Analytical Cross-sectional Study Research Articles

POSTTRAUMATIC STRESS DISORDER AND PSYCHOSOCIAL RISK FACTORS IN FIRST RESPONSE WORKERS TO EMERGENCIES. MIXED METHOD.

First responders to emergencies are exposed to various risks, including psychosocial risk factors. Caring for patients in critical situations, experiencing traumatic events, and working under highly complex conditions increase their probability of developing mental disorders, such as posttraumatic stress disorder (PTSD). The objective of the study was to determine the relationship between PTSD and psychosocial risk factors and to understand the experiences of the disorder in this population. An explanatory sequential mixed method research design was used. The quantitative phase was an analytical cross-sectional observational study (n = 193), and the qualitative phase was phenomenological (n = 5). The psychosocial risk factors that best explained the presence of PTSD symptoms were the influence of non-work conditions on work, religion, emotional avoidance, and professional support as individual factors related to coping strategies. Individual factors such as coping strategies were determining factors that explained the symptoms of PTSD, and the influence of non-work conditions on work. It was identified that the demands of the job and the organizational factors, such as leadership style and lack of institutional support, generate anguish in workers and affect their ability to regulate their emotions when exposed to critical incidents.

Knowledge level and constructs of the theory of planned behaviour (TPB) to the practice of unsafe abortion among postnatal mothers attending Mkonze health center, Dodoma Region, Tanzania

BackgroundUnsafe abortion is now a global agenda because 45% of all global abortions are unsafe, and 97% are occurring in developing countries. In Tanzania, one million reproductive-aged women face unplanned pregnancies per year, and 39% end up with abortion. About 16% of maternal deaths are reported per year in Tanzania, and unsafe abortion takes the second position. There are several efforts to prevent and intervene unsafe abortions, such as equipping healthcare facilities across all levels of healthcare, approval of Misoprostol use, establishment of comprehensive post-abortion care (PAC), revising policy guidelines and standards, provision of emergency contraceptives, and capacity building of healthcare providers. There is little documentation about how the constructs of the theory of planned behaviour, knowledge, and sociodemographics influence the practice of abortion.ObjectivesTo assess the association of knowledge level, sociodemographic characteristics, and constructs of the theory of planned behaviour (TPB) to the practice of unsafe abortion among postnatal mothers at Mkonze Health Center in the Dodoma region.MethodologyIt is an analytical cross-sectional study design conducted in Dodoma-Tanzania and involved 206 postnatal women. A validated questionnaire was used and analysis was performed in the Statistical Package for the Social Sciences (SPSS), through descriptive and inferential statistics.ResultsThe practice of unsafe abortion in the current study is 28/206 (13.6%), influenced bytheir lower educational level and being single women. It was found that the majority had adequate knowledge of unsafe abortion 129 (62.6%), positive attitude 130 (63.1%), good subjective norms 113 (54.9%), and positive perceived behavioral control111 (53.9%). Knowledge, attitude, subjective norms, and perceived behavioral control were not significantly associated with the practice of unsafe abortion.ConclusionThe majority of the respondents had high knowledge, attitudes, subjective norms, and perceived behavior control on unsafe abortion. This is an indicator that the implemented initiatives are effective. Maintaining the ongoing effort and improving strategies are promising to mitigate the burden of unsafe abortion. Future research needs to find out hidden factors associated with attitude and how health beliefs might influence someone’s attitude towards unsafe abortion.

Extraarticular manifestations of juvenile idiopathic arthritis and their impact on health-related quality of life.

