Cross-sectional Observational Study Research Articles

Proximal humeral fractures: association between displacement and fatty degeneration of the supraspinatus muscle.

To evaluate the relationship between initial displacement in proximal humeral fractures and fatty degeneration of the rotator cuff measured by CT according to the Goutallier classification. This cross-sectional observational study evaluated patients with proximal humeral fractures over a six-month period. The study included patients ≥ 18 years old with complete radiological views (anteroposterior, lateral, and Grashey) and a CT scan of the affected shoulder; previous fracture or ipsilateral shoulder surgery were excluded. Neer's classification system and Goutallier stages were used to evaluate the patients. Demographic data were collected and, two groups were analysed according to age (≤ 50 years and > 50 years). Sixty-two patients were included (m = 36, f = 26, ratio 1.3:1); seven patients were excluded. Male patients (36, 58.1%), patients older than 50 years (33, 53.2%) and a low-energy injury mechanism (36, 58.1%) were the most frequent cases. According to the Neer system, the most common proximal humerus fracture was fracture-dislocation in 17 (27.4%) cases. The most common stage in Goutallier's classification was I (some fatty streaks) in 22 (35.4%) cases. Younger patients (≤ 50 years) had more displaced fractures with low fatty degeneration (p = < 0.001) than older patients (> 50 years), who had minimally displaced fractures with greater fatty degeneration (p = 0.567). High-energy mechanisms are associated with younger patients and a more displaced fracture according to the Neer classification. Older patients had a more advanced Goutallier stage and lesser displaced fracture. We should consider a more aggressive approach in the treatment of non-displaced fractures in elderly patients, less conservative and more surgical management, to obtain a better clinical evolution after the treatment of these kinds of fractures. IV.

Levels of Sex Hormones and Abdominal Muscle Composition in Men from The Multi-Ethnic Study of Atherosclerosis

Information on the associations of testosterone levels with abdominal muscle volume and density in men is limited, while the role of estradiol and SHBG on these muscle characteristics are unclear. Therefore, this study aimed to investigate the association between fasting serum sex hormones and CT-derived abdominal muscle area and radiodensity in adult men. Conducted as a cross sectional observational study using data from the Multi-Ethnic Study of Atherosclerosis, our analyses focused on a community-based sample of 907 men aged 45–84 years, with 878 men having complete data. CT scans of the abdomen were interrogated for muscle characteristics, and multivariable linear regressions were used to test the associations. After adjustment for relevant factors, higher levels of both total testosterone and estradiol were associated with higher abdominal muscle area (1.74, 0.1–3.4, and 1.84, 0.4–3.3, respectively). In the final analyses, levels of total testosterone showed a positive association, while an inverse relationship was observed for SHBG with abdominal muscle radiodensity (0.3, 0.0–0.6, and − 0.33, − 0.6 to − 0.1, respectively). Our results indicate a complex association between sex hormones and abdominal muscle characteristics in men. Specifically, total testosterone and estradiol were associated with abdominal muscle area, while only total testosterone was associated with muscle radiodensity and SHBG was inversely associated with muscle radiodensity.Clinical Trial: NCT00005487

Lifespan of Splints in a Sample of German Soldiers Hospitalised with Post-traumatic Stress Disorder (PTSD) in Combination with Sleep Bruxism and Painful Temporomandibular Disorder (TMD).

