Comparative Cross-sectional Study Research Articles

Prevalence and associated risk factors of myocardial ischemia in children living with sickle cell anemia in Lagos, Nigeria.

Myocardial ischemia (MI) in children living with sickle cell anemia (SCA) is rarely reported. MI among children living with this disease could portend untoward outcomes on their quality of life and survival. This study evaluated the prevalence and associated risk factors of MI in children living with SCA during a vaso-occlusive crisis (VOC) compared with those with SCA who had no symptoms nor an MI in the past (those in "steady state") in Lagos, Nigeria. This comparative cross-sectional study was conducted over 10 months (between March and December 2019) among 250 children living with SCA aged 6 months-18 years (125 in VOC and 125 age and sex-matched controls in steady state). The assessment of MI was determined by measuring cardiac troponin T (cTnT) and electrocardiography (ECG). The prevalence of MI measuring cTnT alone in children with SCA during VOC and steady state was 42.4% and 23.2%, respectively. Comparatively, measuring ECG alone, the prevalence of MI in VOC and steady state was 40.8% and 20.8%, respectively. The prevalence of MI measuring cTnT and ECG in children with SCA in VOC and steady state was 38.4% and 20%, respectively. Older age, severity of pain, longer duration of illness, frequent crises per year, elevated white blood cells, and platelet count were significantly associated with MI in participants with SCA. However, with multivariate analysis, age, severity of pain, and elevated platelet counts remained significantly associated with the occurrence of MI. This study affirms the high prevalence of MI in children with SCA irrespective of the diagnostic criteria. Routine evaluation should be done in this cohort to avert MI-associated sequelae.

Factors affecting employment status in people with epilepsy

Aim: People with epilepsy often face difficulties finding and keeping a job in India. This study aimed to determine the employment rate of people with epilepsy, compare it with that of people without epilepsy and to assess the various factors affecting theiremployment status. Methods: A comparative cross-sectional study was done by recruiting 140 people with epilepsy and 140 people without epilepsy (relatives of patients) from an epilepsy clinic in New Delhi, India. Demographic and clinical data were collected using questionnaires. Additionally, five items were added to measure self-perceived importance of work, ability to work and family support for working. Psychometric scales were used to measure the psychosocial variables affecting employment. Questionnaires were completed by people with epilepsy. Results: The employment rate of people with epilepsy was 59.3% as compared to 70.0% in those without epilepsy (P=0.045). Gender, younger age, having fewer family members, higher educational attainment, self-perceived importance of being employed for personal and financial reasons, and the ability to work and family support for working were some of the factors associated with employment status in people with epilepsy (P<0.05). Among the psychosocial variables, epilepsy stigma and perceived social support were found to be significantly associated with being employed (P<0.05). None of the clinical variables were found to be associated. Of those in the study, 56 out of 83 people with epilepsy, who had a job, felt they were underemployed. Conclusions: The employment rate of people with epilepsy was lower than the control population. The majority of those with jobs felt they were underemployed. A host of factors affect employment status in people with epilepsy. This suggests the need for vocational training, raised awareness among the general population, and counselling and other services for people with epilepsy.

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.

Although 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. An Institution-based comparative study was conducted from Nov. 2020 to Jan. 2021. We 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. The 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. Wadera 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.

Breast Cancer and Risk of Depression: A Comparative Cross-Sectional Study Among Women With and Without Breast Cancer in Addis Ababa, Ethiopia.

The extent of symptoms of depression among patients with breast cancer compared with those without the disease is not well documented in Ethiopia and other sub-Saharan African countries. This study examines the prevalence of symptoms of depression in women with breast cancer (n = 436) compared with those without breast cancer (n = 856) in Addis Ababa, Ethiopia, through a comparative cross-sectional study using a validated questionnaire, the Patient Health Questionnaire-9. The association between breast cancer diagnosis and symptoms of depression was evaluated using a multivariable binary logistic regression model. About 39.2% of women with breast cancer had some level of symptoms of depression compared with 23.8% of women without the disease. By severity of symptoms of depression, 13.1% of women with breast cancer reported moderate to severe symptoms of depression compared with 6.8% of women without the disease. Sixty-three percent of women with breast cancer reported difficulties performing routine daily activities, compared with 36.7% of women without the disease. In the multivariable-adjusted model, women with breast cancer were 2 times (adjusted odds ratio, 2.26 [95% CI, 1.49 to 3.44]) more likely to report symptoms of depression compared with those without the disease. Likewise, women with breast cancer were 4.78 (95% CI, 3.51 to 6.52) times more likely to report difficulty in performing routine daily activities compared with women without the disease. Four in 10 women with breast cancer in Addis Ababa reported having symptoms of depression, which was considerably higher than women in the general population. This finding emphasizes the importance of addressing psychosocial needs among women with breast cancer to enhance quality of life and potentially extend longevity.

