Tag: pubmed

BMC Womens Health. 2022 Jun 11;22(1):223. doi: 10.1186/s12905-022-01817-8.

ABSTRACT

BACKGROUND: Pelvic organ prolapse remains a neglected public health problem in developing countries. The burden of pelvic organ prolapse varies by region and ranges from 9 to 20%. It poses an impact on women’s quality of life and affects their role at the community and family level. Although it has negative consequences and extensive burden, the true feature of pelvic organ prolapse is not well known among ever-married women attending health facilities for various reasons in the study area. Therefore, this study was aimed to assess the magnitude of pelvic organ prolapse and associated factors among ever-married women attending health care services in public Hospitals, Eastern Ethiopia.

METHODS: A facility-based cross-sectional study design was conducted from March 4th to April 5th, 2020 among 458 ever-married women attending public Hospitals in Harar town, Eastern Ethiopia. The study subjects were selected through systematic sampling. The data were collected using a structured questionnaire through face-to-face interviews. Data were analyzed using SPSS version 22 (IBM SPSS Statistics, 2013). The prevalence was reported by proportion and summary measures. Predictors were assessed using a multivariable logistic regression analysis model and reported using an adjusted odds ratio with 95% CI. Statistical significance was declared at p-value < 0.05.

RESULT: Of 458 women enrolled in the study, 10.5% of them had pelvic organ prolapse based on women’s reporting of symptoms. History of lifting heavy objects [AOR = 3.22, 95% CI (1.56, 6.67)], history of chronic cough [AOR = 2.51, 95% CI (1.18, 5.31)], maternal age of greater than or equal to 55 years [AOR = 3.51, 95% CI (1.04, 11.76)], history chronic constipation (AOR = 3.77, 95% CI (1.54, 9.22) and no history of contraceptive utilization [AOR = 2.41, 95% CI (1.13, 5.05)] were significantly associated with pelvic organ prolapse.

CONCLUSION: In this study, one in ten ever-married women who visited health facilities for various reasons have pelvic organ prolapse. Modifiable and non-modifiable risk factors were identified. This result provides a clue to give due consideration to primary and secondary prevention through various techniques.

PMID:35690856 | DOI:10.1186/s12905-022-01817-8

BMC Surg. 2022 Jun 11;22(1):223. doi: 10.1186/s12893-022-01671-3.

ABSTRACT

BACKGROUND: To investigate the correlation between physical characteristics and disease of cervical lymph node biopsy specimens after contrast-enhanced ultrasound.

METHODS: All patients were biopsied after CEUS, 235 patients were divided into three groups A, B and C according to the physical characteristics of specimens: 92 patients in group A were complete tissue specimens; 113 patients in group B were discontinuous tissue specimens. There were 30 patients in group C, including a small number of tissue and floc, purulent and bloody specimens. Pathological examination, pathogen culture examination and Gene X-Pert MIB examination were completed for all patients in the three groups, and statistical analysis was conducted on the integrity and traits of the specimens.

RESULTS: Group A included 92 intact tissue specimens, 21 with reactive hyperplasia, 17 with lymphoma, 12 with metastatic carcinoma, 13 with lymphadenopathy, 15 with necrotizing lymphadenitis, and rare lymphadenopathy. In group B, 113 patients were treated with intermittent tissue specimens, including infected lymph nodes, lymphoma in 1 case, metastatic carcinoma in 3 cases and sarcoidosis in 1 case. There were 30 patients in group C, including a small amount of tissue and floc, purulent and bloody specimens, all of which were infected lymph nodes. The χ² value of malignant and benign lymph nodes was 42.401, p = 0.000.

CONCLUSION: The physical characteristics of cervical lymph node biopsy specimens after CEUS are correlated with the disease, which has guiding significance for postoperative specimen selection.

PMID:35690851 | DOI:10.1186/s12893-022-01671-3

J Orthop Surg Res. 2022 Jun 11;17(1):310. doi: 10.1186/s13018-022-03196-0.

