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Open Access August 24, 2022

Epidemiological and Clinical Profile of Deaths due to COVID-19 among Hospitalized Patients in Sidama Region, Ethiopia

Abstract Novel corona virus disease (COVID-19) pandemic, which started in China's Hubei province in 2019, has caused a significant loss of human lives globally. This study describes the epidemiologic and clinical profiles of COVID-19 related deaths among patients admitted to treatment centers in Sidama region, Ethiopia. A cross-sectional study of 186 in hospital COVID-19 related deaths that occurred from [...] Read more.
Novel corona virus disease (COVID-19) pandemic, which started in China's Hubei province in 2019, has caused a significant loss of human lives globally. This study describes the epidemiologic and clinical profiles of COVID-19 related deaths among patients admitted to treatment centers in Sidama region, Ethiopia. A cross-sectional study of 186 in hospital COVID-19 related deaths that occurred from July 2020 to December 2021 in Sidama region were analyzed. Data was extracted from regional emergency operation center death report. Data was entered using Epidata v3.1 and analysis was done using SPSS v.20. Categorical data was summarized using frequency and percentage while continuous data was summarized using median and interquartile range. Association between variables was assessed using chi-square test. More than two-third of the deceased patients were male (135; 72.6%) and median age at death was 60. The majority of deaths (151; 81.1%) occurred in 2021, while April 2021 had the highest death records. Cough and shortness of breath were the main presenting symptoms occurring in 89.2% and 85.5% of deceased patients respectively. Most of the COVID-19 related deaths (64.5%) had associated comorbidities. Diabetes (50%) and Hypertension (39.2%) were the most prevalent comorbidities. Significant proportion of patients (74.73%) presented on severe end of disease spectrum (critical/ severe). Of the deceased patients, around two-third required Intensive care unit (ICU) admission and 111 of them were put on mechanical ventilator. Moreover, the median ICU stay was 4 days. Around half of the death (48.4%) occurred in the first 5 days. The median survival time from symptom onset was 11.5 days with most (43.5%) of the deaths occurring within the first 14 days of symptom onset. Age category was significantly associated with the number of days from onset to death (p=0.006). The case fatality rate was 1.87% which is lower than national and global reports. Unlike previous studies, the prevalence of asthma among deceased patients was low and there were no patients with documented COPD.
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Open Access March 05, 2026

For My Family, I Take It’: A Phenomenological Study of Antihypertensive Medication Use Among Filipino Adults

Abstract Hypertension remains a leading cause of cardiovascular morbidity and mortality. Although effective antihypertensive therapies are available, sustained blood pressure control remains suboptimal due to inconsistent medication use. Most adherence research is quantitative and offers limited understanding of how individuals interpret lifelong treatment within daily life, particularly in culturally [...] Read more.
Hypertension remains a leading cause of cardiovascular morbidity and mortality. Although effective antihypertensive therapies are available, sustained blood pressure control remains suboptimal due to inconsistent medication use. Most adherence research is quantitative and offers limited understanding of how individuals interpret lifelong treatment within daily life, particularly in culturally grounded contexts. To explore the lived experiences of Filipino adults taking antihypertensive medication. A qualitative study grounded in Heideggerian interpretive phenomenology was conducted. Ten Filipino adults diagnosed with hypertension were purposively recruited from outpatient clinics in Manila, Philippines. In-depth semi-structured interviews were transcribed verbatim and analyzed using the six-step IPA framework. Analysis revealed six interconnected themes describing how participants interpreted and sustained medication use: (1) Diagnosis as Disruption; (2) Medication as Protection and Responsibility; (3) The Paradox of the Silent Illness; (4) Everyday Barriers to Sustained Treatment; (5) Constructing Routine and Adaptive Self-Management; and (6) Family as Anchor within Cultural Contexts. These themes reflected emotional adjustment, symptom-driven adherence, financial and work-related barriers, adaptive coping strategies, and strong family-centered motivation. Medication-taking was experienced as an ongoing negotiation shaped by bodily cues, daily demands, and relational obligations. Conclusion: Antihypertensive medication use is shaped by relational, cultural, and socioeconomic contexts, underscoring the need for family-inclusive and culturally responsive hypertension care.
Article
Open Access February 16, 2026

Tuberculosis among elderly patients: diagnostic and therapeutic challenges (2020-2024)

