Many underdeveloped countries still struggle with the public health issue of acute illnesses, especially with the emergence of injuries as a major category of acute diseases. Control of the acute disease is challenging particularly when it occurs as an outbreak, either in isolation or as part of a wider epidemic. This narrative review summarizes the definition, epidemiologic transition, pattern and modes of spread, classification, epidemiologic measures, community burden, prevention, control, and future challenges of acute disease. This review is to provide a reference for epidemiologists, clinicians, researchers, and policymakers.

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Objective: To explore health-improving behaviors during COVID-19 pandemic and to reveal the impact of the risk perception of COVID-19 on these behaviors. Methods: We recruited a total of 510 participants for this cross-sectional study. The data were collected online using a questionnaire booklet covering a form inquiring about the participants’ demographic, physical, and mental characteristics, the Generalized Anxiety Disorder-7 Scale, and the COVID-19 Perceived Risk Scale. Results: The mean age of the participants was (28.7±10.1) years, and 76.1% were females. Of the participants, 31.8% were overweight and obese. While 35.1% experienced negative alterations in their dietary patterns, 23.9% reported positive changes to their diet during the pandemic. Besides, 47.8% reported their sleep to be negatively affected during the pandemic. While the rate of those with extended screen time was 72.5%, it was 44.3% for the participants engaging in regular exercise. More than one-third of the participants (35.9%) had high and severe anxiety. We also found increased risk perception of COVID-19 among females, obese, those with disturbed eating and sleep quality, healthcare workers, and those with severe anxiety. Conclusions: Overall, the pandemic has appeared to have brought both positive and negative impacts on maintaining and improving eating, sleep, physical activity, and mental health.

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Objective: To investigate the value of systemic inflammatory response index (SIRI) and systemic immune-inflammation index (SII) in predicating acute appendicitis complications based on hemogram parameters. Methods: Demographic data, histopathological studies, and laboratory results of the patients who were admitted to the emergency department with a complaint of abdominal pain between January 2020 and June 2022 and were hospitalized with the diagnosis of acute appendicitis for operation by general surgery were examined. Simple appendicitis and complicated appendicitis groups were compared in terms of parameters according to their histopathological examinations. Results: A total of 220 patients who met the inclusion criteria were included in our study. Mean SIRI levels were found to be significantly higher in the complicated appendicitis group than in the simple appendicitis group [6.60 (4.07, 14.40) vs. 3.50 (2.20, 6.80); P=0.002]. Similarly, SII levels were found to be significantly higher in the complicated appendicitis group compared to the simple appendicitis group [2 514.50 (1 132.25, 5 388.00) vs. 1 207.00 (571.50, 2 089.00), P<0.001]. The power of SIRI and SII to indicate complications was higher than white blood cell count and C-reactive protein (area under the curve: 0.753 and 0.786, respectively). Conclusion: SIRI and SII could be used to indicate complications in patients with acute appendicitis.

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Objective: To evaluate the effect of the modified systemic inflammation score (mSIS) on prognosis in patients diagnosed with COVID-19. Methods: In this retrospective cross-sectional study, 181 patients were selected and divided into two groups: patients with and without admission to the intensive care unit (ICU). An albumin level of ≥4.0 g/dL and lymphocyte-to-monocyte ratio (LMR) of ≥3.4 was scored 0, an albumin level of <4.0 g/dL or LMR of <3.4 was scored 1, and an albumin level of <4.0 g/dL and LMR of <3.4 was scored 2. Results: A total of 242 COVID-19 positive patients were initially included in this study. Of these patients, 61 were excluded and 181 patients remained. Among the 181 participants, 94 (51.9%) were female, and the median age was 61 (51, 75) years. The mSIS scale ranged from 0 to 2. After analysis, the median score was 0 (0, 0) in the non-ICU group and 2 (0, 2) in the ICU group (P<0.001). The median white blood cell, lymphocyte counts, and albumin levels were lower in the ICU group (P<0.001, P<0.001, and P<0.001, respectively). In logistic regression analysis lymphocytopenia (OR=5.158, 95% CI=1.249-21.304, P=0.023), hypoalbuminemia (OR=49.921, 95% CI=1.843-1 352.114, P=0.020), AST elevation (OR=3.939, 95% CI=1.017-15.261, P=0.047), and mSIS=2 (OR=5.853, 95% CI=1.338-25.604, P=0.019) were identified as independent predictors of ICU admission. Conclusion: The mSIS can be used as an independent parameter for establishing the intensive care needs of patients with COVID-19.

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Objective: To investigate the trend of animal bites in southern Iran from 2015 to 2019. Methods: This is a cross-sectional study of patients with animal bites who were referred to the Center for Disease Control in the three cities of Larestan, Evaz, and Khonj in Fars province, southern Iran from 2015 to 2019. The trend of animal bites incidence was analyzed using the Cochran-Armitage trend test. Results: In total, from 2015 to 2019, 1 944 cases of animal bites were reported. A total of 79.8% of the cases were men. The overall average incidence of animal bites was 142.93 per 100 000 people. The incidence of animal bites was significantly increased (P_trend<0.001). The highest incidence was in November (79.04 per 100 000 people) followed by January (76.1 per 100 000 people) and February (69.48 per 100 000 people); also, the lowest incidence was in August (47.42 per 100 000 people) and July (50.0 per 100 000 people). Conclusions: The incidence of animal bites has significantly increased. Given the importance of rabies, control and management of animal bites should be emphasized and considered.

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Rationale: Pituitary apoplexy (PA) is a rare endocrine emergency that requires prompt diagnosis and management. Dengue fever-induced-thrombocytopenia may rarely predispose to PA. Patient's Concern: A 58-year-old male patient having known pituitary macroadenoma presented to the emergency department with fever, a sudden onset severe headache, and altered sensorium. Diagnosis: Pituitary apoplexy caused by dengue fever-induced-thrombocytopenia. Interventions: Conservative management with fluids, mannitol, dexamethasone and symptomatic treatment. Outcomes: The patient responded well to the treatment and was discharged uneventfully. Lessons: Although dengue hemorrhagic fever is a rare cause of pituitary apoplexy, it should be considered if a patient presents with headache and altered sensorium, and prompt initiation of treatment is crucial to prevent fatality and neuro-ophthalmic deficits.

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Rationale: Dengue fever is a leading cause of death in tropical and subtropical countries. Although most patients have a self-limited febrile illness, the viral infection can induce virus-mediated host changes, making immunocompetent persons susceptible to deadly fungal infections. However, there are only a few reports of such an association. Here we present a case of this deadly co-infection. Patient’s Concern: A 17-year-old male patient was diagnosed with dengue fever. He presented to us with facial swelling, periorbital edema, and black discoloration over the palate during the second week of his illness. Diagnosis: Diagnostic tests confirmed the presence of fungal hyphae. A diagnosis of post-dengue mucormycosis was made. No other comorbidity or underlying immune deficit was detected. Interventions: The patient underwent surgical debridement and antifungal treatment. Outcomes: The patient recovered and showed signs of palatal healing with an advancing mucosal edge. Lessons: Dengue virus and mucor co-infection has brought to light a new pathogenic paradigm. Clinicians need to be aware of this emerging medical condition and maintain a high index of suspicion for mucor co-infections while treating dengue patients.

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