Hospital-based Study Research Articles

Mental health and insomnia problems in healthcare workers after the COVID-19 pandemic: A multicenter cross-sectional study

BACKGROUND Healthcare workers (HCWs) are at increased risk of contracting coronavirus disease 2019 (COVID-19) as well as worsening mental health problems and insomnia. These problems can persist for a long period, even after the pandemic. However, less is known about this topic. AIM To analyze mental health, insomnia problems, and their influencing factors in HCWs after the COVID-19 pandemic. METHODS This multicenter cross-sectional, hospital-based study was conducted from June 1st, 2023 to June 30th, 2023, which was a half-year after the end of the COVID-19 emergency. Region-stratified population-based cluster sampling was applied at the provincial level for Chinese HCWs. Symptoms such as anxiety, depression, and insomnia were evaluated by the Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, and Insomnia Severity Index. Factors influencing the symptoms were identified by multivariable logistic regression. RESULTS A total of 2000 participants were invited, for a response rate of 70.6%. A total of 1412 HCWs [618 (43.8%) doctors, 583 (41.3%) nurses and 211 (14.9%) nonfrontline], 254 (18.0%), 231 (16.4%), and 289 (20.5%) had symptoms of anxiety, depression, and insomnia, respectively; severe symptoms were found in 58 (4.1%), 49 (3.5%), and 111 (7.9%) of the participants. Nurses, female sex, and hospitalization for COVID-19 were risk factors for anxiety, depression, and insomnia symptoms; moreover, death from family or friends was a risk factor for insomnia symptoms. During the COVID-19 outbreak, most [1086 (76.9%)] of the participating HCWs received psychological interventions, while nearly all [994 (70.4%)] of them had received public psychological education. Only 102 (7.2%) of the HCWs received individual counseling from COVID-19. CONCLUSION Although the mental health and sleep problems of HCWs were relieved after the COVID-19 pandemic, they still faced challenges and greater risks than did the general population. Identifying risk factors would help in providing targeted interventions. In addition, although a major proportion of HCWs have received public psychological education, individual interventions are still insufficient.

Prognostic factors and overall survival of breast cancer in Benin: a hospital-based study.

In Benin, a country in West Africa, breast cancer is the leading cancer in women, both in terms of incidence and mortality. However, evidence on the mortality of breast cancer and its associated factors is lacking in this country. Our aim was to describe and analyze the clinical, histopathological, and prognostic aspects of breast cancer in Benin. A descriptive and analytical study was carried out at the CNHU-HKM and the CHU-MEL, two major tertiary referral hospitals for breast cancer management located in Cotonou, the capital city of Benin. All breast cancer medical records with histological evidence and immunohistochemistry studies were retrospectively collected between January 1, 2014, and September 30, 2020, in these two tertiary referral hospitals and analyzed in the current study. Finally, 319 medical records were included. The mean age at diagnosis was 48.74 years. The tumors were most frequently classified as T4 (47.6%) with lymph node involvement N2 (34.5%), and metastases were clinically noted in 21.9% of cases. Stage was reported in the medical records of 284 patients. Tumors were diagnosed at very late AJCC stages: stage III (47.5%) and stage IV (24.7%). Grades SBR 2 (49.2%) and SBR 3 (32.6%) were the most frequent grades. Triple-negative breast cancer (31.3%) was the most common molecular type. The overall 5-year survival was 48.49%. In multivariable analysis, the poor prognostic factors were lymph node invasion (HR = 2.63; p = 0.026; CI: [1.12, 6.17]), the presence of metastasis (HR = 3.64; p < 0.001); CI: [2.36, 5.62] and the immunohistochemical profile (HR = 1.29; p < 0.001; CI: [1.13, 1.48]). Breast cancer in Beninese is predominant in young adults and is often diagnosed at a late stage. The survival of breast cancer patients in Benin can be improved by enhancing early diagnosis and multidisciplinary management.

Expression Pattern of Estrogen Receptor Alpha and Progesterone Receptor in Gallbladder Carcinoma and Their Association with Clinicopathological Parameters and Overall Survival.

