Search

Abstract Background Ghana is a malaria-endemic country with the entire population at risk. The Northern region of the country recorded the highest malaria case fatality rate (CFR) for two consecutive years: 1.11% in 2013 and 1.07% in 2014. Even though the National Malaria Elimination Programme (NMEP) has achieved a reduction in malaria mortality, the existence of high case fatality in the Northern region was alarming. This study, therefore, aimed to determine the factors associated with malaria mortality in the northern region of Ghana to institute control measures. Methods An unmatched case control study was conducted from July 2015 to August 2015. The study population consisted of patients admitted to health facilities for severe malaria in the Northern region of Ghana. A case was defined as a patient diagnosed with severe malaria at an eligible health facility who died as a result of malaria. A control was a patient diagnosed with severe malaria admitted to an eligible health facility who did not die. Health facilities that recorded CFRs of 1.0% and above were randomly sampled for this study, after which, 10 cases and 20 controls were recruited from each health facility. Information on cases and controls was then abstracted from hospital records using an electronically deployed abstraction tool. Continuous variables were expressed as means and medians, and categorical variables as frequencies and proportions. Multivariable logistic regression was used to assess the strength of the association between malaria mortality and factors predictive of malaria mortality. A p-value of

Background: Ghana is a malaria-endemic country with the entire population at risk. The Northern region of the country recorded the highest malaria case fatality rate (CFR) for two consecutive years: 1.11% in 2013 and 1.07% in 2014. Even though the National Malaria Elimination Programme (NMEP) has achieved a reduction in malaria mortality, the existence of high case fatality in the Northern region was alarming. This study, therefore, aimed to determine the factors associated with malaria mortality in the northern region of Ghana to institute control measures. Methods: An unmatched case control study was conducted from July 2015 to August 2015. The study population consisted of patients admitted to health facilities for severe malaria in the Northern region of Ghana. A case was defined as a patient diagnosed with severe malaria at an eligible health facility who died as a result of malaria. A control was a patient diagnosed with severe malaria admitted to an eligible health facility who did not die. Health facilities that recorded CFRs of 1.0% and above were randomly sampled for this study, after which, 10 cases and 20 controls were recruited from each health facility. Information on cases and controls was then abstracted from hospital records using an electronically deployed abstraction tool. Continuous variables were expressed as means and medians, and categorical variables as frequencies and proportions. Multivariable logistic regression was used to assess the strength of the association between malaria mortality and factors predictive of malaria mortality. A p-value of < 0.05 was considered statistically significant. Results: In all, a total of 95 cases and 190 controls participated in this study. The median ages of cases and controls were 4.1 years (IQR = 21.6) and 5.7 years (IQR = 18.2), respectively. Fifty-four (56.8%) cases were females, while 93 (49.0%) of the controls were females. Factors associated with malaria mortality included: duration of hospital stay less than 24 h [aOR: 12.0, 95% CI (5.9–24.6)], severe pallor [aOR: 2.3, 95% CI (1.1–4.6)], children under 5 years [aOR: 2.8, 95% CI (1.4–5.6)], oral Artesunate/Amodiaquine administration [aOR: 0.4, 95% CI (0.2–0.9)] and sepsis as an additional diagnosis [aOR: 4.1, 95% CI (1.8–9.5)]. Conclusion: Predictors of malaria mortality in the Northern region include children under 5 years, severe pallor, sepsis as an additional diagnosis, and use of oral anti-malarial. Patients with severe pallor and sepsis as co-morbidities should receive proactive management. The NMEP and its partners should implement measures to strengthen the referral system, anaemia prevention and management, and retrain health workers on malaria case management. Malaria control interventions targeted at under five children in the region should be reviewed and enhanced. [ABSTRACT FROM AUTHOR]

