Health Science Reports最新文献

Background and aims: Preoperative anxiety affects many patients, impacting both their readiness for surgery and their postoperative recovery. A multi-center study on preoperative anxiety is limited to the study area. Understanding patients' informational needs and other associated factors is crucial for developing effective strategies and enhancing patient outcomes. This research aims to assess the prevalence of preoperative anxiety and associated factors among adult patients undergoing elective surgery in public hospitals of Bahir Dar City, Northwest Ethiopia, 2023.

Methods: This multi-center hospital-based cross-sectional study was conducted from September 1 to October 30, 2023. A systematic random sampling was used. Data were collected using a structured questionnaire, which included APAIS AND Oslo-3 Scales, on the day before surgery, entered, and analyzed using EpiData version 4.6. and SPSS version 26. Descriptive analysis and binary logistic regression were performed, with p < 0.05 considered statistically significant.

Results: A total of 390 patients participated in the study, with a response rate of 95.8%. The prevalence of preoperative anxiety was 58.2% (95% CI: 53.1%-63.1%). Preoperative anxiety was significantly associated with fear of death (Adjusted odd ratio [AOR] = 5.21, 95% CI: 2.21-12.25), fear of anesthesia (AOR = 4.82, 95% CI: 2.12-10.93), concern about not recovering from anesthesia or illness (AOR = 3.00, 95% CI: 1.27-7.56), unaware of the planned surgery (AOR = 4.79, 95% CI: 2.01-11.43), Not knowing the type of anesthesia (AOR = 3.78, 95% CI: 1.71-8.37), having history of surgery (AOR = 2.48, 95%CI: 1.10-5.60), and poor social support (AOR = 2.71, 95% CI: 1.13-6.51).

Conclusions and recommendations: In this study, nearly one-fifth of the patients (58.2%) experienced preoperative anxiety. The findings highlight the need for all surgical patients to visit a preoperative clinic where they can receive adequate information about their procedure, anesthesia, and overall condition. Strengthening social support systems and ensuring timely evaluation and management of preoperative anxiety are essential to improving patient outcomes.

Background: HIV is a significant aetiological factor in thrombotic microangiopathy (TMA) in regions of high seroprevalence, but description of HIV-associated TMA (HIV-TMA) remains limited to small case series. We sought to describe the presentation, complications of TPE, and mortality and renal outcomes of HIV-TMA.

Methods: We retrospectively reviewed 98 cases of HIV-TMA treated with therapeutic plasma exchange (TPE) between 1/1/2010 and 31/12/2020. The effect of HIV infection and clinical presentation on mortality, TPE complications, and renal outcomes were analysed using regression analysis.

Results: TMA is associated with advanced HIV infection (median CD4 count 151 × 106/mm³ cells and median viral load 117500 copies/mL), usually occurs in the absence of antiretroviral therapy (ART), and shows a predilection for young Black women, reflecting TMA risk factors and local demographics of the HIV pandemic. Neurological deficit is the most common presenting feature (54.1%). HIV-TMA mortality is high despite TPE (49% of cases); better renal function reduces risk of TMA-attributable death (HR 0.97, 95% CI 0.96-0.99, p < 0.001); use of FFP as infusant is associated with increased risk of mortality (HR 3.96, 95% CI 1.60-9.84, p = 0.003). Sepsis frequently complicates TPE (16.3% of courses) and contributes to excess mortality (20.7% of deaths); risk of infection increases with duration of TPE (OR 1.21, 95% CI 1.07-1.37, p = 0.002), implicating augmented immunosuppression in mortality. HIV infection parameters do not significantly affect risk of mortality or sepsis. Residual renal dysfunction is relatively rare in survivors at follow-up.

Conclusion: Mortality remains high in HIV-TMA treated with TPE, and sepsis-related complications are of concern. Randomized prospective studies are needed to evaluate the use of TPE versus plasma infusion (PI) and infusant choice in HIV-TMA. Longer duration follow-up studies are needed to evaluate residual renal dysfunction in survivors of HIV-TMA.

Background and objectives: Systemic inflammation indices derived from complete blood counts (CBC) are accessible markers of inflammatory burden, but their relationship with circulating cytokines in psoriasis remains unclear. We investigated associations between CBC-derived indices and serum cytokines in psoriasis.

Materials and methods: In this cross-sectional study, we included 28 patients with psoriasis and 23 healthy controls. Serum IL-17, IL-22, IL-23, IL-31, IL-33, IL-36, TNF-α, TGF-β, and IFNγ were quantified by ELISA. CBC-derived indices were computed (neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and pan-immune-inflammation value (PIV). Case-control comparisons used the full sample. Cytokine-index associations were evaluated in psoriasis patients using bivariate correlations and multivariate GLM adjusted for age, smoking, and NAFLD. Multiplicity was controlled using Benjamini-Hochberg false discovery rate (BH-FDR); prespecified sensitivity analyses used log-transformed cytokines and Spearman correlations.

