Comparative Cross-sectional Study Research Articles

Knowledge, attitude towards, and utilization of friendly health services among school adolescents in the pastoral community of Guji zone, Ethiopia: an institution-based comparative cross-sectional study

AimAlthough sexual and reproductive health for adolescents is a recognized fundamental human right and a critical component of health policy, it is poorly addressed and seldom researched in pastoral communities. The study aimed to determine the status of sexual and reproductive health knowledge, attitudes, and practice among pastoral school adolescents in Ethiopia.Study designAn Institution-based comparative study was conducted from Nov. 2020 to Jan. 2021.MethodsWe conducted a comparative cross-sectional study at four randomly selected high schools. Seven hundred seventy-three adolescent students participated, with 384 from Gorodola and 389 from Wadara districts, Guji zone Ethiopia. The data was collected using 34 self-administered questions and analyzed using descriptive, t-test, and linear regression models.ResultsThe study found that only 44.2% of all the participants had good knowledge, 46.1% had good attitudes and 35.4% had good utilization of Sexual and Reproductive Health Services. Respondents from Wadara High School had significantly higher mean knowledge scores (49.3% vs. 44.2%, p < 0.01) than those of Gorodola High School. There was no significant difference in mean utilization scores between case and compare (45.08% vs. 37%, p > 0.01). Adolescents who were not communicated on SRH matters, previously utilized FHS, and visited Friendly Health facilities were associated with poor utilization of sexual and reproductive health services.Conclusion and public health contributionsWadera High School adolescents have better Sexual and reproductive health knowledge and utilization than Gorodola high schools. Community public health care providers in Wadara District explain the outcome through their contributions. Within the context of inherent disadvantage in the school environment setting, there is a need to improve sexual and reproductive health education with a greater emphasis on school girls.

Comparative Analysis of AI Chatbots ChatGPT, Gemini, and Copilot’s Answers to Common Cataract Questions

Purpose: To compare the readability and quality of the answers given by artificial intelligence (AI) chatbots to the twenty-five most frequent searches about cataracts on Google. Study Design: Cross sectional comparative study. Place and Duration of study: Serdivan State Hospital's Ophthalmology Department from March 2024 to April 2024. Methods: The word 'Cataract' was entered into Google Trends, and 25 trending searches made worldwide since 2004 were identified. These 25 trending searches were entered separately into AI programs. The answers were examined for quality using the Ensuring Quality Information for Patients (EQIP) test, while the readability was evaluated using the Flesch-Kincaid Reading Ease (FKRE) and Flesch-Kincaid Grade Level (FKGL). Results: The keywords searched most frequently were ‘Cataract surgery,’‘Eye cataract and 'After Cataract’. The EQIP category of all three AI chatbots was found to be 'serious quality issues.' When EQIP scores were compared, ChatGPT had a lower median value than Gemini and Copilot (p:0.001, p:0.007, respectively), while there was no significant difference between Gemini and Copilot (p:0.098). When FKRE values were compared, ChatGPT had a lower median value than Gemini and Copilot (p:0.001, p:0.001, respectively), with no significant difference between Gemini and Copilot (p:0.557). When FKGL values were compared, ChatGPT had a higher median value than Gemini and Copilot (p:0.003, p:0.001, respectively), with no significant difference between Gemini and Copilot(p:0.245). Conclusion: All three AI chatbots had an EQIP category of 'serious issues with quality .'The readability of all three was not at the recommended level.

Sexual dysfunction among female patients with rheumatic diseases.

To demonstrate the burden of sexual dysfunction (SD) among females with rheumatic diseases, we conducted a cross-sectional comparative study in patients with systemic sclerosis (SSc), systemic lupus erythematosus (SLE), and Behçet's syndrome (BS) along with suitable healthy controls (HCs). Age-matched female patients with SSc (n = 50), SLE (n = 49), and BS (n = 54), along with 52 female HCs were included in this study between April and October, 2021. Sociodemographic features were recorded, and psychometric tests, i.e., female sexual function index (FSFI), Beck depression inventory (BDI), body cathexis scale, and marital adjustment test (MAT) were performed. Scale scores were compared, and binary logistic regressionwas usedto identify predictors for SD in the whole group. The total FSFI and body cathexis scores among the patient groups were significantly lower than those of the HCs (p < 0.001). Depression was significantly more frequent in the patient groups. MAT scores did not differ significantly between the study groups. Patients with SSc had the worst scores in each psychometric index, including MAT. Decreased body cathexis score [OR 0.974, 95% CI (0.957-0.991), p = 0.003] and low MAT score [OR 0.937, 95% CI (0.896-0.980), p = 0.005], and being diagnosed with SSc [OR 6.6, 95% CI (1.975-22.498), p = 0.002], SLE [OR 2.7, 95% CI (0.998-7.753), p = 0.050], and BS [OR 2.8, 95% CI (1.100-7.359), p = 0.031],were identifiedas independent predictors for SD. Body cathexis seems to be the most important independent predictor for SD, and the burden of SD appears heavier in patients with SSc, probably due to poor body image satisfaction.

