Cross-sectional Observational Study Research Articles

Correlation of Chronic Cervico-Cranio-Mandibular Pain in Individuals with Adverse Childhood Events: An Observational Study.

This cross-sectional observational study examines the relationship between chronic cervico-cranio-mandibular pain, a significant health concern associated with temporomandibular disorders, and adverse childhood experiences (ACEs). Given the high prevalence of cervical pain and the gap in adequate treatment for temporomandibular disorders, this research highlights the interplay between psychological, social factors, and musculoskeletal health. The study, conducted from January to June 2023, included 114 participants (mean age = 31 ± 12 years, 69.3% female) experiencing chronic cervico-cranio-mandibular pain. Pain severity and dysfunction were assessed, and exposure to ACEs was measured using validated questionnaires. Statistical analysis, performed using Jamovi (v 2.23.28) software. Data revealed a significant correlation between the number of ACEs and both pain intensity (r = 0.254, p = 0.006, η2 = 0.062) and disability (r = 0.262, p = 0.005, η2 = 0.068). However, no significant association was found between ACEs and mandibular functional limitation (p = 0.222). These findings suggest that while early life stressors impact overall health, their specific influence on cervico-cranio-mandibular pain is limited. The study emphasizes the importance of integrated early intervention strategies to mitigate the long-term musculoskeletal repercussions of adverse events, advocating for comprehensive mental health support and preventive measures. This research contributes valuable insights into the necessity of a multifaceted approach to understanding, diagnosing, and treating musculoskeletal disorders, highlighting the complexity of their causes and effects.

Association between Pre-operative Vitamin-D level and Shortterm Clinical Outcomes Regarding Pain & Disability following PLID surgery

Background: Low back pain (LBP) is a common problem affecting 70% of the population in the developed countries and prevalence is also increasing in the developing countries. There were strong associations between vitamin D deficiency and LBP. According to the latest report in Bangladesh 86% (eighty-six percent) people had hypovitaminosis- D. A high prevalence of vitamin D deficiency is seen in patients with degenerative diseases of the spine. Considering the hypovitaminosis D led to musculoskeletal issues we want to examine the level of vitamin D in patients before PLID surgery and observe its impact 01 month postoperatively regarding pain & disability outcomes by Visual Analogue Scale (VAS) & Oswestry Disability Index (ODI). Objectives: The objective of this study was to evaluate an association between preoperative Vitamin-D level and short-term outcome regarding pain & disability following PLID surgery. Materials and Methods: This cross-sectional observational study will be conducted in the Department of Neurosurgery, Bangabandhu Sheikh Mujib Medical University. Patient’s data will be collected in questionnaire/data collection sheet. All the patient will be evaluated by serum Vitamin-D level preoperatively. Patient will be clinically assessed by VAS (Visual Analogue Scale) score and ODI (Oswestry Disability Score) preoperatively and 01 month postoperatively. Then our aim is to determine a relationship between pre-operative Vitamin-D level and mean difference between pre and post-operative VAS & ODI Score. Statistical analysis: Data was processed and analyzed by using computer software SPSS (Statistical Package for Social Sciences) version 22. Appropriate statistical test for data analysis (Unpaired T-test) was done. Statistical significance was set at pvalue <0.05. Results: In this study population, the mean age was 42.84 ± 10.14 years ranging from 31 to 78 years. Out of 38 patients 17 (45%) patients had hypovitaminosis-D and 19 (55%) patient had normal vitamin-D level. 15 (39.5%), 11 (28.9%), 10 (26.3%) and 2 (5.3%) patients were service holder, housewife, Businessman and other (retired) respectively. T-test & Chi square test showed positive association between preoperative vitamin-D level and post-operative clinical outcome regarding pain and disability, with a significant p-value of p = <0.05. Conclusion: Our study has showed an association between Pre-operative Vitamin-D level and post-operative clinical outcome regarding pain & disability, that is, insufficient Vitamin-D level leads to decrease alleviation of symptoms following PLID surgery. Bang. J Neurosurgery 2024; 13(2): 75-85

