Average Age Of Study Subjects Research Articles

Evaluation of Temporal Bone Infections - Comparing Sensitivity of Multiplex Assay to Standard Bacterial Culture

Background: The multiplex assay is a nucleus acid/base assay that can detect a wide array of distinct nucleic acid sequences from different pathogens. This study hopes to show the necessity and utility of this technology in detecting pathogens that cause middle ear infections. Methods: This observational study was conducted from May 2021-July 2022 to assess the sensitivity of a multiplex assay in a microfluidics pouch in the detection of bacterial and viral pathogens in middle ear fluids. Standard bacterial culture was used as a control. Middle ear fluid was obtained from 98 pediatric patients undergoing tympanostomy to treat otitis media. The BioFire PNA panel was used, which detects bacterial, viral, drug resistance, and atypical bacterial nucleic acid targets. Patient demographics, past medical history, and otitis media risk factors were also recorded.
 Results: A total of 107 ear samples were assessed from 98 patients. The average age of study subjects was 3.53 ± 2.99 years. The population of this study was 61.22% male, 75.51% Caucasian, 22.44% African American, and 2.04% Other, 88.78% Non-Hispanic, 10.2% Hispanic, and 1.02% Unknown. We found that Haemophilus influenzae was she most common pathogen detected (multiplex; culture) - (34.58%; 14.02%), followed by Moraxella catarrhalis (10.28%; 4.67%), Streptococcus pneumoniae (6.54%; 2.80%), Staphylococcus aureus (1.5%; 5.61%), and Proteus spp. (.94%; 0%). All bacteria, except Staphylococcus aureus were identified in more ear specimens by multiplex testing than bacterial culture.
 Conclusion: Our study demonstrates that multiplex testing is more sensitive than culture in identification of pathogens in middle ear fluid from patients undergoing tympanostomy for treatment of otitis media. The increased sensitivity for bacterial identification and simultaneous detection of viral targets in a very limited patient specimen make the multiplex assay a novel diagnostic tool which may be useful in the management of patients with otitis media in the future.

Prevalance and characteristics of sarcopenia in older patients with stable chronic obstructive pulmonary disease

Objectives: To determine the rate and characteristics of sarcopenia in older patients with stable chronic obstructive pulmonary disease. Subjects and methods: a cross-sectional descriptive study on 363 stable chronic obstructive pulmonary disease (COPD) patients aged ≥ 60 years old examined and treated at the National Geriatrics Hospital and 19-8 Hospital. Study subjects were measured appendicular skeletal muscle with dual energy adsorption radiographs and diagnosed with sarcopenia based on the criteria of Asian Working Group for sarcopenia – AWGS. Results: Average age of study subjects was 70.7 ± 8.3 (years), male rate was 60.3%. The prevalence of sarcopenia in the study group was 45.2%. 74.6% of patients had a decrease in total appendicular skeletal muscle according to height (ASMI), 68.3% had a decrease in handgrip strength (HGS) and 42.7% had a decrease in walking speed. The ASMI, handgrip strength and walking speed decreased with age. Conclusion: The study highlighted a high rate of sarcopenia (45.2%) in elderly patients with stable stage COPD. The ASMI, handgrip strength and walking speed decreased with age. Therefore, it is necessary to screening and early diagnosis of sarcopenia in elderly COPD patients.

Prevalence and Clinical Impact of Extra-pancreatic Incidental Findings Noted on Magnetic Resonance Imaging and Endoscopic Ultrasound Performed for Pancreatic Cancer Screening

