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Background: Paroxysmal nocturnal hemoglobinuria (PNH) is a rare hematologic disorder characterized by a deficiency of GPIanchored proteins in blood cells. It is associated with hemolysis, thromboembolic events, and bone marrow failure. Management includes complement inhibitors, anticoagulation, and stem cell transplantation. Spontaneous remission of PNH is rarely reported. Case Presentation: A 28-year-old male initially diagnosed with aplastic anemia developed portal vein thrombosis and was subsequently diagnosed with PNH. Due to the unavailability of complement inhibitors, anticoagulation therapy and supportive care were employed. Splenectomy with splenorenal shunt was performed for chronic thrombosis and associated complications. The patient achieved spontaneous remission with normalized blood counts and diminished PNH clone. Conclusion: Managing PNH in resource-limited settings presents challenges due to the unavailability of complement inhibitors. Spontaneous remission of PNH is rarely reported and needs further research. A multidisciplinary approach, accessibility to diagnostic tests, and advanced treatments will enhance PNH management in resource-limited settings. [ABSTRACT FROM AUTHOR]

When faced with the fear of low-quality tap water, households are motivated to seek out and use alternatives. This study investigated the role of quality perception and aesthetics on choices [...]

Background: Healthy life expectancy (HALE) at birth measures the standard of living anticipated. Objective: The purpose of this study was to identify the main global risk factors for HALE at birth. Methodology: The data of 212 countries have been extracted from the data hub of World Health Organization, Worldometer, World Bank, and United Nations. The HALE at birth was considered as the dependent variable and the death rate due to Coronavirus disease 2019 (COVID 19), recovery rate from COVID 19, tuberculosis (TB) incidence, universal health coverage (UHC) service index, tobacco smoking, alcohol consumption rate, human immunodeficiency virus (HIV) prevalence rate, average household size, gross domestic product (GDP), and current health expenditure were considered as the independent variables. Descriptive statistics, Pearson's correlation analysis, and multiple linear regression model were used as the statistical tools to analyze the data. Results: The study results revealed that the HALE is found lowest in Central African Republic (44.9 years) and highest in Singapore (76.2 years). On the other hand, the death rate due to COVID 19 is found highest in Nicaragua (32.0%). In case of the recovery rate from COVID 19, the lowest value is seen in Tajikistan (0.0). Again, the lowest UHC service index is found in Montserrat (0.0). Alcohol consumption rate is found highest in Moldova Republic (15.20). In case of HIV prevalence rate, the highest value is seen in Eswatini (27.30). Average household size is seen highest in Senegal (8.30). The recovery rate from COVID 19, UHC service index, GDP, current health expenditure TB incidence, tobacco smoking, HIV prevalence rate and average household size were significantly correlated with the HALE at birth. Again, the multiple linear regression model identified the UHC service index, alcohol consumption rate, HIV prevalence rate and average household size as the significant factors which are responsible for the variation in HALE at birth worldwide. Conclusion: The UHC service index, alcohol consumption rate, HIV prevalence rate and average household size are the most associate factors of HALE at birth globally. [ABSTRACT FROM AUTHOR]

Background: There is accumulating evidence that roadside pollution is detrimental to health. Traffic police personnel are exposed to roadside pollution due to the nature of their job and are at risk of adverse health outcomes. Objective: This study aims to compare the risk of adverse respiratory symptoms in different categories of traffic police including traffic constables, sergeants, and inspectors. Methods: The study population consisted of 369 randomly selected traffic police personnel from the city of Chittagong in Bangladesh. Information on their occupation and respiratory health symptoms were collected. The health outcomes were coughing, coughing sputum, coughing up blood, shortness of breathing, wheezing, and chest pain Result: The risk of coughing [adjusted Odds Ratio (AOR) = 4.469, 95% CI=1.265-15.793], coughing sputum [AOR= 3.687, 95% CI= 1.004 -13.540], coughing up blood [AOR=1.040, 95% CI=0.227-6.162], shortness of breathing [AOR=3.937, 95% CI=1.069-14.500], wheezing [AOR= 2.464, 95% CI= 0.613-9.906] and chest pain with deep breathing [AOR=2.163,95% CI= 0.560-8.349] was higher in traffic constables compared to inspectors. In sergeants odds increased for coughing up blood [AOR=1.102, 95% CI= 0.283-4.286] and wheezing [AOR=1.260, 95% CI= 0.304-5.229]. Conclusion: There was a substantial difference in the risk of studied respiratory symptoms between different categories of traffic police jobs. Targeted occupational health interventions are recommended. [ABSTRACT FROM AUTHOR]

