Simple Logistic Regression Analysis Research Articles

The effect of induced fetal demise on induction to expulsion interval during later medication abortion: A retrospective cohort

ObjectivesTo investigate the effect of induced fetal demise on the induction to expulsion interval during later trimester medication abortion. Study designThis retrospective cohort was conducted at St. Paul’s Hospital Millennium Medical College, Ethiopia. Later medication abortion cases that had induced fetal demise were compared to matching cases with no induced fetal demise. Data were collected by reviewing maternal charts and analyzed using SPSS version 23. Simple descriptive analysis, χ2 test, and multiple logistic regression analysis were used as appropriate. Odds ratio, 95% CI, and p-value<0.05 were used to present the significance of the findings. ResultsA total of 208 patient charts were analyzed. Seventy-nine patients were provided with intra-amniotic digoxin, 37 patients were provided with intracardiac lidocaine, and 92 had no induced demise. The mean induction to expulsion interval was 17.8 hours in the intra-amniotic digoxin group, which is not statistically different than 19.3 hours in the intracardiac lidocaine and 18.5 hours in the group without induced fetal demise (p-value = 0.61). Expulsion rate after 24 hours was not statistically different among the three groups (5.1% in the digoxin group vs 10.6% intracardiac lidocaine group vs 7.8% in the no induced fetal demise group, p-value = 0.82). Multivariate regression analysis demonstrated that inducing fetal demise was not associated with successful expulsion at<24 hours (adjusted odds ratio [AOR] = 0.19, 95% CI, 0.03–1.29 and AOR = 0.62, 95% CI, 0.11–3.48, for digoxin and lidocaine, respectively) from induction. ConclusionsIn this study, inducing fetal demise using digoxin or lidocaine prior to later medication abortion was not associated with a reduction in the induction to expulsion interval. ImplicationsDuring later medication abortion with mifepristone and misoprostol, inducing fetal demise may not be associated with a change in the length of the procedure. Induced fetal demise may be required for other reasons.

Association of 25(OH)-Vitamin D and metabolic factors with colorectal polyps.

Studies have revealed the association of vitamin D with specific types of cancer development, however, its correlation with colorectal polyps (CRPs) remains unverified. Our study aimed to investigate the relationship between vitamin D levels, metabolic factors, and CRPs. A cross-sectional study from 2017 to 2019 involving 1306 participants was conducted to investigate the association among vitamin D levels, metabolic factors, uric acid and CRPs in Taiwan. CRPs diagnoses were determined via colonoscopies conducted by experienced gastrointestinal physicians, and biopsied polyps were inspected under a microscope by experienced pathologists. We employed both simple and multiple logistic regression analyses to identify significant factors associated with CRPs and adenomatous polyps, respectively. Our result showed that the prevalence of 25(OH)-vitamin D deficiency (≦ 20 ng/mL) and CRPs was 21.21% and 40.89%, respectively. Multiple logistic regression revealed that the risk of CRPs increased with old age, male sex, hyperglycemia, high triglyceride levels, and low 25(OH)D levels after adjustment for other factors. Besides, low 25(OH)D levels were significantly associated with CRPs risk in women, whereas elevated blood pressure was associated with CRPs risk in men. 25(OH)D Deficiency was revealed to be significantly associated with risk of CRPs in adults over 50 years old. Compared to nonadenomatous polyps, older age, higher 25(OH) vitamin D and higher uric acid levels were at increased risk for adenomatous polyps. Our study revealed that vitamin D deficiency was significantly associated with the risk of CRPs, especially in adults over 50 years old and women. We should therefore be concerned about the CRP risk of vitamin D deficiency and metabolic syndrome (especially hyperglycemia, elevated blood pressure in men, and high triglyceride levels) in this population.

Association of serum periostin levels with asthma control status and severity in children

Objectives Periostin is a promising indicator in the pathogenesis of T-helper type-2 allergic reactions. This study aimed to identify the relationship between serum periostin levels and asthma control in children. Procedure In this study, 90 children were recruited and grouped as follows: 30 children in a control group (group I), and another group comprising 60 children with physician-diagnosed asthma (group II). The control status and severity of asthma in patients were assessed in accordance with the recent Global Initiative for Asthma guidelines. Serum periostin concentrations were examined in all enrolled patients using an enzyme-linked immunosorbent assay kit. Results The median (interquartile range) periostin levels of asthmatic children were substantially higher than those of healthy children [23 (13.1, 48) vs. 15 (10.5, 24); P = 0.015]. Based on a simple logistic regression analysis, serum periostin concentrations strongly correlated with asthma (odds ratio = 1.037; confidence interval = 1.008–1.066; P = 0.012). In a receiver operator characteristic curve analysis, the area under the curve for serum periostin was 0.984, with 100% sensitivity and 95.35% specificity in detecting uncontrolled asthma. Conclusion Serum periostin levels were shown to be a helpful biomarker for assessing childhood asthma control in children.

