Health Care Centers Research Articles

Pattern of Utilization of Antenatal Care Services and Adherence Among Females Following Up at Primary Healthcare Centers in Al-Ahsa.

Background Antenatal care (ANC) is a crucial component of maternal and child health, yet disparities in utilization persist globally. This study aimed to assess the patterns of ANC service utilization and adherence among pregnant women attending primary healthcare centers (PHCCs) in Al-Ahsa, Saudi Arabia. Methodology A quantitative, cross-sectional study was conducted among 277 women attending PHCCs in Al-Ahsa. Data were collected through structured questionnaires, assessing demographic characteristics, ANC follow-up patterns, structural and personal barriers, and mental health conditions using the Depression, Anxiety, and Stress Scale. Results Significant regional variations in ANC follow-up patterns were observed, with higher proportions of pregnant women attending ANC in the Middle and Eastern regions. Prominent structural barriers included transportation challenges (structural barrier 3, 61.0%) and limited service availability (structural barrier 6, 56.0%), while personal barriers encompassed transportation problems (personal barrier 6, 36.8%) and forgetfulness regarding appointments (personal barrier 4, 19.9%). Mental health assessments revealed predominantly normal levels of depression, anxiety, and stress, with some regional variations in distress levels. Conclusions The study highlights regional disparities in ANC service utilization and adherence, influenced by structural barriers, personal barriers, and mental health conditions. Tailored interventions addressing these barriers, improving access to care, and providing targeted support are crucial for enhancing ANC service utilization and promoting maternal and child health in Al-Ahsa.

Depression and Anxiety Screening of Patients With Type II Diabetes Mellitus Attending Primary Healthcare Centers in Saudi Arabia.

Diabetes mellitus is a chronic condition affecting both physical and mental health. High blood sugar levels can lead to serious complications if not managed properly. Individuals with diabetes are also at a higher risk of developing mental health disorders like depression and anxiety. The objective was to assess the prevalence of depression and anxiety among patients with type II diabetes attending primary healthcare centers in Makkah, Saudi Arabia. An analytical cross-sectional study design was employed, targeting adults with type II diabetes attending primary healthcare centers in Makkah. A total sample size of 412 participants was selected through systematic random sampling. Data were collected using validated Arabic versions of the patient health questionnaire (PHQ-9) and the general anxiety disorder (GAD-7) questionnaire, along with demographic information. Statistical analysis was conducted with non-parametric tests used to evaluate the significance of outcome variables. The median age of participants was 47 years, with 237 (57.5%) being male and 373 (90.5%) Saudi nationals. Neuropathy was the most prevalent complication, affecting 181 (43.9%) of participants. The median GAD-7 score was 5, and the median PHQ-9 score was 7. Mild to moderate depression was observed in 224 (54.4%), and 194 (47%) had mild-to-moderate anxiety. Significant associations were found between mental health outcomes and several factors: nationality (non-Saudis showed higher depression and anxiety scores, p = 0.010 and p = 0.020, respectively), marital status (divorced participants had the highest mean ranks for both conditions, p = 0.003 for depression and p < 0.001 for anxiety), and monthly income (p = 0.007 for depression and p = 0.008 for anxiety). Additionally, the presence of diabetes complications was strongly associated with higher depression and anxiety scores (p < 0.001 for both). The findings indicate a high prevalence of depression and anxiety among patients with type II diabetes in Makkah. These mental health issues are significantly associated with socio-demographic factors and diabetes complications. Integrated medical and psychological care is needed to improve the quality of life and treatment outcomes for diabetic patients.

Comparative analysis of clinical profile, laboratory profile and outcome in COVID-19 patients with and without hypothyroidism.

