by Tujuba Ayele Tesso, Limatu Kebede Nurgi

by Mohammad Sabeeh Ul Haq, Dua Nilofar Jawed, Nehrish Patel, Waqar Khan, Aisha Alamgir, Shagufta Yamin, Rabia Anwar, Tafazzul Hyder Zaidi, Munawar Khursheed

This study aimed to investigate levels of anxiety/anxiety symptoms and coping methods employed among patients suffering from myocardial infarction admitted in a tertiary care setting in a developing country. It also aimed to study the relationship of anxiety levels and coping strategies with each other and also the influence of various socio-demographic factors on anxiety levels and coping strategies used by the patients.

A cross-sectional study was conducted at National Institute of Cardiovascular Disease (NICVD), Karachi, Pakistan involving 203 patients diagnosed with myocardial infarction. Sampling was conducted by non-probability convenience method. Patients were asked to fill a questionnaire comprising a socio-demographic form, HAM – A scale for anxiety symptoms and brief COPE scale for coping methods. Statistical analysis was performed using independent t-test, ANOVA, MANOVA, Pearson correlation and multiple regressions.

Study comprised 203 patients (134 male, 69 female), 36.9% of the patients showed anywhere from moderate to severe levels of anxiety. Gender, history of myocardial infarction, family visits and hospital satisfaction were found to have statistical significance in influencing mean HAM – A scores among the population. Significant differences in problem focused coping was found among different gender and socio economic classes, while avoidance focused coping differences were found between patients receiving family visits and drug users as well as perceived hospital satisfaction. Hospital satisfaction also influenced emotional focused coping.

This research highlights the importance of providing integrated psychological support for patients with myocardial infarction, specifically on anxiety and coping methods. By examining these factors, we can better understand how they influence mental health outcomes. Addressing anxiety and enhancing effective coping strategies are crucial for improving overall recovery and quality of life for these patients.

by Xiaoyu Li, Xiaodong Wang, Xuan Liao

by Sylvie Nguyen, Jeanne Godon, Jean-Paul Pais de Barros, David Masson, Lionel Piroth, Mathieu Blot, Meningotoxemia collaboration group

Lipopolysaccharide (LPS) is a major virulence factor during both meningococcal and Haemophilus influenzae meningitis. Pneumococcus does not produce LPS but could be responsible for bacterial digestive translocation as a consequence of sepsis. We addressed this question in the context of pneumococcal meningitis.

A cross-sectional study on 24 patients with pneumococcal meningitis (20 (83%) admitted in intensive care unit, 4 (17%) with septic shock) and 34 prospectively-enrolled healthy volunteers. Interleukin 6 and C-reactive proteins plasma concentrations were measured as markers of systemic inflammation. Endotoxemia was measured using mass spectrometry (LC-MS/MS) for detection of molecules bound to the lipid A, namely 3-OH fatty acids.

Meningitis patients had significantly higher levels of plasma C-reactive protein (237 (74–373) vs. 2 (2–2) mg/l, p < 0.001 and interleukin 6 (43 (13–128) vs. 4.6 (4.6–16.6) pg/ml; p < 0.001) than healthy volunteers. However, we observed no significant difference in plasma lipopolysaccharide concentrations between patients and healthy volunteers (674 (554–896) vs. 668 (623–777) pmol/ml; p = 0.546).

Our results suggest that LPS is not a key determinant of the excessive inflammation associated with severe forms of pneumococcal meningitis.

by Essa Tawfiq, Muhammad Haroon Stanikzai, Massoma Jafari, Zarghoon Tareen, Sayed Ali Shah Alawi, Zainab Ezadi, Abdul Wahed Wasiq, Omid Dadras

Mother-newborn skin-to-skin contact (SSC) involves placing the naked infant on the mother’s bare chest within the first hour of birth and is crucial for thermoregulation, bonding, breastfeeding initiation, and promoting neonatal health. This study examined the prevalence, and factors associated with SSC in Afghanistan.

Data from the Afghanistan Multiple Indicator Cluster Survey (MICS) 2022–23 were used and analysed from ever-married women, aged 15–49 years, who delivered a live infant in the past 2 years. The outcome was SSC, placing the naked infant on the mother’s bare chest and initiating breastfeeding within the first hour of birth. Adjusted odds ratios [AOR: (95%CI)] of factors associated with SSC were obtained by a logistic regression model.

Of 11,992 women, 32.9% practiced SSC. The likelihood of SSC was greater in women with primary [1.38 (1.14–1.68)] and secondary or higher [1.29 (1.06–1.57)] education, in women who had access to media [1.36 (1.11–1.65)], and those who owned mobile phones [1.27 (1.11–1.45)]. The likelihood of SSC was lower in women who delivered at home [0.26 (0.21–0.33)], those who delivered at private clinics or hospitals [0.50 (0.41–0.61)], and those with cesarean section [0.12 (0.08–0.17)]. Women living in rural areas, and women with deliveries conducted by traditional birth attendants/community healthcare workers and by relatives/others had lower odds of SSC [0.76 (0.63–0.92), 0.37 (0.27–0.53), 0.45 (0.33–0.59), respectively].

The low prevalence of SSC in Afghanistan highlights the need for targeted health interventions. Efforts should focus on improving access to public clinics and hospitals, enhancing education, training of healthcare providers, and leveraging media and mobile phone access to promote SSC. Interventions should prioritize rural women and women who have undergone cesarean sections to increase SSC rates and improve neonatal health outcomes.