Etiological risk factors for subfertility among Palestinian women in Gaza

The inability to procreate is frequently considered a personal tragedy and a hardship for couples, impacting on the entire family and even the local community. In Gaza strip, Palestine, there has been no study on etiological risk factors for subfertility. The present study aimed to identify risk factors associated with subfertility among women in Gaza, Palestine. One hundred and sixty-nine women in the study group and 115 women in the control group were included. Cases were selected randomly from those referred to the A1 Basma Fertility Center, Gaza, Palestine. Data were collected through close-ended questionnaire, sonography, hormonal analysis and thrombophilia profile that included the methylenetetrahydrofolate reductase （MTHFR 677 C 〉 T）, factor V leiden （1691 G 〉 A） and pro- thrombin （20210 G 〉 A） genes. By using univariate analyses, the effects of different patient-related variables on the presence of subfertility were evaluated. A multiple logistic regression model was constructed, crude and adjusted odds ratios （OR） and 95% confidence intervals （95% CI） were calculated. The findings showed that 73.5 % （169/230） of the women referred to the A1 Basma Center sought treatment for subfertility. Different etiological risk factors were associated with subfertility, the most frequent of which in descending order were： thrombophilic disorders, fallopian tube problems, sex hormone abnormalities and polycystic ovary syndrome with an adjusted OR of 21.42, 13.63, 11.69 and 10.29, respectively. In conclusion, several etiological risk factors are responsible for subfertility among women in Gaza. Comprehensive evaluation of infertile women should be considered in the course of treatment; otherwise, the duration of sterility may be extended.

Maternal Mortality in the Obstetrics and Gynecology Service of Regional Hospital Center of Ouahigouya: Epidemiological, Etiological Aspects and Contributing Factors—About 151 Cases Collected in Three Years from 1st January 2013 to 31 December 2015

The objective of our study was to study the epidemiological, etiological and contributory factors of maternal deaths in the obstetrics and gynecology department of the regional hospital center (RHC) of Ouahigouya from 2013 to 2015. We carried out a descriptive and analytical study on maternal deaths in maternity of the RHC of Ouahigouya, including all patients who died in the obstetrics and gynecology department of the RHC of Ouahigouya from 1 January 2013 to 31 December 2015, which meets WHO’s definition of maternal death. We recorded 151 maternal deaths and 5481 live births, a maternal mortality ratio of 2755 per 100,000 live births. The most affected women were women aged 20 - 24 years (27.8%), multiparous (25.5%), married women (88.7%) and those without income-generating activities (85.4%). The main causes of death from direct obstetrical complications were hemorrhage (38.3%), infections (21.5%), abortions (16.8%) and complications of hypertension disorders (15.8%) and for indirect obstetrical complications, malaria (36.6%), anemia (29.5%), and HIV/AIDS (9.1%). Contributing factors to maternal deaths prior to admission were delay in referral (33.3%) and delay in transfer (31.5%) and delay in admission (32.8%) and delay in diagnosis (23.4). From our study, it appears elsewhere as well as that most maternal deaths are preventable, hence the need for coordinated actions to effectively fight against maternal mortality.

Etiological Factors of Infective Endocarditis in Children Aged 1 Month to 15 Years Hospitalised in the Paediatric Department of CHU Gabriel Touréof Bamako (Mali)

Introduction: In emerging countries where studies are rarer, the epidemiological profile of infective endocarditis resembles that of developed countries at the beginning of the antibiotic era. There is little data available in Mali on this subject, motivating this study, the aim of which was to study the etiological factors of infective endocarditis in children aged between 1 month and 15 years hospitalised in the paediatric department of the CHU Gabriel Touré. Patients and Methods: We conducted a cross-sectional and descriptive study, which took place from August 2018 to August 2019 (13 months), in children aged between 1 month and 15 years hospitalised in the paediatric department of the Gabriel Touré University Hospital with an ultrasound- confirmed cardiac disease and a temperature above 38°C. Results: The hospitalization rate was 0.4%. The average age was 11 months, the sex ratio was 1.35. Respiratory distress (63.6%) and fever (30.3%) were the most common reasons for referral. Congenital heart disease (87.9%) and dyspnoea on feeding (24.2%) were the most common medical histories. IVC was the most frequent congenital heart disease (36.4%). The mean temperature was 39.1°C. Blood cultures were taken in 24 patients (72.7%) and were positive in 27.3%. Staphylococcus aureus was found in 55.6% of cases. Trans-thoracic ultrasound found vegetations in 03 cases. According to the modified DUKE criteria, the diagnosis of endocarditis was retained in 27.30%. The evolution was marked by a high case fatality rate (45.45%). Conclusion: Endocarditis is an uncommon disease in children with a pulmonary portal of entry and Staphylococcus aureus as the main germ. Its mortality remains high.

