P-value Set Research Articles

Determinants Of Adherence To Anti-Glycaemic Drugs Among Patients With Diabetes Attending A Diabetic Clinic Of A Tertiary Hospital In South-South, Nigeria

INTRODUCTION: Adherence to anti-glycaemic drugs are important to achieve optimal glycaemic control and desirable patient health outcomes. Poor adherence could increase diabetic-related morbidities and mortality. This study aimed to assess adherence to anti-glycaemic drugs and its determinants among patients with diabetes who attended the diabetic clinic in the University of Calabar Teaching Hospital, Calabar, Nigeria from January 2018 to December 2021. METHODS: Cross-sectional descriptive study design was used. Systematic sampling technique was used to select 167 study participants. Adherence to diabetic treatment was determined through self-reports of how patients had been taking their medications within the past one week before the interview. Data was analysed using SPSS version 25.0, p-value set at 0.05 and Confidence Interval was set at 95%. RESULTS: of the 167 patients studied, 46.1% were males while 53.9% were females. The prevalence of adherence to anti-glycaemic medication was 61.7%. Forgetfulness, side effects of drugs, feeling that the dose is high, multiple drugs, how/when to take the drug, type of medication and comorbidities were significantly associated with adherence. Binary logistic regression showed that forgetfulness, side effects and comorbidities were significant determinants of adherence. CONCLUSION: There is need for targeted interventions to promote adherence to anti-glycaemic drugs.

Risk assessment for rupture of brain arteriovenous malformations using high-resolution black-blood magnetic resonance imaging: a single-center case series.

Chronic inflammation's role in the pathogenesis, development, and rupture of vascular malformations is undebated. Advanced magnetic resonance imaging techniques with vessel wall studies, specifically Black Blood (bbMRI), may offer insights into vascular wall instability and predict rupture. This case series aims to assess bbMRI as a predictive diagnostic tool for brain arteriovenous malformations (bAVMs) rupture, suggesting early treatment. A prospective study included demographic, clinical, and neuroimaging data from a consecutive series of patients with ruptured or unruptured bAVMs, regardless of age or gender, between October 2018 and March 2024. All patients underwent MRI brain resonance with Black Blood study. Those with impaired renal function were excluded. Statistical analyses tested sample homogeneity. Univariate and multivariate logistical regressions assessed bbMRI as a rupture predictor for bAVMs, with a p-value set at < 0.05. Ninety patients were retrieved: 64 with unruptured and 26 with ruptured bAVMs. The mean age was 31.9 years, and 55 were female. Admission symptoms were headache, neurological deficits, and seizure in 49, 21, and 19 cases, respectively. bbMRI showed wall enhancement in 56 cases, with 19 in the ruptured and 37 unruptured groups. Univariate and multivariate analyses revealed a significant correlation between bbMRI wall enhancement and bAVM rupture (p:0.033; p:0.047). bbMRI may be a useful and feasible diagnostic implement to determine vessel inflammation and the bAVMs prone to rupture. Additional studies are needed to confirm the positive bbMRI as a predictive factor for bAVMs rupture.

Predictors and Predictive Score of In-Hospital Mortality in Diabetic Ketoacidosis: A Retrospective Cohort Study.

Background and Objectives: Diabetic ketoacidosis (DKA) is a critical complication of diabetes mellitus (DM). The primary objective of this study was to identify relevant clinical and biochemical predictors and create a predictive score for in-hospital DKA mortality. Materials and Methods: A 6-year retrospective cohort study of adult patients diagnosed with DKA and admitted to Chiang Mai University Hospital, a tertiary care center in Chiang Mai, Thailand, from 1 January 2015 to 31 December 2021, was conducted. Baseline clinical data and laboratory investigations were collected. The primary outcome was in-hospital mortality. Multivariable logistic regression analysis, clustered by type of diabetes, was performed to identify significant predictors. A predictive risk score was created using significant predictive factors identified by multivariable analysis. The results were presented as odds ratios (ORs) and 95% confidence intervals (CIs), with a significant p-value set at <0.05. Results: Ninety-three patients diagnosed with DKA were included in the study. Ten patients died during admission. Significant predictors for in-hospital mortality of DKA included age > 55 years (OR 7.8, p = 0.007), female gender (OR 3.5, p < 0.001), anion gap > 30 mEq/L (OR 2.6, p = 0.003), hemoglobin levels < 10 g/dL (OR 16.9, p < 0.001), and the presence of cardiovascular disease (OR 1.3, p = 0.046). The predictive risk score ranged from 1 to 14 for low risk, and 14.5-23.5 for high risk of in-hospital mortality. The predictive performance of the scoring system was 0.82 based on the area under the curve, with a sensitivity of 73.8% and specificity of 96.4%. Conclusions: Multiple clinical and biochemical factors, along with a predictive risk score, could assist in predicting in-hospital mortality of DKA and serve as a guide for physicians to identify patients at high risk. Nevertheless, as the predictive score was internally validated with data from a single institution, external validation in diverse healthcare settings with larger datasets or prospective cohorts is crucial to confirm the model's generalizability and predictive accuracy.

