Highest Number Of Participants Research Articles

Assessing the relationship between urban park spatial features and physical activity levels in Residents: A spatial analysis Utilizing drone remote sensing

The park environment is crucial for promoting physical activity (PA). While numerous studies show that park environments influence PA behavior, inconsistencies remain, likely due to varing research methods and parks types. This study employs a fixed spatial grid method to systematically sample four representative parks in Tianjin, China. High-precision orthophoto map (DOM) data from drones provided detailed environmental attributes (like tree canopy area, lawn area, and paved area) and PA characteristics (number of participants, intensity, diversity). The results show: 1) Cluster analysis grouped 1839 park grids into 12 environmental attribute integrations, each correlating with different PA characteristics. “Tree-lined jogging corridors” and “Large sports field areas” exhibit the highest PA intensity, while “Entrance plazas”, “Central plazas,” and “Open sports spaces” have the highest number of participants and PA diversity. 2) Correlation analysis shows that various environmental attributes, including Lawn Area, and Paved Area, are significantly correlated with PA characteristics. 3）Random Forest analysis indicates the key attributes are the paved area for the number of PA participants and PA diversity, and specialized sports facilities area for PA intensity. These findings support urban green space planning and highlight the importance of better park environments for public health.

Regional variations in psoriatic arthritis: Insights from a nationwide multicenter analysis in Türkiye.

The study aimed to investigate and compare clinical features, disease activity, and the overall disease burden among psoriatic arthritis (PsA) patients across seven distinct geographic regions in Türkiye. A multicenter cross-sectional study involving 1,134 PsA patients from 25 referral centers across seven regions was conducted. Demographic and clinical characteristics, comorbidities, joint involvement, extra-articular manifestations, and disease activity measures were evaluated across regions. A total of 1134 PsA patients from seven different geographic regions in Türkiye participated in this study. The highest number of participants was from the Marmara region (n=409), with subsequent representation from Central Anatolia (n=370), Aegean (n=139), Mediterranean (n=60), Black Sea (n=60), Eastern Anatolia (n=60), and Southeastern Anatolia (n=36) regions. There were significant variations in demographic profile, including age, body mass index, age of disease onset, educational status, comorbidities, and family history of both psoriasis and PsA. Clinical features, such as enthesitis, dactylitis, uveitis, and joint involvement, demonstrated significant variation across regions. Additionally, disease activity measures, including pain, patient and physician global assessments, acute phase reactants, disease activity indices, quality of life, and functional status, displayed considerable regional differences. This nationwide study revealed substantial regional diversity in demographic data, clinical characteristics, disease activity, and quality of life among PsA patients in Türkiye. These findings stress the need to customize treatment approaches to address regional needs and to conduct further research to uncover reasons for disparities. It is crucial to enhance region-specific approaches to improve patient care and outcomes for PsA.

Virtual platform to tackle challenges associated with lifelong medical education during the COVID-19 pandemic

BackgroundDuring the COVID-19 pandemic, large in-person conferences were mostly cancelled to avoid further disease contagion. Physicians continued to demand changes in form to enable participation in lifelong medical education programs, and the traditional model of in-person conferences needed to be rethought. As such, a regional branch of the national orthopedic association tried to move in-person conferences onto a virtual platform. This study aimed to investigate the effect of transitioning large in-person conferences to a virtual model during the COVID-19 pandemic, especially examining any differences in the attendance of each type of conference.MethodsIn this retrospective observational study, 776 participants in virtual conferences and 575 participants in in-person conferences were analyzed. Institutions were classified based on their location in a central city and two neighboring cities. Affiliated institutions were divided into resident training hospitals, general hospitals, and private clinics. The change in the number and proportion of participants between the virtual conference year and in-person conference year was calculated.ResultsThe number of virtual conference participants was significantly greater than that of in-person conference participants (P = 0.01). Although the highest number of participants was from central city for both years, the proportion of participants from the two neighboring cities increased. Although the proportion of participants from resident training hospitals and private clinics decreased, the proportion of participants from general hospitals increased.ConclusionsWe implemented a virtual platform to tackle challenges associated with lifelong medical education during the COVID-19 pandemic. The virtual platforms can be helpful for organizations that must hold regular lifelong medical education programs for members spread across a wide geographic region.

