Category: Nevin Manimala

BMC Pregnancy Childbirth. 2022 Jun 2;22(1):465. doi: 10.1186/s12884-022-04734-8.

ABSTRACT

BACKGROUND: Fetal macrosomia defined as birth weight of 4000 g and above regardless of gestational age and associated with adverse maternal and fetal outcomes, especially among women in developing countries like Ethiopia. Despite the observed burden, there is limited evidence on determinants of fetal macrosomia. This study aimed to identify determinants of fetal macrosomia among live births at Wolaita Sodo town Southern Ethiopia.

METHODS: A facility-based matched case-control study design involved 360 singletons deliveries attended at hospitals in Wolaita Sodo town, southern Ethiopia, with 120 cases and 240 controls included. Cases and control were matched by maternal age. Cases were neonates with a birth weight of ≥ 4000, while controls were neonates with a birthweight between 2500gm and less than 4000gm. Data were collected by interviews, measuring, and reviewing mothers’ medical documents. Conditional logistic regression analysis was carried to identify the independent predictor variables. Statistical significance was set using a p-value < 0.05 and 95% CI for AOR.

RESULTS: Male neonates were four times more likely to be macrosomia than female neonates MAOR = 4.0 [95%CI; 2.25-7.11, p < 0.001]. Neonates born at gestational age ≥ 40 weeks were 4.33 times more likely to be macrosomia with MAOR = 4.33 [95%CI; 2.37-7.91, p < 0.001]. Neonates born from physically inactive mothers were 7.76 times more likely to be macrosomia with MAOR = 7.76 [95CI; 3.33-18.08, p < 0.001]. Neonates born from mothers who consumed fruits and dairy products in their diet frequently were 2 and 4.9 times more likely to be macrosomia MAOR = 2.03 [95%CI; 1.11-3.69, p = 0.021] and AOR = 4.91[95%CI; 2.36-10.23, p < 0.001] respectively.

CONCLUSION: Mothers’ physical exercise and consumption of fruit and dairy products were significant predictor variables for fetal macrosomia. Hence, health care providers may use these factors as a screening tool for the prediction, early diagnosis, and timely intervention of fetal macrosomia and its complications.

PMID:35655197 | DOI:10.1186/s12884-022-04734-8

BMC Infect Dis. 2022 Jun 2;22(1):515. doi: 10.1186/s12879-022-07500-5.

ABSTRACT

OBJECTIVES: To identify risk-prone areas for the spread of tuberculosis, analyze spatial variation and temporal trends of the disease in these areas and identify their determinants in a high burden city.

METHODS: An ecological study was carried out in Ribeirão Preto, São Paulo, Brazil. The population was composed of pulmonary tuberculosis cases reported in the Tuberculosis Patient Control System between 2006 and 2017. Seasonal Trend Decomposition using the Loess decomposition method was used. Spatial and spatiotemporal scanning statistics were applied to identify risk areas. Spatial Variation in Temporal Trends (SVTT) was used to detect risk-prone territories with changes in the temporal trend. Finally, Pearson’s Chi-square test was performed to identify factors associated with the epidemiological situation in the municipality.

RESULTS: Between 2006 and 2017, 1760 cases of pulmonary tuberculosis were reported in the municipality. With spatial scanning, four groups of clusters were identified with relative risks (RR) from 0.19 to 0.52, 1.73, 2.07, and 2.68 to 2.72. With the space-time scan, four clusters were also identified with RR of 0.13 (2008-2013), 1.94 (2010-2015), 2.34 (2006 to 2011), and 2.84 (2014-2017). With the SVTT, a cluster was identified with RR 0.11, an internal time trend of growth (+ 0.09%/year), and an external time trend of decrease (- 0.06%/year). Finally, three risk factors and three protective factors that are associated with the epidemiological situation in the municipality were identified, being: race/brown color (OR: 1.26), without education (OR: 1.71), retired (OR: 1.35), 15 years or more of study (OR: 0.73), not having HIV (OR: 0.55) and not having diabetes (OR: 0.35).

CONCLUSION: The importance of using spatial analysis tools in identifying areas that should be prioritized for TB control is highlighted, and greater attention is necessary for individuals who fit the profile indicated as “at risk” for the disease.

PMID:35655177 | DOI:10.1186/s12879-022-07500-5

BMC Musculoskelet Disord. 2022 Jun 2;23(1):526. doi: 10.1186/s12891-022-05490-8.

ABSTRACT

BACKGROUND: Most ergonomics studies on office workstations evaluate the effects of an intervention only by subjective measures such as musculoskeletal pain and discomfort. Limited evidence has been provided regarding risk factor reduction in office environments through standardized methods assessments. The Rapid Office Strain Assessment (ROSA) tool can provide an estimation of risk factor exposure for office workers as a means by which the outcome of interventions can be quantified.

