Single-center Cross-sectional Study Research Articles

Systemic immune-inflammation index as a novel hematological marker for predicting the recurrence of deep venous thrombosis.

To determine whether there was a possible predictive relationship between systemic immune-inflammation index (SII) and recurrence of deep venous thrombosis (DVT). A total of 231 patients with DVT who met the study criteria and whose data could be accessed were enrolled to this retrospective single-centered cross-sectional study. Of them 26 patients with DVT recurrence consisted of the study group (Group 1) while remaining 205 cases without recurrence were considered as the control population (Group 2). The patients' basic clinical features and laboratory results from the complete blood count (CBC) test were recorded and compared between groups. Following univariate analyses, a multivariate logistic regression analysis was performed to identify the independent predictors of the recurrence of DVT. Additionally, a receiver-operating characteristic (ROC) curve analysis was performed to detect the cut-off values of the predictors with sensitivity and specificity rates. There were no significant differences between the groups for basic clinical features, except for diabetes mellitus, pulmonary embolism, and atrial fibrillation. Although the univariate analysis revealed that the median values of NLR, PLR, and SII were significantly higher in the DVT recurrence group, only SII was determined to be a significant and independent predictor of DVT recurrence in the multivariate logistic regression analysis. According to ROC curve analysis, SII of 1685 × 103/mm3 constituted the cut-off value for predicting DVT recurrence with 61.5% sensitivity and 76.6% specificity (AUC = 0.686, p = .001). The present study demonstrated for the first time in the literature that SII significantly predicted the recurrence of DVT.

Peg-asparaginase associated toxicities in children with acute lymphoblastic leukemia: A single-center cross-sectional study

BackgroundLeukemia is the most prevalent type of cancer affecting children, representing approximately 35% of cancer diagnoses in Saudi Arabia. Notably, significant improvement in the overall survival and cure rates for pediatrics with acute lymphoblastic leukemia (ALL) has been attributed to adding asparaginase to the chemotherapy regimen. However, the administration of these agents may lead to a multifactorial range of toxicities that often alter treatment outcomes. ObjectiveThe study aimed to characterize the prevalence of common toxicities related to polyethylene glycol (PEG) asparaginase in children aged 0–14 years diagnosed with ALL. Additionally, it assessed the types of toxicities associated with intravenous (IV) and intramuscular (IM) administration of Peg-asparaginase. MethodIt was an observational retrospective cross-sectional study. Data was extracted from the hospital's electronic health record (EPIC). Using EPIC, we reviewed medical charts of all pediatric patients below 14 years old diagnosed with ALL who received at least one dose of PEG-asparaginase between January 2020 and March 2023. The toxicity grading was based on the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE). ResultsOne hundred and ninety-one patients with ALL were included in the study. Overall, 79 toxicity episodes were experienced by the study patients. Anaphylaxis/hypersensitivity (36.7%) and hepatotoxicity (31.6%) were the most prevalent toxicities reported, followed by pancreatitis and hyperglycemia (12.7% each). According to the CTCAE grading, approximately 70% of toxicities were categorized as Grade 3 and 4. Notably, 60% of the events occurred during the induction and consolidation phase of therapy. Interestingly, there was no significant difference in rates of toxicities between patients receiving IV or IM PEG-asparaginase. ConclusionThe distribution of toxicities highlighted in our study aligns with findings from previously published studies. Furthermore, multivariate analysis indicated that patients with high-risk ALL and T-ALL were more likely to develop toxicities compared to other forms of ALL.

Knowledge, attitude, and practice of healthcare providers on chronic refractory cough: A cross-sectional study

ObjectivePrevious studies from outside China showed that the knowledge, attitudes, and practice (KAP) of chronic refractory cough (CRC) was moderate among physicians. This study examined the KAP toward CRC in Chinese healthcare providers. MethodsThis single-center cross-sectional study was conducted at The Sixth Affiliated Hospital of Nantong University, Yancheng Third People's Hospital, from July 2022 to January 2023 and enrolled healthcare providers. The demographic characteristics and KAP scores were collected using a questionnaire (Cronbach's α = 0.934) developed based on CRC guidelines. ResultsThe study included 539 healthcare providers. The mean knowledge score was 8.27 ± 2.37 (maximum of 14, 59.07%), indicating poor knowledge. The highest rates of inaccuracies pertained to knowledge about the definition of chronic cough, empirical treatment methods, and potential risks of different treatments, suggesting a need for unified training in all aspects of CRC for medical staff. The mean attitude score was 49.74 ± 63.63 (maximum of 60, 82.90%), indicating favorable attitudes. Most healthcare providers believed that CRC affects normal work and life and that it would be necessary to provide more help to patients from the perspectives of drug treatment and psychological counseling. The mean practice score was 23.20 ± 6.28 (maximum of 35, 66.29%), indicating poor practice. ConclusionThis study suggests that healthcare providers in Yancheng have poor knowledge, favorable attitudes, and poor practice of CRC. This study provides points that should be targeted in future training and continuing education activities.