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.

Assessment of Health-Related Quality of Life in Adults Living with HIV Attending Antiretroviral Clinics versus Traditional Healers' Offices in Bukavu City, Democratic Republic of the Congo.

The benefits of antiretroviral therapy (ART) for people living with HIV/AIDS (PLHIV) include immune system strengthening, viral load suppression, and improved health-related quality of life (HRQOL). This present study compares the HRQOL of PLHIV visiting ART clinics versus that of PLHIV attending traditional healers (THs)' offices, assesses the adherence of PLHIV to ART, identifies possible predictors of nonadherence of PLHIV to ART and HRQOL, and estimates the proportion of patients with HIV referred by THs to health centers in Bukavu. Between February and June 2023, a cross-sectional comparative study was conducted on 150 adult PLHIV attending ART clinics and 150 adult PLHIV visiting THs' offices in the 3 urban health zones of Bukavu. The World Health Organization Quality of Life questionnaire (WHOQOL-BREF) and a self-report questionnaire measuring ART adherence were used to collect the data. Regression models were used to identify the predictors of no adherence to ART and the HRQOL of PLHIV. Compared with those attending THs, PLHIV attending ART clinics had higher mean scores in all HRQOL domains. Approximately 84% of the participants were compliant with ART. The predictors associated with nonadherence to ART included illiterate participants [OR=23.3 (95% CI=1.23-439.5), p=0.004] and divorced or separated participants [OR=10.3 (95% CI=1.12-94.4), p=0.034]. The proportion of PLHIV referred to ART clinics by THs was only 10.7%. PLHIV visiting ART clinics had a better HRQOL than did PLHIV attending THs' offices. The rate of adherence to ART among PLHIV who attended ART clinics was high. It is recommended that PLHIV visiting THs be referred to ART clinics for improved HRQOL.

Service delivery in postpandemic period for routine childhood immunization in Assam following capacity building with BRIDGE IPC Skill tool

ABSTRACT Background: For COVID-19 pandemic and associated factors, around 25 million children missed routine immunization in 2021. NFHS-5 for Assam reported 67% coverage with routine immunization in 2019–21 which is below national average (77%) and lowest among Indian States/UTs. Lack of knowledge and skill among provider can reduce coverage. To address vaccine hesitancy and demand generation for routine immunization, BRIDGE IPC Skills (Boosting Routine Immunization Demand Generation) training in routine immunization for frontline workers considered an effective tool. Objectives: To estimate the service delivery in postpandemic period for routine childhood immunization in Assam following capacity building with a BRIDGE IPC Skill tool. Materials and Methods: This cross-sectional comparative study was conducted among immunization service providers from April 2022 to March 2023, where training coverage of service providers on BRIDGE IPC Skill was assessed. Comparison was made between functionalities of trained services by service providers with untrained ones. Results: A total of 2312 session sites were visited, of which 67.7% of frontline workers were trained, while 32.3% were not trained. Alternate vaccine delivery was present in 58.5%. Updated due list was present in 64.1% vs 29.8% in trained and untrained sites. Significant association was found between delivery of key message and status of frontline worker on BRIDGE IPC Skill training. Conclusion: Capacity building of frontline workers on BRIDGE IPC Skill can boost efficiency of frontline workers and may facilitate in addressing gaps that EXIST between health care system and community.

Physiological parameters and training characteristics of endurance runners at Ethiopian Youth Sports Academy (2400 meters above sea level) and Guna Athletics Sport Club (3100 meters above sea level) training camps: a comparative cross-sectional study.

