Abstract:

The study’s objective is to evaluate the clinical effect and application of acupuncture treatment for shoulder pain disorders in terms of effectiveness and safety. A narrative review of RCTs in which acupuncture was used as an intervention for patients with shoulder pain disorders (SPD) was conducted. All randomised controlled trials that evaluate the effects of acupuncture for shoulder pain disorders compared with controls were included. The primary outcomes were pain and shoulder function. Based on the inclusive and exclusive criteria, 22 randomised control trials involving 1801 participants that evaluated the effects of acupuncture for various shoulder pain disorders were retrieved from various databases, and the intervention and results were examined. Eleven studies found that acupuncture treatment had significantly greater effects when compared with other therapies or treatments. Nine studies showed that, when combined with other therapies or treatments, the acupuncture group showed a better therapeutic effect than the therapy group itself. The results also show that acupuncture treatment can produce the same therapeutic effects as physical therapy, manual therapy, the uses of tropical NSAIDs, oral medications, and corticosteroid injections. No serious adverse events were observed. The findings indicated that acupuncture could be a safe and effective treatment for shoulder pain disorders by reducing pain and restoring shoulder functions. The results are consistent with those of past literature reviews. Although there is some evidence for the effectiveness and safety of acupuncture for shoulder pain disorders, the level of evidence is still low. Due to several limitations and heterogeneity, the results are inconclusive, and therefore the findings need to be interpreted with caution. Future large-scale studies should be more rigorous and well-designed RCTs with high-quality studies, a longer study duration with more subjects, an ideal standardised treatment regimen, and transparent reporting.

Keywords: Acupuncture, Shoulder pain, Shoulder disorders, Acupuncture safety, Alternatives therapies, Traditional Chinese medicine, Pain relief.

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Abstract:

Achieving universal health care (UHC) coverage has been at the forefront of the United Nations (UN) agenda for 2030. Inequality in health care service provision continues to increase, hence militating against the achievement of reducing unequal access to health care. Access is a critical component of the healthcare delivery system that is impacted by both spatial and non-spatial elements. This study utilized health facilities, population, and other open-source data to analyze the distribution and spatial accessibility of healthcare service centers by using Geospatial technologies in the Bauchi Local Government Area of Bauchi State - Nigeria. Two traveling scenarios (Driving and Walking) were used to determine the travel time to the nearest health facilities, defined within a maximum of 30 minutes traveling time using AccessMod (Online) and ArcGIS Pro. It was found that 87% and 75% of the population are within 15 and 30 minutes of travel time by driving and walking, respectively, while 1.3% of the population are outside a 15 km radius of any health facility with a ratio of 1 to 4,454 population to a health facility. The result shows a significant spatial disparity in geographic accessibility and spatial coverage, with some parts of the rural areas not having access to the existing health facility network, regardless of the travel scenario chosen. This will offer an innovative approach to reducing gaps in healthcare access and subsequently enhance the efficient and effective delivery of healthcare services in low- and middle-income countries (LMIC) to achieve UHC.

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Abstract:

The coronavirus (Covid-19) is a pandemic that threatens many people’s lives. The objective of this study was to explore the Covid-19 psycho-social impact on Staff working in the United Nations in Burundi from October 2021 to 31st January 2022. This was a cross-sectional study involving 312 study participants. Univariate and bivariate analysis were processed using SPSS 25, and the Chi-square test was calculated with a p<0.05. As a result, all psycho-social components assessed were affected by Covid-19. The Staff experienced a very high level of psycho-social impact (very severe) which varied from 31% for being afraid of financial problems and unhappiness due to missing professional support from colleagues to 47% for being afraid of a family member infected by Covid-19. Also, we assessed their particularity of psycho-social impact due to the exposure of being clinical or non-clinical Staff, whereby, clinical Staff had a lower risk of being affected compared to the non-clinical Staff in some components. For instance, clinical Staff was 0.39 times more affected by fear of being infected by Covid-19 compared to non-clinical Staff (CI= (0.23,0.65). Also, there are some components where the impacts were similar for clinical and non-clinical Staff (Chi-square test p-value > 0.05 and CI of odds ratios cross 1). Thus, UN employees were negatively affected by Covid-19 from a psycho-social standpoint. The study recommends UN agencies in Burundi support staff by providing emergency psychological support and, if required to give medical treatment for job optimization. Hence, staff psycho-social status must be constantly checked and kept stable.

