etiology

Dengue (DEN) virus is a common arboviral infectious disease that poses a significant threat to global public health, putting nearly half of the world's population at risk of infection. It is transmitted by Aedes aegypti and Aedes albopictus mosquitoes. Dengue infection, caused by all four mosquito-borne serotypes (DEN-1 to DEN-4), is endemic in countries with tropical and subtropical climates worldwide. To date, there is no vaccine that provides effective immunity against all DENV serotypes. Additionally, there is limited information regarding the epidemiology and impact of this dangerous disease in regions with recent infection reports. In this study, we aimed to present a summary of the clinical symptoms, pathology, etiology, prevention, and treatment options based on previous studies, to facilitate a better understanding of dengue fever (DF). The results of this study show that the main effects of DF are on vital organs such as the liver (hepatocellular necrosis), lungs (pulmonary edema), kidneys (hematuria and proteinuria), heart (myocarditis), and brain (encephalopathy). These effects can be a major threat to a person's life if diagnosed incorrectly or late. Increasing public awareness through social networks, implementing appropriate waste management systems, removing breeding sites for Aedes aegypti and Aedes albopictus mosquitoes by government institutions, and providing proper laboratory diagnostic and treatment tools for patients with DF are essential solutions that should be prioritized globally.

Preeclampsia (PE) caused 30%-40% of maternal and newborn deaths worldwide. Despite unclear exact cause, strategies exist to mitigate less severe PE effects. This review explores PE etiology, pathophysiology, risk factors, impact, and prevention.

Searching Scopus, PubMed, ProQuest, Google Scholar, and Science Direct for “preeclampsia and pregnancy” and “prevention” yielded 2012–2022 articles.

Preeclampsia features abnormal placental changes, altered immunity response, trophoblast apoptosis, and reduced uterine perfusion. Risk factors include hypertension history, nulliparity, age over 40, BMI over 35 kg/m², family history, amniotic pregnancy, and long pregnancy interval. This condition risks cardiovascular and neonatal morbidity, straining health resources. Prevention involves aspirin, vitamin D, exercise, folic acid, diet, early screening, and antenatal care.

Findings emphasize enhancing health literacy and preeclampsia education in prenatal care to mitigate PE risk among women. Further research, novel therapies, and assessing prevention strategies with accessible educational materials and multidisciplinary approaches are warranted to enhance pregnant women's health literacy and decrease PE risk.

Breast cancer is the most frequent cancer in women throughout the globe, and its management can be difficult due to its complex etiology. Treatment with chemotherapy, surgical procedures, radiation treatment, and hormone therapy are among the most frequently utilized treatments. However, complications and resistance to multiple drugs can cause challenges. This overview addresses how organic medicinal products obtained from edibles and plants can assist with treatment of Breast cancer. The article scrutinizes the ways by which natural substances may exert beneficial impact in the prevention and management of breast carcinoma as well as offers knowledge regarding the therapeutic plant, including its family, part used, kind of extraction, and molecular mechanisms in breast carcinoma. Following an exhaustive analysis of the various plants, we discovered that Peganum normata, Ammi visnaga, Camellia sinensis, Curcuma longa, and Allium sativam L. had potential anti-breast cancer activities. These data were gathered from PubMed, Scopus, and Google Scholar.

The neonatal period, which encompasses the first 28 days of life, is characterized by increased vulnerability to significant health challenges, resulting in elevated mortality rates.

This study aimed to identify the causes of mortality among neonates in the Neonatal Intensive Care Unit (NICU) at Karbala Teaching Hospital for Children in Iraq.

A retrospective study was conducted to extract data on the causes of neonatal mortality from medical records in the Neonatal Intensive Care Unit (NICU) at Karbala Teaching Hospital for Children, covering the years 2017 to 2022. The collected data included the neonate's gender, gestational age, time of death, medical history, and cause of death.

