Cross-sectional Observational Study Research Articles

The Hidden Challenge: Pelvic Floor Symptoms and Their Impact on Performance and Well-Being in Elite Female Rugby Players.

More than half of female ball-sport athletes experience urinary leakage including 60% of Australian rugby union players. Beyond urinary incontinence (UI), the prevalence and impact of other pelvic floor (PF) symptoms in elite female athletes remains largely unknown. This study investigated PF symptom prevalence and impact on performance in elite female rugby players. A cross-sectional observational study was conducted. Australian elite female rugby players (n=56) completed a PF questionnaire during annual medical screening. Validated questionnaires established: presence/severity of UI (ICIQ-UI SF), presence and bother of PF symptoms (PFBQ), urinary tract infection, constipation, voiding difficulty (APFQ) and pelvic pain (adapted UDI-6). Purpose-designed questions established symptom impact on performance and well-being. Data were analysed descriptively. Response/questionnaire completion rates were > 95%. Participants were on average: 22.4years (SD: 5.9); BMI 26.3kg/m2 (SD: 4.6); mostly nulliparous (94%) and played 6.5years of rugby (SD: 4.4). More than half (57%) experienced PF symptoms during sport, most commonly UI (41%). Other PF symptoms experienced during sport included: AI (29%), bladder urgency (21%)/frequency (14%) and pelvic pain (12%). One in two symptomatic players reported an impact on performance (53%) including training reductions (34%); activity avoidance (25%) and concentration loss (9%). Players restricted fluid intake to avoid provoking symptoms. A quarter of players reported PF symptoms that impacted their sports performance. This is the first study to establish that, beyond UI, AI, bladder urgency/frequency and pelvic pain are also prevalent in elite rugby players. Elite female rugby players require assessment and management of PF symptoms to maximise performance and well-being.

<b>Determinants of Contraceptive Service Utilization Among Women of Reproductive Age Visiting Civil Hospital Umerkot</b>

Background: Contraceptive use is essential for improving maternal and child health outcomes, particularly in rural populations where access to family planning is constrained by socio-cultural and economic barriers. In Pakistan, the contraceptive prevalence rate remains suboptimal, with rural women disproportionately affected by limited education, gender norms, and poor health infrastructure. Understanding context-specific determinants is critical to addressing unmet family planning needs. Objective: To determine the prevalence of contraceptive use and identify the socio-demographic, cultural, and healthcare-related factors associated with contraceptive service utilization among women of reproductive age attending Civil Hospital Umerkot, Sindh, Pakistan. Methods: A cross-sectional observational study was conducted over six months in 2023 among 356 married women aged 15–49 years attending the hospital’s outpatient department. Data were collected using structured, interviewer-administered questionnaires assessing demographic characteristics, access to healthcare, contraceptive awareness and usage, spousal support, and cultural influences. Descriptive statistics, chi-square tests, and multivariate logistic regression were used to analyze associations. Results: Current contraceptive use was reported by 25.3% of participants. Secondary education (aOR: 2.64), employment (aOR: 1.98), spousal support (aOR: 3.22), awareness of services (aOR: 2.91), and absence of social stigma (aOR: 1.79) were positively associated with use. Barriers such as joint family structure and male child preference significantly reduced likelihood of use. Contraceptive prevalence declined sharply with accumulation of multiple barriers. Conclusion: Contraceptive service utilization in Umerkot is hindered by low education, limited awareness, patriarchal norms, and structural inaccessibility. Interventions must address these interconnected barriers through community education, male involvement, and health system strengthening.

