Analytical Cross-sectional Study Research Articles

Diagnostic accuracy of transvaginal ultrasonography and hysterosalpingography in the detection of uterine cavity pathologies among infertile women.

Uterine cavity pathology may affect the endometrium or myometrium, resulting in distortion of the uterine cavity, and is responsible for 2%-5% of infertility. The methods for its assessment usually involve imaging modalities like pelvic ultrasonography, often transvaginal-(TVS), and hysterosalpingography-(HSG), with hysteroscopy-(HSC) as the gold standard. However, HSC is not readily available in resource-poor-settings. To determine and compare the diagnostic accuracy of TVS and HSG in detecting uterine cavity pathology using HSC as a gold standard. A cross-sectional analytical study of consenting infertile women for evaluation of the uterine cavity using transvaginal-ultrasonography, hysterosalpingogram, and hysteroscopy. The primary-outcome-measures were the sensitivity, specificity, and accuracy of TVS and HSG in detecting uterine cavity abnormalities using HSG as the gold standard. Eighty-eight participants were analysed for this study. The lesions confirmed on HSC were intrauterine-adhesions (43.1%), endometrial polyps (14.8%), submucous fibroids (18.2%), intrauterine-septum (13.6%), and cavity distortion (14.8%). The overall sensitivity with TVS was 57.7%, with a specificity of 97.6%, a positive-predictive-value (PPV) of 88.2%, and a negative-predictive-value (NPV) of 88.2%, giving a percentage-accuracy of 88.2%. In comparison, HSG had a sensitivity of 72.1%, a specificity of 99.4%, a PPV of 97.4%, and an NPV of 92.0%, giving an overall accuracy of 92.9%. The detection rates of TVS and HSG in this category were: fibroids (97.7% vs 89.8%; p = .0004) and adhesions (73.9% vs 87.5%; p = .0002), respectively. HSG appears to be the superior modality for detection of obliterative uterine cavity pathologies, while TVS is better suited for myometrium and endometrial lesions.

Effect of fetal distress on viability and yield of umbilical cord blood stem cells–a prospective comparative study

IntroductionDifferent factors affect the quality and viability of cord blood stem cells, and therefore the efficacy of umbilical cord stem cell transplantation. Fetal distress is one factor affecting the quantity of CD34+ cells in cord blood. This study was designed to compare the viability and yield of the umbilical cord blood stem cells of women who have undergone emergency lower segment caesarean section for fetal distress or for other causes. Materials and methodsThis cross-sectional analytical study was performed at a tertiary care hospital facility with a total sample size of 68: 34 participants had undergone emergency C-section for fetal distress, and 34 had undergone emergency C-section for other causes. Umbilical cord blood was collected ex-utero in a 350 mL bag with citrate-phosphate-dextrose solution with adenine. Three milliliter of blood were transferred to an ethylenediaminetetraacetic acid (EDTA) tube for cell counts and flow cytometry testing for CD34+. The chi-square test was used to compare the total mononuclear cell, CD34+, and viability between the groups. ResultsThe CD34+ count [mean 4.9 versus 1.1 (× 106 cells/unit)] and total nucleated cell count [mean 14.2 versus 7.5 (× 108/unit)] were significantly higher in cord blood units collected from women who delivered by C-section for fetal distress (p-value <0.05). However, the volume of umbilical cord stem cells and viability of stem cells did not vary significantly based on the presence or absence of fetal distress (p-value >0.05). ConclusionThe current study shows that umbilical cord blood collected during fetal distress has a significantly higher content of stem cells and total nucleated cells than the non-fetal distress group

The effects of HIV and oncogenic human papillomavirus on the tumor immune microenvironment of penile squamous cell carcinoma.