The total mortality rates varied from 9.5% to 12.03% across different years. In 2017, the mortality rate was higher among full-term neonates; however, starting in 2018, the mortality rate for preterm infants significantly exceeded that of term infants. The trends in causes of mortality changed over the years. Septicemia was the leading cause of neonatal mortality in 2017 (42.1%), followed by asphyxia (19.7%) and congenital heart disease (CHD) (10.5%). By 2022, the most common causes of neonatal mortality included prematurity (21.3%), septicemia (17.5%), and CHD (16.3%).

Septicemia, CHD, and asphyxia were the primary causes of mortality in NICUs over the years. Tailored interventions are essential for developing effective healthcare strategies.

Hoarding disorder is a complex condition that significantly impacts individuals' lives, characterized by excessive acquiring, difficulty discarding, clutter, distress, and impairment. This study aimed to examine the extent to which genetics and environment influence difficulty discarding, excessive acquisition, and clutter through the implementation of a classical twin study.

A total of 194 twins, consisting of 100 monozygotic (MZ) and 94 dizygotic (DZ) twins, participated in this study. Hoarding symptoms was assessed using the saving inventory-revised.  To estimate the heritability of hoarding symptoms, the classical univariate twin model was employed.

Based on the univariate analysis, it was found that the heritability estimates for difficulty discarding and excessive acquisition are 0.43 and 0.52, respectively. However, the results did not provide support for the role of genetics in clutter. Instead, it was indicated that the common environment accounts for 0.54 of the variance in clutter, while the specific environment contributes 0.46 to this symptom.

The difficulty discarding and excessive acquisition have been found to be moderately heritable. On the other hand, considering the contribution of genetics and environment to clutter, the results raise doubts about the association of clutter with hoarding. The relatively low genetic influence suggests that this trait may overlap with other behaviors rather than hoarding.

Over the past decade, Iranian households have experienced a decline in dairy product consumption. This study aimed to evaluate the population-attributable risk of prevalent non-communicable diseases related to dairy product consumption.

This cross-sectional analytical study involved 628 adults over 18 years old in Hamadan City in 2021. Clusters were selected based on comprehensive urban health centers. The standardized Iranian version of the food frequency questionnaire was used. Participants were categorized into 3 levels of dairy product consumption: >1 serving per day, 1–2 servings per day, and ≥3 servings per day.

The mean age of the 628 participants was 38.05 (SD: 12.5), with 42.36% being male. Cheese (54.5%), yogurt (39.7%), and milk (30.4%) were consumed most frequently. The prevalence of insufficient dairy product consumption was 48.6%, higher than that reported in previous studies. Insufficient dairy product consumption was associated with hypertension (9.3%), cardiovascular disease (5.6%), and osteoporosis (5.1%).

Individuals with lower education levels, female gender, lowest quartile of socioeconomic status, and those diagnosed with cardiovascular disease were more likely to have insufficient dairy product consumption. Insufficient dairy product consumption was associated with hypertension, cardiovascular disease, and osteoporosis.

Geriatric trauma refers to injuries sustained by elderly individuals, typically those aged 65 years andolder. The management of geriatric trauma in the Emergency Department requires a comprehensive approachthat takes into account the physiological changes associated with aging, as well as the increased vulnerabilityand complexity of injuries in this population. This is a cross-sectional study aimed at evaluating the etiology of trauma in geriatric patients referredto the ED of level-1 an academic center. All patients with complaints of trauma are evaluated and patients over65 years enrolled in the study. Data were analyzed by SPSS 26. 319 patients were investigated, 49.8% male and 50.2% female. The most common underlying diseasesare high blood pressure, diabetes type 2, and ischemic heart disease. The most common trauma cause wasfalling from the same level (48.9%), followed by a fall from a height (16.6%), accidents with cars (16%), andmotorcycles (9.1%). The most common injury was extremities trauma (71.5%) following head trauma (13.2%)and chest trauma (6%). The severity of injury in extremities was higher in women, and chest trauma was moresevere in men. The fall and subsequent car accident had the highest frequency as a cause of trauma in elderlypatients admitted to our academic trauma center. Hypertension and diabetes have also been the most commonunderlying diseases. Head and neck injuries are life-threatening and critical in a larger number of patients thanother injuries, and protecting them can be effective in reducing mortality and serious injuries in elderly traumapatients.