Health Workers' Attitudes Toward Adverse Gender Norms and Implications for Young People's Sexual and Reproductive Health in Nigeria.

Adverse gender norms within the health care system are detrimental to the sexual and reproductive health of young people. This study assessed the attitudes of health workers toward adverse gender norms related to intimate partner relationships across three domains: intimate partner violence (IPV); sexuality; and reproductive health behavior. A cross-sectional quantitative survey was conducted among 255 health workers in youth-friendly primary health centers in Ebonyi State, Nigeria. Attitudes to gender norm statements were assessed on a 3-point scale of agree (3 points), partially agree (2 points), and disagree (1 point). Mean attitude scores were estimated for each statement and the predictors of attitudes were determined through multiple linear regression analysis with p-value set at .05. Majority of the health workers held gender biases regarding male control over sexual decision-making, men's higher desire and value for sex, and the woman's responsibility to prevent pregnancy. Over 40% of the respondents associated women carrying condoms with promiscuity, and 39.6% believed that only men have the "social" rights to purchase condoms. Urban residence predicted health workers' attitudes to adverse gender norms related to sexuality (β = -.179, p = .003). Findings from this study provide a basis for in-service training programs that are designed to change the attitudes of health workers to adverse gender norms and transform their practices.

7161 Similar Progression-Free Survival in Familial Non-medullary Thyroid Cancer and Sporadic Differentiated Thyroid Cancer Patients

Abstract Disclosure: E. Chuki: None. N. Behairy: None. S. Auh: None. A. Makarewicz: None. N. Uttarkar Vikram: None. P. Padmasree: None. C. Cochran: None. S. Gubbi: None. J. Klubo-Gwiezdzinska: None. Background: There is conflicting data on the disease aggressiveness in patients with Familial Non-medullary Thyroid Cancer (FNMTC) as compared with sporadic differentiated thyroid cancer (sDTC). Moreover, limited evidence exists comparing FNMTC and sDTC responsiveness to treatment. Therefore, the goal of this study was to compare response to standard therapy, defined as progression-free survival (PFS), in patients with FNMTC and sDTC. Methods: This was a single-center Institutional Review Board-approved cohort study, including patients diagnosed with FNMTC or sDTC, subjected to standard therapy with a median follow-up of 4.8 years (range 2.1-10 years). Patients with FNMTC were matched to patients with sDTC in a 1:2 ratio using the Ccoptimalmatch package in R based on age, sex, and American Thyroid Association (ATA) risk stratification at presentation. PFS was defined from the date of initial thyroid surgery to the first evidence of progression, assessed by RECIST 1.1 criteria. Demographics, cancer characteristics, and treatment modalities were collected and compared. Kaplan-Meier curves and log-rank tests were employed to assess differences in PFS. SAS 9.4 software was used for analyses, with a p-value set at 0.05. Results: The study consisted of 198 subjects, with 66 patients affected by FNMTC and 132 sDTC cases, aged 43.1±14.3, 69.7% female, 47% low, 45.5% intermediate and 7.6% high ATA risk for recurrence. Within the FNMTC cohort 26 (39.4%) cancer cases were detected by screening. There were no differences in age, sex and ATA risk stratification between the study groups due to exact matching (±1 year for age). No significant differences were observed in histology type (p = 0.49), multifocality (p = 0.59), gross extrathyroidal extension (p = 0.76), or presence of distant metastases (p = 0.09). FNMTC exhibited smaller tumor size at diagnosis (mean 1.2±0.96 vs 1.8±1.5 cm, p &amp;lt; 0.01), and fewer positive lymph nodes (p = 0.02). Initial surgery extent favored more total thyroidectomies in the FNMTC group (p &amp;lt; 0.01), and there was a higher prevalence of repeat neck surgeries in the sDTC group (p = 0.045). There was no difference in utilization of RAI therapy between the groups (p = 0.68). During follow up 15.2% of FNMTC and 12.9% of sDTC patients presented with disease progression. PFS probabilities at 5, 10, 15, 20, and 25 years were similar between both groups (0.8 and 0.85 at 5 years, 0.8 and 0.78 for subsequent years) (p = 0.99). Conclusions: The initial surgical treatment for FNMTC tends to be more extensive than applied in sDTC, despite a smaller tumor size and lower number of metastatic lymph nodes at diagnosis. This strategy could lead to a lower need for repeat neck surgeries. The smaller tumor size at diagnosis of FNMTC might be a result of an active screening of affected families. The similar PFS in patients with FNMTC and sDTC suggests a comparable tumor biology and similar responsiveness to standard therapy. Presentation: 6/3/2024

