Subjects Mean Age Research Articles (Page 1)

Malaria diagnosis by Rapid Diagnostic Test (RDT) is challenged by the newly emerging histidine-rich protein 2 (HRP2) gene deletion in the Plasmodium falciparum species. The alternative lactate dehydrogenase (LDH)-dependent RDTs suffer from low sensitivity, and improvement in the sensitivity of LDH RDTs is the cornerstone for detecting the (HRP2) gene deletion species. This study aimed to evaluate a novel, improved Mologic Malaria Pf LDH-dependent RDT for the diagnosis of P. falciparum malaria in partnership with the Foundation for Innovative Diagnostics (FIND), Switzerland. This is a descriptive cross-sectional study evaluating the clinical performance of the improved Mologic LDH- RDT in two rural sites in Khartoum state, Sudan. Five hundred patients presenting with symptoms suggestive of malaria in the two primary care health centres were enrolled after signing informed consent. Finger-prick blood was collected for examination with microscopy, the index Mologic LDH RDT, the comparator RDT, and preparation of DBS for PCR, the reference method. The mean age of the study subjects was 31years, ranging from 5 to 80years. Out of 500 patients, 210 (42%) were positive by PCR, 200 (40%) by expert microscopy, 193 (38.6%) by index Mologic LDH RDT, and 199 (39.8%) by comparator RDT. The sensitivities of microscopy, index RDT, and comparator RDT were 95.24% (95% CI, 91.4-97.6), 91.9% (95% CI, 87.3-95.2), and 93.81% (95% CI, 89.6-96.6), respectively. All tests were nearly 100% specific for the detection of P. falciparum parasites. The concordance test showed almost perfect agreement with the reference test (κ = 0.929). Six samples were P. falciparum HRP2 Ag negative and were detected by Mologic LDH RDT. A limitation of this study is that there is no confirmation of HRP2 gene deletion by PCR. The novel Mologic LDH RDT showed performance concordant with standard expert microscopy and the comparator HRP2-based RDT. The sensitivity of the Mologic LDH RDT makes it suitable for the clinical management of P. falciparum HRP2 negative malaria.

Background/Objectives: Gut microbiota is profoundly influenced by dysglycemic states, including prediabetes (preDM) and type 2 diabetes (T2D). Although short-chain fatty acids (SCFAs) may serve as proxies reflecting these microbial changes, their predictive role remains elusive. This study aimed to evaluate the association between fecal SCFA concentrations and glycemic status (preDM and T2D), using individuals with normoglycemia (NonDM) as the reference group in a Mediterranean adult population. Methods: This study included a total of 88 participants from the Di@bet.es study who were classified into three groups according to the American Diabetes Association criteria: NonDM (45%), preDM (27%), and T2D (28%), respectively. We evaluated gut microbiota populations through massive sequencing and determined SCFAs concentration using gas chromatography–mass spectrometry. Adjusted multiple logistic regression models were used to estimate associations between SCFAs and metabolic status. Results: The mean age of subjects with preDM and T2D was approximately 68 years, older than that of NonDM participants (about 60 years). About 50% of the subjects in the NonDM and preDM groups were female, whereas in the T2D group, females represented about 25%. The analysis revealed that only fecal acetic acid was significantly reduced in T2D compared to NonDM (p = 0.036) and preDM (p = 0.018) groups. Remarkably, fecal acetic acid was negatively associated with T2D risk when taking preDM as the reference state (OR = 0.561 [95% CI: 0.371–0.846], p = 0.009). Intriguingly, fecal acetic acid was identified as a significant positive predictor of preDM risk, taking the NonDM group as reference (OR = 1.422; p = 0.028), while propionic acid was inversely associated with preDM (OR = 0.714; p = 0.028). Conclusions: Our analysis showed that fecal acetic acid levels were associated with a reduced risk of T2D but also with an increased risk of preDM; however, the biological relevance of these findings remains uncertain.