Endurance performance is impacted by physiological, anthropometrical, diet, genetic, psychological, and training characteristics. Altitude can affect physiological parameters (like maximum oxygen utilization, arterial oxygen saturation (SaO<inf>2</inf>), heart rate, and blood pressure) and training characteristics (duration, frequency, and training load). Thus, this study compared physiological parameters and training characteristics between endurance runners at Ethiopian Youth Sports Academy (EYSA) and Guna Athletics Sport Club (GASC) located which are located at elevation of 2400 and 3100 meters, respectively. A comparative cross-sectional study design was used from September to November 2021. Data was obtained from a total of 120 eligible participants (30 runners and 30 controls at GASC, and 30 runners and 30 controls at EYSA). Sociodemographic and training characteristics were assessed using self-administered standardized questionnaires. SaO<inf>2</inf> and heart rate were measured using finger pulse-oximetry (Nellcor, Oxim N-65; Covidien, Dublin, Ireland). Blood pressure was measured by Folee Digital Blood Pressure Monitor DX-B1 (Jiangsu Folee Medical Equipment Co., Ltd., Zhenjiang, China). The runners of GASC had significantly lower resting SaO<inf>2</inf>, SaO<inf>2</inf> immediately after maximal exertion, training (frequency and load) than runners of EYSA in both sexes. Runners of Guna Athletics Sport Club (RGASC) had significantly higher maximum oxygen utilization (VO<inf>2</inf>max) than Runners Ethiopian Youth Sports Academy (REYSA) in both sexes. Severe exercise-induced hypoxemia (EIAH) and moderate EIAH were developed by male runners of GASC and EYSA respectively. Besides, female runners GASC and EYSA developed moderate and mild EIAH, respectively. Conclusively, there were significant differences in physiological parameters and training load between RGASC and REYSA. High altitude (3100 meters) may have a greater impact on the above variables than moderate hypoxia (2400 meters above sea level). Hence, endurance runner coaches should give emphasis to these variables.

A study on serum zonulin in chronic spontaneous urticaria patients

hronic spontaneous urticaria (CSU) is a widespread disease with a complicated heterogenous pathophysiology. Increased intestinal permeability i.e., leaky gut has been linked to the pathology of many diseases. Zonulin was recently used as a marker for leaky guts. This study aimed to assess the relation between serum zonulin level and CSU and its possible relationship with disease activity. This was a comparative cross-sectional study, which included 97 CSU adult patients and 87 apparently healthy controls. CSU patients had significant lower zonulin level than controls (p&lt;0.001). The median of serum zonulin level was equal to 2.93 ng/ml with interquartile range (IQR) (1.40-4.19) in the CSU group and of 3.92 ng/ml with IQR (2.97-4.69) in the control group. We found a positive correlation between serum zonulin and C-reactive protein with Pearson correlation coefficient of 0.2, (p=0.04). No significant correlation was found between serum zonulin level and urticaria activity score 7 or total immunoglobulin E level. In conclusion, this study found that serum zonulin level is lower in CSU patients than in controls which could be attributed to food restriction, severity of the CSU disease and/or drug intake in the CSU cases.

Pin-prick (Medipin) assessment for neuropathy in diabetes: Prospective screening study in primary care

AimsDiabetic patients are at elevated risk of neuropathy; early detection is desirable to minimise the risk of complications. The Medipin pin-prick device was appraised as a screening tool for diabetic neuropathy. MethodsProspective cross-sectional comparative screening study in primary care setting, involving 389 participants with type 2 diabetes mellitus. The Medipin pin-prick method, involving dorsal application on the hallux of both feet, was compared to 10 g monofilament testing. ResultsThe ternary and semi-quantitative approach for scoring Medipin pin-prick sensation give very similar results (Spearman rho 0.67, P < 0.001). A total of 59 % patients had no signs of neuropathy (sharp sensation), 38 % reported impaired sensation (dull sensation), and an absence of sensation occurred in 3 % of patients. For the monofilament dorsal method, the figures were 79 % no neuropathy, 14 % elevated risk, and 7 % neuropathy respectively, and with the monofilament plantar method 87 % of patients had no neuropathy and 13 % did. Correlation analyses showed that taller patients and those with existing neuropathic pain are at very modest increased risk of neuropathy. ConclusionsThe Medipin pin-prick device can identify diabetic neuropathy and detects (first signs of) neuropathy in relatively more patients than 10 g monofilament testing. The differential targeting of nerve types, namely predominant small (Medipin) versus large (monofilament) fibre, likely underpins the difference in outcomes.

Low thiamine status in adults following low-carbohydrate / ketogenic diets: a cross-sectional comparative study of micronutrient intake and status.

