Materia socio-medica最新文献

Background: Diabetes mellitus is an escalating public health issue, with increasing reliance on urgent care (UC) services for disease management. Differentiating utilization patterns between type 1 (T1D) and type 2 diabetes (T2D) in UC settings is crucial for informing effective primary health care (PHC) strategies.

Objective: The aim of this study was to evaluate the demographic, clinical, and visit-related characteristics of individuals with diabetes attending UC at a PHC center, with specific attention to differences by diabetes type.

Methods: A retrospective cross-sectional study was conducted using electronic health records of all UC visits made by patients with diabetes at a PHC center affiliated with Imam Abdulrahman bin Faisal University. The study period spanned from July 1, 2023, to April 30, 2025. Descriptive and inferential statistics were applied to assess demographic profiles, clinical features, and utilization trends.

Results: Out of 1,070 UC visits, 88.5% were by patients with T2D, who had a mean age of 55.99 years, whereas T1D patients had a mean age of 26.33 years. T1D was more prevalent in normal-weight individuals, while T2D was predominant among those with obesity. Most visits (83.36%) were for medication refills, particularly among T2D patients. T1D patients exhibited higher triage acuity levels, more frequent emergency department transfers, and a greater incidence of acute complications.

Conclusion: The study identifies clear differences in UC utilization between diabetes types. An overreliance on UC for non-urgent needs, especially among T2D patients, underscores the necessity to enhance chronic disease management and triage protocols within PHC settings to optimize resource use and improve patient outcomes.

Background: Fixed drug eruption (FDE) is an adverse drug reaction that recurs at the same site upon re-exposure to the triggering medication. Sulfonamide antibiotics, especially sulfamethoxazole-trimethoprim, are common causes of FDE. Previous studies have linked drug hypersensitivity reactions to specific human leukocyte antigens (HLA).

Objective: This study aimed to investigate the association between HLA-A and FDE induced by sulfamethoxazole-trimethoprim.

Methods: A cross-sectional study was conducted with 30 FDE patients and 30 healthy controls who had tolerated sulfamethoxazole-trimethoprim. Blood samples (3 ml) were collected for HLA-A typing using polymerase chain reaction with sequence-specific oligonucleotides (PCR-SSO).

Results: Twenty-three HLA-A alleles were detected. In the FDE group, the alleles with high frequency were HLA-A*02:07 (12 patients; 40%), HLA-A*11:01 (10 patients; 33.3%), and HLA-A*24:02 (6 patients; 20%). In the control group, the most commonly observed alleles were HLA-A*11:01 (12 patients; 40%), HLA-A*24:02 (6 patients; 20%), HLA-A*24:07 (6 patients; 20%), HLA-A*29:01 (6 patients; 20%), and HLA-A*33:03 (9 patients; 30%). The FDE group had a higher frequency of HLA-A*02:07 than the control group (40% vs. 16.67%, p < 0.05). No differences in the frequencies of other HLA-A alleles were observed between the two groups. Participants with the HLA-A*02:07 allele were 3.33 times more likely to develop FDE caused by sulfamethoxazole-trimethoprim compared to those without the allele (OR = 3.33, 95% CI: 1.09 - 11.14).

Conclusion: The study suggests an association between the HLA-A*02:07 allele and FDE induced by sulfamethoxazole-trimethoprim in the Vietnamese population. Screening for HLA-A*02:07 prior to prescribing sulfamethoxazole-trimethoprim could help identify at-risk individuals and prevent FDE.

Background: Understanding sexual health inequalities among university students is essential to inform targeted public health interventions. Previous studies show that knowledge, attitudes, and behaviors differ based on sociodemographic variables such as gender, age, and level of education.

Objective: This study aims to assess how gender, age, and SRH education influence knowledge, behaviors, and use of sexual and reproductive health (SRH) services among Albanian university students.

Methods: A cross-sectional survey was conducted with 7,679 university students in public and private institutions across Albania. A structured questionnaire assessed SRH knowledge, STI prevention behaviors, and access to healthcare services. Statistical analyses included chi-square tests and logistic regression to examine relationships between sociodemographic variables and SRH outcomes.