Impact of slouching on heart rate variability and cardiovascular health among medical students

Background: Medical students frequently adopt poor postures such as slouching potentially impacting health. Heart rate variability (HRV) serves as an indicator of autonomic nervous system function, correlated with cardiovascular health. Aims and Objectives: The objective of the study was to compare HRV parameters among medical students in three postures: Sitting erect, easy pose (cross-legged), and slouching (stooping head and shoulders). Materials and Methods: A comparative cross-sectional study enrolled 26 male medical students. Participants were instructed to maintain each posture for 5 min while HRV was recorded using a Polar V800. Time domain and frequency domain parameters among different postures were analyzed using Friedman’s test and post hoc tests for pairwise comparisons. P&lt;0.05 was considered significant. Data were expressed as median interquartile range. Results: Significant differences were observed in HRV parameters between postures. The easy pose demonstrated a significantly higher median value of root mean square of differences of successive RR intervals (48.28 ms vs. 35.35 ms) and pNN50% (24.40% vs. 13.62%) compared to slouching. Frequency domain analysis revealed a significantly higher median value of high-frequency (HF) power in easy pose (626.56 ms² vs. 378.15 ms²) and HF normalized unit (33.78 vs. 22.55) compared to slouching. A lower low frequency (LF)/HF ratio and (1.96 vs. 3.43) lower LF normalized unit (66.18 vs. 77.30) was also seen in easy pose. Although statistically not significant, the parasympathetic indicators of HRV were higher in erect sitting compared to slouching posture. Conclusion: Among medical students, adopting the easy pose (cross-legged sitting) appeared to enhance HRV and thus increase parasympathetic activity, whereas adopting slouching postures decreased it.

Knowledge, Attitude and Diagnosing Ability about Oral Cancer among Medical and Dental Students of a Tertiary Medical College in Chitwan, Nepal

Background Oral cancer is one of the most common cancers taking away many lives worldwide. The chances of recovery from oral cancer are good if, detected early. Lack of knowledge, casual attitude, and poor diagnostic skills among medical and dental undergraduate students could delay detection and management. The present study aims to assess and compare the knowledge, attitude, and diagnostic ability of oral cancer among medical and dental undergraduate students in a tertiary care hospital in Chitwan, Nepal.MethodsA comparative cross-sectional study was conducted among 123 (medical- 72, dental- 51) undergraduate students using a pre-fabricated questionnaire with close-ended questions and the responses were recorded in Excel sheets. The recorded responses were analyzed using Statistical Package of Social Sciences (SPSS) software. A chi-square test was performed to analyze the difference in knowledge, attitude, and diagnostic ability among medical and dental undergraduate students.ResultsThe response rate for the study was 96.09%. The study revealed over 80% adequacy of knowledge of oral cancer among the participants. 92.41 % of medical students and 96.45 % of dental students showed a positive attitude towards oral cancer. However, a difference was noted in the diagnostic ability of oral cancer among medical and dental students. 93.13% of dental undergraduates were confident about diagnosing oral cancer whereas the confidence of medical undergraduates was only 40.96%.Conclusions The study highlighted the need to educate medical and dental undergraduates about oral cancer and emphasized the need for the revision of the medical curriculum to improve their confidence in their diagnostic ability of oral cancer.