Previous studies suggest that patients' thyroid status might directly impact the course of Coronavirus disease 2019 (COVID-19). The objective of the study was to determine the clinical profile of COVID-19 patients with hypothyroidism and compare it with that of COVID-19 patients without hypothyroidism. Retrospective observational study. The study was conducted in a tertiary healthcare centre in Tamil Nadu between May and June 2021. The study included 117 patients admitted with hypothyroidism and COVID-19 as well as 117 age and Gender matched COVID-19 patients without hypothyroidism. Data regarding the demography, comorbidities, presenting symptoms, method of diagnosis of COVID-19, computed tomography (CT) severity score, Interleukin 6 (IL-6), D-dimer, oxygen requirement, number of days in hospital and outcome were collected for both groups. Data analysis was conducted, and p<0.05 was considered statistically significant. The study comprised 234 patients over two months, from May to June 2021. Distribution of presenting symptoms showed that the hypothyroidism group presented with a higher incidence of fever (66.67%), loose stool (18.80%) and myalgia (7.69%). Results show that RTPCR+, O2 Requirement, death, D-dimer, IL-6, number of days admitted as well as CT-severity did not show any statistically significant differences (p>0.05) between both groups. The outcomes also showed that both groups reported four mortalities. The results of the study help conclude that the hypothyroidism status of a COVID-19 patient is not associated with higher severity of clinical symptoms, deranged laboratory values as well as mortality. None declared.

P207 MAY MEASURE MONTH 2022 AND 2019: AN ANALYSIS OF BLOOD PRESSURE SCREENING RESULTS PRE COVID-19 AND POST COVID-19 FROM ULAANBAATAR, MONGOLIA

Background: Mongolia has experienced high mortality rates from ischaemic heart disease and haemorrhagic stroke, with hypertension as a major risk factor. Two separate hypertension screening campaigns were conducted: the May Measurement Month (MMM) campaign in May 2019 and a follow-up campaign after the COVID-19 pandemic between July and September 2022. Methods: The 2019 MMM campaign involved screening at 80 sites, primarily workplaces, using trained health volunteers. Blood pressure was measured using clinically verified digital devices. In contrast, the 2022 campaign was conducted at five primary healthcare centers in Ulaanbaatar, with participants voluntarily attending the screening, where blood pressure was measured over three sessions. Results: In 2019, 6522 individuals were screened, with a hypertension prevalence of 32.5%, where 62.2% were aware of their condition and 50.1% were on medication. The control rate among those treated was 27.1%. In 2022, 1774 individuals were screened, showing a higher prevalence of 56.1%, with 95.4% awareness and 52.7% receiving treatment. The control rate for treated individuals was significantly higher at 48.5%. Conclusion: Both campaigns highlight the critical public health issue of hypertension in Mongolia. The increase in hypertension awareness and control rates in 2022 may be due to smaller sample size and participants are already patients who came to visit primary healthcare centers.However, the persistent high prevalence of hypertension underscores the need for continued prioritization and enhanced strategies in hypertension management.

P208 MAY MEASURE MONTH 2023: AN ANALYSIS OF BLOOD PRESSURE SCREENING RESULTS FROM ULAANBAATAR, MONGOLIA

Background and Objectives: In Mongolia, 1 in 3 people have high blood pressure and mortalities due to ischaemic heart disease and haemorraghic stroke has hit record high in the past years. Since 2019, Mongolia has been participating in the world's largest hypertension screening campaign, May Measure Month. After skipping the screening campaign for 2 years, we aimed to screen people for hypertension after the COVID-19 pandemic. Method Screening sites were set up in 14 primary healthcare centers (PHC) of 4 districts in Ulaanbaatar, Mongolia between June and September 2023. Screenees came into the PHC and participated voluntarily and they were aged 18 and above. Questionnaire was completed with three sittings BP measured. Definition was hypertension was as a systolic BP at least 140 mmHg and/or a diastolic BP at least 90 mmHg (using the mean of the second and third readings) or taking antihypertensive medication. We used SPSS version 29.0.2.0 and RStudio for data analysis. Result Total of 5036 respondents were participated. Of which, 44.8% were male and female were 55.2% with mean age 46.8 (±15.8). Hypertensive adult proportion was 42.6% (2143), of whom 85.1% (1823) were aware and 84.0% (1800) were on hypertension treatment. Of those on medication, control rate 53.8% had controlled blood pressure (&lt;140/90). Noncommunicable disease factors including smoking was 26.6%, current vaper 7.6%, alcohol consumption 28.8%, diabetes 7.2%, previously diagnosed heart attack was 3.7% while stroke was 3.5%. Overweight and obese were 36.8% and 14.6% respectively. Conclusion The high hypertension prevalence and inadequately treated hypertension demonstrates that hypertension treatment management is needed to be prioritized.

