Health Science Reports最新文献

Background and Aims

Nonalcoholic fatty liver disease (NAFLD) is a condition of fat accumulation in hepatocytes, not because of excess alcohol intake and disease-causing etiology. The disease occurrence is increased among patients with type 2 diabetes mellitus (T2DM) because of a strong pathophysiological link. Therefore, the aim of this study was to assess the NAFLD status and its associated factors among patients with T2DM in Adama Hospital Medical College, South Eastern Ethiopia, 2022.

Methods

Systematic random sampling was used in an institution-based cross-sectional study design from March to June 2022. Sociodemographic, behavioral, and clinical data were assessed using a structured questionnaire. Fatty liver was diagnosed using ultrasonography. About 5 mL of blood sample was collected for testing liver enzyme, fasting blood glucose, and lipid profile tests using the Cobas C 311 analyzer. EpiData version 3.1 was used for data input, and Stata version 17 for analysis. Binary and multivariable logistic regression were used to show the association of sociodemographic and clinical variables, and one-way ANOVA with post hoc Bonferroni test was used to show significant mean differences among different liver status grading. p < 0.05 was taken as statistically significant.

Results

The prevalence of NAFLD among patients with T2DM was 85.57% (95% CI: 79.8–89.8). Being female and having a longer duration of diabetes had higher odds of having NAFLD. Fasting blood glucose, alanine transaminase, direct bilirubin, total cholesterol, and triglyceride showed a significant mean difference among different NAFLD status as compared to patients with T2DM without NAFLD.

Conclusion

The prevalence of NAFLD was found high. T2DM patients with longer duration of the diabetes and females were found to have a greater risk for NAFLD.

Background and Aims

Organ donation is a vital component of modern healthcare, yet its acceptance varies across populations. Understanding perceptions among future generations and educators is crucial for effective awareness initiatives. This study aimed to assess the knowledge, attitudes, and willingness regarding organ donation among high school students and teachers in the West Bank, Palestine.

Methods

A cross-sectional study was conducted among 508 participants (370 high school students and 138 teachers) between March and May 2025. Data were collected via a structured online questionnaire following ethical approval. Electronic informed consent was obtained, and anonymity was maintained. Statistical analysis included descriptive statistics, independent-samples t-tests, and one-way analysis of variance.

Results

Participants reported moderate mean scores for attitudes (24.16 ± 7.995) and knowledge (6.87 ± 1.598). Students had significantly higher mean knowledge scores than teachers (7.01 vs. 6.51; p = 0.004). Willingness to donate to strangers (students: 20.0%, teachers: 12.3%) or register at a donation center (students: 28.4%, teachers: 39.1%) was low. Among students, gender was significantly associated with knowledge (p < 0.001) and attitudes (p = 0.02). Among teachers, urban residence was associated with knowledge (p = 0.002) and attitudes (p = 0.03). Key influencing factors included family support, religious guidance, and low trust in the healthcare system.

Conclusion

This study reveals a significant gap between knowledge, attitudes, and willingness to donate organs. Culturally tailored educational programs, religious engagement, and enhanced trust in the healthcare system are essential to promote organ donation in Palestine.

Background and Aims

Preventable blindness remains a leading cause of disability in low-income countries (LICs), with 91.5% of cases in Sierra Leone and 83.9% in Rwanda considered avoidable. Reliance on foreign aid has supported eye care development in Africa, yet has also fostered systemic dependency. As donor fundg declines, the need for sustainable, locally led eye health systems becomes urgent. This perspective examines how Rwanda and Sierra Leone, both postconflict LICs reliant on foreign aid, have pursued divergent approaches to eliminate preventable blindness. Rwanda via a nationally led, integrated strategy and Sierra Leone through a fragmented, donor-dependent model.

Methods

A comparative case study was conducted using national policy documents, peer-reviewed literature, Rapid Assessment of Avoidable Blindness (RAAB) surveys, and program evaluations. We assessed governance structure, financing models, workforce capacity, and service delivery. Outcomes included prevalence of blindness (PB), cataract surgical coverage (CSC), workforce growth, and health financing trends.