Comparison of Regional Wall Motion Abnormalities in STEMI and NSTEMI Patients at Mardan Medical Complex

Objectives: This study aims to determine and compare regional wall motion abnormalities (RWMA) in patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI), along with associated common complications. Methodology: A comparative cross-sectional study was conducted in the cardiology department of Mardan Medical Complex from June to November 2023. Patients diagnosed with acute myocardial infarction (both STEMI and NSTEMI) were included. Data were collected using a convenient sampling technique. Ethical approval was obtained prior to data collection, which was performed using a predesigned questionnaire. RWMA assessments were conducted by an expert in accordance with the American Society of Echocardiography guidelines using a Toshiba Xario200 Echocardiography machine. Data were analyzed using SPSS 22. Results: Out of 274 patients, 156 (56.9%) were male and 118 (43.1%) were female, with 136 (50%) from the STEMI group and 136 (50%) from the NSTEMI group. The mean age of the respondents was 57.4 ± 13.1 years. RWMA was observed in both types of MI, with significant differences (p &lt; 0.05) found between STEMI and NSTEMI in several segments: basal anterior (5.83% vs. 1.82%), basal anteroseptal (16.23% vs. 2.55%), basal anterolateral (14.59% vs. 3.23%), basal inferior (18.61% vs. 2.91%), apical anterior (5.09% vs. 1.45%), and apical septal (5.46% vs. 1.82%). Severe left ventricular systolic dysfunction was observed in only 2 (0.73%) STEMI patients, while severe pulmonary hypertension was more common in NSTEMI patients. Conclusion: RWMA is a common finding in STEMI patients. Echocardiography plays a crucial role in the early detection of RWMA, which can improve prognosis and reduce the risk of complications.

The potential effectiveness of community health and nutrition volunteers on mothers’ infant and young children feeding knowledge and practice in remote areas, Hajjah, Yemen

BackgroundThe Infant and young child feeding (IYCF) practices directly affect the health, development and nutritional status of children under two years of age. However, IYCF counseling is one of the Community Health and Nutrition Volunteers (CHNVs) activities provided, which may contribute to improving the IYCF knowledge and practice among mothers. Since establishment of the CHNVs program in Yemen, its outcome has never been evaluated. Therefore, the aim of this study was to evaluate the role of CHNVs in improving the IYCF knowledge and practice among mothers in Hajjah governorate.MethodsA comparative cross-sectional study design was conducted in Bani Qais and Al-Maghrabah districts, Hajjah governorate between January and April 2023. A three-stage cluster sampling method was used to select districts, volunteer villages and households. A total of 926 mothers were interviewed. A pre-tested structured questionnaire was used to collect data. SPSS 26 was used for data analysis. The multinomial logistic regression and Chi-Square test were used to compare the IYCF knowledge and practices among mothers between the volunteer and non-volunteer villages. Odds Ratio (OR) with 95% Confidence Interval (CI) were calculated. A p-value < 0.05 was considered statistically significant.ResultsThe mothers in volunteer villages had significantly better breastfeeding and complementary feeding (CF) knowledge than mothers in non-volunteer villages. The OR of having good and moderate knowledge of breastfeeding were 3.5 (95%CI: 2.4–5.2) and 1.6 (95% CI: 1.2–2.2), respectively. The OR for good and moderate knowledge of CF were 1.7 (95% CI: 1.1–2.7) and 2.2 (95% CI: 1.5-3.0), respectively. Moreover, there is a statistically significant association in prevalence of Exclusively breastfed for the first two days after birth (EBF2D), Mixed milk feeding under six months (MixMF) and Bottle feeding 0–23 months (BoF) between volunteer and non-volunteer villages [(OR = 1.4, 95% CI: 1.0-1.8), (OR = 0.4, 95% CI: 0.2–0.8) and (OR = 0.5, 95% CI: 0.4–0.7), respectively].ConclusionsThe study found that CHNVs play a significant effect in improving the breastfeeding and CF knowledge, and prevalence of EBF2D, MixMF and BoF practices among mothers in their villages compared to non-volunteer villages. Future follow-up study and expansion to other settings in different governorates is recommended.

A comparative study of hormonal contraceptive use and vitamin D levels at Gondar Town 2023.

