Comparative Cross-sectional Study Research Articles

Identifying perceptions and knowledge gaps among pre-clinical and clinical medical students regarding placebo therapy

Background: Misleading definitions and perceptions of placebo and placebo effect result in fewer realizations on the subject, hence reducing its perceived importance and applications. This study aims to assess undergraduate medical students' perceptions and knowledge gaps regarding placebo therapy across different stages of their education. Methods: A comparative cross-sectional study was conducted for six months, from December 2022 to May 2023, among 350 pre-clinical students (1st and 2nd year MBBS) and 526 clinical students (3rd, 4th, and Final-year MBBS) to assess their perceptions regarding placebo and placebo effect through a validated questionnaire. SPSS was used for analyses, and Pearson's Chi-square was applied, keeping the statistically significant value of <0.05. Results: The study included 876 medical students, with 350 pre-clinical and 526 clinical participants. The mean age was 21.32 years (±1.606). A significant gender distribution was observed, with 45.5% males and 54.5% females. Clinical students demonstrated a greater acceptance of placebo use (68.3% vs. 62.3%, p=0.031) and were more likely to find placebo therapy ethical in psychological cases (70.3% vs. 60.3%, p=0.006). Knowledge assessment revealed that 65% had fair knowledge of placebo therapy, 31.8% had good knowledge, while only 3.2% were highly knowledgeable. Conclusion: The study revealed that many pre-clinical and clinical students held misconceptions about placebo therapy, believing it permissible and beneficial in treating organic disorders. This highlights a significant knowledge gap, emphasizing the need for improved education on placebo use and ethics.

Old age from the perspective of LGBTQ+ and heterosexual young: A comparative study.

In today's world, the challenges and achievements of LGBTQ+'s throughout their lives are increasingly gaining attention. However, the specific needs of LGBTQ+'s in the aging process and potential challenges they might face during this period are often overlooked. This study aims to demonstrate LGBTQ+'s and heterosexual young's perspectives on old age. This descriptive, cross-sectional comparative study collected data from 230 LGBTQ+ and 201 heterosexual individuals. Data were collected using a digital survey comprising an 8-item Personal Information Form and a 17-item Questionnaire for Opinions Regarding Old Age. Compared to others, LGBTQ+'s consider old age to be a more problematic period. In this study, it was determined that LGBTQ+'s perceive old age as a bigger problem compared to those in the heterosexual group. It was determined that the possible difficulties that LGBTQ+'s expect to face in old age are mostly related to basic needs such as the need for care and lack of social support. In the heterosexual group, concerns about age-related physical changes such as loss of youth were observed more frequently. It is recommended that studies to be conducted and services to be offered in this area should be of nature that would ensure safety of LGBTQ+'s, protect their basic humanitarian rights and respond to their needs.

Exploring eating disorder risk among Thai transfeminine youth: a comparative study with cisgender females.

Adolescents, particularly vulnerable during puberty, often face heightened concerns about dieting and body image. Transfeminine youth, especially in Asian cultures, are understudied in this context. This study investigates eating disorder risks among Thai transfeminine youth and compares to cisgender females, focusing on the association with body dissatisfaction. This study aims to explore 3 objectives: (1) to assess and compare the prevalence of eating disorder risks between Thai transfeminine youth and cisgender females; (2) to examine the link between body dissatisfaction and eating disorder risks; (3) to identify risk factors associated with abnormal eating disorder screening outcomes. This is a cross-sectional comparative study conducted between September 2021 and October 2022. The study questionnaire includes Thai version of the Eating Attitude Test-26 (EAT-26) to assess the risks of eating disorders and Thai version of the Body Image Concern Inventory (BICI) to assess body dissatisfaction. The questionnaire was distributed through social media platforms to transfeminine and cisgender females, aged 12-25 years. The correlation between eating disorder risks and body dissatisfaction was analyzed with linear regression, while the comparisons between transfeminine individuals and cisgender female groups were analyzed with Wilcoxon rank-sum test. The study included 241 transfeminine individuals and 388 cisgender females, median age 19.0 years (interquartile range [IQR] 18-21) and 18 years (IQR 16-20), respectively. Ninety (37.3%) transfeminine individuals had an EAT-26 score ≥ 20, suggesting concerns for dieting and eating behaviors, compared to 70 (18%) cisgender females (p < 0.001). Risk factors for EDs included obesity (odds ratio [OR] 3.22, confidence interval [CI] 1.36-7.6) and low income (OR 3.66, CI 1.59-8.4). Protective factors were negligible exercise (OR 0.24, CI 0.09-0.66), gender identity disclosure (OR 0.27, CI 0.1-0.77), and high levels of happiness (OR 0.85, CI 0.73-0.98). There is a significant correlation between the positive eating behavior screening and the body dissatisfaction scores. Transfeminine youths show significantly higher concerns about dieting, body weight, and eating behaviors than their cisgender females, highlighting the unique challenges they face. These results emphasize the needs for targeted screening, health care access for treatment and support for eating disorders in transfeminine youths.

