Interventional Pain Management in Trauma: Bridging Acute Injury, Critical Care and Chronic Pain | Chapter 7 | An Overview of Disease and Health Research Vol. 9

Interventional Pain Management (IPM) has emerged as an integral component of modern trauma anaesthesia, particularly in the care of patients with neurotrauma. Traumatic injuries to the nervous system are frequently associated with complex pain syndromes that extend beyond the acute phase and may progress to chronic, function-limiting pain. Reliance on systemic pharmacological therapy alone is often insufficient and may adversely affect neurological assessment, haemodynamic stability, and long-term functional outcomes. This chapter examines the role of IPM across the continuum of neurotrauma and trauma care, including the acute perioperative period, intensive care management, rehabilitation, and chronic pain treatment. Emphasis is placed on the neurobiological mechanisms of trauma-related pain, rational selection of interventional techniques, and safety considerations unique to neurologically vulnerable and critically injured patients. Integration of IPM within a multidisciplinary trauma care framework is presented as a key strategy to enhance patient outcomes and quality of life.

 

 

Author(s) Details

Sony Sony
All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.

 

Shivam Shekhar
All India Institute of Medical Sciences, Deoghar, Jharkhand, India.

 

Please see the book here :- https://doi.org/10.9734/bpi/aodhr/v9/7033

Needlestick and Sharp Injuries among Healthcare Workers in the Operating Theatre| Chapter 6 | An Overview of Disease and Health Research Vol. 9

 

Introduction: The risks and leading occupational accidents that healthcare workers are exposed to include needlestick injury. Most surgeons and healthcare workers face at least one injury during their professional life, and therefore, such injuries are an important problem. The present narrative literature review was carried out to determine situations that caused needle stick injury in the operating theatre, the precautions taken to prevent these injuries and to highlight the importance of this issue in the light of the current literature. In as many as 50% of surgical operations, the mucus membranes and skin of surgical theatre personnel are in contact with patient blood. In as many as 15% of operations, needle sticks or cuts may occur, and the risk increases with procedures involving a high blood loss, longer procedures and more invasive procedures. Surgeons and primary assistants incur the greatest risk at 59.1% for operating theatre injuries. The remainder of injuries are sustained by scrub nurses (19.1%), anaesthesiologists (6.2%), circulating nurses (6%), medical students (3.1%), attendants (0.8%) and others (5.7%). The greatest risk-per-needle of sharps injury to the surgeon occurs with straight suture needles. During the suturing of muscle and fascia with curved suture needles, 59% of suture needle injuries occur. Routine use of blunt suture needles and double gloving by surgeons and healthcare workers is strongly supported for use in the operating theatre as recommended techniques to reduce sharp injuries. Under-reporting rates among surgeons mean that the true rate of sharps injuries remains undetermined, resulting in an unquantified risk to surgeons and, therefore, patients. All healthcare staff should be updated on hospital policy, and hospitals should consider designing a simplified method to ease the process of reporting sharps injuries. Although there is a low risk of transmission of blood-borne viruses with a sharps injury, the consequences of transmission are high, and the healthcare worker should report early and practice appropriate precautions.

 

Author(s) Details

Richard Wismayer
Department of Surgery, Masaka Regional Referral Hospital, Masaka, Uganda, Department of Surgery, Faculty of Health Sciences, Equator University of Science and Technology, Masaka, Uganda and Department of Surgery, Faculty of Health Sciences, Islamic University in Uganda, Kampala, Uganda.

 

Please see the book here :- https://doi.org/10.9734/bpi/aodhr/v9/7026

 

Targeting Chronic Oxidative Stress: Ozone Therapy as a Key Modulator in Restoring Redox Homeostasis | Chapter 5 | An Overview of Disease and Health Research Vol. 9

 

Chronic degenerative diseases—including cardiovascular disorders, type II diabetes, chronic obstructive pulmonary disease, and neurodegenerative conditions—constitute the leading causes of disability and mortality worldwide. These disorders share common pathogenic mechanisms, notably chronic inflammation and sustained oxidative stress, which are only partially addressed by conventional pharmacological therapies. Restoration of redox homeostasis, therefore, represents a critical unmet therapeutic objective.

 

This review examines integrative strategies aimed at modulating oxidative stress, including lifestyle interventions such as caloric restriction and regular physical exercise, as well as selected bioactive dietary compounds. While these approaches contribute to improved metabolic regulation and may enhance endogenous antioxidant defences, their efficacy is often limited by poor adherence, variable bioavailability, and modest or inconsistent clinical impact.