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[5] Cassiani-Miranda, C. A., Campo-Arias, A., Tirado-Otálvaro, A. F., Botero-Tobón, L. A., Upegui-Arango, L. D., Rodríguez-Verdugo, M. S., Botero-Tobón, M. E., Arismendy-López, Y. A., Robles-Fonnegra, W. A., Niño, L., & Scoppetta, O. (2021). Stigmatisation associated with Covid-19 in the general Colombian population. International Journal of Psycho-social Psychiatry, 67(6), 728–736. https://doi.org/10.1177/0020764020972445.

[6] Lakshmi, B. M. (2020). Impact of Covid 19 on the Transport Industry. Generic, 12(8), 1327–1334.

[7] Van Daalen, K. R., Cobain, M., Franco, O. H., & Chowdhury, R. (2021). Stigma: The psycho-social virus spreading faster than Covid-19. Journal of Epidemiology and Community Health, 75(4), 313–314. https://doi.org/10.1136/jech-2020-214436.

[8] Zhou, M. (2022). Covid-19-related stigma and its impact on psychological distress: A cross-sectional study in Wuhan, China. Health Science Reports, 5(5). https://doi.org/10.1002/hsr2.758.

[9] Ali, S. M., & Nausheen, S. (2022). Psycho-social Impact of Covid-19 on Healthcare Workers. Sultan Qaboos University Medical Journal [SQUMJ], 22(1), 82–90. https://doi.org/10.18295/squmj.4.2021.067.

[10] Cerda, A. A., & García, L. Y. (2022). Factors explaining the fear of being infected with Covid-19. Health Expectations, 25(2), 506–512. https://doi.org/10.1111/hex.13274.

[11] SINGH, R., Subedi, M., Sunar, C., Pant, S., Singh, B., Shah, B., & Mahato, S. (2021). Association of psycho-social stigma of Covid-19 with work satisfaction, burnout and fatigue among healthcare workers in Nepal. Global Psychiatry Archives, 4(2), 180–190. https://doi.org/10.52095/gp.2021.3838.1027.

[12] International Council of Nurses. (2020). Protecting nurses from Covid-19 a top priority: A survey of ICN’s national nursing associations. Www.Icn.Ch, (September), 1–9. Retrieved from https://www.icn.ch/system/files/documents/2020-09/Analysis_Covid-19-survey-feedback_14.09.2020-EMBARGOED VERSION_0.pdf.

[13] No, I. Z. A. D. P., Lippens, L., Weytjens, J., Sterkens, P., Lippens, L., & Weytjens, J. (2020). DISCUSSION PAPER SERIES How Do We Think the Covid-19 Crisis Will Affect Our Careers ( If Any Remain )? How Do We Think the Covid-19 Crisis Will Affect Our Careers ( If Any Remain )? 13164.

[14] Bagcchi, S. (2020). Stigma during the Covid-19 pandemic. The Lancet. Infectious Diseases, 20(7), 782. https://doi.org/10.1016/S1473-3099(20)30498-9.

[15] Chersich, M. F., Gray, G., Fairlie, L., Eichbaum, Q., Mayhew, S., Allwood, B., … Rees, H. (2020). Covid-19 in Africa: Care and protection for frontline healthcare workers. Globalization and Health, 16(1), 1–6. https://doi.org/10.1186/s12992-020-00574-3 (Chersich et al., 2020).

