Hospital-based Cross-sectional Study Research Articles

Intraocular pressure and gonioscopic findings in primary angle-closure disease in India—a big data study

AIM: To describe the gonioscopic profile and intraocular pressure (IOP) in primary angle-closure (PAC) disease in patients presenting to a tertiary eye care network in India. METHODS: A cross-sectional hospital-based study that included 31 484 new patients presenting between 2011 and 2021. Patients with a clinical diagnosis of PAC/suspect/glaucoma were included. The data was collected from an electronic medical record system. RESULTS: PAC glaucoma (PACG) (47.55%) was the most common diagnosis followed by PAC (39.49%) and PAC suspect (PACS; 12.96%). Female preponderance (54.6%) was noted with higher mean age at presentation among males (P<0.0001). PACS and PAC showed the highest prevalence in 6th decade but PACG was higher at 7th decade. The probability of angle opening was 95.93%, 90.32% and 63.36% in PACS, PAC and PACG eyes respectively post peripheral iridotomy (PI). Plateau iris syndrome (PIS) was noted in 252 eyes and all showed post dilated rise of IOP. A post dilated IOP rise was also noted with 8.86%, 33.95% and 57.19% eyes with PACS, PAC and PACG respectively with IOP rise between 6-8 mm Hg across the disease spectrum. CONCLUSION: The superior quadrant is the narrowest angle and difficult to open with indentation and post PI. The probability of angle opening is less in PIS especially the complete variety along with post dilated IOP rise. The post dilated IOP rise in angle closure eyes warrants a careful dilatation, especially with PIS.

Serum ferritin level and associated factors among uncontrolled adult type II diabetic follow-up patients: comparative based cross-sectional study

BackgroundUncontrolled type 2 diabetes mellitus (UT2DM) and its associated consequences nowadays have been a global health crisis, especially for adults. Iron has the property to oxidize and reduce reversibly, which is necessary for metabolic processes and excess accumulation of iron indicated by serum ferritin levels could have a significant impact on the pathophysiology of T2DM via generation of reactive oxygen species (ROS). However, no conclusive evidence existed about the association of serum ferritin with the state of glycemic control status. Therefore, this study aimed to evaluate serum ferritin levels and associated factors in uncontrolled T2DM patients and compare them with those of controlled T2DM and non-diabetic control groups.MethodsA hospital-based comparative cross-sectional study was conducted among conveniently selected 156 study participants, who were categorized into three equal groups of uncontrolled T2DM, controlled T2DM, and non-diabetic control groups from October 2 to December 29, 2023 at St. Paul’s Hospital Millennium Medical College. A pre-tested structured questionnaire was used to collect socio-demographic and diabetes-related information. The laboratory tests were done using an automated chemistry analyzer and IBM-SPSS statistical software (version-27) was utilized for data entry and analysis with a significance level of p < 0.05.ResultThe mean serum ferritin level was noticeably higher in uncontrolled T2DM patients as compared to controlled T2DM and control groups (p < 0.001). It was significantly correlated with HbA1c [r = 0.457, p < 0.001], fasting blood sugar (FBs) [r = 0.386, p < 0.001], serum iron [r = 0.430, p < 0.001], and systolic blood pressure (SBP) [r = 0.195, p = 0.047] in T2DM patients. A multivariate logistic regression model revealed that a rise in HbA1c (AOR = 3.67, 95% CI(1.50–8.98), serum iron (AOR = 1.02, 95% CI(1.01–1.04), male gender (AOR = 0.16, 95% CI(0.05–0.57) and being on oral hypoglycemic agent (OHA) monotherapy (AOR = 0.26, 95% CI(0.07–0.95) were key associated factors for the elevated serum ferritin among T2DM patients.ConclusionThe present study demonstrated that T2DM patients had elevated serum ferritin levels which might be related to the existence of long-term hyperglycaemia and that serum ferritin had a significant positive association with HbA1c and FBs, implying that it could be used as an additional biomarker to predict uncontrolled T2DM patients.

Profile and Visual Outcome of Patients having Keratoconus Attending Tertiary Eye Hospital, Nepal

