Correction: Differential Diagnosis, Prevention Measures, and Therapeutic Interventions for Enhanced Monkeypox (Mpox) Care.

[This corrects the article DOI: 10.7759/cureus.60724.].

Differential Diagnosis, Prevention Measures, and Therapeutic Interventions for Enhanced Monkeypox (Mpox) Care.

Monkeypox (Mpox) is a rare viral disease that presents considerable challenges in healthcare settings, necessitating enhanced nursing care for effective management. This review thoroughly explores key aspects related to improving nursing care for Mpox. It commences by examining the background information on Mpox, encompassing its etiology, epidemiology, and modes of transmission. The differential diagnosis of Mpox is investigated, elucidating its clinical presentation, symptoms, and diagnostic methods to differentiate it from similar conditions. Prevention and control measures at both the public health and healthcare levels are scrutinized, including surveillance and reporting, contact tracing, isolation, and vaccination programs. In healthcare settings, infection prevention and control strategies, such as proper utilization of personal protective equipment, hand hygiene, and environmental management, are discussed. Furthermore, therapeutic interventions for Mpox, including symptomatic management, antiviral therapy, and supportive care, are outlined, with a specific emphasis on pain management, fever control, and psychosocial support. Nursing care strategies encompass patient assessment and monitoring, infection prevention strategies, psychosocial support, and patient education. The challenges encountered in enhancing nursing care for Mpox are acknowledged, along with research gaps and areas for further investigation. Finally, innovations in nursing practice for improved care, such as technology integration and simulation-based training, are explored. Enhancing nursing care in Mpox is crucial for positive patient outcomes, reducing transmission risks, and promoting overall well-being. By addressing the unique challenges, conducting further research, and embracing innovative practices, healthcare professionals, particularly nurses, can provide optimal care and contribute to better management of Mpox cases.

Does Cardiac Arrhythmia Predict Worse Outcome in Mild or Moderate Covid-19 Infection?

Covid-19 is a multisystem disease with the lungs being predominantly affected. Cardiac involvement is mostly seen as a rise in troponins, arrhythmias, and ventricular dysfunction. This study aimed to estimate the incidence of arrhythmias seen in Covid-19 infection and assess if arrhythmias predict worsening or mortality. Prospective observational study involving patients with mild to moderate Covid illness admitted in a tertiary care centre. Among the 85 patients (Mean age 45.8 + 14.1 years; 75.31% men), worsening of Covid-19 illness was seen in 29 (34.1%) patients. New onset arrhythmias were detected on Holter in 9 (10.5%) patients. Supraventricular tachycardia was seen in 7 (8.2%) patients of whom 6 showed worsening which was statistically significant (p-value-0.006). Risk factors associated with worsening on univariate analysis were male gender (OR [95%CI] = 6.93(1.49-32.31), p-value - 0.014), new onset supraventricular tachycardia (OR [95% CI] = 14.35 [1.64-125.94], p-value - 0.016) and D-dimer elevation (OR [95% CI] = 1.00(1.00-1.01), p-value - 0.02). On multivariate analysis D-dimer (OR [95% CI] = 1.00(1.00-1.01; p-value 0.046) and supraventricular arrhythmias (OR [95% CI] = 11.12 (1.22-101.14); p-value - 0.033) were independently associated with worsening. Covid-19 infection can lead to cardiac arrhythmias. The development of supraventricular tachycardia in patients with Covid-19 infection predicts higher morbidity and worsening.

Prevalence of hs-CRP among Indians with hypertension.