Drug utilization study of antidepressant drugs in psychiatric outdoor patients at a tertiary care hospital in Southern Rajasthan

Background: The World Health Organization (WHO) defines “Drug Utilization” as the marketing, distribution, prescription, and use of drugs in a society, with special emphasis on the resulting medical, social, and economic consequences. Antidepressants are used to treat depressive illnesses and anxiety disorders. However, these are also employed in the pharmacotherapy of several psychiatric disorders. Very few studies were found regarding the pattern of prescription of antidepressants in outdoor patients in southern Rajasthan. So, this study has been planned to learn about the prescription pattern of antidepressant drugs as per WHO Core Drugs Prescribing indicators at a tertiary care hospital in southern Rajasthan. Methods: A cross-sectional observational study was conducted among 375 patients by convenient sampling over one year duration, in the outdoor Department of Psychiatry at RNT Medical College, Udaipur, Rajasthan. Patient’s prescriptions were analyzed for drug utilisation pattern in OPD after relevant consent. All data was compiled in MS Excel and analyzed using statistical methods. Results: Out of 375 prescriptions analyzed, 48.8% were males and 51.2% were females. Most commonly, patients had a diagnosis of depressive disorder (42.93%), followed by bipolar affective disorder (14.4%). The most common drug class prescribed was SSRI (88.86%). Escitalopram (41.65%) was the most prescribed drug, followed by Sertraline (30.51%). Conclusions: Among the prescribed antidepressants SSRIs were the most common class of drug followed by TCA. Escitalopram was the most common drug to be prescribed followed by sertraline. More than half of the patients receiving antidepressants suffered from non-depressive disorders. Monotherapy was preferred over combination therapy. All patients were prescribed generic drugs.

Pelvic tilt and stiffness of the muscles stabilising the lumbo-pelvic-hip (LPH) complex in tensiomyography examination.

The objective of the study was to initially validate the hypothesis about the relationship between the pelvic tilt angle in the saggital plane and the functional state of muscles stabilising the lumbo-pelvic-hip (LPH) complex expressed as a change in their stiffness in a tensiomyography examination. Forty five women aged 19-30 years took part in an observational (cross-sectional) study. The examination involved measurements using the tensiomyography method (TMG). The stiffness of muscles stabilising the LPH complex expressed as a maximal muscle displacement (Dm variable) was assessed and the relationship between muscle stiffness and the value of the pelvic tilt (PT) in the sagittal plane was determined. The analysis showed significant differences in the values of medians of the muscle displacement (Dm) values in groups identified in terms of the value of pelvic tilt (Table 1) for Erector Spinae (ES) muscles (p = 0.0012), Gluteus Maximus (GM) muscles (p = 0.0004), Rectus Abdominis (RA) muscles (p = 0.0005), Obliquus abdominis externus (OAE) muscles (p = 0.0002*) and Rectus Femoris (RF) muscles (p = 0.0071). The results of the correlation analysis performed using the Spearman rho correlation coefficient between the value of pelvic tilt and muscle stiffness (Dm) show the following significant relations for ES muscles (p = 0<0.0001), GM muscles (p<0.0001), RA muscles (p<0.0001) and OAE muscles (p<0.0001). However, a clear direction of changes in stiffness in accordance with the description of relations defined as Lower Crossed Syndrome was not confirmed. A tensiomyographic examination did not show clear relations between the value of pelvic tilt and stiffness of muscles stabilising the lumbar-pelvic-hip complex. The mechanism of Lower Crossed Syndrome (LCS) may be not the only model explaining the relations between musculofascial structures of the hip-lumbar area. The implications of the LCS should not be the only basis for the therapy of disorders resulting from an incorrect position of the pelvis in the sagittal plane.

