Poor Socioeconomic Status Research Articles

Poor socioeconomic status is associated with delayed femoral fracture fixation in adolescent patients

IntroductionHealthcare disparities continue to exist in pediatric orthopedic care. Femur fractures are the most common diaphyseal fracture and the leading cause of pediatric orthopedic hospitalization. Prompt time to surgical fixation of femur fractures is associated with improved outcomes. ObjectiveThe objective of this study was to evaluate associations between socioeconomic status and timing of femoral fixation in adolescents on a nationwide level. MethodsThe 2016–2020 National Inpatient Sample (NIS) database was queried using International Classification of Disease, 10th edition (ICD-10) codes for repair of femur fractures. Patients between the ages of 10 and 19 years of age with a principal diagnosis of femur fracture were selected. Patients transferred from outside hospitals were excluded. Baseline demographics and characteristics were described. Patients were categorized as poor socioeconomic status (PSES) if they were classified in the Healthcare Cost and Utilization Project's (HCUP) lowest 50th percentile median income household categories and on Medicaid insurance. The primary outcome studied was timing to femur fixation. Delayed fixation was defined as fixation occurring after 24 h of admission. Secondary outcomes included length of stay (LOS) and discharge disposition. ResultsFrom 2016–2020, 10,715 adolescent patients underwent femur fracture repair throughout the United States. Of those, 765 (7.1 %) underwent late fixation. PSES and non-white race were consistently associated with late fixation, even when controlling for injury severity. Late fixation was associated with decreased rate of routine discharge (p < 0.01), increased LOS (p < 0.01) and increased total charges (p < 0.01). ConclusionPatients of PSES or non-white race were more likely to experience delayed femoral fracture fixation. Delayed fixation led to worse outcomes and increased healthcare resource utilization. Research studying healthcare disparities may provide insight for improved provider education, implicit bias training, and comprehensive standardization of care.

FREQUENCY OF SOLITARY RECTAL ULCER SYNDROME AMONG PATIENTS PRESENTING WITH BLEEDING PER RECTUM AT A TERTIARY CARE HOSPITAL

Solitary rectal ulcer syndrome is a multifaceted condition influenced by several clinical, histological, and endoscopic features. Treating this condition, especially in cases of relapse or non-responsiveness, requires a methodical and logical approach. This study aimed to determine the frequency of solitary rectal ulcer syndrome among patients presenting with rectal bleeding at a tertiary care hospital. This descriptive, cross-sectional study was conducted at the Department of Gastroenterology, Ibn-e-Sina Hospital/Multan Medical and Dental College, Multan, from 10-06-2022 to 10-06-2023. A total of 369 patients with rectal bleeding were registered in the study. Baseline investigations, including histopathology, were conducted to diagnose solitary rectal ulcer syndrome. Of the 369 registered patients, 237 (64.2%) were male, and 132 (35.8%) were female, with a mean age of 52.16 ± 9.05 years. Of these, 253 (68.6%) were from rural areas, and 116 (31.4%) were from urban areas. In 224 (60.7%), poor socioeconomic status was noted, while 145 (39.3%) had a middle-income level. Diabetes was present in 97 (26.3%), and hypertension in 134 (36.3%). The mean body mass index was 25.23 ± 1.57 kg/m2, and obesity was present in 56 (15.2%) patients. Solitary rectal ulcer syndrome was observed in 25 (6.8%) patients. The study concluded that there is a high frequency of Solitary rectal ulcer syndrome (SRUS) among patients presenting with rectal bleeding. Solitary rectal ulcer syndrome (SRUS) was significantly associated with increasing age, socioeconomic status, diabetes, hypertension, and obesity. All clinicians treating such patients should anticipate Solitary rectal ulcer syndrome (SRUS) for early diagnosis and proper management, which will improve their prognosis and quality of life.

Socioeconomic status and quality of life among older adults with hypertension in rural Shandong, China: a mediating effect of social capital.