Breastfeeding and genetic factors in the etiology of inflammatory bowel disease in children

Inflammatory bowel disease is a chronic,debilitating disorder of the gastrointestinal tract.The etiology of inflammatory bowel disease has not been elucidated,but is thought to be multifactorial with both environmental and genetic influences.A large body of research has been conducted to elucidate the etiology of inflammatory bowel disease.This article reviews this literature,emphasizing the studies of breastfeeding and the studies of genetic factors,particularly NOD2 polymorphisms.

Psychosocial factors affecting the etiology and management of type 1 diabetes mellitus:A narrative review

Type 1 diabetes(T1D)is one of the most common chronic diseases in children and adolescents worldwide.Its etiopathogenesis results from the interplay of genetic and environmental variables.Among the latter,psychological stress has been implicated in disease onset as well as disease management.Various studies,including large population-based studies,have highlighted the role of stressful life events in the etiopathogenesis of T1D.In this article,we also emphasize the importance of attachment in the early child-caregiver relationship,which can be seen as a measure of the quality of the relationship and is crucial for stress and emotional regulation.It serves as a model for all subsequent relationships in one’s life.We summarize some of the few studies performed in the field of attachment and T1D etiopathogenesis or management.T1D management demands a lifelong therapeutic regimen to prevent acute and chronic complications.In addition to psychological stress,psychological factors such as family functioning,developmental adjustment,autonomy,mental health problems and other factors have been found to relate to metabolic control.Psychological factors need to be understood not as a single directional causality-based principle but as a dynamic bi-or multidirectional system that is affected by the normal developmental transitions of childhood and adolescence.

Lyme Borrelia as the etiological factor in three cases of primary inflammatory choriocapillaropathies

Citation： Jovanovic SV, Petrovic NT, Zivkovic MLJ, Toncic ZG, Sarenac Vulovic TS. Lyme Borrelia as the etiological factor in three cases of primary inflammatory choriocapillaropathies, lnt J Ophthalmo12017 ; 10（12）：1940-1944

TCM syndrome types and the related factors in 145 cases of renal cell carcinoma

Background:To analyze the distribution of traditional Chinese medicine(TCM)syndromes and the related factors in patients with renal cell carcinoma,and to provide further guidance for the relapse prevention and combination of traditional Chinese and Western medicine in postoperative renal cancer patients.Methods:A retrospective survey was conducted to establish a postoperative clinical symptom assessment scale for patients with renal cell carcinoma.The distribution of TCM syndromes in 145 patients with renal cell carcinoma was analyzed statistically.Multivariate logistic regression was used to analyze the correlation between different TCM syndromes and risk factors.Results:The postoperative TCM syndromes of patients with cell carcinoma were mainly spleen-kidney deficiency(38.6%),liver-kidney Yin deficiency(15.9%),spleen-kidney Yang deficiency(13.1%),and damp-heat pouring downward(9.7%).The incidence of severe spleen-kidney Qi deficiency syndrome and spleen-kidney Yang deficiency syndrome was statistically different from that of liver-kidney Yin deficiency syndrome(P<0.05).The history of drinking and body mass index≥24 kg/m2 were risk factors for spleen-kidney Qi deficiency syndrome;the history of hypertension was a protective factor for liver-kidney Yin deficiency syndrome after renal cancer surgery;male was a protective factor for patients with renal cancer who had damp-heat pouring downward syndrome;smoking history and drinking history were risk factors for damp-heat pouring downward;age was a protective factor for spleen-kidney Yang deficiency after renal cancer surgery.Conclusion:This study found that spleen-kidney Qi deficiency syndrome,liver-kidney Yin deficiency syndrome,spleen-kidney Yang deficiency syndrome,dampness and heat injection syndrome were the common TCM syndrome types after renal cell carcinoma patients.There was a correlation between the TCM syndromes of renal cell carcinoma and the risk factors such as drinking history,overweight and obesity,smoking history and drinking history.The distribution of TCM syndromes and its correlation with risk factors in renal cell carcinoma patients after surgery can provide ideas for clinical treatment and prognosis.

