Objectives: Mortality statistics during the coronavirus disease 2019 (COVID-19) pandemic are crucial for the allocation of medical care resources and public health decision-making. This study was initiated to investigate the excess mortality among older adults during the pandemic.Our research focuses on 2 primary areas. First, we analyzed the cumulative excess mortalityacross all age groups to assess the global impact and specifically examined the top 20 countrieswith the highest mortality rates during the pandemic. Second, we explored excess deaths among older adults by categorizing data from the years 2020 and 2021 into age groups: 65–74, 75–84, and above 85. Methods: We analyzed data from the top 20 countries with the highest mortality rates globally, focusing on 3 components: all-cause mortality means, expected deaths mean, and excess deaths mean for both older men and women. Results: Although excess mortality is higher among older men and women across all 3 age groups (65–74, 75–84, and > 85), the highest mean excess mortality was observed in women over the age of 85. Conclusion The results indicate that the severe acute respiratory syndrome coronavirus 2 virus had a disproportionately intense impact on older women. We developed 2 types of statisticalmodels using the data: a binomial distribution model and a correlation coefficient model,both considering the mean excess deaths in older men and women across these 3 age groups.Estimating the excess mortality among older adults will aid in the formulation of healthcare policies for this demographic.

Objectives: Mortality statistics during the coronavirus disease 2019 (COVID-19) pandemic are crucial for the allocation of medical care resources and public health decision-making. This study was initiated to investigate the excess mortality among older adults during the pandemic.Our research focuses on 2 primary areas. First, we analyzed the cumulative excess mortalityacross all age groups to assess the global impact and specifically examined the top 20 countrieswith the highest mortality rates during the pandemic. Second, we explored excess deaths among older adults by categorizing data from the years 2020 and 2021 into age groups: 65–74, 75–84, and above 85. Methods: We analyzed data from the top 20 countries with the highest mortality rates globally, focusing on 3 components: all-cause mortality means, expected deaths mean, and excess deaths mean for both older men and women. Results: Although excess mortality is higher among older men and women across all 3 age groups (65–74, 75–84, and > 85), the highest mean excess mortality was observed in women over the age of 85. Conclusion The results indicate that the severe acute respiratory syndrome coronavirus 2 virus had a disproportionately intense impact on older women. We developed 2 types of statisticalmodels using the data: a binomial distribution model and a correlation coefficient model,both considering the mean excess deaths in older men and women across these 3 age groups.Estimating the excess mortality among older adults will aid in the formulation of healthcare policies for this demographic.

Objectives: Mortality statistics during the coronavirus disease 2019 (COVID-19) pandemic are crucial for the allocation of medical care resources and public health decision-making. This study was initiated to investigate the excess mortality among older adults during the pandemic.Our research focuses on 2 primary areas. First, we analyzed the cumulative excess mortalityacross all age groups to assess the global impact and specifically examined the top 20 countrieswith the highest mortality rates during the pandemic. Second, we explored excess deaths among older adults by categorizing data from the years 2020 and 2021 into age groups: 65–74, 75–84, and above 85. Methods: We analyzed data from the top 20 countries with the highest mortality rates globally, focusing on 3 components: all-cause mortality means, expected deaths mean, and excess deaths mean for both older men and women. Results: Although excess mortality is higher among older men and women across all 3 age groups (65–74, 75–84, and > 85), the highest mean excess mortality was observed in women over the age of 85. Conclusion The results indicate that the severe acute respiratory syndrome coronavirus 2 virus had a disproportionately intense impact on older women. We developed 2 types of statisticalmodels using the data: a binomial distribution model and a correlation coefficient model,both considering the mean excess deaths in older men and women across these 3 age groups.Estimating the excess mortality among older adults will aid in the formulation of healthcare policies for this demographic.

Objectives: Mortality statistics during the coronavirus disease 2019 (COVID-19) pandemic are crucial for the allocation of medical care resources and public health decision-making. This study was initiated to investigate the excess mortality among older adults during the pandemic.Our research focuses on 2 primary areas. First, we analyzed the cumulative excess mortalityacross all age groups to assess the global impact and specifically examined the top 20 countrieswith the highest mortality rates during the pandemic. Second, we explored excess deaths among older adults by categorizing data from the years 2020 and 2021 into age groups: 65–74, 75–84, and above 85. Methods: We analyzed data from the top 20 countries with the highest mortality rates globally, focusing on 3 components: all-cause mortality means, expected deaths mean, and excess deaths mean for both older men and women. Results: Although excess mortality is higher among older men and women across all 3 age groups (65–74, 75–84, and > 85), the highest mean excess mortality was observed in women over the age of 85. Conclusion The results indicate that the severe acute respiratory syndrome coronavirus 2 virus had a disproportionately intense impact on older women. We developed 2 types of statisticalmodels using the data: a binomial distribution model and a correlation coefficient model,both considering the mean excess deaths in older men and women across these 3 age groups.Estimating the excess mortality among older adults will aid in the formulation of healthcare policies for this demographic.

