Scielo RSS http://scielo.isciii.es/rss.php?pid=2695-507520200003&lang=pt vol. 2 num. 3 lang. pt http://scielo.isciii.es/img/en/fbpelogp.gif http://scielo.isciii.es http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2695-50752020000300001&lng=pt&nrm=iso&tlng=pt http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2695-50752020000300002&lng=pt&nrm=iso&tlng=pt http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2695-50752020000300003&lng=pt&nrm=iso&tlng=pt http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2695-50752020000300004&lng=pt&nrm=iso&tlng=pt Abstract Introduction: Recent advances in nanotechnology have introduced new therapeutic materials for periodontal therapy. Previous studies showed that nanoparticles of silver provide high antibacterial activity. Taking this in consideration, it can be used in nonsurgical periodontal therapy. The present study focuses on efficacy of subgingival local drug delivery of silver nanoparticles in comparison with tetracycline in chronic periodontitis. Methods: To understand the effect of silver nanoparticles and tetracycline gel in chronic periodontitis, patients which were divided in different: Group A: Scaling and root planning (SRP) with sub-gingival delivery of silver nanoparticles gel, Group B: SRP with sub-gingival delivery of tetracycline gel and Group C: SRP alone. The other data recorded was Plaque Index (PI), Gingival Index (GI), Probing Pocket Depth (PPD) and Clinical Attachment Level (CAL) at baseline (just before placement of gel), 1 month and 3 months of application of gel. Microbiological evaluation (Colony Forming Units, CFU) were recorded at baseline and after 3 months. Results: The results showed that the use of silver nanoparticles delivery after SRP was as efficacious as tetracycline subgingival delivery to treat chronic periodontitis patients. All the clinical as well as microbiological parameters showed statistically significant difference from baseline to 3 months in all the groups. Conclusions: As compared to other therapeutic modalities employed against infection, silver nanoparticles gel is non-toxic at given concentration, has no side effects and does not require complicated application method or any complex armamentarium. It is well tolerated and well accepted by the patients. Silver nanoparticles gel with SRP gives promising results and it can definitely aid in periodontal diseases. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2695-50752020000300005&lng=pt&nrm=iso&tlng=pt Abstract Introduction: There is the obscurity of published data on surgical management of external abdominal wall hernias in our environment. This study was, therefore, to describe the pattern, outcome, and experience in the surgical management of anterior abdominal wall hernias in Shisong, Cameroon. Methods: This was a descriptive retrospective study conducted at St. Elizabeth Catholic General Hospital, Shisong. The various cases of abdominal wall hernias performed in the hospital during the study period of three years covering January 2017 to December 2019 by the surgical teams were included. We ensured that Ethical clearance and written informed consent were obtained before the start of the project. Information includes detailed sociodemographic data collected and analyzed by using SPSS 22 statistical software. Results: 465 cases of various abdominal wall hernias were included in this study. The most common type of hernia was indirect inguinal hernia (86.5%), and one rare Spigelian hernia was also there. The sub-arachnoid block was the most prevalent form of anesthesia. The various surgical procedures performed, including herniotomy (8.7%), hernioplasty (38.7%), and herniorrhaphy (28.6%), which were done for various inguinal hernias. In contrast, only mesh repair (9%) was performed for epigastric, lumbar, umbilical, Spigelian, and incisional hernia. Amongst the inguinal hernias, 55.2% were right-sided, 40.6% were left-sided, and 4.2% were bilateral, whereas 50% each of femoral hernia was left and right-sided. Overall, the annual recurrence rate for groin hernia was 1.9%. Conclusion: Inguinal Hernia was the most common type of hernia (86.3%). Among the inguinal hernia, the right side was more common (58.42%). The adoption of newer modalities of care should be considered standard. However, in resource-constrained settings like ours in Cameroon, the goal should be to perform a skillful and technically effective technique. Also, it is critical to ensure adequate anesthesia for optimal post-operative pain control, coupled with minimal morbidity. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2695-50752020000300006&lng=pt&nrm=iso&tlng=pt Abstract Introduction: Respiratory tract infections have been known to be a significant health concern for mortality and morbidity since many years. This study was aimed at determining the prevalence of bacterial pathogen causing upper respiratory tract (URTIs) and the susceptibility patterns to frequently used antibiotics among patients attending Abusetta hospital in Tripoli district. Methods: A total of 1,110 throat swabs were collected between Jan, 2011 to December, 2014 and inoculated onto Blood agar, MacCkonkey agar and Chocolate agar then incubated at 37 oC for 24 hours. Bacterial pathogens were determined by bacteriological culture methods and antibiotic susceptibility of the isolates was identified following Clinical Laboratory Standard Institute guidelines (CLSI). Results: Of the 1,110 respiratory samples tested, 71.1% (n = 789) of specimens were positive cultures with the dominant bacterial pathogens being Streptococcus pneumoniae 43.3% (n = 342), followed by Pseudomona aeruginosa 22.8% (n = 180), Staphylococcus aureus 13.8% (n = 109), Escherichia coli 6.9% (n = 55), Enterobacter spp 6.2% (n = 49), Citrobacter 4.5% (n = 36), and Klebsiella 2.2% (n = 18). Most isolates exhibited resistance against the commonly used antibiotics and to at least one antibiotic. Conclusion: The level of antibiotic resistance in this study is alarming and brings to light the timely and suitable diagnosis of the common bacteria causes of URTIs and proper antibiotic administration based on susceptibility test. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2695-50752020000300007&lng=pt&nrm=iso&tlng=pt Abstract Introduction: The antimicrobial agents have saved human from several infectious disease. However, bacteria have capability to develop to become resistant to antibiotics and incorrect use of antibiotics is the main determinants of development of antimicrobial resistance which is a public health issue. Attention on medical students and community people should be emphasized by both education and promotion. Thus, this study was aimed to assess the present knowledge, attitude and behavior of Libyan university students regarding antibiotic use and misuse. Methods: Sample size of 150 students attending faculty of pharmacy of university of Zawia, Libya was participated. The procedure was divided into five groups according to their grades. All the involved participants completed a health questionnaire about their utilization and mal utilization of antibiotics. Data was collected over a period of two months during July and August 201 9. Results: The evaluated data was from 150 students; 132 were females and 18 were males (7.3 : 1.0). 88.0% use antibiotics to cure bacterial infection while 15.3% use it to cure viral infection. 38.0% never use antibiotics to treat respiratory tract infections such as common cold, 34.0% sometimes and 26.0% always . In addition, 61.0% stopped using antibiotic based on physician's instruction while 8.0% when symptoms decreased. Regarding their attitude toward antibiotic misuse, 82.0% agreed that it is necessary to get more education and promotion about pattern of antibiotic use and 73.0% agreed to establish courses on antibiotic rationale use. Conclusion: Students at medical university of Zawia have a considerable knowledge and a great perspective on antibiotics utilization. However, there is still a need for more additional educational programs on antibiotic utilization and mal utilization targeted university students and community people in Libya. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2695-50752020000300008&lng=pt&nrm=iso&tlng=pt Abstract Introduction: In our previous studies it was concluded that the zinc (Zn) level in in human expressed prostatic fluid (EPF) is a first candidate with the role of offering a new, simple, fast, reliable, and non-invasive diagnostic tool for prostate cancer (PCa) screening. However it was unclear how other non-prostatic diseases inherent of the old persons, including heart diseases, atherosclerosis, diabetes, asymptomatic cancer of different localization and some others, impact on a chemical element composition of expressed prostatic fluid. Thus, the purpose of this study was to evaluate whether significant changes in the levels of Zn in EPF exist in patients with bladder cancer (BC). Methods: Prostatic fluid levels of Zn were prospectively evaluated in 17 patients with BC and 51 healthy male inhabitants (control group). Measurements were performed using 109Cd radionuclide-induced energy dispersive X-ray fluorescent microanalysis developed by us. Results: Mean value ± standard deviation of mean (M±SD) for concentration of Zn in the EPF of healthy males and patients with BC was 573±202 mg/L and 625±108 mg/L, respectively. Using both parametric Student’s t-test and non-parametric Wilcoxon-Mann-Whitney U-test it was shown that the Zn concentration in the EPF of patients with BC did not differ from that in healthy subjects. Conclusion: Such serious illness as BC did not impact on the Zn concentration in the EPF. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2695-50752020000300009&lng=pt&nrm=iso&tlng=pt Abstract Introduction: Corona Virus Infectious Disease (COVID-19) is the infectious disease. The COVID-19 disease came to earth in early 2019. It is expanding exponentially throughout the world and affected an enormous number of human beings starting from the last month. The World Health Organization (WHO) on March 11, 2020 declared COVID-19 was characterized as “Pandemic”. This paper proposed approach for confirmation of COVID-19 cases after the diagnosis of doctors. The objective of this study uses machine learning method to evaluate how much predicted results are close to original data related to Confirmed-Negative-Released-Death cases of COVID-19. Materials and methods: For this purpose, a verification method is proposed in this paper that uses the concept of Deep-learning Neural Network. In this framework, Long shrt-term memory (LSTM) and Gated Recurrent Unit (GRU) are also assimilated finally for training the dataset. The prediction results are tally with the results predicted by clinical doctors. Results: The results are obtained from the proposed method with accuracy 87 % for the “confirmed Cases”, 67.8 % for “Negative Cases”, 62% for “Deceased Case” and 40.5 % for “Released Case”. Another important parameter i.e. RMSE shows 30.15% for Confirmed Case, 49.4 % for Negative Cases, 4.16 % for Deceased Case and 13.72 % for Released Case. Conclusions: The outbreak of Coronavirus has the nature of exponential growth and so it is difficult to control with limited clinical persons for handling a huge number of patients within a reasonable time. So it is necessary to build an automated model, based on machine learning approach, for corrective measure after the decision of clinical doctors. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2695-50752020000300010&lng=pt&nrm=iso&tlng=pt Abstract Introduction: Toxocariasis is a zoonotic helminth infection with difficult diagnosis. Determination of specific IgG antibodies alone does not allow to establish the disease stage and to evaluate the treatment efficacy. Therefore it is necessary to identify additional markers that will assist the diagnosis. The purpose of our study was to identify and monitor eosinophil cationic protein (ECP) levels in patients with toxocariasis confirmed by serology and to compare our data with the literature to determine the relevance of this protein as an indicator for recent infection and the effectiveness of the therapy. Material and methods: ELISA (CUSABIO) commercial kit was used for determination of ECP concentration. Sixty serum samples were studied from individuals previously tested and confirmed for toxocariasis by the presence of specific anti-Toxocara IgG antibodies in ELISA (Toxocara IgG Rbiopharm) and the presence of specific bands in Western blot as confirmatory test (LD BIO). Twenty serum samples from clinically healthy blood donors were used as a control group. Results: The mean concentration of serum ECP in the patients with toxocariasis was significantly higher than in clinically healthy subjects. Seventy-two percent of patients affected by toxicariasis showed increased serum concentration of ECP. However, no statistically significant differences were observed in terms of age (p = 0.451) and sex (p = 0.682) of the patients or clinical form of the disease. ECP levels among patients with visceral toxocariasis were relatively higher (mean 22.99 ng / ml ± 13.16 SD) in comparison to those with ocular involvement (15.60 ng/ml ± 9.92 SD). Correlation between the presence of peripheral eosinophilia and the concentration of serum ECP was not also established. Conclusion: Data from our study give us reason to believe that serum levels of ECP could serve as an additional marker indicating recent infection, especially in patients without marked increase in the blood eosinophils. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2695-50752020000300011&lng=pt&nrm=iso&tlng=pt Abstract Everyday routine jobs, as well as suddenly specific situations, as well as severe medical conditions of a nurse, can be considerably psychophysically exhausted. It is therefore important for nurses to find a model to deal effectively with stress and the severity of working conditions. Higher levels of education and lifelong learning contribute to finding new strategies that facilitate work in the intensive care unit. Qualities that give importance to nurse's are communication skills, emotional stability, empathy, flexibility, interpersonal skills, physical endurance, respect, knowledge and many others. The role of a nurse is to establish a balance between technique and humanity, or to bring humanity in the care of a patient, because no one device will replace the caring and sympathy of the nurse. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2695-50752020000300012&lng=pt&nrm=iso&tlng=pt Abstract Hypoxemia is defined as the decrease in arterial partial pressure of oxygen (PaO2) below 80 mmHg. One of the ways to alleviate this condition is through oxygen therapy, which consists of administering oxygen at a concentration higher than atmospheric. This therapy is indicated in various pathologies and is aimed to treat hypoxemia and reduce the patient's myocardial demand and respiratory effort. Classically, this treatment has been carried out using low-flow systems, in which the inspiratory fraction of oxygen (FiO2) cannot be regulated. However, an increase in the use of high-flow oxygen therapy (HFO) has been observed in recent years. These systems allow for greater patient comfort as well as more precise regulation of the FiO2. The purpose of this article is to review respiratory physiology to understand respiratory failure from a clinical and pathophysiological point of view. Likewise, the different oxygen therapy systems most widely used are discussed, as well as their indications for acute and chronic pathologies, both in the pediatric and adult populations. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2695-50752020000300013&lng=pt&nrm=iso&tlng=pt Resumen Background: Children who have been abused could exhibit lesions and diseases in their oral cavity and develop psychological consequences towards the dentist-patient relationship. Objectives: Analyse the oral lesions and diseases, the psychological consequences and understand the role of the dentist in the detection and notification of child abuse. Methods: Systematic review, according to PRISMA statement, with two search strategies in the MEDLINE/PubMed database. 