Diffuse parenchymal lung disease (DPLD) is a group of more than 200 pulmonary diseases that affect the alveoli, pulmonary interstitium, and/or small airways. DPLD patients often present in the outpatient department and inpatient department with acute/subacute worsening in their symptoms. These worsenings are due to a variety of causes that include acute exacerbations (AE), bacterial/viral/fungal infections, pneumothorax, pulmonary thromboembolism, or cardiac compromise. However, regardless of the type of underlying DPLD and the etiology of acute worsening when AE develops, it poses serious difficulties for patients, families, doctors, and the medical system. The current study was performed to evaluate the clinical presentation, etiological factors, and hospital course of DPLD patients presenting with acute/subacute worsening in their respiratory symptoms. A total of 39 hospitalized DPLD patients were recruited as per the inclusion and exclusion criteria. On admission, all relevant investigations were done, and the patients were evaluated thoroughly. All these patients were managed as per standard guidelines with regular monitoring. Based on the clinical course, treatment outcome was categorized as improved (discharged from hospital) or shifted to intensive care unit/mechanical ventilation and improved or died. The mean age of the study subjects was 57.95±11.7 years. The most common symptom reported in the study was dyspnea, followed by cough and fever. The most common etiology observed in the study, leading to hospital admission in DPLD patients, was respiratory infections and AE, followed by cardiac diseases. Out of the total 39 hospitalized DPLD patients, 13 patients required invasive mechanical ventilation, whereas 26 patients (66.7%) were managed with oxygen support/non-invasive ventilation/high-flow nasal oxygen. The univariate logistic analysis showed that patients with diabetes, pedal edema, idiopathic pulmonary fibrosis, regional wall motion abnormalities, and cardiac causes of acute clinical worsening were significant risk factors for the need for mechanical ventilation. On performing multivariate regression, none of the variables was an independent significant risk factor of mechanical ventilation. It is recommended to actively undertake monitoring and treating DPLD in conjunction with managing various concomitant illnesses, which is vital for improving outcomes and lowering the risk of acute clinical worsening and respiratory compromise.

BACKGROUND: Myopia is a common refractive error where light rays from distant objects focus in front of the retina when accommodation is relaxed. It is a major public health issue and one of the leading causes of blindness and visual impairment, with varying prevalence globally. This study aimed to determine myopia prevalence and associated factors among secondary school students. METHODS: A school-based cross-sectional study was conducted from May 10 -June 10, 2023, in which 488 participants from three secondary schools at Finote Selam town were selected by systematic random sampling. Data was collected using pre-tested, structured questionnaire and ophthalmic examination. The data were entered into Epi Data 4.6, then exported and analyzed using SPSS version 25. Descriptive analysis was summarized using frequency, percentage, and summary statistics. Binary logistic regression was used to determine the associated factors, with significance considered a p-value of less than 0.05 and a confidence interval of 95 in multivariable logistic regression. RESULTS: A total of 488 study participants with a response rate of 98.99% were involved in the study. The mean age of subjects was 17.36 years. The prevalence of myopia was 15.37 %( 95%CI: 11.93 –19.10). The factors associated with myopia were gender (AOR=2.63;95%CI:1.41-4.92), residence (AOR=2.04;95%CI:1.08-3.86), family income (AOR=3.43;95%CI:1.74-6.75), family spectacle use (AOR=2.17;95%CI:1.10-4.28), habitual working distance (AOR=2.98;95%CI:1.17-7.58), outdoor activity (AOR=2.47;95%CI:1.22-5.02), and sleep duration (AOR=2.68;95%CI:1.28-5.59). CONCLUSION: considerable prevalence of myopia has been found on the study area. A total 15.37% participants had myopia. habitual working distance and high socioeconomic status were significantly associated with myopia

There is a paucity of information and data on congenital anomalies of the kidney and urinary tract (CAKUT) in the African setting. The aim of this study was to determine the prevalence, pattern and distribution of CAKUT as observed from computed tomography (CT) scans in a black African population. This was a retrospective study carried out in Enugu, Southeast Nigeria. The study population was drawn from subjects who had an abdominopelvic CT scan or CT urography for either urological or non-urological conditions. Data was pulled from three large-volume referral centers for CT scans in the city center, and study period extended from January 2015 to December 2024. Analysis was performed using Statistical Package for Social Sciences (IBM Corp., Armonk, NY, USA) for Windows, version 27.0. Data were described using frequencies and proportions in tables and charts. The records of 3507 subjects were retrieved for this study. A total number of 122 subjects had congenital anomalies of the kidneys or the urinary tract, which gave a prevalence of 3.5% (95% confidence interval: 2.9-4.1%). The mean age of subjects was 39 ± 19.8 years and the majority of them were males (57.4%). The most prevalent anomaly was pelviureteric junction (PUJ) obstruction (1.28%), followed by duplex collecting system. The prevalence of CAKUT from this study was 3.5%. Pelvic ureteric junction obstruction was the most prevalent congenital anomaly of the urinary tract in our setting.

