Hospital-based Study Research Articles

Hospital-based cross-sectional study on the clinical characteristics of children with severe acute respiratory infections in Hungary

BackgroundSevere acute respiratory infection (SARI) is a major cause for hospital admission and associated with high mortality among children worldwide. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza viruses and respiratory syncytial virus (RSV) are the most frequently identified pathogens in children with SARI. The duration of care can be affected by the type of infection and patient characteristics. Therefore, the objective of this study was to identify factors affecting the length of hospitalization in children infected with SARS-CoV-2, influenza A and RSV.MethodsWe collected data on 713 children with SARI from the medical databases of a university hospital in Hungary. To examine whether there is a difference in the length of hospitalization in children with the SARI Kruskal-Wallis test was performed. To determine the factors that may have an impact on the duration of care a multiple logistic regression analysis was executed.ResultsOur results showed that among RSV infected patients the proportions of children requiring intensive care (8.94%), mechanical ventilation (8.94%) and oxygen therapy (13.01%) and suffering from pneumonia (29.27%) were larger than among cases with SARS-CoV-2 and influenza A infection. Considering the age distribution and the duration of care in children with SARI, cases with RSV were significantly younger (p < 0.001) and stayed longer in the hospital (median: 5 days, IQR: 4–7 days, p < 0.001) than those with SARS-CoV-2 and influenza A virus. Multiple logistic regression analysis showed that RSV infection (adjusted odds ratio (aOR): 3.25, 95% confidence interval (CI): 1.43–7.38; p = 0.005), pneumonia (aOR: 3.65, 95% CI: 2.14–6.24; p < 0.001), mechanical ventilation or oxygen therapy (aOR: 3.23, 95% CI: 1.29–8.11; p = 0.012) and underlying illnesses (aOR: 2.39, 95% CI: 1.35–4.23; p = 0.003) significantly increased the odds of hospitalization for more than 4 days.ConclusionsOur research showed that of the viruses causing SARI, RSV had the greatest clinical relevance, contributing to hospital stays of more than 4 days in a large share of paediatric patients below 1 year of age. Our results supply new information on children with SARI, and provide evidence for health policy makers to allocate additional resources to hospitals during SARI epidemics.

Clinical audit on postpartum hemoglobin levels: A study on postpartum anemia

Objectives: The present study was carried out to assess the prevalence of anemia with reference to the Hb levels during postpartum period. The study also investigates the influence of age and mode of delivery on postpartum Hb levels. Material and Methods: It is a hospital-based retrospective descriptive study. The postpartum patients’ data were obtained from the medical records department of a tertiary care hospital. Data of the patients registered for routine blood investigation in the period of December 2023 to January 2024 were collected from the records. Based on patient’s hospital ID, other details including age, Hb level, and mode of delivery data were obtained. Statistical analysis was performed to check the effect of age and mode of delivery on postpartum Hb level by Pearson correlation using IBM Statistical Package for the Social Sciences Statistics version 24.0. Results: About 64.3% of the patients belonged to the age group of 20–30 years and remaining 35.7% within 30–40 years. The percentage of postpartum patients who underwent lower segment cesarean section (LSCS) and normal vaginal delivery (NVD) were 85.7% and 14.3%, respectively. However, cumulative percentage of NVD was higher (100%) than LSCS (85.7%). The postpartum Hb level ranged from 7.9 to 15.2 g/dL. About 54% of patients showed moderate anemia (8–10.9 g/dL), followed by 24% mild (11.9–11 g/dL) and 2% with severe anemic (&lt;8 g/dL) condition. Conclusion: The study highlights the prevalence of PPA associated with both LSCS and NVD modes of delivery. Although the number of anemic patients was higher in LSCS (48) compared to NVD (8), the percentage remains the same at 80% each considering the total number of patients in each category. These observations point out the risk of high-volume blood loss associated with both modes of delivery and emphasize the need for adopting precautionary measures.