P183 PERIPARTUM CARDIOMYOPATHY: MONOCENTRIC DESCRIPTION AT THE NORTHERN REGIONAL MATERNITY HOSPITAL OF THE DOMINICAN REPUBLIC

Background: Peripartum cardiomyopathy (PPCM) is a pathology in which the woman's heart dilates and displays signs and symptoms of heart failure. It is a rare pathology, with a high mortality rate, and predominance in black patients. Its diagnosis and management are not standardized, nor adapted to low income countries. This leads to barriers in identifying and treating the disease in higher-risk countries such as Haiti, making it a relevant issue in the Dominican Republic due to high immigration of haitians to the country. Therefore we aimed to evaluate the association of risk factors and the pharmacological regimen of patients in a public healthcare center in the Dominican Republic. Methods: An observational, retrospective, cross-sectional study was carried out with convenience sampling. This included patients who had been admitted to the Presidente Estrella Ureña Regional Hospital with suspected PPCM during the last 3 years. Variables studied include: sociodemographic factors, toxic habits, pathological and gynecological-obstetric history, cardiovascular, pulmonary and general signs and symptoms. Results: A sample of 19 patients with a median age of 27 years was obtained, 73.4% of them were black. All of the patients who had illness onset in the peripartum period (first 28 days after labor) presented adverse events, infectious comorbidities and “other comorbidities” while 75% of them presented cardiac and pulmonary comorbidities. Regarding treatment, only 77.8% of patients with antepartum onset received treatment in this period. Additionally, 66.7% of patients with antepartum onset developed adverse events that required oxygen-supplementation, versus only 33% of those without adverse events. Conclusions: It is relevant to design tools for calculating the risk of developing PPCM and standardize its disparate diagnosis and treatment, particularly aimed at countries with limited resources. This aims to improve the prognosis in patients with risk factors such as: black race, age over 30 years and living in low/middle-resource countries.

Iron Deficiency Anemia among Sanitation Workers in a Tertiary Care Hospital: A Cross-sectional Study

ABSTRACT Background: Iron deficiency anemia (IDA) has been the main cause of the health burden in India over the past decade. The aim of the present study was to examine the iron status and prevalence of iron deficiency anemia using biochemical markers among sanitation workers working at a tertiary healthcare center. Methodology: This hospital-based cross-sectional observational study was conducted on 80 sanitation workers for a period of 18 months (age 31–40 years). Dietary intake patterns were collected through the structured questionnaires. Blood samples were analyzed for complete blood count, serum iron level and unsaturated iron binding capacity, and ferritin. Total iron binding capacity and percentage transferrin saturation were calculated. Stool samples were screened for intestinal helminthic ova and cysts of intestinal protozoa. Results: Of the 80 sanitation workers, IDA was found in 38.7%; out of this, mild anemia was found in 16 (20%) participants, while 11.3% and 7.5% participants had moderate and severe anemia, respectively. Higher plasma sTfR levels were observed in women with severe iron depletion than in those with iron sufficiency (median 17.6 versus 15.5 nmol/L; P = 0.001). A statistically significant positive correlation between hemoglobin and serum iron, serum ferritin, and transferrin saturation was found. Hemoglobin was positively correlated with white blood cells, red blood cells, hematocrit, and mean corpuscular hemoglobin. Conclusion: This study highlights the presence of mild IDA among sanitary workers and lower levels of iron intake than the recommended dietary allowance.