To assess the incidence and clinical profile of hemifacial spasm (HFS) and the association between HFS and systemic diseases.

This retrospective study was carried out on 85 patients with HFS, presenting at a tertiary eye care center in South India. Demographic and clinical details were recorded for all patients. Of these, the patients who had undergone magnetic resonance imaging (MRI) of the brain were analyzed for primary and secondary HFS.

The mean age of the patients was 56.11 ± 12.51 years. The age at onset of HFS was 54.9 ± 12.7 years. The disease duration was 9.51 ± 7.28 years. Male:female ratio was 1:1.17. The right side was involved in 31 patients (36.47%) and the left side in 54 patients (63.52%). MRI was performed in 54 (63.52%) patients and showed neurovascular conflict in 22 (40.74%) patients and space‑occupying lesions in 2 (3.70%) patients. Forty‑nine (57.64%) patients had primary HFS, while five (5.88%) patients had secondary HFS due to old facial palsy in 3 and space‑occupying lesions in two patients. Twenty (23.52%) patients received botulinum toxin A with a good response. Type of HFS had a significant association with hypertension (P = 0.046) while no significant association was present between laterality of HFS and systemic diseases (P > 0.05 each). Multivariate analysis showed a marginally significant association between type of HFS and hypertension (P = 0.057).

Primary HFS was the main type of HFS with female dominance and predilection for the left side. Hypertension had a relationship with HFS that needs to be investigated further for its causal nature.

Lung cancer, also known as lung carcinoma, is a malignant tumor that begins in the lung. Lung cancer is caused by genetic damage to the DNA of cells in the airways and is often caused by cigarette smoking or inhalation of harmful chemicals. Damaged airway cells gain the ability to multiply unchecked, causing tumor growth. Without treatment, tumors spread throughout the lungs, damaging lung function. Eventually, the lung tumors metastasize and spread to other body parts. On the other hand, lung cancer or bronchogenic carcinoma refers to tumors originating in the lung parenchyma or within the bronchi. It ranks among the primary causes of cancer-related mortality globally. It is estimated that there is an increasing rate of new cases of lung cancer worldwide annually, with an approximately high mortality rate because of lung cancer. It is worth mentioning that lung cancer was a relatively uncommon condition at the beginning of the 20th century. Its dramatic rise in later decades is primarily attributable to the increase in smoking among both males and females. Treatments include surgery, chemotherapy, immunotherapy, radiation, and targeted drugs. This review article describes lung cancer's causes, pathophysiology, and presentation.

The most frequent type of cancer found in the endocrine system is thyroid carcinoma. Among well-differentiated thyroid malignancies, the most commonly occurring type is identified as papillary thyroid carcinoma (PTC), which makes up 70-90% of the cases. A subtype of PTC is papillary thyroid microcarcinoma (PTMC), which includes tumors smaller than 10 mm in diameter. Due to the advancements in diagnostic techniques, the incidence of this type of cancer is on the rise. In this study, we aimed to analyze the factors worsening the PTMC prognosis.

In the first step, we searched various databases for the factors affecting this tumor. The relevant articles were collected and different outcomes of this tumor and its associated factors which were studied in more than one article, were classified. Finally, we conducted a meta-analysis of these outcomes and their related factors.

In the meta-analysis, a significantly association was found between the following factors: recurrence with gender (P<0.001) lymph node metastasis (LNM) (P= 0.003), and extrathyroidal invasion (P<0.001); lymph node metastasis with extrathyroidal invasion (P<0.001), and multifocality (P<0.001); central lymph node metastasis (CLNM) with gender (P=0.001), tumor size (P<0.001), extracapsular invasion (P<0.001), lateral cervical lymph node metastasis (P<0.001), and extrathyroidal invasion (P<0.001); lymph node metastasis resulted in poor outcomes (P<0.001); and finally tumor size with BRAFV600E mutation (P<0.001).