 

In contrast, particular emphasis is placed on controlled ozone therapy administered as major ozonated autohemotherapy, which uniquely exploits a hormetic mechanism to activate endogenous adaptive responses. When applied within a precisely defined therapeutic window, ozone does not act as a direct pharmacological agent but as a transient oxidative stimulus, generating secondary messenger molecules such as hydrogen peroxide and lipid-derived electrophiles. These signals activate key cytoprotective pathways, most notably the Nrf2-dependent phase II antioxidant and detoxification system, leading to enhanced redox balance, modulation of chronic inflammation, and improved tissue oxygen utilisation.

 

Unlike exogenous antioxidant supplementation, which primarily affects the extracellular compartment, ozone therapy induces an intracellular adaptive response by stimulating the body’s own defence systems. This mechanistic distinction may explain its broader and more sustained effects in chronic diseases characterised by progressive oxidative stress. Clinical observations suggest that, when integrated with standard medical treatments and applied before irreversible tissue damage occurs, ozone therapy may offer meaningful functional and symptomatic benefits.

 

Importantly, the translational relevance of redox-modulation therapies depends on the adoption of standardised clinical procedures, precise dosing protocols, and appropriate regulatory oversight to ensure safety, reproducibility and clinical validity. While emerging clinical evidence suggests that controlled ozone therapy may integrate conventional treatments in selected chronic degenerative conditions, further well-designed clinical trials and harmonised guidelines are required before broader clinical implementation.

 

 

Author(s) Details

Emma Borrelli
Neurosurgical Unit, Public Outpatient Clinic of Ozone Therapy, University Hospital Le Scotte, Siena, Italy.

 

Please see the book here :- https://doi.org/10.9734/bpi/aodhr/v9/7024

Tubercular Osteomyelitis of the Skull in a 14-Year-Old Female: A Rare Case Report and Review of the Literature| Chapter 4 | An Overview of Disease and Health Research Vol. 9

 

Background: Skeletal tuberculosis constitutes about 1٪ of all cases. Usually, spine and limb bones are involved. Tuberculosis is endemic in many developing countries, including Bangladesh, where the disease remains highly prevalent. Tubercular osteomyelitis of the skull is a rare entity; therefore, diagnosis is rarely suspected. Given the rarity of the condition, only a few patients with Tubercular osteomyelitis of the skull have been reported in the medical literature.

 

Case Report: This chapter reports one such rare case of an atypical calvarial skull osteomyelitis in a 14-year-old female who presented with swelling on the right frontoparietal region for 3 months. CT scan of the brain and bony window revealed a lytic bony lesion at the right parietal bone with an associated epidural soft tissue component at the right parietal top, causing compression over adjacent parenchyma- possibly eosinophilic granuloma or chronic osteomyelitis. Haematological test reveals no abnormality except ESR 61mm in 1st hour with a normal chest X-ray. The patient was treated surgically by excision of the lesion with cranioplasty using synthetic bone cement. After surgical treatment, the specimen was sent for histopathology, which showed granulomatous inflammation histologically consistent with tuberculosis. She was treated with antitubercular therapy as per the national tuberculosis guideline.

 

Conclusion: Our Case highlights all these aspects of skull tuberculosis with a review of the available literature relevant to skull tubercular osteomyelitis.

 

 

Author(s) Details

Mohammad Humayun Rashid
Department of Neurosurgery, East West Medical College & Hospital, Dhaka, Bangladesh.

 

Rashed Mahmud
Department of Neurosurgery, East West Medical College & Hospital, Dhaka, Bangladesh.

 

Md. Wasiul Alam Taufique
Department of Neurosurgery, East West Medical College & Hospital, Dhaka, Bangladesh.

 

Mafizul Karim
Department of Anaesthesiology, East West Medical College & Hospital, Dhaka, Bangladesh.

 

Md Jahidul Islam
Department of Hospital Management, East West Medical College & Hospital, Dhaka, Bangladesh.

 

Please see the book here :- https://doi.org/10.9734/bpi/aodhr/v9/7016

Quantitative Study on Immunity and Tissue Regenerative Capacity in Hemodialysis Patients with Diabetes: General Characteristics and Paradoxical Aspects | Chapter 3 | An Overview of Disease and Health Research Vol. 9

 

Aims: This chapter aims to present the results of studies on intestinal microbiota, innate and acquired immune responses, and tissue regenerative capacity in hemodialysis patients with T2DM.