PURPOSE: The aim of the study was to evaluate if ROSA scores reflect changes in risk factors after an ergonomics intervention among office workers.

METHODS: Office workers (n = 60) were divided into two groups. The experimental group received a workstation intervention and the control group received no intervention. Changes in ROSA scores were compared before and after the intervention in both groups.

RESULTS: Statistically significant reductions in the ROSA final and section scores occurred after the intervention in the experimental group with (mean reduction of 2.9, 0.8 and 1.6 points for sections A, B and C, respectively). In contrast, no differences were detected in the control group (mean increase of 0.1 point for sections A and C and mean reduction of 0.1 point for Section B).

CONCLUSIONS: These findings show that ROSA scores reflect changes in risk factors after an ergonomics intervention in an office environment. Consequently, this tool can be used for identifying and controlling risk factors among computer workers, before and after interventions.

PMID:35655178 | DOI:10.1186/s12891-022-05490-8

BMC Ophthalmol. 2022 Jun 2;22(1):242. doi: 10.1186/s12886-022-02452-5.

ABSTRACT

BACKGROUND: To assess visual quality and stabilization of refractive changes in corneal edema patients after cataract surgery, using visual acuity (VA) and contrast sensitivity measurements.

METHODS: Sixty-one eyes were analysed, twenty-three with and thirty-eight without corneal edema. Uncorrected and corrected distance VA (UDVA and CDVA) were determined with an EDTRS chart, the contrast sensitivity function (CSF) under photopic and mesopic illumination conditions with a CVS-1000e chart, clinical refraction, and corneal topography. Measurements were taken preoperatively, 1-2 days, 1 and 3-months after surgery. Clinical refraction was converted to vector notation (M, J₀, J₄₅) and SPSS v26.0 was used for data analysis.

RESULTS: An improvement of VA was observed through the postoperative period; changes between visits were significant for CDVA in both groups and for UDVA in the edema sample. Significant astigmatic changes (J₀,J₄₅) between visits were not observed, but M values showed a hyperopic tendency in the edema group and a myopic shift in the control group that did not change between visits, with statistically significant differences between groups. Controls had significantly better contrast sensitivity at high spatial frequencies. Under mesopic conditions, global contrast sensitivity losses were observed in the edema group, which improved between visits in the middle frequency range.

CONCLUSION: Corneal edema patients had a significant reduction of CDVA, and frequency-selective sensitivity losses that evidence a visual quality loss. Clinical refraction may improve visual quality, but in edema patients these losses are related to corneal changes, which did not change at three months after surgery.

PMID:35655163 | DOI:10.1186/s12886-022-02452-5

J Obstet Gynaecol. 2022 Jun 2:1-7. doi: 10.1080/01443615.2022.2081796. Online ahead of print.

ABSTRACT

Advanced glycation end-products (AGE) are complex compounds formed by nonenzymatic glycosylation of proteins, nucleic acids, and lipids with glucose in the blood. We aimed to investigate whether there was a difference in first-trimester serum AGE levels of pregnant women with and without risk factors for gestational diabetes mellitus (GDM) and their obstetric outcomes. There were 44 women in study group who have risk factors for GDM and 44 as controls. Demographic features, serum AGE levels, adverse perinatal and neonatal outcomes were compared between groups. Five patients (11.4%) in the study group and one patient (2.3%) in the control group were diagnosed as GDM (p = .2). The serum AGE values were not statistically different between the study and control groups. There were no statistical differences between groups in terms of adverse perinatal and neonatal outcomes. However, in the group with adverse perinatal outcome (n = 25), AGE values were higher than the control group. The results of our preliminary study suggested that high-risk women for GDM did not have increased serum levels of AGE in the first trimester. Nevertheless, a high first-trimester serum AGE level was found to be associated with adverse perinatal outcomes. IMPACT STATEMENTWhat is already known on this subject? Advanced glycation end products (AGE) are markers that are associated with diabetes and its complications. For pregnant women, a high third trimester serum AGEs levels were found in women who had gestational diabetes.What do the results of this study add? The results of our study revealed that first trimester screening of serum AGE levels of women who had risk factors for gestational diabetes was not discriminate. Nevertheless, a high first trimester serum AGE levels was associated with adverse perinatal outcome.What are the implications of these findings for clinical practice and/or further research? Whether reducing exogenous sources of AGE (western-style diet, smoking) before pregnancy will be associated with better pregnancy outcomes should be investigated in future studies.

PMID:35653797 | DOI:10.1080/01443615.2022.2081796

J Community Health Nurs. 2022 Jul-Sep;39(3):202-212. doi: 10.1080/07370016.2022.2077072.

