STATA Statistical Software Research Articles

Does a Negative Prostate Biopsy Reduce the Risk of Prostate Cancer Reclassification in an Active Surveillance Protocol? An Updated Systematic Review and Meta-Analysis.

To evaluate the association of the negative confirmatory and follow-up biopsy with prostate cancer reclassification in active surveillance protocol. A systematic search was performed in databases, including Scopus, PubMed, Embase, and Web of Science, on June 25th, 2024, to identify relevant studies regarding negative biopsy and reclassification of prostate cancer among men on AS. The patient data including, sample sizes, follow-up duration, the status of performing the confirmatory biopsy, hazard ratio (HR), and 95% confidence intervals (CI) of each reported HR were evaluated in each study. The relationships between negative biopsies and reclassification were assessed using a forest plot. A random-effect meta-analysis was used when high heterogeneity existed among the studies. Otherwise, a fixed-effect meta-analysis was utilized. A p value of less than 0.05 was considered statistically significant. All statistical analyses were performed by using STATA statistical software, version 16. A total of 13 articles were included in the study. These articles were published between 2008 and 2023, with the majority being published in recent years (2020-2023). The included articles evaluated a total of 17,900 patients. Our results regarding reclassification and upgrading are represented according to the confirmatory biopsy and subsequent follow-up biopsies. After a negative confirmatory biopsy, the pooled HR for reclassification was 0.46 (95% CI: 0.38-0.55, p < 0.01). Secondly, the study demonstrated that a decreased chance of cancer upgrading was also connected with negative confirmatory biopsies with a pooled HR of 0.57 (95% CI: 0.45-0.72, p < 0.01). Negative follow-up biopsies were linked to a 55% decrease in the risk of reclassification, according to the pooled HR for reclassification in patients with negative biopsies compared to those with positive biopsies of 0.45 (95% CI: 0.42-0.48, p < 0.01). Also, patients with negative follow-up biopsies had a pooled HR for upgrading of 0.57 (95% CI: 0.48-0.67, p < 0.01), indicating a 43% lower chance of upgrading than in patients with positive biopsies. In active surveillance of PCa patients, a negative confirmatory biopsy decreased the chance of cancer reclassification and upgrading, with the pooled OR 0.46 and 0.57 [p < 0.01], respectively. Also, negative follow-up biopsies were linked to a decreased chance of cancer reclassification and upgrading. Our review recommends extend the follow-up evaluations in PCa patients with negative findings in surveillance biopsy who scheduled for active surveillance.

Comparing radiologists and radiographers' assessment of MRI referrals for low back pain: Insights from two imaging centres in Norway.

This study aimed to evaluate the differences in MRI referral assessments for low back pain (LBP) between radiologists and in-house trained radiographers. This is the second part of a retrospective study where MRI referrals for LBP conducted within two imaging centres in Norway were assessed for justification and referral quality. This study examines differences in how the recruited assessors (four radiologists and two radiographers) evaluated the referrals. The collected data was sorted in Microsoft Excel version 2021. Stata Statistical Software (Release 18) was used for data analysis. Mixed model analysis was used to compare the radiographers and radiologists' assessment of justification and referral quality. Gwet's agreement coefficient AC1/AC2 was used to determine the variation of agreements between the assessors in justification, and Gwet's AC2 between the assessor in referral quality. Kappa statistics was used to assess the interrater reliability between the two professions. A p-value of<0.05 was considered statistically significant. A total n=300 patients' MRI referrals for LBP from the two imaging centres were collected and assessed. The two radiographers and one radiologist assessed 75% of the referrals as justified, while the other radiologists had an overall justification rate ranging from 50 to 60%. In general, radiographers more frequently assigned referrals as being of good and intermediate quality compared to radiologists. The study showed a statistically significant difference (p<.001) between radiographers and radiologists 'assessment of justification and quality of MRI referrals for LBP. Radiographers assessed a higher proportion of referrals as justified and of good quality compared to radiologists, highlighting the need for targeted training to enhance radiographers' referral assessment skills. Radiographers are assigned tasks to justify imaging in radiology departments; however, targeted training is essential to ensure consistent and accurate referral assessments, ultimately enhancing patient care and optimising the use of resources.

