Sleep quality and its contributing factors in patients with gout / 中华健康管理学杂志

Objective:To evaluate the incidence and its impact fortors of sleep disorders among patients with gout.Methods:A total of 414 patients with gout were included in the study. A series of questionnaires including socio-economical and disease related scale, the Pittsburgh Sleep Quality Index (PSQI), Fatigue Scale-14, the Patient Health Questionnaire, the Generalized Anxiety Disorder questionnaire, the 10 cm Visual Analog Scale for total pain, patient self-reported confidence in gout treatment and the Health Assessment Questionnaire-Disability Index were carried out in the patients. The statistical methods used in the study included t test, rank sum test, chi-square test and regression analysis. Results:The median age of gout patients in this study was 54 years and 96.4% were men, the mean serum uric acid level was (474.98±120.14) μmol/L. Among them, 201 (48.6%) patients showed sleep disorders, and the worse sleep quality was reflected in subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency and each dimension of PSQI. It was found that sleep disorders in gout patients were associated with living in rural areas, unemployment, long disease duration, disease stage, depression, anxiety, lack of confidence in regular blood examination and some other factors. In addition, patients with severe pain ( OR=1.087, P=0.029), fatigue ( OR=1.125, P=0.002), tophi ( OR=1.843, P=0.014) and functional disability ( OR=2.916, P<0.001) were more likely to get sleep disorders. Conclusions:The incidence of sleep disorders in patients with gout is high, and it′s associated with disease duration, psychological status, pain, tophi, disease stage, functional disability.

Factors Contributing to Non-Communicable Diseases in a Selected Low Socio-Economic Status Community in Kedah, Malaysia

@#Introduction: Non-communicable diseases (NCDs) are evolving as the leading cause of death worldwide, including in Malaysia. Changes in a socio-economic status have increased at-risk populations with NCDs. The objective of this study is to describe the prevalence of self-reported NCDs and its contributing factors in a selected low socio-economic status community in Kedah, Malaysia. Methods: A cross-sectional study with a self-administered questionnaire was done among convenience samples of 139 adults (age more than 18 years old) living in a selected low socio-economic status community in Kedah. Results: Among 139 respondents with a mean (SD) age 48.5 (13.1), there were 40.3% of respondents reported to have chronic illnesses with a prevalence of hypertension (25.9%), diabetes mellitus (21.6%), hypercholesterolemia (7.2%), chronic respiratory diseases (5.0%), heart disease (2.9%) and stroke (1.4%). The significant contributing factors of NCDs by multiple logistic regression were age, marital and working status. A person with an increase in 1 year of age has 1.05 times the odds to have NCDs (95% CI: 1.01 to 1.09, p-value=0.007). A divorcee has 3.55 times the odds compared to a married person to have NCDs (95% CI: 1.28 to 9.80, p-value=0.015). The non-working individual has 2.27 times the odds compared to working individuals to have NCDs (95% CI: 1.03 to 5.01, p-value=0.042). Conclusion: The prevalence of NCDs is high in this selected low socio-economic status community. The contributing factors are age, marital and working status.

Factors affecting psychological health and suicidal behavior: based on a survey of 10 340 medical students from three universities / 南方医科大学学报

OBJECTIVE@#To explore the factors influencing mental health and suicidal behaviors of medical students and provide a scientific basis for improving their mental health and reducing their suicidal behaviors.@*METHODS@#We conducted a questionnaire-based survey among 11 270 medical students in the first and second years at 3 universities in the southern, northern and central regions of a province in China, and 10 340 valid responses were retrieved. Multiple logistic regression was used to analyze the factors affecting anxiety, depression and suicidal behaviors, particularly the impact of family environment on the mental health status of the medical students.@*RESULTS@#Medical students of the female gender, in their second year in college, with dissatisfaction with their major, coming from poor families, families experiencing domestic violence or dysfunctional family were more likely to develop depression and anxiety; medical students who experienced violence by their parents or guardians and had childhood experience of separation from parents were more likely to develop anxiety (@*CONCLUSIONS@#The mental health and suicidal behavior of medical students are affected by various factors involving family conditions, childhood experience, to which parents and relevant agencies should give due attention.

