STATA Statistical Software Research Articles

Clinico-Epidemiological Profile and Outcome of Acute Poisoning Patients admitted to Intensive Care Unit in A Tertiary Level Private Hospital in Bangladesh

Background: Acute poisoning is a prevalent health issue necessitating Intensive Care Unit (ICU) admission in developing countries. This study evaluates the socio-demographic characteristics, clinical parameters, and outcomes of acute poisoning patients admitted to the ICU in a tertiary level private hospital in Bangladesh. Method: This retrospective cohort study was conducted at tertiary care private hospital in Narayanganj, Bangladesh. Data was collected from ICU medical records from January 2023 to April 2024, enrolling a total of 57 patients aged 18 years or more who presented with acute poisoning. Data analysis was performed using Stata (Statistical Software for Data Science) 17.0(p < 0.05) Results: Out of 57 patients, 52.63% were females, with mean age of 27.84 years. Suicidal intent accounted for 84.21% of cases, and the primary reasons for poisoning included marital (61.40%) and familial disharmony (15.79%). The predominant type of poisoning was due to sedatives (17.54%) followed by aluminium phosphide (14.04%), and stupefying agents (14.04%). Aluminium phosphide poisoning had a 100% fatality rate, while sedatives and several other agents had 100% recovery rate. Statistical analysis showed a significant association between the type of poison and the final outcome (χ2(15) = 38.7996, p = 0.001). Conclusion: The study highlights the prevalence of intentional poisoning among young adults, especially females, with sedatives, aluminium phosphide, and stupefying agents being the most common. The high mortality rate from aluminium phosphide underscores the need for strict regulations and public awareness to control access to these substances. Bangladesh Crit Care J September 2024; 12 (2): 89-95

Evaluating the impact of demographic characteristics on residential mortgage default risk: Evidence from Lebanon

Purpose: This study aims to examine the relationship between borrower's demographic characteristics and default risk in mortgage loans to help financial institutions develop more effective lending policies. Design/Methodology/Approach: Cross-sectional data were elicited from randomly selected 6743 individual accounts from Lebanese housing banks. This study applied the binary logistic and stepwise regression models to analyze the dataset using the Stata statistical software. Model diagnosis is performed using the Hosmer-Lemeshow goodness of fit test, likelihood ratio test, model accuracy classification table and statistically significant test-ROC curve. Findings: The findings revealed that there is a significant relationship between residential loan default risk and borrower’s marital status, nature of job occupation, job economic sector, job location and loan purpose. The performance of the binary logistic regression analysis demonstrates the overall percentage who is correctly classified is 91.61%. Conclusion: The log odds of default risk for widowed borrowers are about 90 percent higher than those of divorced borrowers and that of self-employed borrowers is about 54 percent higher than that of employed borrowers. Borrowers working in the banking and real estate sectors have lower default rates than borrowers working in other economic sectors. In addition, loans granted for renovation purposes have the lowest default rates compared to loans provided for purchase, under-construction and construction purposes. Practical Implications: The empirical results help financial institutions to have early warning signals in detecting financial distress and to differentiate between a high- and low-risk group of borrowers, helping in the development of tailored risk mitigation strategies and adjusting the lending criteria.

Determining the perceived risk of lung cancer and chronic obstructive pulmonary diseases (COPD) among hookah users in Iran.

Hookah consumption is harmful to human health and can cause various diseases. Developing lung cancer and other lung diseases are one of the health consequences of hookah consumption. Measuring the perceived risk for being diagnosed with these conditions among hookah users is necessary. Therefore, this study was conducted to determine the perceived risk of lung cancer and Chronic Obstructive Pulmonary Disease (COPD) in hookah users in Iran. This cross-sectional study was conducted with a descriptive-analytical approach on 340 hookah users between January-May 2023. These people were recruited through convenience sampling. The information on the perceived risk of participants was collected through a questionnaire on the perceived risk of lung cancer and COPD. Data were analyzed through descriptive tests and multiple linear regression tests. These analyses were performed using Stata statistical software version 17. The mean and standard deviation of the perceived risk for lung cancer was 8.41 ± 5.50 and for COPD was 8.51 ± 5.58 out of 20 possible scores. The results of multiple linear regression generally showed that the using other type of tobacco (β = 3.14, p < 0.0001), 2 or more use of hookah in past month (β=-3.41, p = 0.025), unskilled workers (β = 1.79, p = 0.017), married smokers (β=-1.31, p = 0.026), negative attitude toward hookah (β = 0.46, p < 0.0001) were the predictive variables regarding to lung cancer perceived risk. In line with COPD the using other type of tobacco (β = 3.47, p < 0.0001), once a month use of hookah in past month(β=-3.74, p = 0.041) and twice or more use of hookah in past month (β=-4.82, p = 0.008), smokers in contemplation stage (β = 3.91, p < 0.0001), female smokers (β = 3.08, p < 0.0001), unskilled workers (β = 2.42, p = 0.007), negative attitude toward hookah (β = 0.46, p < 0.0001) were the predictive variables to COPD perceived risk. In general, the perceived risk of developing lung cancer and COPD among hookah users was low. Therefore, it is necessary to provide widespread information about the potential harm of hookah in causing lung cancer and COPD, at the community level.