The objective of this study is to investigate extraarticular manifestations (EAMs) in patients with juvenile idiopathic arthritis (JIA) and assess their impact on health-related quality of life (HRQoL) among these patients. This cross-sectional analytic study was carried out on 117 patients with JIA. EAMs were identified clinically by history and examination. Sicca symptoms, peripheral neuropathy, enthesitis, and skin lesions were picked up during clinical examination. Pulmonary involvement was evaluated by high-resolution CT chest. Patients were assessed by abdominal ultrasonography to assess the size of liver and spleen. Atlantoaxial subluxation was evaluated by cervical spine x-rays. Patients were evaluated by Pediatric Quality of Life Inventory-4 (PedsQL-4) and PedsQL-3 arthritis module. The median age of patients was 14years with a median disease duration 4years, 82.9% were females. Of the studied 117 JIA patients, 85 patients (72.6%) had at least one EAM. Persistent fatigue (51.3%) was the most prevalent EAM, followed by recurrent skin rash (16.2%), enthesitis (15.4%), recurrent fever (13.7%), and uveitis (12%). Patients with EAMs scored significantly lower in physical functioning (p = 0.001), emotional functioning (p < 0.001), social functioning (p = 0.005), and school functioning (p = 0.001). Regarding PedsQL arthritis module, patients with EAM had also significantly lower scores than did patients without EAM on the domains of pain and hurt (p < 0.001), daily activities (p = 0.008), and worry (p = 0.001). EAMs are prevalent among JIA patients and have a negative impact on their HRQoL. So, early identification and treatment are highly recommended. Key Points • A large percentage of JIA patients experienced at least one extraarticular manifestation (EAM). • Persistent fatigue and recurrent skin rash are the most prevalent EAMs in JIA patients. • JIA patients with EAMs have worse scores in almost all domains of HRQoL.

Nicotine Dependency Levels Among Adult Electronic Cigarette Smokers in Jeddah, Saudi Arabia: An Analytical Cross-Sectional Study.

Electronic cigarettes (ECs) are a recent method to deliver nicotine with less harmful effects than traditional cigarettes. Studying nicotine dependence in adult EC users is a crucial area, but few measures are available to evaluate nicotine dependence induced by EC. Our study aims to estimate the levels of nicotine dependency among adult EC smokers using a modified Fagerström Test of Nicotine Dependence (e-FTND) in Jeddah, Saudi Arabia, and to identify EC-associated sociodemographic and smoking-related factors affecting nicotine dependency. An analytical cross-sectional study was conducted on adults 18 years of age and older in Jeddah, Saudi Arabia, from December 2023 to March 2024. Data were collected from the participants using a pre-tested structured self-administered questionnaire, and nicotine dependence was assessed using the modified e-FTND. Descriptive statistics such as frequency, mean, and standard deviation were applied. Chi-square was used to assess the association between categorical variables. Ordinal regression was used to predict the nicotine dependency levels with different variables. A total of 344 participants were included in the study. The mean e-FTND score for EC users was 4.14 ± 2.45. Females had a lower likelihood of experiencing higher dependence compared to males (OR = 0.52, 95% CI: 0.32, 0.85). Using ECs for more than three years was associated with higher odds of increased dependence (OR = 3.18, 95% CI: 1.28, 7.98; p < 0.001). The use of Pod system devices lowered the odds of developing high nicotine dependence (OR = 0.32, 95% CI: 0.13, 0.75; p = 0.01) compared to Iqos device users, while mechanical Mod device users exhibited a trend towards higher dependence, although it was not statistically significant. Nicotine concentration in ECs had a significant impact on the degree of nicotine dependence. Higher concentrations were associated with increased odds of higher dependence (12-18 mg: OR = 3.26, 95% CI: 1.55, 6.91; >18 mg: OR = 4.53, 95% CI: 2.37, 8.75; p < 0.001). Most exclusive EC users in the study developed a moderate nicotine dependence level. The EC device type and nicotine concentration were significant drivers of nicotine dependence. Additionally, the personal characteristics of the users, such as male gender and duration of use, were associated with a higher risk of dependence. An in-depth understanding of the magnitude of nicotine dependence among EC users will enhance the opportunity for tailored health-enhancing interventions and policies.

