Retrospective Cross-sectional Study Research Articles

The first involved joints and associated factors in patients with rheumatoid arthritis.

This study aimed to investigate the first involved joints and associated factors in Turkish patients with rheumatoid arthritis (RA). This retrospective cross-sectional study included 300 newly diagnosed and disease-modifying antirheumatic drug-naïve RA patients (240 females, 60 males; mean age: 54±1.2 years; range, 18 to 82 years). Baseline demographic, clinical, and laboratory data were evaluated between January 2022 and December 2022. The patients were divided into four groups according to autoantibody profile: antibody-negative patients (Group 1; both RF and anti-CCP were negative in this group of patients), RF-positive patients (Group 2), anti-CCP-positive patients (Group 3), and patients with dual seropositivity with RF and antiCCP (Group 4). The patients were also divided into two groups according to the size of the first affected joint: patients with SJI at diagnosis and patients without SJI involvement at diagnosis. Rheumatoid factor (RF) and anti-cyclic citrullinated peptide (CCP) antibody positivity rates were 40.3% and 35.6%, respectively. The mean lag time to diagnosis was 25±36 months. At the disease onset, 20% of patients did not have small joint involvement (SJI). Seronegative patients tended to be female (p=0.001), had longer lag time (p=0.001), and had lower levels of C-reactive protein (p=0.025), white blood count (p=0.005), and neutrophil/lymphocyte ratio (p=0.001) compared to the dual seropositive group. Patients presenting with SJI had a younger age (p=0.002), tended to be female (p=0.001), and had lower RF (p=0.034) and anti-CCP (p=0.031) positivity. Only age (p=0.005) and dual seronegativity (RF and anti-CCP; p=0.035) were the independent predictors of SJI in multivariate analysis. The decreasing age and seronegative status were defined as independent risk factors of SJI at the onset of RA. Population-based, prospective studies are needed for earlier diagnosis.

Retrospective cross-sectional study to evaluate outcome of loco-regional flaps in head and neck reconstruction in Sudanese patients

Introduction: The soft tissue of the head and neck region poses both esthetic and functional aspects and must be retorted simultaneously, as any defect will be easy recognizable and will affect the quality of patient’s life. Reconstruction by local- regional flap still the most popular approach used and outcome also better than other options. Objectives: To assess the outcome of loco-regional flaps in head and neck reconstruction in Sudanese patients. Patients and methods: Retrospective cross-sectional, multicenteric study (Soba University Hospital, Khartoum North Teaching Hospital and an associated specialized hospital) – Khartoum, Sudan, 84 patients underwent head/neck reconstruction during the period from 2017 up to 2021 were included. Results: Out of 84 patients, 47.6% were female and 52.4% were male. The etiology of head and neck defects in the majority (69%) was neoplastic, and in 11.9% it was trauma. According to site of defect, in 23.8% of patients was Cheek unit, 21.4% was nasal site, and 16.7% was neck site. Surgery in 85.7% of patients were primary, while in 14.3 was delayed. Fasciocutaneous flaps were used in 64.3%, followed by myocutaneous flap in 28.6%; functional outcome was excellent in 61.9%, adequate in 35.7%, and was inadequate in only 2.4%. The majority of patients 66.2% did not develop any complications. Conclusion: Loco-regional flaps are ideally useful in covering head and neck defects. It has an acceptable esthetic and functional outcome in the majority of cases. It can be considered as a reliable option for reconstruction especially in resource constrained centers.

Outcomes of Anterior Cruciate Ligament Reconstruction in Patients with Associated Anterolateral Ligament Injury.

Objective To evaluate if there is a significant difference in the outcomes of isolated anterior cruciate ligament (ACL) reconstruction in patients with or without associated anterolateral ligament (ALL) injury. Methods We conducted a retrospective cross-sectional study through the analysis of medical records and the application of the questionnaires of the Lysholm Knee Scoring Scale and the International Knee Documentation Committee (IKDC) Subjective Knee Form to patients undergoing isolated ACL reconstruction. Results The 52 participants included were divided into two groups: 19 with associated ALL injury and 33 with no associated ALL injury. None of the patients with associated ALL injury suffered an ACL rerupture, and 21.1% presented injuries to other knee structures after surgery. Among the patients with no associated injury, 6.1% suffered ACL rerupture, and 18.2% presented injuries to other structures after surgery ( p = 0.544). Return to activities at the same level as that of the preoperative period occurred in 60% of the patients with associated ALL injury and in 72% of those with no associated injury ( p = 0.309). The mean score on the Lysholm Knee Scoring Scale was of 81.6 points in patients with associated ALL injury, and of 90.1 in those with no associated injury ( p = 0.032). The mean score on the IKDC Subjective Knee Form was of 70.3 points in patients with associated ALL injury and of 76.7 in those with no associated injury ( p = 0.112). Conclusion There was no statistically significant difference regarding graft injuries or new injuries to other structures, satisfaction with the operated knee, or the score on the IKDC Subjective Knee Form. Return to activity was similar in the groups with and without associated ALL injuries. The scores on the Lysholm Knee Scoring Scale were better, with a statistically significant difference in the group with no associated ALL injuries.

