Nevin Manimala

BMC Public Health. 2023 Jan 5;23(1):31. doi: 10.1186/s12889-022-14807-0.

ABSTRACT

BACKGROUND: There are few thorough studies on the extent and inter-element relationships of heavy metal contamination in printing factory workers, especially in developing countries. The objective of this study was to determine the levels of eight heavy metals, including arsenic (As), cadmium (Cd), chromium (Cr), nickel (Ni), cobalt (Co), lead (Pb), mercury (Hg), and manganese (Mn), in urine and scalp hair of printing industry workers, and assess inter-element correlations.

METHODS: We examined a total of 85 urine samples and 85 scalp hair samples (3 cm hair segments taken from near the scalp) in 85 printing workers from a printing house in Bangkok, Thailand. We used an interviewer-administered questionnaire about participants’ printing techniques, work characteristics, and work environment. Urine and scalp hair samples were analyzed for levels of each element using the inductively coupled plasma optical emission spectrometry (ICP-OES) technique.

RESULTS: As, Cd, Cr, Ni, Pb were detected in urine with the geometric mean concentration range of 0.0028-0.0209 mg/L, and Hg, Pb, Ni, Cd, Co, Mn, Cr were detected in hair samples (0.4453-7.165 mg/kg dry weight) of printing workers. The geometric mean Ni level was significantly higher in the urine of production line workers than back-office personnel (0.0218 mg/L vs. 0.0132 mg/L; p = 0.0124). The other elements did not differ significantly between production line and back-office workers in either urine or hair. There was also a strong, statistically significant positive correlation between Ni and Co levels in hair samples of workers (r = 0.944, p < 0.0001).

CONCLUSIONS: Average concentrations of most of the metals in urine and hair of printing workers were found to be above the upper reference values. The significantly higher concentrations of Ni in production line workers might be due to more exposure to printed materials. A strong inter-element correlation between Ni and Co in hair samples can increase stronger health effects and should be further investigated. This study reveals possible dependencies and impact interactions of heavy metal exposure in printing factory workers.

PMID:36604667 | DOI:10.1186/s12889-022-14807-0

J Orthop Surg Res. 2023 Jan 5;18(1):14. doi: 10.1186/s13018-022-03493-8.

ABSTRACT

OBJECTIVE: To evaluate the efficacy and safety of tranexamic acid (TXA) in hemostasis in patients undergoing posterior lumbar interbody fusion (PLIF) by meta-analysis.

METHODS: This study was registered on the International Prospective Register of Systematic Reviews (PROSPERO) (ID: CRD42022354812). The databases PubMed, Cochrane Library, Web of Science, and Embase were searched for randomized controlled trial (RCT) papers on the use of TXA in patients with PLIF from database establishment to August 2022. Two researchers screened the literature, extracted data, evaluated the risk of bias of the included studies, recorded the authors, sample size, type of study design, and TXA dose of each study, and extracted the intraoperative blood loss, number of blood transfusions, total blood loss, drainage volume, operation time, and incidence of deep venous thrombosis in each study. Meta-analysis was performed using RevMan 5.4 software provided by Cochrane Library.

RESULTS: A total of 14 RCTs with a total of 1681 patients were included in this study, including 836 patients in the TXA group and 845 patients in the control group. The intraoperative blood loss [mean difference (MD) = – 125.97, 95% confidence interval (CI) (- 138.56, – 113.37), P < 0.0001] and less total blood loss [MD = – 204.28, 95% CI (- 227.38, – 181.18), P < 0.00001] in TXA group were lower than the control group. Statistical significance was also observed in postoperative drainage volume [MD = – 115.03, 95% CI (- 123.89, – 106.17), P < 0.00001], operation time [MD = – 8.10, 95% CI (- 14.49, – 1.71), P = 0.01], and blood transfusion rate [odds ratio (OR) = 0.30, 95% CI (0.23, 0.39), P < 0.00001]. However, there was no statistical difference observed in the incidence of deep venous thrombosis [OR = 0.83, 95% CI (0.56, 1.21), P = 0.33].

