SAGE Open Medicine最新文献

Purpose: To evaluate whether hydrogel spacer injection, which increases the distance between the prostate and rectum, prior to local radiation therapy for prostate cancer reduces rectal and bladder toxicity.

Patients and methods: With institutional review board approval (05-004), we retrospectively reviewed rectal and bladder toxicity after local radiation therapy in patients with prostate cancer who were followed up for more than 1 year.

Results: We included 156 patients who had received local radiation therapy. Their ages ranged from 63 to 86 years, with an average of 75 years. Most patients were treated only on the prostate and seminal vesicles. All prostate sites were irradiated as follows: whole pelvis with prostate in 10 patients, whole pelvis with prostate and metastatic sites in six, and prostate and metastatic sites in eight. Radiation therapy (70-74 Gy) was performed for the prostate. Irradiation of 45-46.8 Gy was applied to whole pelvic and para-aortic lymph nodes, with 54-60 Gy applied to bone metastatic sites. In one case, stereotactic body radiation therapy (36 Gy) was performed for a sacral bone metastatic site. The hydrogel spacer was injected in 39 patients. Rectal toxicity was reported in 21 patients without (17.9%) and 3 patients with (7.7%) the hydrogel spacer. Bladder toxicity was reported in five patients without and only one patient with the hydrogel spacer.

Conclusion: Hydrogel spacer injection prior to local radiation therapy for prostate cancer reduces rectal radiation exposure, lowers the risk of rectal complications, and may be a promising method for boosting the irradiation dose in the future.

Introduction: Tinnitus is a common medical condition that affects an individual's quality of life. It affects 5%-43% of the global population. Only a few research studies have been conducted in Palestine, so knowledge of tinnitus prevalence and risk factors is limited. The purpose of this study was to determine tinnitus prevalence and risk factors among young university students in Palestine.

Methods: A cross-sectional study of Palestinian university students was done utilizing an online self-administered questionnaire. The questionnaire for the study was developed using the European School for Interdisciplinary Tinnitus Research-Screening Questionnaire. A logistic regression analysis of the associations between tinnitus and influencing factors was performed to determine the effects of various clinically relevant variables on the likelihood of experiencing tinnitus.

Results: A total of 728 participants responded to the questionnaire aged 20.0 ± 2.0. The overall prevalence of tinnitus was 31%. Having a relative with tinnitus, gastroesophageal reflux, depression and anxiety, hearing difficulties, vertigo, tympanic membrane perforation, chronic otitis, acoustic trauma, head and neck radiotherapy, dental surgery, ear surgery, ear pain, headache, neck pain, temporomandibular joint pain, balance disorders, and nasal septal deviation were significantly associated with tinnitus. The logistic regression analysis showed that suffering from frequent vertigo (at least once per year), from slight hearing difficulty, temporomandibular joint pain, performing ear surgery, and having depression and anxiety is associated with an increased risk of having tinnitus.

Conclusions: The current study concluded that tinnitus is common among Palestinian university students. Furthermore, the study identified several major risk factors for tinnitus. It is critical to explore the possibly modifiable risk factors for tinnitus in order to have a better understanding of the condition and eventually minimize its prevalence.

Background: Traditional birth attendant utilization has become a common malpractice and a leading cause of maternal morbidity and mortality in the developing world, such as Ethiopia. Therefore, this study was aimed at determining the geospatial variation and determinant factors of traditional birth attendant utilization among mothers of reproductive age in Ethiopia.

Methods: The data were taken from the 2019 Ethiopian Demographic and Health Survey. Arc GIS, Excel, and STATA-14 software were used for the data analysis. The adjusted odds ratio with a 95% confidence interval was used to declare significant determinants of traditional birth attendance among mothers of reproductive age in Ethiopia.