Gallbladder cancer (GBC) is a highly aggressive malignant tumor with a poor prognosis. Despite being first described two centuries ago, there are no targeted therapies available beyond conventional cytotoxic therapy. Epidemiological studies have shown that the incidence of gallbladder cancer is higher in females than males. This suggests that the gallbladder may be a female sex hormone-responsive organ, and these hormones might be involved in the pathogenesis of gallbladder cancer. Therefore, we aimed to analyze the expression of ERα and PR in GBC and correlate their expression with clinicopathological variables and overall survival. A total of 235 histopathologically diagnosed GBC cases were included in this hospital-based cross-sectional study. Clinicopathological data were collected, and the expression of ERα and PR was evaluated by immunohistochemistry. The mean age of this study population was 55.47 ± 8.45 with range 28-87years. Females were predominated over male with a male-to-female ratio of 1:3.5. Positive nuclear expression of the ERα and PR was found in 13 (5.5%) and eight (3.4%) cases, respectively. Apart from nuclear staining, cytoplasmic expression of ERα and PR was found in three (1.2%) and 31 (13.2%) cases, respectively. Higher percentage of positive nuclear expression of ER was found in < 50years age (p value = 0.04), parity > 4 (p value = 0.02), advanced pT stage (T3) (p value = 0.01), lymphovascular invasion (p value = 0.02), and liver invasion (p value = 0.04) which were statistically significant. Higher percentage of PR expression was also observed in < 50years age (p value = 0.01), and tumor associated with gallstone (p value = 0.04). There was no significant correlation between cytoplasmic expression of ER, PR, and clinicopathological variables. In multivariate analysis, there was no significant correlation between ER or PR positive expression and overall survival. Although nuclear expression of ERα was significantly associated with progressive disease factors but the positive expression was found in very small percentage of GBC cases. So anti-hormone therapy might be an option in patient with ER α positive gallbladder carcinoma.

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.

Bullet-related bacterial wound infections among injured personnel at emergency site hospitals in Bahir Dar: prevalence, antimicrobial susceptibility and associated factors.

Bullet-related bacterial wound infection can be caused by high-velocity bullets and shrapnel injuries. In Ethiopia, significant injuries were reported that may cause severe wound infections, persistent systemic infections and may lead to amputation and mortality. The magnitude, antimicrobial susceptibility profiles, and factors associated with bacterial wound infections among patients with bullet-related injuries are not yet studied particularly at health facilities in Bahir Dar, Northwest Ethiopia. Therefore, this study was aimed to determine the prevalence, bacterial profiles, antimicrobial susceptibility profiles, and factors associated with bacterial infections among patients with bullet-related injuries at referral health facilities in Bahir Dar, Northwest Ethiopia. A Hospital-based cross-sectional study was conducted among patients with bullet-related injuries at three referral health facilities in Bahir Dar from May 25 to July 27, 2022. A total of 384 patients with bullet-related injuries were included in the study. Sociodemographic and clinical data were collected using a structured questionnaire. Wound swabs were collected aseptically and cultured on Blood and MacConkey agar following bacteriological standards. Biochemical tests were performed to differentiate bacteria for positive cultivation and antimicrobial susceptibility profiles of the isolates were done on Muller Hinton agar using the Kirby-Bauer disk diffusion technique according to the 2021 Clinical Laboratory Standard Institute (CLSI) guideline. The data were entered using Epi-Info version 7.3 and analyzed using SPSS version 25. Descriptive data were presented using frequency, percentages, figures, and charts. Logistic regression was carried out to identify factors associated with bacterial wound infections. P-value < 0.05 was considered statistically significant. The prevalence of bullet-related bacterial wound infection among three referral hospitals in Bahir Dar city was 54.7%. The most commonly isolated Gram-negative organism was Klebsiella spps 49 (23.3%) while among Gram-positive organism, Staphylococcus aureus 58 (27.6%) and coagulase-negative staphylococci (CONS) 18 (8.6%). Contamination, hospitalization and smoking habit were significantly associated with the presence of bullet-related bacterial wound infections. Over 97% multidrug resistant (MDR) bacterial isolates were identified and of theses, E. coli, Proteus species, Citrobactor, and Staphylococcus aureus were highly drug resistant. Increased prevalence of bullet-related bacterial wound infection was noticed in this study. S. aureus followed by Klebsiella species were most commonly isolated bacteria. High frequency of resistance to Ampicillin, Oxacillin, Cefepime, Ceftriaxone, Ceftazidime, Vancomycin, and Norfloxacin was observed. Therefore, proper handling of bullet injuries, prompt investigation of bacterial infections, monitoring of drug sensitivity patterns and antibiotic usage are critical.