Refining a non-invasive prediction model for neurosyphilis diagnosis by using immunoassay to detect serum anti-TP0435 (TP17) and TP0574 (TP47) IgG antibodies: two-centre cross-sectional retrospective study in China

ObjectivesInvasive lumbar puncture is the conventional method for diagnosing neurosyphilis (NS). We investigated a non-invasive alternative method to detect serum Treponema pallidum-specific antibodies against highly immunogenic antigens TP0171 (TP15), TP0435 (TP17), and TP0574 (TP47) by using luciferase immunosorbent assay. MethodsA total of 816 HIV-negative patients suspected of NS from the Beijing and Guangzhou cohorts were retrospectively selected and tested for serum anti-TP15, TP17, and TP47 IgG antibodies. Two diagnostic prediction models were developed using stepwise logistic regression in the Beijing cohort, and evaluated in the Guangzhou cohort for external validation. ResultsSerum antibodies against TP15, TP17, and TP47 showed moderate capability for NS diagnosis in the Beijing cohort and the corresponding area under the receiver operating characteristic curves (AUCs) were 0.722 [95% confidence interval (CI): 0.680–0.762)], 0.780 (95% CI: 0.741–0.817), and 0.774 (95% CI: 0.734–0.811), respectively. An expanded NS prediction model integrated with anti-TP17 and anti-TP47 antibodies showed better performance than the base NS diagnostic model without anti-TP17 and anti-TP47 antibodies with the AUC of 0.874 (95% CI: 0.841–0.906) vs. 0.845 (95% CI: 0.809–0.881) (p = 0.007) in the development cohort, and 0.934 (95% CI: 0.909–0.960) vs. 0.877 (95% CI: 0.840–0.914) (p < 0.001) in validation cohort, respectively. Decision curve analysis revealed that the net benefit of the expanded model exceeded that of the base model when the threshold probability was between 0.10 and 0.95 in both the development and external validation cohorts. DiscussionSerum antibodies against TP17 and TP47 exhibited promising diagnostic capability for NS and significantly enhanced the predictive accuracy of model for NS diagnosis. Our study highlights the potential of serum treponemal antibody detection as a non-invasive method for NS diagnosis to substitute invasive lumbar puncture in NS diagnosis.

Frequency of low-dose dexamethasone suppression test (LDDST) response patterns and their correlation with clinicopathologic signs in dogs suspected of having Cushing's syndrome: A retrospective study

A retrospective cross-sectional study was conducted to assess the frequency of low-dose dexamethasone suppression test (LDDST) patterns in canine patients that had clinicopathologic signs consistent with Cushing's syndrome (CS). Medical records for patients of interest (N = 128) were reviewed between January 2014 and December 2020 to analyse and classify LDDST results based upon the following patterns: lack of suppression, partial suppression, complete suppression, escape, or inverse. Complete suppression, lack of suppression, partial suppression, escape, and inverse patterns were identified in 39.1%, 31.2%, 14.1%, 10.1% and 5.5% of cases respectively. LDDST results were also evaluated with respect to clinical signs, serum alkaline phosphatase (ALP) activity, urine specific gravity (USG) and adrenal ultrasonographic findings. There was no association between LDDST patterns and clinical signs (p = 0.11), increased ALP (p = 0.32), USG (p = 0.33) or adrenal ultrasonographic findings (p = 0.19). In all dogs that demonstrated complete suppression or an inverse pattern, CS was excluded by the attending clinician. The diagnosis of CS was also excluded without further exploration in 23.1%, 7.5% and 5.6% of dogs that demonstrated an escape pattern, lack of suppression and partial suppression pattern, respectively. These results suggest that the clinical significance of LDDST patterns, particularly escape and inverse patterns, are misunderstood by some clinicians, leading them to prematurely exclude the diagnosis of CS.