[16] Danet Danet, A. (2021). Psychological impact of Covid-19 pandemic in Western frontline healthcare professionals. A systematic review. Medicina Clinica, 156(9), 449–458. https://doi.org/10.1016/j.medcli.2020.11.009.

[17] Imran, N., Afzal, H., Aamer, I., Hashmi, A., Shabbir, B., Asif, A., & Farooq, S. (2020). Scarlett letter: A study based on the experience of stigma by Covid-19 patients in quarantine. Pakistan Journal of Medical Sciences, 36(7), 1471–1477. https://doi.org/10.12669/pjms.36.7.3606.

[18] Sun, X., Wandelt, S., Zheng, C., & Zhang, A. (2021). Covid-19 pandemic and air transportation: Successfully navigating the paper hurricane. Journal of Air Transport Management, 94, 102062. https://doi.org/10.1016/j.jairtraman.2021.102062

[19] Rodríguez, B. O., & Sánchez, T. L. (2020). The psycho-social impact of Covid-19 on health care workers. International Braz J Urol, 46(Suppl 1), 195–200. https://doi.org/10.1590/S1677- 5538.IBJU.2020.S124.

[20] Ballard, M., Bancroft, E., Nesbit, J., Johnson, A., Holeman, I., Foth, J. Palazuelos, D. (2020). Prioritising the role of community health workers in the Covid-19 response. BMJ Global Health, 5(6). https://doi.org/10.1136/bmjgh-2020-002550.

[21] Vyas, L., & Butakhieo, N. (2021). The impact of working from home during Covid-19 on work and life domains : an exploratory study on Hong Kong. Policy Design and Practice, 4(1), 59–76. https://doi.org/10.1080/25741292.2020.1863560.

[22] No, I. Z. A. D. P., Lippens, L., Weytjens, J., Sterkens, P., Lippens, L., & Weytjens, J. (2020). DISCUSSION PAPER SERIES How Do We Think the Covid-19 Crisis Will Affect Our Careers ( If Any Remain )? How Do We Think the Covid-19 Crisis Will Affect Our Careers ( If Any Remain )? 13164.

[23] Bhaumik, S., Moola, S., Tyagi, J., Nambiar, D., & Kakoti, M. (2020). Community health workers for pandemic response: a rapid evidence synthesis. MedRxiv, 19. https://doi.org/10.1101/2020.04.28.20082586.

[24] Bhatticharya Sanjay. (2020). The Psycho-social Impact of the Covid-19 Pandemic. Orf, 406, 14.

[25] Chen, W., Ju, Y., Liu, B., Huang, M., Yang, A., Zhou, Y., Wang, M., Liao, M., Shu, K., Liu, J., & Zhang, Y. (2021). Negative Appraisals of the Covid-19 Psycho-social Impact Associated With the Improvement of Depression and Anxiety in Patients After Covid-19 Recovery. Frontiers in Psychiatry, 12(April), 1–8. https://doi.org/10.3389/fpsyt.2021.585537.

[26] (Alghamdi, 2021)Alghamdi, A. A. (2021). Impact of the Covid-19 pandemic on the psycho-social and educational aspects of Saudi university students’ lives. PLoS ONE, 16(4 April), 1–18. https://doi.org/10.1371/journal.pone.0250026.

[27] Nicola, M., Alsafi, Z., Sohrabi, C., Kerwan, A., Al-Jabir, A., Iosifidis, C., Agha, M., & Agha, R. (2020). The socio-economic implications of the coronavirus pandemic (Covid-19): A review. International Journal of Surgery, 78(January), 185–193. https://doi.org/10.1016/j.ijsu.2020.04.018.