Knowledge about neighborhood characteristics that predict disease burden can be used to guide equity-based public health interventions or targeted social services. We used a case-control design to examine the association between area-level social vulnerability and severe COVID-19 using electronic health records (EHR) from a regional health information hub in the greater Philadelphia region. Severe COVID-19 cases (n = 15,464 unique patients) were defined as those with an inpatient admission and a diagnosis of COVID-19 in 2020. Controls (n = 78,600; 5:1 control-case ratio) were a random sample of individuals who did not have a COVID-19 diagnosis from the same geographic area. Retrospective data on comorbidities and demographic variables were extracted from EHR and linked to area-level social vulnerability index (SVI) data using ZIP codes. Models adjusted for different sets of covariates showed incidence rate ratios (IRR) ranging from 1.15 (95% CI, 1.13–1.17) in the model adjusted for individual-level age, sex, and marital status to 1.09 (95% CI, 1.08–1.11) in the fully adjusted model, which included individual-level comorbidities and race/ethnicity. The fully adjusted model indicates that a 10% higher area-level SVI was associated with a 9% higher risk of severe COVID-19. Individuals in neighborhoods with high social vulnerability were more likely to have severe COVID-19 after accounting for comorbidities and demographic characteristics. Our findings support initiatives incorporating neighborhood-level social determinants of health when planning interventions and allocating resources to mitigate epidemic respiratory diseases, including other coronavirus or influenza viruses. [ABSTRACT FROM AUTHOR]

Influenza vaccination is the most cost-effective strategy for influenza prevention. Influenza vaccines have been found to be effective against symptomatic and medically attended outpatient influenza illnesses. However, there is currently a lack of data regarding the effectiveness of inactivated influenza vaccines in Chongqing, China. We conducted a prospective observational test-negative design study. Outpatient and emergency cases presenting with influenza-like illnesses (ILI) and available influenza reverse transcription polymerase chain reaction (RT-PCR) were selected and classified as cases (positive influenza RT-PCR) or controls (negative influenza RT-PCR). A total of 7,307 cases of influenza and 7,905 control subjects were included in this study. The overall adjusted influenza vaccine effectiveness (IVE) was 44.4% (95% confidence interval (CI): 32.5–54.2%). In the age groups of less than 6 years old, 6–18 years old, and 19–59 years old, the adjusted IVE were 32.2% (95% CI: 10.0–48.9%), 48.2% (95% CI: 30.6–61.4%), and 72.0% (95% CI: 43.6–86.1%). The adjusted IVE for H1N1, H3N2 and B (Victoria) were 71.1% (95% CI: 55.4–81.3%), 36.1% (95% CI: 14.6–52.2%) and 33.7% (95% CI: 14.6–48.5%). Influenza vaccination was effective in Chongqing from 2018 to 2022. Evaluating IVE in this area is feasible and should be conducted annually in the future.

Abstract Background Cerebral palsy, a prevalent childhood physical disability, exhibits complex multifactorial causes. This case-control study explores the role of parental age in cerebral palsy risk and associated patterns. Methods A case-control study comparing children with cerebral palsy at ages 3 months to 3 years with age-matched healthy control subjects was conducted between January 2022 and August 2023 at Federal Medical Centre, Abeokuta, Nigeria. Cases were recruited from the pediatric physiotherapy outpatient clinic, while controls were selected from pediatric and children emergency wards. Data were collected retrospectively from electronic medical records. Risk factors were evaluated using conditional logistic regression models. Results We studied 134 subjects with cerebral palsy and 134 age-matched control subjects. Significant risk factors for cerebral palsy included the maternal age 35–39 years (odds ratio 2.16, P < 0.005), maternal age ≥ 40 years (odds ratio 3.83, P < 0.005), paternal age 41–45 (odds ratio 2.00, P < 0.05), paternal age ≥ 46 (odds ratio 6.80, P < 0.05), primiparous (odds ratio 2.2, P < 0.05), paternal low income (odds ratio 2.49, P < 0.05), paternal primary education (odds ratio 24.61, P < 0.05), and maternal primary education (odds ratio 2.39, P < 0.05). Conclusions This research contributes to our understanding of parental age as risk factors associated with cerebral palsy in children. The results also underscore the importance of demographic and socioeconomic factors, especially father’s level of income, maternal parity, and parental education. These findings can guide future research and public health interventions aimed at reducing the burden of cerebral palsy.