Iron Sucrose versus Ferric Carboxymaltose: Effectiveness in Treatment of Postpartum Anaemia following Caesarian Section

Background: Postpartum anemia is a leading cause of maternal mortality and morbidity throughout the world, particularly in developing countries.The most common causes of postpartum anemia are antepartum iron deficiency anemia and blood loss during childbirth. Treatment of anemia with ferric carboxymaltose during labor can considerably reduce maternal and newborn morbidity. The aim of the study is to compare the effectiveness of iron sucrose and ferric carboxymaltose in the treatment of postpartum anaemia following caesarian section. Materials and methods: A comparative cross-sectional study was carried out among the 234 outdoor patients of the Department of Obstetrics and Gynecology at Sheikh Hasina Medical College Hospital, Tangail during the period from July 2017 to June 2020. Results: The pre-transfusion mean of hemoglobin level was 8.9±0.5 gm/dl and the post-transfusion mean of hemoglobin level was 10.4±0.4 gm/dl in group A. The pre-transfusion mean of hemoglobin level was 8.7±0.7 gm/dl and the post-transfusion mean of hemoglobin level was 11.0±0.4 gm/dl in group B. The mean of increased hemoglobin level was 1.5±0.4 gm/dl and 2.3±0.5 gm/dl respectively in both groups. The pre-transfusion mean of ferritin level was 46.3±16.1 ng/mL and the post-transfusion mean of ferritin level was 171.5±25.8 ng/mLin group A. The pre-transfusion level was 46.5±16.2 ng/mL and the post-transfusion mean ferritin level was ±24.9 ng/mLin group B. The mean of increased ferritin level was 125.2±22.2 ng/mL and 149.0± 20.5 ng/mL respectively in both groups. These differences were statistically significant within the study groups (p&lt;0.05). Conclusions: The study revealed that serum ferritin levels increased significantly in the FCC group than ISC group. Ferric carboxymaltose are more effective and safe for the treatment of iron deficiency anemia in postpartum patients. IAHS Medical Journal Vol 7(1), June 2024; 8-12

Water, sanitation, and hygiene service inequalities and their associated factors among urban slums and rural communities in Eastern Ethiopia

BackgroundUnderstanding the level of inadequate water, sanitation, and hygiene (WaSH) services in urban and rural settlements is crucial for prioritizing community interventions and resource allocation. However, there is a lack of evidence regarding discrepancies in WaSH services across rural and urban slum communities in Ethiopia.ObjectiveThis study aims to assess inequalities in households’ WaSH services and their associated factors among urban slums and rural communities in Eastern Ethiopia from February to April 2024.MethodsA comparative community-based cross-sectional study design was conducted, with study participants selected through stratified random sampling using proportional-to-size allocation. Data were entered into Epi Data version 3.1 and then exported to STATA version 17 for analysis. Bi-variable and multivariable logistic regression was conducted, and associations were reported as odds ratios (ORs) with 95% confidence intervals (CI), using a p-value less than 0.05 as the significance threshold.ResultA total of 278 urban and 301 rural households participated in the study, with a response rate of 94%. Key indicators showed that WaSH services were significantly better in urban areas compared to rural households. For example, 98% (95% CI: 96, 99) of urban households had access to an improved water source compared to 76% (95% CI: 71, 80) of rural households. The proportion of households with improved latrines was 44% (95% CI: 38, 50) in urban areas and only 14% (95% CI: 11, 19) in rural areas. Handwashing practices at all five critical times were reported by 52% (95% CI: 46, 58) of urban household heads, compared to 22% (95% CI: 18, 27) of rural households. Additionally, occupation (such as being a farmer, p = 0.000) and water service satisfaction (p = 0.000) were significantly associated with these key WaSH outcomes.ConclusionThe study revealed that the WaSH services in urban slums are considerably better than in rural households. Socioeconomic factors significantly influence the existing disparities in WaSH services. Stakeholders should focus on providing targeted, strategic support to communities to address the challenges in WaSH service provision.

