Cross-sectional Observational Study Research Articles

Assessment of the ulnar nerve stiffness during valgus stress of the elbow using shear wave elastography: an observational cross-sectional study.

Identification of the relationship between valgus stress in the medial elbow and ulnar nerve strain during maximum external rotation of the shoulder is pivotal for the prevention and management of ulnar neuropathies. In this observational cross-sectional study, we aimed to determine the changes in ulnar nerve stiffness under valgus stress at different nerve entrapment sites. Twenty healthy baseball players participated in the study. The stiffness of the ulnar nerve on the throwing side was assessed at two sites, the arcade of Struthers and the Osborne's ligament, at 0°, 60°, and 90° flexion by shear wave elastography using a 10-MHz linear transducer. The arcade of Struthers was defined as the proximal site and the Osborne's ligament as the distal site. Valgus stress was applied to the medial elbow at 0, 30, 50, and 70 N using a Telos stress device, and the stiffness caused by valgus stress was measured. At all elbow flexion angles, the stiffness of the ulnar nerve under 70 N valgus stress was higher than that under 30 N stress. The stiffness of the ulnar nerve at the proximal site was significantly higher than that at the distal site. Valgus stress increases ulnar nerve stiffness. In addition, the stiffness of the proximal site increases.

Impact of flexible work arrangements on job resignation after cancer diagnosis among Japanese young adult cancer survivors.

Many workers had flexible work arrangements during the COVID-19 pandemic. This study aimed to identify the association between flextime and remote working and job resignation among Japanese young adult cancer survivors after diagnosis. This cross-sectional observational study was conducted using an online survey with 401 Japanese young adult cancer survivors diagnosed with adult-onset cancer and aged 20-39years at the time of the survey in January 2022. A multivariable Cox regression analysis was performed to analyze the impact of flextime and remote working on job resignation. In the sample, 264 participants (65.8%) were female, and 185 (46.1%) had been diagnosed with cancer between 1 and 5years ago. After adjusting for potential confounders, the multivariable Cox regression analysis revealed that young adult cancer survivors using remote working only (HR 0.44, 95% CI 0.21-0.96, p = 0.04) and both flextime and remote working (HR 0.37, 95% CI 0.21-0.64, p < 0.01) experienced a lower risk of job resignation after cancer diagnosis compared to those who did not use flextime and remote working. Young adult cancer survivors who used remote working only or remote working combined with flextime could reduce their risk of job resignation after a cancer diagnosis. This study showed that having the option of remote working can be important for young adult cancer survivors' continuing employment. Furthermore, social welfare systems need to promote a workplace culture and climate that allows remote working.

Attitudes and Acceptance of the Palestinian Population Towards COVID-19 Health Precautions and Vaccinations: A Cross-Sectional Study.

COVID-19 is a new pandemic and the best protection against this infection is by vaccination. This study aims to assess the commitment to COVID-19 health precautions and willingness to receive vaccination among the Palestinian population. An online-based survey was carried out for an observational cross-sectional study. A total of 1367 participants were recruited conveniently between February and June 2021. To carry out comparisons, Mann-Whitney or Kruskal-Wallis was used for numerical variables and chi-square or Fisher's exact for categorical. Multiple logistic regression was used to evaluate health precautions and multinomial logistic regression was used to observe willingness for vaccination. The commitment to the majority of health precautions was predicted by perceiving COVID-19 threat, educational level, and city residency (p < 0.05). Social distancing and sterilizer usage were associated with city residency (p < 0.001). Students, males, and unemployed participants were less committed to health precautions (p < 0.05). Vaccination willingness was less predicted by the perception of an ineffective vaccine (p < 0.001), perceiving no threat of COVID-19 (p < 0.05) or perception of threat for old/or chronic diseases (p < 0.05), employed participants (p < 0.05), without chronic diseases (p < 0.05), and not committed to wearing a mask (p < 0.001). COVID-19 threat perception, high education level, and city residency predict more commitment to health precautions, in contrast to male students and unemployed participants. On the other hand, having no chronic diseases, perception of ineffective vaccines, unperceived COVID-19 threat, and unwillingness to wear masks predicted less vaccination acceptance. Therefore, it is critical to increase awareness about the COVID-19 threat, health precautions, and vaccination efficacy. This study is cross-sectional. Future works concerning changes in Attitudes toward COVID-19 health precautions and vaccination should be encouraged, including vaccinated participants.