Discrimination and Harassment in the Workplace: The Lived Experiences of Singaporean LGBTQ+ Individuals

ABSTRACTFostering diversity and inclusivity in the workplace is crucial for staying competitive, yet discrimination and harassment based on sexual orientation and gender identity or expression (SOGIE) remains prevalent. This study aims to investigate experiences of workplace discrimination and harassment among LGBTQ+ individuals in Singapore to inform policy discussions about extending protections to LGBTQ+ workers under the forthcoming Workplace Fairness Legislation. Through an exploratory cross‐sectional survey conducted across March 2023 to August 2023, data were collected from 409 Singaporeans SOGIE minorities between 18 and 85 years old who had ever been employed in Singapore. Statistical analysis was carried out using statistical software STATA version 18, where bivariable (Pearson's chi‐square tests) and multivariable (logistic regression and multivariable linear regression) techniques were used. Over half of participants (n = 208, 50.85%) experienced some form of workplace discrimination or harassment. In multivariable analyses, compared to their Chinese counterparts, Malay participants were more likely to experience discrimination (adjusted Odds Ratio [aOR] = 2.51, confidence interval [CI] 1.05, 5.96) and Indian participants were more likely to experience harassment (aOR = 3.22, CI = 1.39, 7.49). Transgender (aOR = 5.71, CI = 2.25, 14.54) and gender‐diverse (aOR = 3.33, CI = 1.80, 6.16) participants had higher odds of experiencing discrimination or harassment compared to cisgender participants. Empirical studies have shown that legislation is effective in reducing prejudice and discrimination, as well as improving sentiment toward the LGBTQ+ community. In the absence of national legislation, consistently applied company policies are also able to reduce perceived discrimination and improve work attitudes among LGBTQ+ employees. Furthermore, fostering an inclusive culture that is embraced at all levels of the organization has been discovered to be a key tool in creating a supportive workplace environment. Overall, a comprehensive approach that integrates national legislation, supportive company policies, and cultural change would have an enormous impact on the many LGBTQ+ Singaporeans who experience workplace discrimination and harassment.

Effects of Virtual Reality on Relieving Pain During Endoscopy in Adults: A Systematic Review and Meta-Analysis of Randomised Clinical Trials.

Virtual reality is an emerging non-drug treatment for pain caused by endoscopy procedure. We conducted a meta-analysis to evaluate the effectiveness and safety of virtual reality based interventions for pain during endoscopy. PubMed, EMBASE, Cochrane Library, Web of Science and Clinical Trials database were searched until 26 May 2024. Randomised controlled trials on the application of virtual reality in endoscopic examinations were included. The standardised mean difference (SMD) was calculated using random-effects models, and included studies were appraised using Cochrane Risk of Bias tool version 1. Meta- analysis was conducted using Stata Statistical Software version 17.0. Overall, 21 studies enrolling 1721 participants were included. Our results demonstrated that the patients receiving the virtual reality intervention had lower pain scores than those receiving the usual care (SMD = -0.42; 95% CI = -0.65, -0.20). Subgroup analysis showed that real-time assessment of pain scores during the medical process had less heterogeneity (I2 = 20.2%, p = 0.257) and a smaller range of confidence intervals (95% CI = -0.43, -0.14) than retrospective assessment (95% CI = -0.75, -0.09). For different types of endoscopes, virtual reality was statistically significant for reducing pain during colonoscopy (SMD = -0.70; 95% CI = -1.12, -0.28), cystoscopy (SMD = -0.28; 95% CI = -0.53, -0.04) and laparoscopy (SMD = -0.54; 95% CI = -0.98, -0.10). Additionally, statistically significant improvements in relieving anxiety were reported when using virtual reality (SMD = -0.56; 95% CI = -0.78, -0.35). The application of virtual reality can effectively relieve the pain and anxiety of endoscopy. The types of endoscopy and the way of retrospective evaluation of pain scores were the main sources of heterogeneity. More rigorous studies about the relationship between virtual reality and endoscopic pain relief will be needed. The application effect of virtual reality technology on endoscopy was verified by summarising several randomised controlled trials. Patients and healthcare providers can be better informed about the use of such intervention to relieve pain. Virtual reality is recommended as being potentially useful and practical for reducing the pain of endoscopy.

Effectiveness of nutritional education intervention during pregnancy on birth outcomes in sub-Saharan Africa: a protocol for a systematic review and meta-analysis

IntroductionNutritional education intervention during pregnancy is the process of teaching pregnant women about the importance of a healthy diet and how to make healthy food choices. It is an important...

Importance of Urine Culture and Antibiotic Sensitivity for Improving Clinicians' Choice in Treating Urinary Tract Infections.