The Impact of Responsible Investment on the Banking Performance in the small and medium Banks

The purpose of the study is to study the impact of responsible investment on the banking performance in the small and medium banks. This study used the secondary data by using 129 banks from 2018 t0 2023 and the OLS are utilised as a regression. The study utilized the statistical software STATA to test the relation among the variables. We found a positive and significant correlation between the responsible investments on the banking performance. Finally, appropriate recommendations were presented to improve the quality responsible investment on the banking performance in Asian Banks. The study concluded that the impact of investment on the performance of banks utilizing the statistical analysis program shows that there is a statistically important influence of investment on the bank performance of the financial institution. Hence, it is the responsibility of the institution to distinguish among the several investment options, with the goal of starting an investment construction in the institution that is composed and in accordance with the economic limits, and capable of enhancing its goals. In light of the findings extended, the study obtainable a number of references, the most significant of which is the essential for banks in specific and firms in overall to strengthen investment processes in the field of information technology payable to its significance in enhancing services and raising bank performance. The findings of the study will support decision-makers recognize the significance of investment part. The next are the most significant results. We find that the values of banks' investments are mostly from investments.

Association of first-line combination antiretroviral therapy with malaria among adult HIV-infected persons in Jos, Nigeria: a pilot cross sectional study

BackgroundMalaria and human immunodeficiency virus (HIV) infection coexist in significant numbers in some geographic areas including sub-Sahara Africa (SSA). HIV-infected patients are a World Health Organization (WHO) recognized high risk group for increased malaria morbidity. Majority of HIV-infected patients undertaking treatment in SSA are on WHO recognized first-line combination antiretroviral therapy (cART). Considering the immunity-enhancing capacity of antiretroviral therapies on people living with HIV, this study aimed to explore the association between first-line combination antiretroviral therapy (cART) with malaria parasitaemia and antigenaemia in adult HIV-infected persons and to determine the predictors of malaria antigenaemia in adult persons living with HIV.MethodsThe study was conducted at the AIDS Prevention Initiative in Nigeria (APIN) Centre, Jos University Teaching Hospital, Jos, Plateau State, from August 2018 to February 2019. Epi Info statistical tool was used to determine the sample size and power of the study. The study population consisted of three groups. The first group comprised first-line cART-experienced adult HIV-seropositive subjects, the second group comprised ARV-naïve HIV-seropositive adults and the third group comprised HIV-seronegative adults. For this pilot study, 60 persons were recruited into each group via convenience sampling. Malaria rapid diagnostic test (RDT) was performed according to manufacturer’s instruction for all the study participants using SD Bioline Malaria Ag P.f (HRP2/pLDH) (Standard Diagnostics, Hagal-Dong, Korea). All the study participants also had thick and thin blood film malaria microscopy. Data collected was processed and analyzed using the Stata statistical software version 15 (StataCorp, College Station, Texas). Chi square was used to test the association between malaria and first-line cART exposure. Univariate and multivariate analysis were also done to identify factors that were independently associated with malaria antigenaemia.ResultsA total of 180 persons participated in the study and involved 60 participants recruited in each of the three study groups. Overall, the predominant study participants were females (56.67%), traders (27.78%), secondary school leavers (43.33%) and urban dwellers (88.89%). Their mean age and standard deviation was 37.07 ± 11.53 years. Using malaria microscopy, the prevalence of malaria parasitaemia in ARV-naïve HIV-infected persons was 5% and 0% in the first-line cART-experienced HIV-infected persons as well as the HIV-negative persons. Malaria RDT result was positive in 7/60 (11.67%) of the first-line cART experienced HIV-infected participants, 6/60 (10%) of the ARV-naïve HIV-infected group and 1/60 (1.67%) of the HIV-negative group. Of the seven positive malaria RDT results in those on first-line cART, five persons were receiving zidovudine/lamivudine/nevirapine (AZT/3TC/NVP) while the remaining two were receiving tenofovir disoproxil fumarate/lamivudine/efavirenz (TDF/3TC/EFV), thus making an antigenaemia proportion of 16.67% and 6.67% respectively. Being an HIV-infected person on first-line cART (OR = 16.20, p = 0.04), having a headache (OR = 6.21, p = 0.03) and non-usage of window nets (OR = 3.74, p = 0.05) were found to be predictors of malaria antigenaemia.ConclusionMalaria parasite burden in HIV-infected persons on first-line cART is lower than that observed in ARV-naïve HIV-infected persons. Our study suggests that TDF/3TC/EFV may be associated with lower malaria antigenaemia when compared with AZT/3TC/NVP and can be considered an alternative first-line antiretroviral regimen in malaria-endemic regions.

