Hospital-based Case-control Study Research Articles

Association between migraine and pre-eclampsia among pregnant women: a single hospital-based case-control study in India.

Pre-eclampsia and migraine share some similar aspects of pathophysiology such as vascular function, platelet activation, and enhanced clotting. A few observational studies from different demographics showed that pregnant women with a history of migraine were at higher risk of developing pre-eclampsia. However, there is no such evidence available from the Indian context. Hence, a hospital-based case-control study was conducted among Indian women to determine the association between migraine and pre-eclampsia. It was a single-centre case-control study in a tertiary care hospital in India. Cases were pregnant women with clinically diagnosed pre-eclampsia, and controls were normotensive pregnant women. Migraine was diagnosed with a questionnaire adapted from the "International Classification of Headache Disorders (ICHD), 3rd Edition" by the International Headache Society, (IHS). We performed logistic regression to explore the association between migraine and pre-eclampsia. One hundred sixty-four women (82 women per group) were enrolled. The mean age among the cases (24.5years, standard deviation of 2.4years) was slightly higher than the mean age of the controls (23.5years, standard deviation of 2.5years) with a p-value of 0.006. We found that women with a history of migraine were more likely to develop pre-eclampsia (Adjusted Odds Ratio 6.17; p-value < 0.001, 95% Confidence Interval of 2.85 to 13.62). The current findings suggest a significant association between migraine and pre-eclampsia aligning with previous study findings; nevertheless, larger follow-up studies including women from different states in India are needed.

Evaluation of Some Liver Enzymes in HIV/AIDS Patients on Antiretroviral Therapy in University of Abuja Teaching Hospital, Nigeria

Background: Hepatoxicity is a major complication and side effect of antiretroviral therapy (ART). Unfortunately, such studies in this area of evaluating the adverse drug reaction of ART on the liver hepatocytes are only few in number in Nigeria.Objective: To determine the levels of some liver enzymes in HIV/AIDS patients on antiretroviral therapy (ART) and as well evaluate their impact on liver hepatocytes.Methods: This is a hospital-based case-control study. A total of 153 subjects were recruited in the study, and they were divided into three groups: the control group (which consist of apparently healthy subjects), the study group 1 (consist of HIV positive subject not on ART), and study group 2 (consist of HIV/AIDS patients on ART). The liver enzymes Alanine amino Transferase (ALT), Asparate amino Transfarase (AST) and Alkaline Phosphatase (ALP) were determined using enzyme linked spectrophotometric assay methods, according to the manufacturer’s specifications.Results: The mean standard deviation (SD) of ALT and AST activity of the study group 1 showed significant differences when compared with that of the control group P&lt;0.001, but the ALP has no significant differences P&gt;0.05. In Study group 2, (HIV/AIDS patients on ART) showed significant differences of P&lt;0.001 in ALT, AST and ALP.Conclusion: Some liver enzymes were elevated in subjects on antiretroviral therapy; this elevation could be due to hepatotoxicity of the (ART) used by the HIV/AIDS patients on the liver hepatocytes.International Journal of Human and Health Sciences Vol. 08 No. 02 Apr’24 Page: 126-131

Sociodemographic and Lifestyle Characteristics Associated with Maternal Dietary Patterns in Mexico

There is scarce evidence on sociodemographic and lifestyle characteristics that may explain adherence to different dietary patterns (DPs) during pregnancy. Our aims were to identify dietary patterns in a sample of pregnant Mexican women and to describe their association with selected sociodemographic and lifestyle characteristics. This is a secondary cross-sectional analysis of 252 mothers of children that participated as controls in a hospital-based case–control study of childhood leukemia. We obtained parents’ information about selected sociodemographic characteristics, as well as alcohol and tobacco consumption. We also obtained dietary information during pregnancy. We identified DPs using cluster and factor analyses and we estimated their association with characteristics of interest. We identified two DPs using cluster analysis, which we called “Prudent” and “Non healthy”, as well as three DPs through factor analysis, namely “Prudent”, “Processed foods and fish”, and “Chicken and vegetables”. Characteristics associated with greater adherence to “Prudent” patterns were maternal education, older paternal age, not smoking, and being a government employee and/or uncovered population. Likewise, the “Processed foods and fish” pattern was associated with greater maternal and paternal education, as well as those with less household overcrowding. We did not identify sociodemographic variables related to the “Chicken and Vegetables” pattern. Our results may be useful to identify target populations that may benefit from interventions aimed to improve individual dietary decisions during pregnancy.