Background: Cerebral palsy, a prevalent childhood physical disability, exhibits complex multifactorial causes. This case-control study explores the role of parental age in cerebral palsy risk and associated patterns. Methods: A case-control study comparing children with cerebral palsy at ages 3 months to 3 years with age-matched healthy control subjects was conducted between January 2022 and August 2023 at Federal Medical Centre, Abeokuta, Nigeria. Cases were recruited from the pediatric physiotherapy outpatient clinic, while controls were selected from pediatric and children emergency wards. Data were collected retrospectively from electronic medical records. Risk factors were evaluated using conditional logistic regression models. Results: We studied 134 subjects with cerebral palsy and 134 age-matched control subjects. Significant risk factors for cerebral palsy included the maternal age 35–39 years (odds ratio 2.16, P < 0.005), maternal age ≥ 40 years (odds ratio 3.83, P < 0.005), paternal age 41–45 (odds ratio 2.00, P < 0.05), paternal age ≥ 46 (odds ratio 6.80, P < 0.05), primiparous (odds ratio 2.2, P < 0.05), paternal low income (odds ratio 2.49, P < 0.05), paternal primary education (odds ratio 24.61, P < 0.05), and maternal primary education (odds ratio 2.39, P < 0.05). Conclusions: This research contributes to our understanding of parental age as risk factors associated with cerebral palsy in children. The results also underscore the importance of demographic and socioeconomic factors, especially father's level of income, maternal parity, and parental education. These findings can guide future research and public health interventions aimed at reducing the burden of cerebral palsy. [ABSTRACT FROM AUTHOR]

Introduction: Asphyxia at birth remains the leading cause of neonatal morbidity and mortality worldwide, accounting for ∼23% of all neonatal deaths. Although the causes vary from country to country, early identification and treatment of risk factors can improve the situation. Objectives: To determine the risk factors of birth asphyxia in hospital-delivered neonates in Dodoma, Tanzania. Methods: A matched case-control study was conducted from May to July 2017 at Dodoma Region Referral Hospital. Data were collected using a semistructured questionnaire and a standard antenatal care index card. Cases were neonates diagnosed with asphyxia at birth (N = 100), while controls were neonates not diagnosed with asphyxia at birth (N = 300). A binary logistic regression model was used to assess the independent variables associated with birth asphyxia and reported as crude and adjusted odds ratios along with their 95% confidence intervals. Results: A total of 400 newborns and their birth mothers were involved in the study. The average age of the case mothers was 26.9 years (SD = 7.85) and that of the control mothers was 27.24 years (SD = 6.08). Place of residence, anemia, maternal age, prenatal visits attended, use of herbs during labor, previously complicated pregnancy, duration of labor, meconium-stained amniotic fluid, and mode of delivery were predictors of birth asphyxia. Conclusion: The study showed that most predictors of birth asphyxia can be prevented. The results suggest appropriate health education before conception, effective follow-up through prenatal care, early identification and treatment of high-risk pregnant women, and proper monitoring of labor and delivery. [ABSTRACT FROM AUTHOR]

Background: Dengue fever is a serious health problem that burdens public health and the economy. The aims to analyzing the risk factors for dengue fever in endemic areas in Sikka Regency. Methodology: This research uses a case control study design with a ratio of 1:1. Cases are families whose members were diagnosed with dengue fever based on positive dengue NS1/IGM laboratory results (132). Controls are families whose members do not suffer from dengue fever coming from the same group as cases (132). Multivariate analysis with logistic regression in the STATA application. Results: The total number of cases was 132 cases, (51%) male, with the majority in the 5–15-year age group (39.3%). House Index (62.5%), Breteau Index (386%), Container Index (49.93%), ABJ (37.5%). Multivariate analysis of variables that were risk factors were knowledge (AOR 2.48; 95% CI, 1.128- 4.928), habit of hanging up used clothes with value (AOR 2.93; 95% CI, 1.292 - 6.688), habit of storing water. in open containers (AOR 2.53; 95% CI, 1, 257- 5.090), residential density (AOR 2.20; 95% CI, 1.153 – 4.229), and the dominant risk factor is larval density (AOR 13.97; 95% CI, 6.793 – 28.735) with a probability (96.8%) of causing dengue fever. Conclusions: Behavioral factors that influence the incidence of dengue fever are knowledge, attitude, the habit of hanging up used clothes, the habit of storing water in open containers, and the habit of not draining water containers regularly, while wearing long-sleeved clothes and the use of medication have no influence on the incidence of dengue fever.

