Background: COPD is the third leading cause of mortality worldwide. CKD is a major healthcare concern that commonly coexists with COPD, increasing morbidity and mortality of both conditions. Methods: Utilizing data from the CDC WONDER database, COPD and CKD-related deaths from 1999 to 2020 were identified. Age-adjusted mortality rates (AAMRs) per 100,000 individuals were determined, using ICD-10 codes J40-44 and N18 for COPD and CKD, respectively. Joinpoint regression was used to analyze trends and annual percentage change (APC) variations for deaths stratified by year, sex, and geographical groups. Results: From 1999 to 2020, 172,439 COPD and CKD-related deaths were identified. Most occurred in inpatient medical facilities (44%), followed by nursing homes/long-term care facilities (23.6%), decedent’s homes (23.4%), and hospice/outpatient/ER facilities (5.5% each). Overall, AAMRs increased from 1999 to 2020 (APC 3.82). Males had higher AAMRs (27.49) than females (13.38), although the rise was more significant in females. When stratified by race, there was a consistent rise in AAMRs across all groups. Most notably, NH American Indian/Alaska Natives had the greatest increase in AAMR (21.05), while NH Asian/Pacific Islanders had the least (8.83). Non-metropolitan areas had greater AAMRs than in urban areas (23.21 vs. 17.87). AAMRs also varied regionally: Midwest (28.43), South (23.49), West (22.44), and Northeast (21.62). States in the upper 90th percentile of COPD & CKD-related deaths included West Virginia, North Dakota, Kentucky, Vermont, and Indiana, which had four times the AAMRs of states in the lower 10th percentile. Conclusion: The consistently rising mortality rate in COPD and CKD patients raises an important need to be explored. Persistent disparities exist, particularly among NH American Indian/ Pacific Islander males and individuals in the Midwest and rural areas, highlighting the need for targeted interventions for vulnerable groups and regions.

Mpox with digestive manifestations in a 16-year-old adolescent girl; A case report

TIPS to treat Chylous Ascites due to CirrhosisMuhammad AmirIntegris Health Baptist Medical Center, Oklahoma, USAEmail: muhammad.amir@integrishealth.orgAsad Ullah FarooqKing Edward Medical University, Lahore, PakistanEmail: asadfarooq1023@gmail.comRida ZahidRawalpindi Medical College, Rawalpindi, PakistanEmail: ridazahid91@gmail.comMahnoor FarooqKing Edward Medical University, Lahore, PakistanEmail: mahnoorfarooq81@gmail.comAymar AkilimaliDepartment of research, Medical Research Circle, Goma, DR Congoaymarakilimali@gmail.comCorresponding Author :Aymar AkilimaliDepartment of research, Medical Research Circle, Goma, DR CongoEmail: aymarakilimali@gmail.comORCID ID: Https://orcid.org/0000-0001-9393-1215Author Contributions :Author 1: Resources and ConceptualizationAuthor 2: Conceptualization and Original Draft WritingAuthor 3: Review & EditingAuthor 4: Original Draft WritingAuthor 5: Review & Editing

Pediatric tuberculosis remains a neglected health emergency, particularly in fragile contexts such as North Kivu province in the Democratic Republic of Congo. While more than one million children contract tuberculosis each year worldwide, the majority of cases remain underdiagnosed, resulting in preventable morbidity and mortality. In North Kivu, armed conflict, massive displacement, chronic malnutrition, overcrowding, and a weak health system create fertile ground for the spread of tuberculosis and complicate child care. Limited access to diagnostic tools (radiography, GeneXpert), insufficient BCG vaccination coverage, and a lack of appropriate pediatric drug formulations exacerbate the situation. National and international tuberculosis control strategies remain largely focused on adults, leaving children on the margins of policies and interventions. This editorial calls for an urgent and targeted response, including active contact tracing, improved access to diagnostic tools, the availability of appropriate medications, community outreach, and the involvement of humanitarian actors. Coordinated and context-specific action is essential to ensure that children in North Kivu no longer remain the invisible victims of a preventable and curable disease.