Evaluation of increased posterior tibial slope as a risk factor for anterior cruciate ligament injury

Individuals who sustain anterior cruciate ligament (ACL) injury have an increased risk of developing early onset post traumatic osteoarthritis of the knee despite treatment received [1]. An increase in the posterior tibial slope is postulated to increase the risk of ACL rupture [2]. Measurement of the posterior tibial slope in individuals would serve as a means of screening and identifying those at increased risk of developing ACL injuries to take measures towards prevention. The aim was to measure and compare the mean value of the posterior tibial slope in adult patients with or without ACL injury. This was a hospital-based case-control study comprising 80 patients divided into two matched groups. Posterior tibial slope was measured on the plain lateral radiograph of the knee using the proximal tibial anatomic axis measurement protocol in all participants. Independent sample t-test was used to compare the means of the measured posterior tibial lope between cases and controls. The difference in the measured mean posterior tibial slope between the ACL injured group and the non-ACL injured group was found to be statistically significant with those in the ACL injured group having higher mean values (12.71 ± 1.2° vs 10.25 ± 1.1°) with a P value of &lt; 0.001. Individuals with ACL injury have a significantly greater posterior tibial slope than those without ACL injury when measured on the lateral plain radiograph of the knee using the proximal tibial anatomic axis measurement protocol.

Association of Risk Factors with Female Pattern Hair Loss

Introduction: Female Pattern Hair Loss (FPHL) is one of the main causes of hair loss in adult women and has a major impact on individual’s quality of life. It evolves from the progressive miniaturization of follicles that lead to a subsequent decrease of the hair density, leading to a non-scarring diffuse alopecia. In spite of the high frequency of the disease and the relevance of its psychological impact, its pathogenesis is not yet fully understood, being influenced by genetic, hormonal, and environmental factors. Objective: To evaluate etiological factors associated with female pattern hair loss. Materials &amp; Methods: This was a hospital-based case control study, conducted in the Department of Dermatology &amp; Venereology, Bangabandhu Sheikh Mujib Medical University (BSMMU) from March, 2021 to August, 2022. In this study, total 100 females aged 18 to 45 years were enrolled. Among them, 30 females had history of hair loss &gt;6 months, presented to outpatient department, BSMMU were included as case &amp; 70 healthy females who had no history of hair loss included as control according to inclusion &amp; exclusion criteria. Diagnosis of FPHL was made clinically &amp; Ludwig classifications were used to assess the degree of hair loss. Information on possible risk factors for FPHL was collected using a questionnaire interview. Result: The mean age of the patients with FPHL was 41.0±7.77 years with majority belongs to &gt;40 years of age group &amp; their mean duration of hair loss was 26.3±12.0 months. Among the patients of FPHL, 36.7% had history of inadequate intake of iron containing food, 66.7% had family history of alopecia, 36.7% had history of increased bleeding during their menstruation, 20.0% had multiple (&gt;3) childbirth &amp; 23.3% had hypertension. About 86.7% patients with FPHL had low serum ferritin (&lt;30ng/ml) with mean serum ferritin level was 20.25±16.07ng/ml and 66.7% patients of FPHL had low Hb (&lt;12 µg/l) with mean Hb was 11.47±1.52 µg/l. In the multivariate logistic regression analysis significant association found with FPHL were age (OR 2.013, 95% CI 0.672-3.714), family history of alopecia (OR1.231, 95% CI 0.162-1.991) and lower serum ferritin level (OR1.090, 95% CI 1.043-1.139). Conclusion: Age, family history of alopecia, lower serum ferritin may be implicated as risk factors for female pattern hair loss. Medicine Today 2023 Vol.36 (1): 7-11

Determinants of cardiovascular disease among type 2 diabetic patients attending diabetic follow-up clinic in Arba Minch general hospital, southern Ethiopia: an unmatched case-control study.

Cardiovascular disease (CVD) is a major cause of death and disability among patients with type 2 diabetes, especially in low-income and middle-income countries. Type 2 diabetes mellitus (T2DM) patients have a 2-4-fold increased risk of CVD. There is limited data about cardiovascular disease risks and its determinants among T2DM patients in Ethiopia. This study aimed to identify possible predictors of cardiovascular diseases among adults with T2DM in southern Ethiopia. A hospital-based unmatched case-control study was conducted at southern Ethiopia Arbaminch Hospital on 196 randomly selected patients with type 2 diabetes on follow-up (98 cases and 98 controls). The authors collected data using a structured interviewer-administered questionnaire, laboratory checklist, and additional document review of T2DM patients. A multivariable binary logistic regression was fitted to identify cardiovascular disease determinants, and the findings were presented using an adjusted odds ratio (AOR) with a 95% CI. The mean reported age (±SD) of the cases and the controls was 56.3.3 (±8.9) and 52.3 (±9.3) years, respectively. The two identified independent determinants of cardiovascular disease with AOR [95% CI] were hypertension [AOR=4.953, 95% CI (2.47, 9.93) and persistent urine albuminuria [AOR=12.9, 95% CI (3.98, 41.7)]. This study showed that having high blood pressure and persistent urine albuminuria are independent predictors of cardiovascular disease in T2DM patients. The current study setting needs an intervention for mitigating these cardiovascular disease determinants.

