Health Science Reports最新文献_第4页

Intraoperative Low-Dose Glucocorticoids in Surgical Patients With Abdominal Sepsis: A Multicenter Retrospective Cohort Study

IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL

Health Science Reports

Pub Date : 2025-02-19 DOI: 10.1002/hsr2.70360

Tianzhu Tao, Yue Shi, Xiaofei Ye, Weidong Mi, Jingsheng Lou

Background and Aims

Abdominal sepsis refers to a severe and potentially life-threatening condition characterized by the presence of infection, inflammation, and tissue damage within the abdominal cavity. Glucocorticoids (GCs) play an important role in regulation of the host immune and inflammation responses involved in sepsis and surgery. This study aimed to investigate the potential impact of intraoperative GCs administration on the clinical outcome of surgical patients with abdominal sepsis.

Methods

This retrospective cohort study included a 1:1 propensity score–matched cohort of surgical patients afflicted with abdominal sepsis at two medical centers from January 2008 to December 2022. Patients were classified into low-GCs, high-GCs, and non-GCs groups according to the dosage of steroids used intraoperatively, and in-hospital mortality was designated as the primary outcome.

Results

This study included a total of 476 patients, with 217 in the non-GCs group, 213 in the low-GCs group, and 46 in the high-GCs group. The overall in-hospital mortality rate was 7.56%. After propensity score matching (PSM), there were 168 cases in both the low-GCs group and the non-GCs group, with no significant differences observed between the groups regarding mortality rate, length of hospital-stay, and duration of intensive care unit (ICU) stay. In patients with septic shock, the use of low-dose GCs increased the urine output and decreased the requirements for vasopressors on the first postoperative day, however, it had no impact on the in-hospital mortality or ICU stay. Moreover, prophylactic use of GCs during anesthesia induction did not decrease the incidence of intraoperative hypotension or necessity of vasopressors use.

Conclusion

Intraoperative administration of low-dose GCs demonstrates a transient improvement in hemodynamics of patients with septic shock, however, it did not lead to improved clinical outcomes. Further research remains necessary to elucidate the optimal perioperative dosing strategy.

{"title":"Intraoperative Low-Dose Glucocorticoids in Surgical Patients With Abdominal Sepsis: A Multicenter Retrospective Cohort Study","authors":"Tianzhu Tao, Yue Shi, Xiaofei Ye, Weidong Mi, Jingsheng Lou","doi":"10.1002/hsr2.70360","DOIUrl":"https://doi.org/10.1002/hsr2.70360","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Abdominal sepsis refers to a severe and potentially life-threatening condition characterized by the presence of infection, inflammation, and tissue damage within the abdominal cavity. Glucocorticoids (GCs) play an important role in regulation of the host immune and inflammation responses involved in sepsis and surgery. This study aimed to investigate the potential impact of intraoperative GCs administration on the clinical outcome of surgical patients with abdominal sepsis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study included a 1:1 propensity score–matched cohort of surgical patients afflicted with abdominal sepsis at two medical centers from January 2008 to December 2022. Patients were classified into low-GCs, high-GCs, and non-GCs groups according to the dosage of steroids used intraoperatively, and in-hospital mortality was designated as the primary outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study included a total of 476 patients, with 217 in the non-GCs group, 213 in the low-GCs group, and 46 in the high-GCs group. The overall in-hospital mortality rate was 7.56%. After propensity score matching (PSM), there were 168 cases in both the low-GCs group and the non-GCs group, with no significant differences observed between the groups regarding mortality rate, length of hospital-stay, and duration of intensive care unit (ICU) stay. In patients with septic shock, the use of low-dose GCs increased the urine output and decreased the requirements for vasopressors on the first postoperative day, however, it had no impact on the in-hospital mortality or ICU stay. Moreover, prophylactic use of GCs during anesthesia induction did not decrease the incidence of intraoperative hypotension or necessity of vasopressors use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Intraoperative administration of low-dose GCs demonstrates a transient improvement in hemodynamics of patients with septic shock, however, it did not lead to improved clinical outcomes. Further research remains necessary to elucidate the optimal perioperative dosing strategy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36518,"journal":{"name":"Health Science Reports","volume":"8 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hsr2.70360","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143446787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Rowell Syndrome: A Comprehensive Review on Pathogenesis of a Rare and Challenging Entity and the Horizon of Targeted Therapeutics

IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL

Health Science Reports

Pub Date : 2025-02-17 DOI: 10.1002/hsr2.70470

Azadeh Khayyat, Seyed Amir Zohouri, Mohammad Ali Esmaaeil Pour, Parvaneh Hatami, Bruce R. Smoller

Background

Rowell syndrome (RS), an infrequent illness characterized by a combination of erythema multiforme-like manifestations and systemic lupus erythematosus, poses diagnostic and clinical issues to the healthcare system. Initially discovered by Dr. Virginie Rowell in 1963, the disorder manifests as an overlapping illness with various dermatological and rheumatological conditions, necessitating precise assessment.

Method

The review encompasses demographic characters, dermatological signs and symptoms, triggering or contributing factors, laboratory studies, diagnosis and therapy challenges, and the outcome of RS. Through an analysis of the literature, this study identifies sunlight, medication use, COVID-19 vaccination, and bacterial infections as contributing predisposing risks. Laboratory abnormalities revealed positive antinuclear antibodies and rheumatoid factor as common features, supporting the autoimmune origin of this illness.

