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Author(s): Geoffrey BabughiranaiD*, Victor Onama, Ali Salah
Objectives: Somalia has some of the worst infant, child and maternal mortality ratios in the world and was unable to achieve its Millennium Development Goals of health and nutrition. This study aimed to examine whether the project achieved its intended outcome in fragile Somalia. Design: The study adopted a quantitative and analysis method. Setting: Data collection involved household surveys and anthropometric measurements. A pre-and post-intervention data collection and analysis was conducted aimed at comparing the performance of the priority indicators, determining if the change was significant with a 95% confidence interval. Participants: It was with caregivers, mainly women of reproductive age (15-49 years) and children 0-59 months as the main participants. Main Outcome Measures: The focus was on Baseline compare to end line, End line Puntland Vs Somaliland and Key indicators to National Targets. Descriptive and inferential statistical analysis of the household questionnaires was conducted using SPSS data analysis software. Cross-tabulation using the McNemar’s Chi-square test was used to compare key outcomes. Results: From baseline to end line, there was statistically significant improvement breastfeeding practices, mothers practice for health timing and spacing of pregnancy, mothers practicing the recommended child birth practices care for children under five when sick and a reduction in the utilization of pregnancy care services and practice of vaccination of children. Comparison of Key indicators to National Targets revealed that the project achieved more in appropriate treatment of childhood illnesses, delivery practices, contractive use, infant and young child feeding, but fell short in the immunization services and ANC services. Conclusions: The health and nutrition care system in Somalia remains weak, poorly resourced and inequitably distributed with the root causes being multipronged. However, the results from this study show that if interventions are appropriately funded, there will always be improvement in the key health and nutrition indicators.
Author(s): Abel Ning CaballeroiD, Mariuska Forteza SáeziD*, Migdalia Pérez TrejoiD, Danay Corrales OteroiD
Non-Hodgkin lymphomas represent the third leading cause of cancer in the pediatric age group. Primary renal lymphoma is an uncommon presentation. We describe the diagnosis and treatment of a 6-year-old boy who presented with bilateral renal involvement, abdominal pain, vomiting, and weight loss. Initial investigations were consistent with presumed non-oliguric end-stage renal disease and anemia. Subsequent imaging demonstrated enlarged kidneys bilaterally. Histology revealed a Burkitt lymphoma that was highly responsive to chemotherapy, including the anti-CD20 monoclonal agent rituximab. Specific treatment was introduced with corticosteroids, vincristine, cyclophosphamide, and rituximab, resulting in the resolution of acute renal failure within 72 hours and complete response at the second induction with ANHL 1131 protocol.
Author(s): Bamgboye M. AfolabiiD*, Susan A. HoldbrookeiD, Oluwatosin O. Odubela
Cognizance of the implication of Covid-19 pandemic on health and well-being resulted in an upsurge in use of several dietary and herbal supplements (DHS) for the prevention and/or prophylaxis against the new disease. Objectives: To evaluate the pattern of DHS consumption among Nigerians with Non-Communicable Diseases (NCD) for the prevention and treatment of COVID-19. Design: Cross-sectional questionnaire survey. Setting: Adolescents, and adults residing in Nigeria. Participants: Participants with NCD (n = 165) from a larger study (n=645) were recruited from different geo-political zones and various ethnic groups. Primary and Secondary Outcomes: Prevalence and determinants of the use of different DHS for the prevention and treatment of COVID-19 in Nigeria, and sources of information for DHS use. Results: Hypertension was the most prevalent NCD (63.6%) in the study and both breast cancer and anxiety disorder were the least (0.6%). Overall, 75.2% of the respondents had less than 8 hours of sleep daily and almost all did not smoke cigarette at all. The proportion of male and female hypertensives who believed that dietary supplements are necessary during infectious disease outbreak such as Covid-19 was moderately high (55.2%), higher among asthmatics (65.0%), diabetes (68.4%), those with kidney disease (100.0%) and ulcer (83.3%). All or almost all the respondents with hypertension (96.2%), asthma (95.0%), diabetes (100.0%) and kidney disease (100.0%), consumed supplements more during Covid-19 pandemic in Nigeria. The proportion of those who consumed supplements more during the pandemic in Nigeria was higher among male (56.4%) than among the female (43.6%) hypertensives, though the difference was not statistically significant (χ²=2.93, P-value=0.09). Vitamin C was the commonest vitamin taken by respondents with ulcer (83.3%), kidney disease (83.3%), diabetes (57.9%), asthma (50.0%), hypertension (48.6%) and the two respondents with breast cancer (1, 100.0%) and anxiety disorder (1, 100.0%) respectively. Calcium and zinc were the commonest minerals taken by respondents with ulcer (50.0%, 16.7%), diabetes (10.5%, 5.3%), asthma (30.0%, 10.0%) and hypertension (13.3%, 11.4%) respectively. High proportions (83.3%, 80.0%) of those with kidney disease and with asthma consumed DHS to maintain good health. Health workers were the dominant source of information for most on the use of supplements during Covid-19 pandemic in Nigeria. Conclusions: The findings showed widespread use of DHS for the prevention and treatment of COVID-19 among persons with NCD. The use of DHS in this study was mainly guided by health workers with a marginal role of social media and Mass media. These findings call for a more robust consolidative tactic towards DHS to ensure its proper and safe use.