Knowledge, attitude and practices study of acaricide usage and tick control in South Omo Zone pastoral areas, South-Western Ethiopia

Although acaricide chemotherapy is widely used to control tick infestation in Ethiopia, its effectiveness is uncertain due to misusage by herdsmen. Currently, there is no study being conducted in the South Omo Zone of Ethiopia which shows the knowledge, attitude, and practice (KAP) and associated factors of acaricide usage by herdsmen. Therefore, this study was conducted to assess KAP of 120 (83 male and 37 female) pastoralist and agro-pastoralist of Bena-Tsemay district through structured questionnaire survey. Accordingly, Ivermectin was the most preferred acaricide by majority (62.5%) of the herdsmen. Half (50%) of the herdsmen confessed that price of acaricide is the defining variable for acaricide preference in their location where 60.83% of them obtain acaricides from private drug shops. Majority (60%) of the respondents said that they obtain information about acaricide usage from drug sellers in the vet drug shops. According to 72.50% of the respondents, acaricide application/injection on the infested herd was conducted by the herdsmen. A 95.83% of our interviewee revealed that there was no training or awareness creation being given on how to inject or apply acaricide on tick infested animals. Moreover, all responders (100%) confessed that they didn't have a practice of weighing animals and measuring acaricide dosage prior to injection/application. The incidence of acaricide poisoning on animal and personnel was reported by 19.17% and 22.5% of respondents, respectively. Simple logistic regression analysis revealed that gender (OR = 5.09, OR 95% CI = 2.30–11.72), practice of acaricide rotation (OR = 3.22, OR 95% CI = 1.41–7.64) and personnel preference for acaricide application (OR = 2.66, OR 95% CI = 1.18–6.15) were significantly (P < 0.05) associated with the knowledge score of the respondents. On the other hand, respondent's attitude score was significantly (P < 0.05) associated with their acaricide rotation practice (OR = 3.20, OR 95% CI = 1.39–7.53) and personnel preference for acaricide application (OR = 6.61, OR 95% CI = 2.78–16.93). Similarly, practice of acaricide rotation (OR = 5.31, OR 95% CI = 2.26–12.96) and personnel preference for acaricide application (OR = 7.21, OR 95% CI = 3.03–17.99) were significantly linked with the practice score of the respondents towards acaricide usage. In conclusion, ticks are the major challenge in the study area despite widespread usage of acaricides. Because of extensive misusage of available acaricides, awareness creation should be applied to narrow KAP gaps and to conserve the efficacy of these chemicals. Furthermore, acaricide efficacy investigation (in vitro and in vivo) should be conducted to know the status of commonly used acaricides in the area.

Authoritarian Parenting and Bullying Behavior in Adolescents in Bali

Introduction: Bullying in adolescents harms all parties involved, the victims, perpetrators, bystanders present during the bullying event, and even the institution or schools. One important factor related to bullying among adolescents is parenting style.&#x0D; Methods: This study was a survey study involving the population of adolescents in Bali. A total of 783 eligible students recruited by consecutive sampling technique were participated in the study. Data was collected using a Google form questionnaire that was distributed through a Whatsapp group. Data were analyzed using the simple logistic regression analysis to discover the relationship between authoritarian parenting style and bullying behavior among adolescents.&#x0D; Results: Findings revealed that adolescents with authoritarian parenting styles posed a risk of being bullies by 3.87 higher than adolescents who received permissive and democratic parenting styles (95% CI:1.75 – 8.57) with a significance value of 0.001.&#x0D; Conclusion: This study showed that adolescents with authoritarian parenting have a 3.87 times higher risk of becoming bullies than adolescents who received permissive and democratic parenting.