Result

Medications vary, with systemic corticosteroids used as the initial therapy, and appropriate proper outcomes are observed with rituximab and hydroxychloroquine. Recent discoveries in biological agents and targeted immunotherapies have provided useful options for personalized care.

Conclusion

In summary, our study provides detailed and valuable data to deepen our knowledge about RS, showing the need for further investigations to discover the mechanisms underlying its pathogenesis and to identify novel targeted agents that can individualize the treatment plan.

{"title":"Rowell Syndrome: A Comprehensive Review on Pathogenesis of a Rare and Challenging Entity and the Horizon of Targeted Therapeutics","authors":"Azadeh Khayyat, Seyed Amir Zohouri, Mohammad Ali Esmaaeil Pour, Parvaneh Hatami, Bruce R. Smoller","doi":"10.1002/hsr2.70470","DOIUrl":"https://doi.org/10.1002/hsr2.70470","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Rowell syndrome (RS), an infrequent illness characterized by a combination of erythema multiforme-like manifestations and systemic lupus erythematosus, poses diagnostic and clinical issues to the healthcare system. Initially discovered by Dr. Virginie Rowell in 1963, the disorder manifests as an overlapping illness with various dermatological and rheumatological conditions, necessitating precise assessment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>The review encompasses demographic characters, dermatological signs and symptoms, triggering or contributing factors, laboratory studies, diagnosis and therapy challenges, and the outcome of RS. Through an analysis of the literature, this study identifies sunlight, medication use, COVID-19 vaccination, and bacterial infections as contributing predisposing risks. Laboratory abnormalities revealed positive antinuclear antibodies and rheumatoid factor as common features, supporting the autoimmune origin of this illness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Result</h3>\u0000 \u0000 <p>Medications vary, with systemic corticosteroids used as the initial therapy, and appropriate proper outcomes are observed with rituximab and hydroxychloroquine. Recent discoveries in biological agents and targeted immunotherapies have provided useful options for personalized care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In summary, our study provides detailed and valuable data to deepen our knowledge about RS, showing the need for further investigations to discover the mechanisms underlying its pathogenesis and to identify novel targeted agents that can individualize the treatment plan.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36518,"journal":{"name":"Health Science Reports","volume":"8 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hsr2.70470","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prevalence of Depression Among Infertile Women at Center for Fertility and Reproductive Medicine in Ethiopia: A Cross-Sectional Study

IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL

Health Science Reports

Pub Date : 2025-02-17 DOI: 10.1002/hsr2.70434

Zerihun Beyene, Abraham Fessehaye Sium, Genet Gebremedhin, Bethel Dereje

Background

Screening for depression and understanding its predictors is essential as it can inform the type and extent of psychological intervention that needs to be provided before or during infertility treatment. This study aimed to determine the prevalence of depression and associated factors among infertile women who received care at a Center for Fertility and Reproductive Medicine (CFRM) in Ethiopia.

Methods

This was a cross-sectional study conducted at CFRM in St. Paul's Hospital Millennium Medical College (Ethiopia) on women with infertility over a period of 3 months, from November 11, 2019 to February 2020. Data were collected prospectively through face-to-face interviews with the study participants using PHQ-9. Data were analyzed using SPSS version 23. Simple descriptive statistics and bivariate and multivariate regression analysis were performed as appropriate. Frequency, percentage, adjusted odds ratio (AOR) along with 95% CI were used to present the finding.

Results

A total of 381 infertile women were approached, and 32 women did not respond, constituting a repose rate of 91.6%. Among the 349 infertile women included in the final analysis, the prevalence of depression was found to be 42.1% (147/349). Low monthly income (AOR = 4.4, 95% CI, 1.3−14.5), unemployment (AOR = 4.3, 95% CI, 1.2−11.5), history of divorce (AOR = 4.4. 95% CI, 1.4−13.0), and partner's low level of education (AOR = 3.2, 95% CI, 1.2−8.9) were associated with detection of depression among the infertile women included in the study.

Conclusion

The prevalence of depression among infertile women is lower than reports from previous studies. Regardless of this relatively low prevalence, our study supports integration of depression screening and psychological treatment for those affected before and during infertility treatments, as a vital component of healthcare infertile women.

{"title":"Prevalence of Depression Among Infertile Women at Center for Fertility and Reproductive Medicine in Ethiopia: A Cross-Sectional Study","authors":"Zerihun Beyene, Abraham Fessehaye Sium, Genet Gebremedhin, Bethel Dereje","doi":"10.1002/hsr2.70434","DOIUrl":"https://doi.org/10.1002/hsr2.70434","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Screening for depression and understanding its predictors is essential as it can inform the type and extent of psychological intervention that needs to be provided before or during infertility treatment. This study aimed to determine the prevalence of depression and associated factors among infertile women who received care at a Center for Fertility and Reproductive Medicine (CFRM) in Ethiopia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a cross-sectional study conducted at CFRM in St. Paul's Hospital Millennium Medical College (Ethiopia) on women with infertility over a period of 3 months, from November 11, 2019 to February 2020. Data were collected prospectively through face-to-face interviews with the study participants using PHQ-9. Data were analyzed using SPSS version 23. Simple descriptive statistics and bivariate and multivariate regression analysis were performed as appropriate. Frequency, percentage, adjusted odds ratio (AOR) along with 95% CI were used to present the finding.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 381 infertile women were approached, and 32 women did not respond, constituting a repose rate of 91.6%. Among the 349 infertile women included in the final analysis, the prevalence of depression was found to be 42.1% (147/349). Low monthly income (AOR = 4.4, 95% CI, 1.3−14.5), unemployment (AOR = 4.3, 95% CI, 1.2−11.5), history of divorce (AOR = 4.4. 95% CI, 1.4−13.0), and partner's low level of education (AOR = 3.2, 95% CI, 1.2−8.9) were associated with detection of depression among the infertile women included in the study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The prevalence of depression among infertile women is lower than reports from previous studies. Regardless of this relatively low prevalence, our study supports integration of depression screening and psychological treatment for those affected before and during infertility treatments, as a vital component of healthcare infertile women.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36518,"journal":{"name":"Health Science Reports","volume":"8 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hsr2.70434","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143423635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Associated Factors in Terms of Having Multiple Sex Partners in Nepal: A Cross-Sectional Study

IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL

Health Science Reports

Pub Date : 2025-02-16 DOI: 10.1002/hsr2.70467

Devaraj Acharya, Mohan Kumar Sharma, Ramesh Adhikari, Bishnu Bahadur Khatri, Naveen Panta, Krishna Prasad Tripathi, Laxmi Kanta Sharma, Pramshu Nepal, Sumant Ghimire

Background and Aims

A sex partner is considered to someone with whom a person engages in sexual activity. This could be casual partner or interpersonal relationship, depending on the context. An individual who engages in a sexual relationship with more than one partner, either simultaneously or consecutively, is considered to have multiple sex partners. This study aims to determine the factors and behaviors that lead to having multiple sex partners in Nepal.

Methods

This study utilized secondary data from a nationally representative “Nepal Demographic and Health Survey (NDHS) 2022.” A multistage, probability proportional sampling, cross-sectional method was used. A total of 4913 men between the ages of 15 and 49 years from 476 different clusters were surveyed. Bivariate and multivariate analyses were carried out using SPSS 25 version, and (p < 0.05) was considered statistically significant.

Results

In this study, it was found that 55.2% of the population had multiple sexual partners based on the reported number of sexual partners a men has had since becoming sexually active. Significant factors associated with having multiple sexual partners included the age of the respondents, province, level of education, religion, ethnicity, use of the internet, occupation, wealth index combined, ecological region, current working status, and area of residence. Respondents aged between 20 and 24 years and those between 25 and 29 years are more likely to have multiple sex partners (crude Odds Ratio (cOR) = 1.570; 95% confidence interval (CI): 1.113–2.215) and (cOR = 1.505; 95% CI: 1.076–2.112), even after adjusting for other all compounding variables, than those from other age groups, keeping all other variables constant. After age, province, ethnicity, occupation, and area of residence of the respondents were significant predictors linked to having multiple sex partners.

Conclusion

To be engaged with just one or more partners in sexual activity is a personal choice; however, the risks associated with having multiple sexual partners should be taken into account.

{"title":"Associated Factors in Terms of Having Multiple Sex Partners in Nepal: A Cross-Sectional Study","authors":"Devaraj Acharya, Mohan Kumar Sharma, Ramesh Adhikari, Bishnu Bahadur Khatri, Naveen Panta, Krishna Prasad Tripathi, Laxmi Kanta Sharma, Pramshu Nepal, Sumant Ghimire","doi":"10.1002/hsr2.70467","DOIUrl":"https://doi.org/10.1002/hsr2.70467","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>A sex partner is considered to someone with whom a person engages in sexual activity. This could be casual partner or interpersonal relationship, depending on the context. An individual who engages in a sexual relationship with more than one partner, either simultaneously or consecutively, is considered to have multiple sex partners. This study aims to determine the factors and behaviors that lead to having multiple sex partners in Nepal.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study utilized secondary data from a nationally representative “Nepal Demographic and Health Survey (NDHS) 2022.” A multistage, probability proportional sampling, cross-sectional method was used. A total of 4913 men between the ages of 15 and 49 years from 476 different clusters were surveyed. Bivariate and multivariate analyses were carried out using SPSS 25 version, and (<i>p</i> < 0.05) was considered statistically significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In this study, it was found that 55.2% of the population had multiple sexual partners based on the reported number of sexual partners a men has had since becoming sexually active. Significant factors associated with having multiple sexual partners included the age of the respondents, province, level of education, religion, ethnicity, use of the internet, occupation, wealth index combined, ecological region, current working status, and area of residence. Respondents aged between 20 and 24 years and those between 25 and 29 years are more likely to have multiple sex partners (crude Odds Ratio (cOR) = 1.570; 95% confidence interval (CI): 1.113–2.215) and (cOR = 1.505; 95% CI: 1.076–2.112), even after adjusting for other all compounding variables, than those from other age groups, keeping all other variables constant. After age, province, ethnicity, occupation, and area of residence of the respondents were significant predictors linked to having multiple sex partners.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>To be engaged with just one or more partners in sexual activity is a personal choice; however, the risks associated with having multiple sexual partners should be taken into account.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36518,"journal":{"name":"Health Science Reports","volume":"8 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hsr2.70467","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143423887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Teenage Pregnancy and Its Associated Factors Among Girls Aged 13–19 Years in Apac District, Uganda: A Community-Based Cross-Sectional Study

IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL

Health Science Reports

Pub Date : 2025-02-16 DOI: 10.1002/hsr2.70471

Ewach Gracious Faith, Emmanuel Asher Ikwara, Musinguzi Marvin, Isaac Isiko

Background

This study examined teenage pregnancy among girls aged 13–19 years in Apac District, Uganda, focusing on socioeconomic, cultural, and behavioral factors. It aimed to identify prevalence and key contributors to inform targeted interventions and improve adolescent reproductive health.

