Introduction Dengue fever, a mosquito-borne viral infection, is a significant public health concern, particularly in tropical and subtropical regions. Thrombocytopenia, a hallmark of dengue infection, is often associated with disease severity. Recent studies have suggested a potential link between liver dysfunction and thrombocytopenia in dengue-infected patients. This study aimed to investigate the correlation between liver indices (alanine aminotransferase [ALT], aspartate aminotransferase [AST], and bilirubin levels) and thrombocytopenia in dengue-infected children.  Materials and Methods This cross-sectional study was conducted in the Department of Biochemistry, at the Mamata Academy of Medical Sciences over a period of six months (January to June 2021). The study was approved by the institutional ethics committee, and written informed consent was obtained from the parents or guardians of all participants. A total of 150 pediatric patients diagnosed with dengue fever were enrolled in this cross-sectional study. Liver function tests and platelet counts were analyzed, and statistical correlations were assessed. Results indicated a significant inverse correlation between platelet counts and elevated liver enzymes (ALT and AST), suggesting that liver dysfunction may contribute to the pathogenesis of thrombocytopenia in dengue-infected children.  Results The mean age of the study population was 7.2 ± 3.1 years, with a male-to-female ratio of 1.3:1. Thrombocytopenia was observed in 85% of patients, with 45% classified as moderate and 25% as severe. Elevated ALT and AST levels were detected in 70% and 80% of patients, respectively.   The mean duration of illness at the time of enrollment was 4.5 ± 1.2 days. 85% of the patients had thrombocytopenia, highlighting its high prevalence in dengue-infected children. The severity of thrombocytopenia was categorized as follows: Mild (100,000–150,000/μL): 30% of patients. Moderate (50,000–100,000/μL): 45% of patients. Severe (<50,000/μL): 25% of patients. The majority of patients (45%) had moderate thrombocytopenia, while a significant proportion (25%) had severe thrombocytopenia, which is concerning as it increases the risk of bleeding complications. Conclusion This study provides evidence of a significant correlation between elevated liver indices (ALT and AST) and thrombocytopenia in dengue-infected children. These findings suggest that liver dysfunction may contribute to the pathogenesis of thrombocytopenia in pediatric dengue cases. Monitoring liver function tests in dengue-infected children may help identify patients at risk of severe thrombocytopenia and guide clinical management. Further research is needed to elucidate the underlying mechanisms and explore potential therapeutic interventions targeting liver dysfunction in dengue infection.

Introduction: Aeroallergens may trigger symptoms in sensitized children with asthma. Documentation of sensitization is crucial to enable effective implementation of measures to prevent asthma exacerbations. To document the sensitization patterns of very young children (≤2 years) with asthma. This study was conducted in view of the crucial importance of aeroallergens in childhood. The purpose of this study was to determine the prevalence of sensitization to common aeroallergens in children with residing in our region and to elucidate the association of aeroallergen sensitization with severity. Methods: This study was conducted at a tertiary care center in northern India. We are following a cohort of pediatric asthma patients (up to 18 yrs) from the Pediatric Chest Clinic since August 2009. Eligibility criteria were children with asthma who stayed in Delhi and nearby areas and willing to follow up 3 monthly regularly for at least 1 year. The diagnosis and treatment of asthma was based on the Global Initiative for Asthma (GINA) guidelines. At enrolment, baseline data was collected, spirometry was performed [6], and FENO measurement was done. Asthma was classified as per the NAEPP guidelines [8]. The patients were followed up every 3 months, symptom diary was maintained, and control was assessed as per GINA guidelines. The cohort included 243 asthmatic children. Results: Children with recurrent (4 or more episodes of wheezing in the past year) ages between 2yrs to 10 yrs. The total number of the patients included in the study was 120 patients, 60 (50%) male and 60 (50%) with Mean Age = 6.15 years. Out of the 60 male cases, 45 (75%) had positive SPT to at least one of the aeroallergens and 15 (25%) were negative for all aeroallergens tested. Out of the 60 female cases, 42(70%) had a positive SPT to at least one of the aeroallergens and 18(30%) were negative for all aeroallergens. Out of 120 children, 87 (87.5%) had positive SPT to at least one of the aeroallergens. The highest prevalence of positive skin reaction was recorded for mite allergens among them Dermatophytosis pteronyssinus (80.6%), D. farinae (80.7%), Bloomia (68.7%), among Fungi group, Aspergillus fumigates (11.9%) Alternaria alternate (10.5%), Cladosporium herbarum (2.8%) Cat, cockroach and pigeon showed positive in (19.5%) (14.9%) and (4.4%) of cases respectively. Among Pollen group Cynodon dactyl (8.9) & Parthenium hysterophorus (7.4) The frequency of positive tests to an individual allergen is depicted in the table (8). In the studied population, the highest a prevalence of positive skin reactions was documented for the D. pteronyssinus and D. farinae with a frequency of (80.5%) of cases, and the lowest for Dog. Conclusion: SPT is an effective way to determine aeroallergen with minimal expense & greater selection of antigen. Specific allergen identification helps in implementing specific allergen preventive measures. Dust mites are the most common aeroallergen in all age groups. Among Dust Mites Dermatophagoides Farinae, Dermatophagoides pteronyssiuns & Blomia are most common. Incidence of aero allergy in children with recurrent wheeze increases with age. Indoor allergens are more common than outdoor allergens.