Prediction of common bile duct stones in acute cholecystitis patients at time of hospital admission

Background Early diagnosis of common bile duct stone (CBDS) is crucial since its presence affects surgical therapy and acute calculous cholecystitis (ACC) has a comparable clinical picture whether or not a CBDS is present. Aim At the time of hospital admission, we sought to discover predictors of CBD stones in acute cholecystitis (AC) patients. Methods Between January 2020 and December 2022, we chose 90 patients who had typical ACC and had previously visited the emergency room at Minia University Hospital in Egypt. The 90 AC patients were split into two groups: the 63 AC patients without CBD stones and the 27 AC patients with CBD stones. The data were obtained and compared between the two groups include gender, age, history of chronic calcular cholecystitis (CCC), white blood cells (WBC), liver function tests (LFT), and common bile duct (CBD) diameter. Results By using simple logistic regression analysis for prediction of CBD stones, old age &gt; 55 years, CBD diameter more than 6 mm and elevated liver functions including total bilirubin, direct bilirubin, serum glutamic-pyruvic transaminase (SGPT), serum glutamic-oxaloacetic transaminase (SGOT), alkaline phosphatase (ALP) and gamma-glutamyl transferase (GGT) was associated with CBD stones. By using multiple logistic regression analysis, only 2 variable showing significant association with CBD stones, including old age &gt; 55 years (P = 0.013, odds ratio 9.26, confidence interval 1.6–53.61) and direct bilirubin (P = 0.008, Odds ratio 55.67, confidence interval 2.89–1072.35). Conclusion Age, abnormal LFTs greater than twofold, and dilated CBD &gt;6 mm in AC patients increase the likelihood of concurrent CBDS. Knowing about these results might assist physicians develop clinical suspicions for an earlier diagnosis and improved management of CBDS.

Risk Factors for Intraoperative Hypothermia during Holmium Laser Enucleation of the Prostate

Introduction: Holmium laser enucleation of the prostate (HoLEP) is considered a size-independent gold standard for benign prostatic hyperplasia (BPH), and there is no upper limit of prostate weight that can be treated. Tissue retrieval can be time-consuming in cases of significant prostatic enlargement, which may lead to intraoperative hypothermia. As there are few studies on perioperative hypothermia in HoLEP, we conducted a retrospective study of patients who underwent HoLEP at our hospital. Methods: The data of 147 patients who underwent HoLEP at our hospital were retrospectively collected and analyzed for the occurrence of intraoperative hypothermia (temperature <36°C); age, body mass index (BMI), anesthesia method, body temperature, total fluid infusion, operation time, and irrigation fluid were the explanatory variables. Results: Intraoperative hypothermia was observed in 46 of 147 patients (31.3%). Simple logistic regression analysis showed that age (odds ratio [OR]: 1.07, 95% confidence interval [CI]: 1.01–1.13, p = 0.021), BMI (OR: 0.84, 95% CI: 0.72–0.96, p = 0.017), spinal anesthesia (OR: 4.92, 95% CI: 1.86–14.99, p = 0.002), and surgical time (OR: 1.04, 95% CI: 1.01–1.06, p = 0.006) were predictors of hypothermia. The decrease in body temperature was more pronounced with longer-duration surgery and reached 0.58°C at 180 min. Conclusion: General anesthesia, instead of spinal anesthesia, is recommended in high-risk patients with advanced age or low BMI to avoid intraoperative hypothermia during HoLEP. Two-stage morcellation may be considered for large adenomas, when a prolonged operative time and hypothermia are anticipated.

The effectiveness of penile curvature treatment by cavernous body rotation and plication of the tunica albuginea

BackgroundThere are several approaches to the surgical treatment of the penile curvature conditionally divided into three large groups: tunica albuginea plication (TAP), corpus cavernosum rotation (CR), and transplantation of various materials. The study aims to compare the effectiveness of TAP and CR techniques in the treatment of penile curvature. There was a prospective randomized study of the effectiveness of surgical treatment of patients with an established diagnosis of the penile curvature from 2017 to 2020 in Irkutsk, Russian Federation. The final analysis of the results included 22 cases.ResultsThe analysis of the comparative intergroup effectiveness of the treatment performed based on the criteria established in the study showed good treatment results in 8 (88.8%) patients in the CR group and 9 (69.2%) patients in the TAP group (p = 0.577). The other patients obtained satisfactory results. There were no negative outcomes. Simple logistic regression analysis showed that the preoperative flexion angle > 60 degrees (OR 2.7; 95% CI 0.12; 5.28; p = 0.040) was significant in predicting the complaints of penile shortening during TAP. Both methods are safe, effective, and bring minimal risk of complications.ConclusionThus, the effectiveness of both treatment methods is comparable. However, TAP surgery is not recommended for patients with an initial curvature of more than 60 degrees.

