Significant Associated Factors Research Articles

Empowering Maternal Choice: Exploring Factors Influencing Early Postpartum Contraceptive Adoption Intention Among Pregnant Women in Northeast Ethiopia

Background: Despite progress in access to family planning services in many sub-Saharan African countries in recent decades, advances in early postpartum contraceptive adoption remain low, and the unmet need for early postpartum contraceptives is high. According to the Ethiopia Demographic and Health Survey report, early postpartum modern contraceptive method uptake is still unacceptably low in Ethiopia. Objectives: This study aimed to determine the magnitude of intention to adopt early postpartum modern contraceptive methods and its associated factors among pregnant women in Dessie and Kombolcha town zones, northeast Ethiopia. Methods: A community-based cross-sectional study was deployed from 15 January–15 February 2023, in the Dessie and Kombolcha zones, northeast Ethiopia, among pregnant women. The study involved 780 pregnant women using the cluster sampling technique. A census was conducted in 20 randomly selected clusters to identify eligible pregnant women. Actual data were collected home-to-home in the community through face-to-face interviews. Data were collected by Open Data Kit (ODK) and exported to STATA 17 for analysis. A multivariable logistic regression analysis was performed, and the goodness of the model was checked by Hosmer–Lemeshow’s test statistic and rock curve. An adjusted odds ratio with a 95% confidence interval and p-value < 0.05 was considered statistically significant. Result: The study revealed that 49.6% of pregnant women lack autonomy and 50% lack knowledge about early postpartum contraception, with participants’ wealth index status ranging from rich (36.6%) to poor (33.2%). The study found that 75.8% of pregnant women intended to adopt early postpartum modern contraceptive methods early after childbirth. After controlling the potential confounders, mother’s age (AOR = 6.2 [2.6–14.6], birth interval (AOR = 2.5 [1.6–3.7]), have paid work (AOR = 1.9 [1.3–2.8]), health facility from home (AOR = 2.6 [1.5–4.4]), last delivery Place (AOR = 2.4 [1.1–5.7]), knowledge on (AOR = 1.5 [1.1–2.1]), and antenatal care follow-up (AOR = 1.9 [1.2–3.3]) were significant associated factors of intention to uptake early postpartum modern contraceptive methods among pregnant women. Conclusions: The study found that 75% of the participants had the intention to adopt contraceptive methods during the early postpartum period. Identified factors influencing this intention were age, birth interval, women’s employment status, area of residence, distance to health facilities, last delivery place, knowledge of early postpartum modern contraception, gravidity, and antenatal care follow-up. These findings highlight the need for targeted interventions to address these factors, framing the intended users and enabling access to early adoption of postpartum contraceptive methods.

Baseline characteristics and associated factors for hypertension in children with chronic kidney disease: results from the Korean Cohort Study for Outcome in Patients with Pediatric Chronic Kidney Disease study.

Hypertension is one of the most important complications of chronic kidney disease (CKD) as it exacerbates disease progression in children. The aim of this study is to identify characteristics and factors associated with hypertension in children with CKD. This is a cross-sectional study using baseline data from the 10-year ongoing cohort study named KNOW-PedCKD (Korean Cohort Study for Outcome in Patients with Pediatric Chronic Kidney Disease). We enrolled finally 378 patients aged <18 years at seven major pediatric nephrology centers in Republic of Korea. Blood pressure was measured and samples and clinical data were collected during the patients' annual hospital visits. We found that 30.7% of the patients had hypertension (n = 116); specifically, 16.4% (n = 62) had systolic hypertension, and 22.8% (n = 86) had diastolic hypertension. Multiple logistic regression analysis indicated that older age (odds ratio [OR], 1.13; p < 0.001), female sex (OR, 2.32; p = 0.002), a high left ventricular mass index (OR, 1.05; p < 0.001), and a high urine protein/creatinine ratio (OR, 1.12; p = 0.02) were significant associated factors for systolic or diastolic hypertension. This study analyzed the associated factors for hypertension in children with CKD. Hypertension is associated with various factors, including age, sex, heart status, and proteinuria. Therefore, clinicians should consider these factors during patient evaluations to improve health outcomes.

Less than one in five teenage women in Ethiopia know about emergency contraception.