Predictors of under-weight among children younger than 24 months in Nimule Border Town, Eastern Equatoria State, South Sudan: a community-based cross sectional study

BackgroundUnderweight is a public health problem globally, and more severe in South Sudan with wide sub-regional differences. In Nimule border town, which represents other border towns in South Sudan, data on underweight among children below two years is unavailable. Thus, this study set out to assess predictors of underweight among children younger than 24 months in Nimule border town, Magwi County, Eastern Equatoria State, South Sudan.MethodsAn analytical cross-sectional study was conducted in Nimule boarder town targeting 390 children younger than two years. Systematic sampling and simple random sampling methods were used. Data were collected through a researcher-administered questionnaire with both open and closed ended questions. Data was entered in EpiData and then exported into Statistical Package for Social Sciences research (SPSS) version 20 for analysis. Descriptive data analysis was conducted and data were summarized into frequencies and percentages, means with standard deviations, and medians with interquartile ranges. Bivariate analysis was conducted with the Chi-squared and Fisher's exact tests for categorical independent variables, and the student’s t-test for numerical variables. Finally, multivariate analysis was done via logistic regression analysis and results were stated as odds ratios (OR) with corresponding 95% confidence interval (CI). The level of statistical significance was set at 5%.ResultsOut of the total 390 participants, 112 (28.7%) were under weight. The study showed primary (aOR, 0.38; 95% CI, 0.12–1.18; P = 0.095) and secondary (aOR, 0.37; 95% CI, 0.12–1.17; P = 0.091 levels of education were associated with underweight but not tertiary level of education (aOR, 0.76; 95% CI, 0.21–2.74; p = 0.671). Household income of 5000 to 10,000 (aOR, 0.26; 95% CI, 0.10–0.68; P = 0.006) and above 10,000 (aOR, 0.11; 95% CI, 0.04–0.28; P < 0.001) South Sudanese pounds, supplementary feeding before 6 months (aOR; 0.01; 95% CI, 0.02–0.05; P < 0.001) were associated with underweight and irregular hand washing (aOR; 2.17; 95% CI, 1.14–4.11; P = 0.018) was associated with increased odds of underweight.ConclusionsThis study established a high prevalence of underweight. Maternal level of education particularly primary, secondary, higher household incomes in excess of 5,000 South Sudanese pounds reduced the risk of underweight. While irregular hand washing was a risk factor for underweight.

Maternal and neonatal outcome in pregnant women undergone induction of labor at Muhimbili National Hospital, Dar Es Salaam, Tanzania

IntroductionLabor induction is a common obstetric intervention aimed at initiating labor when spontaneous onset is delayed or deemed necessary for maternal or fetal well-being. Despite its widespread use, the practice’s impact on maternal and neonatal outcomes remains a subject of ongoing research and debate. This study aims to evaluate the maternal and neonatal outcomes associated with labor induction in a tertiary hospital setting in Tanzania.MethodologyA descriptive analytical cross-sectional study was conducted over a seven-month period from January 2021 to July 2021 at Muhimbili National Hospital in Dar es Salaam, Tanzania. A total of 120 pregnant women who underwent labor induction during this period were included in the analysis. Data on maternal demographics, obstetric characteristics, indications for induction, methods of induction, labor outcomes, and neonatal outcomes were collected from medical records and analyzed descriptively.ResultsAmong 4773 deliveries during the study period, 120 women underwent labor induction, accounting for 120 (2.5%) of all deliveries. The most common indications for induction were postdate pregnancy 60 (50%), hypertensive disorders of pregnancy 38 (31.7%), and premature rupture of membranes 22 (17.5%). The majority of induced women 74 (61.7%) delivered vaginally, with 46 (38.3%) undergoing cesarean section. Maternal complications were minimal, with the most common being failed induction of labor 17 (14.2%). Neonatal outcomes were generally positive, with 120 (100%) of neonates having Apgar scores of 7 or higher at five minutes, although 10 (8.3%) required admission to the neonatal ward for further care.ConclusionLabor induction at Muhimbili National Hospital demonstrated favorable maternal and neonatal outcomes, with low rates of maternal complications and positive neonatal Apgar scores. Postdate pregnancy emerged as the most common indication for induction. While the study highlights the benefits of labor induction, its retrospective nature and single-center setting limit the generalizability of findings. Prospective studies with larger sample sizes are warranted to validate these findings and inform evidence-based obstetric practices.