CONCLUSION: The application of TXA in PLIF can reduce intraoperative blood loss, total blood loss, drainage volume, the incidence of transfusion events, and operation time without increasing the risk of deep venous thrombosis.

PMID:36604661 | DOI:10.1186/s13018-022-03493-8

BMC Psychiatry. 2023 Jan 5;23(1):13. doi: 10.1186/s12888-022-04494-x.

ABSTRACT

BACKGROUND: Type 2 diabetes mellitus is the most common health problem globally. Depression and anxiety can exacerbate disease complications, make patients suffer more, and increase healthcare costs. Even though, depression and anxiety are common among type 2 diabetes mellitus patients, there have been limited studies conducted about the determinants of depression and anxiety in Ethiopia. Therefore, the purpose of this study was to assess the magnitude and determinants of depression and anxiety symptoms among Type 2 diabetes mellitus patients, attending out-patient treatment at Harari regional state government hospitals, Eastern Ethiopia.

METHOD: An institutional based cross-sectional study was conducted from March to April at Harari regional state government hospitals in eastern Ethiopia. A total of 421 participants were recruited using the systematic sampling technique. Data was collected by using Afan Oromo version of interviewer-administered structured and semi-structured questionnaires. Depression and Anxiety symptoms were assessed by the Hospital Anxiety and Depression Scale. Bivariate and multivariate logistic regression analysis was done to identify variables related to both depression and anxiety symptoms. The association was described using an adjusted odds ratio and a 95% confidence interval (CI), with P-values of 0.05 used as a cutoff for a significant association in the adjusted analysis.

RESULT: Out of the 416 participants included in this study, 42.3%, 40.4% had depression and anxiety symptoms, respectively. Being female (Adjusted Odds Ratio = 1.85(1.09-3.15)), no formal education (Adjusted Odds Ratio = 2.65, (1.04-6.73)), age ≥ 70 (Adjusted Odds Ratio = 2.88 (1.28-6.48)), family history of mental illness (Adjusted Odds Ratio = 1.71 (1.35-3.82)) and poor social support (Adjusted Odds Ratio = 2.35(1.12-6.03)) were statistically associated with depression. While having a family history of mental illness (AOR 1.74(1.03-2.95)), being widowed (AOR = 3.45(1.49-8.01)), and having poor social support (AOR = 2.15(1.12, 4.89)) were statistically significant associated with anxiety at a p-value < 0.05.

CONCLUSION: Current study results showed that the magnitude of depression and anxiety were relatively high among type 2 diabetes mellitus patients.Having a family history of mental illness and poor social support were statistically associated with both depression and anxiety symptoms. Screening, early detection, and appropriate treatment of depression and anxiety symptoms in type 2 diabetes mellitus patients should be prioritized by health care providers.

PMID:36604654 | DOI:10.1186/s12888-022-04494-x

BMC Public Health. 2023 Jan 6;23(1):35. doi: 10.1186/s12889-023-14978-4.

ABSTRACT

BACKGROUND: Lower physical activity and sedentary behavior have been identified as modifiable risk factors for cardiovascular disease (CVD). However, the quantitative, dose-response association between activity-to-sedentary ratio (ASR) and mortality is unknown.

METHODS: Prospective cohort studies with participants 50 to 80 years that reported the association between recreational physical activity, sedentary behavior, and all-cause mortality were included from the 2007 to 2014 United States National Health and Nutrition Examination Survey (NHANES) and followed through December 31, 2015. Cox or Weibull regression models and restricted cubic splines were used to determine the association between ASR and all-cause mortality.

RESULTS: Sixty deaths occurred among 498 CVD survivors, with a median of 56 months of follow-up. After accounting for all covariates, CVD survivors with an ASR between 0.21 and 0.57 (hazard ratio [HR], 0.47; 95% confidence interval [CI], 0.25-0.87) and those with an ASR more than 0.57 (HR, 0.40; 95% CI, 0.20-0.81) were at significantly lower risk for mortality than participants with an ASR < 0.21. Moreover, a nonlinear negative association and an L-shaped association were observed for the level of ASR with risk of mortality among CVD survivors (P for nonlinearity = 0.004). What’s more, adjusting for covariates, a statistically significant interaction (P for interaction = 0.016) between sex and ASR, an increase of ASR more than and equal to 0.18 was associated with a lower risk of mortality among males (HR, 0.23; 95% CI, 0.12-0.46).