ABSTRACT

BACKGROUND: In knee osteoarthritis, progressive degeneration of the articular cartilage surface produces disability and chronic pain. Intra-articular injections of stromal vascular fraction (SVF) could be an innovative approach to manage patients with early knee osteoarthritis.

METHODS: Between June 2019 and November 2020, 123 patients were recruited to receive intra-articular injection of SVF. Radiographic evidence of degenerative joint disease was classified according to Kellgren and Lawrence grades. Knee injury and osteoarthritis outcome score (KOOS) and visual analog scale (VAS) were collected preoperatively, at 1 month, and after 6 months from injection.

RESULTS: There was a statistically significant improvement of KOOS and VAS of all patients to 6 months (p < 0.05). The mean KOOS before injection was 51.4 ± 16.5, after 1 month it was 75.5 ± 15.8, and at 6 months it was 87.6 ± 7.7. Stratifying the mean KOOS according to Kellgren-Lawrence Grades, the difference remained statistically significant (p < 0.05). The patients’ mean VAS before injection was 6.5, after 1 month it was 3.5, and after 6 months it was 2.4. No complications were observed.

CONCLUSIONS: Intra-articular knee injection of SVF is safe and effective to ameliorate the clinical and functional scores in patients with early knee osteoarthritis for 6 months.

PMID:35690837 | DOI:10.1186/s13018-022-03196-0

Pilot Feasibility Stud. 2022 Jun 11;8(1):124. doi: 10.1186/s40814-022-01079-z.

ABSTRACT

BACKGROUND: Hip fractures in older adults are significant contributors to severe functional decline and disability as well as hospitalization and increased health care costs. Research shows that timely referral to geriatric rehabilitation leads to better patient outcomes. Currently, a wide variability in the timing, the frequency, and the choice of appropriate setting for rehabilitation of hip fracture patients exists.

AIM: Evaluate the feasibility, acceptability, and preliminary effectiveness of PATH4HIP, a pathway intervention for timely transfer of post-operative geriatric hip fracture patients from hospital to rehabilitation to home.

METHODS: This is a single-arm, pragmatic feasibility study to measure reach, effectiveness, adoption, implementation, and maintenance of PATH4HIP, a pathway for post-operative hip fracture patients from a large academic health science center to a geriatric rehabilitation service in Ottawa, Canada. During a 6-month period, all hip fracture patients, 65 years of age or older who have undergone surgery and have met the eligibility criteria (n = 96), will be transferred to the geriatric rehabilitation service no later than post-operative day 6. Patients (n = 10-12) and clinicians who are working on the orthopedic team (n = 10-12) and on the geriatric rehabilitation service (n = 10-12) will be invited to participate in an interview to share their feedback on the intervention’s feasibility and acceptability and to provide suggestions to improve PATH4HIP. Descriptive statistics will be used to summarize results of the quantitative data and content analysis will be used to analyze the qualitative data. The study will be open for recruitment from January to July 2022.

DISCUSSION: If feasible, PATH4HIP will result in the reduction of the post-operative acute care length of stay to less than or equal to 6 days, while having no detrimental effect on rehabilitation outcomes such as functional gains, or discharge destination.

PMID:35690813 | DOI:10.1186/s40814-022-01079-z

Confl Health. 2022 Jun 11;16(1):34. doi: 10.1186/s13031-022-00463-z.

ABSTRACT

BACKGROUND: The burden of malaria remains the highest in sub-Saharan Africa and South Sudan is not an exception. The country has borne the brunt of years of chronic warfare and remains endemic of malaria, with increasing mortality and morbidity. Limited data still exists on factors influencing the recurrence of severe malaria, especially in emergency contexts such as South Sudan, affected by various conflicts and humanitarian situations. This study therefore aimed to investigate factors influencing severity of occurrence malaria in selected primary healthcare centres in South Sudan. This would assist and guide in malaria prevention, treatment, and eradication efforts.