Client’s pre-operative expectations and outcome of cataract surgery at the Jos University Teaching Hospital, Jos, Plateau State, Nigeria

Objectives: A cataract is an opacity of the natural crystalline lens that causes vision loss. It is the most common cause of blindness worldwide, accounting for 39% of the 42 million blind people in the world. The optimum outcome from a cataract surgery can be achieved if post-operative subjective outcomes meet pre-operative expectations. It is expressed in different ways including patient satisfaction. This study evaluated clients’ pre-operative expectations and the outcome of cataract surgery at Jos University Teaching Hospital. Materials and Methods: A quasi-experimental, prospective hospital-based study that consecutively recruited 109 participants aged 18 years and above for 6 months. Data regarding the sociodemographic characteristics, pre-operative visual function, and expected post-operative outcome were collected preoperatively, and the subjective outcome and level of patient satisfaction were also assessed 6 weeks after surgery using a visual function index questionnaire. Data were analysed using the Statistical Package for the Social Sciences’ version 23. Frequencies and percentages were determined for categorical variables; mean and standard deviation, median, and interquartile range were calculated for continuous variables. Correlation was used to measure the relationship between overall satisfaction and expected or achieved visual function. A significant level was determined at P &lt; 0.05. Results: A total of 109 participants were seen in this study, of which 60 (55%) were males. The mean age of participants in the study was 64.5 ± 11.1 years. The median (interquartile range) expected and actual post-operative outcome scores were 100 (80–100) and 98 (75–100), respectively. The majority of the participants, 86 (78.9%), were satisfied with the outcome of cataract surgery, and the predictors of satisfaction were insertion of posterior chamber intraocular lens, absence of complications, and absence of ocular comorbidities. We found a significant strong positive correlation between subjective outcome and satisfaction (r = 0.538, P ≤ 0.0001). Conclusion: The majority of the clients were satisfied with the outcome of their surgeries which meets the high expected outcomes from the clients pre-operative. Adequate counselling, training, and retraining of surgeons are key to improving and maintaining satisfaction with the outcome of cataract surgery.

Prevalence and factors associated with cerebral malaria among children aged 6 to 59 months with severe malaria in Western Uganda: a hospital-based cross-sectional study

IntroductionCerebral malaria, caused by Plasmodium falciparum, represents the most severe neurologic complication of malaria. Its association with high morbidity and mortality rates, especially among young children, underscores its clinical significance. In sub-Saharan Africa, including Uganda, cerebral malaria remains a major health challenge, contributing significantly to the high child mortality rate. Despite advances in malaria control, the burden of cerebral malaria among children under five is substantial, reflecting the need for targeted interventions and improved management strategies. This study aimed to determine the prevalence of cerebral malaria and identify associated factors among children admitted with severe malaria at a tertiary hospital in western Uganda.MethodsThis was a cross-sectional, descriptive, and analytical study involving children aged 6 to 59 months admitted with severe malaria. The study was conducted from January to March 2023 at Fort Portal Regional Referral Hospital. Severe and cerebral malaria were defined as per the WHO criteria. Sociodemographic, clinical, and laboratory data were collected and analyzed using IBM SPSS version 27. Logistic regression analysis was used to evaluate the factors associated with cerebral malaria. A p-value < 0.05 indicated statistical significance.ResultsA total of 250 children were recruited (mean age 33.1 ± 17.3 months). The prevalence of cerebral malaria was 12.8% (95% CI: 8.9–17.6). Cerebral malaria was independently associated with male sex (aOR: 3.05, 95% CI: 1.20–7.77, p = 0.02), abnormal bleeding (aOR: 13.22, 95% CI: 11.54–15.16, p = 0.001), history of convulsions (aOR 12.20, 95% CI: 10.7–21.69, p = 0.010), acute kidney injury (aOR: 4.50, 95% CI: 1.30–15.53, p = 0.02), and hyponatremia (aOR: 3.47, 95% CI: 1.34–8.96, p = 0.010).Conclusions and recommendationsThe prevalence of cerebral malaria was high among children with severe malaria. Factors associated with cerebral malaria included male gender, history of convulsions, abnormal bleeding, acute kidney injury, and hyponatremia. Targeted interventions and early management are essential to improve clinical outcomes.

Determinants of antiretroviral therapy adherence among people living with HIV in a poor urban setting in Ghana: a hospital-based cross-sectional study.