Prevalence of neural tube defect and its identification during antenatal period: a cross-sectional study in eastern Indian state.

To estimate the prevalence of neural tube defects among all birth outcomes in Odisha during 2016-2022. Additionally, to estimate the identification rate of neural tube defects during Pradhan Mantri Surakshit Matritva Abhiyan sessions. A population-based cross-sectional study with a household survey for neural tube defects using pictorial card as well as a hospital-based study for antenatal ultrasonography data. The sample population was selected through multistage random sampling. In the first stage, one district from each zone was selected randomly. In the second stage, using simple random sampling, one community health centre and one urban primary health centre were selected from each district. In the third stage, the population from a block and ward were picked from the selected rural and urban settings, respectively. All married women in the reproductive age group (18-49 years) residing in these cluster villages in the selected districts were enrolled. The study surveyed 49 215 women and recorded 50 196 birth outcomes, including 49 174 live births, 890 stillbirths and 132 medical terminations of pregnancy. A total of 30 neural tube defect cases were detected. The overall prevalence rate of neural tube defect was 0.59 per 1000 birth outcomes. Spina bifida was the most prevalent neural tube defect with the prevalence of, followed by anencephaly and encephalocele. Despite 26 860 mothers receiving antenatal ultrasonography Pradhan Mantri Surakshit Matritva Abhiyan session, data on neural tube defects and other birth defects detected through these scans is unavailable. This study found a low prevalence of neural tube defect in Odisha, which is far lower compared with the older studies from India. There is an urgent need to strengthen the quality of antenatal care services provided under Pradhan Mantri Surakshit Matritva Abhiyan through better training regarding anomaly scans and better data keeping at public healthcare facilities. CTRI/2021/06/034487.

Influence of sleep quality and other associated factors on glycemic control among diabetic patients: A hospital-based study

The glycemic control of diabetes patients is influenced by a variety of risk factors, some of which are adjustable and others of which are not. Diabetes and sleep quality are most frequently correlated in both directions. To evaluate the quality of sleep and pinpoint the risk factors for inadequate glycemic control in individuals with diabetes. : This cross-sectional study included seventy consecutive patients who met the inclusion criteria. The Pittsburgh Sleep Quality Index (PSQI) scale was used to evaluate the quality of sleep. Siemens- ID 29984, dimension RxL Max, Architect plus ABBOT (ci 4100), completely automatic seven-part cell-counter by Horiba Pentra Dx and Siemens ADVIA Centaur XPT (Immonoassay system) were utilized for the biochemical tests.: Of the 70 participants in the study, 22 patients [31.4%] reported having good sleep quality, while 15 patients [21.4%] had average sleep quality and 33 patients [47.1%] had poor sleep quality. Patients with managed and uncontrolled blood sugar showed varying degrees of sleep quality; 48.4% and 17.9% showed good sleep quality, 29% and 15.4% showed moderate sleep quality, and 22.6% and 66.7% showed poor sleep quality. A statistically significant difference (p&amp;#60;0.001) was seen in the sleep quality of the two groups. : In summary, the results of our study suggested that diabetics with poor sleep quality are more likely to have poor glycemic control. A significant modifiable risk factor for improved glycemic management in diabetic patients is sleep quality.

A study on clinico-demographic and microbiological profile of surgical site infection (SSI) in a tertiary care hospital, Kolkata: An alarming trend

The Centres for Disease Control and Prevention (CDC) estimates surgical site infections SSI is major contributor of healthcare associated infections (HAI). Multidrug resistant (MDR) Gram-negative bacilli are emerging pathogens. This study aimed to determine the magnitude of SSI and identify predominant pathogens with their antimicrobial susceptibility patterns. It is a hospital-based descriptive cross-sectional study including 2070 suspected SSI specimens from 25809 surgeries between 1July 2021 to 30 June 2023. Organisms’ identification and AST was done by both conventional and automated methods. Data was collected and analysed on MS-Excel sheet with various charts and tables. In our study SSI rate was 6.3%, much higher than previous study (2.83%) from this institution. SSI rate was highest in plastic surgery (8.2%). Major pathogens of SSI were Gram-negative bacilli e.g., (26.34%), (25.59%) and (74.69%) was predominant among Gram-positive cocci. Gram-negative bacilli including enterobacterales and non-fermenter and showed resistance to major classes of broad- spectrum antibiotics. Methicillin resistance (MRSA) was 43.9%, which indicates need to improve infection control practices. Our study showed significant higher proportion of SSI as compared to previous studies from the same institute with alarming number of isolated MDR Gram-negative bacilli. So, this study focusses the need of robust infection control practices and strict implementation of antimicrobial stewardship to overcome challenges of antimicrobial resistance.