Background: Keratoconus is a bilateral, asymmetric, chronic, progressive ectasia of the cornea in which patients experience distorted vision that is usually treated with rigid contact lenses when spectacles no longer provide adequate vision. The aim of the study is to find out the clinical profile and visual outcome of the patient having Keratoconus. Materials and Methods: The hospital based cross sectional study was done at Biratnagar Eye Hospital, Biratnagar. All the diagnosed Keratoconus patients referred from cornea clinic to contact lens clinic for contact lens trial were included in this study between 1stJanuary 2017 to 31st December 2019. Diagnosis was done by using keratometry and pachymetry findings or by using corneal topography findings and slit lamp examination. Results: Total 133 patients were enrolled in the study among them the mean (±SD) age was 20.2 (±6.9) with a minimum of 9 and a maximum of 50 years of age. Most of them were male 89 (67%) and 78 (58.7%) patients were between 16 to 25 years of age group. Most of the eyes had moderate 161 (63.4%) type in which the amount of refractive was high 201 (79%) and RGP contact lens 245 (96.4%) was tried for vision correction. Normal vision (0.0 to 0.5 Log MAR) was found in 255 (96%) of eyes among them 194 (73%) of eyes got better than 0.2 log MAR visual acuity after the contact lens trial. Conclusion: Keratoconus was found mostly in younger male patients and gas permeable contact lenses were most commonly used treatment modality.

Enteral tube feeding practices and associated factors among nurses working in South Wollo Zone Specialized and General Hospitals, Wollo, Ethiopia, 2022

BackgroundEnteral tube feeding is recommended as a route for nutrient delivery in critically ill patients. The practice of enteral tube feeding by nurses significantly influences patient treatment outcomes. Therefore, this study aimed to identify the practices of enteral tube feeding and the associated factors among nurses working in South Wollo Zone Specialized and General Hospitals, Wollo, Ethiopia, 2022.MethodsA hospital-based cross-sectional study design was conducted on 420 nurses from 1st August to 1st September 2022. Simple random sampling methods were used to select study participants. Data were collected using self-administered questionnaires and an observational checklist. The data were entered into Epi Data version 4.6 and analyzed using SPSS version 26. Variables with a p-value &amp;lt;0.05, a 95% confidence interval, and an adjusted odd ratio were considered to be significantly associated with enteral tube feeding practice.ResultA total of 400 nurses participated in the study, yielding a 95.2% response rate. The overall good practice of enteral tube feeding among nurses was 114 (28.5%) with a 95% CI of 23.8–33. Enteral tube feeding practice was significantly associated with a lack of adequate resources (AOR = 0.359, 95% CI: 0.192–0.673), unfamiliarity with current guidelines (AOR = 0.346, 95% CI: 0.203–0.586), lack of awareness (AOR = 0.511, 95% CI: 0.306–0.673) and the thermal effect of food (AOR = 0.56, 95% CI: 0.348–0.889).ConclusionThe enteral tube feeding practice among nurses was found to be 28.5%. Significant determinants of enteral tube feeding practice included a lack of awareness, inadequate resources in the institution, and unfamiliarity with the current guidelines for enteral feeding. To improve enteral feeding practices, it is recommended that sufficient resources be provided, guidelines be made readily available, and training programs be conducted for the nursing staff.

Surgical management of pancreatic cancer in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: a 5 years retrospective descriptive study

IntroductionThe incidence of Pancreatic cancer is different in different parts of the world. It is a cancer with the worst prognosis of all malignancies. Pancreatic cancer is predominantly a disease of an older population. There are different environmental (modifiable) and non-modifiable risk factors associated with the development of pancreatic cancer. At present, surgical resection is the only potential cure for pancreatic cancer. However, as only 10–20% of the patients have resectable disease at the time of diagnosis. The morbidities associated with surgeries for pancreatic cancers remain high though the post-operative mortality has shown significant reduction in the past few decades. So far, no study has been conducted to investigate pancreatic cancer in Ethiopia.ObjectivesTo assess the clinico-pathologic profile, associated factors, surgical management and short-term outcome of patients with pancreatic cancer in Tikur Anbessa Specialized hospital.MethodsA 5 years retrospective hospital-based cross-sectional study was conducted on 52 patients operated with the diagnosis of pancreatic cancer with either curative or palliative intents. The study period was from April 2016 to July 2021. The data collected includes demographic profile, associated risk factors and comorbidities, clinical presentations, biochemical parameters, pathologic features of the tumors as well as type of treatment offered and short term treatment outcome. The data was analyzed using SPSS version 25.ResultThe mean and median age of patients was 54.1 and 54.5% respectively. Males constitute about 52% the patients. 21% of the patients have potential risk factors; whereas only 10 (19.2%) of the patients had medical comorbidities. Median duration of symptoms at diagnosis was 12 weeks. Abdominal pain (88.5%) was the most common presenting symptom followed by anorexia (80.8%) and significant weight loss (78.8%), while 71.2% of the patients have jaundice. On clinical evaluation, 69.2% were jaundiced, while 34.6% had a palpable gallbladder. More than two third of patients presented with advanced disease. 76.9% of the tumors are located in the head of pancreas. More than three quarters (77%) of the surgeries performed were palliative. Postoperative morbidity and mortality were 19.2% and 3.8% respectively.ConclusionAge at first diagnosis of pancreatic cancer is relatively earlier in our setup. Most patients present with advanced condition, only amenable for palliative measures. The post-operative morbidity and mortality are more or less comparable with similar studies. The need for adjuvant therapy in pancreatic cancer should be emphasized.