Covid-19 vaccination in pregnancy and placental pathology

Objective: To describe and determine the association between Covid-19 vaccination in pregnancy and placental pathology. Methods: Conducted in a tertiary hospital in Medan, Indonesia, from April 30th 2022 to June 30th 2022, this single-center cross-sectional study involved Covid-19 vaccinated and unvaccinated women with singleton full-term pregnancies delivering live fetuses via cesarean section. Maternal characteristics, placental pathologies, and the placental index were documented at enrollment. The association between Covid-19 vaccination status and placental pathology was assessed. Results: The study enrolled 200 pregnant women, including 110 vaccinated women and 90 unvaccinated women. No significant differences were observed in birthweight (P=0.48), placental index (P=0.48), and placental pathology findings [intervillous bleeding (P=0.20), increased syncytial knots (P=0.83), chorangiosis (P=0.13), villous stromal edema (P=0.13), vascular dilation and congestion (P=0.13), and vascular wall thrombus (P=0.71)] between the vaccinated and unvaccinated groups. Conclusions: This study revealed no statistically significant association between Covid-19 vaccination and placental pathology. The findings support the safety of Covid-19 vaccination during pregnancy, in regards to changes of the placental pathology.

Influence of Donor Factors on Descemet Membrane Endothelial Keratoplasty (DMEK) Graft Preparation Outcome.

To determine which donor characteristics, like previous diseases and surgeries, influence the severity of the DM/endothelial lamella preparation prior to DMEK-surgery. Retrospective cross-sectional single-center study is presented. Eight hundred and forty-six eyes with DMEK-surgery between 01/2018 and 01/2021 performed at the University Hospital Cologne, Germany, were included. Information regarding the donors' previous diseases and surgeries were provided by a large database of a cornea bank (Multi Tissue Bank Mecklenburg-Vorpommern) and merged with the Cologne DMEK database, which contains information regarding preparation characteristics of the surgeon-prepared graft directly preoperatively. Three preparation groups (easy, difficult and very difficult) were correlated to the donors' previous diseases and surgeries. The following characteristics were used for the assignment in one of the three groups: stripping difficulty, rolling and staining behavior, central and peripheral adherences, tissue fragility and DM-splitting. Significant risk factors for DM-splitting were diabetes mellitus (DMel) type II, heart failure, chronic kidney disease and previous cataract surgery (p=0.022, p=0.012; p=0.047 and p<0.001 respectively). Previous DMel (especially type 2) was significantly associated with the occurrence of central adherences (p=0.009). Several cardiovascular diseases (p-values between <0.001 and p=0.038), DMel type II, chronic kidney disease and previous cataract-surgery were associated with peripheral adherences (p=0.004; p=0.020 and p<0.001 respectively). Furthermore, pseudophakic donor eyes presented a higher degree of fragility of the graft (p<0.001). Age was a significant risk factor for difficult preparation (p<0.001). The staining of the graft was poorer in donors with chronic kidney disease (p=0.037). Donor diabetes mellitus type 2, heart failure, previous cataract surgery, chronic kidney disease and age are associated with a difficult DMEK graft preparation. For every one-year increment in donor age, the odds of having very difficult preparation were increased by 3%. Also, chronic kidney disease predisposes to a poor tissue staining with trypan blue during preparation.

Comprehensive analysis of vulnerability status and associated affect factors among prehospital emergency patients: a single-center descriptive cross-sectional study.