Vitamin D deficiency is an emerging public health problem globally, with devastating health consequences. Some studies suggest that exogenous sex hormones, found in hormonal contraceptives, may enhance vitamin D levels. However, the reasons for this association are not fully understood, as women using hormonal contraception may have different lifestyle habits affecting their vitamin D status. Therefore, this study seeks to explore the relationship between hormonal contraceptive use and vitamin D levels. A Facility based comparative cross-sectional study was conducted in Gondar town from February to April 2023, involving a total of 162 women using three types of hormonal contraceptives (Norplant, DMPA, and COC) and 162 age and BMI-matched non-users as controls in a 1:1 ratio. Participants were selected using systematic random sampling. A semi-structured questionnaire was used to collected data regarding the socio-demographic, economic, obstetric, lifestyle, and clinical information. 5 milliliters of blood samples were collected from each participant for Laboratory analysis of serum vitamin D, calcium, and alkaline phosphates using a Beckman Coulter chemistry analyzer. Independent t-tests, ANOVA with post hoc Bonferroni test was used to compare statistics between the two groups, and logistic regression models to identify factors associated with Vitamin D deficiency. The mean serum Vitamin D levels of Norplant, DMPA, and COC users were 24.08 (± 5.17), 24.83 (± 5.52), and 31.90 (± 6.94) respectively; whereas control group has mean Vitamin D level of 22.00 (± 7.97). On the current study the prevalence of Vitamin D deficiency (< 20 ng/ml) among hormonal contraceptive users was found to be 21.6% (35/162), whereas 48.14% (78/162) of non-user controls had vitamin D deficiency. The odds of having Vitamin D deficiency was higher among participants who attained higher education, who never eat fish and have never been used vitamin D Supplements. However, the use of combined oral contraceptives (COC) shown to reduce the odd of having vitamin D deficiency by 90%. Similarly, individuals with normal and hypercalcemia state shown to have lower odd of having Vitamin D deficiency. Users of combined oral contraceptives (COC) had significantly higher mean serum Vitamin D levels compared to users of Norplant and DMPA, as well as non-users. The prevalence of Vitamin D deficiency was lower among COC users compared to non-users, highlighting a potential protective effect of COC use against Vitamin D deficiency.

Serum Lipid Profile in Preeclamptic and Eclamptic Patients in North-Central Nigeria

Abstract Context: Preeclampsia and eclampsia contribute to 13% of maternal mortality. Central to its etiology are abnormal placentation and endothelial dysfunction. Studies of the maternal spiral arteries of these patients have revealed severe atherosis, extensive widespread endothelial dysfunction, and suspicion of abnormal lipid metabolism. Aim: This study was designed to determine the serum lipid profile in preeclamptic/eclamptic patients and compare it with normotensive controls. Materials and Methods: It was a comparative cross-sectional study, conducted in the Obstetrics and Gynecology unit, University of Ilorin Teaching Hospital. The study population was a total of 192 women comprising 96 pregnant women with preeclampsia/eclampsia and an equal number of normotensive pregnant women who were matched for age, gestational age, and body mass index, as controls. Total serum cholesterol, triglycerides, low-density cholesterol, and high-density cholesterol were determined. Results: The mean total cholesterol among the subjects was 4.79 ± 1.46 mmol/l, compared with the controls which was 4.69 ± 2.05 mmol/l (P = 0.673). The mean high-density lipoproteins (HDL) in the subjects were 1.27 ± 0.71 mmol/l, compared to the control which was 1.73 ± 0.73 mmol/l (P = 0.013). The mean triglyceride in the subjects was 2.41 ± 0.92 mmol/l, and that of the controls was 2.74 ± 0.92 mmol/l (P = 0.001). Mean low-density lipoproteins (LDL) were 2.85 ± 1.32 mmol/l in the subjects and 2.83 ± 1.48 mmol/l in the controls (P = 0.917). There was no relationship between lipid levels and the severity of the disease. Eclampsia was however associated with a higher total serum cholesterol, while intrauterine fetal demise was associated with significantly lower mean triglycerides. Conclusion: HDL and triglycerides are significantly lower in preeclamptic and eclamptic patients.

Correlation of Serum Electrolyte Imbalances With Diabetic Duration and Medication Use: A Cross-Sectional Comparative Study

Correlation of Serum Electrolyte Imbalances With Diabetic Duration and Medication Use: A Cross-Sectional Comparative Study

Relationship Between Serum Copper, Zinc Level and Tumour Aggressiveness in Invasive Cervical Cancer