METHODS: We conducted an unmatched case-control study using routinely collected clinic data for individuals aged 1 year and above who received a diagnosis of severe malaria at 3 primary healthcare centres (PHCC); Malual Bab PHCC, Matangai PHCC and Malek PHCC between September 15, 2019 to December 15, 2019 in South Sudan. Patient characteristics were analyzed using simple descriptive statistics. Inferential statistics were also conducted to identify the associated factors influencing recurrence of severe malaria. All analyses were conducted using R Version 3.6.2.

RESULTS: A total of 289 recurrent malaria cases were included in this study. More than half of the participants were female. Overall, the prevalence of severe recurrent malaria was 66.1% (191) while 74.4% (215) did not complete malaria treatment. Among those who did not complete malaria treatment, 76.7% (165) had severe recurrent malaria, while among those who completed malaria treatment 35.1% (26) had severe recurrent malaria (p < 0.001). There is a significant association between marital status (OR 0.33, 95% CI 0.19-0.56, p < 0.001), employment status (OR 0.35, 95% CI 0.14-0.87, p = 0.024), the use of preventive measures (OR 3.82, 95% CI 1.81-8.43, p < 0.001) and nutrition status (OR 0.22, 95% CI 0.13-0.37, p < 0.001). When adjusted for employment, marital status, nutritional and prevention measures in turns using Mantel-Haenszel test of association, this effect remained statistically significant.

CONCLUSIONS: Our study showed that there is a high prevalence of severe recurrent malaria in South Sudan and that a significant relationship exists between severe recurrent malaria and antimalarial treatment dosage completion influenced by certain personal and social factors such as marital status, employment status, the use of preventive measures and nutrition status. Findings from our study would be useful for effective response to control and prevent malaria in endemic areas of South Sudan.

PMID:35690836 | DOI:10.1186/s13031-022-00463-z

BMC Public Health. 2022 Jun 11;22(1):1171. doi: 10.1186/s12889-022-13606-x.

ABSTRACT

BACKGROUND: Appropriate health-seeking behaviour (HSB) is crucial for improving health outcomes and achieving universal health coverage (UHC). Accessing healthcare through the state social health insurance scheme (SSHIS) could lead to improved HSB. The study explores the influence of access to healthcare through health insurance on the HSB of the enrollees of the SSHIS in southeast, Nigeria.

METHODS: A descriptive cross-sectional study undertaken in twelve health facilities in Anambra state using quantitative and qualitative research methods. Data were collected through a facility-based survey (n = 447) and sex-disaggregated focus group discussions (n = 12) of health insurance enrollees. Univariate and bivariate analyses were performed for quantitative data, while qualitative data were analyzed using a manual content approach.

RESULT: The findings revealed a positive change in enrollee’s HSB post-health insurance enrollment. Majority (83%) of the respondents reported that they immediately take action when ill post-health insurance enrollment as against 34% (pre-health insurance) resulting in a 49% increase, with a statistically significant difference (p < 0.02). There was a statistically significant association between positive HSB and marital status (p < 0.04); educational level (p < 0.00); occupation (p < 0.03) and ownership of health facility (p < 0.00). There was an increase in the percentage of enrollees who use the hospital as their first choice of provider during an illness episode post-health insurance enrollment. This increased from 37.4% to 90.2% (post-health insurance enrollment), representing a 52.8% increase, which is statistically significant (p < 0.03), in seeking care in hospitals. Similarly, the percentage (46%) of enrollees using patent medicine vendors (PMVs) as their first choice of provider when ill prior to enrollment in health insurance decreased to 8.1% post-health insurance enrollment, representing a 38% decline with a statistically significant (p < 0.00) drop in PMV patronage. Reasons for positive HSB include low cost of services and availability of quality care such as quality drugs, presence of doctors, and other skilled health workers by the health insurance facilities.