Prenatal exposure to genocide and subsequent adverse childhood events are associated with DNA methylation of SLC6A4, BDNF, and PRDM8 in early adulthood in Rwanda.

We investigated associations between prenatal genocidal trauma, including maternal rape, and postnatal adverse childhood experiences (ACEs) on DNA methylation of genes associated with the stress response. In a comparative cross-sectional study of 91 Rwandan young adults, categorized by prenatal exposure to genocide and maternal rape, genocide without rape, and unexposed controls, we analyzed DNA methylation from dried blood spots and assessed ACEs and depression and anxiety symptoms at age 24. Prenatal exposure to maternal rape was associated with DNA methylation changes in BDNF and SLC6A4, with the association in BDNF attenuated after including ACE exposure in the model. Genocide exposure without rape was associated with methylation changes in PRDM8 after adjusting for early adversity. Methylation in BDNF and SLC6A4 correlated with depression and anxiety symptoms. These findings underscore the impact of prenatal and postnatal trauma on DNA methylation and mental wellbeing, emphasizing the need for continued support for survivors in the decades after conflict.

Prevalence of active trachoma and its associated factors among children aged 1–9 years in previous leprosarium and non-leprosarium areas in eastern Ethiopia: a community-based comparative study

BackgroundTrachoma is a neglected tropical disease that mainly affects impoverished and marginalized communities with inadequate shelter and sanitation. Nevertheless, the prevalence of active trachoma and the specific factors contributing to it among communities residing in former leprosy settlements in eastern Ethiopia are not well explored. Therefore, the objective of this study was to compare the prevalence of active trachoma and its associated factors among children aged 1-9 years in the previous leprosarium and non-leprosarium areas, as well as urban and rural areas in eastern Ethiopia.MethodsA community-based comparative cross-sectional study was conducted among 580 systematically selected households from January 1 to 30, 2024. Data were collected by interviewing the children’s caregivers, observing the child and environment, and conducting a clinical examination of their eyes. Data were entered in EpiData version 4.6 and exported to Statistical Package of Social Science (SPSS) version 26 software for analysis. A chi-square test was also done. The association was presented as an adjusted odds ratio with a 95% confidence interval, and variables with a p-value less than 0.05 were regarded as statistically significant.ResultsThe overall prevalence of active trachoma was 12.9% (95% CI: 10.5%-15.3%). The prevalence of active trachoma was 15.6%, 9.8%, 18.3%, and 7.5% among children in previous leprosy and non-leprosy settlements and rural and urban areas, respectively (x²=5.65, p-value = 0.017). Having eye discharge (AOR = 10.7’; 95% CI: 4.32, 26.51), latrine distance from home of less than 10 m(AOR=3.12; 95% CI: 1.16–8.34), being a rural resident (AOR=4.1; 95% CI: 1.69-10.18), presence of solid waste around their home (AOR=6.5; 95% CI: 2.14-19.72), and household monthly income less than 5000 Ethiopian birrs (AOR=2.9; 95%CI: 1.04-8.30) were statistically associated with active trachoma in the previous leprosy settlements. In the non-leprosy settlements, children who had eye discharge (AOR = 7.6; 95% CI: 5.37, 58.05), latrine distance from home of less than 10 m (AOR=3.12; 95%CI: 1.11, 8.77), habit of playing with soil (AOR=9.0; 95% CI: 2.92, 28.24), and presence of animal dung (AOR=6.98; 95% CI: 3.44, 48.47) were statistically associated with active trachoma.ConclusionIn this study, the prevalence of active trachoma among children aged from 1-9 years old was higher than the WHO target for the elimination of active trachoma (&amp;lt;5%) in every district. Therefore, targeted treatments and raising awareness on proper hygiene and sanitation are required to alleviate the problem.

Muscular Endurance Training: Bridging Gym Practices with Science Recommendations

This study investigated the effectiveness of training methodologies for improving muscular endurance in young adult males and whether these practices align with scientific recommendations. A cross-sectional descriptive comparative study was conducted with 115 male participants aged 18 to 26. Data on various training parameters were collected using a self-administered questionnaire. The results indicated that participants exhibited discrepancies in their training practices compared to established scientific recommendations. An important percentage of study participants did not exercise according to the recommended guidelines regarding exercise sequencing, intensity, repetitions, rest periods, and training supervision. Participants who followed the recommendations regarding intensity, sets, repetitions, weekly training frequency, and supervision achieved higher objective accomplishment scores. Thus, there are notable discrepancies between everyday gym practices and scientific recommendations for improving muscular endurance in young adult men. Adherence to current recommendations and professional supervision are essential for maximizing training effectiveness, preventing injuries, and facilitating future adaptations.