Introduction: The most effective treatment for gallstone disease symptoms is Laparoscopic Cholecystectomy (LC). Gallbladder retrieval is a crucial step, with direct extraction and endobagassisted extraction being commonly used techniques. Direct extraction may lead to increased bile spillage and port-site infections, whereas the endobag provides protection against contamination but may increase operative time. Aim: To compare the outcomes of direct gallbladder extraction versus endobag-assisted extraction in LC, focusing on bile spillage, port-site infections, operative time, postoperative pain and hospital stay duration. Materials and Methods: This prospective observational study was conducted in the Department of General Surgery, SRM Medical College Hospital and Research Institute, Kattankulathur, Chengalpattu, Tamil Nadu, India, from December 2024 to March 2025. A total of 60 patients undergoing elective LC were randomised into two groups: Group A (direct extraction) and Group B (endobag extraction). Primary outcomes included intraoperative complications (gallbladder perforation and bile spillage) and postoperative complications (port-site infections and pain levels). Secondary outcomes assessed operative time and hospital stay duration. Continuous variables were expressed as means with standard deviations, and categorical variables as frequency counts and percentages. An independent t-test was used for comparing continuous variables and the Chi-square test for categorical data. A p-value <0.05 was considered statistically significant. Results: The mean age of subjects in Group A was 38.1±13.9 years {males: 16 (53.3%), females: 14 (46.7%)}, and in Group B, it was 44.3±12.5 years {males: 13 (43.3%), females: 17 (56.7%)}. The endobag group (Group B) had significantly lower rates of bile spillage (6.7% vs. 23.3%, p-value=0.036) and port-site infections (3.3% vs. 16.7%, p-value=0.019) compared to direct extraction (Group A). Group B also demonstrated significantly shorter operative times (32.2±3.7 minutes vs. 39.1±5.4 minutes, p-value <0.001) and hospital stay durations (1.5±0.5 days vs. 2.2±0.8 days, p-value <0.001). Postoperative pain scores on the 1st day (5.4±1.3) and 3rd day (2.2±0.8) were significantly lower in Group B (p-value <0.001). Conclusion: Endobag-assisted gallbladder extraction significantly reduces bile spillage, port-site infections, and postoperative pain while decreasing the duration of hospital stay. It is a safer alternative to direct extraction, particularly in high-risk patients.

Introduction: The long-term consequences of COVID-19, also known as post-acute sequelae of SARS-CoV-2 infection (PASC), remain incompletely understood. Early studies have highlighted persistent multi-system symptoms, including anxiety, but data beyond one year are limited. This study aimed to evaluate the incidence of anxiety symptoms over three years among COVID-19 survivors. This cohort study aimed to investigate the longitudinal outcomes of COVID-19 survivors, with a focus on the persistence and development of sequelae. Methods: The study enrolled a cohort of 109 subjects who were admitted with real-time polymerase chain reaction (RT-PCR)-confirmed COVID-19 in a tertiary care hospital in south-central India. Due to the retrospective enrollment in 2023, participants were interviewed to recall their anxiety status at discharge (2021) and one year after discharge (2022). This was followed by a prospective assessment of anxiety, two years (2023), and three years (2024) after discharge. The study involved the collection of quantitative data using a standardized questionnaire based on the Hamilton Anxiety Rating Scale (HAM-A), sent to the subjects via non-contact methods such as digital platforms or telephonic conversations. After data gathering, the data were tabulated on a Microsoft Excel spreadsheet and analyzed with the help of the IBM SPSS trial version 21. Statistical analysis included descriptive statistics, chi-square tests, and ordinal logistic regression.Results: The mean age of the study subjects was 36.08 ± 15.31 years, with the majority being females. Corresponding to the time of discharge from the hospital, varying levels of anxiety were found among the participants, with most of them having mild anxiety, followed by severe anxiety and mild to moderate anxiety. The major contributors to the severe as well as mild to moderate anxiety were impaired intellectual abilities, insomnia, and depressed mood. The mean baseline HAM-A score at the time of discharge, one year, two years, and three years after discharge were 17.06 ± 10.71, 10.46 ± 8.38, 4.32 ± 5.21, and 1.13 ± 2.58, respectively.Conclusion: Longitudinal follow-up showed a notable improvement in anxiety scores over a period of three years, with the mean score falling drastically at each year, suggesting a positive trend in mental health recovery. Findings support the need for integrated long-term mental health support and the need for primary case mental health screening.

