Recent advances in the diagnosis and management of typhoid fever in Africa: A review.

Typhoid fever, a classical disease of enteric origin caused by Salmonella species of bacteria, is among the most important diseases threatening public health in Africa. The African continent is a marker for both low resources within the healthcare system and poor disease control policy formulations in managing endemic infectious diseases. Since the colonial era, the Widal serological test has been used to confirm typhoid fever in Africa, however recent studies recommend blood culture, and when blood culture cannot be obtained, clinical findings, laboratory Widal test confirmation, and ruling out other febrile illnesses as confirmatory pathway to diagnose typhoid fever in Africa. Managing typhoid fever relies on antimicrobials. In 1980s chloramphenicol was the medication of choice. Years later, amoxicillin and co-trimoxazole were adopted. However, the instantaneous rise of resistant strains of Salmonella enterica confers an important challenge to treat the burdensome enteric fever. The current treatment algorithm of typhoid fever in Africa relies significantly on the use of fluoroquinolones, macrolides, and cephalosporins. Developed nations have successfully addressed and controlled typhoid fever via improvement in accessing safe water and food, better sanitary and hygienic behaviours, and vaccines development. Nevertheless, there is significant evidence to infer improvement in the diagnosis management of typhoid fever over the last few decades, and efforts are underway to control the disease spread in Africa. This review aims to provide an overview of the latest developments in typhoid fever diagnosis and management in Africa and provide key recommendations for a coordinated approach to mitigate typhoid in the continent.

Current management of acute ischemic stroke in Africa: A review of the literature.

BACKGROUND AND PURPOSE: Acute ischemic stroke is one of the leading causes of disability and mortality globally, with increasing incidence in Africa, as the continent is already burdened with infectious diseases. Rapid diagnosis and efficient treatment are crucial, as even a slight delay in reperfusing the brain significantly affects the recovery outcome. Neuroimaging is vital for optimal care and thrombolytic or endovascular therapy in specialized stroke care units. This review aims to discuss the burden of acute ischemic stroke in Africa and how health care systems have tried to reduce the incidence and improve outcomes for the disease. METHODS: Data were collected through the online databases PubMed, Ovid MEDLINE, ScienceDirect, and Embase. All articles related to acute ischemic stroke in Africa were considered. RESULTS: The medical care for acute ischemic stroke in Africa is far from optimal, with little adherence to recommended protocols. There is a lack of public awareness of the disease, imaging infrastructure, personnel, stroke care units, and recovery facilities due to poor funding. Poor knowledge of stroke signs and symptoms results in delay in treatment and poor prognosis. CONCLUSIONS: We urge African leaders and private entities to invest in stroke care by building appropriate infrastructures, providing medical equipment, and implementing guidelines and sustainable follow-up systems. Telehealth is a suggested strategy to mitigate the scarcity of health personnel, and international and national efforts to increase treatment affordability should be doubled. Further extensive research on the impact of acute ischemic stroke on the African population is encouraged.

Russia-Ukraine conflict and COVID-19: a double burden for Ukraine's healthcare system and a concern for global citizens.

The conflict between Ukraine and Russia significantly influences the healthcare sector. The ongoing COVID-19 pandemic and the armed conflict have badly devastated the established healthcare system. Only 36.08% of the Ukrainian population has received the COVID-19 vaccination, with the majority receiving two doses, and currently, Ukraine records the highest mortality rate in the world. In addition to the conflict injuries, increased susceptible deaths to COVID-19 can be found due to inadequate vaccination rates for the disease. To save their lives and for their well-being, many individuals have been relocating to the underground metro stations, other cities, nearby towns and countries. In these settings, social distancing, hand sanitation and wearing masks are not prioritised. In the current circumstances, the broken healthcare system needs to be rebuilt, and the Non-Governmental Organizations (NGOs), doctors and all the front-line workers should extend their humanitarian support to the Ukrainian population. Conclusion: It is an arduous task for healthcare organisations to supply vaccines and medicines in this 'armed conflict' between Russia and Ukraine. This can only happen when both parties extend their support to rebuild the shattered healthcare infrastructure.