The clinicopathological evaluation of diseases of external ear in tertiary diseases

Background: As the major part of outpatient department (OPD) comprises of diseases related to external ear, it is a need to acknowledge the topic. These diseases are sometimes seasonal and variable according to climate. Diseases may vary according to patients’ anatomy. Histopathological examination along with clinical prospective is required to remove the diseases. Advancement in radiology has made easier to determine the extension and involvement of disease. Aim of the study is to evaluate the extent of disease, its causative factors, various associations and effect of treatment. Methods: The observational cross sectional study is done on 211 patients. Detailed study is done and microscopic evaluation is done whenever required. Biopsies and pus samples taken for the histopathological and microbial examination. The data collected and entered in Microsoft excel and analysed data is presented in from of frequency and percentage shown by pie charts and tables. Results: Out of total 211 patients the commonest involved age group (56.4%) belongs to 21-40 years with 109 (51.7%) females and 102 (48.3%) males. 91% of the patients belong to lower rural socioeconomic status. Most common pathology found in my study was otomycosis in 95 (30%) cases. Other pathologies included otitis externa in 57 (27%) cases, auralmass in 33 (15.6%) cases perichondritis, keloid, preauricular sinus, pseudocystand EAC stenosis in descending order. Conclusions: Aural polyps and aral masses are found to be more intrusive. Prompt consideration of such cases should be done as they have tendency of extending intracranially.

Serum Magnesium Levels in Patients Admitted to Intensive Care Unit and its Association with Sequential Organ Failure Assessment Score – A Cross-sectional Observational Study

Abstract Background: Magnesium deficiency has been reported in 20%–65% of patients in an intensive care unit (ICU) setting. They have mortality rates 2–3 times higher and prolonged hospitalization compared with those who have normal serum Mg levels. Objective: The objective of the study was to study serum magnesium levels in patients admitted to ICU and its association with sequential organ failure assessment (SOFA) score. Materials and Methods: A hospital-based cross-sectional study was carried out among 100 patients admitted to ICU. Detailed history, thorough physical examination, serum magnesium measurement, and routine investigations were performed. Based on serum magnesium levels, patients were divided into three groups: hypomagnesemia (&lt;1.7 mg/dL), normomagnesemia (1.7–2.4 mg/dL), and hypermagnesemia (&gt;2.4 mg/dL). SOFA score was calculated within 24 h of ICU admission. Results: Majority were male (65%). Majority were 41–60 years old (46%). Magnesium levels ranged from 1.0 mg/dL to 3.7 mg/dL, with a mean of 1.79 ± 0.59. The mean value of magnesium in the hypomagnesemia group was 1.225 ± 0.117, in the normomagnesemia group was 1.98 ± 0.2, and in the hypermagnesemia group was 2.96 ± 0.32. The mean SOFA score was significantly higher in patients with hypomagnesemia compared to patients with normomagnesemia and patients with hypermagnesemia (P &lt; 0.05). The incidence of hypomagnesemia was 57.6% in patients with diabetes mellitus compared to 32.8% in those without diabetes. This difference was found to be statistically significant (P &lt; 0.05). The odds of being diabetic in those with hypomagnesemia were 2.746 times more than those without hypomagnesemia. Conclusions: This study highlights the magnitude of magnesium disturbances on admission in critically ill patients admitted to ICU in the given settings. Hypomagnesemia is associated with a high SOFA score.

Minimal Clinically Important Differences With the Outcomes of the App-Based Japanese Allergic Conjunctival Diseases Quality of Life Questionnaire: Cross-Sectional Observational Study.