Abstract:

The effects of the Covid-19 pandemic on mental health have been apparent from the beginning. Housework and social constraints Implemented an important pandemic issue would be being unprepared. Future physical health and longevity are predicted by mental health. It would portend ongoing pandemic health problems. India has rules about social segregation and lockdowns that affect the economy, the people, and the environment. When the environment is unhealthy, it hurts the economy and people’s lives. In May 2021, 1.49 percent of cases in this state ended in death. As of May 2022, there have been 78,77,577 cases in Maharashtra, and 1,47,842 people have died. The present study tried to find out that the Covid-19 pandemic has influenced depression, anxiety, and stress levels in elders. The goal of this study is to find out how Covid-19 affects the amount of stress, anxiety, and depression in the elderly population. Data were collected from rural and urban hospitals by using a questionnaire that captured general information about the participants and a DASS-21 questionnaire. Collected data is calculated using the chi-square test and DASS interpretation is carried out. The current study discovered that a significant proportion of the elderly suffer from stress, anxiety, and depression, symptoms in the geriatric population because of Covid-19 when compared to stress scale or depression in rural & urban areas, in Maharashtra. More research may be carried out to reflect the psychological status of the geriatric population to validate the study’s conclusions.

References:

[1] J. Riou and C. L. Althaus, “Pattern of early human-to-human transmission of Wuhan 2019 novel coronavirus (2019-nCoV), December 2019 to January 2020,” Eurosurveillance, vol. 25, no. 4, pp. 1–5, 2020, Doi: 10.2807/1560-7917.ES.2020.

[2] R. E. Grolli et al., “Impact of Covid-19 in Mental Health in Elderly: Psychological and Biological Updates,” Mol. Neurobiol., vol. 58, no. 5, pp. 1905–1916, 2021, Doi: 10.1007/s12035-020-02249-x..25.4.2000058.

[3] A. Joshi, “Covid-19 pandemic in India: through psycho-social lens,” J. Soc. Econ. Dev., vol. 23, no. S2, pp. 414–437, 2021, Doi: 10.1007/s40847-020-00136-8.

[4] G. Maggi et al., “Mental health status of Italian elderly subjects during and after quarantine for the Covid-19 pandemic: a cross-sectional and longitudinal study,” Psychogeriatrics, vol. 21, no. 4, pp. 540–551, 2021, Doi: 10.1111/psyg.12703.

[5] N. Salari et al., “Prevalence of stress, anxiety, depression among the general population during the Covid-19 pandemic: a systematic review and meta-analysis,” Global. Health, vol. 16, no. 1, pp. 1–11, 2020.

[6] L. García-Fernández, V. Romero-Ferreiro, P. D. López-Roldán, S. Padilla, and R. Rodriguez-Jimenez, “Mental Health in Elderly Spanish People in Times of Covid-19 Outbreak,” Am. J. Geriatr. Psychiatry, vol. 28, no. 10, pp. 1040–1045, 2020, Doi: 10.1016/j.jagp.2020.06.027.

[7] S. M. H. Javadi and N. Nateghi, “Covid-19 and Its Psychological Effects on the Elderly Population,” Disaster Med. Public Health Prep., vol. 14, no. 3, pp. e40–e41, 2020, Doi: 10.1017/dmp.2020.245.

[8] R. B. Hirst et al., “The 5-HTTLPR long allele predicts two-year longitudinal increases in cortisol and declines in verbal memory in older adults,” Int. J. Geriatr. Psychiatry, vol. 35, no. 9, pp. 982–988, 2020, Doi: 10.1002/gps.5319.

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[10] T. P. S. Oei, S. Sawang, Y. W. Goh, and F. Mukhtar, “Using the Depression Anxiety Stress Scale 21 (DASS-21) across cultures,” Int. J. Psychol., vol. 48, no. 6, pp. 1018–1029, 2013, Doi: 10.1080/00207594.2012.755535.

[11] D. S. Hui, E. I. Azhar, Z. A. Memish, and A. Zumla, “Human Coronavirus Infections—severe acute respiratory syndrome (SARS), Middle East Respiratory Syndrome (MERS), and SARS-CoV-2,” Encycl. Respir. Med., no. January, pp. 146–161, 2022, Doi: 10.1016/b978-0-12-801238-3.11634-4.