Postoperative Hemoglobin Drop and the Associated Factors among Elective Orthopedic Surgeries in Northern Tanzania

Background. Having an estimated level of Hb drop in different orthopedic surgeries would help plan for surgery from pre- to postoperative periods. The aim of this study was to assess the Hb drop and the associated factors during the intraoperative period among elective orthopedic surgeries. Methods. This was an analytic cross-sectional study conducted between October 2022 and March 2023, which included all patients admitted for elective orthopedic surgery who met the inclusion criteria. Data were collected before and after the patient was operated on. Information was analyzed using t-tests and ANOVA to establish the statistical significance of the Hb drop. Results. A total of 195 participants were enrolled. The majority of the participants were male (62.1%), with the main etiology of symptoms being motor traffic accidents (31.8%). The most affected site was the femur (36.4%), followed by the spine (23.6%). The highest mean Hb drop was in total hip replacement surgeries (4.19 g/dL), with the overall mean Hb drop being 2.75 g/dL. A statistically significant difference was identified in diathermy use, duration of surgery, and patients with chronic illnesses. Conclusion. With a mean Hb drop of 2.75 g/dL, the application of diathermy and surgeries with shorter durations resulted in a reduced Hb drop. These factors should be incorporated to minimize the drop in Hb in orthopedic surgeries. Accounting for differences in surgeries, there should not be delays in patients who have a preoperative Hb level that can sustain the mean Hb drop recorded in the study.

Factors Associated with the Perception of Prehospital Internship Training of Dental and Other Health Sciences Students in the COVID-19 Context

During the COVID-19 pandemic, pre-internship training of Health Sciences students took on an essential role. The shift to virtual practices and a project-based learning approach brought challenges, but also opened doors for adaptation and learning in a constantly evolving healthcare landscape. To determine the factors associated with the perception of Peruvian health sciences students during the period of isolation due to the COVID-19 pandemic regarding their training prior to hospital internship. A Cross-sectional analytical study was performed. Students from professional schools of health sciences who entered the hospital internship 2022 and students from the year prior to the internship from a Peruvian public university were evaluated. Data collection was performed with a 49-question questionnaire. Female participants were more prevalent with 384 (70.98%) students while the medical career had the highest participation with 152 respondents (28.1%) followed by the dental career with 134 (24.77%). In the adjusted logistic regression model no influence of associated factors on students' perception of their preparedness for hospital internship in the isolation period due to the COVID-19 pandemic was found. Peruvian Health Sciences students self-perceive themselves prepared for hospital internship in Comprehensive Care, Prevention, Collaboration and Self-Learning, but less so in Practical Skills, Understanding Science, Interpersonal Skills and Confidence.

Comparative study of two laboratory techniques for the detection of HLA-B27 in patients with axial spondyloarthritis: a cross-sectional analysis

BackgroundThe diagnostic and prognostic relevance of Human Leukocyte Antigen B-27 (HLA-B27) in Axial Spondyloarthritis (AxSpA) is undeniable, with 70% of Ankylosing Spondylitis (AS) patients carrying the B27 gene, contrasted with a mere 4.35% in the general population. Flow cytometry (FC) and Polymerase Chain Reaction (PCR) have emerged as the predominant techniques for routine HLA-B27 typing. While various studies have compared these methods, none have catered to the unique characteristics of the Brazilian demographic. Therefore, this research aims to compare FC and PCR in a Brazilian cohort diagnosed with AxSpA.MethodsAn analytical cross-sectional study was undertaken involving 62 AxSpA outpatients from a Brazilian University Hospital. Both FC and PCR-SSP assays were utilized to ascertain HLA-B27 typing. The outcomes (either confirming or refuting the allele’s presence) underwent rigorous scrutiny. Agreement between the methodologies was assessed using the kappa statistic. A p-value of < 0.05 was deemed statistically significant.ResultsOf the participants, 90.3% (n = 56) were HLA-B27 positive according to FC, while 79% (n = 49) were identified as positive using the PCR method. FC exhibited a sensitivity rate of 98% paired with a specificity of 38.5%. The Positive Predictive Value for FC stood at 85.7%, and the Negative Predictive Value was 83.5%. Consequently, the overall accuracy of the FC method was gauged at 85.5%. A kappa coefficient of κ = 0.454 was derived.ConclusionsFC demonstrated noteworthy sensitivity and satisfactory accuracy in HLA-B27 detection, albeit with a reduced specificity when contrasted with PCR-SSP. Nevertheless, given its cost-effectiveness and streamlined operation relative to PCR, FC remains a pragmatic option for preliminary screening in clinical practice, especially in low-income regions. To optimize resource allocation, we advocate for a refined algorithm that initiates by assessing the relevance of HLA-B27 typing based on Choosing Wisely recommendations. It then leans on FC, and, if results are negative yet clinical suspicion persists, advances to PCR. This approach aims to balance diagnostic accuracy and financial prudence, particularly in regions contending with escalating medical costs.

