Category: Nevin Manimala

BMC Womens Health. 2023 Jan 17;23(1):23. doi: 10.1186/s12905-023-02169-7.

ABSTRACT

BACKGROUND: Teenage pregnancies are persistently high among adolescent women in high fertility countries in sub-Saharan Africa. It has been attributed to the high unmet need for family planning in this population. The aim of this study was to determine the prevalence and factors associated with teenage pregnancy in high fertility countries in sub-Saharan Africa.

METHODS: Data for this study was obtained from the most recent Demographic and Health Surveys. A total weighted sample of 33,391 adolescent girls who had ever had sexual contact were included. A multilevel mixed-effect binary logistic regression model was fitted to identify the significant associated factors for teenage pregnancy. Finally, the Adjusted Odds Ratio (AOR) with a 95% confidence interval was used to declare as statistically significant.

RESULTS: The overall teenage pregnancy in sub-Saharan Africa high frtility countries was 24.88% (95% CI, 24.42, 25.35). Educational status; no formal education (AOR = 1.39, 95% CI, 1.23, 1.56) and primary education (AOR = 1.45, 95% CI, 1.30, 1.62), not working (AOR = 1.32, 95% CI, 1.21, 1.45), being married (AOR = 67.88, 95% CI, 61.33, 75.12), poor (AOR = 1.47, 95% CI, 1.32, 1.65) and middle wealth quantile (AOR = 1.21, 95% CI, 1.07, 1.35), knowledge about contracptives (AOR = 2.45, 95% CI, 2.19, 2.74), unmet need for family planning (AOR = 2.42, 95% CI, 2.14, 2.74), Angola (AOR = 9.59, 95% CI, 7.82, 11.77), Chad (AOR = 3.05, 95% CI, 2.49, 3.74), DR.Congo (AOR = 3.77, 95% CI, 3.06, 4.65), and Mali (AOR = 1.84, 95% CI, 1.47, 2.28) were factors significantly associated with teenage pregnancy.

CONCLUSIONS: This study found that teenage pregnancy remains a common public health problem in the study areas. Level of education, marital status, occupation, wealth index, unmet need for family planning, knowledge about contraceptives, and country were significantly associated with teenage pregnancy. Hence, for sustainable development goal 3 to be realized by 2030, there must be investment in policy implementation and evaluation, as well as engagement with stakeholders in adolescents’ sexual and reproductive health.

PMID:36650514 | DOI:10.1186/s12905-023-02169-7

BMC Med Educ. 2023 Jan 17;23(1):32. doi: 10.1186/s12909-023-04018-5.

ABSTRACT

OBJECTIVE: This descriptive study aimed to examine whether student past coursework performance, student or research supervisor characteristics, and the type of research project are related to the overall academic performance of a pharmacy student completing an honours research program.

METHODS: Data on undergraduate honours students who completed a Bachelor of Pharmacy degree at The University of Sydney, Sydney, Australia, between Jan 2015 and Dec 2020 was collected. This included socio-demographic characteristics, type of project undertaken, and academic outputs. Data was also collected on each supervisor’s academic role, level of experience, research area, and where they completed their PhD. Descriptive statistics were used to describe the study cohort and correlation analysis and unpaired t-tail analyses were conducted using SPSS software.

RESULTS: This five year study included 130 students of which 67% were female and 60% were domestic students. Each student was supervised by one of 48 individual academics who were a mix of early- (31%), mid-career (29%), and experienced researchers (40%) for pharmaceutical science (50%), clinical (45%), and education (5%) projects. Just less than half (49%) of students published one peer-reviewed journal article. Female students outperformed male students (p = 0.031) with female students also twice as likely (15%) to receive a university medal eligible mark compared with male students (7.0%). Similarly, domestic students were twice as likely (15%) to receive a university medal eligible mark when compared with international students (7.7%). Students who undertook a pharmaceutical science-based project outperformed education-based project students (p = 0.0235). Students who had published at least one peer-reviewed journal article outperformed those who had not published (p = 0.0014).