Evaluation of Cardiac Biomarkers in Chronic Heart Failure

Chronic heart failure (CHF) is a global health burden associated with significant morbidity and mortality. Cardiac biomarkers play a crucial role in the diagnosis, prognosis, and management of CHF. This study aims to evaluate the levels of key cardiac biomarkers—particularly B-type Natriuretic Peptide (BNP), N-terminal proBNP (NT-proBNP), Troponins (cTnI and cTnT), and Galectin-3—in patients with chronic heart failure and to correlate these levels with disease severity. A cross-sectional analysis of 50 CHF patients was performed. Biomarker levels were measured using ELISA and chemiluminescence assays. Statistical correlation was made with clinical data including NYHA classification, echocardiographic parameters, and comorbidities. The study reinforces the clinical utility of biomarkers in the stratification and therapeutic monitoring of CHF. Chronic Heart Failure (CHF) is a complex clinical syndrome characterized by the heart's inability to pump sufficient blood to meet the metabolic demands of the body. It represents a major public health challenge globally, leading to high rates of hospitalization, reduced quality of life, and increased mortality. The early and accurate assessment of disease severity and prognosis is essential for timely intervention and better management. In recent years, cardiac biomarkers have emerged as indispensable tools not only in diagnosing CHF but also in monitoring its progression and guiding therapy.This study aims to evaluate and correlate the levels of selected cardiac biomarkers—namely B-type Natriuretic Peptide (BNP), N-terminal pro-B-type Natriuretic Peptide (NT-proBNP), Cardiac Troponin I (cTnI), and Galectin-3—in patients diagnosed with chronic heart failure. The objective was to analyze the relationship of these biomarkers with clinical severity (NYHA class), echocardiographic parameters (e.g., LVEF), and other comorbid conditions. A cross-sectional observational study was conducted on 50 CHF patients, using ELISA methods for biomarker estimation. The findings demonstrate a significant correlation between elevated levels of NT-proBNP and Galectin-3 with worsening NYHA functional class and reduced left ventricular ejection fraction, reinforcing their prognostic value. Troponin I, although traditionally associated with acute coronary syndromes, was found to be elevated in a considerable proportion of CHF patients, suggesting ongoing subclinical myocardial injury. Galectin-3, a marker of fibrosis and inflammation, showed promise in identifying patients at higher risk of disease progression. This study concludes that cardiac biomarkers provide crucial diagnostic and prognostic information in chronic heart failure. Incorporating biomarker profiling into routine clinical assessment may enhance individualized care, aid in risk stratification, and improve therapeutic outcomes. The integration of a multimarker strategy could potentially refine the clinical approach and enable earlier identification of deteriorating cardiac function in CHF patients. Keywords: Chronic Heart Failure, Cardiac Biomarkers, NT-proBNP, Troponins, Galectin-3, NYHA Classification, Prognosis

Comparison of communicative-linguistic indices between Late Talkers and typically developing children through the Dynamic Communication Evaluation coding scheme

ABSTRACT Late Talkers (LTs) are at risk for persistent developmental language disorders and show a slowdown in the acquisition of both language and communication skills. The Dynamic Communication Evaluation (DCE) is an event-based coding scheme for the analysis of intentional communicative acts produced via parental interaction, including categories of socio-communicative pragmatics and structural linguistic complexity. This cross-sectional observational study compares the communicative-linguistic competencies detected through the DCE of LTs with those of typical development children. The participants included 19 LT children (24–38 months old) with a vocabulary size lower than the 5th percentile on the Italian version of the MacArthur-Bates CDI, and the findings were compared to the performance of 19 typically developing (TD) children (25–37 months old). The groups were matched for chronological age. Correlations between communicative and linguistic labels and age were found in the LT group in greater numbers than in the TD group. A comparison between the two groups revealed lower abilities in LT than TD children in communicative-pragmatic indices – such as joint attention, responsiveness, and request of information – and in linguistic indices. Socio-communicative pragmatic, lexical, morphosyntactic, and phonological skills influenced each other during development in children with slow language emergence. The findings have clinical implications regarding early identification. Systematic observations appear to have clinical value because they support quantitative and qualitative data collection and guide intervention.

Qualitative analysis of experiences, burdens, and needs among patients with hypertrophic cardiomyopathy in Japan.

To identify factors affecting the health-related quality of life (HR-QOL) of symptomatic patients with hypertrophic cardiomyopathy (HCM) using qualitative interviews exploring patients' experiences and perceptions. This cross-sectional observational study was conducted using qualitative web-based or telephone interviews. Adult patients with HCM in Japan who were experiencing burden because of HCM were included. In-depth interviews were conducted using a semi-structured interview guide. The data were analyzed using a thematic analysis approach. Nineteen patients completed the interview. Ten HR-QOL-related themes were identified. Many patients were unaware that they had HCM symptoms, either no longer noticing them following life adjustments or attributing them to factors other than HCM. HCM affected multiple life aspects, including work, family, and social life. Patients resisted disclosing their disease to others and strongly resisted invasive treatment. Patients highly trusted their physicians but were reluctant to discuss their mental burdens and daily life challenges with them. This first qualitative study of HR-QOL in patients with HCM in Japan suggests that deeper physician - patient communication is needed to understand patient burden and needs, as patients have difficulty discussing their burdens with physicians and may lack awareness of HCM symptoms. NCT06181617 (ClinicalTrials.gov).