Without a cure, antiretroviral therapy (ART) continues to be the primary mode of managing HIV, transforming it from a formerly lethal disease to a less severe one. Adherence to ART can be impacted by several factors, including poor quality of care. A quantitative cross-sectional study design was used to assess the factors that influence adherence to ART among adults receiving care at two health facilities in Accra. A structured interviewer-administered questionnaire was used to collect data on factors associated with medication adherence using a modified four-item Medication Adherence Rating from 255 people living with HIV (PLHIV). Descriptive statistics were used to summarise the data, while multiple binary logistic regression was used to assess the factors influencing adherence to ART. Adherence to HIV medication was 44.7% among PLHIV. Adherence was positively correlated with high client health service satisfaction (adjusted OR [AOR]: 26.59, 95% CI 7.46 to 94.82, p<0.001), increased privacy at the HIV clinics (AOR: 3.40, 95% CI 1.40 to 8.21, p<0.007) and among PLHIV who had been diagnosed with HIV for ≥5 y (AOR: 7.59, 95% CI 2.76 to 20.85, p<0.001). Adherence to ART was significantly low among study participants. The study highlights the importance of maintaining privacy and confidentiality at the facility while ensuring client satisfaction with HIV care to promote adherence to ART.

Prevalence of Vancomycin-Resistant Enterococcus spp. Isolates in Southeast Iran, Zahedan

Background: Enterococci are clinically significant, especially in individuals with compromised immune systems, which are recognized as a critical contributor to nosocomial infections. Objectives: This study aimed to determine antibiotic susceptibility profiles and vancomycin-resistance Enterococcus (VRE) isolates in Zahedan, Iran. Methods: A hospital-based cross-sectional study was conducted at Ali Ibne Abi Talib Hospital from March 2019 to February 2022. Clinical samples included urine, blood, abscesses and other body fluids from patients referred to this hospital during the study period. A total of 3000 patients were included in the study, and the Kirby-Bauer method was used to test isolates identified by morphological and biochemical characteristics for antibiotic susceptibility. Data were analyzed using SPSS software version 20. P-values &lt; 0.05 were considered statistically significant. Results: Out of 3000 culture-positive clinical samples comprised of 82 urine, ten blood, one tracheal, two wound, and one pulmonary isolate, were identified as Enterococcus faecalis (69.1%), Enterococcus faecium (7.3%), and Enterococcus spp. (23.6%). Moreover, two-thirds of isolates were multidrug-resistant (MDR). Although 66.7% and 63.9% were sensitive to nitrofurantoin and linezolid, resistance to ciprofloxacin (74.2%) and ampicillin (65.9%) was frequently observed. Nitrofurantoin or linezolid were the only effective antibiotics for UTIs. In addition, 50% of isolates were resistant to vancomycin. Conclusions: Based on the results, a combination of vancomycin/or linezolid and nitrofurantoin for urine infections was effective against Enterococci in this clinical center. Nevertheless, continuous and frequent surveillance for resistance patterns is necessary for the reasonable and evidence-based use of antibiotics.

Hematological profile and its correlation with reverse transcription–polymerase chain reaction-based serial quantitative detection of BCR-ABL in chronic myeloid leukemia patients at a referral cancer center

Abstract BACKGROUND: There are variations in the hematological profile among the Indian population affected with chronic myeloid leukemia (CML). The range of white blood cell count (WBC) was 0.46 × 109/mm3 to 1.86 × 109/mm3. Similarly, range for hemoglobin was 9–11 g/dl. WBC count can be as low as 0.18 × 109/mm3 even though CML is a myeloproliferative disorder. OBJECTIVE: The objective of this study was to correlate BCR-ABL expression with the hematological and myeloid proliferative parameters. METHODS: The present study was a single-center, hospital-based follow-up study among 66 cases of CML. The sample of patients was analyzed for BCR-ABL gene expression; hematological parameters and myeloid proliferative parameters such as band forms, myelocytes, metamyelocytes, and blast were also measured. Some patients reported twice, some thrice, and the total count after all follow-up for all 66 cases was 179. RESULTS: The mean age was 43.15 years. Men were more than women with male-to-female ratio of 1.6:1. The mean hemoglobin was lesser at 10.8 g/dl. Median total count was normal at 5610 (interquartile range = 2750) per μl. Mean neutrophils, lymphocytes, monocytes, basophils, and platelets were normal. The eosinophil count was raised. The BCR-ABL gene expression was positively and significantly correlated with total count. It was negatively and significantly correlated with lymphocytes and monocytes. It was not correlated with other hematological parameters. All the myeloid proliferative parameters, namely, band forms, myelocytes, metamyelocytes, and blast, were positively and significantly correlated with BCR-ABL gene expression. CONCLUSION: Total count and all myeloid proliferative parameters were positively and significantly correlated with BCR-ABL gene expression. Lymphocytes and monocytes were negatively correlated. These parameters can be used to track the disease progression in patients with CML.

