Chi-square Test Research Articles

Pattern of Cleft Lip and Palate Clefts at a Tertiary Care Hospital in Saudi Arabia.

Clefts of the lip and palate (CL/P) and cleft palate (CP) are the most common craniofacial congenital anomalies. Clefts are classified as syndromic and nonsyndromic. Nonsyndromic clefts have no known genetic causes. This study combines prospective and retrospective studies to review the patterns of CL/P and CP and associated syndromes and conditions in patients registered for CL/P surgery at a tertiary care pediatric center in our tertiary care hospital in Saudi Arabia. It included patient data from May 2015 through April 2023. Patient record forms and SPSS (IBM version 20.0) were used to collect and analyze data. A significance level of 5% was used, with p ≤ 0.05 considered statistically significant. Of the 319 patients who met our inclusion criteria, 175 were male. Of the total, 99 had a left unilateral isolated cleft lip, 61 had a right unilateral isolated cleft lip, 69 had a bilateral cleft lip, and 90 had an isolated CP. Of the total, 140 had CL/P. Around 242 were nonsyndromic. The Chi-square test revealed a significant association between the prevalence of isolated CP and CLP and gender. The prevalence of left unilateral isolated cleft lip and bilateral and isolated CP was significantly associated with syndromic and nonsyndromic cases. Males are more likely to be affected by orofacial clefts, which is consistent with the global trend. Isolated CP was the most common orofacial cleft. Within the sample, syndromes' association with orofacial clefts was significantly weaker than that of isolated and bilateral clefts.

The addition of nimotuzumab during concurrent chemoradiotherapy improved survival outcomes in locally advanced nasopharyngeal carcinoma patients with optimal response to induction chemotherapy

ObjectiveTo investigate the impact of response to induction chemotherapy (IC) on survival outcomes in patients with locally advanced nasopharyngeal carcinoma (LANPC) and evaluate the efficacy of adding nimotuzumab to concurrent chemoradiotherapy (CCRT) based on different responses to IC.MethodsWe retrospectively included patients with stage III-IVA NPC who underwent IC with and without nimotuzumab during CCRT. Statistical analysis included the chi-square test, propensity score matching, Kaplan-Meier survival analysis, and Cox proportional hazards model.ResultsAmong 383 identified patients, 216 (56.4%) received nimotuzumab during CCRT, while 167 (43.6%) did not. Following IC, 269 (70.2%) patients showed a complete response (CR) or partial response (PR), and 114 (29.8%) had stable disease (SD) or progressive disease (PD). The response to IC independently influenced disease-free survival (DFS) and overall survival (OS). Patients achieving CR/PR demonstrated significantly higher 3-year DFS (80.3% vs. 70.6%, P = 0.031) and OS (90.9% vs. 83.2%, P = 0.038) than those with SD/PD. The addition of nimotuzumab during CCRT significantly improved DFS (P = 0.006) and OS (P = 0.037) for CR/PR patients but not for those with SD/PD.ConclusionsThis study emphasizes the importance of IC response in LANPC and highlights the potential benefits of nimotuzumab during CCRT for improving survival outcomes in CR/PR patients. Tailored treatment approaches for SD/PD patients warrant further investigation.

Susceptibility weighted imaging for detection of thrombus in acute ischemic stroke: A cross-sectional study.

Susceptibility-weighted imaging (SWI) can help in the diagnosis of thrombus within the vessel in acute ischemic stroke, known as susceptibility vessel sign (SVS), and detection of SVS within the vessel can predict treatment modality and outcome. In this study, the purpose is to correlate the SVS on SWI with different parameters of stroke. This prospective cross-sectional study enrolled consecutive stroke patients with vessel occlusion on magnetic resonance angiography (MRA) over 1 year. The relationship between SVS on SWI with risk factors, territory involved, and length of thrombus was correlated with the National Institutes of Health Stroke Scale (NIHSS). A total of 105patients were enrolled in this study. Sixty-two percent (66 out of 105) of patients showed SVS on SWI with MRA-positive occlusion. A positive correlation was observed between SVS on SWI and the risk factor (p = 0.003, chi-square test), with 86% of patients with heart disease and 47% with hypertension exhibiting SVS. Additionally, a positive correlation was observed between SVS on SWI and territorial occlusion (p = 0.000, chi-square test). A moderate positive correlation was observed between the NIHSS and thrombus length (p = 0.002, Pearson's correlation coefficient), with a Pearson's coefficient of 0.367. SWI can be useful in identifying the location of the thrombus, and NIHSS can determine the thrombus length in acute stroke. A higher incidence of SVS can be associated with risk factors, and it also depends upon the site of occlusion of the vessel.