Serum NT-proBNP levels in diabetes and its association with obesity, inflammation and glycemic status

Background: Type 2 diabetes mellitus (T2DM) patients are more prone to develop cardiovascular complications, and there is a dire need of a routine screening tool for risk assessment of heart failure (HF) in them. Aims and Objectives: The current study was conducted to estimate the levels of serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations in subjects with and without T2DM and evaluate the association between NT-proBNP and body mass index (BMI), waist circumference as markers of obesity, hemoglobin A1c (HbA1c), plasma fasting blood sugar (FBS), plasma postprandial blood sugar (PPBS),duration of diabetes as markers of glycemic control and serum C-reactive protein (CRP),an inflammatory marker in diabetic subjects. Materials and Methods: A hospital-based cross-sectional non-interventional study was done with 82 non-diabetic healthy volunteers and 82 T2DM patients. Anthropometric measurements (waist circumference [WC] and body mass index [BMI]) were recorded, and blood was analyzed for serum NT-proBNP, C-reactive protein (CRP), plasma fasting blood sugar (FBS), postprandial blood sugar (PPBS), and hemoglobin A1c (HBA1c). Data collected were analyzed by statistical software with P&lt;0.05 as the significance level. Results: Serum NT-proBNP level was significantly higher in diabetic group (P&lt;0.001) compared to non-diabetic group statistically. Correlation analysis in diabetic subjects showed a significant positive correlation of NT-proBNP with CRP (ρ+0.576, P&lt;0.001), duration of diabetes (ρ+0.780, P&lt;0.001), plasma FBS (ρ+0.524, P=0.003), plasma PPBS (ρ+0.673, P=0.013), and HbA1c (ρ+0.571, P=0.001) but there was no statistically significant correlation of NT-proBNP with BMI or WC values although the correlation was negative for both. Conclusion: The present study provides a novel perspective that measuring serum NT-proBNP may help in the earlier identification of impending HF in diabetic individuals assisting in prompt intervention which may be further confirmed by larger studies.

Determinants of Adverse Pregnancy Outcomes among Women Attending Antenatal Care-Clinic in Public Health Facilities in Nyando Sub-County, Kenya

Adverse pregnancy outcome (APO) refers to gestation results other than vaginal birth, which include premature birth, miscarriage and low birth weight which are main causes of maternal and neonatal illness and death. In Kenya, the maternal mortality ratio stands at 355 deaths per 100,000 live births. In Kisumu County maternal mortality rate stands at 495 per 100,000 live births per year and Nyando Sub-County has the second- worst record of adverse pregnancy outcomes. Therefore, the current the current study assessed the determinants of adverse pregnancy outcomes among women attending 4 selected public health facilities in Nyando Sub-County. In this multicenter hospital-based cross-sectional study, n=301 women who delivered at the 4 randomly selected hospitals Nyando Sub-County hospital and visited the ANC department at least twice were systematically randomly recruited from November 2022 to September 2023. Data was collected using pre-tested and structured questionnaire which consisted of sections of demographic and obstetric characteristics. Presence of at least one maternal complication was used to determine the presence of APO. SPSS version 27 was used for data analysis. Chi-square ( 2) was used to compare proportions based on pregnancy outcomes as normal and adverse. Association between socioeconomic status and APO, obstetric factors and APO as well as ANC visits and APO were determine using Binary logistic regression. Of the 301 participants, 96 (31.9%) had normal pregnancy outcome (NPO) while 205 (68.1%) had APO. Woman’s age, parity, marital status, family income and education were associated with APO p=0.001, p=0.001, p=0.001, p=0.001 and p=0.04 respectively. With regard to obstetric factors, women of between 16-35 years were less likely to develop APO [OR=0.410, 95% CI=0.260-0.670, p=0.001]. In terms of gestation period with 37 weeks as the reference group, women with 28-37 weeks of gestation are less likely to develop APO [OR=0.114, 95% CI=0.132- 0.497, p=0.001]. The study did not find any association with the number of ANC visits [OR=0.39 95% CI=0.36-1.26, p=0.314] however, women visiting ANC in the second trimester less likely to develop APO [OR=0.221, 95% CI=0.142-0.927, p=0.001]. Therefore, both sociodemographic and obstetric factor affect pregnancy outcome and early ANC visit is associated with better or normal pregnancy outcome.