This cross-sectional longitudinal observational study aimed to clarify the question of whether painful temporomandibular disorders (TMD) in psychiatrically confirmed patients hospitalised for post-traumatic stress disorder (PTSD) therapy after using splint therapy (ST) show long-term therapeutic effects in the case of functional disorders. One hundred fifty-three (153) inpatients (123 male and 20 female soldiers, age 35.8 ± 9.2 years, 26.6 ± 2.2 teeth) with confirmed PTSD (Impact of Event Scale - Revised ≥33), grade 3 to 4 chronic pain according to von Korff's Chronic Pain Scale and the research diagnostic criteria of painful TMD (RDC-TMD) were recorded. All participants received a maxillary occlusal splint that was worn at night. Control check-ups of the therapeutic effect of the splint were conducted for up to 9 years during psychiatric follow-ups. TMD pain worsened in 22 (14.4%) patients within the first 6 weeks and led to the removal of the splint. The pain intensity (PI) at BL was reported to be a mean of VAS 7.7 ± 1.1. Six weeks after ST (n = 131), the average PI was recorded as VAS 2.6 ± 1.3. Based on the last examination date of all subjects, the average PI was recorded as 0.7 ± 0.9. Seventy-two (72) patients used a second stabilisation splint in the maxilla after 14.4 ± 15.7 months, and 38 patients used between 3 and 8 splints during their psychiatric and dental treatment time (33.7 ± 29.8 months). The presented data shows that therapeutic pain reduction remained valid in the long term despite continued PTSD. The lifespan of a splint seems to be dependent on individual factors. Long-term splint therapy appears to be accepted by the majority of patients with PTSD and painful TMD.

Cardiovascular risk assessment using SCORE2 in a population with hypertension - the reality at a primary health care unit

Introduction and Objectives: Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in Portugal, thus it is important to identify individuals at risk. Patients with hypertension have an increased risk of adverse cardiovascular (CV) events. The role of LDL cholesterol (LDL-C) in atherosclerotic CVD is well-established. SCORE2, a new CV risk calculation tool, is used to predict the 10-year risk of fatal or non-fatal CVD. The aim of this study was to understand the impact of SCORE2 on CV risk assessment in a population with hypertension from a moderate risk country, compared to the previously used SCORE.Methods: This observational cross-sectional study analyzed a population census of 3146 patients diagnosed with hypertension without complications (K86). After applying inclusion and exclusion criteria, 654 patients were included. Data from medical records were collected to calculate and compare SCORE and SCORE2 categories and LDL-C targets.Results: Patients were classified into SCORE categories: 188 (28.75%) low, 448 (68.5%) moderate, 17 (2.6%) high and 1 (0.15%) very high risk. Using SCORE2, individuals in the SCORE low risk category were reclassified, requiring new targets: 149 individuals (80%) as low to moderate and 39 (20%) as high risk. These differences became more evident when considering SCORE moderate and high-risk categories, where 358 patients (77%) received a higher CV risk categorization, and therefore a lower LDL-C target. There was a significant increase in individuals failing to meet the target when using SCORE2, compared to SCORE (p<0.001).Conclusion: These findings support the importance of CV risk assessment using SCORE2 algorithm in patients with hypertension.

Effects of obesity on clinical outcomes in diminished ovarian reserve patients undergoing intracytoplasmic sperm injection cycles.

The aim of this study is to evaluate the effects of obesity on clinical outcomes in diminished ovarian reserve (DOR) patients undergoing intracytoplasmic sperm injection cycles. In this retrospective observational cross-sectional study, women admitted to current clinic with DOR undergoing intracytoplasmic sperm injection were divided into 2 groups according to the obesity. Patient age, body mass index, anti-mullerian hormone, baseline follicle stimulating hormone and baseline estradiol levels, antral follicle count, total gonadotropin dose, day of stimulation, number of mature (MII) oocytes, and clinical pregnancy were evaluated. There were no statistically significant differences between groups in terms of age, anti-mullerian hormone, baseline follicle stimulating hormone, baseline estradiol levels, antral follicle count, and clinical pregnancy (P > .05). Total gonadotropin dose, the days of ovarian stimulation were higher and number of MII oocyte were less in the obese group (P < .05). Logistic regression analyses also revealed that the days of ovarian stimulation and number of MII oocyte were significant factors in the study group. ROC curve analysis showed obesity is a negatively affecting factor in DOR patients. Obesity causes more gonadotropin dose longer days of stimulation, and less number of MII oocyte. However clinical pregnancy rate is not negatively affected by obesity according to the current study.

Combined corneal biomechanical and tomographical indices in subclinical and forme fruste keratoconus.