Sexual dimorphism assessment through morphological analysis of the sella turcica in multislice computed tomography scans.

Sexual dimorphism assessment through morphological analysis of the sella turcica in multislice computed tomography scans.

FREQUENCY OF DIFFERENT PRESENTATIONS IN MYOCARDIAL INFARCTION PATIENTS WITH AND WITHOUT DIABETES

Background: Myocardial infarction (MI) presents with a spectrum of symptoms, and diabetic patients often exhibit atypical or less pronounced presentations, which may delay diagnosis and treatment. Understanding the variation in symptomatology between diabetic and non-diabetic patients is essential for timely intervention. Objective: To determine the frequency of various clinical presentations of myocardial infarction and compare symptom patterns between diabetic and non-diabetic patients. Study Design: Cross-sectional observational study. Setting: Cardiology Department, Rehman Medical Institute, Peshawar. Duration of Study: From February 23, 2025, to May 23, 2025. Methods: A total of 164 patients (both diabetic and non-diabetic), aged 35 to 90 years, and diagnosed with MI were included. Clinical symptoms such as chest pain, arm pain, epigastric pain, jaw pain, nausea/vomiting, anxiety, and cold sweats were recorded and compared between the diabetic and non-diabetic groups. Data were analysed using descriptive statistics and Chi-square tests, with a p-value <0.05 considered statistically significant. Results: The mean age of participants was 65.7 ± 16.47 years, with males comprising 56.7% of the cohort. Chest pain was the most commonly reported symptom (72%). Diabetic patients had a significantly higher frequency of epigastric pain (16.5%, p = 0.03), anxiety (32.9%, p = 0.01), and cold sweats (43.0%, p = 0.04) compared to non-diabetics. Other symptoms, such as arm pain, jaw pain, and nausea/vomiting, showed no statistically significant differences between the two groups. Conclusion: Chest pain remains the predominant presenting symptom in both diabetic and non-diabetic MI patients. However, diabetic patients are more likely to present with atypical symptoms such as epigastric pain, anxiety, and cold sweats. These findings underscore the need for heightened clinical suspicion and broader diagnostic criteria when assessing diabetic patients for MI.

The prevalence of dental caries among Schoolchildren in a sample of schools in Ajdabiya City; A cross-sectional study

Background: Dental caries is an infectious microbiological disease of the teeth that results in localized dissolution and destruction of the calcified dental tissues. It remains one of the most prevalent pathological conditions among children in most countries. Preventive measures are the cornerstone of successful treatment for dental caries in children.Aims: The aim of this study is to determine the prevalence of caries among schoolchildren in the city of Ajdabiya and to lay the foundation for future awareness and educational programs on oral and dental health. These initiatives aim to prevent early tooth loss resulting from dental caries.Methods: This observational cross-sectional study was conducted among 690 schoolchildren (both female and male) in six randomly selected government schools in Ajdabiya city, located in northeastern Libya. A clinical examination was performed on the children. If caries were detected, a mark was placed next to the symbol representing the affected tooth on a designated recording sheet, according to the age groups targeted in the study. Data were analyzed using SPSS version 25.Results: The prevalence of dental caries among the study population was high, at 84%, with the highest rates observed among 9- and 10-year-old children—95% and 94%, respectively.Conclusions: Dental caries is considered a highly prevalent public health problem among children worldwide. This study highlights a high prevalence of dental caries among schoolchildren in Ajdabiya city, correlating with the mixed dentition stage—a phase in which permanent teeth have erupted while primary teeth are still present.

Changing trends in drug overdose mortality in Spain, 2001-2022.