Results

Rwanda reduced PB from 1.6% (95% CI: 1.0–2.2) to 1.1% (95% CI: 0.7–1.4) (2006–2015), while CSC increased from 47.2% to 68.4%. National initiatives such as integration of eye health into the health sector strategic plan, community-based health insurance coverage for 83.5% of the population, and task-shifting to 2797 trained primary eye care nurses, expanded access to over 2.4 million people. Sierra Leone's PB increased from 4.9% (95% CI: 3.8–6.0) to 5.4% (95% CI: 4.3–6.7) (2011–2021), and CSC improved from 40.5% to 50.5%. Despite formal eye health policies, 55% of health expenditures remain out-of-pocket, and 36.2% of financing derives from donors, leaving the system fragmented and aid-dependent.

Conclusion

Nationally led, integrated strategies like Rwanda's prove more effective than donor-dependent models in sustainably reducing preventable blindness. This highlights the need for African countries to prioritize integrated financing, workforce development, and data-driven policy frameworks, actions critically urgent amid shrinking global health aid.

Background

Coronavirus disease 2019 (COVID-19) is a lethal global pandemic that originated in Wuhan, China at the end of 2019. As with other viral infectious diseases, the introduction of an effective vaccine is crucial for stopping the spread of the pandemic.

In Iraq the COVID-19 vaccination campaign started on March 2, 2021.

Aim of the Study

To determine the influence of the vaccine on new virus infection in Baghdad in terms of its effectiveness on the illness, hospitalization, and mortality.

Methods

A prospective observational study of patients with SARS-CoV-2 infection who were had a newly positive Real time PCR testing for SARS-CoV-2 at Al-Yarmouk Hospital or Al-Adel Primary Health Care Center, and correlate their symptoms to their state of vaccination.

Results

A total of 539 patients tested positive for COVID-19 via PCR (328 females and 211 males). Among these, 265 patients (49.2%) were vaccinated, while 274 (50.8%) were not. Being vaccinated and receiving the full doses showed the strongest association with decreased disease severity, reduced hospitalization rates, and lower mortality rates (p < 0.05 for all). The type of vaccination was significantly correlated with disease severity (p < 0.001), with more severe or critical symptoms reported in patients vaccinated with BBIBP-CorV compared to those vaccinated with BNT162b2 or ChAdOx1 nCoV-19 (AZD1222). However, no correlation was found with hospitalization or mortality rates.

Conclusion

COVID-19 vaccination, while not preventing infection, markedly reduced disease severity and mortality—especially with full dosing and among high-risk groups. The differential effectiveness observed among vaccine types highlights the importance of optimizing vaccine strategies based on real-world outcomes, particularly in resource-constrained settings like Iraq.

Background and Aims

Butylphthalide (NBP) is a neuroprotective agent that ameliorates cerebral ischemia-hypoxia and reperfusion injury. However, evidence regarding whether NBP can improve neurological prognosis in patients with cardiac arrest (CA) remains limited. The present study aims to evaluate the efficacy and safety of butylphthalide treatment in improving neurological function in patients with cardiac arrest.

Methods

This research constituted a single-center, randomized, double-blind, placebo-controlled trial. Those meeting the inclusion criteria were randomly allocated to either the NBP group or the Placebo group at a 1:1 ratio. The primary outcome was the proportion of patients with a Cerebral Performance Category (CPC) score of 1 or 2 in each group at 90 days after randomization.

Results

A total of 70 patients were included in the final analysis, of whom 34 were in the placebo group and 36 in the NBP group. No statistically significant differences were observed in baseline characteristics between the two groups (p > 0.05). Similarly, no statistically significant differences were noted between the two groups in the proportion of patients with CPC scores of 1 or 2 at 90 days, in-hospital mortality, or Glasgow Coma Scale (GCS) scores at discharge (p > 0.05). However, compared with the placebo group, the NBP group exhibited significantly lower levels of brain injury biomarkers, including neuron-specific enolase (NSE), glial fibrillary acidic protein (GFAP), and ubiquitin C-terminal hydrolase L1 (UCHL1), after 14 days of treatment (p < 0.001). Additionally, no statistically significant differences were found between the two groups in terms of safety outcomes (p > 0.05).

Conclusion

Although butylphthalide treatment significantly reduced levels of brain injury biomarkers in patients with cardiac arrest, it did not significantly improve their 90-day neurological prognosis.

Background and Aims

Various anthropometric differences and co-morbidities have been associated with disparities in postoperative outcomes following spinal surgery. Gender has been identified in previous studies as a potential factor influencing the prevalence of conditions like lumbar disc radiculopathy, degenerative disc disease, and cauda equina syndrome. Our study aimed to evaluate the effect of gender as a risk factor on the rate of perioperative and early postoperative complications after tubular microdiscectomy for lumbar disc prolapse.