Objective: This study investigated the association between Coronavirus Disease 2019 mRNA vaccination and stroke in Qatar. Methods: Between December 1, 2020, and April 11, 2023, a matched case-control study was conducted to investigate the association between 3036 acute stroke cases and 3036 controls drawn from the entire population of Qatar. Results: The adjusted odds ratio (aOR) for vaccination among cases compared to controls was 0.87 (95% CI: 0.75-1.00). The aOR was 0.74 (95% CI: 0.45-1.23) for a single vaccine dose, 0.87 (95% CI: 0.73-1.04) for primary-series vaccination (two doses), and 0.91 (95% CI: 0.66-1.25) for booster vaccination (three or more doses). The aOR was 0.87 (95% CI: 0.72-1.04) for BNT162b2 and 0.86 (95% CI: 0.67-1.11) for mRNA-1273. Subgroup analyses, considering different durations since vaccination, also demonstrated no association. Subgroup analyses based on nationality, age, number of coexisting conditions, or prior infection status yielded similar results. Subgroup analysis, stratified by stroke type, suggested an association between vaccination and cerebral venous sinus thrombosis (aOR of 2.50 [95% CI: 0.97-6.44]), but it did not reach statistical significance. Conclusion: There was no evidence of an increased risk of stroke following vaccination, both in the short term and in the long term, extending beyond a year after receiving the vaccine.

Pulmonary tuberculosis is an infectious disease that is a health problem in the world. In Indonesia, most cases of tuberculosis attack the productive age. Cases of pulmonary tuberculosis in Rantau Alai District in 2022 amounted to 380 cases, with the number of positive cases as many as 29 cases resulting in disability in the lungs and extrapulmonary organs and even death. The purpose of this study was to analyze the relationship between knowledge and behavior of the host with the incidence of pulmonary tuberculosis at productive age in Rantau Alai Subdistrict, Ogan Ilir Regency. This study used a case-control design with 108 respondents selected by simple random sampling. Then, the data analysis test was carried out, namely the chi-square test and multiple logistic regression test. The results showed that there was a significant relationship between knowledge (p-value0.001), household contact (p-value

Abel Teklit Haile,1,2 Robel Gemechu Haile,1– 3 Esrom Hagos Gebrehiwot,1– 3 Eden Workalemahu Abeje1– 3 1Research Department, Saint Peter Specialized Hospital, Addis Ababa, Ethiopia; 2Department of Internal Medicine, Wollo University, Dessie, Ethiopia; 3School of Public Health, Gamby Medical and Business College, Addis Ababa, EthiopiaCorrespondence: Abel Teklit Haile, Email teklitabelhaile@gmail.com; Robel Gemechu Haile, School of Public Health, Gamby Medical and Business College, Addis Ababa, Ethiopia, Email robelgemechu439@gmail.comBackground: The association of COVID-19 with venous thromboembolism is of particular interest as there are reports that have associated thrombotic events with the pandemic. COVID-19 may predispose to venous thromboembolism. There is initial evidence suggesting that individuals with COVID-19 may be more prone to developing venous thromboembolism (VTE). This study aims to assess venous thromboembolism and associated factors in 19 patients admitted to Addis Ababa’s field hospital for COVID-19.Objective: To identify associated factors that affect the development of thromboembolism in patients admitted with the diagnosis of COVID-19.Methods: To determine the risks of VTE patients, an institution-based case control research was conducted using SPSS version 26, multivariable binary logistic regression analysis was used.Results: Significant factors associated with the development of VTE in COVID-19 patients included having a severe case (AOR = 0.38, 95% CI = 0.149– 0.961), risk factors for VTE (AOR = 2.57, 95% CI = 1.18– 5.33), diabetes (AOR = 3.745, 95% CI = 1.715– 8.176), chest pain (AOR = 4.13, 95% CI = 1.89– 9), stage 1 hypertension levels (AOR = 3.67, 95% CI = 1.37– 9.836), and hospital anticoagulation (AOR = 11.78, 95% CI = 5.25– 26.4).Conclusion: The results of VTE in individuals with COVID-19 imply a direct association between severe COVID-19 and diabetes, having risk factors, hypertension, and hospital anticoagulation.Keywords: COVID-19, venous thromboembolism, case control, logistic regression, Addis Ababa, Ethiopia

