Facteurs associés à la césarienne en salle de travail chez les patientes à bas risque périnatal, "cas de l'hôpital général de référence Bonzola" à Mbujimayi (RDC) / Associated factors of cesarean section in workroom in patients with Low perinatal risk "case of the Bonzola Reference General Hospital

Contexte et objectifs : La césarienne est une intervention de plus en plus pratiquée en obstétrique pour sauver les vies. Les objectifs de cette étude étaient d'identifier les facteurs associés à la décision de césarienne en salle de travail et de déterminer les conduites thérapeutiques et obstétricales qui peuvent augmenter la probabilité d'accoucher par voie haute. Méthodes : Il s'agissait d'une étude castémoins réalisée dans le service de gynéco-obstétrique de l'Hôpital Général de Bonzola (HGR) à Mbujimayi du premier Mai 2020 au 30 Avril 2021. La population cible était constituée de toutes les parturientes à bas risque. Le modèle de régression logistique sur logiciel épi-info 7 a été utilisé pour la détermination des facteurs prédictifs d'indication de la césarienne chez les parturientes. Résultats : Les indications de la césarienne étaient dominées parla dilatation stationnaire avec 56,2% de cas et l'ARCF avec16,7% de cas ; un Apgar≤ 3 et un poids de naissance ≥ 4000g ont été retenus comme caractéristiques néonatales essentielles de la césarienne en cours de travail. Après analyse multivariée par régression logistique, un score de Bishop ˂ 6 avec col défavorable, unedilatation ˂ 3 cm à l'admission et une thérapeutique faite à l'ocytocine, rupture artificielle des membranes et G10% pendant le travail étaient des éléments identifiés comme facteurs de risque de la césarienne en cours du travail. Conclusion : Certains facteurs permettent de prédire le risque de césarienne chez les parturientes à faible risque obstétrical. La connaissance de ces facteurs de risque peut permettre aux praticiens de le prévenir ou de mieux préparer les patientes à affronter cette intervention.

Background and Objectives: Cesarean section is an increasingly common life-saving procedure in obstetrics. The objectives of this study were to identify the factors associated with the decision to perform a cesarean section in the labor room and to determine the therapeutic and obstetric practices that can increase the probability of giving birth by high way. Methods: This was a case-control study conducted in the gynecology-obstetrics department of the General Hospital of Bonzola (HGR) in Mbujimayi from May 1, 2020 to April 30, 2021. The target population consisted of all low-risk parturients. The logistic regression model on epi-info 7.2.0 software was used to determine the predictive factors for the indication of caesarean section among parturients. Results: Indications for cesarean section were dominated by stationary dilatation with 56.2% of cases and ARCF with16.7% of cases; an Apgar≤ 3 and a birth weight ≥ 4000g were retained as essential neonatal characteristics for cesarean section in labor. After multivariate analysis by logistic regression, a Bishop score ˂ 6 with unfavorable cervix,dilatation ˂ 3 cm on admission, and therapy done with oxytocin, artificial rupture of membranes, and G10% during labor were identified as risk factors for cesarean section in labor. Conclusion: Certain factors predict the risk of cesarean section in parturients at low obstetrical risk. Knowledge of these risk factors may allow practitioners to prevent it or to better prepare patients for this procedure.

Técnica de duplo espaço modificada para mastopexia de aumento / Modified double space technique for augmentation mastopexy

Introdução: A mastopexia com prótese continua sendo um desafio para todos os cirurgiões plásticos. Resultados consistentes ainda são difíceis de se obter por muitas razões e alguns autores defendem a cautela devido a complicações. Métodos: Este estudo retrospectivo inclui 92 casos consecutivos mastopexia de aumento em tempo único realizados pelo mesmo cirurgião, entre março de 2012 e outubro de 2019. Resultados: O seguimento médio foi de 14 meses para o grupo de mastopexia de aumento. Três pacientes (3,3%) tiveram contratura capsular grau III. O índice de revisões foi de 25,3%: 7,6% com recidiva da ptose, revisão de cicatrizes em 6,5%, 1,1% de assimetrias. Três pacientes (3,3%) apresentaram ruptura da fixação da alça muscular, quatro pacientes (4,4%) tiveram deformidades dinâmicas. Conclusão: A técnica modificada de duplo espaço apresenta em nossa experiência resultados consistentes a longo prazo, e as taxas de revisão/complicação foram semelhantes a alguns estudos, mas maiores do que outros. Cirurgia prévia da mama, tabagismo, amamentação e cirurgia bariátrica anterior não aumentam as taxas de complicações e revisões. Pode ser uma das opções para a cobertura e suporte dos implantes em procedimentos de mastopexia de aumento.

Introduction: Mastopexy with prosthesis remains a challenge for all plastic surgeons. Consistent results are still difficult to obtain for many reasons, and some authors advocate caution due to complications. Methods: This retrospective study includes 92 consecutive single-stage augmentation mastopexy cases performed by the same surgeon between March 2012 and October 2019. Results: The median follow-up was 14 months for the augmentation mastopexy group. Three patients (3.3%) had grade III capsular contracture. The revision rate was 25.3%: 7.6% with ptosis recurrence, scar revision in 6.5%, and 1.1% asymmetries. Three patients (3.3%) had ruptured muscle loop fixation, four patients (4.4%) had dynamic deformities. Conclusion: The modified double-space technique in our experience shows consistent long-term results, and revision/complication rates were similar to some studies but higher than others. Prior breast surgery, smoking, breastfeeding, and previous bariatric surgery do not increase rates of complications and revisions. It can be one of the options for covering and supporting implants in augmentation mastopexy procedures.

