SAGE Open Medicine最新文献

Background: Pelvic organ prolapse is among the common gynecologic problems worldwide. Although mortality from pelvic organ prolapse is rare, it burdens social, psychological, economic, daily activities, and sexual life.

Objectives: To assess the quality of life and associated factors among women with pelvic organ prolapse attending hospitals in Western, Ethiopia.

Methods: A cross-sectional study was conducted at four hospitals in West Ethiopia, from January 1 to June 15, 2023, involving women with pelvic organ prolapse. A single population proportion formula (95% confidence, 23.52% prevalence, 0.05 margin of error) yielded a sample size of 276. A validated quality of life tool by Digesu (2005) on the Prolapse quality of life questionnaire was administered by trained staff to assess quality of life. Data were analyzed using SPSS (version 26), employing descriptive statistics and bivariate analyses, with candidate variables for multivariable analysis selected at a p value of 0.25. Multivariable linear regression was performed after assessing model fit, considering a p < 0.05 as statistically significant.

Results: A total of 232 (84.1% response rate) women attending or followed by four participating hospitals were involved in the study. The mean age of all women was 50.7 ± 9.2 years. Most of the participants (81.9%) were married; however, three women (1.3%) who were not married also developed a prolapse. Nearly a third (30.2%) had attended primary school; however, only 70 (30.2%) had no formal education. More than three-fourths (78.9%) had no mental or medical illnesses. The prolapse quality of life score was 45.3 ± 4.1. The higher quality of life was contributed to by sleep/energy and severity measures. Attending tertiary education and living with comorbidities were associated with quality of life.

Conclusion: The quality of life of women living with pelvic organ prolapse was similar. It is affected by education levels and the presence of comorbidities. Further studies are warranted to establish the factors associated with quality of life by recruiting subjects through probability sampling methods.

Background: Perinatal death, which includes stillbirth and early neonatal death, represents a profoundly distressing experience for mothers, particularly in low-resource environments where formal bereavement support is frequently inadequate. Despite the significant occurrence of perinatal loss in southwest Ethiopia, there is a lack of evidence regarding maternal coping mechanisms and the factors that influence them.

Objective: The purpose of this study was to explore the coping strategies of perinatally bereaved mothers in public health facilities in Southwest Ethiopia, 2025.

Methods: A descriptive cross-sectional study based in facilities was carried out from January to June 2025, involving 417 mothers with a history of perinatal death who were receiving maternal health services at public health facilities in Ilubabor and Buno Bedele Zones. Data collection was performed via the culturally adapted Brief Coping Orientation to Problems Experienced Inventory through face-to-face interviews. Multivariate logistic regression analysis was employed to determine the predictors of coping strategies via statistical software (Statistical Package for the Social Sciences 24 version) with a 95% confidence interval and a p < 0.05.

Results: The prevalence of positive coping strategies among participants was 55.4% (95% confidence interval: 50.6%-60.2%). Significant factors of positive coping included sufficient social support (adjusted odds ratio = 4.10; 95% confidence interval: 1.91-8.81), maternal education at the secondary level or higher (adjusted odds ratio = 2.42; 95% confidence interval: 1.12-5.21), attendance at antenatal care (adjusted odds ratio = 2.37; 95% confidence interval: 1.05-5.33), high levels of religious involvement (adjusted odds ratio = 2.18; 95% confidence interval: 1.01-4.72), and access to bereavement counselling (adjusted odds ratio = 3.19; 95% confidence interval: 1.38-7.39). Negative coping strategies are often associated with stigma, low educational attainment, and inadequate access to healthcare.

Conclusion: More than 44% of mothers resorted to negative coping strategies, highlighting a significant deficiency in bereavement support. Improving social, educational, and health system interventions-especially by incorporating bereavement counselling into public maternal health services-has the potential to enhance maternal mental health outcomes.

Objectives: This retrospective cohort study investigated the impact of COVID-19 on altered sodium and potassium in older adults with delirium compared to a non-COVID pneumonia control group.