Improving the quality of life (QoL) of older adults is becoming an important global issue. However, very few studies have been focused on the relationship between socioeconomic status (SES) and QoL in older adults with hypertension. The purpose of this study is to investigate (a) the status of QoL and (b) the mediating effect of social capital in the relationship between SES and QoL, among rural older adults with hypertension in China. Using multistage stratified random sampling, a face-to-face questionnaire survey was conducted among rural older adults with hypertension in Shandong province of China from June to July 2021. Three typical measures representing SES were used, namely, annual household income, educational level, and employment status. Individual social capital and QoL were assessed by the Resource Generator-China Scale (RG-China) and a 34-item simplified Patient Report Outcome (PRO)-specific scale for older adults with hypertension, respectively. A total of 950 rural older adults with hypertension were included in the analysis. The mediation model based on bootstrap analyses was employed to explore the relationship between SES and QoL and the mediating role of social capital in the SES-QoL nexus. The sampled rural older adults with hypertension had an upper-middle level of QoL, and the average score was 132.57 ± 19.40. SES was positively correlated with both QoL and individual social capital; individual social capital was significantly positively correlated with QoL. Controlling for sociodemographic variables, SES was still significantly associated with individual social capital (β = 0.140, P < 0.001), and the higher the individual social capital, the better QoL (β = 0.153, P < 0.001). Individual social capital played a partially mediating role in the association between SES and QoL (indirect effect = 0.021, 95% CI: 0.010-0.038), which accounted for 9.38% of the total effect. This study provides evidence that the effect of SES on QoL was partially mediated by individual social capital among rural older adults with hypertension in China. The government should pay more attention to the rural older hypertensive population with lower SES and strive to reduce the negative impact of poor SES on their QoL, based on effective strategies including improving their individual social capital.

Pulmonary function tests and their associated factors in people living with HIV at Jimma medical center; Ethiopia: a comparative cross-sectional study.

People living with HIV (PLHIV) have a greater risk of developing respiratory disorders. The problems are linked to poor socio-economic status, high viral load, low CD4 counts, and antiretroviral therapy. Despite the high prevalence of respiratory disorders, the association between HIV infection and pulmonary function status, as well as the associated factors, is not well established in resource-limited countries. A comparative cross-sectional study was conducted from September 24 to October 15 2020 at Jimma Medical Center among people living with HIV who were arranged into an age-sex-matched comparison group. Data were collected using a pretested structured questionnaire administered via face-to-face interviews. The collected data included socio-demographic, respiratory, HIV infection, and substance use variables. Pulmonary function tests were conducted using an SP10 spirometer. The collected data were entered and analyzed using SPSS version 26. Independent t-test and multiple linear regressions were carried out to identify factors associated with the pulmonary function status of the study participants. A total of 96 PLHIV and 96 matched control individuals participated in the study. The mean of pulmonary function test parameters among the PLHIV respondents was FVC (l) (67.35 ± 19.12, p0.003), FEV1s (l) (61.76 ± 16.04, p0.001), and PEFR (50.14 ± 23.32, p0.001), with a significant lowering in the study group. Female sex, respiratory symptoms, duration of HIV, duration of treatment, and khat chewing were associated with lowered FEV1s (l) (p < 0.05) in HIV-positive respondents. PLHIV had significantly lower mean lung function parameters than HIV-uninfected participants. As a result, health providers should screen HIV-positive patients with respiratory symptoms, prolonged duration of HIV infection, prolonged treatment, and khat chewing for non-infectious lung disorders while treating them.

Analysing the progress in service delivery towards achieving universal health coverage in Nigeria: a scoping review

BackgroundAttainment of universal health coverage (UHC) requires optimal utilization of health services. Poor coverage and inequitable access to healthcare could hinder improvement in service delivery towards UHC. The study analyzed the progress in service delivery coverage and equity in access to care within the Nigerian health systems based on the tracer indicators of the WHO framework for monitoring UHC.MethodsWe searched the literature in databases: PubMed, Scopus, Directory of Open Access Journals, Google Scholar, Science Direct and websites of relevant health Ministries, Agencies, and Organizations between March to December 2022. Search terms were identified in four broader themes: Service delivery coverage, equity, UHC and Nigeria. Data were collected through a review of 37 published articles (19 peer-reviewed articles and 8 grey documents). We synthesized the findings in thematic areas using the WHO framework for monitoring UHC.ResultsThe findings show a slow improvement in service delivery coverage across the UHC tracer indicators; reproductive, maternal, newborn and child health, infectious diseases, non-communicable diseases and service capacity and access. With regards to equity in access to care across the tracer indicators, there has been a great disparity in the utilization of healthcare services among rural dwellers, lower educational level individuals and those with poor socio-economic status over 20 years. However, there was remarkable progress in the ownership and use of long-lasting insecticide-treated nets among rural and lowest-wealth quantile households than their urban counterpart.ConclusionThere is poor coverage and persistent inequitable access to care among the tracer indicators for monitoring progress in service delivery. Attaining UHC requires concerted efforts and investment of more resources in service delivery to address inequitable access to care and sustainable service coverage for improved health outcomes.