A comprehensive study of adverse effects of chemotherapy on female breast cancer patients in NORI Cancer Hospital, Islamabad in a developing country.

Breast cancer is one of the top three malignancies worldwide. While radiotherapy, hormone replacement therapys, and chemotherapy are treatments, chemotherapy causes adverse effects that hinder daily life activities. To assess the prevalence, severity, and association of symptomatic toxicities in female breast cancer patients affecting various organ systems post systemic chemotherapy (adjuvant and neoadjuvant), and their impact on daily activities. Additionally, to determine the severity of adverse effects in specific age groups and their association with family history and disease stage. An observational study was conducted on 253 female breast cancer patients receiving chemotherapy at NORI Cancer Hospital from May to October 2023. Data collection tools included the NCI-PRO-CTCAE standardized questionnaire and patient medical records. Analysis was performed using descriptive statistics, T-tests, and Chi-square tests. Among the 253 patients, 41.4% were aged 41-50. Significant weight changes (p = 0.034) were observed with more than three chemotherapy cycles. Notable associations included increased chemotherapy cycles with gastrointestinal (mouth/throat sores p = 0.031, vomiting p = 0.021), respiratory (cough p = 0.04), cardiovascular (arm/leg swelling p = 0.007, palpitations p = 0.052), integumentary (hair loss p = 0.000, skin dryness p = 0.054), and musculoskeletal (fatigue p = 0.002) adverse effects. Positive family history and the 18-30 age group also showed significant associations with adverse effect severity. Disease stage significantly influenced the nervous system (stage 2 p = 0.007, stage 3 p = 0.01). The severity of adverse effects varies among age groups, depending on disease stage, genetics, and treatment duration. These patient-reported outcomes highlight the need for better management strategies considering prognostic factors and treatment adverse effects.

Pencil push-up training compared with binocular vision training in the management of slight post-operative under-correction of intermittent exotropia: A prospective study.

This study aims to compare the effectiveness of pencil push-up training and binocular vision training in treating post-operative mild under-correction in patients with intermittent exotropia. A prospective cohort study was conducted, including patients who underwent surgery for intermittent exotropia at Children's Hospital of Nanjing Medical University between June 2022 and January 2023 and experienced post-operative mild under-correction (-8∆ to -15∆). Patients were divided into two groups: pencil push-up training group and binocular vision training group. All patients underwent measurements of exodeviation and stereoacuity at distance and near, sensory fusion, and fusion convergence amplitude. The data were analyzed using independent sample t-tests, repeated measures analysis of variance, and Chi-square tests. There were no statistically significant differences in exodeviation at distance and near between the two training groups before the training. After 6 months of training, the exodeviation at distance and near achieved a significant decrease in both groups (P < 0.05), and the pencil push-up training group showed a similar distance and near exodeviation compared to the binocular vision training group (t = 1.58, P ＞ 0.05; t = 0.43, P ＞ 0.05). After 6 months of training, the binocular vision training group exhibited significantly superior stereoacuity and fusion convergence amplitude compared to the pencil push-up training group (P < 0.001). Both pencil push-up training and binocular vision training are effective in reducing exodeviation in patients with post-operative mild under-correction of intermittent exotropia. However, binocular vision training demonstrates superior efficacy in restoring stereopsis and fusion convergence amplitude compared to pencil push-up training.