Poliovirus returns to the UK after nearly 40 years: current efforts and future recommendations.

On 22 June 2022, the UK Health Security Agency declared a 'rare national incidence' after finding poliovirus in sewage in London for the first time in nearly 40 years. Although no cases of the disease or accompanying paralysis have been documented, the general public's risk is considered minimal. However, public health experts recommend that families are up to date on their polio vaccines to decrease the chance of harm. This article discusses the epidemiology of poliovirus by examining the aetiology of the disease and current mitigation policies implemented to prevent the spread of type 2 vaccine-deceived poliovirus in the UK. Finally, by examining the clinical features of polio, which range from mild gastroenteritis episodes, respiratory sickness, malaise and severe paralysis type, this article offers an advice on particular therapies and tactics to avoid poliovirus outbreaks and other future outbreaks.

Dengue fever outbreak in Cook Island: A rising concern, efforts, challenges, and future recommendations.

The Cook Island government has made several efforts to ensure zero confirmed cases and transmission of COVID-19, especially among visiting travelers. However, the Cook Island ministry of health has to deal with the new strain of dengue fever outbreak, known as dengue fever type 2 (DEN-2), by adopting several measures to control its spread, especially in the affected parts of the subtropical country. This paper aims to describe the dengue fever response taken in Cook Island and suggest recommendations to control the risk of transmission in endemic parts of the world.

Viral infections amidst COVID-19 in Africa: Implications and recommendations.

Viral infections have been on the rise for the past decades. The impact of the viruses worsened amidst the pandemic burdening the already overwhelmed health care system in African countries. This article sheds light on how the coronavirus together with the already existing viral infections, some of which re-emerged, impacted the continent. The strategies in place such as immunization, education, will have to be strengthened in all African countries to reduce the burden. Furthermore, governments can further collaborate with other countries in creating guidelines to reduce co-infection of the diseases.

Bird flu outbreak amidst COVID-19 pandemic in South Africa: Efforts and challenges at hand.

Over the months of April and May 2021, South Africa has witnessed several outbreaks of highly infective avian influenza (H5N1) in different poultry farms. This came as a shock to a country that was already battling with the deadly COVID-19 pandemic. The emergence of the virus has spurred import bans and massive culls in the poultry business. Local experts have also called for a restriction on the movement of people and cars in and out of their chicken farms. Employees have also been encouraged to shower in the mornings when they arrive at the farms and wear fresh clothes, as the flu spreads very quickly. In a country that is already facing the economic implications of the COVID-19, this has the potential to cause a significant dent in the economy, as well as severely impact people's day-to-day life. Bird flu-also called avian influenza-is a viral infection that can infect not only birds but also humans and other animals. The threat of a new influenza pandemic has prompted countries to draft national strategic preparedness plans to prevent, contain and mitigate the next human influenza pandemic. This paper describes the South African burden, current efforts, and preparedness against the avian influenza virus.

Lassa fever amidst the COVID-19 pandemic in Africa: A rising concern, efforts, challenges, and future recommendations.

Lassa fever, caused by the Lassa virus of the Arenaviruses family, is a re-emerging public health concern that has led to 300,000 infections and 5000 deaths annually in Africa. Highly prevalent in Sierra Leone, Liberia, Guinea, Nigeria, Côte d'lvoire, Ghana, Togo, and Benin, patients infected with the virus can manifest with cough, sore throat, headache, nausea, and vomiting among other symptoms. Coexisting with the coronavirus disease 2019 (COVID-19) pandemic and its impacts, cases of Lassa fever in the African population have been reported to decrease due to hesitancy in visiting clinics that leads to unreported cases-all contributing to a silent outbreak in West Africa. Thus, to overcome current burdens, gaps, and challenges caused by Lassa fever amidst COVID-19 in Africa, various recommendations for efficient control of transmission, measures for disease containment, and strategies to correct misperceptions were made.

