Clinical Epidemiology and Global Health最新文献

Introduction

Chinese Resident Physician Standardized Training has been established to enhance medical training standards and physician capabilities since 2014. Studies indicate high rates of depression and low satisfaction among resident physicians, underscoring the need for surveys to inform policy and enhance their well-being. This study aimed to investigate the satisfaction of resident trainees in southwest China.

Methods

A cross-sectional survey was conducted from February 2024 to March 2024 in 5 hospitals from 3 cities in southwest China, using convenience sampling to collect data from residents through a self-administered online questionnaire. The data including demographics, training perspectives, and suggestions was analyzed using SPSS 25.0 with Ordinal Logistic regression to identify factors influencing satisfaction.

Results

The survey yielded 484 valid responses from 547 collected questionnaires, with an effective rate of 88.48 %. Participants were predominantly first-year residents, female, aged 26–30, and specialized in internal medicine, surgery, general medicine, and medical technology. The majority (78.93 %) expressed overall satisfaction with their residency training, but income satisfaction was lower at 64.05 %. Gender and neutral responses to certain aspects of training as predictors of dissatisfaction, including the training organized by the teaching management department, the training environment, the importance attached to residency training and the program's usefulness for future clinical work. Open-ended feedback from trainees highlighted the need for increased income, improved clinical training, and reduced workload.

Conclusions

Our study found 78.93 % of residents satisfied with their training programs. Female residents and those with neutral views or income dissatisfaction were less satisfied. Increasing income, improving clinical training, and reducing workload could further boost satisfaction and program quality.

Objective

Method

Results

Conclusions

Background

Gestational diabetes mellitus (GDM), a form of diabetes occurring during pregnancy in non-diabetic women, can lead to complications such as preeclampsia, gestational hypertension, and cesarean section delivery. This study aimed to investigate the incidence of GDM and its association with blood group type among pregnant women with pregnancy-induced hypertension in Northwest Ethiopia.

Methods

A cross-sectional comparative study was conducted in Northwest Ethiopia from December 2021 to April 2022, involving 240 pregnant women. Convenience sampling was used to select 120 women diagnosed with pregnancy-induced hypertension (PIH) and 120 women without PIH. Data on demographics, dietary habits, and BMI were collected using a structured questionnaire, and blood samples were analyzed for glucose levels. Statistical analysis was performed with a 95 % confidence interval.

Results

Among the total of 240 pregnant women included in the study, 16.25 % (95 % CI: 18.3–34.6) were diagnosed with gestational diabetes mellitus. Of these, 12.9 % had pregnancy-induced hypertension, while 3.35 % did not have pregnancy-induced hypertension. Several risk factors were identified for the development of GDM, including a BMI greater than 25 kg/m2, rural residence, family history of diabetes, previous history of GDM, blood types AB and O, and Rh positive.

Conclusions

The study findings demonstrate a significantly higher incidence of gestational diabetes mellitus among pregnant women with pregnancy-induced hypertension (25.8 %) compared to those without pregnancy-induced hypertension (6.7 %). These results highlight the importance of considering blood group type and other identified risk factors in assessing the risk and management of GDM in pregnant women with pregnancy-induced hypertension.

Background

Material and methods

Statistical analysis used

Results

Conclusions

Background

Vaginal trichomoniasis is a sexually transmitted disease causes adverse health outcomes, the causative agent is Tichomonas vaginalis. Infected women develop abnormal vaginal discharge with vaginitis. While, men mostly suffer from prostatitis and urethritis.

Objectives

This study aimed to detect the rate of T.vaginalis infection in association with risk factors, measurement of blood parameters, interleukine-2 (IL-2) and interleukine-8(IL-8) levels among individuals.

Methods

A total of 500 females were tested, a vaginal swab and blood were collected from the participants, and they were within the age range of 18–70 years old. High vaginal swabs were examined microscopically using wet mount preparation, the blood used for measurement of blood parameters using coulter count machine and IL-2 and IL-8 levels were evaluated using ELISA technique.