Assessing changes in quality of life in patients with hay fever-related allergic conjunctivitis requires validated and clinically meaningful metrics. A minimal clinically important difference (MCID) that can be applied to assess Domain II of the Japanese Allergic Conjunctival Disease Quality of Life Questionnaire (JACQLQ) in a smartphone app setting has yet to be determined. This cross-sectional observational study aimed to determine MCIDs for the app-based JACQLQ in assessing hay fever-related allergic conjunctivitis. This study used data from a crowdsourced, cross-sectional, observational study conducted via the smartphone app "AllerSearch" between February 1, 2018, and May 1, 2020. Participants were recruited through digital media and social networking platforms and voluntarily provided electronic informed consent. Participants completed the JACQLQ, which includes items on daily activity and psychological well-being, as well as a visual analog scale to measure stress levels related to hay fever. Data were collected through the app, ensuring comprehensive user input. MCIDs were determined using both anchor- and distribution-based methods. The face scale of the JACQLQ Domain III and stress level scale for hay fever were used as anchors to estimate the MCID; ranges were derived from these MCID estimates. In the distribution-based method, MCIDs were calculated using half the SD and SE of the JACQLQ Domain II scores. SEs were derived from the intraclass correlation coefficient of an app-based JACQLQ test-retest reliability metric. A total of 17,597 individuals were identified, of which 15,749 individuals provided electronic consent. After excluding those with incomplete data, 7590 participants with hay fever were included in the study (mean age 35.3, SD 13.9 years; n=4331, 57.1% of women). MCID ranges calculated using the anchor-based method were 1.0-6.9, 1.2-5.6, and 2.1-12.6 for daily activity, psychological well-being, and total JACQLQ Domain II scores, respectively. Using the distribution-based method, the intraclass correlation coefficients were odds ratio (OR) 0.813 (95% CI 0.769-0.849) for daily activity, OR 0.791 (95% CI 0.743-0.832) for psychological well-being, and OR 0.841 (95% CI 0.791-0.864) for total JACQLQ Domain II scores. In addition, the distribution-based method resulted in 2 MCIDs based on half the SD and SE of measurement for daily activity (4.8 and 4.2), psychological well-being (3.4 and 3.1), and total JACQLQ Domain II (7.8 and 6.4) scores. The final suggested MCID ranges for daily activity, psychological well-being, and total JACQLQ Domain II scores were 4.2-6.0, 3.1-4.7, and 6.4-10.5, respectively. MCID ranges for the JACQLQ estimation could help to standardize the app-based quality of life assessment for patients with hay fever-related allergic conjunctivitis. These MCIDs enhanced the precision of remote symptom monitoring and facilitated timely, data-driven interventions, ultimately improving the overall management and outcomes of allergic conjunctivitis through mobile health platforms.

Clinical and bacteriological profile and antibiotic sensitivity pattern in spontaneous bacterial peritonitis among children with idiopathic nephrotic syndrome

Background: Spontaneous bacterial peritonitis is a serious complication of childhood nephrotic syndrome (NS). A precise knowledge of organism causing peritonitis is important primarily to treat infection and decrease morbidity, prevent antibiotic resistance and finally to reduce mortality. Objectives were to observe the clinical and bacteriological profile and antibiotic sensitivity pattern of peritonitis in childhood NS. Methods: This cross-sectional observational study was conducted in pediatric nephrology department of Bangabandhu Sheikh Mujib medical university (BSMMU). The 44 diagnosed patient of spontaneous bacterial peritonitis among childhood idiopathic NS were enrolled as cases. The peritoneal fluid was obtained following standard procedure and examined for gross appearance, cytogical and biochemical analysis, microscopic examination with gram stain and peritoneal fluid culture along with antibiotic sensitivity. Results: All patients had complaints of abdominal pain followed by fever, vomiting, lethargy and anorexia. All cases had edema and ascites followed by abdominal tenderness, abdominal wall rigidity, rebound tenderness and cellulitis in areas other than abdominal wall. Peritoneal fluid showed neutrophilic pleocytosis and exudative fluid. We observed 27.27% gram + cocci, 6.82% gram-bacilli in gram stain examination. Here, only 6.9% cases showed positive growth including 2.3% E. coli, 2.3% Pseudomonas, 2.3% Acinetobacter and remaining 93.1% cases showed no growth. We also described the antibiotic sensitivity pattern in this study. Conclusions: In our study, patients predominantly had abdominal pain, fever, edema, ascites and abdominal tenderness. We found only 6.9% cases showed positive growth which included E. coli, Pseudomonas and Acinetobacter and demonstrated the antibiotic sensitivity and resistance pattern for these organisms.