Results: Among 5,753 mothers of reproductive age, 34.59% of them utilized traditional birth attendants in Ethiopia during the 2019 Ethiopian Demographic and Health Survey. There was a geospatial variation of traditional birth attendants among mothers of reproductive age in Ethiopia; the Global Moran's index value was 0.39 with a p-value <0.001. The significant factors associated with traditional birth attendant utilization were the age of mothers; higher odds were observed among older mothers aged 35-49 years (AOR = 1.31; 95% CI (1.04-1.63)); educational level of mothers (AOR = 3.04; 95% CI (2.13-4.33)); higher odds were observed in uneducated mothers, wealth index (AOR = 2.76; 95% CI (1.83-4.19)); higher odds were observed among the poorer and poorest households, place of residence (AOR = 5.69; 95% CI (3.35-9.67)); and the regions; the highest odds were observed in Somali (AOR = 12.1; 95% CI (4.99-25.68)) and Afar (AOR = 7.13; 95% CI (2.37-21.38)).

Conclusions: The utilization of traditional birth attendants among reproductive-age mothers became a major public health concern, and the distribution showed geo-spatial variations among the regions of the country. We recommend taking appropriate measures to alleviate the current problem by improving access to maternal healthcare services.

Background: Rheumatoid arthritis is a severe inflammatory arthritis that causes irreversible damage to joints and bones, resulting in deformities and disabilities. Population-based studies on the co-occurrence in patients with rheumatoid arthritis are lacking despite shared mechanisms with other autoimmune diseases.

Objectives: This study aimed to determine the prevalence and association of autoimmune diseases among patients with rheumatoid arthritis and explore the associations between autoimmune diseases and treatment options for rheumatoid arthritis.

Method: This retrospective study was conducted from 2019 to 2023 at King Fahad Armed Forces Hospitals, Jeddah, Saudi Arabia. Data were cleaned in Excel and analyzed using IBM SPSS version 29. The activity of the disease was assessed through clinical manifestations, laboratory findings, and its associations with other autoimmune diseases.

Results: Our study included 365 patients with rheumatoid arthritis, predominantly female (89%), and observed diverse demographics and comorbidities. Prevalent conditions included diabetes mellitus (28.2%), hypertension (27.3%), and dyslipidemia (14.7%). Other autoimmune diseases were present in 24.9% of patients, with notable associations with age at rheumatoid arthritis diagnosis and endocrine, rheumatology/dermatology, and pulmonary disorders (p < 0.001). Treatment approaches varied, with prednisolone (24.4%) and methotrexate (55.1%) being predominant. No significant associations were observed between autoimmune disorders and specific treatment modalities (p > 0.05).

Conclusion: Our study provides a thorough overview of rheumatoid arthritis in a large cohort, revealing demographic trends, comorbidities, autoimmune disease prevalence, treatment preferences, and associations. Relationships with age at rheumatoid arthritis diagnosis and other autoimmune diseases were noted. Treatment approaches varied, with no significant associations between autoimmune disorders and specific modalities.

Objectives: To assess the influence of age and gender on ocular biometric values and corneal astigmatism features in individuals undergoing phacoemulsification surgery and intraocular lens implantation.

Methodology: This retrospective study measured ocular biometrics and corneal keratometric astigmatism using the IOLMaster 700 instrument prior to phacoemulsification surgery and intraocular lens implantation.

Results: Analysis included ocular biometric and keratometric values from 3385 eyes of 3385 patients. Lens thickness (p < 0.001, r = 0.387), mean keratometry (p < 0.001, r = 0.156), and corneal astigmatism (p < 0.001, r = 0.082) were positively correlated with age. Conversely, axial length (p < 0.001, r = -0.133), anterior chamber depth (p < 0.001, r = -0.244), and horizontal white-to-white corneal diameter (p < 0.001, r = -0.226) exhibited negative correlations with age. Increasing age led to a significant shift towards against-the-rule astigmatism (p < 0.001, r = 0.248). Mean keratometry was significantly lower in males than females (p < 0.001). Axial length, anterior chamber depth, lens thickness, and white-to-white corneal diameter were higher in males compared to females (all ps ⩽ 0.001). Corneal astigmatism types differed significantly between genders (p < 0.001), with against-the-rule being more prevalent among males (52.9%) and with-the-rule astigmatism having the highest prevalence among females (40.3%).