Patterns and factors associated with electrolyte abnormalities among patients with heart failure in Uganda.

Electrolyte abnormalities (EAs) worsen the clinical course of patients with heart failure (HF). The patterns of EAs vary among patients with HF. This study investigated patterns and factors associated with EAs among patients with HF admitted to Hoima Regional Referral Hospital (HRRH) in western Uganda. This hospital-based cross-sectional study used quantitative data of 384 HF patients admitted at HRRH between 21st February and 15th May 2023. Data on sociodemographic, lifestyle, and medical characteristics were collected and presented as descriptive statistics. EAs were considered electrolyte values below or above the reference normal ranges. Bivariate and multiple logistic regression analyses were conducted to establish associations. An association with a p < 0.05 is considered statistically significant. Of 384 HF patients, 342 (89.1%) had EAs. Hypocalcemia was the most common EA, 165 (43.0%). Among the patients, 69 (18.0%) were on diuretics, 185 (48.2%) were on angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs), and 105 (27.3%) were on calcium channel blockers (CCBs). Additionally, 264 (68.8%) had a history of hypertension, and 20 (5.2%) demonstrated good drug adherence. Patients with good drug adherence had lower odds of EAs (Adjusted Prevalence Odds Ratio [Adjusted POR] = 0.2, 95% CI: 0.1-0.7, p = 0.009). Those on diuretics had higher odds of EAs compared to those on ACEIs/ARBs and CCBs, with an Adjusted POR of 5.7 (95% CI: 1.3-15.0, p = 0.019). A history of hypertension also increased the odds of EAs (Adjusted POR = 4.0, 95% CI: 1.9-8.4, p < 0.001). The prevalence of EAs in patients with HF at HRRH was high, with hypocalcemia being the most common. Patients with good drug adherence had lower odds of EAs. On the other hand, diuretic use and a history of hypertension were associated with increased odds of EAs.

Clinical profile and etiological spectrum of patients presenting with corneal hydrops over a 12-year period.

To describe the demographics, clinical characteristics, and management of corneal hydrops in patients presenting to a multi-tier ophthalmology hospital network in India. Cross-sectional hospital-based study. Of the total of 3,140,941 new patients presenting between October 2010 and March 2022, patients with a clinical diagnosis of corneal hydrops in at least one eye were included in the study. All the data was collected using an electronic medical record system. 1291 eyes of 1110 patients were diagnosed with corneal hydrops and included in the study and 961 patients (83.69%) had a unilateral affliction. Corneal hydrops was noted to be significantly more common in males (62.43%) and adults (62.7%). The most common age group at presentation was during the second decade of life with 472 (42.52%) patients. They were more commonly from the higher socio-economic status (77.3%) and from the urban geography (44.23%). In the 1291 eyes, 567 (43.92%) eyes had a visual impairment of blindness (> 20/400-20/1200) followed by moderate visual impairment (> 20/70-20/200) in 166 (12.86%) eyes. Overall, the most common etiology was keratoconus in 1,082 (83.81%) eyes followed by primary congenital glaucoma (PCG) in 91 (7.05%) eyes. Surgical intervention to hasten the recovery of hydrops was performed in 7.82% of eyes with ectasia and as a definite management in 7.05% eyes with PCG. Visual rehabilitation was with contact lenses in 29.1% eyes and keratoplasty in 13.94% eyes. Corneal hydrops is predominantly unilateral and is more common in males. Keratoconus was the commonest etiological condition; however, the risk of hydrops was highest in keratoglobus, followed by PMD. Most affected age was the second decade of life and visual impairment was severe in majority (60%). A surgical intervention was performed in a third of the cases.