The risk of thyroid cancer after hysterectomy and oophorectomy: a meta-analysis.

The purpose of this meta-analysis is to assess whether there is an association between hysterectomy and oophorectomy and risk of primary thyroid cancer. PubMed, Cochrane Library, Embase, and Web of Science were searched for eligible studies published from database inception to May 13, 2024, using medical subject headings (MeSH) and keywords. All statistical analyses were performed using Stata statistical software (version 14.0). If P > 0.1 and I2 ≤ 50%, a fixed-effects model was adopted. If I2 > 50% a random-effects model was adopted. The funnel plot and Egger's test were used to evaluate publication bias. A total of 11 studies explored the association between a history of hysterectomy, oophorectomy and the risk of thyroid cancer. The pooling analysis shows that a history of hysterectomy, oophorectomy is associated with an increased risk of thyroid cancer (HR = 1.597; 95% CI: 1.467-1.738; I2 = 57.1%, P = 0.01 < 0.1). In the subgroup analysis, a follow-up duration exceeding 20 years is linked to an elevated risk of thyroid cancer (HR = 1.772; 95% CI: 1.301-2.414; I² = 81.70%, P = 0.004 > 0.001). Hysterectomy combined with salpingo-oophorectomy is associated with a higher risk of thyroid cancer incidence (HR = 1.633; 95% CI: 1.449-1.841; I² = 51.10%, P = 0.069 > 0.001). Studies that balanced smoking, alcohol consumption, and history of thyroid disease demonstrated an association between hysterectomy and increased risk of thyroid disease (HR = 1.734; 95% CI: 1.591-1.891; I² = 31.30%, P = 0.225 > 0.001). Our meta-analysis reveals a heightened risk of primary thyroid cancer following hysterectomy and oophorectomy. These findings underscore the importance of considering potential cancer risks when determining surgical approaches and implementing preventive measures prior to these procedures.The meta-analysis was conducted in adherence to the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) (1). The protocol was pre-registered on the International Prospective Register of Systematic Reviews (PROSPERO) platform, with the registration number CRD42024546451. https://www.crd.york.ac.uk/PROSPERO/#recordDetails, identifier CRD42024546451.

Performance analysis of indicators in teaching hospitals after the Health Transformation Plan: a Case Study in Iran

BackgroundThis study aimed to examine the status of performance indicators in hospitals affiliated with Qazvin University of Medical Sciences (QUMS) before and after the implementation of the Health Transformation Plan (HTP).MethodsThis longitudinal descriptive-analytical study was conducted utilizing hospital data. The study collected data using a checklist that included both general characteristics of the participating hospitals and performance indicators such as “the number of outpatient visits,” “the number of paraclinical patients,” “the number of surgeries,” and “the number of inpatients” on a monthly basis for 2012–2019. The intervention examined in this study was the implementation of the HTP in May 2014. The data collected was analyzed using interrupted time series and STATA statistical software version 15.ResultsThe study examined seven hospitals affiliated with QUMS, including general, trauma, pediatric, gynecology, and psychiatry hospitals. The findings indicated a significant increase in outpatient visits, paraclinical patients, and inpatients in the first month after the intervention. Specifically, there was an increase of 1739 in the number of outpatient visits, an increase of 513 in the number of paraclinical patients, and an increase of 135 in the number of inpatients (p < 0.001).ConclusionThe HTP has improved patients’ access to medical services. It achieved this by reducing out-of-pocket payments for healthcare services and implementing programs such as developing clinics, improving the quality of visits, and retaining doctors in deprived areas. The reduction in out-of-pocket payments has been particularly beneficial for individuals who lack financial resources and previously faced barriers to accessing healthcare services.

Association between pregnancy intention and completion of newborn and infant continuum of care in Sub-Saharan Africa: systematic review and meta-analysis