Methods

This study employed a descriptive cross-sectional design in Apac District, Uganda. It surveyed 432 teenage girls (13–19) using structured questionnaires to examine sociodemographic, behavioral, and sociocultural factors affecting teenage pregnancy. Data analysis was conducted in Excel and SPSS.

Results

This study identified critical factors influencing teenage pregnancy among girls aged 13–19. A striking 84.1% of pregnant adolescents are aged 13–14, demonstrating age as a primary risk factor. Educational disparities emerge, with no formal education significantly lowering pregnancy odds (AOR: 0.16, CI: 0.03–0.80). Conversely, higher parental education correlates with increased risk (AOR: 3.50, CI: 1.50–8.15). Cultural influences are notable; Muslim (AOR: 4.60, CI: 1.56–13.58) and Protestant affiliations (AOR: 2.09, CI: 1.08–4.09) elevate risks, while early marriage (AOR: 7.57, CI: 3.44–16.64) and schooling challenges (AOR: 6.97, CI: 3.18–15.31) further exacerbate vulnerability.

Conclusion

This study highlights the critical factors contributing to teenage pregnancy in Apac District, Uganda, including younger age, educational disparities, and cultural affiliations. Early marriage and schooling challenges also increase vulnerability, emphasizing the need for targeted interventions to improve maternal health outcomes.

背景本研究调查了乌干达阿帕克区 13-19 岁少女怀孕的情况，重点关注社会经济、文化和行为因素。研究旨在确定少女怀孕的发生率和主要诱因，以便采取有针对性的干预措施，改善青少年生殖健康状况。方法本研究在乌干达阿帕克区采用了描述性横断面设计。通过结构化问卷调查了 432 名少女（13-19 岁），研究了影响少女怀孕的社会人口、行为和社会文化因素。数据分析使用 Excel 和 SPSS 进行。结果这项研究确定了影响 13-19 岁少女怀孕的关键因素。令人吃惊的是，84.1% 的怀孕少女年龄在 13-14 岁之间，这表明年龄是主要的风险因素。受教育程度存在差异，未受过正规教育可显著降低怀孕几率（AOR：0.16，CI：0.03-0.80）。相反，父母受教育程度越高，风险越高（AOR：3.50，CI：1.50-8.15）。文化影响也很显著；穆斯林（AOR：4.60，CI：1.56-13.58）和新教信仰（AOR：2.09，CI：1.08-4.09）增加了风险，而早婚（AOR：7.57，CI：3.44-16.64）和就学挑战（AOR：6.97，CI：3.18-15.31）进一步加剧了脆弱性。结论本研究强调了导致乌干达阿帕克区少女怀孕的关键因素，包括年龄较小、教育差异和文化归属。早婚和就学方面的挑战也增加了脆弱性，因此强调有必要采取有针对性的干预措施，以改善孕产妇的健康状况。

{"title":"Teenage Pregnancy and Its Associated Factors Among Girls Aged 13–19 Years in Apac District, Uganda: A Community-Based Cross-Sectional Study","authors":"Ewach Gracious Faith, Emmanuel Asher Ikwara, Musinguzi Marvin, Isaac Isiko","doi":"10.1002/hsr2.70471","DOIUrl":"https://doi.org/10.1002/hsr2.70471","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study examined teenage pregnancy among girls aged 13–19 years in Apac District, Uganda, focusing on socioeconomic, cultural, and behavioral factors. It aimed to identify prevalence and key contributors to inform targeted interventions and improve adolescent reproductive health.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study employed a descriptive cross-sectional design in Apac District, Uganda. It surveyed 432 teenage girls (13–19) using structured questionnaires to examine sociodemographic, behavioral, and sociocultural factors affecting teenage pregnancy. Data analysis was conducted in Excel and SPSS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study identified critical factors influencing teenage pregnancy among girls aged 13–19. A striking 84.1% of pregnant adolescents are aged 13–14, demonstrating age as a primary risk factor. Educational disparities emerge, with no formal education significantly lowering pregnancy odds (AOR: 0.16, CI: 0.03–0.80). Conversely, higher parental education correlates with increased risk (AOR: 3.50, CI: 1.50–8.15). Cultural influences are notable; Muslim (AOR: 4.60, CI: 1.56–13.58) and Protestant affiliations (AOR: 2.09, CI: 1.08–4.09) elevate risks, while early marriage (AOR: 7.57, CI: 3.44–16.64) and schooling challenges (AOR: 6.97, CI: 3.18–15.31) further exacerbate vulnerability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study highlights the critical factors contributing to teenage pregnancy in Apac District, Uganda, including younger age, educational disparities, and cultural affiliations. Early marriage and schooling challenges also increase vulnerability, emphasizing the need for targeted interventions to improve maternal health outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36518,"journal":{"name":"Health Science Reports","volume":"8 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hsr2.70471","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Intestinal Parasitic Infections and Associated Behavioral Risk Factors in a Squatter Community in Butwal, Nepal: A Pilot Study

IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL

Health Science Reports

Pub Date : 2025-02-16 DOI: 10.1002/hsr2.70473

Shristi Bhandari, Rajendra Prasad Parajuli, Pitambar Dhakal, Kishor Pandey

Background

Intestinal parasitic infections (IPIs) are among the most prevalent illnesses worldwide. The morbidity associated with IPIs results in health and economic burdens for billions of people worldwide, especially in low-income nations. Increasing urbanization in Nepal has resulted in the formation of squatter communities in urban centers. These communities often face a disproportionate burden of health issues due to the quality of their living environment. This study aims to determine the prevalence of and risk factors for IPIs in the squatter community of Butwal, Nepal.