Simenafil, a potent and highly selective oral phosphodiesterase type 5 (PDE5) inhibitor, is currently under investigation for erectile dysfunction (ED) treatment. To evaluate the efficacy and safety of simenafil for ED treatment. This was a multicenter, randomized, double-blind, placebo-controlled, parallel group, phase 3 study in men aged 18-75years with a history of ED of 6months or more. The subjects were randomized in a ratio of 1:1:1:1 to on-demand receive fixed-dose either placebo or simenafil (2.5mg, 5mg or 10mg) for 12weeks. Primary efficacy endpoints were the least square mean (LSM) changes from baseline to week 12 in the erectile function (EF) domain of the International Index of Erectile Function (IIEF), percentages of "yes" responses to sexual encounter profile (SEP) diary question 2 (SEP Q2: Were you able to insert your penis into your partner's vagina?) and question 3 (SEP Q3: Did your erection last long enough for you to have successful intercourse?). A total of 765 patients were randomized and 92.3% completed the study. The mean age of subjects was 41.3years and 81.6% had moderate to severe ED (mean overall International Index of Erectile Function-Erectile Function (IIEF-EF) domain score 13.4). After 12weeks of treatment, doses of 2.5, 5, and 10mg of simenafil exhibited substantial increases than placebo in IIEF-EF score (12.3, 12.3, 12.7 vs. 9.6), the percentages of "yes" responses to SEP Q2 (40.58%, 42.43%, 43.98% vs. 32.05%), and SEP Q3 (61.91%, 63.70%, 65.19% vs. 46.70%) (all P < .001). Adverse drug reactions (ADRs) occurred in 36.2% of patients who received simenafil (32.6% in simenafil 5mg group, the clinically recommended dose) and in 30.9% of those who received placebo. The most common (≥2%) ADRs were dizziness, headache, flushing, nasal congestion, and dry mouth, and most were mild or moderate. Furthermore, abnormal vision (PDE6 related) and myalgia (PDE11 related) did not occur in patients who received simenafil. Simenafil is highly effective in all 3 dose groups and has a low effective dose and good safety profile, providing a novel, favorable treatment option for patients with ED. The efficacy and safety evaluation of simenafil in difficult-to-treat patients with ED, ED patients with other concomitant diseases, and other ethnic populations was not performed. Simenafil is an effective and well-tolerated therapy for patients with ED.

Assessment of programmed death ligand 1 (PD-L1) expression in cervical intraepithelial neoplasia and carcinoma cervix