Background and Aim: Urinary tract infection (UTI) might be associated with bacteremia and congenital anomalies of the kidney and urinary tract (CAKUT) in neonates, which can lead to renal parenchymal scarring and chronic kidney disease in complicated situations. We aimed to determine the occurrence of UTI in neonatal sepsis. Methods: A cross-sectional study was conducted on 500 term extramural hospitalized neonates suspected to have infection. They underwent a detailed history, physical examination, and comprehensive sepsis workup. The diagnosis of neonatal UTI was based on a positive urine culture obtained by suprapubic aspiration (SPA). Results: Out of 500 neonates included in our study (324 boys and 176 girls), blood culture was positive in 84 (36.5%) neonates in the early onset sepsis group (n=230) and in 130 (48.1%) neonates in late onset sepsis group (n=270) (p < 0.05). In both early onset sepsis (EOS) and late onset sepsis (LOS) groups, blood culture was found to be positive in a greater proportion of male (41.3%) versus female (29.3%) patients (p <0.05). The most common organism isolated from blood and urine culture was Klebsiella followed by E-coli. Urine culture was positive in 34 (6.8%) patients of whom 29 (85%) culture positive cases were from the LOS group (p <0.05). Conclusion: UTI is not uncommon among the hospitalized neonates, and UTI evaluation among septic neonates can prove beneficial for the prevention of long-term sequelae of neonatal UTI. [ABSTRACT FROM AUTHOR]

Background: Fanconi anemia (FA) is an inherited bone marrow failure syndrome associated with characteristic dysmorphology primarily caused by biallelic pathogenic germline variants in any of 22 different DNA repair genes. There are limited data on the specific molecular causes of FA in different ethnic groups. Methods: We performed exome sequencing and copy number variant analyses on 19 patients with FA from 17 families undergoing hematopoietic cell transplantation evaluation in Pakistan. The scientific literature was reviewed, and we curated germline variants reported in patients with FA from South Asia and the Middle East. Results: The genetic causes of FA were identified in 14 of the 17 families: seven FANCA, two FANCC, one FANCF, two FANCG, and two FANCL. Homozygous and compound heterozygous variants were present in 12 and two families, respectively. Nine families carried variants previously reported as pathogenic, including two families with the South Asian FANCL founder variant. We also identified five novel likely deleterious variants in FANCA, FANCF, and FANCG in affected patients. Conclusions: Our study supports the importance of determining the genomic landscape of FA in diverse populations, in order to improve understanding of FA etiology and assist in the counseling of families. [ABSTRACT FROM AUTHOR]

Background: Neonatal acute kidney injury (AKI) carries significant morbidity and mortality, particularly among very low birth weight (VLBW) neonates. We aimed to evaluate the short-term outcomes and the risk factors of AKI in VLBW infants. Methods: All extramural VLBW neonates without AKI and congenital renal abnormalities were enrolled. Serum creatinine (SCr) was estimated on days 0, 4, and 10. Neonatal AKI was defined an increase in SCr by ≥0.3 mg/dL from the previous value within a period of 48 h or >1.5 time from baseline within 7 days. Results: Neonatal AKI developed in 26 (13.8%) out of 189 neonates studied. Among AKI group, 5 (19.2%) had stage 1, 9 (34.4%) neonates reached stage 2, and 12 (46.1%) neonates reached stage 3 AKI. Neonates with AKI had a significantly lower gestational age and birth weight (P < 0.001). Mortality in VLBW neonates with AKI was significantly higher as compared to those without AKI (crude hazard ratio 6.2; 95% confidence interval: 2.36-15.79, P <0.05). Conclusions: AKI is common in extramural VLBW neonates, is inversely correlated with gestational age and birth weight, and carries poor outcome. [ABSTRACT FROM AUTHOR]

Byline: Mohd. Ashraf, Naveed. Shahzad, Mohd. Irshad, Sheikh. Hussain, Parvez. Ahmed The recent standardization and validation of definitions of pediatric acute kidney injury (pAKI) has ignited new dimensions of pAKI [...]