Evaluation of combined corneal tomographic and biomechanical parameters in subclinical/forme fruste keratoconus (ScKC/FFKC). Cross-sectional observational case-control study. Thirty-one eyes with ScKC (fellow eye of KC with any one sign keratometry >47 diopters, cylinder >1.5 D, central corneal thickness <500 μm, with/without abnormal topography) or FFKC (fellow eye of KC with normal topography and slit lamp examination) >13 years (cases) and 44 eyes of age-matched 22 healthy subjects (controls). Clinically diagnosed KC, presence of corneal scars, and prior ocular surgery eyes. Sixteen Pentacam, 15 Corvis ST, and five Sirius parameters were analyzed using paired sample t-test, and a subsample found to be significantly different was used in receiver operating characteristic curve analysis. The Youden index was calculated, and Pearson's correlation analysis was done. Five Pentacam, three Corvis ST, and two Sirius parameters had an area under curve (AUC) >0.75. Tomographic and biomechanical index (TBI) (cutoff 0.59, 95% specificity, 77% sensitivity), Belin Ambrosio enhanced ecstasia display (cutoff 1.8, 81% specificity, 80% sensitivity), and symmetry index of posterior corneal curvature (cutoff 0.16, 97% specificity, 67% sensitivity) best identified early KC. TBI strongly correlated with maximum Pentacam parameters in both cases and controls. Corvis biomechanical index strongly correlated only in cases, and SP-A1-SD weakly correlated in cases. Upon combined analysis, the average sensitivity and specificity, respectively, of top three parameters (according to AUC) from Pentacam and Corvis ST were 74.1% and 95.4% for posterior elevation and TBI. A trial was registered in Clinical Trial Registry of India on January 28, 2022. The Trial Registration Number is REF/2022/01/050638.

Comparison of dietary patterns and daily food intake across kidney disease stages in England: a-posteriori cluster analysis

ObjectiveDietary patterns are rapidly becoming a major focus of medical nutrition therapy in CKD and the analysis of dietary patterns has emerged as a practical approach to evaluate qualitative as well as quantitative aspects of overall diet. In an a-posteriori data-driven approach, dietary patterns are based on the actual food intake of the population evaluated. Investigation of dietary patterns in CKD are not well described, and, to our knowledge, have not been conducted in a UK-based cohort. MethodsAdult participants with a diagnosed kidney condition (CKD 1-5 not requiring dialysis) were recruited into a multi-centre observational cross-sectional study. Dietary intake was assessed using the European Prospective Investigation of Cancer in Norfolk Food Frequency Questionnaire. Logistic Principal Components Analysis was used to identify food group clusters. Differences between groups were assessed using univariate general linear modelling. ResultsIn total, 696 patients were included. The mean age was 64.7 (±14.0) years, 61% of the cohort were male. Most participants were White British (89%). The mean eGFR was 36.6 (±20.9) ml/min/1.732. We found differences in food group intake across stages (e.g., greater intake of nuts and seeds intake in CKD 1-2 versus CKD 4) and across sex (e.g., females had a higher intake of fruit and vegetables versus males). Comparison with the reference cohort revealed that, overall, the CKD cohort had reduced intakes of food stuffs such as cereals and cereal products, but higher intakes of groups such as meat and meat products. There were limited differences in micronutrients, although Vitamin B2 and calcium were higher in earlier stages. ConclusionOverall, the findings from a novel a-posteriori approach underline the complex diversity of food patterns in CKD. The findings from our study may inform dieticians and other healthcare providers about the need to consider treatment modalities and stages when giving dietary recommendations.