The local antibiogram is essential to prevent the development of multidrug-resistant organisms. The aim of the study was to find out the synchronization of empirical antibiotics with the sensitivity pattern of the urine culture report and to study the differences in the organisms and sensitivity patterns in urinary tract infection (UTI) with and without other comorbidities. UTI, diagnosed by a positive urine culture report of 300 consecutive patients above the age of 18, was studied retrospectively. The data were processed using the statistical software STATA 14. Out of 300 patients, 58.3% were females. The mean [standard deviation (SD)] age was 54.19 (19.06) years. The most common associated comorbidity was diabetes mellitus (DM) (34.7%). Lower urinary tract symptoms (LUTS) were the most common presenting symptom, followed by dysuria and fever. The most common organism was Escherichia coli in both nondiabetic and diabetic patients (67.3% and 60.6%). Comparing diabetics and nondiabetics, recurrent UTI (15.4 vs 5.1%), infection with extended-spectrum beta-lactamase (ESBL) organisms (67.3 vs 51.5%), and prolonged hospitalization (75 vs 61.2%) were observed more in diabetics. The most common empirical antibiotic chosen was cefoperazone-sulbactam in the diabetic group and levofloxacin in the nondiabetic group. Empirical antibiotics in diabetics matched with the sensitivity in 57.1% of ESBL cases and 47% of non-ESBL cases, while in nondiabetics, this alignment was 40.5% in ESBL cases and 61% in non-ESBL cases. Resistance to oral fluoroquinolone, cotrimoxazole, and nitrofurantoin was 78, 59.3, and 39.6%, respectively, while resistance to meropenem and amikacin was 35.6 and 25.6%. The increasing prevalence of ESBL-positive strains and rising resistance to common antimicrobial drugs raise concerns for future therapeutic options.

Effectiveness Of non-Pharmacological Strategies in The Management of Type 2 Diabetes In Primary Care: A Systematic Review And Network Meta-analysis

Introdução Despite the increasing number of drugs and various guidelines on the management of type 2 diabetes mellitus (T2DM), several patients continue with the disease uncontrolled. There are several non-pharmacological treatments available for managing T2DM, but various of them have never been compared directly to determine the best strategies. Objective: This study evaluated the comparative effects of non-pharmacological strategies in the management of T2DM in primary care or community settings. Métodos We have performed a systematic review and network meta-analysis (NMA) following the Cochrane collaboration and reported according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) Statement. We included randomized controlled trials if non-pharmacological strategies in the management of type 2 diabetes were applied in adult patients with T2DM in primary care. The primary outcome was glycemic control (glycated hemoglobin [HbA1c] [%]). We developed search strategies for Embase, Medline, Latin American and Caribbean Health Sciences Literature, Cochrane Central Register of Controlled Trials, Trip database, Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL). Four reviewers assessed the studies for their eligibility and their risk of bias in pairs and independently. A NMA have been performed using Stata Statistical Software 18 (Stata Statistical Software: Release 18. College Station, TX, StataCorp LLC, USA). Resultados After removing duplicates, the search strategies yielded 4314 studies. After a thorough evaluation of the references, 129 studies encompassing a total of 35,975 individuals have been included in this review. Twenty and three strategies were founded. The most frequent strategy was diabetes self-management and support (DSMES), followed by diabetes self-management education, technology enabled DSMES, self-monitoring of blood glucose, multidisciplinary approach, health coach, benchmarking, low carb diet, low fat diet, plate diet, food substitution diet, yoga, leaflet, group outpatient visit model, patient-centered communication and shared decision making, and some combinations among two or more strategies. The most frequent comparator has been usual care (92%). The consistency assumption could be accepted at the overall level of each treatment ( test for inconsistency: chi2( 8) =11.01, p= 0.2011). Regarding relative rankings, DSMES associated with social support showed a 35% probability of being the best treatment in terms of HbA1c reduction, followed by plate diet (16.9%), low fat diet (11.8%) and food substitution diet (10%). Discussão e conclusões Although several systematic reviews have evaluated the effectiveness of these strategies in the management of T2DM,to the best of our knowledge to date, there are no systematic reviews and NMA considering the direct and indirect effects of non-pharmacological interventions targeting a greater control of T2DM. Conclusion: This review has founded 23 non-pharmacological strategies in the management of type 2 diabetes in primary care, being the most frequent DSMES, and DSMES associated with social support presented the highest probability to be the best in terms of HbA1c reduction. This research has been supported by the São Paulo Research Foundation (Grant number: 2021/07229-0)

Bortezomib for the treatment of Multiple Myeloma: A Systematic Review and Meta-Analysis

