Analytical Cross-sectional Study Research Articles

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

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

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

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

The relationship between dental anxiety and oral health literacy with oral health-related quality of life

Background and AimDental anxiety is a prevalent issue in society, characterized by an uneasy sensation and anticipation of negative experiences in dental settings. In essence, dental anxiety, oral health literacy, and quality of life may have a relationship with each other, however, there is a shortage of evidence examining the interplay between these factors. Therefore, this study aimed to assess the relationship between dental anxiety and oral health literacy (OHL) with oral health-related quality of life (OHRQOL).MethodsThis is an analytical cross-sectional study conducted on 155 patients referred to the Department of Oromaxillofacial Diseases. Three questionnaires consisting of dental anxiety scale, oral health impact profile- 14, and oral health literacy adult questionnaire were used to measure anxiety, health literacy, and the quality of life-related to oral health. Scores were recorded and analyzed by IBM SPSS 24 software using independent samples T-test and ANOVA. Besides, the confirmatory modeling through the goodness of fit index of the model was applied.ResultsThis study involved 155 participants, with a mean age of 38.44 ± 14 years. The majority were females, comprising 99 individuals (63.9%). In this study, 89 patients (57.4%) had dental anxiety. The mean OHL score in the examined participants was 9.88 ± 3.97. Both factors of anxiety (p < 0.001) and OHL (p = 0.012) had a significant effect on the OHRQOL. There was no significant difference in the mean OHRQOL among the three categories of OHL (p = 0.085). The confirmatory modeling showed that only the fourth (p = 0.065) and fifth (p = 0.146) questions of the OHL questionnaire had no significant effect on the total score of OHL. Besides, both factors of anxiety (p < 0.001) and OHL (p = 0.012) had a significant effect on OHRQOL. With an increase of one unit in anxiety, the OHRQOL score increases by 0.31 and for a one-unit increase in the OHL score, the OHRQOL score decreases by 0.66 units.ConclusionIn conclusion, it seems that considering various dimensions of oral and dental health can help patients to have reduced psychological anxiety. Notably, further multicenter studies assessing diverse variables related to dental anxiety, OHL, and OHRQOL, and considering more comprehensive study designs with longitudinal follow-up could help provide insights into how changes in dental anxiety and OHL over time affect OHRQOL.

Exploring predictors and prevalence of postpartum depression among mothers: Multinational study

BackgroundPostpartum depression (PPD) affects around 10% of women, or 1 in 7 women, after giving birth. Undiagnosed PPD was observed among 50% of mothers. PPD has an unfavorable relationship with women’s functioning, marital and personal relationships, the quality of the mother-infant connection, and the social, behavioral, and cognitive development of children. We aim to determine the frequency of PPD and explore associated determinants or predictors (demographic, obstetric, infant-related, and psychosocial factors) and coping strategies from June to August 2023 in six countries.MethodsAn analytical cross-sectional study included a total of 674 mothers who visited primary health care centers (PHCs) in Egypt, Yemen, Iraq, India, Ghana, and Syria. They were asked to complete self-administered assessments using the Edinburgh Postnatal Depression Scale (EPDS). The data underwent logistic regression analysis using SPSS-IBM 27 to list potential factors that could predict PPD.ResultsThe overall frequency of PPD in the total sample was 92(13.6%). It ranged from 2.3% in Syria to 26% in Ghana. Only 42 (6.2%) were diagnosed. Multiple logistic regression analysis revealed there were significant predictors of PPD. These factors included having unhealthy baby adjusted odds ratio (aOR) of 11.685, 95% CI: 1.405–97.139, p = 0.023), having a precious baby (aOR 7.717, 95% CI: 1.822–32.689, p = 0.006), who don’t receive support (aOR 9.784, 95% CI: 5.373–17.816, p = 0.001), and those who are suffering from PPD. However, being married and comfortable discussing mental health with family relatives are significant protective factors (aOR = 0.141 (95% CI: 0.04–0.494; p = 0.002) and (aOR = 0.369, 95% CI: 0.146–0.933, p = 0.035), respectively.ConclusionThe frequency of PPD among the mothers varied significantly across different countries. PPD has many protective and potential factors. We recommend further research and screenings of PPD for all mothers to promote the well-being of the mothers and create a favorable environment for the newborn and all family members.