CONCLUSIONS: An negative correlation between ASR and mortality in CVD survivors, especially in males when ASR is more than 0.18. Our novel findings provide further insights into easing the global burden of deaths.

PMID:36604643 | DOI:10.1186/s12889-023-14978-4

BMC Public Health. 2023 Jan 5;23(1):24. doi: 10.1186/s12889-022-14917-9.

ABSTRACT

BACKGROUND: Both depression and anxiety are worldwide burden that is not being abated with our current knowledge and treatment of the condition. Numerous clinical trials have supported that physical activity (PA) can reduce the depression and anxiety in adolescents, but little is known about its mechanism of action. Therefore, the study objectives were to explore the potential relationship between physical activity and depression and anxiety from the perspective of body image and body mass index (BMI), and to provide an important reference for future self-esteem education and health promotion intervention.

METHODS: The participants in this study were 251 Chinese college students between 17 and 22 years old. Participants completed the International Physical Activity Questionnaire-Short Form (IPAQ-SF), the Body Image Questionnaire (BIQ), the Self-rating Depression Scale (SDS) and the Self-rating Anxiety Scale (SAS). A descriptive and correlational approach was used, using the PROCESS macro for Statistical Package for the Social Sciences (SPSS).

RESULTS: (1) Physical activity was significantly negatively correlated with both depression and anxiety (t = -0.216, p < 0.001; t = -0.184, p < 0.01). (2) Body image had a significant moderating effect on the relationship between physical activity and anxiety among college students, but there was no moderating effect between depression and physical activity. BMI has no moderating effect on the two interrelationships.

CONCLUSION: There is only body image that moderates the relationship between anxiety and physical activity.

PMID:36604631 | DOI:10.1186/s12889-022-14917-9

BMC Public Health. 2023 Jan 5;23(1):30. doi: 10.1186/s12889-023-14985-5.

ABSTRACT

BACKGROUND: In resource-constrained settings like Namibia, breast self-examination (BSE) is considered an important cost-effective intervention that is critical to the early detection of breast cancer, and better prognosis. Even though BSE is a simple, quick, and cost-free procedure, its practice varies across different contexts. Knowing the determinants of BSE is necessary to inform the implementation of policies and targeted interventions to improve the practice across the population. In Namibia, estimating the magnitude of BSE practice and its determinants using nationally representative data has received limited scholarly attention. Hence, the present study sought to examine the prevalence and determinants of BSE practices among women of reproductive age in Namibia.

METHODS: This study relied on the 2013 Namibia Demographic and Health Survey (NDHS), analysing data from women aged 15-49 years. Statistical analyses including bivariate and multivariate logistic regression analyses were done using Stata version 14. Adjusted odds ratio (AOR) and confidence interval (CI) are presented. We followed the ‘Strengthening the Reporting of Observational Studies in Epidemiology’ (STROBE) statement.

RESULTS: Only 30.67% of the respondents practiced BSE. The odds of performing BSE were higher among those with health insurance coverage [AOR = 1.59, 95% CI: 1.34, 1.89], those who were separated from their spouses [AOR = 1.36, 95% CI: 1.03, 1.80], those within the richest wealth index [AOR = 1.69, 95% CI: 1.23, 2.33, p ≤ 0.001], and among Catholics [AOR = 0.84, 95% CI: 0.71, 0.98]. Women with secondary [AOR = 2.44, 95% CI:1.78, 3.35, p ≤ 0.001] or higher education [AOR = 3.39, 95%CI:2.24, 5.14] had higher odds of performing BSE. Women aged between 20-49 years had a significantly higher likelihood to practice BSE. Compared to women who live in Khomas, those living in Erongo, Karas, and Omaheke, were more likely to practice BSE than those in Kavango, Ohangwena, Omusati, Oshana, and Oshikoto.