Methods

This retrospective multicenter study, conducted in two specialized spine centers in Baghdad, Iraq, involved 302 patients with lumbar disc herniation (174 males and 128 females) from January 2016 to January 2022. Data collection included comprehensive assessments of clinical and surgical outcomes, utilizing the Core Outcome Measures Index (COMI) score at 2, 6, and 12 weeks.

Results

A total of 134 males (77%) and 104 females (81%) were below 40 years old, while 40 males (23% of males) and 24 females (18.8% of females) were 40 or older. There was a significant difference in mean operative times (p < 0.001). The most common specific complication was spondylodiscitis with six males (3.4% of males) and three females (2.3% of females), while the most common general complication was post-op back spasm with six males (3.4% of males) and four females (3.1% of females). It's noteworthy to emphasize that our analysis showed a non-significant association of gender with the presence of either specific or general complications (p > 0.05).

Conclusion

Gender has a minimal impact on most perioperative and early postoperative complications. Longer operative times in females raise questions about gender-specific differences across spine surgeries and specialties, necessitating further research. We also note a shift in the age profile for disc prolapse patients, emphasizing the need for additional research into contributing factors among younger populations.

Background

Previous reviews on severe acute malnutrition recovery in Ethiopia were limited by outdated data and narrow scope. This study used recent and regionally diverse data, including from conflict-affected areas, to inform current nutrition efforts.

Objective

To provide up-to-date information on the recovery rate of Children under five from severe acute malnutrition in Ethiopia.

Methods

A systematic review and meta-analysis of observational studies published between January 2015 and July 2025 was conducted. PubMed, Scopus, Web of Science, Google Scholar, and African Journals Online were searched. The pooled prevalence was estimated using random-effects model with 95% confidence intervals. Publication bias was assessed using funnel plots and Egger's test.

Results

The pooled recovery rate of under-five children from severe acute malnutrition was 71.37% (95% CI: 67.57–75.16%). Anemia (AHR = 0.75, 95% CI: 0.63–0.87), shock (AHR = 0.52, 95% CI: 0.13–0.92), HIV/AIDS (AHR = 0.71, 95% CI: 0.44–0.97), use of a nasogastric tube (AHR = 0.62, 95% CI: 0.31–0.93), vomiting (AHR = 0.65, 95% CI: 0.43–0.86), diarrhea (AHR = 0.71, 95% CI: 0.56–0.86), tuberculosis (AHR = 0.47, 95% CI: 0.34–0.60), and pneumonia (AHR = 0.73, 95% CI: 0.61–0.84) were associated with decreased recovery rate. Conversely, the use of amoxicillin (AHR = 2.10, 95% CI: 1.54–2.70), vitamin A supplementation (AHR = 1.50, 95% CI: 1.21–1.79), absence of malaria (AHR = 1.51, 95% CI: 1.03–1.98), deworming (AHR = 1.45, 95% CI: 1.04–1.82), and provision of ready-to-use therapeutic food (AHR = 1.63, 95% CI: 1.07–2.20) were associated with improved recovery rate.

Conclusion

The recovery rate of under-five children from severe acute malnutrition in Ethiopia remained below national and international targets. Strengthening early detection and management of symptoms and comorbidities, along with scaling up proven interventions, is essential to improving recovery rate.

Background and Aim

In rural Ethiopia, where patriarchal norms prevail, women's limited decision-making autonomy significantly restricts their reproductive health (RH) service utilization. However, scarcity of data persists. Hence, this study assesses the prevalence, determinants, and barriers to RH decision-making autonomy among married women in rural parts of Seden Sodo district, Southwest Ethiopia.

Methods

A community-based mixed-methods study was conducted from December 2022 to January 2023 among 594 systematically selected married women in the Seden Sodo district, Southwest Ethiopia. The quantitative data were collected using structured interviewer-administered questionnaires and analyzed by SPSS version 27. Women's decision-making autonomy was assessed across four key reproductive health areas including family planning, antenatal care, place of delivery, and postnatal care using a weighted scoring system: 2 for sole decision-maker, 1 for joint decisions, and 0 if the husband decided alone. Women who scored above the mean were considered autonomous. Sixteen key informants participated in qualitative interviews analysed thematically to explore contextual barriers with triangulation of the findings.