CONCLUSION: Health insurance has been established as an effective strategy for improving appropriate HSB. Hence, increasing coverage of health insurance among the uninsured is crucial in improving access to quality and affordable health care towards achieving UHC, particularly in developing countries.

PMID:35690808 | DOI:10.1186/s12889-022-13606-x

J Orthop Surg Res. 2022 Jun 11;17(1):306. doi: 10.1186/s13018-022-03151-z.

ABSTRACT

INTRODUCTION: Due to the global COVID-19 pandemic, a ban on sports outside one’s home and a prohibition on travel between communities were imposed in spring 2020 in Tyrol, Austria. The aim of this study was to evaluate the impact of these restrictions on a level one trauma center. The objective was to identify the most common injury patterns to ensure targeted prevention in times of an ongoing pandemic.

MATERIAL AND METHODS: Patients who presented themselves to our trauma center between weeks 7 and 22 in 2020 were retrospectively compared to a mean of the patients of the three previous years (2017-2019). The evaluated variables were the number of patients, age, gender, country of residence, place of accident, time of treatment, injured body region and anatomical structure, number of surgical intervention and severely injured patients.

RESULTS: Comparing the mean count of treated patients per week in 2020 of the pre-lockdown period (n = 804.6) with the lockdown period (n = 201.8) a decrease in admissions by 69.7% could be observed. The admission incidence was 9.9 times higher in previous years than in 2020 during the lockdown period. Among the injuries treated during the lockdown the largest increase in relative numbers was in home injuries, head or face injuries and superficial or penetrating injuries. There was a decrease of seriously injured patients as well as patients that needed surgery during the lockdown compared to previous years.

CONCLUSIONS: We observed a significant change in the pattern and volume of injuries during a strict lockdown. Intervention programs to reduce the risk of home injuries should be introduced. Furthermore, in order to save resources during a pandemic, specific guidelines on patient management and treatment should be established for the respective medical specialties.

TRIAL REGISTRATION: 1157/2020, 10.12.2020.

PMID:35690778 | DOI:10.1186/s13018-022-03151-z

BMC Public Health. 2022 Jun 11;22(1):1170. doi: 10.1186/s12889-022-13268-9.

ABSTRACT

BACKGROUND: High screen viewing time has detrimental effects on children’s health, development, and behavior developing. Children are being exposed to more and more media devices at an earlier age. This study was aimed to determine the amount of daily screen time and its variation and to assess potential factors of screen time by identifying the trajectory of screen time among children aged 1 to 5 years.

METHOD: This study was based on a representative sample of Changsha young children from a cohort study during 2015-2020. The demographic information and children’s screen viewing time were collected by parents or caregivers through face-to-face interviews. The Latent growth model was used to test the effects of outdoor play on screen viewing time at eight time points, meanwhile, unconditional and conditional models were examined sequentially.

RESULT: After excluding respondents with missing key variables, we included 953 children in the final analysis. Children’s outdoor play was slightly increased at 18 months and subsequently declined at 24-60 months, with a maximum duration of 2.96 h per day. Children’s average screen time was increased at 18-36 months, and decreased at 42-54 months, with a slight increase at 60 months. The duration of media exposure peaked at 1.4 h/d at age of 36 months and 60 months. Standardized coefficients of the outdoor play at age of 12 months showed negative effects on the screen time in children, but with positive influence at age of 24, 36, and 42 months (P < 0.01).

CONCLUSION: High proportions of young Chinese children in Changsha had more screen time than the AAP recommended according to our analysis. Significant predictors of screen time included pregnancy computer use, paternal educational level, and outdoor play in this study, however, further understanding of risk factors is needed to promote great public health efforts to reduce children’s screen exposure.

PMID:35690770 | DOI:10.1186/s12889-022-13268-9

BMC Pediatr. 2022 Jun 11;22(1):340. doi: 10.1186/s12887-022-03400-4.