Salivary Gland Tumours in Children and Adolescents-A Study in Shaheed Monsur Ali Medical College &amp; Hospital, Uttara, Dhaka, Bangladesh

Introduction: Salivary gland carcinomas (SGCs) are rare neoplasms in adults, but are exceedingly infrequent in children, with a reported annual incidence of 0.8–1.4 per million populations under 20 years old. Like other pediatric very rare tumors, SGCs in children and adolescents often present diagnostic and therapeutic challenges for pathologists, surgeons, and pediatric oncologists. Objective: To assess the salivary gland tumours in children and adolescents. Methods: A cross-sectional observational study was carried out at Dept. of ENT, Shaheed Monsur Ali Medical College &amp; Hospital, Uttara, Dhaka, Bangladesh from January to June 2023. Total 60 patients included in our study. Our pre-operative clinical diagnoses were based on size, shape, mobility, fixity of the tumour to the underlying structures, ulceration of overlying skin, involvement of facial nerve by its malignant transformation and fine needle aspiration cytology. All patients, or their guardians, gave their informed consent for data collection within the national rare tumour group and analysis. Results: Total sixty (60) cases of salivary gland tumours were available for our study. Out of 55% were male and 45% were female patients. Incidence of tumours is highest in the age group of 41-50 with 13 cases (21.6% of the total). The least affected age group was the 0-10 group with only one patient (3.3%). Women accounted for 16 cases of the total 33 benign neoplasias (55% of the total). Of the 33 benign tumour, 18 were in males (54.5% of all benign tumours) and 15 were in females (45.5%). Total 60 operated cases). Of these, 32 were pleomorphic adenomas (53.3%) and 1 was an adenolymphoma (1.6%). the total number of malignant tumours confirmed by HPE were 27 (45%). Of these, most numerous was adenoid cystic carcinoma in 8 cases (13.3%). squamous cell carcinoma and muco epidermoid carcinoma were found in 6 cases each (10%). There were 4 and 3 cases of adenocarcinoma (6.6%) and acinic cell carcinoma (5%) respectively. The parotid glands were also the sole location for the 3 acinic cell carcinomas. No tumours were found in the sublingual gland. The majority of the tumours found in the parotid gland were benign tumours, mainly pleomorphic adenomas with 24 cases (75% of the total parotid tumours). Conclusions: The tumours were equally distributed between males and females. The tumours were most commonly found in the third to fifth decades of life. The most common benign tumour and the most common tumour overall was pleomorphic adenoma making up 54.5% of all tumours. Surgical excision was the most commonly done treatment. The most commonly done surgical procedure was superficial parotidectomy.

Evaluation of retinal nerve fiber layer and choroidal structure in obese children and adolescents

Aim: Obesity-related vascular damage and endothelial dysfunction have deleterious effects on the ocular vasculature. It was aimed to examine optical coherence tomography (OCT) parameters in obese and overweight children and to define their relationship with metabolic markers in this study. Methods: The patient group consisted of 26 obese, 24 overweight patients aged between 8 and 18 years. The control group consisted of 25 healthy children with normal body mass index (BMI). This was a cross-sectional observational study. Serum glucose, lipid parameters, and homeostasis model assessment of insulin resistance (HOMA-IR) were investigated. Measurement of choroidal thickness was performed with Cirrus HD-OCT (Carl Zeiss Meditec Inc., Dublin, CA, USA). Retinal nerve fiber layer (RNFL) thickness was determined by an automatic computer algorithm without the need for user measurement. Results: There were no differences in subfoveal, nasal, temporal choroidal thickness, and RNFL between obese, overweight, and control groups (p&gt;0.05). A positive (linear) moderate relationship was found between RNFL and the HOMA-IR of 26 patients in the obese group (r=0.389) (p=0.049). A positively weak correlation was found between height and RNFL in obese patient group (r=0.264, p=0.028). Conclusion: In the study, RNFL thickness increased as HOMA-IR level increased in obese children and adolescents. RNFL decreased as the height increased in obese children and adolescents. We believe that more comprehensive data about the effect of obesity on RNFL and choroidal thickness will be obtained with prospective studies in which the obese patient group with insulin resistance is taken separately and disease durations are defined, and long-term patient follow-up is performed.