Introduction Multiple myeloma (MM) is an incurable malignant neoplasm that accounts for approximately 1% of all cancers and 10% of hematological malignancies. Bortezomib is one of the most commonly used medications in first-line treatment and subsequent relapses, either as a single agent or in combination with other therapies. Objective: To assess the effects of bortezomib on progression-free survival (PFS), overall response rate (ORR), adverse events in patients with MM. Methods We have performed a systematic review and included randomized (RCT) and non- -randomized controlled studies where bortezomib was compared in similar or dissimilar background therapies in each arm. Embase, Medline, LILACS, and CENTRAL were our data source. Two reviewers independently selected studies, assessed the risk of bias, and extract data from the included studies. Similar outcomes were plotted in the meta-analysis using the Stata Statistical Software 18. The relative risk (RR) was calculated with a 95% confidence interval as the effect size of bortezomib. For the OS and PFS, we calculate the overall odds ratio (OR) from the hazard ratios of each included study. We used the Grading of Recommendations Assessment, Development, and Evaluation system to evaluate the certainty of evidence. Results We identified 7,996 references, and 28 studies fulfilled our eligibility criteria. Sixteen studies were randomized, and 12 were non-randomized (retrospective studies). In the studies with similar background therapies in each arm, bortezomibe improves PFS ( Peto OR 0.71, 95% CI 0.64 to 0.78, , 7 RCTs, 2572 participants, moderate-quality evidence), , and there was no difference in ORR between the groups. In studies with different background therapies in each arm, bortezomib continued to improve PFS (Peto OR 0.86, 95% CI 0.80 to 0.93, , 8 RCTs, 4209 participants, moderate-quality evidence), but not in studies where participants had previously used bortezomib (Peto OR 1.7, 95% CI 1.46 to 1.97 , 2 RCTs, 1084 participants), the same occurred in ORR (RR 1.14, 95% CI 1.01 to 1.29 and RR 0.81, 95% CI 0.75 to 0.89, respectively). In both similar and dissimilar background therapies bortezomibe increases the risk of neuropathy adverse events (RR 2.9, 95% CI 2.18 to 3.87, 5 RCTs, 1901 participants, and RR 4.57, 95% CI 2.50 to 8.35, 9 RCTs, 1901 participants, respectively). In all non-RCT studies bortezomibe was compared with active control. The meta-analysis of PFS was not performed due to study design (retrospective studies), from the 5 studies that evaluated this outcome, in 2 studies patients had a significantly longer PFS, and in 3 studies although bortezomib had better PFS, there was no statistically significant difference between groups. Discussion e conclusions Regarding PFS in the studies with dissimilar background therapies, bortezomib has often been compared with newer therapies. Even though we were unable to isolate the effect of bortezomib, when we performed subgroup analysis according to previous use of bortezomib, it is clear that for those patients without previous use, there is a better intervention effect. Patients who had previous contact with the drug, and were later re-exposed to it, clearly did not benefit from this re-exposure. Conclusion:Bortezomib has been approved by the FDA and other regulatory agencies for about 20 years. Thus, we have data from RCT and retrospective studies that highlight their effectiveness and long-term safety profile. This project was funded by the Call for Financial Support for Studies in Health Technology Assessment of the National Council for Scientific and Technological Development (CNPq) in partnership with the Brazilian Health Ministry through the DGITIS/SCTIE, grant number: 423641/2021-2.

Clean delivery kit use in low-and middle-income countries: a systematic review and meta-analysis

BackgroundThe use of Clean Delivery Kits (CDKs) promotes healthy birth outcome. Nevertheless, representative data are lacking for low- and middle-income countries. Thus, study aimed at determining the overall estimate of clean delivery kit use among low and middle income countries.MethodsA comprehensive review of the Science Direct, Scopus, Google Scholar, EMBASE, and PubMed databases was part of the current investigation. Microsoft Excel (version 14) was used to extract the data, and STATA statistical software was used for analysis. The presence of publication bias was assessed using DOI Plots in the study. By calculating I2 and doing an overall estimation analysis, heterogeneity was evaluated. Furthermore, a subgroup analysis was carried out according to the sample size, publication year, and study design.ResultsOut of 654 articles, 12 met the inclusion criteria and were included in the analysis, covering 19,889 study participants. In low- and middle-income countries, the pooled proportion of clean delivery kits use was 54% (95%CI: 31. 60, 76.82, I2 = 70%). Notably, the cross-sectional study revealed the lowest incidence of delivery kit use, with a proportion of 54.29%, while the cohort study revealed the highest proportion, at 72.37%. In studies with sample sizes < 500, clean delivery kit use was higher (60.28%) compared to studies with sample sizes > 500 (45.75%). Lastly, the proportion of clean delivery kits was found to be 62.53% for studies published after 2010, compared to 48.25% for studies published before 2010.ConclusionIn summary, the proportion of clean delivery kits use was 54%. Healthcare systems should focus on different strategies to improve clean delivery kit use.