Prehospital emergency care is a critical but often understudied aspect of healthcare. Patient vulnerability in this setting can significantly impact outcomes. The aim of this study was to investigate the vulnerability status and to determine associated affect factors among prehospital emergency patients in China. In this cross-sectional study conducted in China, from April 2023 to July 2023, we assessed the vulnerability of prehospital emergency patients using the Safety in Prehospital Emergency Care Index (SPECI) scale. We conducted a detailed questionnaire-based survey to gather demographic and disease-related information. We employed the SPECI scale, consisting of two subscales, to evaluate patient vulnerability. Statistical analyses, including t-tests, ANOVA, and multiple linear regression, were used to identify factors associated with vulnerability. The study included a total of 973 prehospital emergency patients, with a response rate of 81.9%. These patients exhibited a low-to-moderate level of vulnerability, with an average SPECI score of 14.46 out of 40. Vulnerability was significantly associated with age (particularly those aged 60 and above), disease severity (severe conditions increased vulnerability), disease type (circulatory diseases correlated with higher vulnerability), alterations in consciousness, and chronic diseases. Unexpectedly, digestive system diseases were negatively correlated with vulnerability. Addressing patient vulnerability in prehospital care is essential. Tailored interventions, EMS provider training, and interdisciplinary collaboration can mitigate vulnerability, especially in older patients and those with severe conditions.

Use of a Handheld Ultrasonographic Device to Identify Heart Failure and Pulmonary Disease in Rural Africa

Agreement in lung ultrasonography findings between clinicians using a handheld ultrasonographic device and expert sonographers using a high-end ultrasonographic machine has not been studied in sub-Saharan Africa. To determine the agreement in ultrasonographic findings and diagnoses between primary care clinicians trained in lung ultrasonography, board-certified expert sonographers, and senior physicians. This cross-sectional single-center study was conducted from February 1, 2022, to April 30, 2023 at a referral center in rural Tanzania. Individuals 5 years or older with respiratory symptoms and at least 2 distinct respiratory signs or symptoms were eligible. A total of 459 individuals were screened. Participants provided their medical history and underwent a clinical examination and lung ultrasonography performed by a clinician, followed by a lung ultrasonography performed by an expert sonographer, and finally chest radiography and a final evaluation performed by a senior physician. Other tests, such as echocardiography and Mycobacterium tuberculosis testing, were conducted on the decision of the physician. Clinicians received 2 hours of instruction and three 2-hour sessions of clinical training in the use of a handheld lung ultrasonographic device; expert sonographers were board-certified. Percentage agreement and Cohen κ coefficient for sonographic findings and diagnoses compared between clinicians and expert sonographers, and between clinicians and senior physicians. The median (IQR) age of 438 included participants was 54 (38-66) years, and 225 (51%) were male. The median (range) percentage agreement of ultrasonographic findings between clinicians and expert sonographers was 93% (71%-99%), with κ ranging from -0.003 to 0.83. Median (range) agreement of diagnoses between clinicians and expert sonographers was 90% (50%-99%), with κ ranging from -0.002 to 0.76. Between clinicians and senior physicians, median (range) agreement of diagnoses was 89% (55%-90%), with κ ranging from -0.008 to 0.76. Between clinicians and senior physicians, diagnosis agreements were 85% (κ, 0.69) for heart failure, 78% (κ, 0.57) for definite or probable tuberculosis, 50% (κ, 0.002) for viral pneumonia, and 56% (κ, 0.06) for bacterial pneumonia. In this cross-sectional study, the agreement of ultrasonographic findings between clinicians and sonographers was mostly substantial. Between clinicians and senior physicians, agreement was substantial in the diagnosis of heart failure, moderate in the diagnosis of tuberculosis, but slight in the diagnosis of pneumonia. These findings suggest that handheld ultrasonographic devices used in addition to clinical examination may support clinicians in diagnosing cardiac and pulmonary diseases in rural sub-Saharan Africa.

Psychological Distress Associated with Enforced Hospital Isolation Due to COVID-19 during the "Flatten the Curve" Phase in Morocco: A Single-Center Cross-Sectional Study.