Behavioral Correlates of Caregiver-Reported Oral Health of Children with Cleft Lip and/or Cleft Palate Ages 14 to 48 Months: An Observational Study.

To identify behaviors associated with poor caregiver-reported oral health in a population of young children with cleft palate with or without cleft lip (CP ± L). Observational cross-sectional study. U.S. Cleft Outcomes Research NETwork (CORNET) Consortium Eight hundred thirty-four caregivers of US children with CP ± L ages 14 to 48 months who provided demographic and medical information and answered 8 items on oral health behaviors (eg, sugar-sweetened beverage intake frequency, having a regular source of dental care, toothbrushing, and fluoride exposure). Caregiver-reported oral health status of the child (poor/fair vs good/very good). Logistic regression models were used to generate confounder-adjusted odds ratios (OR) and evaluate associations between oral health behaviors and caregiver-reported oral health status of the child. The mean age of children was 25.5 ± 7.5 months, 82.7% were white, and 24.1% were Hispanic/Latino. About 16.7% of caregivers reported their child's oral health as fair/poor. Children consuming 2+ servings of juice and/or sugar-sweetened beverages daily (OR: 2.18; 95% confidence interval [CI]: 1.2, 4.0; P = 0.011), those drinking bottled water (OR: 1.75; 95% CI: 1.0, 3.1; P = 0.049), and those consuming 1+ servings of meal replacement drinks daily (OR: 2.86; 95% CI: 1.2, 6.5; P = 0.015) had increased odds of fair/poor caregiver-reported child oral health. Sugar-sweetened beverages and meal replacement drinks, as well as bottled water intake, were associated with poorer caregiver-reported oral health for children with CP ± L. Future research should focus on ways to improve beverage-related behaviors in children with CP ± L to prevent dental diseases and promote oral health.

Dynamics of the gut microbiome in individuals at risk of rheumatoid arthritis: a cross-sectional and longitudinal observational study

ObjectivesThis work aimed to resolve the conflicting reports on Prevotellaceae abundance in the development of rheumatoid arthritis (RA) and to observe structural, functional and temporal changes in the gut microbiome...

Echocardiographic Assessment of Left Atrial Mechanics in Patients with Atrial Fibrillation Undergoing Electrical Cardioversion: A Systematic Review.

Background: To date, only a few studies have evaluated left atrial (LA) mechanics in patients with atrial fibrillation (AF) scheduled for electrical cardioversion (ECV). The present systematic review has been primarily designed to summarize the main findings of these studies and to examine the overall effect of AF on left atrial reservoir strain (LASr) in patients undergoing ECV. Methods: All the echocardiographic studies evaluating the effect of AF on LA mechanics in patients scheduled for ECV, selected from the PubMed and EMBASE databases, were included. There was no limitation of time period. The risk of bias was assessed by using the National Institutes of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Results: The full texts of 12 studies with 880 AF patients were analyzed. The pooled ECV success rate was 91.5% (range 65.8-100%). Over a median follow-up of 5.4 months (range 0.3-12 months), 35.2% of the patients (range 5-68.8%) experienced AF recurrence. At baseline, the average LASr was 11.4% (range 6.2-17.7%). A reduced LASr before ECV was strongly correlated with reduced left atrial appendage (LAA) flow velocities and/or thrombosis. The main independent predictors of cardioversion failure were impaired LASr and previous AF history. A severe LASr deterioration was independently correlated with AF recurrence after ECV. The other independent predictors of AR relapses were LA asynchrony, reduced difference between post- and pre-ECV LASr, and reduced right atrial reservoir strain. Conclusions: LASr assessment before ECV may provide useful prognostic information about AF relapses and improve the refinement of the thromboembolic risk of AF patients scheduled for ECV.