The mediating role of organizational culture in the effect of VUCA on intention to stay at work

Purpose: This study aims to assess the impact of VUCA (volatility, uncertainty, complexity, and ambiguity) on employees’ intention to stay at work and to evaluate whether organizational culture serves as a mediating factor in this relationship, addressing an identified gap in the existing literature. Design: This is a cross-sectional observational study. The study population comprised 258 white-collar employees in service sector companies based in Istanbul, Turkey. Data were collected using an online survey (Google Forms) and face-to-face interviews from 7 April 2024 to 07 June 2024. Three scales were employed in this study: the VUCA scale, the Intention to Stay at Work scale, and the Organizational Culture scale. Organizational culture was examined as a potential mediator. Methods: Confirmatory factor analysis (CFA) was performed to validate the scales used. Correlation analysis and structural equation modeling (SEM) were applied to examine relationships between variables. Statistical analyses were conducted using SPSS 24.0 and AMOS 24.0 software. Findings: VUCA was found to have a negative effect on both the intention to stay at work and the organizational culture. Organizational culture had a significant positive impact on the intention to stay at work. Additionally, organizational culture partially mediated the relationship between VUCA and the intention to stay at work. All hypotheses were supported by the data. Originality: There is no study in the literature investigating the relationship between VUCA, intention to stay at work, and organizational culture variables. This study provides novel insights into the relationship between VUCA, organizational culture, and employees’ intention to stay at work. It highlights the mediating role of organizational culture in the VUCA-intention to stay at work relationship, contributing uniquely to the literature.

Perinatal Outcome and Preventable Causes of Morbidity and Mortality in Eclampsia: A Cross-Sectional Observational Study in a Tertiary Hospital in Bangladesh

Background: Eclampsia poses a substantial threat to perinatal health in developing countries, with Bangladesh experiencing a notable impact on infant well-being. This cross-sectional observational study, conducted at Enam Medical College Hospital, Savar, Dhaka, aimed to investigate perinatal outcomes in eclampsia patients and identify preventable causes of perinatal mortality and morbidity associated with this condition. The study period spanned from June 2015 to July 2017, with a focus on understanding the specific factors contributing to adverse perinatal events in this population. Methods: A total of 155 eclampsia patients were enrolled in the study, resulting in the delivery of 161 babies, including six sets of twins. The study employed a comprehensive observational approach, assessing maternal and fetal conditions to analyze their correlation with perinatal outcomes. Data collection and analysis were conducted in the Department of Obstetrics and Gynaecology at the tertiary hospital, employing standard protocols and statistical methods to derive meaningful insights. Results: The study revealed a perinatal death rate of 27.32%, with stillbirth accounting for 15.52% and early neonatal death for 11.80%. In contrast, 84.47% of babies were born healthy. Among live-born neonates, 27.94% experienced jaundice, while 30.88% had no complications. Prematurity emerged as a significant contributor to perinatal loss in eclampsia cases. The findings underscore the critical role of early referral of eclampsia patients, the implementation of timely resuscitative measures, and improved neonatal care as potential avenues to enhance perinatal outcomes. Conclusion: In conclusion, this study highlights the importance of addressing stillbirth as a predominant component of perinatal death in eclampsia cases. Prematurity was identified as a key factor contributing to adverse perinatal outcomes. Early referral of eclampsia patients and the implementation of resuscitative measures, coupled with enhanced neonatal care, are crucial interventions that can potentially mitigate perinatal morbidity and mortality associated with eclampsia in the context of a tertiary hospital setting in Bangladesh. These findings provide valuable insights for healthcare practitioners and policymakers to guide strategies aimed at improving perinatal outcomes in similar healthcare settings.

Pattern of Cleft Lip and Palate According to Gender in Children of Bangladesh

Background: Cleft defects are the most common congenital anomalies of the orofacial region. The typical distribution of cleft type is cleft lip, cleft palate and combined cleft lip and palate. To determine the frequency of Cleft Lip (CL), Cleft Palate (CP) and combined cleft lip and palate (CLP) according to gender. Materials and methods: It is a cross sectional observational study with some analytical components which was carried out in the Department of Anatomy of Chittagong Medical College From April 2021 to March 2022. It was conducted among 100 children of cleft lip and palate. Data was collected from LMRF (Lions Mukhlesur Rahman Foundation) Children Hospital, Smile train (CMSOGH) cleft project and Chattogram Maa Shishu O General Hospital, Agrabad Chattogram. The data were recorded in a predesigned questionnaire. Variables were presented as percentages (%) and were compared by Chi-Square test. All statistical analysis were performed using SPSS statistics for Windows, version 26.0. Finally the results were presented using tables and figures. Results: Among the 100 participants there were 58 male and 42 female children with a ratio of 1.38:1. 68% had combined cleft lip and palate, 22% had isolated cleft palate and only 10% had isolated cleft lip. Among the 10 children with cleft lip 4 were male and 6 were female. 80% of the cleft lip was on the left side. Among 22 children of cleft palate 9 were male and 13 were female. Lastly among 68 children of cleft lip and palate 45 were male and only 23 were female. 44% of cleft lip and palate was on the left side, 32% bilateral and only 24% was on the right side. Conclusion: This study reported the pattern of cleft defects with gender distribution in our country which shows females are more likely to have isolated CL and CP and males have CLP predominantly. Chatt Maa Shi Hosp Med Coll J; Vol.22 (2); July 2023; Page 3-7