Purpose: Fracture blisters, a common soft-tissue complication of pilon fractures, are associated with post-operative wound infections, delays in definitive fixation, and alterations in surgical plan. The purpose of this study was to (1) identify the delay in surgery attributable to the presence fracture blisters and (2) investigate the relationship of fracture blisters to comorbidities and fracture severity. Methods: Patients with pilon fractures at an urban level 1 Trauma center from 2010 to 2021 were identified. The presence or absence of fracture blisters was noted, along with location. Demographic information, time from injury to external fixator placement, and time to definitive open reduction internal fixation (ORIF) were collected. Pilon fractures were classified according to AO/OTA guidelines using CT imaging and plain radiographs. Results: 314 patients with pilon fractures were available for analysis, eighty (25%) of whom were found to have fracture blisters. Patients with fracture blisters had longer time to surgery compared to those without fracture blisters (14.2 days vs 7.9 days, p < 0.001). A greater proportion of patients with fracture blisters had AO/OTA 43C fracture patterns, compared with those without fracture blisters (71.3% vs 53.8%, p = 0.03). Fractures blisters were less likely to be localized over the posterior ankle (12%, p = 0.007). Conclusion: The presence of fracture blisters in pilon fractures are associated with significant delays in time to definitive fixation and higher energy fracture patterns. Fracture blisters are less commonly located over the posterior ankle which may support the implementation of a staged posterolateral approach when managing these injures. [ABSTRACT FROM AUTHOR]

Background: This study aimed to explore the diagnostic value of serum adenosine deaminase (ADA) in patients with myelodysplastic syndromes (MDS) and identify potential risk factors for MDS. Methods: Eighty patients with MDS and 80 healthy individuals were included. The serum ADA level was found to be significantly higher in patients with MDS compared with that of healthy controls (p = 0.014). Results: The receiver operator characteristic curve (ROC) for ADA had an area under curve (AUC) of 0.807 (p = 0.0018). Serum ADA level of 4.5 U/L had a sensitivity of 71.43% and specificity of 80% for MDS diagnosis. The multivariate analysis showed hemoglobin (Hb, OR = 1.322, 95% CI: 1.035 - 2.323, p = 0.039), prothrombin time (PT, OR = 1.524, 95% CI: 1.156 - 3.280, p = 0.042), fibrinogen (OR = 1.335, 95% CI: 1.022 - 2.775, p = 0.027), calculated international normalized ration (INR, OR = 2.212, 95% CI: 1.320 - 3.085, p = 0.038), D-dimer (OR = 2.043, 95% CI: 1.623 - 4.293, p = 0.038), fibrin degradation product (FDP, OR = 2.525, 95% CI: 1.129 - 3.340, p = 0.029), and serum ADA (OR = 2.057, 95% CI: 1.248 - 3.572, p = 0.033) were independently associated with MDS. Conclusions: Serum ADA might be a potential biomarker in the diagnosis of MDS. Serum ADA level, Hb level, PT, fibrinogen level, INR, D-dimer, and FDPs were independent risk factors of MDS. [ABSTRACT FROM AUTHOR]

Background: Neonatal seizure is a common medical emergency that signals severe insult to the neonatal brain. It is a major risk factor for neonatal morbidity and mortality. It has a wide worldwide variation, ranging from 5 per 1000 live births in the United States of America to 39.5 per 1000 live births in Kenya. To decrease this significant figure, it is better to investigate its causes further. Therefore, this study aimed to assess its determinants since there was no prior evidence about it in the context of study area. Objective: Aim to assess the determinants of neonatal seizures among neonates admitted to neonatal intensive care units in the Awi Zone Hospitals, 2023. Methods: An institution based unmatched case-control study was conducted on 531 admitted eligible neonates from January 1, 2023, to May 30, 2023. A pretested tool was employed to collect data. The collected data were coded, edited, and entered into Epi-data version 3.1 and then exported to SPSS 26. Chi-square and odds ratios were used to assess the relationship between factors associated with the occurrence of neonatal seizure. Model goodness of fit was tested by Hosmer and Lemeshow. Bivariate and multivariate analysis was declared at P 37.5 °C [AOR; 4.82 (95 %, CI: 1.82–12.76)], blood glucose level 37.5 °C, blood glucose level