Exploring Digital Dermatology: An Analysis of Ichthyosis Content on TikTok.

Background TikTok is among the most popular social media sites, and its utilization for health information is growing each day. The present study assesses the popularity and quality of the top 100 most-liked videos on TikTok tagged with "#ichthyosis." This study aims to do so by assessing contributions from physician, and nonphysician sources (such as from patients) to guide healthcare professionals interested in leveraging this platform for public health.  Methodology A cross-sectional analysis of the top 100 most-liked videos tagged with "#ichythosis" on TikTok as of January 3, 2024, was conducted. The parameters assessed for this study include observable characteristics, content type, and whether the creator was a physician or nonphysician. The quality of the content was measured using the DISCERN scale.  Results Based on these results, 14 of the top 100 videos were posted by physicians with 1,912,975 as the mean number of views. There were 86 videos posted by nonphysician creators averaging 2,675,341 views. Videos posted by nonphysician creators had a higher average number of views, number of likes, and number of comments but less average saves. Videos made by physicians and educational content had the highest average DISCERN scores, whereas nonphysician, awareness, and personal experience content had the lowest average DISCERN scores.  Conclusions Physicians are deemed trustworthy, reliable sources of healthcare-related information on TikTok. This study emphasizes the importance of physicians continuing to provide reliable, evidence-based health information on social media platforms such as TikTok.

Neuroinflammation-on-a-chip for multiple sclerosis research: a narrative review.

Introduction: Multiple sclerosis (MS) is a chronic inflammatory condition that impacts the central nervous system. It is distinguished by processes like demyelination, gliosis, neuro-axonal harm, and inflammation. The prevailing theory suggests that MS originates from an immune response directed against the body's own antigens within the central nervous system. Aim: The main aim of this research paper "Neuroinflammation-on-a-Chip" for studying multiple sclerosis is to enhance our comprehension of MS development, demonstrate the application of cutting-edge technology, and potentially provide valuable insights for therapeutic approaches. Methods: The available literature for this Narrative Review was searched on various bibliographic databases, PubMed, NCBI, and many other medical references using an individually verified, prespecified approach. Studies regarding the significance of MS and its neuroinflammatory pathogenesis in addition to the development and optimization of neuroinflammatory-on-a-chip and the advancement in innovations in this field have been reviewed in this research for a better understanding of "Neuroinflammation-on-a-chip for multiple sclerosis". The level of evidence of the included studies was considered as per the Centre for Evidence-Based Medicine recommendations. Results: Several studies have indicated that the brain-chip model closely mimics cortical brain tissue compared to commonly used conventional cell culture methods like the Transwell culture system. Additionally, these studies have clearly demonstrated that further research using brain chips has the potential to enhance our understanding of the molecular mechanisms and roles of blood-brain barrier (BBB) transporters in both normal and disease conditions. Conclusion: Understanding neuroinflammation processes remains essential to establish new MS treatments approaches. The utilization of brain chips promises to advance our understanding of the molecular processes involving BBB transporters, both in normal and diseased states. Further research needs to be addressed in order to enhance the performance and understanding of neuroinflammation on a chip, hence aiming to provide more effective treatments for all CNS diseases.

Tailoring epilepsy treatment: personalized micro-physiological systems illuminate individual drug responses.

Introduction: Approximately 50 million people worldwide have epilepsy, with many not achieving seizure freedom. Organ-on-chip technology, which mimics organ-level physiology, could revolutionize drug development for epilepsy by replacing animal models in preclinical studies. The authors' goal is to determine if customized micro-physiological systems can lead to tailored drug treatments for epileptic patients. Materials and methods: A comprehensive literature search was conducted utilizing various databases, including PubMed, Ebscohost, Medline, and the National Library of Medicine, using a predetermined search strategy. The authors focused on articles that addressed the role of personalized micro-physiological systems in individual drug responses and articles that discussed different types of epilepsy, diagnosis, and current treatment options. Additionally, articles that explored the components and design considerations of micro-physiological systems were reviewed to identify challenges and opportunities in drug development for challenging epilepsy cases. Results: The micro-physiological system offers a more accurate and cost-effective alternative to traditional models for assessing drug effects, toxicities, and disease mechanisms. Nevertheless, designing patient-specific models presents critical considerations, including the integration of analytical biosensors and patient-derived cells, while addressing regulatory, material, and biological complexities. Material selection, standardization, integration of vascular systems, cost efficiency, real-time monitoring, and ethical considerations are also crucial to the successful use of this technology in drug development. Conclusion: The future of organ-on-chip technology holds great promise, with the potential to integrate artificial intelligence and machine learning for personalized treatment of epileptic patients.

