Study of gastro-oesophageal reflux disease in patients with mild-to-moderate chronic obstructive pulmonary disease in India.

BACKGROUND AND OBJECTIVE: To study the incidence and pattern of gastro-oesophageal reflux disease (GORD) in patients with mild-to-moderate chronic obstructive pulmonary disease (COPD) using dual-probe 24-h oesophageal pH recording. METHODS: This was a prospective study of 50 patients with mild-to-moderate stage COPD based on the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. A detailed history of illness along with spirometry was done in all patients. In the study group, reflux symptoms were measured using a validated scoring system. All the patients underwent oesophageal manometry and dual-probe 24-h oesophageal pH recording. RESULTS: Symptoms of gastro-oesophageal reflux were present in 38 patients. Twenty-four-hour oesophageal pH monitoring revealed pathological reflux in 31 out of 38 symptomatic and 8 out of 12 asymptomatic patients. The overall rate of GORD was 78% in our study. Only distal GORD was observed in 11 (28.9%), and both distal and proximal GORD was observed in 20 (52.6%) out of the 38 symptomatic subjects. In the remaining 12 asymptomatic patients, eight had GORD. Distal GORD was present in six (50%) patients, and two (16.6%) had both distal and proximal GORD in this group. Isolated proximal GORD was not observed in any patient. CONCLUSIONS: There is an increased occurrence of GORD in patients with even mild-to-moderate COPD.

The balanced discrete triplet Lindley model and its INAR(1) extension: properties and COVID-19 applications.

This paper proposes a new flexible discrete triplet Lindley model that is constructed from the balanced discretization principle of the extended Lindley distribution. This model has several appealing statistical properties in terms of providing exact and closed form moment expressions and handling all forms of dispersion. Due to these, this paper explores further the usage of the discrete triplet Lindley as an innovation distribution in the simple integer-valued autoregressive process (INAR(1)). This subsequently allows for the modeling of count time series observations. In this context, a novel INAR(1) process is developed under mixed Binomial and the Pegram thinning operators. The model parameters of the INAR(1) process are estimated using the conditional maximum likelihood and Yule-Walker approaches. Some Monte Carlo simulation experiments are executed to assess the consistency of the estimators under the two estimation approaches. Interestingly, the proposed INAR(1) process is applied to analyze the COVID-19 cases and death series of different countries where it yields reliable parameter estimates and suitable forecasts via the modified Sieve bootstrap technique. On the other side, the new INAR(1) with discrete triplet Lindley innovations competes comfortably with other established INAR(1)s in the literature.

Patterns of horse and camel- related injuries: A descriptive analysis from a national trauma registry (2007-2021).

BACKGROUND: The large animal-related injuries are emerging major trauma but remain underestimated public health problem worldwide. We aimed to determine the incidence, clinical characteristics, mechanisms and patterns of horse and camel-related injuries (HCRIs) in a Middle Eastern country. METHODS: A retrospective analysis of all patients who were hospitalized due to HCRIs was conducted. Data included patient's demographics, mechanism of injury, anatomical location and severity of injury, and hospital outcomes. RESULTS: Between November 2007 and December 2021, there were 273 hospitalized patients with HCRIs representing1.3 % of the total trauma admissions. Of these, 145 (53.1 %) and 128 (46.9 %) were horse (HRI) and camel-related injuries (CRI) respectively. The most common presenting age group of the cohort was 20-29 years and 88 % were males. Patients with HRIs were younger (27.5 ± 11 years) than CRIs (34 ± 13.5 years). Injuries to the extremities were the most common (62 % vs. 40 %), followed by the head injury (25.5 % vs. 31 %) among the HRIs and CRIs, respectively. The most common mechanism of injury was falling off followed by getting kicked by the HCRIs. Major trauma (ISS ≥12) was found in 23 % of HRIs (47.5 %) and CRIs (52.5 %). Only 5 % of patients had shock index >0.90 on admission; two thirds were due to CRIs. There were four fatalities (1.5 %), all attributed to traumatic brain injury, of which three were due to HRIs and one due to CRIs. CONCLUSION: This study reveals that HCRIs predominantly affect young adult males and may involve serious injuries, exhibit distinct injury patterns, however, it is associated with low mortality. Preventive measures need to be revisited.