To measure the evolution of drug overdose mortality in Spain between 2001 and 2022. A repeated cross-sectional observational study using nationwide mortality data from Spain, 2001-2022, among individuals aged 15-64 years. The outcome was overdose deaths [International Classification of Diseases, 10th revision (ICD-10) codes: X40-X44, X60-X64, X85, Y10-Y14]. Annual age-standardized mortality rates (ASMRs) per million person-years were estimated. Joinpoint regression assessed changes in trends using annual percentage change (APC) and average APC (AAPC). Overdose deaths were grouped by the underlying drug categories involved: nonopioid analgesics, antipyretics and antirheumatics (X40/X60/Y10); antiepileptic, sedative-hypnotic, antiparkinsonism and psychotropic drugs (X41/X61/Y11); narcotics and psychodysleptics (X42/X62/Y12); other drugs acting on the autonomic nervous system (X43/X63/Y13); other and unspecified drugs, medicaments and biological substances (X44/X64/Y14); and drugs, medicaments and biological substances in the context of assault (X85). Intentionality (based on ICD-10 code characters) within the underlying drug categories was assessed. All analyses were stratified by sex. In Spain, 15 862 overdose deaths occurred during 2001-2022. ASMR increased by 49.0% over the period, from 24.7 [95% confidence interval (95%CI) = 23.0, 26.5] to 36.8 (95%CI = 34.7, 39.0) deaths per million person-years. APC showed a statistically significant change in trends in 2010, shifting from a -3.3% (95%CI = -7.3 to -1.7) decline to an increase of 3.4% (95%CI = -0.3 to 6.5). In 2018, a more abrupt change was observed, with the APC further increasing to 13.8% (95%CI =9.3, 22.5). Females showed an earlier trend change (2006) with an AAPC 1.7 times higher (3.4%; 95%CI =2.4, 4.7) than males (2.0%; 95%CI =1.2, 2.7). Leading drug categories were other and unspecified drugs, medicaments and biological substances, followed by narcotics and psychodysleptics. In males, trends followed the overall pattern; in females, the antiepileptic, sedative-hypnotic, antiparkinsonism and psychotropic drugs category predominated, mostly due to intentional overdoses. Between 2001 and 2022, drug overdose deaths in Spain increased substantially, beginning in 2010 and further accelerated in 2018, though population rates remain low. The most prevalent underlying ICD-10 drug categories were other and unspecified drugs, medicaments and biological substances-likely reflecting polydrug use-and narcotics and psychodysleptics. The observed rise in deaths involving antiepileptic, sedative-hypnotic, antiparkinsonism and psychotropic drugs, particularly intentional overdoses among females, highlights the need for sex-based interventions.

Plasma testosterone concentration is correlated with circulating immune cell abundance in transgender young people on gender-affirming hormone treatment

Sex hormones, such as oestrogen and testosterone, display significant immune modulatory properties. This is highly relevant for transgender (trans) people who undergo gender-affirming hormone (GAH) treatment. However, only a limited number of studies have evaluated the immunological impact of GAH treatments, and almost none have assessed the impact in trans young people. Following recruitment to the Gender and IMmunity study (GIM) (n =100), biological samples were collected from trans young people (n = 47) including: trans males (birth-registered females taking testosterone-based GAH) and trans females (birth-registered males taking oestrogen-based GAH). All trans participants had taken GAH for at least 6 months. Samples were also collected from control individuals not taking GAH (n = 53). Immune profiles were evaluated using an 18-colour flow cytometry panel. In addition, the commercially available 37-parameter MaxPar panel was used for analysis of a subset of samples (n = 36) by mass cytometry (CyTOF). Immune cell abundance was compared across experimental groups, and correlated with plasma concentrations of oestradiol and testosterone using multiple regression models. From multiple comparisons analyses grouped by birth-registered sex, several differences were detected in the trans groups compared to control groups, in particular relating to abundance of B and T cell subsets. These differences appeared to be mainly associated with levels of plasma testosterone. The most notable differences were in trans males, who had lower numbers of CD11c+ B cells and higher numbers of CD4+ regulatory T cells (Tregs) compared to control females. Using CyTOF, further analysis of B and T cells subsets revealed the frequency of naïve B cells was higher in trans males compared to control females. This also correlated with testosterone concentration in this group. Differences in the abundance of other T cell subsets were detected in both trans males and trans females, however only a decrease in CD161+ T effector memory cells in trans males, compared to control females, was associated with lower testosterone levels. This cross-sectional observational study of young trans individuals suggests that testosterone treatment may have immune modulatory effects, which should be investigated further, including functional studies. While oestrogen treatment was associated with differences in some immune cells in trans females compared with controls, these were generally not associated with plasma oestradiol levels but rather with testosterone levels. Continued immunological research of young trans individuals taking GAH treatment is crucial for positive long-term health outcomes.