Diagnostic Role of Serum Adenosine Deaminase In Smear-negative Pulmonary Tuberculosis

Background: Diagnosis of tuberculosis is not always easy, particularly if it is a case of sputum smear-negative pulmonary tuberculosis (SNPTB). Patients with respiratory symptoms resembling SNPTB are difficult to differentiate based on clinical features, chest X-ray, and Xpert MTB/RIF negativity. So, additional diagnostic test with high sensitivity and specificity is needed to increase the yield of the ongoing diagnostic strategy for SNPTB. Adenosine deaminase (ADA) is now being widely used for the diagnosis of TB particularly in effusion fluids due to its simplicity, low cost, and quick available results, it is not always possible to access effusion fluids and therefore, it would be helpful to take advantage of serum levels. Therefore, the purpose of the study was to assess the role of serum ADA in the diagnosis of SNPTB. Methods: This cross-sectional analytical study was conducted in Dhaka Medical College &amp; Hospital, Dhaka from March 2019 to September 2021. A total of 140 patients were included in this study and divided into two groups according to selection criteria: Group I (SNPTB, n=62), and Group II (non-TB pulmonary diseases, n=78). ADA estimation was carried out using the sensitive colorimetric method described by Guisti and Galanti with a BIOSIC kit. After the collection of all the required data, analysis was done by SPSS 24.0. Results: The mean age of the study patients was 48.02 ± 9.60 years (23-73 years) with male predominance in both Group I and Group II (71 % and 60.3%, respectively, p&gt;0.05). Non-TB pulmonary cases were significantly older than SNPTBpatients (52 ± 8.56 vs 43.02 ± 8.49 years, p&lt;0.001). SNPTB patients had a significantly higher frequency of cough, fever, and weight loss compared to non-TB pulmonary cases (p&lt;0.05). In contrast, chest pain and shortness of breath were more frequent in Group II than in Group I (p&lt;0.05). Serum ADA was significantly higher among SNPTB patients compared to non-TB pulmonary cases (48.16 ± 12.13 vs 18.64 ± 7.85 IU/L, p&lt;0.001). ROC analysis of serum ADA in the diagnosis of patients with SNPTB found an AUC of 0.9850 (95% CI, 0.969-1.00) which was statistically significant (p&lt;0.001). A cut-off value of serum ADAe”33 IU/L showed sensitivity, specificity, NPV, PPV, and accuracy of 93.55%, 94.87%, 94.87%, 93.55%, and 94.29%, respectively to correctly diagnose SNPTB cases. Conclusion. This study finding stated that serum ADA may be a useful marker to distinguish SNPTB from non-TB respiratory diseases. However, further study with a more generalized study population is recommended. Bangladesh J Medicine 2024; 35: 61-69

Knowledge, attitudes, and practices regarding self-medication for acne among medical students in Beni-Suef University.

To evaluate medical students' knowledge, attitudes, and self-medication practices for acne vulgaris. An analytical cross-sectional study was conducted at Beni-Suef University's Faculty of Medicine from January 2023 to June 2023. A pre-structured questionnaire was used for the study. A total of 297 students (85.1 %) used self-medications for acne without a prescription. The total knowledge score of self-medication among the study participants was 3.81 ± 2.23. About 71.4 % knew about precautions, and 72.7 % of the participants reported that self-medication is part of self-care. There was a statistical significance between the total mean knowledge score and age (p=0.007), gender (p=0.013), and academic year (p=0.001). A significant portion of students self-medicate about acne. The total knowledge score of self-medication was to some extent not relatively high. Educational programs can be developed to increase medical students' awareness of the risks and benefits of self-medication, information on appropriate use of medications, and when to seek medical attention.