[12] L. A. Eaton and S. C. Kalichman, “Social and behavioral health responses to Covid-19: lessons learned from four decades of an HIV pandemic,” J. Behav. Med., vol. 43, no. 3, pp. 341–345, 2020, Doi: 10.1007/s10865-020-00157-y.

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[15] J. Roy, R. Jain, R. Golamari, R. Vunnam, and N. Sahu, “Covid-19 in the geriatric population,” Int. J. Geriatr. Psychiatry, vol. 35, no. 12, pp. 1437–1441, 2020, Doi: 10.1002/gps.5389.

[16] J. Gustavsson and L. Beckman, “Compliance to recommendations and mental health consequences among elderly in sweden during the initial phase of the Covid-19 pandemic—a cross sectional online survey,” Int. J. Environ. Res. Public Health, vol. 17, no. 15, pp. 1–10, 2020, Doi: 10.3390/ijerph17155380.

[17] K. Lee, G. C. Jeong, and J. Yim, “Consideration of the psychological and mental health of the elderly during Covid-19: A theoretical review,” Int. J. Environ. Res. Public Health, vol. 17, no. 21, pp. 1–11, 2020, Doi: 10.3390/ijerph17218098.

[18] M. Sabe, N. Zhao, and S. Kaiser, “A systematic review and meta-analysis of the prevalence of cocaine-induced psychosis in cocaine users,” Prog. Neuro-Psychopharmacology Biol. Psychiatry, vol. 109, no. January 2021, Doi: 10.1016/j.pnpbp.2021.110263.

[19] A. Barone et al., “The effects of sustained Covid-19 emergency and restrictions on the mental health of subjects with serious mental illness: A prospective study,” J. Community Psychol., no. April, pp. 1–14, 2022, Doi: 10.1002/jcop.22886.

[20] B. Lábadi et al., “Psychological well-being and coping strategies of elderly people during the Covid-19 pandemic in Hungary,” Aging Ment. Heal., vol. 26, no. 3, pp. 570–577, 2022, Doi: 10.1080/13607863.2021.1902469.

Abstract:

The nitric oxide produced by the endothelial nitric synthase (NOS3) gene helps to maintain cerebral blood flow (CBF) after traumatic brain injuries (TBI). The aim is to determine the prognostic role of NOS3 894 G>T gene in traumatic hemorrhagic contusion and outcome. A cross-sectional study was conducted for 90 patients who attended the National Centre for Neurological Sciences, Khartoum, Sudan. Non-Sudanese patients, hemorrhagic contusions associated with other types of brain bleeding, and patients with chronic disease were excluded. An initial CT scan was used upon admission to detect brain edema, anatomical site, and the number of contusions. The Glasgow coma scale (GCS) was used upon admission to assess the trauma severity. The Glasgow outcomes scale (GOS) was used upon discharge to assess the outcome. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used for NOS3 genotyping. The result shows that 93.3% of patients were male, while 32.2% of them were female. It further indicates that 58.9 % had a mild injury; 60% of the patients were presented with frontal lobe injury, 14.4% had multiple sites injury, and 22.2% had brain edema. The number of deaths was 8 (8.9%). The genotyping of NOS3 revealed that 94.4% of patients had homozygous GG and 5.6% heterozygous GT. G allele represented 97.2% of NOS3 alleles. NOS3 894 G>T genotypes were not significantly associated with patients, linguistic afflation’ and outcome. The study concluded that NOS3 894G>T gene has no prognostic role in traumatic hemorrhagic contusion and outcome.

References:

[1] Alahmadi, H., Vachhrajani, S., and Cusimano M., 2010, The natural history of brain contusion: an analysis of radiological and clinical progression. J Neurosurg,112(5),1139-1145, https://doi.org/10.3171/2009.5.JNS081369.