The treatment pattern of advanced HR-positive and HER2-negative breast cancer in central southern China: a hospital-based cross-sectional study

AimsThis investigation aims to elucidate the treatment status of advanced HR+/HER2- breast cancer patients in Hunan Province of Central Southern China from November 2021 to December 2022.MethodsData from 301 patients with advanced HR+/HER2- breast cancer were collected from the breast cancer investigation project in Hunan under the guidance of the Chinese Society of Clinical Oncolfogy (CSCO). The data included the clinical characteristics of patients and the status of first-line and second-line rescue treatment.ResultsFirst-line chemotherapy and endocrine therapy for mBC accounted for 40% (121/301) and 60% (180/301) of treatments, respectively. AI (21%), AI plus CDK4/6 inhibitor (28%), and fulvestrant (24%) or fulvestrant plus CDK4/6 inhibitor (18%) were the most common first-line endocrine therapies. Taxane-based chemotherapy was the most common first-line chemotherapy (59%). Second-line chemotherapy and endocrine therapy for mBC accounted for 43% (72/166) and 57% (94/166) of treatments, respectively. Fulvestrant (23%) or fulvestrant plus CDK4/6 inhibitor (29%) were the most common second-line endocrine therapies. The prevalences of AI and AI plus CDK4/6 inhibitor decreased to 19% and 11%, respectively. T (taxane)-based chemotherapy was still the most common chemotherapy regimen (46%). Third-line chemotherapy was more prevalent than endocrine therapy (57% vs. 41%). T (taxane)-based chemotherapy was still the most common chemotherapy regimen (46%). Fulvestrant plus CDK4/6 inhibitor was the most common endocrine therapy (33%). AI, AI plus CDK4/6 inhibitor, and fulvestrant accounted for 21%, 12% and 18% of third-line endocrine therapies, respectively.ConclusionsCompared to chemotherapy, endocrine therapy was a more favorable choice for first-line and second-line treatment for HR+/HER2- advanced breast cancer patients in Hunan Province.

Treatment satisfaction and medication adherence and predictors among patients with heart failure in Ethiopia: a hospital-based cross-sectional study

Treatment satisfaction and medication adherence and predictors among patients with heart failure in Ethiopia: a hospital-based cross-sectional study

Magnitude and outcome of road traffic accidents among patients admitted in dessie town governmental hospitals, Northeast Amhara, Ethiopia, 2022

BackgroundRoad traffic accidents(RTA) are a major public health problem worldwide, accounting for almost 1.24 million deaths per year and it is the number one cause of death among those aged group 15–29 years. Even though there are great benefits from access to road transportation there also poses a great challenge in the individual’s daily activities ranging from minor injury to death.ObjectiveThis study aimed to assess the magnitude and outcome of road traffic accidents among patients admitted in Dessie Town Governmental Hospitals, Northeast Amhara, Ethiopia, 2022.MethodsA five-year hospital-based retrospective descriptive cross-sectional study design was conducted among 377 road traffic accident patients admitted to Dessie Town Governmental hospitals. Data were collected by simple random methods based on patient chart reviews from June 7/, 2022 to May 23/ 2017 using a checklist adapted from the WHO standard hospital-based road traffic accident questionnaires after obtaining consent from the concerned authority. EPI-Data software version 7.2 for data entry and SPSS version 25 for statistical analysis were used. Descriptive and inferential statistics were used. Statistical significance was declared at a p-value of < 0.05 with an adjusted odds ratio (AOR) and a 95% confidence interval (CI) in the final multinomial logistic regression model.ResultsThe magnitude of road traffic accidents was 59%, using of logistic multi nominal logistic regression we found results such that, road traffic victims who had unstable vital signs at admission (AOR = 6.4,95% CI; 2.5–16.6), didn’t get prehospital treatment (AOR = 9.3,95% CI; 4–20), and severe injury (AOR = 9, 95% CI;7-15.4), had a Glasgow coma scale of 3–5 (AOR = 5.2,95% CI; 1.4–20) were found predictors for death were as unstable vital signs at admission (AOR = 3.79,95%CI;2.1–6.8), Doesn’t get prehospital treatment (AOR = 2.8, 95% CI; 1.4–5.7), Hospital stay for one to two months duration (AOR = 6,95% CI;2.3–15), and greater than two months duration (AOR = 6.5,95%CI;2.5–17) were found predictors for disability among road traffic victims.Conclusions and recommendationsRoad traffic accidents constitute a major public health problem in our setting and contribute significantly to excessively high morbidity and mortality. Unstable vital signs at admission, Client doesn’t get prehospital treatment, severely injured client, and had a Glasgow coma scale of 3–5 were found predictors for death were as an unstable vital sign at admission, Client doesn’t get pre-hospital treatment, Hospital stays for one to two months duration, and greater than two months duration were found predictors for disability among road traffic victims.