Backgrounds: Sleep paralysis is a parasomnia disorder connected to being unable to move your body though the experiencing person remains conscious. Factors involving this disorder are: stress, PTSD, lifestyle factors including the amount of sleep, and the amount of caffeine consumed. Our study aim is to assess the symptoms, duration, time of occurrence and body position during SP episodes and frequency of SP episodes with these variables. Methods: 412 participants took part in this quantitative cross-sectional study. Data was collected through online questionnaire. Ethical consideration was taken into account. Results: A significant correlation with a p-value of 0.000 was discovered between the quantity of SP episodes and SP symptoms with unable to move your body is the most frequent 44.7% among people who experience SP (48.1%). Significant association was found between frequency of SP episodes with duration (few seconds 20.9%), time of occurrence (upon falling asleep 23.8% and body position during SP (on back 26.5%) having p value of 0.000, 0.000 and 0.000 respectively. A noteworthy correlation was discovered between the frequency of SP episodes and PTSD and stress having a p value of 0.009 and 0.009 respectively. Significant association was also found between frequency of SP episodes with caffeine intake (38.1%) and smoking (2.9%) having a p value of 0.000 and 0.000. Conclusions: This study suggests a relationship between sleep paralysis and lifestyle and psychological factors.

A document by Christian TAGUE. Click on the document to view its contents.

Introduction:Bowel perforation needs an urgent clinical intervention and it significantly increase the mortality in the patients. Bowel perforation is rarely seen in post-partum mother. (1) Bowel perforation after a normal vaginal delivery (NVD) is rarer than a Caesarean section (C-section). (1)Appendicitis can be operated during pregnancy but post-partum appendicitis is very rare. (2) In perforated appendicitis, “gas under diaphragm” in plain radiograph is also a very rare incident. (3). Post partum perforated appendicitis is also rarely reported. The most common differential diagnosis are peptic perforation and bowel perforation. Other differential diagnosis are Meckel’s diverticulitis, Ischemic colitis, bowel obstruction, cholecystitis, Fitz Hugh Curtis syndrome, round ligament syndrome, pelvis thrombophlebitis, torsion of adnexal structures etc.From early 1900, surgeon’s are publishing papers related to appendicitis during pregnancy, so currently surgeons are well aware of the diagnosis and management of the appendicitis during pregnancy. Babler had published a paper related to this in 1908. (4) Harris J Timerman had published a paper in 1942, presenting two cases of post-partum appendicitis. (5).So, here we are presenting a very rare case of post-partum perforated appendicitis, a diagnostic dilemma. The abdominal pain and tenderness can be misinterpreted as labour pain and the septic peritonitis can lead to a preterm labour and preterm delivery. (6)Highlights:Post-partum Bowel perforation and Post Partum appendicitis are rare“Gas under diaphragm” due to perforate appendix is also rarePerforated Appendicitis in post-partum period is also rare

Introduction:

A document by Innocent MUFUNGIZI. Click on the document to view its contents.

Introduction Tuberculosis (TB) in Nigeria is a serious disease that is fast becoming deadly. In Nigeria, the burden and mortality of the disease are high, making it one of the infectious diseases with a significant public health challenge. Aim This paper is aimed at examining the prevalence of TB in Nigeria, with emphasis on one of its strains, namely XDR-TB, and factors promoting the disease and its strains, among others. Methodology A literature search was done about Tuberculosis in Nigeria using the keywords; ‘Drug Resistance; Factors; Infection Rate; Mortality Rate; Nigeria; XDR-TB’ through databases such as PubMed, ResearchGate, Google Scholar and World Health Organization between a 10-year-period. Result We found that Nigeria is among the 10 countries in the world with very high tuberculosis incidence and mortality. A number of factors aid the prevalence of the disease in Nigeria: poverty, malnutrition, overpopulation and overcrowding, ignorance, stigma and discrimination, etc. When it comes to the diagnosis of tuberculosis, Nigeria encounters a lot of challenges. For instance, the country lacks access to quality diagnostic facilities, the healthcare system is ill-equipped, and a good number of the populace lacks the necessary awareness about the dangerous nature of the disease. Conclusion The Nigerian government, health workers, key stakeholders, and communities, both affected and non-affected, should all come together to fight off Tuberculosis and its spread in Nigeria. In order to be successful, the eradication effort against TB in Nigeria has to permanently eliminate the causative agent and risk factors everywhere in the country as pathogen prevalence is globally reduced to zero, hence removing the risk of re-infection.