CONCLUSION: Factors that affected honours performance were student gender, residential status, type of project undertaken, and whether a student had published a peer-reviewed journal article.

PMID:36650513 | DOI:10.1186/s12909-023-04018-5

BMC Med Inform Decis Mak. 2023 Jan 17;23(1):9. doi: 10.1186/s12911-023-02102-w.

ABSTRACT

BACKGROUND: Globally, 38% of contraceptive users discontinue the use of a method within the first twelve months. In Ethiopia, about 35% of contraceptive users also discontinue within twelve months. Discontinuation reduces contraceptive coverage, family planning program effectiveness and contributes to undesired fertility. Hence understanding potential predictors of contraceptive discontinuation is crucial to reducing its undesired outcomes. Predicting the risk of discontinuing contraceptives is also used as an early-warning system to notify family planning programs. Thus, this study could enable to predict and determine the predictors for contraceptive discontinuation in Ethiopia.

METHODOLOGY: Secondary data analysis was done on the 2016 Ethiopian Demographic and Health Survey. Eight machine learning algorithms were employed on a total sample of 5885 women and evaluated using performance metrics to predict and identify important predictors of discontinuation through python software. Feature importance method was used to select top predictors of contraceptive discontinuation. Finally, association rule mining was applied to discover the relationship between contraceptive discontinuation and its top predictors by using R statistical software.

RESULT: Random forest was the best predictive model with 68% accuracy which identified the top predictors of contraceptive discontinuation. Association rule mining identified women’s age, women’s education level, family size, husband’s desire for children, husband’s education level, and women’s fertility preference as predictors most frequently associated with contraceptive discontinuation.

CONCLUSION: Results have shown that machine learning algorithms can accurately predict the discontinuation status of contraceptives, making them potentially valuable as decision-support tools for the relevant stakeholders. Through association rule mining analysis of a large dataset, our findings also revealed previously unknown patterns and relationships between contraceptive discontinuation and numerous predictors.

PMID:36650511 | DOI:10.1186/s12911-023-02102-w

BMC Musculoskelet Disord. 2023 Jan 18;24(1):37. doi: 10.1186/s12891-023-06156-9.

ABSTRACT

BACKGROUND: To compare the clinical and radiologic outcomes after anterior cervical dynamic or static plate fixation for short segment cervical degenerative disc diseases (DDD) for more than 5 years.

METHODS: Sixty-four patients who underwent anterior cervical one level discectomy or corpectomy with an anterior cervical plate system were followed for an average of 6.8 years for clinical and radiographic outcomes. Among the sixty-four patients, thirty-eight patients were fixed with a static plate (ORION and CSLP plate system) and the other twenty-six patients were fixed with a dynamic plate (ABC plate). Radiographic data were collected included the global sagittal alignment of the cervical spine (C2-C7), the local height and angle of the operated level pre-operatively, postoperatively and at last follow-up. A clinical assessment was performed at pre-operatively, three months postoperatively and final follow-up using the Japanese Orthopedic Association (JOA) /Visual Analogue Score(VAS)/ Neck Disablility Index(NDI) scoring system.

RESULTS: The mean follow-up time was 6.8 years. At final review, there were two cases of suspicious pseudarthrosis which were from ABC plate fixation group while the other cases all gained solid fusion. The height of fusion segment gained significantly improvement for both dynamic and static plate group post-operation, and all groups demonstrated a significant loss in height postoperatively. Generally, for the one level ACDF group, the height decrease was 0.5 mm for static plate and 1.6 mm for dynamic group which was significantly different(p < 0.05). And for one level ACCF group, this type of difference was not seen in which decreasing was 1.7 mm for static group and 1.8 mm for dynamic group. Segmental lordosis of the fusion segments was increased significantly both post-operation and final follow-up than before-operation for both one and two segments fusion. Global cervical lordosis from C2-C7 was increased in the early postoperative period in all groups, and at final follow-up the total lordosis was still getting better compared with early postoperative period, but this increase was not statistically significant. Clinical assessment of JOA/NDI showed that there was significantly improvement 3-month post-operation compared with pre-operation, and the score could get a slight further improvement at the final follow-up.