Objectives: Mortality statistics during the coronavirus disease 2019 (COVID-19) pandemic are crucial for the allocation of medical care resources and public health decision-making. This study was initiated to investigate the excess mortality among older adults during the pandemic.Our research focuses on 2 primary areas. First, we analyzed the cumulative excess mortalityacross all age groups to assess the global impact and specifically examined the top 20 countrieswith the highest mortality rates during the pandemic. Second, we explored excess deaths among older adults by categorizing data from the years 2020 and 2021 into age groups: 65–74, 75–84, and above 85. Methods: We analyzed data from the top 20 countries with the highest mortality rates globally, focusing on 3 components: all-cause mortality means, expected deaths mean, and excess deaths mean for both older men and women. Results: Although excess mortality is higher among older men and women across all 3 age groups (65–74, 75–84, and > 85), the highest mean excess mortality was observed in women over the age of 85. Conclusion The results indicate that the severe acute respiratory syndrome coronavirus 2 virus had a disproportionately intense impact on older women. We developed 2 types of statisticalmodels using the data: a binomial distribution model and a correlation coefficient model,both considering the mean excess deaths in older men and women across these 3 age groups.Estimating the excess mortality among older adults will aid in the formulation of healthcare policies for this demographic.

Rickets, one of the leading causes of bony deformities and short stature, can be calciopenic (inciting event is defective intestinal calcium absorption) or phosphopenic (inciting event is phosphaturia). Early diagnosis and timely treatment of rickets are crucial for correction of the limb deformities. Guidelines exist for nutritional rickets, but the diagnosis and management of the relatively uncommon forms of rickets are complex. This consensus aims to formulate a simplified diagnostic approach for rickets, especially in resource-limited settings. The consensus statement has been formulated by a 29-member committee from the Endocrine Society of Bengal. The process included forming a working group, conducting a literature review, identifying controversies, drafting, and discussion at a consensus meeting. Participants rated their agreement with the clinical practice points, and a 70% consensus was required. Input integration and further review led to the final consensus statements. Children with suspected rickets should initially be examined for distinctive skeletal deformities. The diagnosis of rickets should be confirmed with characteristic radiographic abnormalities. It is advisable to order tests for serum calcium, inorganic phosphorus (Pi), liver function, 25-hydroxyvitamin D (25OHD), parathyroid hormone, creatinine, and potassium in all patients with rickets. In cases of refractory rickets, it is also recommended that assessments be conducted for spot urine calcium, Pi, creatinine, and, blood gas analysis. In children with rickets and metabolic acidosis, tests for glycosuria, uricosuria, aminoaciduria, low molecular weight proteinuria, and albuminuria should be conducted. In children with resistant calciopenic rickets and sufficient serum 25OHD levels, serum 1,25(OH)2D concentration should be tested. 1,25(OH)2 D and fibroblast growth factor 23 estimation is useful for certain forms of phosphopenic rickets.

Approximately 0.7% of patients taking angiotensin-converting enzyme inhibitors (ACEIs) develop ACEI-induced angioedema (ACEI-IA). With no approved treatments for ACEI-IA, the risk of complications is concerning. Tranexamic acid (TXA) has the potential to prevent intubations and resolve ACEI-IA by inhibiting the downstream production of bradykinin. In this review, we aim to evaluate the safety and efficacy of TXA use in ACEI-IA. We queried the PubMed database for studies involving TXA for ACEI-IA from January 2003 to January 2023. Seven studies met the study inclusion criteria. Our results demonstrate that TXA may improve angioedema symptoms and prevent intubation. In addition, its availability, low cost, and safety profile support its use for improving the symptoms and complications of ACEI-IA in an emergency setting.

Free flap procedure provides an overall success rate of 97%, which decreases to 85% in hypercoagulable states. COVID-19, as a pro-thrombotic disorder, therefore seems detrimental to free flap survival. We encountered a case of unique pattern of free flap partial failure in a young male who underwent extremity reconstruction. The patient was diagnosed as COVID-19 positive on the 3rd day post-reconstruction. The flap survived well for the first 7 days post-operatively, but gradually the skin got necrosed and the subcutaneous fat layer was preserved when debriding. To our knowledge, this is the only case in which the skin of the free flap of a COVID-19 positive patient was necrosed almost entirely subsequently, while the subcutaneous fat was relatively preserved.
Humans ; Male ; Thigh/surgery* ; Free Tissue Flaps/surgery* ; Plastic Surgery Procedures ; COVID-19 ; Lower Extremity/surgery* ; Vascular Diseases ; Postoperative Complications/surgery*

Ephs belong to the largest family of receptor tyrosine kinase and are highly conserved both sequentially and structurally. The structural organization of Eph is similar to other receptor tyrosine kinases; constituting the extracellular ligand binding domain, a fibronectin domain followed by intracellular juxtamembrane kinase, and SAM domain. Eph binds to respective ephrin ligand, through the ligand binding domain and forms a tetrameric complex to activate the kinase domain. Eph-ephrin regulates many downstream pathways that lead to physiological events such as cell migration, proliferation, and growth. Therefore, considering the importance of Eph-ephrin class of protein in tumorigenesis, 7,620 clinically reported missense mutations belonging to the class of variables of unknown significance were retrieved from cBioPortal and evaluated for pathogenicity. Thirty-two mutations predicted to be pathogenic using SIFT, Polyphen-2, PROVEAN, SNPs&GO, PMut, iSTABLE, and PremPS in-silico tools were found located either in critical functional regions or encompassing interactions at the binding interface of Eph-ephrin. However, seven were reported in nonsmall cell lung cancer (NSCLC). Considering the relevance of receptor tyrosine kinases and Eph in NSCLC, these seven mutations were assessed for change in the folding pattern using molecular dynamic simulation. Structural alterations, stability, flexibility, compactness, and solvent-exposed area was observed in EphA3 Trp790Cys, EphA7 Leu749Phe, EphB1 Gly685Cys, EphB4 Val748Ala, and Ephrin A2 Trp112Cys. Hence, it can be concluded that the evaluated mutations have potential to alter the folding pattern and thus can be further validated by in-vitro, structural and in-vivo studies for clinical management.