Penile squamous cell carcinoma (PSCC) occurs more frequently in some developing countries compared to developed countries. Infection with HIV and/or high-risk human papillomavirus (hrHPV) are risk factors for penile cancer development. The tumor microenvironment of PSCC may predict prognosis and may inform on the best targets for immunotherapy. We evaluated the immune microenvironment of penile tumors histologically, and determined whether and/or how HIV and/or hrHPV infections affect this tumor microenvironment. We conducted a prospective analytical cross-sectional study in which penile cancer tumors from 35 patients presenting at the University Teaching Hospital in Lusaka, Zambia were histologically staged and assessed for presence of tumor infiltrating immune cells and expression of immune checkpoints. Immunohistochemistry was used to evaluate immune checkpoints and infiltrating immune cells, while multiplex real-time polymerase chain reaction was used for hrHPV genotyping. The median age of all participants was 55 years. About 24% had advanced histological stage, 83% were HIV+, and 63% had hrHPV detected in their tumors using multiplex real-time polymerase chain reaction. PDL1 expression was significantly higher in HIV- participants than HIV+ participants (p = 0.02). Tumors with multiple hrHPV infections had a significantly higher number of cells expressing TIM3 than those with one hrHPV (p = 0.04). High grade tumors had a significantly higher infiltrate of FoxP3+ cells (p = 0.02), CD68+ cells (p = 0.01), CD163+ cells (p = 0.01), LAG3+ cells (p = 0.01), PD1+ cells (p = 0.01) and TIM3+ cells (p = 0.03) when compared with low grade tumours. There was significant moderate to strong positive correlation of cells expressing PD1 and LAG3 (⍴ = 0.69; p = 0.0001), PD1 and TIM3 (⍴ = 0.49; p = 0.017) and TIM3 and LAG3 PDL1 (⍴ = 0.61; p = 0.001). In conclusion, the tumor microenvironment of penile squamous cell carcinoma seems to be affected by both HIV and HPV infections. TIM3 appears to be a potential therapeutic target in PSCC patients with hrHPV infections.

Tacrolimus Intrapatient Variability on Graft Outcomes inAdherent Renal Transplantation Patients: A Cross-SectionalStudy.

Tacrolimus is the mainstem of immunosuppressive therapy in kidney transplant patients. It has high intrapatient variability (Tac-IPV), which has been reported to affect graft function by predisposing patients to rejection or nephrotoxicity. We conducted this study with the aim of assessing the influence of Tac-IPV on 2-year graft function, biopsy-proven rejection, and infections in compliant renal recipients. In this single-center retrospective analytic cross-sectional study, 250 patients who underwent transplantation from March 21, 2018, to March 20, 2020 and had at least three outpatient tacrolimus trough levels on the same daily dose 6 to 12 months after transplantation were recruited. Tac-IPV was defined as a coefficient variation of > 15%. Graft function, biopsy-proven rejection, cytomegalovirus (CMV) and BK virus viremia, and calcineurin inhibitor (CNI) toxicity were evaluated. Of 202 transplant recipients, 128 were included with a mean age of 45.48 ± 13.14 years. The median Tac-IPV was 13.28% with 43.75% of patients with Tac-IPV > 15%. There were no significant differences in graft function, rejection, CNI toxicity, and CMV viremia among the groups during the 24-month study (P > .05). However, BK viremia was significantly higher among patients with Tac-IPV > 15% (13 vs. 2.9%, P = .042). The risk of antibody mediated rejection alone (22.7 vs. 2.9%) or any kind of rejection (22.7 vs. 11.8%) was significantly higher in patients with higher Tac-IPV, and in those who had mean trough levels below 7 ng/mL (P = .015, .032; respectively). Tac-IPV is low in adherent patients (with the median of 13.28%) and maintaining tacrolimus trough level above 7 ng/mL can overcome the adverse graft outcome of Tac-IPV in compliant kidney transplant recipients. DOI: 10.52547/ijkd.7815.

Knowledge, attitude, intentional practice and individualized determinants of COVID-19 vaccine uptake among adults: A cross-sectional study in Tanzania.

The study assessed the knowledge, attitude, intentional practice and individualized factors of COVID-19 vaccine uptake among adults in Tanzania. Hospital-based analytical cross-sectional study. Quantitative approaches were adopted to study 312 randomly selected adults using an interviewer-administered structured questionnaire. Descriptive analysis established frequencies and percentages of variables at a 95% confidence interval and a 5% significance level. Mean age was 24.66 ± 6.503 of which 61.5% were males. 86.9% of them were not vaccinated. 57.7% of respondents had inadequate knowledge about the COVID-19 vaccine, and 61.5% had negative attitudes towards it. 63.8% of adults demonstrated an unwillingness to be vaccinated. Participants' sociodemographic characteristics profiles were significantly associated with COVID-19 vaccine knowledge, attitude and willingness to uptake it (p < 0.05). Findings highlight the need for large-scale interventions to address the low uptake vaccine. Adults' willingness to get a coronavirus vaccine was comparatively low. Sociodemographic profiles, knowledge and attitude were associated significantly with low uptake of the COVID-19 vaccine among adults in Tanzania.

