Even though depression is one of the most common psychiatric disorders, it is under-recognized in hemodialysis (HD) patients. Existing literature does not provide enough information on evaluation of predictors of depression among HD patients. The objective of the current study was to determine the prevalence and predictors of depression among HD patients. A multicenter prospective follow-up study. All eligible confirmed hypertensive HD patients who were consecutively enrolled for treatment at the study sites were included in the current study. HADS questionnaire was used to assess the depression level among study participants. Patients with physical and/or cognitive limitations that prevent them from being able to answer questions were excluded. Two hundred twenty patients were judged eligible and completed questionnaire at the baseline visit. Subsequently, 216 and 213 patients completed questionnaire on second and final follow up respectively. The prevalence of depression among patients at baseline, 2nd visit and final visit was 71.3, 78.2 and 84.9% respectively. The results of regression analysis showed that treatment given to patients at non-governmental organizations (NGO’s) running HD centers (OR = 0.347, p-value = 0.039) had statistically significant association with prevalence of depression at final visit. Depression was prevalent in the current study participants. Negative association observed between depression and hemodialysis therapy at NGO’s running centers signifies patients’ satisfaction and better depression management practices at these centers.

Existing literature does not provide enough information on evaluation of factors associated with pre-dialysis controlled hypertension among euvolemic hemodialysis (HD) patients. We conducted a study to evaluate the rate and factors influencing pre-dialysis controlled hypertension among euvolemic HD patients. A multicenter prospective follow-up study. Tertiary care teaching hospital and its associated private dialysis centers. This study included 145 euvolemic eligible hypertensive patients. Various sociodemographic, clinical factors and drugs were investigated and analyzed by using appropriate statistical methods to determine the factors influencing hypertension control among the study participants. On baseline visit, the mean pre-dialysis systolic and diastolic BP (mmHg) of study participants was 161.2 ± 24. and 79.21 ± 11.8 retrospectively, and 30 (20.6%) patients were on pre-dialysis goal BP. At the end of the 6-months follow-up, the mean pre-dialysis systolic BP and diastolic BP (mmHg) of the patients was 154.6 ± 18.3 and 79.2 ± 11.8 respectively, and 42 (28.9%) were on pre-dialysis goal BP. In multivariate analysis, the use of calcium channel blockers (CCBs) was the only variable which had statistically significant association with pre-dialysis controlled hypertension at baseline (OR = 7.530, p-value = 0.001) and final (OR = 8.988, p-value < 0.001) visits. In present study, the positive association observed between CCBs and controlled hypertension suggests that CCBs are effective antihypertensive drugs in the management of hypertension among euvolemic HD patients. This study involved a group of patients from tertiary-level teaching hospital and its associated private dialysis centers of Malaysia. To the best of the authors’ knowledge, this is the first study to assess the factors influencing pre-dialysis controlled hypertension in a cohort of 145 euvolemic HD patients in a Malaysian setting. For determining the factors influencing hypertenion control multivariate analysis was conducted. Being a prospective follow-up study, the findings of the present study need to be interpreted with caution since it is limited to only 6 months follow up. Nevertheless, a multicenter study with a large sample size and longer follow up time is needed to confirm the findings of the current study. This study involved a group of patients from tertiary-level teaching hospital and its associated private dialysis centers of Malaysia. To the best of the authors’ knowledge, this is the first study to assess the factors influencing pre-dialysis controlled hypertension in a cohort of 145 euvolemic HD patients in a Malaysian setting. For determining the factors influencing hypertenion control multivariate analysis was conducted. Being a prospective follow-up study, the findings of the present study need to be interpreted with caution since it is limited to only 6 months follow up. Nevertheless, a multicenter study with a large sample size and longer follow up time is needed to confirm the findings of the current study.

Relational interaction between T-Lymphocytes and SARS-CoV-2: A review

Antimicrobial resistance (AMR) is a pressing global health challenge, particularly affecting low- and middle-income countries (LMICs). This study aims to evaluate the spread of AMR both across time and across the different regions of the world. We analysed the clinical isolates from 65 countries. A country specific time series forecasting i.e., SARIMA, LSTM, and SARIMA-LSTM hybrid models was performed for Acinetobacter baumannii in Argentina (2004-2030) as a case study to demonstrate model applicability for national level prediction. Moreover, Interrupted Time Series (ITS) regression was applied to predict antibiotic resistance trends and assess the global impact of National Action Plans (NAPs). Southeast Asia and Africa exhibited the highest AMR burdens, with Indonesia (0.65), Egypt (0.52), and Malawi (0.49) with highest resistance scores. An income-based gradient was observed across key pathogens, third-generation cephalosporin and carbapenem-resistant Escherichia coli, Klebsiella pneumoniae, and Acinetobacter baumannii were significantly more prevalent in LMICs. Gender-wise analysis revealed significantly higher resistance rates in males across most antibiotics, especially levofloxacin. Age-stratified analyses revealed higher resistance in elderly populations, particularly to fluoroquinolones and β-lactams. Forecasting for A. baumannii in Argentina (2004-2030) indicated a continued upward resistance across β-lactam and fluoroquinolones, with LSTM achieving the lowest RMSE across five antibiotics. The ITS revealed a pre-NAP decline but no significant post-implementation change. This study provides a comprehensive data-driven framework to monitor and forecast AMR, evaluate policy interventions, and hence suggest targeted intervention and strategies for each income group and region and moving beyond "one-size-fits-all" approach.

Background: Hypertension is highly prevalent and uncontrolled among hemodialysis patients. In Pakistan published data does not provide enough information about the management and factors associated with uncontrolled hypertension in hemodialysis patients. Objective: This study was conducted to evaluate the factors influencing the pharmacotherapeutic management and control of hypertension in hemodialysis patients. Methods: A prospective follow-up study was conducted on hemodialysis patients who were enrolled at study sites between 1 June 2020 and 31 December 2020. The predialysis blood pressure (BP) readings were recorded as mean SBP and DBP at baseline and for each of 6 months. Multivariate analyses were applied to analyze the factors associated with uncontrolled hypertension in hemodialysis patients. Results: The average predialysis BP (SBP and DBP) of study participants at baseline visit was 158.41 and 87.22 mmHg respectively. After 6 months the study participants have 150.27 mmHg and 80.03 mmHg average predialysis SBP and DBP respectively. Only 28.1% of hemodialysis patients were on target BP after 6 months. Results of multivariate analysis have shown that the use of beta-blockers and calcium channel blockers (CCBs) were significantly associated with hypertension control at baseline [odds ratio (OR) = 1.432, P value = 0.034] (OR = 1.499, P value = 0.045) and at after 6 months (OR = 2.824, P value = 0.015) (OR = 1.883, P value = 0.032). Conclusion: This study revealed that among the antihypertensive drugs, CCBs and beta-blockers provided better management in controlling hypertension among hemodialysis patients.