 

Study Design: It is a quantitative study that used two types of biological samples: blood and faeces.

 

Place and Duration of Study: Institute of Virology and University Research Institute laboratories, between January and June 2024. 

 

Methodology: The study was conducted on 60 patients divided into two groups: the test group (patients with ESRD and T2DM) and the control group (ESRD only). The intestinal microbiota was investigated using a genetic study. As markers for innate immunity (inflammation), the IL-6, sIL-6R, IL-1β, TNFα, IL-10, and NGAL serum levels (ELISA kits). As a cellular immunity marker, TNFβ/LTα was investigated. Regenerative capacity was studied using NT-3 (this is the first study to do so) and VEGFβ (another marker that is scarcely found in this patient category) (ELISA kits).

 

Results: The results proved a marked polarisation. IL-6 and sIL-6R presented significant increases in both groups, especially in diabetics. IL-6 generates trans-signalling through sIL-6R, with proinflammatory and anti-regenerative effects, confirmed through a significant reduction in NT-3 and VEGF-β. Statistical analysis has allowed us to conclude that the high level of IL-6 significantly influences IL-1β, TNF-β, NT-3, VEGF-β and IL-10 behaviour. But we were very surprised to find unexpected immunological changes and tissue regenerative capacity in an 82-year-old female patient, diagnosed with insulin-requiring T2DM, with multiple complications, including ESRD.

 

Conclusions: Although this research is in its early stages, it generates important conclusions and directions for further research. Regarding the particular case presented, we support the following causal hypotheses: genetically conditioned IL-6 overproduction (possibly acquired post-infection), together with its predominant anti-inflammatory and pro-regenerative signalling through IL-6R membrane receptors; the possibility that the extremely high levels of growth factors predict severe decompensation of the two associated diseases.

 

 

Author(s) Details

 

 

Mihaela Gheorghiu
Pathophysiology and Immunology Department, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania.

 

Maria-Florina Trandafir
Pathophysiology and Immunology Department, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania.

 

Coralia Bleotu
“Stefan S. Nicolau” Institute of Virology, Bucharest, Romania.

 

Octavian Savu
“N.C. Paulescu” National Institute of Diabetes, Nutrition and Metabolic Diseases, Bucharest, Romania and Doctoral School of “Carol Davila”, University of Medicine and Pharmacy, Bucharest, Romania.

 

Please see the book here :- https://doi.org/10.9734/bpi/aodhr/v9/7002

A Retrospective Analysis of National Surveillance Data on the Epidemiology of Meningitis in Niger (2005 – 2020) | Chapter 2 | An Overview of Disease and Health Research Vol. 9

 

Background: Bacterial meningitis is a major public health problem, especially in low-income countries. It is caused by Nesseria meningitidis (Nm), a Gram-negative bacterium of the family Neisseriaceae that infects humans only. In Africa, epidemics of meningitis caused by Neisseria meningitides have been a public health problem for over a century.

 

Aim: This study analysed national surveillance data and isolates from Niger to describe the epidemiology of bacterial meningitis from 2005 to 2020.

 

Methods: A retrospective study was conducted using nationwide case-based surveillance data of all reported meningitis cases in Niger from 2005 to 2020. A modified case definition was used to classify the cases. Data were collected and analysed using Stata 12.0.

 

Results: Neisseria meningitidis (Nm) was recorded over the entire period from 2005 to 2020. A total of 47,953 suspected meningitis cases and 3,276 deaths (CFR=6.83%) were reported, corresponding to an incidence of 189.01 cases per 100,000 population. The male represented 55.41% (sex-ratio male: female = 1.30), and 40.52% were 5 -14 years old. A total of 29,998 cases were reported through RNL, of which 10,979 (36.60%) were confirmed, and 6,149 (56.01%) were confirmed by culture. The predominant organism identified was N. meningitidis serogroup A (33.91%). All regions reported meningitis cases, and a consistent and substantial reduction was seen in confirmed NmA cases, with no cases occurring in the country after the completion of mass campaigns. Nevertheless, other pathogen species and Nm variants, including NmX, NmC, and Streptococcus pneumoniae, have become more prevalent.

 

Conclusion: Increased surveillance of multiple serogroups throughout is necessary, as well as consideration of vaccination with combination vaccines rather than just using a single strain, as is currently the case with NmA.

