SAGE Open Medicine最新文献

Objectives: Household hygiene and food safety are essential parts of food security; better food safety and hygiene will help reduce the chances of illness for young children and family members rarely studied in the selected area of coastal Bangladesh. The study aimed to discover the knowledge, attitude, and practice levels for cleanliness, hygiene, and food safety in the household.

Methods: In this study, we employed a cross-sectional survey with simple random sampling to collect data from 384 childbearing mothers. The survey used the pretested, validated, and standardized (knowledge, attitude, and practice) questionnaire-model-based interview guide.

Results: According to our study analysis, the knowledge, attitude, and practice scores among mothers were inadequate for household cleanliness and hygiene management. In the area context, knowledge efficiency was related to family type (joint and nuclear). Family economic conditions strongly influenced mothers' attitudes and behavior toward knowledge, attitude, and practice score. Unemployed and illiterate mothers have lower knowledge, attitude, and practice scores. Educated mothers have better knowledge, attitude, and practice score compared to illiterate mothers (p < 0.014). Nuclear family knowledge, attitude, and practice attitude was much greater (p < 0.04) and wealthier families showed better practice (p < 0.001) toward cleanliness and food safety in the household level.

Conclusions: The study discovered the mothers' and household members' attention need to improve the knowledge, attitude, and practice toward proper hygiene and food safety at the household level of marginalized populations in coastal Bangladesh.

Objective: Several circulating microRNAs, including microRNA-126-3p, have been identified as diagnostic and prognostic biomarker of cardiovascular disease. However, whether microRNA-126-3p is an independent risk predictor for coronary artery calcification is unclear.

Methods: In this prospective single-center study, we collected blood samples from coronary artery atherosclerosis patients (n = 54), patients with coronary artery calcification (n = 33) and controls (n = 56). Total RNA was extracted from plasma and blood cells with TRIzol reagents. The microRNA-126-3p level was determined via quantitative real-time polymerase chain reaction (RT-PCR).

Results: MicroRNA-126-3p levels were significantly increased in patients with coronary artery calcification than in coronary artery atherosclerosis patients or controls. The highest expression of microRNA-126-3p was observed in patients with moderate calcification who were diagnosed with Grade 2 calcification by coronary angiography. Age, microRNA-126-3p expression in veins, hypertension and diabetes significantly influence the occurrence of coronary artery calcification, among which diabetes and venous microRNA-126-3p expression were found to be independent risk factors for coronary artery calcification.

Conclusions: Taken together, the data in this study suggest that circulating microRNA-126-3p may be a novel noninvasive biomarker for coronary artery calcification. Regulating microRNA-126-3p expression may be an effective and promising strategy for the diagnosis and treatment of cardiovascular diseases, especially coronary artery calcification.

Background: Type 2 diabetes mellitus is usually associated with long-term macrovascular and microvascular complications that negatively impact the patient's quality of life and add economic burden to the healthcare system. Understanding patients' perspectives on medication nonadherence is essential for planning the appropriate methods and strategies to improve medication adherence among patients with uncontrolled diabetes.

Aim: Therefore, this study aims to explore patients' perceptions of the barriers to medication adherence through the Social Health determinants framework.

Method: After obtaining ethical approval, qualitative face-to-face interviews with a sample of patients with type 2 diabetes mellitus (uncontrolled diabetes) were conducted. Interviews were audio-recorded, and then the data were analyzed using thematic analysis to identify essential themes related to the patient's views.

Results: Fifteen patients with type 2 diabetes mellitus were interviewed. Potential barriers to antidiabetic medications were identified and categorized based on the Social Determinants of Health domains. The patient's health perceptions and behaviors were found to positively or negatively impact medication adherence. Beliefs toward antidiabetic medications, polypharmacy, medication-related problems, and the relationship between patients and their healthcare providers that related to healthcare access and quality domains were also reported as potential barriers to medications. Financial constraints, social stigma, and family support were other social health determinants factors that were found to have either positive or negative impacts on adherence. Nevertheless, using mobile health applications was suggested to facilitate medication adherence.