Factors associated with spinal instability in low back lumbar diseases with leg pain: Analysis of sagittal translation and segmental angulation.

Determining the association between radiographic spinal instability assessment and lower back lumbar diseases with lower limb symptoms can contribute to evidence-based assessment and treatment in clinical practice and rehabilitation. Therefore, radiological evidence of lumbar spine instability assessment, such as sagittal translation (ST) and segmental angulation (SA), is clinically important. To identify factors associated with the assessment of spinal instability in lumbar disc herniation with leg pain and discogenic low back pain using ST and SA. We examined 112 patients with lumbar disc herniation with leg pain and 116 with discogenic low back pain at our clinic from 2016 to 2021. Data on age, gender, sports activities, and occupation were collected from medical records. Additionally, ST and SA of L4 and L5 during maximum trunk flexion and extension were measured using radiography. Simple and multiple logistic regression analyses were used for statistical analysis. Simple logistic regression analysis showed that ST and SA (odds ratio [OR]: 1.11; 95% confidence interval [CI]: 1.03-1.19) were associated with lumbar disc herniation. Multiple logistic regression analysis showed that only ST was associated with lumbar disc herniation (OR: 2.29; 95% CI: 1.78-3.00). Multiple logistic regression analysis showed that ST was associated with lumbar disc herniation with leg pain and had a stronger association than SA.

Risk Factors for Ambulatory Surgery Conversion to Extended Stay Among Patients Undergoing One- or Two-Level Posterior Lumbar Decompression.

A retrospective observational study. To investigate the factors associated with the conversion of patient status from Ambulatory surgery (AMS) to observation service (OS) (fewer than 48 hours) or Inpatient (greater than 48 hours). AMS is becoming increasingly common in the U.S. because it is associated with a similar quality of care compared to inpatient surgery, significant costs reduction, and patients' desire to recuperate at home. However, there are instances when AMS patients may be subjected to extended hospital stays. Unanticipated extension of hospitalization stays can be a great burden not only to patients, but to medical providers and insurance companies alike. Data from 1,096 patients underwent one- or two-level lumbar decompression AMS at an in-hospital, outpatient surgical facility between January 1, 2019 to March 16, 2020 were collected. Patients were categorized in three groups based on length of stay: 1) AMS, 2) OS, or 3) Inpatient. Demographics, comorbidities, surgical information, and administrative information were collected. Simple and multivariable logistic regression analyses were conducted comparing AMS patients and OS/Inpatient as well as OS and Inpatients. Of the 1,096 patients, 641 (58%) patients were converted to either OS (n=486) or Inpatient (n=155). The multivariable analysis demonstrated that age (>80y old), high ASA grade, history of sleep apnea, drain use, high estimated blood loss, long operation, late operation start time, and a high pain score were considered independent risk factors for AMS conversion to OS/Inpatient. The risk factors for OS conversion to Inpatient were an ASA Class 3 or higher, CAD, DM, hypothyroidism, steroid use, drain use, dural tear, and laminectomy. Several surgical factors along with patient specific factors were significantly associated with AMS conversion. Addressing modifiable surgical factors might reduce the AMS conversion rate and be beneficial to patients and facilities.

Intentional paediatric poisoning presentations to emergency departments during the COVID-19 pandemic.

To characterise paediatric poisoning presentations to EDs and determine if the advent of the COVID-19 pandemic was associated with increased intentional paediatric poisoning presentations. We performed a retrospective analysis of paediatric poisoning presentations to three EDs (two regional and one metropolitan). Simple and multiple logistic regression analysis were performed to determine the association between COVID-19 and intentional poisoning events. In addition, we calculated the frequency with which patients reported various psychosocial risk factors as being an implicating factor in engaging in an intentional poisoning event. A total of 860 poisoning events met inclusion criteria during the study period (January 2018-October 2021), with 501 being intentional, and 359 unintentional. There was an increased proportion of intentional poisoning presentations during the COVID-19 pandemic (261 intentional and 218 unintentional in the pre-COVID-19 period vs 241 intentional and 140 unintentional during the COVID-19 period). In addition, we found a statistically significant association between intentional poisoning presentations and an initial COVID-19 lockdown (adjusted odds ratio 26.32, P < 0.05). 'The COVID-19 lockdown' or 'COVID-19' was reported to be implicating factor for psychological stress in patients who presented with intentional poisonings during the COVID-19 pandemic. Intentional paediatric poisoning presentations increased during the COVID-19 pandemic in our study population. These results may support an emerging body of evidence that the psychological strain of COVID-19 disproportionately impacts adolescent females.

