STATA Statistical Software Research Articles

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 <.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

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.

Oral Health-Related Quality of Life Improvement After Treatment With Fixed and Removable Dental Prostheses.

Missing teeth negatively affect oral functions and masticatory efficiency, which in turn can reduce a person's quality of life (QoL). This study is aimed at evaluating the effect of dental prostheses on oral health-related quality of life (OHRQoL) in adults. This is an observational study to measure patients' OHRQoL using a cohort study design before and after treatment with different dental prostheses (fixed and removable). Ninety-seven patients who received dental prostheses responded to a questionnaire before dental prosthetic treatment and then after the completion of the treatment. The conduction was face-to-face or via telephone interviews. The questionnaire is divided into two parts to verify the demographic and the patient's related factors and to measure OHRQoL using the Oral Health Impact Profile-5 (OHIP-5). Descriptive statistics, inferential statistics, and multivariable analysis were conducted using Stata Statistical Software: Release 14.2 (2016; StataCorp LLC, College Station, Texas, United States) and were at a 0.05 significance level. Data were collected from the 97 patients, of which 70% were male with a mean age of 39.5 and 30% were female with a mean age of 43. The educational level showed that only 15% of the patients received a bachelor's degree and that the remaining 85% stopped at a high school general educational level. The received prosthetic treatment consisted of 23% single crowns, 29% fixed partial dentures (FPD), 20% removable partial dentures (RPD), and 28% complete dentures. Self-reported overall health indicated that 64% of the patients had very good health and 36% had good health or a lower quality of health. There was a significant difference in OHIP scores before prosthetic treatment (M=5.4, SD=0.57) and after prosthetic treatment (M=3.2, SD=0.49) with no significant difference in the reduction in OHIP scores between fixed prostheses (M=-2.8, SD=0.64) and removable prostheses (M=-1.5, SD=0.74). The amount of improvement in OHIP answers after wearing a prosthesis was significant (p<0.0001). Linear regression indicated that having a history of discomfort from general oral health improved (decreased OHIP score) by 2.2 after prosthetic dental treatment compared to participants without a history of general oral health discomfort when all other variables are held constant. Within the limitations of this study, it can be concluded that restoration of missing teeth with a dental prosthesis has an immense impact on individuals' QoL, regardless of the type of dental prosthetic restoration.

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.

Trends in In-Hospital Mortality in Patients Admitted With Cardiovascular Diseases in the United States With Demographics and Risk Factors of All Cardiovascular In-Hospital Mortality: Analysis of the 2021 National Inpatient Sample Database.

Introduction and background Cardiovascular diseases (CVDs) encompass a range of disorders involving coronary artery diseases, valvular heart diseases, myocardial diseases, pericardial diseases, hypertensive heart diseases, heart failure (HF), and pulmonary artery diseases. Given the high prevalence of CVDs, understanding both overall and in-hospital mortality rates from these diseases is crucial. Unsurprisingly, most research, procedures, and new pharmacological interventions aim to reduce these rates. No recent studies have comprehensively detailed in-hospital mortality rates, demographics, and risk factors for all CVDs combined. Yet, in-hospital mortality rates due to CVD significantly impact patients' families and healthcare teams and serve as a critical measure of healthcare system development and effectiveness. Therefore, analyzing in-hospital mortality rates is essential for filling the gap in the recent comprehensive analysis of in-hospital mortality rates, demographics, and risk factors of all CVDs. Method The study used data from the National Inpatient Sample and the Nationwide Inpatient Sample (NIS) Databases of 2021 and HCUP tools. The NIS database extrapolates national estimates based on a stratified sample of 20% of US hospital discharges. Results were expressed as probability and relative risk using the t-test, with a P-value <0.05 being statistically significant. Statistical analyses were done using Stata statistical software version 18 (StataCorp LLC, College Station, TX, US). Results This study included 6,666,752 hospital admissions in the United States. Of these, 2,337,589 patients were admitted with CVDs and related symptoms, with 70,552 deaths occurring during hospitalization, resulting in an in-hospital mortality rate of 3.01% due to CVDs. Our study showed all CVD-induced in-hospital mortality combined was found to have a higher association with diabetes but a lower association with hypertension, hyperlipidemia, alcohol, and smoking. Conclusion The highest rates of cardiovascular disease in-hospital mortality are cardiac arrest, rupture of the cardiac wall as a complication of acute myocardial infarction, cardiogenic shock, rupture of papillary muscle as a complication of acute myocardial infarction, and rupture of chorda tendinea as a complication of acute myocardial infarction. The most common causes of CVD in-hospital mortality are non-ST-elevation myocardial infarction (NSTEMI) (19.20%), ST-elevation myocardial infarction (STEMI) (17.80%), cardiac arrest (15.10%), hypertensive heart disease with heart failure (12.50%), ventricular fibrillation (4.70%), ventricular tachycardia (3.30%), and aortic stenosis (2.10%). The most common risk factors for CVD in-hospital mortality are age, male gender, and diabetes. Proper diabetes control and management might be the highest preventive measure for all CVD-induced in-hospital mortality.

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.