Investigation on occupant injury severity in rear-end crashes involving trucks as the front vehicle in Beijing area, China / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>Rear-end crashes attribute to a large portion of total crashes in China, which lead to many casualties and property damage, especially when involving commercial vehicles. This paper aims to investigate the critical factors for occupant injury severity in the specific rear-end crash type involving trucks as the front vehicle (FV).</p><p><b>METHODS</b>This paper investigated crashes occurred from 2011 to 2013 in Beijing area, China and selected 100 qualified cases i.e., rear-end crashes involving trucks as the FV. The crash data were supplemented with interviews from police officers and vehicle inspection. A binary logistic regression model was used to build the relationship between occupant injury severity and corresponding affecting factors. Moreover, a multinomial logistic model was used to predict the likelihood of fatal or severe injury or no injury in a rear-end crash.</p><p><b>RESULTS</b>The results provided insights on the characteristics of driver, vehicle and environment, and the corresponding influences on the likelihood of a rear-end crash. The binary logistic model showed that drivers' age, weight difference between vehicles, visibility condition and lane number of road significantly increased the likelihood for severe injury of rear-end crash. The multinomial logistic model and the average direct pseudo-elasticity of variables showed that night time, weekdays, drivers from other provinces and passenger vehicles as rear vehicles significantly increased the likelihood of rear drivers being fatal.</p><p><b>CONCLUSION</b>All the abovementioned significant factors should be improved, such as the conditions of lighting and the layout of lanes on roads. Two of the most common driver factors are drivers' age and drivers' original residence. Young drivers and outsiders have a higher injury severity. Therefore it is imperative to enhance the safety education and management on the young drivers who steer heavy duty truck from other cities to Beijing on weekdays.</p>

Post Neonatal Tetanus: 20 Years Experience as Seen at the University of Port Harcourt Teaching Hospital.

Aims: To review the status of post neonatal tetanus at University of Port Harcourt Teaching Hospital with a view of highlighting the morbidity and mortality trend. Study Design: Retrospective descriptive study. Place and Duration of Study: Department of Paediatrics, University of Port Harcourt Teaching Hospital between1995-2015. Methodology: This was a 20 year retrospective review of the records of all post neonatal tetanus cases managed at Department of Paediatrics, University of Port Harcourt Teaching Hospital. Results: One hundred and fourteen cases of post neonatal tetanus were studied. Male to female ratio was 1.7:1. The ages ranged from 0.16 to16 years with a mean age of 9.74±4.4 years. Most cases were above 5years of age and either unimmunized or incompletely immunized. The portal of entry was specified in 37 (32.7%) of cases and of these, broomstick injury was the commonest portal of entry accounting for 17 (45.9%). The duration of hospital stay ranged between 1-35 days and case fatality rate was 27.4%. Conclusion: Post neonatal tetanus has remained a major cause of morbidity and mortality in our Teaching Hospital. Injuries especially broomstick injuries predispose to the majority of the cases. Completion of routine tetanus toxoid immunization in infancy and booster doses should be ensured.