Anxiety and depression and health-related quality of life among adults with migraine: a National Population-Based Study.

Adults who suffer from migraines are highly susceptible to mental illnesses that may have significant association with their HRQoL. Therefore, this study aimed to investigate how anxiety and depression related to HRQoL in adults with Migraine. Data from the Medical Expenditure Panel Survey for 2017 to 2020 were used to identify adult patients 18 years of age and older with a migraine diagnosis. The Physical and Mental Component Summary (PCS & MCS) scores from the SF-12 were used to calculate HRQoL. To adjust for a wide range of variables, multivariate linear regressions were used to evaluate the association between depression and anxiety and HRQoL among adults with migraine. Among the 1,713 identified adults with migraines, 11.2% experienced depression, 14.6% experienced anxiety, and 13.7% had both conditions. Compared to migraineurs who had only migraine, adults with comorbid depression and anxiety had the lowest mean scores on the PCS and MCS. Additionally, migraineurs who had depression had significantly lower HRQoL MCS scores (depression: β = -7.552, p < 0.001), and those with anxiety had significantly lower HRQoL MCS scores (anxiety: β = -4.844, p < 0.001) compared to those without these comorbidities. Notably, individuals with migraines who exercise had higher scores on both PCS and MCS than those who did not exercise. This nationally representative sample provides insights into the associations between depression and anxiety with poor HRQoL among individuals with migraines. Additionally, it revealed the negative impact of concurrent chronic diseases, and poor socioeconomic status on HRQoL, while emphasizing the beneficial effects of regular exercise. This study highlights the clinical, policy, and public health implications for improving healthcare planning, resource allocation, and promoting lifestyle changes to reduce depression and anxiety in migraine sufferers.

Street Hawking and Truancy as Predictor of Academic Performance Amongst Secondary School Students in Ondo State, Nigeria

The paper examined street hawking as predictor of truancy among secondary school students in Ondo State, Nigeria. The population of the study comprised all the secondary school teachers. A simple random sampling technique was used to select 200 teachers. The instrument for data collection was self-constructed questionnaire titled “Street Hawking and Truancy” on four-point Likert scale. Pearson product movement correlation was used to determine the correlation coefficient which was 0.76. Three hypotheses were formulated to guide the study. The hypotheses were tested using analysis. The result indicated that there was a significant relationship between street hawking and truancy amongst secondary school students. The result also showed that there was a significant relationship between street hawking and academic performance of secondary school students, and finally the result revealed that there was a significant relationship between street hawking and academic performance of secondary school students. The study concluded that there was a positive relationship between street hawking, truancy and academic performance due to so many factors such as inability to pay school fee, unauthorized extra fees being charged by school authorities, poor socio-economic status of the students. The study recommended amongst others that the state’s constituted law enforcement agents should further intensify efforts towards apprehending any student found roaming about the streets during official school hours.

Studies on some aspects of the fish Endoparasites (Cestodes)

Parasitic diseases are the major cause of morbidity and mortality in man, domesticated animals and wild life. Cestodes are multicellular, bilaterally symmetrical and parasites of great importance to human health. Intestinal infections of cestodes are very common in country and areas with poor socio-economic status are endemic unhygienic living and food habits promote the spread of infection causing high morbidity and complications. Mixed intestinal infection due to cestodes and nematodes is quite common and therefore, there is a need to study the cestode parasites whose prevalence is high. Cestodes infect almost all vertebrates. The freshwater fish species found in Nagapur Reservoir, Parli-Vaijnath, Dist. Beed (M.S.) were observed for the infection of cestode parasites. It was found that the freshwater fishes like Mystus seenghala and Mastacembelus armatus were infected by the cestode parasites. After detail study they were identified as Gangesia senghali (Hiware, 1999), Circumoncobothrium yamaguti (Jadhav et al., 1990). The cestode parasites were found in the small intestine of the host fishes.