Socio-Demographic and Clinical Profile of COVID-19 in Children

Background: Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 is a global pandemic. Infection by COVID-19 in children is not so common but gradually the numbers of children affected with COVID-19 are increasing day by day. Covid-19 has spread around Bangladesh and children are also being infected with comparatively fewer symptoms and lower case-fatality rates. To describe the epidemiological and clinical characteristics of hospitalized children with COVID-19. Materials and methods: This cross sectional observational study was conducted among 154 COVID-19 children who were admitted in COVID-19 dedicated Chattagram Maa Shishu O General Hospital, Chattagram from 15 April 2020 to 21 August 2022. Their signs, symptoms, sex, age distribution, laboratory results and familial contact were analyzed. Results: Among 154 children total RT-PCR positive cases were 82 (52%) and suspected cases were 72 (47%). Among positive casesmale-female ratio was 1.78:1. Most of the children (64%) were in school going age (6-18 years).70% children were from urban area and 30% from rural area. Most of the children (78%) came from middle and upper middle socioeconomic group and 22% from lower socioeconomic group. About 74% children were affected from family member.Main symptoms of the children were cough (72%), and fever (62%), fever with cough (56%) and diarrhoea (26%). About 58% of the children had additional symptoms including sore throat, nasal congestion, fatigue, headache, body ache, vomiting, abdominal pain, 32 patient came with shortness of breath. 7 patients had comorbidities. Among those 1 with CKD, 1 CP, 2 TB and 3 patients had asthma. Total 6 patients were died, 2 patients from positive cases and 4 patients from suspected cases. Among those 1 was CP child. About 14% patients showed lymphopenia, 14% showed leucopenia, 38% patient had neutropenia. C-Reactive Protein (CRP) and serum ferritin were high in only 52% and 38% cases respectively. There were 30% patients who had normal Chest X-Ray and 12% had bilateral consolidation and 58% had patchy opacities. Conclusion: The clinical manifestations in children are variable. However, fever and cough have mostly been profiled. Though the severe condition is rarely reported in children compared with adults, life-threatening complications, and death associated with COVID-19 disease have been documented. But it is evident that they may play a role in transmission of disease. Chatt Maa Shi Hosp Med Coll J; Vol.22 (2); July 2023; Page 14-17

Perception of Medical Students Regarding Clinical Trials and Its Impact After Educational Intervention – A Questionnaire-Based Study

Background and Aims: Clinical trials are gold standard for research and evaluating the efficacy and safety of healthcare interventions. Teaching about clinical trials is part of the pharmacology curriculum for undergraduate medical students. The aim of this study is to evaluate the knowledge, attitude and perception (KAP) of undergraduate medical students towards clinical trial. Methodology: An observational cross-sectional study was conducted at a medical college of Ahmedabad, using standardised self-administered questionnaires having total 25 questions regarding KAP, prepared by the authors. The pre- and post-KAP questionnaires (after educational intervention) were offered to the participants after taking an informed consent. Analysis was done using SPSS software, version 26. P value &lt;.05 was considered as significant. Results: We surveyed 212 medical students; there was an improvement in the overall scores of knowledge domain from 79.67 to 92.19%, about 31.44% improvement in the attitude toward clinical trial and 78.17-91.12% improvement in the perception. There was improvement in median score of 84.76% in having ‘sufficient’ knowledge, 91.18% in having ‘positive’ attitude and 91.63% of respondents having ‘favourable’ perception, regarding clinical trials. Conclusion: The results of this study depict the intervention has enhanced KAP regarding clinical trial among the medical students. The medical undergraduates are future innovators, clinicians and scientific explorers. It would be better if they are trained at earlier days of learning about clinical trials/research and medical ethics to ensure that future medical students receive better training in understanding and conducting clinical trials.

