Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.

Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

I first read Davidson 30 years ago: at that time it was already in its 5th edition. A brief comparison shows that it then contained about 440,000 words in 1,100 pages: the current edition has compressed 625,000 words into 800 pages. I think I bought it as a student because it was cheap: but also because it seemed to be comprehensive and straightforward, and I have used it as a basis for my medical knowledge ever since. So I miss some of the old pictures of the acute skin rashes such as scarlet fever: in fact infectious disease has been transferred to the back and genetic factors take the first chapters. But careful linguistic comparison will still uncover the old phrases which some of us know by heart-there are minor changes such as 'alarming reactions to intravenous iron are uncommon, but have occasionally been noted', which becomes 'alarming systemic anaphyllactic reactions can occur'. Sir Stanley Davidson made 'no attempt to describe every rare disease or syndrome, but devoted most of the space available to those disorders most commonly encountered in practice'. I have grown up with successive editions, and have gradually come to appreciate the problems of the authors in the compression of knowledge. Having got to know many of them personally as real people rather than as names I can still recommend the book. It is the essential starting point for the study of internal medicine and for many doctors will remain their base reference work. The present editors have kept up-to-date and been prepared to prune the dead wood. There are many competitors in the market, and the publishers must take care with layout and illustration, although Davidson is still the best value for money. I will continue to recommend it to my clinical students: they will need to read it and know it to pass final MB. Postgraduates will need to remember the facts, but also to be able to place them in a broader perspective. The older consultant will still happily read it, and to get to know the authors themselves is really to complete your medical education. Dr John Macleod and his team have successfully kept alive the primary objective 'to provide a rational and easily comprehensible basis for the practice of medicine'. The book is economical in price and compact in size, but still contains the essential truths for the practice of good medicine.

Davidson's Principles and Practice of Medicine

It is time to face the evidence of a worldwide unsustainable food system. Its complexity makes it extremely fragile to any climatic, socio-economic, political or financial crisis. Thus, we urgently need appropriate understanding and new strategies to really accommodate present and future population needs and well-being. In that context, we need sustainable diets, with low-input, local and seasonal agro-ecological food productions as well as shortdistance production-consumption nets for fair trade. Cultural heritage, food quality and culinary skills are other key aspects determining sustainable dietary patterns and food security. Nutrition education about appropriate food choices remains essential everywhere. It thus appears very urgent to profoundly change our food strategy and to promote fair, culturally-appropriated, biodiversity-based, ecofriendly, sustainable diets. Authorities should urgently assume their responsibilities by orienting and supporting the appropriate and sustainable foodstuff productions and consumptions in all parts of the world.

Sustainable Diets and Biodiversity: Directions and Solutions for Policy, Research and Action. International Scientific Symposium, Biodiversity and Sustainable Diets United Against Hunger, FAO Headquarters, Rome, Italy, 3-5 November 2010.

Overweight is increasing in transition countries, while iron deficiency remains common. In industrialized countries, greater adiposity increases risk of iron deficiency. Higher hepcidin levels in obesity may reduce dietary iron absorption. Therefore, we investigated the association between body mass index (BMI) and iron absorption, iron status and the response to iron fortification in populations from three transition countries (Thailand, Morocco and India). In Thai women (n=92), we examined the relationship between BMI and iron absorption from a reference meal containing ∼4 mg of isotopically labeled fortification iron. We analyzed data from baseline (n=1688) and intervention (n=727) studies in children in Morocco and India to look for associations between BMI Z-scores and baseline hemoglobin, serum ferritin and transferrin receptor, whole blood zinc protoporphyrin and body iron stores, and changes in these measures after provision of iron. In the Thai women, 20% were iron deficient and 22% were overweight. Independent of iron status, a higher BMI Z-score was associated with decreased iron absorption (P=0.030). In the Indian and Moroccan children, 42% were iron deficient and 6.3% were overweight. A higher BMI Z-score predicted poorer iron status at baseline (P<0.001) and less improvement in iron status during the interventions (P<0.001). Adiposity in young women predicts lower iron absorption, and pediatric adiposity predicts iron deficiency and a reduced response to iron fortification. These data suggest the current surge in overweight in transition countries may impair efforts to control iron deficiency in these target groups. Interactions of the ‘double burden’ of malnutrition during the nutrition transition may have adverse consequences.

Adiposity in women and children from transition countries predicts decreased iron absorption, iron deficiency and a reduced response to iron fortification

Human Cognitive Abilities

Objective: To determine the prevalence of anaemia and factors associated with iron deficiency among school children in rural Kenitra, Morocco. Methods: 295 students between 6 and 16 years old composed the study group. The level of haemoglobin was measured in a group of 295 school children. The iron status was determined by ferritin level in serum, and anaemia was defined when haemoglobin Keywords : Anaemia, Iron deficiency, Serum ferritin, School children, Morocco East African Journal of Public Health Vol. 5 (2) 2008: pp. 62-66

