, which weighed between 170 and 190 g (mean weight = 180 ± 10 g) were randomly assigned to five groups (5 rats per group): normal control, CCl4 control, silymarin, total saponins and total tannins groups. With the exception of normal control group, the rats were exposed to CCl4 (single oral dose of 1.0 mL/kg body weight, bwt). Rats in the silymarin group were administered 100 mg silymarin/kg bwt (standard cardioprotective drug), while those in the two treatment groups received 150 mg/kg bwt of total saponins or tannins orally for a period of 28 days. Activities of antioxidant enzymes such as catalase, superoxide dismutase (SOD), glutathione peroxidase (GPx) and glutathione reductase (GR) were evaluated in heart homogenate. The results showed that there were no significant differences in the concentrations of cardiac total protein (TP) among the groups (p > 0.05). The activities of the antioxidant enzymes and level of reduced glutathione (GSH) were significantly lower in CCl4 control group than in normal control group, but they were increased by total saponins/tannins treatment (p < 0.05). However, the level of cardiac malondialdehyde (MDA) elevated by CCl4 intoxication was markedly reduced after treatment (p < 0.05). These results indicate that total saponins and tannins of D. guineense stem bark may enhance antioxidant defense in rats hearts exposed to CCl4
Double Chamber Devices and its Advantages
How to select primary packaging materials for Lyophilized products (Different kinds of Double chamber vial, PFS and cartridges, Rubber stoppers for Lyophilized products. Packaging challenges and Solutions.
Gastrointestinal and Nutrition Tables in Latest GastrointestinalResearch in Islamic Civilization in Middle Ages
Research on Islamic civilization shows that gastrointestinal diseases are rooted in social lifestyles and are a sociological phenomenon. The science and craft of medicine evolved to such an extent that Muslim physicians presented a set of general rules in medicine, including gastroenterology, including Ibn Rushd in his book Generalities in Medicine. One of general laws of medicine in Middle Ages was about the functioning of gastrointestinal tract in relation to disease and health. In this general law, the systematic relationship between digestion and place, including village and city, time of year and days and hours of day and night, age of people, pollution and air pollution, is regulated in health table. By referring to this limit, one can choose food that is useful for maintaining health and also be safe from diseases. Spread of health is legacy of Islamic medicine in Middle Ages for world of science, which can be used even now. In this general law, occurrence of all diseases is due to digestive problems and incorrect choice of food. He considers urban lifestyle in nutrition as cause of all diseases. In Islamic medicine, there is a direct relationship between food and its type of digestion and lifestyle to maintain health. According to Ibn Khaldun, who has introduced himself as a commentator on works of Averroes who invented eight hundred years ago the “Trophology and “Ecotrophology” which developed in Europe in second half of twentieth century, was ago, Ibn Khaldun as sociologist studied issue pathology of nutrition from propht to averroes and interoduced hypotheses in nutrition about view of Islamic civilization and writes: Urban diet style is cause of disease: 1. Wrong food composition. people of city add all kinds of ingredients and condiments to food and produce dozens of indistinct forms of food and fruit that are not recognizable to human temperament. 2. Inactivity among city dwellers. 3. Stinking air and air pollution 4. Overeating and starting to eat new food before digesting t previous food Research hypothesis is presentation of a panoramic image of human nutrition knowledge of Qur’an by human maker, which is a firm image and in accordance with reality and there is a firm and definite logical relationship between gastrointestinal tract and food and health that can be plotted in a quantitative graph in Islamic civilization.