Comparison of ten formulae for calculating low-density lipoprotein cholesterol with direct low-density lipoprotein cholesterol measurement

ABSTRACT Background: Accurate lipid profile assessment, mainly low-density lipoprotein cholesterol (LDL-C) measurement, is crucial for diagnosing and managing cardiovascular disease (CVD). The widely used Friedewald formula for LDL-C calculation has limitations, prompting the exploration of alternative equations. Aims: This study aims to compare ten LDL-C calculation formulas with direct measurement among study participants attending a tertiary care centre. Materials and Methods: Conducted from September 2021 to July 2022 at a tertiary healthcare centre in India, the study involved 114 participants aged 18 years or older. The exclusion criteria were high-serum triglyceride (TG) levels, renal failure, diabetes, liver diseases or unwillingness to participate. Blood samples were analysed for total cholesterol, TG, high-density lipoprotein cholesterol and LDL-C. The very-low-density lipoprotein cholesterol level was calculated. The LDL-C formulas evaluated were Friedewald, Anandaraja, De Cordova, Vujovic, Ahmadi, Puavillai, Chen, Hattori, Martin–Hopkin and Sampson. Results: Vujovic’s formula showed a negligible mean difference and strong correlation (r = 0.916, P &lt; 0.001) with direct LDL-C estimation across TG concentrations. Sampson’s formula performed best for TG &lt;150 mg/dL, whereas Vujovic’s formula excelled for 151–399 mg/dL TG concentrations. All formulas were highly correlated with direct LDL-C levels (P &lt; 0.001). Bland–Altman analysis indicated Vujovic’s formula as the closest match to direct measurement, with a mean bias of −1.42 ± 20.59 mg/dL. Conclusion: Vujovic’s formula demonstrated the slightest difference and strong correlation with direct LDL-C measurement, outperforming other formulas. This finding enhances the accuracy of LDL-C assessment and improves CVD risk management in clinical practice.

Physician practices in referring rheumatoid hand and thumb carpometacarpal arthritis cases to hand surgeons.

To investigate the referral practices across different medical specialties and identify possible barriers to hand surgery referral. Rheumatoid hand deformities (RHDs) and thumb carpometacarpal (CMC) arthritis may require surgery once deformities occur. However, in Saudi Arabia, the rate of referrals to hand surgeons remains low. This was a cross-sectional study that included 102 consultants of family medicine, rheumatology, and orthopedics across various regions of Saudi Arabia. A total of 30 institutions were contacted and requested to distribute a survey questionnaire to their physicians; these institutions included 8 private hospitals, 16 government hospitals, and 6 primary healthcare centers. The survey included questions on the incidence, rate, management, knowledge, and referral of patients with RHD and CMC arthritis using a 5-point Likert scale. The Kruskal-Wallis H test was utilized in our analysis to evaluate the differences in responses among the 3 specialties. For RHD and thumb CMC arthritis, the referral rate was higher among orthopedic surgeons compared to rheumatologists and family medicine physicians. The main barriers to referral were patient refusal, medical treatment alone being deemed adequate, and a lack of awareness of surgical options for management. Our findings highlight discrepancies in patterns of physician referral of RHD and thumb CMC arthritis cases to hand surgeons, indicating the need for targeted interventions to improve referral rates and enhance patient outcomes.

Evaluation of Medical Waste Generated from Government Hospitals and Healthcare Centers in the City of Hodeidah, Yemen

In the present study, the current status of medical waste management in the city of Hodeidah was presented in terms of its definition, components, sources, and threats that may result from improper handling. This investi-gation aims to study the potential environmental and health impacts of existing medical waste produced by the government hospitals and healthcare entities in Hodeidah City, in addition to comparing the applied methods and procedures with the methods and procedures that are applied in developed countries. The research study was carried out from January 2022 until January 2023, and targeted ten government hospitals and healthcare institutions in Hodeidah City. It relied on descriptive and analytical scientific methods, which aim to describe and analyze medical solid waste generated from the selected institutions. The result of the study showed that the total quantities of waste produced in all studied government health facilities amounted to approximately 599,038 kg/year. The percentage of non-hazardous waste was about 67% against hazardous waste which was 33%. Hospitals that receive more patients and have more beds as well as a multiplicity of their specialties generate larger medical wastes. The present research investigation revealed that government hospitals and healthcare centers in the city of Al-Hodeidah have low levels of health and safety conditions. They do not meet the local and international standards and requirements in the Medical Waste Management Guides and Recommendations. The poor management situation of medical waste could expose Yemeni citizens to danger. The healthcare insti-tutions should be supervised and controlled and ensure management of medical waste following environmental regulations and laws.