CONCLUSION: Our study demonstrated a statistically similar fusion rate between dynamic and static cervical plate fixation. However, the height gained with static plate fixation for single segment disease was maintained better than with dynamic plate fixation and there was no difference between JOA outcome scores between groups. Despite the reported improved biomechanics of dynamic plate fixation, further research needs to be done to show the clinical advantage of dynamic plate fixation.

PMID:36650488 | DOI:10.1186/s12891-023-06156-9

BMC Musculoskelet Disord. 2023 Jan 18;24(1):36. doi: 10.1186/s12891-022-06116-9.

ABSTRACT

BACKGROUND: Latent and active myofascial trigger points (MTrPs) in knee-associated muscles may play a key role in pain management among patients with knee osteoarthritis (KOA). The aim of this study was to investigate the effect of dry needling treatment on pain intensity, disability, and range of motion (ROM) in patients with KOA.

METHODS: This randomized, single-blinded, clinical trial was carried out for 6 weeks of treatment and 6-month follow-up. A total of 98 patients met the entry criteria and were randomly assigned to the dry needling latent and active myofascial trigger point (MTrPs) with the stretching group or the oral diclofenacwith the stretching group. Numeric Pain Rating Scale (NPRS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and ROM were statistically analyzed before and after treatment and at the 6-month follow-up.

RESULTS: A total of 42 patients in the dry needling group (DNG) and 35 patients in the diclofenac group (DG), respectively, completed the study, and there was no significant difference in the general data between the two groups. After treatments, both the groups showed a good effect in knee pain, function, and ROM, However, the DNG showed a significantly better result than the DG. Especially in the results of the 6-month follow-up, the DNG showed much better results than the DG.

CONCLUSIONS: Dry needling on latent and active MTrPs combined with stretching and oral diclofenac combined with stretching can effectively relieve pain, improve function, and restore knee ROM affected by KOA. However, the effects of dry needling and stretching are better and longer lasting than those of oral diclofenac and stretching for at least 6 months.

TRIAL REGISTRATION: Registered in the Chinese Clinical Trial Registry ( www.chictr.org.cn ) in 17/11/2017 with the following code: ChiCTR-INR-17013432.

PMID:36650486 | DOI:10.1186/s12891-022-06116-9

BMC Psychiatry. 2023 Jan 17;23(1):44. doi: 10.1186/s12888-023-04540-2.

ABSTRACT

BACKGROUND: Accumulating evidence showed that dietary habits might modify the risk of depression. This study aimed to evaluate the longitudinal association of egg consumption with depressive symptoms in the Chinese elderly.

METHODS: We analyzed the data from Zhejiang Ageing and Health Cohort Study including 8289 participants. The Patient Health Questionnaire-9 scale (PHQ-9) was used to assess depressive symptoms at baseline and three waves of follow-up (2015, 2016, and 2019-2020). A PHQ-9 cut-off score ≥ 5 was used to define depressive symptoms. The participants with depressive symptoms at baseline were excluded. Egg consumption was evaluated through the diet habits section of the baseline questionnaire. Self-reported egg consumption was measured as the number of eggs per week and categorized into three categories. Log-binomial regression models with Generalized Estimating Equations were utilized to evaluate the association of egg consumption with depressive symptoms and estimate relative risks (RRs).

RESULTS: The mean age of included participants was 68.6 years. After 6 years of follow-up, 1385 (16.7%) participants were indicated with depressive symptoms by PHQ-9 at least once. Compared with non-consumers or less-than-weekly consumers, participants consuming < 3 eggs/week and ≥ 3 eggs/week had 30% (RR = 0.70, 95%CI 0.62-0.80) and 38% (RR = 0.62, 95%CI 0.54-0.71) lower risks of depressive symptoms, respectively. A linear association was confirmed (P for trend < 0.01), and each egg increment per week was associated with a 4% lower risk of depressive symptoms (RR = 0.96, 95%CI 0.93-0.99). Sensitivity analyses yielded consistent results to the main analyses.