Clinical Profile of Ocular Trauma at a Tertiary Care Hospital

Background: Ocular trauma is preventable and one of the leading causes of ocular morbidity and blindness. Approximately 6 million people are blind from eye injuries, 2.3 million with bilateral visual impairment and 19 million with unilateral visual loss worldwide. In developing countries like ours the incidence of eye injuries is very high. This study has been conducted in the view of public health importance to provide information on magnitude, clinical and epidemiological profile of ocular injuries. Methods: A hospital based, cross sectional observational study, conducted during September 2014 - March 2016 in tertiary care center in Jharkhand, all cases of ocular trauma were included in the study. Demographic profile (age, sex, locality, occupation), nature and cause of injury was recorded. Detailed ophthalmological examination including visual acuity, slit lamp examination, indirect ophthalmoscopy, B-scan, intraocular pressure measurement, gonioscopy, computed tomography brain with orbit, Magnetic Resonance Imaging, X-Ray were done in relevant cases. Results: Total of 948 patients of ocular trauma were included. Most patients belong to the age group 21-40 years (60.87%), with mean age of 29.79 + 16.47 years. Males were affected more (73.52%) than females (26.47%). Closed globe injuries were more (75%) than open globe injuries (25%). Anterior segment was involved in (94.30%) and posterior segment in (8.86%). Work-related ocular injuries formed the commonest mode of injury (41.8%) followed by road traffic accident (30.37%). Conclusion: Ocular trauma is one of the most common causes of unilateral blindness. Targeting groups most at risk with health education, providing effective eye protection and strict implementation of traffic rules may decrease the occurrence of ocular injuries.

Assessment of Serum Omentin-1 and Interleukin-6 in the Diagnosis of Early Stages of Diabetic Nephropathy: A Cross-Sectional Observational Study

Assessment of Serum Omentin-1 and Interleukin-6 in the Diagnosis of Early Stages of Diabetic Nephropathy: A Cross-Sectional Observational Study

The impact of iron deficiency on patients under evaluation for colorectal cancer, a prospective cross-sectional study

Background and objective Iron deficiency affects more than 60% of colorectal cancer patients at the time of diagnosis. Iron deficiency ultimately leads to anemia, but additionally, iron deficiency might impact other domains of colorectal cancer patients’ health and well-being. The aim of this study was to evaluate the impact of iron deficiency on fatigue, quality of life, cognition, and physical ability in patients undergoing evaluation for colorectal cancer. Methods Multicenter, prospective, observational cross-sectional study (2021–2023). Fatigue was the primary outcome, measured using the Focused Assessment of Cancer Treatment-Anemia questionnaire (FACT-An). Quality of Life, Cognition, Aerobe capacity, mobility, and peripheral muscle strength were tested as secondary outcomes. Multivariate analysis was performed to estimate the impact of iron deficiency on all outcomes. Results Two hundred and one patients were analyzed, 57% being iron deficient. In multivariate regression analysis, iron deficiency was not associated with fatigue: FACT-An (r = −1.17, p = 0.57, 25% CI: −5.27 to 2.92). Results on quality of life, cognition, and mobility were non-significant and with small regression coefficients. Iron deficiency showed a nearly significant association with reduced hand-grip-strength (r = −3.47 kg, p = 0.06, 25%CI −7.03 to 0.08) and reduced 6 min walking distance (r = −40.36 m, p = 0.07, 25%CI: −84.73 to 4.00). Conclusion Iron deficiency in patients undergoing evaluation for colorectal cancer was not associated with fatigue, quality of life, or cognition, but might affect aerobic endurance and peripheral muscle strength to a degree that is clinically relevant.

Dentists’ stress level during the COVID-19 pandemic and their opinion on the oral health status of their patients

Background and aims. “Severe acute respiratory syndrome coronavirus 2” (SARS-CoV-2) is the name of the etiological agent of the pandemic Corona Virus Disease (COVID-19) which was declared on March 11, 2020 by the WHO and which affected all countries of the world, including Romania. Our study aimed to evaluate the psycho-affective implications and economic consequences for dentists in Romania during the COVID-19 (Corona Virus Disease) pandemic state of emergency and their opinion on the patients’ oral health impact. Methods. A cross-sectional observational and analytical study based on a questionnaire was conducted. Dentists who work in Romania affiliated in 2020 to the Romanian College of Dental Practitioners was the target population. Results. Three hundred and seventy-three dentists participated in this survey. The age of the respondents ranged from 24 to 70. Men and women have the same expectation regarding the lockdown effect of worsening the oral health of the general population (worst, 79.5% of women and 81.3% of men, P=0.8842). Conclusions. The anxiety regarding the bank rates, supplementary investments, risk of COVID-19 infection and exposure to COVID-19 related mass-media information proved to be significantly higher among young dentists.