Characterization of Etiology and Pattern of Dental Extraction among Patients Presenting to Dental Department of a Tertiary Care Centre: A Descriptive Cross-sectional Study

Introduction: Dental extraction is a common curative treatment against pain provided to the patients. A limited number of scientific literature are available that characterizes the reasons for teeth extractions in Nepalese population. The aim of this study is to find out the causes for dental extraction in patients and explore the relationships between demographic variables and loss of teeth in the Nepalese population.Methods: This is a descriptive cross-sectional study performed to assess the predictors and reasons for permanent tooth extraction among the Nepalese patients who visited dental department in a tertiary health care center from 18th June 2022 to 17th June 2023. Ethical approval was obtained from the Institutional Review Committee (Approval No: 52/22). Demographic details were recorded, diagnosis established and the teeth in question were extracted. Descriptive statistical analysis was performed.Results: A total of 465 (42.66%) permanent teeth were extracted from the 1090 patients, out of which 198 (18.16%) were male and 267 (24.49%) were female patients between the age of 10 years to 70 years. Among all the participants, 726 (66.60%) patients were educated while 364 (33.40%) were uneducated, 165 (15.13%) extraction were done due to peridontal disease and 213 (19.54%) of extraction was done due to endodontic disease.Conclusions: Endodontic and periodontal diseases were the most common causes of dental extraction. Permanent molars and incisors were extracted the most.

Admission Rate of Patients Visiting Emergency Department in a Tertiary Care Center in Kathmandu

Introduction: Emergency departments serve as the initial point of contact for patients with a wide range of conditions. Not all patients visiting get admitted to the hospital. The admission rate varies from 20% in the United States to 40.83% in Nepal. Given the variability in these results across different regions, there is a need to better understand the admission rates from the Emergency Department.Methods: A descriptive cross-sectional study was conducted after obtaining ethical approval( Reference Number: 58 (6-11)E2 081/082) in the Emergency Department of a tertiary health care center. Retrospective data was collected from the data register. The data from April 2023 to April 2024 was collected. A sample size of 222 was calculated and convenience sampling was done. Demographic details like age, sex, and data regarding admission status were collected. Data was collected in MS Excel and was analyzed using JASP software. Results: Out of 222 patients that presented to the emergency department, 53 (23.87%)(18.26-29.47,95 % Confidence Interval) were admitted to the ward or intensive care unit of the hospital, whereas 167 (75.23) got discharged, 1 (0.45%) was brought dead and 1 (0.45%) expired. The median age of patients was 43 (IQR: 26-62). The admission rate of females was 20 (17.24%), whereas for males it was 33 (31.13%).Conclusions: The prevalence of admission of patients visiting the emergency department was higher than similar US based studies. There was a higher percentage of female patients presenting to theemergency department, while those being admitted were mostly males.

Enhancing self-esteem and self-compassion to mitigate suicide risk: a feasibility and acceptability study among Japanese university students

ObjectivesSuicide is a serious mental health problem among university students. The current study aimed to examine the effectiveness of a novel intervention that targets suicide risk by enhancing self-esteem and self-compassion. MethodsParticipants were recruited from the healthcare center at a Japanese University. Measurements of suicidal risk, self-compassion, self-esteem, and other psychological variables were collected at baseline, post-intervention, four-week follow-up, eight-week follow-up, and twelve-week follow-up. Participants also provided feedback on the program's acceptability. ResultsA total of 17 participants consented to participate in the intervention, 14 completed post-treatment assessment, 10 completed the four-week follow-up assessment, and 8 completed the eight-week and twelve-week follow-up assessment. Following the intervention, the study observed moderate to large improvements in self-esteem, self-compassion, hopelessness, depression, and suicide risk. The participants also reported reliable changes in clinical outcomes and positive perceptions of the program. ConclusionsThe psychoeducation program exhibited high acceptability and feasibility and promising early outcomes. Despite the small sample size and lack of a control group, these findings suggest potential benefits of the program. Further studies for examining the efficacy of the program are highly warranted.

