Comparative Cross-sectional Study Research Articles

Knowledge and attitudes of medical students toward death: a cross-sectional comparative study between an Arab and a Western University

BackgroundCultural factors influence attitudes toward death, and gender disparities are evident. Prior studies show that medical students have limited knowledge about death and are uncomfortable with it. Moreover, there is limited research that has examined factors that influence medical students’ knowledge and attitudes toward death.ObjectivesThe objectives of the study were to compare cultural and gender differences in relation to knowledge and attitudes toward loss and grief and to screen for complicated grief among medical students at the Arabian Gulf University and the University of Toronto.MethodsA cross-sectional study was disseminated to medical students at both universities in 2022. The variables in the survey included four parts: demographic characteristics of the participants, religious observance, history of encountering loss of a loved one, grief following loss, attitude toward death, and learning about how to deal with grief and death during medical school. The brief grief questionnaire and the death attitude profile-revised scales were used.ResultsThe study sample consisted of 168 medical students, with 74.1% being female. Complicated grief scores were higher among Arabian Gulf University students (3.87 ± 2.39) than among University of Toronto students (2.00 ± 1.93) and were higher for participants with a higher degree of religious observance in both schools (p < 0.05). Death avoidance (p = 0.003), approach acceptance (p < 0.001), and escape acceptance (p = 0.038) domains were significantly higher among Arabian Gulf University students than among University of Toronto students. Almost three-quarters of University of Toronto students reported not being taught about grief, compared to 54% of Arabian Gulf University students.ConclusionsArabian Gulf University medical students scored higher on complicated grief, most likely due to cultural and religious factors. Females at both institutions as well as those who indicated a higher level of religious observance reported higher scores of complicated grief. The study highlights how cultural and religious beliefs influence medical students’ attitudes toward death and bereavement. It provides valuable insight into the knowledge and attitudes of medical students toward loss.

Comparative Sonographic Evaluation of the Gallbladder in Sickle Cell Disease Patients and Apparently Healthy Non-Sickle Cell Disease Individuals in a Nigerian Town

Background: Sickle cell disease (SCD) is an autosomal recessive blood disorder with multi-organ manifestations including the gall bladder. Studies have shown that individuals with sickle cell disease have strong tendency of developing pigment gallstones due to chronic red blood cell hemolysis and increased bilirubin levels.&#x0D; Aim and Objectives: The aim of this study was to evaluate and compare the gallbladder changes which includes volume, wall thickness, presence of biliary sludge and prevalence of calculi between age and sex-matched sickle cell disease patients and apparently healthy, normal non-SCD individuals.&#x0D; Materials and Methods: This was a cross-sectional comparative study of 50 known SCD patients attending the Haematology clinic of sub-urban tertiary health facility in Nigeria, and equal number of age and sex-matched apparently healthy, non-SCD volunteers attending the Well people clinic of the same hospital as controls. Each subject was evaluated for gallbladder volume, wall thickness, presence of biliary sludge and gallstones using a 3.5-5MHz curvilinear array transducer of a Mindray ultrasound machine, DC-6 model, 2016.&#x0D; Data Analysis: The data collected was analysed using the IBM Statistical Package for Social Sciences (SPSS) version 21.&#x0D; Statistical test was considered significant at p-value ≤ 0.05 and a confidence interval of 95%.&#x0D; Results: Out of the 100 subjects who underwent scanning, 50 were patients with sickle cell disease, consisting of 29 males (58.0%) and 21 females (42.0%), while the remaining 50 were non-sickle cell disease volunteers serving as controls, comprising 24 males (48.0%) and 26 females (52.0%). Their ages ranged from 2 to 65 years.&#x0D; The mean age of the cases and controls was 22.1±14.7 years and 19.9±12.6 years respectively. Among the patients; 8 (16.0%) had cholecystitis and 10 (20.0%) had gallstones, with no detectable abnormality in the controls.&#x0D; Conclusion: The ultrasonographic prevalence of gallbladder abnormalities was recorded only in patients with sickle cell disease when compared to apparently healthy controls as shown with increased prevalence with age.