Factors Affecting Nurses’ Use of Personal Protective Equipment During the COVID-19 Pandemic: A Cross-Sectional Study

Background: A critical preventive measure during the rapid global spread of COVID-19 was the use of personal protective equipment (PPE) by healthcare professionals, especially nurses. Objectives: This study aimed to examine the factors that influenced nurses' use of PPE during the COVID-19 pandemic. Methods: An analytical cross-sectional study was conducted in 2021 and 2022. A convenience sample of 423 nurses was selected from those working in teaching hospitals affiliated with Tehran University of Medical Sciences. Data were collected using a researcher-developed questionnaire and analyzed with SPSS software version 26. Descriptive statistical tests, such as frequency, percentage, mean, and standard deviation, were used to analyze the data. Additionally, inferential tests such as the independent sample t-test and one-way analysis of variance (ANOVA) were employed. The significance level was set at P &lt; 0.05. Results: Females constituted 70.20% of the sample. The means and standard deviations for individual and organizational factors were 3.41 ± 0.65 and 3.64 ± 0.83, respectively. The relationships between gender and individual factors, as well as education and organizational factors, were found to be statistically significant. There was also a statistically significant relationship between departments and both individual and organizational factors, and between marital status and organizational factors (P &lt; 0.05). Conclusions: Organizational factors, including the provision of adequate PPE, were the most significant contributors to nurses' use of PPE. Conversely, the non-use of PPE was partly influenced by physical complications, such as skin issues, associated with PPE usage. Managers and policymakers can use the results of this study as a guide for future policy and decision-making to reduce or eliminate the factors inhibiting and to strengthen the factors contributing to the proper use of PPE.

Exploring the burden of irritable bowel syndrome among university students in Saudi Arabia: A study on prevalence, psychological associations, and well-being.

Patients with irritable bowel syndrome (IBS) experience not only a detrimental impact on their physical health but also a significant influence on their psychological well-being. This study aimed to assess the prevalence of IBS among university students, investigating the sociodemographic and lifestyle factors influencing its onset. Furthermore, it explored the potential impact of psychological factors such as depression, anxiety, and overall well-being on the prevalence of IBS. A cross-sectional analytical study was conducted at Saudi Arabian universities in November and December 2023. To collect data, an anonymous, validated, predesigned questionnaire was used. The diagnosis of IBS was carried out using the validated Arabic version of the Rome IV questionnaire. We used the Arabic version of the World Health Organization Well-being Index to assess the participants' well-being. We used the Arabic version of the Hospital Anxiety and Depression Scale (HADS) to identify people who show clinically significant symptoms of anxiety and depression. Our study included a total of 379 university students, 46.7% were female 86.0% of participants resided in urban areas, and 7.2% had been previously diagnosed with IBS. The prevalence of IBS among participants was found to be 31.9%. We observed a significant association between marital status and IBS (χ2 = 3.95, P = .047). Furthermore, the highest prevalence of IBS was observed among students majoring in literary and scientific disciplines (χ2 = 0.952, P = .049). Individuals with IBS demonstrate a significantly higher prevalence of anxiety (71.90% vs 41.09%, P < .001) and depression (64.46% vs 42.64%, P < .001) compared to those without IBS. Furthermore, people with IBS had a slightly higher prevalence of poor well-being (38.84%) compared to those without IBS (33.72%), but this association was not statistically significant. In multivariate analysis, having a family history of IBS [OR = 1.75 (95% CI, 1.06-2.87), P = .029] having borderline anxiety [OR = 7.58, 95% CI (2.12-27.06), P = .012] and anxiety [OR = 16.07, 95% CI (4.57-56.52), P < .001], and depression [OR = 2.97, 95% CI (1.13-7.83), P = .010] were the main significant predictors of IBS among university students. The high prevalence of IBS among university students was associated with a family history of IBS as well as depression and anxiety. Increasing awareness, multidisciplinary support, and access to mental health services is required to ensure university students' well-being.