Correlation between intestinal ultrasound and fecal calprotectin with endoscopic severity scores for determining the activity in patients with Crohn's disease.

Crohn's disease (CD) is a chronic inflammatory bowel disease characterized by relapsing and remitting inflammation of the gastrointestinal tract. Reliable and non-invasive methods to assess disease activity are crucial for guiding treatment and improving patient outcomes. This study investigates how intestinal ultrasound (IUS) parameters and fecal calprotectin (FC) levels correlate with endoscopic severity scores in Crohn's disease (CD). AIM ANDOBJECTIVE: To assess the effectiveness of IUS as a complementary tool to conventional methods in predicting disease severity in CD by correlating IUS parameters, specifically bowel wall thickness (BWT) and color Doppler flow (CDF), with FC levels and Simple Endoscopic Score for Crohn's Disease (SES-CD). A cross-sectional observational study was conducted on 45 patients with confirmed CD at the Department of Gastroenterology. Clinical data, FC levels, SES-CD scores, and IUS measurements were collected and analyzed. The correlation between BWT, FC, and SES-CD scores was assessed using Pearson correlation, and the sensitivity and specificity of combined IUS and FC parameters were calculated. The study found significant correlations between higher CDF scores and increased FC levels in the ileum (P = 0.002) and ascending colon (P < 0.001). BWT showed a significant positive correlation with SES-CD in the descending colon (r = 0.440, P = 0.003) and rectosigmoid (r = 0.366, P = 0.014). The combination of BWT > 3mm and FC > 250µg/g demonstrated high sensitivity and specificity, particularly in the ileum (sensitivity 88.6%, specificity 78.9%) and descending colon (sensitivity 80.9%, specificity 87.7%). Combining IUS parameters, particularly BWT and CDF, with FC levels provides a robust method for predicting disease severity in CD. This approach can enhance disease monitoring, reduce reliance on invasive procedures, and improve patient management in clinical practice.

Population-scale cross-sectional observational study for AI-powered TB screening on one million CXRs

Traditional tuberculosis (TB) screening involves radiologists manually reviewing chest X-rays (CXR), which is time-consuming, error-prone, and limited by workforce shortages. Our AI model, AIRIS-TB (AI Radiology In Screening TB), aims to address these challenges by automating the reporting of all X-rays without any findings. AIRIS-TB was evaluated on over one million CXRs, achieving an AUC of 98.51% and overall false negative rate (FNR) of 1.57%, outperforming radiologists (1.85%) while maintaining a 0% TB-FNR. By selectively deferring only cases with findings to radiologists, the model has the potential to automate up to 80% of routine CXR reporting. Subgroup analysis revealed insignificant performance disparities across age, sex, HIV status, and region of origin, with sputum tests for suspected TB showing a strong correlation with model predictions. This large-scale validation demonstrates AIRIS-TB’s safety and efficiency in high-volume TB screening programs, reducing radiologist workload without compromising diagnostic accuracy.

Practice of Antibiotic Usages and Factors Influencing Hospital Outcome Among Patients with Suspected Systemic Bacterial Infections at a Tertiary Care Teaching Hospital

Practice of Antibiotic Usages and Factors Influencing Hospital Outcome Among Patients with Suspected Systemic Bacterial Infections at a Tertiary Care Teaching Hospital

The usefulness of transvaginal ultrasonography in the diagnosis of pelvic venous disorders