Teenage women's fertility health faces significant challenges from unintended pregnancies and unsafe abortions. Using an emergency contraception within a defined time period could prevent unintended pregnancy and its damaging consequences, like unintended childbirth and unsafe abortion. Despite it being an appropriate contraception, the knowledge of teenage women about emergency contraception is lower among women in developing countries. Therefore, this study aimed to examine the magnitude of emergency contraception knowledge and its associated factors among teenage women in Ethiopia. Data for this study was obtained from the recent Demographic and Health Surveys. A total weighted sample of 3,381 teenage reproductive women were included. The significant associated factors with emergency contraception knowledge among teenage reproductive women were determined by fitting a multilevel mixed-effect binary logistic regression model. Finally, Adjusted Odds Ratio (AOR) with a 95% confidence interval and a P value of less than 0.05 was used to declare statistical significance. In Ethiopia, the magnitude of teenage women who knew about emergency contraception was 19.47% (95%CI: 18.17, 20.84). Age 17 years (AOR = 1.76, 95%CI, 1.24, 2.48) and age 19 years (AOR = 2.18, 95%CI, 1.47, 3.22), primary education level (AOR = 2.76, 95%CI, 1.60, 4.76), secondary and above educational level (AOR = 4.70, 95%CI, 2.62, 8.44), being protestant followers (AOR = 0.63, 95%CI, 0.45, 0.87), being muslim followers (AOR = 0.68, 95%CI, 0.49, 0.93), media exposure (AOR = 3.36, 95%CI, 2.59, 4.34), rural residence (AOR = 0.45; 95%CI: 0.22, 0.86), and high community level education (AOR = 140, 95%CI: 1.32, 2.00) were factors significantly associated with knowledge of emergency contraception among teenage women. This finding concluded that less than one in five teenage women knew about emergency contraception in Ethiopia. The knowledge of emergency contraception among teenage women in Ethiopia was substantially associated with women's age, education level, religion, media exposure, residency and community-level education. Hence, there is a need to implement comprehensive awareness programs and promotion of emergency contraception as a way of curbing cases of unintended pregnancies among teenage women. Government and non-governmental organizations should design targeted educational initiatives and media campaigns to improve emergency contraception knowledge among young teenagers, women with lower educational backgrounds, and rural teenagers.

Factors associated with acute kidney injury and outcomes in patients with malaria in a district hospital in Rwanda

Introduction: Acute kidney injury (AKI) remains one of the complications of severe malaria. Evidence on associated factors and outcomes for patients with complicated malaria and AKI is limited in Rwanda. Aim: To assess the factors associated with acute kidney injury and outcomes in patients with malaria in a district hospital in Rwanda. Method: A retrospective study design was applied. A census sampling strategy was used to select 122 files of patients admitted as severe malaria patients in 2016- 2017. A developed clinical audit form was used to collect data from patients’ files. Both descriptive and inferential statistics were used to analyze data. Results: Among the confirmed severe malaria files, 44% of participants were over 50 years and 52.5% were males. The majority, (91.5%) had community-based health insurance and 16.3% had acute kidney injury. The significant associated clinical factors were dehydration (p=.01), high-grade fever (p=.002), profuse sweating (p=.034), vomiting (p=.043), and diarrhea (p=.025). Of the 20 patients who developed AKI, 55% completely recovered, 15% died and 30% of cases were transferred to the highest facilities for hemodialysis. Conclusion: The existence of AKI among severe malaria patients was evident with some recovering and others dying. There is a need for educating healthcare professionals, mostly at district hospitals about the diagnosis and management of AKI as a result of complicated malaria. Keywords: Acute kidney injury; severe malaria; complications of malaria.

Exploring the role of help‐seeking behavior, family financial socialization, and capability on financial well‐being

AbstractObjectiveThis study develops a conceptual framework for examining the associations between family financial socialization and financial capability on individuals' financial well‐being and explores the mediating role of financial help‐seeking when determining financial well‐being.BackgroundIndividuals' family financial socialization and financial capability are associated with their financial well‐being. This study extends the literature by examining whether seeking financial help can indirectly mediate the association between these factors and individuals' financial well‐being.MethodThis study used the 2016 National Financial Well‐Being Survey data set, consisting of 6,394 adults, and employed structural equation modeling with full information maximum likelihood and bootstrap estimation for empirical analyses.ResultsFinancial knowledge and perceived financial capability were positive contributors to financial well‐being. Family financial socialization showed positive direct and mixed indirect effects on help‐seeking behaviors. When mediated by help‐seeking behaviors, family financial socialization had significantly positive total and indirect associations and a negative direct association with financial well‐being.ConclusionThis study found that financial help‐seeking behavior was a significant factor in the indirect association between family financial socialization, financial knowledge, and well‐being.ImplicationsProviding access to professional advice and encouraging family finance discussions can enhance people's financial well‐being.