BACKGROUND AND AIMSIncidental findings on pancreatic cancer screening tests can influence costs and patient preferences. We sought to determine the prevalence and clinical impact of extra-pancreatic incidentally findings noted on screening magnetic resonance imaging (MRI) and endoscopic ultrasound (EUS). METHODSWe identified 200 consecutive patients who underwent MRI (n = 100) and EUS (n = 100) for pancreatic cancer screening at our institution from 2015 to 2020. Extra-pancreatic incidental findings on MRI and EUS were recorded. Medical records were searched to determine follow-up and final diagnosis for incidental findings. Incidental findings were categorized as potentially serious or not serious. RESULTSDuring the study period, 180 consecutive patients who underwent MRI (n = 90) and EUS (n = 90) for pancreatic cancer screening met inclusion criteria. The average age of study subjects was 62 years, and were mostly female (67%), and white (84.4%). The most common indication for screening was BRCA 1 of 2 pathogenic variant (60%). Overall, incidental findings were noted in 52.2% patients undergoing screening and a diagnosis of extra-pancreatic malignancy was made in 2.2% patients. Incidental findings were noted in 84.4% patients undergoing MRI compared with 20% undergoing EUS (RR=4.9; P < 0.001). Potentially serious incidental findings were noted in 16.7% patients undergoing MRI compared with 6.7% undergoing EUS (P = 0.005). Patients undergoing MRI were 1.7-times more likely than those undergoing EUS to require invasive testing or follow-up (P = 0.057). CONCLUSIONAn almost 5-fold difference in prevalence of incidental findings was noted between patients undergoing MRI and EUS for pancreatic cancer screening. This should be discussed with patients when counseling them on choosing between these modalities.

Association Between Pre-Term Labour and Inter Pregnancy Interval

Objectives: To determine the frequency of preterm labour in association with interpregnancy interval among pregnant women visiting tertiary care Hospital. Subject and Methods: This prospective cross-sectional study was performed at Unit-I, Obstetrics and Gynaecology Department, Civil Hospital Karachi; from June to November 2020. A total of 190 women with singleton pregnancy confirmed by ultrasound were included. After taking detailed medical history regarding previous fetal death and C-section was recorded either patient goes into preterm labour or not and confirmed by history for short and prolong interpregnancy interval (IPI). Data was collected by pre-designed study proforma. Results: The average age of study subjects was 26.27±4.07 years. The frequency of preterm labour among the pregnant women was 51.05%. The rate of preterm was significantly higher in those women who had with short inter interpregnancy interval (p=0.0005). Conclusion: Our findings clearly show that a short interval in inter-pregnancy is a cause of premature birth. Preterm birth can also be indicated by the antenatal care visits, inter-pregnancy complications, and having a birth defect. Premature birth minimization can enhance overall newborn's health and can lead to considerable minimization of neonatal death in the future. Keywords: Preterm labor, prolong pregnancy interval, neonatal health

Effectiveness of Mindfulness-Based Intervention Technique in Reducing Stress Levels of Anesthesiology and Intensive Therapy Residents

Abstract Background: An anesthesiologist is expected to be able to manage intraoperative crises that can occur at any time. We aimed to determine the effectiveness of mindfulness-based intervention (MBI) technique in reducing stress levels of anesthesiology and intensive therapy residents at the Faculty of Medicine, University of Indonesia. Materials and Methods: This research was an experimental study with paired one group design. The MBI program lasted 4 weeks, consisted of one formal face-to-face training and 4 weeks of informal training (homework). Thirteen study subjects met the inclusion criteria and did not enter the exclusion criteria. One study subject was excluded because the subject did not complete the informal training. Data collection on the Perceived Stress Scale 10-Item (PSS-10) was conducted before and after training. Results: The average age of study subjects was 29.75 years; 75% are women. Four participants were in the 1st year of education (33%), 3 participants were in the 2nd year of education (25%), 2 participants were in the 3rd year of education (16.67%), and 3 participants were in the 4th year of education (25%). PSS-10 score in the study subjects significantly decreased after applying the MBI technique for 4 weeks (P = 0.001). Conclusion: MBI is effective in reducing stress levels of anesthesiology and intensive therapy residents at the-blinded.