Chronic Pelvic Pain (CPP) is one of the most common condition encountered in the daily practice of gynaecologists. Prevalence estimates for CPP vary from 6.4 to 25.4% depending on population and established criteria, resulting in a heavy social and economic burden. Among the possible reasons of CPP one of the most challenging are Pelvic Venous Disorders (PeVD). PeVD are a group of diseases characterized by the coexistence of CPP and varicose veins localized in the pelvis and lower abdomen. Although pelvic venography is considered the gold standard for diagnosing PeVD, in the clinical practice of a gynaecologist Transvaginal Ultrasonography (TVUS) is the predominant diagnostic method modality in patients with symptoms of PeVD. Our study aimed to assess the usefulness of TVUS in diagnosing PeVD and to determine ultrasound parameters that are useful in identifying such patients. This observational cross-sectional study included 197 patients hospitalized between September 2022 and April 2024. Pelvic venography was performed in 195 patients who met the ultrasonographic criteria for PeVD. Of the 195 patients in whom the TVUS revealed the presence of at least one parameter characteristic for PeVD, pelvic venography confirmed the TVUS findings in 187 (95.9%). PeVD was confirmed in 94.5% of patients with one positive ultrasound parameter, 95.1% with two positive ultrasound parameters, 96.4% with three positive ultrasound parameters, and 100% with four positive ultrasound parameters. Primary gynaecological diagnostics based predominantly on TVUS appears to be crucial in identifying patients with PeVD. Using appropriate criteria, high efficiency in the first-line diagnostics of such patients could be obtained.

CLINICO-LABORATORY PROFILE OF SCRUB TYPHUS CASES AMONG ADULTS PRESENTING WITH ACUTE FEBRILE ILLNESS.

To determine the frequency and clinico-epidemiological profile of patients with scrub typhus and to assess the performance characteristics of an ICT based rapid assay for its diagnosis. This was an observational cross-sectional study conducted on 175 adults ≥18 years of age presenting with acute onset of fever (temperature >38°C) for <14 days with any of the following features: eschar, rash, lymphadenopathy, hepatosplenomegaly, jaundice and multi-organ involvement. Immunocompromised patients, such as those with HIV/AIDS, malignancy, patients on cytotoxic drugs and on systemic corticosteroid therapy were excluded from the study. Cases were recruited from medicine wards of Lok Nayak Hospital. Serum from the cases was tested for Orientia tsutsugamushi specific IgM antibody by ELISA and rapid assay. The performance characteristics of rapid assay was evaluated by comparing it with ELISA as the reference standard. Out of 175 cases, 36 (20.6%) were reactive for scrub typhus IgM ELISA, while 139 (79.4%) were non-reactive. Maximum number of scrub typhus cases were in the age group of 21-30 years (41.7%) with both genders affected equally. Majority of the scrub typhus cases resided in urban areas (69.4%), belonged to lower middle class (38.9%) and were seen between the monsoon months of July and October (75%). Eschar, lymphadenopathy, jaundice, ascites, ARDS, myocarditis, DIC, raised LDH, raised ALP, hyperbilirubinemia, hyperphosphatemia, hypoalbuminemia and leucocytosis were found to be significantly associated with scrub typhus. The sensitivity and specificity of the scrub typhus IgM rapid assay when compared to IgM ELISA was 22.2% and 100.0%, respectively, with low kappa value of 0.312. The frequency of scrub typhus in AFI was found to be 20.6%. In view of the poor sensitivity, the RDT used in our study cannot be recommended as the screening assay for serodiagnosis of scrub typhus.

Comprehensive genotypic and phenotypic analysis of Bietti crystalline dystrophy: insights from a large cohort study.

In this cross-sectional observational study, we conducted comprehensive ophthalmic evaluations, including fundus imaging, fundus autofluorescence (FAF), swept-source optical coherence tomography (SS-OCT), microperimetry, and electroretinography, in 164 patients with Bietti crystalline dystrophy (BCD) from 159 families. The mean age of onset was (29.9±8.9) years, with night blindness being the most common onset symptom (54.3%). FAF revealed diffuse hypoautofluorescence in 86.7% of eyes, and SS-OCT identified outer retinal tabulations (ORTs) in 69.9% of eyes, indicative of severe retinal pigment epithelium (RPE) dysfunction. Microperimetry demonstrated a gradual decline in retinal sensitivity and fixation stability with disease progression, particularly in advanced stages. We identified 34 distinct CYP4V2 variants, three of which were novel. Patients with biallelic truncating mutations experienced earlier disease onset and progressed to legal blindness at a younger age. These findings provide a comprehensive overview of structural and functional deterioration in BCD and underscore the significant impact of truncating mutations on disease progression.