HIV Risk Perception and Assessment among Youths in Rivers State, Nigeria: A Comparative Cross-sectional Study

Introduction: HIV/AIDS remains a major global public health issue with increasing cases among young people. Several risky sexual behaviours put these youths at higher risk of HIV infection affecting their health and general well-being. Perception of health risk is a key dimension of most health behaviour models. This study assessed the risk factors of HIV infection, HIV risk perception and assessment among youths in Rivers State, Nigeria.&#x0D; Methods: This was a comparative descriptive cross-sectional study investigating HIV risk perception among youths in a rural and an urban local government in Rivers State. A multistage sampling technique was used in the selection of the youths from two LGAs. A structured, pre-tested, questionnaire was used to elicit information from the respondent. Data was subjected to descriptive and inferential statistics set at P &lt; 0.05 using SPSS version 21 and EPI INFO version 7.0.&#x0D; Results: Respondents mean age was 19.04 + 3.34 and 18.50+ 2.86 years rural and urban community respectively. There were more female respondents 52.2% in the rural area and more male respondent 59.2% in the urban area. More youths in the rural than the urban (56.2% vs. 39.5%; p=0.018) were sexually active. The proportion that did not use condoms consistently in the last 12 months preceding the survey was more in the rural than the in urban area (72.6% vs. 46.6%; p&lt;0.001). A larger proportion of youths in the urban areas than the rural areas (79.7% vs.61.5%) perceived themselves to have little or no risk. However, more of rural youths than urban youths (51.4% vs.36.6%) were assessed to be high risk. The sensitivity of perceived risk in the rural was higher than in the urban (37.4% vs.30.6%) while the specificity of perceived risk in the rural was lower than in the urban (63.3% vs.88.0%) population.&#x0D; Conclusion: We found differences in the sexual risk factors to HIV among youths. Youths in rural area are more likely than their urban counterpart to underestimate their personal risk of contracting HIV. Training intervention to improve HIV/AIDS knowledge, risk perception and reduction in risky sexual behavior among the youths is crucial.

Severity of Neuropathy-Related Disability and Associated Factors of Diabetic Peripheral Neuropathy in a Tertiary Healthcare Center: A Comparative Cross-Sectional Study.

The widespread presence of diabetic peripheral neuropathy (DN) and its related variables among diagnosed diabetes mellitus (DM) patients in Kerala lacks sufficient evidence. The objective of this study was to evaluate the frequency of DN and its related risk variables among those with DM who were receiving care at a tertiary health institution in Kerala. This study was conducted in a tertiary health center in Kerala using a cross-sectional design. The diagnosis of diabetes was established by assessing the glycated hemoglobin A1c (HbA1c) level and the fasting blood glucose (FBG) level. A validated survey questionnaire was employed to gather demographic data as well as the medical history of DM and associated ailments. A thorough physical examination, BMI, and blood pressure were recorded. Dermatological, musculoskeletal, neurological, and vascular assessments were conducted. The subjects were assessed for neuropathy using a neuropathy disability score (NDS). Consequently, those who met the criteria for DM were classified into two groups: those with neuropathy and those without neuropathy. All research participants underwent laboratory examinations such as blood lipid profiles, HbA1c, and vitamin B12 complex concentrations. The study included 200 DM patients; 120 men and 80 women. Study participants were 40-70 years old, with a median age of 53. The prevalence of DN significantly increased with age (p<0.001). The longer a patient had DM, the higher the prevalence of DN, and this variance in percentage was statistically significant (p<0.009) with an OR (odds ratio) of 9.246. A statistically significant 81 (40.5%) of participants graduated, compared to 119 (59.5%) with only higher secondary education or less (OR = 2.042; p = 0.014). Approximately 107 (53.5%) of individuals earned an income under two lakhs, and this disparity was deemed statistically significant (p = 0.003) with an OR of 2.357. In the group of individuals being studied, 53 (26.5%) of them experienced a decrease in pressure sensation, 47 (23.5%) had a decrease or absence of vibration perception, 48 (24%) had an absence or decreased pinprick response, and 46 (23%) had an absent ankle reflex. The study found that the most commonly reported symptoms were tingling (n = 44; 22%), numbness (n = 42; 21%), burning (n = 37; 18.5%), pricking (n = 29; 14.5%), and pain (n = 27; 13.5%). A strong association was found between DN and glycemic status, namely, FBG levels exceeding 140 mg/dL(OR = 4.511, p < 0.001) and HbA1c levels exceeding 6.5% (OR = 3.87, p < 0.001). The prevalence of abnormal vitamin B12 levels in individuals with DN was 63% (p = 0.19), indicating that the finding was not statistically significant. Within the group of individuals with DN being studied, 22% exhibited mild neuropathy, 34% displayed moderate neuropathy, and 44% had severe neuropathy. The DN individuals had significantly reduced ankle dorsiflexion in cases of severe NDS scores compared to those with mild to moderate NDS scores (p = 0.009). During the binary logistic regression analysis, it was shown that the duration of DM (OR = 1.73; p = 0.038) and FBG levels (OR = 2.87; p = 0.018) were determined as predictors for DN. The findings of this study reveal that the duration of diabetes, age, literacy level, income, HbA1c, and FBG were substantially related to a higher likelihood of DN among diabetic patients.