ABSTRACT

PURPOSE: To determine the incidence of anxiety and depression and examine their cross-sectional associations with chronic pain and quality of life among older adults in rural China.

DESIGN: Observational, multi-center, cross-sectional study.

METHODS: A structured, self-report questionnaire was administered. Descriptive statistics analysis and stepwise multiple linear regression analysis were performed.

FINDINGS: 244 participants (female: 47.1%) filled out the questionnaires. 87 (35.7%) had symptoms of anxiety and 123 (50.4%) had symptoms of depression. The sensory pain descriptor, affective pain descriptor, physical component summary, and mental component summary significantly influenced symptoms of anxiety while affective pain descriptor, physical component summary, and mental component summary significantly influenced symptoms of depression.

CONCLUSION: Subjective pain experiences and QoL, including physical and mental domains, are strongly related to symptoms of anxiety and depression among older adults in rural China.

CLINICAL EVIDENCE: Interventions that highlight subjective pain experiences and QoL may help to relieve symptoms of anxiety and depression in older adults.

PMID:35653791 | DOI:10.1080/07370016.2022.2077072

J Community Health Nurs. 2022 Jul-Sep;39(3):193-201. doi: 10.1080/07370016.2022.2058876.

ABSTRACT

PURPOSE: To evaluate learning experience and clinical outcomes after intervention.

DESIGN: A mixed study.

METHODS: A multiple cohort sample (n=75) of community nurses underwent an SP simulation. A survey and 12- and 24-month incident data were used to evaluate the learning experience and clinical outcomes.

FINDINGS: The nurses were highly satisfied with their learning. In addition, their ability to identify near-misses and the presence of incidents showed a statistically significant improvement (p < .05).

CONCLUSIONS: SP simulation effectively improved learning experience and clinical outcomes regardless of nurses’ experience.

CLINICAL EVIDENCE: Simulation learning can have a positive impact on clinical outcomes.

PMID:35653790 | DOI:10.1080/07370016.2022.2058876

J Obstet Gynaecol. 2022 Jun 2:1-6. doi: 10.1080/01443615.2022.2081492. Online ahead of print.

ABSTRACT

The aim of the study was to examine the severity of clinical symptoms of acute cystitis and the level bacteriuria in female patients who underwent to laparoscopic surgery followed by a postoperative administration of dienogest 2 mg and combined oral contraceptives pills (COCP). One hundred and forty five women who had a laparoscopic surgery prospectively were enrolled. Criteria inclusions were the age from 30 to 45 years old; body mass index (BMI) absence of previous hormonal therapy at least 6 month and recent performed a laparoscopy surgery for endometriosis. The women (n = 35) who had uterine myoma, abnormal coagulation profile; concomitant neoplastic diseases; chronic pelvic inflammatory disease and chronic recurrent cystitis were excluded from study. The female patients were assigned into both groups treatment: group I (n = 54) and group II (control, n = 56) who received dienogest 2 mg once daily and COCP, respectively. During follow-up three female patients of group I were withdrawn due to prolonged genital bleedings. The final analysis included 105 women. The patients of both groups had a low level of bacteriuria <10³ CFU/ml without clinical symptoms of acute cystitis before treatment. The level of bacteriuria in-group I significantly increased from 10² to 10⁶ CFU/ml whereas in-group II did not exceed 10² CFU/ml during 4 weeks of hormonal treatment. The differences of values of acute cystitis symptom score (ACSS) for differential, typical, quality of life domains were statistically significant after 4, 8 and 12 weeks of therapy in-group I compared with group II. During 3 months of hormonal treatment with dienogest 2 mg in group I, the acute cystitis developed in 10 (18.5%), in 19 (38%) and in 34 (68%) women at 4, 8 and 12 weeks of follow-up, respectively. All cases of acute cystitis in-group I were successfully treated with fosfomycin trometamol 3 g single dose or nitrofurantoin 50 mg four times a day during 5 days. We concluded that the dienogest might increase the level bacteriuria and severity of clinical symptoms of acute cystitis during a postoperative prophylaxis of endometriosis.Impact statementWhat is already known on this subject? Dienogest is a 19-nortestosterone derivative progestogen that is highly selective for progesterone receptors with high efficacy for reducing endometriosis-related pelvic pain syndrome. The administration of dienogest is a standard treatment option after laparoscopic excision of endometrial heterotopic tissue with prophylactic purpose. However, there are some adverse events, which are a cause for discontinuation.What do the results of this study add? Despite the low incidence of urinary tract infection (1-5.4%) reported in different studies this study has shown that there was a significant increase of level bacteriuria and severity of clinical symptoms of cystitis in the dienogest group.What are the implications of these findings for clinical practice and/or further research? The implications of these findings are that the administration of dienogest may lead to enhancing of clinical symptoms of cystitis and increasing bacteriuria in some women after operative treatment of endometriosis.