Determinants of early-onset colorectal cancer: a multicenter case-control study in Iran.

We aimed to study the risk factors of early-onset colorectal cancer (CRC) incidence in the Iranian population. Early onset CRC in Iran is a relevant health issue that deserves further epidemiological efforts to be defined and controlled as far as possible. Early age screening of low-tract of the intestine would be particularly useful in families of colorectal cancer patients. We analyzed data from a multicenter hospital-based case-control study in Iran (The Iranian Study of Opium and Cancer). Sociodemographic and lifestyle information was collected using validated questionnaires. Multivariate logistic regressions estimated the odds ratios (OR) and 95% confidence intervals (CIs) for the association of early-onset CRC in individuals under the age of 50 and potential risk factors, including physical activity, socioeconomic status, body shape at age 15, dietary factors, vitamin D, cigarettes and waterpipe smoking, opium use and family history of CRC. Additionally, a subgroup analysis was conducted for individuals with a very young age of CRC onset (i.e. <35 years). We analyzed data of 189 developed CRC below age 50 (99 colon and 90 rectum), and 66 patients under the age 35 (13 colon and 21 rectum). Early CRC was inversely associated with vegetables (OR, 0.59; 95% CI, 0.38-0.92 for 422-576 g/day) and vitamin D (OR, 0.49; 95% CI, 0.26-0.94), and positively associated with red meat intake (OR, 1.80; 1.15-2.83 per 25.65 g/day). Vegetables (OR, 0.51; 95% CI, 0.27-0.98 for 576 g/day), red meat (OR, 2.05; 95% CI, 1.11-3.79 for 25.65 g/day), vitamin D (OR, 0.29; 95% CI, 0.10-0.86) and opium use (OR, 2.61; 95% CI, 1.01-6.74) were associated with early rectum cancer. Results were heterogeneous by cancer site for high fruit and vegetables intakes and cigarette smoking. Family history was associated with CRC (OR, 3.16; 95% CI, 1.29-10.9) and rectum cancer (OR, 3.22; 95% CI, 1.24-14.4) in subjects younger than 35, and, to a lesser extent, with CRC and rectum cancer before age 50. Early-onset CRC was related to the intake of vegetables, vitamin D and red meat in Iran. Early-onset rectum cancer was associated with regular opium use. Family history was associated with early CRC and early rectum cancer, particularly below the age of 35.

Association between Interleukin-6 Gene Polymorphism (rs1800795 and rs1800796) and Type 2 Diabetes Mellitus in a Ghanaian Population: A Case-Control Study in the Ho Municipality.

There is no conclusive evidence on the association between interleukin- (IL-) 6 gene polymorphism and type 2 diabetes mellitus (type 2 DM). Thus, this study is aimed at evaluating the role of rs1800795 and rs1800796 polymorphisms in the pathogenesis of type 2 DM among Ghanaians in the Ho Municipality. We recruited into this hospital-based case-control study 174 patients with type 2 DM (75 DM alone and 99 with DM+HTN) and 149 healthy individuals between 2018 and 2020. Demographic, lifestyle, clinical, anthropometric, and haemodynamic variables were obtained. Fasting blood samples were collected for haematological, biochemical, and molecular analyses. Genomic DNA was extracted, amplified using Tetra-primer amplification refractory mutation system-polymerase chain reaction (T-ARMS-PCR) technique, and genotyped for IL-6 gene polymorphism. Logistic regression analyses were performed to assess the association between IL-6 gene polymorphism and type 2 DM. The minor allele frequency (MAF) of the rs1800795 and rs1800796 polymorphisms was higher in DM alone (57.5%, 62.0%) and DM with HTN groups (58.3%, 65.3%) than controls (33.1%, 20.0%). Carriers of the rs1800795GC genotype (aOR = 2.35, 95% CI: 1.13-4.90, p = 0.022) and mutant C allele (aOR = 2.41, 95% CI: 1.16-5.00, p = 0.019) as well as those who carried the rs1800796GC (aOR = 8.67, 95% CI: 4.00-18.90, p < 0.001) and mutant C allele (aOR = 8.84, 95% CI: 4.06-19.26, p = 0.001) had increased odds of type 2 DM. For both polymorphisms, carriers of the GC genotype had comparable levels of insulin, HOMA-IR, and fasting blood glucose (FBG) with those who carried the GG genotype. IL-6 levels were higher among carriers of the rs1800796GC variant compared to carriers of the rs1800796GG variant (p = 0.023). The rs1800796 polymorphism, dietary sugar intake, and exercise status, respectively, explained approximately 3% (p = 0.046), 3.2% (p = 0.038, coefficient = 1.456), and 6.2% (p = 0.004, coefficient = -2.754) of the variability in IL-6 levels, suggesting weak effect sizes. The GC genotype and mutant C allele are risk genetic variants associated with type 2 DM in the Ghanaian population. The rs1800796 GC variant, dietary sugar intake, and exercise status appear to contribute significantly to the variations in circulating IL-6 levels but with weak effect sizes.