(1) Background: although much research has highlighted the mental health challenges faced by patients in hospital isolation during the COVID-19 pandemic, data from low-middle-income countries, including Morocco, are lacking. The main objective of this study was to assess the psychological distress of patients undergoing enforced hospital isolation during the initial phase of the COVID-19 pandemic in Morocco. (2) Methods: we conducted a cross-sectional study between 1 April and 1 May 2020, among patients hospitalized in isolation for suspected or confirmed COVID-19 at the Ibn Sina University Hospital of Rabat, Morocco. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS). Binary logistic regression was performed to identify variables associated with anxiety and depression, with a cutoff of ≥8 used for both scales to create dichotomous variables. (3) Results: among 200 patients, 42.5% and 43% scored above the cut-off points for anxiety and depression, respectively. Multiple logistic regression identified female gender, a higher education level, a longer duration of isolation, and a poor understanding of the reasons for isolation as significant factors associated with anxiety. Conversely, female gender, chronic disease, a longer duration of isolation, and a poor understanding of the reasons for isolation were factors significantly associated with depression. (4) Conclusions: our study underscores high rates of anxiety and depression among patients forced into hospital isolation during the initial phase of COVID-19 in Morocco. We identified several factors associated with patients experiencing psychological distress that may inform future discussions on mental health and psychiatric crisis management.

Metabolic Dysfunction Associated Liver Disease in Patients Undergoing Coronary Computed Tomography Angiography.

In this single-center cross-sectional study on patients undergoing coronary computed tomography angiography (CCTA), we assessed the prognostic significance of metabolic dysfunction associated steatotic liver disease (MASLD), metabolic syndrome (MetS), and CCTA-derived parameters for predicting major adverse cardiovascular events (MACE). Over a mean follow-up of 26.9 months, 2038 patients were analyzed, with 361 (17.7%) experiencing MACE. MASLD was associated with a higher MACE incidence (25.90% vs. 14.71% without MASLD, p < 0.001). Cox regression revealed significant associations between MASLD, coronary calcium score (CCS), number of plaques (NoP), epicardial fat volume (EFV), and MACE, with hazard ratios of 1.843, 1.001, 1.097, and 1.035, respectively (p < 0.001 for all). A composite risk score integrating CCS, NoP, EFV, and MASLD demonstrated superior predictive value for MACE (AUC = 0.948) compared to individual variables (p < 0.0001 for all). In conclusion, MASLD is linked to an elevated risk of MACE, and a comprehensive risk-scoring system incorporating imaging and clinical factors enhances MACE prediction accuracy.

Factors Associated with Malaria in Pregnancy among Women Attending Fort Portal Regional Referral Hospital in Fort Portal City, Western Uganda

Globally, there was a significant decrease in the number of malaria-risk pregnancies between 2007 and 2020. The risk of Plasmodium falciparum or Plasmodium vivax malaria increased by 25% in Africa compared to 2007. Due to the fast-expanding population and associated rise in pregnancies in malaria-endemic areas, the number of people at risk in Africa has increased despite malaria rates declining in the region. This study determined the prevalence and factors associated with malaria in pregnancy among women attending Fort Portal Regional Referral Hospital. This was a single-center health facility-based cross-sectional study. Data was collected using a face-to-face interview through a structured questionnaire from willing participants. After collecting the data, the principal investigator checked the completed questionnaires for consistency and completeness. Data was coded, cleaned, and entered into the computer using Microsoft Excel, and then analyzed using SPSS version 20. Logistic regression analysis was done to ascertain the relationship between dependent and independent variables. Descriptive statistics were summarized in the form of frequency tables, pie charts, p-values, and odds ratios. A total of 253 pregnant mothers attending ANC were enrolled in this study. The majority (38.3%) of the study participants were aged 30-39 years, attained secondary education (52.2%), earned 100,000–200,000 per month (56.9%), and were housewives (51.0%). In this study, the prevalence of malaria in pregnancy was 10.3%. Age, level of education, income status, and residence, use of an ITN, gravidity, and ANC follow-up were significantly associated with malaria in pregnancy at multivariate logistic regression analysis. Malaria continues to be a major public health issue among pregnant mothers. Age, level of education, income status, and residence, use of an ITN, gravidity, and ANC follow-up were factors significantly associated with malaria in pregnancy. Keywords: Pregnancies, Malaria, Plasmodium, ITN, ANC.