Methods

A total of 170 individuals were recruited for a cross-sectional study via convenience sampling. Information pertaining to demographic, socioeconomic, and behavioral factors was obtained via structured questionnaires, personal interviews, and direct witnessing during the field visit. Stool samples (n = 170) were examined for intestinal parasite eggs and oocysts via direct wet mount and concentration techniques.

Results

Overall, the prevalence of parasites was 28.8% (5.3% protozoa, 24.7% helminths). Six species of intestinal parasites were detected. Ascaris lumbricoides (21.2%) was the most dominant helminthic parasite, followed by Trichuris trichiura (2.9%), Entamoeba histolytica (2.4%), Cryptosporidium sp. (1.8%), Giardia lamblia (1.8%), and hookworm (1.8%). Multivariate regression analysis revealed that participants who did not trim their nails once a week were more prone to getting a parasitic infection.

Conclusion

The relatively high prevalence of IPIs among participating residents of the Butwal slum may contribute to an increased risk of IPI transmission due to inadequate hygiene behaviors. Among the participants in this study, more than one quarter stated that they do not trim their nails every week, and approximately one-fifth indicated open defecation. Standardized health education regarding the benefits of hand and nail hygiene behaviors may contribute positively in reducing the parasitic burden and interrupting the chain of transmission in developing urban areas such as Butwal.

{"title":"Intestinal Parasitic Infections and Associated Behavioral Risk Factors in a Squatter Community in Butwal, Nepal: A Pilot Study","authors":"Shristi Bhandari, Rajendra Prasad Parajuli, Pitambar Dhakal, Kishor Pandey","doi":"10.1002/hsr2.70473","DOIUrl":"https://doi.org/10.1002/hsr2.70473","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Intestinal parasitic infections (IPIs) are among the most prevalent illnesses worldwide. The morbidity associated with IPIs results in health and economic burdens for billions of people worldwide, especially in low-income nations. Increasing urbanization in Nepal has resulted in the formation of squatter communities in urban centers. These communities often face a disproportionate burden of health issues due to the quality of their living environment. This study aims to determine the prevalence of and risk factors for IPIs in the squatter community of Butwal, Nepal.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 170 individuals were recruited for a cross-sectional study via convenience sampling. Information pertaining to demographic, socioeconomic, and behavioral factors was obtained via structured questionnaires, personal interviews, and direct witnessing during the field visit. Stool samples (<i>n</i> = 170) were examined for intestinal parasite eggs and oocysts via direct wet mount and concentration techniques.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, the prevalence of parasites was 28.8% (5.3% protozoa, 24.7% helminths). Six species of intestinal parasites were detected. <i>Ascaris lumbricoides</i> (21.2%) was the most dominant helminthic parasite, followed by <i>Trichuris trichiura</i> (2.9%), <i>Entamoeba histolytica</i> (2.4%), <i>Cryptosporidium</i> sp. (1.8%), <i>Giardia lamblia</i> (1.8%), and hookworm (1.8%). Multivariate regression analysis revealed that participants who did not trim their nails once a week were more prone to getting a parasitic infection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The relatively high prevalence of IPIs among participating residents of the Butwal slum may contribute to an increased risk of IPI transmission due to inadequate hygiene behaviors. Among the participants in this study, more than one quarter stated that they do not trim their nails every week, and approximately one-fifth indicated open defecation. Standardized health education regarding the benefits of hand and nail hygiene behaviors may contribute positively in reducing the parasitic burden and interrupting the chain of transmission in developing urban areas such as Butwal.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36518,"journal":{"name":"Health Science Reports","volume":"8 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hsr2.70473","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143423804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparing Cesarean Incisional Complications in Women With and Without Enoxaparin: A Quasi-Experimental Study

IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL

Health Science Reports

Pub Date : 2025-02-16 DOI: 10.1002/hsr2.70472

Leili Hafizi, Freshteh Khoshniat, Masoumeh Mirteimouri, Safoura Khazaeian

Background and Aims

Although some women who undergo cesarean section need to receive prophylactic Enoxaparin due to the increased risk of thromboembolism during their puerperium period, the question is always raised of whether this drug with the mechanism of increased bleeding may increase surgical wound complications. Hence, the present study was conducted with the aim of a comparative study on complications of abdominal incision in cesarean section patients with and without receiving Enoxaparin.

Methods

A quasi-experimental study was conducted on 789 cesarean section participants (317 receiving Enoxaparin and 472 control subjects), 20–40 years pregnant women in Imam Reza and Ummal-Banin hospitals in Mashhad, Iran. All participants who scored three or more for thromboembolism risk based on the National Protocol received Enoxaparin after surgery. Those with underlying wound complication risk factors were excluded from the study. Then, both groups were evaluated for abdominal incision complications up to 2 weeks after their delivery and were compared with each other. A p value < 0.05 was considered significant.

Results

In total, 5% of patients in the Enoxaparin group and 5.5% in the control group had ulcer complications (p = 0.7). The frequency of the type of complication between the two groups was as follows: hematoma (p = 0.8), ecchymosis (p = 0.5), wound infection (p = 0.9), wound partial dehiscence (p = 0.09), wound total dehiscence (p = 0.3), secondary closure of the incision (p = 0.7) which had no meaningful statistical difference.

Conclusion

Based on the outcomes obtained in the present study, prescribing Enoxaparin after a cesarean in cases receiving this drug for thromboembolic prophylaxis did not significantly increase the complications of abdominal incision, and there was no need for more incision care.