Cognizance of patients’ rights towards health in a teaching hospital in Sindh, Pakistan: A comparative study

Objectives The objective of this study is to compare cognizance of patients’ rights among patients and doctors. Material and Methods The comparative cross-sectional study was undertaken in various wards of a teaching hospital in Sindh, Pakistan to explore cognizance of patients’ rights among patients and doctors. A total of 390 patients and 417 doctors were selected from the general medicine and general surgery wards of a teaching hospital in Sindh, Pakistan, from December 01, 2021 to February 28, 2022, through convenience sampling. A validated, pre-guided questionnaire was used for data collection. SPSS version 26.0 was used for analysis. The cumulative and segregated analysis of mean ± standard scores of patients’ and doctors’ cognizance regarding patients’ rights were assessed using an independent t-test. Result The segregated analysis of the mean scores of cognizance of patients’ rights among patients and doctors revealed that the majority of associations were statistically significant (p &lt; 0.05), with a few exceptions. These included the right to receive the best available care and respect (p = 0.29), the right to know about their treatment in an understandable language (p = 0.23), and the right to receive healthcare in a hygienic, clean, and safe environment (p = 0.79). Conclusion There is a significant difference in the levels of cognizance regarding patients’ rights between patients and doctors.

A Comparative Cross-sectional Study to Assess Knowledge Regarding Human Rights of Mentally Ill between Patient with Severe Mental Illness and People Without Mental Illness

Abstract Background: Human rights violation of mental illness (MI) in society by people without MI (PWMI) has been a common occurrence. The present study aims to compare the knowledge regarding the human rights of the mentally ill between asymptomatic patients with severe MI (SMI) and PWMI. Materials and Methods: A cross-sectional comparative design was adopted to study the knowledge regarding the human rights of MI among selected asymptomatic patients with SMI and people with PWMI (n = 122). Purposive sampling technique was used to collect the data through face-to-face interview using a structured questionnaire. Descriptive and inferential statistics were used to analyze the data. Results: In the present study, findings revealed that mentally ill patients are still struggling for their rights to be accepted as a part of society. MI patients are being discriminated against by the community because of their MI without getting equal treatment even after their recovery is accepted by both SMI and PWMI. SMI patients did not find the community a safe place contrary to PWMI. PWMI was aware of the rights and policies against harassment of mentally ill other than SMI patients. Conclusion: The study finds that the mentally ill patients are discriminated on various aspects and are not fully aware of their rights which conclude that community needs to be educated regarding the human rights of mentally ill to protect and promote the rights of PWMI.

Human-immunodeficiency virus infection associated with the impaired Th1 and pro-inflammatory cytokine response in latent tuberculosis-infected individuals: A comparative cross-sectional study.

Tuberculosis (TB) and HIV co-infections are extensively overlapping, especially in developing countries. HIV infection is known as a major risk factor for the reactivation of latent TB into active TB. Although not fully understood and needs further study, HIV infection might enhance the reactivation of latent TB by breaching immune control mechanisms. We investigated the influence of HIV infection on the cytokine response of LTB-infected individuals. Heparinized venous blood was collected from 40 ART-naïve HIV-infected and 30 HIV-negative healthy controls for LTB screening, plasma collection, and PBMC isolation and stimulation. The level of cytokines in plasma and their production by PBMCs stimulated with purified protein derivative (PPD), staphylococcus enterotoxin B (SEB), or unstimulated PBMCs were analyzed using a cytometric bead array (CBA) assay. PPD-induced IL-2 by PBMCs was higher in LTB-infected groups compared with HIV-negative LTB-negative groups (p = 0.0015). When LTB-infected groups were co-infected with HIV (HIV+LTB+), the IL-2 (p < 0.0001) and IFN-gamma (p = 0.0144) production by PPD-stimulated PBMCs was reduced. The level of IL-2 (p = 0.0070), IL-6 (p = 0.0054), and TNF-alpha (p = 0.0045) in plasma were lower in HIV+LTB+ individuals compared with HIV-negative LTB-positive (HIV-LTB+) groups. Our findings suggested that HIV co-infection in LTB-positive individuals is associated with the diminished production of PPD-induced Th1 (IFN-gamma and IL-2) cytokines by PBMCs and in the plasma level of IL-2 and proinflammatory cytokines (IL-6 and TNF-alpha).