Conclusions: Mean keratometry and lens thickness increased, while axial length and anterior chamber depth decreased with age. Males exhibited higher values for axial length, anterior chamber depth, and lens thickness, whereas females had steeper corneas.

Introduction: Kangaroo Mother Care is a valuable technique recognized for its impact on bonding, breastfeeding, and thermoregulation in newborn infants, transcending considerations of weight, gestational age, or clinical condition.

Objective: This study aimed to assess mothers' feelings and perceptions regarding the implementation of the Kangaroo Mother Care procedure.

Method: In this qualitative investigation, individual interviews were conducted with 25 postnatal mothers who had experienced Kangaroo Mother Care with their infants. While, 12 unique responses were acquired. These interviews served as a means to explore and document the mothers' perspectives on Kangaroo Mother Care. The analysis of field notes identified four themes and one subtheme, which were coded into categorical distinctions.

Results: A total of 25 postnatal mothers, along with their newborns participated in this study. The majority of postnatal mothers fall within the age range of 20-30 years (48%), followed by 30-40 years (40%), Regarding newborn, majority were full-term (64%), followed by premature (28%) The findings revealed several significant outcomes. Mothers reported a marked improvement in their perception of Kangaroo Mother Care, describing reduced pain, enhanced comfort, and an overall positive sentiment. Many expressed that practicing KMC was a novel and delightful experience, marking their first engagement in this procedure. Moreover, a majority expressed a willingness to continue Kangaroo Mother Care in the future, hoping for its continued implementation within hospital settings. This enthusiasm aligns with recognizing Kangaroo Mother Care as a priority in nursing mother care.

Conclusion: In conclusion, the study underscores the potential benefits and positive impact of Kangaroo Mother Care on mother's experience. The findings advocate for the broad implementation of Kangaroo Mother Care as a valuable strategy in neonatal care, offering a holistic approach to improving the well-being of both mothers and newborns. These insights emphasize the importance of promoting and integrating Kangaroo Mother Care into neonatal care protocols, contributing to enhanced neonatal health and maternal satisfaction.

Objectives: There is a lack of indicators to distinguish between interleukin-6 inhibitors responders and tumor necrosis factor inhibitors responders in the treatment of rheumatoid arthritis. Osteoporosis is a complication of rheumatoid arthritis and is closely related to inflammatory pathology. The purpose of this study was to evaluate whether bone mineral density can distinguish interleukin-6 inhibitors responders from tumor necrosis factor inhibitors responders in rheumatoid arthritis.

Methods: Either interleukin-6 inhibitors or tumor necrosis factor inhibitors was introduced as the first biologics to patients naïve to both corticosteroid and osteoporosis treatment. Correlations between baseline bone mineral density and Clinical Disease Activity Index after 3 months were analyzed.

Results: The subjects were 26 rheumatoid arthritis patients with a median age of 60 years old, disease duration of 1.4 years, Clinical Disease Activity Index of 13.7, and C-reactive protein of 1.69 mg/dL. The subjects were divided into two groups (high (H) and low (L)) according to their femoral bone mineral density with a cutoff of young adult mean of 80%. Six in group H and 11 in group L received interleukin-6 inhibitors, and nine in group H received tumor necrosis factor inhibitors. Clinical Disease Activity Index remission rate by interleukin-6 inhibitors was significantly greater in group L (8/11 (72.7%)) than in group H (1/6 (16.7%); p < 0.05). In the whole group H, significantly more patients obtained Clinical Disease Activity Index remission by tumor necrosis factor inhibitors (7/9, 77.8%) than by interleukin-6 inhibitors (1/6 (16.7%); p = 0.04).

Conclusions: In patients with rheumatoid arthritis, interleukin-6 inhibitors may be more beneficial for patients with low femoral bone mineral density, whereas tumor necrosis factor inhibitors may be advantageous for those with preserved bone mineral density.

Objective: We aimed to assess performance parameters in a Hawassa Tuberculosis Culture Laboratory, in the Sidama Regional Public Health Institute.