CORRELATION OF CARDIAC MARKERS WITH THYROID STIMULATING HORMONE IN SUBCLINICAL HYPOTHYROIDELDERLY

Cardiac markers (CPK-MB and TroponinT (TnT)) are often used to differentiate between cardiac and non cardiac chest pain. Subclinical hypothyroidism (SCH) has increased incidence of cardiovascular risk factors and disease. Elderly have an increased incidence of SCH. However, no study has specifically examined the association between cardiac markers and SCH in elderly population. Aims and Objectives: To determine the association of cardiac markers with thyroid stimulating hormone (TSH) in elderly patientswith subclinical hypothyroids and euthyroid. Method: The present study was designed as a retrospective cross-sectional study conducted in Biochemistry department of Adesh institute of medical sciences and research (AIMSR) Bathinda from a period of May 2023 to April 2024.The data was obtained from the lab computers and the subjects were divided into four groups. Group 1 included patients who had MI and SCH. Group 2 consisted of patients who had MI and were euthyroid. Group 3 were those who presented with chest pain only (no MI) and SCH. Group 4 were those who had acute chest pain (no MI) and were found to be euthyroid. Results:Our study showed significant correlation of TSH with CPK-MB (r=0.69, p=0.001)and Troponin T ( r=0.201, p= 0.04) in Group 1 while a non significant correlation was found in Group 2, CPK-MB (r=0.06, p=0.67) and Troponin T (r= 0.156, p= 0.57). There was a significant correlation of TSH with CPK-MB (r=0.71, p=0.02) and Troponin T (r=0.84, p= 0.001) in Group 3. A nonsignificant correlation was found in Group 4, between TSH and CPK-MB (r=0.116, p=0.68) and Troponin T (r= 0.001, p= 0.99). Conclusion: Elevations of TSH levels may cause a significant rise in the cardiac markers in SCH elderly as compared to euthyroid.

A Retrospective Database Analysis to Investigate if Electrolytes in Venous Blood are Equivalent to the Levels in Arterial Blood.

In a critically ill patient, when an arterial blood sample is processed on an arterial blood gas (ABG) analyzer, it also measures electrolytes apart from analyzing the blood gases. The turnaround time for ABG analysis is way too less compared to the conventional electrolyte analysis with a serum sample. This study intends to investigate whether values of electrolytes estimated in arterial blood can substitute the routinely practiced method. This is a retrospective cross-sectional study. The source of data is patients' reports of serum electrolytes and ABG analysis from the Clinical Biochemistry laboratory, CIMS Teaching Hospital, Chamarajanagar between January and June 2021. The electrolytes report of 200 patients from whom both arterial and venous blood samples were sent to the Clinical Biochemistry laboratory on the same day and at the same time for analysis were selected. The data was compiled, compared, and correlated using a suitable statistical tool. The mean and standard deviation of sodium (135.62 ± 5.20 in venous vs 134.08 ± 8.49 in arterial blood), potassium (4.20 ± 0.64 vs 3.80 ± 0.75), and chloride (102.28 ± 4.99 vs 96.33 ± 8.11) were observed. However, when the concordance correlation coefficient and Bland-Altman plot analysis were made there was no agreement between electrolytes analyzed on serum in an autoanalyzer with that of ABG analyzer. We conclude that the electrolytes measured by a conventional autoanalyzer on a serum sample cannot be replaced by values analyzed on a blood gas analyzer. Devaki RN, Kasargod P, Roopa Urs AN, Chandrika N. A Retrospective Database Analysis to Investigate if Electrolytes in Venous Blood are Equivalent to the Levels in Arterial Blood. Indian J Crit Care Med 2024;28(5):442-446.

Identification of predictive factors for surgical site infections in gastrointestinal surgeries: A retrospective cross-sectional study in a resource-limited setting

Identification of predictive factors for surgical site infections in gastrointestinal surgeries: A retrospective cross-sectional study in a resource-limited setting

Diabetes control in public assistance recipients and free/low-cost medical care program beneficiaries in Japan: a retrospective cross-sectional study

IntroductionPrevious research has highlighted the association between socioeconomic factors and diabetes management. This study aimed to elucidate the blood glucose control status among individuals with low income (ie, recipients of...