Recognition of psychological comorbidity and psychotherapeutic treatment status of ventricular assist device patients.

Due to its high impact on quality of life and mental health, close monitoring and often psychotherapy is recommended for patients with a ventricular assist device (VAD). This study investigates the psychological comorbidity and the corresponding psychotherapeutic treatment situation of VAD patients. Special attention is also given to the professional perspective VAD team (assistant and senior cardiologists and specialized nurses). We conducted a cross-sectional observational study. Data from 50 VAD patients (mean age = 53.52, standard deviation = 13.82 years, 84.0% male) and their VAD team were analyzed. The presence of a psychological disorder was evaluated by structured clinical interviews for DSM-IV (SCID-I-Interviews). Patients answered a questionnaire regarding their current psychotherapeutic treatment status and their attitude towards psychotherapy. The VAD team answered a questionnaire about the patients' needs for psychotherapy and indicated whether they addressed this topic with the patient. Data were analyzed descriptively, by analysis of variance and t-test. A total of 58% of VAD patients suffered from at least one significant psychological disorder, 79.3% of those were not in psychotherapy. The VAD team could not identify the patients who suffered from a psychological disorder (F = 1.90; p = 0.18). They perceived more need for psychotherapy than they addressed with their patients (T = 3.39; p < 0.001). While there is a high psychological morbidity among VAD patients, only few receive psychotherapy. Psychological comorbidity is not easily detected by the VAD team. Standardized psychosocial care could be implemented by regular psychological assessments and further information of patients and their VAD teams.

The Efficacy of Bedside Chest Ultrasound in the Detection of Traumatic Pneumothorax

Background Chest X-rays have long been used to diagnose pneumothorax. In trauma patients, chest ultrasonography combined with chest CT may be a safer, faster, and more accurate approach. This could lead to better and quicker management of traumatic pneumothorax, as well as enhanced patient safety and clinical results. Aim The purpose of this study was to assess the efficacy and utility of bedside US chest in identifying traumatic pneumothorax and also its capacity to estimate the extent of the lesion in comparison to the gold standard modality chest computed tomography. Methods This was an observational cross-sectional study of 160 patients with traumatic pneumothorax. This sample was collected from all chest trauma patients admitted to Al-Kindy Teaching Hospital in Baghdad-Iraq between November 2021 and September 2022. Such patients were to have a bedside chest US and chest CT scan performed by a skilled radiologist to detect lung point signs and lung sliding, which would be used to determine the patient's pneumothorax status. Results According to the study's findings, about 77.5% of the patients evaluated were men. Furthermore, 40.6% of patients experienced blunt trauma. Chest ultrasound revealed positive pneumothorax in 50 cases (31.2%), while positive pneumothorax was confirmed by computed tomography in 53 cases (33.1%) with no significance in the detection of pneumothorax between the two imaging modalities p-value(0.719). Comparably, there was no significant difference in estimating the size of a pneumothorax between the two modalities (p-value = 0.547). Chest ultrasound diagnostic accuracy showed a sensitivity of approximately 92.45%, specificity of 99.07%, and diagnostic accuracy of 96.88%. Conclusion Our findings indicated that chest ultrasound might be a valuable rapid diagnostic tool for traumatic pneumothorax in the emergency department in addition to diagnosis. It eliminates the need to transport patients for a CT chest scan.

Performance Power: Boosting Saudi Arabia’s Health System Disaster Readiness (2017–2023)