A Comprehensive Examination of the Association Between the ACE2 Gene with the Susceptibility to COVID-19 and the Occurrence of Diabetes Mellitus

Background: The rate of transmission, as well as the risk of death associated with COVID-19, is significantly higher than that of previous epidemics. Among the underlying health conditions frequently observed in affected populations, diabetes stands out as one of the most prevalent. Individuals with diabetes who contract Covid-19 face a heightened risk of disease progression compared to those with other conditions. Materials and Methods: A case-control study was implemented to assess biomarkers using classical lab work procedures and genetic markers using congenital PCR, then the association between ACE2 gene, COVID-19 and Diabetes Mellitus were implemented. Results: The analysis of the ACE2 (ID; DD) group revealed statistically significant differences between the groups. However, the II as well as I groups did not demonstrate any notable differences. The chi-square method employed, with a p-value set at &lt; 0.05, indicating statistical significance. Among the manage organization, those with covid-19 , and humans with diabetes plus covid19, the ACE2 D genotype was the most common genotype, accounting for 72.6%, 85%, and 54% of the full population, respectively. After this, the DD, ID, and I genotypes have been applied to the samples. Conclusions: The ACE2 D genotype showed significant prevalence in COVID-19 and diabetes populations, while the II and I genotypes showed no notable differences, highlighting ACE2 D’s potential importance

PSII-11 Temporal variables of the four-beat stepping gaits of the Mountain Pleasure Horse

Abstract The Mountain Pleasure Horse (MPH) is the oldest gaited horse breed in North America with genetic testing finding the breed is ancestral to all other American gaited horse breeds according to the MPH Association (MPHA). Further, the breed is classified as “threatened” according to the Livestock Conservancy with only 2,670 purebred MPHs living today. To expand numbers, the registration books for the MPHA were opened in 2009; however, 5 yr later the books were closed due to negative consequences including potential changes within the gait. Therefore, to ensure the preservation of the gait of the MPH, the objective of this study was to define the temporal variables of the four-beat stepping gaits of the purebred MPH. The six horses utilized for this study were MPHA registered with permanent registration status and were verified to be purebred using blood typing and pedigree tracing with pedigrees tracing back to the foundation sires on both sides of the pedigree as identified by the MPHA. Horses were ridden by their respective trainers at a flat walk and saddle rack following MPHA judging guidelines with those strides utilized for the study being selected by representatives of the breed association. A total of 10 strides for each horse (n = 60) for each gait were selected. Student’s paired t-tests were utilized to determine differences in temporal variables between gaits with P-value set at 0.05. Comparisons were also made within gaits using student’s paired t-test to determine differences between lateral and diagonal variables. Both gaits had a lateral footfall pattern that alternated between bipedal and tripedal support. The saddle rack was performed at a faster velocity than the walk with a longer stride length and shorter stride and stance durations (Table 1). Advanced placements and bipedal support were similar between gaits with lateral and diagonal variables similar within gaits (Flat Walk Lateral-Diagonal Comparisons: Advanced Placement; P = 0.31, Bipedal Support; P = 0.08; Saddle Rack Lateral-Diagonal Comparisons: Advanced Placement; P = 0.23, Bipedal Support; P = 0.11), thus, indicating the gaits had a regular rhythm with no couplets. These variables assist in distinguishing between the gaits of the MPH and between those performed by other gaited horse breeds.