Self-care activities in pediatric patients with type 1 diabetes mellitus.

Effective diabetes self-management and collaborative responsibility sharing with parents are imperative for pediatric patients with type 1 diabetes mellitus, particularly as they gradually assume more self-care responsibilities. The primary goal of this study was to assess differences in adherence to self-care activities regarding sociodemographics and clinical characteristics in pediatric patients with type 1 diabetes. The secondary goal of this study was to understand the level of parental involvement in diabetes management and to assess the pediatric patients' behaviors (independent or dependent on disease self-management) that relate to sociodemographic and clinical characteristics. This was a comparative cross-sectional and correlational study. The study sample included 182 children and adolescents who had been diagnosed with type 1 diabetes at least 3 months prior. Data collection instruments included a sociodemographic and questionnaire about Adherence to self-care activities and parental involvement in diabetes self-management, as well as a documentation sheet for recording clinical data. A majority of participants (71%) exhibited non-adherence to self-care tasks, despite 78.0% asserting their independence in diabetes self-management. Notably, insufficient parental involvement in administering insulin therapy significantly predicted severe hypoglycemic episodes. Pediatric patients dealing with type 1 diabetes demonstrate a substantial degree of autonomy in managing their condition, paradoxically coupled with self-reported non-adherence to critical self-care responsibilities. Notably, children (aged 8-12) rely more heavily on parental support, especially concerning insulin therapy administration. The study underscores the crucial role of parental engagement in insulin therapy, as its deficiency significantly predicts the likelihood of severe hypoglycemic episodes.

Relationship Between Postural Stability and Proprioception, Pain, Quadriceps Strength, and Muscle Tightness in Athletes With Patellar Tendinopathy.

Athletes with patellar tendinopathy (PT) have postural stability deficits; however, the underlying mechanisms and factors responsible remain unknown. The effect on postural stability in PT of decreased quadriceps strength, altered proprioception, lower-limb muscle tightness, and knee pain, which explain postural stability deficiency in other populations, is uninvestigated. Proprioceptive acuity, muscle tightness, quadriceps strength, and pain predict postural stability in athletes with PT. Cross-sectional comparative study. Level 2. A total of 43 athletes with PT and 43 healthy athletes were enrolled. Static and dynamic postural stability, proprioceptive acuity, muscle tightness, quadriceps strength, and pain were evaluated using a force platform, Y-balance test (YBT), a weight discrimination protocol, a goniometer, an isometric dynamometer, and a valid questionnaire, respectively. Athletes with PT had significantly worse static and dynamic postural stability in the affected limb (AL) compared with the nonaffected limb (NAL) (P < 0.01) and the control group (P < 0.01). Athletes suffering from PT revealed lower quadriceps strength (P < 0.01), proprioceptive acuity (P = 0.02), and higher muscle tightness in the AL compared with the NAL and controls. Quadriceps weakness of the AL and pain in athletes with PT explained the variance of dynamic postural stability impairment. Athletes with PT have postural stability deficiency compared with healthy peers. Our results demonstrate that quadriceps muscle weakness and pain are the factors that explain postural stability impairment. These results can assist clinicians in the design of therapeutic balance rehabilitation programs by acting not only on pain relief but also on quadriceps strengthening through resistance training to avoid subsequent injuries in athletes with PT.