Introduction: The 2016 self-assessment based on joint external evaluation (JEE) identified certain gaps, which prompted the need for additional improvement. This study attempted to address an approach to enhance preparedness using the performance management system’s components focusing on related areas in the JEE tool by the International Health Regulations (IHR). Methods: This was an observational cross-sectional study including all hospitals and regional health directorates within the Ministry of Health, Saudi Arabia. Entities preparedness was calculated using the JEE tool. Moreover, the implementation of the performance management system was also assessed for Saudi Arabia from the year 2017 to 2022. Additionally, the feedback was collected using the survey from the 11 National Preparedness Index (NPI) coordinators. Results: Total readiness was found to be 52% only, which was far less than the planned value of 75%. While regarding the implementation of the performance management system, it was noted that there was a progressive increase in the implementation from 10% in the year 2017 to 81.25% in the year 2022. Considering the feedback responses of NPI coordinators, it was found that 100% of coordinators agreed that the NPI has supported enhancing Health emergency preparedness and that the follow-up and support from the NPI team played an important role in NPI score improvement. Conclusion: The analysis indicated that while there are areas of progress, Saudi Arabia is still working on strengthening fundamental public health functions and emergency preparedness. This is evident when comparing a range of indicators with those of many countries under the purview of the World Health Organization (WHO).

Molecular circadian clock disruption in the leukocytes of individuals with type 2 diabetes and overweight, and its relationship with leukocyte-endothelial interactions.

Alterations in circadian rhythms increase the likelihood of developing type 2 diabetes and CVD. Circadian rhythms are controlled by several core clock genes, which are expressed in nearly every cell, including immune cells. Immune cells are key players in the pathophysiology of type 2 diabetes, and participate in the atherosclerotic process that underlies cardiovascular risk in these patients. The role of the core clock in the leukocytes of people with type 2 diabetes and the inflammatory process associated with it are unknown. We aimed to evaluate whether the molecular clock system is impaired in the leukocytes of type 2 diabetes patients and to explore the mechanism by which this alteration leads to an increased cardiovascular risk in this population. This is an observational cross-sectional study performed in 25 participants with type 2 diabetes and 28 healthy control participants. Clinical and biochemical parameters were obtained. Peripheral blood leukocytes were isolated using magnetic bead technology. RNA and protein lysates were obtained to assess clock-related gene transcript and protein levels using real-time PCR and western blot, respectively. Luminex XMAP technology was used to assess levels of inflammatory markers. Leukocyte-endothelial interaction assays were performed by perfusing participants' leukocytes or THP-1 cells (with/without CLK8) over a HUVEC monolayer in a parallel flow chamber using a dynamic adhesion system. Participants with type 2 diabetes showed increased BMAL1 and NR1D1 mRNA levels and decreased protein levels of circadian locomotor output cycles kaput (CLOCK), cryptochrome 1 (CRY1), phosphorylated basic helix-loop-helix ARNT like 1 (p-BMAL1) and period circadian protein homologue 2 (PER2). Correlation studies revealed that these alterations in clock proteins were negatively associated with glucose, HbA1c, insulin and HOMA-IR levels and leukocyte cell counts. The leukocyte rolling velocity was reduced and rolling flux and adhesion were enhanced in individuals with type 2 diabetes compared with healthy participants. Interestingly, inhibition of CLOCK/BMAL1 activity in leukocytes using the CLOCK inhibitor CLK8 mimicked the effects of type 2 diabetes on leukocyte-endothelial interactions. Our study demonstrates alterations in the molecular clock system in leukocytes of individuals with type 2 diabetes, manifested in increased mRNA levels and decreased protein levels of the core clock machinery. These alterations correlated with the impaired metabolic and proinflammatory profile of the participants with type 2 diabetes. Our findings support a causal role for decreased CLOCK/BMAL1 activity in the increased level of leukocyte-endothelial interactions. Overall, our data suggest that alterations in core clock proteins accelerate the inflammatory process, which may ultimately precipitate the onset of CVD in patients with type 2 diabetes.

