Neurological and Psychiatric Manifestations of Long COVID-19 and Their [18F]FDG PET Findings: A Review.

For more than two years, lingering sequalae of COVID-19 have been extensively investigated. Approximately 10% of individuals infected by COVID-19 have been found to experience long-term symptoms termed "long COVID-19". The neurological and psychiatric manifestations of long COVID-19 are of particular concern. While pathogenesis remains unclear, emerging imaging studies have begun to better elucidate certain pathological manifestation. Of specific interest is imaging with [18F]FDG PET which directly reflects cellular glycolysis often linked to metabolic and inflammatory processes. Seeking to understand the molecular basis of neurological features of long COVID-19, this review encompasses the most recent [18F]FDG PET literature in this area.

Emerging PET Tracers in Cardiac Molecular Imaging.

18F-fluorodeoxyglucose (FDG) and 18F-sodium fluoride (NaF) represent emerging PET tracers used to assess atherosclerosis-related inflammation and molecular calcification, respectively. By localizing to sites with high glucose utilization, FDG has been used to assess myocardial viability for decades, and its role in evaluating cardiac sarcoidosis has come to represent a major application. In addition to determining late-stage changes such as loss of perfusion or viability, by targeting mechanisms present in atherosclerosis, PET-based techniques have the ability to characterize atherogenesis in the early stages to guide intervention. Although it was once thought that FDG would be a reliable indicator of ongoing plaque formation, micro-calcification as portrayed by NaF-PET/CT appears to be a superior method of monitoring disease progression. PET imaging with NaF has the additional advantage of being able to determine abnormal uptake due to coronary artery disease, which is obscured by physiologic myocardial activity on FDG-PET/CT. In this review, we discuss the evolving roles of FDG, NaF, and other PET tracers in cardiac molecular imaging.

Multimodal Pediatric Lymphoma Detection using PET and MRI.

Lymphoma is one of the most common types of cancer for children (ages 0 to 19). Due to the reduced radiation exposure, PET/MR systems that allow simultaneous PET and MR imaging have become the standard of care for diagnosing cancers and monitoring tumor response to therapy in the pediatric population. In this work, we developed a multimodal deep learning algorithm for automatic pediatric lymphoma detection using PET and MRI. Through innovative designs such as standardized uptake value (SUV) guided tumor candidate generation, location aware classification model learning and weighted multimodal feature fusion, our algorithm can be effectively trained with limited data and achieved superior tumor detection performance over the state-of-the-art in our experiments.

Impact of milk on malnutrition and cognitive skills among school children: Evidence from gift milk initiative from a tribal state of India.

Background: The objective of this study was to assess the impact of fortified milk on various aspects of growth and development among school children in a tribal-predominant district of Jharkhand, India. Materials and Methods: A longitudinal study was planned in 16 schools (eight in intervention group and eight in control group) of Latehar district of Jharkhand in India. Out of the total 962 study participants, only 528 study participants were considered in study analysis, who were present both during baseline and endline study after 1 year of milk introduction. The study participants were assessed for nutrition, intelligence quotient, and hemoglobin levels with the help of study tools and instruments. Results: The decrease in malnutrition was more evident in the intervention group during endline assessment, with 95% confidence interval (95% CI; 7.37, 7.42) and 95% CI (10.63, 10.58) for the difference in proportion in the intervention and control groups for stunting and thinness, respectively. This was statistically significant (P < 0.05). Anemia also improved with better cognition in the intervention group, and the difference was statistically significant (P < 0.05). Conclusion: In our study, beneficial effects of milk on malnourished children were evident, particularly in combating stunting and thinness, and it also had a positive impact on cognitive skills in school children.

An epidemiological study on morbidity profile and predictors of health seeking behaviour among elderly population in a tribal dominant state of India: A regression analysis.

Background: Ageing is defined as a process of deterioration in the functional capacity of an individual that results from structural changes, with the advancement of age. Globally the geriatric population has increased from 8% in 2012 to 8.5% in 2015 and expected to rise by 22% in 2050. Hence we planned to study morbidity profiles and predictors of health-seeking behaviour among the elderly population in Ormanjhi, Ranchi. Methodology: A community based cross sectional study was conducted in Ormanjhi, Ranchi, Jharkhand for a period of six months (March-August 2018). The study was done among 206 geriatric populations fulfilling the eligibility criteria, selected by cluster sampling and those not giving their consent were excluded from the study. Data collected were entered in Microsoft Excel and analysis was done on Statistical Package for Social Sciences (SPSS) version 20.0. Results: A total of 206 geriatric populations fulfilling the study criteria, were enrolled during the study. The majority of the age group was found between 60-69 years (71.8%). Around 202 (98.1%) of which resided in rural areas, nearly half 102 (49.5%) depended on pension for livelihood and 108 (52.4%) were illiterate. Two-fifth of the study subjects (40.3%) consulted a government doctor if any health problems occurred followed by 30.5% preferred a private doctor and 20.1% consulted unqualified practitioners. Most of the study participants (64.5%) did not seek medical care due to financial reasons followed by 14.5% considered it a minor illness than 13% complained that health facility far away and 8.1% considered that old age itself as a disease. Non tribal ethnicity, participants who had their own source of income and co-morbidity were significantly associated with health seeking behaviour. Conclusion: Most participants in this study suffered from morbidities which also affect their quality of life. It was also observed that most of them were not dependent on others for their daily activities. Health seeking behaviour was found to be appropriate in nearly two third (70%) of elderly subjects in Ranchi, Jharkhand.