Low-carbohydrate diets (LCD) are popular for weight loss but lack evidence about micronutrient sufficiency in real-life use. This study assessed the intake and biochemical status of selected micronutrients in people voluntarily following LCDs. A cross-sectional study was conducted (2018-20) among 98 adults recruited as self-reporting either LCD (n = 49) or diets not restricting carbohydrates (controls; n = 49). Diets were assessed using the 130-item EPIC-Norfolk food-frequency questionnaire. Red-blood-cell thiamine diphosphate (TDP) was measured for thiamine status using HPLC. Plasma magnesium, zinc, copper, and selenium were measured using inductively coupled plasma mass spectrometry. Between-group biomarker comparisons were conducted using ANCOVA and adjusted for age, sex, body mass index (BMI), and diabetes status. LCD-followers (26% male, median age 36 years, median BMI 24.2 kg/m2) reported adhering to LCDs for a median duration of 9 months (IQR 4-36). The most followed LCD type was 'their own variations of LCD' (30%), followed by ketogenic (23%), 'palaeolithic' (15%), and Atkins diets (8%). Among controls, 41% were male (median age 27 years, median BMI 23kg/m2). Median macronutrient intakes for LCD vs control groups were carbohydrate 16%Energy (E) vs. 50%E; protein 25%E vs. 19%E; and fat 55%E vs 34%E (saturated fat 18%E vs. 11%E). Two-thirds of LCD followers (32/49) and half of the controls (24/49) reported some use of dietary supplements (p = 0.19). Among LCD-followers, assessing from food data only, 21 (43%) failed to meet the reference nutrient intake (RNI) for thiamine (vs.14% controls, p = 0.002). When thiamine from supplementation (single- or multivitamin) was included, there appeared to be no difference in thiamine intake between groups. Still, red-blood-cell TDP was lower in LCD-followers than controls (407 ± 91 vs. 633 ± 234 ng/gHb, p < 0.001). Three LCD-followers were thiamine-deficient (RBC thiamine < 275 ng/gHb) vs. one control. There were no significant differences in dietary intakes or plasma concentrations of magnesium, zinc, copper, and selenium between groups. Following LCDs is associated with lower thiamine intake and TDP status than diets without carbohydrate restriction, incompletely corrected by supplement use. These data, coupled with a lack of RCT evidence on body weight control, do not support recommending LCDs for weight management without appropriate guidance and diet supplementation.

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.

Thriving Through Pain: A Whole-Person and Resilience Comparative Study Using Mobile Health Application Technology for Individuals With Self-Reported Pain Challenges

BackgroundPain is a complex condition and affects one's life beyond physical symptoms. National pain management recommendations include a whole-person approach that includes strengths (or resilience). PurposeThe purpose of this study was to examine de-identified data from the MyStrengths+MyHealth application to examine, Strengths, Challenges, and Needs for the population and a subset of the data for those with and without self-reported Challenges in the Pain concept. DesignThis cross-sectional comparative study used de-identified consumer-generated whole-person strengths data from the MyStrengths+MyHealth (MSMH) application. MethodsData was collected from various community settings between 2019 and 2023 and approved by the University's Institutional Review Board. From the sample population (N=1737), we identified those with self-reported Pain (n=1280) and without self-reported Pain (n=457) and compared Strengths, Challenges, and Needs. ResultsThe sample population (N=1737) was largely in the age range of 45-64 years (51.2%), Male (56.4%), White (90.5%), non-Hispanic/Latino (86.6%), and Married (74.2%). The Pain group (n=1280) reported significantly fewer Strengths (p<0.001) and more average Challenges and Needs (p<0.001) than the Without Pain Group (n=457) across all concepts. For the Pain Group, the most frequent Strength reported was Role Change (70.5%), the most frequent Challenge Nutrition (96.1%), and the greatest Need was Income (89.9%). ConclusionsDespite reporting Challenges and Needs, the Pain Group identified many Strengths. The Pain Group identified Role Change (70.5%) as a top Strength was surprising and may suggest adaptability to chronic pain. MSMH has potential to empower individuals to provide a comprehensive whole-person assessment and resilience which may be particularly useful for those living with chronic pain. Clinical ImplicationsThis study has clinical implications for supporting the use of digital health tools such as mobile applications for capturing contextual data directly from patients to enable nurses to provide more accessible and personalized care to patients.

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.

IMPACT OF ANTIHYPERTENSIVE DRUGS ON C REACTIVE PROTEIN (HS-CRP) AND NEUTROPHIL LYMPHOCYTE RATIO (NLR)