Results: Psoriasis patients had higher levels of all cytokines (all p < 0.001) and higher SIRI versus controls (p < 0.001; q = 0.005). PIV showed a nominal case-control difference (p = 0.022) that did not remain significant after BH-FDR (q = 0.055), while NLR, PLR, and SII did not differ. In adjusted multivariate GLM, TGF-β showed a global association with the joint set of indices (Pillai's trace = 0.295; p = 0.039) that did not survive BH-FDR (q = 0.507) and was attenuated with log-transformation. Nominal univariate effects for TNF-α on SIRI (F = 4.600; p = 0.039) and PIV (F = 5.660; p = 0.023) did not remain significant after BH-FDR.

Conclusions: SIRI was consistently elevated in psoriasis, whereas PIV showed a nominal difference versus controls. Across exploratory analyses, SIRI and PIV showed the most consistent directional co-variation with cytokines, but associations were modest. These findings are hypothesis-generating and support further validation in larger cohorts to determine whether CBC-derived indices can serve as scalable adjunct markers of inflammatory activity in psoriasis.

Background: Toxoplasma gondii (T. gondii) infection poses significant risks during pregnancy, yet data on seroprevalence and genotype diversity in Ethiopia are scarce.

Objective: This study aimed to determine the seroprevalence, associated risk factors, and genotype distribution of T. gondii among pregnant women in Northwest Ethiopia.

Methods: A cross-sectional study was conducted among 554 pregnant women attending antenatal care in public hospitals between January 2022 and April 2024. Systematic random sampling was used. ELISA detected T. gondii-specific IgG and IgM antibodies, and PCR-RFLP targeting B1 and SAG2 loci were used for genotyping.

Results: Overall seroprevalence was 54.3%, with 6.1% testing IgG-positive only, 9.4% IgM-positive only, and 38.8% positive for both. Cat ownership (AOR = 2.2; 95% CI: 1.4-3.5) and dog ownership (AOR = 4.9; 95% CI: 2.9-8.1) were significantly associated with infection. Among 28 IgM-positive samples, Type II strains predominated (50%), followed by Types I and III (25% each).

Conclusion: These findings support targeted screening and pet-handling education to reduce the risk of congenital toxoplasmosis. Further molecular surveillance is recommended to inform public health strategies.

Background and aims: Hepatitis B is a serious, communicable liver disease resulting from hepatitis B virus infection. Healthcare workers (HCWs), including nursing students, are at elevated risk of exposure. We assessed Jordanian nursing students' knowledge, attitudes, and practices (KAP) toward HBV and explored predictors of better KAP.

Methods: We conducted a cross-sectional online survey (March-August 2022) among 617 nursing students (years 3-5) at two Jordanian universities using a previously validated questionnaire (43 knowledge, 8 attitude, 3 practice items). Scores ≥ 70% were classified as "good." Descriptive statistics and χ² tests were used, and multivariable logistic regression examined associations with KAP (α = 0.05).

Results: Overall knowledge was satisfactory, particularly for transmission routes; 73.1% answered diagnostic items correctly. Misconceptions persisted about oral and airborne transmission (≤ 50% correct). Only 8.1% and 18.6% correctly identified treatment criteria and the urgency of treatment, respectively. Most students reported prior HBV vaccination (75.7%) and personal protective equipment use during patient contact (~71%); however, only 45.4% had undergone anti-HBV testing before clinical rotations. In multivariable analyses, higher academic year, prior HBV-related coursework, and clinical encounters with HBV patients were associated with better KAP (all p < 0.05).

Conclusion: Jordanian nursing students demonstrated acceptable knowledge of HBV transmission but notable gaps in treatment knowledge, newborn immunization timing, and safe sharps disposal. Curricular enhancements should correct misconceptions about non-transmission via food or air, reinforce post-vaccination antibody testing and revaccination of nonresponders, and strengthen training on treatment indications and neonatal prophylaxis. Targeted education-particularly in earlier academic years-may improve HBV-related KAP among future HCWs.

Background and aims: This study explored the practical perspectives of healthcare professionals in Jordan regarding integrating artificial intelligence (AI) tools into clinical practice and describes their concerns about AI's ethical implications.

Methods: The study utilized a cross-sectional, questionnaire-based survey that was conducted with employed physicians in Jordan from April through September 2025. The survey used a validated instrument to assess the participants' AI experience, willingness to adopt AI, practical and ethical concerns associated with AI, and support for the recommended actions. The data were analyzed using descriptive statistics and logistic regression.

Results: In this study, 297 physicians participated (median age = 36.0; IQR = 19.0). Around 72% of the participants (n = 214) reported having prior experience with AI, while 50.8% (n = 151) expressed an openness to using AI tools in their clinical practice. Physician concerns about AI included a lack of ability to manage complex cases (n = 216, 72.8%), jeopardizing the physician-patient relationship (n = 204, 68.7%), and diminishing their cognitive ability (n = 210, 70.7%). Other ethical concerns included cultural differences (n = 213, 71.7%), and unclear accountabilities for any errors resulting from using AI (n = 209, 70.4%). Physicians who reported being more willing to adopt AI tools had significantly shorter median ages (adjusted odds ratio [AOR] = 0.971, p = 03) and had prior experience with AI (AOR = 0.262, p < 001) and had daily patient case loads of at least 10 patients (AOR = 1.895, p = 05).