Results

Only 53.2% (95% CI: 49–57) of women demonstrated autonomous RH decision-making. Merchant occupation (AOR = 6.88, 95% CI: 3.12–15.14), age at marriage age > 18 years (AOR = 5.49, 95% CI: 3.20–9.43), husband's education (AOR = 3.51, 95% CI: 2.10–5.90), favourable RH perceptions (AOR = 2.08, 95% CI:1.05–4.12) and women's education (AOR = 0.47, 95% CI: 0.30–0.76) were significantly associated with RH decision-making autonomy. Qualitative analysis revealed three key barriers: entrenched male dominance in health decisions, female economic marginalization, and mobility restrictions impeding service access.

Conclusion and Recommendation

While approximately half of rural women demonstrate some RH decision-making autonomy, significant barriers persist. Therefore, programs promoting women's economic participation, challenging patriarchal norms, and engaging male partners are critical to enhancing autonomous RH decisions and improving maternal health outcomes.

Background and Aims

This clinical study evaluated the three-dimensional discrepancies between digital and conventional definitive impressions of edentulous arches for complete denture fabrication.

Methods

Ten edentulous patients (n = 16 arches: 8 maxillary and 8 mandibular) were enrolled. For each case, three digital data sets were acquired: (1) a direct intraoral scan (IOS), (2) a scan of a conventional definitive impression obtained using a 3D-printed custom tray (CI3D), and (3) a scan of a conventional definitive impression made with an acrylic special tray (CI). All STL files were first reversed in Geomagic Design X and then aligned using best-fit algorithms in Geomagic Control X, with IOS considered the reference data set. Statistical analyses were performed using SPSS and Python for supporting data visualization. Dimensional discrepancies were evaluated using absolute 3D distance and root mean square (RMS) deviation. Paired-sample t-tests were used to compare CI3D and CI deviations from IOS. Subgroup analyses were conducted for maxillary and mandibular arches, and correlation analysis was performed between deviation metrics.

Results

No statistically significant differences were found between CI3D and CI in their deviations from the IOS reference. The overall mean difference between groups was −0.11 ± 1.62 mm, and the RMS difference was −0.10 ± 0.68 mm (p = 0.75 and 93, respectively). Subgroup analysis revealed no significant differences in maxillary or mandibular arches (all p > 0.5). A moderate positive but not significant correlation (r = 0.31, p = 0.21) was observed between mean deviation in CI and RMS deviation in CI3D.

Conclusion

Within the limitations of this clinical study, which included edentulous ridges with minimal to moderate bone loss (Cawood and Howell Class III), 3D-printed and acrylic tray-based conventional definitive impressions demonstrated comparable dimensional accuracy to intraoral scanning, showing no statistically significant or clinically relevant differences between techniques.

Background and Aims

Pediatric systemic lupus erythematosus (SLE) is a complex autoimmune disease influenced by genetic and environmental factors such as sunlight and temperature. This retrospective study investigated the association between meteorological and geographical factors and active pediatric SLE in Fars province, southwest Iran.

Method

The residential addresses of pediatric patients with active SLE who were hospitalized at the main referral hospital of southwest Iran in Shiraz City between March 2016 and January 2023 were extracted from their medical records and geographically mapped. The influence of meteorological factors, such as temperature, humidity, evaporation, rainfall, as well as geographical parameters including land cover, slope, and altitude, on active pediatric SLE was evaluated using geographic information system (GIS) analysis. Data were analyzed using univariate and multivariate binary logistic regression analysis.

Results

This study included 143 pediatric patients with active SLE from 34 out of a total of 8181 city/village areas. There was a significant positive association between urban setting and active pediatric SLE (OR = 75.949, CI = 9.521–605.846) while mean annual rainfall demonstrated a significant negative association (OR = 0.997, CI = 0.994–1.000) in the univariate analysis. Multivariate analysis revealed that urban setting was the only significant factor positively correlated with active pediatric SLE (OR = 56.567, CI = 6.731–745.372). There was no association between other meteorological and environmental factors and active pediatric SLE.

Conclusion

This study found that living in urban areas and lower annual rainfall are significant risk factors for active pediatric SLE in Fars province, probably due to increased exposure to pollutants and ultraviolet radiation. While previous studies have linked SLE activity to temperature and humidity, no such associations were observed here, highlighting the need for further research on regional environmental influences on SLE.