Self-Perception of Sexual Dysfunction of Adult Brazilian Women of Reproductive Age: A Cross-Sectional Study.

Sexual dysfunction (SD) comprises disorders in sexual desire, arousal, orgasm, and lubrication. The importance of self-perceived SD relies on its relation to personal values, sex education, and partnership. We aimed to analyze the association between self-perceived SD and the Female Sexual Function Index (FSFI) in adult women of reproductive age and the correlation between age and sexual function. This analytical cross-sectional study included 285 women aged 18 to 49 years, sexually active for at least four weeks, cisgender and heterosexual, and with Internet access. Women were divided into control (CG, control group; without SD) or study group (SG, study group; with SD) and responded to a self-applicable online survey containing a sociodemographic characterization, an interview about SD knowledge, and the FSFI test. The Chi-square test of independence (χ2) analyzed the association between self-perceived SD and FSFI-assessed SD. Pearson's correlation coefficient investigated the correlation between age and FSFI. Included women had a mean age of 29.57 years ± 7.11 years. Self-perceived SD showed a moderate association (Cramer's V = 0.590) with the FSFI score (χ2 [2] = 91.500; p < 0.001). A weak, negative, and significant correlation was observed between age and the FSFI desire domain (r = -0.120; p = 0.030; r2 = 1.440). Women with self-perceived SD were 68% more likely to present FSFI-assessed SD. Regarding the FSFI desire domain, sexual function decreased with age.

Prevalence and Risk Factors of Constipation in Trauma Patients: A Prospective Cohort Study.

Hospitalized patients are well described as having a high prevalence of constipation. While the risks associated with constipation in trauma patients are well known, the prevalence rate is not. This study aims to measure the prevalence of constipation and associated risk factors in trauma patients. This study is a single-center analytic cross-sectional study on constipation in hospitalized trauma patients aged 18-65years, admitted from January 2021 to July 2021 to the trauma service at The Royal Melbourne Hospital, a Level I major trauma and teaching hospital servicing the state of Victoria, Australia. Exclusion criteria include patients with traumatic brain injury, blunt or penetrating abdominal or spinal injuries, pregnancy, and gastrointestinal comorbidities. A total of N =99 patients were studied, of which n =78 (78.8%) were male with a median (interquartile range) age of 46years (33-58). The overall prevalence of constipation was 76%. The univariate analysis demonstrated higher constipation rates in males and patients with multisystem injuries. However, in the multivariate analysis, mode of toileting and mobility were not associated with constipation after adjusting for confounding factors. This study demonstrated a high prevalence of constipation in all trauma patients. There is a strong association between the development of constipation in patients with multisystem injuries when compared to those with single system.

Maternal Experiences during Pregnancy, Delivery, and Breastfeeding Practices: A Community-based Analytical Cross-sectional Study.

Evidence on variation in the information provided to mothers during antenatal and postnatal periods, its influence on breastfeeding awareness, and practice in urban and rural settings of India is scarce. The aim of the study was to assess the variation in mothers experience during pregnancy, delivery, and maternity period across settings and its influence on breastfeeding practices in the first six months of infants' life. A community-based analytical cross-sectional study was carried out in urban and rural settings of Coimbatore, Tamil Nadu, among 800 mothers who had delivered between one year and six months before the date of the survey using simple random sampling. The proportion of mothers with less than four antenatal visits were significantly higher in urban areas (urban vs rural, 11.4% vs 6.2%). The mean scores for positive experiences during pregnancy (MD -0.99, 95% CI -1.31 to -0.69), experiences during birth and maternity period (MD -0.59, 95% CI -0.83 to -0.35) were significantly lower in the urban areas compared to rural areas. The prevalence of exclusive breastfeeding was 75.8% and 85.0% in urban and rural areas, respectively. Mothers not satisfied with experiences during delivery and maternity period (OR 1.69, 95% CI 1.18 to 2.42) and from urban areas (OR 1.81, 95% CI 1.27 to 2.59) were at significantly increased risk of nonexclusive breastfeeding. The present study showed that mothers from urban areas were not provided with appropriate, adequate, and timely information by the healthcare providers. It is the need of the hour to train and motivate healthcare providers regarding maternal awareness of antenatal, intranatal, and postnatal care practices including breastfeeding and infant care.