Demographic and clinical characteristics, seizure disorders, and antiepileptic drug usage in different types of corpus callosum disorders: a comparative study in children

BackgroundThis study aimed to investigate the demographic and clinical characteristics, types of seizure disorders, and antiepileptic drug usage among individuals with different types of corpus callosum disorders.MethodsA total of 73 individuals were included in the study and divided into three groups based on the type of corpus callosum abnormality: hypoplasia (H), agenesis (A), and dysgenesis (D). Demographic data, including gender and preterm birth, as well as clinical characteristics such as seizure disorders, attention deficit hyperactivity disorder (ADHD), severe developmental delay/intellectual disability, and other brain malformations, were analyzed. The types of seizure disorders and antiepileptic drugs used were also examined.ResultsThe H group had the highest number of participants (n = 47), followed by the A group (n = 11) and the D group (n = 15). The A group had the highest percentage of males and preterm births, while the D group had the highest percentage of seizure disorders, other brain malformations, and severe developmental delay/intellectual disability. The A group also had the highest percentage of ADHD. Focal seizures were observed in all three groups, with the highest proportion in the A group. Focal impaired awareness seizures (FIAS) were present in all groups, with the highest proportion in the D group. Generalized tonic-clonic seizures (GTCS) were observed in all groups, with the highest proportion in the H group. Different types of antiepileptic drugs were used among the groups, with variations in usage rates for each drug.ConclusionThis study provided insights into the demographic and clinical characteristics, seizure disorders, and antiepileptic drug usage among individuals with different types of corpus callosum disorders. Significant differences were found between the groups, indicating the need for tailored management approaches. However, the study has limitations, including a small sample size and a cross-sectional design. Further research with larger sample sizes and longitudinal designs is warranted to validate these findings and explore the relationship between corpus callosum abnormality severity and clinical outcomes.

Recruiting Persons With Dementia: A Systematic Review of Facilitators, Barriers, and Strategies.

Study recruitment of persons with dementia is challenging. We aimed to assess facilitators, barriers, and strategies to identify and approach persons with dementia for recruitment to dementia care studies. We systematically searched MEDLINE/PubMed, CINAHL, Web of Science, and other sources (ORRCA [Online Resource for Research in Clinical triAls]; pertinent evidence syntheses; citation searching) and narratively summarised the results (PROSPERO CRD42022342600). Facilitators and barriers consisted of "characteristics of participants, researchers, clinical contact persons", "study characteristics", and "communication with participants". The highest number of participants were recruited by study information in electronic and print formats, as well as by networking and collaboration. Advertisements proved to be the most expensive way of recruitment. There is limited evidence on the impact of recruitment strategies to identify persons with dementia for recruitment to dementia care studies. Our analysis of facilitators and barriers may inform research teams in designing strategies to identify persons with dementia for recruitment purposes.

Ley orgánica de regulación de la eutanasia: conocimiento e implicación de los médicos en España tras un año de su aplicación

Background and aimsThe Organic Law Regulating Euthanasia (LORE, for its initials in Spanish) came into force in June 2021. This study aims to examine knowledge of the LORE among physicians licensed in Spain as well as their involvement with and the impact of the law. MethodsThis work is a descriptive, cross-sectional study conducted by means of a survey. Information was gathered through a self-administered questionnaire. ResultsThe survey was answered by 1446 physicians licensed in Spain. The sample's demographic characteristics were as follows: 54.7% were women, the mean age was 52±14 years, and 66.0% worked in a hospital. Catalonia was the autonomous community with the most participants (44.6%). Regarding specialties, anesthesiology and resuscitation had the highest number of participants (21.9%), followed by family and community medicine (18.5%). The LORE was known in detail by 24.3% of physicians, 58.0% had a positive opinion of it, and 31.1% had direct experience with the euthanasia procedure. Practitioners working in the hospital setting perceived the law more favorably compared to those in the primary care setting (62.3% vs. 47.3%, p<0.01). ConclusionsMost doctors did not have in-depth knowledge of the LORE, although a majority supported its existence, particularly those in hospital medicine. Most physicians who viewed the LORE negatively were male, older, and worked in primary care. A minority of physicians considered registering as conscientious objectors.