Burden and determinants of renal dysfunction and in-hospital mortality among acute stroke patients in Ethiopia: A hospital-based observational study.

Stroke, a leading global cause of mortality and neurological impairment, is often complicated by renal failure, exacerbating in-hospital risks and mortality. Limited understanding exists regarding renal failure prevalence in Ethiopian acute stroke patients. This study examines renal function abnormalities in acute stroke patients at Jimma Medical Center (JMC). A hospital-based cross-sectional study was conducted at JMC from December 5, 2023, to March 15, 2024. A structured data collection tool was developed after comprehensive review of pertinent literature, encompassing variables pertinent to the study objectives. Following data quality assurance, information was coded and inputted into EpiData version 3.1, subsequently analyzed using Statistical Package for Social Sciences (SPSS) version 26.0. Multivariable logistic regression analysis was performed to adjust for confounding variables, with statistical significance set at P < .05. The mean age of participants was 60.5 ± 15.5 years, with 129 (64.5%) being male. Forty-five participants (22.5%, 95% confidence interval [CI] = 16.9, 28.9) exhibited renal dysfunction. Advanced age (≥70 years), hypertension, diabetes mellitus (DM), cardiac disease, history of transient ischemic attack (TIA)/stroke, and hemorrhagic stroke type were identified as significant predictors of renal dysfunction among hospitalized stroke patients. The mortality rate was 3.7 times higher in stroke patients with renal dysfunction compared to those with normal renal function (adjusted odds ratio [AOR] = 3.7, 95% CI: 1.41, 6.22). Renal function abnormalities were prevalent among hospitalized acute stroke patients, emphasizing the significance of renal dysfunction as a frequent comorbidity. Older age, hypertension, DM, cardiac disease, history of TIA/stroke, and hemorrhagic stroke type emerged as statistically significant predictors of renal dysfunction. Furthermore, renal dysfunction was identified as a significant predictor of in-hospital mortality following stroke.

Prevalence of metabolic syndrome and its risk factors among newly diagnosed type 2 diabetes mellitus patients – A hospital-based cross-sectional study

ABSTRACT Context: Metabolic syndrome (MetS) raises the chance of cerebrovascular accidents and cardiovascular illness in type 2 diabetes mellitus (T2DM) individuals. Early identification of MetS allows for suitable prophylactic and treatment strategies to reduce the risks. Aim: To estimate the prevalence of MetS and its risk factors in T2DM individuals. Settings and Design: This cross-sectional study investigated MetS and its component’s prevalence among newly diagnosed T2DM at the tertiary care hospital. Methods and Material: The study was conducted from January 2022 to December 2022 and included 300 participants above 18 years, with most being men (55%, 165), and using the World Health Organization (WHO) STEPS questionnaire for assessing selected risk factors. Along with blood glucose, different components of MetS were assessed, that is serum triglyceride (TG) level, serum high-density lipoprotein (HDL) level, blood pressure (BP) and waist circumference (WC), as per the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) criteria. Statistical Analysis Used: Data analysis includes mean and standard deviation (SD) for numerical variables with an unpaired t-test to compare means and percentage and proportions for categorical variables with the Chi-square test for the associations. Multivariate logistic regression was used for assessing the predictors of MetS Results: The prevalence of components of MetS, that is obesity, hypertension (HTN), TG and HDL components, was 64.0% (192), 45.7% (137), 46.0% (138) and 30% (90), respectively. Overall, MetS was 57% (170). Moderate activity of 150 min/week, sitting/reclining, WC, diastolic BP, TG and HDL had a significant association with MetS Conclusions: MetS was highly associated with newly diagnosed T2DM with obesity being the most common component.

Assessment of clinical and histopathological characteristics in COVID-19-associated mucormycosis (CAM) patients correlating with outcome: A hospital-based cross-sectional study