Has the COVID-19 pandemic resulted in more advanced breast cancer? A hospital-based retrospective study.

The suspension of breast cancer screening during the COVID-19 pandemic altered patient diagnosis and management. This study investigates the impact of the COVID-19 lockdowns, screening delays and reduced healthcare attendance on changes in tumour and treatment characteristics, particularly for biologically more aggressive breast cancers. This retrospective single-hospital analysis utilized data from a prospective cancer database between July 2019 and June 2022. Patient, tumour and treatment factors were compared across pre-pandemic, pandemic and post-pandemic groups. Symptomatic breast cancer increased from 42.3% in the pre-, 53.1% in the pandemic and 57% in the post- respectively (P ≤ 0.05). Compared to the pre-pandemic group (4.6%), an increase in stages 3 or 4 breast cancers in the pandemic (8.5%) and post-pandemic (7.1%) was found. Increased node-positivity in Ki67 > 20%, grade 3 or ER- tumours post-pandemic (+5.4%, +14.8%, +33.4%, respectively) was identified. More neoadjuvant chemotherapy was found in both the pandemic (+4.3%) and post-pandemic (+11.3%, P = 0.0261) groups. An increase in hypofractionated radiotherapy in the post-pandemic group (+9.4%) was also identified. Our study identified a decrease in early-stage cancers and an increase in node positivity, particularly for biologically more aggressive tumours. An increase in the number of patients receiving neoadjuvant chemotherapy or hypofractionated radiotherapy during the pandemic and post-pandemic periods was also identified.

A study of asymptpmatic hypoglycemia in at risk newborn babies admitted at a tertiary care hospital

: Babies often have blood glucose levels that are 70% of their mothers at birth. Within an hour, it reaches its lowest point, which can be as low as 20 to 25 mg/dl. All healthy newborns experience this low point and have lower than average blood glucose levels. These are just temporary, and they gradually increase in the first few days of a newborn's life. : To determine the proportion of asymptomatic hypoglycemia in at risk newborn babies. To study plasma sugar level at various time, point during first 48hr of life and the effect of risk factor associated with asymptomatic hypoglycemia. : A Hospital-based longitudinal observational study was conducted among 303 patients at Department of Pediatrics of tertiary care Hospital during June 2021 – July 2021. : Total 159 were males and 154 were females. Among the study participants, 203(83%) cases were from Urban area, while 50(17%) were from Rural area. No. of 114(37.6%) babies had asymptomatic hypoglycemia, identified by routine screening. In total various risk factors was found in which among 29% cases had LGA, 41% had preterm and 30% had weight less than 2 kg. : Screening of at risk newborn helps in the early detection of asymptomatic hypoglycemia which will help in the prevention of adverse neurodevelopmental outcome. Routine screening helped to decrease morbidity and mortality due to hypoglycemia. The first 24 hours of life is a crucial part, at - risk babies are more prone to hypoglycemia hence routine screening is recommended in high-risk babies.

Prevalence of abnormal electrocardiographic findings and associated factors among patients with epilepsy at Jimma Medical Center, Ethiopia; Hospital-based cross-sectional study.