Etiologies and Associated Factors of Generalised Pruritus Sine Materia in the Dermatology-Venerology Department of CHUD-Borgou/Alibori (Benin)

Introduction: The aim was to identify the etiologies of generalised pruritus sine materia and to determine the associated factors in Parakou. Methods: This was a retrospective observational study conducted from January 2011 to June 2022. The patients included were of all ages and both sexes in whom the sine materia nature of the pruritus was noted after clinical examination. These patients had an etiological assessment available or not, complete or partial. For each patient, socio-demographic, socio-cultural, socio-economic and clinical data were collected using a pre-established survey form. They were then processed and analysed using Epi Data 3.1 and SPSS version 21 software respectively. Results: The incidence of generalised pruritus sine materia was 0.89% (73 cases/8214 consultants). The predominant etiologies were aquagenic pruritus (16.4%) and intestinal parasitosis (12.3%). After a bi-variate analysis, two risk factors were identified: frequency of towel change greater than 1 month (OR = 3.02;CI95% = 0.98 - 9.31;P = 0.0486) and use of cold water for bath (OR = 3.28;CI95% = 1.09 - 9.81;P = 0.0274). Conclusion: The etiologies and associated factors of generalised pruritus sine materia found in Parakou are varied but are linked to lifestyle. There is an urgent need to raise public awareness of the need to improve lifestyle in order to reduce the frequency of pruritus sine materia. .

The application of the “Treatment in Accordance with Three Categories of Etiologic Factors” theory in the prevention and treatment of epidemic diseases in traditional Chinese medicine since the Ming and Qing Dynasties

“Treatment in accordance with three categories of etiologic factors”(consideration of the climatic and seasonal conditions,environment and individual’s constitution in the treatment of diseases),that is,treatment following time,place and individual,is one of the basic principles followed by Chinese medicine in the clinical treatment of diseases.This paper analyzes the similarities and differences in traditional Chinese medicine treatment of patients with epidemic diseases in different regions and periods since the Ming(1368-1644 C.E.)and Qing(1636-1912 C.E.)Dynasties.In addition,the theory of epidemic disease prevention and control based on the application of“treatment in accordance with three categories of etiologic factors”was discussed to inspire and guide the prevention and treatment of COVID-19.

Non-viral factors contributing to hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is a major cause of cancer death worldwide, accounting for over half a million deaths per year. The geographic pattern of HCC incidence is parallel to exposure to viral etiologic factors. Its incidence is increasing, ranging between 3% and 9% annually depending on the geographical location, and variability in the incidence rates correspond closely to the prevalence and pattern of the primary etiologic factors. Chronic infections with hepatitis B viruses or hepatitis C viruses have both been recognized as human liver carcinogens with a combined attributable fraction of at least 75% of all HCC cases. Multiple non-viral factors have been implicated in the development of HCC. Increased body mass index and diabetes with subsequent development of non-alcoholic steatohepatitis represent significant risk factors for HCC. Other non-viral causes of HCC include iron overload syndromes, alcohol use, tobacco, oral contraceptive, aflatoxin, pesticides exposure and betel quid chewing, a prevalent habit in the developing world. Wilson disease, α-1 antitrypsin deficiency, Porphyrias, autoimmune hepatitis, Schistosoma japonicum associated with positive hepatitis B surface antigen, and thorotrastray are also contributing hepatocellualar carcinoma. In addition, primary biliary cirrhosis, congestive liver disease and family history of liver cancer increase the risk of HCC incident. In conclusion,clarification of relevant non-viral causes of HCC will help to focus clinicians on those risk factors that are modifiable. The multilevel preventative approach will hopefully lead to a reduction in incidence of non-viral HCC, and a decrease in the patient morbidity and mortality as well as the societal economic burden associated with HCC.