Noise exposure and its impact on health in an auto parts manufacturing enterprise / 中华劳动卫生职业病杂志

Objective: To learn about the noise exposure and health status of workers and analyze factors that may affect the health outcomes of workers in an auto manufacturing enterprise in Tianjin City. Methods: In September 2020, occupational hygiene survey, noise exposure level detection and occupational health examination data collection were carried out in an auto parts manufacturing enterprise. Chi square test and unconditional logistic regression analysis were used to analyze the health effects of noise exposure and hearing loss of 361 noise exposure workers. Results: The rates of over-standard noise exposure, hearing loss and hypertension were 69.39% (34/49) , 33.24% (120/361) and 11.36% (41/361) , respectively. There were upward trends on age and noise-working years for hearing loss and hypertension rates (χ(2)=-5.95, -6.16, -2.81, -2.74, P<0.05) . Unconditional logistic regression analysis showed that age>35 years old, noise exposure length of service >10 years and noise L(EX, 8 h)>85 dB (A) were risk factors for hearing loss (OR=3.57, 95%CI: 1.09, 11.75; OR=4.05, 95%CI: 1.97, 8.25; OR=1.75, 95%CI: 1.00, 3.05; P=0.036, 0.001, 0.047) . Conclusion: This company has a high rate of job noise exceeding the standard, and noise-exposed workers have more serious hearing loss. Age, noise exposure and high noise exposure are risk factors for hearing loss.

Risk factors associated with SARS-CoV-2 pneumonia in the pediatric population / Factores de riesgo asociados con neumonía por SARS-CoV-2 en población pediátrica

Abstract Background: Currently, there are a few studies on the clinical characteristics of the pediatric population with COVID-19 and pneumonia. This study aimed to analyze data associated with the development of pneumonia in children and adolescents with SARS-CoV-2 infection throughout Mexico. Methods: We conducted a secondary analysis of the database of the Dirección General de Epidemiología of the Mexican Government. We included children under the age of 19 who were confirmed with SARS-CoV-2 infection by reverse transcription-polymerase chain reaction (RT-PCR) test. The dependent variable was the diagnosis of pneumonia. Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated. Multiple logistic regression models were performed to adjust factors associated with pneumonia. Results: A total of 1443 children with a COVID-19 diagnosis were included. The median age of the participants was 12 years (interquartile range 25, 75: 5, 16). Pneumonia occurred in 141 children (9.8%). The main risk factors were age < 3 years (OR, 3.5; 95%CI, 2.45-5.03); diabetes or obesity (OR, 12.6; 95%CI, 4.62-34.91); and immunocompromise (OR, 7.03; 95%CI, 3.97-13.61). Conclusions: Children < 3 years with COVID-19 and comorbidities, especially diabetes or obesity, and immunocompromised patients have a higher risk of developing pneumonia.

Resumen Introducción: Hasta ahora existen pocos estudios sobre las características clínicas de la población pediátrica con neumonía por COVID-19. El objetivo de este estudio fue analizar los datos que se asocian con el desarrollo de neumonía en niños y adolescentes con infección por SARS-CoV-2 en México. Métodos: Se llevó a cabo un análisis secundario de la base de datos de la Dirección General de Epidemiología del Gobierno Mexicano. Se incluyeron menores de 19 años con infección por SARS-CoV-2 confirmada mediante la prueba de retrotranscripción acoplada a la reacción en cadena de la polimerasa (RT-PCR). La variable dependiente fue el diagnóstico de neumonía. Se calcularon las razones de momios (RM) y los intervalos de confianza del 95% (IC95%). Se realizaron modelos de regresión logística múltiple para ajustar los factores asociados a neumonía. Resultados: Se incluyeron 1443 niños con diagnóstico de COVID-19. La mediana de edad de los participantes fue de 12 años (rango intercuartilar 25-75: 5-16). La neumonía se presentó en 141 niños (9.8%). Los principales factores de riesgo fueron edad < 3 años (RM: 3.5; IC95%: 2.45-5.03), diabetes u obesidad (RM: 12.6; IC95%: 4.62-34.91) e inmunocompromiso (RM: 7.03; IC95%: 3.97-13.61). Conclusiones: Los niños con COVID-19 menores de 3 años y con comorbilidad, especialmente diabetes u obesidad, y los inmunocomprometidos presentan mayor riesgo de desarrollar neumonía.

Perspectivas de mulheres encarceradas sobre fatores de risco à infecção sexualmente transmissível: estudo exploratório e qualitativo / Perspectives of incarcerated women on risk factors for sexually transmitted infection: exploratory and qualitative study

Resumo Objetivo: Conhecer a perspectiva de mulheres encarceradas sobre os fatores de risco para infecções sexualmente transmissíveis. Método: Trata-se de um estudo exploratório e qualitativo, realizado em uma emissora pública feminina do centro-norte de Mato Grosso, Brasil, em novembro de 2019. A coleta de dados foi realizada por meio de entrevista com 53 mulheres. Para a análise dos dados, foi utilizado o software IRAMUTEQ versão 0.7, que apresenta gráficos de similaridade. Resultado: Os resultados mostram que existem fatores que extrapolam o âmbito dos recursos individuais para o autocuidado, que dificultam ações preventivas, como as condições arquitetônicas e as normas disciplinares na prisão. Essas peculiaridades ambientais impõem outros fatores que aumentam o risco de infecções sexualmente transmissíveis, como dificuldade para limpar roupas e uso compartilhado do banheiro. Conclusão: Portanto, estratégias que unem as necessidades dessas mulheres aos riscos inerentes e somadas à realidade prisional se apresentam como uma forma favorável para que a prisão deixe de ser apenas um espaço de recrudescimento e para que a guarda seja cumprida. a geração de novas pessoas, com o resgate da dignidade. e consciência / condições para autocuidado contra infecções e outros problemas de saúde.

Abstract Objective: To know the perspectives of incarcerated women on the risk factors for sexually transmitted infections. Method: This is an exploratory and qualitative study, carried out in a female public channel in the mid-north region of Mato Grosso, Brazil, in November 2019. The data collection was carried out through an interview with 53 women. For data analysis, IRAMUTEQ version 0.7 software was used, which presents similarity graphs. Result: The results show that there are factors that go beyond the scope of individual resources for self-care, which hinder preventive actions, such as architectural conditions and disciplinary rules in prison. These environmental peculiarities impose other factors that increase the risk of sexually transmitted infections, such as difficulty in cleaning clothes and shared use of the bathroom. Conclusion: Therefore, strategies that unite the needs of these women with the inherent risks and added to the prison reality are presented as a favorable way for the prison to stop being only a space of recrudescence, and for custody to be fulfilled. the generation of new people, with the recovery of dignity. and awareness / conditions for self-care against infections and other health problems.