Microengineered neuronal networks: enhancing brain-machine interfaces.

The brain-machine interface (BMI), a crucial conduit between the human brain and computers, holds transformative potential for various applications in neuroscience. This manuscript explores the role of micro-engineered neuronal networks (MNNs) in advancing BMI technologies and their therapeutic applications. As the interdisciplinary collaboration intensifies, the need for innovative and user-friendly BMI technologies becomes paramount. A comprehensive literature review sourced from reputable databases (PubMed Central, Medline, EBSCOhost, and Google Scholar) aided in the foundation of the manuscript, emphasizing the pivotal role of MNNs. This study aims to synthesize and analyze the diverse facets of MNNs in the context of BMI technologies, contributing insights into neural processes, technological advancements, therapeutic potentials, and ethical considerations surrounding BMIs. MNNs, exemplified by dual-mode neural microelectrodes, offer a controlled platform for understanding complex neural processes. Through case studies, we showcase the pivotal role of MNNs in BMI innovation, addressing challenges, and paving the way for therapeutic applications. The integration of MNNs with BMI technologies marks a revolutionary stride in neuroscience, refining brain-computer interactions and offering therapeutic avenues for neurological disorders. Challenges, ethical considerations, and future trends in BMI research necessitate a balanced approach, leveraging interdisciplinary collaboration to ensure responsible and ethical advancements. Embracing the potential of MNNs is paramount for the betterment of individuals with neurological conditions and the broader community.

Unlocking the gut-heart axis: exploring the role of gut microbiota in cardiovascular health and disease.

Introduction: Gut microbiota has emerged as a pivotal player in cardiovascular health and disease, extending its influence beyond the gut through intricate metabolic processes and interactions with the immune system. Accumulating evidence supports a significant association between gut microbiota and cardiovascular diseases such as atherosclerosis, hypertension, and heart failure. Dietary patterns have been identified as key factors shaping the composition of the gut microbiota and exerting notable impacts on cardiovascular health. Probiotics and prebiotics have shown promise in mitigating the risks of cardiovascular disease by modulating key cardiovascular parameters. Faecal microbiota transplantation (FMT) has recently emerged as a novel and intriguing therapeutic strategy. Aim: This review paper aims to explore and elucidate the multifaceted role of gut microbiota in cardiovascular health. It will also address the prevailing challenges and limitations in gut microbiota studies, emphasizing the importance of future research in overcoming these obstacles to expand our understanding of the gut-heart axis. Materials and methods: A comprehensive literature search was conducted using various databases including ClinicalTrials, Google Scholar, PubMed, ScienceDirect, MEDLINE, and Ovid Resources. The search strategy included utilizing keywords such as "Gut microbiota," "Randomized controlled trials (RCTs)," "Gut-heart axis," "Dysbiosis," "Diet," "Probiotics," "Prebiotics," "Faecal Microbiota transplantation," "cardiovascular disease," "Meta-analyses," and other compatible terms thereof. Only articles written in English were considered, and selection criteria included relevance to the research objectives, reasonable sample sizes, and robust methodology. In addition to the identified articles, meta-analyses, animal models and studies, and references from the selected articles were also examined to ensure a comprehensive review of the literature. Results: Dietary patterns exert a significant influence on the composition of the gut microbiota, and certain diets, such as the Mediterranean diet, have been associated with a favourable gut microbiota profile and a reduced risk of cardiovascular disease (CVD). Probiotics and prebiotics have emerged as potential interventions to mitigate CVD risks by modulating blood pressure, glycemic control, lipid profiles, and gut dysbiosis. Another innovative therapeutic approach is FMT, which involves transferring faecal material from a healthy donor to restore a balanced gut microbiota. FMT holds promise for improving cardiometabolic parameters in individuals with CVD, although further research is needed to elucidate its precise mechanisms and assess its effectiveness. Conclusion: The gut microbiota is emerging as a potential therapeutic target for CVD prevention and management. However, current research has limitations, including the need for larger and more diverse studies, the challenges of establishing causality, and concerns regarding the long-term consequences and safety of gut microbiota modulation. Despite these limitations, understanding the gut-heart axis holds promise for the development of personalized therapies and interventions for cardiovascular health. Further research is needed to expand our knowledge and address the ethical and safety issues associated with gut microbiota modification.