Endometrioma patients are under-treated with endocrine endometriosis therapy.

Is there a difference in the use of endocrine endometriosis therapy in endometriosis patients with and without endometrioma? Patients with endometriomas received significantly less endocrine endometriosis treatment (present intake in 42.5%) compared to patients with other forms of endometriosis and without endometriomas (present intake in 52.1%). Endocrine endometriosis therapy in patients with endometriomas reduces the risk of recurrence and therefore the risk of further surgery and subsequent irreversible damage to ovaries which results into reduced antral follicle counts (AFC), anti-Mullerian hormone levels (AMH), and early menopause. However, there is evidence of increasing rejection of endocrine endometriosis treatment in this population. A total of 838 premenopausal woman with dysmenorrhea and/or endometriosis (mean age 30.7 ± 6.9 years, range 15-54 years) were included in this observational cross-sectional multicenter study. Data including the extent of dysmenorrhea, prevalence of other comorbidities like migraine with aura and migraine never with aura, diagnosis of endometriosis, history of endometriosis surgery, and hormone therapy, were collected in a retrospective online survey from May to November 2023. Patients visiting two university hospital endometriosis centers between January 2017 and March 2023, and with available email address, were invited for study participation by email in May 2023. Further recruitment of participants was achieved through the website and social medial channels of the German Endometriosis Association. Participation in the online survey was open between May and November 2023. In the subgroup of women (with dysmenorrhea) without surgically confirmed endometriosis (SCE) (n = 277), 95 (34.3%) were currently undergoing endocrine treatment for dysmenorrhea and contraceptional purposes. On the contrary, in the subgroup of patients with SCE (n = 561), 275 (49.0%) were currently undergoing hormonal treatment. Subjects with SCE therefore significantly more commonly took endocrine treatment (F = 16.587, P < 0.001) compared to those without SCE. Endometriomas were present in 254 patients (45.2% of all SCE patients), and these patients were significantly less likely to have used hormonal treatment (i) in the present and (ii) in the past (i. n = 113 42.5%, ii. n = 187, 73.9%) compared to patients with other forms of endometriosis (n = 261) (i. n = 139, 52.1%, ii. n = 220, 84.3%) (i. F = 3.976, P = 0.047, ii. F = 8.297, P = 0.004). Various reasons for rejection of endocrine endometriosis treatment were analyzed, when comparing endometrioma subjects to patients with other types of endometriosis, but no statistical differences were found. This study is limited by its retrospective design and an online questionnaire with patient-reported outcomes. A selection bias due to the voluntary nature of the study and the online recruitment is also possible. The results show that patients often refuse endocrine endometriosis treatments without a rational medical reason. According to the literature, this unnecessarily exposes these patients to a higher risk for endometrioma recurrence and subsequently a higher risk of repeat surgery and permanent damage to ovarian function. This study was funded by the University of Luebeck (budget for university teaching and research). A.C. was supported by DFG (CRC/TR 296 'Local control of TH action', LocoTact, P07) and by funds of University of Luebeck, medical section (LACS01-2024). N.B. was supported by the DFG (BR4328.2-1, GRK1957), the Michael J Fox Foundation, the Collaborative Center for X-linked Dystonia-Parkinsonism and the EU Joint Programme-Neurodegenerative Disease Research (JPND). C.C., H.G., C.G., I.A., A.K., A.R. received no funding for this study. There were no competing interests. N/A.

Study of the Correlation between the Extent and Clinical Severity, and the Histopathological Characteristics of Geographic Tongue.

Geographic tongue is an oral lesion with an unknown etiology. Recently, the Geographic Tongue Area and Severity Index (GTASI) has been proposed to assess the area and severity of geographic tongue, aiming to measure the clinical severity of the condition. However, this index does not account for the histopathology, which vary based on the clinical stage of the lesion and the biopsy area. The present study aimed to evaluate the correlation between GTASI score and its histopathological features. This cross-sectional observational study included 40 participants diagnosed with GT confirmed both clinically and histopathologically. Considering GT severity, a vast majority 60% of cases were classified as mild, with females' predominance in both mild and severe categories. The average age of participants was 56 years for mild and severe cases and 47 years for moderate ones. The prevalent histopathological features of geographic tongue included parakeratosis, acanthosis, spongiosis, basal layer hyperplasia, mono- and polymorphonuclear exocytosis, suprapapillary hypotrophy, claviform epithelial ridges, fusion of epithelial ridges, conjunctival papillary edema, and chronic subepithelial infiltration, with no significant differences taking into consideration clinical severity level. Papillary vascular ectasia, Munro microabscesses, Kogoj pustules, and dense connective tissue were more prevalent in with more severe cases of GT. Mild inflammatory infiltrate intensity was predominant in persons with mild GT, while moderate infiltrate intensity was found predominantly in moderate cases of GT. The clinical severity level of GT closely corresponds with its histopathological characteristics.