Predictors of quality of life among geriatric population in a tribal dominant state of India: A community based analytical study.

Background: Improving the quality of life of the geriatric population along with maintaining their health and promoting social participation still poses a major public health challenge in the twenty-first century. Hence, we planned to measure the quality of life (QOL) in each domain namely physical, psychological, social, and environmental using the world health organization quality of life brief version (WHO QOL-BREF) questionnaire and to assess the predictors of QOL among the elderly population. Methodology: A community-based cross-sectional study was conducted in Ormanjhi, Ranchi, Jharkhand for a period of 6 months. The study was carried out among 206 geriatric populations fulfilling the eligibility criteria. The data collected were entered in MS Excel and analyzed using SPSS version 20. The QOL scores were expressed in terms of mean and standard deviation, and the difference between mean scores was tested by using student t-test/analysis of variance (ANOVA). The predictor associated with QOL was done by multiple linear regression analysis. P value less than 0.05 was considered statistically significant. Results: A total of 206 geriatric people fulfilling the study criteria were enrolled during the study. The majority of the people were of the age between 60 and69 years (71.8%). Most of them 202 (98.1%) resided in rural areas, 108 (52.4%) of them were illiterate by education, and nearly half 102 (49.5%) depended on pension for livelihood. Nontribal ethnicity, backward category, illiteracy, low socio-economic status, nuclear family, elderly person having no own source of income, currently living alone, person having more co-morbidity, and less activities of daily living (ADL) score were significantly associated with low QOL score. Conclusion: Overall QOL was good to excellent in Ranchi, Jharkhand. We concluded that QOL is affected by many different factors.

The effects of limb laterality and age on the inflammation and bone turnover of the acromioclavicular shoulder joint: 18 F-fluorodeoxyglucose and 18 F-sodium-fluoride-PET/computed tomography study.

PURPOSE: The acromioclavicular (AC) joint is a common site of injury and degenerative changes such as osteoarthritis (OA) of the shoulder. Physical manifestations of OA are preceded by molecular changes, detection of which may enhance early prophylaxis and monitoring of disease progression. In this study, we investigate the use of 18 F-FDG and 18 F-NaF-PET/CT to assess the effects of limb laterality and age on the inflammation and bone turnover of the AC shoulder joint. METHODS: We analyzed FDG and NaF-PET/CT scans of 41 females (mean age of 43.9 ± 14.2 years) and 45 males (mean age of 44.5 ± 13.8 years) using a semiquantitative technique based on predefined ROI. RESULTS: There was a greater NaF uptake in the right side of the AC joint compared with the left in both females (left: 2.22 ± 1.00; right: 3.08 ± 1.18; P < 0.0001) and males (left: 2.57 ± 1.49; right: 2.99 ± 1.40; P = 0.003). No consistent correlation between age and NaF or FDG uptakes were found in both females and males. There was also a positive correlation between FDG and NaF uptakes in both left ( P = 0.01; r = 0.37) and right ( P = 0.0006; r = 0.53) AC joints of male subjects. CONCLUSION: Our study is the first to reveal the varying effect of right-left limb laterality and aging on FDG and NaF uptake at the AC joint. Future studies correlating the history of shoulder trauma, pain, and degenerative change with FDG and NaF-PET/CT findings will be critical in the adoption of molecular imaging in the clinical setting.

Knowledge and practices of nursing staffs related to Maternal Nutrition and Infant and Young Child Nutrition (MIYCN) services at Rajendra Institute of Medical Sciences, Jharkhand, India: A cross-sectional study.