The Consonance Between Medical Practitioners and Pharmacists Regarding Antimicrobial Stewardship Practices - An Observational Study.

To determine the consonance between medical practitioners and clinical pharmacists about antimicrobial resistance and stewardship in their practices. Descriptive cross-sectional study. Place and Duration of the Study: Department of Pathology and Department of Pharmacology, Jinnah Sindh Medical University, Karachi, Pakistan, from September 2023 to January 2024. Medicinal and Clinical Pharmacy professionals were included in the study through purposive sampling technique. The study employed a methodological approach using a predesigned questionnaire administered through Google Forms, based on a 4-step scale strategy. Through an extensive literature review, item development, expert validation, and pilot testing, the questionnaire aimed to assess medical practitioners' and pharmacists' knowledge and perceptions regarding antibiotic practices and antimicrobial stewardship (AMS). Following a pilot test involving 30 participants and a Cronbach's alpha analysis yielding a value of 0.7 for internal consistency, minor modifications were implemented before dissemination to the participants. The responses were analysed using descriptive statistics, Chi-square test, and Kappa index. Out of the total 200 participants, 130 responded within the stipulated timeframe, resulting in an overall response rate of 65%. Among the respondents, medical practitioners constituted 60% (n = 78), while clinical pharmacists comprised 42% (n = 52) of the total. The general agreement level between medical practitioners and clinical pharmacists was determined to be 0.39, indicating a fair level of concordance between the two cohorts. The present investigation emphasised the agreement level between medical practitioners and pharmacists, the two key components of the AMS programme. Nevertheless, a consistent deficiency in knowledge was observed across both cohorts, underscoring the necessity for a heightened level of consensus among the study participants. Antimicrobial stewardship, Antimicrobial resistance, Anti-bacterial agents, Pharmacists.

Temporomandibular joint disorder among Peruvian music students of different instrumental specialties

Background Music, a profound human expression, can have physical implications for its practitioners. Musicians face various physical challenges that can impact their well-being, with craniofacial and temporomandibular pain being prevalent yet understudied. Temporomandibular joint disorder (TMJD) affects up to one-third of the population, though prevalence varies by study. While musculoskeletal issues like carpal tunnel syndrome are well-documented in musicians, craniofacial and temporomandibular pain is less explored. This study aims to determine the differences in TMJD frequency among music students of different instrumental specialties. Methods The sample was composed of students between 12 and 25 years of age from the National University of Music of Peru. A stratified random probability sample was chosen. Data were collected using a structured instrument covering general data, academic information, dental malocclusion, the Fonseca Simplified Anamnestic Index, and the Global Stress Perception Scale. Statistical analysis included Pearson's Chi-square test and a generalized linear model regression. Results The sample included 71.4% males with a median age of 23 years. Class II dental occlusion was most common (51.4%). TMJD prevalence was: 14.3% no TMJD, 60.0% mild TMJD, 22.9% moderate TMJD, and 2.9% severe TMJD. Metal wind (PR=0.04, 95%CI [0.00; 50.04], p=0.002) and woodwind players (PR=0.03, 95%CI [0.00; 0.56], p=0.018) had lower TMJD prevalence compared to plucked string and percussion players. Post-regression analysis indicated significant differences between metal wind and percussion students (p=0.030) and between percussion and woodwind students (p=0.025). These results are supported by the adjusted ratio of proportions analysis, which maintains statistical significance. Conclusion We found significant differences in TMJD prevalence among music students based on their instrumental specialty, with lower rates in metal wind and woodwind players compared to plucked string and percussion players.