Customer-Care Initiatives of Service Providers and the Uptake of Breast and Cervical Cancer Screening Services in Mutare, Zimbabwe

Social marketing globally promotes social mobilization to increase uptake of recommended health services. The Ministry of Health and Child Care in Zimbabwe markets breast and cervical cancer screening for reproductive-age women. Despite efforts, uptake remains low, particularly in Mutare district. To address this, an analytical cross-sectional study was conducted in Dangamvura suburb to explore the relationship between service providers&amp;apos; customer-care initiatives and screening uptake. Qualitative and quantitative data was collected via interviews with 96 women aged 18 to 49, randomly selected from Dangamvura Poly-Clinic departments. Of these women, 13.5% were screened for breast cancer, 30.3% for cervical cancer, and 78.8% expressed intent to screen. 90.3% had accurate knowledge of breast and cervical cancer, but only 30.3% could identify screening sites. Among those screened, 75.8% intended to retest. Primary motivations for screening included a desire for health status knowledge (39.2%) and reproductive system issues (32.1%). Main barriers for non-screened women were lack of motivation (56%) and fear of positive results (16.7%). Logistic regression indicated protective factors for screening uptake: history of reproductive issues (AOR: 9.0678, p: 0.0029), prior breast cancer screening (AOR: 21.4347, p: 0.0006), and age 31 to 49 (AOR: 0.1754, p: 0.0066). Overall, uptake was low, influenced by customer factors (age, reproductive issues, prior breast cancer screening) and cost factors (perceived wait times, screening duration, perceived costs). Future interventions aimed at improving uptake of screening services should be tailored to address fears, misconceptions, and lack of motivation to screen among women of reproductive age.

COVID-19 and COVID-19 vaccination experiences and perceptions among health workers during the pandemic in Ebonyi state, Nigeria: An analytical cross-sectional study

Background COVID-19 continues to be a disease of global public health importance and requires long-term management and control. Health workers’ (previous) experiences and perceptions regarding the COVID-19 pandemic and COVID-19 vaccination/vaccination process will influence not only their subsequent use of control measures but also public experiences/perceptions. We explored the COVID-19 and COVID-19 vaccination and the vaccination process experiences and perceptions, and their predictors, among the health workers in Ebonyi state, Nigeria. Methods We conducted an online-offline analytical cross-sectional survey between March 12 and May 9, 2022 among all categories of health workers (clinical/non-clinical, public/private) working/living in Ebonyi state who consented to participate and were selected by convenience/snowballing techniques. A structured electronic questionnaire was used to collect data: self-administered via WhatsApp and interviewer-administered via KoBoCollect for participants who did not have WhatsApp. Data was analysed using descriptive statistics and bivariate/multivariate generalized linear models. Results Of the 1276 health workers surveyed: 55.8% had strong COVID-19 experience and perception, 80.7% had good COVID-19 vaccination expectation and perception, and 87.7% had positive COVID-19 vaccination process experience and perception. The most important predictors of the extent and level of COVID-19 and COVID-19 vaccination and the vaccination process experiences and perceptions were level of place of work (primary-secondary/tertiary), level of attitude towards COVID-19 (vaccination), and level of knowledge about COVID-19. Another important predictor was place of work (public/private). Conclusions The evidence indicate the factors that should guide subsequent policy actions in the strategies to enhance the COVID-19 and COVID-19 vaccination and the vaccination process experiences and perceptions of health workers (and their use of control measures) in Ebonyi state, Nigeria, and other similar contexts. It also indicate factors to be considered by future policy actions regarding similar diseases.

Gallbladder Wall Thickening for Early Detection of Plasma Leakage Among Children with Dengue Fever Admitted in a Tertiary Care Hospital