Is there a difference in the clinical profile and outcome of women using levonorgestrel IUD for abnormal uterine bleeding and those using it for contraception?: A comparative cross-sectional study.

The most common indications for Levonorgestrel intrauterine device (LNG-IUD) are contraception and management of abnormal uterine bleeding (AUB). This study was conducted with the aim of exploring the differences in the clinical profile and outcome of women using LNG-IUD for contraception and AUB. This was a retrospective comparative cross-sectional study of women who underwent LNG-IUD (52 mg) between 2012 and 2017. Their electronic health records were reviewed until the last documented follow-up or until December 2021. A total of 235 women had LNG-IUD with an age range of 21 to 62 years and a mean of (37.98 years±6.76). Of these women, 153/235 (65.1%) had it for contraception and 82/235 (34.89%) had it for AUB. The follow-up was 1-94 months with (mean ± SEM) follow-up for the AUB group of (21.48±2.31) months and for contraception group was (20.74±1.76) months (p-value of 0.80). There was a significant difference between the two groups in the age and body mass index (BMI), where women who had LNG-IUD for AUB were older (mean of 42.54±6.49 years, p-value <0.001) and had higher BMI (31.88±7.52 kg/m2, p-value =0.011). All LNG-IUDs that were indicated for contraception were inserted in an outpatient setting. However, 68.3% in the AUB, the insertion was in the operating theater in conjunction with hysteroscopy. After combining both expulsion and removal of LNG-IUD during the follow-up period, there was no significant difference between the 2 groups in the overall retention rate during the follow-up (p-value =0.998). this study shows that women using LNG-IUD for the management of AUB are older and have a higher BMI compared with those using it for contraception. AUB women experienced more expulsion compared with the contraception group, but there was no difference between the 2 groups in the overall survival/retention of LNG-IUD.

Does COVID-19 Infection Change Thyroid Hormone Levels? A Comparative Cross-Sectional Study in Iran

Background: There is a paucity of research investigating the changes in thyroid hormones in individuals affected by coronavirus disease 2019 (COVID-19). Objectives: This study aimed to evaluate the levels of thyroid hormones in individuals affected by COVID-19 infection in Ahvaz, Iran. Methods: This was a comparative cross-sectional study on 78 patients with COVID-19 infection and 80 individuals without infection. Thyroid-stimulating hormone (TSH), triiodothyronine (TT3), and tetraiodothyronine (TT4) were measured in hospitalized patients at baseline and one month after recovery and in participants without infection. The data were analyzed using a paired t-test, the Chi-square test, the Wilcoxon test, and the analysis of covariance (ANCOVA). Results: The level of TSH at baseline in the hospitalized patients was significantly lower than that in the control group (1.24 ± 1.08 vs. 2.05 ± 1.02 mlU/L, respectively, P &lt; 0.0001). The mean level of TT3 was 1.20 ± 0.24 and 1.28 ± 1.25 ng/dL in the case and control groups, respectively (P = 0.188). The level of TT4 in the case group was high at baseline in comparison to the control group (8.48 ± 2.27 vs. 7.76 ± 1.43 ng/dL, P = 0.076), which was reduced in the follow-up period. Thirty-five (44.8%) patients had severe disease and were admitted to the intensive care unit (ICU). The level of TSH was non-significantly lower in patients with severe disease than those with moderate disease. Conclusions: Patients with COVID-19 infection showed abnormalities in thyroid hormones, such as decreased levels of TSH and TT3. Patients with severe COVID-19 showed lower levels of TSH and unchanged levels of TT3 and TT4 in comparison to the patients with moderate disease. Further investigation into thyroid function in patients with COVID-19 is recommended.