Prevalence of Depression and Generalized Anxiety Among LGBTQ+ Medical Students in Thailand.

This study evaluated the prevalence and associated factors of depression and generalized anxiety among LGBTQ+ in five medical schools in Thailand. The Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were used to assess major depressive disorder (MDD) and generalized anxiety disorder (GAD), respectively, and multivariable logistic regression was employed to identify associated factors. Of 1,322 students, 412 (31.16%) identified as LGBTQ+. The prevalence for MDD and GAD among LGBTQ+ students were 32.77% and 17.23%, respectively. Significant associated factors for both MDD and GAD were a history of psychiatric illness (AOR for MDD = 2.32, p = .020; AOR for GAD = 3.67, p < .001), educational problems (AOR for MDD = 6.62, p < .001; AOR for GAD = 5.12, p < .001), and dissatisfaction with gender identity or sexual orientation (AOR for MDD = 1.92, p = .019; AOR for GAD = 2.47, p = .005). Additional factors associated with MDD were preclinical years (AOR = 2.30, p = .023), financial struggles (AOR = 2.05, p = .021), and inadequate peer support (AOR = 2.57, p = .044). In conclusion, nearly one-third and one-fifth of Thai LGBTQ+ medical students suffer from MDD and GAD, respectively. Our findings suggest that Thai medical schools should promote LGBTQ+ inclusivity to enhance students' identity satisfaction. Peer support groups should be encouraged, especially for preclinical LGBTQ+ students who face educational and financial challenges.

Hepatitis B vaccination status among patients with end-stage kidney disease on haemodialysis in Ethiopia: a multi-center cross-sectional study

BackgroundChronic kidney disease patients, especially those on hemodialysis, are at increased risk of developing hepatitis B virus (HBV) infection. Guidelines suggest that all patients with chronic kidney disease patients should be vaccinated against HBV, but these guidelines are sub-optimally implemented. Notably, there is a lack of studies in Ethiopia examining the hepatitis B vaccination status among patients with end-stage renal disease.ObjectiveTo assess the vaccination status of hepatitis B and associated factors among people with end-stage renal disease who were on hemodialysis.MethodsA multi-center cross-sectional observational study was conducted in six randomly selected dialysis centers in Ethiopia, from May 2023 to September 2023. Logistic regression analysis was used to evaluate factors associated with vaccination status. A person is considered to be vaccinated against hepatitis B if he/ she has taken at least one dose of HBV. Vaccination status was determined by patient’s recall and verification from medical record.ResultsOnly 16% of patients with end-stage renal disease on hemodialysis were vaccinated against hepatitis B virus (16.6%; with CI = 12.18, 21.83), of which 30% had received one dose, 57.5% had two doses, 12.5% had three doses, and only five had a booster dose. Post-secondary education (AOR = 5.47; 95% CI = 1.41, 21.2; P < 0.014) and dialysis for more than three years (AOR = 19.75; 95% CI = 4.06, 96.1; P < 0.001) were significant factors associated with having received hepatitis B vaccination.ConclusionOnly a small minority of Ethiopian hemodialysis patients have received hepatitis B vaccination. The level of education of patients and the duration of time on dialysis were significant associated factors that affected the vaccination status of patients with end-stage renal disease. So, strong intervention is needed according to the identified factors to raise the vaccination status of patients.