A comparative study of antenatal depression among urban and rural pregnant women in Gimbi District, Oromia, Ethiopia

BackgroundAntenatal depression (AND) is a form of clinical depression that can be caused by stress and worries that can bring pregnancy to more severe levels. It has negative impacts on women, the family, and the community at large. The comparative study of antenatal depression among rural and urban pregnant women was less studied in Ethiopia and in this study area in particular.ObjectiveThe objective of the study was to compare the prevalence of antenatal depression and its associated factors among pregnant women in Gimbi rural and urban residents in Ethiopia in 2023.MethodsA community-based comparative cross-sectional study design was used from 1 February to 30 March 2023. A systematic random sampling method was used to select study participants. Data were collected using pretested interviewer-administered structured questionnaires. Binary logistic regression analysis was used to identify factors associated with antenatal depression. Variables with a p-value of 0.25 or less in the bi-variable logistic regression model were candidates for a multi-variable logistic regression model.ResultsThe prevalence of antenatal depression was 56 (21.5%), 95% CI: [16.9–25.5] among rural participants and 50 (19.2%) [95%] CI: [14.6–23.8] among urban participants. Having complications during pregnancy (AOR: 4.92, 95% CI: 1.35, 17.88), ever had depression (AOR: 3.20, 95% CI: 1.30, 7.85), consuming alcohol (AOR: 3.78, 95% CI: 1.24, 11.49), and educational status (can read and write) (AOR: 2.14, 95% CI:1.05, 4.67) were factors associated with antenatal depression among urban mothers, while no antenatal care follow-up (AOR: 6.6, 95% CI: 2.63, 16.85), unplanned pregnancy (AOR: 4.51, 95% CI:1.10, 1.86), and having complications during pregnancy (AOR: 2.77, 95% CI: 1.30, 5.92) were factors associated with antenatal depression among rural mothers.ConclusionThe prevalence of antenatal depression among rural mothers was higher than the prevalence of antenatal depression among urban mothers in the Gimbi district. Having complications during pregnancy, ever had depression, consuming alcohol, and educational status were associated factors with antenatal depression among urban mothers; having complications during pregnancy, unplanned pregnancy, and no ANC follow-up were factors associated with antenatal depression among rural mothers. Therefore, quality family planning and ANC services should be provided for the women to reduce unplanned pregnancies and experience complication-free pregnancy periods.

Neurocognitive dysfunction in adolescents with recent onset major depressive disorder: a cross-sectional comparative study.

The aim of this study was to examine the neurocognitive deficits associated with the first episode of major depressive disorder (recent onset depression, ROD) in adolescents as compared to adult patients. Cross-sectional neurocognitive data from the baseline assessments of the PRONIA study with N = 650 (55.31% females) were analyzed. Based on a principal component analysis of eleven neurocognitive tests, we constructed an overall neurocognitive performance (NP) score. We examined mean score differences in NP between the groups of healthy controls (HC) and ROD and between adolescents (15-21years) and adults (22-40years) within a GLM approach. This accounts for unbalanced data with focus on interaction effects while controlling for effects of medication and educational years. Our results show lower NP for the ROD as compared to the HC group (d = -0.29, p = .046) and lower NP for the adolescent group as compared to the adult group (d = -0.29; p < .039). There was no interaction between these two group effects (F = 1.11; p = .29). Our findings suggest that the detrimental effect of ROD on neurocognitive functioning is comparable in adolescent and adult patients, since lower scores in adolescent patients are explained by effects of age and education. Neurocognitive impairment is an under addressed issue in clinical treatment guidelines for adolescent MDD. We suggest efficient monitoring in clinical practice by using an aggregate of the Digit Symbol Substitution Test and the Trail Making Test B, which highly correlated with the overall score of NP (r = 0.82).