Dengue Incidence and the Prevention and Control Program in Malaysia

The trend of dengue incidence in the regions and many countries has shown an increasing trend for the past few decades. The World Health Organization (WHO) reported that the incidence increased dramatically over the last 50 years and that dengue virus infections expanded to new countries, and from urban to rural settings. Malaysia is one of the countries that experience similar situation. The trend of dengue incidence in Malaysia has continued to increase since 2001 until 2014. In 2001, the dengue incidence rate (IR) was 72 cases in 100,000 population and progressively increased to 361 cases in 100,000 populations in 2014. There were temporary decrease of the incidence rate in 2011 and 2012 to 69.9 and 76 cases per 100,000 populations. Despite the close monitoring and continuous efforts from the Ministry of Health and Municipals to conduct the prevention and control activities, the number of dengue cases continues to increase due to multiple uncontrolled factors. There are at least five major factors that influence the transmission of dengue disease which include the dengue virus, the human as the host, the environmental condition such as cleanliness, the vectors and its behavior and the climate change. Due to these multiple factors that influence the disease pathophysiology and transmission of dengue virus, the control of mosquito-borne viral infection is very challenging and different from managing other infectious diseases. In addition, the rapid urbanization, population growth and human behavior together with international travel, making the control of dengue transmission even more difficult. Based on the circumstances, Ministry of Health Malaysia has implemented the intergrated strategy for dengue prevention and control program in the National Dengue Strategic Plan (NDSP) since 2011. There are seven strategies included in the NDSP which is strengthening of the dengue surveillance, practicing intergrated vector management, emphasizing on the dengue case management, social and community mobilization towards the prevention activity, ensuring rapid response in managing the dengue outbreak and developing new innovative method through dengue research. Most of the factors that contribute to the occurrence of dengue cases are difficult to be controlled and these leave with only manipulation and intervention with the environment, vector control and changing the human behavior for the prevention and control of dengue.

Evaluation of the Radiographic Contributing Factors of Hallux Valgus Interphalangeus / 대한족부족관절학회지

PURPOSE: To statistically evaluate the contributing role of the 3 radiographic factors (Obliquity, Asymmetry, Joint deviation) of the hallux valgus interphalangeus with comparison to the normal control group. MATERIALS AND METHODS: The study is based on the standing foot AP radiographs of the 77 feet (56 patients) of the hallux valgus interphalangeus out of 119 feet of randomly sampled patients of the age range 20 to 60. Fractures or other foot disorders have been excluded. Obliquity, asymmetry and joint deviation factors formed by proximal and distal phalanges of hallux are measured by one observer and evaluated the statistical significance of the contribution of the 3 factors to the hallux interphalangeal angle (HIA). RESULTS: The average age of the patients were 36.0 years old and average HIA was 14.5 degrees +/- 2.8 degrees. Obliquity was measured 4.8 degrees +/- 2.90 degrees, asymmetry 8.2 degrees +/- 3.28 degrees and joint deviation 2.0 degrees +/- 1.85 degrees. All 3 factors showed the statistical significance as the contributing factors to the HIA and among them, the asymmetry played the biggest role (p<0.05). CONCLUSION: Hallux interphalangeal angle is formed by 3 radiographic factors (Obliquity, Asymmetry, Joint deviation), and among them the asymmetry factor plays the biggest role.

Analysis of the Contributing Factors of Graduates' Obtaining Employment / 中华医学教育探索杂志

The present situation of obtaining employment is serious for graduates. They often come up against a series of problems during obtaining employment. According to this, we put forward three important factors contributed to graduates' success in obtaining employment: good ideological political quality, psychological health and well-knit working ability.

Thoracic Kyphosis and Myofascial Pain Syndrome in Male Adolescents

OBJECTIVE: To assess the prevalence and contributing factors for myofascial pain syndrome in male adolescents and to evaluate the association of thoracic kyphosis and myofascial pain syndrome. METHOD: Four hundred thirteen male students of three high schools and one middle school were randomly selected. With the diagnostic criteria of palpable taut band, spot tenderness and pain recognition, myofascial pain syndrome in trapezius and infraspinatus were diagnosed. Thoracic kyphosis and pressure pain threshold were measured and contributing factors were collected with questionnaire. The relation between thoracic kyphosis and pressure pain threshold was evaluated and contributing factors for myofascial pain syndrome were compared. RESULTS: The prevalence of myofascial pain syndrome was 31.5% in trapezius and 1.0% in infraspinatus. Mean pressure pain thresholds were low in latent trigger point and myofascial pain syndrome group in comparison with normal group (p<0.05). There was no statistically significant correlation between thoracic kyphosis and pressure pain threshold. Aging and uncomfortable desk and chair were associated with high risk of myofascial pain syndrome. CONCLUSION: Myofacial pain syndrome is common in male adolescents and inadequate posture due to uncomfortable desk and chair rather than physical attributes like thoracic kyphosis is a contributing factor. Proper education and prevention are needed.