Resumen Objetivo: Conocer las perspectivas de las mujeres encarceladas sobre los factores de riesgo a las infecciones de transmisión sexual. Metodo: Se trata de un estudio exploratorio y cualitativo, realizado en una cadena pública femenina en la región media norte de Mato Grosso, Brasil, en noviembre de 2019. La recolección de datos se realizó a través de una entrevista a 53 mujeres. Para el análisis de los datos se utilizó el software IRAMUTEQ versión 0.7, que presenta gráficos de similitud. Resultado: Los resultados demuestran que existen factores que van más allá del ámbito de los recursos individuales para el autocuidado, que dificultan las acciones preventivas, como las condiciones arquitectónicas y las normas disciplinarias en la prisión. Estas particularidades ambientales imponen otros factores que aumentan el riesgo de infecciones de transmisión sexual, como la dificultad para limpiar la ropa y el uso compartido del baño. Conclusión: Por tanto, estrategias que unen las necesidades de estas mujeres con los riesgos inherentes y sumadas a la realidad carcelaria se presentan como una vía favorable para que la prisión deje de ser solo un espacio de recrudecimiento, y para que la custodia se cumpla con la generación de nuevas personas, con la recuperación de la dignidad. y conciencia / condiciones para el autocuidado frente a infecciones y otros problemas de salud.

COVID-19 and Brazilian's mental health: risk factors and related symptoms / COVID-19 e saúde mental de brasileiros: fatores de risco e sintomas associados / COVID-19 y salud mental de brasileños: factores de riesgo y síntomas asociados

In a pandemic, it is necessary to understand who is at higher risk for psychological difficulties. Thus, we aim to investigate psychological symptoms in a Brazilian sample during the COVID-19 pandemic and their associations with sociodemographic, health, and pandemic-related variables. We included 1358 individuals assessed via an online survey through a questionnaire that included sociodemographic and other questions related to the pandemic and the SRQ-20. The results showed that younger adults and women were at a higher risk for minor mental disorders. An investigation about subgroups revealed three clusters representing symptom's severity. The cluster with most symptoms was younger people, had their income most impacted by the pandemic, and had more frequent diagnoses of mental disorders. The subgroups were discriminated mostly due to cognitive-emotional symptoms. We discussed the determinants that can contribute to mental health vulnerability and highlighted the need for state actions for those more vulnerable.

Em uma pandemia, é necessário entender quem possui maior risco de dificuldades psicológicas. O objetivo deste estudo foi investigar os sintomas psicológicos mais prevalentes em uma amostra brasileira, durante a pandemia da COVID-19 e associações com variáveis sociodemográficas, de saúde e pandêmicas. 1.358 indivíduos responderam a um survey online por meio de questionário, que incluiu questões sociodemográficas e relacionadas à pandemia, e o SRQ-20. Os resultados mostraram que mais jovens e mulheres estão em maior risco de transtornos mentais menores (MMD). Uma investigação sobre subgrupos revelou três grupos que representam a gravidade dos sintomas. O cluster com mais sintomas era mais jovem, teve sua renda mais impactada pela pandemia e tinha diagnósticos de transtornos mentais mais frequentemente. Os subgrupos foram discriminados principalmente devido a sintomas cognitivo-emocionais. Discutimos os determinantes que podem contribuir para a vulnerabilidade em saúde mental e destacamos a necessidade de ações estatais para os mais vulneráveis.

En una pandemia, es necesario comprender quién está en mayor riesgo de tener dificultades psicológicas. El objetivo fue investigar los síntomas psicológicos más prevalentes en una muestra brasileña, durante la pandemia de COVID-19, y las asociaciones con variables sociodemográficas, de salud y pandémicas. 1358 personas que fueron evaluadas a través de un cuestionario que incluía aspectos sociodemográficos y relacionados con la pandemia y el SRQ-20. Los resultados mostraron que más jóvenes y mujeres tienen un mayor riesgo de trastornos mentales menores. Una investigación en subgrupos reveló tres grupos que representan la gravedad de los síntomas. El grupo con más síntomas era más joven, sus ingresos se vieron más afectados por la pandemia y tenían más diagnósticos de trastornos mentales. Los subgrupos fueron discriminados principalmente por síntomas cognitivo-emocionales. Discutimos los determinantes que pueden contribuir a la vulnerabilidad en salud mental y resaltamos la necesidad de acciones estatales para los más vulnerables.

Asociación entre el tiempo de comunicación verbal entre padres e hijos y los niveles de adiposidad de preescolares chilenos / Association between parents-children verbal communication time and the adiposity levels of chilean pre-schoolchildren

RESUMEN Objetivos Determinar la asociación entre el tiempo de comunicación verbal de padres e hijos en etapa preescolar y sus niveles de adiposidad; en segundo lugar, se busca describir las variables sociodemográficas y de composición corporal de dichos preescolares en relación con la comunicación verbal entre padres e hijos. Materiales y Métodos Estudio descriptivo, transversal y de carácter multicéntrico en el que participaron 70 preescolares. Las variables medidas fueron "niveles de adiposidad de los preescolares", variables sociodemográficas de padres y tiempo de comunicación verbal "entre padres e hijos". Resultados Con base en el tiempo de comunicación entre padres e hijos (se consideró como "bajo tiempo de comunicación" un tiempo de menos de 100 min/día y como "elevado tiempo de comunicación", uno que fuera mayor o igual a 100 min por día), se hallaron diferencias significativas en las variables peso en la clasificación nutricional de obesidad (TC<100 min/día 20.6±4 vs. TC≥100 min/día 18.4±3 kg, P=0.039), zpeso/talla (TC<100 min/día 1.791±8 vs. TC≥100 min/día 1.010±4, P=0.030), masa grasa en kg (TC<100 min/día 7.5±3 vs. TC≥100 min/día 6.3±2 kg, P=0.046), masa grasa en % (TC<100 min/día 36.3±2 vs. TC≥100 min/día 33.9±3%, P<0.05). La talla y la razón peso/talla no presentaron asociación significativa mediante el estado nutricional y las categorías de diferentes tiempos de comunicación verbal entre padres e hijos por día. Además, la masa muscular fue asociada significativamente al tiempo de comunicación verbal entre padres e hijos en las categorías de obesidad (TC<100 min/día 5.7±3 vs. TC≥100 min/día 5.1±3 kg, P=0.047) y masa magra del tronco (TC<100 min/día 5.2± 4 vs. 4.6±3 kg, P=0.039). Conclusiones El tiempo diario de comunicación verbal entre padres e hijos se asocia significativamente a mayores niveles de adiposidad mediante el peso, zpeso/talla y masa grasa. Estos hallazgos requieren de mayor y más compleja investigación para corroborarse.