Accessibility to formal education among persons with epilepsy in Mahenge, Tanzania

BackgroundEpilepsy is estimated to affect 50 million people globally, with 80% living in sub-Saharan Africa (SSA). Children with epilepsy (CWE) in SSA are often socially isolated, and many do not get access to school. This study aimed to explore the barriers hindering accessibility to formal education among CWE in Mahenge, Tanzania. MethodsThe study was conducted in June 2022 in four villages (Mdindo, Msogezi, Mzelezi and Sali) using quantitative and qualitative methods. The quantitative included 203 persons with epilepsy (PWE), while the qualitative involved six focus group discussions and 17 in-depth interviews. Quantitative and qualitative data were analyzed using Stata and Nvivo software, respectively. ResultsOf the 203 PWE, 62 (30.5%) had never enrolled in school, while 77 (54.6%) of those enrolled dropped-out before completing it. The perceived barriers to accessing education were categorized as individual barriers (such as frequent seizures, learning difficulties, anti-seizure medication side effects and perceived stigma), Community barriers (such as stigma and discrimination, negative beliefs and misconceptions, relocation to farms and poor socio-economic status), and Institutional barriers (including lack of knowledge about epilepsy among stake-holders, topography and distance to schools). ConclusionThere is a high rate of dropouts and non-enrolment of CWE in schools within the Mahenge area. Negative beliefs and low awareness of the community about epilepsy and formal education contribute to this issue. This calls for more advocacy to raise community awareness on epilepsy. The government should enforce an inclusive education policy and provide free and uninterrupted anti-seizure medication for seizure control.

School-to-Work Transitions under Unequal Conditions: A Regionalised Perspective on the ‘Discouraged Worker’ Hypothesis

Against the background of considerable regional disparities, we test the “discouraged worker” hypothesis, which postulates that poor regional socioeconomic conditions foster students’ aspirations for more education, ultimately leading to an extension of their educational careers. Our two dependent variables are (i) whether students aspire to prolong their general school careers or enter vocational training and (ii) whether they in fact prolong their school careers. To that end, we link regional-level data to individual-level data from the German National Educational Panel Study (NEPS). To describe regional conditions adequately, we illustrate geographical patterns in socioeconomic conditions relevant for school-to-work transitions (e.g., labour market conditions and availability of vocational training opportunities). We compare two operationalisations of regional areas: (i) administrative districts and (ii) public transport areas. Our results show that students are more likely to aspire to prolong their general school careers in socioeconomically deprived regions. Moreover, the effects are stronger when school-based vocational training opportunities are scarce. The effects on actual transitions vary according to the school track attended and the availability of educational alternatives in the general school system. Finally, the operationalisation of regions varies regarding effect sizes and corresponding levels of statistical significance.

Racial/Ethnic Disparities in the Alzheimer's Disease Link with Cardio and Cerebrovascular Diseases, Based on Hawaii Medicare Data.

There is an expanding body of literature implicating heart disease and stroke as risk factors for Alzheimer's disease (AD). Hawaii is one of the six majority-minority states in the United States and has significant racial health disparities. The Native-Hawaiians/Pacific-Islander (NHPI) population is well-known as a high-risk group for a variety of disease conditions. We explored the association of cardiovascular disease with AD development based on the Hawaii Medicare data, focusing on racial disparities. We utilized nine years of Hawaii Medicare data to identify subjects who developed heart failure (HF), ischemic heart disease (IHD), atrial fibrillation (AF), acute myocardial infarction (AMI), stroke, and progressed to AD, using multistate models. Propensity score-matched controls without cardiovascular disease were identified to compare the risk of AD after heart disease and stroke. Racial/Ethnic differences in progression to AD were evaluated, accounting for other risk factors. We found increased risks of AD for AF, HF, IHD, and stroke. Socioeconomic (SE) status was found to be critical to AD risk. Among the low SE group, increased AD risks were found in NHPIs compared to Asians for all conditions selected and compared to whites for HF, IHD, and stroke. Interestingly, these observations were found reversed in the higher SE group, showing reduced AD risks for NHPIs compared to whites for AF, HF, and IHD, and to Asians for HF and IHD. NHPIs with poor SE status seems to be mostly disadvantaged by the heart/stroke and AD association compared to corresponding whites and Asians.