Racial Difference in Hospital and Critical Care Admissions andMortality before and during the COVID-19 Pandemic
Purpose: To explore the racial difference in hospital and intensive critical care (ICU) admissions and mortality during COVID-19 pandemic compared to the pre-COVID period. Methods: This was a retrospective observational study. Results: The racial proportion of hospital admissions was not changed. Either all-cause or non-COVID ICU admission rate increased significantly in White patients (9.7% during vs 8.1% pre-COVID, p<.0001). Non-COVID ICU admission rate increased for Black or African American patients (14.4% during vs 11.0% pre-COVID, p=0.05). For White or Caucasian patients, either all-cause mortality (3.9% during vs 3.0% pre-COVID) or non-COVID mortality (3.8% during vs 3.0% pre-COVID) increased significantly. For Black or African American patients, all-cause mortality increased significantly (3.4% during vs 1.6% pre-COVID, p=.03). Compared to White patients, COVID-19 incidence rate was significantly higher among Asian, Black or African American and Hispanic patients. ICU admission rate and mortality of minority COVID-19 patients were not different from White or Caucasian patients. Conclusions: The COVID-19 pandemic did not affect the racial proportion of admissions. The ICU admission rate and mortality did not change for most of races except for White or Caucasian and Black or African American patients and the increase was caused by COVID-19 patients as well as non-COVID patients.
Diagnostic Dillema of Dumbell Shaped Spinal Lesions-An InterestingCase
36 year old male with Progressive back pain, weakness in his Right lower limb and Paraesthesia over right side of his body since 3 months. Weakness was insidious onset, gradually progressive, (Distal to Proximal progression). Paraesthesia over right side of his body involving right chest, abdomen and lower limb Similar progression of weakness in his left lower limb, with no sensory disturbances on left side. Conscious, oriented. Tone: Hypertonia + in Right LL: Modified Ashworth Grade 3, Left LL: Normal. Power: MRC Grade: Right: 3/5, Left : 4/5 across all joints. Right foot drop present + Hypoesthesia below D5 dermatome to touch, pain, temperature on Right by: 60%, Left: 30%. Hyperactive deep tendon reflexes + in both lower limbs, Babinski reflex + Bilaterally and ankle clonus + on right side.
Spontaneous Pneumothorax as a Rare Complication of Covid-19Viral Pneumonia: A Single-Center Retrospective Descriptive Study
Introduction: A pneumothorax is the unusual presence of air in the pleural space; it can be spontaneous or iatrogenic with an incidence of 15% in critically ill patients. COVID-19 has a spectrum of disease ranging from mild to life threatening illness occurring in 1% of hospitalized patients. We herein describe the incidence of pneumothorax in Covid-19 hospitalized patients and present the clinical, laboratory and radiological characteristics of patients developing pneumothoraxes and its impact on total survival. Methods: This single-center retrospective study was conducted in Rafic Hariri University Hospital in Beirut, in the COVID-19 center. From a total of 2726 patients who were diagnosed with COVID-19 pneumonia according to WHO guidelines and were hospitalized between February 2020 and August 2021, 28 patients developed at least one pneumothorax during their hospital stay and were enrolled in this study. Results: From a total of 2726 patients, 28 were diagnosed to have pneumothorax and/or pneumomediastinum, with an overall incidence of 1.02% with a mortality rate of 89.3%. Twenty-one patients were males with a mean age of 54 years and 13 patients were smokers. All patients had at least one chronic disease and were found to have elevated inflammatory markers. The time from onset of symptoms to admission has a mean of 8.25 days and from admission to onset of pneumothorax 13.85 days. Fourteen patients (50%) had a large pneumothorax and 39.3% had a small pneumothorax on CT scan and 82 % were found to have patchy ground glass opacities with 17.8% having mild (<40 %) lung involvement, 35.7% having moderate (40- 70%) lung involvement and 28.5% with severe (>70%) lung involvement. Oxygen requirement varied between HFNC (67.9%) and IMV (64.3%) and all patients were on steroid therapy. Chest tube was placed in 78.6%. Discussion: The incidence of pneumothorax in COVID-19 patients was 1.02% slightly higher than other studies with a male predominance. Risk factors were variable: age, BMI, comorbidities, smoking history, use of mechanical ventilation, imaging findings, use of steroids, and increase in acute inflammatory markers. All