A person with epilepsy experiences recurrent seizures as a result of a persistent underlying disorder. About 50 million people globally are impacted by it, with 4 million of those being in Sub-Saharan Africa. One of the most frequent comorbidities that raise the mortality and morbidity rates of epileptic patients is abnormal Electrocardiographic (ECG) findings. Thus, the purpose of this study is to evaluate the prevalence of abnormal ECG findings in epileptic patients that might lead to increased risk of sudden cardiac death. A hospital based cross-sectional study was at Jimma Medical Center of Ethiopia on epileptic patients who were on follow-up at neurologic clinics during the data collection period. The malignant ECG characteristics and was identified using the ECG abnormality tool. To facilitate analysis, the gathered data was imported into Epidata version 3.1 and exported to the SPSS version 26. The factors of abnormal ECG and sudden death risk were examined using bivariate logistic regression. The study comprised 190 epileptic patients, with a mean age of 32 years. There were more men than women, making up 60.2%. A 43.2% (n = 80) frequency of ECG abnormalities was identified. According to the study, early repolarization abnormalities were the most common ECG abnormalities and increased with male sex and the length of time a person had seizures (AOR) of 4.751 and 95% CI (.273,.933), p = 0.029, compared to their female counterparts. The frequency of malignant ECG alterations in epileptic patients on follow-up at Jimma Medical Center in Ethiopia is described in the study. According to the study, there were significant ECG alterations in epileptic individuals. Male gender and longer duration of epilepsy raise the risk of abnormal ECG findings that could result in sudden cardiac death.

Epidemiology and demographic risk factors for myopia in Ghana: a 5-year retrospective study

PurposeTo explore the epidemiology and demographic risk factors for myopia among a clinical sample.MethodsIn a hospital-based retrospective study, eligible subjects were grouped into either myopia or non-myopia. Demographic data, including age, sex, occupation, area of residence, region of residence, and ethnicity, were analysed. Other clinical information analysed included the degree of myopia and intervention provided for the myopia.ResultsOverall, the medical records of 15807 patients were retrieved between January 2015 and December 2019, with 50.9% being males. The mean ± SD age of the patients was 42.81 ± 18.99 years. A total of 44.4% of the patients were myopic. Age, type of ethnic group, occupation, and area of residence were associated with myopia. Demographic risk factors for myopia included occupations such as professionals (OR: 2.93; 95% CI 2.44–3.52), technicians and associated workers (OR: 6.71; 95% CI 5.15–8.74), service workers (OR: 11.74; 95% CI 9.62–14.33), skilled agriculture and fishery (OR: 1.88; 95% CI 1.41–2.50), craft workers (OR: 3.41; 95% CI 2.75–4.25), armed forces (OR: 10.26; 95% CI 7.54–13.97), students (OR: 3.49; 95% CI 2.76–4.42), the unemployed (OR: 6.64; 95% CI 5.44–8.11), as well as Ewe (OR: 1.46; 95% CI 1.17–1.82) and Ga-Adangbe (OR: 1.28; 95% CI 1.05–1.54) ethnicities.ConclusionEwe and Ga-Adangbe ethnicities, and specific occupations are risk factors for myopia.

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

Clinical Characteristics and Fatality Risk Factors for Patients with Listeria monocytogenes Infection: A 12-Year Hospital-Based Study in Xi'an, China.

Listeriosis is a severe food-borne disease caused by Listeria monocytogenes infection. The data of listeriosis in Xi'an population are limited. The aim of this study is to evaluate the clinical features and fatality risk factors for listeriosis in three tertiary-care hospitals in Xi'an, China METHODS: The characteristics of demographic data, underlying diseases, clinical manifestations, laboratory indicators, cranial imaging examination, antibiotics therapeutic schemes, and clinical outcomes were collected between 2011 and 2023. Logistic regression analysis was performed. Seventy-one etiologically confirmed listeriosis patients were enrolled, including 12 neonatal and 59 non-neonatal cases. The majority of neonatal listeriosis presented as preterm (50%) and fetal distress (75%). The main clinical manifestations of non-neonatal listeriosis included fever (88%), headache (32%), disorder of consciousness (25%), vomiting (17%), abdominal pain (12%), and convulsions (8%). The fatality rate in neonatal cases was higher than in non-neonatal listeriosis (42 vs. 17%). Although no deaths were reported in maternal listeriosis, only two of 23 patients had an uneventful obstetrical outcome. Five maternal listeriosis delivered culture-positive neonates, three of whom decreased within 1week post-gestation due to severe complications. Twenty-eight cases were neurolisteriosis and 43 cases were bacteremia. Neurolisteriosis had a higher fatality rate compared with bacteremia listeriosis (36 vs. 12%). The main neuroradiological images were cerebral edema/hydrocephalus, intracranial infection, and cerebral hernia. Listeria monocytogenes showed extremely low resistance to ampicillin (two isolates) and penicillin (one isolate). The fatality risk factors were the involvement of the central nervous system, hyperbilirubinemia, and hyponatremia for all enrolled subjects. Hyperuricemia contributed to the elevation of fatality risk in non-neonatal listeriosis. When the patients suffered with symptoms of fever and central nervous system infection, they should be alert to the possibility of listeriosis. Early administration of ampicillin- or penicillin-based therapy might be beneficial for recovery of listeriosis.