The Diagnostic Role of Antinuclear Antibody: A Study of Clinical Utility in a Tertiary Hospital

Abstract Introduction: Various studies reported unnecessary and inappropriate serology testing of rheumatic diseases leading to a significant waste in healthcare utilization. The purpose of this study is to evaluate the clinical utility of antinuclear antibody (ANA) testing in a real-world setting within a tertiary hospital for systemic lupus erythematosus (SLE) and other ANA-associated rheumatic diseases (AARDs), as well as to identify patient characteristics and test results that predict rheumatic disease association. Subjects and Methods: This is a retrospective study of patients aged 15 years or older who underwent ANA testing at Aseer Central Hospital from January 2018 to December 2022. Data collected included patient demographics, clinical presentations, referral physician type, ANA test results, and final diagnoses. Descriptive statistics characterized patient demographics and ANA test results. Sensitivity, specificity, and predictive values of ANA testing were calculated for SLE and AARD diagnoses. Chi-squared test was used to identify the predictive values of AARDs. Results: Of the 2141 patients tested for ANA at Aseer Central Hospital, 583 (27.2%) tested positive, with a higher proportion of females (80.8%). Notably, 85.1% of patients who tested ANA positive were under 55 years old. The highest ANA test-positive proportion was noticed by rheumatologist physician’s referral (67.6%), referral symptoms including joint symptoms (38.3%), mucocutaneous symptoms (19.7%), renal disease symptoms (14.4%), and hematological abnormalities (14.2%). The sensitivity and specificity of ANA for diagnosing SLE were 86.4% and 79.3%, respectively, with a positive predictive value (PPV) of 31.7% and a negative predictive value (NPV) of 98.1%. The sensitivity and specificity of other AARDs were 85.4% and 73.9%, respectively, with a PPV of 6% and an NPV of 99.6%. Significant associated factors with AARDs included younger age (&lt;55 years), female patients, higher ANA titer, rheumatologist referral, and clinical indications such as sicca symptoms, myopathy, mucocutaneous symptoms, and hematological abnormalities (P &lt; 0.001). Conclusion: In this study, ANA testing showed a good sensitivity and NPV in ruling out AARDs; however, its poor specificity and PPV suggest that positive ANA findings should be interpreted cautiously. Younger age, female gender, higher ANA titer, rheumatologist referral, and specific clinical indications were significantly associated with AARDs, suggesting the importance of targeted ANA testing in clinical practice.

Choice intention for the national volume-based procurement drug and its associated factors: a cross-sectional study on patients with late-life depression in China

BackgroundThe national volume-based procurement (NVBP) policy has significantly decreased prices and increased the accessibility of NVBP drugs. Nevertheless, issues such as heightened adverse reactions and suboptimal efficacy have arisen. Concerns regarding the quality of low-cost medications and the absence of long-term research have been widely recognized. This has led to caution among patients with late-life depression (LLD) due to their delicate health and the severity of their condition. This study evaluated the choice intention for NVBP drugs and associated factors in older patients with LLD.MethodsA weighted sample of 408 participants between December 2022 and March 2023 were included. Data were collected via face-to-face interviews and questionnaires. To identify significant associated factors of choice intention, a multilevel logistic regression model was employed.ResultsOver half (53.68%) of older patients with LLD intended to choose NVBP drugs. Associated factors included self-assessed poor economy, higher out-of-pocket expenses, monthly household income exceeding CNY 6000, absence of other non-communicable chronic diseases, ordinary registration, urban employee medical insurance, no requirements for brand-name drugs, adverse reactions after using NVBP drugs, and rejection of physicians’ recommendation for NVBP drugs. The interaction effect between the real economic condition and patients self-assessed economy significantly influences choice intention for NVBP drugs. Among 124 patients with self-assessed poor economy, 75 showed a higher intention to use NVBP drugs. In these patients, age, medical insurance reimbursement, and brand awareness were significantly associated with choice intention.ConclusionEconomic factors, physical conditions, medical needs, and physician recommendations significantly influenced the choice intention for NVBP drugs. The choice intention can be improved by strengthening physician-patient communication, increasing the scope and proportion of medical insurance reimbursement, improving substitution studies, and conducting post-marketing re-evaluations of NVBP drugs.