Relation between adenomyosis and elastographic characteristics of the cervix.

Is there a possible etiologic link between cervical stiffness and adenomyosis? Women with adenomyosis have a stiffer internal cervical os than those without adenomyosis. An increased myometrial contractility during menses, leading to breaches in the endometrial basal lamina and subsequent infiltration of endometrial cells into the myometrium, has been proposed as a possible pathogenic mechanism for adenomyosis. Intense menstrual pain has already been shown to be associated with an increased stiffness, at elastography, of the internal cervical os. A cross-sectional study on 275 women was performed between 1 February and 31 July 2022. Among the participants, 103 were and 172 women were not affected by adenomyosis as evaluated by ultrasonography. General and clinical characteristics of the patients were collected. Strain elastography was used to document tissue stiffness at different regions of interest of the cervix, i.e. the internal cervical os, the middle cervical canal, the anterior and the posterior cervical compartment. Tissue stiffness was expressed as a colour score from 0.1 = blue/violet (high stiffness) to 3.0 = red (low stiffness). Simple and multiple logistic regression analyses were used to evaluate the relation between the presence of adenomyosis, as the dependent variable, and independent factors. Women with adenomyosis had a higher prevalence (P = 0.0001) and intensity (P = 0.0001) of pain during menses, between menses and at intercourse compared to control. The internal cervical os colour score was lower (higher stiffness) in women with adenomyosis (0.55 ± 0.29 versus 0.67 ± 0.26; P = 0.001) and the middle cervical canal/internal cervical os colour score ratio was greater (3.32 ± 4.36 versus 2.59 ± 4.99; P = 0.008), compared to controls. Upon logistic regression modelling (R2 = 0.077), the internal cervical os stiffness was an independent factor related to adenomyosis (odds ratio (OR) 0.220, 95% CI 0.077, 0.627; P = 0.005) along with age (P = 0.005) and the use of gonadal steroid therapies (P = 0.002). We obtained the same results using a different logistic regression model (R2 = 0.069), by substituting the internal cervical os stiffness with the ratio of the middle cervical canal/internal cervical os stiffness (OR 1.157, 95% CI 1.024, 1.309; P = 0.019). Women did not undergo surgery therefore we have no histological confirmation of the adenomyosis diagnosis. Strain elastography is a semiquantitative analysis and can be conditioned by the force applied by the operator during the analysis. The data were obtained mainly in White women in a single centre. To the best of our knowledge, this is the first study indicating that women with adenomyosis have an increased stiffness of the internal cervical os. The results indicate that a stiff internal cervical os, as determined by elastography, is a possible contributor to the development of adenomyosis. These findings may have clinical significance and should prompt further investigation. None. N/A.

COVID-19 Pandemic Fatigue and Its Sociodemographic, Mental Health Status, and Perceived Causes: A Cross-Sectional Study Nearing the Transition to an Endemic Phase in Malaysia.

This study aimed to explore the socio-demographic characteristics, mental health status, and perceived causes of pandemic fatigue with COVID-19 pandemic fatigue among the general population of Malaysia. The data was collected online during the transition from the COVID-19 pandemic phase to the endemic phase in Malaysia from 1 to 30 April 2022. Sociodemographic data, Depression Anxiety Stress Scale-21 (DASS-21), perceived causes of pandemic fatigue, and the Fatigue Assessment Scale (FAS) were included in the survey. The chi-square test and a simple logistic regression analysis were used to identify predictors of pandemic fatigue. The completed survey (N = 775) included individuals aged 18 years or above [mean 31.98 (SD = 12.16)] from all states in Malaysia. Pandemic fatigue prevalence was 54.2%. Severe to extremely severe depression, anxiety, and stress symptoms were detected in 11.2%, 14.9%, and 9.1% of the participants, respectively. Younger age, non-Malay ethnicity, living alone, and higher income categories were significantly higher in the fatigued group. Higher DASS-21 scores on all domains were associated with higher FAS scores. Meanwhile, high scores for perceived tiredness from complying with the COVID-19 Standard Operating Procedure (SOP), perceived risk of infection from COVID-19, perceived hardship due to the pandemic, perceived public complacency during the pandemic, and perceived changes due to the pandemic were associated with a higher FAS score. This study provides valuable information for policymakers and mental health professionals worldwide on pandemic fatigue and its associated factors, including mental health status in Malaysia.