ABSTRACT

BACKGROUND: We investigated risk factors for sustained virological non-suppression (viral load ≥ 1000 copies/ml on two tests 48 weeks apart) among children and adolescents accessing HIV care in public sector clinics in Harare, Zimbabwe and Blantyre, Malawi.

METHODS: Participants were enrolled between 2016 and 2019, were aged 6-19 years, living with HIV, had chronic lung disease (FEV z-score < -1) and had taken antiretroviral therapy (ART) for at least six months. We used multivariate logistic regression to identify risk factors for virological non-suppression after 48 weeks, among participants who were non-suppressed at enrolment.

RESULTS: At enrolment 258 participants (64.6%) were on first-line ART and 152/347 (43.8%) had virological non-suppression. After 48 weeks 114/313 (36.4%) were non-suppressed. Participants non-suppressed at baseline had almost ten times higher odds of non-suppression at follow-up (OR = 9.9, 95%CI 5.3-18.4, p < 0.001). Of those who were non-suppressed at enrolment, 87/136 (64.0%) were still non-suppressed at 48 weeks. Among this group non-suppression at 48 weeks was associated with not switching ART regimen (adjusted OR = 5.55; 95%CI 1.41-21.83); p = 0.014) and with older age. Twelve participants switched regimen in Zimbabwe and none in Malawi.

CONCLUSIONS: Viral non-suppression was high among this group and many with high viral load were not switched to a new regimen, resulting in continued non-suppression after 48 weeks. Further research could determine whether improved adherence counselling and training clinicians on regimen switches can improve viral suppression rates in this population.

TRIAL REGISTRATION: Secondary cohort analysis of data from BREATHE trial (Clinicaltrials.gov NCT02426112 ).

PMID:35690762 | DOI:10.1186/s12887-022-03400-4

BMC Musculoskelet Disord. 2022 Jun 11;23(1):566. doi: 10.1186/s12891-022-05520-5.

ABSTRACT

BACKGROUND: Rheumatic and musculoskeletal diseases (RMD) are associated with depression, fatigue, and disturbed sleep – symptoms that often impact behavior and activity. Patient reported outcomes (PROs) are a way of collecting information on the patient symptom experience directly from the individual. The purpose of this study was to measure and compare user smartphone sensor and activity data in adults with RMDs and assess associations with PROs.

METHODS: We invited adults with RMDs enrolled in the FORWARD Databank to participate by installing a custom app on their smartphone and answering PROs (pain, global, HAQ-II) questions daily and weekly over 3 years. Passive data collected included mobility distance, unique calls and text messages, call durations, and number of missed calls. Confounders included sociodemographic, clinical, passive phone behavior, and seasonal factors. Kappa statistics between PRO and flares were computed to measure agreement. The agreement between daily and weekly VAS pain was estimated using the intraclass (ICC) correlation of a two-way random effect model. The relationship between the weekly PRO outcomes and the passive phone data was analyzed with a linear mixed-effect model (LMM), including a random intercept for participant and slope for time in the study with an unstructured covariate structure.

RESULTS: Of the 446 participants, the mean (SD) age was 54 (12) years, most (65.5%) had rheumatoid arthritis (RA), the vast majority (91%) were female, and the US Northeast has the least representation (12%). Longer reaction times, interaction diversity, and higher mobility were associated with worse PROs while longer text messages were associated with better PROs. Participants in this study showed good levels of adherence which holds promise for future interventions using passive behavior measures in self-management and clinical follow-up.

CONCLUSION: This is the first study to examine passive smartphone behavior with PROs in RMDs and we found significant associations between these behaviors and important health outcomes of pain and function. As smartphone usage continues to change, future studies should validate and expand on our findings with a goal of finding changes in patient symptoms passively through mobile device monitoring.

PMID:35690753 | DOI:10.1186/s12891-022-05520-5