Background: The first 1000 days of life is a unique window of opportunity when the foundation of overall optimum health and neurodevelopmental growth across the lifespan is established. Objective: To explore the level of knowledge and practice of service providers in delivering maternal, infant, and young child nutrition (MIYCN) services at the point of care. Methodology: This was a cross-sectional study done in the department of Obstetrics and Gynecology and Pediatrics of RIMS, Ranchi, Jharkhand from May to September 2019. Result: The practices and counseling skills of nursing staff pertaining to maternal nutrition interventions like IFA and calcium supplements was good. Though counseling on maternal minimum dietary diversity, frequency, and quantity of meals was done during the antenatal care period, its knowledge and expected total weight gain during pregnancy were suboptimal. The practice of early initiation of breastfeeding was significantly higher in those who delivered normally (79%) than those by cesarean section (7%). The nursing staff's knowledge and technical skills on early initiation and exclusive breastfeeding were good, but inadequate for cesarean section. Forty-one percentage of recently delivered women were counseled on colostrum feeding, 17% about positioning and attachment, and 38% on exclusive breastfeeding (EBF) during the first 6 months. In the pediatrics OPD and immunization clinic, 93% of mothers with an infant below 6 months of age, received counseling on EBF, 47% on feeding during illness, and 13% on breastfeeding difficulties and their solutions. Sixty percentage of mothers of children >6 months old received counseling on timely introduction of complementary feeding and 40% on minimum dietary diversity. Forty percentage of mothers were counseled on feeding techniques during and after illness. Conclusion: The nursing staffs were providing the services related to MIYCN during antenatal, intranatal, and postnatal services, sick child visits, and immunization visits but their technical knowledge and skills on the specific components were not in accordance with the standard guidelines.

Effect of milk supplementation on the status of micronutrients among rural school children aged 5-19 years in a tribal predominating district of India.

BACKGROUND: In the tribal state of Jharkhand, there have been very few studies on micronutrient deficiency and how it is addressed among school children. This study was conceived and undertaken to assess the effect of milk supplementation on the micronutrient status of school children. DESIGN: A comparative observational study was conducted among school children of a tribal district in India during 2017-2018. Two groups of schools/clusters were randomly selected, one with milk supplementation and the other without supplementation. A total of 318 children from the two groups of schools were recruited for biochemical analysis of certain micronutrients, such as calcium, vitamin D, vitamin B12 and iron (haemoglobin level), using cluster random sampling. Data were analysed using SPSS V.20.0 software, and multiple logistic regression analysis was done to determine the predictors of serum calcium and vitamin B12 level among school children. RESULTS: Almost all children from both groups had vitamin D deficiency. A higher risk of lower serum vitamin B12 level (OR 2.59, 95% CI 1.61 to 4.16) and calcium level (OR 3.36, 95% CI 1.74 to 6.49) was observed in children of the control group. The difference in the proportion of anaemia in the two study groups was found to be statistically insignificant. Milk consumption was found to be the only significant predictor of normal vitamin B12 and calcium level in the present study. CONCLUSIONS: In this study, it was concluded that milk consumption may help in improving the calcium and vitamin B12 status of school children of a tribal state, whereas it does not have any significant effect on vitamin D level.

A comparative study of epidemiological investigations of malaria outbreaks and related deaths in two districts of Jharkhand during the same prewinter season using shoe-leather epidemiology.

BACKGROUND: Following news of deaths in two districts of Jharkhand (West Singhbum and Garhwa) in November 2016, epidemiological investigations were contemplated to investigate any current outbreak of falciparum malaria and deaths attributed to it. METHODOLOGY: The epidemiological investigations, verbal autopsy of suspected deaths attributed to malaria and keys interviews were conducted in the 2nd and 4th week of November 2016 in Khuntpani and Dhurki block of West Singhbum and Garhwa districts, respectively, following a strict protocol. RESULTS: The affected villages were Argundi and Korba-Pahariya and their adjacent tolas in Khuntpani and Dhurki block. Undoubtedly, there was the continuous transmission of falciparum malaria in both the regions in October and November 2016. The total cases (according to case definitions) were 1002, of them, 338 and 12 patients were positive for Plasmodium falciparum positive (Pf +ve) and Plasmodium vivax positive (Pv +ve), respectively, in the affected areas of Khuntpani block. In Dhurki block, out of the total of 631 patients fulfilling the case definition, 65 patients were PF +ve and 23 Pv +ve. Comparing to the last year, there is remarkably high number of falciparum cases. Verbal autopsy of deceased individuals showed that malaria might be one of the strongly probable diagnoses, but not conclusively. CONCLUSION: According to epidemiological investigation, verbal autopsy and key interviews conducted, it may be concluded that there is a definite outbreak of falciparum malaria in the area and environment is congenial for malaria and other tropical diseases.

A Pilot Study of Obesogenic Eating Behaviors in Children With Migraine.

We studied associations between migraine severity and obesogenic eating behaviors in children with a prospective cross-sectional, clinic-based study. Migraine severity was quantified using the PedMIDAS tool and attack frequency. Eating behaviors were assessed using the Dutch Eating Behaviour Questionnaire and the Child Eating Behaviour Questionnaire. Food intake was assessed using a Food Intake Questionnaire. Statistical tests of association between eating behavior, food intake, and adiposity with migraine severity were performed. Sixty children (mean age = 10.9 years, standard deviation = 3.1; 26 males) were recruited. There was a positive correlation between the Child Eating Behaviour Questionnaire desire to drink subscale and PedMIDAS scores (r = 0.41, P = .01). Attack frequency was associated with higher intake of high fat or sugar content food and drink (r = 0.27, P = .04). No association between migraine severity and adiposity was found. Suggestion that migraine severity in children is associated with certain obesogenic eating behaviors requires further large study investigation.