Comparison of Functional Echocardiographic Markers in Septic and Non-Septic Neonate

Background: Neonatal sepsis accounts for significant morbidity and mortality and its hemodynamics is complex. Functional echocardiography is emerging at a rapid pace and currently it is considered as a key tool for providing real time information on cardiovascular performance. Objective: To assess and compare functional Echocardiographic markers in septic and non-septic neonate. Methodology: This cross-sectional comparative study was conducted in the Department of Neonatology, BSMMU over an Eighteen-month period from March 2022 to August 2023. 25 neonates including term baby and preterm ≥ 34 weeks with early or late-onset sepsis satisfying the inclusion criteria were enrolled for the study and compared with same gestational age matched healthy control. Result: Comparison of functional echocardiographic parameters between two groups were statistically significant in respect to right and left ventricular output and tricuspid annular plane systolic excursion. Cardiac output was increased (rt. ventricular output 277.4 ± 74.2 Vs 209 ± 70, lt. ventricular output 339.5 ± 43.2 Vs 276 ± 74.9, p-values were 0.002 and 0.001 respectively) and tricuspid annular plane systolic excursion (0.49 ± 0.13 Vs 0.74 ± 0.34, p value 0.001) was decreased in septic neonate compared to healthy counterpart. The result was also statistically significant result in respect to right and left ventricular output and tricuspid annular plane systolic excursion (p-values were 0.039, 0.004 and 0.01) respectively in comparison between preterm septic and non-septic newborn. When compared between the term neonates (37 weeks to 40 weeks) of both groups, there were also statistically significant result in respect to right ventricular output, left ventricular output and tricuspid annular plane systolic excursion (p- values were 0.006,0.03 and 0.025) respectively. Conclusion: Significant cardiovascular changes like cardiac output and right ventricular systolic dysfunction evidenced by Functional Echocardiography, were common association of neonatal sepsis in comparison to non-septic neonate.

Health related quality of life and associated factors among children living in previous leprosarium and nonleprosarium areas of Eastern Ethiopia

Children and their families living in leprosarium areas may have a lower quality of life than the general population. However, there is limited evidence on health-related quality of life and its associated factors among children living in previous leprosarium settlement areas. Hence, this study aimed to compare the health-related quality of life among children living in previous leprosarium and non-leprosarium settlement areas in eastern Ethiopia. A community-based comparative cross-sectional study was conducted among 515 randomly selected children aged 8 to 18 years living in the Amir Nur and Babile districts from January to February 30, 2024. Data were collected through interviews with children and parents using the Pediatric Quality of Life Inventory Version 4. The data were analyzed using STATA version 14. Simple and multiple linear regression was employed to identify associations between independent and outcome variables. The overall mean health-related quality of life scores were 73.98 ± 18.47 and 77.67 ± 14.72 in the child self-reports (P = 0.01) and 55.78 ± 12.03 and 55.61 ± 8.50 (P = 0.85) in the parent proxy reports in the previous leprosarium and nonleprosarium settlement areas, respectively. In multiple linear regression, child education (β = 14.69; 95% CI: 8.69, 20.69), the absence of neglected and tropical diseases (β = 4.02; 95% CI: 0.66, 7.37), and child face washing habits (β = 5.54, 95% CI: 2.14, 8.95) increase health-related quality of life. However, a previous history of neglected and tropical diseases (β = -8.54; 95% CI: -12.93, -4.15) and the absence of hand washing facilities (β = -8.57; 95% CI, -15.22, -1.92) decrease the mean health-related quality of life. Based on child self-reports, one in four children from previous leprosarium areas had poor health-related quality of life compared to children living in none leprosarium areas. Children’s educational status, their daily habits of washing their face, not having neglected, and tropical diseases had improved health-related quality of life. To improve health-related quality of life, stakeholders should pay attention to and work on the early detection and treatment of neglected and tropical diseases, child education, and proper sanitation practices in the leprosarium community.

Comparison of hematologic parameters, serum electrolytes, and lipid profiles among dyspeptic patients with and without Helicobacter pylori infection attending Jimma Medical Center, Jimma, South West Ethiopia.