Prevalence of Malaria Infection among Pregnant Women Attending Antenatal Clinic in Nnamdi Azikiwe University Teaching Hospital, Nnewi

Malaria is a major health problem affecting people in the tropics and sub-tropical regions of the world. This cross-sectional hospital-based study was carried out to determine the prevalence of malaria infection among pregnant women attending a tertiary hospital in Nnewi, Anambra State, Nigeria. A total of 100 venous blood samples were collected from pregnant women into EDTA tubes and examined using field-stained thick and thin films for identification of malaria parasites. Demographic information such as age, trimester and insecticide-treated nets usage was obtained using a structured questionnaire. Data was analyzed using Statistical Package for the Social Sciences version 22. The chi-square test was used to determine the difference among the variables studied and P≤ 0.05 were considered significant. Out of the 100 blood samples examined, 27 were infected and had an overall prevalence of 27%. Women within the age bracket of 31-35 years had the highest prevalence rate 11(36.7%) while no infection was recorded in the 41-45 years age group 0(0.0%). Pregnant women in their first trimester had the highest infection prevalence of 13(35.1%) while those in their third trimester had the least prevalence of 5(17.9%). In relation to ITN’s usage, pregnant women who don’t normally sleep under ITNs had the highest infection prevalence 23(31.5%) while those who usually sleep under ITNS had the least prevalence rate 4(14.8%). It is pertinent to periodically check the malaria infection status of pregnant women attending antenatal services. Prophylactic treatment should be routinely administered to avoid pregnancy complications due to malaria infection.

Environmental factors and chronic kidney disease: a case-control study

Chronic kidney disease (CKD) is a non-communicable disease that includes a range of different physiological disorders causing abnormal renal function and progressive decline in the glomerular filtration rate (GFR). This study aimed to investigate the associations of several Environmental factors with CKD in the Iranian population. This is the second phase of a hospital-based case-control study, which was conducted on 700 participants (350 CKD cases and 350 controls, age and gender frequency matched). Multiple logistic regression was applied to measure the associations between the selected factors and CKD. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. All p-values were two-sided and the results were considered statistically significant at p < 0.05. The results suggested that environmental factors including proximity of residence to mines (OR yes/no=3.98, 95%CI: 2.20–7.21, p < 0.001), proximity of residence to mobile antenna (OR yes/no=2.20, 95%CI: 1.24–3.89, p = 0.006), and exposure to chemicals (OR chemical/no=4.40, 95%CI: 2.27–8.53, p < 0.001), were significantly associated with a higher risk of CKD. The present study covered a large number of factors in association with CKD and highlighted the importance of some environmental factors in development of CKD.‌ One of the main causes of heat in the work environment being a risk factor is dehydration caused by high heat. In order to reduce damage to the kidneys in jobs that deal with high heat, the following tips are recommended: drinking fluids, reducing working hours and shifts, proper ventilation in the workplace, using suitable clothes and heat protection.

Prevalence and Risk Factors Associated With Carpal Tunnel Syndrome Among Sudanese Females: A Cross-Sectional Study.

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy resulting from compression of the median nerve. This condition is more common in females than in males. The earlier the diagnosis, the better the prognosis and treatment outcomes. This is a cross-sectional hospital-based study conducted at Soba Teaching Hospital in obstetrics and gynecology outpatient clinic in Khartoum in the period from February 2022 to March 2022. A simple random sampling was applied, and an interview was conducted using a four-partquestionnaire. The first part was based on socio-demographic data, the second was lifestyle, and the third and fourth were based on the Boston Carpal Tunnel Questionnaire (BCTQ). The data were analyzed using the statistical package for social sciences (SPSS) software, version 23 (IBM Corp., Armonk, NY) to find the correlation between the various variables. A total of 113 women participated in the study (response rate=100%). The prevalence of CTS was found to be 5%. No significant association was found between lifestyle and medical history, e.g., obesity and oral contraceptives and CTS were p=0.167, 0.841 respectively. Conversely, there was a significant association between age and residency, with p=0.005 and 0.049, respectively. The prevalence of CTS is increasing in Sudan. Therefore, it is essential to thoroughly assess patients for any symptoms related to hand pain by asking detailed questions during consultations. In addition, further studies covering more states are neededto better understand the regional variation in CTS prevalence.