Introduction: Birth asphyxia is one of the leading causes of neonatal mortality, which accounts for around 24 % of overall neonatal mortality. Neonatal death usually results from preventable factors. Thus, this study has aimed to identify the determinant factors of birth asphyxia among newborns in South Gondar Zone public hospitals. Methods: Institution based unmatched case control study and systematic random sampling technique was conducted in South Gondar zone public hospitals from March October 2021 to May 20/2021. A pretested interviewer administered questionnaire and a data retrieving checklist was used for data collection. Cases were selected if one of the following was present at birth: (gasping, no breathing, or breathing rate of below 30 per minute). Epidata version 4.6 software was used for data entry and bivariate logistic regression and multivariable logistic regression techniques were used for data analysis using SPSS version 23. Result: In this study, Instrumental delivery (AOR = 3.19, 95%CI: 1.23–8.36), labor abnormality (AOR = 3.24, 95%CI: 1.31–8.03), cord prolapse (AOR = 7.06, 95%CI:2.25–22.50),APH (AOR = 4.68,95%CI:2.00–10.95) and preterm birth (AOR = 3.84,95%CI:1.32–11.20) were predictors of birth asphyxia. Conclusion: Labor abnormality, ante-partum hemorrhage, cord prolapse, instrumental delivery and preterm birth were independent predictors of birth asphyxia.

Besufekad Mulugeta,1 Esubalew Tesfahun,2 Tadesse Mamo,2 Erzik Mohammaed,1 Ermiyas Endewent,1 Mollawork Ayele1 1Department of Internal Medicine, Debre Berhan University, Debre Berhan, Ethiopia; 2Department of Epidemiology, Debre Berhan University, Debre Berhan, EthiopiaCorrespondence: Besufekad Mulugeta, Department of Internal Medicine, Debre Berhan University, 445, Debre Berhan, Ethiopia, Tel +251913625319, Email besufekad521@gmail.com; besufikadmulugeta@dbu.edu.etBackground: Community-acquired pneumonia among adults remains an important cause of morbidity and mortality in both industrialized and developing countries, including Ethiopia. Moreover, despite the availability of the best clinical standards, morbidity and mortality from community-acquired pneumonia have not improved over the last few decades. Therefore, prompt assessment and correction of modifiable risk factors are crucial to reduce morbidity and mortality. However, there are limited data on the determinants of community-acquired pneumonia among adults in the current study area.Purpose: This study aimed to identify the determinants of community-acquired pneumonia among adult patients visiting Debre Berhan University Hospital, Ethiopia, May 2023.Methods: A hospital-based unmatched case–control study design was conducted to select 113 cases and 113 controls using a consecutive sampling technique. Using the SPSS version 25 software bi-variable and multivariable logistic regression analyses were performed to identify the determinants of community-acquired pneumonia. Adjusted odds ratios with 95% confidence intervals and p-values < 0.05 were used to assess the level of significance.Results: In this study, recent history of common cold [AOR: 4.35, 95% CI: (2.22, 8.51)], recent history of toothache [AOR: 2.51, 95% CI: (1.18, 5.33)], and not brushing teeth regularly [AOR, 2.79; 95% CI: (1.32, 5.88)] were significantly associated with community-acquired pneumonia.Conclusion: In this study, common cold, recent history of toothache, and lack of regular oral hygiene were significantly associated with community acquired pneumonia in adults. Therefore, health promotion of oral hygiene and the common cold is recommended to decrease the risk of pneumonia.Keywords: community acquired pneumonia, determinants, case control, oral hygiene