A multimodal approach for fostering knowledge transfer in engineering design activity: an eye-tracking and fNIRS study

Knowledge transfer in engineering design activity involves effectively applying prior practical experience in novel contexts. While related works fostering knowledge transfer focus on educational practices and experience generalisation, recent advancements enable us to analyze its complex cognitive processes using neuroimaging technology. This paper proposes a multimodal approach for facilitating knowledge transfer in engineering design, utilising functional near-infrared spectroscopy (fNIRS) and eye-tracking technologies based on neurocognitive profiling. We conducted knowledge transfer experiments using mixed and extended design tasks. Meanwhile, The analysis focused on gaze duration, gaze counts, brain region activation levels, functional connectivity, and effective connectivity of the participants. Finally, we employed stepwise linear regression to identify significant and potential associated factors of knowledge transfer. By combining eye-tracking predictors and brain network predictors, a multivariate linear discriminant analysis (LDA) significantly differentiated between participants in near-transferred and far-transferred states, achieving an accuracy of 91.16% using leave-one-out cross-validation. The ‘basic-supplementary-target task’ method effectively improved the knowledge transfer performance by 27.6%. Our findings demonstrate the efficacy of the proposed multimodal approach in facilitating knowledge transfer in engineering design activities.

Exploring factors influencing the hearing test and hearing aid adoption among Japanese older adults: Implications of recognizing the hearing loss–dementia relationship

ObjectiveThe hearing aid adoption rate among older adults in Japan is lower than that in other developed countries. Herein, a survey was conducted to identify this bottleneck and develop countermeasures. This study aimed to examine whether raising awareness of the relationship between hearing loss and dementia is significant for hearing tests and adopting hearing aids. MethodsA questionnaire was administered to participants aged 65 or older who visited a general hospital to determine the background factors (1) for a recent history of hearing tests, (2) for the desire to visit an otolaryngologist and have a hearing test, (3) for recognizing the hearing loss–dementia relationship, and (4) for adopting hearing aids. ResultsA total of 517 patients (mean age, 78.06; SD 6.97), representing 2.4% of the region's older-adult population, participated in the survey. A history of hearing tests within five years was significantly associated with recognizing the hearing loss–dementia relationship (adjusted OR 2.36, 95% CI 1.49–3.72). The desire to visit an otolaryngologist or have a hearing test was significantly associated with recognizing the hearing loss–dementia relationship (adjusted OR 1.70, 95% CI 1.02–2.85). Moreover, 39.3% were aware of the hearing loss–dementia relationship. The significant associated factors were being female (OR 2.50, 95% CI 1.64–3.81) and having interpersonal hobbies (OR 1.66, 95% CI 1.11–2.49). The significant background factors for adopting hearing aids were older age (OR 6.95, 95% CI 1.90–25.40), self-reported severe hearing impairment (OR 5.49, 95% CI 2.55–11.80), and living alone (OR 2.63, 95% CI 1.18–5.89). Recognizing the hearing loss–dementia relationship was not a significant factor. ConclusionRaising awareness of the hearing loss–dementia relationship was not associated with adopting hearing aids for self-reported hearing impairments. However, it may be associated with otolaryngology visits and hearing tests. Thus, steps like hearing screening for older adults are also essential.

Disparity by caste and tribe: Understanding women's empowerment and health outcomes in India

AimWomen's empowerment status varies greatly in India according to caste, class, ethnicity and region. This paper aims to investigate the caste/tribe disparity in women's empowerment by region, the main correlates of each domain of empowerment, and the association of women's empowerment with nutritional and health care access outcomes, specifically anaemia, menstrual hygiene, and institutional delivery. MethodologyUsing National Family Health Survey-5 (2019–2021) data, we have created a modified survey-based women's empowerment index (SWPER) using principal component analysis with Oblique varimax rotation. The first four components are interpreted as an attitude to violence, freedom of movement, decision-making power and social independence. Several multivariate regression models were used to understand the factor associated with empowerment and the association of women's empowerment with different health outcomes. ResultsThe results indicate that women from the forward castes are the most empowered in most domains except decision-making. However, after controlling other background variables, the forward castes women are found to be the most empowered in attitude to violence, whereas Scheduled Castes and Scheduled Tribes women were found to be the most empowered women in decision-making. With regards to social independence, deprived castes women are more empowered than the forward castes women. The likelihood of empowerment in social independence domain increases with increasing wealth. There are wide regional variations in empowerment level between different social groups. Caste/tribe identity plays a significant role in determining health outcomes in India. Among all empowerment domains, social independence emerges as the most significant associated factor with improved health across all caste/tribe groups. ConclusionThe path to women's empowerment in India must recognize the intersectionality of caste/tribe identities, and address regional disparities. Social independence emerges as a critical determinant across all caste/tribe groups for improving health. Measures should be taken to empower women through the underlying factors of social independence.