Intimate partner violence; breaking the silence on male victims in Nigeria

Globally, men have always been seen as perpetrators of aggression in romantic relationship which constitute intimate partner violence (IPV). In Nigeria, they are mostly considered as the villains due to the patriarchal nature of the society. However, there have many cases of violence by intimate partners where men were the victims. Very few of such cases were reported either to the hospital or to the police due to many reasons ranging from sociocultural, ethnic, economic and religious values among others. In a patriarchal society like Nigeria, men experience various form of violence which could be physical, psychological, sexual and socioeconomic from intimate partners. Therefore, this article attempts to review the reported incidence of male victims of IPV in Nigeria and the peculiarities involved while providing recommendations. Some of the factors identified for the low incidence report includes; lack of routine screening for domestic violence in health facilities, the fact that psychological violence is not considered as violence in some Nigerian society, shame about disclosing family violence, poor socioeconomic status and many more. Additionally, a major predictor of female-perpetrated IPV was childhood exposure to violence. This paper recommends that several actions which would improve the report of IPV against men while ameliorating IPV in Nigeria may involve: raising public awareness, legal protection, increasing health care worker sensitivity, provision of support services, research and proper data collection among others.

Rational Actions of Widows Post Earthquake Disaster in Palu City

Earthquakes not only affect material losses, but also affect the socioeconomic lives of widowed women forcing them to act rationally to survive and avoid the threat of poverty. The study aims to analyze the impact of earthquake natural disasters with rational actions of widowed women after the earthquake disaster in Palu City. The research method uses a qualitative descriptive approach. Data collection was carried out through limited observation, in-depth interviews, FGDs and document studies so as to obtain primary and secondary data. Informants were purposively selected as many as 6 people. The data is analyzed interpretively. The validity of the data is done through triangulation. The results showed that in the face of poor post-disaster socioeconomic conditions, there are five models of strategies or rational survival actions carried out by widowed women, namely, borrowing business capital, building an entrepreneurial career, finding a new job, becoming a daily freelancer, and getting married. The forms of rational action carried out by widows are instrumental rational actions, value rationality actions and effective rational actions. It suggested the importance of socio-economic empowerment of widowed women appropriately and sustainably.

Investigating household catastrophic health expenditure and coping mechanisms in patients with Chronic Kidney Disease in Enugu, Nigeria: a single center experience

The methods of financing healthcare expenditure for any country are vital in determining the health status of the country. To meet the rising costs of seeking health care, many poor households in managing chronic disease conditions like Chronic Kidney Disease (CKD) often resort to coping strategies that are further detrimental to their well-being. CKD is the 12th highest cause of death and 17th highest cause of disability worldwide. This study assessed the incidence of household catastrophic health expenditure and payment coping mechanism of patients with CKD. It was a descriptive cross-sectional study involving 100 patients with various stages of CKD attending the Nephrology clinics of University of Nigeria Teaching Hospital Enugu, South eastern Nigeria. They were recruited using a systematic sampling technique. A questionnaire was used to collect data. Data were collected using pre-tested semi-structured questionnaires and analyzed using descriptive statistics of frequencies, percentages, mean, standard deviation and interquartile range. Chi-square was used to test for association between payment coping mechanisms used by patients across socioeconomic groups. The study demonstrated uniformly high incidence of catastrophic expenditure for all the respondents both at 10% and 40% threshold (100% and 97%) respectively, with cost of treatment uniformly distributed among the various socioeconomic classes. Most of the patients assessed their treatment by paying out of pocket without reimbursement (88%), with money from personal bank savings being the commonest coping mechanism especially among the poorest Socioeconomic Status (SES) class, and borrowing among the least poor SES class. The study concluded that the prevalence of catastrophic expenditure was very high across all the socioeconomic status. It is recommended that the Nigerian Health Insurance program should be expanded to cover at least dialysis treatment of CKD, if not all aspects of CKD management in order to protect these patients and their household from ill-health mediated catastrophic expenditure.