About half of the world's populations are infected with Helicobacter pylori, which may create atherogenic lipid profiles and contribute to atherosclerosis and related cardiovascular disease. Furthermore, it has been connected to hematological symptoms like anemia. Even though the high prevalence of H.pylori and its associated complications, including cardiovascular disease and anemia, in Ethiopia, there is little data regarding the risk factors associated with H.pylori infection, such as hematologic parameters, electrolyte imbalances, and lipid profiles. A comparative cross-sectional study design with a consecutive sampling technique was employed at Jimma Medical Center among 108 dyspeptic patients. Five (5) ml of blood samples were collected from each participant, and serum was extracted and analyzed using a COBAS 6000 core for the lipid and electrolyte, and whole blood was used with a SYSMEX XN 550 to determine hematological parameters. Data were entered in to Epi-data version 4.6 and exported to SPSS version 25 for analysis. Simple descriptive statistics and chi-square test were used to present the socio-demographic characteristics of the study subjects. Student t-test was used for data comparison and p-value < 0.05 was considered statistically significant. H.pylori infected patients had significantly decreased levels of red blood cell count (p = 0.002), hemoglobin (p = 0.012), mean corpuscular hemoglobin concentration (p < 0.001), platelet count (p = 0.001), and sodium level (p = 0.006) when compared to the uninfected group. However, total cholesterol (p = 0.001), and low density lipoprotein (p = 0.021) were increased in H.pylori infected patients when compared to the uninfected group. This study revealed that H.pylori infection can cause derangements of hematologic parameters, electrolyte imbalances, and alterations of lipid parameters which considered as risk factors for anemia and cardiovascular diseases.

Association of serum uric acid levels with glycated haemoglobin in diabetic patients and healthy controls

ABSTRACT Introduction: Uric acid is formed from purine degradation. Hyperuricemia has emerged as a risk factor for various metabolic diseases including Diabetes mellitus (DM). Uric acid may act as a glucometabolic indicator for Type 2 Diabetes mellitus (T2DM). Glycated haemoglobin (HbA1c) is an indicator of long-term glycaemic control used for diagnosing and monitoring T2DM. However, the association between HbA1c and uric acid is controversial. The present study aimed to study the association of serum uric acid (SUA) levels with HbA1c. Materials and Methods: This cross-sectional comparative study was conducted in a Tertiary Care Hospital in Northern India after permission from the institutional Ethical committee. The study included patients attending the Outpatient Department of the hospital during the study period. Diagnosed cases of DM as per World Health Organization criteria were included as cases. Controls comprised of apparently healthy subjects of the age group 18–50 years attending OPD Patients and Health Care workers. Both cases and control were divided into two groups those with normal uric acid levels and the hyperuricemia group in both males and females to study the association between HbA1c and uric acid levels. Results: The study constituted 1460 participants of which 880 control and 580 DM. The overall prevalence of hyperuricemia was 17.8%. HUA prevalence was 17.04%–18.9% in the control and diabetic population, respectively. SUA levels in T2DM patients were negatively correlated with glycated HbA1c, and FBS whereas positively correlated with glycated HbA1c in controls. Conclusion: While non-diabetic individuals tend to exhibit higher SUA levels, a decreasing trend has been observed in diabetic individuals. A negative association was observed between SUA level and HbA1c in DM in contrast to controls. Therefore, the utilization of SUA as a marker for assessing glucose metabolism should be approached with careful consideration taking care of these complex dynamics.

Exposure to household air pollution and childhood multimorbidity risk in Jimma, Ethiopia

BackgroundChildhood multimorbidity, characterized by the simultaneous occurrence of multiple medical conditions in children, is a global concern. Notably, exposure to household air pollution has been linked to various health issues, particularly affecting vulnerable segments of the population residing in poorly ventilated homes. However, evidence regarding the impact of household air pollution on the risk of multimorbidity in low-income settings remains scarce. Therefore, this study aims to investigate the association between household air pollution and childhood multimorbidity in Jimma, Ethiopia.MethodsA comparative cross-sectional study was conducted to collect data from 280 children under the age of five who lived in households using solid fuel (n = 140) and clean fuel (n = 140). The Demographic Health Survey morbidity questionnaire was used to collect information from mothers about common childhood illnesses. Multiple logistic regression analysis was employed to explore the relationship between the use of solid fuel for cooking in households and the likelihood of childhood multimorbidity. In addition, Poisson regression estimation was used to determine if exposure to solid fuel could increase the number of morbidities.ResultsThe overall prevalence of childhood multimorbidity was 34.3% [95% CI: 0.29–0.40]. Among these cases, 23.9% were among children from solid fuel user households, whereas about 10.4% were from clean fuel user households. Adjusted for all possible socioeconomic, demographic, water, sanitation, hygiene, and health care covariates, children living in solid fuel user households had more than three times the odds of childhood multimorbidity compared to children living in clean fuel user households (AOR = 3.14, 95% CI [1.42–6.95], p &amp;lt; 0.001). Moreover, household air pollution from solid fuel use was positively associated with an increased number of individual morbidity conditions, with an adjusted β coefficient of 0.46 (IRR = 1.58, 95% CI [1.17–2.13], p = 0.003).ConclusionSolid fuel use was an independent predictor of childhood morbidity risk. Efficient policies and strategies, such as the integration of environmental regulation policies into the healthcare system aimed at the reduction of harmful air pollutants and their adverse health effects on children, need to be implemented.