Methods: A cross-sectional survey was conducted between 27 October 2020 and 31 May 2021, on 439 clinical specimens. The specimens were processed using standard procedures, and the final suspension was inoculated into a Microbial Growth Indicator Tube and Lowenstein-Jensen media slant. Ziehl-Neelsen staining and the Bioline test kit were used to identify and confirm Mycobacterium tuberculosis. The data were analyzed using the IBM Statistical Package for Social Sciences (SPSS, version 26).

Results: Out of a total of 439 specimens that were processed, the recovery rates for smear-positive specimens were 61% (25 out of 41) and 58.5% (24 out of 41) for the Mycobacterial Growth Indicator Tube, and the Lowenstein-Jensen methods, respectively. For smear-negative samples, the recovery rates were 4.5% (18 out of 398) for both methods. Only 4 (0.9%) specimens were rejected. The mean turnaround times to detect mycobacteria from smear-positive samples were 14 and 32 days for the Mycobacterial Growth Indicator Tube and Lowenstein-Jensen methods, respectively. The standard deviations were ±6.3 days and ±9.7 days, respectively. For smear-negative samples, the mean turnaround times were 17.7 and 31 days for the Mycobacterial Growth Indicator Tube and Lowenstein-Jensen methods, respectively. The standard deviations were ±9.2 days and ±9.6 days, respectively. The contamination rates for the Mycobacterial Growth Indicator Tube and Lowenstein-Jensen methods were 9.8% (43 out of 439) and 9.6% (42 out of 439), respectively. The detection rate of nontuberculosis mycobacteria was 1.4% (6 out of 439).

Conclusion: It demands attention to improve the low recovery rate among smear-negative cultures and culture contamination rates.

Objectives: The safe surgery checklist, presented by the World Health Organization in 2008, is an aid to performing surgical interventions safely. Research indicates that the use of checklists in clinical activities leads to a reduced number of adverse events. However, research suggests that the use of checklists differs between different institutions and even between units in the same organisation. The intention of this study is to identify factors regarded by the health personnel in 'the sharp end' as obstacles to using the checklist.

Methods: The study has a qualitative, case-based design. It is performed by the Hazard Identification method, which is a method for revealing safety hazards based on workers' experiences.

Results: Obstacles were identified related to the content of the list, areas of use, distribution of responsibilities connected with the use of the list, and finally the organisation and management of safety efforts related to clinical activities. The use of checklists must be part of a system's perspective, and deviations from checklists must be discussed in the organisation. The informants also claimed that checklists should be implemented for interventions located outside the operating theatres and for emergency treatments.

Conclusions: Even though the majority of employees believe that checklists are necessary, many surrounding factors are perceived as obstacles to their use. Not least, site-specific factors may be revealed by use of the Hazard Identification method.

Background: In the realm of academia, the publication of scientific research is not merely an act of dissemination; it serves as a pivotal milestone that signifies the culmination of rigorous investigation, critical analysis, and intellectual contribution.

Aim: To examine the challenges and barriers encountered by faculty members in the process of publishing their work.

Methods: The study utilized a descriptive cross-sectional design and was conducted from 1 March to 1 May 2022. A convenience sample of 358 faculty members from eight universities in Egypt, representing a diverse range of faculties. These faculties comprised five practical disciplines, namely, Nursing, Medicine, Science, Pharmacy, and Engineering, as well as three theoretical faculties including Al-Alsun (Languages), Arts, and Commerce. The universities involved in the study included Ain Shams, Cairo, Mansoura, Benha, Assiut, 6th of October, British University in Egypt (BUE), among others. Data were collected through an online questionnaire that included staff characteristics and barriers to scientific research and publishing. Hypothesis testing was conducted using appropriate statistical analysis methods (e.g., Chi-square test) to assess the relationships between faculty members' characteristics and barriers to publishing.

Results: The faculty staff in our study reported the highest barriers to publishing scientific research in the domains of the reviewing process (74%), institutional support (67%), and scientific publishing process (60.9%). Conversely, the lowest barriers were found in the domains of frustration after rejection (55.1%), scientific writing barriers (46.1%), and loss of passion and causation of publishing barriers (41.3%).

Conclusions: The results highlighted the need for increased support and resources to overcome these barriers and foster a positive culture of research and publishing in Egyptian universities.