Quality of life of children and adolescents living with HIV in India: a systematic review and meta-analysis

ABSTRACT Children and adolescents living with HIV (CALHIV) encounters compromised health and well-being especially in developing countries. Understanding the health-related quality of life (HRQOL) of CALHIV living in India is vital in planning and developing comprehensive care approach. A systematic review and meta-analysis were conducted to explore and examine the HRQOL of CALHIV in India. Five electronic databases were searched, retrieving 2,729 citations with a final eight studies that met the inclusion criteria. Methodological quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools. The included studies predominantly evaluated quality of life using the Paediatric Quality of Life Inventory, with a mean self-reported HRQOL score of 77.62 (95% CI 72.91–82.34, I 2 = 93%). HRQOL of CALHIV observed to be better than other chronically ill children. However, CALHIV demonstrated lower HRQOL than the matched general population. Younger age children and boys reported better HRQOL. Poor socio-economic status, immunological status and advanced clinical stages noted to be adversely affecting HRQOL. HRQOL of children reared in institutional care reported to better or in par with family reared children. The review highlights the sparse evidence investigating the HRQOL of children with HIV in India, and the need for further well-designed studies in this population. A population-specific holistic-care approach recommended to be benefiting the well-being of CALHIV.

Association of Risk Factors with At-Risk Cases of Autism

AbstractA neurological condition known as autism spectrum disorder (ASD) first manifests before the age of 3. Numerous factors may have an impact on the development of autism; however, its precise causes are yet unknown. The research aims to identify certain risk factors that associate with children at a higher risk of developing autism. This study is a descriptive analysis of 80 children who were identified as being at risk for autism and meeting the requirements of the Modified Checklist for Autism in Toddlers at the community health center. A semistructured proforma was used to collect the baseline data from the mother and the child. Through the use of a thoughtfully created checklist, each child enrolled in the study had a thorough history completed, including the suspected prenatal, intranatal, neonatal, and infant risk factors with the help of their mothers. Descriptive statistics with frequency percentages were adopted for the demographic data of the participants. To find the association between possible risk factors and at-risk cases of ASD, an independent t-test was used. Fisher's exact test and Pearson's chi-squared test (p = 0.05, confidence interval = 95%) were used to find how the risks (odds ratios) of the factors studied affect the incidence of ASD. It was discovered that prenatal risk factors, such as pregnancy-related infections and medication use, were statistically significantly linked to an increased risk for autism. Significant intranatal risk factors for autism risk included a breech presentation, cesarean section, forced labor, and resuscitation at birth. Similar to this, the neonatal risk factors included maternal hemorrhage, Rh or ABO incompatibility, birth injuries, and feeding problems. Poor socioeconomic status and seizures were the baby risk variables, both of which were statistically significant and linked to an increased chance of autism. The results of the study support an array of perinatal, intranatal, neonatal, and infant risk factors linked to the likelihood of developing autism.

Tinea capitis outbreak and other superficial mycosis in an urban community of Medellín

Introduction. Dermatophytoses are superficial fungal infections of the keratinized epithelium like tinea capitis. The latte mainly affects school-vulnerable populations. Carpinelo is a peripheral neighborhood in Medellín with poor socioeconomic conditions and where a suspected tinea capitis outbreak took place. Objective. To study and characterize, clinically and microbiologically, patients with suspected dermatophytosis in Carpinelo. Material and methods. We carried out a descriptive and longitudinal study with an active case search of tinea capitis in children and their relatives from the Jardín Educativo Buen Comienzo community in Carpinelo. Patients were clinically evaluated, and samples of scales and hair were taken to perform mycological studies with a 10 % potassium hydroxide and culture in Sabouraud and Mycosel agar. We analyzed the data with the statistical program SPSS™. 25 version. Results. Fifty-seven individuals were studied: 47 were children with a mean age of six years and a ratio of 2:1 male to female. Patients with confirmed diagnosis presented the following clinical forms: tinea capitis (78.95%), tinea faciei (15.79%) or tinea corporis (10.52%). Out of the total, 69.76% of the patients had previous treatment with steroids. The direct test was positive in 53.84% of the samples, and 46.15% had positive cultures. The isolated species were: Microsporum canis (77.77%), Trichophyton spp. (11.11%), Trichophyton rubrum (5.55%), and Malassezia spp. (5.55 %). Conclusion. Tinea capitis was the most common clinical form, and M. canis was the most frequently isolated species. The use of steroids as the first and only option for empiric treatment was worth of notice. The findings of this study point out the importance of microbiological diagnosis in choosing the best treatment for the patients.

Health-Related Quality of Life after Cataract Surgery in Armenia: A Cross-Sectional Survey.