Clinical Features Related to OCT Angiography Artifacts in Patients with Diabetic Macular Edema

To investigate the frequency and type of artifacts on OCT angiography (OCTA) images and the relationship with clinical features in eyes with diabetic macular edema (DME). Retrospective, cross-sectional comparative study. One hundred ninety-two eyes of 140 patients with DME were included. Medical records, OCT and OCTA images (Spectralis), and ultrawidefield color fundus photographs (Optos plc) were evaluated. The frequency of artifact types (segmentation, motion, projection artifact, and low signal) was determined. The relationships between artifact types and clinical features such as best-corrected visual acuity (BCVA), mean central retinal thickness (CRT), foveal avascular zone (FAZ) area, perimeter, circularity index, perfusion density (PD), vessel density (VD), fractal dimension (FD) in the superficial capillary plexus, intermediate capillary plexus (ICP), and deep capillary plexus (DCP), flow voids (FVs) in the choriocapillaris, presence of hard exudate (HE), and cataract were determined. The mean age was 71.6 ± 11.4 years, and 86 (61.4%) out of 140 were men. Artifacts were present in 63 (32.8%) of 192 eyes. Twenty-nine (15.1%) eyes had segmentation artifacts, 12 (6.3%) had motion artifacts, 11 (5.7%) had projection artifacts, and 18 (9.4%) had low signal. Best-corrected visual acuity, PD, VD, and FD in ICP and DCP were significantly lower; and CRT, FAZ area and perimeter in ICP and DCP, and presence of cystoid macular edema, HE, and cataract were higher in eyes with artifacts versus eyes without artifacts (P < 0.05 for each). Multivariate linear regression analysis showed a significant association between segmentation artifacts and decreased BCVA (odds ratio [OR],5.277; P= 0.02), increased CRT (OR, 1.015; P < 0.001), increased area of FAZ in DCP (OR, 6.625; P= 0.02), and increased perimeter of FAZ in DCP (OR, 1.775; P < 0.04); there was also a significant association between projection artifacts and presence of HE (OR, 2.017; P= 0.02) and between motion artifacts and presence of cataract (OR, 4.102; P= 0.01). OCT angiography artifacts were present in one third of DME eyes, with segmentation artifacts being the most frequent type. Determining OCTA artifacts is crucial to ensure accurate clinical evaluation. These data could help in developing more standardized clinical protocols for image acquisition and interpretation used in clinical practice and research. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Availability of essential, generic medicines before and during COVID-19 at selected public pharmaceutical supply agencies in Ethiopia: a comparative cross-sectional study

ObjectivesLockdowns and border closures impacted medicine availability during the COVID-19 pandemic. This study aimed to assess the availability of essential, generic medicines for chronic diseases at public pharmaceutical supply agencies...

Dental Caries in Children with Sickle Cell Disease and Its Association with the Use of Hydroxyurea and Penicillin Prophylaxis in Dar Es Salaam.

This comparative study sets out to report dental caries status among individuals with Sickle Cell Disease (HbSS) against those with sickle cell trait (HbSA) and those without the disease (HbAA) as controls. The study further assessed the impact of penicillin chemoprophylaxis and hydroxyurea use on dental caries among Sickle Cell Disease participants. This was a comparative cross-sectional study in which 93 children aged 30 to 60 months were recruited. There were 60 participating children who had SCD (HbSS), 17 with SCD trait (HbAS) and 16 were without SCD or SC trait (HbAA). A questionnaire was used to record sociodemographic details including mean age in months and sex and on haemoglobin genotype for all the participants. Specifically, for the participants with HbSS, information on their whether they are taking hydroxyurea (HU), and penicillin chemoprophylaxis was recorded. To assess the prevalence of dental caries, clinical examination of all primary maxillary and mandibular teeth to determine the presence or absence of dental caries lesions was also recorded. A total of 1197 teeth from 93 children were examined, whereby, 45 (2.4%) of them had dental caries. The participating children with HbAA genotype (6.6%, N=21) had more dental caries than their HbSS counterparts (2.0%, N=24), while none of the participants with HbAS exhibited dental caries. Among the participants with HbSS, males and those who use HU were 3.79 and 3.07 times more likely to have dental caries than their counterparts, female and non-users of HU, respectively. Dental caries was observed to be low among participants with HbSS when compared to those with HbAA. More research utilizing more robust methodologies is recommended.