Voluntary Care for Older People: A symbolic Health Efficacy of Community-based Health Meetings

Community healthcare in Indonesia relies on volunteer workers who engage their clients outside fixed health facilities with limited resources and formal training. These volunteers are called cadres who learn their tasks to improve community wellbeing through ongoing engagement and without prior skills. They are drawn from the community to serve the community. This paper is based on field research carried out with cadres through interviews and visits to integrated health meetings (Posyandu) held by primary healthcare centres for older adults in villages. The paper first discusses the recruitment requirements and the incentives for being a healthcare volunteer. It suggests that both recruitment and incentives are rooted in community values of helping and doing good for the community. Volunteer cadres must have a direct normative and semiotic connection with clients, as they must be members of the community who speak the same language and understand local norms. In line with this community-centred approach, the paper then focuses on the health efficacy of Posyandu as a recurring structured symbolic event held in the village. The argument is made that a more qualitative approach should be taken to understanding the efficacy of these meetings, drawing on research methods from the anthropology of ritual (symbolic and therapeutic) healing.

Ethical Approaches in Secondary Findings Report from Exome Sequencing Analysis

In Whole Exome Sequencing (WES) and Whole Genome Sequencing (WGS) approaches, incidental findings (IFs) or more precisely secondary findings (SFs) have indicated controversial reports. To address SFs issues, well-known guidelines have been released such as the versions of the American College of Medical Genetics and Genomics (ACMG); however, when, to whom, why, and how these SFs should be reported are the key questions that need to be addressed ethically. The current review aimed to investigate the papers with a focus on the ethical approaches regarding IFs/SFs. In this comprehensive review, we searched the PubMed data-base for related publications, and 58 papers were selected as the narrowest reports. There was a positive tendency to disclose the SFs by the professionals and an enthusiasm in patients to be informed about all of their genetic reports. Several studies have addressed that guidelines could not cover all aspects of IFs/SFs ethically and medically. The main focus of these studies was the modernized opt-in informed consent according to some items including prenatal/post-natal or pediatric/adulthood issues. Other foci are genetic variant clinical actionability, cancer status, population-based backgrounds, time- and cost-effectiveness, the education level of sub-jects and clinicians, and the combinations of pharmacogenomics findings to introduce medicinal treatments and personalized prescrip-tions leading to more suitable healthcare. Altogether, concerns remain about the ethical approaches in the SFs; however, the present review introduced remarkable solutions which will be ethically and practically possible to be utilized. This review also found that recent reports are concentrated on the high-volume Exome Sequencing tests of subjects from biobanks and healthcare centers.

Knowledge and Associated Factors Affecting the Use of Contraceptive Among Women Attending Two Selected Primary Health Care Centre in Ogun State

Knowledge and Associated Factors Affecting the Use of Contraceptive Among Women Attending Two Selected Primary Health Care Centre in Ogun State

Facilitators and barriers in the implementation of a fall prevention program based on physical activity for elderly people living in the community: A qualitative study.

Physical activity is recognized as beneficial for older individuals in preventing falls. Achieving high adherence to exercise programs among the elderly poses challenges for administrations and healthcare systems. This study explored the facilitators and barriers perceived by both the participants and nurse trainers involved in an exercise program aimed at preventing falls in primary healthcare. Sixteen semi-structured interviews with elderly people who had participated in the Otago Exercise Program and a focus group of nurse trainers of this program were conducted between October 2018 and September 2019 in primary health care centers in Lleida, Spain. Interviews were transcribed and analyzed using inductive thematic analysis with Atlas.ti 8 software. Analysis revealed five overarching categories and 17 subcategories. Key facilitators included personal motivation, the perceived benefits of exercise, and the supportive role of nurse trainers. Primary barriers encompassed factors such as the excessive duration of the program, not considering personal preferences for individual or group participation, and differences in physical condition among group participants. To increase participation and adherence to exercise programs, it is necessary to consider the important role of the nursing professionals that recommend program enrolment and the participants' personal motivations. The program with group sessions is a model that is easy to integrate into Primary Healthcare centers, which must always take into account the preferences and physical conditions of the participants.