Methods: Electronic Medical Records (EMRs) from a university hospital database were reviewed for electrolyte abnormalities and delirium. We identified 319 patients with COVID-19, of which 108 (33.8%) had an episode of delirium during COVID. In a second cohort of 306 older adults with non-COVID pneumonias, we identified 106 (34.6%) with delirium during pneumonia.

Results: Electrolyte disturbances were more commonly present in non-COVID pneumonias versus in those with COVID (p < 0.001). Hypokalemia was more frequent in the non-COVID group (p < 0.006), while hypernatremia was more often identified in the COVID group (p < 0.0321). Delirium in COVID patients was more commonly associated with hypernatremia than with other electrolyte abnormalities.

Conclusions: Because hypernatremia can be associated with seizures and cerebral hemorrhage, our findings highlight the need for careful monitoring and management of hypernatremia in hospitalized COVID patients, especially in light of its observed association with delirium.

Background: Uterine artery doppler velocimetry has proven to be efficient in the prediction of preeclampsia and intrauterine growth restriction. We aimed to determine its value among high-risk Bahamian women and the most predictive parameter.

Methods: We prospectively observed 128 women to detect the frequency of preeclampsia and intrauterine growth restriction development in relation to uterine artery doppler velocimetry. The main outcome measures were resistance index, pulsatility index and notching.

Results: The mean difference of 0.082 (±0.011; 95% CI: -0.096, -0.069) in the resistance index and 0.122 (±0.011; 95% CI: -0.144, -0.100) in the pulsatility index between those without preeclampsia and those with, was statistically significant (p < 0.001). The mean RI had a better prognostic value than the mean pulsatility index (OR: 2.623E+51 (95% CI: 2.577E+25, 2.671E+77); p < 0.001. Notching showed a statistically significant with the development of intrauterine growth restriction.

Conclusion: The best predictor of preeclampsia was the Resistance Index indices, while end diastolic notching was the best predictor for intrauterine growth restriction.

Objectives: A newly established hospital in Singapore has introduced a pioneering multidisciplinary diabetic foot programme to provide comprehensive care for patients with diabetic foot ulcers. This study evaluates the early outcomes of a multidisciplinary diabetic limb salvage programme. Over the first 100 days of operation, the diabetic foot programme managed 106 patients.

Methods: A descriptive statistical analysis was conducted to evaluate clinical characteristics and outcomes at 100 days of follow-up.

Results: The majority of patients were Malay (46.2%) and male (61.3%), with a median age of 63.5 years. Most patients had long-standing diabetes and poor glycaemic control (77.8%), leading to high rates of diabetes-related complications. A total of 18.3% of patients had osteomyelitis, and 11.7% had gangrene. Of the 106 patients, 61.3% required inpatient management, 25.5% underwent revascularisation, and 34.9% had diabetic foot ulcer-related surgeries. According to Wound, Ischaemia and Foot Infection 12-month risk stratification, nearly 30% of patients were at medium to high risk of major lower extremity amputation. Minor lower extremity amputation occurred in 15.1% of patients and 4.7% required major lower extremity amputation. The 30-day mortality rate was 3.8%, and the average length of stay was 15.7 days. The time from admission to revascularisation was 4.4 days, and the time to diabetic foot ulcer-related surgery was 4.2 days. Wound healing was documented in 34.8% of patients at 100 days of follow-up, with a healing time of 63.2 days.

Conclusion: Our guidelines based, multidisciplinary diabetic limb salvage programme demonstrated favourable limb salvage outcomes despite high predicted amputation risks. The early outcomes of this programme highlight the effectiveness of early medical optimisation, infection control, revascularisation and active wound care.

Purpose: To investigate changes in anterior scleral thickness (AST) in patients with Posner-Schlossman Syndrome (PSS).

Methods: Sixty-two patients with PSS were enrolled. AST was measured using swept-source optical coherence tomography at 0 mm (AST0), 1 mm (AST1), 2 mm (AST2), and 3 mm (AST3) from the scleral spur.