Comparison of body mass index and fat mass index to classify body composition in adolescents—The EVA4YOU study

The objectives of this study were to develop age- and sex-specific reference percentiles for fat mass index (FMI) and fat-free mass index (FFMI) in adolescents aged 14 to 19 years and to determine differences in overweight/obesity classification by FMI and body mass index (BMI). The EVA4YOU study is a single-center cross-sectional study conducted in western Austria. Cardiovascular risks including anthropometric measurements and bioelectrical impedance analysis were assessed in adolescents (mean age 17 years). FMI and FFMI were calculated as the ratio of fat mass (FM) and fat-free mass (FFM) to the square of height and compared to study population–specific BMI percentiles. One thousand four hundred twenty-two adolescents were included in the analysis. Girls had a significantly higher mean FM and FMI and a significantly lower mean FFM, FFMI (p < 0.001, each), and mean BMI (p = 0.020) than boys. Body composition classification by FMI and BMI percentiles shows a concordance for the < 75th and > 97th percentile, but a significant difference in percentile rank classifications between these two cut-off values (all p < 0.05). Based on FMI, 15.5% (221/1422) of the whole population and 29.4% (92/313) of those between the 75th and 97th percentiles are classified one category higher or lower than those assigned by BMI. Conclusion: Classification of normal or pathologic body composition based on BMI and FMI shows good accordance in the clearly normal or pathologic range. In an intermediate range, FMI reclassifies categories based on BMI in more than a quarter of adolescents. Cut-off values to differentiate normal from pathologic FMI values on a biological basis are needed.Trial registration: The study is registered at www.clinicaltrials.gov (Identifier: NCT04598685; Date of registration: October 22, 2020).What is Known:• Chronic non-communicable diseases (NCDs) are the leading cause of morbidity and mortality globally, with major risk factors including unhealthy diets, harmful behaviors, and obesity. Obesity in children and adolescents is a key risk factor for later NCDs, which is commonly measured by Body Mass Index (BMI).• BMI can be misleading as it doesn't distinguish between fat mass (FM) and fat-free mass (FFM), leading to potential misclassification of obesity in children. Previous studies have already suggested the use of the Fat Mass Index (FMI) and Fat-Free Mass Index (FFMI) as a more accurate measures of body composition.What is New:• This study adds the first age- and sex-specific reference values for FMI and FFMI in Austrian adolescents using bioelectrical impedance analysis (BIA) as a safe and secure measurement method of a large representative cohort.• We found percentile misclassification between BMI and FMI when categorizing for obesity, especially in intermediate categories of body composition. Furthermore, when comparing the new reference values for FMI and FFMI to existing ones from the US, UK, and Germany we could show a good alignment within the European cohorts and major differences with American values, indicating and confirming the difference of FMI and FFMI for different populations of different ethnical background, living on different continents.

Determinants of non-alcoholic fatty liver disease in young people: Maternal, neonatal, and adolescent factors.

To assess the impact of maternal, neonatal, and adolescent factors on the development of non-alcoholic fatty liver disease (NAFLD) in a cohort of 14- to 19-year-old adolescents. This study is part of the Early Vascular Ageing in the YOUth study, a single-center cross-sectional study conducted in western Austria. Maternal and neonatal factors were extracted from the mother-child booklet, adolescent factors were evaluated by a face-to-face interview, physical examination, and fasting blood analyses. Liver fat content was assessed by controlled attenuation parameter (CAP) using signals acquired by FibroScan® (Echosense, Paris, France). The association of maternal, neonatal, and adolescent factors with CAP values was analyzed using linear regression models. In total, 595 adolescents (27.2% male) aged 17.0 ± 1.3 years were included. 4.9% (n = 29) showed manifest NAFLD with CAP values above the 90th percentile. Male sex (p < 0.001), adolescent triglyceride levels (p = 0.021), Homeostatic Model Assessment for Insulin Resistance index and BMI z-score (p < 0.001, each) showed a significant association with liver fat content in the multivariable analysis. Maternal pre-pregnancy BMI was associated with CAP values after adjustment for sex, age, and birth weight for gestational age (p < 0.001), but this association was predominantly mediated by adolescent BMI (indirect effect b = 1.18, 95% CI [0.69, 1.77]). Components of the metabolic syndrome were the most important predictors of adolescent liver fat content. Therefore, prevention of NAFLD should focus on lifestyle modification in childhood and adolescence.

Mortality Analysis in Geriatric Patients With Acute Kidney Injury Admitted in the Intensive Care Unit: A Single-Center Cross-Sectional Study.