Dental caries as a health risk for visual acuity in relation to salivary transforming growth factor beta-1 among students aged 8-10 years: A cross-sectional study.

Dental caries and an impairment in visual acuity (VA) may both be caused by a variety of risk factors. Various conditions of the eye can appear as a consequence of overall inflammation and active dental caries. The present study aims to assess dental caries and salivary status by measuring the transforming growth factor beta-1 (TGF-β1) and flow rate between visually impaired students compared with students with normal vision. Research was performed employing a cross-sectional comparative study design conducted among representative 653 students aged 8-10 years at primary schools in Al-Diwaniyah governorate using the Snellen E chart for measuring VA status. Partitioning the students according to the degree of VA into normal students with normal VA of 6/9 or better and students with visual impairment of 6/12 or worse was done. Sub-sample of 180 students was recruited randomly from both groups, age and gender-matched participants for salivary analysis, and dental caries assessment measured by decay, missed, filled index, according to the World Health Organization in 2013. Out of 653 students, only 70 students suffer from a decrease in VA. Dental caries was more prevalent in those who had a decrease in VA compared with normal groups. For primary teeth decay, missed, filled teeth index (DMFT/dmft), the result was not significant but highly significant for DMFT/dmft. A significant decrease in salivary flow rate and increased salivary TGF-β1 level among visually impaired students was found. According to the current research, the study population that has impaired VA, dental health status has greatly deteriorated.

A Comparative Study of the Efficacy of Platelet-rich Plasma Therapy versus Topical Application of 0.1% Tretinoin Gel in the Management of Striae Gravidarum

Abstract Aim: To determine the relative efficacy of platelet rich plasma therapy versus topical 0.1% tretinoin gel in the management of striae gravidarum. Objectives: To determine the degree of response to platelet rich plasma therapy in comparison with topical 0.1% tretinoin gel in striae gravidarum and to determine the treatment of choice amongst platelet rich plasma and topical 0.1% tretinoin gel. Material and Methods: Study design - A randomised control cross sectional comparative study among the female patients with striae gravidarum was carried out at department of Dermatology, Venereology &amp; Leprosy, Base Hospital, Delhi Cantt, New Delhi. Results: There was early and fast clinical improvement in PRP group with continuous clinical improvement noticed in successive sittings although degree of improvement was lower in 5th and 6th sittings. There was also an earlier plateau of response, in tretinion group after 04 sittings with mild or little improvement in the last 02 sittings in comparison to the PRP group. Conclusion: Platelet Rich Plasma therapy was effective as compared to topical 0.1% Tretinoin gel in the management of Striae gravidarum. PRP had better treatment outcome as well as patient satisfaction.

Association of Socio-demographic factors with Polycystic Ovarian Syndrome; A Comparative Study

Objective: To compare the association of Socio-demographic factors in Polycystic Ovarian Syndrome (PCOS) patients with healthy controls. Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of Biochemistry and Molecular Biology, Army Medical College, Rawalpindi, Pakistan, in collaboration with Department of Gynecology and Obstetrics PEMH, Rawalpindi, Pakistan from Apr to Aug 2023. Methodology: The study comprised 300 females within reproductive age groups. Participants were separated into two groups. Group-I included 150 diagnosed PCOS patients, and Group-II had 150 healthy females selected by non-probability purposive sampling. Results: The PCOS patients exhibit a higher mean weight than the control Group (p-value; 0.017). The comparison of PCOS patients and controls showed significant association with physical activity (p-value: 0.038), hirsutism (p-value: 0.010) and Ferriman-Gallwey score (p-value: 0.001) and consanguineous marriages (p-value: 0.076). Conclusion: This study underscores the significance of socio-demographic factors in the manifestation of PCOS in Pakistan, emphasizing the need for early diagnosis, intervention, and tailored healthcare strategies, particularly among young women.