ABSTRACT Background: The second wave of the COVID-19 pandemic led to a very dreaded complication of mucormycosis. Immunosuppressive action of the COVID-19 virus, co-morbidities, for example, diabetes mellitus (DM), hypertension, use of steroids, and humidified oxygen, are among the important factors that make the patients susceptible to developing mucormycosis. Objective: The present study was conducted to identify and understand all the significant histological changes including the type and extent of tissue involvement, the pattern of inflammation, the volume of fungal hyphae, hemorrhage, etc., in patients with COVID-19 associated mucormycosis (CAM) and correlate with clinical outcome. Method: It was a retrospective cross-sectional observational study involving all the patients of CAM, who underwent debridement or biopsy over a period of 5 months, from April 01, 2021, to August 31, 2021. CAM was classified based on the radiological evaluation, clinical features, and organs involved. Different demographic, clinical, laboratory, and histologic parameters were recorded. The variables were assessed for their association with poor clinical outcomes using multiple logistic regression. P &lt; 0.05 was considered statistically significant. Results: A total of 146 patients were included in the study with a mean age of 49.4 years and 71.2% were male. Sino-naso-palatal was the most common type of CAM (32.9%), while sino-naso-cerebral was the least common (14.3%). DM was present in 54.1% of patients, out of which 26.6% were recently diagnosed. The death occurred in 21.9% of patients. Maximum mortality was observed in CAM of sino-naso-cerebral involvement (42.9%). Total leucocyte count (TLC) [OR = 0.87; 95%CI: 0.76-0.97; P = 0.02] and C-reactive protein (CRP) [OR = 0.97; 95%CI: 0.96-0.99; P = 0.008] were significantly associated with poor outcomes. Other factors, that is, high prothrombin time, DM, ferritin, and the involvement of muscle, skin, and cartilage, were also associated with poor clinical outcomes but were not statistically significant. Similarly, high fungal volume and the presence of thrombosis were also associated with poor outcomes but were not statistically significant. Conclusion: CAM more commonly affects males with co-morbidities. TLC and CRP were significantly associated with poor outcomes. Histologically, the involvement of skin, muscle, and cartilage and the presence of excessive fungal hyphae and thrombosis were also associated with poor outcomes.

Are first-trimester pregnant women consuming adequate and diverse diet? A hospital-based cross-sectional study in Karachi, Pakistan

BackgroundMaintaining a healthy and diverse diet during pregnancy is crucial for maternal well-being and fetal development. The first trimester marks the beginning of vital developmental processes influenced by maternal nutritional status. Therefore, we aimed to determine dietary adequacy and diversity among first-trimester pregnant women.MethodsIn this cross-sectional study, we recruited 306 first-trimester pregnant women from the antenatal clinics of Aga Khan University Hospital, Karachi (January 2020 to September 2021). Eligible women possessed smartphones (for the mHealth intervention trial) and reported no major comorbidities or medication use. Data about socio-demographic, obstetric, and dietary history were collected through interviews using a structured questionnaire. Booking weight, height, blood pressure, and haemoglobin levels were extracted from medical records. An aggregate dietary risk score (DRS) was calculated separately for quantity and quality by summing the DRS for each of the six major food groups. A score of 0 was assigned to adequate, 1.5 to intermediate, and 3 to inadequate quantity or quality categories. Data were analysed using STATA 14.0.ResultsThe mean ± SD for DRS quantity and quality were 10.6 ± 2.4 and 7.5 ± 2.5, respectively. Adequate dietary quantity and quality per week for starch-based food were reported by 14.4% and 21.2%, for vegetables by 0.3% and 49%, for fruits by 41.2% and 88.6%, for animal and plant protein by 19% and 0%, for milk and milk products by 1% and 37.6% and for oils and fats by 90.5% and 8.8%, respectively. Sweet and savoury snacks were eaten by 74.8% and 53.9%, respectively. Ready-made meals, carbonated beverages, packaged juices, and additional salt were consumed by 55.2%, 46.4%, 34.3%, and 7.5%, respectively. The median (IQR) water intake was 6 (4–8) glasses/day.ConclusionsDuring the early stages of pregnancy, women enrolled for antenatal care at an urban private tertiary care hospital report inadequate dietary intake for various food groups, except for the quantity of oils/fats and the quality of fruit consumption. Poor dietary practices underscore the need for focused and impactful dietary counselling during the initial stages of pregnancy.

Association between atrial cardiopathy and stroke severity in acute ischemic stroke

In this hospital-based cross-sectional analytic study, we retrospectively reviewed clinical data of patients with acute ischemic stroke (AIS) between January 2017 and April 2023. Atrial cardiopathy was defined as any presence of the following: left atrial diameter ≥ 52 mm (males) or ≥ 47 mm (females), elevated P-wave terminal force in V1 > 5000 μV ms, or serum N terminal pro B type natriuretic peptide > 250 pg/ml. Initial stroke severity was defined by the National Institutes of Health Stroke Scale (NIHSS; moderate-to-severe, ≥ 5; and severe, ≥ 15). Univariate and multivariate binary logistic regression analyses were performed to assess the association between atrial cardiopathy and stroke severity. Among 662 AIS patients (mean age 70 years [interquartile range 61–78], 31.3% women), 303 (45.8%) had atrial cardiopathy. Multivariable logistic regression analysis showed that the presence of atrial cardiopathy was significantly associated with a higher odd of moderate-to-severe stroke (adjusted odds ratio [OR] 2.16, 95% confidence interval [CI] 1.46–3.20, p < 0.001) and severe stroke (adjusted OR 4.89, 95%CI 2.45–9.76, p < 0.001). This association remained significant in a sensitivity analysis excluding those with atrial fibrillation or coronary artery disease. Findings of the current study revealed that the association of atrial cardiopathy was with initial stroke severity independent of atrial fibrillation and was even confirmed in patients without atrial fibrillation; future studies to explore improved stroke prevention strategies for patients with atrial cardiopathy are needed.