Outcome indicators of non-surgical therapy of peri-implantitis: a prospective case series analysis.

This study aims to identify patient and implant indicators influencing the non-surgical therapeutic outcomes of peri-implantitis at 6months of follow-up. This case series involved patients with at least one implant diagnosed with peri-implantitis according to the 2017 World Workshop criteria. Non-surgical therapy consisted of mechanical debridement of the peri-implant pockets combined with metronidazole 500mg 3 times a day for 7days. At baseline and at 6months, clinical and radiographic variables were collected to calculate treatment success (probing pocket depth reduction to 5mm without bleeding on probing or < 5mm irrespective of bleeding on probing at all implant sites, and lack of bone loss progression). The primary outcome was treatment success (%) at 6months. The influence of the patient and implant/prosthetic variables upon disease resolution was assessed through simple and multiple logistic regression analyses at patient and implant level, using generalized estimation equations models. A total of 74 patients and 107 implants were analyzed at 6months. Disease resolution was established in 25.7% of the patients and 24.1% of the implants. Patients with stage IV and grade C periodontitis, inadequate oral hygiene at baseline, and wide diameter (≥ 4.5mm) presented significantly greater treatment failure, whereas smokers and former smokers demonstrated a tendency toward failure. At 6months, there was a significant decrease in probing pocket depth and bleeding on probing of 1.08 ± 1.06mm and 14%, respectively. Radiographically, a significant gain in marginal bone level of 0.43 ± 0.56mm was observed. Disease resolution after non-surgical treatment of peri-implantitis is negatively influenced by the loss of support of the adjacent periodontium, poor baseline oral hygiene, and wide diameter implants (≥ 4.5mm). This study helps to discriminate the clinical situations in which non-surgical treatment is less likely to achieve treatment success at short term.

Vaccination status and knowledge of CPR do not affect medical students' decision to perform BLS during the COVID-19 pandemic

Abstract Funding Acknowledgements Type of funding sources: None. Introduction To address the risks of transmission by COVID-19, various recommendations been released by medical societies, which include strongly advocating for the use of personal protective equipment. In addition, hands-only cardiopulmonary resuscitation (CPR) has also been promoted among cardiac arrest victims. Some studies which evaluated healthcare practitioners’ attitudes towards CPR during the pandemic showed negative attitudes in responding to those who have unknown COVID-19 status citing safety as the primary reason. At present, there is no study which evaluates the attitudes of medical students towards Basic Life Support (BLS) during the pandemic. Purpose The study aimed to determine the factors associated with willingness of medical students to perform basic life support in out-of-hospital cardiac arrest during the COVID-19 pandemic. Methods This is a cross-sectional study using online surveys. We performed face validation and pilot study on 39 medical students. The main survey was disseminated in Metro Manila schools wherein 349 medical students participated. Questions included demographic data, prior BLS training, and vaccination status, evaluated knowledge of CPR, and determined their attitudes on CPR during the pandemic. Results Results showed that 338 (97%) were willing to do CPR during the pandemic. Majority are fully vaccinated (99%) and are BLS-trained (75%). The median total knowledge score was 7 out of 10. Of all participants, 37 (11%) had a perfect score. Most (79%) had a passing mark. Majority (61%) claimed that a victim’s vaccination status does not play a role in deciding to perform CPR. Among the unwilling, 55% factored in a victim’s vaccination status. Most who agreed to perform CPR will do so if they are provided with adequate protection (55%). Simple and multiple logistic regression analyses showed that students who will do CPR on a patient who is not fully vaccinated or has unknown vaccination status have about 5 times higher odds of having the will to perform BLS during the pandemic. It also found that there is no correlation between knowledge, vaccination status, and prior training with choosing to perform BLS during the pandemic. This means that if a student is willing to do CPR on a victim wherein chances of contracting COVID-19 infection are higher, then their likelihood of performing BLS regardless of victim status, during the pandemic is five times more likely. Conclusion Most Filipino medical students are willing to perform BLS during the pandemic and in spite of risks of COVID-19 transmission. Their adequate knowledge, full vaccination status, or prior training did not influence their decision. In a pandemic situation, the students’ willingness to perform CPR among those with unknown COVID-19 status influences their decision to perform BLS in general.

Susceptibility to smoking and determinants among never-smoking high school students in Thailand.