A Comparative Study on Serum Levels of “Thymic Stromal Lymphopoietin” Between Patients with Psoriasis Vulgaris and Healthy Individuals: A Case-Control Study

Abstract Background: Thymic stromal lymphopoietin (TSLP) is a cytokine initially implicated to be associated with allergic disorders inducing Th2 response. Emerging studies have shown that TSLP is also involved in autoimmune diseases. In psoriasis, TSLP acts in synergy with T cell-derived CD40L to promote the release of IL-23 from dendritic cells. IL-23 is responsible for the inappropriate immune reaction and keratinocyte proliferation in psoriasis. Targeting TSLP could be a novel therapeutic approach in the treatment of psoriasis. Objective: To compare the serum levels of TSLP between patients with psoriasis and healthy individuals. Materials and Methods: A prospective hospital-based case-control study was carried out on 38 patients with psoriasis. The severity of psoriasis was graded into mild, moderate, and severe according to PASI. A total of 30 healthy individuals with matched age and sex were taken as controls. 5 ml of venous blood was collected, centrifuged, and the collected serum was stored at -80°C until quantitative assessment by sandwich enzyme-linked immunosorbent assay (ELISA) technique. Results: TSLP has been found to be significantly elevated in the sera of cases (0.1380178 pg/ml) than in controls (0.1125974 pg/ml). There was also a significant proportionate increase in the mean TSLP with the mean PASI score. Limitations: The sample size was small and we could not follow-up the cases to study the changes in TSLP levels with remission of the lesions. Conclusion: We found that serum TSLP was elevated in psoriasis patients and correlated with disease severity, indicating a possible pathogenetic role.

Clinical Outcome and Factors with Dietary Behaviors in Pregnant Women with Listeria monocytogenes: A Hospital-Based Case-Control Study in Shanghai.

Listeriosis is a globally rare foodborne disease that causes fetal-placental infection, leading to adverse pregnancy outcome, while limited research among pregnant women is available in China. This study was therefore aimed at analyzing the incidence, clinical manifestations, and clinical outcome of listeriosis among pregnant women and its associated dietary behavior risk factors in prevention. A hospital-based case-control study had been conducted from January 2017 to December 2021. Clinical data, laboratory information, and questionnaires including dietary behaviors and personal hygiene were collected within 2 days after case diagnosis. There were 48 pregnant women, including 12 cases and 36 controls, with an average age of 31.19 ± 3.75 years. The incidence of admission-based listeriosis among pregnant women was 1.6058 per 10,000. The 12 strains were divided into 3 serotypes: 1/2a(83.33%), 1/2b(8.33%), and 4b(8.33%). Among the cases, 5 cases (41.67%) resulted in abortion, 3 cases (25%) induced preterm labor, and 4 cases (33.33%) had full-term deliveries after treatment. There were 7 live births in the case group, among which 6 were admitted to the neonatal intensive care unit (NICU), while 1 case had a healthy fetal outcome. All patients in the control group gave birth to live fetuses. Epidemiological investigation revealed that pregnant women dining at restaurants three or more times per week might increase the risk of having Listeria infection. There were no significant differences in dietary consumed behaviors, hand hygiene, and refrigerator usage behaviors between case and control groups. The study suggested that dining at restaurants might be associated with Listeria infection among pregnant women. Therefore, it is essential to enhance education on listeriosis serious consequences and promote healthy dietary and hygiene habits among pregnant women.

Stillbirth rate and associated factors at the Bamenda Regional hospital, North-West region, Cameroon, from 2018 to 2022: a case control study