Integrated nomogram to predict HER2 expression in breast tumor: Clinical, Ultrasound, and Photoacoustic imaging approaches

BackgroundHER2 is a key biomarker for breast cancer treatment and prognosis. Traditional assessment methods like immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) are effective but costly and time-consuming. Our model incorporates these methods alongside photoacoustic imaging to enhance diagnostic accuracy and provide more comprehensive clinical insights. Materials and methodsA total of 301 breast tumors were included in this study, divided into HER2-positive (3+ or 2+ with gene amplification) and HER2-negative (below 3+ and 2+ without gene amplification) groups. Samples were split into training and validation sets in a 7:3 ratio. Statistical analyses involved t-tests, chi-square tests, and rank-sum tests. Predictive factors were identified using univariate and multivariate logistic regression, leading to the creation of three models: ModA (clinical factors only), ModB (clinical plus ultrasound factors), and ModC (clinical, ultrasound, and photoacoustic imaging-derived oxygen saturation (SO2)). ResultsThe area under the curve (AUC) for ModA was 0.756 (95 % CI: 0.69–0.82), ModB increased to 0.866 (95 % CI: 0.82–0.91), and ModC showed the highest performance with an AUC of 0.877 (95 % CI: 0.83–0.92). These results indicate that the comprehensive model combining clinical, ultrasound, and photoacoustic imaging data (ModC) performed best in predicting HER2 expression. ConclusionThe findings suggest that integrating clinical, ultrasound, and photoacoustic imaging data significantly enhances the accuracy of predicting HER2 expression. For personalised breast cancer treatment, the integrated model could provide a comprehensive and reproducible decision support tool.

Evaluation of appropriateness of antibiotic prescribing in primary healthcare institutions in China using proxy indicator

Our objectives were to develop a set of proxy indicators (PIs) suited for assessing antibiotic use appropriateness in China's primary healthcare institutions (PHIs), and assess performance scores of these PIs while exploring factors that influence the antibiotic appropriateness. We selected potential PIs for the PHIs through a RAND-modified Delphi procedure, and assessed clinimetric properties, focusing on measurability, applicability, and potential for improvement. PIs with favorable clinimetric properties were used to evaluate antibiotic prescription appropriateness by calculating performance scores of each PI. Institutions were categorized into three clusters representing different levels of appropriateness. We used the chi-square test and an ordinal logistic regression model at PHI level to explore factors influencing antibiotic appropriateness. Eighteen PIs were developed through two rounds of online surveys and one face-to-face meeting involving 20 stakeholders. All PIs met the clinimetric properties criteria and were used to analyze 209,662 antibiotic prescriptions across 269 PHIs. The percentage of PHIs meeting the target ranged from 3.1% to 69.3%, with 6 PIs below 10%. The appropriateness of antibiotic prescriptions was significantly associated with percentages of patients' gender of the PHIs. The varied and suboptimal performance of the PIs indicated the need for diverse efforts to enhance the rational antibiotic use at PHI level. It was necessary to devise distinct sets of PIs for diverse settings in future endeavors. This work was supported by the National Natural Science Foundation of China (grant numbers 72374009, 81973294).

Orofacial clefts in Costa Rica, 1996-2021: Analysis of surveillance data.

Orofacial clefts (OFCs) are among the most common birth defects (BD). In 2008, a series of improvements began in the Costa Rican Birth Defect Register Center (CREC). We aim to explore trends between 1996 and 2021. A trend analysis of OFCs from 1996 to 2021 and a descriptive analysis of OFCs from 2010 to 2021 were performed based on data from the CREC, the national BD surveillance system. Prevalence at birth was calculated according to the type: cleft palate (CP), cleft lip with or without CP (CL ± P), and presentation (isolated, multiple non-syndromic, or syndromes). We used joinpoint regression to identify if a significant change in trend occurred; the average annual percent change (AAPC) was determined. Marginal means and prevalence ratios by subperiod (1996-2009 as referent and 2010-2021) were estimated using Poisson regression and compared using Wald's chi-square tests (α ≤.05). We found a significant AAPC for OFCs prevalence of +1.4: +0.6 for isolated, +2.9 for multiple non-syndromic, and +7.7 for syndromes (p < .05). When comparing the OFC's prevalence of the subperiod 2010-2021 (11.86 per 10,000) with 1996-2009 (9.36 per 10,000) the prevalence ratio was 1.3 (p < .01): 1.1 (p < .05) for isolated, 1.6 (p < .01) for multiple non-syndromic, and 3.3 (p < .01) for syndromes. The prevalence of OFCs from 2010 to 2021 was 9.1 for CL ± P and 2.8 for CP. Seventy-one percent of the OFCs were isolated, 22% multiple non-syndromic, and 7% syndromes. The trend in OFCs' prevalence is toward increasing, mainly due to improvements in the surveillance system.