ABSTRACT Objective To determine the association between the time of verbal communication parents-children with the adiposity levels of pre-schoolchildren, and secondly to describe the socio-demographic, and body composition outcomes of pre-schoolchildren by the verbal communication parents-children time. Materiales y Methods A descriptive, cross-sectional study of multi-centric application, with participation of (n=70) pre-scholars. The outcomes described were the adiposity, socio-demographic data of parents and the time of verbal communication parents-children. Results Considering a low (<100 min/day) versus a high (≥100 min/day) time of verbal communication parents-children, there were significant differences in the weight of the obesity classification "total communication/day" [TC] (TC<100 min/day 20.6±4 vs. TC≥100 min/day 18.4±3 kg, P=0.039), zweight/height (TC<100 min/day 1.791±8 vs. TC≥100 min/day 1.010±4, P=0.030), lean mass in kg (TC<100 min/day 7.5±3 vs. TC≥100 min/day 6.3±2 kg, P=0.046), body fat in % (TC<100 min/day 36.3±2 vs. TC≥100 min/day 33.9±3%, P<0.05). The height and ratio weight/height do not showed significant association with the time of verbal communication parents-children. Additionally, muscle mass (TC<100 min/day 5.7±3 vs. TC≥100 min/day 5.1±3 kg, P=0.047), and trunk lean mass (TC<100 min/day 5.2± 4 vs. 4.6±3 kg, P=0.039) were significantly associated with the main outcome. Conclusions The daily time of verbal communication parents-children is significantly associated with higher levels of adiposity by the weight, zweight/height, and body fat in pre-schoolchildren. These findings require major and more complex research for corroborating.

Prevalence and associated risk factors of refractive errors among medical students in Western Odisha: a cross-sectional study

Background:prevalence of refractive errors among medical students pursing higher studies is very high. Very little data about the prevalence of refractive errors among medical students in western Odisha is available. So, this Present study was undertaken with an objectivewere to estimate the prevalence of refractive errorsamong medical students of VIMSAR, Burla,Western Odisha, Indiaand to study the association between various risk factors with the prevalence of refractive errors.Methods:A cross-sectional study was conducted among undergraduates i.e. (from 1styear to final year) students of VIMSAR, Burla for a period of 2 months i.e.FebruarytoMarch 2020 with sample size of 200.A pre-designed, semi-structured questionnaire was prepared and distributed to students. To assess refractive errors among study population auto refractometer was used.Results:The overall prevalence of refractive errors in our study was 65%.Most common type of refractive error was Myopia i.e. 113 (86.92%) among the medical students followed by Astigmatism (10.77%) and Hypermetropia (2.31%) respectively. It was observed in our present study that the prevalence of refractive errors was highly associated withincrease in study duration, use of electronic gadgets such as smartphones and computers and with the presence of family history this group difference was found to be significantly associated withchi-square=9.4183,78.9173,114.235 and 56.1899respectively with P<0.05.Conclusion:High prevalence of refractive errors was found among medical students of VIMSAR, Burla which emphasis on the need for routine ophthalmological evaluation and their proper assessment and management

Prevalence of hypertension and its risk factors among high school children in Bangalore, India

Background: Hypertension is a prominent health disorder that leads to 12.8% of deaths worldwide. Although predominantly considered a disorder of the adults, the roots of hypertension start from childhood. In the past children usually suffered from secondary hypertension. However, now with increased incidence of obesity, reduced physical activity, unhealthy dietary habits, use of tobacco and alcohol among adolescents there is now an increased prevalence of primary hypertension in this age group. The present study was conducted with the objective of assessing the prevalence of hypertension and its modifiable risk factors in high school children.Methods: The study was conducted among high school students aged 13 to 16 years in urban Bangalore. A self-administered questionnaire was used to assess the lifestyle. Age, sex, height, weight and resting blood pressure were recorded. Odds ratio, Chi square test and logistic regression were used in the analysis.Results: There were 550 students who participated in the study, 300 (54.54%) were males and 250 (45.45%) were females. The prevalence of prehypertension was 21.6% and hypertension was 8.9%. Logistic regression revealed that overweight, obesity, high salt intake, tobacco use, and stress were significantly associated with elevated blood pressure.Conclusions: There is a rise in the prevalence of hypertension among high school students. Changes in lifestyle seem to influence the development of hypertension in this age group. Behaviour change communication should be used to reduce the modifiable risk factors and promote healthy lifestyle among adolescents.