Predictive ability of complete blood count, mean platelet ratio, mean platelet volume, and neutrophil/lymphocyte ratio for severe pneumonia among RT-PCR or radiologically proven COVID-19 patients.

Immuno-inflammatory markers related to white blood cells, and platelets are shown to be associated with COVID-19 infection, and considered to be independent markers for clinical outcomes and mortality. The present study aimed to study the predictive value of these hematologic parameters in progression of COVID-19 to severe pneumonia. This was an analytical cross-sectional study conducted among RT-PCR or radiologically proven COVID-19 patients in a tertiary care hospital in Rajasthan. Semi-structured questionnaire was used to collect the epidemiological information of the patients with COVID-19. Complete blood count and other laboratory parameters were also studied among the patients. Mean age of participants in the study was 52 years, with about 70% being males. Cough and breathlessness were the most common symptoms among the patients. It was found that the parameters related to white blood cells were significantly different between patients with COVID-19 infection and severe pneumonia (except absolute monocyte count). NLR was significantly higher among those with severe pneumonia. In the univariate analysis, age (OR - 1.02), NLR (OR - 1.16), and albumin (OR - 0.45) were found to be significant predictors of progression to severe pneumonia. In the final model, adjusted for confounders, only NLR and albumin levels significantly predicted progression to severe pneumonia among COVID-19 patients. The study consolidates the predictive ability of NLR for severe pneumonia. It is an important finding, as health facilities with limited access to laboratory investigations can rely on simple markers in routine practice to predict the progression of COVID-19 infection to severe pneumonia.

Association of periodontal disease with gestational diabetes mellitus among postpartum women at a private tertiary care hospital of Karachi, Pakistan: a cross-sectional study

Due to the overlapping aetiology of Gestational Diabetes Mellitus (GDM) and Periodontal disease (PD), which are prevalent metabolic disorder and chronic inflammatory disorder in pregnant women respectively, they are often at risk of developing both diseases simultaneously. This study aims to evaluate the association of periodontal disease and gestational diabetes mellitus among post-partum women who delivered within 24 h at private tertiary care hospital, Karachi, Pakistan. Analytical cross sectional study with sample size of 178 by non- probability purposive sampling, a total of 101 postpartum women (57%) were diagnosed with periodontal disease and 50 (28%) were GDM positive. Of those who had PD, 35% (n = 35/101) were GDM positive. An insignificant association of the prevalence ratio of GDM in women with periodontal disease was found. [PR = 1.7; 95% CI: 0.2–3.2; p-value 0.07] A statistically significant association was found between the prevalence ratio of GDM in women with obesity. It was 2.6 times compared to women who were not obese (p value < 0.01, 95% CI: 1.3–5.1). There is insignificant association found between the prevalence ratio of GDM in women with periodontal disease in our setting. Women who are overweight or tend to gain weight should be closely monitored and guided to take dietary measures.

Social Media Usage and it's Relationship with Depression among Nursing Students of a Private University

Social media is a group of electronic and digital appliances which has its basis on internet and allow sharing, transforming and exchanging ideas, information, educational material and content. In the 21st century, internet usage has been increased significantly. Our life has been entirely changed by the internet and social media. Social media cause different health related issues and academic decline among students. Objective: To observe the relationship between social media use and depression among nursing students. Methods: Cross-sectional analytical study was performed on 120 nursing students. Ethical permission was obtained from Ethical Review Committee, Sohail University, Karachi. Descriptive statistics was performed on demographic variables. Pearson Correlation test was performed to check the relationship between social media use and depression. Results: Beyond 120 participants, males were in majority (57.5%). Mostly (58.3%) participants were in their 1st and 2nd year, 20.8% were married and 69.2% were living with their friends. Largely (77.5%) belong to Generic BSN program and 55.0% partakers were using social media from 0-4 hours per day. Mostly (44.2%) participant have moderate to extreme level of depression. We found positive correlation of social media use with depression. Conclusions: The findings of this study suggest significant correlation between depression and social media use. Spending more time on using social media can lead to depression. Therefore, policy makers should pay attention in planning to minimize the harmful effects of social media usage among students.

Prediction of newborn assessment according to maternal nutritional status: a model based on decision trees.