Sub-fertility is an upsetting situation for childless couples who are experiencing a lot of physical, mental, social, and economic trauma. Many women go to an infertility clinic or gynecologist without their husbands because it is still considered a female issue, but male factors play a significant role in its etiology. Semen analysis is the most fundamental, useful and inexpensive means of assessing male factor infertility. This descriptive cross-sectional study was directed among sub-fertile males of infertile couples visiting the CARE (Centre for Assisted Reproduction) in Department of Obstetrics and Gynaecology of BIRDEM, Dhaka. The study was conducted among 126 males who were sub-fertile and aimed to evaluate the patterns of sperm parameters using semen analysis. After receiving informed consent and meeting eligibility criteria, participants were interviewed and semen analysis reports were obtained. Semen from the male partners were analyzed in the laboratory using the World Health Organization (WHO) 2021 criteria for human semen characteristics. Data were analyzed by using SPSS- 22. A total of 126 participants’ semen analysis and background characteristics were evaluated by using WHO standard for semen normality criteria, 2021. The WHO standard for semen normality criteria, 2021 was used to evaluate the semen analysis and background characteristics of 126 participants. The mean age (Mean±SD) of the study subjects was 34.92±6 years with their age range 21 – 52 years; among these respondents most of them (84.10%) were in the most productive fertile age group 21-40 years. In this study primary sub-fertility was observed in 68.3% of men and maximum of them (43.7%) were demanding to conceive over 3-5 years.Study found the following normal parameters of semen analysis; those are, 4.76% of the men had &lt;1.4 ml semen volume per ejaculation, nearly one-fourth (22.22%) of men had sperm concentration &lt;16 million/ml, more than half (55.56%) of the men’s total sperm motility was &lt;42% and 17.46% of them were found abnormal morphology of sperm (teratospermia). The mean (Mean±SD) of semen volume was 2.59±0.99 ml, pH was 7.27±0.69, sperm concentration was 59.38±52.34 million/ml and the mean of total motility of the sperm was 36.70±24.71%; however mean of immotile sperm was 51.99±28.04% and normal morphology of sperm was 35.52±24.49%. An abnormal patterns of semen parameters were seen in majority (58.73%) of men; among them more than one-third (34.9%) of them were asthenozoospermia, 11.1% was azoospermia, Oligoasthenoteratozoospermia was 7.1%, Oligospermia 8% and Oligoasthenozoospermia 4.8%. According to age-wise distribution maximum cases of asthenospermia (20.6%) were observed between the age group of 31-40 years. Single-factor abnormalities was observed in 47.6% cases and 11.11% had combined factor abnormalities. This study found that asthenozoospermia was the main single factor abnormality or sub-fertile state, followed by azoospermia. Male partners of sub-fertile couples attending infertility clinics consistently have abnormal semen parameters, which are prevalent with primary sub-fertility. This study similarly found that asthenozoospermia and azoospermia were common abnormalities in male partners. Bangladesh Med J. 2024 Jan; 53(1): 18-25

Objectives An increase in prevertebral soft-tissue thickness (PVST) on lateral cervical spine radiographs raises suspicion of underlying cervical spine pathology. Variation in the magnification of radiographs performed at different institutions makes it difficult to differentiate between normal and abnormal. The ratio of PVST and anteroposterior diameter of the vertebral body eliminates the effect of magnification. Material and Methods One hundred normal lateral cervical-spine radiographs were assessed for individuals aged 18-63 years. The PVST and anteroposterior diameter of the corresponding vertebral body were calculated for C1-C7 level using a Vernier caliper (least count of 0.01 mm) by 3 independent observers. The ratio was calculated by dividing PVST by the anteroposterior diameter of the corresponding vertebral body. Mean, range, and standard deviation were calculated. Student’s t-test, analysis of variance (ANOVA), and Lin’s concordance correlation coefficient were used. Results The mean age of study subjects was 35.29 years (range: 18-63 years). Out of a total of 300 readings at each cervical vertebrae, the mean ratio of PVST and its corresponding anteroposterior diameter of vertebral body for C1 to C7 were 0.46, 0.31, 0.27, 0.47, 0.79, 0.77, and 0.66, respectively. This ratio was found to be maximum for C5 and minimum for C3 for all observers. The ratio was significantly higher in females at C4 level (p=0.002), whereas significantly higher in males at C6 level (p=0.04). No significant age-wise difference was observed except at the C7 level (p=0.02). Interobserver agreement between observers 1 and 2 was 0.92, whereas it was 0.89 and 0.90 between observers 2 and 3, and observers 1 and 3, respectively. Conclusion This study establishes the normal limits of the ratio of PVST and corresponding anteroposterior vertebral body diameter in the Indian population.

Objectives: The objectives of the study were: (1) To study the sociodemographic profile of cerebral palsy (CP) cases attending the District Early Intervention Center (DEIC) at Sishu Bhawan. (2) To study the risk factors of CP. (3) To study the associated comorbid conditions of CP. Methods: It is a hospital-based study conducted at DEIC, Sishu Bhawan, Cuttack, from July 2016 to June 2017. All cases (150) of CP children in the age group of 6 months–14 years attending DEIC during the study period were taken as study subjects. The mothers/caregivers of the children were interviewed, and the data thus collected were analyzed by the Statistical Package for the Social Sciences version 17. Results: The mean age of the study subjects was 2.87 years±2.48 standard deviation. The male–female ratio was 2.4. The risk factors associated with CP were PIH, antepartum hemorrhage, low birth weight, hyperbilirubinemia, seizures, birth asphyxia, etc. The common comorbid conditions are malnutrition, mental retardation, seizure, hearing and vision impairment, speech difficulty, and behavioral problems. Conclusion: Prevention of prenatal, perinatal, and postnatal risk factors of CP and better management of high-risk cases will reduce the occurrence of CP.