IMPACT OF THE COVID-19 PANDEMIC ON THE REGULAR IMMUNIZATION OF CHILDREN IN THE MOSTAR HEALTH CENTER

Introduction: Vaccines for protection against 10 infectious diseases are available in the Program of Regular Immunization in the Federation of Bosnia and Herzegovina. These vaccines save the lives of up to 3 million people worldwide every year. The latest report of the Institute of Public Health of the Federation of Bosnia and Herzegovina on regular immunization carried out during 2020 shows that the rate of vaccination of children during the 2019 coronavirus disease (COVID-19) pandemic with regular vaccines has decreased compared to previous years. Such a situation in the health system leads to a potential risk of outbreaks of infectious diseases that are prevented by vaccination.Objective: To examine the impact of the COVID-19 pandemic on the regular immunization of children in the Mostar Health Center.Materials and methods: A retrospective cross-sectional epidemiological study was conducted. Data on regular immunization of children from theMostar Health Center, Herzegovina-Neretva County in the Federation of Bosnia and Herzegovina from 2017, 2018, 2021 and 2022 were used.Results: A statistically significant difference was obtained in vaccination against measles, mumps and rubella during a period of four years. Vaccination with the mentioned vaccines was significantly higher in 2017 and 2018 than in 2021 and 2022.Conclusion: It was shown that the COVID-19 pandemic affected the regular immunization of children in the Mostar Health Center.Keywords: regular immunization of children, COVID 19 pandemic, MMR vaccine, Mostar

Prediction models for COVID-19 disease outcomes

ABSTRACT SARS-CoV-2 has caused over 6.9 million deaths and continues to produce lasting health consequences. COVID-19 manifests broadly from no symptoms to death. In a retrospective cross-sectional study, we developed personalized risk assessment models that predict clinical outcomes for individuals with COVID-19 and inform targeted interventions. We sequenced viruses from SARS-CoV-2-positive nasopharyngeal swab samples between July 2020 and July 2022 from 4450 individuals in Missouri and retrieved associated disease courses, clinical history, and urban-rural classification. We integrated this data to develop machine learning-based predictive models to predict hospitalization, ICU admission, and long COVID. The mean age was 38.3 years (standard deviation = 21.4) with 55.2% (N = 2453) females and 44.8% (N = 1994) males (not reported, N = 4). Our analyses revealed a comprehensive set of predictors for each outcome, encompassing human, environment, and virus genome-wide genetic markers. Immunosuppression, cardiovascular disease, older age, cardiac, gastrointestinal, and constitutional symptoms, rural residence, and specific amino acid substitutions were associated with hospitalization. ICU admission was associated with acute respiratory distress syndrome, ventilation, bacterial co-infection, rural residence, and non-wild type SARS-CoV-2 variants. Finally, long COVID was associated with hospital admission, ventilation, and female sex. Overall, we developed risk assessment models that offer the capability to identify patients with COVID-19 necessitating enhanced monitoring or early interventions. Of importance, we demonstrate the value of including key elements of virus, host, and environmental factors to predict patient outcomes, serving as a valuable platform in the field of personalized medicine with the potential for adaptation to other infectious diseases.

Retrospective analysis of an outbreak of scarlet fever in United Arab Emirates.

Scarlet fever is an infectious disease caused by Streptococcus pyogenes. However, there is limited data regarding the disease in the Arab World, including the United Arab Emirates. To analyse a scarlet fever outbreak in United Arab Emirates. This retrospective cross-sectional study included scarlet fever cases diagnosed at the Kanad Hospital, Al Ain, United Arab Emirates in 2022 and 2023. Data were retrieved from the hospital records and analysed using SPSS version 23.0. Chi-Square, Mann-Whitney, and Monte Carlo tests were applied. Two hundred and twenty-two cases (13.5% in 2022 and 86.5% in 2023) were confirmed (P<0.001). Majority (67.1%) of the patients were aged 3-6 years, with a mean age of 4.56 ± 1.99 years. Rash, fever and sore throat were observed in 100%, 99.1%, and 82.0% of cases, respectively. The majority (85.1%) were managed as outpatients and 77.0% responded to oral penicillin. Patients' age was not significantly associated with nonresponse to penicillin and in-hospital admission. The outbreak had winter and summer peaks, with the highest incidence occurring during January and February 2023. This study serves as a valuable reference for other studies, which should include antimicrobial susceptibility testing and the prevailing genetic variance of Streptococcus pyogenes.