Results

Out of 500 individuals, the prevalence of T. vaginalis infection was 45(9.0 %). The maximum infection rates were reported among age group (18–28) years, rural residents, illiterates, married women (16.7 %), (15.9 %),(30.0 %),(11.7 %),respectively. Moreover, high positivity of infection revealed among low economical level 12.5 % compared to only 1.7 % in high economy group. Unemployed women, those with bad vaginal hygiene showed high incidence of infection 10.5 % and 6.3 %, respectively. It was noted a significant decrease in red blood cells and hemoglobin concentration, however, there was a significantly increased in white blood cells among infected subjects. Furthermore, the levels of both interleukin-2 and interleukin-8 were significantly higher among infected individuals compared to healthy ones.

Conclusions

Effective strategies for disease awareness are needed and should include health promotion, education, and prevention.

Background

Dengue infection is increasingly recognized as one of the world's emerging infectious diseases. The present study was carried out with the aim of assessing knowledge and health beliefs regarding Dengue fever among community in an urban slum area of Pune. This cross-sectional study was undertaken in an urban slum area of Urban Health Centre, Pashan, which is a field practice area of Department of Community Medicine.

Aim & objectives

This study is aimed at understanding the perception towards the Dengue Prevention using the Health Belief Model (HBM) approach, prevention measures adopted, their knowledge, opinion and confidence towards various control measures.

Methods

A Cross-Sectional Study using a pre-tested, semi-structured questionnaire was conducted for assessing on knowledge, health beliefs and practice of dengue control.

Results

About 26.1 % knew the causes of dengue, 56.2 % had poor knowledge on the severity of dengue. The knowledge on causes (69.9 %), signs and symptoms (77.1 %), treatment (51.2 %) and carriers (86.3 %) of dengue was poor. The knowledge regarding insects breeding spots, potential breeding spots inside (26.1 %) and outside (38.1 %) and prevention was almost poor. The data was collected from the questionnaire, entered and analysed using Statistical Package for Social Sciences (SPSS) version 21.0.

Conclusion

Most people living across the community behaved in a similar manner, irrespective of age, education and socio-economic status. Perceptions of the community as explained by Health Belief Model was greatly influenced by their approach to the available health care services and for the subsequent behavioural change.

Background

Methods

Results

Conclusions

Aim

To explore the effectiveness of the cardiometabolic index (CMI), lipid accumulation product (LAP), and waist-to-thigh ratio (WTR) in identifying insulin resistance (IR) in females who are clinically not having diabetes mellitus (DM).

Methods

This cross-sectional study was conducted in Sri Lanka between 2020 and 2023. A total of 282 female participants aged 18 to 35 were recruited. Their anthropometric measurements, fasting blood sugar (FBS) levels, IR by HOMA-IR, lipid profile, and blood pressure were assessed. All females with FBS levels >100 mg/dl were excluded from the study.

Results

The study participants were divided into two groups, normal-weight controls (N = 142, BMI:18.0–22.9 kg/m²) and overweight/obese cases (N = 140, BMI:23.0–24.9 kg/m², Obesity: >25 kg/m²), based on their BMI values. The mean values of CMI, LAP, and WTR in cases were 3.56 ± 0.63, 49.97 ± 17.75, and 1.88 ± 0.17, respectively. Significant associations were identified between all adiposity indexes, IR and lipid profile parameters (p < 0.05). In this female cohort, despite being clinically non DM, the prevalence of IR was significantly higher (52.83 %). ROC analysis results showed greater sensitivities for detecting IR with higher AUC as follows: CMI = 0.854(0.811–0.899), LAP = 0.869(0.829–0.910), and WTR = 0.828(0.779–0.877). The normal-weight controls were assessed to check the prevalence of metabolically-obese normal-weights (MONW,65.5 %) and metabolically-healthy normal-weights (MHNW,35.5 %) among the population, given the higher prevalence of IR. The detection accuracy of MONW females in the ROC assay was; CMI > LAP > WTR > VAI.

Conclusions

CMI had the highest accuracy for detecting IR, with the accuracy of all four indexes ranked as follows: CMI > LAP > WTR > VAI.