Objective: To determine whether it is possible to predict the assessment of the newborn according to maternal nutritional status through a decision tree model. Methods: Cross-sectional analytical study. A total of 326 medical records of pregnant women from a Peruvian public hospital were reviewed, in 2021. The newborn was assessed using the APGAR score, gestational age at birth, birth weight, weight and height for gestational age. Maternal nutritional status included pregestational body mass index and gestational weight gain. The prediction was made using a supervised machine learning model called a “decision tree.” Results: The APGAR score at one minute and height for gestational age were not possible to predict by maternal nutritional status. The probability of having full-term gestational age at birth is 97.2% when gestational weight gain is &gt; 5.4 kg (p = 0.007). The highest probabilities of adequate birth weight were with gestational weight gain between 4.5 kg (p &lt; 0.001) and 17 kg (p &lt; 0.001) and with pregestational body mass index ≤ 36.523 kg/m2 (p = 0.004). Finally, the highest probability of adequate weight for gestational age is when gestational weight gain is &lt; 11.8 Kg (p &lt; 0.001) and with a pregestational body mass index ≤ 36.523 Kg/m2 (p = 0.005). Conclusions: It is possible to predict the assessment of the newborn based on the mother’s nutritional status using machine learning

The Status of Dermoscopy in Chile: First National Study in Dermatologists.

Scientific evidence supports dermoscopy as an essential tool in dermatological diagnosis. The objective is to know the factors that influence its use in Chilean dermatologists. Analytical cross-sectional study. An adapted version of the survey was submitted from the pan-European study by Forsea et al to members of the Chilean Society of Dermatology, between September and December 2020. Analysis using descriptive statistics and multivariate analysis with ordinal logistic regression looking for factors associated with greater use of. One hundred and ninety-eight responses, mean age 46.3 years and 14.6 years on average practicing as dermatologists. 61.6% trained in dermoscopy during their residency. 98% use a dermatoscope. More than 80% consider dermoscopy useful for the diagnosis of melanomas, follow-up of melanocytic lesions, and diagnosis of pigmented and non-pigmented tumors. Between 50% and 70% consider it useful for monitoring non-melanocytic lesions, nail and hair pathologies. Greater confidence when evaluating pigmented and non-pigmented tumors and capillary pathology. Adjusting for age, sex, confidence, and education, participation in teaching was associated with greater use of dermoscopy in non-pigmented and pigmented tumors, and capillary pathology. Percentage of participation in the survey and training in dermoscopy higher than in the reference study, recognizing the usefulness of dermoscopy for the diagnosis and follow-up of tumor pathologies. Participating in teaching is a strong independent factor that is associated with a greater use of dermoscopy in Chile. Dermoscopy is positioned as a tool widely used by Chilean dermatologists in their daily practice.

Impact of the COVID-19 pandemic on pharmacy students: A comprehensive survey

The COVID-19 pandemic has caused numerous changes in all aspects of human life and behavior, especially in the education system. Because of these reasons, our study aimed to evaluate the approaches and attitudes of pharmacy faculty students to the COVID-19 pandemic as a survey study. This study is an analytical cross-sectional study. It was conducted with the online questionnaire technique. The questionnaire form consists of 5 different sections, and the participants were asked questions aiming to determine the level of knowledge, behavioral patterns, and approaches to online education of pharmacy faculty students against the COVID-19 pandemic, along with socio-demographic questions. 151 pharmacy students, 99 (65.6%) female and 52 (34.4%) male, participated in our study. When the participants with COVID-19 infection were asked about their post-infection approach, 31 (50%) of the participants stated that "no change in the ways of protection", 20 (32.3%) felt the need for more protection, and 11 (17.7%) also announced that he had loosened the protection measures. It has been shown that there is an increase in students’ anxiety during the pandemic. In addition, it was determined that a high rate of vaccination and vaccines were relied upon. Our data show that the COVID-19 pandemic has brought about some changes in the attitudes and behaviors of pharmacy students. Time will tell the long-term results of this study, in which we showed how these changes caused by the pandemic affect pharmacy students in the short term.