Conclusion: Social Determinants of Health, such as education about type 2 diabetes mellitus, quality and access to healthcare, and social stigma and support, might significantly affect medication adherence among type 2 diabetes mellitus patients. This study's findings can aid the development of suitable patient-specific tools and strategies to enhance medication adherence.

Introduction: Obesity is a worldwide pandemic that has many contributing factors. There is very scarce data available on this issue for the population in Syria. We aim to evaluate the body mass index and related obesity rates of medical students as they are the role model for the general population. We aim to explore the breadth of potential associated factors including psychological, physical activity, dietary, and a broad array of lifestyle and socio-demographic factors.

Methods: This is a cross-sectional study that was conducted at a major university in Damascus. Paper-based questionnaires were distributed that included the International Physical Activity Questionnaire short version and the Depression, Anxiety and Stress Scale.

Results: The mean body mass index was 23.5 (±4.2) kg/m² with 540 participants enrolled in this study. Males had significantly higher body mass index than females by 2.5 kg/m² (p < 0.001, χ² = 47.9, V = 0.3). In our sample, 304 (60.68%) had normal body mass index (18.5-24.99), 40 (7.98%) were considered underweight (body mass index ⩽ 18.5), 120 (23.95%) were considered overweight (body mass index = 25-29.99) and 37 (7.39%) were considered obese. While many factors were found to be significantly associated with body mass index and obesity, only physical activity, depression, having a first-degree family history with obesity and poor dietary habits were associated in regression analyses evaluating all predictors concurrently.

Conclusion: The findings reflect an ongoing epidemic of obesity. Our findings can guide targeted intervention for this young population who will become doctors and health role models in the future. More studies should be conducted to find the best possible ways to tackle this issue in the future.

Objective: Although pharmaceutical care provision is the primary goal of the pharmacy profession, its actual implementation has been lacking in developing nations. Therefore, this study investigated pharmacy professional's understanding, attitudes, and practice toward pharmaceutical care.

Methods: A cross-sectional study was conducted from 30 July 2022 to 30 August 2022, at all community and hospital pharmacies in Motta town, Northwest Ethiopia. Data were gathered using a self-administered questionnaire and analyzed using SPSS version 26.0. A logistic regression model with a p-value of 0.05 and a 95% confidence interval was applied to identify factors associated with understanding, attitude, and practice.

Result: The study had a 97.7% response rate. Of the 130 participants, 71 (54.6%) were females. Slightly more than half (56.2%) of the participants were aware of the aim (56.2%) of pharmaceutical care and responsibilities (56.9%) of pharmacy professionals in the pharmaceutical care process. However, most participants lack awareness of the similarities and differences between clinical pharmacy and pharmaceutical care. Concerning their attitude, most participants (66.9%) believed that pharmaceutical care provision should be the primary responsibility of pharmacy professionals, and it will benefit patients (61.6%) and the healthcare system (60.8%). Pharmacy professionals frequently evaluate their patients and identify health or drug therapy-related problems and potentially available therapeutic alternatives. However, they rarely engaged in any health screening activities or provided feedback to the doctor on the patient's progress. Training status, sex, and years of practice/understanding were significantly related to pharmacy professionals' level of understanding, attitudes, and practice toward pharmaceutical care, as both years of practice and understanding are related to practice.

Conclusion: Our study revealed a deficit in pharmacy professionals' understanding, attitude, and practice toward pharmaceutical care in Motta town, Northwest Ethiopia. Policymakers, health authorities, and educational institutions should work together to develop strategies and instructional initiatives that optimize pharmaceutical care provision and thus achieve optimal patient outcomes and lower healthcare costs.

Objectives: ICD-10-based approaches often provide the basis for retrospective estimation of potential palliative care need. Applying the ICD-10-based Murtagh et al. classification from 2014 (Murtagh classification), developed using mortality data, to administrative claims data leads to inconsistencies in estimating palliative care need. The aim of the study was to refine the classification for palliative care need estimation in deceased individuals with cancer and non-cancer diagnosis.