Polb 001, an Oral Broad-Spectrum Anti-Inflammatory with the Potential to Prevent Cytokine Release Syndrome (CRS)

Background Cytokine Release Syndrome (CRS) is a well-recognized toxicity that occurs with high frequency following treatments such as T-cell engaging antibodies, Chimeric Antigen Receptor (CAR) T cells and other T-cell boosting immunotherapies. In addition to patient mortality and morbidity, the high frequency of CRS associated with these treatments represents a barrier to delivery in the outpatient setting. The need for inpatient management of CRS adds to the costs of these treatments and contributes to restricting their availability. Current treatments are dominated by reactive administration of tocilizumab, steroids or anakinra. POLB 001 is a p38 MAPK inhibitor in development for severe influenza infections and CRS. In vivo, POLB 001 acts as a broad-spectrum anti-inflammatory by potently inhibiting the expression of proinflammatory cytokines such as IL-1β, IL-6, IL-8, IL-10, TNFα, COX-2. Methods In this single-center, randomized, double blinded, placebo-controlled, multiple dose study (NCT05765955), 36 healthy volunteers were orally administered 30, 70 or 150 mg POLB 001 or placebo BD (3:1 active to placebo) for 7 days. Each subject was then challenged with intradermal lipopolysaccharide (LPS) and intravenous LPS which drive local and systemic inflammation, respectively. The study objectives were to study the effect of POLB 001 on inflammatory responses following LPS challenge, including cytokine analysis, exploratory analysis including PK and metabolite profile and the safety and tolerability of POLB 001. Results No deaths or serious adverse events occurred during the study. The most commonly reported AE was headache, with the highest number of participants and events in the placebo group (8 (88.9%) subjects and 14 events) followed by the POLB 001 30 mg group (6 (66.7%) subjects and 11 events). Other reported AEs included chills (also more frequent in placebo group) and dizziness (placebo, POLB001 30, 70, 150 mg groups, frequency 22.2%, 11.1%, 33.3%, 22.2%, respectively). POLB 001 reduced levels of activated p38 (phospho-p38) in circulating monocytes by 32.0-60.9%. Reductions were seen in all cytokines measured. Significant reductions were seen in plasma IL-6, IL-8, IL-10 and TNFα. IL-1β levels were below the LLOQ in active and placebo groups. LPS-driven C-Reactive Protein (CRP) was reduced by 70 and 150 mg doses of POLB 001 (33.1 and 33.3%, respectively). Intravenous LPS challenge elevated body temperature by 1°C and HR by &amp;gt;25 BPM with a peak 3 hours following infusion. POLB 001 significantly reduced HR elevations with an estimated difference in peak HR of -8.8 and -7.8 in the 70 and 150 mg groups respectively. Conclusion POLB 001 is safe and tolerable in healthy volunteers. In a human LPS challenge model driving an acute systemic inflammatory response, POLB 001 showed anti-inflammatory effects and clinically meaningful parameters of inflammation were also reduced. The results support further clinical development of POLB 001 for inflammatory diseases and CRS. POLB 001 is undergoing preclinical evaluation in humanized mouse models (NSG-(KbDb)null (IA)null) of T-cell engaging bispecific antibodies, CD19 CAR-T cell therapy for hematological malignancies and for CD28 induced cytokine storm. A Phase 2 trial of POLB 001 in Multiple Myeloma patients receiving T-cell engaging antibodies is planned.

Organic law regulating euthanasia: knowledge and involvement of doctors in Spain one year after its implementation

Background and aimsThe Organic Law Regulating Euthanasia (LORE, for its initials in Spanish) came into force in June 2021. This study aims to examine knowledge of the LORE among physicians licensed in Spain as well as their involvement with and the impact of the law. MethodsThis work is a descriptive, cross-sectional study conducted by means of a survey. Information was gathered through a self-administered questionnaire. ResultsThe survey was answered by 1446 physicians licensed in Spain. The samples' demographic characteristics were as follows: 54.7% were women, the mean age was 52 ± 14 years, and 66.0% worked in a hospital. Catalonia was the autonomous community with the most participants (44.6%). Regarding specialties, anesthesiology and resuscitation had the highest number of participants (21.9%), followed by family and community medicine (18.5%). The LORE was known in detail by 24.3% of physicians, 58.0% had a positive opinion of it, and 31.1% had direct experience with the euthanasia procedure. Practitioners working in the hospital setting perceived the law more favorably compared to those in the primary care setting (62.3% vs. 47.3%, p < 0.01). ConclusionsMost doctors did not have in-depth knowledge of the LORE, although a majority supported its existence, particularly those in hospital medicine. Most physicians who viewed the LORE negatively were male, older, and worked in primary care. A minority of physicians considered registering as conscientious objectors.