Relevance of the Immunohistochemical Expression of p53 and E-cadherin in the Grading of Urothelial Carcinoma: A Single-Center Cross-Sectional Observational Study

Relevance of the Immunohistochemical Expression of p53 and E-cadherin in the Grading of Urothelial Carcinoma: A Single-Center Cross-Sectional Observational Study

Mobile phone addiction and self-injury in adolescents with MDD: mediation by self-esteem and depression, and the failure of usage restrictions

BackgroundPrevious studies have suggested a significant association between mobile phone addiction (MPA) and non-suicidal self-injury (NSSI) in general adolescents. However, limited research has analyzed this relationship in clinical populations, such as those with major depressive disorder (MDD), and the potential mediation mechanisms remain unclear.MethodsThis cross-sectional observational study analyzed data from 2343 adolescents with MDD (77.9% females; mean age = 14.99 years, SD = 1.65). Using mediation models, we explored the roles of self-esteem and depression severity (measured by Patient Health Questionnaire-9) in the relationship between MPA and NSSI. Additionally, we evaluated the associations between existing school-implemented mobile phone usage policies and levels of MPA, self-esteem, depression symptoms, and NSSI.ResultsMPA was significantly associated with NSSI, with low self-esteem and increased depression severity almost entirely mediating this effect (log-odds = 0.016, 95%CI = 0.02–0.013). Subdomains of MPA, including inability to control craving, feelings of anxiety, and productivity loss, followed similar mediation models, while the subdomain of withdrawal/escape had a partial effect mediated by depression severity. Additionally, enforced restrictions on mobile phone usage in schools did not show positive effects on related variables and even exacerbated MPA by increasing cravings and reducing productivity.ConclusionOur study suggests that MPA in adolescents with MDD may be an important risk factor for NSSI occurrence, and that reducing the negative impact of mobile phone usage on self-esteem and depressive symptoms, rather than simply restricting usage, may be crucial for effective intervention.

Upper airway obstruction patterns among non-obese individuals with snoring and obstructive sleep apnea

BackgroundSnoring is an inspiratory noise due to partialobstruction of the upper airways. It is commonly linked to a sleep problem known as obstructive sleep apnea (OSA). The clinical criteria of OSA in non-obese patients are distinct and warrant more investigation, despite being well-studied in the obese population.ObjectiveThe aim of this study is to provide a diagnostic profile of snoring and OSA in non-obese patients using various assessment tools in order to identify upper airway obstruction patterns and potential risk factors in these patients to improve their management and prevent related comorbidities.MethodologyAn observational cross-sectional study of 30 non-obese (BMI < 29.9) snorers (18 males and 12 females) with a mean age of 38.13 ± 8.4 years. All patients underwent polysomnography and thorough clinical examination, including searching for possible risk factors/co-morbidity, Epworth Sleepiness Score (ESS), Mallampati score, awake upper airway endoscopy combined with Muller maneuver, and drug-induced sleep endoscopy (DISE).ResultsOSA presented in 80% of our patients, the age range of 17–58 years, apnea–hypopnea index (AHI) mean 20.63 ± 17.8 event/h, and its severity was mild 7 (23.3%), moderate 6 (20%), and severe 11 (36.7%). Findings of oral and nasal examination showed no association with AHI. Also, sleep endoscopy findings regarding specific structures causing upper airway obstruction showed no significant association. A positive correlation was found between the extent of retropalatal airway collapse and AHI. A notable association was found between smoking and AHI as a risk factor for OSA in non-obese individuals. No significant relationship was found between ESS, concomitant diseases, and AHI.ConclusionOSA is common in non-obese patients and probably may be attributed to retropalatal/oropharyngeal airway collapse and associated with smoking as a risk factor. Further studies are warranted to reveal other pathophysiological aspects in this group of patients.

Self-help offers for people with severe mental illness: who uses which format?