BackgroundThe newborn and infant continuum of care such as essential newborn care, early initiation and exclusive breastfeeding, and immunisation are highly recommended for improving the quality of life and survival of infants. However, newborn and infant mortality remains high across Sub-Saharan African countries. While unintended pregnancies are associated with adverse newborn and infant health outcomes, there is inconclusive evidence on whether pregnancy intention influences newborn and infant continuum of care completion. Therefore, this review aimed to pool findings reported in the literature on the association between pregnancy intention and newborn and infant health care across the continuum of care in Sub-Saharan Africa.MethodsWe searched MEDLINE Complete, EMBASE, CINAHL Complete, and Global Health databases for studies potentially eligible for this systematic review and meta-analysis. Two researchers independently screened the identified articles by abstract and title, and then full-text using Covidence. We used the Newcastle–Ottawa Scale to assess the quality of the included studies. The Cochran’s Q test and I2 were executed to detect and quantify the presence of statistical heterogeneity in the studies. Meta-analysis was done for each outcome when more than one original study reported relevant data, using Stata statistical software version 18.ResultsEleven studies were included from a total of 235 articles identified by the search. The odds of completing essential newborn care (pooled odds ratio: 3.04, 95% CI: 1.56, 5.90), early initiation of breastfeeding (pooled odds ratio: 1.30, 95% CI: 1.13, 1.52), exclusive breastfeeding (pooled odds ratio: 2.21, 95% CI: 1.68, 2.89), and being fully immunised (pooled odds ratio: 2.73, 95% CI: 1.16, 6.40) were higher among infants born to women with intended pregnancies as compared to women with unintended pregnancies.ConclusionIntended pregnancy was positively associated with essential newborn care completion, early initiation and exclusive breastfeeding, and full immunisation of infants in SSA countries. Thus, policy-makers and stakeholders should strengthen the provision of quality family planning services to prevent unintended pregnancy. Furthermore, follow-up of women with unintended pregnancies is needed to increase women’s opportunity to access essential newborn health care services that further reduce the risk of newborn and infant morbidity and mortality.Systematic review registrationPROSPERO registration number CRD42023409148.

Patient satisfaction with quality of care at out-patient departments in selected health facilities in Kumasi, Ghana

BackgroundHealth care is an indispensable element for economic growth and development of individuals and nations. Healthcare service quality is associated with patient satisfaction, ensuring the safety and security of patients, reducing mortality and morbidity, and improving the quality of life. Patient satisfaction with health service is linked to increased utilization following contendness with healthcare received from health providers. There is an increasing public perception of poor quality of care among patients visiting public health facilities in Ghana which translates into service dissatisfaction. Meanwhile, patient dissatisfaction will more likely result in poor utilization, disregard for medical advice, and treatment non-adherence. The study was conducted to assess patients’ satisfaction with quality of care at the outpatient departments of selected health facilities in Kumasi, Ghana.MethodsAn institutional-based analytical cross-sectional study was conducted among patients (aged ≥ 18 years) visiting outpatient departments of selected health facilities in Kumasi from October - December, 2019. A systematic sampling technique was adopted to collect quantitative information from 385 respondents using a structured questionnaire. At 95% confidence interval and 5% alpha level, two-level logistic regression models were performed. Model I estimated the crude associations and the effect of covariates was accounted for in Model II. The results were presented in odds ratio with a corresponding 95% confidence interval. All analysis were performed using STATA statistical software version 16.0.ResultsOut of the 385 participants, 90.9% of the participants were satisfied with the services they received. Being married [AOR = 3.06, 95%CI = 1.07–8.74], agreeing that the facility is disability-friendly [AOR = 7.93, 95%CI = 2.07–14.43], facility has directional signs for navigation [AOR = 3.12, 95%=1.92–10.59] and the facility has comfortable and attractive waiting area [AOR = 10.02, 95%CI = 2.35–22.63] were associated with satisfaction with health service among patients. Spending more than 2 h at the health facility [AOR = 0.45, 95%CI = 0.04–0.93] and having perceived rude and irritating provider [AOR = 0.14, 95%CI = 0.04–0.51] had lower odds of satisfaction with health service received.ConclusionThere is a high patient satisfaction with services received at out-patient departments which is influenced by a multiplicity of factors; being married, and agreeing that the facility is disability-friendly, has directional signs for navigation, and the waiting area is comfortable and attractive. The study findings call for the need to develop and implement health delivery interventions and strategies (i.e. patient-centered interventions, disability-friendly facilities, and sustainability and improvement of quality service) to improve and sustain patient satisfaction levels with health care service. These strategies must be directed towards addressing inequalities in infrastructural development and inputs needed for healthcare delivery in the health system.

Prevalence of hypomineralized second primary molars and association with socioeconomic characteristics and dental caries in a Brazilian population of preschoolers: a cross-sectional study.