Prevalence, associated risk factors and antibiotic resistance pattern of bacterial uropathogens among pregnant women in a tertiary care hospital of Bangladesh

Aims@#The study was designed to determine the prevalence of urinary tract infection (UTI) in pregnant women depending on their various clinical and socio-demographic factors, and to assess the antibiotic susceptibility pattern of the responsible uropathogens in a tertiary care hospital of Dhaka, Bangladesh. @*Methodology and results@#A total of 100 midstream urine samples were collected from pregnant women and different clinical and socio-demographic variables viz. age, gestational weeks, living conditions, and level of education associated with UTI were determined. Bacterial isolation was carried out using blood and MacConkey agar and identified according to their phenotypic characteristics. Antibiogram profiling of the isolates was done by disc diffusion method. From 48% of positive UTI samples, the highest bacteriuria was recorded within the age group of 26-30 years (n=19; 59.38%) and in both, 1st and 3rd trimester period (50%). There was no significant association between the studied risk factors and bacteriuria, except for the age of the pregnant women. Most predominantly isolated bacteria was Escherichia coli (n=39; 81.25%), followed by Klebsiella pneumoniae (n=9; 18.75%). In E. coli, the highest resistance was recorded against ceftriaxone (87.18%), followed by cephalexin (84.61%) and ceftazidime (79.49%); whereas K. pneumoniae showed 100% resistance to ceftriaxone and cephalexin. Netilmicin was found as the only effective antibiotic against E. coli showing 100% sensitivity. For K. pneumoniae, azithromycin, imipenem, chloramphenicol, gentamicin, ciprofloxacin, amikacin and nitrofurantoin were found as the most efficacious drugs. @*Conclusion, significance and impact of study@#As the emergence of drug resistance is ever increasing, the study necessitates the continuous surveillance of antibiotic susceptibility of uropathogens to ensure safety and better treatment to the mother and fetus.

Risk Factors Of Pulmonary Tuberculosis Among Diabetes Mellitus Patients: A Case-Control Study In Dr. Kariadi General Hospital, Semarang, Indonesia

@#Diabetes mellitus (DM) is a well-known risk factor for tuberculosis (TB). Prevalence of TB among DM patients ranged from 1.7 % to 36 %. Limited information has been reported regarding TB among DM patients in Indonesia. This case-control study aimed to investigate prevalence and related factors of pulmonary TB among DM patients in Dr. Kariadi General Hospital. Cases of pulmonary TB were defined by a positive acid-fast bacilli smear or molecular rapid test and thorax x-ray. Data were presented as frequency and percentage comparing the case and control group. Chi-square continued by Binary logistic regression analyses were done to determine the relationship between the parameters and TB status performed by the SPSS 16. Prevalence of 8.02% or 72 patients were diagnosed as having pulmonary TB from 898 registered patients with DM. Of the 72 TB patients, 30 completed the data as case group, and 45 DM patients without TB determined as a control group. Comparison between the case and control group study found differences in household contact (63.3 % and 4.4 %, respectively), random plasma glucose (76.7 % and 33.3 %), duration of DM (40 % and 71 %), and treatment compliance (30 % and 68.9 %). The final model in Binary logistic regression involved household contact, random plasma glucose level, and treatment compliance. The prevalence of pulmonary TB among DM patients in Dr. Kariadi General Hospital was 8.02%. Risk factors that were associated with this occurrence were: household contact, high random plasma glucose level, and poor treatment compliance.

Factores de riesgo que influyen en el abandono de la Lactancia Materna. 2017-2018 / Risk factors that influence the abandonment of Breastfeeding. 2017-2018 / Fatores de risco que influenciam o abandono da amamentação. 2017-2018

RESUMEN Introducción: la leche materna contiene todos los nutrientes necesarios para el desarrollo del niño y tiene varias ventajas sobre cualquier sustituto desarrollado. Es considerada la vacuna más perfecta de todos los tiempos; debido al incremento del abandono de la lactancia materna exclusiva antes de los seis meses de vida se hace necesario identificar los factores de riesgo que influyen en esto. Objetivo: identificar los factores de riesgo bio-sociales que influyen en el abandono de la lactancia materna exclusiva antes del sexto mes de vida en el Policlínico13 de Marzo, Bayamo, Granma; en el período de enero a diciembre del 2018. Método: se realizó un estudio descriptivo retrospectivo de caso y control, con el propósito de identificar los factores de riesgo que influyen en el abandono de la lactancia exclusiva antes del sexto mes de vida. En el grupo caso se incluyeron las que abandonaron la lactancia materna y en el grupo control las que ofrecieron lactancia exclusiva a su hijo hasta el 6to mes de vida; se les pidió un consentimiento informado y se aplicó un cuestionario a las madres objetos de estudio. Resultados: se estudiaron 147 madres, en elgrupo caso el abandono la lactancia fue más frecuente en menores de 20 años, con nivel secundario o preuniversitario, con familias disfuncionales en el 73,5% y según lo referido por tener la sensación de que el bebé pasa hambre, no se llena o no tienen suficiente leche en el pecho. Conclusiones: la edad materna inferior de 20 años, el bajo nivel de escolaridad, la familia disfuncional y la desacertada percepción de que él bebé pasa hambre o no se llena por no tener suficiente leche en el pecho, son los principales factores que provocan el abandono de la lactancia en nuestra investigación causando la introducción de otros tipos de leche disponibles.

ABSTRACT Introduction: breast milk contains all the nutrients necessary for the development of the child and has several advantages over any developed substitute. It is considered the most perfect vaccine of all time; Due to the increase in the abandonment of exclusive breastfeeding before six months of life it is necessary to identify the risk factors that influence this. Objective: to identify the bio-social risk factors that influence the abandonment of exclusive breastfeeding before the sixth month of life in the Polyclinic March 13, Bayamo, Granma; in the period from January to December 2018. Method: a retrospective case-control and descriptive study was carried out, with the purpose of identifying the risk factors that influence the abandonment of exclusive breastfeeding before the sixth month of life. In the case group were included those who abandoned breastfeeding and in the control group those who offered exclusive breastfeeding to their child until the 6th month of life; Informed consent was requested and a questionnaire was applied to the mothers under study. Results: 147 mothers were studied, in the case group, breastfeeding abandonment was more frequent in children under 20 years of age, with secondary or pre-university level, with dysfunctional families in 73.5% and as referred to as having the feeling that the Baby goes hungry, does not get full or do not have enough breast milk. Conclusions: the maternal age under 20 years of age, the low level of schooling, the dysfunctional family and the misguided perception that the baby is hungry or not full due to not having enough breast milk, are the main factors that cause abandonment of breastfeeding in our research causing the introduction of other types of milk available.