Affiliate Stigma, Resilience and Quality of Life among Parents of Children with Autism Spectrum Disorder in Two Public Hospitals in Kelantan, Malaysia.

Often, the indirect impact of autism spectrum disorder (ASD) presents the family with significant challenges. One of these challenges is affiliate stigma due to parental affiliation with their child. This study aimed to explore affiliate stigma, resilience and quality of life (QoL) among parents of children with ASD. Cross-sectional study of 144 parents of children with ASD were recruited from two main tertiary hospitals in Kelantan, Malaysia, a developing country in Southeast Asia. Pearson correlation was used to examine the relationship between parental affiliate stigma, resilience and QoL. Simple and multiple linear regression analyses were used to identify the significant associated factors of affiliate stigma, resilience and QoL. Correlational analyses revealed that perceived affiliate stigma demonstrated an inverse relationship with resilience and QoL. Additionally, resilience had a positive relationship with QoL. Regression analyses revealed that the father's employment status, the mother's level of education, having a disability card, the child's age at ASD diagnosis, comorbidities of the child and ASD severity perceived by parents were associated with parental affiliate stigma, resilience and QoL. Study findings highlight the contribution of socio-demographic characteristics of children with ASD and their families in the determination of affiliate stigma, resilience and QoL.

Nucleus drop following phacoemulsification surgery: Incidence, risk factors and clinical outcomes.

To determine the incidence, risk factors and clinical outcomes in patients with nucleus drop (ND) following phacoemulsification surgery at a tertiary care ophthalmic institute. Medical records of patients with ND during phacoemulsification between January'2019 and December'2022 were reviewed retrospectively. Incidence of ND was calculated overall, and according to surgical expertise levels and surgical steps. Associated pre- and intra-operative risk factors were assessed. Clinical outcome parameters [best-corrected visual acuity (BCVA) and intraocular pressure (IOP)] were compared with respect to timing of PPV (immediate vs early vs delayed), location (sulcus vs scleral fixated-IOL) and timing of IOL placement (primary vs secondary). Among 93,760 phacoemulsifications, ND was noted in 130 patients (0.1%). Significant direct and associated pre-operative risk factors were advanced cataract, glaucoma, posterior polar cataract, and diabetes mellitus. Junior medical consultants had 40 ND (mostly in non-complex cases), whereas senior medical consultants had 90 ND (mostly in complex cases). ND most frequently occurred during emulsification of nuclear fragments. Sulcus placement of IOL during primary surgery yielded significantly better visual outcome compared to secondary procedures, although timing of PPV had insignificant effect. 77.1% had BCVA of 6/12 or better at final follow-up. Timing of IOL implantation, PPV, and type of IOL did not have any significant effect on IOP. Though the incidence of ND is low, it is a dreaded complication. Accurate pre-operative evaluation, risk stratification, distribution of cases among surgeons based on their surgical expertise, and immediate or early management of ND yields better anatomical and functional outcomes.

Prevalence of vitamin B 12 deficiency and associated factors among primary school children: North East Ethiopia: multicenter cross-sectional study

BackgroundThe prevalence of Vitamin B12 deficiency is common and is more frequent in low- and middle-income countries with a poor or inadequate diet of animal foods. In Ethiopia, researches related to the status of micronutrients in children are limited. Therefore, this study aimed to assess the prevalence of vitamin B12 deficiency and associated factors among primary school children.MethodsA cross-sectional study design was conducted from January 10-February 30/2023. A total of 514 students were selected using a systematic random sampling technique. Face-to-face interviews using a structured questionnaire, document review, anthropometric measurement, and laboratory studies were implemented to collect data. Data was analyzed by STATA version 14 and summarized by using frequency tables and graphs. Logistic regression analysis was done to identify factors associated with vitamin B12 Deficiency.ResultsAbout 34% of the students were found to have vitamin B12 deficiency. Not Consuming animal products (AOR = 1.83, 95% CI:1.20–2.79) and low body mass index (AOR = 1.62, 95% CI:1.05–2.47) were associated with vitamin B12 deficiency.ConclusionsThe study revealed a notable high deficiency of vitamin B12 in primary school students. Consumption of animal products and BMI were identified as statically significant associated factors with serum concentration of vitamin B12.