Epidemiological observations and management challenges in extrapedal mycetoma: A three-decade review of 420 cases.

Mycetoma is a serious, destructive, disfiguring chronic granulomatous inflammatory disease affecting the subcutaneous tissues that spread to involve the skin, deep tissues and bone. The disease predominately affects the limbs, and extrapedal mycetoma is rarely reported. The reported extrapedal ones are characterised by high morbidity and mortality. This communication reports on 420 patients with extrapedal mycetoma seen and managed at the Mycetoma Research Centre (MRC), University of Khartoum, between January 1991 and December 2021. In this descriptive, cross-sectional, hospital-based study, the electronic records of all mycetoma-confirmed patients seen during the study period were carefully and meticulously reviewed. The confirmed patients with extrapedal mycetoma were included in this study. The study included 420 patients with extrapedal mycetoma, 298 (70.7%) had eumycetoma, and 122 (29.3%) had actinomycetoma. There were 343 male patients (81.7%) and 77 (18.3%) females, with a male-to-female ratio of 4:1. Their ages ranged between 1.5 and 95 years, with a median of 28 years. Most of the patients were students and farmers. The majority of patients were from El Gezira, North Kordofan, and the White Nile States. Mycetoma was painful in 21%, and a family history of mycetoma was recorded in 11.5% of patients. The buttocks (37.9%) and head and neck (16.9%) were affected most. Less frequently affected sites were the trunk and back (12%) each, abdominal and chest walls (4.5%) each and loin (1%). The prominent clinical presentation findings were multiple sinuses discharging grains (55%), massive swellings (46%), and lymphadenopathy (11.5%). Less commonly observed clinical findings were local hyperhidrosis (5.3%) and dilated tortuous veins close to mycetoma lesions (0.5%). The study showed that 204 patients (48.6%) had clinical improvement in terms of decreased lesion size and healing of sinuses following medical therapy. Sixty-six patients (15.7%) had no noticeable improvement. The lesion continued progressing despite treatment in 44 patients (10.5%). In the study, 118 patients were on regular follow-up, and in this group, a cure was documented in 25 patients (21.1%) with eumycetoma and 23 (19.4%) with actinomycetoma. Post-operative recurrence among eumycetoma patients was 40%, with a 1% mortality rate. The treatment outcome was unsatisfactory, characterised by a low cure rate, high recurrence (40%) and follow-up dropout (57%) rates. This emphasises the importance of early case detection and management, objective health education programmes and thorough patient counselling to urge people to seek treatment early and reduce dropouts.

3D intraoral scanning techniques support the effects of crown morphology on dental caries

BackgroundWith the development and utilization of three-dimensional (3D) intraoral scanning (IOS) technology, the morphological characteristics of teeth were quantitatively assessed. In this research, we aimed to explore the prevalence of dental caries in relation to each measurable morphological indicator of the tooth body via 3D intraoral scanning techniques.MethodsA hospital-based single-centre study was conducted at our hospital from Dec. 2021 to Apr. 2023. A total of 53 patients were involved in the study, providing complete morphological data for 79 teeth. Each patient completed an oral hygiene routine questionnaire and underwent examination by an experienced dentist to evaluate caries conditions before undergoing 3D intraoral scanning to obtain a digital dental model. Geomagic Studio 2014 was used to extract oral morphological data from the models. The acquired data were entered, cleaned and edited using Excel 2016 and subsequently exported to SPSS version 25.0 for analysis. Chi-square analysis and logistic regression analyses were employed to test the associations.ResultsAmong the participants, 33 (61.1%) were female, with a mean age of 26.52 ± 10.83 years. Significant associations were found between dental caries and the vertical distance between the distal tip and the gum (OR 14.02; 95% CI 1.80-109.07; P = 0.012), the distal lateral horizontal distance of occlusion (OR 0.40; 95% CI 0.18–0.90; P = 0.026), and the mesial horizontal distance of occlusion (OR 2.20; 95% CI 1.12–4.31; P = 0.021). The Hosmer–Lemeshow test indicated a P value of 0.33.ConclusionsThe vertical distance between the distal tip and the gum, the distal lateral horizontal distance of the occlusion and the mesial horizontal distance of the occlusion were the influencing factors for dental caries (identified as independent risk factors). We hypothesize that these factors may be associated with the physiological curvature of teeth and the role of chewing grooves in plaque formation over time. However, further studies involving larger population samples and more detailed age stratification are still needed.