CONCLUSION: We conclude that the determinants of BSE practice are age, educational level, marital status, health insurance coverage, religion, mobility in the last 12 months, early sexual debut, parity, household wealth index, and region of residence. Any policy or intervention to improve BSE practice among Namibian women of reproductive age must target adolescent girls, those with no formal education, those without health insurance coverage, multiparous women, and those in the poorest wealth index.

PMID:36604629 | DOI:10.1186/s12889-023-14985-5

BMC Neurol. 2023 Jan 5;23(1):3. doi: 10.1186/s12883-022-03037-x.

ABSTRACT

BACKGROUND AND PURPOSE: Mild cognitive impairment is an age-dependent pre-dementia state caused by varied reasons. Early detection of MCI helps handle dementia. Vascular factors are vital for the occurrence of MCI. This study investigates the correlation between deep medullary veins and multi-dimensional cognitive outcomes.

MATERIALS AND METHODS: A total of 73 participants with MCI and 32 controls were enrolled. Minimum Mental State Examination and Montreal Cognitive Assessment were used to examine the global cognitive function, and different cognitive domains were measured by specific neuropsychological tests. MRI was used to assess the visibility of the DMV and other neuroimage markers.

RESULTS: DMV score was statistically significantly higher in the MCI group compared with the control group (P = 0.009) and independently related to MCI (P = 0.007). Linear regression analysis verified that DMV score was linearly related to global cognition, memory, attention, and executive function after adjusting for cerebrovascular risk factors.

CONCLUSION: DMV score was independently related to the onset of MCI, and correlates with overall cognition, memory, attention, and executive function in outpatients.

PMID:36604624 | DOI:10.1186/s12883-022-03037-x

BMC Emerg Med. 2023 Jan 5;23(1):1. doi: 10.1186/s12873-022-00767-6.

ABSTRACT

BACKGROUND: It is important to determine the severity of inhalation injury in severely burned patients. The oxygenation index PaO₂/FiO₂(PF) ratio is a key clinical indicator of inhalation injury. Sequential organ failure assessment (SOFA) is developed to assess the acute incidence of critical illness in the population. We hope to provide an assessment of survival or prognostic factor for severely burned patients with inhalation injury based on the respiratory SOFA score.

METHODS: This is a retrospective cohort study of all admissions to Department of Burn and Plastic Surgery at West China Hospital of Sichuan University from July 2010 to March 2021. Data was analyzed using Cox regression models to determine significant predictors of mortality. Survival analysis with time to death event was performed using the Kaplan-Meier survival curve with the log-rank test. All potential risk factors were considered independent variables, while survival was considered the risk dependent variable.

RESULTS: One hundred eighteen severe burn patients with inhalation injury who met the inclusion and exclusion criteria were admitted, including men accounted for 76.3%. The mean age and length of stay were 45.9 (14.8) years and 44.3 (38.4) days. Flame burns are the main etiology of burn (74.6%). Patients with the respiratory SOFA score greater than 2 have undergone mechanical ventilation. Univariate Kaplan-Meier analysis identified age, total body surface area burned (TBSA), ICU admission and the respiratory SOFA score as significant factors on survival. Cox regression analysis showed that TBSA and the respiratory SOFA score were associated with patient survival (p < 0.001). In some patients with severe burns and inhalation damage, the survival probability drops to less than 10% (TBSA greater than 80%: 8.9% and respiratory SOFA score greater than 2: 5.6%). This study statistically found that the TBSA with the respiratory SOFA score model (AUROC: 0.955) and the rBaux score (AUROC: 0.927) had similar predictive value (p = 0.175).

CONCLUSION: The study indicates that a high respiratory system SOFA score was identified as a strong and independent predictor of severely burned patients with inhalation injury during hospitalization. When combined with TBSA, the respiratory SOFA scores can dynamically assess the severity of the patient’s lung injury and improve the predictive level.

PMID:36604623 | DOI:10.1186/s12873-022-00767-6

BMC Med Res Methodol. 2023 Jan 5;23(1):3. doi: 10.1186/s12874-022-01759-7.