COVID-19 vaccination, perceptions about the vaccine and willingness to take the vaccine among unvaccinated individuals at two Ugandan border points of entry

BackgroundA recent systematic review shows high COVID-19 vaccine effectiveness in fully-vaccinated people in Africa. However, vaccine uptake has varied across populations. We assessed the uptake, perceptions of and willingness to take the COVID-19 vaccine among unvaccinated individuals at two Ugandan border points of entry.MethodsThis was a cross-sectional quantitative study conducted at Malaba and Mutukula points of entry into Uganda between February and March 2023. We targeted people living in, working at, or transiting through the two points of entry, including truck drivers, point-of-entry customs officers and female sex workers, market vendors, among others. Data were collected on socio-demographic characteristics, vaccine uptake, perceptions and willingness to take the vaccine among unvaccinated individuals. We computed descriptive statistics and determined the factors associated with uptake of and willingness to take the vaccine using a modified Poisson regression model. Data analysis was conducted using STATA statistical package (version 14.0).ResultsOf the 854 respondents, 50% (n = 427) were from Mutukula. Overall, 80.3% (n = 686) of the respondents reported that they had received at least one vaccine dose; no booster doses were reported. Respondents perceived that the vaccine was efficacious against COVID-19. COVID-19 vaccine uptake was associated with age-group 35–44 years [adjusted Prevalence Ratio [aPR] (95%CI) = 1.13 (1.01, 1.27)] or 45 + years [aPR (95%CI) = 1.19 (1.07, 1.33)]; being a truck driver [aPR (95%CI) = 1.16 (1.04, 1.29)] or health worker [aPR (95%CI) = 1.18 (1.05, 1.32)]; and the belief that the COVID-19 vaccine is protective against COVID-19 [aPR (95%CI) = 1.32 (1.10, 1.58)]. Nearly 60% of unvaccinated respondents (n = 99) were willing to take the COVID-19 vaccine. Willingness to take the vaccine was associated with the belief that one can contract the coronavirus if not vaccinated [aPR (95%CI) = 3.67 (1.90, 7.10)] or the community was at risk of COVID-19 [aPR (95%CI) = 1.86 (1.33, 2.62)].ConclusionCOVID-19 vaccine uptake was high in this setting while nearly six out of every ten unvaccinated individuals were willing to take the vaccine. Our findings lend credence for ongoing vaccination efforts at points of entry to contain the importation of new COVID-19 variants into the country.

Disease activity and maternal-fetal outcomes in pregnant women with prolactinoma: A systematic review and meta-analysis.

Women with prolactinoma are usually infertile, but can conceive after surgery or treatment with dopamine agonists (DA). To evaluate the impact of pregnancy in prolactinoma's natural course and in maternal-fetal outcomes. MEDLINE, EMBASE, LILACS, and CENTRAL. Observational studies that included at least three pregnant women with prolactinoma. Two independent reviewers selected studies, assessed the risk of bias, and extracted data from the included studies. Fifty-two studies were included, involving 2544 pregnancies in 1928 women. The Stata Statistical Software 18 was used for proportional meta-analyses. The overall frequency of pregnant women on DA treatment at conception was 97% and for either continuing or resuming treatment during pregnancy was 6%. The overall frequency of miscarriage was 10% (95% confidence interval [CI], 8%-12%), 3% for prematurity (95% CI, 2%-5%), 4% for symptomatic tumor growth during pregnancy (95% CI, 2%-8%), 4% for visual impairment (95% CI, 2%-7%), 6% for headache (95% CI, 4%-9%), and 4% for development of gestational diabetes (95% CI, 3%-7%). The overall frequency of congenital malformations was 2% (95% CI, 1%-4%), 2% for perinatal mortality (95% CI, 1%-2%), and 6% for low birth weight (95% CI, 3%-9%). Moreover, prolactinoma's size is a significant modifier for visual impairment. Pregnancy in women with prolactinoma is safe in relation to fetal and maternal outcomes with low frequencies of miscarriage, prematurity, symptomatic growth, visual impairment, headache, congenital malformations, perinatal mortality, and low birth weight.

The Prevalence of Childhood Asthma, Respiratory Symptoms and Associated Air Pollution Sources Among Adolescent Learners in Selected Schools in Vhembe District, South Africa.

A cross-sectional survey was conducted with 2855 adolescents from fourteen (14) selected schools in communities exposed to high levels of air pollution from indoor residual spraying (IRS) that is used for malaria vector control in the Vhembe region. Data were collected using a self-administered standardized International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Statistical software STATA version 17 was used to analyze the data. Binary logistic regression was used to determine the relationship between air pollution sources and childhood asthma/symptoms. The prevalences of asthma, 'wheeze ever' and 'wheeze in the past' were 18.91%, 37.69% and 24.69%, respectively. The results from the adjusted binary logistic regression model indicated that exposure to tobacco smoke (OR = 1.84; 95% CI: 1.08-3.16), smoking a water pipe (OR = 1.65; 95% CI: 1.16-2.36) and the use of paraffin as fuel for heating (OR = 1.70; 95% CI: 0.97-2.88) and cooking (OR = 0.48; 95% CI: 0.29-1.00) were significant risk factors for asthma. Trucks passing through the streets, having a cat at home and using open fires were significantly associated with 'wheeze in the past'. Finally, using gas for cooking (OR = 0.72; 95% CI: 0.53-0.99), open fires for heating (OR = 0.53; 95% CI: 0.35-0.80) and smoking a water pipe (OR = 2.47; 95% CI: 1.78-3.44) were associated with 'wheeze ever'. School children living in these communities had an increased risk of developing asthma and presenting with wheezing due to exposure to environmental air pollution sources.