Influence of environmental factors on the onset and courseof inflammatory bowel disease

Numerous environmental factors have been linked with inflammatory bowel disease. These include smoking, diet, hygiene, drugs, geographical and psychosocial factors. These factors may either increase the risk of or protect against developing this condition and can also affect the course of illness in a positive or negative manner. A number of studies have examined the influence of environmental factors on inflammatory bowel diseases as a whole as well as on ulcerative colitis and Crohn's disease separately. As there are differences in the pathogenesis of ulcerative colitis and Crohn's disease, the effect of environmental factors on their onset and course is not always similar. Some factors have shown a consistent association, while reports on others have been conflicting. In this article we discuss the current evidence on the roles of these factors on inflammatory bowel disease, both as causative/protective agents and as modifiers of disease course.

High Risk Factors of Pancreatic Carcinoma

Over the past decades, cancer has become one of the toughest challenges for health professionals. The epidemiologists are increasingly directing their research efforts on various malignant tumor worldwide. Of note, incidence of cancers is on the rise more quickly in developed countries. Indeed, great endeavors have to be made in the control of the life-threatening disease. As we know it, pancreatic cancer（PC） is a malignant disease with the worst prognosis. While little is known about the etiology of the PC and measures to prevent the condition, so far, a number of risk factors have been identified. Genetic factors, pre-malignant lesions, predisposing diseases and exogenous factors have been found to be linked to PC. Genetic susceptibility was observed in 10% of PC cases, including inherited PC syndromes and familial PC. However, in the remaining 90%, their PC might be caused by genetic factors in combination with environmental factors. Nonetheless, the exact mechanism of the two kinds of factors, endogenous and exogenous, working together to cause PC remains poorly understood. The fact that most pancreatic neoplasms are diagnosed at an incurable stage of the disease highlights the need to identify risk factors and to understand their contribution to carcinogenesis. This article reviews the high risk factors contributing to the development of PC, to provide information for clinicians and epidemiologists.

TCM diagnosis and treatment theory of chronic complete occlusion of coronary artery based on etiology and pathogenesis

Chronic total occlusive disease of the coronary artery belongs to the category of"chest palsy"and"true heart pain"in traditional Chinese medicine.Its etiology has two aspects:deficiency of blood,blood stasis,qi stagnation,and phlegm.Failure can be caused by deficiency or disease.The pathogenesis of this disease is caused by obstruction of the heart pulse,and its pathogenesis can be transformed into each other.The theory of traditional Chinese medicine believes that the general rule is not painful.Therefore,the treatment of coronary CTO lesions should be based on the combination of Tong and Tong tonic.The chronic complete occlusive disease of the coronary artery can be treated through Xuanbi Tongyang,Huoxue Tongluo,and Aroma Wentong.Based on the Chinese medicine's understanding of the etiology and pathogenesis of coronary CTO lesions,it provides a basis for the diagnosis and treatment of traditional Chinese medicine,solves the problems of interventional medicine in western medicine,and gives play to the unique advantages of traditional Chinese medicine for clinical diagnosis and treatment.

Kidney Stones in Transfusion-Dependent Thalassemia: Prevalence and Risk Factors

Purpose: As patients with transfusion-dependent thalassemia (TDT) are living longer, novel morbidities are being recognized. The purpose of this review is to summarize the current knowledge regarding the prevalence and risk factors of nephrolithiasis in patients with TDT. Methods: A non-systematic, narrative review of the current literature published up to August 2021 was conducted. Results: Nephrolithiasis has been reported in 18% - 59% of patients with TDT, which is at least twice the prevalence in the general US population. The risk factors for nephrolithiasis can be classified into behavioral (dietary and lifestyle), environmental, metabolic, disease-specific, and genetic factors. While clarifying the true prevalence of nephrolithiasis in different age groups and diagnostic categories of TDT requires further research, prevention, and management of nephrolithiasis is a growing clinical concern. Physicians should be aware of the potential increased risk of stone disease in splenectomized and diabetic patients as well as those treated with certain chelation regimens. Conclusions: The etiology of nephrolithiasis and potential TDT-specific risk factors that may put patients at greater risk are highlighted. There is insufficient evidence at this time to recommend universal screening for nephrolithiasis using ultrasound. Evidence-based recommendations on monitoring, prevention, and management of nephrolithiasis in TDT are provided.