Certain laboratory parameters can be used to quickly guide the diagnosis of a child with signs of acute illness, and C-reactive protein (CRP) is among the best characterized such biomarkers. We conducted a systematic literature search using PubMed to identify the most recent original articles or reviews published between 1 January 2016 and 30 September 2021, on the topic of the clinical utility of CRP in pediatric practice, using the following two-word combinations: "C-reactive protein” and "children”, and "CRP” and "children”. Although it does not have a high specificity to differentiate between viral or bacterial etiology, CRP can be used successfully in the clinic in the follow-up of children with acute infectious diseases, including newborns. We have identified in the literature an association between obesity, metabolic disorders, neuro-psychological status and CRP value. In conclusion the latest data show that CRP is an easy and reliable marker, but its value must be integrated into the patient's clinical context

Osteoporosis-associated bone loss is manifested as chronic pain, fractures and reduced quality of life. Osteoporosis increases the risk of fracture, especially in elderly people. Here we present the role of family doctor in osteoporosis management for the prevention of the occurrence of fractures, also particularities of medical and non-medical therapeutics. The preventive aspects and actual therapies plans of the disease are presented as a useful tool for healthcare givers implicated in osteoporosis treatments. In conclusion, family doctors play an important role in the global strategy for the prevention and treatment of osteoporosis and its socio-economic consequences.

This case report describes a relatively rare and specific situation of vancomycin-resistant E. faecium infective endocarditis. Such cases are not described on the published literature and the guidelines. As a consequence, their management is relegated to suboptimal treatment with possible side effects of antimicrobial agents.

Introduction This study aimed to explore the factors contributing to COVID-19 vaccine hesitancy (VH) among healthcare workers (HCWs) who missed the first dose of the COVID-19 vaccine in Nigeria. Methods We conducted a qualitative study of the factors contributing to COVID-19 VH among HCWs at the University College Hospital, Ibadan using purposive sampling technique. Each interview session was held through telephone conversation. Qualitative data were analyzed using Colaizzi’s phenomenological method. Results The mean age of the 15 HCWs was 34.33±3.77 years, 10 (66.7%) were females, 6 (40.0%) were physiotherapists. Three themes were identified. The first theme, "Factors contributing to COVID-19 VH among healthcare workers” had five clusters: i) Lack of adequate information regarding the COVID-19 vaccine, ii) Challenges with immunization schedule, iii) Fear of side effects of the COVID-19 vaccine, iv) Lack of trust in the government, and v) Concerns about the safety of the COVID-19 vaccine. The second theme, "Healthcare workers’ perception on the solution to COVID-19” had three clusters: i) Adherence to non-pharmaceutical measures, ii) Vaccine production: key to submerging the COVID-19 pandemic, and iii) Healthcare workers’ perception of their roles in patient education on the COVID-19 vaccine. The third theme, "Recommendations to encourage COVID-19 vaccine acceptance among healthcare workers” had three clusters: i) Disclosure of extensive information on COVID-19 vaccine components, ii) Decentralization of COVID-19 vaccine collection points, and iii) Procurement of other brands of the COVID-19 vaccine.