Structural relations of illness perception, fatigue, locus of control, self-efficacy, and coping strategies in patients with multiple sclerosis: a cross-sectional study

BackgroundPatients with multiple sclerosis (MS) experience extensive problems due to fatigue and illness perception. Reducing these problems may improve these patients’ quality of life (QoL). Accordingly, the current study is aimed at investigating the mediating role of self-efficacy, locus of control, coping strategy, and outcome expectancy in the relationship between illness perception and fatigue severity in patients with MS.MethodsIn a cross-sectional analytical study, data of 172 MS patients were collected by self-report questionnaires including illness perception questionnaires (IPQ-R), Multiple Sclerosis Self-Efficacy (MSSES) scale, health locus of control (MHLC), coping strategies in MS(CMSS), outcome expectancy, level of physical activity (IPAQ-SF), patient activation measure (PAM-13) and fatigue severity scale (FSS). The data were analyzed using linear and multiple regression analysis in SPSS software version 24 (SPSS Inc., Chicago, IL, USA).ResultsThe final model explained 62% of the fatigue variance. Illness perception both directly and indirectly (through self-efficacy, physical activity level, internal health locus of control, patient activation, and negative coping strategies) could predict the participants’ fatigue severity. Among the mediating variables, internal health locus of control, self-efficacy, and negative coping strategies had the greatest impact, respectively. moreover, outcome expectancy variable did not a mediating role in the aforementioned relationship.ConclusionsTo enhance the well-being of MS patients and to improve the efficiency of treating MS related fatigue, a comprehensive treatment protocol is needed, encompassing psychological factors affecting fatigue severity.

Characteristics of her2-positive breast cancer, and the current use of anti-her2 therapy and its related factors

ABSTRACT Objective: To describe the characteristics of patients with HER2-positive breast cancer and to identify the proportion of patients using anti-HER2 therapy, and treatment-making related factors. Methods: An analytical cross-sectional study was conducted on 79 patients with BC and HER2-positive diagnosed by immunohistochemistry (IHC) or with FISH at the Oncology Department of Hue University of Medicine and Pharmacy Hospital and Oncology Center of Hue Central Hospital from 1/2021 to 12/2022. Clinical and pathological features, type of drug, number of cycles using anti-Her2 therapy were recorded using medical documents. The decision-making related factors were recorded by questionnaire interviewing patients and relatives. Exclusion criteria included recurrent or previously treated tumors; having contraindications with anti-HER2 therapy; not being willing to participate in the study. SPSS 22.0 was used for the analysis. Results: Mean age was 54.14 ± 11.03. Patients with right-sided BC accounted for 53.1%. 60.8% of tumors were located in the upper right quadrant of the breast. Patient’s self-report of lumps was the most common cause of hospitalization (77.2%). By ultrasound, 60.2% of participants had a tumor size of 2 - 5cm. Abnormal lymph nodes were identified in 40.8% of patients. Histopathologically, invasive ductal carcinoma was found in the majority of tumors (75.9%). Stage II was predominant with 59.5% and 7.6% of patients with stage IV. The rate of treatment with Trastuzumab in our study was 27.8%. The main reason that patients refused anti-HER-2 therapy was financial problems (96.5%). The awareness of anti-HER2 therapy among patients and their relatives was significantly associated with the treatment decision (p = 0.007). Conclusion: Regarding the positive-HER2 BC patients, invasive ductal carcinoma was the major histopathological finding. More than half of the patients were classified as stage II of the disease. The rate of patients undergoing antiHER2 therapy was 27.8%. Financial problems were found to be the main reason for refusal of treatment. Awareness of anti-HER2 therapy is significantly associated with the patient’s decision on treatment.