Nurse Job Satisfaction in King Khalid General Hospital in Hafer Al Batin

This study aimed to detect aspects associated with ex-pat nurse job satisfaction in King Khalid General Hospital in Hafer AL Batin City in the Kingdom of Saudi Arabia A descriptive cross-sectional method for utilized to evaluate the relationship between the Job satisfaction variables among ex-pat nurses in King Khalid General Hospital. 53 nurses participants in this survey. The majority of respondents were male and they paid fairly for their work the supervisor as competent has the highest number of respondents more than half feel they get an adequate level of recognition when they do a good job the positive team dynamic has the highest number of participants and that can significantly improve job satisfaction.

A hospital-based study of dyslipidemia in patients with subclinical hypothyroidism

Overt hypothyroidism usually leads to dyslipidemia. The relationship between overt hypothyroidism and dyslipidemia is well established, to that of subclinical hypothyroidism is controversial. Also, Subclinical hypothyroidism if untreated can lead to overt hypothyroidism. So, the present study was conducted to investigate dyslipidema in patients with subclinical hypothyroidism. The study population comprised of total 111 cases having subclinical hypothyroidism and 111 cases of healthy controls. Those with normal T3 and T4 with thyroid stimulating hormone above 4.68 IU/ml were considered subclinical hypothyroidism and were further evaluated for lipid profile. Highest number of participants in the cases belonged to age group 60-71 (36.0%) whereas in control group it was 40-49 years (32.4%). No significant differences were found between lipid parameters between case and control (p &gt;0.05). Serum triglyceride, high density lipoprotein, very low-density lipoprotein was positively correlated with thyroid stimulating hormone (r=0.152, r=0.056, r=0.152, respectively and p=0.110, p=0.560, p=0.110, respectively) whereas total cholesterol, low density lipoprotein was negatively correlated with thyroid stimulating hormone in the cases (r=-0.089, r=-0.118, respectively) and the relation was not statistically significant (p=0.351, p=0.216, respectively). Among control group, serum total cholesterol, high density lipoprotein, low density lipoprotein were positively correlated with thyroid stimulating hormone (r=0.197, r=0.196, r=0.132, respectively) whereas triglyceride, very low density lipoprotein were negatively correlated with thyroid stimulating hormone (r=-0.009, r=-0.025, respectively). Subclinical hypothyroidism may or may not lead to dyslipidemia. Even euthyroid group can have lipid abnormalities. So, screening for hyperlipidemia in general population is more useful rather than patients with subclinical hypothyroidism.

An interplay of Progesterone, Leukemia Inhibitor Factor and Interleukin-6 in the window of implantation; Impact on fertility

BackgroundThe process of implantation is crucial for the initiation of conception and hence fertility. In addition to a number of factors, it is regulated by a cross talk of gonadotrophins [Luteinizing Hormone (LH), Follicle Stimulatory Hormone (FSH)], ovarian steroids [Estrogen (Et), Progesterone (Pt)] and cytokines [Leukemia inhibitory factor (LIF) and Interleukin 6 (IL6)]. These biomarkers are chief players of implantation. ObjectiveWe aimed to explore the role of gonadotrophins (LH, FSH, LH/FSH ratio), ovarian steroids (Et, Pt) and cytokines (LIF, IL6) in the implantation process. This aim was achieved by comparing these hormones and cytokines in the fertile and infertile groups [Polycystic ovaries (PCOs), endometriosis, unexplained infertility (Uex-IF)] and finding their association in all study groups. MethodsA case control study conducted from October 2020-March 2023. A total of 135 infertile women (with PCOs, Uex-IF, and endometriosis) and 177 fertile women (matched for age and BMI) were selected. Levels of ‘Et’, ‘Pt’, ‘LIF’ and, ‘IL6′ were estimated using Enzyme Linked Immunosorbent Assay (ELISA). LH and FSH values were obtained from hospital desk records.The Independent Student'st-test was used to compare fertile and infertile groups. One-way ANOVA test was used to compare more than two groups, and Pearson’s chi-square (χ2) test was employed to compare percentages of variables. Pearson correlation analysis was performed to assess the associations and correlations. A p value < 0.05 was considered statistically significant. ResultsSignificantly higher levels of LIF and IL6 were observed in fertile women compared to infertile women. Pt levels were significantly greater in the fertile group than in the infertile group. The FSH/LH ratio was significantly higher in the fertile group. Among infertile women, PCOs (71%) and Uex-IF (91%) exhibited lower Pt levels than the fertile controls (p < 0.01), but these levels remained within the reference range (RR). Among the fertile group (81%), levels of LIF within the RR were significantly higher compared to those with Uex-IF (49%) and females with endometriosis (37%). Moreover, the highest number of participants (57%) with Uex-IF exhibited IL6 levels significantly below the RR in comparison to the fertile group and infertile groups (PCOS and endometriosis). However, lower levels of IL6 were observed in women with Uex-IF.In the control group, LIF exhibited a significant positive correlation with IL6 (r = 0.370), Pt (r = 0.496), Et (r = 0.403), and LH (r = 0.428). Among women with PCOs, LIF showed a significant positive correlation with IL6 (r = 0.443), Pt (r = 0.607), and LH (r = 0.472). In cases of Uex-IF, LIF demonstrated a significant positive correlation with IL6 (r = 0.727). Females with endometriosis displayed a significant positive correlation between LIF and IL6 (r = 0.535) as well as Pt (r = 0.605). In fertile women, a positive correlation was observed between LH and IL6 (r = 0.197, p = 0.009), LIF (r = 0.428, p = 0.000), Pt (r = 0.238, p = 0.001), and Et (r = 0.356, p = 0.000). Furthermore, a positive correlation was found between LH and LIF (r = 0.472, p = 0.000) in women with PCOs. ConclusionElevated levels of Pt were found to increase the production of LIF in fertile females. However, infertile females with PCOs and Uex-IF exhibited deficient levels of Pt, supporting its role as a biomarker for successful implantation in infertile women. These females showed decreased levels of gonadotropins as well as reduced LH/FSH ratio and diminished secretion of receptivity marker LIF, in addition to reduced Pt secretion. This suggests that reduced gonadotropin levels contribute to a lower LH/FSH ratio, resulting in decreased Pt secretion and ultimately leading to low levels of LIF, thereby causing impaired implantation in women with PCOs and Uex-IF. The exploration of low levels of LIF in patients with endometriosis requires further investigation. The significantly low levels of IL6 in the Uex-IF group elucidate the role of this cytokine in association with decreased Pt and LIF synthesis within this group.