Health-related quality of life and its associated factors among infertile women compared with fertile women in public hospital Addis Ababa, Ethiopia: a comparative cross-sectional study

BackgroundInfertility can have detrimental physical, psychological, and social effects that significantly impact health-related quality of life. Although the impact of infertility on quality of life is well established, there is a lack of research comparing the quality of life between fertile and infertile women in Ethiopia.MethodsA hospital-based comparative cross-sectional study was conducted among 287 infertile and 301 fertile women. Participants were selected using systematic random sampling. A structured, validated tool was used to collect data. An independent sample t-test was conducted to determine if there was a difference in the study participants' quality of life domains and the mean total quality of life score. Multiple linear regressions were used to correlate quality of life scores with significant predictor factors for the infertile group.ResultsInfertile women had a mean total Herbal of 66.54 ± 10.18, and fertile women (72.68 ± 7.57) were found to be statistically different between the groups. All domains except the physical domain were significantly different between the groups. Duration of marriage (β = -0.529), number of previous sexual partners (β = -0.410), total number of working hours per day (β = -0.345), types of infertility (β = -0.34), and history of the sexually transmitted disease (β = -0.277), in decreasing order of effect, were found to be associated with the quality of life of infertile women (R2 = 0.725).ConclusionsThe study found that infertile women had a lower mean HRQoL score compared to fertile women, with all domains except for the physical domain being significantly different between the two groups. This suggests that infertility can have a significant impact on various aspects of a woman's life, including her emotional well-being, social functioning, and psychological health. The factors associated with the quality of life of infertile women were the duration of marriage, the number of previous sexual partners, the total number of working hours per day, the types of infertility, and the history of sexually transmitted diseases, with duration of marriage having the strongest association. These findings highlight the need for healthcare providers to address the psychological and social aspects of infertility.

Association of smartphones use, ocular symptoms and binocular dysfunctions in adolescents: a hospital-based cross-sectional study

ABSTRACT Purpose Given the current scenario of increased smartphone use in youth, this study aims to evaluate the proportion of ocular symptoms and binocular dysfunction and their association with smartphone use in adolescents through a hospital-based cross-sectional study. Methods The participants were asked to fill out questionnaires related to smartphone use and symptoms of eyestrain experienced (Balik et al. and Kucer). They were asked about the following seven symptoms: blurring of vision, redness, visual disturbance, secretion, inflammation, lacrimation, and dryness. Each symptom out of the 7, was scored on a scale of 0–1 and was used to calculate an Ocular Symptom Score (OSS) by summing the scores of each symptom.Depending upon the duration of smartphone usage, the participants were classified into four groups: <2 hours/day, 2–4 hours/day, 4–6 hours/day, and >6 hours/day. Binocular functions were assessed using near point of convergence (NPC), near point of accommodation (NPA), Accommodative convergence/Accommodation (AC/A) ratio, dissociated heterophoria, and binocular accommodative facility (BAF). Results A total of 123 smartphone user adolescents, aged 10–19 years were included in this study. The mean age of the study population was 16.58 + 2.8 years, out of which 52.03% were males. Prevalence of ocular symptoms was higher in groups with greater duration of smartphone use (2 to 4, 4 to 6, and >6 hours/day as compared to <2 hours/day: 90.48%, 94.74%, 100% vs. 75% respectively). The mean of NPC was 8.51, it was highest in subjects using smartphones for >6 hours. (p-value = .001). The mean AC/A ratio was 2.83 + 1.03: 1. A low AC/A ratio was associated with a longer duration of smartphone usage (p-value = .0001). The mean of BAF was 7.4 + 3.18 cycles/min, only 30 (24.4%) participants had BAF beyond the normal range (<5 cycles/min). The mean of BAF was lowest in the group with >6 hours/day of smartphone use (p-value < .0001). No significant change was found in NPA and dissociated heterophoria with the duration of smartphone usage. Conclusion Higher duration of smartphone use (>2 hours/day) is associated with various ocular symptoms and binocular dysfunction. However, additional research is necessary to authenticate the results of the study.