PMID:35653789 | DOI:10.1080/01443615.2022.2081492

J Obstet Gynaecol. 2022 Jun 2:1-6. doi: 10.1080/01443615.2022.2069483. Online ahead of print.

ABSTRACT

A retrospective observational study of new patients who visited the gynaecology outpatient clinic at Tygerberg Hospital, South Africa, between February and June 2019 was conducted to determine the association between body mass index (BMI) and gynaecological disorders. BMI was calculated and analysed concerning the presenting complaint and final diagnosis. From the sample of 651 patients, 18.4% had a normal BMI and 47.3% were classified as overweight or obese class 1. Older age was associated with a higher BMI (p = .013). Hypertension was most prevalent (26.7%) and associated with excess weight (p < .001). Disorders significantly associated with obesity were infertility (odds ratio [OR] 1.013, 95% confidence interval [CI] 0.992-1.033, p = .001), polycystic ovarian syndrome (OR 1.058, 95% CI 1.028-1.089, p = .006), pelvic organ prolapse (OR 1.027, 95% CI 0.995-1.060, p = .0291) and postmenopausal bleeding (OR 1.038, 95% CI 1.009-1.068, p = .048). Chronic pelvic pain and endometriosis were associated with a low BMI. IMPACT STATEMENTWhat is already known on this subject? It is well known that obesity has multiple negative effects on health. It affects women’s health on many levels including their endocrine balance as well as pressure effects on the pelvic floor. The association between gynaecological disorders and excess weight has been described mainly in the context of separate gynaecological conditions.What the results of study add? This study described the large numbers of women with obesity in the South African context. It adds to the body of knowledge by looking at the association of BMI, not only obesity, and a large range of the most seen gynaecological conditions in the study setting.What the implications are of these findings for clinical practice and/or further research? This study highlights the importance of lifestyle and nutritional implications on women’s health. For clinical practice, this knowledge needs to be applied with every opportunity to counsel women on how their weight can affect their gynaecological health. The focus of further research should focus on the most effective strategies to combat obesity in a holistic patient-centered approach.

PMID:35653780 | DOI:10.1080/01443615.2022.2069483

J Obstet Gynaecol. 2022 Jun 2:1-7. doi: 10.1080/01443615.2022.2070730. Online ahead of print.

ABSTRACT

Information and Communication Technologies increase healthcare education. Since the COVID-19 pandemic outbreak, they have been gaining importance. Our aim was to assess the effects of a web-based questionnaire used in a pelvic floor consultation. We performed a prospective intervention study analysing the use of a web-based questionnaire prior to a first appointment. Fifty-two women used the questionnaire and 52 did not. All patients filled in a paper-based survey relating to satisfaction and pelvic floor knowledge after the appointment. Women in the intervention group showed better knowledge. They had 11% more correct answers for organ prolapse definition [CI 95% (-0.30 to 0.07)], 25% more correct answers for incontinence definition [CI 95% (-0.41 to -0.08)] and 23% better incontinence classification [CI 95% (-0.34 to 0.09]. More patients in the web-questionnaire group started primary therapy in the first consultation (38% versus 16%). Measurements of the total mean time in the consultation room revealed no statistically significant differences [19.36 (SD 4.96) and 21.19 (SD 4.62) minutes, respectively; p = .05] and satisfaction levels were similar.After using our web-based questionnaire, the time for medical histories reduced and patient knowledge increased without changing satisfaction levels. Impact statementWeb-based questionnaires (WBQ) and information web links may help to reduce time of history taking while time for physical examination, counselling and treatment discussion increases. Also, patient knowledge improves.What is already known on this subject? There are reviews showing how Information and Communication Technologies (ICT) can improve health quality and sanitary education. Since the Covid-19 pandemic started, ICT use has been accelerated and traineeship and learning has been enforced. However, there is not extensive research on its use in gynaecological consultations.What do the results of this study add? We have proved that the use of a WBQ and information web links before face-to-face first visit in a pelvic floor service improves patient knowledge. We have also worked to provide scientific evidence to an ICT tool.What are the implications of these findings for clinical practice and/or further research? The most important implications for clinical practice are the improvement of patient-provider communication, the time reduction for history taking in contrast to time increase for physical examination, counselling and treatment discussion.Apart from that, WBQ may help to measure qualitative information, because it is registered and can be used as patient reported outcomes (PRO) to increase quality of care. Further research should focus on other benefits of WBQ such as achieving better patient satisfaction.

PMID:35653774 | DOI:10.1080/01443615.2022.2070730