Introduction Acute kidney injury (AKI) is an abrupt reduction in kidney function that causes nitrogenous waste and other waste products to be retained. Methods This cross-sectional study wasconducted from February 2015 to January 2016. The study received approval from the Independent Ethics Committee, which included patients over 60 with AKI.The study duration was 12 consecutive months to ascertain the etiology, severity, and hospital outcomes of AKI. Results The common etiologies of AKI included drug-induced (25%), age-related (21.67%), cardiac (13.33%), respiratory (20%), tropical (15%), and pancreatitis (15%) cases. Another predominant etiology observed was obstructive nephropathy (55%), with the highest (37.5%) mortality rate. The distribution of patients based on KDIGO criteria showed no significant difference in mortality percentages among classes (p=0.177). Conservative management without renal replacement therapy was the most common approach to treat AKI, with a 39% mortality rate. Conclusion Among different causes of AKI in the geriatric age group, drug-induced AKI, and obstructive nephropathywere predominantly associated with hospital mortality.

Assessment and Factors Contributing to the Quality of Life in Diabetes Mellitus Patients: A Cross-Sectional Single-Center Study.

Introduction Diabetes mellitus(DM) is one of the most commonchronic illnesses worldwide, with its prevalence rising rapidly every year. This condition adversely affects vasculature, leading to several potentially devastating complications like cerebrovascular mishaps, myocardial infarction, retinal damage, and renal compromise. These sequelae could lead to serious disabilities and negatively impact quality of life (QoL). Objectives This study aims to assess the QoL of adult diabetic patients in Saudi Arabia and determine influencing socio-demographic factors. Methods This is a cross-sectional study targeting adult diabetic patients visiting the Imam Medical Center in Riyadh, Saudi Arabia, from October 2022 to June 2023. The study encompasses diabetic patients of both genders aged 18 or more but excludes those diagnosed recently, i.e., within less than one year. A validated Arabic questionnaire, available online, was used to assess the QoL of the diabetic patients enrolled in this study. The sample size was 244 adult diabetic patients recruited from the Imam Medical Center through their official social media sites. Results The cohort of 244 patients recruited in this study were mostly aged between 18 and 30 (44.7%), females (52.5%), and married (47.5%). Furthermore, 58.6% of the participants were found to hold a bachelor's degree, 48.8% were employed, and 36.1% earned less than 5000 Saudi riyals each month. Of the total patients, 36.5% were diagnosed with diabetes 1-5 years ago, while 30.5% were diagnosed 5-10 years ago. Type 1 diabetes afflicted 48.4% of participants, whereas 47.1% were affected by type 2 diabetes. It was also determined that type 2 diabetic patients have higher overall QoL scores than type 1 diabetic patients. QoL had a high mean score of 22.05±4.4. The psychological/spiritual domain has the greatest mean score of 24.06±5.4, while the social and economic domain has the lowest (20.58±4.6). The majority of participants (71.3%) did not have other chronic conditions, whereas hypertension (18%) is the prevalent comorbidity, followed byrespiratory ailments (7.4%) and cardiovascular disease (3.3%). Furthermore, people with hypertension had a higher total QoL and four life domain scores than those with cardiovascular and respiratory disorders. Conclusion The relevance of the findings is that it could aid health practitioners in developing techniques to encourage patients to undertake self-care to improve physiological management of the condition and reduce complications.

Association Between Anterior Hip Capsule Thickening and Sagittal Pelvic Alignment Among Patients With Developmental Dysplasia of the Hip.

The pathogenesis and pathology of secondary osteoarthritis (OA) of the hip, which is mainly due to developmental dysplasia of the hip (DDH), in Japan are obscure. There are some reports on the thickening of the hip capsule, but the relationship between the thickness of the hip capsule and the pelvic alignment due to hip deformity is not well known. This research investigated whether the capsular thickness of female DDH patients was related to pelvic alignment. This single-center cross-sectional study included female patients aged 50-79 years (n=13) who had undergone primary total hip arthroplasty (THA) due to secondary hip OA with a background of DDH. The part of the hip capsule including the iliofemoral ligament was resected and measured directly with a digital caliper. The Sharp angle, center-edge (CE) angle, sacral slope (SS), pelvic tilt (PT), pelvic incidence (PI), and lumbar lordosis angle (LLA) were measured with an X-ray image to investigate the relationship between the capsular thickness and the pelvic posture. Pearson's correlation coefficient showed a negative correlation between hip capsular thickness and Sharp angle (r=-0.57, p>0.05). No significant correlation was found between the thickness of the hip capsule and the sagittal X-ray parameters including SS, PT, PI, LLA, and CE angle in the coronal plane. The thickness of the hip capsule is moderately associated with the Sharp angle on the coronal plane. The results of this study suggest that the thickness of the joint capsule does not necessarily relate to the degenerative process among patients with DDH and the process can be complex to apply two-dimensional postural indices for the explanation.