Knowledge and Awareness of Oral and Perioral Piercing and Its Complications Among the Population in Riyadh.

Background and objective Body piercing was a cultural custom associated with religious or ceremonial rites in antiquity. Currently, it has grown in popularity among teenagers and young people as a form of self-expression. Young adults are now frequently seen with body and oral piercings, which can cause several complications. Patients with intraoral piercing often present with poor dental and periodontal health, as well as various complications and side effects. The general public is often poorly informed about the risks they are exposed to after intraoral piercing and the strategies for minimizing them, and even healthcare professionals often have limited knowledge of the risks and complications that may arise after this procedure. To the best of our knowledge, no published data assessing the knowledge of oral and perioral piercing among the population living in Riyadh City, Saudi Arabia are currently available. In light of this, we conducted this study to assess the level of awareness and knowledge of oral piercing and its complications among the population living in Riyadh city and evaluate the correlation of nationality, sex, age, and socioeconomic status (educational level, area of residence, and income) with the level of individual knowledge. Methods This was a cross-sectionalobservational study with a sample size of 1,099. A confidence interval (CI) of 95%, a standard deviation of 0.5, and a margin of error of 5% were employed to determine the sample size. A structured questionnaire was used as the study tool and was distributed in several residential areas in Riyadh, such as North, South, Middle, Eastern, and Western Riyadh City. The data collection was performed using simple random sampling via electronic questionnaires distributed to participants living in Riyadh. Results A total of 1,054 individuals completed the survey. Of these, 95.6% were Saudi nationals. Approximately 85.5% of the participants (n = 901) were women, 52.4% were aged 20-29 years (n = 552), and most participants (62.9%, n = 663) had a low monthly income (<5,000 Saudi Riyals); in terms of residence, the highest number of participants were from the northern region of Riyadh (37.1%, n = 391). Most participants had heard of or seen an oral or perioral piercing (89.1%, n = 939). However, very few of them had received an oral piercing themselves (10.7%, n = 113) or had afamily member with an oral piercing (18.7%, n = 197). Participants reported that the most commonly observed site for oral piercing was the lip (29.8%, n = 314), and teenagers were the most common age group with oral piercings (76.3%, n = 804). Regarding the adverse effects, most participants reported being awareof the negative consequences of oral piercingin the mouth (72.2%, n = 761). Sex and age were the only factors that showed a significant association with participants' level of knowledge. Women were significantly more knowledgeable and had higher scores (ß: 0.41; 95% CI: 0.13, 0.69) than men (p<0.05). Additionally, participants aged 20-29 years had significantly higher knowledge scores (ß: 0.39; 95% CI: 0.15, 0.63) than younger participants (p<0.05). Conclusions Based on our findings, participants' knowledge and awareness about oral piercing is adequate in general. However, thereshould be more efforts to educatethe people of Riyadh about the complications of these piercings as well as raise awareness about proper oral hygiene methods.