BackgroundStillbirth is a common adverse pregnancy outcome worldwide, with an estimated 2.6 million stillbirths yearly. In Cameroon, the reported rate in 2015 was 19.6 per 1000 live births. Several risk factors have been described, but region-specific risk factors are not known in the northwest region of Cameroon. This study aims to determine the stillbirth rate and associated factors at the Bamenda Regional hospital, North-West region of Cameroon.Materials and methodsA Hospital-based case‒control study conducted from December 2022 to June 2023 on medical files from 2018 to 2022 at the Bamenda Regional Hospital. Cases were women with stillbirths that occurred at a gestational age of ≥ 28 weeks, while controls were women with livebirths matched in a 1:2 (1 case for 2 controls) ratio using maternal age. Sociodemographic, obstetric, medical, and neonatal factors were used as exposure variables. Multivariable logistic regression was used to determine adjusted odds ratios of exposure variables with 95% confidence intervals and a p value of < 0.05.ResultsA total of 12,980 births including 116 stillbirths giving a stillbirth rate of 8.9 per 1000 live births. A hundred cases and 200 controls were included. Factors associated with stillbirths after multivariable analysis include nulliparity (aOR = 3.89; 95% CI: 1.19–12.71; p = 0.025), not attending antenatal care (aOR = 104; 95% CI: 3.17–3472; p = 0.009), history of stillbirth (aOR = 44; 95% CI: 7-270; p < 0.0001), placenta abruption (aOR = 14; 95% CI: 2.4–84; p = 0.003), hypertensive disorder in pregnancy (aOR = 18; 95% CI: 3.4–98; p = 0.001), malaria (aOR = 8; 95% CI: 1.51-42; p = 0.015), alcohol consumption (aOR = 9; 95% CI: 1.72-50; p = 0.01), birth weight less than 2500 g (aOR = 16; 95% CI: 3.0–89; p = 0.001), and congenital malformations (aOR = 12.6; 95% CI: 1.06–149.7;p = 0.045).ConclusionThe stillbirth rate in BRH is 8.9 per 1000 live births. Associated factors for stillbirth include nulliparity, not attending antenatal care, history of stillbirth, placental abruption, hypertensive disorder in pregnancy, malaria, alcohol consumption, birth weight less than 2500 g, and congenital malformations. Close antenatal care follow-up of women with such associated factors is recommended.

Effect of housing construction material on childhood acute respiratory infection: a hospital based case control study in Bangladesh

Despite several studies conducted to investigate housing factors, the effects of housing construction materials on childhood ARI symptoms in Bangladesh remain unclear. Hence, the study aimed to measure such a correlation among children under the age of five. A hospital-based case–control study was conducted, involving 221 cases and 221 controls from January to April 2023. Bivariate and multivariate binary logistic regression was performed to measure the degree of correlation between housing construction materials and childhood ARI symptoms. Households composed of natural floor materials had 2.7 times (95% confidence interval 1.27–5.57) and households composed of natural roof materials had 1.8 times (95% confidence interval 1.01–3.11) higher adjusted odds of having under-five children with ARI symptoms than household composed of the finished floor and finished roof materials respectively. Households with natural wall type were found protective against ARI symptoms with adjusted indoor air pollution determinants. The study indicates that poor housing construction materials are associated with an increased risk of developing ARI symptoms among under-five children in Bangladesh. National policy regarding replacing poor housing materials with concrete, increasing livelihood opportunities, and behavioral strategies programs encouraging to choice of quality housing construction materials could eliminate a fraction of the ARI burden.

Evaluation of IL-4 and IL-13 Single Nucleotide Polymorphisms and Their Association With Childhood Asthma and Its Severity: A Hospital-Based Case-Control Study.

Asthma is a common, chronic, atopic respiratory disease that is on the rise among children and adults worldwide. Various environmental, genetic, and biological interactions contribute to the surge in susceptibility to this disease. Interleukin (IL) genes, particularly IL-4 and IL-13, have been linked to asthma pathogenesis. The present study aims to investigate the genetic aberrations, specifically single nucleotide polymorphisms (SNPs) of IL-4 and IL-13, and their association with childhood asthma and its severity. An unmatched hospital-based case-control study was conducted in a tertiary care hospital in Assam, India. The sample size was calculated to be 120 (60 cases and 60 controls) using the Epi Info software version 7.2 (Centers for Disease Control and Prevention, Atlanta, GA, USA), assuming a confidence interval of 95%, a power of the study at 80%, a ratio of control to cases as 1, a proportion of controls with exposure at 22%, and a proportion of cases with exposure at 46%. A total of 53 clinically diagnosed cases of childhood asthma in the age range of three to 12 years and 39 healthy controls free from respiratory diseases and having no history of asthma and/or allergy of the same age group attending a tertiary care hospital were included in the study. Children who never had asthma or allergies and who did not suffer from any upper or lower respiratory infections for the previous four weeks were considered controls. Prior informed consent and ethical clearance were obtained. Very seriously ill cases and controls were excluded from the study. The genetic investigation used polymerase chain reaction (PCR), followed by restriction fragment length polymorphism (RFLP), to discover SNPs in the IL-4 and IL-13 genes. Sequencing analysis was done for the cases with +2044 G>A of the IL-13 gene in relation to the severity of the disease. The difference in the proportions of specific SNPs between cases and controls was analyzed using the χ2test (a p-value of <0.05 was considered significant). Both the rs2070874 and rs2243250 polymorphisms of IL-4 showed no statistically significant associations. The mutation of the IL-13 gene in 1111C>T was higher among cases than controls. Both genotypic and allelic distributions of the +2044G>A polymorphism of the IL-13 gene revealed a significant association (p<0.05) with the severity of the disease. Genetic aberrations in SNPs of IL-4 and IL-13 are prevalent among the pediatric patients of the study region. The SNP +2044G>A of IL-13 is instrumental in disease manifestation and severity among the pediatric population of the study region.