Hematological, Biochemical, and Inflammatory Markers in Patients Suffering from SARS-CoV-2 in Kassala, Sudan: A Cross-Sectional Hospital-Based Study

Introduction: Sudan faces the impact of SARS-CoV-2, emphasizing the urgency of timely detection and effective management. This study, conducted in Kassala, Sudan, aimed to evaluate key hematological, biochemical, and inflammatory markers in confirmed and suspected COVID-19 patients. Methodology: A cross-sectional hospital investigation was carried out in Kassala State, eastern Sudan, spanning from September 2020 to January 2021. Clinical and sociodemographic data were collected from individuals suspected of having COVID-19 using a structured questionnaire. Nasopharyngeal swab was targeted for the detection of SARS-CoV-2 while a blood sample was processed for haematological and biochemical parameters. Results: The study included 371 participants, revealing a prevalence of COVID-19 PCR positive of 61.7% (229/371). In particular, most were male (65%), with a mean age of 42.9±19.9 years. A substantial case fatality rate of 15.7% (36/229) was observed, predominantly among people 60 years and older (P &lt; 0.001). RT-PCR-confirmed patients exhibited significant associations with elevated erythrocyte sedimentation rate, C-reactive protein levels, prolonged Prothrombin time, extended partial thrombin time, leucocytosis, neutrophilia, lymphopenia and hypocalcemia (P &lt; 0.000). Conclusion: This study illuminates the impact of COVID-19 on crucial hematological, renal electrolyte, inflammatory, and coagulation markers. These findings have the potential to enhance patient outcomes and reduce mortality rates by guiding informed actions and shaping public health policies.

Qualification rate and associated factors regarding COVID-19 clinical skills training based on scenario simulation teaching to medical staffs in China: a hospital-based cross-sectional study

BackgroundThe coronavirus disease (COVID-19) pandemic has accentuated the need for effective clinical skills training in infectious diseases. This study aimed to explore the influencing factors of infectious disease clinical skills training based on scenario simulation teaching for medical staff in China.MethodsThis hospital-based, cross-sectional study was conducted at the Third People’s Hospital of Shenzhen between March and December 2022. Scenario simulation teaching was applied, and factors such as gender, educational level, professional background, and previous experience were examined to determine their impact on qualification outcomes.ResultsThe study included participants primarily between the ages of 20–40 years, with a higher proportion of women holding university degrees. Nurses and physicians were more likely to qualify, indicating the significance of professional backgrounds. Women showed a higher likelihood of qualifying than men and higher educational attainment correlated with better qualification rates. Prior experience with protective clothing in isolation wards was a significant determinant of successful qualification. Multivariate analysis underscored the influence of sex, education, and previous experience on training effectiveness.ConclusionScenario simulation is an effective strategy for training clinical skills in treating infectious diseases. This study highlights the importance of considering sex, education, professional background, and prior experience when designing training programs to enhance the efficacy and relevance of infectious disease training.

Clinical profile and associated comorbidities of cerebral palsy in children visiting Orotta National Referral Hospital, Eritrea: a cross-sectional study

BackgroundCerebral Palsy (CP) is one of the most common physical disabilities in children. This study aimed to explore the clinical spectrum of CP at Orotta National Referral and Teaching Hospital, including CP subtypes, gross motor function, patterns of associated comorbidities, and possible risk factors in children aged 2 to 12 years.MethodsA hospital-based cross-sectional study was conducted from January to April 2022 in 153 children with suspected motor symptoms. The Surveillance of CP in Europe (SCPE) decision tree was used as an inclusion criteria guideline and the evaluation of the participants was done using a standardized questionnaire and clinical examination. Descriptive statistics, chi-square test, and logistic regression were employed to statistically analyze the data.ResultsEighty-four children who fulfilled the clinical criteria were included in the study. The median age was 5-years [IQR: 3.8] with an equal distribution of males and females. Quadriplegic CP was the most common subtype (51.2%) followed by unilateral (hemiplegic) CP (22.6%), and dyskinetic CP (14.3%). Most children had severe gross motor impairment GMFCS level IV-V and females were almost three times more likely to have GMFCS level IV/V than males (AOR: 2.70; CI: 1.08–6.72; p-value = 0.033.) More than half (52.4%) of the neonates either did not cry within five minutes and/or needed breathing resuscitation, 55.3% had to be admitted to the NICU with a median of 5 days’ hospital stay. Between the first week of birth and the first year of life, 28.6% had trouble feeding, 26.2% had an infection, 10.7% had difficulty breathing, 20.2% had seizures and 6% had jaundice. Feeding problems (64.3%), speech problems of some sort (91.7%), and epilepsy (46.4%) were the most commonly associated comorbidities with CP.ConclusionsThe clinical profile of the CP patients was found to be dominated by the spastic subtype and moderate to severe disability. Since perinatal risk factors were found to be dominant, strengthening maternal and child healthcare systems is recommended to minimize incidents of preventable risk factors and the burden of the disability.