Assessment of Midwives’ Knowledge and Application of the Modified WHO Partograph at Ga South Public Health Facilities, Greater Accra, Ghana

Background The partograph, one of the vital tools available for the midwife, was originally developed from Friedman’s 1954 Cervicograph by Philpott and Castle in 1972. It was later modified and adopted by the WHO as a universal ‘gold standard’ tool for recording and monitoring progress in labour and providing interventions in cases of abnormal labour. The goal of this study was to assess the level of knowledge of midwives and their utilisation of the modified WHO partograph at the Ga South Municipality in the Greater Accra Region of Ghana. Methodology An institution-based quantitative cross-sectional study was conducted within the municipality from February to March 2019. One hundred and ten (110) midwives were recruited using the census approach. Data were collected using a structured self-administered questionnaire. STATA statistical software version 14 was used for descriptive analysis and results were reported in the form of percentages and frequencies using charts and tables. Pearson’s Chi-Square estimation was also performed to test the association between selected variables with a p value &lt;.05 as the threshold for statistical significance. Results Of the 110 participants, 105 (95.5%) of the midwives could properly describe the partograph and 104 (94.5%) understood that it was used as a tool for vital decision-making, while 92 (83.6%) indicated that partograph contributes in reducing maternal and new-born deaths. Almost all participants, 109 (99.09%) knew all the parameters of the partograph and were also aware that plotting the partograph begins at a cervical dilation of 4 cm. Also, while a good number of participants 103 (93.64%) knew that cervical dilation on the partograph is carried out every four hours during the active phase of labour, 110 (100%) indicated that progress of labour is assessed by the degree of cervical dilation and descent of the presenting part. Routine usage of the partograph was recorded among the majority of midwives, 102 (92.7%), to record and monitor the progress of labour in expectant women. Bivariate analysis showed a significant association between the use of the modified WHO partograph and the knowledge of midwives on Ghana Health Service (GHS) policies ( p = .045). There was, however, no positive association determined among age ( p = .66), rank ( p = .77), years of professional experience ( p = 1.00), place of work ( p = .51), work shift and highest qualification ( p = 1.00) as far as knowledge and use of the WHO modified partograph are concerned. Conclusion The findings of the study underscore the desirable level of knowledge and usage of the partograph among study participants. This affirms that the knowledge and usage of the partograph within the facilities in Ga South health facilities hold the prospect of enhancing the safety of expectant mothers.

Season-dependent characteristics of shock-related injuries in the Arctic zone of the Arkhangelsk region

Relevance. Studying the dynamics of injury rates, injury types and severity, as well as the treatment quality across various country regions, in particular the Arctic, is a prerequisite for managerial, healthcare, and strategic efficiency prior to and during hospital stay, taking into account the climate, geography, social and economic characteristics of every Russian Federation constituent.The objective is to analyse shock-related injuries in the Arctic zone of the Arkhangelsk region to understand season-related injury dynamics.Methods. Retrospective case series description parameters were used to study 140 patients with traumatic shock admitted to the Arkhangelsk Regional Clinical Hospital (ARCH) - a tier 1 trauma center. The analysed medical registration records included patient ambulance record and token (form 114/u), inpatient medical record (form 003/u), surgery logbook (form 008/u), patient radiographs, CT and nuclear MRI reports, as well as laboratory results. The study was conducted in accordance with ethical standards of the Declaration of Helsinki and European Community Directives (8/906 EC) and was approved by the local ethics committee of the Northern State Medical University of the Russian Ministry of Healthcare, Arkhangelsk (protocol no. 02/4-15 dated 04/08/2015). Statistical application package STATA ver.12 was used for statistical data processing.Results and discussion. The research demonstrated that the incidence of shock trauma is 4 times higher in men than in women. The vast majority of the injured are of working age. Seasonal distribution analysis per type of injuries and shock severity, including due to alcohol abuse, was carried out. The number of shock injuries is highest in winter, mainly due to road accidents which constitute 75.6 % of all injuries in winter. Throughout the year, over 50 % of shock injuries are combined injuries, that outperform isolated and multiple injuries in number. In particular, numerous combined injuries occur in winter with a responsible for almost 60 % among all other injuries. The majority the injured with shock-related trauma presented with stage 2 shock (49.3 %), whereas stage 1 and stage 3 shock was diagnosed in 27.9 % and in 21.4 % respectively. In winter, one in four patients with a shock-related injury presented with stage 3 shock. Alcohol-associated shock injuries are more numerous in summer (35.3 %), showing almost the same incidence as road traffic, domestic, and street injuries.Conclusion. The analysis of various types of injuries and season-related incidence of shock injuries in the Arctic territory of the Arkhangelsk region provides evidence to justify preventive measures to reduce the injury rates. Intensified efforts are required to minimise road traffic accidents in winter and combat alcohol abuse responsible for most injuries in summer. Since the vast majority of shock injuries occur in winter, in cold months ambulances must be equipped with local heating facilities, such as evacuation thermal bags with autonomous electric heating, thermal blankets, infusion warmers for blood transfusion and infusion sets.