Attitude and Acceptance towards COVID-19 Booster Doses among Literacy Advantaged Population in Pakistan: A Cross-Sectional Study.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has affected billions of lives and is expected to impose a significant burden on the economy worldwide. Vaccination is the only way to prevent the infection. However, convincing people to get themselves vaccinated is challenging in developing countries such as Pakistan. Therefore, a cross-sectional questionnaire-based study was conducted (n = 982 participants) all over Pakistan to evaluate the perception, knowledge, attitude, and acceptance of the general public towards the SARS-CoV-2 vaccine, in general, and a booster dose of SARS-CoV-2, in particular. The highest number of participants were from the province of Punjab (84.5%), followed by Islamabad (3.8%), Sindh (3.7%), Khyber Pakhtunkhwa (2.7%), Baluchistan (2.6%), Gilgit Baltistan (1.4%), and Azad Jammu and Kashmir (1.4%). A total of 915 participants were vaccinated against COVID-19, out of which 62.2% received one booster dose, followed by double booster doses (25.5%) and single vaccine shots (12.3%). The highest number of vaccinated participants were from Punjab (85.8%), followed by Islamabad (3.9%), Sindh (2.8%); Khyber Pakhtunkhwa (2.6%); Baluchistan (2.3%); Gilgit-Baltistan (1.3%); and Azad, Jammu, and Kashmir (1.2%). Among the vaccinated individuals, 71.4% were unemployed, 27.4% were employed (653), and 1.2% were retired from service. However, no significant association was observed among genders and educational levels in regard to acceptance of the booster vaccine. The outcomes of the study revealed that the increased acceptance of booster doses of the SARS-CoV-2 vaccines among the public was associated with the intent of personal and family protection. Moreover, individuals with low socioeconomic status and pregnant females showed the least acceptance towards the vaccine inoculation. The study also revealed a decline trend of accepting SARS-CoV-2 vaccine among children.

Prevalence of Stress and Sleep Disorders among Medical Students at Al-Kindy College of Medicine and its impact on Academic Performance

Introduction: Sleep, an essential therapeutic part of human physiology, Sleep problems was widespread among students in medical colleges, and excessive stress and the pressure of holding grades can affect their sleep quality. The relationship between sleep, stress and cognition/learning is far more complex than perceived. Material and Method: Cross sectional study was conducted in Al-Kindy College of Medicine, during the period from (2022 to 2023) academic year. The electronic questionnaire was distributed among all students. Analysis of data was carried out using IBM SPSS version 24. Results: A total of (500) medical students' online surveys were analyzed from AL-Kindy College of Medicine, The highest number of participants was from the fifth year with (114) students, and percentage of (22.8%), whereas the lowest number of participants was from the second year with (68) students (13.6%). There were about (258) male with percentage of (51.6%), and (242) female with percentage of (48.4) participated in this study. The majority of students (160) with percentage of (32%) were sleeping (6) hours/day, and a minority (1) student with percentage of (0.2%) had 3 hours sleeping/day. There was a significant relationship between sleep hours and sleep deprivation like, about (297) students, with prevalence of (59.4%) agreed that sleeplessness negatively affected their academic performance, while (41) students with percentage of (8.2%) disagreed. According to the effect of stress, the prevalence of sleep disorders among undergraduate medical students was shown that (169) students with percentage of (33.8%), were always stressed, while (34) students with percentage of (6.8 %), were rarely affected by stress. According to the causes of stress, the majority of students (198), with percentage of (39.6%), were had too much study, while (1) student, with percentage of (0.2%), was had no significant reason. Other (174) students, with percentage of (34.8%), were under stress because of exams and (127) students, with percentage of (25.4%), were under stress because of life events. Conclusions: Sleep disorders are common among medical students. The study also reveals that there is a strong, positive and significant relationship between stress levels sources of stress and sleep deprivation which is associated with poor academic performance. Recommendations: Keeping bedtime and wake time consistent, including on weekends. Regular activity helps promote a good night's sleep. Also schedule exercise at least a few hours before bedtime and avoid stimulating activities before bedtime. Further research is required in this field.