Revolutionizing neurotherapeutics: blood-brain barrier-on-a-chip technologies for precise drug delivery.

Introduction: The blood-brain barrier (BBB) is a critical neurovascular unit regulating substances' passage from the bloodstream to the brain. Its selective permeability poses significant challenges in drug delivery for neurological disorders. Conventional methods often fail due to the BBB's complex structure. Aim: The study aims to shed light on their pivotal role in revolutionizing neurotherapeutics and explores the transformative potential of BBB-on-a-Chip technologies in drug delivery research to comprehensively review BBB-on-a-chip technologies, focusing on their design, and substantiate advantages over traditional models. Methods: A detailed analysis of existing literature and experimental data pertaining to BBB-on-a-Chip technologies was conducted. Various models, their physiological relevance, and innovative design considerations were examined through databases like Scopus, EbscoHost, PubMed Central, and Medline. Case studies demonstrating enhanced drug transport through BBB-on-a-Chip models were also reviewed, highlighting their potential impact on neurological disorders. Results: BBB-on-a-Chip models offer a revolutionary approach, accurately replicating BBB properties. These microphysiological systems enable high-throughput screening, real-time monitoring of drug transport, and precise localization of drugs. Case studies demonstrate their efficacy in enhancing drug penetration, offering potential therapies for diseases like Parkinson's and Alzheimer's. Conclusion: BBB-on-a-Chip models represent a transformative milestone in drug delivery research. Their ability to replicate BBB complexities, offer real-time monitoring, and enhance drug transport holds immense promise for neurological disorders. Continuous research and development are imperative to unlock BBB-on-a-Chip models' full potential, ushering in a new era of targeted, efficient, and safer drug therapies for challenging neurological conditions.

Pancreatic cancer: from early detection to personalized treatment approaches.

Pancreatic cancer is notorious for its persistently poor prognosis and health outcomes, so some of the questions that may be begged are "Why is it mostly diagnosed at end stage?", "What could we possibly do with the advancing technology in today's world to detect early pancreatic cancer and intervene?", and "Are there any implementation of the existing novel imaging technologies?". Well, to start with, this is in part because the majority of patients presented would already have reached a locally advanced or metastatic stage at the time of diagnosis due to its highly aggressive characteristics and lack of symptoms. Due to this striking disparity in survival, advancements in early detection and intervention are likely to significantly increase patients' survival. Presently, screening is frequently used in high-risk individuals in order to obtain an early pancreatic cancer diagnosis. Having a thorough understanding of the pathogenesis and risk factors of pancreatic cancer may enable us to identify individuals at high risk, diagnose the disease early, and begin treatment promptly. In this review, the authors outline the clinical hurdles to early pancreatic cancer detection, describe high-risk populations, and discuss current screening initiatives for high-risk individuals. The ultimate goal of this current review is to study the roles of both traditional and novel imaging modalities for early pancreatic cancer detection. A lot of the novel imaging techniques mentioned seem promising, but they need to be put to the test on a large scale and may need to be combined with other non-invasive biomarkers before they can be widely used.