Assessing the impact of telemedicine interventions on systolic and diastolic blood pressure reduction: A systematic review and meta-analysis.

Hypertension, characterized by high blood pressure, poses a significant risk for cardiovascular diseases, stroke, and heart attack. Managing it is particularly challenging in areas with limited healthcare access and for patients who cannot attend regular in-person visits. Telemedicine interventions offer a promising solution by improving patient adherence and facilitating timely treatment adjustments. This study aims to systematically evaluate the impact of these telemedicine interventions on reducing systolic and diastolic blood pressure. A comprehensive search of PubMed, Scopus, and Web of Science was conducted to identify relevant studies. Two independent reviewers screened and selected eligible articles, extracting key data using a standardized form. The quality of the included studies was assessed with the Mixed Methods Appraisal Tool (MMAT). A random effects model was used to combine the results, with treatment effects measured using standardized mean differences (Hedges's g). Consistency of findings was evaluated through statistical tests, including the Q test and I² statistic, to assess heterogeneity. Data analysis was conducted using Stata statistical software version 17.0. Of the 2700 articles retrieved, 35 studies were selected for inclusion in the analysis. Using a random-effects model, the overall effect size was Hedges's g = -0.22 (95% CI: -0.30 to -0.15; p-value < 0.001), indicating a small but meaningful reduction in blood pressure (systolic and diastolic). Telemedicine interventions had a greater impact on systolic blood pressure (Hedges's g = -0.27, 95% CI: -0.39 to -0.15; p-value < 0.001) compared to diastolic blood pressure (Hedges's g = -0.17, 95% CI: -0.26 to -0.07; p-value < 0.001), though both reductions were clinically relevant. This study demonstrates that telemedicine interventions significantly reduce both systolic and diastolic blood pressure, with a more pronounced effect on systolic pressure. The overall effect size indicates a small but meaningful improvement in hypertension management. These findings highlight the potential of telemedicine as an effective strategy for enhancing patient outcomes in hypertension care.

A Prospective Randomised Comparative Study of Baska Mask and I-Gel for Airway Management in Elective Surgeries: Focus on Airway Sealing Pressure, Insertion Time, and Haemodynamic Response

Introduction: General anesthetic procedure requires a safe and open airway. Endotracheal intubation is the gold standard for airway management; it is being replaced by supraglottic airway devices because they are easy to introduce, better tolerated and results in a lesser haemodynamic response. As both the Baska mask and I-gel have a non-inflatable self-sealing mechanism, these two devices were compared in our study in terms of time taken for insertion, airway sealing pressure, the number of attempts, hemodynamic changes, and complications. Methods: A Prospective comparative study was conducted on 90 patients (45 in each group), aged 18-60 years, undergoing elective surgeries under general anesthesia at Tertiary care Hospital, Madurai. Patients were randomized into two groups using the computer generated statistical software STATA version14 (Texas, USA): Group B: Airway was secured by insertion of Baska mask. Group I: Airway was secured by insertion of I Gel. Following assessments were done to evaluate the SAD: Time taken to insert the device, airway sealing pressure, rate of successful insertion, number of attempts, Haemodynamic parameters, laryngopharyngeal morbidity. Data were analyzed using Student t-tests and chi-square tests, with p &lt; 0.05 considered significant. Results: The mean airway sealing pressure of the Baska mask (26.1+6.1 cmH2O) was significantly higher than that of the I-gel (23.1± 5.9 cmH2O) with a P value of 0.019 which was statistically significant. In our study the time taken to insert the device, for Baska mask it was 18.9+4.1 seconds and for the I gel it was 17.2±5.1 seconds with a P value of 0.089 which was statistically insignificant. In our study there was no statistical difference between Baska mask and I-gel groups in regards to hemodynamic changes (Heart rate and Mean arterial pressure). This may be due to the same stress response produced by the both devices. Conclusion: Baska mask is superior to I-gel in positive pressure ventilation under general anaesthesia for short surgical procedures with statistically significant higher airway sealing pressure though it has comparable time of insertion, haemodynamic changes and laryngopharyngeal morbidity.