Prevalance and characteristics of sarcopenia in older patients with stable chronic obstructive pulmonary disease

Objectives: To determine the rate and characteristics of sarcopenia in older patients with stable chronic obstructive pulmonary disease. Subjects and methods: a cross-sectional descriptive study on 363 stable chronic obstructive pulmonary disease (COPD) patients aged ≥ 60 years old examined and treated at the National Geriatrics Hospital and 19-8 Hospital. Study subjects were measured appendicular skeletal muscle with dual energy adsorption radiographs and diagnosed with sarcopenia based on the criteria of Asian Working Group for sarcopenia – AWGS. Results: Average age of study subjects was 70.7 ± 8.3 (years), male rate was 60.3%. The prevalence of sarcopenia in the study group was 45.2%. 74.6% of patients had a decrease in total appendicular skeletal muscle according to height (ASMI), 68.3% had a decrease in handgrip strength (HGS) and 42.7% had a decrease in walking speed. The ASMI, handgrip strength and walking speed decreased with age. Conclusion: The study highlighted a high rate of sarcopenia (45.2%) in elderly patients with stable stage COPD. The ASMI, handgrip strength and walking speed decreased with age. Therefore, it is necessary to screening and early diagnosis of sarcopenia in elderly COPD patients.

Profile of Suspected Cholera Patients during May – November 2017 in Sanaa City Secondary Analysis

Introduction: From 27 April to 3 August 2017, 453,175 suspected cholera cases and 1,930 deaths (CFR: 0.4%) have been reported in 95.6% (22/23) of Yemen governorates, and 89.2% (297/333) of the districts.&#x0D; The five most affected governorates were Amanat Al-Asima, Al Hudaydah, Hajjah, Amran and Dhamar with 53% (239,877/453,175) of the cases reported since 27 April 2017. In amanat al Asimah (Sana'a city) 55563 cases 61 deaths are registered in that period with case fatality rate 0.1% and attack rate 1.68%&#x0D; Objectives: To study Profile of suspected cholera patients in Sanaa city.&#x0D; Materials and Methods: A retrospective descriptive study was carried out by using secondary analysis of available data collected from (DTCs), (ORCs) and other health facilities by department of epidemiological surveillance – Sanaa city health office.&#x0D; Results: A total of 92995 suspected cholera patients were included in the study whereas the average age of study subjects was 22.7 years where standard deviation (SD) 18.8 most affected age groups were (15-29),(5-14),(&lt;5) the predominant of the study subjects from Sanaa city (96%) from Ma'ain, Bani-Alhareth, AND Al-Sabain districts Most cases are reported from DTCs (59300), ORCs (29547) Cases starts to appear in week 17 reaches a peak in weeks 24,25 and then slowly decreases. 155 suspected cholera cases were culture positives&#x0D; Conclusion: 1. Cholera is one of the urgent health problems in Sana’a city&#x0D; &#x0D; Cholera distribution is not gender sensitive, the most affected age group is (15-29) years, followed by (5-14) then under five&#x0D; Cases are mainly distributed in Ma'ain, Bani-Alhareth, &amp; Al-Sabain within Sana’a city (50% of the total cases).&#x0D; The main cholera health care facilities are mainly DTCs and ORCs supported by WHO &amp; UNICEF&#x0D; Most of the subjects seek medical care within the first 2 days after onset of symptoms&#x0D; The peak of cholera suspected cases is registered in weeks 24 &amp; 24.&#x0D; Confirmed cholera cases by culture are 155 from 655 specimen tested whereas 1984 are positive by cholera RDT&#x0D; &#x0D; Recommendations:1. More cholera control interventions are necessary and urgent to eradicate it.&#x0D; &#x0D; More field related research must be carried out to guide control and management interventions.&#x0D; Some interventions must be concentrated on the age groups 5-14 &amp; under five and at the most affected areas.&#x0D;

Serum Interleukin-6 is Not Linked with Sleep-Quality, Restless Legs Syndrome, and Depression, But with 6-Month Survival in Hematological Malignancies.