To analyze the prevalence of hypomineralized second primary molar (HSPM) and its association with socioeconomic characteristics and dental caries in a Brazilian population of preschoolers. 603 preschoolers, enrolled in public preschools in Itajaí (state of Santa Catarina, Brazil), took part in the study. To assess the participants' socio-economic characteristics, an original questionnaire was formulated and sent to the children's parents. The clinical evaluation was carried out by a calibrated examiner using the deft/DMFT index for dental caries and Ghanim et al. (Ghanim et al., Eur Arch Paediatr Dent, 2015) criteria for HSPM. The data were analyzed through Poisson regression, using STATA statistical software, and the association analyses were presented by prevalence ratios (PR). The prevalence of at least one HSPM-affected second molar was 24.5%. The prevalence of HSPM was associated to the city's geographical regions of the Educational hubs (p < 0.001). A significant association was found between dental caries and HSPM (p = 0.003; PR: 1.31; 95% CI 1.09-1.56). Children with HSPM were 31% more likely to experience dental caries than children without HSPM. Geographical regions of educational hubs were also significantly associated with HSPM (p < 0.001). None of the socioeconomic characteristics was associated with HSPM (p > 0.05). HSPM is a common developmental defect of enamel in children in our study. The HSPM distribution was associated with the city's geographic regions. Children with HSPM are more likely to experience dental caries. Socioeconomic characteristics were not associated with HSPM.

Difficulty with mobility among the aged in Ghana: Evidence from Wave 2 of the World Health Organization's Study on Global Ageing and Adult Health.

Globally, the population is rapidly ageing, stemming from a recent decline in mortality, and an increase in life expectancy. About 727 million people globally were aged ≥65 in 2020, and 1 in 6 people will be ≥65 years by 2050. About 7% of Ghana's population was over 60 years in 2010, and projected to be 12% by 2050. However, the aged are confronted with degenerative conditions that translate into difficulty with mobility. The study was conducted to investigate the difficulty with mobility among the aged in Ghana. The study utilised a cross-sectional dataset of the 2014/2015 (wave 2) Study on Global Ageing and Adult Health and included 1,856 participants aged ≥50 years. The survey command was applied to adjust for sampling biases and the design of the study. At 5% alpha level, a chi-square test of independence was conducted to determine the association between dependent and independent variables. At 95% confidence interval and 5% alpha level, three-level multilevel logistic regression models were performed. The fixed-effects were presented in odds ratio and the random effects were presented using the Intra-Class Correlation. All analysis were performed using STATA statistical software version 16.0. Out of the 1,856 participants, 40.3% had difficulty with mobility. Additionally, age (80 and above) [AOR = 3.05, 95%CI = 1.78-5.22], self-reported poor/bad health status [AOR = 2.39, 95%CI = 1.35-4.23], having severe/extreme difficulty performing household activities [AOR = 25.12, 95%CI = 11.49-44.91], experienced severe/extreme bodily pains [AOR = 4.56, 95%CI = 2.16-9.64], severe/extreme sleep problems [AOR = 4.15, 95%CI = 1.68-10.29], and participants with difficulty with sight/vision [AOR = 1.56, 95%CI = 1.16-2.10] had higher odds of difficulty with mobility. The aged in Ghana had relatively higher prevalence (40.3%) of difficulty with mobility which is influenced by demographics, health status, and degeneration associated with ageing. This highlights the need to provide social support and strengthen social capital for the aged in Ghana, especially those with difficulty with vision, experiencing bodily pains and had poor health status. Additionally, the Government and stakeholders should provide assistive devices for the aged and geriatric care including recreational fields and care homes to address the health and physical needs of the aged in Ghana.

The impact of internet usage preferences on labor income: Evidence from China.

The widespread application and iterative updating of computers and Internet communication technologies have not only increased productivity and enhanced intra- and inter-enterprise collaboration, but have also led to significant changes in the labor market and residents' labor income. In the digital era, accepting digital technology and possessing a certain degree of digital literacy have become the necessary abilities for people to survive and develop. However, the differences in digital literacy caused by individual differences will inevitably bring about a series of chain reactions. Therefore, it is necessary to study the subtle impact of Internet usage preference on residents' labor income in the context of digital transformation to promote digital equity. This study aims to empirically analyze micro-level survey data to reveal the impact of individual differences in internet usage preferences on their labor income. The findings provide theoretical references for government policy formulation and individual development. A function model was established to analyze the impact of individual internet usage preferences on labor income. Relevant data from the authoritative Chinese General Social Survey (CGSS2017) were selected, and empirical analyses for significance, heterogeneity, and robustness were conducted using the ZINB and CMP models in the Stata statistical software. (1) Higher Internet Usage Frequency (IUF) increases the likelihood of higher income. (2) Engaging in Online Social Networking (OSN) helps in accumulating social capital, leading to higher labor income. Meanwhile, participating in Online Entertainment (OE) relieves work and life stresses, thereby increasing labor income. Proficiency in Accessing Online Information (AOI) is associated with higher labor income, while frequent involvement in Online Business (OB) is correlated with higher personal income. Additionally, the Marginal utility of these internet usage preferences indicate that OB > AOI > OSN > OE. (3) Individual variations in physical, psychological, and social characteristics significantly influence the labor income effects of internet usage preferences. (4) There are substantial differences in the labor income effects of internet usage preferences between urban and rural areas and across different regions. (5) Education attainment has a positive mediating effect on the labour income effect of individual Internet use preferences, and enhancing residents' digital literacy has a positive effect on increasing their labour income and alleviating inequality in digital gains. (6) The popularity of Internet technology is the background that triggers an individual's Internet use, and the acceptance of a particular Internet technology is catalyzed by an individual's perception of the value and difficulty of mastering that technology; an individual's biased learning or proficiency in a particular Internet technology in order to gain higher competitiveness and value in the labour market is an important internal driving force.