Coexistence of Iron Deficiency Anaemia (IDA) and Beta Thalassaemia Trait (B-TT)

Background: The WHO estimates that about 7% of the world population are thalassaemia trait and increasing number of cases are being detected. The world population of carrier of b thalassamia is reported to be more than 100 million. Bangladesh also lies in thalassaemic Belt. A conservative world health report estimates that 3% of our populations are carrier of b thalassaemia which means that there are 3-6 million of b thalassaemia are in Bangladesh. To manage thalassaemia and thalassaemia trait, our traditional concept is not to give iron or iron conaining food. But concomitant iron deficiency anaemia in thalassaemia trait patient may be fatal. Those patients should be evaluated by serum ferritin or by the iron profile and treatment should be supplemented with rational amount of iron. Methodology: This cross sectional observational study was carried out on 75 patients from 03 to 59 years of age of both sex of Beta Thalassaemia Trait, in the department of Medicine and Haematology of Dhaka Medical College Hospital (DMCH) and Bangabandhu Sheikh Mujib Medical University (BSMMU) from January, 2015 to December, 2015. The patients previously diagnosed as Beta Thalassaemia Trait was included in study population. Result: In this study out of 75 Beta Thalassaemia Trait patients, 21 had evidence of Iron Deficiency Anaemia (IDA) and 54 patiens had no evidence of IDA. Thus the frequency of coexistent Beta Thalassaemia Trait and IDA in this study is 28%. The mean Hb concentration was 9.66 gm/dL (±1.54) which is 8.48 gm/dL (±1.43) and 10.12 gm/dL(±1.34) in Beta Thalassaemia Trait with IDA patients and Beta Thalassaemia Trait without IDA patients respectively. So the Hb concentration is significantly lower in b-TT with IDA patients than those without IDA (p-value &lt; 0.001). The mean of Hb A2 level was 4.87(%) (±0.54) which is 4.44(%) (±0.40) and 5.03(%) (±0.50) in Beta Thalassaemia Trait with IDA patients and Beta Thalassaemia Trait without IDA patients respectively. So the Hb A2 level is significantly lower in Beta Thalassaemia Trait with IDA patients than those without IDA (p-value &lt; 0.001). Conclusion: From this study, it could be concluded that the frequency of IDA in Beta Thalassaemia Trait is about 28%. The degree of anaemia is more severe and the level of Hb A2 is much lower in Beta Thalassaemia Trait with IDA patients than Beta Thalassaemia Trait without IDA. J Dhaka Med Coll. 2022; 31(2) : 182-186

The association between osteoporosis and frailty: a cross-sectional observational study and mendelian randomization analysis

BackgroundOsteoporosis and frailty are two common features in the elderly population. Despite many review articles mentioning the association between osteoporosis and frailty, there is a lack of original research directly investigating their relationship. Therefore, this study was conducted to examine the correlation between osteoporosis and frailty.MethodsWe conducted a cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES), using logistic regression analysis to assess the association of osteoporosis with the frailty index. In addition, we further explored the causal relationship between them using Mendelian randomization (MR) study.ResultsIn the cross-sectional study, 19,091 non-frailty participants and 5878 frailty participants were included in this study. We observed a significant positive association between osteoporosis and frailty after adjusting for demographic characteristics, body mass index (BMI), smoking, and alcohol use (OR = 1.454, 95% CI [1.142,1.851], P = 0.003). Moreover, the MR study showed a bidirectional causal relationship between osteoporosis and frailty. When osteoporosis was used as an exposure factor, the frailty pooled OR value calculated utilizing the inverse variance weighted (IVW) method was 2.81 (95% CI [1.69, 4.68], P = 6.82 × 10− 5). When frailty was used as an exposure factor, the OR value calculated using the IVW method was 1.01 (95% CI [1.00,1.01], P = 3.65 × 10− 7).ConclusionsOsteoporosis was positively correlated with frailty, and the results remained robust after adjusting for covariates. Further, MR studies have shown a bidirectional causal relationship between osteoporosis and frailty.