Abstract Background: Tuberculosis (TB) in the elderly poses significant diagnostic and therapeutic challenges due to immunosenescence, comorbidities, and atypical clinical presentation. This study evaluates the epidemiological and clinical characteristics of TB in patients aged ≥65 years. Methods: A retrospective descriptive study was conducted including all TB cases reported between 2020 and [...] Read more.
Background: Tuberculosis (TB) in the elderly poses significant diagnostic and therapeutic challenges due to immunosenescence, comorbidities, and atypical clinical presentation. This study evaluates the epidemiological and clinical characteristics of TB in patients aged ≥65 years. Methods: A retrospective descriptive study was conducted including all TB cases reported between 2020 and 2024. Data from the National Tuberculosis Program were analyzed for demographic characteristics, clinical form, bacteriological confirmation, comorbidities, and treatment outcomes. Results: Of 1,335 TB cases, 352 (26.4%) occurred in individuals aged ≥65 years. Pulmonary TB accounted for 80.7% of cases. Men represented 63.4% of patients, and 56.8% lived in urban areas. Bacteriological confirmation was achieved in 82% of pulmonary cases, and treatment success exceeded 85%. Diabetes mellitus (26.5%) and arterial hypertension (31%) were the most common comorbidities. An increase in TB cases was observed in the post-COVID-19 period. A significant association was found between age and clinical form of TB (p < 0.001). Conclusions: Elderly individuals constitute a substantial proportion of TB cases and frequently present with chronic comorbidities. Despite diagnostic challenges, favorable treatment outcomes were achieved, highlighting the need for integrated and early management strategies in this population.
Brief Report
Open Access November 28, 2025

Determinants of the Carotid Tortuosity Index: Evidence from Digital Subtraction Angiography

Abstract Introduction: Stroke remains one of the leading causes of death and disability worldwide, with ischemic stroke accounting for most cases. Structural vascular factors such as carotid artery tortuosity have gained attention as potential markers of vascular aging and cerebrovascular risk. The carotid tortuosity index (CTI), defined as the ratio of actual vessel length to the straight-line [...] Read more.
Introduction: Stroke remains one of the leading causes of death and disability worldwide, with ischemic stroke accounting for most cases. Structural vascular factors such as carotid artery tortuosity have gained attention as potential markers of vascular aging and cerebrovascular risk. The carotid tortuosity index (CTI), defined as the ratio of actual vessel length to the straight-line distance between two fixed points, provides a quantitative measure of arterial curvature. A CTI value of ≥1.2 indicates pathological tortuosity. Although noninvasive modalities such as CTA and MRA are frequently used, digital subtraction angiography (DSA) remains the gold standard for evaluating vessel geometry due to its higher spatial precision. This study aimed to determine the association of age, sex, and hypertension with CTI measured by DSA. Methods: A cross-sectional study was conducted from November to December 2025 at the Neurointervention Clinic, RS Pelni Jakarta, Indonesia, involving 61 adult patients who underwent carotid DSA. CTI was measured bilaterally using digital imaging software and classified as <1.2 (non-tortuous) or ≥1.2 (tortuous). Clinical data, including age, sex, and hypertension status, were collected from medical records and analyzed using bivariate tests. Results: Older age (≥65 years), female sex, and hypertension were significantly associated with higher CTI values on both carotid sides. Tortuosity was more common among hypertensive patients and elderly females, indicating the influence of vascular remodeling and chronic hemodynamic stress. Conclusion: Carotid tortuosity increases with age, hypertension, and female sex. DSA-based CTI measurement provides a reliable and precise approach for evaluating vascular changes associated with cerebrovascular risk.
Article
Open Access January 23, 2025

Diminished Returns of Educational Attainment on Hypertension Prevalence among American Indian and Alaska Native Adults: National Health Interview Survey 2023