Review: The vital role of traditional Chinese medicine (TCM) in the prevention and treatment of COVID-19 and the etiology and pathogenic mechanism of COVID-19 based on TCM theory

"Yi"is defined in traditional Chinese medicine theory as the general pathological conditions of epidemics.Throughout thousands of years of history,TCM has been playing an essential role in preventing and treating epidemics in China.Showing significant efficacy against severe acute respiratory syndrome(SARS)in 2002 and 2003,a medical intervention involving TCM was applied at the beginning of the pandemic of the corona virus disease 2019(COVID-19),and has been found with good preventive and curative value in clinical practice.In this study,the etiology and pathogenic mechanism of COVID-19 was discussed on a TCM theory basis,and the clinically effective prevention and treatment methods/prescriptions were summarized.It is suggested that TCM has been playing a unique and vital role in preventing and treating COVID-19,and thus contributes greatly to public health.

Risk Factors Associated with Various Subtypes of Ischemic Stroke: A Prospective Study in BSMMU, Dhaka, Bangladesh

Introduction: Stroke is the main cause of adult disability and the second most leading cause of death worldwide. The number of deaths due to stroke is 5.54 million worldwide. Globally, 70% of strokes and 87% of both stroke-related deaths and disability-adjusted life years occur in low and middle-income countries. Method: This was a prospective observational cross-sectional study conducted at Indoor, Outdoor, Stroke and Neuro-Intervention clinic of the Department of Neurology, Bangabandhu Sheikh Mujib Medical University Hospital (BSMMU), Dhaka, Bangladesh, from June-2019 to May-2020. A total of 220 ischemic stroke patients aged above 30 years confirmed by CT scan/MRI of brain. Data were collected with a pre-structured questionnaire from the patients, investigations reports and face-to-face interviews and analyzed using IBM SPSS software version 23.0. Proper consent was taken from the participants. The collected data were ANNOVA tests and association within the risk factors and the patterns of subtypes of ischemic stroke where P < 0.05 considered significant. Results: Among the 220 stroke patients, large-artery atherosclerosis (LAA), cardio-embolism (CE), small-vessel occlusion (SVO, stroke of other determined etiology (SODE) and stroke of undetermined etiology (SUDE) were being observed 84 (38.18%), 14 (6.36%), 63 (28.64%), 12 (5.45%) and 47 (18.18%). Eighty-Six (39.09%) prevalence of subtypes was found in rural areas whereas 134 (60.91%) were in urban areas. The significant risk factors are associated with the prevalence of various subtypes (p < 0.05). Conclusion: This study prevails the people of Bangladesh are vulnerable to various subtypes of ischemic stroke. The higher prevalence of large-artery atherosclerosis (LAA) in our patients suggests the presence of uncontrolled hypertension, diabetes mellitus, smoking habit and dyslipidemia.

Interpretation of diagnosis and treatment scheme of COVID-19 in Hunan province (the third trial version) based on three factors and measures

The similarities and differences between"Novel Coronavirus Infected pneumonia in Hunan province(trial second edition)"and"Novel Coronavirus Infected pneumonia(Trial seventh edition)"released by the National Health Commission and their ideas were interpreted based on"suiting measures to three factors".①In Hunan program,the third version of the trial adjustment more suitable for local characteristics of the disease;②The prevention program population classification is clear,support,eliminate pathogenic factors of the primary and secondary distinct;③The cause of disease is prominent,damp and toxin are mixed with dryness,and the treatment is mainly to moisten the lung and clear away heat,and the prescription is mostly Xinliang light agent.