Factors Associated with Preoperative Anxiety in Patients Undergoing Ambulatory Hand Surgery: A Cross-Sectional Observational Study

Factors Associated with Preoperative Anxiety in Patients Undergoing Ambulatory Hand Surgery: A Cross-Sectional Observational Study

An observational cross-sectional study on the characteristics of children and adolescents with non-specific spinal pain stratified by pain severity

BackgroundDistinguishing self-limiting (‘trivial’) from potentially consequential spinal pain in childhood and adolescence is crucial to prevent over- or under-medicalization. The aim of this study was to stratify participants for severity of spinal pain and to investigate associations of pain severity with potential consequences of pain and some psychophysical and clinical factors.MethodsIn 2020 and 2021, children and adolescents took part in a voluntary population-based spine screening event across Switzerland organized by the Swiss Chiropractors Association. The screening consisted of a questionnaire (14 questions) based on the Young Spine Questionnaire and a clinical examination by a chiropractor. Three subgroups of pain severity [no pain (including mild, occasional pain), one-sited moderate pain, one-sited severe or moderate/severe pain at multiple sites of the spine] were formed by combining the self-reported measures for pain intensity and pain frequency for two recall periods (lifetime, last week) according to literature. Multivariable logistic regression analyses were conducted to determine the associations between pain severity and potential pain consequences (impact of spinal pain on health and seeking medical advice because of spinal pain), as well as between pain severity and some psychophysical factors (head and/or belly pain, sleep problems, daytime tiredness) and clinical measures [trunk symmetry (rib hump), trunk muscle endurance (plank position)].ResultsOf all participants (N = 457; 6–16 years; mean age = 10.9 ± 3.0 years; 220 boys), those with most severe spinal pain and with one-sited moderate pain in the last week had higher odds for reporting an impact of spinal pain on their health (OR = 13.5, 95%CI = 4.9–36.8; OR = 4.7, 95%CI = 1.5–14.4) and for searching medical advice because of spinal pain (OR = 11.6, 95%CI = 4.5–30.1; OR = 3.9, 95%CI = 1.6–9.2). Headache and/or belly pain (OR = 2.6, 95%CI = 1.2–5.5) and daytime tiredness (OR = 3.2, 95%CI = 1.3–7.9) increased the odds for having most severe pain compared to having no pain. The clinical measures were not associated with pain severity.ConclusionStratification by pain severity, particularly when asked for pain in the last week, might help to minimize over- and under-medicalization of spinal pain in childhood and adolescence. Prospective studies are needed to clarify the relevance of the investigated clinical tests in the context of adolescent spinal pain.

The first cross-sectional comparative observational study of sexual dysfunction in Emirati and non-Emirati Parkinson’s disease patients (EmPark-SD) in the United Arab Emirates

Sexual dysfunction (SD) is a common non-motor symptom in people with Parkinson’s disease (PD) yet underreported and undertreated specifically in many ethnic PD groups because of religious, social and personal perceptions. We conducted the first single-centre cross-sectional study in the United Arab Emirates of SD in 513 consecutive patients who agreed to complete the survey questionnaires. Data was collected on SD using the Nonmotor Symptoms Scale (NMSS), Index of Erectile Function, and Female Sexual Function Index. Our results show that the non-Emirati group had higher NMSS-SD scores than the Emirati group. SD was reported independent of ethnicity, race and disease stage (p < 0.001). SD correlated with worsening quality of life (p < 0.001) and anxiety domain, especially in young PD patients (p < 0.001). Our data concludes that there is no significant difference in SD between different ethnicity groups, contrary to common perception. SD appears to be underreported in this population and needs addressing using culturally sensitive bespoke counselling.

Determination of urine volume and glomerular filtration rate using d-serine and d-asparagine.

