Self-administered versus clinician-performed BinaxNOW COVID rapid test: a comparison of accuracy.

We conducted a single-center study at a free community testing site in Baltimore City to assess the accuracy of self-performed rapid antigen tests (RATs) for COVID-19. Self-administered BinaxNOW RATs were compared with clinician-performed RATs and against a reference lab molecular testing as the gold standard. Of the 953 participants, 14.9% were positive for SARS- CoV-2 as determined by RT-PCR. The sensitivity and specificity were similar for both self- and clinician-performed RATs (sensitivity: 83.9% vs 88.2%, P = 0.40; specificity: 99.8% vs 99.6%, P = 0.6). Subgroup comparisons based on age and race yielded similar results. Notably, 5.2% (95% CI: 1.5% to 9.5%) of positive results were potentially missed due to participant misinterpretation of the self-test card. However, the false-positive rate for RATs was reassuringly comparable in accuracy to clinician-administered tests. These findings hold significant implications for physicians prescribing treatment based on patient-reported, self-administered positive test results. Our study provides robust evidence supporting the reliability and utility of patient-performed RATs, underscoring their comparable accuracy to clinician-performed RATs, and endorsing their continued use in managing COVID-19. Further studies using other rapid antigen test brands are warranted.IMPORTANCEAccurate and accessible COVID-19 testing is crucial for effective disease control and management. A recent single-center study conducted in Baltimore City examined the reliability of self-performed rapid antigen tests (RATs) for COVID-19. The study found that self-administered RATs yielded similar sensitivity and specificity to clinician-performed tests, demonstrating their comparable accuracy. These findings hold significant implications for physicians relying on patient-reported positive test results for treatment decisions. The study provides robust evidence supporting the reliability and utility of patient-performed RATs, endorsing their continued use in managing COVID-19. Furthermore, the study highlights the need for further research using different rapid antigen test brands to enhance generalizability. Ensuring affordable and widespread access to self-tests is crucial, particularly in preparation for future respiratory virus seasons and potential waves of reinfection of SARS-CoV-2 variants such as the Omicron variant.

Current understandings of the pathogenesis of type 1 diabetes: Genetics to environment.

Type 1 diabetes (T1D) is an autoimmune disease that usually strikes early in life, but can affect individuals at almost any age. It is caused by autoreactive T cells that destroy insulin-producing beta cells in the pancreas. Epidemiological studies estimate a prevalence of 1 in 300 children in the United States with an increasing incidence of 2%-5% annually worldwide. The daily responsibility, clinical management, and vigilance required to maintain blood sugar levels within normal range and avoid acute complications (hypoglycemic episodes and diabetic ketoacidosis) and long term micro- and macro-vascular complications significantly affects quality of life and public health care costs. Given the expansive impact of T1D, research work has accelerated and T1D has been intensively investigated with the focus to better understand, manage and cure this condition. Many advances have been made in the past decades in this regard, but key questions remain as to why certain people develop T1D, but not others, with the glaring example of discordant disease incidence among monozygotic twins. In this review, we discuss the field's current understanding of its pathophysiology and the role of genetics and environment on the development of T1D. We examine the potential implications of these findings with an emphasis on T1D inheritance patterns, twin studies, and disease prevention. Through a better understanding of this process, interventions can be developed to prevent or halt it at early stages.

Pattern and determinants of use of traditional treatments in children attending Gaafar Ibnauf Children's Hospital, Sudan.

Traditional Sudanese medicine is based on experiences of every day people, systems of taboos, customs and deep-rooted traditions. This is a cross-sectional, hospital-based study done in Gaafar Ibnauf Children's Hospital including inpatient and outpatient subjects from October 2009 to January 2010, to identify the pattern and determinants of use, prevalence and commonest types of traditional treatments in Sudanese children. Of the hundred interviewed families 70% were using traditional treatments, causing delay in presentation to hospital in 24% of children. Eighty seven percent of illiterate mothers used traditional treatments while only 46% of secondary education mothers used it. Percentage of use of traditional treatments increased from 61.5% to 88.9% with the increase in child's age. The commonest traditional treatment used was sesame oil (77%), followed by cautery (40%). Sesame oil was used mainly for flu and to maintain health. Only two mothers practiced removal of canines for reasons of vomiting and diarrhea. All mothers believed that mint, hilba and harjal are effective but 79% of them believed that cautery is not effective; 74% thought that sesame oil is effective while only 56% believed that rice water is effective. All mothers who practiced removal of canines thought that it is not effective. Except for cutting the uvula, most of practiced treatments had no significant sequelae. A quarter of studied mothers used rice water to treat vomiting and diarrhea, which we consider a useful healthy practice. Health education is needed for mothers through mass media and in health facilities.