e22013 Background: Data from some clinical studies have shown that MEK inhibitors have obtained effective results in the treatment of patients with inoperable Type I neurofibromatosis-related plexiform neurofibroma (NF1-PN). The aim of this study was to evaluate the efficacy and safety of the MEK inhibitor FCN-159 in pediatric type I neurofibromatosis-related plexiform neurofibroma. Methods: The study is a single-center, single-arm, prospective study to enroll 20 subjects, who will be given 5 mg/m 2 FCN-159 orally daily according to their body surface area, and the primary follow-up indicator will be the reduction in tumor volume of the children as assessed by MRI technique every 4 months, and other indicators will include pain, motor function, safety, and adverse events. Results: This study was conducted from 2023-10 onwards. All 20 subjects have been enrolled to date, with 19 subjects having valid follow-up data. The mean age of subjects at registration was 94.8 months (30-191 months), the mean volume of selected target tumors at follow-up was 89.8 cm 3 (11.4-257.7 cm 3 ), and the current median follow-up time was 8 months (2-14 months). After completing MRI after the appropriate time, 79% (15/19) of patients showed a shrinking or shrinking trend in the target tumor, with a median percent reduction in tumor volume of 29.9% (5%-59.6%). Tumor volume reduction of up to 20% in 42% (8/19) of patients (29.9%-59.6%). One patient (5%) discontinued treatment due to disease progression, two patients were discharged from the group for other treatment options, and seven patients (36.8%) did not reach 20% shrinkage of the target tumor (5%-18.6%), but all showed a trend toward shrinkage. Mean pain numeric rating scale (lansky) decreased from 2.92 at baseline to 0.58 (p = 0.025). The most common adverse reactions were decreased albumin (11 cases), asymptomatic creatine kinase elevation (8 cases), rash (8 cases), oral ulcers (4 cases), and onychomycosis (5 cases). Except for one Grade 3（CTCAE 5.0 ）adverse event neoplastic tumor, there were no other Grade 3 or higher adverse reactions or serious adverse reactions. Conclusions: In this study, 79% of pediatric NF1-PNs showed a trend toward tumor shrinkage or atrophy within the first 14 months of treatment with FCN-159. Patients had significantly lower mean pain scores, but adverse effects were also common. Subsequent, more substantial studies are still needed to evaluate the effectiveness and long-term adverse effects of FCN-159. Clinical trial information: The retroactive filing operation is underway, with a filing number of MR-11-24-053360 .

1638 Background: Adults with cancer in the U.S. face an elevated mortality risk compared to the general population, with social risk factors playing a critical role – particularly among those with comorbidities. However, traditional mortality risk prediction models often focus on treatment exposures and basic demographic factors, overlooking social risk factors. We aim to develop a machine learning (ML) model that integrates comprehensive social risk factors with traditional predictors to predict overall survival for adults with cancer in the U.S. Methods: We analyzed data from 6,181 nationally representative adults diagnosed with cancer from the National Health Interview Survey (NHIS; 2013-2014). A total of 74 risk factors, including basic demographics (e.g., age at the survey, sex, marital status, body mass index [BMI]), personal and household socioeconomic status (SES; e.g., education, food insecurity), lifestyle, social support, and health status (e.g., chronic health conditions [CHCs], disability), were included in modeling. The primary endpoint was 5-year overall survival from the survey completion date, with secondary endpoints of 1- and 2-year survival. Death from any cause after the survey was defined as an event, and subjects were censored 5 years post-survey. The sample was randomly split into 70% training and 30% testing. A random survival forest (RSF) model predicted survival. The time-dependent area under the receiver operating characteristic (AUROC) curve and the Brier score (BS) assessed the model performance. Both AUROC and BS range from 0 to 1, with higher AUROC for higher accuracy (discrimination) and lower BS for better alignment between predicted and observed risk (calibration). The Shapley additive explanations (SHAP) values were used to interpret variable importance in the established RSF model. Results: The mean age of subjects during the survey was 65.6±13.8 years, and 40.2% were male. For the established RSF model, the AUROC (mean ± standard deviation) for predicting 1-, 2-, and 5-year survival was 0.795 ± 0.026, 0.810 ± 0.018, and 0.831 ± 0.011, respectively, reflecting high and improved predictive accuracy over time. The BS for 1-, 2-, and 5-year survival was 0.039 ± 0.004, 0.065 ± 0.005, and 0.119 ± 0.005, respectively, indicating excellent calibration. The top five variables ranked by SHAP values include age at the survey (0.048), use of special equipment due to health problems (0.029), employment status (0.020), number of CHCs (0.016), and BMI (0.015). Conclusions: By integrating social risk factors with traditional risk predictors, we developed an ML model that predicts overall survival with high accuracy and excellent calibration for adults with cancer in the U.S. Identifying key risk social factors enables targeted interventions, potentially improving health outcomes and management for the adult cancer population.