The Effect of Antibiotic Therapy Before Percutaneous Nephrolithotomy on the Frequency of Postoperative Complications: A Retrospective Cross-Sectional Study

Background: Percutaneous nephrolithotomy (PCNL) is commonly used in the treatment of large renal stones. Postoperative infections are a common consequence of these procedures. Objectives: The purpose of this study is to evaluate the effects of antibiotic therapy before PCNL on the possibility of developing fever and common complications after the procedure. Methods: We carried out a retrospective cross-sectional study involving 708 patients who had undergone PCNL at Razi Hospital in Rasht, covering the period from 2012 to 2022. Patients were allocated into two groups: Group 1 included 454 patients who had received antibiotic therapy, and group 2 included 254 patients who had not received pre-operative antibiotic therapy. Results: In group 1, there were 241 males (53.1%) and 213 females (46.9%), while in group 2, there were 138 males (54.3%) and 116 females (45.7%). In group 1, 82.7% of patients treated with antibiotics had a negative culture. The hospitalization time was 4.00 ± 1.75 days for group 1 and 2.26 ± 1.56 days for group 2. Fever was observed in 39 patients (11.2%) in group 1. Sepsis was seen in only one patient (0.3%) in group 1. There is a significant relationship between total hospitalization time (P = 0.000), hospitalization after the operation (P = 0.000), hypertension (P = 0.009), ischemic heart disease (P = 0.050), history of shock wave lithotripsy (P = 0.003), hydronephrosis (P = 0.000), age (P = 0.004), and hemoglobin levels (P = 0.000) with antibiotic therapy. Conclusions: Surgeon overprescription of antibiotics may lead to resistance, complicating outcomes and extending hospital stays after PCNL. Some complications remain unaffected by antibiotic therapy due to surgical experience.

Early Intervention in Septic Arthritis of the Hand, Optimizing Patient Outcomes in Hand Infections-A Five-Year Retrospective Study.

Background and Objectives: Hand septic arthritis is a potentially debilitating condition that can significantly affect patient functionality and quality of life. Understanding the demographic, clinical, and microbiological characteristics of this condition is crucial for its effective treatment and management. This study aimed to analyze the demographic and clinical profiles of patients with hand septic arthritis, to identify common microbial pathogens, and to evaluate the impact of various factors on clinical course and treatment outcomes. Material and Methods: This cross-sectional retrospective study examined patients diagnosed with septic arthritis of the hand, focusing on their demographic data, clinical presentation, causative organisms, treatment methods, and outcomes. Data on age, sex, cause of infection, affected sites, surgical interventions, microbiological findings, and patient outcomes were also collected. Results: This study found a higher prevalence of septic arthritis in males and identified bite as the predominant cause. Staphylococcus aureus is the most common pathogen. A large number of patients did not exhibit bacterial growth, and bacterial resistance did not significantly affect the outcome. Outcomes were statistically influenced by the timing of medical presentation and the presence of comorbidities. Conclusions: Early diagnosis and intervention are critical for effective management of hand septic arthritis. This study underscores the need for a comprehensive approach that considers patient demographic and clinical characteristics to optimize treatment outcomes. Awareness and preventive measures are essential to reduce the incidence and severity of this condition.

Waning of Humoral Immunity to Vaccine-Preventable Diseases in Children Treated for Acute Lymphoblastic Leukemia: A Single-Center Retrospective Cross-Sectional Analysis.

The survival rates of children with acute lymphoblastic leukemia (ALL) have improved over the years, but infections remain a significant cause of morbidity and mortality. Chemotherapy has a range of harmful side effects including the loss of protective antibodies against vaccine-preventable diseases. The objective of this study was to evaluate the serological status of pediatric ALL cases before and after the intensive chemotherapy. Children treated and followed up for ALL at Dokuz Eylül University were included in this retrospective cross-sectional study. Antibody levels against hepatitis A, hepatitis B, and rubella were routinely assessed both at the time of diagnosis and six months after completion of chemotherapy. However, measles, mumps, and varicella antibody levels were evaluated just six months after the treatment. Seventy-eight children who completed chemotherapy for ALL were recruited. All participants had nonprotective antibody levels for at least one of the diseases. The highest seropositivity rate was found for hepatitis A (55.1%) and the lowest for measles (17.9%) after chemotherapy. Overall, 50.7%, 30.6%, and 45.7% of the patients significantly lost their humoral immunity against hepatitis B, hepatitis A, and rubella, respectively. Patients in the higher-risk group for ALL had a lower seropositivity rate than the other risk group patients. There were statistically significant relations between the protective antibody rates of hepatitis A and varicella and the age of the patients. Except for the hepatitis A vaccination, pre-chemotherapy vaccination did not affect post-chemotherapy serology. On the other hand, all children with a history of varicella before the diagnosis showed immunity after chemotherapy. All patients, including those previously fully vaccinated, are at great risk of infection due to the decrease in protective antibody levels after chemotherapy. There is a need for routine post-chemotherapy serologic testing and re-vaccination based on the results obtained.