Self-help can play an important supplementary role in the treatment of people with severe mental illness; however, little is known about the utilization of the various approaches. This study describes the use of various self-help options by patients with severe mental illness and examines potential predictors. As part of the observational cross-sectional study on patients with severe mental illness (IMPPETUS, N = 397), trained staff collected sociodemographic, illness-associated and treatment-associated data between March 2019 and September 2019. Binary logistic regression was used to analyze apossible association with the use of self-help. The participants most frequently reported using self-help literature (n = 170; 45.5%) followed by self-help groups (n = 130; 33.2%), electronic mental health applications (n = 56; 15.5%) and self-management approaches (n = 54; 14.8%). Trialogue seminars (n = 36; 9.9%) were the least used by the participants. The utilization of the various approaches is influenced by sociodemographic and disease-related characteristics (age, education, marital status, migration background, age at onset of initial mental health problems, psychosocial functioning level) but not by factors associated with treatment. The potential of self-help is not being fully utilized in the sample investigated. The reported use of self-help approaches by the participants ranged between 10% and 46%. The various formats address specific target groups. More targeted information must be provided about the various options and the use of self-help in routine treatment must be actively fostered in order to increase the utilization of self-help.

Comparison of infrared thermography of the face between mouth-breathing and nasal-breathing children.

To compare the temperature of thermoanatomic points and areas of the upper and lower lips between mouth-breathing and nasal-breathing children. This cross-sectional observational study had a sample of 30 nasal-breathing and 30 mouth-breathing children aged 4 to 11 years. One front-view, one left-view, and one right-view infrared thermogram of the face were acquired from each participant. A total of 14 thermoanatomic points plus the upper lip and lower lip areas were marked on the front-view thermograms, while on the side-view thermograms, six thermoanatomic points were marked. The research also calculated the difference between the temperature of the upper and lower lip areas (∆T area) and between the temperature of the points on the upper and lower lips (∆T points). The normalized mean temperatures of points and areas and temperature differences were compared between groups with the t-test and Mann-Whitney test. The temperature of the thermoanatomic points closest to the lip (nasolabial, Labial Commissure, and lower labial), areas of the lips, and external acoustic meatus was lower in mouth breathers than in nasal breathers, which did not happen for most other points. ∆T area and ∆T points were not different between the groups. Thermography is a promising complementary diagnostic tool, since showed mouth-breathing children had lower temperatures in the region of the lips than nasal breathers.

Home Biofilm Management in Orthodontic Aligners: A Systematic Review.

Background. Transparent aligners are recently introduced orthodontic devices considered promising for the improvement of oral health conditions, in terms of faster treatment times and enhanced comfort, especially if compared with traditional fixed orthodontic therapy. This systematic review aimed to evaluate at-home protocols for proper oral hygiene and aligners cleaning during orthodontic treatment. Methods. A search was conducted using the following four databases: PubMed, Cochrane Library, Web of Science, and Scopus. The systematic review (registered as CRD 42024562215) followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines and included prospective studies, randomized controlled trials (RCTs), controlled clinical trials, and in vivo and ex vivo studies; they had to assess treatment with invisible orthodontics compared to treatment with fixed orthodontics, home oral hygiene, or aligner disinfection protocols. The evidence in the studies was evaluated for risk of bias using the RoB-2 (for RCTs and randomized crossover studies) and ROBINS-I tools (for observational studies). Results. Eleven studies were included in this systematic review: four RCTs, four crossover studies, and three cross-sectional observational studies. Seven studies considered patients undergoing orthodontic treatment, whereas four examined orthodontic aligners. The cleaning protocols of the aligners were evaluated based on the analysis of residual biofilm on the thermoplastic surfaces. Studies included were characterized by a low level of certainty, thus further evidence is needed. Conclusions. The most effective protocols entailed a combination of mechanical and chemical agents, suggesting that it is fundamental for patients undergoing aligner treatment to focus on individually tailored home oral hygiene protocols.