Insomnia among coronavirus disease 2019 survivors: A single-center cross-sectional study.

Since the coronavirus disease 2019 (COVID-19) epidemic, insomnia has become one of the longer COVID-19 symptoms. This study aimed to investigate insomnia among COVID-19 survivors and explore the occurrence and influencing factors of insomnia. A cross-sectional study was performed from December 2022 to February 2023 through an online questionnaire star survey with 8 questions. The insomnia severity index scale (ISI) was used to assess the severity of insomnia. Univariate analysis was used to analyze the factors related to COVID-19 infection. A total of 564 participants (183 males and 381 females) were surveyed in the present study. The prevalence of insomnia was 63.12%. Among these insomnia patients, there were 202 (35.82%) with sub-threshold symptoms, 116 (20.57%) with moderate symptoms, and 38 (6.74%) with severe symptoms. Univariate analysis indicated that there were statistically significant differences in the prevalence of insomnia among COVID-19 survivors of different ages, occupations, and educational levels (P < .05). Of the 356 insomnia patients, 185 (51.97%) did not take any measures against insomnia, while those who took drugs only, physical exercise only, drugs and physical exercise, and other measures were 90 (25.28%), 42 (11.80%), 17 (4.78%), and 22 (6.18%), respectively. Additionally, of the 107 insomnia patients with drug therapy, 17 (15.89%) took estazolam, 16 (14.95%) took alprazolam, 39 (36.45%) took zopiclone, and 35 (32.71%) took other drugs to improve insomnia symptoms. The prevalence of insomnia symptoms remains high among COVID-19 survivors in China. Education level and occupation may be the influencing factors. Unfortunately, most patients with insomnia do not take corresponding treatment measures.

Relationship Between COVID-19 and MINOCA: A Pilot Cross-Sectional Study

Introduction: Evidence suggests that COVID-19 infection increases the likelihood of myocardial infarction with no obstructive coronary arteries (MINOCA), particularly in females. This study hypothesizes that patients with COVID-19 and acute myocardial infarction (AMI) who underwent coronary angiography will have a higher proportion of MINOCA than those with AMI without COVID-19. Objective: This study aimed to assess if COVID-19 infection is associated with MINOCA in patients who underwent coronary catheterization. Methods: This was a single-center cross-sectional pilot study that gathered information using the electronic medical records of a tertiary care institution between February 2020 and October 2021. Patients were divided into two groups: those with AMI and COVID-19 (AMICOVID+) and those with AMI without COVID-19 (AMICOVID-). The primary outcome was to evaluate the relationship between COVID-19 and MINOCA, expressed in relative frequencies and p-values calculated by the Chi-squared test and corroborated by a sensitivity analysis using logistic regression. Results: Of the 28 patients that met the inclusion criteria, 14 (50%) had AMICOVID+, and 14 (50%) had AMICOVID-. MINOCA was significantly higher in the group with AMICOVID+ compared to AMICOVID- (85.7% vs. 21.4%. p = 0.001), showing no effect modification when sensitivity analysis was carried on. The raw data for statistical analyses was also included in the appendices. Conclusion: MINOCA was in a significantly higher proportion in the AMICOVID+ group than in the AMICOVID- group. However, this study had a small sample size; therefore, these results must be corroborated in different populations with larger sample sizes.

Role and relevance of dentists in a multiprofessional palliative care team: results of a cross-sectional survey study