Odontogenic Tumors in Children and Adolescents: A Retrospective Analysis at a Tertiary-Level Health Care Facility in Bangladesh

Introduction: This study presents the oral and maxillofacial pathological features of several types of odontogenic tumors in children and adolescents less than 18 years of age from a Bangladeshi tertiary-level healthcare facility. Materials and Methods: In this retrospective cross-sectional study, the World Health Organization (WHO) categorization for head and neck tumors in 2022 was used to assess the frequency of odontogenic tumors in children and adolescents. Data relating to sex, age, and tumor site were retrieved and presented. The Chi-square test was implemented to study the association between gender, age, and site with different types of odontogenic tumors. Results: A total of 106 cases were found, and all the cases were benign. Ameloblatoma (75.47%) was the most common tumor, followed by odontogenic myxoma (9.44%), cemento-ossifying fibroma (5.66%), and odontoma (4.72%). A male (60.38%) predominance was observed in the gender distribution, but no statistically noteworthy (P = 0.43) relationship was found. Most of the cases were found in the 13–18 age group (63.21%), with a mean age (standard deviation) of 13.01 (2.29) years. There was no statistical significance found between age group and tumor type (P = 0.78). The mandibular (95.28%) predominance was found over the maxilla (4.72%) (Mandible: Maxilla = 20.2:1) and was statistically significant (P= 0.002). In the mandible, the posterior region (88.68%) was mostly affected. Conclusions: Early detection of odontogenic tumors is rare, and as people aged, they become more common. Ameloblatoma was the most prevalent odontogenic tumor in the jaws, followed by odontogenic myxoma, cemento-ossifying fibroma, and odontoma. Adolescents experience odontogenic tumors more frequently than children do. The mandible was observed to predominate over the maxilla in terms of site distribution. The mandible's posterior portion was primarily affected. Update Dent. Coll. j: 2024; 14(1):19-23

Influence of Organisational-Level Factors on Delayed Door-to-Balloon Time among Patients with ST-Elevation Myocardial Infarction.

This study aimed to estimate the door-to-balloon (DTB) time and determine the organisational-level factors that influence delayed DTB times among patients with ST-elevation myocardial infarction in Oman. A cross-sectional retrospective study was conducted on all patients who presented to the emergency department at Sultan Qaboos University Hospital and Royal Hospital, Muscat, Oman, and underwent primary percutaneous coronary interventions during 2018-2019. The sample included 426 patients and the median DTB time was 142 minutes. The result of the bivariate logistic regression showed that patients who presented to the emergency department with atypical symptoms were 3 times more likely to have a delayed DTB time, when compared to patients who presented with typical symptoms (odds ratio [OR] = 3.003, 95% confidence interval [CI]: 1.409-6.400; P = 0.004). In addition, patients who presented during off-hours were 2 times more likely to have a delayed DTB time, when compared to patients who presented during regular working hours (OR = 2.291, 95% CI: 1.284-4.087; P = 0.005). To meet the DTB time recommendation, it is important to ensure adequate staffing during both regular and irregular working hours. Results from this study can be used as a baseline for future studies and inform strategies for improving the quality of care.

Prevalence of Hemoplasma spp. positivity in potential feline blood donors and study of the association with selected clinical variables.