Cataract surgery helps to enhance visual function and improve the quality of life of cataract patients. The present study assessed visual outcomes and explored health-related quality of life (HRQoL) and factors associated with it following cataract surgery in Armenia. An interviewer-administered survey along with the ophthalmologic examination was conducted among 248 patients. It explored socio-demographic characteristics, use of eye care services, smoking status, comorbidities, and receiving and giving social support. A Short Form Health Survey (SF-36) was used to measure HRQoL. Simple and multivariable linear regression was used for the analysis. About 72.8% of examined eyes had good visual outcomes, while 17.7% had borderline outcomes. Poor visual outcomes were detected in 9.5% of the eyes. The mean composite SF-36 score for physical health was 50.8, while the mean composite score for mental health was 49.9. Gender, socioeconomic status, having a non-communicable disease, and receiving and giving tangible social support were significantly associated with SF-36 physical component in the adjusted analysis, while the variables which demonstrated significant association with the mental component included socioeconomic status, having a non-communicable disease, and giving tangible support. The visual outcome after cataract surgery in Armenian patients is below WHO-recommended standards. The quality of ophthalmological surgical care should be monitored to maximize the visual outcome in Armenian patients, with a focus on women, patients with poor socioeconomic status, and those with non-communicable diseases.

Risk Factors of Health-Related Quality of Life among Gastrointestinal Cancer Survivors in the U.S.: With a Focus on Social and Behavioral Determinants of Health (SBDH).

Increasing numbers of long-term gastrointestinal (GI) cancer survivors highlight the importance of understanding the factors contributing to their health-related quality of life (HRQoL). We investigated the risk factors of HRQoL, including demographics, clinical characteristics, and social and behavioral determinants of health (SBDH). Data on adult GI cancer survivors (n = 3201) from the Behavioral Risk Factors Surveillance System (BRFSS) surveys from 2014-2021 (except for 2015) were analyzed. Unadjusted/adjusted logistic regression was used. The majority were women (54%) and white (78%), with a median age of 67. Survivors who were 65 years or older, diagnosed with colorectal cancer, or who had fewer comorbidities were more likely to report significantly better HRQoL. Significant social factors of poor HRQoL included unmarried, racial and ethnic minorities, poor socioeconomic status, and poor healthcare access. Significant behavioral factors of poor HRQoL were lack of physical activity, heavy alcohol consumption, and current smoking, with lack of physical activity being the most significant factor. The SBDH has a critical role in HRQoL. Future studies are warranted to develop a tailored survivorship intervention, such as physical rehabilitation, and to explore machine learning/artificial intelligence-based predictive models to identify cancer survivors at a high risk of developing poor HRQoL.

MYOCARDITIS IN CHILDREN PRESENTING WITH MEASLES- DATA FROM A TERTIARY CARE HOSPITAL IN PAKISTAN

Background: Measles is one of the commonest contagious diseases in children associated with numerous systemic complications.&#x0D; Objective: To find the frequency of Myocarditis in children suffering from measles.&#x0D; Methodology: This cross-sectional study was conducted in the department of pediatrics, MTI Lady Reading Hospital Peshawar from 6th December 2019 to 5th June 2020. A total of 96 patients of both genders and age range from 1-12 years having measles for more than one week were enrolled in the study after informed consent. Ethical approval for the study was obtained from Ethical Review board. Patient demographic data were collected on a structured proforma and frequency of children having clinical presentation of myocarditis was recorded. Data were entered and analyzed using SPSS 22.&#x0D; Results: The frequency of Myocarditis was 7.3% in children presented with Measles. The mean age was 6.6± 3.06 years. There were 47.9% males and 52.1% females. Most patients belonged to middle socioeconomic status i.e. 61.5%. Maternal education was 49% in 6-10 years of age group. In sampled population 46.9% belonged to urban area and 5.1% belonged to rural area. There were 18.8% vaccinated children and 81.3% were not vaccinated for measles. Myocarditis was significantly associated with younger age group (p-value 0.028), however there was no difference of gender (p-value 0.781). Children with low socioeconomic status had significantly higher frequency (p-value 0.05) of myocarditis.&#x0D; Conclusion: Myocarditis is commonly presented in children having measles especially patients in younger age group and belonging to poor socioeconomic status.