A cross-sectional study on domestic violence among infertile women in western Iran

Background: To date, no study has examined domestic violence among infertile women in western Iran. Aims: This study aims to investigate the prevalence of domestic violence among infertile women in the region. Materials and Methods: A cross-sectional study was carried out at the infertility clinic in Hamadan. A total of 200 eligible infertile women, with a mean age of 31.48 ± 4.57 years, were recruited for the study. The Domestic Violence Questionnaire (DVQ) was administered to all participants. Data analysis was performed using Stata Statistical Software (version 17), with a significance level set at P ≤ 0.05. Results: This study included 200 infertile women with an average age of 31.48 ± 4.57 years. The mean duration of infertility was 1.9 ± 0.76 years. Regarding education, approximately 66% of the women and 69% of their spouses had completed high school or attained a diploma. Female-related causes accounted for 72.5% of infertility cases. Among the participants, 59.4% reported experiencing domestic violence. Emotional violence scored the highest percentage (67.5%), while sexual violence had the lowest percentage (43.63%). Statistical analysis revealed significant associations between age, spouse’s education level, frequency of sexual intercourse, and the level of violence experienced by women. Conclusion: The findings of this study reveal that 59.4% of women experienced various forms of domestic violence. Moreover, significant associations were observed between domestic violence and factors such as age, spouse’s education level, and frequency of sexual intercourse.

A Systematic Review and Meta-analysis of the Relationship between Statin Intake and Esophageal Cancer.

Esophageal cancer is a malignant tumor with a low survival rate. Statins, commonly prescribed for their lipid-lowering effects, have been suggested to possess potential chemopreventive properties against various cancers, including esophageal cancer. This systematic review studied the association between statin intake and esophageal cancer. To conduct this systematic review and meta-analysis, we reviewed studies published between 1980 and June 2023 in Web of Science (WOS), Embase, MEDLINE/PubMed, Scopus, and Cochrane Library databases according to the PRISMA guidelines. Data extraction, quality assessment, and statistical analyses were performed using predefined protocols. We used various statistical tests conducted by Stata statistical software. Statistical significance was considered significant at p < 0.05. Twenty-one studies were collected and analyzed. The meta-analysis demonstrated that the odds ratio (OR) of esophageal cancer in patients treated with statins was 0.65 (95% CI: 0.57-0.75, p < 0.001) compared to the non-receiving group. The ORs for case-control and cohort studies were 0.67 (95% CI:0.54-0.83, p < 0.001) and 0.62 (95% CI:0.55-0.71, p < 0.001), respectively. The investigation into the relationship between the statins intake and the incidence of esophageal cancer did not reveal any indication of publication bias according to both Begg's test (p = 0.966) and Egger's test (p = 0.113). The results revealed that the odds of esophageal cancer in patients treated with statins decreased by 35% compared to patients not treated with statins. However, further well-designed prospective studies are needed to validate these findings and understand the underlying mechanisms of statins in preventing esophageal cancer.

Comparative analysis of prescription patterns and errors in government versus private hospitals in Dhaka: A cross-sectional study.

Prescription errors can inadvertently compromise the effectiveness and increase the risk of adverse events. This study aims to compare prescription patterns and errors between government and private hospitals in Dhaka, Bangladesh, by evaluating the World Health Organization (WHO) prescription indicators, polypharmacy, and omission errors. Between September 2021 and November 2021, a total of 399 prescriptions were collected from outpatient departments of various government and private hospitals from patients or their attendants. The data were analyzed using the statistical package STATA 15. Chi-square and Fisher's exact test were employed to determine associations (p < 0.05) among various types of categorical data. Of the collected prescriptions, 48% (n = 192) were from government, while 52% (n = 207) were from private hospitals. The mean number of medicines per prescription was 5.16 for government and 5.87 for private hospitals. Generic names were absent (0%) in both types of hospitals. Antibiotics were present in 34.37% of prescriptions from government and 51.69% from private hospitals. Moreover, injection were found in 17.70% of government and 18.35% of private hospitals' prescriptions. Government hospitals adhered to 67.97% of the essential drug list, whereas private hospitals adhered to 80.42%. Associations between hospital types were observed in missing age, and comorbidities, while no association was found in inscription mistakes. Missing dates and signatures were also associated with hospital types. Polypharmacy was observed in 49.47% of government hospitals and 71.01% of private hospitals. Additionally, polypharmacy in females, pediatrics, geriatrics, and missing comorbidity were also associated with hospital types (p < 0.05). Both government and private hospitals exhibited similar deviations from the WHO prescribing indicators. While government hospitals showed more omission errors, private hospitals exhibited higher rates of polypharmacy. Physicians in both types of hospitals should be vigilant about omission errors, maintain the WHO prescribing indicators, and minimize polypharmacy.