Work-restricting musculoskeletal pain after bariatric surgery or usual obesity care in the Swedish Obese Subjects study.

The objective of this study was to study the recovery from, and incidence of, work-restricting musculoskeletal pain after bariatric surgery compared with usual obesity care. Pain in different body regions was monitored using questionnaires in the nonrandomized, prospective, controlled Swedish Obese Subjects (SOS) study, which included 2007 participants treated with bariatric surgery and a matched control group of 2040 participants receiving usual obesity care at primary health care centers. Self-reported pain in the neck and shoulders, back, hips, knees, and ankles was captured from questionnaires administered at baseline and after 1, 2, 3, 4, 6, 8, 10, 15, and 20 years. Compared with matched controls, bariatric surgery was associated with better recovery from baseline work-restricting knee and ankle pain in both the short (1-4 years) and long term (up to 20 years), as well as from back and hip pain in the short term. In participants without pain at baseline, bariatric surgery was associated with a lower incidence of developing new pain in the knee and ankle in the short and long term. Bariatric surgery was associated with better recovery from pain, primarily in weight-bearing joints, as well as with prevention of pain development in the knee and ankle compared with matched controls receiving usual obesity care.

Effects of iranian guidelines on primiparous women’s childbirth experience: A randomized controlled trial

Background. Currently, birth experience is considered an indicator for evaluating the quality of care provided during labor and birth. This study examined the effect of the Iranian positive birth experience guideline on the birth experience of primiparous women. Methods. This randomized controlled clinical trial was conducted at Taleghani Hospital, Tabriz, Iran (2019). Thirty pregnant women admitted to labor after checking the eligibility criteria were randomly assigned to intervention (developed guidelines) and control (routine hospital care) groups. Women’s birth experience was evaluated 24 hours postpartum using the Childbirth Experience Questionnaire (CEQ 2.0). An independent sample t-test was employed to compare the average scores between the groups. Results. The mean (standard deviation) of the total score of birth experience in the intervention and control groups was 3.0 (0.4) and 2.1 (0.5), respectively. The average score of the childbirth experience in the intervention group was significantly greater than that of the control group [Mean difference: 0.9; 95% confidence interval: 0.5–1.2; P &lt; 0.001]. Conclusion. The Iranian guideline for improving birth experiences was able to improve primiparous women’s birth experiences more effectively than routine care. Practical Implications. The findings of this study can be considered in the policies and management of healthcare centers.

Prevalence and clinical correlates of nonmotor symptoms in Parkinson's disease in a tertiary health-care center in Turkey.

The objective was to determine the prevalence and clinical correlates of nonmotor symptoms in Parkinson's disease patients in movement disorders outpatient clinics. We enrolled all consecutive PD patients who visited our movement disorders outpatient clinics between January and December 2023; and agreed to participate in the study. In addition to the evaluation of demographic and clinical features, clinical scales, including the MDS-UPDRS, NMSS, and FOOGQ, were performed. Overall, we enrolled 163 PD subjects with a mean age of 63.9 ± 10.4 (F/M = 27/136). The disease duration was 3.5 (20) y [median (range)]. The median score of the NMSS was 41 points. The NMSs burden levels were severe in 25.2%, and very severe in 25.2% of the subjects. The subitems with the highest scores were sleep/fatigue, mood/cognition, urinary, and miscellaneous. The analyses within the patient group with newly diagnosed PD also revealed high NMSS scores. Comparisons of the NMSS between distinct PD stages revealed greater NMSS scores in the severe stage than in the mild stage (p = 0.001). Correlation analyses between the clinical scores and the NMSS scores revealed positive correlations between the NMSS scores and the scores on all the clinical scales including the MDS-UPDRS 1-4, and FOGQ. We reported the first data regarding the NMS burden in PD patients from Turkey. We found a high prevalence and severity of various domains of NMSs, most of which were sleep/fatigue, mood/cognition, urinary, and miscellaneous. More than half of the patients had severe to very severe NMS burden. Although NMSs were more common severe-stage disease, they were also prevalent in the subgroup with newly diagnosed patients.