Clinical outcomes with utilization of high-potency topical steroids in patients with lichen sclerosus-associated vulvar cancer

ObjectivesTo evaluate the impact of high-potency topical steroid use on risk of recurrence of lichen sclerosus-associated vulvar cancer. MethodsThis is a retrospective cohort study evaluating patients with lichen sclerosus (LS)- associated vulvar squamous cell cancer (VSCC). Demographic and clinical outcome data were compared between two comparison groups: patients who received steroids, mainly clobetasol, and patients who did not receive steroids following treatment of LS-related vulvar cancer. Categorical variables were compared using Fisher's exact test or chi-square test. Continuous variables were compared using a two-sided student's t-test. Time to recurrence (TTR) and overall survival (OS) were analyzed using Kaplan-Meier survival plot and compared using Mantel-Cox log rank test. Cox proportional hazard regression models were conducted to generate hazard ratios for both TTR and OS. A p value of <0.05 was considered statistically significant. ResultsA total of 49 patients were included, with 36 patients receiving steroid treatment and 13 patients in the expectant management group. The median age of diagnosis was 68. The average BMI was 31.7 +/− 7.0. The median length of follow up was 41 months. The majority of patients were diagnosed with stage I VSCC. There was no difference in demographics or oncologic management of vulvar cancer between the two cohorts. Overall recurrence was decreased among patients who received steroid treatment when compared to patients who did not, 12 patients (33.3%) versus 9 patients (69.2%) respectively (p = 0.048). ConclusionsHigh-potency topical steroid use following treatment of lichen sclerosus-associated vulvar squamous cell carcinoma is associated with decreased risk of recurrence and prolonged median time to recurrence.

Comparison of Machine Learning Models to a Novel Score in the Identification of Patients at Low Risk for Diabetic Retinopathy

PurposeTo develop an easily applicable predictor of patients at low risk for diabetic retinopathy (DR). DesignAn experimental study on the development and validation of machine learning models and a novel retinopathy risk score to detect patients at low risk for diabetic retinopathy. SubjectsAll individuals aged 18 years or older who participated in the telemedicine retinal screening initiative through Temple University Health Systems from October 1, 2016 through December 31, 2020. The subjects must have documented evidence of their diabetes mellitus diagnosis as well as a documented hemoglobin A1C recorded in their chart within 6 months of the retinal screening photograph. MethodsThe charts of 1930 subjects (1590 evaluable) undergoing telemedicine screening for DR were reviewed, and 30 demographic and clinical parameters were collected. DR is a dichotomous variable where low risk is defined as no or mild retinopathy using the International Clinical Diabetic Retinopathy severity score. Five machine learning models (MLM) were trained to predict patients at low risk for DR using 1050 subjects and further underwent 10-fold cross validation to maximize its performance indicated by the area under the receiver operator characteristic curve (AUC). Additionally, a novel retinopathy risk score (RRS) is defined as the product of hemoglobin A1c closest to screening and years with diabetes mellitus. RRS was also applied to generate a predictive model. Main Outcome MeasuresThe performance of the trained machine learning models and the RRS model was compared using DeLong’s test. The models were further validated using a separate unseen test set of 540 subjects.The performance of the validation models were compared using DeLong’s test and chi-square tests. ResultsUsing the test set, the AUC for the RRS was not statistically different from four out of five MLM. The error rate for predicting low-risk patients using the RRS was significantly lower than the naive rate (0.097 vs 0.19; p<0.0001), and it was comparable to the error rates of the machine learning models. ConclusionThis novel retinopathy risk score is a potentially useful and easily deployable predictor of patients at low risk for DR.