The Igbo version of the Global Physical Activity Questionnaire (GPAQ)- A cross-cultural adaptation study

BackgroundPhysical activity (PA) plays a critical role in preventing non-communicable diseases, and maintaining the overall health and well-being of adults. PA surveillance has become a global concern leading to the development of numerous surveys for its measurement. Global Physical Activity Questionnaire (GPAQ) merges the advantages of both the short and long versions of the International Physical Activity Questionnaire (IPAQ) by incorporating various domains (work, transport, and leisure time), while still maintaining a significantly shorter length. This study aimed to cross-culturally adapt the original English version of GPAQ to the Igbo culture and environment.MethodsThe original version of GPAQ (GPAQ) was translated, synthesized, back-translated, and subjected to expert panel review before producing the final Igbo version of the GPAQ (GPAQ-I). The GPAQ and GPAQ-I were administered to 155 community-dwelling adults (36.1% males and 63.9% females) living in Nnewi who were recruited consecutively. The data obtained was analyzed using frequency counts, percentages, mean, standard deviations, Spearman rank order test, and Mann-Whitney U test with p-value set at 0.05.ResultsThere was no significant difference in the scores on the English and Igbo versions of the GPAQ (p < 0.001). The correlations between the corresponding domains and total scores on both versions of the GPAQ (rho = 1.0)showed excellent concurrent agreement.ConclusionThe successfully adapted GPAQ-I demonstrated a strong agreement with the original English version. Further psychometric testing is required to fully establish its internal consistency, reliability, and validity.

Assessment of the Difference Between General Practitioners and Specialists in Antibiotic Prescription for Emergency Patients

Background:Endodontic emergencies are one of the most common emergencies that dentists face during their career. Objectives: This study aimed to evaluate and assess the difference between general dentists and endodontists in managing endodontic emergency cases. Also, it highlights the risk of bacterial resistance due to an inappropriate antibiotic prescription. Methods: A cross-sectional study conducted at King Abdul-Aziz University Dental Hospital, a self-administered survey was distributed to 521 dental patients. The response rate was 82.9% (432 out of 521). The survey, available in both paper and electronic formats, comprised 24 questions organized into three main sections: the first section collected demographic and medical history data, the second focused on the patients' dental history related to emergencies, and the third detailed the treatment received during emergencies and the methods employed. A Fisher's exact test was utilized to assess significant differences between general dental practitioners and endodontic specialists regarding their initial steps, reasons for treatment, swelling conditions, biting and chewing conditions, and final treatments. Data analysis involved simple descriptive statistics, including percentages, frequency distributions, pie charts, and bar graphs. Statistical significance was determined with a p-value set at ≤ 0.05. Results: The study revealed that decay was the most prevalent reason for endodontic treatment, with immediate treatment being the preferred choice among dentists. Despite the well-documented issue of endodontic treatment failure due to inadequate coronal sealing, the majority of general dentists performed root canal treatments followed by either temporary or permanent restorations. Additionally, the study found that general dentists prescribed antibiotics more frequently than endodontists. Conclusion: The study findings indicate the need to develop intervention programs targeting clinicians to enhance knowledge about prescribing antibiotics for endodontic emergencies.

Growth Assessment in Exclusively Breastfed Against Mixed Fed Infants in Two Hospitals of Fako Division, Southwest Region, Cameroon

Background: Improving breastfeeding rates around the world could save the lives of more than 820,000 children under age 5 every year, the majority (87%) being under 6 months of age. The optimal duration of exclusive breastfeeding is one of the crucial public health issues of WHO. Although breastfeeding provides many health benefits to infants, there is not enough information in our setting to support this assertion. Objective: To determine the prevalence of exclusive breastfeeding and evaluate the growth of exclusive breastfed against mixed fed babies in two hospitals of Fako division. Materials and Methods: A hospital-based, analytic cross-sectional study was carried out with 186 mother-infant pairs from February to April 2022. Data collection consisted of the administration of a pretested questionnaire and anthropometric measurements were taken. Nutritional status and prevalence of respiratory and gastrointestinal infections were then assessed. Bivariate and Multiple logistic regression analysis was done with p-value set at &lt;0.05. Results: The prevalence of exclusive breastfeeding in our setting was 43% while the prevalence of mixed feeding was 57%. The main reasons for practicing mixed feeding were: maternal school or work resumption (43.4%) and insufficient breastmilk (34%). The most common reason for practicing exclusive breastfeeding was medical advice (70%). On multivariate analysis, having a paid job (OR: 0.44, 95 % C.I: 0.203-0.968, p= 0.04) was the only significant predictor of mixed feeding. The incidence of diarrhea was significantly more prevalent (OR: 7.583, 95% C.I: 2.527-22.753, p=0.00) in mixed fed infants compared to exclusively breastfed infants. Conclusion: The prevalence of exclusive breastfeeding in our setting is low so there is need to improve and strengthen breastfeeding education during Antenatal visits. Our findings highlight the importance of breastfeeding to protect against diarrhea-specific morbidity and strengthens the current WHO recommendation of exclusive breastfeeding till 6 months. These results prove the relationship between feeding method and infant morbidity and provides more data with the aim of encouraging more mothers to practice exclusive breastfeeding hence reducing infant morbidity and mortality.