Background

Glycosylated hemoglobin (HbA1c) has a glucose residue attached to the terminal NH2 group (valine residue) of one or both HbA beta chains. HbA1c levels are not affected by blood glucose levels alone. HbA1c results are affected by several factors, such as anemia, structural hemoglobinopathies and thalassemia syndromes. HbA1c concentrations are affected by conditions that affect erythrocyte turnover. Iron deficiency anemia is the most common form of anemia. The prevalence of anemia among pregnant women in India is above 50 %. Although many forms of anemia are associated with the lowering of HbA1c, iron deficiency has been shown to shift HbA1c slightly upward. Research on this topic has yielded a variety of findings. In some research, there was no association observed between anemia and HbA1c levels; in other investigations, there was a rise or fall in this number. Iron deficiency anemia and HbA1c′s relationship is therefore still unclear. Therefore, this study aims to determine the correlation between Iron deficiency anemia and HbA1c levels among non diabetic pregnant women with anemia.

Methodology

This prospective observational study was conducted among singleton pregnant women attending antenatal clinic OPD in a private tertiary hospital in Chengalpattu, Kanchipuram district. After the complete review of their obstetric record, blood was collected in 5 ml sterile syringes and transferred equally to the two separate test tubes containing ethylene-diamine-tetra acetic acid (EDTA) anticoagulant for determining RBC indices and HbA1c levels. The difference in mean between two independent samples (between Anemia and Non-anemia) was determined using an independent sample t-test, and the difference between two independent proportions was calculated using a z-test. Bivariate Pearson's correlation analysis was used to adjudicate the relationship between red blood cell indices and HbA1c level, and correlation coefficient (r)was calculated, and the p-value of <0.05* was considered statistically significant.

Results

Bivariate Pearson's correlation analysis was done to determine the relationship between HbA1c levels and red blood cells in anemic pregnant women. HbA1c levels negatively correlated with Hemoglobin (r = −0.875, p < 0.01*), PCV (r = −0.732, p =<0.01*) and transferrin saturation (r = 0.224, p < 0.01*) and it was statistically significant. Other indices, such as serum iron concentration and TIBC, demonstrated no correlation with HbA1c level.

Conclusion

This study shows that the reliability of Hba1c in diagnosing diabetes among pregnant women with iron deficiency anemia is misguiding and can be considered after treating the condition. Also, more studies are needed to improve our understanding of this topic.

Background

The Government of Kenya adopted the practice of 7.1% chlorhexidine digluconate (CHX) application for all newborns. However, challenges in implementation have arisen, as some counties in Kenya do not align with the underlying criteria for this recommendation. Therefore, we aimed to evaluate CHX adoption and associated factors in Kiambu County, Kenya.

Methods

A cross-sectional survey was conducted among 434 caregivers attending their 6-week well-child clinics using multistage sampling. Descriptive statistics summarized sociodemographic data and CHX cord care uptake, while logistic regression analyzed associations between variables and CHX uptake.

Results

The prevalence of use of CHX in Kiambu county was 41.0%. Twenty-two percent (22%) of the mothers were provided CHX post-delivery and 100% used it. Of the 78% who weren't provided CHX post-delivery, 39% were given prescriptions for CHX. The 61% who were not issued a prescription resorted to the use of surgical spirit (34.8%), dry cord care (9.2%) and saliva (3%). In public facilities, being married [AOR 0.19 (0.11–0.33)] and index use of CHX [AOR 0.17 (0.08–0.35)] were associated with non-adherence. Being employed [AOR 2.46 (1.26–4.77)] and delivering in hospital [COR 3.29 (1.69–7.08)] increased the likelihood of using CHX.

Conclusion

Weak prescription and adherence to the CHX cord care policy in Kiambu county has led to women turning to alternative substances for cord care. Quality improvement strategies are necessary to enhance adherence to guidelines, such as refining county-specific recommendations for cord care and providing corresponding patient education, or issuing definitive prescriptions for CHX post-delivery.