Prevalence and Prognostic Factors Associated with Early Recovery of Olfactory Dysfunction in COVID-19 Patients.

The prevalence of smell dysfunction, along with its risk factors, has been evaluated in previous literature; however, little has been established regarding its relation to other factors such as disease severity, history of coronavirus disease-2019 (COVID-19) vaccinations, and medical treatment for COVID-19 infection. These factors may impact the overall recovery of olfaction in COVID-19 patients. This study investigated the prevalence of early olfactory recovery from COVID-19 infection and its associated factors. This study was a prospective cohort study on 348 COVID-19 patients with a new onset of anosmia or hyposmia. Smell sensation scores on the olfactory self-assessment test were collected at baseline and every week until 6 weeks of follow-up. The primary outcome was the prevalence of early olfactory recovery. The secondary outcomes were analyzing factors associated with early olfactory recovery and the median time to complete recovery of smell loss. The prevalence of early olfactory recovery was 63.1% (95% CI: 0.58-0.68), and significant associated factors in multivariate analysis included patients without allergic rhinitis (OR 2.22, 95% CI: 1.12-4.40, P = 0.023) and no alteration of taste perception (OR 1.62, 95% CI: 1.02-2.57, P = 0.042). The median time to complete recovery from smell loss was 2 weeks. The present study found that the prevalence of early olfactory recovery within 2 weeks was 63.1%. The median time to olfactory recovery was also 2 weeks. Patients without allergic rhinitis and taste alteration had a significantly better chance of early recovery of olfactory function.

Interest in daily clinical practice of screening for gouty disease in patients with psoriatic arthritis

Abstract Objectives Psoriatic arthritis (PsA) and gout are two prevalent rheumatic diseases, that can be associated as part of a rheumatism known as “Psout”. Both conditions are associated with cardiovascular (CV) risk, thus their co-occurrence could have significant implications for the management of CV risks and patient care. This study aimed to determine the prevalence of gout within a PsA patient cohort and, consequently, to identify factors associated with this pathological association. Methods This is an observational, descriptive, cross-sectional, single-center study, including patients diagnosed with PsA. Demographic, clinical, biological and imaging data were collected. We identified the proportion of patients simultaneously affected by PsA and gout and compared characteristics between those with and without gout. Results The prevalence of gout among PSA patients was 9.8% (12/122), with a prevalence of 23% for asymptomatic hyperuricemia and 7.4% presenting with specific ultrasound signs of gout. Significant associated factors in univariate analysis included weight, hypertension, diabetes, certain medications (diuretics, aspirin, lipid-lowering agents), impaired renal function, elevated fasting blood glucose, lipid abnormalities, and specific US signs of gout. Conclusion Our study has described the existence of patients simultaneously affected by PsA and gout (“Psout”). Performing joint ultrasound along with uric acid level measurements in PsA patients can enable personalized therapeutic care.

Clinical Outcomes of Secondary Duodenal Self-Expandable Metallic Stenting for Duodenal Stent Dysfunction in Patients with Malignant Duodenal Obstruction: A Retrospective Multicenter Study.

Malignant duodenal obstruction has become more common with the development of palliative therapies.The outcomes of endoscopic ultrasound-guided gastrojejunostomy (EUS-GJ) are comparable to those of surgical gastrojejunostomy or duodenal stenting. However, EUS-GJ is technically challenging. Duodenal self-expandable metallic stent (SEMS) placement is popular; however, obstructions are common. Duodenal SEMS obstruction can be managed with the insertion of a second SEMS in a stent-in-stent manner. Therefore, we aimed to analyze the clinical outcomes of secondary duodenal SEMS placement in patients with malignant duodenal obstruction. We retrospectively analyzed the data of patients who underwent secondary duodenal stent insertion for duodenal stent dysfunction between January 2016 and December 2021. The primary outcome was stent patency. The secondary outcomes were clinical success, factors associated with dysfunction, patient survival, and adverse events. A total of 109 patients were included. The mean age was 64.4±11.2 years, and 63 patients (57.8%) were male. Ninety-two patients (84.4%) had pancreaticobiliary cancer. Clinical success was achieved in 94 cases (86.2%). Twenty-three patients experienced stent dysfunction with 231 days of median stent patency (95% confidence interval [CI], 169 to not available). After a multivariable Cox hazard analysis of stent patency, the Eastern Cooperative Oncology Group performance status (hazard ratio [HR], 2.13; 95% CI, 1.20 to 3.81; p=0.010) and the first stent patency ≥6 months (HR, 0.33; 95% CI, 0.11 to 0.95; p=0.050) remained significant associated factors. Adverse events occurred in five patients (4.6%). Secondary duodenal stent insertion is a viable option for first duodenal stent obstruction. Further comparative studies involving surgery or EUS-GJ for obstructed duodenal stents are warranted.