ASSOCIATION OF BODY IMAGING, PHYSICAL ACTIVITY PATTERN, AND POSTPARTUM DEPRESSION AMONG WORKING MOTHERS: A CROSS-SECTIONAL STUDY

Background: A Working mother goes through a phase in her life in which she is expecting to take care of her child, look after her house responsibilities, and prove herself to be a perfect employee as well. These three things eventually led her to a cognitive condition a ‘Postpartum Depression’. Postpartum depression is an issue that faces negligence on a serious note, even though this issue is something that can not only destroy the mental health condition of a woman suffering from it, but also her partner and children. Being a working mother during the postpartum period plays a major role in increasing the chances of postpartum depression. Every mother wants herself to stay fit and healthy to balance both life at work and home perfectly. Inner self also wants to slay that ‘ideal’ body image for satisfaction. Plan to form a proper physical activity strategy and leniency from workplace highlight the importance of extensive postpartum support systems to ease the process of returning to work so that working mothers will be able to easily cope with their mental, physical, and emotional problems, eventually being able to alleviate all the challenges. Objective: The objective of this study is to investigate the association of body imaging, physical activity, and postpartum depression among working mothers. Methodology: This observational cross-sectional study has followed a non-probability convenient sampling that involved 169 working mothers aged between (21 to 45 years). Data collection procedure has been done via International Physical Activity Questionnaire (IPAQ), Body Shape Questionnaire (BSQ) and Edinburgh Postnatal Depression Scale (EPDS) questionnaires and the tests that has been performed includes chi square test, correlation regressions, cross-tab relations, descriptive statistics, reliability, multicollinearity, normality, homogeneity and diagnostic statistics. Result: The study, conducted among 169 working postpartum mothers in Karachi, investigated the interrelationships between depression (EPDS), physical activity (IPAQ), and body shape concerns (BSQ). According to EPDS results, 40.24% had no depression, 26.26% were borderline, and 35.5% were identified as having postnatal depression, most prevalent among women aged 26–30 and mothers with one child. IPAQ findings showed that 68.64% engaged in moderate activity, 20.12% in low activity, and only 11.24% in high activity levels. BSQ results revealed that 98.8% had mild body shape concerns, particularly among women aged 26–35 and those with one child. Descriptive statistics showed an average respondent age of 29.17 years and an average child count of 1.66. Correlation analysis indicated weak positive associations between depression and physical activity (4.00%) and depression and body shape concern (1.00%). EPDS items showed strong internal correlation (up to 75.1%), IPAQ items peaked at 54.9%, and BSQ correlations ranged up to 32.5% (with a minimum of -10.0%). Chi-square tests confirmed significant associations among key variables, rejecting null hypotheses. Conclusion: This study highlights the psychological vulnerabilities faced by working mothers in the postpartum period, emphasizing the significant, though statistically weak, interplay between depressive symptoms, physical inactivity, and body dissatisfaction. Despite high mild body shape concerns and moderate activity levels in the sample, a considerable proportion of mothers reported postnatal depression. The results stress the importance of promoting physical activity and positive body image to improve mental well-being in postpartum women. Moreover, the research calls for workplace and societal interventions to support maternal mental health, especially during the critical return-to-work transition. Although the findings are informative, the study's generalizability is limited by its cross-sectional design, non-random sampling, and exclusion of certain groups. Nonetheless, the study contributes valuable data for future culturally sensitive research and policy formulation.

The Long-Term Impact of Preterm Birth on Metabolic Bone Profile and Bone Mineral Density in Childhood