IJCM_94A: Risk Factors for Short Birth Intervals in women: A Case-Control Study from a Tertiary Health Care facility in Central India

Background: The interval between successive pregnancies, commonly referred to as the birth interval, plays a crucial role in maternal and child health outcomes. Optimal birth spacing is associated with improved maternal nutritional status, reduced risks of adverse pregnancy outcomes, and enhanced child survival. Conversely, short birth intervals, defined as intervals less than 24 months between two consecutive live births, have been linked to an increased likelihood of adverse maternal and child health consequences. Through a comprehensive examination of the contextualized risk factors, we aim to provide evidence that can guide healthcare practitioners, policymakers, and public health professionals in their efforts to improve maternal and child health outcomes in Central India. Objective: To determine risk factors for short birth interval among women in the tertiary health care centre of Central India. Methodology: A hospital-based unmatched case-control study was employed on 45 cases and 45 controls. Cases were women who gave birth within the last 6 months and with at least two consecutive alive births with a birth interval of less than 33 months. Controls were women who gave birth within the last 6 months and had a birth interval between 33 to 59 months between two successive live births. The data was collected by predesigned and pretested semi structured questionnaire from selected respondents. Results: Some important risk factors identified in the present study were age less than 30 years, use of contraception and shorter duration of breastfeeding. Conclusion: Encouraging postpartum family planning and effective breastfeeding will go a long way to reduce the prevalence of short birth interval and its consequences on maternal, neonatal and child health

Exploring Serum Zinc and Copper Levels as Potential Biomarkers in Polycystic Ovary Syndrome: A Cross-Sectional Study From Northeast India.

Introduction Polycystic ovary syndrome (PCOS) is a prevalent hormonal disorder characterized by irregular menstrual cycles, ovarian cysts, and elevated androgen levels. The potential association between trace elements, specifically copper (Cu) and zinc (Zn), and PCOS has been explored, but a definitive relationship remains unclear. This study aims to investigate the levels of these trace elements in women with PCOS and their potential implications. Methods The study, conducted at Gauhati Medical College & Hospital, involved 60 individuals with PCOS and a matched control group. Ethical approval was obtained, and participants provided written informed consent. The study spanned from July2021to June2022, utilizing a hospital-based case-control study design. Diagnostic criteria adhered to the Rotterdam criteria, and serum copper and zinc levels were quantified using a double-beam UV spectrophotometer. Results In the PCOS group, the mean age was 23.01 ± 3.60 years, while the control group had a mean age of 23.34 ± 3.59 years, with no significant age difference. Mean copper levels were 147.32 ± 16.53 μg/dl in PCOS and 106.88 ± 15.60 μg/dl in controls, indicating a significant increase in PCOS (p < 0.0001). Mean zinc levels were 93.99 ± 6.76 μg/dl in PCOS and 85.42 ± 12.69 μg/dl in controls, also significantly higher in PCOS (p < 0.0001). Conclusion The study highlights significant differences in serum copper and zinc levels between women with PCOS and healthy controls, suggesting potential implications for the syndrome's pathophysiology. Further research is warranted to elucidate the precise roles of these trace elements in PCOS and explore therapeutic interventions.

Migraine among women with endometriosis: a hospital-based case-control study in Bangladesh

BackgroundEndometriosis is a disease among women of reproductive age, which causes several health problems like dysmenorrhoea, dyspareunia and subfertility. It also increases psychological stress and often results in marital disharmony. Similarly, migraine is more frequent among this group of women. Several studies have shown an association between endometriosis and migraine among groups of population completely different from Bangladesh. ObjectiveThe present study was conducted to identify the association between endometriosis and migraine among Bangladeshi population. Study DesignThis non-randomized case-control study was performed with cases of endometriosis and controls without endometriosis who were confirmed by laparoscopy or laparotomy. Among the study participants, we identified as cases of migraine in one group of respondents who were already diagnosed as patients of migraine and the others with complaints of headache were further confirmed by a medicine specialist. Patients were recruited from the department of obstetrics and gynaecology at the Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) General Hospital & Ibrahim Medical College. The study was approved by the Ethical Review Committee of BIRDEM. Multivariate logistic regression was used to identify the association between endometriosis and migraine using odds ratios and 95% confidence intervals. ResultsIn our study, out of the 1496 patients who underwent laparoscopy or laparotomy during the study period, the frequency of endometriosis was found to be 12.7%. We enrolled 190 confirmed endometriosis cases and an equal number of controls without endometriosis, maintaining the age distribution of the controls similar to that of the cases. The distribution of age, BMI, education and marital status of the patients with endometriosis were similar to that of controls. The average ages of respondents were 30.6 years in both the case and control groups. Regarding occupation, cases included more students than in controls (12% vs 0%). The odds of suffering from dysmenorrhoea and dyspareunia among the cases were 3.3 (P value <0.001, 95% CI: 2.66-4.15) and 9.5 (P value <0.001, 95% CI: 5.3-17.9) times higher than that of controls respectively. In addition, the odds of menstrual irregularity was 60% lower among the cases compared to that of controls (OR = 0.4, P value <0.001 95% CI: 0.24-0.64). No significant difference was observed in having primary subfertility and secondary subfertility among the two groups of respondents. Univariate regression analysis showed patients with endometriosis have 6.13 times higher odds (P value <0.001, 95% CI: 2.5-18.4) of having migraine, 2-time higher odds for headache (P value = 0.01, 95% CI: 1.2-3.2) compared to control patients. Further, the age and BMI-adjusted multivariate model showed subjects with endometriosis have 5.4 times higher odds of having migraine compared to non-endometriosis patients (P value <0.001, 95% CI: 2.11-16.4). Also, the higher the age of reproductive age of women, the more the odds of having migraine. For one year increase in age increases the odds of having migraine by 23% (OR = 1.23. 95% CI: 1.13-1.16, p-value = <0.001). ConclusionThe study results support the association between endometriosis and migraine among the Bangladeshi population, which is similar to relevant studies conducted in other geographical locations. The groups of physicians who treat patients suffering from the two diseases, endometriosis and migraine, should keep this interrelationship in mind to ensure a better quality of a patient's life.