Knowledge and attitude toward cervical cancer screening among women aged 30–49 years attending selected health facilities in Ethiopia: Using structural equation model

BackgroundAccording to estimates, there were 570,000 new cases of cervical cancer in 2018, making it the fourth most common malignancy among women worldwide. Almost all 342,000 deaths from cervical cancer take place in low- and middle-income countries, accounting for 90 % of deaths. Few studies use structural equation modeling to comprehensively analyze the predictors of cervical cancer screening. ObjectiveThe purpose of this study was to assess knowledge and attitude towards cervical cancer screening and its associated factors among women aged 30–49 years in Ethiopia. MethodsA facility-based cross-sectional study was conducted among eligible women attending health centers in Oromia and the southern nationality People regions. A systematic random sampling method was used to select 916 respondents. The data was collected using a structured interviewer-administered questionnaire. Structural equation modelling was employed to assess the direct and indirect relationship between knowledge and attitude toward cervical cancer screening. ResultsThe overall proportion of knowledge and attitude towards cervical cancer detection among women 30–49 years of age were 28 % and 57 %, respectively., income (adjusted β= 0.075, 95 % CI: 0.042, 0.091), being urban (adjusted β= 0.088, 95 % CI: 0.062, 0.093), being employee (adjusted β= 0.119, 95 % CI: 0.113, 0.342), the number of parity (adjusted β= 0.014, 95 % CI: 0.012, 0.021), usage of contraceptive (adjusted β= 0.719, 95 % CI: 0.057, 0.082) and family history of cervical cancer (adjusted β= 0.211, 95 % CI: 0.18, 0.302) were statistically significant associated factors with knowledge and Being smoker (adjusted β=-0.157, 95 % CI: 0.265, −0.141). Having multiple sexual partnership (adjusted β= 0.169, 95 % CI: 0.148, 0.349), having formal education (adjusted β= 0.118, 95 % CI: 0.052, 0.294), live in urban area (adjusted β= 0.116, 95 % CI: 0.023, 0.347), knowledge (adjusted β= 0.42, 95 % CI: 0.301, 0.567) were statistically significant associated factors with the attitude of women toward cervical cancer screening. Conclusionsand recommendation: The study highlights a lack of awareness of cervical cancer screening, highlighting the need for improved routine practices, education campaigns, and treatment provision.

The effect of birth memory, recall level, and related factors on breastfeeding attitude of mothers in the postpartum period: a prospective study

This study was conducted to examine the effect of birth memory, recall level, and related factors on postpartum mothers’ breastfeeding attitudes. This is a correlational prospective study. The study was conducted in the postpartum clinic of a city hospital in a province located in the Central Anatolia Region of Turkey. The study included a total of 248 mothers in the early postpartum period. Data were obtained via a Personal Information Form, a Labor Monitoring Form, the Birth Memories and Recall Questionnaire (BirthMARQ), the Birth Satisfaction Scale (BSS), and the Iowa Infant Feeding Attitude Scale (IOWA). A positive correlation was found between mothers’ level of birth memory and recall and breastfeeding attitude on postpartum day 1, month 1, and month 3. In the regression analysis, emotional memory and coherence and reliving, which are the sub-dimensions of the birth memory and recall scale affecting breastfeeding attitude, were found to be significant associated risk factors for the 1st postpartum day, consistency and reliving for the 1st month, and birth memory and recall for the 3rd month. No relationship was found between mothers’ breastfeeding attitude and birth satisfaction on postpartum day 1, month 1, and month 3. Positive birth memory and recall positively affected mothers’ breastfeeding attitude. No relationship was found between mothers’ labor satisfaction and breastfeeding attitude. Supporting women for the formation of positive birth memory and recall for the labor process may positively improve breastfeeding attitudes of mothers in the postpartum period.