[2] Kurland, D., Hong, C., Aarabi, B., Gerzanich, V., and Simard, J. M., 2012, Hemorrhagic Progression of a Contusion after Traumatic Brain Injury: A Review. J Neurotrauma,29(1),19-31, https://www.liebertpub.com/doi/10.1089/neu.2011.2122.

[3] Hassan, S. A., Gassoum, A.F., Aldeaf, S.A., Arbab, M.A., and Musa, H. H., 2020, Association between Acute Inflammatory Cells and Mutation in ICAM-1 gene with Injury Severity and Outcome among Traumatic Cerebral Hemorrhagic Contusion. J Acute Med ,10(1),1-8, https://pubmed.ncbi.nlm.nih.gov/32995149/.

[4] Hassan, S.A., Arbab, M.A., and Musa, H.H., 2020, Association of RETN -420 C/G genotypes with CRP, Brain edema, GCS, and GOS among Traumatic Cerebral Hemorrhagic Contusion. J Emerg Med Trauma Acute Care,2020(1), https://doi.org/10.5339/jemtac.2020.4.

[5] Hassan, S.A., Arbab, M.A., Abdelrahman, S.F., Aldeaf, S.A., Gassoum, A.F.,and Musa, H.H, 2020, The significance of mutation in IL-1B gene and circulatory level for prediction of trauma severity and outcome in Traumatic Cerebral Hemorrhagic Contusion. J Acute Med,10(2),70-76, https://pubmed.ncbi.nlm.nih.gov/32995158/.

[6] Kondkar, A.A., Azad, T.A., Sultan, T., Osman, E.A., Almobarak, F.A., Al-Obeidan, S.A., 2020, Association of endothelial nitric oxide synthase (NOS3) gene polymorphisms with primary open- angle glaucoma in a Saudi cohort. Plos One,15(1),e0227417,https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0227417

[7] Geller, D.A., Lowenstein, C.J., Shapiro, R.A., Nussler, A.K., Di Silvio, M., Wang, S.C., Nakayama, D. K., Simmons, R.L., Snyder, S.H., and Billiar, T.R., 1993, Molecular cloning and expression of inducible nitric oxide synthase from human hepatocytes. PNAS, 90(8),34913495,https://doi.org/10.1073/pnas.90.8.3491.

[8] Nasyrova, R.F., Moskaleva, P.V., Vaiman, E.E., Shnayder, N.A., Blatt, N.L.,and Rizvanov, A.A., 2020, Genetic Factors of Nitric Oxide’s System in Psychoneurologic Disorders. Int J Mol Sci,21(5),1604,https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7084194/.

[9] Hancock, D.B., Martin, E.R., Vance, J.M.,and Scott, W.K., 2008, Nitric oxide synthase genes and their interactions with environmental factors in Parkinson’s disease. Neurogenetics, 9(4), 249–262, https://link.springer.com/article/10.1007/s10048-008-0137-1.

[10] Marsden, P.A., Heng, H.H., Scherer, S.W., Stewart, R.J., Hall, A.V., Shi, X.M., Tsui, L.C., and Schappert, T.K., 1993, Structure and chromosomal localization of the human constitutive endothelial nitric oxide synthase gene. J Biol Chem, 268(23),17478-17488, https://pubmed.ncbi.nlm.nih.gov/7688726/.

[11] Robertson, C.S., Gopinath, S.P., Valadka, A.B., Van, M., Swank, P.R., and Goodman, J.C., 2011, Variants of the Endothelial Nitric Oxide Gene and Cerebral Blood Flow after Severe Traumatic Brain Injury. J Neurotruma, 28(5),727-737, https://pubmed.ncbi.nlm.nih.gov/21332418/.