Methods: A retrospective population-based study comparing Murtagh classification to a new ICD-10-based classification (revised by expert opinion) was conducted using outpatient and inpatient claims data, including billing codes for palliative care. Palliative care need was estimated for diagnoses groups and was contrasted with palliative care utilization rates in the last year of life. Our dataset included records of 417,405 individuals who deceased in 2016-2019.

Results: Out of individuals deceased in 2019 (n = 117,436), 81.4% had at least one diagnosis from the new classification, while 97.0% had at least one diagnosis from the Murtagh classification. Classification revision thus identified fewer individuals as potentially in need of palliative care. Among individuals with cancer, 70.7% (vs. 55.7% via Murtagh classification) received palliative care. In non-cancer subgroups, the utilization rate was considerably lower, with a maximum of 36.7% (vs. 33.7% via Murtagh classification) in 2019. Similar results were observed for the other years.

Conclusion: Compared to the ICD10-based Murtagh classification, the revised ICD-10-based classification enables more realistic estimations if the cause of death is unavailable and reveals higher rates of palliative care coverage and differences especially in cancer versus non-cancer diseases. German Clinical Trials Register (DRKS00024133).

Background: Skin is the largest organ in the body and has multiple significant functions. A malformation or injury that compromises its integrity can lead to major issues or even mortality. Wound healing is a vital physiological process of the human skin which facilitates the repair of any damage and the preservation of homeostasis. Possible complications or infections that are fatal may ensue if the patient does not recover within the specified time. Therefore, it is essential to develop biomaterials which facilitate tissue regeneration and exhibit robust biological properties. We conducted a meta-analysis of randomized controlled trials to compare combinations of skin replacements and skin grafts to skin grafts alone for wound treatment, as measured by the Vancouver Scar Scale.

Methods: This meta-analysis utilized various databases, including as PubMed, ProQuest, Web of Science, Science Direct, Scopus, EBSCOhost, and ClinicalTrials.gov, to conduct a comprehensive search for randomized controlled trials that compared the effectiveness of combined skin substitutes and skin grafts to skin grafts alone in the treatment of wounds. The results primarily consisted of scar features assessed using the Vancouver Scar Scale.

Results: Meta-analysis was conducted on a sample of 216 participants from 7 randomized controlled trials. The trials were conducted from 2002 to 2015. The study demonstrated that the use of skin substitutes resulted in a statistically significant improvement in Vancouver Scar Scales ratings compared to skin grafts alone. The mean change was 1.38 (95% CI: 0.13-2.63; p = 0.03).

Conclusion: This meta-analysis indicates that the use of skin replacements provides substantial advantages and effectively aids in the closure of wounds. There is no inherent superiority among different skin substitutes. Instead, their suitability for specific patient wound circumstances is the determining factor. A comprehensive and advantageous skin substitute of significant magnitude is needed, rather than relying solely on grafts.

Aim: The purpose of this study was to explore the experiences of pregnant women who suffer the stressful effects of preeclampsia and eclampsia through pregnancy, delivery, and postpartum.

Methods: A descriptive exploratory approach was adopted to gather in-depth data from women diagnosed with preeclampsia and eclampsia during pregnancy from February to March 2022. Purposive sampling was used to enlist 12 participants from a Municipal Hospital in the Ahafo region of Ghana. Data were analyzed thematically following Braun and Clark approach.

Results: The study found that women had strong negative emotional reactions after being diagnosed with preeclampsia or eclampsia. They frequently felt guilty, angry, scared, in denial, or disbelief about their condition. Many women held mistaken beliefs about the diseases (they misconstrued eclampsia to be epilepsy) and isolated themselves, mainly because of false perceptions and stigma around their illness in the community. Participants expressed unfulfilled needs for informational and emotional support. The information they received about their condition was insufficient, contradictory, and confusing. Some women also felt pressured into having cesarean deliveries without enough discussion or say in the decision-making process.