Root canal morphology of permanent mandibular anterior teeth in a Pakistani population: A cone beam computed tomography assessment.

To investigate the incidence of accessory canals and the variation in root canal morphology of permanent mandibular incisors and canines in Pakistani population using Cone Beam Computed Tomography (CBCT). A cross-sectional study was conducted in University College of Dentistry, The University of Lahore, Pakistan after getting institutional ethical permission from January 2020 to September 2022. The data included records of 111 patients consisting of 444 permanent mandibular incisors and 222 permanent mandibular canines. Accessory root, root canals and Vertucci canal configuration for each tooth was recorded. Data analysis was done using SPSS v20. Descriptive statistics were calculated for each anatomical parameter. Chi-square test was applied to determine association of gender with the presence of accessory roots and root canals. Among the 111 records evaluated, 48.6% were males and 51.4% were females. No accessory root was found in the central and lateral incisors. However, an accessory root was found in 4.9% of the canines. The incidence of accessory canals in the central incisors, lateral incisors and canines was 18.9%, 25.2% and 10.4% respectively. The most common canal configuration in teeth with accessory canals was Type-III, followed by Type-II and Type-V. None of the central or lateral incisor showed accessory root while it was detected in 4.9% canines. The frequency of accessory root canal was found to be 18.9%, 25.2% and 10.4% in central incisors, lateral incisors and canines respectively. The most common canal configuration was Type-I, followed by Type-III and Type-II. Type-V, VI and VII were less common.

The Association between Statins Intake and Risk of Post Stroke Pneumonia: A Systematic Review and Meta-Analysis.

This research aimed to examine the relationship between the intake of statins and the risk of post-stroke pneumonia in a systematic review and meta-analysis study. An extensive search of published articles on March 21st, 2023, was done in several databases, like Web of Science (ISI), PubMed, Cochrane Library, Embase, Scopus, and Google Scholar. The Newcastle Ottawa Scale (NOS) checklist was employed to evaluate the quality of observational studies. Statistical tests (Chi-square test and I2) and graphical techniques (Forest plot) were used to determine whether heterogeneity existed in the meta-analysis studies. Funnel plots and Begg and Egger's tests were used to assess the publication bias. Seven studies (5 cohort and 2 case-control studies) were retrieved to examine the association between statins and post-stroke pneumonia. The sample size of the studies compiled in the meta- analysis was obtained to be 68,966 participants. Meta-analysis demonstrated that the overall odds of post-stroke pneumonia in the statin group was equal to 0.87 (95% CI: 0.67 - 1.13; p-value 0.458). Subgroup analysis indicated that the odds of post-stroke pneumonia in the statin group was equal to 0.93 (95% CI: 0.73-1.18; p-value = 0.558) in the cohort studies, and equal to 0.92 (95% CI: 0.37-2.26; p-value = 0.857) in the case-control studies. The examination of the association between the intake of statins and post-stroke pneumonia showed no evidence of publication bias (Begg's test, p-value = 0.368; Eggers test, p-value = 0.282). In this study, no relationship has been observed between receiving statins and the risk of post-stroke pneumonia.

Seroprevalence of brucellosis among high-risk individuals in Madinah, Saudi Arabia