Analysis of the Vulnerability Profile of tuberculosis co-infection in people living with HIV

Introduction: studies that seek to identify and outline the vulnerability profile contribute to directing necessary interventions to be carried out in people with tuberculosis (TB) and HIV (acronym in English for human immunodeficiency virus) co-infection, to achieve the end of TB. Objective: to describe the profile of people with tuberculosis and HIV co-infection, from 2016 to 2018, in Espírito Santo, Brazil. Methods: this is a cross-sectional descriptive study, using secondary data from the Notifiable Diseases Information System (SINAN) for TB and HIV, through a methodological process of database preparation and descriptive data analysis, the information was encoded and stored anonymously in a database in Excel for Windows®; Afterwards, the STATA statistical package, version 16 (Stata Corp LP, College Station, TX, USA) was used to carry out descriptive analyses with identification of relative and absolute values, and tables were generated for data analysis. The study was approved by the Research Ethics Committee of the Health Sciences Center of the Federal University of Espírito Santo (CEP/CCS/UFES) under opinion number 4022892 on 05/12/2020. Results: of a total of 4,428 cases, 325 cases were TB-HIV co-infection, 322 cases were located in the SINAN-TB database and three cases were located after linking with the SINAN-HIV database that presented a record of negative results for the diagnostic test of HIV in the SINAN-TB database. There was a profile with a predominance of men (71%), young people (20 to 39 years old) (52%), mixed race (59%), up to 8 years of schooling (25%), of which 29% reported alcohol consumption, 26% used illicit drugs, and 37% were smokers, who had the pulmonary form of the disease (66%), they reported adherence to antiretroviral therapy (65%) and only 44% had a cure outcome at closure and 20% stopped treatment; the majority of cases (61%) did not undergo directly observed treatment and only 6.9% of cases reported receiving assistance from the government’s income transfer program. Conclusion: in order to ensure greater coverage of tuberculosis control in PLHIV patients, it is necessary to expand the dialogue between health and social support policies; enable access to health services such as antiretroviral treatment for all people diagnosed with HIV, and timely directly observed treatment (DOT) for people who present this vulnerability profile. Carrying out new studies is essential to contribute to technological advancement and planning in health service actions.

Predictive significance of the blood eosinophilia for chronic sinusitis with nasal polyp recurrence: A systematic review and meta-analysis.

Chronic sinusitis with nasal polyps (CRSwNP) is a complex inflammatory condition characterized by recurring nasal polyps, often necessitating repeated interventions. Blood eosinophilia has emerged as a potential biomarker for predicting disease recurrence. The present study aims to assess the predictive significance of blood eosinophilia for the recurrence of nasal polyps. To accomplish this objective, we employed the appropriate search keywordsto explore internationaldatabases such as Web of Science, PubMed, Embase, and Scopus. Through this process, we extracted scholarly articles that assessed the prognostic value of blood eosinophilia in the recurrence of nasal polyps. The statistical software STATA (version 15) was employed, along with random and fixed-effects models, to appraise the compiled data. Nine articles met inclusion criteria, with a total sample size of 1279 individuals (569 recurrent polyp individuals and 710 non-recurrent polyp individuals). Cumulative Odds ratio analysis revealed that CRSwNP is associated with high blood eosinophile percentage compared to the non-CRSwNP group (p=0.01, OR=1.26, 95%Cl (1.15,1.36). The cut-off value of blood eosinophil percentage (>0.78) had relatively good, and statistically significant predictive potential. No significant publication bias was observed for the included studies. Our findings indicate that the utilization of blood eosinophils holds significant predictive value and can serve as a valuable tool for detecting recurrence in patients with CRSwNP. Based on the outcomes of our comprehensive analysis, we propose a threshold of >0.78 as a reliable indicator for assessing the probability of recurrence in CRSwNP patients.