Introduction Plasmid-mediated quinolone resistance (PMQR) is a growing concern worldwide. Reports from Nigeria suggest quinolone-resistant clinical isolates are common, however, reports on the prevalence of PMQR genes are few. This study aimed to determine the prevalence ofPMQR genes in quinolone-resistant isolates from a tertiary healthcare hospital in Nigeria. Methods This was a cross-sectional study involving 390 gram-negative bacilli from diverse clinical infections. The isolates were characterized by the MicrobactTM identification kit and susceptibility patterns determined by the Kirby-Bauer disc diffusion technique. All quinolone-resistant isolates were investigated for the carriage of PMQR genes by multiplex polymerase chain reaction (PCR). Data analysis was performed with appropriate descriptive and inferential statistics. Results The isolates were distributed as Escherichia coli (n=121, 31.0%), Klebsiella species (n= 112, 28.7%), Pseudomonas aeruginosa (n=59, 15.1%), Proteus species (n=43, 11.0%), Salmonella species (n=6, 1.3%) and others. They were commonly resistant to nalidixic acid (62.6%), co-amoxiclav (57.7%), norfloxacin (52.3%), ofloxacin (52.1%) and ciprofloxacin (51.0%), but were least resistant to imipenem (n=36, 9.2%). Of 244 quinolone-resistant isolates, 180 (73.8%) harboured one or more PMQR gene with high prevalence of efflux-mediating determinants (qepA, 22.5%, oqxAB, 21.1%), and aminoglycoside acetyltransferase (aac(6’)-Ib-cr, 19.7%). A proportionately low level of target-protecting determinants: qnrB, 13.2%, qnrS, 8.7%, qnrA, 5.9%, qnrD, 4.5% and qnrC, 4.2% was found. Conclusions There is widespread quinolone resistance and distribution of PMQR genes in clinical isolates in Nigeria with a preponderance of efflux-mediating determinants and aminoglycoside acetyltransferase. This emphasizes the need for antimicrobial stewardship to guide the appropriate use of antibiotics and prevent the spread of resistance genes.

Introduction In this study, the hematological and inflammatory parameters of patients admitted to the emergency department with abdominal pain were examined and predictive values were determined. Methods A total of 12682 patients who applied to Sakarya Training and Research Hospital adult emergency service with abdominal pain between 01/01/2019-31/12/2019 were included in the study. Patients were divided into groups, as follows: Group 1: Patients discharged from the emergency room, Group 2: Patients who were hospitalized from the emergency department and discharged without surgery, Group 3: Patients who were hospitalized from the emergency department and underwent surgery. Results A total of 12682 patients were included in the study. In the operated group the median CRP level (23.1 [0.1-377.4] mg/dL) was the highest, the mean WBC number (13.8±6.2 K/µL) was the highest, the median lymphocyte percentage (12.8 [0.2-55.6] %) was the lowest, the median neutrophil number (9.9 [1.0-43.8] K/µL) was the highest, the mean platelet number (254.2±88.1 K/µL) was the highest, the median neutrophil/lymphocyte ratio (6.1 [0.5-425.2]) was the highest and the median platelet/lymphocyte ratio 143.9 [16.9-2019.4] was the highest. Conclusions Our large-scale study shows that hematological-inflammatory parameters, which are routinely studied in patients presenting with abdominal pain, can be used to distinguish patients who will be discharged from the emergency service and those who require hospitalization.

Antimicrobial resistance has gained our attention, extending the interest in bacteriology research and upgraded it in such a way that we no longer look at bacteria only as dangerous enemies, but also as fantastic allies. Why allies? Microbiota is one of the greatest, but an almost invisible armour the human body owns which functions similarly to an external immune system. What is known so far is that the human microbiome is a very dynamic and protective layer consisting of beneficial microbes which defend us from the threatening ones.