Non-alcoholic fatty liver disease among patients undergoing ultra-sonography abdomen and its associated factors in a tertiary care hospital, Kakinada

Background: Non-alcoholic fatty liver disease (NAFLD) presents a growing global health concern, characterized by the accumulation of hepatic lipids in the absence of significant alcohol consumption. Its prevalence has surged worldwide, including in India, where it has reached alarming levels. Despite its silent progression, NAFLD can lead to severe complications, including liver cirrhosis and hepatocellular carcinoma. Objectives of the study to assess prevalence and its associated factors, which are essential for effective management and prevention strategies. Methods: An observational, analytical cross-sectional study was conducted in a tertiary care hospital in Kakinada, Andhra Pradesh, from June to July 2022. Among 100 subjects, chosen through the simple random sampling. Ethical approval was granted before conducting study. Data on demographics, lifestyle risk factors, anthropometry, and ultrasound findings were collected using a pretested and validated case record form. Statistical analysis was carried out using SPSS software, employing appropriate tests to explore associations between NAFLD and various variables. Results: Among 100 participants, the prevalence of NAFLD was found to be 41%. Significant associations were observed between NAFLD and variables such as BMI (p=0.034), waist-hip ratio (p=0.002), and history of diabetes mellitus (p=0.000). Lifestyle factors, including increased cooking oil consumption, were identified as significant risk factors. Conclusions: The study highlights the high prevalence of NAFLD among subjects undergoing ultrasound abdomen in Kakinada. Significant associations were observed with BMI, waist-hip ratio, and diabetes mellitus history. Promoting healthy behaviours is crucial for NAFLD prevention and management.

Evaluation of Medical Students' Satisfaction With Using a Simulation-Based Learning Program as a Method for Clinical Teaching.

Objectives This cross-sectional analytical study aims to evaluate medical students' awareness and satisfaction regarding the utilization of simulation-based learning (SBL) as a method for clinical teaching at King Saud University (KSU) over the past 12 months. It seeks to understand how such learning methods enhance students' self-satisfaction and clinical skills, facilitate the application of learned knowledge, and assess the role of instructors in providing ample practice opportunities in the skills laboratory. Furthermore, the study aims to assess the satisfaction levels of students in both preclinical and clinical years regarding the time allocated for skills laboratory sessions and the integration of high-fidelity technology in simulation-based training programs at KSU. Methods In this cross-sectional study, a total of 306 male and female medical students from the College of Medicine at KSU participated, comprising 196 preclinical students (first, second, and third years) and 110 clinical students (fourth and fifth years). Quantitative data was collected through a structured questionnaire on a 5-point Likert scale that showed degrees of satisfaction. The satisfaction was measured based on a 5-point Likert scale that shows the degree of satisfaction from (very dissatisfied, dissatisfied, neither dissatisfied nor satisfied, satisfied, and very satisfied), and we calculated the p-value based on an independent t-test, and the percentage represented the percentage of students who chose satisfied and very satisfied. Results The results showed overall satisfaction with SBL (mean: 3.98, 71.10%), and it was recognized as a useful and effective method of learning skills. It is reported that it helped the students implement what they learned. At the same time, lower satisfaction was identified in areas with less allocated time for skill labs. Moreover, lack of accessibility and lack of trained staff were reported, and they should be addressed by providing staff with proper training. Conclusion The results of the study will help to understand how students' learning needs should be addressed. Moreover, providing simulation-based training is a pathway compliant with the best educational standards that should be adapted according to each institution's singularities. Besides offering further results, the study presents suggestions for further research.

Plasma NGAL (Neutrophil Gelatinase Associated Lipocalin) Levels in Septic Patients With &amp; Without Acute Kidney Injury: A Plausible Biomarker

Introduction: Acute kidney injury is extremely common among septic patients. Its early recognition among critically ill patients can help in better prognosis and decrease the risk of longer hospital stay and dialysis requirement. Creatinine is considered as a gold standard for diagnosis of Acute Kidney Injury but it has its own disadvantages. New biomarkers for Acute Kidney Injury that can help in its early recognition are the need of time. Many plasma and urinary markers including Neutrophil Gelatinase Associated Lipocalin are being studied. Its role in earlier detection of septic Acute Kidney Injury in septic patients in our set of population still needs extensive research where incidence of sepsis associated complications leading to death is extremely high. Aims and Objectives: To measure plasma Neutrophil Gelatinase Associated Lipocalin levels in septic patients with and without acute injury compare pNGAL levels in two groups, and to measure specificity and sensitivity of plasma Neutrophil Gelatinase Associated Lipocalin levels in both sets of patients. Place and Duration of study: A cross sectional analytical study was carried out in National Health Research Complex, Shaikh Zayed Hospital, Lahore over a period of 3 years from 2016-2019 Material and Methods: This is a cross-sectional analytical study carried out in ninety two patients that are divided in two groups on the basis of creatinine levels measured at 72hrs. First group consists of septic patients who developed Acute Kidney Injury (AKI) and second group consists of septic patients Without Acute Kidney Injury(WAKI). Plasma NGAL levels are compared in two groups. SPSS v 20 was used for analysis, p-value ? 0.05 was considered significant. Results: The plasma NGAL level at 24 hours for group without Acute Kidney Injury was 126.4±15.4 ng/ml and for the group which developed Acute kidney Injury was 191.1±15.9 ng/ml and the difference was clearly significant with p- value &lt;0.001. Conclusion: pNGAL levels are significantly raised than the cut-off value of 150ng/ml at 0hrs in septic patients who developed AKI as compared to septic patients who didn’t develop AKI.