Results: Female students reported higher engagement in preventive practices such as gynecological visits and Pap tests (p < 0.001), while male students reported earlier sexual debut and less consistent condom use. Prior SRH education significantly increased the likelihood of STI/HIV testing (p < 0.001). Age was positively associated with STI awareness but not necessarily with service use. Only 11.4% of respondents reported STI testing, and 7.6% had been tested for HIV, while 53.8% were unaware of available testing services.

Conclusion: This study highlights disparities in SRH knowledge and service utilization driven by gender, age, and educational exposure. Tailored public health programs that integrate SRH into university curricula and emphasize outreach to young men and underserved populations are needed to reduce inequities and promote preventive behaviors.

Background: Nasal obstruction was a common symptom encountered in otolaryngology, arising from various etiologies, including both mucosal and structural factors.

Objective: The aim of this study was to evaluate the quality of life of patients after nasal septoplasty.

Methods: A prospective, longitudinal 6-month study was conducted on 52 patients who underwent septoplasty or rhinoplasty and were followed up at Hanoi Medical University Hospital from April 2023 to April 2024. The effectiveness of the surgery was assessed through clinical nasal symptoms, and the quality of life of patients was evaluated using the SF-36 Quality of Life Assessment Tool (Short Form-36).

Results: In the study group, 27 (51.9%) patients were female. The nasal obstruction scores significantly decreased from preoperative (2.67 ± 0.47) to 1 month (1.1 ± 0.75) and 6 months (0.65 ± 0.68) postoperative (p<0.05). The facial pain scores significantly decreased from preoperative (1.46 ± 1.11) to 1 month (1.1 ± 1.05) and 6 months (0.79 ± 0.89) postoperative (p<0.05). The rhinitis scores significantly decreased from preoperative (1.42 ± 1.11) to 1 month (1.02 ± 1) and 6 months (0.77 ± 0.9) postoperative (p<0.05). The average quality of life scores according to the 8 factors of the SF-36 Quality of Life Assessment Tool increased at 1 month and 6 months postoperative. The differences were statistically significant (p<0.05).

Conclusion: Nasal septoplasty significantly improves clinical symptoms and the quality of life of patients. The SF-36 is a reliable outcome measure for the success of nasal septal surgery.

Background: The etiology of oral ulceration is multicausal with numerous predisposing factors. Studies by various authors cite Helicobacter pylori infection as a possible cause of certain oral ulcerations.

Objective: The aim of the study is to prove the presence of Helicobacter pylori in the oral cavity of patients with oral ulcerations, as well as to examine the relationship between the presence of Helicobacter pylori in the oral cavity and the development of oral ulcerations.

Methods: The study included regular patients at the Department and Clinic of Oral Medicine and Periodontology, Faculty of Dental Medicine, University of Sarajevo, suffering from oral ulcerations, as well as healthy patients without oral diseases. The diagnosis of oral ulceration is based on a thorough history, clinical examination, and exclusion of other oral diseases. All patients were taken anamnestic data on the existence of digestive system diseases, and by reviewing medical documentation, a previously diagnosed digestive system disease by a gastroenterologist was recorded. A cytological smear was taken in all 80 cases, in patients with ulcerative lesions a smear was taken from the lesion and in healthy subjects from the mucous membrane of the palate, cheek and tongue. Highly sensitive and specific polymerase chain reaction (PCR) was used to determine the presence of Helicobacter pylori in the oral cavity and oral lesions.

Results: The results of our study showed that there is no statistically significant difference between the presence of Helicobacter pylori in the oral cavity of patients with oral ulcerations and subjects with healthy mucosa.

Conclusion: Helicobacter pylori is not a risk factor for the development of oral ulcerations and can be found on the oral mucosa as a transient pathogen.

Background: The prevalence of obesity and obesity-related clinical conditions, including metabolic-associated steatotic liver disease (MASLD), sarcopenia, and a wide spectrum of pathological manifestations, is rising globally. According to WHO, BMI is the only anthropometric measure currently used to classify obesity, overweight, and underweight. However, emerging research suggests that obesity is a complex pathological state influenced by multiple etiological factors. Given the limitations of BMI, there is a growing need for a more comprehensive assessment of body composition, particularly fat mass quantity and distribution. Bioelectrical impedance analysis (BIA) provides valuable anthropometric data that can help differentiate obesity phenotypes and guide improved therapeutic approaches.