[12] Nassereddine, S., Idrissi, H.H., Habbal, R., Abouelfath, R., Korch, F., Haraka. M., Karkar, A., and Nadifi, S., 2018, The polymorphism G894 T of endothelial nitric oxide synthase (eNOS) gene is associated with susceptibility to essential hypertension (EH) in Morocco. BMC Medical Genetics, 19(1),127. https://bmcmedgenet.biomedcentral.com/articles/10.1186/s12881-018-0638-1.

[13] Luo, Z., Jia, A., Lu, Z., Muhammad, I., and Adenrele, A., Song, Y., 2019, Associations of the NOS3 rs1799983 polymorphism with circulating nitric oxide and lipid levels: a systematic review and meta-analysis. Postgrad Med J, 95(1125), 361-371, https://pmj.bmj.com/content/95/1125/361.

[14] Ahn, M.J., Sherwood, E.R., Prough, D.S., Lin, C.Y., and DeWitt, D.S., 2004, The effects of traumatic brain injury on cerebral blood flow and brain tissue nitric oxide levels and cytokine expression. J Neurotrauma,21(10),1431-1442, https://www.liebertpub.com/doi/10.1089/neu.2004.21.1431.

[15] Harish, G., Mahadevan, A., Pruthi, N., Sreenivasamurthy, S., Puttamallesh, V., Prasad, T. S., Shankar, S. K., and Bharath, M., 2015, Characterizations of traumatic brain injury in human brains reveals distinct cellular and molecular changes in contusion and per contusion. J Neurochemistry, 134(1), 156-172, https://onlinelibrary.wiley.com/doi/abs/10.1111/jnc.13082.

[16] https://www.qiagen.com/us/products/discovery-and-translational-research/dna-rna-purification/dnapurification/genomic-dna/qiawave-dna-kits/

[17] Veenith, T., Goon, S.H., and Burnstein, R.M., 2009, Molecular mechanisms of traumatic brain injury: the missing link in management. World J Emerg Surg , 4(1), 7-10, https://wjes.biomedcentral.com/articles/10.1186/1749-7922-4-7.

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[19] Tanus-Santos, J.E., Desai, M., and Flockhart, D.A., 2001, Effects of ethnicity on the distribution of clinically relevant endothelial nitric oxide variants. Pharmacogenetics, 11(8), 719-725, https://pubmed.ncbi.nlm.nih.gov/11692081/.

[20] Davidson, J, Cusimano, M. D., and Bendena, W,G., 2015, Post-Traumatic Brain Injury: Genetic Susceptibility to Outcome. Neuroscientist, 21(4), 424-41, https://pubmed.ncbi.nlm.nih.gov/25059577/.

Abstract:

In 2015 Namibia reported 55 deaths due to cervical cancer, and the prevalence of HIV was 13,3% among adults aged between 15 -49. There is an increased risk of cervical cancer among women living with HIV, the prevalence of this type of cancer and the association with risk factors is unknown at the Omaruru Hospital. High prevalence of HPV infection, advanced HIV disease, tobacco, multiple sexual partners, parity, and poor socio-economic conditions are listed among contributing factors that increase morbidity and mortality of cervical cancer, which can be controlled & cured if diagnosed early. This research aimed to determine the prevalence of cervical Cancer among HIV-positive women on ARVs and assess the risk factors contributing to the emergence of cervix cancer in this population. The approach methodologic used was a retrospective cross-sectional of 49 women randomly selected among those who were done pap smears at the Omaruru ART clinic between August 2016 to August 2017. There was no positive result for cervical cancers found. Hence, the prevalence of HPV was found to be 16,32%, with Cervical dysplasia 3 cases of CIN I and 5 cases of CIN II with no association established with risk factors, and a case of CIN II in a primigravida with multiple sexual partners were found. To conclude, a meaningful analysis with STATA 14 revealed no positive results for cervical cancer from the 49 cases with no risk factors association established,30.61% of negative HPV (30 - 39 years;28.57% (40-50 years), CIN II aged 30 to 39 years (4%);4% (40- 50 years) 2% above 50 years old. The HPV prevalence (16,32%,),3 cases of CIN 1, and 5 cases of CIN II are indicators that more efforts need to be made.