Frecuencia y factores asociados a problemas de salud mental en trabajadores vacunados contra el COVID-19 de un hospital público peruano

Introduction: The pandemic increased stress and underdiagnosed mental health issues in the workplace. Objective: To determine the frequency of mental health problems and their associated factors among vaccinated workers at the Dos de Mayo National Hospital (HNDM). Methods: A cross-sectional analytical study was conducted using secondary data from a mental health survey carried out by the HNDM Mental Health Service in October 2021. The Self-Reporting Questionnaire (SRQ) was administered to all HNDM workers who had received the full vaccination scheme. Statistical analysis included chi-square tests and logistic regression to identify associated factors. Results: Of 2109 workers, 2.7% presented mental health problems, with a higher prevalence in women (3.4%) compared to men (1.5%), and more frequent in the age groups 18-29 years (4.8%) and 50-59 years (4%). Divorced/separated individuals (7%) had a higher prevalence compared to single (2.8%) or married (2%) individuals. Multivariate analysis indicated a positive association with women (ORa: 2.30; 95% CI: 1.22-4.84) and divorced/separated individuals (ORa: 3.00; 95% CI: 1.12- 7.25) compared to married/cohabiting individuals. There was a negative association in the 30-39 years (ORa: 0.43, 95% CI: 0.19-0.96) and 40-49 years (ORa: 0.30, 95% CI: 0.11-0.81) age groups compared to 18-29 years. No signi cant associations were found for other variables. Conclusion: One in forty HNDM workers presented mental health problems, with higher risks observed among women, younger and older age groups, and divorced/separated individuals. Improved screening and support for early intervention are recommended.

Relationship of Plasma Osmolarity within Hospital Mortality in Patients with Acute Pulmonary Embolism

Relationship of Plasma Osmolarity within Hospital Mortality in Patients with Acute Pulmonary Embolism

Hipertrigliceridemia asociada a resistencia a la insulina en niños con obesidad

Introduction: Hypertriglyceridemia has been linked to insulin resistance. Objectives: To evaluate the relationship and predictive capacity of hypertriglyceridemia for insulin resistance in obese children. Methods: A cross-sectional analytical study was conducted in obese children aged 6 to 14 years, treated at the Belén Hospital of Trujillo between 2014 and 2019. Fifty-eight randomly selected medical records were analyzed. Insulin resistance was measured using the Homeostasis Model Assessment (HOMA) index (≥3). Descriptive, correlational analyses, and Odds Ratio (OR) calculations were used, along with predictive indicators such as sensitivity and specificity. Results: Of the 58 children studied, 58.6% had elevated triglyceride levels and 74.1% showed insulin resistance. There was a significant correlation between triglyceride levels and the HOMA index (coef.: 0.543; p&lt;0.001). Elevated triglyceride levels (OR=18.91; 95% CI: 3.67-97.36; p&lt;0.001), fasting glucose (OR=46.20; 95% CI: 5.39-396.06; p=0.010), fasting insulin (OR=52.89; 95% CI: 6.11-457.55; p&lt;0.001), and the presence of acanthosis nigricans (OR=36.17; 95% CI: 4.28-305.98; p&lt;0.001) were significantly associated with insulin resistance. Hypertriglyceridemia showed a sensitivity of 74.4% and a specificity of 86.7% for predicting insulin resistance. Conclusion: Hypertriglyceridemia is significantly associated with insulin resistance in obese children and has an acceptable performance as a predictor. This factor may serve as an early marker and predictor to implement appropriate preventive measures in vulnerable populations.