Objective: This study aims to analyze body composition using BIA in a randomly selected sample of adults from primary healthcare settings in Bosnia and Herzegovina. The primary goal is to assess total body weight, fat mass quantity, fat distribution, and obesity types prevalent in this population. Additionally, the study seeks to establish reference values for further diagnostic, preventive, and therapeutic strategies to improve public health outcomes.

Methods: A cross-sectional study was conducted on adults (≥18 years) in Gračanica, Bosnia & Herzegovina (B6H), from January 2021 to January 2025. Inclusion criteria required participants to provide signed informed consent, while exclusion criteria included acute systemic diseases, severe dehydration, and fasting for more than 24 hours. Anthropometric parameters measured included age, height, weight, BMI, body fat mass (BFM), fat-free mass (FFM), percent body fat (PBF), waist-hip ratio (WHR), and bone mineral content (BMC). Data were analyzed using SPSS (version 18), with results presented as medians, interquartile ranges, and percentiles (5th, 25th, 50th, 75th, and 95th).

Results: A total of 4,628 adults participated in the study, of whom 2,824 (61.0%) were female and 1,804 (39.0%) were male. The median age was 45 years (IQR: 29 years). The findings revealed that over one-quarter of the B&H population is obese, with abdominal obesity being the predominant type. This phenotype is associated with the highest risk for metabolic syndrome and MASLD.

Conclusion: Our study highlights a high prevalence of obesity among the examined individuals in primary care settings in B&H, with abdominal obesity being the most common type. This phenotype is strongly associated with metabolic complications. BIA-derived parameters of fat distribution and visceral fat mass may serve as valuable tools for improving obesity classification and developing more effective preventive and therapeutic strategies.

Background: Benign acute childhood myositis (BACM) is a rare complication of viral URTIs, usually occurring in winter. It is characterized by acute onset of bilateral calf pain and difficulty/refusal to walk. A prodromal phase precedes these manifestations, consisting of catarrhal and constitutional symptoms. These are associated with increased muscle-specific enzymes, usually normal inflammatory parameters, and leukopenia.

Objective: Our study aimed to define the demographic, clinical, and laboratory characteristics of BACM patients and determine the etiology leading to their development.

Methods: Medical charts for patients diagnosed with BACM from October to April 2023/2024 at the Pediatric Clinic Clinical Center University of Sarajevo, Department of Allergology, Rheumatology, and Immunology were reviewed retrospectively. Relevant medical information was collected for 20 patients. Statistical analysis was done in Microsoft Excel 2013.

Results: Demographic analysis demonstrated male predominance (75%), with primarily school-aged children affected (median age 8.36). Most cases occurred in winter (60%). The majority of patients presented with bilateral calf pain (100%), difficulty walking (90%), and fever (100%). All cases demonstrated increased CK levels, with median values of 3779 U/L; a notable number had leukopenia (70%). The most commonly isolated pathogen was Influenza B virus (75%).

Conclusion: BACM is relatively rare but presents acutely and leads to plenty of distress for both patients and their parents. A child with coryzal symptoms complicated by bilateral calf pain or difficulty/refusal to walk and an increase in CK levels should raise suspicion of BACM. The condition is self-limiting and usually resolves without complications.

Background: Skin cancer is one of the most common malignancies globally, yet awareness and protective behaviors remain limited in many populations. In Vietnam, there is a lack of research examining knowledge, attitudes, and practices (KAP) related to skin cancer, particularly among future healthcare providers.

Objective: This study aimed to assess the current levels of KAP regarding skin cancer and sun protection and to identify associated factors among medical students at Hanoi Medical University.

Methods: A cross-sectional study was conducted among 923 undergraduate medical students at Hanoi Medical University during the 2024-2025 academic year. Data were collected using a structured online questionnaire, including validated scales for knowledge (SCSK), attitudes (SSEAS), and practices (SEPI).