Abstract Background: Research on Minorities’ Diminished Returns (MDRs) consistently reveals that social determinants of health, especially educational attainment, do not yield equal health benefits across racial and ethnic groups in the United States. MDRs suggest that social stratification, segregation, lower education quality, and labor market discrimination contribute to diminished health returns [...] Read more.
Background: Research on Minorities’ Diminished Returns (MDRs) consistently reveals that social determinants of health, especially educational attainment, do not yield equal health benefits across racial and ethnic groups in the United States. MDRs suggest that social stratification, segregation, lower education quality, and labor market discrimination contribute to diminished health returns of education among minoritized groups. However, few studies have tested the relevance of MDRs in American Indian and Alaska Native (AIAN) populations compared to non-Hispanic White adults. Objectives: This study aimed to examine the strength of the inverse association between educational attainment and hypertension prevalence, hypothesizing that the protective effect of education on hypertension risk is reduced among AIAN adults relative to non-Hispanic Whites. Methods: Using data from the 2023 National Health Interview Survey (NHIS), we analyzed a nationally representative sample of adults aged 18 and older. Logistic regression models examined the association between educational attainment and self-reported hypertension diagnosis, stratified by racial/ethnic group (AIAN vs. non-Hispanic White). Models were adjusted for key covariates, including age, gender, income, and insurance status. Results: Higher educational attainment was associated with a lower prevalence of hypertension in the combined sample of AIAN and non-Hispanic White adults. However, this protective association was significantly weaker among AIAN adults compared to non-Hispanic White adults, as evidenced by a significant interaction between race and education. Conclusion: AIAN adults exhibit a higher prevalence of hypertension even at higher levels of educational attainment compared to non-Hispanic White adults, supporting the relevance of MDRs for AIAN populations. This finding underscores the need for public health interventions that address structural barriers and contextual factors unique to AIAN populations. Policies focused solely on educational access may be insufficient to reduce hypertension risk among AIAN adults without addressing broader social and structural inequities.
Article
Open Access December 04, 2023

The Effect of Nutrition on the Autonomous Nervous System: A Systematic Review

Abstract Nutrition plays a key role in regulating the autonomic nervous system (ANS), which is responsible for controlling involuntary bodily functions such as heart rate, breathing, digestion and body temperature. Some nutrients, such as amino acids, vitamins and minerals, have a specific role in the ANS. For example, amino acids are necessary for the synthesis of neurotransmitters, such as serotonin and [...] Read more.
Nutrition plays a key role in regulating the autonomic nervous system (ANS), which is responsible for controlling involuntary bodily functions such as heart rate, breathing, digestion and body temperature. Some nutrients, such as amino acids, vitamins and minerals, have a specific role in the ANS. For example, amino acids are necessary for the synthesis of neurotransmitters, such as serotonin and dopamine, which regulate mood and anxiety. Vitamins and minerals are important for the proper functioning of the ANS, such as vitamin B12, magnesium and zinc. A balanced diet can help reduce oxidative stress and inflammation, which can negatively affect ANS functioning. On the other hand, a nutrient-poor diet can lead to dysfunctions in the ANS, such as hypertension, changes in heart rate and digestive disorders. Digestive problems such as constipation, diarrhea, irritable bowel syndrome (IBS) and functional dyspepsia can occur when the ANS is not working properly. It is important to maintain a healthy and balanced diet to ensure the proper functioning of the autonomic nervous system.
Systematic Review
Open Access June 28, 2022

A Case Report of Sagittal Sinus Thrombosis and Pulmonary Embolism in an Asymptomatic SARS-CoV-2 Infection

Abstract Background: Vascular thrombotic events such as pulmonary embolisms have been frequently reported in the course of SARS-Cov-2 infection. However, sagittal sinus thrombus is extremely rare, and patients may lack other appealing Covid-19 infection symptoms. Case report: 46-year-old female with past medical history of Hyperlipidemia, Hypertension presented to [...] Read more.
Background: Vascular thrombotic events such as pulmonary embolisms have been frequently reported in the course of SARS-Cov-2 infection. However, sagittal sinus thrombus is extremely rare, and patients may lack other appealing Covid-19 infection symptoms. Case report: 46-year-old female with past medical history of Hyperlipidemia, Hypertension presented to Emergency room with headache, chest pain, vomiting. SARS-CoV-2 IgG Antibodies were reactive. Except for elevated PTT-Lupus Anticoagulant at 50 Sec, Hypercoagulable workup was negative. The MRI venogram findings were consistent with the Dural thrombus of superior sagittal sinus. Patient subsequently developed chest pain, and Computed tomography angiography found pulmonary emboli within segmental branches of the right lower lobe pulmonary artery. Patient was managed in the ICU with Heparin and switched to Coumadin for discharged. Conclusion: The incidence of Cerebral Venous Sinus thrombus (CVST) among Covid-19 patients is inferior to 0.02%. And most of the patients lack typical Covid-19 presentations such as pneumonia. The lack of symptoms may promote the insidious course of pre-thrombotic events that lead to CVST. However more Retrospective studies are necessary to established consistent odd ratios. Due to the higher mortality associated with CVST and the ongoing of Covid-19 pandemic, we recommend a higher level of clinical suspicion.
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Case Report
Open Access February 10, 2022