Keywords: Cervical cancer prevalence, Cervical cancer screening, HPV prevalence, HIV women on antiretroviral treatment, primigravida, multiple sexual partners.

References:

[1] Center of Control Diseases (CD, 2016). Cervical Cancer. Available at: https://www.cdc.gov/cancer/cancer. Access date (20/12/2017).

[2] Odendal L. (2011). Anti-retroviral therapy reduces the risk of progression to cervical cancer in women with HIV. Available at: http://www.aidsmap.com/Cervical-cancer-in-women-with-HIV/page/1669155/data. Access data (23/02/2018).

[3] Center of Disease Control (CDC,2015). Global Statistics. Available at: https://www.hiv.gov/overview/data-and-trends/global-statistics. Access date (20/02/2018).

[4] Siegel RL, Miller KD and Jemal. A (2016). Cancer statistics. Cervical cancer screening and prevention. Available at: contemporaryobgyn.modernmedecine.com/contemporary-obgyn/news/. Access date (20/02/2018).

[5] Cancer Research UK (2017). Publications. Available at https://publications.cancerresearchuk.org. Access date (23/02/2018).

[6] Global Cancer Statistics (2017). CANSA. Available at: www.cansa.org.za/global-cancer-statistics. Access date (23/02/2018).

[7] World Health Organization (WHO,2012). Human Papillomavirus (HPV) and Cervical Cancer. Available at: https://www.who.int/mediazantre/factsheets/fs380. Access date (19/02/2018).

[8] Scott Dryden-Peterson, Memory Bvochora-Nsingo, Gita Suneja, Jason A. Efstathiou, Surbhi Grover, Sebathu Chiyapo, Doreen Romagola-Masire, Malebogo Kebabonye-Pusoentsi, Rebecca Clayman, Abigail C. Mapes, Neo Tapea, Aida Asmelash, Heluf Medhin, Akila N. Viswanathan, Anthony H. Russel, Lilie L. Lin, Mukendi Kss.A. Kayembe, Mompati Mmalane, Thomas C. Randall, Bruce Chabner and Shahin Lockman (2016). Journal of Clinical Oncology: HIV infection and survival among women with Cervical Cancer. Available at http://ascopubs.org/doi/abs/10.1200/JCO.2016.67.9613?journalCode=jco (Access date 24/05/2017).

[9] Ramadhani S. Chambuso, Stephen Shadrack, Salum J. Lidenge, Ntoli Mwakibete and Rui M. MedeirosShowMore. Influence of Hiv/AIDS on Cervical Cancer (2015). A Retrospective Study from Tanzania. Available at: https://ascopubs.org/doi/abs/10.12oo/JGO.2015.002964. Access date (12/12/20117).

[10] Center of Disease Control (2010). Cervical Cancer Screening for Wh017o women attends STD Clinic. Available at: http://wwwcdc.gov/sts/treatment/2010/cc-screening.htm.Accessdate .05/06/2.

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[12] Anorlu RI. Cervical cancer: the sub-Saharan African perspective. 2008;16(32):41–9. Available at https://www.cdc.gov/vitalsigns/pdf/2014-11-vitalsigns.pdf(accessed date 06/06/2017).

[13] National Cancer Institute (2016). HIV and Cervical Cancer Risk. Available at :http://journal.waocp.org/article_47592_359eb14730d5a9bd14e2b38745e045a4.pdf. Access date (12/12/2017).

[14] Center of Disease Control (CDC,2017). Cervical cancer screening recommendation and considerations. Available at: https://www.cdc.gov/cancer/knowledge/provider-education/cervical/recommendations.htm .Access date (19/02/2018).

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