To prevent youth from becoming smokers, it is essential to understand factors contributing to them becoming susceptible to smoking. The aim of this study was thus to estimate the prevalence of smoking susceptibility among neversmoking youth in Thailand and to identify determinants associated with such behavior. Cross-sectional data for 4572 eighth-grade students (aged 13-15 years) from 120 secondary schools were obtained from a classroom-based survey using a self-administered questionnaire. Using data from never-smoking students (n=3180), simple and multiple logistic regression analyses were performed to identify factors associated with smoking susceptibility. Frequencies and proportions for descriptive statistics are reported along with adjusted odds ratios and 95% confidence intervals for logistic regression models. A total of 16.4% of Thai never-smoking youth were susceptible to smoking. Several variables of interest were identified in multivariable analysis as significantly associated with increased susceptibility to smoking: being male (AOR=3.16; 95% CI: 25.4-3.92), having a positive attitude toward smoking - agreeing that smoking displays maturity (AOR=1.49; 95% CI: 1.07-2.09), the perception that smoking helps relieve stress (AOR=1.57; 95% CI: 1.14-2.15), the presence of current smoking peers (AOR=2.04; 95% CI: 1.57-2.66), exposure to secondhand smoking in public (AOR=1.51; 95% CI: 1.17-1.94), exposure to online cigarette and smoking-related advertising occasionally (AOR=1.98; 95% CI: 1.49-2.65), attendance at schools where there are sometimes anti-smoking education activities (AOR=1.57; 95% CI: 1.18-2.07); as well as exposure to anti-tobacco messages rarely (AOR=1.40; 95% CI: 1.05-1.87), occasionally (AOR=1.48; 95% CI: 1.12-1.96) and infrequently (AOR=1.41; 95% CI : 1.07-1.87). Approximately one in six Thai never-smoking youth was found to be susceptible to smoking. Findings suggest it should be useful to supplement relevant tobacco prevention and control efforts by considering such interpersonal and socio-environmental determinants, among vulnerable people to smoke.

Can the effectiveness of tonsillectomy for PFAPA syndrome be predicted based on clinical factors.

To evaluate the clinical factors associated with the outcome of tonsillectomy in children with periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome, thereby clarifying who would most likely benefit from that surgery. This was a case-control study of 53 PFAPA patients who underwent tonsillectomy and were divided into a complete-resolution group and a postoperative-fever group. Logistic regression analyses were performed using 17 clinical factors as variables to identify factors associated with the surgical outcome. Hierarchical cluster analysis was also performed to evaluate for relationships between phenotypes and surgical outcomes. Thirty-nine (73.6%) patients had complete resolution after tonsillectomy. In simple logistic regression analysis, the surgical outcome showed significant positive trends with late-onset (odds ratio [OR] 7.1, P=0.02) and presence of headache (OR 6.5, P=0.01). In stepwise multiple logistic regression analysis adjusted for age at onset, presence of headache was significantly associated with complete resolution (OR 6.5, P=0.01). The complete resolution rates for each combination of headache status and age at onset were as follows: presence of headache/age at onset ≥36 months, 100% (14/14); presence of headache/age at onset <36 months, 76.9% (10/13); absence of headache/age at onset ≥36 months, 75.0% (6/8); and absence of headache/age at onset <36 months, 43.8% (7/16). In hierarchical cluster analysis, complete resolution, age at onset, and headache were in the same cluster. PFAPA patients with headache and late onset responded well to tonsillectomy. The mechanisms underlying this association may warrant further investigation.

Relationships between Exclusive Breastfeeding, and History of Illness, and Stunting in Children Under Five