The prevalence of hypertension in the early twentieth century varied in India, ranging from 2-15% in Urban India and 2-8% in Rural India. In the inter heart and inter stroke study, hypertension accounted for 17.9% and 34.6% of population attributable risk for coronary artery disease and stroke respectively. CRP appears in serum in response to a variety of inflammatory stimuli .Raised level of hs-CRP is seen with increasing with age, during an infection, inflammation, coronary artery diseases, obesity, sepsis, smoking and vasculitis. CRP is also a factor in the development of atherosclerotic plaque. Although CRP was believed to be a marker of vascular inflammation, recent research indicates that it plays an active role in atherogenesis. So in this study we measured serum hs- CRP in patients with essential hypertension and correlated with blood pressure. The study consists of 50 patients with essential hypertension with antihypertensive medications. in the age group of 40 to 60 years of both sexes and 25 normotensive subjects with no history of cardiovascular, neoplastic, hepatic, renal, infectious or auto immune disease. IHEC clearance and informed consent were obtained. hs-CRP was measured by ELISA kit. Our study showed significantly elevated serum hs-CRP level in hypertensive subjects in comparison with control subjects. To find out the relationship between physiological and biochemical parameters with CRP Pearson correlation coefficient has been applied. The level of significance has been fixed as 5% (p<0.05). SPSS15 software has been used for calculation. Our study showed significantly elevated serum hs-CRP level in hypertensive subjects in comparison with control subjects. But there is no correlation of hs-CRP level with both systolic and diastolic pressure. Several studies have shown inflammatory markers such as CRP as an independent determinant of endothelium dependent vascular function among patient with coronary heart disease (CHD) in patients with hypertension. There was no significant correlation was observed between levels of hs-CRP and systolic and diastolic blood pressure in this study but there was a significant elevation hs-CRP level was observed in hypertensive patients.

Lipid and renal profile in assessing the severity of alcoholic liver disease.

Lipid and Renal dysfunction in Alcoholic liver disease (ALD) patients occurs either due to multi-organ involvement or secondary to alcoholism. This study was conducted to evaluate the role of lipid and renal parameters in assessing the severity of progression of ALD. Sixty cases of ALD (two groups based on compensated and decompensated features) and thirty healthy controls for comparison were included. Lipid profile (Total Cholesterol, LDL, HDL and Triglycerides) and renal parameters (serum urea, creatinine and uric acid), total and direct bilirubin, total protein and albumin were measured using automated chemistry analyzer. There was a significant decrease in Total cholesterol ,LDL and HDL levels and increased triglycerides when compared to controls (mean of 128.4 ± 59 vs 155 ± 27.2, 77 ± 44.3 vs 97.4 ± 27.2, 28.3 ± 18 vs 39.5 ± 14.1 and 115.8 ± 70.4 vs 91 ± 38 mg/dL respectively). Lipid profile showed a linear decrease while progressing from compensated to decompensated ALD. Renal parameters revealed a statistically significant decrease in serum urea ,increased creatinine and uric acid levels when compared to controls (17.57±2.96 vs23.73±4.94, 1.12±0.55 vs0.88±0.16,6.60±1.32 vs 4.68±1.40 mg/dL respectively).Total cholesterol and HDL showed a linear decrease when ALD progresses. Serum uric acid showed an early increase in compensated stage of ALD. This study inferred that Total cholesterol, TGL, HDL and uric acid can be used for assessing the severity of progression of ALD.

Mass loadings of triclosan and triclocarbon from four wastewater treatment plants to three rivers and landfill in Savannah, Georgia, USA.

Triclosan (TCS) and triclocarbon (TCC) are bactericides used in various consumer and personal-care products. Recent studies have revealed considerable levels of these bactericides in wastewater, aquatic wildlife, and human samples. Consequently, in this study we measured TCS and TCC in influent and effluent, sludge, and pond water/sediment samples from four wastewater treatment plants (WWTPs) and three major rivers in Savannah, Georgia (USA). Among these treatment plants, the Wilshire plant showed elevated concentrations of TCS (influent, 86,161; effluent, 5370 ng/L), whereas TCC was greater in the Georgetown plant (influent, 36,221) and the Wilshire plant effluent (3045 ng/L). Clearance of TCS and TCC were 95 and 92%, respectively, in the President Street plant, 94 and 85%, respectively, in the Wilshire plant, 99 and 80%, respectively, in the Travis Field plant, and 99 and 99%, respectively, in the Georgetown plant. Based on the mass flow estimate, 138 g/day of TCS and 214 g/day TCC are released into the Savannah River from the President Street, Travis Field, and Wilshire plants and 1.60 g/day TCS and 1.64 g/day TCC are released to the Ogeechee River from the Georgetown plant. Based on the sludge data, the loading estimate can be calculated that 32 and 0.004 g/day TCS and 53 and 0.01 g/day TCC (nonincinerated and incinerated, respectively) are deposited in landfill from the President Street plant alone, whereas 4.6, 26, and 6.8 g/day TCS and 3.8, 23, and 5.9 g/day TCC (wet sludge) were produced and dumped in landfill from the rest of the WWTPs. Incineration of wet sludge can eliminate 99.99% of TCS and TCC. Concentrations of TCS and TCC in water and sediment were greater in the Vernon River, followed by the Savannah River and the Ogeechee River.