 

 

Author(s) Details

Alkassoum S. I.
Département de Santé Publique, Université Abdou Moumouni, FSS, Niamey, Niger.

 

Abdoulaye Z.
Département de Santé Publique, Université Abdou Moumouni, FSS, Niamey, Niger.

 

Goni A.
Département de Santé Publique, Université de Zinder, Niger.

 

Amadou O.
Université Dan Dicko Dan Koulodo, Maradi, Niger.

 

Djibo A.
Département de Santé Publique, Université Abdou Moumouni, FSS, Niamey, Niger.

 

Emoud T.
Hopital Général de Référence, Niamey, Niger.

 

Ibrahim M. L.
Centre de Recherche Médicale et Sanitaire, Niamey, Niger.

 

Adeossi E.
Département de Médecine et Spécialités Médicales, Université Abdou Moumouni, FSS, Niamey, Niger.

 

 

Please see the book here :- https://doi.org/10.9734/bpi/aodhr/v9/6803

Interlinking Depression and Oral Health: A Public Health Perspective | chapter 1 | An Overview of Disease and Health Research Vol. 9

 

Depression is one of the most common and disabling psychiatric disorders worldwide, and exerts a profound impact on physical, emotional, and social health. It is characterised by depressive symptoms such as relentless sadness, loss of interest in enjoyable activities, changes in appetite and weight, sleep disturbances or hypersomnia, fatigue or loss of energy, impaired concentration, feelings of guilt, and suicidal thinking. The aetiology of depression arises from a complex interplay of genetic, neurobiological, psycho-social and environmental factors. People who have experienced major life events, early life trauma, or chronic stress are most at risk. Recent studies provide compelling evidence that there is a strong yet overlooked link between depression and oral health. Patients with depression lead suboptimal oral health lives due to poor oral hygiene behaviours, unhealthy dietary habits, additional tobacco and alcohol use, and being less likely to seek dental care. Depression involves dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, systemic inflammation, immunosuppression, and the decrease of salivary gland function, which all increase susceptibility to oral sepsis, xerostomia and dental caries. Similarly, the reversed pathway of the relationship could be suggested, as poor oral health leads to psychological discomfort, poorer quality of life, and increased depression symptoms. The chapter is a summary of details regarding the epidemiology of the condition; classification of depression; biological and behavioural mechanisms involved with the relationship between depression and oral health, preventive measures for the condition & treatment strategies. It highlights the need for collaboration among dental and mental health workers who deal with the public health concern of the burden of Depressive Disorders. This study aimed to explore the association between depression and oral health by examining the different categories of depression, their impact on oral health, and recommended preventive measures to bridge gaps in awareness and care in this area.

 

 

Author(s) Details

Abdulhameed G. Albeshr
King Abdulaziz Medical City for National Guard, Riyadh, Saudi Arabia.

 

Yazeed A. Alhabdan
King Abdulaziz Medical City for National Guard, Riyadh, Saudi Arabia.

 

Ahmad M. Albanyan
King Abdulaziz Medical City for National Guard, Riyadh, Saudi Arabia.

 

Alanoud M. Alanazi
King Abdulaziz Medical City for National Guard, Riyadh, Saudi Arabia.

 

Duaa Obaidallah
King Abdulaziz Medical City for National Guard, Riyadh, Saudi Arabia.

 

Maha Al-Aswad Al-Enezi
King Abdulaziz Medical City for National Guard, Riyadh, Saudi Arabia.

 

Nora AlAgil
King Abdulaziz Medical City for National Guard, Riyadh, Saudi Arabia.

 

Rand H. Almujel
King Abdulaziz Medical City for National Guard, Riyadh, Saudi Arabia.

 

Abdullah F. Alhussain
King Abdulaziz Medical City for National Guard, Riyadh, Saudi Arabia.

 

May M. Aleraij
King Abdulaziz Medical City for National Guard, Riyadh, Saudi Arabia.

 

Setah T. Alanazi
King Abdulaziz Medical City for National Guard, Riyadh, Saudi Arabia.

 

Shadyah E. Alfaori
King Abdulaziz Medical City for National Guard, Riyadh, Saudi Arabia.

 

Shatha Faisal Aldhawi
King Abdulaziz Medical City for National Guard, Riyadh, Saudi Arabia.

 

Reham F. Alsaleh
Private Dental Clinic, Riyadh, Saudi Arabia.

 

Please see the book here :- https://doi.org/10.9734/bpi/aodhr/v9/6728