In conclusion, it is essential to note that greater awareness and understanding of this tumor characteristics and special and separate attention to PTMC can significantly improve the society overall health.

Laryngeal cancer comprises 30%-40% of head and neck malignancies, and it is the most common malignancy in otolaryngology. The main risk factors for laryngeal cancer are tobacco use, excessive alcohol consumption, gastroesophageal reflex, Plummer-Vinson syndrome, exposure to heat, chemicals, and some viral infections. This literature review summarizes all known data over the past decade with an assessment of the main etiological factors related to cancer incidence, general measurement issues in the cancer epidemiology and the current state of science in relation to laryngeal cancer. The geographical distribution of laryngeal cancer also reveals some important aspects. Europe remains the most prevalent continent for this type of malignancy, whilst the epidemiologic burden in Africa remains low. Overall, there are clear differences in morbidity and mortality from laryngeal cancer between urban and rural areas, with gender inequalities. In some countries, the incidence rates are high in rural areas, and in some, such as in China, the urban population is more affected. High rates of laryngeal cancer are closely associated with both low average income and a high percentage of the population with lower-than-average education countries with higher Socio-demographic Index (SDI) have made greater improvements in the treatment of LC than countries with lower SDI. Epidemiological data on risk factors can provide valuable information for developing cancer prevention strategies.

The presented study aimed to characterise periapical disease in teeth with primary non-surgical root canal treatment in persistent or emergent categories and their risk association.

A retrospective observational study that evaluated permanent teeth with primary non-surgical root canal treatment, was conducted clinically and radiographically for over one year. The following variables were analysed: gender, age, type and location of tooth, previous diagnosis, treatment conditions, and type of coronalrestoration. The supplementary variables included the perspectives of the treatment outcome, such as Remains normal, Improvement, and Failure. Statistical analysis was performed using a univariate analysis that estimated the average and proportion for each factor according to the result of the primary non-surgical root canal treatment. The multiple correspondence analysis identified the hierarchy between active variables and their association with the results.

A total of 232 teeth in 155 participants were analysed. A χ2 value, (P=0.023) showed that the emergent disease is associated with patients around the age of 50. The multiple correspondence analysis identified a tendency of grouping between the emergent disease and the short filling category, followed by symptomatic pulpitis as a previous diagnosis. The persistent disease was associated with errors and overfillings. An inadequate root filling and taper density adversely impacted the treatment outcome.

The length of obturation influenced the presence of failure. Short fillings were associated with emerging periapical disease. Errors and overfillings contributed to the persistent disease in the populations studied.

Antibiotic resistance is a significant problem that restricts the options for treating bacterial pneumonia. This research aimed to determine the bacterial causes of pneumonia and antibiotic resistance among hospitalized patients in southwest Ethiopia.

We collected and analyzed 150 sputum samples from individuals with community-acquired pneumonia from April 1st to October 30th, 2019. Standard bacteriological procedures were used to identify the bacteria. Kirby Bauer's disk diffusion method was used to assess the bacteria's susceptibility patterns. Production of carbapenemase and extended-spectrum-lactamase were confirmed phenotypically. Odds ratios and the chi-square test were computed.

On the whole, bacterial pathogens were verified in 50% of the sputum samples. The predominant bacterial isolates were Klebsiella species, followed by Pseudomonas aeruginosa, Staphylococcus aureus and Streptococcus pneumoniae. About 77.5% of isolates were multidrug resistant. Moreover, 40.5% and 10.8% of the isolates were ESBL and carbapenemase producers, respectively. Aging, tobacco smoking, previous history of pneumonia, heart disease, and chronic respiratory disease had association with sputum culture-positivity.

As a result, it is important to regularly monitor the bacterial etiologies and their patterns of resistance. Additionally, sociodemographic and clinical characteristics should all be taken into account while managing patients with pneumonia empirically in this context.