Patterns of Infertility and Sociodemographic Characteristics among Patients with Infertility Attending Benjamin Mkapa Hospital in Tanzania: Analytical Cross-Sectional Study

(1) Background: Infertility is a global health problem that affects one of six couples worldwide, leading to significant negative impacts on their quality of life. Despite numerous studies on infertility patterns and sociodemographic characteristics, there remains a lack of clarity on these aspects among patients seeking care in Tanzania. (2) Methods: This hospital-based analytical cross-sectional study aimed to determine infertility patterns and sociodemographic characteristics among 385 randomly selected male and female patients attending the Benjamin Mkapa Hospital. Structured interviews using a clinical proforma collected data on the patterns of infertility and sociodemographic characteristics of the participants. The analysis included descriptive statistics and logistic regression. (3) Results: The findings indicated that the dominant pattern of infertility for both male and female participants was secondary infertility, accounting for 59.00% (228). Multivariate logistic regression analysis for both male and female patients revealed sociodemographic characteristics of infertility: age (38–43) years, AOR 5.068, 95% CI 1.573–16.33, p = 0.007), and duration of cohabiting or marriage of more than 10 years (AOR 0.406,95% CI 0.189–0.873, p = 0.021). (4) Conclusion: Integrating reproductive health education on appropriate fertility age into the reproductive health package and enhancing fertility care in public hospitals in Tanzania is recommended.

Cost–benefit analysis of mammography screening: the perspective of Nigerian healthcare providers

IntroductionThere is no national breast cancer screening implemented in Nigeria. The National Cancer Control Plan (NCCP) has a goal of making screening services and early detection of cancer available for...

Epidemiological and Typing Features of HPV Co-Infections in MSM with Mpox: A Hospital-Based Prospective Study

ObjectivesRecent mpox outbreaks highlight diverse transmission modes, with sexual behavior prominent in China's IIb strain. Nevertheless, despite HPV being a common sexually transmitted pathogen, there is a paucity of research into its coexistence and genotype distribution within this patients population. MethodsWe conducted a study at the Third People's Hospital of Shenzhen from May to September 2023. We collected information on mpox patients, including their sociodemographic and clinical characteristics. Anal swabs were collected for HPV genotyping. ResultsAmong 73 MSM mpox cases, HIV positivity was 56.2% (41/73) and HPV positivity 80.4% (41/51). Multiple HPV infections were prevalent (56.9%, 29/51), especially among HIV-positive (93%, 27/29). HPV16 (29.3%, 12/41) was the most common high-risk genotype, followed by HPV59 (26.8%, 10/41), HPV42 (19.5%, 8/41), HPV6 (14.6%, 6/41), and HPV54 (14.6%, 6/41). HPV infection was significantly associated with HIV infection (p=0.001). Additionally, HIV infection (p=0.001) and PCR-detected positive sites for mpox (p=0.047) were associated with high-risk HPV infection. ConclusionsIn this study, most of the mpox patients were found to be infected with HPV, mostly with high-risk types and multiple infections. Therefore, it is strongly recommended that mpox-infected individuals intensify HPV-related screening, prevention, and treatment measures.