An Advanced Knee Simulator Model Can Reproducibly Be Used for Ligament Balancing Training during Total Knee Arthroplasty.

A critical and difficult aspect of total knee arthroplasty (TKA) is ligamentous balancing for which cadavers and models have played a large role in the education and training of new arthroplasty surgeons, although they both have several shortcomings including cost, scarcity, and dissimilarity to in vivo ligament properties. An advanced knee simulator (AKS) model based on computed tomography (CT) scans was developed in the setting of these challenges with cadavers and previous models. In this study, we compared the ligament balancing between AKS and human cadaveric knees to assess the validity of using the AKS for ligament balancing training during TKA. A CT scan of a TKA patient with varus deformity was used to design the AKS model with modular components, using three-dimensional printing. Three fellowship-trained arthroplasty surgeons used technology-assisted TKA procedure to plan and balance three cadaver knees and the AKS model. Medial and lateral laxity data were captured using manual varus and valgus stress assessments for cadavers and the model in an extension pose (10 degrees of flexion from terminal extension) and between 90 and 95 degrees for flexion. After preresection assessments, surgeons planned a balanced cruciate-retaining TKA. Following bony cuts and trialing, extension and flexion ligament laxity values were recorded in a similar manner. Descriptive statistics and Student's t-tests were performed to compare the cadavers and model with a p-value set at 0.05. Preresection medial/lateral laxity data for both extension and flexion were plotted and showed that the highest standard deviation (SD) for the cadavers was 0.67 mm, whereas the highest SD for the AKS was 1.25 mm. A similar plot for trialing demonstrated that the highest SD for the cadavers was 0.6 mm, whereas the highest SD for the AKS was 0.61 mm. The AKS trialing data were highly reproducible when compared with cadaveric data, demonstrating the value of the AKS model as a tool to teach ligament balancing for TKA and for future research endeavors.

Predictors and Prevalence of Alcohol and Cannabis Co-use Among Filipino Adolescents: Evidence From a School-based Student Health Survey.

This study explored the prevalence and predictors of alcohol and cannabis co-use among 9263 Filipino adolescents, using data from the 2019 Global School-based Student Health Survey (GSHS). We conducted a cross-sectional secondary analysis of the GSHS, targeting adolescents aged 13-17 years and excluding cases with incomplete data on alcohol and cannabis use. Our analysis employed the bivariate chi-square test of independence and multivariable logistic regression using Stata version 18 to identify significant predictors of co-use, with a p-value threshold set at 0.05. The weighted prevalence of co-users was 4.2% (95% confidence interval [CI], 3.4 to 5.3). Significant predictors included male sex (adjusted odds ratio [aOR], 4.50; 95% CI, 3.31 to 6.10; p<0.001) and being in a lower academic year, specifically grade 7 (aOR, 4.08; 95% CI, 2.39 to 6.99; p<0.001) and grade 8 (aOR, 2.20; 95% CI, 1.30 to 3.72; p=0.003). Poor sleep quality was also a significant predictor (aOR, 1.77; 95% CI, 1.29 to 2.44; p<0.001), as was a history of attempted suicide (aOR, 5.31; 95% CI, 4.00 to 7.06; p<0.001). Physical inactivity was associated with lower odds of co-use (aOR, 0.45; 95% CI, 0.33 to 0.62; p<0.001). Additionally, non-attendance of physical education classes (aOR, 1.48; 95% CI, 1.06 to 2.05; p=0.021), infrequent unapproved parental checks (aOR, 1.37; 95% CI, 1.04 to 1.80; p=0.024), and lower parental awareness of free-time activities (aOR, 0.63; 95% CI, 0.45 to 0.87; p=0.005) were associated with higher odds of co-use. Factors not significantly linked to co-use included age group, being in grade 9, always feeling lonely, having no close friends, being bullied outside school, and whether a parent or guardian understood the adolescent's worries. The findings highlight the critical need for comprehensive interventions in the Philippines, addressing not only physical inactivity and parental monitoring but also focusing on sex, academic grade, participation in physical education classes, sleep quality, and suicide attempt history, to effectively reduce alcohol and cannabis co-use among adolescents.

Chemical Characterization and Effect of a Lactobacilli-Postbiotic on Streptococcus mutans Biofilm In Vitro.