A Retrospective, Cross-sectional Hospital-based Study to Determine the Epidemiological, Clinical and Comorbidity Characteristics in Older Adults with Psoriasis

Abstract Background: Psoriasis is extensively studied among middle-aged adults, but not many have studied psoriasis in older adults(geriatrics). OBJECTIVES: To analyze epidemiological, clinical, comorbidities and therapeutic profile of geriatric psoriasis(GP). METHODS: All consenting clinically diagnosed psoriatic patients ≥60 years were divided into two groups: Elderly psoriatic(EP)(60-75 years) [...] Read more.
Background: Psoriasis is extensively studied among middle-aged adults, but not many have studied psoriasis in older adults(geriatrics). OBJECTIVES: To analyze epidemiological, clinical, comorbidities and therapeutic profile of geriatric psoriasis(GP). METHODS: All consenting clinically diagnosed psoriatic patients ≥60 years were divided into two groups: Elderly psoriatic(EP)(60-75 years) and Ultra elderly psoriatic(UP)(>75 years). The dermatologist filled their clinical characteristics’ standardised questionnaire to determine comorbidities, drug interactions profile and compared with age-matched controls using Chi square test. RESULTS: Prevalence of GP is 14.5%(Average age:68 years; Sex ratio=2.5:1)among geriatrics attending dermatology OPD. Most common(49.9%) as well as initial site affected(39.3%) were Palms±Soles. Nummular plaque (90.2%) was most common type. Superficial fungal infection(26.9%) and pruritus(90.8%) were commonly associated cutaneous disease and symptom(p<0.05) respectively. Hypertension(49.7%),Diabetes Mellitus(22.8%), dyslipidemia(25.8%) and Metabolic syndrome(MS)(17.8%) were associated systemic comorbidities. Dyslipidemia and MS(p<0.0001) were more common among GP(163) than controls(963). Drug aggravated psoriasis could not be linked to polypharmacy. Although, topicals were mainstay, oral Methotrexate was most efficacious systemically. CONCLUSION: Our findings suggest a trimodal age of psoriasis onset at 68 years. As age advances, psoriasis severity decreases, unstable guttate lesions decrease; palms±soles commonly involved; infrequent familial occurrence with Polypharmacy not aggravating psoriasis. Active screening for cardiovascular comorbidities in all geriatric psoriasis patients is highly recommended.
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Open Access December 25, 2021

Contributions of Physical Activity in Individuals with a Diagnosis of Depression: A Literature Review

Abstract This study is a literature review with a qualitative approach. It is justified by the significant increase in diseases acquired through lifestyle habits that generate health risks, which impair and are responsible for decreasing longevity and decreasing quality of life, such as hypertension, depression, obesity and respiratory tract diseases. Physical activity is recognized as a protective factor [...] Read more.
This study is a literature review with a qualitative approach. It is justified by the significant increase in diseases acquired through lifestyle habits that generate health risks, which impair and are responsible for decreasing longevity and decreasing quality of life, such as hypertension, depression, obesity and respiratory tract diseases. Physical activity is recognized as a protective factor for health, and its benefits are associated with the reduction of chronic diseases and a decrease in the risk of premature death from diseases related to a sedentary lifestyle. The objective of this research is to search and identify, within the scientific literature, if there are in fact contributions from the practice of physical activity in subjects diagnosed with depression. For the categorization of studies and selection of materials, the following keywords were determined: physical exercise and depression and physical activity and depression. As inclusion criteria for data analysis and interpretation, the following were considered: articles in Portuguese, full texts, published in health journals, between the years 2005 to 2015. As exclusion criteria, we considered articles found by descriptors that did not contain one or more of the inclusion criteria. In this study, articles were selected by searching the Scientific Electronic Library Online (SciELO) and Lilacs. The choice of these databases was prioritized due to the quality and reliability of the materials available, and their easy access. 77 articles were found, of which 4 were selected to be part of this research. It can be noted that physical activity showed positive aspects and possible contributions and can be considered as a bias in an adjunct to conventional pharmacological treatments. The need for further clarification about the disease in relation to psychological, social and physiological issues is also evident, thus opening the possibility for further studies and research on the subject, so that in this way they can guide possible interventions that help in the treatment of the depression.
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