Background:Serum interleukin (IL)-6 has been found to be associated with sleep quality, mood, and survival in patients with solid tumors. Results in these studies were confounded by knowledge of diagnosis to study subjects. Moreover, such data among subjects with hematological malignancies and data regarding restless legs syndrome is limited. The present study was, therefore, conducted to assess the sleep quality, depression, and restless leg syndrome in hematological malignancies and to study if there is any role of IL6 associated with it.Methods:Sixty-six subjects having hematological malignancy were included in this study after excluding the potential confounders. Sleep quality was examined using Pittsburg Sleep Quality Index, depression by the Patient Health Questionnaire-9. Diagnosis of RLS was made through clinical examination. Serum for measurement of IL-6 was collected at baseline and after 1 month of initiation of chemotherapy. Patients were followed up for 6 months.Results:Average age of study subjects was 50.16 years with male predominance. Nearly 22.7% had clinical depression, 28.8% had poor quality sleep, and restless legs syndrome (RLS) was reported in 6.1% cases. Nearly 22.7% patients died at 6 months. Disturbed sleep at baseline was associated with depression (odds ratio [OR] =7.89) and poor 6 months survival. Serum IL-6 did not show any association with sleep quality, restless-legs-syndrome, and depression. However, baseline high level of serum IL-6 (OR = 26.06) and low level after chemotherapy (OR = 0.03) were associated with poor survival at 6 months.Conclusion:Poor quality sleep, depression, and RLS are prevalent among adult subjects with hematological malignancies. Sleep disturbance, high pretreatment inflammatory and lowering of inflammatory load after chemotherapy increase likelihood for poor prognosis. Serum IL-6 did not show any association with sleep quality, restless legs syndrome and depression.

Predicator of Pregnant Women's Self-care Behavior against Air Pollution: An explanation based on the Extended Parallel Process Model (EPPM).

IntroductionAir pollution is one of the most important problems of metropolitan cities. The level of air pollution in the city of Ahvaz is so much higher than the standard level, that it can create risks, particularly for pregnant women in the area. The aim of the study was to examine the predictors of self-care behavior of pregnant women against air pollution according to Extended Parallel Process Model (EPPM) in Ahvaz.MethodsIn this cross-sectional study, 330 pregnant women who were referred to health care centers in western Ahvaz in 2015 were examined. The data collection tool was a reliable and valid researcher-made questionnaire consisting of three parts: The first part was demographic information, the second part according to the extended parallel process model, included perceived susceptibility, perceived severity, response efficacy, and self-efficacy. The third part examined self-care behavior. Then, the collected data was analyzed by using the software SPSS 16. Data analysis was done by using Spearman’s correlation coefficient and linear regression.ResultsThe average age of study subjects was 26.07 ± 2.3 years, and most (45.5%) were in the second trimester of pregnancy. These findings showed that self-efficacy constructs (β = 0.41) and response efficacy (β= 0.15) have predictive power of self-care behavior (p < 0.05).ConclusionThe findings showed that self-efficacy and response efficacy, are important factors to predict air pollution self-care behavior. Therefore, to develop a theory-based behavioral modification program for pregnant women, more emphasis on these constructs is recommended.

Teriparatide (PTH 1-34) Treatment Increases Peripheral Hematopoietic Stem Cells in Postmenopausal Women

Cells of the osteoblast lineage play an important role in regulating the hematopoietic stem cell (HSC) niche and early B-cell development in animal models, perhaps via parathyroid hormone (PTH)-dependent mechanisms. There are few human clinical studies investigating this phenomenon. We studied the impact of long-term daily teriparatide (PTH 1-34) treatment on cells of the hematopoietic lineage in postmenopausal women. Twenty-three postmenopausal women at high risk of fracture received teriparatide 20 mcg sc daily for 24 months as part of a prospective longitudinal trial. Whole blood measurements were obtained at baseline, 3, 6, 12, and 18 months. Flow cytometry was performed to identify hematopoietic subpopulations, including HSCs (CD34+/CD45(moderate); ISHAGE protocol) and early transitional B cells (CD19+, CD27-, IgD+, CD24[hi], CD38[hi]). Serial measurements of spine and hip bone mineral density (BMD) as well as serum P1NP, osteocalcin, and CTX were also performed. The average age of study subjects was 64 ± 5 years. We found that teriparatide treatment led to an early increase in circulating HSC number of 40% ± 14% (p = 0.004) by month 3, which persisted to month 18 before returning to near baseline by 24 months. There were no significant changes in transitional B cells or total B cells over the course of the study period. In addition, there were no differences in complete blood count profiles as quantified by standard automated flow cytometry. Interestingly, the peak increase in HSC number was inversely associated with increases in bone markers and spine BMD. Daily teriparatide treatment for osteoporosis increases circulating HSCs by 3 to 6 months in postmenopausal women. This may represent a proliferation of marrow HSCs or increased peripheral HSC mobilization. This clinical study establishes the importance of PTH in the regulation of the HSC niche within humans. © 2014 American Society for Bone and Mineral Research.