Postbiotic is the term used to define the soluble factors, metabolic products, or byproducts released by live probiotic bacteria or after its lysis. The objective of this study was to carry out the chemical characterization of the postbiotic of Lacticaseibacillus rhamnosus LR-32 and to evaluate its in vitro effect on the development of the Streptococcus mutans biofilm. After the cultivation of the probiotic strain, the postbiotic was extracted by centrifuging the culture and filtering the supernatant. This postbiotic was characterized by using gas chromatography coupled with mass spectrometry (GC-MS), and then it was used to determine the growth inhibition of S. mutans in its planktonic form; additionally, its effects on the following parameters in 48 h biofilm were evaluated: viable bacteria, dry weight, and gene expression of glucosyltransferases and VicR gene. The control group consisted of the biofilm without any treatment. A paired t-test was performed for statistical analysis, with the p-value set at 5%. Seventeen compounds of various chemical classes were identified in the postbiotic, including sugars, amino acids, vitamins, and acids. The treatment with the postbiotic led to an inhibition of the growth of S. mutans in its planktonic form, as well as a decrease in the number of viable bacteria, reduction in dry weight, and a negative regulation of the gene expression of gtfB, gtfC, gtfD, and vicR in its biofilm state, compared with the nontreated group (p < 0.05). The postbiotic of L. rhamnosus impaired the development of S. mutans biofilm.

Various Patterns of the Derangement of Liver Function Tests in End-Stage Renal Disease Patients on Maintenance Hemodialysis-A Single Centered Study from Pakistan

Background: Chronic kidney disease (CKD) patients on maintenance hemodialysis often present with various comorbidities, among which liver dysfunction is not uncommon. The prevalence of hepatitis B and C among this population suggests a multifaceted interaction between liver health and renal impairment. Studies have indicated that serum aminotransferase levels are inversely related to the severity of CKD and may be affected by hemodialysis. Objective: This study aimed to delineate the patterns and etiologies of liver function test derangements in an end-stage renal disease (ESRD) cohort on maintenance hemodialysis, assessing the association between dialysis duration and liver enzyme levels. Methods: In this cross-sectional observational study, 91 ESRD patients undergoing hemodialysis at a single center were evaluated. Liver function patterns were classified as hepatocellular, cholestatic, or mixed based on serum levels of aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALKP), and gamma-glutamyl transferase (GGT). Statistical analysis was performed using SPSS version 25, with a significant p-value set at ≤ 0.05. Results: The average age of patients was 44 ± 15 years. The majority had been on dialysis for one (41.8%) or two years (33%). Hepatitis C (20.9%) was the predominant cause of viral hepatitis, followed by Hepatitis B (13.2%). Sepsis was identified as a major contributor to liver enzyme derangement (58.2%). The most common pattern of deranged liver enzymes was mixed (49.5%), followed by cholestatic (27.5%) and hepatocellular (23%). Elevated transaminases were noted, with AST at 227.8 ± 264.1 IU/mL and ALT at 237.1 ± 281.8 IU/mL. Conclusion: In the studied ESRD population, sepsis was the leading cause of liver dysfunction, with a higher incidence of mixed liver enzyme pattern derangements. The elevated aminotransferase levels contrast with previous studies, suggesting the need for enhanced infection control and consistent monitoring of liver health in the hemodialysis setting.

Magnetic resonance imaging assessment of the patterns and distributions of spinal disc degeneration in patients residing in Lagos State

Background: Degenerative disc disease is a condition in which intervertebral discs losses its structure thereby resulting in loss of cushioning, fragmentation and herniation most times related to ageing. Structural defects and failure are common causes of degenerative disc disease. In some cases, the spine loses flexibility and bone spurs may pinch a nerve root, causing pain or weakness. The aim of this study was to assess the prevalence and distribution of disc degeneration over the spines in patients residing in Lagos state using magnetic resonance imaging. Materials and methods: This was a cross-sectional prospective study conducted among 163 patients presented for spinal magnetic resonance imaging (MRI) scan due to disc degeneration in some selected radio-diagnostic centres in Lagos State, Nigeria. The spine structural appearance, intervertebral disc structural appearance, signal intensity, pathologies, gender, age, height, weight and BMI of the patients will be recorded. Both descriptive (mean, percentage, charts and frequency) and inferential statistics (Chi-square) statistics were used for statistical analysis with p-value set at 0.05. Results: Out of 163, 96(58.9%) were female while males were 67(41.1%). The age of the study population ranges from 20 years to 90 years with a mean age of 57.17 ± 12.35. Grade V was highest 64 (39.3%) followed by 32 (25.8%) grade IV and least 10 (6.1%) were grade II. The study found the most common affected on L4/L5 disc with 35 (21.5%) adults demonstrating disc degeneration, while 17 (10.4%) adults demonstrated no disc degeneration. There is no statistically significant association between gender and pattern of disc degeneration (χ2 = 5.943, p =0.203). Conclusion: The majority of the patients had the grade V patterns of degenerated discs based Pffirman grading system. The most affected disc was the L4/L5 disc followed by the L3/L4 disc. There were negative correlations but not statistically significant between weight and BMI respectively and patterns of the disc degeneration diseases. There exist positive correlations but not statistically significant between age and height respectively, and patterns of the disc degeneration diseases. There is no statistically significant association between gender and pattern of disc degeneration.