{"title":"Comparing Cesarean Incisional Complications in Women With and Without Enoxaparin: A Quasi-Experimental Study","authors":"Leili Hafizi, Freshteh Khoshniat, Masoumeh Mirteimouri, Safoura Khazaeian","doi":"10.1002/hsr2.70472","DOIUrl":"https://doi.org/10.1002/hsr2.70472","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Although some women who undergo cesarean section need to receive prophylactic Enoxaparin due to the increased risk of thromboembolism during their puerperium period, the question is always raised of whether this drug with the mechanism of increased bleeding may increase surgical wound complications. Hence, the present study was conducted with the aim of a comparative study on complications of abdominal incision in cesarean section patients with and without receiving Enoxaparin.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A quasi-experimental study was conducted on 789 cesarean section participants (317 receiving Enoxaparin and 472 control subjects), 20–40 years pregnant women in Imam Reza and Ummal-Banin hospitals in Mashhad, Iran. All participants who scored three or more for thromboembolism risk based on the National Protocol received Enoxaparin after surgery. Those with underlying wound complication risk factors were excluded from the study. Then, both groups were evaluated for abdominal incision complications up to 2 weeks after their delivery and were compared with each other. A <i>p</i> value < 0.05 was considered significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 5% of patients in the Enoxaparin group and 5.5% in the control group had ulcer complications (<i>p</i> = 0.7). The frequency of the type of complication between the two groups was as follows: hematoma (<i>p</i> = 0.8), ecchymosis (<i>p</i> = 0.5), wound infection (<i>p</i> = 0.9), wound partial dehiscence (<i>p</i> = 0.09), wound total dehiscence (<i>p</i> = 0.3), secondary closure of the incision (<i>p</i> = 0.7) which had no meaningful statistical difference.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Based on the outcomes obtained in the present study, prescribing Enoxaparin after a cesarean in cases receiving this drug for thromboembolic prophylaxis did not significantly increase the complications of abdominal incision, and there was no need for more incision care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36518,"journal":{"name":"Health Science Reports","volume":"8 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hsr2.70472","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

University Students' Sociodemographics, Physical Inactivity, and Inadequate and Poor-Quality Sleep Are Associated With Their Overweight/Obesity: Findings From a Case–Control Study in Bangladesh

IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL

Health Science Reports

Pub Date : 2025-02-13 DOI: 10.1002/hsr2.70454

Md. Hasan Al Banna, Mohammad Hamiduzzaman, Shammy Akter, Abdul-Aziz Seidu, Ayesha Begum, Nilufa Yeasmin, Satyajit Kundu, Mst. Umme Hafsa Begum, Mst Sadia Sultana, Bernard Kissi-Abrokwah, Najim Z. Alshahrani, Md. Shafiqul Islam Khan, Md. Nazmul Hassan

Background and Aims

Evidence confirms a high prevalence of general and abdominal obesity among university students in Bangladesh. The primary objective of this case–control study was to examine the association between overweight/obesity and sleep patterns (including sleep duration and quality) among university students in Bangladesh. The secondary objective was to identify the sociodemographic and lifestyle-related factors that predict overweight/obesity in the study population.

Methods

The sociodemographics and body mass index (BMI) were gathered from a sample of 330 university students (setting: one public university in Bangladesh). Sleep health was measured by the 19-item Pittsburgh Sleep Quality Index (PSQI) and compared between the cases (BMI ≥ 23.0 kg/m²) and controls (BMI = 18.5–22.9 kg/m²). Bivariate and multiple stepwise regression analyses were performed.

Results

One hundred and sixty-five overweight/obesity students and 165 control subjects participated in the study. The peak age for overweight/obesity was 22–25 years in the students, and about 67% of the cases were poor-quality sleepers compared to 53% of the students in the control group. Multiple stepwise regression analysis showed that students' overweight/obesity was associated with being female (adjusted odds ratio, aOR = 2.12; 95% confidence interval, CI: 1.25, 3.61), short sleep duration ( ≤ 7 h/night) (aOR = 1.12, 95% CI: 1.04, 2.66), poor quality of sleep (aOR = 1.82, 95% CI: 1.16, 2.87), and physical inactivity (aOR = 1.89; 95% CI: 1.12, 3.55).

Conclusion

Key factors associated with overweight/obesity among Bangladeshi university students include age (22–25 years), gender (higher prevalence in female students), sleep duration and quality, and physical inactivity. These findings highlight the need for targeted interventions addressing sleep health, physical activity, and healthy lifestyles to mitigate overweight/obesity among university students.