&amp;lt;i&amp;gt;Background: &amp;lt;/i&amp;gt;Cervical cancer, a leading cause of cancer-related morbidity and mortality, exhibits considerable variability in aggressiveness. The role of trace elements such as copper and zinc in influencing tumor behavior and progression has garnered attention. This study investigates the relationship between serum copper and zinc levels and tumor aggressiveness in invasive cervical cancer.&amp;lt;i&amp;gt; Methods:&amp;lt;/i&amp;gt; A cross-sectional comparative study was conducted among 150 women with invasive cervical cancer attending the outpatient department and Colposcopy Clinic of the Department of Gynecological Oncology, BSMMU, Dhaka, from April 2022 to March 2023. Participants were divided into two groups based on tumor aggressiveness: Group 1 (less aggressive) and Group 2 (more aggressive), with 75 women in each group. Serum copper and zinc levels were measured and analyzed for differences between groups. &amp;lt;i&amp;gt;Result:&amp;lt;/i&amp;gt; Serum copper levels were significantly higher in Group 2 (152.31 ± 41.81 µg/dL) compared to Group 1 (139.31 ± 25.52 µg/dL) with a p-value of 0.023. Conversely, serum zinc levels were significantly lower in Group 2 (55.24 ± 28.13 µg/dL) compared to Group 1 (66.29 ± 31.58 µg/dL) with a p-value of 0.025. The copper/zinc ratio was significantly higher in Group 2 (2.76 ± 1.20) compared to Group 1 (2.10 ± 1.00) with a p-value of &amp;lt;0.001. &amp;lt;i&amp;gt;Conclusion:&amp;lt;/i&amp;gt; Elevated serum copper levels and copper/zinc ratio, along with decreased zinc levels, are associated with more aggressive cervical cancer. These findings suggest that trace element imbalances may serve as biomarkers for assessing tumor aggressiveness and could inform future therapeutic strategies.

Thyroid function evaluation in pediatric nephrotic syndrome: a study in a developing country

BackgroundIn steroid-resistant nephrotic syndrome (SRNS), protracted proteinuria leads to the loss of thyroxine-binding proteins resulting in low thyroid hormones and in damage renal tubules and exhausts the thyroid reserve. This study aimed to assess thyroid function in those patients with SRNS and steroid-sensitive nephrotic syndrome (SSNS). A comparative cross-sectional study evaluated the thyroid status of 50 children with an equal age- and sex-matched SSNS, and controls were enrolled in this study. Demographic data, clinical examination, renal profile, and thyroid function tests were conducted for them.ResultsSubclinical non-autoimmune hypothyroidism was significantly prevalent in 54% of SRNS patients and 12% of SSNS patients (p < 0.001). No cases of overt hypothyroidism were detected. Albumin and protein/creatinine ratio emerged as significant independent factors influencing subclinical hypothyroidism with odds ratio (OR) 0.624, 95% CI (0.425–0.916), and 1.315 OR (1.315) and 95% CI (1.035–1.672), respectively.ConclusionSubclinical non-autoimmune hypothyroidism among patients with SRNS might occur, especially with protracted proteinuria necessitating regular screening of thyroid function in this cohort.

EFFICACY OF EARLY-ONSET SEPSIS CALCULATOR IN THE PREDICTION OF ANTIBIOTICS USAGE AMONG NEONATES: A LOCAL SETTING STUDY

Early-onset sepsis (EOS) in neonates is a critical condition that requires timely diagnosis and appropriate management to prevent adverse outcomes. However, overuse of antibiotics in neonates can lead to complications, including antimicrobial resistance. The EOS calculator is a clinical tool designed to assess the risk of sepsis in neonates, helping to guide antibiotic use. Its efficacy in predicting antibiotic administration in high-risk neonates needs further evaluation. Objective: To evaluate the efficacy of the EOS calculator in predicting the use of antibiotics in neonates admitted to the neonatal intensive care unit (NICU) at a tertiary care hospital. Methods: This comparative cross-sectional study was conducted in the Pediatrics Department of Combined Military Hospital, Peshawar, from August 2020 to June 2022. A total of 982 neonates admitted to the NICU due to a high risk of infection were included. Upon admission, the attending clinician applied the EOS calculator to each neonate. However, the results were kept confidential, and routine management, including antibiotic administration, was carried out based on clinical signs and relevant investigations. The use of antibiotics within 72 hours of admission was compared to the recommendations of the EOS calculator. Statistical analysis used chi-square tests to assess the association between antibiotic use and the EOS calculator's recommendations. Results: Out of the 982 neonates included, 590 (60.1%) were male, and 392 (39.9%) were female, with a mean age of 1.38±4.53 days. Within 72 hours of admission, 562 (57.2%) neonates did not receive antibiotics according to local protocols. A statistically significant association was observed between the clinical use of antibiotics and the recommendations of the EOS calculator (p-value &lt;0.001), demonstrating that the calculator could effectively predict antibiotic needs. Conclusion: The EOS calculator proved to be an effective tool in predicting the likelihood of sepsis in neonates at high risk of infection. Its use can guide clinicians in making informed decisions about antibiotic administration, reducing unnecessary antibiotic exposure while ensuring timely treatment for those who need it. Incorporating the EOS calculator into neonatal sepsis management protocols can enhance patient outcomes and help prevent the overuse of antibiotics in neonates.