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.

Correlation of alanine aminotransferase levels and a histological diagnosis of steatohepatitis with ultrasound-diagnosed metabolic-associated fatty liver disease in patients from a centre in Nigeria

BackgroundMetabolic-associated fatty liver disease (MAFLD) is defined as the occurrence of hepatic fat accumulation in patients with negligible alcohol consumption or any other cause of hepatic steatosis. This study aimed to correlate the ultrasound-based diagnosis of MAFLD with the histological diagnosis of nonalcoholic steatohepatitis (NASH) and alanine aminotransferase (ALT) levels in patients with MAFLD.MethodsThis was a hospital-based cross-sectional study of 71 patients with MAFLD diagnosed by ultrasound. Percutaneous liver biopsy was performed for histological evidence of NASH in all patients, regardless of liver function test (LFT) values, provided that they had no contraindications. Liver histology was graded using the NASH Clinical Research Network MAFLD Activity Score. The data obtained were entered into SPSS version 21 and analysed using descriptive and inferential statistics. The significance level was set at < 0.05.ResultsA total of 71 patients (26 males and 45 females) with MAFLD were included. Thirty-nine (76.5%) patients with MAFLD and normal ALT levels had NASH, while 14 (82.4%) had elevated ALT levels. There was no statistically significant difference in the histological grade of NASH between patients with normal and elevated ALT levels. A weak correlation was found between the severity of steatosis on ultrasound scan and NASH incidence (p = 0.026). The sensitivity and specificity of ALT levels for predicting NASH according to the area under the receiver operating characteristics (AUROC 0.590) at an ALT cut-off value of 27.5 IU/L were 55.8% and 64.7%, respectively.ConclusionNASH can occur in patients with MAFLD, irrespective of alanine transaminase (ALT) levels, and ultrasound grading of the severity of steatosis cannot accurately predict NASH. Liver biopsy remains the investigation of choice.

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

Prevalence of Vitamin D Deficiency among Patients Attending Tertiary Level Hospitals in Bangladesh: Hospital-Based Cross-Sectional Study

Introduction: Vitamin D (Vit D) is essential for calcium and phosphate homeostasis, critical for bone growth and remodeling. Its deficiency leads to conditions like osteomalacia and rickets, with adverse effects on osteoporosis, growth, and skeletal health. This study aimed to assess Vitamin D Deficiency prevalence among patients in Bangladeshi tertiary-level hospitals. Materials and Methods: A prospective cross-sectional study was conducted from January to December 2019 at Cumilla Medical College Hospital and Central Medical College Hospital. We enrolled 1250 patients meeting inclusion criteria and collected data via a pre-designed questionnaire. Results: Most participants (31.8%) were aged 31-40, with a mean age of 37.31±13.37. Male patients constituted 53.3%, and 46.7% were female. Rural residents accounted for 52.6%, while 25.8% lived in urban areas, and the rest abroad, mainly the Middle East. The majority (88.5%) belonged to middle-class families, and only 1.5% reported sufficient sun exposure. Strikingly, 54.2% were Vitamin D deficient, 40% had insufficient levels, and only 6.4% had adequate Vit D. Conclusion: This study highlights a significant prevalence of Vitamin D deficiency among patients in Bangladeshi tertiary hospitals. The data underscore the urgent need for healthcare authorities to address this public health concern. Policymakers and healthcare providers should be aware of the potential long-term health consequences of Vitamin D deficiency, emphasizing the importance of strategies to promote adequate Vit D levels in the population. Medicine Today 2023 Vol.36 (1): 17-22