{"title":"University Students' Sociodemographics, Physical Inactivity, and Inadequate and Poor-Quality Sleep Are Associated With Their Overweight/Obesity: Findings From a Case–Control Study in Bangladesh","authors":"Md. Hasan Al Banna, Mohammad Hamiduzzaman, Shammy Akter, Abdul-Aziz Seidu, Ayesha Begum, Nilufa Yeasmin, Satyajit Kundu, Mst. Umme Hafsa Begum, Mst Sadia Sultana, Bernard Kissi-Abrokwah, Najim Z. Alshahrani, Md. Shafiqul Islam Khan, Md. Nazmul Hassan","doi":"10.1002/hsr2.70454","DOIUrl":"https://doi.org/10.1002/hsr2.70454","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Evidence confirms a high prevalence of general and abdominal obesity among university students in Bangladesh. The primary objective of this case–control study was to examine the association between overweight/obesity and sleep patterns (including sleep duration and quality) among university students in Bangladesh. The secondary objective was to identify the sociodemographic and lifestyle-related factors that predict overweight/obesity in the study population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The sociodemographics and body mass index (BMI) were gathered from a sample of 330 university students (setting: one public university in Bangladesh). Sleep health was measured by the 19-item Pittsburgh Sleep Quality Index (PSQI) and compared between the cases (BMI ≥ 23.0 kg/m<sup>2</sup>) and controls (BMI = 18.5–22.9 kg/m<sup>2</sup>). Bivariate and multiple stepwise regression analyses were performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One hundred and sixty-five overweight/obesity students and 165 control subjects participated in the study. The peak age for overweight/obesity was 22–25 years in the students, and about 67% of the cases were poor-quality sleepers compared to 53% of the students in the control group. Multiple stepwise regression analysis showed that students' overweight/obesity was associated with being female (adjusted odds ratio, aOR = 2.12; 95% confidence interval, CI: 1.25, 3.61), short sleep duration ( ≤ 7 h/night) (aOR = 1.12, 95% CI: 1.04, 2.66), poor quality of sleep (aOR = 1.82, 95% CI: 1.16, 2.87), and physical inactivity (aOR = 1.89; 95% CI: 1.12, 3.55).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Key factors associated with overweight/obesity among Bangladeshi university students include age (22–25 years), gender (higher prevalence in female students), sleep duration and quality, and physical inactivity. These findings highlight the need for targeted interventions addressing sleep health, physical activity, and healthy lifestyles to mitigate overweight/obesity among university students.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36518,"journal":{"name":"Health Science Reports","volume":"8 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hsr2.70454","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143404617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Effect of Honey Supplementation on Skeletal Muscle-Related Inflammatory Markers Among Military Graduates After Overtraining

IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL

Health Science Reports

Pub Date : 2025-02-13 DOI: 10.1002/hsr2.70428

Esmail Karami, Mohammad Reza Parvizi, Mohammad Reza Izadi, Emad Jowhari Shirazi

Aims and Objectives

Honey possesses specific anti-inflammatory properties. We evaluated the effects of oral honey supplementation on skeletal muscle-related inflammatory markers among military graduates after overtraining.

Methods

This randomized double-blind controlled trial was conducted on 42 overtrained military graduates who were randomly assigned to receive either honey supplementation (5 mL of 12% honey solution twice daily for 6 weeks) or a placebo for 6 weeks. In our study, we utilized Milk Vetch Sahand honey as the intervention. Serum levels of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), aldolase A, and creatine kinase (CK) were evaluated using the enzyme-linked immunosorbent assay method before and after the intervention.

Results

A total of 21 male participants with a mean age of 20.75 years were included in each group. No significant differences were found between the groups in the pre-intervention assessment of inflammatory biomarkers. However, in the post-intervention assessment, participants who received honey exhibited significantly smaller increases in CRP (p < 0.001), TNF-α (p = 0.001), aldolase A (p < 0.001), and CK levels (p < 0.001) compared to the controls. The mean changes in these biomarkers were notably lower in the honey group indicating a potential anti-inflammatory effect of honey.

Conclusion

This study demonstrates that honey supplementation significantly reduces inflammatory biomarkers such as TNF-α, CRP, aldolase A, and CK in military graduates experiencing overtraining, underscoring its potential to alleviate inflammation associated with intense physical training. To confirm and extend these findings, further research with larger sample sizes and longer follow-up periods is recommended.

{"title":"The Effect of Honey Supplementation on Skeletal Muscle-Related Inflammatory Markers Among Military Graduates After Overtraining","authors":"Esmail Karami, Mohammad Reza Parvizi, Mohammad Reza Izadi, Emad Jowhari Shirazi","doi":"10.1002/hsr2.70428","DOIUrl":"https://doi.org/10.1002/hsr2.70428","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and Objectives</h3>\u0000 \u0000 <p>Honey possesses specific anti-inflammatory properties. We evaluated the effects of oral honey supplementation on skeletal muscle-related inflammatory markers among military graduates after overtraining.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This randomized double-blind controlled trial was conducted on 42 overtrained military graduates who were randomly assigned to receive either honey supplementation (5 mL of 12% honey solution twice daily for 6 weeks) or a placebo for 6 weeks. In our study, we utilized Milk Vetch Sahand honey as the intervention. Serum levels of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), aldolase A, and creatine kinase (CK) were evaluated using the enzyme-linked immunosorbent assay method before and after the intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 21 male participants with a mean age of 20.75 years were included in each group. No significant differences were found between the groups in the pre-intervention assessment of inflammatory biomarkers. However, in the post-intervention assessment, participants who received honey exhibited significantly smaller increases in CRP (<i>p</i> < 0.001), TNF-α (<i>p</i> = 0.001), aldolase A (<i>p</i> < 0.001), and CK levels (<i>p</i> < 0.001) compared to the controls. The mean changes in these biomarkers were notably lower in the honey group indicating a potential anti-inflammatory effect of honey.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study demonstrates that honey supplementation significantly reduces inflammatory biomarkers such as TNF-α, CRP, aldolase A, and CK in military graduates experiencing overtraining, underscoring its potential to alleviate inflammation associated with intense physical training. To confirm and extend these findings, further research with larger sample sizes and longer follow-up periods is recommended.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36518,"journal":{"name":"Health Science Reports","volume":"8 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hsr2.70428","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143404473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prognostic Models of Mortality Following First-Ever Acute Ischemic Stroke: A Population-Based Retrospective Cohort Study

IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL

Health Science Reports

Pub Date : 2025-02-13 DOI: 10.1002/hsr2.70445

Mustapha Mohammed, Hadzliana Zainal, Siew Chin Ong, Balamurugan Tangiisuran, Fatimatuzzahra Abdul Aziz, Norsima N. Sidek, Abubakar Sha'aban, Umar Idris Ibrahim, Surajuddeen Muhammad, Irene Looi, Zariah A. Aziz

Background and Aims

There is a lack of population-based studies focusing on guideline-based prognostic models for stroke. This study aimed to develop and validate a prognostic model that predicts mortality following a first-ever acute ischemic stroke.