contributed to the lung fragility and occurrence of air leak which was a bad prognostic factor leading to a mortality of 89.3% and higher morbidity and hospital stay. Pneumothorax in COVID-19 patients needs a high index of suspicion, a prompt diagnosis and a rapid treatment. Conclusion: COVID-19 viral pneumonia caused very rarely spontaneous pneumothorax that can occur at any time during the course of the disease. Mechanical ventilation, imaging’s characteristics mainly ground-glass opacities and crazy paving and use of steroids can all exacerbate the development of pneumothorax. High index of suspicion is needed for early diagnosis and appropriate treatment to decrease the length of hospital stay and the overall morbidity and mortality
Adherence to Antiretroviral Therapy by Pregnant Women AccessingAntenatal Clinic at The University of Port Harcourt Teaching Hospital,Tertiary Institution in Rivers State
Background: Non-adherence to antiretroviral therapy (ART) by pregnant women living with HIV/AIDS is a problem that has been reported to have adverse effects on the mother and the unborn child and this is a major public health issue in high- and low-income nations. Virological and clinical success depends critically on elevated adherence to ART, without which maternal disease can develop, with its attendant increase in the risk of vertical mother-to-child transmission. The level of non-adherence to ART is high in many communities in Nigeria. This study assesses the level of ART adherence and identifies factors that influence nonadherence among pregnant women living with HIV/AIDS. Materials and methods: This was a descriptive cross-sectional study of 236 HIV pregnant women on ART assessing the PMTCT services of the Antenatal Clinic at the O&G Department of the University of Port Harcourt Teaching Hospital. The study was carried out for a period of three months. The respondents were selected using a multistage sampling method and were interrogated using semi structured questionnaires. Statistical package for Social Sciences (SPSS) V22 and Chi‑square test with a p value of < 0.05 as statistically significant were used for data analyses. Results: Out of the 236 respondents that were used for the study, 16.1% reported ART adherence problems while 83.9% reported 100% adherence, which is considered good. Constant exhaustion and frequent sleeping were the basic explanations given for missing out doses by the non-adherents. Socio-demographic variables found to be significantly associated with adherence were marital status 59.1% and age 63%, with married women and younger women more likely to adhere to ART instructions. Conclusion: This study shows that pregnant women can achieve good adherence to ART medication if encouraged. There is the need for more comprehensive awareness programmes on ART adherence and on other possible constraints to adherence to achieve the adherence rate of 100% recommended by the Federal Ministry of Health, Nigeria
Prevention of mother-to-child transmission
Secondary Intracranial Hypertension After Ciprofloxacin Treatment:A Case Report
A 30-year-old man developed secondary osteomyelitis after a traumatic amputation of his right index finger. The infection was treated with ciprofloxacin. Approximately 4 weeks after starting treatment, he complained of a progressive decrease in visual acuity, retro-ocular pain and bitemporal headache. A diagnosis of intracranial hypertension was established. Blood sample analysis, infectious profile, cerebrospinal fluid analysis, and neuroimaging were normal. Visual acuity and other symptoms progressively improved after stopping drug treatment. There were no complications or sequelae. Intracranial hypertension due to fluoroquinolones is described in the medical literature, its appearance during such treatments, despite being a rare adverse event, should be monitored.
Open Garbage Dumps and Dog Bites in Srinagar, Kashmir
Cytokine Storm Syndrome in Covid-19 Patients: Characteristicsand Diagnosis
Cytokine storm syndrome (CSS) is a critical condition induced by a cascade of cytokine activation, characterized by overwhelming systemic inflammation, hyperferritinaemia, haemodynamic instability and multiple organ failure. At the end of 2019, the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China, and rapidly developed into a global pandemic. There is a dramatic increase of inflammatory cytokines in patients with COVID-19, suggesting the existence of cytokine storm in some critical illness patients. Here, we summarize the pathogenesis, clinical manifestation of CSS, and highlight the current understanding about the recognition and diagnosis of CSS in COVID-19.