Socioeconomic and cultural factors associated to metabolic control of diabetic children and adolescents from northwest Mexico

Diabetes prevalence among children and adolescents is growing and constitutes an important public health issue. The aim of this study was to analyze the metabolic control of 100 children and adolescents diagnosed with diabetes during 2000–2006 in northwest Mexico. Medical records of children and adolescents were reviewed collecting clinical, sociodemographic and familiar data. The main indicator of metabolic control was glycated hemoglobin (HbA1c). The average age of study subjects was 11.4 ± 3.9 years; prevalence of obesity was 24%. Sixty one percent of the sample had an average HbA1c of 9.1± 2.7, with the highest values in the adolescent group. A significant association was found between inadequate metabolic control and socioeconomic variables such as mother's education and health care services. In general, there is a poor metabolic control of children and adolescents with diabetes in northwest Mexico, and it is attributable to the socioeconomic and cultural factors surrounding them.

The effect of training on the knowledge levels and beliefs regarding breast self-examination on women attending a public education centre

The aim of this study was to evaluate the effect of subject training on the level of knowledge about breast self-examination (BSE) and breast cancer in women attending a public education centre. This research was structured according to pre-test-post test, one group research design principles. The study involved 91 course attendees at the Erzincan Public Education Centre (73.4%). The average age of study subjects was 21.4+/-5.4. Of the 91 participants in the study, 3.3% (n=3) had a family history of breast cancer and 5.5% (n=5) have had a lump in their breasts. In pre-test questions, the rate of correct answers was between 13.2% and 68.1%. After training, the rate of correct answers increased to between 79.1% and 96.7% and attendees demonstrated an increase in the accuracy of their beliefs about breast cancer (health risk, susceptibility). The perception of self-efficacy, an important variable in the process of behaviour change, is a necessary component of changing and maintaining the practice of BSE. The results of this work and others demonstrate that education administered by nurses can increase positive perceptions about BSE self-efficacy. Education in BSE is easily administered, requires no special tools, could lead to early diagnosis of breast cancer if performed regularly and should be taught to all women aged 20 years and above.

Factors associated with therapy noncompliance in type-2 diabetes patients.

To identify the frequency and factors associated with therapy noncompliance in type-2 diabetes mellitus patients. A cross-sectional study was carried out in 79 patients with type-2 diabetes mellitus seen in major hospitals of Mexico City. Patients were visited at home, from March 1998 to August 1999, to measure compliance with prescribed therapy. Complying patients were defined as those taking at least 80% of their pills or 80% of their corresponding insulin dose. The degree of compliance with therapy components (diet, amount of exercise, and keeping appointments) was measured. The average age of study subjects was 59 years (SD 11 years); 73% (n = 58) were female subjects. The overall frequency of noncompliance was 39%. Noncompliance rates were: 62% for dietary recommendations, 85% for exercise, 17% for intake of oral hypoglycemic medication, 13% for insulin application, and 3% for appointment keeping. Hypertension plus obesity was the only factor significantly associated with noncompliance (OR 4.58, CI 95% 1.0, 22.4, p = 0.02). The frequency of therapy noncompliance was very high, especially for diet and exercise.

Perceptions and Practices Relating to Condom Use among Urban Men in Haiti

This report is based on a survey conducted in 1986-87 of sexually active adult male residents in a low-income community of Port-au-Prince, Haiti. The objectives were to investigate knowledge of and attitudes toward condoms; to evaluate the effectiveness of the existing condom distribution program; and to obtain information that can be used in the design of strategies to increase condom acceptance and use among men throughout Haiti. A final sample of 706 sexually active adult male residents in stable unions, including a specially drawn sample of male partners of condom acceptors, were interviewed in their homes. Although condoms are almost universally known, they are rarely used. The majority felt that the responsibility for family planning should be borne by the woman. Whereas condoms may be of limited popularity for family planning purposes in Haiti, it should be determined whether they might be more acceptable as an effective means of controlling the spread of AIDS and other STDs.