Length of Hospital Stay in Adolescents Receiving High-Dose Oral Contraceptive Pills with and without Conjugated Equine Estrogen for the Treatment of Acute Abnormal Uterine Bleeding.

IntroductionThe most common risk factors for ostomy complications include the cause of stoma emergence (cancer, inflammatory bowel diseases), the type of stoma, concomitant diseases, and stoma care during pre- and postoperative periods.AimIn this study, authors assessed the impact of stoma care and stoma site designation prior to surgery based on the occurrence of ostomy complications.Material and methodsThe study included 104 patients (49 women, 54 men, with the mean subject age being 57 years) in whom a stoma was diagnosed in 2010–2022. The study was conducted in a group of patients who were diagnosed with an intestinal stoma between 2010–2022.Results and discussionThe overall risk of ostomy complications was 84.62%, and the most common complication in the analysed arm was dermatitis around the stoma, which occurred in 78 patients (75% of participants). The study found a 13-fold increase in the risk of ostomy complications in patients who were not under the care of a stoma nurse and in whom a stoma site was not determined prior to surgery (RR = 13.11, CI: 4.21–58.64, &lt;i&gt;P&lt;/i&gt; &lt; 0.001). The analysis found a lower risk of dermatitis in patients under the care of a stoma nurse when compared to stoma patients without such care (RR = 0.38, CI: 0.16–0.78, &lt;i&gt;P&lt;/i&gt; = 0.014).ConclusionsThe outcomes of this study confirmed that the stoma site should be determined prior to any surgical procedure in which there is a risk of stoma emergence. In addition, every patient with a stoma should be under the care of a stoma nurse pre- and post-operatively.

Knowing the Pattern of pathogens in community-acquired lung abscess (CALA) is important in the choice of initial empiric antibiotics. Early studies established the anaerobes as the predominant pathogen, followed by aerobic streptococci and aerobic Gram-negative bacilli. However, recent reports indicated that Klebsiella pneumoniae and aerobic streptococci predominated. We performed a retrospective study on CALA cases from all public hospitals in Hong Kong over a nine-year period. Only cases with uncontaminated specimens sent for bacterial culture were included. Cases caused by mycobacteria and fungi were excluded. There were 606 eligible subjects-episodes. Mean age of subjects was 57.7 years and male to female ratio was 3.3:1. Two hundred and thirty-two subjects had at least one positive bacterial culture, with a total of 338 pathogens isolated. Anaerobes were the predominant pathogen group with 103 isolates (30.5% of total). This was followed by aerobic streptococci (90, 26.6%), aerobic Gram-negative bacilli (67, 19.8%), and Staphylococcus aureus (56, 16.6%). Isolation of Staphylococcus aureus was closely linked to intravenous drug abuse, while isolation of Klebsiella pneumoniae (28 cases) was related to extrapulmonary abscesses, particularly of the liver. There were 14 cases of Pseudomonas aeruginosa with underlying chronic lung disease and major organ failure being risk factors. Anaerobes and aerobic streptococci appear to be the major pathogens for primary CALA. Secondary lung abscess caused by haematogenous spread is commonly attributable to Staphylococcus aureus or Klebsiella pneumoniae . Choice of empiric antibiotics should take these into consideration together with local patterns of antibiotic resistance.