Characteristics of Cancer in Subjects Carrying Lynch Syndrome-Associated Gene Variants in Taiwanese Population: A Hospital-Based Study in Taiwan

Lynch syndrome (LS) is an autosomal dominant disorder characterized by increased risks of colorectal and endometrial cancers. LS is defined by pathogenic variants in mismatch repair (MMR) genes, including MLH1, MSH2, and MSH6. Data on the prevalence and associated cancer risks of LS in the Han Chinese population remain limited. In this study, using a broad biobank approach through the Taiwan Precision Medicine Initiative (TPMI), we identified LS-associated MMR gene variants within a cohort of 42,828 participants from a Taiwanese medical center. A total of 89 individuals were found to carry pathogenic MMR variants: MLH1 (n = 22, 25%), MSH2 (n = 47, 53%), and MSH6 (n = 20, 22%). The overall prevalence of MMR variants was calculated, and cancer incidence rates among carriers were determined. The prevalence of MMR variants in the study population was 1 in 481. The distribution of MLH1, MSH2, and MSH6 variants were 24.7%, 52.8%, and 22.5%, respectively. Cumulative cancer incidence rates of carriers were 40.9% for MLH1 carriers, 29.8% for MSH2, and 40% for MSH6. Among the 19 individuals who underwent colonoscopy screening, the prevalence of polyps was similar to that of the control group (adenoma detection rate: 32% vs 26%, p = 0.585). A meticulous analysis of the detected polyps in seven participants, considering factors such as location, size, morphology, and pathological features, showed no significant differences from controls. A significant cancer risk is associated with LS-related MMR variants in the Taiwanese population. The apparent under diagnosis of LS highlights the urgent need for enhanced surveillance and genetic counseling in this demographic. Our findings suggest that adjustments in the current screening protocols may be warranted to better identify and manage at-risk individuals.

Delirium management and current practice among Intensive Care Units Doctors, Khartoum

Delirium is a brain dysfunction characterized by attention and cognitive disturbances in a fluctuating manner. The international guidelines recommend daily screening for delirium. The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and Intensive Care Delirium Screening Checklist (ICDSC) are the most commonly used methods for assessing delirium. This study aimed to identify barriers and gaps in knowledge and practice. This was a hospital-based Cross-Sectional study. Stratified random sampling was used in this study. 72 ICU doctors were randomly selected. Statistical analyses were performed using IBM SPSS version 23. Descriptive data were presented, and the chi-squared test was used to determine the associations among variables. Statistical significance was set at p &lt; 0.05. More than 70% of the doctors were ≤ 30 years of age and female. A total of 69.4% of the participants had &lt; 1year of experience. In total, 94.4% of the participants worked in medical ICUs. Less than 20% of the doctors used delirium assessment tools, with a statistically significant difference based on experience (p=0.012). Delirium was not regularly assessed in 13.9% of the patients. Non-pharmacological management was applied by 76.4% of doctors, and communication with patients was the most frequent (75%). Haloperidol was the most commonly used drug (83.3%). A total of 40.3% of doctors did not stop delirium medication on ICU discharge. A regular delirium assessment was performed. However, the use of validated assessment tools is uncommon. Nonpharmacological management of delirium is important and is mostly performed. Our doctors prescribed antipsychotics for the treatment of both forms of delirium, and almost half of them did not stop the medications on ICU discharge. Medication reconciliation and contact with the next in-charge of the patients are important.

A Cross Sectional Study of the Prevalence of Retinopathy in Patients with Chronic Kidney Disease on Hemodialysis in a Tertiary Care Centre in Chengalpattu District, South India

Context: Many studies have reported varying proportions of retinopathy among cases with chronic kidney disease (CKD). Cases with severe grades of CKD were more likely to develop ocular complications, especially diseases which occurs due to small vessel pathology. Aim: To estimate the prevalence of various types of retinopathies in patients with CKD undergoing hemodialysis in a tertiary care centre in South India. Settings and Design: The outpatient Department of Ophthalmology and Hemodialysis unit of Nephrology, Karpaga Vinayaga Institute of Medical Sciences from January 2022 to June 2023 A cross-sectional hospital-based observational study in a low resource setting. Methods and Material: The study consists of 28 patients who were known cases of CKD on hemodialysis. Patients underwent complete ocular evaluation and findings were noted. The pre hemodialysis values of blood urea and serum creatine, hemoglobin, liver function tests and vital parameters were also noted. Data analysis was done utilising version 20 of Statistical Packages for the Social Sciences (SPSS). Results: 56 eyes of 28 patients on hemodialysis were studied. The mean age was 53 years + 10.9 with a male preponderance. 31.6% had retinopathy of which 26.3% had hypertensive retinopathy and 5.3% had diabetic retinopathy. This is contrary to the previous studies that have reported a higher incidence of diabetic retinopathy in patients with end stage CKD. Hypertension resulted in CKD earlier than diabetes. Conclusion: The results emphasize the importance of frequent eye examination in patients with CKD to identify retinopathy earlier, thus potentially averting permanent vision impairment.