Factors Influencing the Incidence of Heart Disease

Introduction:Understanding the causes of heart disease is a relatively new field in medicine.In fact,heart disease was relatively rare before the early 1900s.Aim:The aim of this review study is to investigate the risk factors associated with the development of heart disease and its prevention.Material Methodology:A scrutinized review of the Greek and international literature was carried out.The material of the study was manuscripts on the subject found in Greek and international electronic databases such as:Google Scholar,Mednet,PubMed and the Association of Hellenic Academic libraries(HEAL-Link).Results:The risk factors for the development of heart disease are metabolic factors,i.e.,hypertension,diabetes,cholesterol and obesity;environmental factors,i.e.,smoking,lack of physical activity or exercise,poor dietary patterns and alcohol consumption;and other factors such as age,gender,heredity,socioeconomic status and psychological factors.Conclusions:Heart diseases are multifactorial diseases and the only way to successfully treat them is to take into account all the risk factors for their development,and to treat them systematically.

Correlation Analysis of Traditional Chinese Medicine Syndrome Types and Influencing Factors of Asthmatic Bronchitis in Children

Objective:To explore the correlation between traditional Chinese medicine(TCM)syndrome types and the influencing factors of asthmatic bronchitis in children,as well as to provide clinical syndrome differentiation basis and reference for the treatment of children with asthmatic bronchitis.Methods:The clinical data of 197 inpatients with asthmatic bronchitis in our hospital from March 2021 to March 2022 were collected,referring to“Zhu Futang Practical Pediatrics”(7th Edition,2002)and“Chinese Medicine Industry Standards-Standards for Diagnosis and Efficacy of Pediatric Diseases and Syndromes of Traditional Chinese Medicine”(1994,State Administration of Traditional Chinese Medicine)for diagnosis,classification,and analysis of TCM syndrome types and the influencing factors of asthmatic bronchitis in children.Results:(i)cold asthma syndrome contributed to the majority of TCM syndrome types of pediatric asthmatic bronchitis;(ii)gender had a great influence on TCM syndromes types in children with asthmatic bronchitis,and the differences among the TCM syndrome types were statistically significant(P<0.05);(iii)there was no significant difference in the distribution of TCM syndrome types of pediatric asthmatic bronchitis among different age groups(P>0.05);(iv)birth status had no effect on the distribution of TCM syndrome types of pediatric asthmatic bronchitis(P>0.05);(v)no significant correlation was observed between the mode of delivery and the distribution of TCM syndrome types in children with asthmatic bronchitis(P>0.05);(vi)children with cold asthma syndrome,heat asthma syndrome,and mixed cold and heat syndrome were not breastfed,and there was no significant difference in the feeding methods of children with mixed deficiency and excess syndrome(P>0.05);(vii)no significant correlation was observed between the TCM syndrome types of pediatric asthmatic bronchitis and family history of asthma/allergy(P>0.05);(viii)a significant correlation was observed between different TCM syndrome types and history of drug and food allergy(P<0.05);(ix)normal or high eosinophil percentage was commonly observed in children with asthmatic bronchitis,and there was no significant difference among the different TCM syndrome types(P>0.05).Conclusion:The TCM syndrome types of pediatric asthmatic bronchitis are related to gender,feeding history,allergy history,and other factors,which may be influencing factors of the TCM syndrome types of pediatric asthmatic bronchitis.

Etiology, pathogenesis, and diagnosis of neovascular glaucoma

Neovascular glaucoma is defined as iris and/or anterior chamber angle neovascularization associated with increased intraocular pressure. It is a secondary glaucoma that is most frequently caused by severe retinal ischemia. The most common diseases responsible for the development of neovascular glaucoma are diabetic retinopathy, ischemic central retinal vein occlusion,and ocular ischemic syndrome. Uncommon causes include ocular radiation, ocular tumors, uveitis and other miscellaneous conditions. Vascular endothelial growth factor is an important and likely predominant agent involved in the pathogenesis of intraocular neovascularization and neovascular glaucoma. The evolution of clinical and histopathological changes from predisposing conditions to the occurrence of rubeosis iridis and neovascular glaucoma is divided into four stages: prerubeosis, preglaucoma, open angle glaucoma, and angle-closure glaucoma.