Background: Plasma leakage is defined as e”20% elevation of hematocrit from baseline or evidence of plasma leakages such as pleural effusion, ascites, or hypoalbuminemia. In the early phase, these signs of plasma leakage are usually difficult to ascertain by physical examination and laboratory tests. Objective: This study aimed to investigate whether gallbladder wall thickening (GBWT) in the febrile phase of the disease can be used to detect the occurrence of plasma leakage in dengue patients. Methods: A cross-sectional analytical study was conducted during a 4-month period in Dr. M R Khan Shishu Hospital and ICH from September 2021 to December 2021. Children from 6 months to 14 years who were admitted with acute onset of fever less than 3 days with NS1 positivity were included consecutively. Laboratory tests and abdominal Ultrasonography were also performed to confirm the occurrence of plasma leakage. Result: Out of 114 patients, the majority were male (64%), in the 5-&lt;10-year age group(48.25%). Common presentations include fever (100%), flushed appearance (66.7%), abdominal pain (66.7%), vomiting (44.7%), bodyache (39.5%), During the febrile phase, 56patients were presented with GBWT, 49 of which showed plasma leakage during treatment. The sensitivity and specificity of GBWT during fever were 89% and 88%. PPV and NPV were 87% and 90% respectively. In risk factor analysis, Gallbladder wall thickening was found statistically significant (&lt;.009) predictor of plasma leakage in dengue. Conclusion: Gallbladder wall thickening during the febrile phaseis a predictor of plasma leakage in Dengue. BANGLADESH J CHILD HEALTH 2022; VOL 46 (3) : 138-143

Utilization of Pre-Exposure Prophylaxis (Prep) Among HIV Discordant Couples in Four Mongu Urban Health Facilities - Zambia

Utilization of Pre-Exposure Prophylaxis (Prep) Among HIV Discordant Couples in Four Mongu Urban Health Facilities - Zambia

Decreased mitochondrial respiration associates with frailty in community-dwelling older adults

Aging population has led to an increased prevalence of chronic and degenerative pathologies. A manifestation of unhealthy aging is frailty, a geriatric syndrome that implies a non-specific state of greater vulnerability. Currently, methods for frailty diagnosis are based exclusively on clinical observation. The aim of this study is to determine whether the bioenergetic capacity defined as mitochondrial oxygen consumption rate (OCR) of peripheral circulation mononuclear cells (PBMC) associates with the frailty phenotype in older adults and with their nutritional status. This is a cross-sectional analytic study of 58 participants 70 years and older, 18 frail and 40 non-frail adults, from the ALEXANDROS cohort study, previously described. Participants were characterized through sociodemographic and anthropometric assessments. Frail individuals displayed a higher frequency of osteoporosis and depression. The mean age of the participants was 80.2 ± 5.2 years, similar in both groups of men and women. Regarding the nutritional status defined as the body mass index, most non-frail individuals were normal or overweight, while frail participants were mostly overweight or obese. We observed that OCR was significantly decreased in frail men (p &amp;lt; 0.01). Age was also associated with significant differences in oxygen consumption in frail patients, with lower oxygen consumption being observed in those over 80 years of age. Therefore, the use of PBMC can result in an accessible fingerprint that may identify initial stages of frailty in a minimally invasive way.

Sexuality in obese and pre-obese women: a cross-sectional analytical study

Sexuality in obese and pre-obese women: a cross-sectional analytical study

Comparison of Recovery Rate and Early Complications Between Primary Resection and Two-stage Operation in the Treatment of Acute Non- Complicated Sigmoid Volvulus

Background: This study compares recovery rates and early complications associated with primary resection and a two-stage operation in treating acute sigmoid volvulus, a gastrointestinal emergency requiring prompt intervention. Proper diagnosis and appropriate operative approaches are crucial for lifesaving treatment. Objectives: This study was aim to compair of recovery rate and early complecations between two operative procedures. Methods: The cross-sectional analytical study was conducted from May to October 2015in National Institute Cancer Research and Hospital, Mohakhali, Dhaka, Bangladesh, involved 50 patients with acute non-complicated sigmoid volvulus, randomly divided into two groups, with the outcome variable being the only difference between two groups. Results: Two stage operation patients experienced 24% stomal complications, while one stage operation patients did not experience any late complication. The mean time for one stage operation was longer, and one stage operation resulted in 200 ml blood loss compared to 156 ml in two stage operations. Conclusion: In consideration of anastomotic leakage, operative time, operative blood loss post-operative hospital stay, two stage operation was better than primary resection. J Rang Med Col. March 2024; Vol. 9, No. 1: 59-64

Clinical and Laboratory Predictors of Mortality in Pediatric Patients with Severe Dengue at Dhaka Shishu Hospital