Frequency of Leg Pain, Edema, and its Associated Factors among Nurses Working on Shift Duty in Private Tertiary Care Hospital, Karachi

Background: Long-standing hours cause nurses to be at high risk of lower extremity pain and edema that can lead to varicose veins and deep venous thrombosis. Objective: To determine the frequency of leg pain and edema and to determine the factors associated with leg pain and edema among nurses working in shifts on duty. Methods: It was a cross-sectional study, carried out at Ziauddin Hospital Karachi on 242 male and female nurses. Non-probability purposive sampling method was used to access the participants. Data was collected on a questionnaire designed for the study, Pain numeric rating scale was used to record pain. A chi-square test of independence was applied to the association. The p-value ≤ 0.05 was considered statistically significant. Results: Out of a total of 242 nurses, the majority 84 (56.4%) were male nurses and 65(43.6%) were female nurses. Lower extremity pain was reported in 55 % and leg edema in 22.53% of participants. A significant association between right leg pain, left leg pain, low extremity pain, and leg edema was found with gender; females were more prone as compared to male nurses (p&lt;0.001). Furthermore, a significant association between pain and leg edema is established in participants who were on double duty. The highest number of participants with leg pain and edema were observed in the sub group with body weight of 68 kg and above. There was a significant association between leg edema and the body weight. Conclusion: It is concluded that the frequency of leg pain and edema was much higher in nurses with body weight of 68kg and above and working double duty in a shift in a tertiary care private hospital.

Self-efficacy resources program for behavior changes

Self-efficacy resources program for behavior changes

Pemeriksaan Kesehatan Lansia Dhuafa Binaan Pimpinan Wilayah Aisyiyah Provinsi Kalimantan Timur

The poor elderly are people aged 60 years and over, who experience socio-economic problems so they do not carry out their health checks due to limitations. This community service aims to detect health problems early in elderly poor people who have difficulty accessing health facilities due to their limitations. This early detection of health is carried out free of charge with the aim of helping poor elderly people who cannot carry out health checks due to various obstacles, held at the Siti Khadijah Orphanage, Jalan Merdeka Samarinda, on September 24, 2022. Participants in the detection of health problems consisted of 51 elderly people, checking their blood pressure, weight, height, current blood sugar, uric acid, and cholesterol. From this examination, the highest number of participants were the elderly as much as 90.2%, the elderly who were detected to have high blood pressure as much as 60.8%, had diabetes mellitus as much as 21.6%, had high cholesterol levels based on sex as much as 35.3%, and who experienced hypercholesterolemia as much as 43.1%, and 45.1% who are obese.

Clinical Profile Analysis of Tuberculosis Patients Attended in a Tertiary Care Hospital in Bangladesh

Background: Despite noteworthy socio-economic development and advances in medical science, tuberculosis (TB) remains a major public health problem. Although it is a curable disease, still millions of people suffer and a large number of patients die from this infectious disease. Now a day, the prevalence and nature of tuberculosis are not in a consistent stage. So we need more current information regarding this issue. Aim of the study: The aim of this study was to assess the clinical profile of tuberculosis patients attended in a tertiary care hospital in Bangladesh. Methods: This was a prospective, observational study which was conducted in the department of Medicine, North Bengal Medical College, Sirajgonj, Bangladesh during the period from January 2020 to June 2022. In total 87 diagnosed patients with tuberculosis, treated in the mentioned hospital were selected as the study subjects. Before data collection, proper written consents were taken from all the participants. For data collection a predesigned questionnaire was used in data collection. Collected data were processed, analyzed and disseminated by using MS Excel and SPSS version 23.0 program as per necessity. Results: In this study, the male-female ratio of the participants was 1.7:1. The highest number of participants were from the 41-50 years’ age group which was 27.59%. BMI (Kg/m2) was found ≥18.5 in 61% and &lt; 18.5 was found in 39% of patients. Majority (56%) of the cases were ‘non- smoker’. As the types of TB, pulmonary Koch’s, CNS tuberculosis, abdominal Koch’s, and TB lymphadenitis were found in 43% 21%, 14%, and 13% of participants respectively which was noticeable. In this study, among all the participants, cough and fever were found as two most frequent symptoms which were found in 93% and 84% of patients respectively. Conclusion: Fever and cough are the two most frequent symptoms in tuberculosis patients. Although the death rate among TB patients is not alarming, the treatment success rate of the first treatment attempt is not satisfactory among tuberculosis patients.