Background and Aim: Brucellosis is a highly contagious, neglected zoonotic disease of major importance worldwide. The disease is endemic in many countries, burdening healthcare systems and the livestock industry and representing a persistent public health concern in these countries. Brucellosis is considered an important occupational hazard for livestock workers. Limited studies have investigated human brucellosis in Saudi Arabia. Therefore, this study aimed to estimate the prevalence of brucellosis among employees of high-risk brucellosis professions, including veterinarians, animal herders, and abattoir workers in Madinah, Saudi Arabia, and to determine the associated risk factors. Materials and Methods: A cross-sectional study was conducted in Madinah, Saudi Arabia, during the period of January–March 2023. Ninety blood samples were collected from individuals occupationally at risk of exposure to Brucella infections. Serum samples were examined for immunoglobulins (Ig)M and IgG antibodies against Brucella using an indirect enzyme-linked immunosorbent assay. Before sample collection, a predesigned online questionnaire was used to collect the participants’ sociodemographic characteristics and the probable risk factors for human brucellosis. A Chi-square test was used to compare the differences among groups; p &lt; 0.05 were considered statistically significant. Results: Among the 90 participants among the high-risk individuals, Brucella IgM and IgG seropositivity were found in 8 (8.8%) and 11 (12.12%) cases, respectively. IgM mono antibody positivity was observed in 4 (4.44%) and 7 (7.77%) of the study population who tested positive for IgG only. Dual positivity for IgM and IgG antibodies was observed in 4 (4.44%) participants. No significant association was determined between seropositivity and age, urbanicity, education, occupation, and duration of exposure (p &gt; 0.05). Conclusion: Brucellosis is a high-risk occupational disease among workers with close contact with livestock. This study demonstrates that the seroprevalence of brucellosis among occupationally high-risk individuals in Madinah, Saudi Arabia, is relatively low compared to other countries in the region. Nevertheless, educational programs should be implemented to improve knowledge regarding brucellosis, particularly among high-risk individuals. Keywords: Brucella IgG, Brucella IgM, brucellosis, Madinah, serological assays, undulant fever, zoonosis.

Comparison of surgical site infection in patients undergoing laparoscopic cholecystectomy with or without prior ERCP.

Objective: To compare the risk of surgical site infections in patients undergoing laparoscopic cholecystectomy with or without prior ERCP. Study Design: Prospective Comparative study. Setting: Surgical Unit-I of Holy Family Hospital, Rawalpindi. Period: December 2021 to May 2022. Methods: Total 140 patients were included. Group A had ERCP before their laparoscopic cholecystectomy. Those, who had laparoscopic cholecystectomy without first undergoing ERCP included in Group B. For this study, we used SPSS to analyze the data we gathered (version 23.0). Two groups were compared for surgical site infection using the Chi-square test. The level of significance was set at P 0.05. Results: Total 140 patients with biliary tract disease (choledocholithiasis, cholangitis and cholelithiasis) were enrolled in this study. In group-A, there were 16(22.9%) males and 54(77.1%) females, while in Group-B, there were 14(20.0%) males and 56(80.0%) females. In patients with prior ERCP group, 28(40.0%) developed surgical site infections, while in patients without ERCP group, 13(18.6%) developed surgical site infections with a p-value of 0.005, which is statistically significant. Conclusion: An increase in the incidence of SSI following laparoscopic cholecystectomy by two- fold is connected with pre-operative (ERCP) so we plan to assess if this technique is linked to a higher risk of wound infection after surgery. we suggest that long term use of antibiotics can reduce the rate of SSI and longer stay of patients in hospital.

Prevalence of antibiotic use for childhood diarrhoea in Uganda after an ORS scale-up intervention: a repeated cross-sectional study

BackgroundDiarrhoea kills 500,000 children every year despite availability of cheap and effective treatment. In addition, a large number are inappropriately treated with antibiotics, which do not benefit the patient but can contribute to the development of antibiotic resistance. We investigated whether the prevalence of antibiotic use among children under the age of five with diarrhoea in Uganda changed following a national intervention to increase the use of oral rehydration salts (ORS), and whether any socioeconomic characteristics were associated with antibiotic use.MethodsA cross-sectional survey was conducted among caregivers of children under the age of five and among private health care providers and drug sellers in Uganda in 2014. This was compared to a similar survey among private health care providers, and the national demographic and health survey in Uganda in 2016. Logistic regression was used to find associations between antibiotic use and socioeconomic characteristics, and chi-square test and independent sample t-test were used to find significant differences between groups.ResultsThe prevalence of antibiotic use among children under the age of five with diarrhoea in Uganda decreased from 30.5% in 2014 to 20.0% (p < 0.001) in 2016. No associations between socioeconomic characteristics and the use of antibiotics were significant in both 2014 and 2016.ConclusionsThe use of antibiotics in children with diarrhoeal disease decreased significantly in Uganda between 2014 and 2016. However, the extent of the contribution of the ORS scale-up programme to this decrease cannot be determined from this study.