Comprehensive Characterization of Blue Wire NiTi File Failure: A Comparative Analysis of Cyclic Fatigue and Torsional Resistance Properties

This study compared the fatigue resistance and elemental composition of two blue heat-treated nickel–titanium (NiTi) files used in root canal preparation as follows: Tia Tornado Blue (TTB) and Race Evo (RE) file systems. For cyclic fatigue testing, the two systems were tested where each file was rotated inside an artificial metal canal submerged in either sodium hypochlorite or saline solution until fracture. Time to fracture was recorded. For torsional fatigue testing, the file tip was secured while the file was allowed to rotate at a fixed rate until fracture. Torque at failure was recorded. The two experiments were performed at simulated body temperature and the length of fractured segments was measured. Statistical analysis was carried out with a significance level (p-value) set at 5%. The mean cycles to fracture for RE were superior to that of TTB irrespective of the solution used (p &lt; 0.05). TTB’s cyclic fatigue resistance decreased in NaOCl (p &lt; 0.0001). RE demonstrated lower torque at failure (p = 0.002). All files were fractured at comparable lengths (p = 0.218). Although RE is considered more resistant to cyclic fatigue, it showed inferior torsional resistance compared with TTB. The NaOCl negatively affected the TTB’s cyclic fatigue resistance.

Barriers to Early Treatment Seeking among Patients with Sexually Transmitted Infections in a Rural Community Setting at Kaproron Health Centre IV

Our study aimed to establish barriers to early treatment seeking among patients with sexually transmitted infections at Kaproron Health Centre IV. This was a facility-based cross-sectional survey employing quantitative methods. The study enrolled a total of 122 randomly selected participants who had consented to participate in the study. Data was collected using a pretested interviewer-administered questionnaire and analysed using STATA software version 14. Descriptive statistics were used to present data as graphs and tables of frequencies while for inferential statistics odds ratios and P-value set at 0.05 corresponding to a 95% confidence interval were used. The study revealed that 56.86% of the participants sought their STI treatment late. Participants’ age, sex, symptom severity and cost of services at Kaproron Health Centre IV presented as significant barriers to early STI treatment seeking. Participants aged 36-45 (AOR-0.16, p-0.04, CI-0.03-0.88) and ≥46 years (AOR-0.17, p-0.05, CI-0.03-0.98) had lower odds of seeking treatment early which was similar for female participants (COR-0.38, p-0.02, CI-0.17— 0.86). Conversely, participants with severe STI symptoms (COR-2.8, p-0.02, CI-1.19-6.58) and those who reported STI services at Kaproron Health Centre IV as affordable (AOR-3.73, p-0.011, CI-1.35-10.25) were 3.73 times more likely to seek early treatment. A higher proportion sought STI treatment late. Age, gender, symptom severity and service costs presented significant barriers to seeking early treatment. Mass STI screening programs should target individuals aged 26 and above, females and impoverished communities. Keywords: STI treatment, Patients, Age, Gender, Symptom severity.

Post-exercise heart rate recovery and its speed are associated with resting-reactivity cardiovagal modulation in healthy women