Association between early spontaneous abortion and homocysteine metabolism.

The purpose of this study is to explore the effects of homocysteine (HCY) metabolism and related factors on early spontaneous abortion. We conducted a hospital-based case-control study and included a total of 500 cases and 1,000 controls in Shaanxi China. Pregnant women waiting for delivery in the hospital were interviewed to report their characteristics and other relevant information during pregnancy. The unconditional Logisitic regression model was applied to assess the association between early spontaneous abortion and HCY metabolism and related factors. The multiplicative model was applied to assess the effects of interaction of HCY metabolism and related factors on early spontaneous abortion. The logit test method of generalized structural equation model (GSEM) was used to construct the pathway diagram of HCY metabolism and related factors affecting early spontaneous abortion. Folic acid supplementation and adequate folic acid supplementation during periconception were the protective factors of early spontaneous abortion (OR = 0.50, 95% CI: 0.38-0.65; OR = 0.44, 95% CI: 0.35-0.54). The serum folate deficiency, higher plasma HCY in early pregnancy, the women who carried the MTHFR 677TT genotype were the risk factors of early spontaneous abortion (OR = 5.87, 95% CI: 1.53-22.50; OR = 2.94, 95% CI: 1.14-7.57; OR = 2.32, 95% CI: 1.20-4.50). The women's educational level and maternal and child health care utilization affected the occurrence of early spontaneous abortion by influencing the folic acid supplementation during periconception. The folic acid supplementation during periconception affected the occurrence of early spontaneous abortion by influencing the level of serum folate or plasma HCY in early pregnancy. The maternal MTHFR 677 gene polymorphism affected the occurrence of early spontaneous abortion by influencing the level of serum folate in early pregnancy. In terms of the risks for early spontaneous abortion, there was multiplicative interaction between higher plasma HCY in early pregnancy, serum folate deficiency in early pregnancy and maternal MTHFR 677TT genotype (OR = 1.76, 95% CI: 1.17-4.03), and there was multiplicative interaction between higher plasma HCY and serum folate deficiency in early pregnancy (OR = 3.46, 95% CI: 2.49-4.81), and there was multiplicative interaction between serum folate deficiency in early pregnancy and maternal MTHFR 677TT genotype (OR = 3.50, 95% CI: 2.78-5.18). The above interactions are all synergistic. The occurrence risk of early spontaneous abortion was significantly increased if multiple factors existed at the same time. Our study is the first time to construct the pathway of HCY metabolism and related factors affecting early spontaneous abortion, and provides a comprehensively new idea to prevent and reduce the occurrence of spontaneous abortion.

Prevalence of Increased QTc Dispersion Among Hypertensive Patients and Its Correlation to Clinical Risk Factors: A Hospital-Based Case-Control Study.