CONCLUSIONS: Egg consumption is prospectively related to a lower risk of depressive symptoms in the Chinese elderly. More prospective studies are needed to verify the association.

PMID:36650485 | DOI:10.1186/s12888-023-04540-2

BMC Public Health. 2023 Jan 18;23(1):122. doi: 10.1186/s12889-023-15050-x.

ABSTRACT

BACKGROUND: Neonatal health is a cornerstone for the healthy development of the next generation and a driving force for the progress of population and society in the future. Updated information on the burden of neonatal disorders (NDs) are of great importance for evidence-based health care planning in China, whereas such an estimate has been lacking at national level. This study aims to estimate the temporal trends and the attributable burdens of selected risk factors of NDs and their specific causes in China from 1990 to 2019, and to predict the possible trends between 2020 and 2024.

METHODS: Data was explored from the Global Burden of Disease study (GBD) 2019. Six measures were used: incidence, mortality, prevalence, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs). Absolute numbers and age-standardized rates (with 95% uncertainty intervals) were calculated. The specific causes of NDs mainly included neonatal preterm birth (NPB), neonatal encephalopathy due to birth asphyxia and trauma (NE), neonatal sepsis and other neonatal infections (NS), and hemolytic disease and other neonatal jaundice (HD). An autoregressive integrated moving average (ARIMA) model was used to forecast disease burden from 2020 to 2024.

RESULTS: There were notable decreasing trends in the number of deaths (84.3%), incidence (30.3%), DALYs (73.5%) and YLLs (84.3%), while increasing trends in the number of prevalence (102.3%) and YLDs (172.7%) from 1990 to 2019, respectively. The corresponding age-standardized rates changed by -74.9%, 0.1%, -65.8%, -74.9%, 86.8% and 155.1%, respectively. Four specific causes of NDs followed some similar and different patterns. The prediction results of the ARIMA model shown that all measures still maintained the original trends in the next five years. Low birth weight, short gestation, ambient particulate matter pollution and household air pollution from solid fuels were the four leading risk factors.

CONCLUSION: The health burden due to NDs is declining and is likely to continue to decline in the future in China. Delaying the increasing burden of disability may be the next target of concern. Targeted prevention and control strategies for specific causes of NDs are urgently needed to reduce the disease burden.

PMID:36650483 | DOI:10.1186/s12889-023-15050-x

BMC Womens Health. 2023 Jan 17;23(1):21. doi: 10.1186/s12905-023-02168-8.

ABSTRACT

BACKGROUND: Child marriage has long been a public health concern around the world, because it has the potential to deprive adolescent girls of their sexual reproductive health rights and limits their ability to reach their full potential in life. The prevalence of child marriage has been consistently higher in sub-Saharan Africa than elsewhere. However, fewer studies have explored the influence of both individual and community-level influences on early marriage in sub-Saharan Africa. This study, therefore, examined individual and community-level factors associated with child marriages in Zambia.

METHODS: Data came from the Zambia Demographic and Health Surveys (ZDHS) conducted in 2007, 2013-14 and 2018. A pooled weighted sample of 9990 women aged 20-29 years was used in the analysis. Stata software version 17 was used to perform statistical analysis, taking into account complex survey design. The association between individual- and community- level factors and early marital behavior was assessed using multilevel logistic regression models.

RESULTS: The prevalence of child marriage among women aged 20-29 was 44.4 percent (95% CI: 42.1, 46.7) in 2018, declining from 51.5 percent (95% CI: 48.9, 54.0) in 2007. Women with secondary or higher level of education [aOR = 0.36, 95% CI = 0.26-0.49] and [aOR = 0.07, 95% CI = 0.03-0.18] and those whose age at first birth was (15-19 year) or (20-29 years) were associated with less likelihood of experiencing child marriage. Communities with a high percentage of women who gave birth at a young age [aOR = 1.36, 95% CI = 1.15-1.62] were more likely to experience child marriage. Individual and community-level characteristics accounted for 35% of the overall variations in communities’ likelihood of experiencing early marriage. Even after controlling for both individual and community-level influences, the intra-class correlation revealed that around 4.5 percent of the overall variations remained unexplained.