Background: Dengue fever, particularly in its severe form, poses a significant health challenge in tropical regions like Bangladesh. Understanding the clinical and laboratory predictors of mortality in pediatric patients with severe dengue is crucial for improving management strategies and patient outcomes. Methods: This cross-sectional analytical study was conducted at the Department of Pediatrics, Dhaka Shishu (Children) Hospital, Dhaka, Bangladesh, from January 2019 to December 2020. It included 300 pediatric patients diagnosed with severe dengue. Results: Of the 300 participants, 286 (95.33%) survived, while 14 (4.67%) succumbed to the disease. Major bleeding, refractory shock, a significant rise in hematocrit, signs of pleural effusion, and ascites were significantly associated with mortality. Hematologically, a low platelet count (&lt;15000/mm3) was a strong predictor of mortality. Elevated serum ferritin levels (&gt;500 micrograms/L) were also significantly associated with increased mortality risk. Conclusions: The study highlights major bleeding, refractory shock, significant hemoconcentration, pleural effusion, ascites, low platelet count, and high serum ferritin levels as key predictors of mortality in pediatric patients with severe dengue. These findings underscore the need for comprehensive clinical monitoring and targeted management strategies to improve outcomes in pediatric dengue patients. J Rang Med Col. March 2024; Vol. 9, No. 1:10-15

A psychological insight of Moroccan adults' immunisation behaviour towards emergency vaccines.

The psychology of vaccination behaviour explains how thoughts and feelings influence people's willingness to receive vaccines. Understanding vaccination behaviour is crucial to successfully managing vaccination campaigns. Investigating factors associated with immunisation stress among students at Mohammed First University. This study was conducted on students at Mohammed First University institutions. This study is a descriptive and analytical cross-sectional study. It was conducted on 305 students at Mohammed First University institutions using a 90-item questionnaire. Three hundred and five participants have been included in this survey. Overall, 65.5% of the students in our sample had a positive perception towards COVID-19 vaccines. Nevertheless, 34.5% had a negative opinion regarding immunisation. According to the analysis of perceived stress scale, 40% (n = 122) of students expressed moderate to high stress regarding vaccination. Students with a negative perception of vaccine showed a higher level of stress than those with a positive one. Stressed students tended to be older than others, coming from other institutions, other than the medical faculty, and were renting alone. Vaccine accessibility was the less significant reason associated with stress regarding vaccination. Moreover, participants with high levels of confidence in social media, exhibited higher stress. Nevertheless, those who believed in scientific journals were significantly less stressed. These results reflect a positive perception and acceptance of vaccines, with a considerable level of stress regarding vaccination.Contribution: This study suggests emphasising the mental health of Moroccan young adults, to better sensitise and inform them about immunisation.

Assessment of Serum Insulin and VASPIN Levels Among Type 2 Diabetes Mellitus Patients with or Without Obesity: A Cross-sectional Analytical Study

ABSTRACT Introduction: A collection of diverse conditions together referred to as diabetes mellitus frequently manifest as periods of hyperglycemia and glucose intolerance, which can be caused by insufficient insulin, improper insulin action, or both. A medical condition known as obesity is the accumulation of excess body fat to the point that it may be harmful to one’s health. It has been determined that the adipokine vaspin (visceral adipose tissue-derived serpin A12) belongs to the family of serine protease inhibitors. Insulin, a polypeptide hormone, is released by the pancreatic beta cells. This hormone is both anti-catabolic and anabolic. Insulin decreases blood glucose levels by preventing its synthesis and encouraging its storage and use. Methodology: In total, 125 male and female participants of various ages participated in the current study. They included 25 healthy controls, 50 non-obese and 50 obese non–insulin-dependent diabetes mellitus patients, who visited the MDM Hospital’s outpatient clinic in Jodhpur, Rajasthan. Commercially available reagents and kits were utilized for the analysis of serum insulin and vaspin samples. Standard statistical tools were utilized to evaluate the parameters. Results and Discussion: When results were compared with healthy participants and non-obese NIDDM subjects, obese NIDDM subjects showed statistically significant higher fasting serum insulin and serum vaspin levels (P &lt; 0.0001). Conclusion: Our study’s conclusions demonstrated a strong correlation between blood insulin and vaspin levels and diabetes and obesity. Vaspin has a positive impact on insulin resistance, obesity, type 2 diabetes, and metabolic syndrome. It also enhances glucose tolerance and insulin sensitivity, reducing diabetes complications. This novel biomarker has the potential to enhance diabetes mellitus outcomes by facilitating prompt diagnosis, improved management, and reduction of complications.