Knowledge, attitude and practices around breast cancer and screening services among women of reproductive age in Turbo sub-county, Kenya

BackgroundOnly 12% of Kenyan women use breast cancer (BC)screening programs. Early identification is critical for reducing the condition's associated morbidity and mortality. Unfortunately, few studies have been conducted on the screening program's implementation and the causes for the low usage rates in Turbo Sub-County, Kenya. The purpose of this study was to learn about women of reproductive age's (WRA) practices, attitudes, and knowledge regarding BC screening programs, as well as to investigate the potential association between lifestyle factors and BC screening service utilization. MethodsMixed-method approaches were used in an analytical cross-sectional study design. The study included 317 participants selected randomly. An interviewer-administered questionnaire was used to collect quantitative data while focus group discussion (FGD) and key informant interview (KII) guides were used for collecting qualitative data. The Statistical Package for Social Sciences (SPSS) version 26 was used to manage quantitative data, whereas NVivo version 12 was used to analyze qualitative data. Chi-square, Fisher's exact test, and multiple logistic regression were used to assess the degree of relationship between BC screening service uptake and independent variables. The qualitative data was transcribed verbatim, and the transcripts were automatically coded to generate themes. ResultsThe participants' mean age was 30.14 (9.64). Breast cancer screening services were used by 10.21% of the population. Women who were aware of the signs and symptoms of BC were 71.5 times more likely to undergo screening than their counterparts. Similarly, those with positive attitudes toward BC and screening programs were 84 times more likely to get screened than those with negative attitudes. Breastfeeding increased the likelihood of BC screening by OR = 37 (95% CI: 0.00–0.32), physical activity by OR = 37 (95% CI: 0.00–0.25), and chronic illnesses by OR = 37 (95% CI: 0.00–0.17). ConclusionKnowledge of signs and symptoms of BC and a positive attitude towards perceived barriers enhanced the probabilities of BC screening. Being physically active, breastfeeding, and having a chronic disease all increased the odds of BC screening uptake. To improve screening rates, it is necessary to provide sufficient information to those who are least likely to be screened.

Association between gait speed and balance disorders in older adults from 12 high Andean Peruvian communities, 2013-2019.

Gait speed is associated with a higher prevalence of balance disorders in older adults residing at high altitudes. This study investigated this association in older adults from 12 high-altitude Andean Peruvian communities. We performed a secondary data analysis from an analytical cross-sectional study of adults >60 years of age, residing in 12 high-altitude Andean Peruvian communities, enrolled between 2013 and 2019. The exposure and outcome variables were gait speed (categorized in tertiles), and balance disorders (defined as a functional reach value of ≤20.32 cm), respectively. We built generalized linear models of the Poisson family with a logarithmic link function and robust variances, and estimated crude prevalence ratios (cPR) and adjusted prevalence ratios (aPR) with 95% confidence intervals (CIs). We analyzed 418 older adults; 38.8% (n=162) were male, and the mean age was 73.2 ± 6.9 years. The mean gait speed and functional reach were 0.66 ± 0.24 m/s and 19.9 ± 6.48 cm, respectively. In the adjusted regression model, the intermediate (aPR=1.88; 95% CI: 1.39-2.55; p<0.001) and low (aPR=2.04; 95% CI: 1.51-2.76; p<0.001) tertiles of gait speed were associated with a higher prevalence of balance disorders. The intermediate and low tertiles of gait speed were associated with a higher prevalence of balance disorders among older adult residents of 12 high-altitude Andean communities. We recommend further research on the behavior of this association to propose interventions for these vulnerable groups and reduce the impact of geriatric conditions.

The Effect of Neonatal Intensive Care Nurses' Attitudes Towards Palliative Care on Death Anxiety and Burnout: An Analytic Cross-Sectional Study.