Knowledge, Attitude and Practice of Parents of Children with Childhood Asthma in a Tertiary Care Hospital

Back ground: Asthma is one of the most common reasons that children visit doctors, miss days at school or are admitted to hospital. If asthma is well managed, child should be able to lead a healthy and active life. Methods: The study aims to investigate parental knowledge, attitudes about childhood asthma, and practices regarding the management of their children’s asthma. An observational cross-sectional study was conducted among parents of children aged between 2 and 12 years with asthma who had visited the outpatient or inpatient department of Pediatrics at Dhaka Medical College Hospital over a period of approximately 6 months. Data were collected using a preformed Knowledge, Attitude, and Practice (KAP) questionnaire. Results: Total 110 parents of children with childhood asthma were interviewed in this study. There were 63 (57.3%) male and 47 (42.7%) female with M:F ratio 1.34:1 (Slightly male predominance). Most of the patients 57(87.6%) visited in out-patient department (OPD). Almost half of the parents (52.7%) knew their children had asthma. Most of the parents (80.9%) thought oral form of drug (syrup/ tablet) is better than inhaler. Almost two-third parents believed asthma can be cured and they did not know the importance of adherence with asthma medications. The overall parental knowledge was poor (49.09%). Nearly half of them (49.09%) had negative attitude about childhood asthma &amp; 50.9% parents had poor practice about avoidance of allergens, use of asthma medications and regular follow up of their children. Knowledge, attitude and practice are significantly associated with education, socioeconomic condition and living area. Statistically significant positive correlation has been found between knowledge and practice, but knowledge and attitude has not showed significant positive correlation. J Dhaka Med Coll. 2022; 31(2) : 194-200

Patient-Portal Compared with Supplemental In-Office Tablet Screening for Health-Related Social Needs in Primary Care.

Screening for health-related social needs (HRSN) has become more widespread but the best method of delivering the screening tool is not yet known. Describe HRSN screening completion rate, specifically portal-based and in-person tablet-based screening. Cross-sectional retrospective observational study. Adults age 18 or older who had a non-acute primary care visit at one of three internal medicine primary care clinics at a large, urban, academic medical center between July 2022 and July 2023. We identified the proportion of individuals who were screened using the HRSN questionnaire, whether screening was completed by patient-portal or tablet, as well as the degree of burden of HRSN. Using the electronic health record, we explored associations between sociodemographic characteristics and HRSN attributes. Our study included 24,597 patients, of whom 37% completed the HRSN questionnaire. A smaller proportion of Black/African American patients and those with Medicaid insurance completed the questionnaire, yet they comprised a greater percentage of those who screened positive for unmet HRSN (p ≤ 0.001). Most patients completed the questionnaire by patient-portal (86.1%) compared with in-office tablets (14.0%). A larger proportion of those who completed screening by tablet screened positive for HRSN. Of all patients screened, 21.8% were positive for an unmet HRSN and 11.5% had more than one unmet HRSN. A majority of patients are not being screened for HRSN and results illustrate disparities when screening patients for HRSN through portal-based compared with supplemental in-office tablet-based screening. Prevalence of unmet HRSN varied by demographics such as race and insurance status.

Patient-Portal Compared with Supplemental In-Office Tablet Screening for Health-Related Social Needs in Primary Care.

Screening for health-related social needs (HRSN) has become more widespread but the best method of delivering the screening tool is not yet known. Describe HRSN screening completion rate, specifically portal-based and in-person tablet-based screening. Cross-sectional retrospective observational study. Adults age 18 or older who had a non-acute primary care visit at one of three internal medicine primary care clinics at a large, urban, academic medical center between July 2022 and July 2023. We identified the proportion of individuals who were screened using the HRSN questionnaire, whether screening was completed by patient-portal or tablet, as well as the degree of burden of HRSN. Using the electronic health record, we explored associations between sociodemographic characteristics and HRSN attributes. Our study included 24,597 patients, of whom 37% completed the HRSN questionnaire. A smaller proportion of Black/African American patients and those with Medicaid insurance completed the questionnaire, yet they comprised a greater percentage of those who screened positive for unmet HRSN (p ≤ 0.001). Most patients completed the questionnaire by patient-portal (86.1%) compared with in-office tablets (14.0%). A larger proportion of those who completed screening by tablet screened positive for HRSN. Of all patients screened, 21.8% were positive for an unmet HRSN and 11.5% had more than one unmet HRSN. A majority of patients are not being screened for HRSN and results illustrate disparities when screening patients for HRSN through portal-based compared with supplemental in-office tablet-based screening. Prevalence of unmet HRSN varied by demographics such as race and insurance status.