Comparative cross-sectional study on sexual function of couples during pregnancy: Assisted reproductive techniques versus spontaneous conceptions.

This study aims to compare the sexual functions of couples undergoing assisted reproductive techniques (ART) with those conceiving spontaneously during pregnancy. A total of 102 couples participated in this cross-sectional study, with 68 couples in the spontaneous conception group and 34 couples in the ART group. Data collection was conducted face-to-face in the antenatal clinic using separate "Descriptive Information Form" for women and men, "Female Sexual Function Index (FSFI)" for women, and "Libido Scoring System (LSS)" for men. Descriptive statistical methods, Chi-square and Fisher exact tests, t-test, and Pearson correlation test were used for data analysis. It was observed that the mean FSFI total scores of women who conceived spontaneously and through ART during pregnancy were at a good level (≥30), while the mean LSS scores of their partners were at a moderate level (5-7). No statistically significant distinction existed among the groups. Further research is advisable by adjusting the sample selection criteria, such as gravida, duration of ART treatment, and gestational age.

Association of Vitamin D Deficiency and Type-2 Diabetes Mellitus in Adults

Objective: To find the relationship of vitamin D deficiency with type-2 diabetes mellitus in adults. Study Design: Comparative cross-sectional study. Place and Duration of Study: Combined Military Hospital, Peshawar Pakistan, from Oct 2020 to Mar 2021. Methodology: Patients with type-2 Diabetes and non-diabetics were selected outdoors and indoors using consecutive sampling techniques. Vitamin D serum levels were measured in all participants. Vitamin D serum level &lt;10ng/ml was considered deficient in Vitamin D. Demographic data, duration of type-2 diabetes mellitus, diet, and co-morbidities, wererecorded. Participants were separated into groups such as Group-1, which includes diabetic patients, and Group-2, which contains control (normal/non-diabetic) patients. Results: In the current study, 100 participants were examined. In Diabetes-Group, Vitamin D deficiency was documented in 15(30%) patients, while in the Control (normal/no-diabetics) Group, no patients were found to have Vitamin D deficiency (p&lt;0.001). No significant association of Vitamin D Deficiency was recorded with age (p=0103) and gender of participants in both groups (p=0.719). Conclusion: In adults, type-2 diabetes mellitus is associated with Vitamin D deficiency, and diabetic patients may need to be screened for Vitamin D deficiency.

Comparison of Pre-Mixed Human Insulin with Insulin Analog in Diabetic Control at Tertiary Care Hospital

Objective: To compare the effect of pre-mixed human insulin with insulin analogue in diabetic control among type-2 Diabetes mellitus patients at tertiary care hospital. Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of Medicine, Pak Emirates Military Hospital, Rawalpindi, Pakistan, from Jun 2021 to Apr 2022. Methodology: Eleven hundred and fifty-six patients with poorly controlled type-2 diabetes on oral hypoglycemic agents requiring insulin were recruited for the study. Patients were divided into two groups via a lottery method. Group-A received the pre-mixed human insulin, while Group-B received the Insulin analogue advised by the consultant endocrinologist or medical specialist according to the requirements based on recent investigations. Diabetes control was compared in both groups at the end of twelve weeks of treatment. Results: Out of 1156 patients with type-2 diabetes mellitus included in the study, 810(70.1%) were male, while 346(29.9%) were female. The mean duration of DM in the study participants was 3.42±4.44 years. At the end of three months, 978(84.6%) patients had good glycemic control, while 178(15.4%) patients had poor glycemic control. Statistical analysis revealed that the type of insulin used to manage these patients had no significant relationship with glycemic control in our study participants (p-value&gt;0.05).Conclusion: No statistically significant difference was observed in the number of patients achieving adequate glycemic control between those using pre-mixed human insulin and those using insulin analogue in our study.