Many studies showed the association between inflammation and Hypertension. Inflammatory markers may highlight the state of inflammation in hypertensive patients. This study aimed to investigate impact of antihypertensive drugs on high sensitive C-reactive protein (hsCRP) and neutrophil lymphocyte ratio (NLR). A comparative cross sectional study was conducted on 86 hypertensive patients attending cardiology outpatient clinic in Al-Gamhuoria Modern General Hospital, Aden, in the period from October to December 2023. Participants were divided into three groups: patients treated with mono-therapy from inhibitors of renin angiotensin aldosterone system (RAASI), patients treated with mono-therapy antihypertensive not acting on RAAS (NRAASI) and patients treed with combination of them (drug combination). Data on Age, Sex, BP level, BMI, duration of hypertension (HTN), family history of HTN, and medications used were collected. Blood samples for measuring HsCRP, neutrophils, lymphocytes were drawn. Descriptive statics and chi-square tests were used for data analysis. Almost equivalent distribution for males and females between groups, with a large proportion of the patients within each group laid in the age group 35-55 years. The median values of hypertension duration were 36, 48, and 54 months for RAASIs, NRAASIs and drug combination group, respectively. The target BP was obtained by 46.9% 45.5% and 50% of patients treated with RAASIs, NRAASIs and drug combination respectively. There was a statistically significant difference between SBP and DBP in patients with controlled BP and those with uncontrolled SBP levels and treated by different drug regimens (P=0.000 for each Bp level). There were significant differences between values of hs-CRP of patients with controlled (P=0.000) or uncontrolled (P=0.046) BP and treated with different modalities. The median differences in NLR between the groups were statistically significant; including groups of all patients P=.032, of patients having controlled BP P=0.014 as well as uncontrolled BP P=0.038. Comparing the uncontrolled of BP of the three groups we found the highest prevalence (9.3%)of patients with uncontrolled BP and had the lower level hsCRP (≤3mg /l) was in RAASIs group, while those with higher prevalence (11.6%) of uncontrolled BP and higher level of hs-CRP ( &gt;3mg/l) was in drug combination group. In conclusion, hypertensive patients treated with RAASI, NRAASI and drug combination and reached BP target showed significant reduction in hsCRP and NLR. Patients with uncontrolled BP treated with RAASIs revealed slightly lower hs-CRP than other groups. Careful selection of antihypertensive drugs may affect risks of CVD. This study recommends further prospective studies exploring the anti-inflammatory effect of antihypertensive drugs to ameliorate possible risks of cardiovascular disease.

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.

COMPARISON OF IMMUNOHISTOCHEMICAL EXPRESSION OF INSULIN LIKE GROWTH FACTOR 1 RECEPTOR (IGF-1R) IN BENIGN AND MALIGNANT SALIVARY GLAND TUMORS

Objectives: To evaluate the difference in immunohistochemical expression of insulin-like growth factor-1 receptor (IGF-1R) in diagnosed cases of benign and malignant salivary gland tumors.Materials and Methods: This Comparative Cross-Sectional Study was conducted at the department of Pathology, Peshawar Medical and Dental College, Peshawar. A total of 100 Salivary Gland Tumors from 56 male and 44 female patients were included in the study, with an average age of 43.50 ± 15.21. The Immunohistochemical Expression of Insulin-like Growth Factor 1 Receptor was determined on both benign and malignant salivary gland tumors using the Bio SB Polyclonal IGF-1R antibody (rabbit, BT-AP04398). The collected data were analyzed using SPSS version 25.Results: For the immunohistochemical expression of IGF-1R on benign and malignant salivary gland tumors, the Allred Scoring method was utilized. P value of &lt;0.05 was considered significant, but no positive signifi cance was found between the expression of IGF-1R and salivary gland tumors.Conclusion: IGF1R expression was positive in various SGTs but no statistically significant difference was seen in multiple histopathological types of benign and malignant SGT

Comparison of Bracket Failure with Resin Modified Glass Ionomer Cement and Resin-Based Adhesive

A high strength of bonding materials is needed for orthodontic attachments to sustain therapeutic forces and patients’ masticatory habits. Objectives: To compare the bond strength of the resin modified glass ionomer cement (RMGIC) and resign based adhesive system which leads to bracket failure in orthodontic treatment (failure to bracket attachment) for the duration of 6 months at the a tertiary care hospital at Hyderabad, Sindh Pakistan. Methods: This comparative cross-sectional study involved 30 patients, each with 20 brackets, using non-probability sampling. Participants were between the ages of 13 and 30 with fully erupted permanent teeth and mild skeletal discrepancies. Quadrants were randomized, and 120 attachments were placed in total, split evenly between the two types of materials. The study involved bonding orthodontic brackets using either composite resin or RMGIC. The teeth were prepared and cleansed, and the brackets were bonded following standard procedures. Patients were monitored each month for six months (six visits) to check for any debonded or missing brackets. Chi-Square test was run to compare bracket failure between two groups. Results: There were significant differences in bracket failure rates between the composite and RMGIC sides. Composite had a lower failure rate, with 90% of brackets remaining intact compared to 63.3% with RMGIC (p=0.04). Gender comparisons showed both male and female participants experienced more failures with RMGIC than with composite, with p-values of 0.039 and 0.038, respectively. Conclusion: RMGIC could not withstand the forces experienced during fixed appliance treatment as effectively as composite resin, resulting in a higher debonding rate.

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.