Can L-Carnitine Replace Tumor Necrosis Factor-Alpha Blockers? A Systematic Review and Dose–Response Meta-Analysis

Background: L-carnitine (LC), an amino acid-like molecule, has been shown to reduce tumor necrosis factor-alpha (TNF-α), although some research has not confirmed its impact. This study aimed to identify the effects of LC supplementation on TNF-α levels through a systematic review and meta-analysis of randomized controlled trials (RCTs). Methods: This study followed the PRISMA 2020 statement and searched the Web of Science, PubMed, Embase, and Scopus for related papers on LC supplementation’s effects on TNF-α in adults. The meta-analysis was performed using the 17th version of the Stata Statistical Software, and the I2 statistic was used to assess the impact of heterogeneity. The Cochrane risk of bias tool was used to evaluate the risk of bias in the included studies. Results: Seventeen RCTs were included based on the full-text review, and the data from 14 studies were included in the meta-analysis. Based on the results, oral LC did not have a significant impact on TNF-α levels (Cohen’s d: -0.19 [95% CI: -0.71 to 0.33]; I2 : 97.39%). However, parenteral LC had significantly reduced TNF-α levels (Cohen’s d: -1.60 [95% CI: -3.06 to -0.15]; I2 : 88.92%). Oral LC doses of 0.75 and 6 g/day were effective, while duration of LC administration was associated with significant findings in 2, 36, and 48 weeks. The dose and duration of LC administration ineffective independently of TNF-α levels (P = 0.35 and P = 0.70 for dose and duration of administration, respectively). Conclusion: In this meta-analysis, oral LC supplementation failed to be superior to TNF-α blockers.

Assessing MRI referrals’ appropriateness for low back pain post a radiology-initiated intervention

IntroductionThis study evaluated a pilot intervention to reduce low-value Magnetic Resonance Imaging (MRI) referrals for Low Back Pain (LBP). MethodsThis before-after intervention study analysed MRI referrals for LBP at two private imaging centres in Norway. MRI referrals for LBP obtained before and after an intervention of information campaigns and sending a return letter to clinicians for declined referrals were evaluated on information, quality, and justification rates. Four radiologists and two radiographers assessed the referrals. A point system was used to calculate referral quality. Each referral was given a score ‘good’ when rated above 5.5 and ‘poor’ below 2.5. Justification was based on assessors categorised rating as justified, unjustified or need more information. Stata Statistical Software (Release 18) was used for analysis. A mixed model analysed variations of the referrals pre- and post-intervention. A p-value of <.05 in variations was considered statistically significant. ResultsA total n = 300 patients’ referrals (150 referrals pre- and post-intervention) were collected and assessed. Post-intervention, 68% of referrals were justified, up from 63% pre-intervention. The assessment showed a 4% decrease in referrals with poor scores and a 2% increase in those rated as good or intermediate quality post-intervention. These changes were not statistically significant. ConclusionIt is important to state that it was not possible in our study to identify the subgroup of referrals that are known to be from clinicians who had received a return letter, although the information campaign targeted all referrers. Despite the limitations our findings suggest that providing reasons for declined referrals can serve as an educational tool for clinicians and contribute to the reduction of low value MRI for LBP. Implications for practiceRadiology department initiatives that raise awareness and offer referral criteria guidance to clinicians can serve as valuable educational tools, and further emphasize the importance of providing comprehensive information in MRI referrals for LBP.

Choosing the right equation for calculating indirect LDL-Cholesterol (LDL-C) in adult Pakistani population: Evaluation of seven equations using big data analytics

ObjectiveCardiovascular diseases (CVDs) are a leading cause of mortality worldwide. Low density lipoprotein cholesterol (LDL-C) contributes to the atherogenic process. However, direct LDL-C (d-LDL) has rarely been estimated by the gold standard method because it is cumbersome and expensive. We aim to evaluate calculated low density lipoprotein (LDL-c) by various equations with reference to directly measured LDL-C in the Pakistani adult population as a cost-effective alternative. MethodsWe retrospectively evaluated the validity of seven equations for estimating calculated LDL-C by computing correlation coefficients (r) and Bland Altman plots to assess agreement (mean %) for (d-LDL) and calculated (LDL-c) on all seven equations. Statistical analysis was performed in Stata Statistical Software: Release 17, College Station, TX: StataCorp LLC. ResultsWe analyzed 247082 direct assays of lipid profiles of adults aged ≥18 years. The mean LDL-C levels computed on Friedewald, de Cordova, Chen, Hattori, Vujovic, Teerakanchana, Sampson equations were 106.8 ± 31.4, 103.7 ± 25.0, 108.6 ± 28.2, 100.1 ± 29.5, 115.2 ± 31.2, 113.1 ± 28.3 and 110.3 ± 30.6 respectively. Friedewald and Hattori equations correlated strongly with direct LDL-C (r = 0.937) for each followed by Sampson (r = 0.935) and Vujovic (r = 0.931). However, the median bias was least for the Friedwald equation (−1.6) compared to the other equations. ConclusionIn contrast to the global literature advocating for the use of newer equations, although the conventional and widely utilized Friedewald equation remains the best alternative for calculated LDL-C estimation in adult Pakistani population.