Undernutrition and associated factors among school-age children in Wolaita Zone, South Ethiopia: a comparative cross-sectional study.

Nutritional deficiencies in school-age children are a public health concern, especially in resource-limited countries. A school feeding program involves the provision of food on-site or taken home to reduce hunger. It is implemented in several developing nations; however, little is known about the association of school feeding programs with the nutritional status of school-age children in the study area. The study aimed to determine the magnitudes and associated factors of undernutrition among school-age children with school feeding programs (SFPs) and non-school feeding programs (N-SFPs) in Kindo Didaye woreda, South Ethiopia. A school-based comparative cross-sectional study was conducted in Kindo Didaye district from May to June 2023. A total of 612 participants were included in the study. The data were collected from each selected student's parents by using a structured interviewer-administered questionnaire. The weight and height of the children were measured, and a household dietary diversity assessment was conducted. The data were analyzed using SPSS version 25. A binary logistic regression analysis was carried out. A p-value of <0.05 and 95% confidence interval (CI) were used to establish a statistically significant association. The magnitude of undernutrition among the school-age children was 38.9%: 43.3% in the children from the SFP schools and 34.5% in the children from the N-SFP schools. Stunting was 24.1% among the children in the schools with SFPs and 16% among the children in the N-SFP schools, whereas thinness was 33.8% among the children in the SFP schools and 25.6% among the children in the N-SFP schools. The children who were in the older age group [adjusted odds ratio (AOR) = 4.4, 95%CI; 2.22-8.85], consumed less than three meals per day at home (AOR = 6.03; 95%CI 3.9-9.3), and did not eat breakfast at all before going to school (AOR = 3.5; 95%CI 1.15-10.76) were more likely to become undernourished. The children whose fathers received secondary and above education (AOR = 0.52; 95% CI (0.27-0.971) had lower odds of becoming underweight. The magnitude of undernutrition was high in the current study. Existing interventions that work to improve the nutritional status of school-age children should be strengthened. Children should consume any type of food as breakfast at home before going to school regardless of the presence of school feeding programs and at least three times a day.

PROPORTION OF EARLY ONSET SEPSIS IN LOCAL NICU AND IDENTIFICATION OF MATERNAL RISK FACTORS

Early onset neonatal sepsis (EOS) remains a significant cause of morbidity and mortality in neonatal intensive care units (NICUs). Identifying maternal risk factors associated with EOS is crucial for early diagnosis and prevention. Objective: To evaluate the prevalence of early onset sepsis in neonates admitted to the local neonatal intensive care unit (NICU) and identify maternal risk factors associated with neonatal sepsis. Methods: A comparative cross-sectional study was conducted at the Pediatrics Department, Combined Military Hospital Peshawar, from January 2021 to May 2022. One thousand neonates admitted to the NICU due to any indication were included. A consultant paediatrician or neonatologist diagnosed neonatal sepsis based on clinical signs and laboratory findings. Maternal factors such as age, premature rupture of membranes (PROM), maternal fever, and chorioamnionitis were analyzed for their association with early onset sepsis. Data were statistically analysed using SPSS, with p-value &lt;0.001 considered significant. Results: Out of 1000 neonates, 690 (69%) were male and 310 (31%) were female. The mean maternal age was 33.38 ± 4.53 years. EOS was observed in 123 neonates (12.3%), while 877 (88.7%) neonates showed no signs of sepsis. PROM and chorioamnionitis were significantly associated with early-onset sepsis (p-value &lt;0.001). Conclusion: Early onset neonatal sepsis is a common condition in neonates admitted to the NICU. Neonates born to mothers with PROM or chorioamnionitis were at a significantly higher risk of developing EOS. These findings emphasise the importance of addressing maternal risk factors in reducing the incidence of neonatal sepsis.