Background In Ghana and other sub-Saharan African countries, hypertension (HTN) prevalence is rapidly increasing. Hypertensive left ventricular hypertrophy (LVH) is associated with excess fibrous tissue deposition throughout the myocardium. This could lead to ventricular arrhythmias and sudden cardiac death. Increased corrected QT dispersion (QTcd) can cause ventricular repolarization and be used to identify patients at risk of ventricular tachyarrhythmia. The measurement of increased QTcd among hypertensive patients is a simple screening tool to stratify patients at cardiovascular risk. Methods A case-control hospital-based study was conducted on 200 consecutive hypertensive patients. Age- and sex-matched control groups of 200 normotensive individuals who gave informed consent were also recruited. The baseline clinical and demographic characteristics of participants were acquired using structured questionnaires. A physical examination and a resting 12-lead ECG were performed. Increased QTcd and LVH were determined. Results The mean age of hypertensive patients was 50.99±6.73 and 48.19±7.17 for the controls (p-value 0.63). The study population was predominantly female (1:2.4 male:female ratio). Higher mean values for QTcd and LVH (Sokolow-Lyon) were observed among hypertensive patients compared to controls. The prevalence of increased QTcd was 45.0% among hypertensive patients compared to 16.5% in controls (χ2=38.14, p-value <0.0000001, odds ratio = 4.14). Conclusion Increased QTcd is prevalent among hypertensive Ghanaians. Its measurement can be an effective non-invasive screening tool to risk-stratify hypertensive patients.

Pesticide exposure and risk of cholangiocarcinoma: A hospital-based matched case-control study.

Cholangiocarcinoma (CCA) caused by Opisthorchis viverrini is a well-known and significant public health issue in northeastern Thailand; however, a link between pesticide exposure (PE) and CCA risk has not yet been established. Therefore, our research objective was to investigate the relationship between PE and CCA risk. A hospital-based matched case-control study was carried out. All cases (in-patients) and controls (out-patients) were volunteers at a tertiary hospital in northeast Thailand. Between 2015 and 2019, 178 incident cases of pathologically-confirmed CCA and 356 controls were selected from the check-up clinic from the Srinagarind Hospital outpatient database (two controls per case). The recruited controls were individually-matched to the CCA cases based on sex, age (±5 years) and admission date (±3 months). During face-to-face interviews, a standardised pre-tested questionnaire was used to collect data. Multivariable conditional logistic regression was used to analyse the data. The respective frequency of PE between the 178 CCA cases and 356 controls was 77.0% versus 87.6% for never used, 14.6% versus 5.3% for have used but stopped and 8.4% versus 7.0% for currently using. After adjusting for the highest educational attainment, smoking behaviour, alcohol use and family history of cancer, PE was not significantly associated with CCA (p-value = 0.086). Using volunteers who have never used PE as the reference group, the respective odds of developing CCA for those who have ever used but have since stopped and are currently using was 2.04 (adjusted OR = 2.04; 95% CI: 1.03-4.04) versus 0.83 (adjusted OR = 0.83; 95% CI: 0.39-1.76) times more likely to develop CCA than those who had never used PE. There is no association between PE and the risk of CCA. Notwithstanding the finding, future research should focus on enhancing PE assessment methods that consider complex chemical mixtures, chemicals of interest, historical exposure and exposure pathways. Moreover, there is need for more extensive and longer population-based cohort studies that include younger, non-occupationally exposed individuals during periods of developmental susceptibility.

Exploring the association between ultra-processed foods and COPD: a case-control study

BackgroundWhile it is known that the overconsumption of ultra-processed foods (UPFs) is associated with a heightened risk of respiratory ailments, the specific effects of UPF intake on COPD remain unclear. This study was designed to explore the potential link between COPD and the consumption of UPFs among adult individuals in Iran.MethodsIn this hospital-based case-control study conducted at Alzahra University Hospital in Isfahan, Iran, we enrolled 84 patients newly diagnosed with COPD, along with 252 healthy controls matched for age and sex. COPD was defined based on the results of spirometry tests, specifically when the forced expiratory volume per second (FEV1) was less than 80% or the ratio of FEV1 to forced vital capacity (FVC) was less than 70%. To evaluate the dietary intake of the participants, we utilized a validated food frequency questionnaire (FFQ) consisting of 168 items. Additionally, we gathered data on potential confounding factors using a pre-tested questionnaire.ResultsThe mean ages for the case and control groups were 57.07 and 55.05 years, respectively. Our study found no significant association between the intake of ultra-processed foods (UPFs) and the likelihood of COPD, with an odds ratio (OR: 0.78, 95% CI: 0.34–1.77). This lack of association persisted even after adjusting for factors such as energy intake, sex, and age (OR: 0.48; 95% CI: 0.19–1.21). Further controlling for potential confounders like body mass index (BMI), physical activity, and smoking status did not alter this finding (OR: 0.367; 95% CI: 0.123–1.1008, P = 0.074).ConclusionsIn our study, we observed no significant association between the intake of Ultra-Processed Foods (UPFs) and the odds of Chronic Obstructive Pulmonary Disease (COPD). This finding remained consistent even after adjusting for factors such as energy intake, sex, age, Body Mass Index (BMI), physical activity, and smoking status. Therefore, within the scope of our study, it appears that the consumption of UPFs does not significantly impact the likelihood of developing COPD. However, we recommend further research to deepen our understanding of the intricate relationship between dietary habits and respiratory health.