Background: The relationship between left-ventricular hypertrophy (LVH), left-ventricular mass index (LVMI), body mass index (BMI), and their corresponding pulmonary function test parameters remains unknown. Methods: In this prospective observational study, we assessed the pulmonary function of subjects with LVH. The severity of airway obstruction was graded into five levels using the FEV1% predicted value and the prevalence of obstruction with left-ventricular mass was also correlated. Results: Our study included 289 subjects [142 (49.1%) LVH and 147 (50.8%) non-LVH]. The mean age of subjects with LVH was 56 ± 17.8 years. Sixty-two subjects with normal BMI had LVH. One-hundred forty-two subjects with LVH underwent spirometry; 9 (6.3%), 16 (11.3%), 18 (12.7%), 49 (34.5%), and 48 (33.8%) had mild, moderate, moderately severe, severe, and very severe obstruction before the administration of bronchodilator, respectively. After bronchodilator administration, the numbers (n%) were 13 (9.15%), 17 (11.9%), 27 (19%), 52 (36.6%), and 30 (21.1%), respectively. There was a strong inverse relationship (r = -0.87, r = -0.86) for pre bronchodilator and post bronchodilator, respectively; R2 = 0.76 and R2 = 0.74 for pre and post bronchodilator respectively, P < .001 for both) between LVMI and FEV1%. Conclusions: LVH was associated with high prevalence of obstructive pulmonary disease. The severity of obstruction was correlated with left-ventricular mass. The early screening of such underlying obstruction may help to reduce the risk of further complications.

Background/Objectives Odontogenesis is a complex process involving interactions between odontogenic and ecto-mesenchymal cells, mediated by growth factors and signaling pathways. Disruptions in these pathways lead to various dental anomalies. This study aimed to evaluate the prevalence and patterns of non-syndromic hypodontia among the Nepalese population. Methods A total of 5,075 panoramic radiographs taken between 2012 and 2020 were retrospectively reviewed. The mean age of the study subjects was 20.17 ± 5.51 years (range: 8 to 40 age), comprising 1,805 males (35.56%) and 3,270 females (64.43%). Hypodontia was diagnosed based on the absence of crown calcification of permanent teeth. Prevalence, distribution, and symmetry of hypodontia were assessed, with categorical associations analyzed using the Chi-square test (p&lt;0.05). Results The study analyzed 5,075 panoramic radiographs, consisting of 1,805 males (35.56%) and 3,270 females (64.43%). Hypodontia was identified in 400 subjects, 200 males (50%) and 200 females (50%), representing 7.88% of the population. A total of 655 missing teeth were recorded, 45.8% in females and 54.2% in males. Despite an equal number of affected males and females, a statistically significant association was found between gender and overall hypodontia prevalence in the sample (p &lt; 0.05), with males showing a higher likelihood of being affected. Maxillary lateral incisors were the most affected (47.33%), followed by mandibular second premolars (19.08%) and maxillary first premolars (17.56%). The maxillary arch had a significantly higher prevalence of hypodontia than the mandibular arch (p &lt; 0.05). Unilateral hypodontia was more prevalent than bilateral hypodontia (p &lt; 0.05). The most common associated dental anomalies were rotated adjacent teeth and retained deciduous teeth, but they were not statistically significant (p&gt; 0.05). Conclusion The prevalence of hypodontia among the Nepalese population was 7.8%. The findings of this study align with global trends, particularly the higher frequency of hypodontia in the maxillary lateral incisors.

The Healing Scale was developed to measure subjects' sense of healing. This study aimed to investigate the association between the Healing Scale scores and symptom improvement in terminally ill cancer patients. A sub-analysis of a previous sound-based intervention study was performed. Data from 18 terminally ill cancer patients were analyzed. The Healing Scale and symptoms were measured before and 30 minutes after the intervention. Correlations between the Healing Scale score and symptoms before intervention, and improvement of the Healing Scale and symptoms were analyzed using Pearson's rho. The mean age of subjects was 69.4 years and 33.3% were female. At baseline, higher Healing Scale Scores were significantly correlated with greater symptom burden, particularly well-being (ρ=-0.57), shortness of breath (ρ=-0.55), and lack of appetite (ρ=-0.50). At post-intervention, improvements in the Healing Scale scores showed moderate to strong correlations with reductions in shortness of breath (ρ=-0.68), tiredness (ρ=-0.58), and well-being (ρ=-0.56). These findings suggest that the Healing Scale may be a valuable outcome measure in palliative care research and clinical practice and may help to evaluate subjective aspects of patient healing and well-being that are often overlooked by traditional symptom scales. Further studies with larger sample sizes are required to validate the present findings in palliative care settings.