Background/Objectives: Recent data on long-term consequences of prematurity on bone health are conflicting. The aim of this study was to assess the metabolic bone profile and bone mineral density (BMD) in prepubertal children born prematurely and to examine possible associations between bone health parameters and perinatal morbidity factors. Methods: This cross-sectional observational study included 144 children of mean (SD) age 10.9 (1.6) years: 49 children born very preterm (≤32 gestational weeks), 37 moderate-to-late preterm (32+1 to 36+6 gestational weeks), and 58 born at term (controls). Serum levels of calcium/Ca, phosphorus/P, alkaline phosphatase/ALP, 25-hydroxyvitamin D/25(OH)D, bone formation markers (osteocalcin/OC, procollagen type I C-terminal propeptide/PICP, and insulin growth factor-1/IGF-1), and bone resorption markers (serum tartrate-resistant acid phosphatase 5b/bone TRAP5band urinary calcium-to-creatinine ratio) were measured. Total-body and lumbar-spine BMD and BMD Z-scores were calculated using dual-energy X-ray absorptiometry/DXA. Results: Children born very preterm showed significantly higher ALP, OC, PICP, and bone TRAP5b levels compared to controls, as well as compared to children born moderate-to-late preterm. Total-body and lumbar-spine BMD Z-scores were significantly lower in the very preterm-born group compared to controls. Gestational diabetes, preeclampsia, and bronchopulmonary dysplasia were associated with lower total-body BMD in the very preterm-born population. Conclusions: Preterm birth is associated with impaired metabolic bone profile and lower total-body and lumbar-spine BMD in childhood. Moderate-to-late preterm-born children exhibit altered metabolic bone parameters compared to very preterm-born children. Further research in children might allow better insight into the long-term impact of preterm birth on bone health.

Complementary and alternative medicines among people living with HIV: results from the CAMPER study.

BackgroundWe analyzed the prevalence of complementary/alternative medicines (CAM) in people living with HIV (PLWH) and effects on immunovirological response, treatment adherence, and quality of life (QoL).MethodsA multicentre cross-sectional observational study involving PLWH who were stably on combination antiretroviral therapy (cART) between 2018 and 2019. Participants completed a modified International Questionnaire to Measure Use of Complementary and Alternative Medicine (I-CAM-Q). CAM use was analyzed using descriptive statistics and multivariable logistic regression models were implemented to study factors associated.ResultsCAM use (predominantly vitamins and dietary supplements: 64.2%) was reported by 38.5% of the 548 participants. Higher CAM use was noted in men who have sex with men, Caucasians, people with hepatitis C virus, and those with higher level of education. 76.3% used CAM for a better well-being, energy restoration, and aesthetic purposes. Multivariable analysis identified ethnicity, HIV acquisition route, HCV status, level of education, plasma undetectability and cardiovascular diseases as significant factors influencing CAM use. Immunovirological response, treatment adherence, and QoL were not significantly different between CAM users and non-users.ConclusionsThe study highlighted a high prevalence of CAM use in PLWH, revealing no adverse effects on treatment efficacy or clinical outcomes. Demographic factors influence CAM use, underscoring the need for healthcare providers to explore CAM use, promoting information and safe care.

Proportion of Peripheral Neuropathy among Diabetic Patients Attending at Tertiary Level Hospitals

Background: The most prevalent consequence of Diabetes Mellitus (DM) is Peripheral Neuropathy (PN), which is frequently undiagnosed and untreated and consequently leading to physical and emotional damage to an individual. Therefore, this study was designed to explore the proportion of peripheral neuropathy among diabetic patients in tertiary care setting. Methods: This cross-sectional observational study among 403 participants was conducted at the out-patient department of Dhaka Medical College Hospital, Sir Salimullah Medical College, BIRDEM Hospital for one year of period. Data collection was conducted with a pre tested semi structured questionnaire and were analyzed using the statistical software SPSS 26. Results: Mean age of the respondents was 50.92±10.56 (SD) years with a majority in age group 60-69years (29%). Male and female was observed as equally 51.9% male and 48.1% male. The majority of patients (60.5%) have been living with diabetes for 2-5 years. Significant proportion of the patients (64%) have uncontrolled diabetes, while only 36% have achieved control over their condition. Overall, 48.4% respondents had peripheral neuropathy among diabetic respondents. Among the respondents with peripheral neuropathy, 97(24.1%) respondents had mild NSS, 69(17.1%) had moderate NSS and 29(7.2%) had severe NSS. BMI (25.75±2.65 and 24.81±2.98 kg/m2), HbA1C (8.48±0.78 and 7.98±1.13 %) and triglyceride level (318.79±46.28 vs. 282.52±76.45 mg/dl) were significantly higher among peripheral neuropathy respondents compared to non-neuropathy respondents. Conclusion: The findings have important clinical implications Lifestyle modifications, such as weight management and diet control, may also be essential in preventing or managing peripheral neuropathy. Early detection of intervention to manage pain should be a priority.