Pilot evaluation of the effectiveness of an ergonomics awareness educational programme addressed to middle-school children.

Ergonomics programmes addressed to children fit the health-promoting schools (HPS) framework. Beyond the integration of ergonomics in curricula, an important aspect is the effectiveness of the programme. This pilot study aims to evaluate the effectiveness of the programme proposed to a sample of middle-school children (aged 10-13 years) of the metropolitan city of Cagliari. The programme was designed along the lines of the INAIL (Italian National Institute for Insurance against Accidents at Work) scheme and proposed to 260 children. It consisted of three phases: 1) assessment of students' background with a pre-intervention questionnaire (completed by 142 students); 2) teaching of the ergonomics training modules and evaluation of the weight of a sample of 160 backpacks, and of students' perception to be able to sit by putting their feet on the ground; 3) evaluation of conceptual understanding of ergonomics concepts with a post-intervention questionnaire (completed by 107 students out of the 142 students who completed phase 1). There was a substantial improvement in the percentage of correct responses post-intervention, confirmed by the chi-square test, regarding concepts about ergonomics, backpack weight and handling. Most of the backpacks exceeded the maximum allowed value, and 20% of students were perceived to be unable to sit putting their feet on the ground. The practical application of ergonomics pedagogy proved effective in the school setting and should be integrated into school curricula. The prevention technicians can offer a holistic approach, while the teachers are essential to implement the programme on a large scale. Effectiveness evaluation is necessary to guide resource allocation and implement and sustain the HPS approach. A tailored programme has a greater chance of reaching its target audience and maximizing effectiveness.

Peran Rumah Sakit dalam Pencegahan dan Pengendalian Infeksi di Rumah Sakit

This study aims to determine the role of hospitals in preventing and controlling infections at Royal Prima Indonesia Hospital. The research method uses a cross-sectional study. The study results showed that the chi-square statistical test analysis of the role of hospitals in preventing and controlling infections at Royal Prima Medan Hospital showed a p-value = 0.283, which means the p-value&gt; 0.05. In conclusion, there is no relationship between the hospital's role and the PPI team's compliance in preventing and controlling infections. Suggestions should be made so the hospital can provide ongoing training and education to improve compliance with standard precautions every three months. Keywords: Role of Hospitals, Prevention and Control of Infection

Obesity and its association with self-efficacy and metabolic risk factors by region of birth among 40-year-olds participating in the Swedish targeted health dialogues

ObjectiveTargeted Health Dialogues (THD) is a public health intervention program that aims at preventing cardiovascular disease. THDs were implemented in the Swedish region Scania, in 2020, with the novelty of being conducted in a metropolitan area with a multiethnic population.This study investigated the prevalence of obesity among 40-year-old THD participants in Scania by region of birth, and its associations with self-efficacy and additional metabolic risk factors. MethodsCross-sectional data were retrieved from measurements in the THDs. Study participants included 1831 40-year-olds. Differences in characteristics by region of birth were assessed using chi-squared and ANOVA tests. The associations between overweight, obesity, and high waist-hip ratio (WHR) and SE and metabolic risk factors (blood pressure, LDL cholesterol, plasma glucose) were assessed using binominal and ordinal logistic regression, adjusted for sex and education and tested for interactions by region of birth. Results35.1 % of the participants were overweight (BMI 25–29.9), and 18.7 % were obese (BMI ≥30) with the highest levels among participants born outside Sweden (p = 0.005). Abdominal obesity was also more prevalent among participants born outside Sweden (p = 0.002). Obesity was associated with increased odds of having low self-efficacy (OR per BMI-level: 1.48 (CI 1.24–1.76) and additional metabolic risk factors. No interactions with region of birth were detected. ConclusionsThe prevalence of obesity differed between region of birth and obesity was associated with having low self-efficacy. These findings underline the need to customise lifestyle interventions in a multiethnic population to increase health equity.