PurposeDespite the multiprofessional concept surrounding palliative care patients (PCPs) and their high prevalence of oral issues, licensed dentists (LDs) are often not included in their treatment team. This study aimed to examine the current state of cooperation and to determine whether and how LDs should be included in the care for PCPs.MethodsThis single-centre cross-sectional study was conducted at the University Hospital Muenster, Germany. We surveyed three participant groups: PCPs, LDs, and healthcare professionals (HCPs). Questionnaires were tailored for each group, with some questions common for comparison.ResultsThe study encompassed the results of 48 questionnaires from LDs, 50 from PCPs along with 50 from HCPs. Consensus was reached among all parties (LDs: 73% (n = 35/48); HCPs: 94%, n = 47/50; PCPs: 60%, n = 30/50) that involving LDs in the treatment concept is favourable. On the other hand, a significant discrepancy emerged in the perception of the dental treatment effort required by PCPs. While LDs (81%; n = 39/48) and HCPs (64%; n = 32/50) were convinced of increased effort, PCPs (34%; n = 17/50) largely did not share this perspective. To enhance patient care and formulate appropriate treatment plans, LDs consider both training (58%; n = 28/48) and guidebooks (71%; n = 34/48) to be valuable and would attend or use such resources.ConclusionThis study sheds light on the current gaps in including LDs in palliative care teams and emphasizes the importance of multidisciplinary collaboration to address oral health needs effectively. Development of continuing education options and collaborative models between LDs and HCPs needs to be further expanded in future.

COVID-19 Ocular Manifestation: A Cross-Sectional Study

Introduction The world is infected with a new strain of the coronavirus family known as COVID-19. This virus strain attacked several organs in the human body, causing symptoms ranging from mild to severe and, in some cases, life-threatening. Multiple organs, including the eye, can get infected. Methods The study was a single-center prospective cross-sectional study that included patients with a recent COVID-19 infection. The study was conducted in the ophthalmology department of Erbil Teaching Hospital in Erbil City from June 2021 to April 2022. The participants were recruited from the outpatient clinic in a non-probability convenience sampling way. Results The study included 75 patients. The most common ocular disease encountered in COVID-19 patients was posterior subcapsular cataract (12, 16.0%). Their ages are between 26 and 56 years old. The cataract developed in twelve patients (12, 16.0%), and it was bilateral in nine cases (18 eyes) with a varying degree of density. The next most common manifestation was multiple punctate epitheliopathy found in nine patients, which was bilateral in all of them. Follicular conjunctivitis was encountered in eight patients; it resolved in a period of 5 to 8 days after the prescription of topical anti-inflammatory medications. Conclusion COVID-19 infection is a multi-systemic disease that can cause a variety of ocular clinical symptoms and complications. Blurred vision and conjunctivitis-like features are the most common ocular presentations of the infection.

An observational study ascertaining the prevalence of bullae and blebs in young, healthy adults and its possible implications for scuba diving.

Introduction: Intrapulmonary air-filled cavities, e.g., bullae, blebs, and cysts, are believed to contribute topulmonary barotrauma (PBT) and arterial gas embolism (AGE) in divers. However, literature is unclear about the prevalence of bullae in healthy adults, ranging from 2.3-33.8%. While this could in part be explained due to increasing quality of radiologic imaging, such as computed tomography (CT) scans, other methodological factors may also affect these findings. This study aims to ascertain the prevalence of bullae in young and healthy adults. Methods: This single-center cross-sectional observational study re-assessed the CT scans of adults (aged 18-40) performed for a clinical suspicion for pulmonary embolism, from 1 January 2016 to 1 March 2020. Presence of bullae was recorded in an electronic database. Chi-square and Fisher exact tests were used for statistical analyses. Additionally, a multivariate logistic regression analysis was performed to study the independent predictive value of identified risk factors. Results: A total of 1,014 cases were identified, of which 836 could be included. Distribution amongst age groups (18-25, 26-30, 31-35, and 36-40) was almost equally, however, 75% of the population was female. Of the male proportion, 41% smoked, compared to 27% in females. In 7.2% (95% CI 5.6-9.1) bullae were identified. The prevalence increased with increasing age (p < 0.001), with odd ratios up to 5.347 (95% CI 2.164-13.213, p < 0.001) in the oldest age group. Males and smokers had higher odds ratios for bullae of 2.460 (95% CI 1.144-4.208; p = 0.001) and 3.406 (95% CI 1.878-6.157, p < 0.001), respectively. Similar results were seen in the multivariate logistic regression analysis, where age, male sex and smoking were all statistically significant independent risk factors for bullae. Discussion: Bullae were seen in 7.2% of a healthy population up to 40years old. Increasing age, smoking, and being male were identified as statistically significant risk factors, both in independent and in multivariate logistic regression analyses. Our observations may warrant a re-evaluation of the contribution of bullae to PBT and AGE, as the latter two occur very rarely and bullae appear to be more frequently present than earlier assumed.