REASSURED evaluation of the Bioline HCV point-of-care testing for diagnosing hepatitis C virus infection in primary healthcare settings of Ghana: a study protocol

IntroductionHepatitis C virus (HCV) infection is a silent epidemic that needs a comprehensive and contextualised approach to manage. Access to readily available, affordable and acceptable HCV point-of-care (POC) in vitro...

Food handling practices and sanitary conditions of charitable food assistance programs in eThekwini District, KwaZulu-Natal, South Africa

Unsafe food handling practices by food handlers have dire health and financial implications worldwide. Each year, approximately 600 million people, or about 1 in 10 people, are said to become ill from eating contaminated food, and 420,000 people inadvertently die. According to the 2019 World Bank report on the economic burden of foodborne diseases, the annual cost of treating foodborne illnesses is estimated to be US$ 15 billion, and the total productivity loss caused by foodborne diseases in low- and middle-income countries is estimated to be US$ 95.2 billion annually. The purpose of this study was to assess the food handling practices and sanitary conditions of the charitable food assistance programs (CFAPs) in the eThekwini District of KwaZulu-Natal, South Africa. A descriptive cross-sectional study was conducted among 196 CFAPs in eight study settings across five municipal planning regions (MPRs) of the eThekwini District between January 2021 and May 2021. Data were collected using a standardized 37-item observational checklist and analysed through Stata Statistical Software (TX: StataCorp. 2021 LLC.: Release 17. College Station). Compliance levels were calculated using the compliance score (C-score), whereby 0.0–0.20 (0–20%), 0.21–0.40 (21–40%), 0.41–0.60 (41–60%), 0.61–0.80 (61–80%), and 0.81–1.00 (81–100%) were determined as very poor, poor, average, good, and very good, respectively. Statistically significant associations were declared at p < 0.05. Compliance with food hygiene, storage, and packaging was very poor (C-score = 0.003), as were personal hygiene and staff facilities (C-score = 0.147), as well as product information/labelling (C-score = 0.003). Similarly, waste management and pest control systems (C-score = 0.203), compliance with health and hygiene education/training (C-score = 0.335), as well as use and maintenance of transport (C-score = 0.333), all scored ‘poor’. Only the design of premises and facilities had an average compliance score (C-score = 0.43). Given CFAPs’ role in mitigating the impact of poverty, their strict compliance with hygiene protocols is of utmost importance. Systems for identifying and correcting common noncompliance in CFAPs are required.

Prevalence of Oral Potentially Malignant Disorders Among Tobacco Users in Kolkata: A Hospital-Based Study.

Introduction Tobacco consumption is a significant public health threat worldwide and a looming pandemic. World Health Organization data display that about five million people face premature death per year worldwide due to tobacco use. India is a leading nation among tobacco users in this regard. The aim of the present study was to determine the most prevalent tobacco consumption habit and the oral potentially malignant disorders (OPMDs) found in such users with an assessment of awareness and change in various habits. Material and methods A cross-sectional study over a duration of six months was carried out, in which every patient visiting the hospital OPD was assessed and evaluated for tobacco-related habits. A detailed history of the duration and frequency of the habit, the type of tobacco product consumed, and the predominant reason for its consumption among males and females were recorded and evaluated. An oral examination was performed to determine the evidence of OPMDs. Subjects under the age of 13 years and with systemic/metabolic disorders with oral manifestations were excluded from the study. Data obtained were subjected to statistical analysis using Stata Statistical Software, version 13.1 for Windows (released 2013 StataCorp LLC, College Station, TX). Results Data revealed a higher prevalence of tobacco consumption in males, with chewing tobacco followed by smoking and a mixed form of habit being predominant. Misri chewing was most common in females. Subjects in the 20-50 years age group were most commonly affected, with tobacco pouch keratosis being the most prevalent lesion followed by leukoplakia, with stress being a major causative factor for tobacco consumption. Conclusion The present study promulgated the prevalence of OPMDs in consumers of various kinds of tobacco products, which is highly valuable in the early detection of OPMDs. OPMDs remain unnoticed until advanced stages due to their asymptomatic or mildly symptomatic nature and due to a relative lack of awareness about the deleterious effects of tobacco usage despite an upsurge in tobacco cessation-related content on digital media. Thus, healthcare sector professionals can be appropriately guided to ensure efficient patient care at an early stage.

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 &lt; 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