Measurement of glomerular filtration rate (GFR) is subject to inaccurate urine collection. Clearances of d-serine and d-asparagine, rare enantiomers of amino acids, are the measures of GFR since they are almost free of tubular secretion and reabsorption. We hypothesize that d-serine and d-asparagine can accurately determine urine volume and GFR. This cross-sectional observational study included 209 living kidney transplant donors and recipients for whom GFR was measured using the clearance of inulin. Assuming that urine excretions of d-serine and d-asparagine are constant and using urine levels of d-serine and d-asparagine from each urine collection, an equation for estimated urine volume (eUV) was established. Based on the eUV, the abnormal urine volume was replaced with an estimate with which the GFR was re-evaluated. Clearances of d-serine and d-asparagine were minor in proportional biases when compared with that of creatinine. Using 627 urine collection, the equation for eUV (mL/min) was established as 21.88/urine d-Ser (0.40+ 0.20 × log10(urine d-Asn)). Using eUV, we identified 20 instances where urine collection volumes varied significantly from the estimated values. After replacement with eUV, measured GFR (mGFR) was corrected to adjusted mGFR, which was within approximately 20mL/min/1.73m2 of the mGFR. d-Serine and d-asparagine are nearly completely excreted in urine after glomerular filtration, enabling the estimation of urine volume and correct mGFR. Besides reflecting GFR, d-serine and d-asparagine can be used to estimate urine volume. By applying the eUV method, mGFR determined using clearance methods becomes more accurate.

Bilateral Involvement in Childhood Presumed Trematode Induced Granulomatous Anterior Uveitis

ABSTRACT Purpose This study aims to elucidate the clinical spectrum of trematode-induced uveitis (TIU), with a particular focus on its bilateral presentation and providing significant insights into its pathophysiology. Methods A prospective cross-sectional observational study was conducted at the uveitis outpatient clinic of Mansoura University Ophthalmic Center. The study involved children diagnosed with presumed TIU. Comprehensive clinical evaluations were performed, including detailed history taking and thorough ophthalmological examinations of both the anterior and posterior segments, emphasizing the unaffected fellow eye. Results The cohort consisted of 80 children, with a male predominance of 98.75%. The proportion of bilateral involvement was observed in 12 out of 80 (15%). The involvement of the fellow eye was observed as follows: conjunctival hyperemia (3/80), conjunctival phlycten-like lesions (3/80), ciliary injection (10/80), corneal immune infiltration (4/80), retro-corneal membrane (5/80), anterior chamber granuloma (5/80), peripheral anterior synechiae (3/80), complicated cataract (2/80), diffuse cyclitis and choroid thickening (12/80), and intermediate uveitis (11/80). Conclusion This study demonstrates that TIU is not confined to the initially affected eye; the fellow eye may also be affected in a significant number of cases. Therefore, it is crucial to conduct thorough examinations of both eyes in patients diagnosed with TIU to ensure comprehensive clinical management.

Impact of the COVID-19 pandemic on the clinical features of patients with chronic obstructive pulmonary disease: an observational cross-sectional study.

The presence of chronic obstructive pulmonary disease (COPD) and COVID-19 infection is a detrimental combination for patients and can cause negative clinical consequences. The investigation aimed to compare sociodemographic and clinical parameters of COPD individuals hospitalized for exacerbations before and at the end of the COVID-19 pandemic. An observational cross-sectional study including 222 patients with COPD was conducted in two stages: a survey and assessment of clinical and laboratory data of patients hospitalized from September 2022 to March 2023 (n=98) and processing of the medical histories of patients with COPD who received hospital treatment in 2017 and 2018 (n=124). A comparative analysis of patients who received inpatient treatment for COPD showed that the frequency of patients with Global Initiative for Chronic Obstructive Lung Disease (GOLD) I was half as high after the COVID-19 pandemic, whereas the individuals with GOLD IV were more frequent during the same period (p<0.05). Multiple regression analysis proved the effects of smoking status and previous COVID-19 infection on the health status of patients with COPD according to COPD Assessment Test data (p<0.05). There was an increase in the frequency of comorbid pathologies in the post-COVID period: hypertension, coronary heart disease, gastrointestinal diseases, anemia (p<0.05), and other diseases. This study highlights the significant influence of the COVID-19 infection on people with COPD, which manifested as impaired lung function and an increased incidence of comorbidities.