Author(s): David Palm*, Rashmi Lamsal, Valerie Pacino, Shinobu Watanabe-Galloway
Background: Many studies have found that Veterans and their family members have experienced more mental health disorders and substance use. The purpose of this study compared mental health and substance use risk indicators between U.S. military Veteran and non-Veteran- connected families, so earlier and more targeted interventions can be developed. Methods: The data for this study were based on the 2016 and 2019 Behavioral Risk Factor Surveillance System (BRFSS) survey in Nebraska. The comparisons between Veterans and non-Veteran connected families were made on a set of 9 indicators, including general health status (fair/poor), poor mental health defined as not good on 14 or more of the past 30 days (yes/no), ever told they had depression (yes/no), current cigarette smoker (yes/no), current smokeless tobacco use (yes/no), current e-cigarette use (yes/ no), any tobacco use (yes/no), any alcohol consumption in the past 30 days (yes/no), and binge drank in the past 30 days (yes/no). A Chi-Square test was used to determine significant differences between the indicators. Results: When comparisons were made between Veterans and non-Veterans, some significant differences were found in both 2016 and 2019. For example, in 2016, non-Veterans were more likely to have poor mental health, ever told they had depression, be a current smoker, and engage in binge alcohol drinking. Significant differences were also found between non-Veterans and the spouses and significant others of Veterans for selective risk factors in 2016 and 2019. For example, in both years, spouses and significant others of Veterans were considerably more likely to have greater mental health distress and depression. However, they were less likely to use alcohol or engage in binge drinking. Conclusion: These results indicate that spouses and significant others of Veterans are more likely to suffer from depression and other mental health conditions than Veterans themselves and the non-Veteran population. Organizations serving military families should develop a greater knowledge and understanding of the culture of military families to implement strategies that effectively support Veteran spouses and partners.
Introduction: Thyroid benign (TBN) and malignant (TMN) nodules are a common thyroid lesion. The differentiation of TMN often remains a clinical challenge and further improvements of TMN diagnostic accuracy are warranted. The aim of present study was to evaluate possibilities of using differences in chemical elements (ChEs) contents in nodular tissue for diagnosis of thyroid malignancy. Methods: Contents of ChEs such as aluminum (Al), boron (B), barium (Ba), calcium (Ca), chlorine (Cl), coper (Cu), iron (Fe), iodine (I), potassium (K), lithium (Li), magnesium (Mg), manganese (Mn), sodium (Na), phosphorus (P), sulfur (S), silicon (Si), strontium (Sr), vanadium (V), and zinc (Zn) were prospectively evaluated in “normal” thyroid (NT) of 105 individuals as well as in nodular tissue of thyroids with TBN (79 patients) and to TMN (41 patients). Measurements were performed using a combination of non-destructive and destructive methods: instrumental neutron activation analysis with high resolution spectrometry of short-lived radionuclides and inductively coupled plasma atomic emission spectrometry. Results: It was observed that in TMN tissue the mean mass fraction of I was lower while the mean mass fractions of K, Mg, and P were higher than in both NT and TBN groups of samples. It was demonstrated that I content is nodular tissue is the most informative parameter for the diagnosis of thyroid malignancy. It was found that “Sensitivity”, “Specificity” and “Accuracy” of TMN identification using the I level in the needle biopsy of affected thyroid tissue was significantly higher than that using US examination and cytological test of fine needle aspiration biopsy. Conclusions: It was concluded that determination of the I level in a needle biopsy of TNs using non-destructive instrumental analytical method is a fast, reliable, and very informative diagnostic tool that can be successfully used as an additional test of thyroid malignancy identification.