Conclusion: These findings reveal important psychosocial impacts of preeclampsia/eclampsia and gaps in condition-specific education and empathetic, patient-centered communication. Improving provider knowledge and counseling skills along with community awareness may help address these unmet needs among Ghanaian women facing this threat to maternal health.

Objective: This study aimed to assess hepatic fibrosis, using noninvasive tests, among patients with chronic hepatitis B virus infection in Nigeria.

Methods: The study was a retrospective cross-sectional, hospital-based, multicentered study. The data of adult Nigerians who were aged 18 years and above who had been diagnosed with chronic hepatitis B infection and were not on treatment were extracted from three tertiary health institutions across Nigeria. Sociodemographic and relevant clinical data were obtained from the case notes of the patients. Fibrosis-4 and aspartate aminotransferase platelet ratio index scores were calculated to determine the presence and severity of liver fibrosis in the patients. The data obtained were analyzed using Statistical Package for the Social Sciences (version 25.0). A p-value of less than 0.05 was considered as statistically significant.

Results: The data of a total of 234 patients were extracted for this study from across 3 tertiary hospitals in Nigeria. There were 132 (56.4%) males and 102 (43.6%) females in a ratio of 1.29:1 with a mean age of 37.92 ± 12.34 years. The fibrosis-4 score of the patients showed that 62.8% had "Normal/Mild Fibrosis," 25.6% had "Moderate Fibrosis," and 11.5% had "Severe Fibrosis/Cirrhosis." The aspartate aminotransferase platelet ratio index score of the patients showed that 64.1% had "No Fibrosis," 20.9% had "Mild Fibrosis," 6.4% had "Moderate Fibrosis," and 8.5% had "Severe Fibrosis/Cirrhosis." The median fibrosis-4 score of the patients was 1.18 (0.77-1.74), while the median aspartate aminotransferase platelet ratio index score was 0.40 (0.26-0.69). Liver ultrasonography detected cirrhosis in 8.5% of the patients. All the patients were not yet on treatment for hepatitis B infection.

Conclusion: The prevalence of hepatic fibrosis is high among patients with chronic hepatitis B virus infection in Nigeria and a large number of these patients were not yet on therapy. Noninvasive assessment of hepatic fibrosis should be considered as a critical part of the work-up of patients with chronic hepatitis B infection.

Objectives: In Pakistan, the degradation of drinking water quality is exacerbated by the increasing population size and rapid industrialization. Contaminated water serves as the predominant source of numerous diseases, including diarrhea, gastroenteritis, and typhoid. This article explores the evolution of waterborne diseases across 21 districts of the Khyber Pakhtunkhwa province in Pakistan by monitoring changes in the clustering solutions.

Methods: The data employed in this study were sourced from 21 districts of KP by the Director-General Health Services. Cluster analysis was utilized to uncover patterns in waterborne disease incidence, while principal component analysis was employed to reveal underlying patterns and reduce dimensionality. Additionally, the MONItoring Clusters (MONIC) framework was applied for change detection, facilitating the identification of significant shifts in disease patterns over time and aiding in the understanding of temporal dynamics.

Results: Our analysis indicates that two clusters survived consistently over time, while other clusters exhibited inconsistency. Profiling of the surviving clusters (C₁₂ → C₂₄ → C₃₂ → C₄₃) suggests a gradual increase in cases of bloody diarrhea in the Swat Valley, Hangu, Karak, and Lakki Marwat regions. Similarly, profiling of the surviving clusters (⊙→ C₂₂ → C₃₄ → C₄₄) suggests an increase in the acute watery diarrhea (non-cholera) and typhoid fever in the regions of Peshawar, Nowshera, and Swabi.

Conclusion: The findings of this study hold significant importance as they pinpoint the most vulnerable regions for various waterborne diseases. These insights offer valuable guidance to policymakers and health officials, empowering them to implement effective measures for controlling waterborne diseases in the respective regions of Khyber Pakhtunkhwa, Pakistan.