This study aimed to determined the effect of neonatal intensive care nurses' attitudes towards palliative care on death anxiety and burnout. This was an analytic cross-sectional study conducted with 215 neonatal intensive care nurses working a children's hospital with Turkey's largest NICU bed capacity. The mean Neonatal Palliative Care Attitude Scale total score was 3.04 ± 0.78, and the mean scores of the organization, resources, and clinician subscales were 3.16 ± 0.86, 2.87 ± 0.80, and 3.10 ± 0.97, respectively. The participants' mean Death Anxiety Scale score was 57.65 ± 21.46, and the mean Burnout Inventory score was 39.21 ± 17.61. The organization subscale explained 17% of the variance in death anxiety, and the organization and resources subscales explained 31% of the variance in burnout. Neonatal intensive care nurses' palliative care attitudes are moderate; they face obstacles in providing and improving their attitudes in this field. The high level of obstacles increases nurses' death anxiety and burnout.

Evaluation of the Knowledge and behavior of Indonesian Mothers About Infantile Colic

Introduction: Infantile colic is a functional gastrointestinal disorder (GSCF) found in 20-30% of infants aged 5 months which is characterized by recurrent prolonged periods of infant irritability, fussing, or crying without obvious cause and cannot be prevented or resolved by parents. Infantile colic is often associated with higher mothers depression and lower quality of life. Mothers' knowledge and behavior of infantile colic varies greatly. This research to investigate the knowledge and behavior of Indonesian mothers regarding infantile colic and related factorMethods: A cross-sectional analytic observational study with the target of 100 mothers with babies aged 0-12 months was performed using an electronic questionnaire in Google forms. The questionnaire consists of multiple-choice questions regarding the mothers' knowledge and behavioral to infantile colic.Results: As many as 82% of mothers understand that infantile colic as recurrent prolonged periods of crying that occur without obvious cause and cannot be prevented or resolved by parents, however only 12% of mothers know that most infantile colic will disappear by the age of 5 months. Forty percent mothers had babies with infantile colic; 97.5% of them were worried about their baby's condition and 7.5% of the mothers gave them medication. There was no significant difference between mothers' age and number of children with inadequate mother-infant interaction (P = 0.770 and P = 0.647)Conclusion: The knowledge and behavior of mothers in Indonesia regarding infantile colic is quite good, however parental reassurance still needs to be improved, especially to reduce maternal anxiety.

Cardiovascular manifestations in pediatric multisystem inflammatory syndrome associated with COVID-19 in a tertiary care pediatric center in Mexico City

The objective is to expose the cardiovascular alterations in patients diagnosed with pediatric inflammatory multisystem syndrome (PIMS) associated with COVID-19 during the SARS-CoV-2 pandemic, in order to understand the disease, its evolution, and optimal management upon diagnosis. Retrospective, observational, cross-sectional analytical study of patients diagnosed with PIMS according to the criteria of the World Health Organization at the National Institute of Pediatrics, from March 2020 to December 2021. During the study period, 77 patients with PIMS were diagnosed. The results showed correlation between the shock state and alteration of laboratory markers (platelets 144217.29 ± 139321.6 μL [p < 0.001], procalcitonin 27.37 ± 38.37 ng/ml [p = 0.05] and ferritin 1937.87 ± 2562.63 [p < 0.001]). The ventricular function in patients with shock was significantly lower compared to those without shock (49.6 ± 9.1% vs. 58.1 ± 8.4 %; t-Student p < 0.001), as well as injury to the left coronary artery (p = 0.02). There is a correlation between NT-proBNP and ventricular dysfunction (Kruskal-Wallis p = 0.007). Statistical significance was found in the association between death, elevation of inflammatory markers and ventricular dysfunction (p < 0.001). The cardiovascular alterations observed, in order of frequency, were pericardial effusion (25.7%), myocarditis (15%), mild ventricular dysfunction (13.5%) and small coronary aneurysm with predominance of the left coronary artery and the anterior descending one.

The Relationship Between Digital Game Addiction and Levels of Anxiety and Depression in Adolescents Receiving Cancer Treatment.