Clinical Evaluation of a Novel CRISPR-Cas12a-Based RID-MyC Assay for the Diagnosis of Fungal Endophthalmitis

ObjectiveThis study evaluates the RID-MyC (Rapid Identification of Mycoses using CRISPR) assay, a CRISPR/Cas12a-based diagnostic tool, for its efficacy in diagnosing fungal endophthalmitis (FE), comparing it with panfungal PCR and culture methods. DesignA comparative cross-sectional study assessing the performance of the RID-MyC assay against established diagnostic modalities for FE. SubjectsThe study included 133 intraocular samples from 117 patients with suspected microbial endophthalmitis. MethodsThe study compared the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the RID-MyC assay against panfungal PCR and culture. The Limit of Detection (LoD) for Aspergillus flavus and Candida albicans was determined for both RID-MyC and panfungal PCR across three different media: nuclease-free water (NFW), aqueous humor (AH), and vitreous humor (VH). Discrepancy analysis was conducted for discordant results, incorporating clinical outcomes and responses to antifungal treatment. Main Outcome MeasuresThe study primarily assessed the sensitivity, specificity, PPV, and NPV for clinical samples. Time to diagnosis was also evaluated. ResultsThe RID-MyC assay demonstrated a sensitivity of 88.24% (CI: 63.56% to 98.54%) and specificity of 93.1% (CI: 86.86% to 96.98%), with PPV and NPV of 65.22% (CI: 48.45% to 78.91%) and 98.18% (CI: 93.62% to 99.50%), respectively. Discrepancy analysis enhanced sensitivity to 90.48% (CI: 69.62% to 98.83%) and specificity to 96.43% (CI: 91.11% to 99.02%). The RID-MyC assay was 10 to 1000-fold more sensitive than panfungal PCR in detecting Aspergillus flavus and Candida albicans in intraocular specimens. The time to diagnosis with the RID-MyC assay was consistently under two hours. ConclusionsThe RID-MyC assay may advance the rapid and precise diagnosis of FE, with possible relevance to other invasive fungal conditions.

Non-inferiority of Cataract Surgery in a Stand-Alone Unidirectional Airflow System Versus in a Conventional Operating Room: A Retrospective Study.

To demonstrate the non-inferiority of a stand-alone unidirectional airflow system, the SurgiCube (Surgi-Cube International BV), for cataract surgery compared to a conventional operating theater (OT). This was a retrospective and comparative cross-sectional study conducted at the Rothschild Foundation, Paris, France. All patients who underwent cataract surgery using the SurgiCube between February 2020 and February 2023 were included and compared to a separate group of patients with cataract surgery performed in a conventional OT and under topical anesthesia during the same period. Patients with less than 1 month of follow-up after surgery were excluded. We collected relevant information from the patient's medical records. Main outcome measures, incidence of endophthalmitis, intraoperative and postoperative complication incidence, 1-month logarithm of minimum angle of resolution (logMAR) visual acuity and intraocular pressure, and operating times were analyzed. A total of 1,901 eyes in the SurgiCube group were compared to 5,474 eyes in the OT group. The occurrence of endophthalmitis was 0.05% (n = 1) in the SurgiCube group versus 0.07% (n = 4) in the OT group (P = 1.00; odds ratio = 0.72 [95% CI = 0.01 to 7.28]). The percentage of procedures with at least one perioperative complication was 2.6% in the SurgiCube group and 2.7% in the OT group (P = .87; odds ratio = 0.96 [95% CI = 0.68 to 1.34]). The percentage of procedures with a postoperative complication was 6.31% in the SurgiCube group and 6.6% in the OT group (P = .59; odds ratio = 0.94 [95% CI = 0.75 to 1.17]. Average visual acuity at 30 days was 0.04 logMAR in the SurgiCube group and 0.07 logMAR in the OT group (P = .62). The average operating times were 16.8 and 19.7 minutes for the SurgiCube and OT groups, respectively (P < .001). The average occupation room times were 26.2 and 32.3 minutes for the SurgiCube and OT groups, respectively (P < .001). Cataract surgery in the SurgiCube seems to be non-inferior to cataract surgery in a conventional OT. [J Refract Surg. 2024;40(11):e884-e891.].