Prevalence of onychomycosis among psoriasis patients: a clinico-mycological and dermoscopic comparative cross sectional study

Onychomycosis, a nail infection caused by dermatophytes, yeast, and molds makes up roughly half of all onychopathies and is the most prevalent nail condition in the world. Clinically, nail psoriasis and onychomycosis can frequently be difficult to distinguish from one another. To assess the prevalence of onychomycosis in patients with psoriasis. Fifty patients with psoriasis associated with nail disease were included in this study. After taking clinical history, nail samples were gathered for dermoscopic inspection, culture, direct microscopy with 20% KOH solution, and nail clipping with PAS stain. Of the 50 patients recruited, 43 were males and 7 were females, with mean age 6–71 years (mean ± SD 44.06 ± 16.2). Eleven patients (22%) tested positive for onychomycosis. Dermatophytes were isolated from 2% of patients, yeast from 14% of patients, and non-dermatophytic mold from 38% of patients. Histopathological results revealed fungal hyphae and spores in 18% of patients. The most prevalent dermoscopic sign in psoriatic patients with onychomycosis was spikes (81.8%) with statistical significance (P-value < 0.001), while nail pitting was the most prevalent dermoscopic feature in nail psoriasis. This study lays the way for an accurate diagnosis of nail lesions by highlighting the significance of cooperation between mycology, histology, and dermoscopy in the diagnosis of onychomycosis in patients with nail psoriasis.

Association between coagulation indicators and menorrhagia among women in Kenya.

Despite the significant burden of menorrhagia (bleeding > 80 mL every menstrual cycle) among women in Western Kenya, it remains unknown whether coagulation disorders are an important underlying cause of this condition in the region. This study assessed differences in coagulation profiles, associations between menorrhagia and coagulation profiles and compared morphological features of platelets among women attending Bungoma County Referral Hospital in Kenya. A comparative cross-sectional study of women with and without menorrhagia, aged 18-45 years, was performed between December 2022 and September 2023. Sociodemographic factors, prothrombin time (PT), activated partial thromboplastin time, thrombin time, fibrinogen, international normalised ratio (INR), and platelet count were compared between groups, and associations with menorrhagia were assessed. Prothrombin time and INR levels above normal references were deemed increased. A total of 428 (214 per group) women were included. Family history of bleeding disorders (p < 0.0001) was more frequent in menorrhagic than in non-menorrhagic women. Additionally, menorrhagic women had high PT (p < 0.0001) and high INR (p < 0.0001) levels. Menorrhagia was significantly associated with an increased PT (odds ratio = 2.129, 95% confidence interval = 1.658-2.734; p < 0.0001) and increased INR (odds ratio = 7.479, 95% confidence interval = 3.094-18.080; p < 0.0001). In this population in Western Kenya, menorrhagia was associated with a family history of bleeding disorders, increased PT, and increased INR. Routine assessment of the coagulation profile and family history of bleeding disorders is crucial for diagnosing and managing menorrhagia. Our findings suggest that menorrhagic and non-menorrhagic women differ in terms of PT and INR, which may be predictive of menorrhagia.

Platelet indices as predictors of poor glucoregulation in type 2 diabetes mellitus adults at Bishoftu General Hospital, Ethiopia.

Diabetes is a chronic metabolic syndrome that has become a global public health problem with significant morbidity and mortality. It is a pro-inflammatory and pro-thrombotic condition characterized by increased platelet activation and alterations in platelet indices. However, the use of platelet indices as predictors of poor glucoregulation has not been fully evaluated in this context, and evidence for their role as predictors of poor glycemic status in diabetic patients is limited. To evaluate platelet indices and determine their prognostic significance in relation to inadequate glucoregulation among individuals diagnosed with type 2 diabetes at Bishoftu General Hospital in Ethiopia, from June 15 to August 12, 2022. A comparative cross-sectional study was conducted in 261 participants including 174 individuals with type 2 diabetes mellitus (T2DM) and 87 non-diabetic controls. The systematic random sampling technique was used to select par-ticipants. Data were collected using structured questionnaires, physical measurements, checklists, and laboratory tests. Platelet parameters and fasting blood glucose levels were determined from blood samples using Sysmex-XN550 and CobasC311 analyzers, respectively. The hematology analyzer output was checked and participants were also screened for malaria parasites using a prepared blood smear. Collected data were entered into Epi-data version 3.1 and exported to SPSS version 25 for analysis. The χ 2 test, Mann-Whitney U test, Kruskal-Wallis test, post hoc test, Spearman correlation, and receiver operating characteristic curve were used for analysis. A P value < 0.05 was considered statistically significant. The results of our study indicate that diabetic patients have significantly higher levels of platelet distribution width (PDW), mean platelet volume (MPV), platelet large cell ratio (PLCR), and plateletcrit (PCT) compared to healthy individuals (P < 0.001). Furthermore, these indices were found to be significantly elevated in individuals with poor glycemic control in T2DM compared to those with good glycemic control and healthy controls. We also observed significant correlations between these indices and various anthropometric and clinical variables. Our findings suggest that PDW, with a cut-off value of 15.75 fL and an area under the curve (AUC) of 0.803, MPV, with a cut-off value of 12.25 fL and an AUC of 0.774, PLCR, with a cut-off value of 36.3% and an AUC of 0.775, and PCT, with a cut-off value of 0.24% and an AUC of 0.761, can serve as predictors of poor glycemic control in patients with diabetes mellitus. The observed correlation between diabetic patients and a significant increase in platelet indices has highlighted their potential as predictors of poor glycemic control in diabetes. Therefore, regular screening and profiling of platelet indices is recommended as part of the follow-up process for individuals with diabetes mellitus.