The present study sought to expand upon prior investigations of the relationship between post-exercise heart rate recovery (HRR) and cardiovagal resting-reactivity modulation. HRR from 1st to 5th min after maximal exercise test was correlated with a cardiovagal index of heart rate variability (SD1) at resting (supine and orthostatic positions) and its reactivity after the orthostatic stress test in 34 healthy women. Statistical analysis employed non-parametric tests with a p-value set at 5%. HRR, ∆%HRR, and coefficient of HRR (CHRR) at the 3rd and 5th min correlated with SD1 and SD1n (normalized units) in the supine position (rs = 0.36 to 0.47; p = < 0.01). From the 1st to 5th min, HRR, ∆%HRR, and CHRR correlated with SD1 and SD1n in the orthostatic position (rs = 0.29 to 0.47; p = ≤ 0.01 to 0.05), except for HRR at 5th min with SD1n (p = 0.06). Following the orthostatic stress test, HRR at 3rd and HRR, %∆HRR at 5th min correlated with ∆absSD1 (rs = 0.28 to 0.35; p = 0.02 to 0.05). All HRR measurements at 1st min correlated with ∆absSD1n (rs = 0.32 to 0.38; p = 0.01 to 0.03), and the CHRR at 1st min correlated with ∆%SD1(rs = 0.37; p = 0.01). After the sample was divided into high and low cardiovagal modulation subgroups, the subgroup with high modulation at rest (supine and orthostatic) and higher cardiovagal reactivity (reduction) showed faster HRR (p = ≤ 0.01 to 0.05; ES:0.37 to 0.50). HRR throughout the 1st to 5th min positively correlates with cardiovagal modulation in the orthostatic position, and the 3rd and 5th min positively correlate with cardiovagal modulation in both postures at rest. Faster HRR following the maximal exercise test is associated with high resting-reactivity cardiovagal modulation in healthy women.

Prevalence, patterns, and risk factors for endoscopy-related musculoskeletal injuries among endoscopists in Nigeria

Abstract Introduction: Musculoskeletal issues are quite common among endoscopists especially considering the complexity of GI endoscopy with prolonged examination time. In particular, the combination of repetitive movements, long procedure time, high volume and setup of the endoscopy suite provide the basis for these health issues. Considering the increasing number of new endoscopic interventional and diagnostic procedures, ergonomics in gastrointestinal endoscopy has not been addressed to the same extent. There has been no study on musculoskeletal injuries among practicing endoscopists in Nigeria. This study was designed to study the prevalence, patterns and risk factors for endoscopy-related musculoskeletal injuries among endoscopists in Nigeria. Methods: This was a nationwide cross-sectional questionnaire-based study in which practicing endoscopists in Nigeria were administered an online Google form. The questions on the questionnaire were adapted from the Nordic Musculoskeletal Questionnaire (NMQ). The questionnaire also included social demographic variables. There were 66 respondents which included gastroenterology physicians and surgeons. Data was analyzed with IBM-SPSS version 25. Inferential statistics was done using chi-square with p-value set at 0.05. Results: The Prevalence of endoscopy-related musculoskeletal injuries among endoscopists in Nigeria is very high. The commonest sites affected were the wrist/hands, lower back, neck and shoulders. These injuries prevented about one-third of the endoscopists from carrying out their normal activities while the injuries were severe enough to necessitate therapy in more than two-thirds of the respondents. The only statistically significant risk factor for endoscopy-related musculoskeletal injury was female sex. Conclusion: Most of the endoscopists in Nigeria have not had any form of training on ergonomics. While most of the endoscopists adopted the correct posture while performing endoscopies, a significant number did not practice ergonomic timeout nor use the finger grip technique. Thus there was a knowledge gap as well as a practice gap. A proper ergonomic education is a key step in preventing endoscopy-related musculoskeletal injury.

Relation of Iron Deficiency Anemia in Pre-Menopause Women with Calcium and Vitamin D Levels at Teaching Hospital

Background: Iron deficiency anemia (IDA) is a common condition influenced by various factors, such as age, symptom duration, and other biochemical markers. Premenopausal women often experience premenstrual syndrome (PMS), which is frequently associated with reduced blood levels of calcium and vitamin D. Given the worldwide public health concern of osteoporosis, understanding lifetime preventive measures is crucial. Methods: This study aimed to explore the relationship between IDA and various clinical characteristics in 161 participants. We evaluated parameters including age, symptom duration, and levels of calcium and vitamin D to identify potential associations with IDA. Data for the 161 patients were collected using a predesigned proforma, as approved by the ethics committee. The Chi-square test was employed to determine statistical significance, with a P-value threshold set at 0.05. Results: The average age of participants was 38.6 years, with the majority (58.4%) reporting symptoms for an average duration of 58.4 months. Among them, 54% had confirmed cases of IDA. However, there was no significant age-related correlation with IDA. Notably, a strong correlation was observed between IDA and low vitamin D levels, which were present in 79.8% of the patients. Conversely, no significant relationship was found between calcium levels and IDA. Conclusion: Current research underscores the complex interplay between IDA and various clinical factors. Low vitamin D levels appear to be strongly linked with IDA, whereas age and symptom duration are not reliable indicators of the condition. This emphasizes the importance of considering multiple factors in the diagnosis and treatment of IDA, particularly focusing on the potential role of vitamin D in its pathogenesis. Further prospective studies are needed to confirm and expand upon these findings, potentially leading to improved treatment and diagnostic strategies for patients with IDA.