ABSTRACT

BACKGROUND: In inter-rater agreement studies, the assessment behaviour of raters can be influenced by their experience, training levels, the degree of willingness to take risks, and the availability of clear guidelines for the assessment. When the assessment behaviour of raters differentiates for some levels of an ordinal classification, a grey zone occurs between the corresponding adjacent cells to these levels around the main diagonal of the table. A grey zone introduces a negative bias to the estimate of the agreement level between the raters. In that sense, it is crucial to detect the existence of a grey zone in an agreement table.

METHODS: In this study, a framework composed of a metric and the corresponding threshold is developed to identify grey zones in an agreement table. The symmetry model and Cohen’s kappa are used to define the metric, and the threshold is based on a nonlinear regression model. A numerical study is conducted to assess the accuracy of the developed framework. Real data examples are provided to illustrate the use of the metric and the impact of identifying a grey zone.

RESULTS: The sensitivity and specificity of the proposed framework are shown to be very high under moderate, substantial, and near-perfect agreement levels for [Formula: see text] and [Formula: see text] tables and sample sizes greater than or equal to 100 and 50, respectively. Real data examples demonstrate that when a grey zone is detected in the table, it is possible to report a notably higher level of agreement in the studies.

CONCLUSIONS: The accuracy of the proposed framework is sufficiently high; hence, it provides practitioners with a precise way to detect the grey zones in agreement tables.

PMID:36604617 | DOI:10.1186/s12874-022-01759-7

BMC Infect Dis. 2023 Jan 5;23(1):2. doi: 10.1186/s12879-022-07975-2.

ABSTRACT

BACKGROUND: Chlamydia trachomatis and Mycoplasma infections have been regarded as severe challenges to public health worldwide because their potential risk of leading to serious reproductive complications. C. trachomatis is the most common sexually transmitted bacterial infections and the prevalence has been increasing in recent years. As a newly discovered pathogen, Mycoplasma genitalium has gradually been recognized as important sexually transmitted infection and even been called a “new chlamydia”. There are no official epidemiological data of M. genitalium in China especially in women with lower reproductive tract infection. This work aims to understand the prevalence and risk factors of M. genitalium and C. trachomatis in women with lower reproductive tract infections and to provide reference for the formulation of health policy in China.

METHODS: This study was conducted in the gynecological clinics of 12 hospitals geographically located in different regions in China. Women with purulent cervical secretions or abnormal vaginal microecology were included as the research group, and those with normal vaginal microecology and cervical secretions were included as the control group. A total of 2190 participants were recruited in this project including 1357 of research group and 833 of control group. All participants were required to complete questionnaires, whose vaginal discharge were collected for vaginal microecology test and cervical discharge for detection of M. genitalium and C. trachomatis.

RESULTS: The prevalence of C. trachomatis and M. genitalium were 7.1% (96/1357) and 3.8% (51/1357), respectively in research group. The prevalence of C. trachomatis and M. genitalium varied in different regions. Infection rates of C. trachomatis and M. genitalium were higher in women with abnormal vaginal microecology (C.t P = 0.038, M.g P = 0.043), especially in women with bacterial vaginosis and mixed vaginitis, of which C. trachomatis showed statistical differences (bacterial vaginosis, P = 0.035; mixed vaginitis, P = 0.0001) and M. genitalium was close to statistical differences (bacterial vaginosis, P = 0.057; mixed vaginitis, P = 0.081). Alcoholism and abnormal vaginal microecology were positively correlated with both C. trachomatis and M. genitalium infection. Increasing age, being married and multi-parity were negatively correlated with C. trachomatis infection. There is a positive correlation between multiple sexual partners, diversed styles of sex and C. trachomatis infection.

CONCLUSIONS: Women with lower genital dysbiosis have an increased risk of C. trachomatis and M. genitalium. The overall prevalence of M. genitalium is lower than that of C. trachomatis, while they have similarities in the characteristics of infection. Although M. genitalium is not routinely screened as C. trachomatis in young women, attention should be paid to M. genitalium infection in young women with abnormal vaginal microecology or having childbearing needs.

PMID:36604611 | DOI:10.1186/s12879-022-07975-2