Cool mama: Temperature regulation during high-intensity interval running in pregnant elite and recreational athletes

BackgroundRegular exercise during pregnancy is beneficial, but athletes often exceed the recommended 150 min of moderate-intensity activity, incorporate high-intensity exercises. The upper limit for exercise intensity and duration on fetal and maternal safety remains uncertain. A concern is a maternal core body temperature of >39.0 °C, potentially increase the risk of heat-related fetal malformations and complications during pregnancy. Blood flow redirection for thermoregulation could compromise fetal cardiovascular function, increasing the risk of miscarriage and preterm labor. This study evaluated whether pregnant women (gestational weeks 25–35) were at risk of exceeding a core body temperature of 39.0 °C during high-intensity running. We also investigated effects on skin temperature, fluid loss, and thermal sensation, comparing pregnant athletes to non-pregnant controls. MethodsIn this comparative cross-sectional study, 30 elite and recreational athletes (pregnant n = 15) completed up to five high-intensity treadmill-intervals. Core and skin temperature were continuously measured. Body weight was utilized to calculate the amount of fluid loss. ResultsHighest core body temperature were 38.76 °C and 39.56 °C in one pregnant and non-pregnant participant, respectively. Pregnant participants had lower core body temperatures (mean difference −0.47 °C, p ≤ 0.001) initially and a smaller increase (0.10 °C, p ≤ 0.003) during later intervals compared with the non-pregnant controls. Pregnant participants also showed a greater increase in skin temperature (4.08 ± 0.72 °C vs. 3.25 ± 0.86 °C, p = 0.008) and fluid loss (0.81 ± 0.19 L vs. 0.50 ± 0.12 L, p˂0.001). ConclusionPhysiological changes in pregnancy may enhance thermoregulation, indicating that high-intensity interval runs are unlikely to pose a risk of exceeding a core body temperature of 39 °C for pregnant athletes.

Is the cadaveric model valid for examining orthopaedic manual therapy techniques? A cross-sectional comparative study in vivo and in vitro

BackgroundCadaveric models are sometimes used to test the effect of manual techniques. We have not found any studies comparing the effect of tibiotarsal joint distraction on cadaveric models versus live models for clinical use. The aim was to compare the effect on tibiotarsal joint distraction movement when applying three force magnitudes of tibiotarsal axial traction technique force between a cadaveric model and volunteers. In addition, to compare the magnitude of force applied between the cadaveric model and volunteers. Finally, to assess the reliability of applying the same magnitude of force in three magnitudes of tibiotarsal axial traction force. MethodsA cross-sectional comparative study was conducted. Sixty ankle joints were in open-packed position and three magnitudes of tibiotarsal axial traction technique force were applied. Tibiotarsal joint distraction movement was measured with ultrasound. FindingsNo differences were found in applied force or tibiotarsal joint distraction between volunteers and cadavers in each magnitude of force (p > 0.05). The application of the technique showed moderate reliability for detecting low forces in both models. For medium and high force, it showed good reliability in the in vitro model and excellent reliability in the live model. InterpretationThe amount of distraction produced in the tibiotarsal joint was similar in volunteers and cadavers. The cadaveric model is a valid model for testing and investigating orthopaedic manual therapy techniques. The force applied was similar in the two models. Medium and high force detection showed good reliability, while low force showed moderate.