Hemotropic mycoplasmas, hemoplasmas, are epi-erythrocytic parasitic bacteria that can be transmitted through blood transfusion. To study the prevalence of hemoplasma infection of potential feline blood donors and investigate the association between Hemoplasma spp. quantitative polymerase chain reaction (qPCR) positivity in blood units and selected variables. Seven thousand five hundred seventy-three blood units from 4121 privately-owned potential donor cats. Retrospective observational cross-sectional study. The Banco Sangue Animal (BSA)-Animal Blood Bank medical database was reviewed for all feline donations performed in 2022 in Portugal, Spain, and Belgium. Baseline characteristics and results of blood-borne pathogens screening tests were extracted from the medical records. Two hundred twelve of 4034 Portuguese donor cats and 2 of 70 Spanish donor cats tested positive for Hemoplasma spp. qPCR in 2022 leading to an overall estimated prevalence of 5.2% (95% CI: 4.5%-5.9%) in potential blood donors. Using multivariable generalized estimation equation models, Hemoplasma spp. qPCR was more often positive among blood units issued from male cats (OR = 1.9, 95% CI: 1.4-2.6, P < .0001), units positive for FeLV (OR = 2.8, 95% CI: 1.4-5.6, P = .0023), and units collected in winter months (OR = 2.5, 95% CI: 1.7-3.6, P < .0001). This study underscores the importance of Hemoplasma spp. and other relevant blood-borne pathogens screening at every donation. Implementing stringent screening protocols is crucial to mitigate the risk of hemoplasma transmission via blood transfusions, thereby safeguarding the health and welfare of cats receiving transfusions.

Fertility and pregnancy outcomes in women with Turner syndrome: A single centre experience.

Many women with Turner syndrome (TS) will consider fertility options and pregnancy. We wished to examine the fertility and pregnancy outcomes in women with TS undergoing oocyte donation (OD) treatment or spontaneous pregnancy in a large single-centre cohort. General population reference dataor data from those with idiopathic premature ovarian insufficiencywere used as comparators. A retrospective single-centre cross-sectional study. Seventy-four women with TS underwent OD treatment with a total of 105 pregnancies, and 31 women with TS had 71 spontaneous conceptions. Fertility outcomes included clinical pregnancy and live birth rate. Pregnancy outcomes included miscarriage rate, prevalence of hypertension, gestational diabetes, lower segment caesarean section (LSCS), small for gestational age (SGA), prematurity and vertical transmission of TS. In those with TS, OD pregnancies were associated with increased rates of LSCS and SGA compared to spontaneous pregnancies; LSCS (OR: 4.19, 95% CI: 1.6-10.8,p = .003) and SGA (OR: 2.92, 95% CI: 1.02-8.38,p = .04). There were no recorded cardiac events but 5 (17.2%) cases of vertical transmissions of TS in daughters were identified. OD in those with TS was associated with a lower live birth rate per cycle started (OR: 0.53, 95% CI: 0.34-0.84,p = .008) and a higher rate of miscarriage compared to women with POI (40% vs. 26.2%,p = .04). We show that pregnancy in women with TS, whether OD or spontaneously conceived, carries obstetric risks, and therefore, women with TS, considering pregnancy, should receive comprehensive pre-pregnancy counselling and optimal obstetric care.

Socio-demographic and infrastructural variables influencing maternal risk concentration among ever-married women of reproductive age in rural West Bengal, India.

The risk of a woman dying as a result of pregnancy or childbirth during her lifetime is about one in six in the poorest parts of the world. The present study aims to determine prevalence of maternal risk and the influencing variables among ever-married women belonging to the reproductive age group (15-49) of Birbhum district, West Bengal. A cohort-based retrospective cross-sectional study was carried out among the sample of 229 respondents through a purposive stratified random sampling method and a pre-designed semi-structured questionnaire. The ordinal logistic regression (OLR) model was taken as a tool of assessment. Before developing the proportional OLR model, we have checked the multicollinearity effect among the predictors and the first-order effect modifier was evaluated as well. We performed data analysis using SPSS version 26. The result shows that illiterate women (Odds ratios [OR]=2.81, 95% CI, 0.277-1.791), from lower standard of living (OR=1.14, 95% CI, -0.845-1.116), married before the age of 15years (OR=21.96, 95% CI, -0.55-6.73) and between the age of 15-18years (OR=24.51. 95% CI, -0.45-6.85) are more likely to be affected by the higher concentration of maternal risk. Other important predictor is the time of pregnancy registration. Considering the transport and related en-route causalities, the result portraying a clear picture where the distance and travel time becoming significant factors in determining the concentration of maternal risk. Incidences of child marriages should be restricted. Eradicating factors influencing an individual's decision to seek care would be an essential contribution in excluding the dominant maternal risk factors.