Respiratory Rate Oxygenation (ROX) index as predictor of high flow nasal cannula in pediatric patients in pediatric intensive care unit

BackgroundHigh-flow nasal cannula (HFNC) is often used in pediatric populations with respiratory distress. In adults, the respiratory-rate oxygenation (ROX) index is used as a predictor of HFNC therapy; however, children have age-associated differences in respiratory rate, thus may not be applicable to children. This study aims to find the reliability of ROX index and modified P-ROX index as predictors of HFNC therapy failure in pediatric patients.MethodsSubjects in this analytical cross-sectional study were taken from January 2023 until November 2023 in Cipto Mangunkusumo Hospital. Inclusion criteria are children aged 1 month to 18 years with respiratory distress and got HFNC therapy. Receiver operating characteristics (ROC) analysis was used to find mP-ROX index cutoff value as a predictor of HFNC failure. The area under curve (AUC) score of mP-ROX index was assessed at different time point.ResultsA total of 102 patients, with 70% of the population with pneumonia, were included in this study. There are significant differences in the ROX index between the successful and failed HFNC group therapy (p < 0.05). This study suggests that mP-ROX index is not useful as predictor of HFNC therapy in pediatrics. While ROX index < 5.52 at 60 min and < 5.68 at 90 min after HFNC initiation have a sensitivity of 90% and specificity of 71%, sensitivity of 78% and specificity of 76%, respectively.ConclusionmP-ROX index is not useful as a predictor of HFNC therapy in pediatrics. Meanwhile, ROX index at 60 min and 90 min after initiation of HFNC is useful as a predictor of HFNC failure.

COVID-19 vaccination uptake among healthcare workers in Ghana: A comprehensive analysis of knowledge, attitude, perceived vaccine effectiveness, and health belief model constructs.

The novel Coronavirus Disease 19 (COVID-19) caused devastating effects globally, and healthcare workers were among the most affected by the pandemic. Despite healthcare workers being prioritized in COVID-19 vaccination globally and in Ghana, hesitancy to receive the vaccines resulted in delayed control of the pandemic. In Ghana, healthcare workers had a vaccine acceptance of 39.3% before the vaccine rollout. Consequently, this study assessed the uptake of COVID-19 vaccination and associated factors among healthcare workers in Ghana in the post-vaccine roll-out period. This was an analytical cross-sectional study that used a semi-structured questionnaire to collect data on COVID-19 vaccination uptake and influencing factors. 256 healthcare workers were selected in Ayawaso West Municipality of Ghana using a stratified random sampling approach. Descriptive statistics were used to examine socio-demographic factors and Likert scale responses. Bivariable and Multivariable logistic regression were performed using IBM SPSS version 22 to identify predictors of vaccine uptake and a statistical significance was declared at p<0.05. More than three-fourths of participants 220 (85.9%) had received at least one dose of the COVID-19 vaccination, while 36 (14.9%) were hesitant. More than half 139 (54.3%) had adequate knowledge about COVID-19 vaccination and the majority 188 (73.4%) had positive perceptions about its effectiveness. Moreover, 218 (85.2%) of HCWs had a positive attitude towards COVID-19 vaccination. Positive attitude towards COVID-19 vaccination (AOR = 4.3; 95% CI: 1.4, 13.0) and high cues to action (AOR = 5.7; 95% CI: 2.2, 14.8) were the factors that significantly predicted uptake of COVID-19 vaccination among healthcare workers. COVID-19 vaccination among HCWs in Ghana is promising. However, hesitancy to receive the vaccination among a significant proportion of HCWs raises concerns. To ensure vaccination of all healthcare workers, interventions to promote vaccination should target key determinants of vaccination uptake, such as attitude towards the vaccination and cues to action.