Measuring concern about smile appearance among adults.

To adapt and estimate the psychometric properties of Utrecht Questionnaire for esthetic outcome assessment in rhinoplasty (OAR) to assess concern about smile appearance and to estimate the influence of demographic characteristics on this concern in adults. This was a cross-sectional observational study. Individuals aged between 18 and 40 years participated in the study. The Portuguese version of OAR was adapted for smile assessment in dental practice and was named Questionnaire for Outcome Assessment of Smile Aesthetic (OA-Smile). Data validity was estimated using factorial validity [confirmatory factor analysis (CFA)-CFI, Tucker-Lewis index (TLI), SRMR)] and convergent validity (average variance extracted). Reliability was assessed using the alpha ordinal coefficient (αordinal) and the omega coefficient (ω). A structural model was elaborated to assess the contribution of demographic characteristics to smile appearance concerns. Model fit was evaluated, and the z-test (α = 5%) was used to estimate the significance of the path estimates (β). 2.523 subjects participated in the study [mean age = 32.86 (SD = 11.39) years, 68.1% female]. The factor model of orofacial appearance (OA)-Smile presented an adequate fit to the data [CFA: comparative fit index (CFI) = 0.99, TLI = 0.99, SRMR ≤ 0.05]. Convergent validity (AVE ≥ 0.80) and reliability (αordinal and ω ≥ 0.85) were adequate. The structural model presented an acceptable fit (CFI = 0.974; TLI = 0.991 and SRMR = 0.053). Women, younger people, single people, people with lower income, people using dental prostheses, undergoing dental treatment, and those who do not like their smile were more concerned about their smile appearance. Nonprobability sampling, online data collection, and cross-sectional design are considered limitations of the study. OA-Smile is a suitable scale to assess smile appearance concerns, and the data obtained with this scale were valid and reliable. Demographic characteristics should be considered when measuring concerns about smile appearance.

Psychological Distress and Associated Factors Among Elementary School Teachers: A Cross-Sectional Study.

Teachers can face demanding and stressful working conditions. Classroom environments in elementary schools are dynamic and challenging, which can be mentally and emotionally exhausting for teachers. This study aimed to investigate the prevalence of psychological distress and identify associated factors among elementary school teachers. This is an analytical, observational cross-sectional study. The participants consisted of 450 teachers selected using the cluster sampling method from elementary schools of Tabriz, Iran. Multiple regression analysis was performed to examine the associations between teachers' psychological distress and potential factors. The study found a significant proportion of participants (54.2%) experiencing psychological distress. Multiple regression analysis revealed age, sex, work experience, school type, family income status, teachers' efficacy, emotional labor, and presenteeism were statistically associated with teachers' psychological distress. To address teachers' psychological distress, schools need to adopt policies that promote teacher well-being and mental health support. The high prevalence of psychological distress among elementary school teachers raises concerns and highlights the need for attention. Schools and administrators must provide teachers with the resources and support they need to succeed in their roles. Interventions targeting the identified associated factors must be planned to improve the mental health of elementary school teachers and enhance their overall performance.

Clinical relevance and frequency of cytoplasmic patterns observed in ANA-Hep-2: experience of Cairo University Hospitals.