Results: The mean knowledge score was 13.84 (SD = 3.3), with 57.7% of students classified as having low knowledge. Attitude scores were moderate, with 33.4% demonstrating a positive attitude. Practices were poor overall, with 71.4% engaging in inadequate sun protection behaviors. Higher knowledge was associated with academic program, year of study, gender, ethnicity, rural background, personal or family history of skin cancer, and trusted information sources. Favorable attitudes were linked to academic year, program, having freckles, exposure to reliable information, and beliefs about sunscreen. Better practices were associated with being female, in later years, having skin conditions, previous sunburn, internet use, and a preference for lighter skin.

Conclusion: The study revealed substantial gaps in skin cancer knowledge and protective behaviors among medical students, despite generally favorable attitudes. These findings underscore the need for targeted educational interventions, especially during early academic training, to enhance skin cancer prevention efforts among future healthcare professionals.

Background: Emergency departments (EDs) in Saudi Arabia are seeing more patients and facing a shortage of resources. Prioritizing care based on medical urgency requires triage systems. Understanding triage and raising public awareness are key for improving ED effectiveness and patient satisfaction. However, few studies have examined these issues among Saudi citizens, particularly in the Najran area.

Objective: The purpose of this study is to evaluate the overall attitudes, degree of awareness, and depth of knowledge regarding the emergency triage system in the Najran population. Despite the significance of triage, little research has been done in Saudi Arabia to determine how the general public views this approach.

Methods: A cross-sectional descriptive study with analytical components was conducted from February to August 2025 targeting residents of Najran, Saudi Arabia. An online self-administered Arabic questionnaire was filled up by 452 participants. The survey assessed awareness, knowledge, and attitudes toward the ED triage system in addition to demographic data. SPSS version 26.0 was used to analyze the data.

Results: The results showed that 58.8% of participants had strong or excellent knowledge of the triage system, and 82.9% had high or very high awareness of it. A strong majority, 88.1%, had positive views on triage and recognized its role in providing fair and efficient emergency care. Age and education were significant predictors of higher awareness, knowledge, and understanding. Knowledge was also found to have a strong positive correlation with both awareness and attitudes.

Conclusion: Despite a lack of specific information, most Najran locals support and are aware of the ED triage procedure. To increase public awareness, maximize ED utilization, and improve patient experience, educational programs aimed at demographic groups - especially younger and less educated people, are advised.

Background: Lymphadenopathy is a common finding in clinical practice. The cause of enlarged nodes on clinical examination alone is challenging and there may be multiple reasons for this enlargement. It may become enlarged due to stimulation by infectious agents or the involvement of metastasis or malignant diseases, such as lymphoma.

Objective: The aim of the study was to investigate the diagnostic role of fine needle aspiration cytology of lymph nodes in metastatic cancer and lymphoma.

Methods: A total of 48 FNAC lymph nodes suspicious for malignancy were sampled with follow-up biopsy in Clinical Center of University of Sarajevo from 2017 to 2023. Lymph nodes were aspirated using 20-22 G needle with minimally 2 passes, spread on slides, air-dried, stained with May-Grünwald-Giemsa or Papanikolaou and residual material sent for cytoblock.

Results: Out of 48 cytological samples, 30 (62.5%) revealed metastatic epithelial cells and 12 (25%) lymphoproliferative neoplasm. Three samples were suspected for malignancies, one sample was unrepresentative, one inconclusive and one falsely negative. Histopathological confirmation had 35 patients, while others were confirmed based on clinical presentation and radiological techniques. Compared to histopathological diagnosis, cytology had a sensitivity of 89.47%, specificity of 93.33%, positive predictive value (PPV) 95.04% and negative predictive values (NPV) 86.13% for epithelial metastatic cancer. The overall diagnostic test accuracy was 91.06%. For lymphoproliferative neoplasms cytology in comparison to histopathology had sensitivity 85.71%, specificity 91.18%, PPV 76.4% and NPV 95.04%. The overall diagnostic test accuracy was 89.81%. In both ways cytology is showing significant possibility to be used as a primary tool in detecting cancers.

Conclusion: FNAC is a fast, reliable, and efficient method for diagnosing malignant lymphadenopathy. The cytological diagnosis can sometimes be accepted as the definitive diagnosis without further correlation with histopathology, especially in advanced malignancies and known primary malignancies.