Conclusion: While Jordanian physicians recognize AI's benefits, they express significant ethical, practical, and contextual concerns. This study highlights the unique concerns of Jordanian physicians, which differ from those in other countries, and underscores the need for region-specific policies addressing training, cultural adaptation, and regulation to support AI integration in clinical practice.

Background and aims: The increasing consumption of junk food (JF) by university students in low- and middle-income countries like Bangladesh is a developing public health issue. This study examined the prevalence of JF consumption and awareness of its health risks among Bangladeshi university students.

Methods: A cross-sectional study was conducted using a structured interview-based questionnaire among 516 students. Data were analyzed using descriptive statistics and χ ² tests, with p < 0.05 considered significant.

Results: Nearly 68% students consumed JF from restaurants, with 51.9% eating it occasionally. Local snacks were preferred by 77.3% of students, while 47.3% consumed packaged snacks. Around 59% ate small portions, and 38% consumed carbonated soft drinks with JF. Awareness of JF's health risks was high (87.6%), with most students recognizing its link to obesity, diabetes, and hypertension. Statistical analysis revealed significant associations between academic level and the consumption of packaged snacks (χ ² = 7.919, p = 0.02, Cramer's V = 0.124). In contrast, beliefs regarding the increased risk of heart disease with JF consumption (χ ² = 2.181, p = 0.34, Cramer's V = 0.065) were not statistically significant. Awareness of additives as JF components was also significant (χ ² = 9.525, p = 0.009, Cramer's V = 0.136), indicating varied understanding across academic levels.

Conclusion: Despite high awareness, JF consumption remains widespread among university students in Bangladesh. The findings indicate a gap between knowledge and practice and underscore the importance of future studies to identify nutrition-focused interventions in university settings.

Background and aims: The prevalence of gestational diabetes mellitus (GDM) in Saudi Arabia is believed to affect 36% of all pregnant women. Many adverse outcomes affect the lives of the neonates of these mothers. Therefore, this study aims to assess the association between GDM and neonatal health outcomes in Jeddah City, Saudi Arabia.

Methods: A retrospective cohort design was used. Two hundred neonatal records were reviewed: 100 for neonates of mothers who had GDM and 100 without GDM for control. The two groups were compared in terms of neonatal outcomes.

Results: The gestational age and the glycemic level of neonates of mothers without GDM were significantly higher than those with GDM (39± weeks vs. 37 weeks and 63± vs. 55 mg/dL, p ≤ 0.05). Neonates of mothers with GDM required cesarean section deliveries more than neonates of mothers without GDM (92% vs. 40%, p ≤ 0.05). Also, these neonates were more prone to develop respiratory distress syndrome and congenital anomalies than neonates of mothers without GDM (21% vs. 11% and 17% vs. 4%, p ≤ 0.05).

Conclusion: This study provides empirical evidence demonstrating the negative effect of GDM on neonatal health outcomes, mainly in terms of hypoglycemia, respiratory distress syndrome, and congenital anomalies. Therefore, it highlights the importance of adequate glycemic control by specifying proper treatment together with dietary intervention and exercise programs to improve outcomes. All authors have read and approved the final version of the manuscript. Corresponding author had full access to all the data in this study and takes complete responsibility for the integrity of the data and the accuracy of the data analysis.

Background and aims: Menstrual hygiene remains a critical public health issue in Africa, where many women and girls face inadequate water, sanitation, and hygiene (WASH) facilities, limited access to menstrual products, and persistent social stigma. Mobile health (mHealth) interventions have been effective at addressing systemic issues in other health domains, yet their role in improving menstrual hygiene in African contexts remains unclear. This scoping review aimed to identify and map empirical evidence on mHealth interventions for menstrual hygiene in Africa, assess reported impacts, and highlight research and policy gaps.

Methods: This scoping review followed the Arksey and O'Malley framework and adhered to the PRISMA-ScR reporting guidelines. A comprehensive search of nine databases was conducted to retrieve all relevant studies published from inception to April 7, 2025. Eligible studies were to be empirical, peer-reviewed studies conducted in Africa, and published in English. Screening and selection were undertaken independently by two reviewers, with conflicts resolved by consensus. Data extraction, collation, and summarization could not be done as no study was found eligible for inclusion into this review.

Results: A total of 687 records were retrieved; however, none of them met the inclusion criteria, primarily due to non-relevance of the population, context, or outcomes of interest. Hence, this scoping review is empty.

Conclusions: The absence of published empirical research on mHealth interventions for menstrual hygiene in Africa highlights a critical knowledge gap. Considering the significant menstrual health challenges across the continent and the proven potential of mHealth in other public health areas, this represents a missed opportunity for policy intervention and public health innovation. There is an urgent need for context-specific research, community engagement, and multisectoral collaboration to design, implement, and evaluate mHealth strategies that address menstrual hygiene needs in Africa, informing both local and global sexual and reproductive health policies.