Background: Exclusive breastfeeding can affect a child's immune system against infectious diseases and malnutrition. Children under five who experience repeated infectious diseases and malnutrition will have the opportunity to experience stunting problems. Riskesdas (2018) shows that the prevalence of stunting under five in the Province of East Nusa Tenggara (NTT) is higher (42.6%) than the average prevalence of stunting in Indonesia (30.8%). The results of the initial survey found that the coverage of exclusive breastfeeding was very low and the morbidity rate for children under five was still high in the Working Area of the Kokar Health Center, Alor Barat Laut District, Alor Regency, NTT. Subjects and Method: A case control study conducted in Adang Village, the work area of the Kokar Health Center, Alor Barat Laut District, Alor Regency in October-November 2021. The size of the study sample was 132 toddlers with 66 case samples and 66 control samples taken by simple random sampling. The dependent variable was the incidence of stunting. The independent variables were the history of exclusive breastfeeding and the history of illness. The analysis used is simple logistic regression analysis and followed by Odd Ratio (OR) analysis. Results: The history of exclusive breastfeeding (OR=4.57; CI95%= 1.58 to 13.21; p= 0.003) and the history of illness (OR=5.33; CI95%= 2.53 to 11.24; p &lt;0.001) were associated with the incidence of stunting. Further test results showed that every child under five who had a history of bad exclusive breastfeeding had a 4.5 times greater risk of experiencing stunting and a child under five who had a history of illness more often had a 5.3 times greater risk of experiencing stunting. Conclusion: The incidence of stunting in the Northwest Alor District, Alor Regency, NTT Province is influenced by a history of exclusive breastfeeding and a history of infectious diseases or illness. Keywords: history of exclusive breastfeeding, history of illness, incidence of stunting, infectious diseases, nutritional intake Correspondence: Intje Picauly, Department of Nutrition, Faculty of Public Health, Universitas Nusa Cendana, Kupang City, East Nusa Tenggara, Indonesia, Jl. Adi Sucipto Penfui, Penfui, Maulafa, Kupang, Nusa Tenggara Timur. Mobile: +62822-3714-5517. Email: intjepicauly@staf.undana.ac.id. Journal of Maternal and Child Health (2023), 08(01): 116-124 https://doi.org/10.26911/thejmch.2023.08.01.11

Insights Into Metformin XR Pharmacotherapy Knowledge Among Community Pharmacists: A Cross-Sectional Study.

There is a little knowledge on the extent to which healthcare providers understand and accept the professional recommendations and appropriate dosing strategy regarding metformin XR. To evaluate UAE community pharmacists' knowledge, attitude, and practices (KAP) concerning metformin XR. This is a cross-sectional research study conducted amongst licensed community pharmacists. The survey took place via a questionnaire and physical interviews were held. The survey used in this study included questions on demographics and questions on the participants' attitudes, knowledge and practices concerning metformin XR. The factors influencing KAP regarding metformin XR were examined via simple logistic regression analysis. Threehundred fifty-three (n = 353) participants were recruited in the study. Independent pharmacies constituted 57.5% of this study sample and 42.5% were chain pharmacies. The average knowledge score about metformin XR tablets was 42.5% with a confidence interval (CI) of 95% [37.3%, 47.4]. Better knowledge scores on metformin XR tablets was observed in respondents aged ⩾40 years (OR 2.97, 95% CI 1.63-5.4), having greater than 10 years in terms of experience (OR 2.28; 95% CI 1.25-4.16) and pharmacist graduated from Regional or international universities (OR 2.08; 95% CI 1.34-3.24). About 78% (n = 275) of the participants believed that metformin XR tablets have better efficacy and 63.2% (n = 233) indicated that metformin IR was associated with greater adverse effects. This study demonstrated a distinct gap in knowledge, attitude and practice pertaining to metformin XR among community pharmacists in the UAE. The community pharmacists need to enhance their practice by receiving accurate and reliable data to support their decision-making on the prescribing of metformin XR. The implementation of novel guidelines and evidence dissemination strategies may help bridge this gap.

Subcutaneos Implantable Cardioverter: Defibrillator: Is the Conventional Pre-Implant Screening Enough to Assess Eligibility?

Aims: The subcutaneous implantable cardioverter-defibrillator (S-ICD) requires screening prior to implantation. Surface anatomical landmarks (SAL) guide the screening. The heart silhouette shows variations, therefore, these landmarks may differ. We aimed to determine the concordance between SAL and fluoroscopy guided screening, and analyze discordance predicting factors. Methods: We performed a conventional SAL guided screening (CS) in left and right parasternal electrode position (LPP/RPP) to candidates for S-ICD. Subsequently, we performed a fluoroscopy guided screening (FGS) according to cardiac silhouette. Screenings in which at least the result of one sensing vector did not coincide were considered “discordant”. A comparison was done between discordant vs. concordant cases. A simple binary logistic regression analysis was performed to assess the risk of being discordant individually for each of the variables. Results: The results of CS and FGS were compared in 110 patients (220 comparisons: 110 LPP and 110 RPP). 90 (40.91%) were discordant in at least one sensing vector (46 in LPP and 44 in RPP). In 3 patients (2.73%) the indication of which type of defibrillator was implanted changed according to the FGS. There were no significant differences between the discordant and concordant screening patients. Conclusion: There is a level of discordance between CS and FGS. There were no analyzed factors that were able to predict discordance between these two screening methods. It might be reasonable to perform FGS before implant.