Antinuclear antibodies (ANA) are the most common biomarkers observed in autoimmune diseases. Cytoplasmic staining patterns on ANA-Hep-2 are gaining recognition but with scanty information about their clinical and diagnostic role. The aim is to assess the frequency of cytoplasmic ANA patterns in autoimmune diseases, and to evaluate their possible associations with clinical diagnoses and autoantibodies. This observational cross-sectional study was conducted by examining and/or reviewing ANA by indirect immunofluorescence assay during a 13-month period. This was followed by testing the group of patients with a positive cytoplasmic staining pattern (n = 92) using the Microblot-Array ANA plus for the presence of 44 specific autoantibodies. Out of 2741 samples, 1791 (65.3%) tested negative, 845 (30.9%) tested positive nuclear staining patterns, 56 (2.0%) positive solitary cytoplasmic staining patterns, and 49 (1.8%) positive mixed nuclear and cytoplasmic patterns. Ninety-two cases (3.4% of the total cases) were analyzed using Microblot-Array ANA plus, with reticular as the most frequent cytoplasmic pattern, followed by dense fine speckled. The most frequently associated disease with reticular pattern was primary biliary cholangitis (28.9%), and the most frequently detected autoantibodies were against M2 (66.7%). The most frequently associated disease with dense fine speckled pattern was systemic lupus erythematosus (69.4%), and the most frequently detected autoantibodies were against nucleosome (57.7%) and ribosomal P0 (53.8%). This study highlights the significance of reporting cytoplasmic staining patterns and their importance in assessment of autoimmune diseases. Larger cohort studies on treatment naïve patients are recommended.

Pattern of Non-prescription Drug Use in Febrile children Prior to Outpatient Visit in a Semi Urban Tertiary Hospital

Background: Use of drugs without any prior medical consultation is a common practice in lower and middle income countries which causes health hazards and misuse or overuse of drugs. Fever is a common symptom for which parents seek medical care according to their knowledge and ability. Objective: To observe the patterns of drug use, source of drugs, and identify the factors associated with the use of non-prescription drugs in febrile children. Methods: This is a hospital based observational cross sectional study conducted over a period of four months in the Ashulia Women and Children Hospital (AWCH). Study population was the febrile children attending paediatric out patient department. Data was collected from parents/caregiver through a pretested questionnaire. Result: Among 614 study children 77.2% had fever for less than 5 days and out of them 544(90.7%) children were treated with different types of drugs. Out of them 90.1% children had drugs without any prescription mostly from drug retailers (54.8%). Commonly used drug was antipyretic (99.3%) followed by antibiotic (49.1%) and antihistamine (31.9%) and 73.16% children were treated with multiple drugs. Cefixime (40.8%) was found to be a widely used antibiotic. Perception of mild illness (53.3%) was reported predominantly as a cause of using drugs without medical advice. Conclusion: This study reveals use of multiple drugs including antibiotics for treating febrile illness of children prior to medical consultation and treatment was most commonly taken from drug retailers. BANGLADESH J CHILD HEALTH 2023; VOL 47 (1) : 39-42

Association of Physical Fitness with Leisure Time Physical Activity in Individuals with Spinal Cord Injury

Abstract Background: Physical fitness of persons with spinal cord injury (SCI) is related to their upper limb strength and range of motion. A change in these factors may impact their participation in physical fitness, and consequently leisure time activities. The objective of the study was to examine an association of physical fitness with leisure time physical activity (LTPA) in people with SCI. Materials and Methods: This was a cross-sectional observational study conducted among 30 male and female participants with SCI. Physical fitness and LTPA were assessed using a 6-min push test and physical activity recall assessment for people with SCI, respectively. Spearman’s Rank correlation coefficient was used to estimate the correlation between physical fitness and LTPA in persons with SCI. Results: The mean age of the participants was 33.6 ± 7.73) years. This study found a positive weak to no correlation between physical fitness and LTPA in individuals with SCI (r s = 0.1008) that was statistically nonsignificant (P &gt; 0.596). In this study, 28 (93.33%) participants had good physical fitness, and 19 (63.33%) participants performed LTPA for 20 min or more in a day, whereas 11 (36.67%) performed less than 20 min per day. Conclusion: Though most of the participants had good physical fitness, they performed only exercise-based activities such as walking with orthosis, pushups exercises, and resistance training exercises for upper limb muscles in their leisure time. They did not participate in LTPA such as sports, gardening, swimming, and other recreational activities. Furthermore, studies can be done to understand the perception of physiotherapists and SCI individuals toward the participation of LTPAs.