Self-care practices and associated factors among hypertensive patients at public hospitals in North Shewa zone, Ethiopia

BackgroundHypertension significantly contributes to premature mortality worldwide, highlighting the need for effective self-care to manage its complications. However, there is limited research on self-care practices among hypertensive patients in Ethiopia. This study assessed self-care practices and associated factors in hypertensive patients at public hospitals in North Shewa zone, Amhara Region, Ethiopia.MethodsA hospital-based cross-sectional study was conducted with 450 participants using multi-stage sampling and interviewer-administered questionnaires. Data were processed with Epi-Data 4.6.0.6 and analyzed using SPSS 23. Descriptive statistics summarized the results, while bivariable and multivariable logistic regression identified factors associated with self-care practices. Crude and adjusted odds ratios with 95% confidence intervals were calculated, with significance at p &amp;lt; 0.05.ResultsOut of 450 participants, 231 (51.3, 95% CI: 46.4–55.6%) exhibited poor hypertension self-care practices. Factors associated with poor self-care included having a college-level education (AOR = 0.27, 95% CI: 0.07–0.95), university-level education (AOR = 0.36, 95% CI: 0.13–0.98), being widowed/widower (AOR = 5.30, 95% CI: 1.05–27.2), poor knowledge of hypertension (AOR = 4.51, 95% CI: 2.44–8.59), inadequate stress management (AOR = 3.10, 95% CI: 1.64–5.74), and first diagnosis during a check-up (AOR = 7.72, 95% CI: 4.22–13.8).ConclusionThis study highlights inadequate self-care among hypertensive individuals, affected by factors such as education, marital status, knowledge, stress management, and diagnostic practices. Personalized interventions focusing on health education, stress management, and proactive screening are essential for improving health outcomes. Additionally, psychological support enhances emotional well-being and self-care engagement in hypertension patients, leading to better health outcomes and quality of life.

Patterns of Viral Pathogens Causing Upper Respiratory Tract Infections in Children Under 13 Years Old: A Retrospective Analysis

Background: Respiratory viral infections strain healthcare globally, accounting for 15% of encounters in the UAE. However, seasonal prevalence in the region remains unclear. This hospitalbased study aims to understand viral causes of upper respiratory tract infections (URTIs) in children under 13, focusing on influenza and RSV. Methods: We conducted a retrospective chart review at Hatta Hospital in Dubai, collecting data from pediatric patients under 13 years old with URTI diagnoses from 2022 to 2023. Nasopharyngeal aspirate samples were analyzed using a multiplex chain reaction (mPCR) assay to identify viral pathogens. Data were collected from the hospital’s emergency department, walk-in clinic, and admitted patients. Results: During the study period, 2714 samples were analyzed, with 1870 (69%) testing positive for any respiratory pathogen. Most infected individuals were males (56.7%), aged between 1 and 3 years (37.9%). Single viral infections were predominant (85.3%), with 27.3% attributed to Human Enterovirus/Rhinovirus, 26.6% to Influenza A, and 10.2% to respiratory syncytial virus (RSV). The RSV season was observed to span from August to December, peaking in October, while Influenza A had semi-seasonal peaks in June and October. Hospital admissions varied significantly between single (21%) and multiple viral infections (27%). Of 340 children hospitalized with single viral infections, 28.2% were infected with Human Enterovirus/Rhinovirus, 16.7% with RSV, and 13.5% with Influenza A. Conclusion: The study provides insights into viral epidemiology among children in the UAE, highlighting the high prevalence and seasonal peaks of viral pathogens. Awareness of these trends can reduce unnecessary streptococcal testing and antibiotic overuse. Understanding the seasonal patterns aids in optimizing prophylactic measures and vaccination strategies for RSV and influenza, benefiting high-risk infants and children.