Temporal pattern of humoral immune response in mild cases of COVID-19.

Understanding the humoral response pattern of coronavirus disease 2019 (COVID-19) is one of the essential factors to better characterize the immune memory of patients, which allows understanding the temporality of reinfection, provides answers about the efficacy and durability of protection against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and consequently helps in global public health and vaccination strategy. Among the patients who became infected with SARS-CoV-2, the majority who did not progress to death were those who developed the mild COVID-19, so understanding the pattern and temporality of the antibody response of these patients is certainly relevant. To investigate the temporal pattern of humoral response of specific immunoglobulin G (IgG) in mild cases of COVID-19. Blood samples from 191 COVID-19 real-time reverse transcriptase-polymerase chain reaction (RT-qPCR)-positive volunteers from the municipality of Toledo/ Paraná/Brazil, underwent two distinct serological tests, enzyme-linked immunosorbent assay, and detection of anti-nucleocapsid IgG. Blood samples and clinicoepidemiological data of the volunteers were collected between November 2020 and February 2021. All assays were performed in duplicate and the manufacturers' recommendations were strictly followed. The data were statistically analyzed using multiple logistic regression; the variables were selected by applying the P < 0.05 criterion. Serological tests to detect specific IgG were performed on serum samples from volunteers who were diagnosed as being positive by RT-qPCR for COVID-19 or had disease onset in the time interval from less than 1 mo to 7 mo. The time periods when the highest number of participants with detectable IgG was observed were 1, 2 and 3 mo. It was observed that 9.42% of participants no longer had detectable IgG antibodies 1 mo only after being infected with SARS-CoV-2 and 1.57% were also IgG negative at less than 1 mo. At 5 mo, 3.14% of volunteers were IgG negative, and at 6 or 7 mo, 1 volunteer (0.52%) had no detectable IgG. During the period between diagnosis by RT-qPCR/symptoms onset and the date of collection for the study, no statistical significance was observed for any association analyzed. Moreover, considering the age category between 31 and 59 years as the exposed group, the P value was 0.11 for the category 31 to 59 years and 0.32 for the category 60 years or older, showing that in both age categories there was no association between the pair of variables analyzed. Regarding chronic disease, the exposure group consisted of the participants without any comorbidity, so the P value of 0.07 for the category of those with at least one chronic disease showed no association between the two variables. A temporal pattern of IgG response was not observed, but it is suggested that immunological memory is weak and there is no association between IgG production and age or chronic disease in mild COVID-19.

Risk Perception and Preventive Practice During the COVID-19 Pandemic in the General Population.

Background People's perceptions of the COVID-19 pandemic and its associated risk are very essential to prevent the spread of the infection. The awareness among individuals may contribute to preventing COVID-19 infections. Coronavirus disease is a serious public health issue. However, preventive practices toward COVID-19 are relatively unknown. The present study aims to survey the risk perception and preventive practice during the COVID-19 pandemic among the general population in Odisha. Method A cross-sectional online survey among 395 participants was conducted by adopting the convenience sampling technique. The tools used for the surveyconsist of three divisions: collection of sociodemographic data, assessment of risk perception toward COVID-19, and assessment of preventive practices during COVID-19 through an online survey method. Results The majority (83.29%) of the participants strongly agreed that social distancing is necessary to control the transmission of COVID-19, 65.82% strongly agreed that lockdown is relevant to control COVID-19 spread, 49.62% strongly agreed that wearing a mask protects from the infection, and 40.25% strongly agreed that they will be able to connect with healthcare professionals if they are infected with COVID-19 infection. The finding revealed that the highest number of participants are always practicing all the preventive measures such as maintaining hand hygiene (77.21%), wearing a mask (68.10%), avoiding shaking hands (87.59%), willingness to seek medical help (90.37%), avoiding going to the market or meeting friends (80.75%), discussing preventive measures related to COVID-19 with their family members (76.45%), and eating only homemade food (87.34%). Conclusion This study found that an average number of study participants who had the highest level of practice on preventive measures are those who had higher perceived risk among the general population. Expanding the knowledge regarding the infection and its ill effect on health through the proper channel can bring a drastic change in the attitude of the general public. As many people depend on television and social media for acquiring information about COVID-19, any information that reaches the public should be accurate and based on evidence. To avoid miscommunication and the further spread of COVID-19, health education and awareness have to be implemented to increase self-efficacy and risk identification among the general public, which eventually increases the practice of preventive measures.