Adolescents diagnosed with cancer are vulnerable to symptoms of anxiety, depression, and posttraumatic stress. To examine the relationship between digital game addiction and levels of anxiety and depression in adolescents receiving cancer treatment. This analytical cross-sectional study was carried out with 120 adolescents aged 12-17 years who were receiving cancer treatment. Data were collected using the Digital Game Addiction Scale (DGAS-7) and the Hospital Anxiety and Depression Scale (HADS). Data were analyzed using independent-samples t test, 1-way analysis of variance, Pearson correlation analysis, and simple linear regression. The mean age of the adolescents participating in the study was 15.21 ± 1.64 years. The mean DGAS-7 score was 15.19 ± 5.58, whereas the mean HADS Anxiety subscale score was 8.54 ± 4.33, and the mean HADS Depression subscale score was 7.72 ± 3.96. A positive, statistically significant relationship was found between the DGAS-7 mean score and the HADS Anxiety and Depression subscale mean scores (P < .001). As the addiction levels increased in adolescents diagnosed with cancer, their anxiety and depression levels also increased. Health professionals should be mindful that in adolescents diagnosed and treated for cancer, digital game addiction and levels of anxiety and depression may mutually reinforce each other.

Cardiac autonomic neuropathy in diabetic patients; an analytical cross-sectional study

Cardiac autonomic neuropathy in diabetic patients; an analytical cross-sectional study

Examining the relationship between Life’s Essential 8 and atherosclerotic cardiovascular disease among Adults in the United States: Insights from the National Health and Nutrition Examination Surveys (2017-2020)

The American Heart Association recently updated the assessment of cardiovascular health (CVH) with the Life&amp;rsquo;s Essential 8 (LE8) score. Our cross-sectional analytical study utilized data from 5042 adults in the United States (US) from the 2017 to 2020 NHANES surveys to examine the relationship between CVH assessed by LE8 metrics and the prevalence of atherosclerotic cardiovascular disease (ASCVD). Multivariate linear regressions were utilized to explore the relationship between CVH metrics and ASCVD, while linear probability models were used to predict ASCVD prevalence based on achieved LE8 scores. Controlling for relevant covariates revealed an inverse association between LE8 metrics and ASCVD prevalence. Improvements in LE8 were linked to a 29% reduction in ASCVD prevalence, with transitions to higher LE8 quartiles predicting a 4.8% reduction in ASCVD prevalence. Subgroup analysis indicated significant effects of age, education, and gender on ASCVD prevalence, with younger age, college education, and the female gender being associated with lower prevalence (P &lt; 0.05). Higher LE8 scores correlated with decreased ASCVD prevalence, while factors such as younger age, college education, and the female gender were also associated with lower ASCVD prevalence. Conversely, transitioning from married to divorced/widowed/separated status was linked to increased ASCVD prevalence (P &lt; 0.01).

Zinc, antioxidant enzymes in preeclampsia, and association with newborn outcome

BackgroundThe etiology of preeclampsia (PE) may be associated with the increased of production of reactive species and decreased antioxidant activity of enzymes. Inadequate intake of Zn can affect gestational health due to its biological functions, such as its role in the antioxidant defense system. The study aimed to assess the nutritional status of Zn and antioxidant enzymes in postpartum women and its correlation with neonatal outcomes. MethodsA cross-sectional analytical study was carried out at a referral gynecology and obstetrics hospital. A total of 119 women (PE = 58, HP = 61) participated in the study. A quantitative food-frequency questionnaire was used to assess food consumption and further analyze the dietary Zn levels.Zinc levels in plasma and erythrocytes samples were analyzed by flame atomic absorption spectrometry, catalase (CAT), superoxide dismutase (SOD) and glutathione peroxidase (GPx) levels were determined by UV-Vis spectrophotometry. ResultsPlasma and dietary intake Zn results were considered adequate and without statistical difference between groups. SOD levels were significantly higher in the HP group (p = 0.011), and CAT levels were higher in the PE group (p = 0.050). There was a positive correlation between SOD activity in women with PE and the weight of their newborns (r = 0.336, p=0.021). ConclusionThe results showed adequate Zn levels (consumption and serum levels) in the groups studied, although with a reduction of plasma Zn in the PE group compared to the PH group.Zinc in plasma fractions and erythrocytes are important markers for oxidative stress, in particular, plasma Zn seems to be related to the rapid response to preeclampsia. The activity of antioxidant enzymes was elevated in the groups studied. Better SOD activity improves birth weight in children of pregnant women with preeclampsia.