CONCLUSION: Prevalence of child marriage has reduced over the years but is still high in Zambia. Both individual and community- level factors influenced child marriage in Zambia. There is a need to strengthen strategies that keep girls in school to delay their exposure to early sexual debut and child marriage. Designing of reproductive health interventions in the country should consider integration of community factors such as economic insecurity and access to reproductive health information.

PMID:36650478 | DOI:10.1186/s12905-023-02168-8

BMC Oral Health. 2023 Jan 17;23(1):23. doi: 10.1186/s12903-023-02716-6.

ABSTRACT

BACKGROUND: Autism is a lifelong neurodevelopmental disorder that poses challenges during dental treatment. Advanced behavior guidance techniques (BGTs) have been used to provide dental care for autistic people who have specific characteristics and complex dental treatment. This study was conducted to evaluate parental acceptance and analyze parents’ opinions of advanced BGTs during dental treatment in autistic people.

METHODS: This cross-sectional study was conducted on 141 parents of autistic people from the Mahidol Dental Hospital and the Autism online community. Informed consent was obtained before enrolling participants in the study. All parents were asked to rate their acceptance after watching VDO clips: passive restraint by device (PRBD), oral sedation (OS), and general anesthesia (GA) to evaluate parental acceptance of advanced BGTs through an online questionnaire survey. The online questionnaire included a visual analog scale (VAS) and open-ended questions to collect their opinions on each advanced BGT. Participants were categorized into two subgroups as follows: 81 in the “Experience group” and 60 in the “No experience group” according to their autistic people’ advanced BGT experience. Friedman’s two-way analysis of variance and the Mann-Whitney U test were used for statistical analyses. Open-ended questions were analyzed using quantitative content analysis.

RESULTS: PRBD was ranked the highest, followed by GA and OS. Parents in the “Experience group” rated significantly higher acceptance of their BGT experience than parents in the “No experience group” in all the three advanced BGTs.

CONCLUSIONS: All advanced BGTs were particularly accepted in this study. Previous experience of advanced BGTs had an influence on parental acceptance. Parents commented on their opinions toward each advanced BGT with a variety of perspectives.

TRIAL REGISTRATION: The protocol was approved by the ethical committee of the Faculty of Dentistry/Faculty of Pharmacy, Mahidol University (COA.No.MU-DT/PY-IRB 2021/022.1702) and was registered with Thai Clinical Trials Registry (TCTR20220521001).

PMID:36650476 | DOI:10.1186/s12903-023-02716-6

Int J Med Robot. 2023 Jan 17:e2500. doi: 10.1002/rcs.2500. Online ahead of print.

ABSTRACT

BACKGROUND: The aim of this study was to compare intraoperative and postoperative outcome between a robot-assisted vs. a navigated transpedicular fusion technique.

METHODS: This retrospective analysis included patients who underwent transpedicular posterior fusion of the spine due to trauma, pyogenic spondylodiscitis and osteoporosis. Surgery was done either with a robot-assisted or a percutaneous navigated transpedicular fusion technique. The outcome analysis included the duration of surgery, the radiation exposure, the postoperative screw position and complications.

RESULTS: Sixty patients were operated and 491 screws were analysed in total. No statistical difference was seen in the applied cumulative effective radiation dose per patient. Radiological assessment revealed a more accurate screw placement with robot-assistance. A learning curve could be observed in the robot-assisted fusion.

CONCLUSIONS: Robot-assisted and navigated transpedicular fusion techniques are both effective and safe. Robot-assisted transpedicular spine fusion goes along with higher placement accuracy but its implementation needs an adequate learning curve. This article is protected by copyright. All rights reserved.

PMID:36649651 | DOI:10.1002/rcs.2500