RESUMO Introdução: o leite materno contém todos os nutrientes necessários para o desenvolvimento da criança e possui várias vantagens sobre qualquer substituto desenvolvido. É considerada a vacina mais perfeita de todos os tempos; Devido ao aumento do abandono do aleitamento materno exclusivo antes dos seis meses de vida, é necessário identificar os fatores de risco que influenciam isso. Objetivo: identificar os fatores de risco biossociais que influenciam o abandono do aleitamento materno exclusivo antes do sexto mês de vida na Policlínica em 13 de março, Bayamo, Granma; no período de janeiro a dezembro de 2018. Método: foi realizado um estudo descritivo retrospectivo de caso e controle, com o objetivo de identificar os fatores de risco que influenciam o abandono do aleitamento materno exclusivo antes do sexto mês de vida. No grupo caso foram incluídos aqueles que abandonaram a amamentação e no grupo controle aqueles que ofereceram aleitamento materno exclusivo ao filho até o sexto mês de vida; Foi solicitado o consentimento informado e aplicado um questionário às mães estudadas. Resultados: foram estudadas 147 mães, no grupo caso, o abandono do aleitamento materno foi mais frequente em menores de 20 anos, com nível secundário ou pré-universitário, com famílias disfuncionais em 73,5% e referido como tendo a sensação de que o O bebê passa fome, não fica cheio ou não tem leite materno suficiente. Conclusões: idade materna abaixo de 20 anos, baixa escolaridade, família disfuncional e a infeliz percepção de que o bebê está com fome ou não está cheio por não ter leite suficiente, são os principais fatores que causam o abandono amamentação em nossa pesquisa, causando a introdução de outros tipos de leite disponíveis.

Prevalence and pattern of hypertension among elderly in Osun state, Nigeria

Background: Hypertension is a major public health challenge worldwide. It is acknowledged as an important risk factor for cardiovascular morbidity and mortality, particularly among the elderly. This study aimed to investigate the prevalence and pattern of hypertension among the elderly in Osun state, Nigeria.Methods: A descriptive cross-sectional design was used. The study involved 425 respondents aged 60 years and above selected randomly in five local government areas in Osun state. The blood pressure was measured (using a standardized Accoson® type pneumatic mercury sphygmomanometer); weight and height of the respondents were checked and recorded in mmHg, Kg and meters respectively. Data were presented using descriptive statistics, charts and frequency distribution table. Statistical association between categorical variables was assessed using Chi-square method at 5% level of significance.Results: Prevalence of hypertension among elderly was 44.7%. Among other factors, respondents’ body mass index BMI was found significantly associated with hypertension, p=0.009. However, prevalence of hypertension was higher for respondents that were; rural dwellers, female, not living with spouse, without viable source of income and engaging in little or no physical activity compared to their counterparts. Respondent’s BMI and sex were also found to be statistically significantly associated, p=0.011.Conclusions: Prevalence of hypertension was high among the elderly in this study. Health interventions aimed at reducing the diseases should encourage increased physical activities and incorporate financial empowerment schemes particularly for elderly women in rural settings.

Ocorrência de infecções de sítio cirúrgico pós-cesárea em uma maternidade pública / Ocurrencia de infecciones de sitio quirúrgico post-cesárea en una maternidad pública / Occurrence of possessional surgical site infections in a public maternity

Resumo Objetivou-se identificar ocorrências de infecção do sítio cirúrgico pós-cesárea em uma maternidade. Trata-se de um estudo transversal retrospectivo com abordagem quantitativa desenvolvido em uma maternidade pública de referência em obstetrícia localizada na Região Nordeste do Brasil. A amostra constou de 53 prontuários de mulheres com infecção no sítio cirúrgico pós-cesárea no período de 2010 a 2013 e o instrumento de coleta de dados foi um formulário estruturado. Os dados foram analisados em software estatístico Statistical Package for the Social Sciences versão 20.0 apresentados na forma descritiva com frequências e percentuais. Os resultados mostraram taxa de infecção no sítio cirúrgico pós-cesárea de 2,92%; as usuárias apresentaram como fatores de risco baixa escolaridade, ocorrência de infecção urinária, hipertensão arterial, obesidade e tabagismo. Observou-se que a taxa de infecção no sítio cirúrgico pós-cesárea e fatores de risco identificados ressaltam a necessidade de investigação prévia e registro destes com cuidados preventivos de orientação e preparo das usuárias de forma segura com protocolos que direcionem condutas mais uniformes no tratamento destas infecções.

Resumen El objetivo fue identificar casos de infección del sitio quirúrgico post cesárea en una maternidad. Se trata de un estudio transversal retrospectivo con abordaje cuantitativo desarrollado en una maternidad pública de referencia en obstetricia localizada en la Región Noreste de Brasil. La muestra constó de 53 prontuarios de mujeres con infección en el sitio quirúrgico post-cesárea en el período de 2010 a 2013 y el instrumento de recolección de datos fue un formulario estructurado. Los datos fueron analizados en software estadístico Statistical Package for the Social Sciences versión 20.0 presentados en la forma descriptiva con frecuencias y porcentajes. Los resultados mostraron tasa de infección en el sitio quirúrgico post cesárea del 2,92%; las usuarias presentaron como factores de riesgo baja escolaridad, ocurrencia de infección urinaria, hipertensión arterial, obesidad y tabaquismo. Concluye que la tasa de infección en el sitio quirúrgico post cesárea y factores de riesgo identificados resalta la necesidad de investigación previa y registro de éstos con cuidados preventivos de orientación y preparación de las usuarias de forma segura con protocolos que direccionan conductas más uniformes en el tratamiento de estas infecciones.