Methods

The study included 899 adult patients ( ≥ 18 years) with confirmed diagnosis of first-ever acute ischemic stroke enrolled in the Malaysian National Stroke Registry (NSR) from January 2009 to December 2019. The primary outcome was mortality within 90 days post-stroke (266 events [29.6%]). The prognostic model was developed using logistic regression (75%, n = 674) and internally validated (25%, n = 225). Model performance was assessed using discrimination (area under the curve (AUC]) and calibration (Hosmer-Lemeshow test [HL]).

Results

The final model includes factors associated with increased risk of mortality, such as age (adjusted odds ratio, aOR 1.06 [95% confidence interval, CI 1.03, 1.10; p < 0.001]), National Institutes of Health Stroke Scale (NIHSS) score aOR 1.08 (95% CI 1.08, 1.13; p = 0.004), and diabetes aOR 2.29 (95% CI 1.20, 4.37; p = 0.012). The protective factors were antiplatelet within 48 h. aOR 0.40 (95% CI 0.19, 0.81; p = 0.01), dysphagia screening aOR 0.30 (95% CI 0.15, 0.61; p = 0.001), antiplatelets upon discharge aOR 0.17 (95% CI 0.08, 0.35; p < 0.001), lipid-lowering therapy aOR 0.37 (95% CI 0.17, 0.82; p = 0.01), stroke education aOR 0.02 (95% CI 0.01, 0.05; p < 0.001) and rehabilitation aOR 0.08 (95% CI 0.04, 0.16; p < 0.001). The model demonstrated excellent performance (discrimination [AUC = 0.94] and calibration [HL, X² p = 0.63]).

Conclusion

The study developed a validated prognostic model that excellently predicts mortality after a first-ever acute ischemic stroke with potential clinical utility in acute stroke care decision-making. The predictors could be valuable for creating risk calculators and aiding healthcare providers and patients in making well-informed clinical decisions during the stroke care process.

{"title":"Prognostic Models of Mortality Following First-Ever Acute Ischemic Stroke: A Population-Based Retrospective Cohort Study","authors":"Mustapha Mohammed, Hadzliana Zainal, Siew Chin Ong, Balamurugan Tangiisuran, Fatimatuzzahra Abdul Aziz, Norsima N. Sidek, Abubakar Sha'aban, Umar Idris Ibrahim, Surajuddeen Muhammad, Irene Looi, Zariah A. Aziz","doi":"10.1002/hsr2.70445","DOIUrl":"https://doi.org/10.1002/hsr2.70445","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>There is a lack of population-based studies focusing on guideline-based prognostic models for stroke. This study aimed to develop and validate a prognostic model that predicts mortality following a first-ever acute ischemic stroke.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study included 899 adult patients ( ≥ 18 years) with confirmed diagnosis of first-ever acute ischemic stroke enrolled in the Malaysian National Stroke Registry (NSR) from January 2009 to December 2019. The primary outcome was mortality within 90 days post-stroke (266 events [29.6%]). The prognostic model was developed using logistic regression (75%, <i>n</i> = 674) and internally validated (25%, <i>n</i> = 225). Model performance was assessed using discrimination (area under the curve (AUC]) and calibration (Hosmer-Lemeshow test [HL]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The final model includes factors associated with increased risk of mortality, such as age (adjusted odds ratio, aOR 1.06 [95% confidence interval, CI 1.03, 1.10; <i>p</i> < 0.001]), National Institutes of Health Stroke Scale (NIHSS) score aOR 1.08 (95% CI 1.08, 1.13; <i>p </i>= 0.004), and diabetes aOR 2.29 (95% CI 1.20, 4.37; <i>p</i> = 0.012). The protective factors were antiplatelet within 48 h. aOR 0.40 (95% CI 0.19, 0.81; <i>p</i> = 0.01), dysphagia screening aOR 0.30 (95% CI 0.15, 0.61; <i>p</i> = 0.001), antiplatelets upon discharge aOR 0.17 (95% CI 0.08, 0.35; <i>p </i>< 0.001), lipid-lowering therapy aOR 0.37 (95% CI 0.17, 0.82; <i>p</i> = 0.01), stroke education aOR 0.02 (95% CI 0.01, 0.05; <i>p</i> < 0.001) and rehabilitation aOR 0.08 (95% CI 0.04, 0.16; <i>p</i> < 0.001). The model demonstrated excellent performance (discrimination [AUC = 0.94] and calibration [HL, <i>X</i><sup>2</sup> <i>p </i>= 0.63]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The study developed a validated prognostic model that excellently predicts mortality after a first-ever acute ischemic stroke with potential clinical utility in acute stroke care decision-making. The predictors could be valuable for creating risk calculators and aiding healthcare providers and patients in making well-informed clinical decisions during the stroke care process.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36518,"journal":{"name":"Health Science Reports","volume":"8 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hsr2.70445","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143404569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0