19 publications were included after the application of selection and eligibility criteria. Results: Physical-abuse-related lesions and Münchausen syndrome are not pathognomonic; this requires the detection of indicators of suspicion. Physical-neglect diseases usually have associated other chronic health problems. Specifically, diseases related to sexual abuse are the oral infection caused by Treponema pallidum and Neisseria gonorrhoeae; while other lesions and diseases might only suggest abuse. The most frequent psychological sign of child abuse in the dentist-patient relationship is dental phobia. Typically, when detecting and notifying, dentist face the following barriers: insufficient information; fear of wrong suspicion; impact in the professional practice; fear of consequences on the minor; fear of violence against the dentist; lack of knowledge of necessary documents/procedures; fear of judicial statement. Conclusions: Child-abuse-related lesions and diseases often appear in the oral region. Dentists play a fundamental role in the detection and notification of those. It is essential to establish training and action protocols as well as reliance strategies in the patient-dentist relationship. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2695-50752020000300014&lng=pt&nrm=iso&tlng=pt Abstract Objective: This article aims to explore the role and responsibility of physicians in the era of social media; the authors take as an example of the current pandemic of Coronavirus disease 2019 (COVID-19). Also, we highlight how social media impact the way populations trust and follow the recommendations of the governments. Methods: We identified relevant articles to date using a manual library search, journal publications on the subject, and critically reviewed them. Results: We critically examined the fake news around COVID-19 disease: the disease origin, manifestations, symptoms, and treatments. The authors also explore the high expectation of people and changes in behaviors that led to risky manners, including self-medication after American President Donald Trump has claimed a major benefit of treatment with chloroquine in COVID-19. Surprisingly, the potential BCG vaccination trials in the COVID-19 pandemic were also greeted with much controversy and rejection, especially in Africa. This paper ends with some advice to various stakeholders, including leaders of global health national health organizations, and physicians on the measures to be taken in case of a similar situation in the future. Conclusions: Social media offer significant benefits for individual and public health promotion, especially when used wisely and prudently. They equally provide opportunities for advancement and professional development. However, any careless use of such platforms poses a formidable danger to health care practitioners. Lately, there are existing guidelines issued by health care organizations and professional societies which provide sound and useful principles that health care practitioner should follow to avoid pitfalls. The authors also end by stressing the importance of culturally adapting prevention messages in the context of such a pandemic. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2695-50752020000300015&lng=pt&nrm=iso&tlng=pt Abstract The present world has observed the SARS-CoV2 or COVID-19 spreading rapidly with a rising death toll and transmission rates with an absence of proper data management and information sharing. The current traditional database storage system has the limitations of a centralized control system and tampering of data, particularly when it is being shared with others. The Novel technology known as “Blockchain” is a distributed ledger technology that acts as a shared database, keeping all its copies synced and verified. The objective of this article is to study the concept of a Blockchain based pandemic data management system that would ensure unified patients’ data storage and reliable data management to trackdown coronavirus to combat against this and future pandemics. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2695-50752020000300016&lng=pt&nrm=iso&tlng=pt Abstract The promotion of student engagement in simulation-based learning depends on authenticity, fidelity, and realism. Moulage is a simulation of illnesses or physical signs onto standardized patient or manikin via using makeup techniques or other elements acting as visual and tactile cues to promote learner engagement through more real-world experience. Therefore, moulage may be used broadly in medical education wherein its authenticity helps to improve the learning outcomes and performance of students in different medical branches such as dermatology, surgery, emergency medicine, anatomy, and forensic medicine. Nowadays, Moulage is already used in the assessment of a medical student as well as in the learning process in many medical schools. However, although the use of moulage as a creative simulation tool in medical education has a positive impact on the educational process, it faces many obstacles and challenges at the same time along with its tangible benefits. Therefore, moulage is not magic as well as it is not fantasy or mock, but it is a fantastic vehicle for representing and simulating the real event promoting realism and motivating students' engagement and immersion. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2695-50752020000300017&lng=pt&nrm=iso&tlng=pt Resumen This paper reviews the therapeutic effects of Commiphora myrrh in different diseases. It is organized by sub-themed sections: nature and history of myrrh, its use in different cultures, its chemical action, and effect on virus or/and bacteria, benefits of its utilization for respiratory problems and oral diseases. A literature research for the Myrrh or C. myrrh was performed using Cochrane Library databases and Medline. Forty two papers, including abstracts and full articles published from 2007 to 2020, in the area of interest were reviewed. It was found that Myrrh or C. myrrh is one of the medicinal plants believed to have therapeutic effects in various diseases. It has medicinal properties, such as immunomodulatory, anti-inflammatory, cytotoxic, antioxidant, antimicrobial, hepatoprotective, anti-tumor, anti-ulcer, and analgesic activities. Besides, Myrrh has also shown to have antiviral properties that help in preventing different types of viral diseases. It noticed in the State of Qatar, sales of herbs and Myrrh has escalade since the surgency of COVID-19 cases, so is there a belief in Myrrh's effectiveness to be used during COVID-19? Studying the effectiveness of Myrrh mouthwashes to combat COVID-19 can emerge as a promising avenue in the field of research. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2695-50752020000300018&lng=pt&nrm=iso&tlng=pt Abstract A severe pandemic of CoronaVirus disease 2019 (COVID-19), according to World Health Organization (WHO), appeared in China in December 2019, and spread rapidly. The majority of the patients had mild symptoms and good prognosis after recovery; however some patients developed severe inflammatory reaction and passed away from multiple organ complications. The novel coronavirus, Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) is a beta-coronavirus and is similar with the Severe Acute Respiratory Syndrome Corona Virus 1 (SARS-CoV-1) and the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). SARS-CoV-2 and -1 have the same host receptor, the angiotensin-converting enzyme 2 (ACE2). The pathogenesis of SARS-CoV-2 infection in humans remains unclear. The immune response is essential to control and reduce SARS-CoV-1 and -2 infections, however, irregular and exaggerated immune responses may lead to the immunopathology of the disease and the lung lesions. This article presents the immunological features of SARS-CoV-2 infection and its potential pathogenesis based on the recent observations of the International literature. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2695-50752020000300019&lng=pt&nrm=iso&tlng=pt Abstract Introduction: We report a case of gastroschisis seen in our center, highlighting the rarity of this clinical entity. The author equally reviewed the existing literature covering the epidemiology, etiopathogenesis, management options, and outcomes of gastroschisis in low-income countries in sub-Saharan Africa and compares the reports with middle-income and high-income countries across the world. Case presentation: A preterm female neonate with a clinical diagnosis of gastroschisis at a primary care center was referred to the Neonatology Service of our tertiary care institution. She received optimal resuscitation and interdisciplinary management. Besides, the baby underwent an initial covering with an improvised silo bag of exposed bowel with unfavorable outcomes. Conclusion: The specific etiological factors for gastroschisis are yet to be established. The condition is considered a multifactorial disease. More frequently than ever, it's becoming easy to make prenatal diagnosis utilizing ultrasonography with high yield. Gastroschisis is a low-prevalence disease with an excellent prognosis if initial management is adequate. Interestingly, the condition requires highly skilled personnel of both specialized and primary care. Once the clinicians are well equipped, they can readily ensure correct initial management. Besides, the patient can equally benefit from an appropriate and timely referral to tertiary care centers to avoid future complications. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2695-50752020000300020&lng=pt&nrm=iso&tlng=pt Abstract We report a case of a 25-year-old male with a long history of watering from both the eyes. Complete ocular examination of the patient was carried out under slit lamp. Out of four, three punctums were found absent in our patient. Our case highlights a rare case of epiphora from both the eyes. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2695-50752020000300021&lng=pt&nrm=iso&tlng=pt Abstract Worm infestation issue is a common health condition observed mostly in Asian countries. The prevalence of worms in children is higher due to the habit of playing in mud or outdoors which is not found in the case of an infant. Very rarely worm infestation is observed in infants. There is a need for an investigation to be carried out for live worms in the stool. Sometimes the change in the diet of the infant, irregular bowel movements, and worm-like things in stool makes an alarming situation. We report the original case of a 6-month-old infant camouflaging for worm infestation due to the presence of the thread-like parasite in stool. The routine stool and chemical analysis of black thread thing from stool revealed solid diet fibers of banana and not any parasitic infection. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2695-50752020000300022&lng=pt&nrm=iso&tlng=pt Abstract Worm infestation issue is a common health condition observed mostly in Asian countries. The prevalence of worms in children is higher due to the habit of playing in mud or outdoors which is not found in the case of an infant. Very rarely worm infestation is observed in infants. There is a need for an investigation to be carried out for live worms in the stool. Sometimes the change in the diet of the infant, irregular bowel movements, and worm-like things in stool makes an alarming situation. We report the original case of a 6-month-old infant camouflaging for worm infestation due to the presence of the thread-like parasite in stool. The routine stool and chemical analysis of black thread thing from stool revealed solid diet fibers of banana and not any parasitic infection.