Abstract The objective of this study was to identify the occurrence of post-cesarean surgical site infection in a maternity hospital. This is a cross-sectional retrospective study with a quantitative approach developed in a reference public maternity in obstetrics located in the Northeast Region of Brazil. The sample consisted of 53 medical records of women with post-cesarean surgical site infection from 2010 to 2013, and the data collection instrument was a structured form. The data were analyzed in Statistical Package for Social Sciences version 20.0 presented in descriptive form with frequencies and percentages. The results showed post-cesarean surgical site infection rate of 2.92%; the users presented as low risk factors schooling, occurrence of urinary infection, hypertension, obesity and smoking. It was concluded that the post-cesarean surgical site infection rate and identified risk factors underscore the need for prior investigation and registration of these with preventive care of orientation and preparation of the users in a safe way with protocols that guide more uniform conduct in the treatment of these infections.

Types And Risk Factors Of First Time Stroke: A Saudi Hospital- Based Study

Background: The purpose of this study was to explore the stroke types and the risk factors of the first-time stroke in the holy city of Madinah Munawarah. Methods: A prospective hospital-based research study was carried out over the year of 2014. The patients with the diagnosis of the cerebrovascular accident were enrolled in the study. The details of patients’ history, demographic data, stroke type, and risk factors were collected. Results: First-time stroke were determined in 164 patients (91 male and 73 female) during the entire periods of this study with a mean age of 67.52 ± 2.31 years. The prevalence of types of stroke was ischaemic strokes in 133 patients (% 81.1), intercerebral hemorrhage in 24 patients (14.63%), and subarachnoid hemorrhage in one patient (0.6%). The most common risk factors recorded were hypertension (86.6%), diabetes mellitus (63.4%), and ischaemic heart disease (41.5%). There was no significant relationship between the frequency of ischaemic stroke and intercerebral hemorrhage stroke ( p> 0.05). Conclusion: The study indicates that hypertension, diabetes, and ischaemic heart disease are critical risk factors for developing stroke and fairly commensurate with the global reported risk factors. Further research is needed to investigate stroke patterns and other possible risk factors concurrently with Saudi national prevention programs.

Modifiable risk factors of noncommunicable diseases in urban adolescents of Girdhar Nagar, Ahmedabad: A cross-sectional study

Background: Noncommunicable diseases (NCDs) have become a major health burden globally. The four main NCDs (heart disease, stroke, diabetes, and cancers and chronic respiratory diseases) share four modifiable risk factors: Tobacco use, harmful alcohol use, physical inactivity, and unhealthy diet. To minimize the burden of NCD epidemic, main risk behaviors common among young people must be curbed. Measurement of NCD risk factors is necessary to plan out the interventions and would also serve as a stepping stone in achieving primordial prevention of NCDs. Objective: The objective of the study was to measure the modifiable risk factors of NCDs among school-going adolescents of urban Ahmedabad. Materials and Methods: This cross-sectional study was conducted from November 2016 to January 2017 among two schools of Girdhar Nagar ward, Ahmedabad. 581 adolescents of a private and a government-run school, studying in class 8th–10th, of ages 12–16 were interviewed using GSBHS tool after taking informed consent. Appropriate anthropometric and blood pressure (BP) measurements were taken. Statistical analysis: Epi info ver. 7.0 and MS Excel 2007 used for analysis. Chi-square test, t-test, and multiple regression were applied. P < 5% was considered significant. Results: 52% (303) of the subject studied were boys and 48% (278) were girls. Among all, 66% (384) were physically inactive, 88% (511) were not consuming ≥5 servings of fruits and vegetables/day, 65% (376) and 78% (452) regularly consumed soft-drinks and fast food, respectively. 1.5% (9) of the subjects smoked and 3%(15) consumed smokeless form of tobacco. No student admitted consuming alcohol. 11% (65) were overweight and 13% (73) were obese. Raised systolic BP (>140 mmHg) was found in 3% (18) and raised diastolic BP (>90 mmHg) was found in 0.5% (3) of study subjects. Conclusion: One or more risk factors were found to be prevalent in all subjects. The presence of one or more modifiable risk factors in every adolescent point toward the dire need of school-based interventions for the prevention of NCDs in future adults.

Cardiovascular Risk Assessment among Patients with Hypertension Presenting at a Family Medicine Clinic in Southwest Nigeria

Aims:To determine the 10-year cardiovascular risk (CV) and its association with socio-demographic characteristics of hypertensive patients. Study Design:This was across-sectional study.Place and Durationof Study:Family Medicine Clinic of the University College Hospital, Ibadan, Nigeria, between June 2013 and September 2013.Methodology:We included 345 hypertensive patients (84 men, 261 women) aged 30 years and above with no clinical history suggestive of cardiovascular disease. Data collection was with an interviewer-administered semi-structured questionnaire, physical examination and blood investigation. CV risk was determined by using General Framingham cardiovascular risk profile for use in primary care Results:The mean+SD age of the 345 respondents was 57.4+9.7 years and 75.7% were female. High proportion of the respondents (42.3%) were in the high CV risk category of 10-year risk for cardiovascular disease while 27.0% and 30.7% had intermediate and low CV risk respectively. CV risk was significantly associated with age (p < .001), sex (p < .001), family type (p= .047), level of education (p=.02), employment status (p<.001) and occupational class (p=.007). Logistic regression showed advanced age (OR=0.014, 95% CI =0.002-0.094) and male gender (OR=26.765, 95% CI = 8.802-81.383) as the predictors of high CV risk. Conclusion:The findings show that CV risk assessment should be part of patients’ evaluation by physicians and necessary intervention should be instituted on time in order to reduce the burden of cardiovascular disease in Nigeria.