Results: AST0, AST1, AST2, and AST3 were significantly reduced in PSS-affected eyes compared with that in fellow eyes. Furthermore, we divided patients into two subgroups based on the course of PSS: the short-term (PSS course < 1 year) subgroup and the long-term (PSS course ⩾ 1 year) subgroup. In the short-term subgroup, no significant differences in AST parameters (AST0, AST1, AST2, and AST3) were observed in PSS-affected and fellow eyes, while in the long-term subgroup, all the AST parameters (AST0, AST1, AST2, and AST3) were significantly reduced in PSS-affected eyes compared with that in fellow eyes.

Conclusions: PSS-affected eyes demonstrated significantly reduced AST compared with that in fellow eyes. Moreover, a significant reduction of the AST was observed in long-term PSS-affected eyes, but not in short-term PSS-affected eyes. This indicates that changes in AST in PSS are time-dependent and progressive. Significant reduction of the AST is observed only after a certain period of time.

Background: Improper disposal of medications is a growing global concern, leading to environmental contamination and public health risks, including accidental poisoning and antimicrobial resistance. This study assessed public knowledge, attitudes, and practices regarding disposing of unused and expired medications among community pharmacy visitors in Kathmandu, Nepal.

Methods: A cross-sectional study was conducted using the Return and Disposal of Unused Medication questionnaire among 395 randomly selected participants, and a 100% response rate was achieved. Descriptive and inferential statistics, including chi-square tests, were used to identify significant associations with the Statistical Package for Social Sciences version 23.

Results: Over half of the respondents (n = 247, 62%) understood the proper disposal methods for unused and expired medication. Additionally, a majority of participants (n = 366, 92%) exhibited a positive attitude, while more than two-thirds (88.1%) were aware of the detrimental effects of incorrect medicine disposal on the environment. Approximately 43% (n = 171) of respondents reported having unused medicines stored at home, with analgesics (46%) and antibiotics (42%) being the most common types. Most participants disposed of expired medicines in household garbage bins and retained unused medications at home until their expiration. Furthermore, a significant association was identified between respondents' knowledge levels and their actual practices in medicine disposal (p < 0.001).

Conclusion: Despite positive attitudes, gaps in practice highlight the urgent need for awareness campaigns and structured disposal programs. The findings suggest actionable measures, including national guidelines and pharmacy-led take-back programs, to mitigate improper disposal of unused and expired medicines.

Background: Meatoplasty is a surgical procedure that is used to treat chronic ear conditions such as chronic otitis media, cholesteatoma, and external auditory canal stenosis. Despite its widespread use, there is a lack of comprehensive analysis of the effectiveness of different meatoplasty approaches and their long-term outcomes. This systematic review aims to systematically analyze the existing studies to evaluate the effectiveness of meatoplasty and its approaches with a focus on surgical outcomes, postoperative complications, and patient satisfaction across diverse surgical approaches and patient demographics.

Methods: The searches from databases like PubMed and Google Scholar for studies on meatoplasty in chronic ear surgeries from 2010 to 2024. Seventeen studies were selected based on predefined inclusion criteria, focusing on success rates, complications, and long-term outcomes. Data were extracted on patient demographics, surgical techniques, and outcomes, and the quality of evidence was assessed using the Newcastle Ottawa Scaleand the Cochrane risk of bias assessment tool.

Results: The analysis of the included studies revealed diverse patient populations and varying meatoplasty approaches for treating chronic ear conditions. Most studies reported positive outcomes, with significant improvements in ear dryness, hearing, and symptom relief. Postoperative complications, such as meatal stenosis and granulation tissue, were rare and manageable, while the long-term follow-up was crucial for preventing restenosis. However, meatoplasty proved effective in restoring ear canal function, with both one-cut and Z-plasty techniques showing favorable results.

Conclusion: Advancements in meatoplasty and related surgical techniques have shown great success in managing chronic ear conditions, alleviating symptoms, enhancing hearing, and improving overall quality of life. Their effectiveness is evident in high graft success rates and low complication rates, with innovative approaches and careful postoperative care effectively managing rare issues like stenosis, ensuring favorable long-term results.