Risk Factors of Anaemia Among Rural School Children in Kenitra, Morocco

Introduction Confinement, because of the COVID-19 pandemic, could have problems on the mental health of the population Teachers responsible for giving distance courses during this period could be psychologically stressed The aim is to assess the magnitude results of burnout and associated factors among primary school teachers in Kenitra in Morocco during this confinement period
 Methods
 This is a cross-sectional study, which was conducted during the two months of April and May 2020 Burnout was evaluated by the Maslach Burnout Inventory MBI with 16 items, specific to the context of Moroccan teachers and the factors of stress were assessed using a questionnaire developed by the research team We used the Chi-square test to determine the association between two qualitative variables anda logistic regression for an overall statistical analysis
 Results
 The average age was 386 ± 99 years The MBI revealed that 68 teachers (54%) were victims of burnout, of which 47 (38%) had a low level; 15 (12%) had a moderate level and six (5%) had a severe burnout Logistic regression analysis has shown that the risk factors for burnout during this confinement period are: the use and development of skills in new information and communication technologies (p<0,05); work/family conflict (p<0,05); social support (p<0,05); and the workload related to distance education (p≤0,05)
 Conclusion
 In light of these results, interventions aimed at promoting mental well-being teachers during and after confinement should be implemented immediately

Assessment of burnout among primary teachers in confinement during the covid-19 period in morocco: Case of the kenitra

Iron deficiency anaemia is the major public health problem encountered in the world. In Children this trouble has deleterious consequences on the global health and weak cognitive development. This study aims to determine the prevalence of anaemia and iron deficiency and its association with socio-economic and anthropometric parameters of the Schoolchildren in a rural coastal region of Morocco. 295 students between 6 and 16 years old composed the study sample. The level of Haemoglobin was measured in a sub group of 280 school children. The iron status was determined by ferritin level in serum. A questionnaire was developed to collect information on the socio-economic and demographic status of the family such as the size of household the working status of parents and their level of education. The mean haemoglobin concentration was 12.41 g/dl in boys and 12 5 g/dl in girls whereas the mean seric ferritin level was 26 7 microg/l in boys and 27 9 microg/l in girls. The overall prevalence of anaemia was 12 2 % and iron deficiency was found in 20.4 %. Serum ferritin (SF) serum iron concentrations and mean corpuscular volume (MCV) were significantly correlated with Hemoglobin There was an inversely significant relationship between education of the mother and anaemia in children (p=0.01) but not with gender nor parents employment. It is concluded that anaemia is relatively less prevalent in this study population. Further studies are needed to explore the dietary determinants of this situation. (authors)

/pdf/iron-deficiency-and-anaemia-in-rural-school-children-in-a-z3jay1n632.pdf

Iron deficiency and anaemia in rural school children in a coastal area of Morocco.

Iron deficiency anaemia is an important health problem in Morocco. This study was conducted to estimate the prevalence of anaemia among school children in Kenitra. The sample represents school children of all educational levels and age ranged between 6-15 years. The level of hemoglobin, haematocrit, mean corpuscular volume, mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration was measured in a group of 271 school children. The seric iron was assessed and anaemia was defined when hemoglobin < 11.5 g dL(-1). A questionnaire was developed to obtain information about the daily food consumption and socio-economic conditions. The prevalence of anaemia was 16.2%. The mean hemoglobin concentration was 12.53 g dL(-1) in boys and 12.52 g dL(-1) in girls. The results suggest that iron deficiency is an important determinant of anaemia in this population. There was a significant relationship between education of the mother and anaemia in children (p = 0.004) but not with the family income. It is concluded that improving the economic status of the family, women education and health education about balanced animal and plant food consumption are recommended strategies to reduce the burden of anaemia.

https://docsdrive.com/pdfs/ansinet/pjbs/2015/191-195.pdf

Prevalence of Iron Deficiency Anaemia Among School Children in Kenitra, Northwest of Morocco.

The aims of this study was to investigate the impact of aluminum nitrate administered in drinking water during 90 days (sub-chronic toxicity), on body weight gain, motor activity, brain aluminum accumulation and especially in recognition memory of wistar rats. Two groups of young female wistar rats were used. Treated rats received (80 mg L(-1)) of aluminum nitrate diluted in drinking water, while control rats received a drinking water only, for 3 months. An evolution of body weight, a motor activity, object recognition memory (NOR) and brain aluminum concentration has been evaluated. The body weight was taken weekly, whereas the memory abilities and the motor activity are measured once every fortnight alternatively, by submitting rats to the open field test and to the novel object recognizing memory test. The results have showed a significant decrease in rats' body weight (p < 0.05). Though, no significance was registered for motor activity. Nevertheless, a high significance is showed for recognition memory compared to control rats (p < 0.01), especially at the end of testing period, even the difference between control and aluminium treated rats in brain aluminum levels was not significant.

Ahmed Omar Touhami Ahami

Papers

Risk Factors of Anaemia Among Rural School Children in Kenitra, Morocco

Assessment of burnout among primary teachers in confinement during the covid-19 period in morocco: Case of the kenitra

Iron deficiency and anaemia in rural school children in a coastal area of Morocco.

Prevalence of Iron Deficiency Anaemia Among School Children in Kenitra, Northwest of Morocco.

Impact of aluminum sub-chronic toxicity on body weight and recognition memory of wistar rat.