Trocar-site hernia after gynecological laparoscopic surgery: a 20-year, single-center experience / 中华医学杂志(英文版)

Background@#Trocar-site hernia (TSH) is a serious complication after laparoscopic procedures. Although it is a rare entity, it can have life-threatening consequences. This study aimed to retrospectively analyze the potential associated factors for TSH following gynecologic laparoscopy and summarize prevention strategies based on our experience.@*Methods@#We searched for gynecological laparoscopic surgeries in the medical records system of Peking Union Medical College Hospital (PUMCH) from August 1998 to July 2018 and further sifted through the results for cases involving TSH. All included patients were divided into different groups according to patient characteristics, and the rate of TSH was compared among groups. Moreover, the detailed information of all patients with TSH was recorded and analyzed. Statistical analyses were performed with GraphPad Prism 6.@*Results@#The approximate total rate of post-operative TSH among gynecologic laparoscopy procedures performed at PUMCH in the last 20 years was 0.016% (9/55,244). The rate of TSH was significant higher in elder patients (≥60 years old; 3/2686, 0.112%) than in younger patients (<60 years old, 6/52,558; 0.011%, P = 0.008). Moreover, the approximate rate of TSH was significantly higher after single-incision laparoscopic surgery (SILS, 2/534, 0.357%) than conventional laparoscopic surgery (7/54,710, 0.013%, P = 0.003). The average age of patients with TSH was 53.4 years (range, 35.0-79.0 years). Two of the nine patients had late-onset TSH following SILS; the other seven had early-onset TSH following conventional laparoscopy. Five TSH cases occurred at right lateral port sites, and the remaining three occurred at the umbilical port site. All patients underwent repair surgery, and one required small bowel resection.@*Conclusion@#Older age and SILS are potential associated factors for TSH development, while reducing excessive manipulation and improving suturing skills, especially at the umbilical trocar site following SILS and the right lateral trocar site, can avoid herniation.

Correlation between serum alkaline phosphatase level and early functional outcomes in young patients with acute ischemic stroke / 国际脑血管病杂志

Objective To investigate the correlation between serum alkaline phosphatase (ALP) level and early functional outcomes in young patients with acute ischemic stroke. Methods From January 2017 to December 2018, consecutive young patients (18-45 years old) with acute ischemic stroke admitted to the Department of Neurology, Fuyang People's Hospital were enrolled. According to the modified Rankin Scale score at discharge or on the 14th day of hospitalization (whichever occurs first), the patients were divided into poor outcome group ( > 2) and good outcome group (0-2). Multivariate logistic regression analysis was used to determine the independent correlation between the serum ALP level and outcomes. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of baseline serum ALP level for poor outcomes. Results A total of 200 young patients with acute ischemic stroke were enrolled, and 138 (69. 0％) in the good outcome group and 62 (31. 0％) in the poor outcome group. Univariate analysis showed that the serum ALP level (87. 72 ±25. 60 U/L vs. 81. 70 ±22. 95 U/L; t = -4. 464, P < 0. 001) and baseline National Institutes of Health Stroke Scale (NIHSS) score (median and interquartile range: 9 [8- 12] vs. 2 [1-4]; Z = -10. 540, P < 0. 001) in the poor outcome group were significantly higher than those in the good outcome group. Multivariate logistic regression analysis showed that high serum ALP levels (odds ratio 1. 030, 95％ confidence interval 1. 001-1. 060; P = 0. 040) and high baseline NIHSS score (odds ratio 2. 387, 95％ confidence interval 1. 799-3. 142; P < 0. 001) were the independent risk factors for early poor outcomes. ROC curve analysis showed that the optimal cut-off value of the baseline serum ALP level predicting poor outcome was 86. 25 U/L, and its sensitivity and specificity were 53. 2％ and 79. 7％, respectively. Conclusions High serum ALP level is independently associated with poor early outcomes in young patients with acute ischemic stroke. Baseline serum ALP level has certain predictive value for poor outcomes.

TheMRIevaluationandriskfactorsanalysisofchronicinjuryof medialcollateralligamentinpatientswithosteoarthritis / 实用放射学杂志

Objective Toexploretheriskfactorsofchronicinjuryofmedialcollateralligament(MCL)inpatientswithosteoarthritis(OA). Methods Thestudywasconductedretrospectivelyandatotalof191patientsinourhospitalfromFebruary2017toApril2018were collected,amongthem,86casesofOApatientswithchronicinjuryofMCLastheobservationgroup,42casesofpatientswithacute MCLinjurycausedbytraumaasthecontrolgroup1,63casesofOApatientswithoutMCLinjuryascontrolgroup2.TheMRImanifestationsof kneejointsintheobservationgroupandthecontrolgroup1werecompared,thedifferencesofthedamagemechanismsbetweenthe twogroupswereanalyzed.TheMRImanifestationsandrelatedclinicaldataoftheobservationgroupandthecontrolgroup2wereanalyzed,and thefactorsthatmightcausethechronicinjuryofMCL wereidentifiedbyunivariateregressionanalysis,thenwereincludedinthe non-conditional L o g istic regression m odel for m ultivariate analysis and the risk factors and protective factors of chronic injury of MCLwerefinallyscreenedout.Results Thedifferencesinthe MRImanifestationsbetweentheobservationgroupandthecontrol group1,includingthegradingoftheMCLinjury,thegradingandthedislocationofmedialmeniscus,thedistributionofbonemarrow edema,theanteriorandposteriorcruciateligamentinjuriesandthestenosistypesofthejointspacewerestatisticallysignificant(P<0.05).The resultsrevealedthatthechronicinjuryofMCLwasrelatedtoage,sex,medialmeniscusdislocation,thegradingofmedialmeniscus, osteophyte,anteriorcruciateligamentinjury,posteriorcruciateligamentinjury,andthestenosistypeofthejointspaceusingtheunivariateanalysis (P<0.05).Theresultsrevealedthatosteophyte(OR=38.231,95%CI:6.573-222.370),medialmeniscusdislocation (OR=6.504, 95%CI:1.508-28.046),anteriorcruciateligamentinjury(OR=7.236,95%CI:1.188-44.090)wereriskfactorsforchronicinjury ofMCLinOApatientsandlateraljointspacestenosis(OR=0.014, 95%CI:0.002-0.092)andpatella-femoraljointspacestenosis (OR=0.006,95%CI:0.000-0.071)wereprotectivefactorsusing multiple L o g istic regression model.Conclusion Thepathogenicfactorsaredifferentbetweenchronicinjuryof MCLin OA patients andacuteinjuryofMCL.Osteophyte,medialmeniscusdislocation,anteriorcruciateligamentinjuryareriskfactorsforchronicinjury ofMCLinOApatients,andlateraljointspacestenosisandpatella-femoralspacestenosisareprotectivefactors.