Role of Chewing Gum in Enhancing Post-Operative Recovery 0f Bowel Function after Lower Segment Cesarean Section

Background: The frequency of cesarean sections globally exceeds the World Health Organization's recommended rates, leading to an increased focus on postoperative recovery, particularly the restoration of gastrointestinal (GIT) function. The delayed return of intestinal activity, known as postoperative ileus, can extend hospital stays and elevate healthcare costs. Chewing gum has been proposed as a simple, non-pharmacological intervention to stimulate the GIT and potentially expedite recovery. Objective: This study aimed to evaluate the efficacy of chewing gum in improving GIT activity and recovery in patients following a cesarean section, contributing to the evidence base for postoperative care practices in obstetrics and gynecology. Methods: A cross-sectional comparative analytical study was conducted at the Department of Obstetrics and Gynecology, KRL Hospital Islamabad, from May 2021 to November 2021. Two hundred patients undergoing elective cesarean sections were divided into two groups: Group A (n=100), who received chewing gum postoperatively, and Group B (n=100), who did not. The primary outcomes measured were the time to first bowel sound, time to first flatus, and time to first defecation. Data were analyzed using SPSS version 25, with a significance level set at p≤0.05. Results: Group A demonstrated a significantly faster time to first bowel sound (3.75 ± 1.31 hours vs. 7.01 ± 1.94 hours, p=0.001), first flatus (7.97 ± 1.96 hours vs. 14.75 ± 3.57 hours, p=0.001), and first defecation (32.37 ± 3.56 hours vs. 48.20 ± 6.06 hours, p=0.001) compared to Group B. These findings were consistent across age stratifications, with significant improvements in GIT recovery times in younger (18-25 years) and older (26-35 years) subsets of patients. Conclusion: Chewing gum post-cesarean section significantly accelerates the recovery of GIT functions, reducing the time to first bowel sound, flatus, and defecation. This study supports the inclusion of chewing gum as a low-cost, effective method in postoperative care protocols for cesarean section patients, potentially improving patient outcomes and reducing healthcare costs.

Prevalence of Psychological Distress and Burnout among Physicians, Nurses, and Health Professionals during the COVID-19 Pandemic: A Comparative Cross-Sectional Multicentre Study

Prevalence of Psychological Distress and Burnout among Physicians, Nurses, and Health Professionals during the COVID-19 Pandemic: A Comparative Cross-Sectional Multicentre Study

Effect of Moringa Oleifera leaves powder on hemoglobin level in second-trimester pregnant women of Karachi, Pakistan.

Background: Anemia, particularly iron-deficiency anemia during pregnancy, has substantial implications for maternal health and fetal growth. Moringa leaves are known to be rich in iron and may offer a dietary solution to combat anemia in pregnant women. However, evidence on the association between fresh Moringa leaf consumption and maternal hemoglobin levels during pregnancy is lacking. Hence, this study aims to assess the impact of Moringa Oleifera leaf powder supplementation on hemoglobin levels during the second trimester of pregnancy in Karachi, Pakistan. Methodology: A community-based comparative cross-sectional study was conducted at Koohi Goth Women's Hospital, Karachi, Pakistan, from November 2021 to May 2023. The study involved 200 pregnant women who consumed fresh Moringa leaves and 200 non-consumers. Data were collected through an interviewer-administered structured questionnaire, and hemoglobin levels were measured using HemoCue Hb 301. Results: The demographic characteristics of the study participants were analyzed, revealing that most participants in both groups were between 20 and 30 years old. Additionally, most participants in both groups were pregnant for the first time. Hemoglobin (Hb) levels were measured across trimesters, with the Moringa leaf extract group showing levels of 9.43 ± 0.62 g/dL in the first trimester, 8.98 ± 1.12 g/dL in the second trimester, and 9.09 ± 1.04 g/dL in the third trimester. The folic iron group exhibited a higher increase in hemoglobin concentration (10.14 ± 0.91 g/dL) compared to the Moringa leaf extract group (8.98 ± 1.12 g/dL), but the difference between the two groups was not statistically significant. Conclusion: In conclusion, iron-rich foods such as Moringa leaves and iron tablets are recommended to enhance hemoglobin levels in pregnant women.