Belto Tebabal,1 Tadele Fentabil Anagaw,2 Ayinengida Adamu,3 Desta Debalkie Atnafu3 1Department of Public Health, Amhara Regional Health Bureau, Bahir Dar, Ethiopia; 2Department of Health Promotion and Behavioral Science, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia; 3Department of Health System Management and Health Economics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, EthiopiaCorrespondence: Tadele Fentabil Anagaw, Tel +251-927692916, Email tadele27@gmail.comBackground: Blood donation is a technique in which blood is collected from a healthy individual for transfusion to someone else. WHO estimates that it is necessary to donate blood to 2% to 3% of the country’s population to meet blood needs. However, blood donation remains challenging in developing countries.Objective: This study aimed to identify factors influencing blood donation practices among healthcare providers in public hospitals in Bahir Dar City.Methods: This institution-based unmatched case-control study was conducted in Bahir Dar City Public Hospitals from May 01 to May 25, 2022. Total sample size was 491 (123 cases and 368 controls) and then the study subject was selected by using simple random sampling technic and collect data through self-administered questionnaire. Bi-variable and multi-variable binary logistic regression analyses were used to determine the association between dependent and independent variables. Finally, the results are presented in charts and tables, and the AOR and CI are reported. Statistical significance was set at P < 0.05.Results: Fear of anemia (adjusted odds ratio (AOR): 0.02; 95% CI 0.007– 0.078), lack of opportunity (AOR: 0.42; 95% CI 0.22– 0.83), lack of time (AOR: 0.03; 95% CI, 0.005– 0.199), profession (AOR: 0.15; 95% CI, 0.05– 0.42), aware of free medical checkup (AOR: 31.79; 95% CI 13.13– 76.94), willingness to donate blood (AOR: 5.09; 95% CI 2.25– 11.50), blood group type (AOR: 5.67; 95% CI 1.42– 22.68), and higher work experience (AOR: 7.99; 95% CI 2.59– 24.67) were found to be significantly associated with blood donation practice.Conclusion: This study revealed that multiple factors influenced the practice of blood donation among healthcare providers. Therefore, access to blood donation areas and emphasizing the importance of donor blood donation are important for facilitating blood donation.Keywords: blood donation, blood donation practice, case control, health care providers

Introduction: The 2022-2023 highly pathogenic avian influenza (HPAI) H5N1 outbreak in the United States (U.S.) is the largest and most costly animal health event in U.S. history. Approximately 70% of commercial farms affected during this outbreak have been turkey farms. Methods: We conducted a case-control study to identify potential risk factors for introduction of HPAI virus onto commercial meat turkey operations. Data were collected from 66 case farms and 59 control farms in 12 states. Univariate and multivariable analyses were conducted to compare management and biosecurity factors on case and control farms. Results: Factors associated with increased risk of infection included being in an existing control zone, having both brooders and growers, having toms, seeing wild waterfowl or shorebirds in the closest field, and using rendering for dead bird disposal. Protective factors included having a restroom facility, including portable, available to crews that visit the farm and workers having access and using a shower at least some of the time when entering a specified barn. Discussion: Study results provide a better understanding of risk factors for HPAI infection and can be used to inform prevention and control measures for HPAI on U.S. turkey farms. [ABSTRACT FROM AUTHOR]

Background: Diabetic Retinopathy (DR) is one of the major microvascular complications of diabetes. Being a complex disease, it is important to delineate the genetic and environmental factors that influence the susceptibility to DR in a population. Therefore, the present study was designed to investigate the role of genetic and lifestyle risk factors associated with DR susceptibility in a North-Indian population. Methods: A total of 848 subjects were enrolled, comprising of DR cases (n = 414) and healthy controls (n = 434). The Sequenom MassARRAY technology was used to perform target genome analysis of 111 SNPs across 57 candidate genes and 14 intergenic region SNPs that are involved in the metabolic pathways associated with type 2 diabetes (T2D) and DR. Allele, genotype and haplotype frequencies were determined and compared among cases and controls. Logistic regression models were used to determine genotype-phenotype and phenotype-phenotype correlations. Results: The strongest association was observed with TCF7L2 rs12255372 T allele [p < 0.0001; odds ratio (OR) = 1.81 (1.44–2.27)] and rs11196205 C allele [p < 0.0008; OR = 1.62 (1.32–1.99)]. Genotype-phenotype and phenotype-phenotype correlations were found in the present study. Conclusion: Our study provides strong evidence of association between the TCF7L2 variants and DR susceptibility. Key points: Association of TCF7L2 rs12255372 and rs11196205 with Diabetic Retinopathy (DR). Association of lifestyle risk factors with DR. Genotype-Phenotype interactions among DR cases. [ABSTRACT FROM AUTHOR]

Studies can be observational or experimental. With an observational study, the investigator does not determine the assignment of subjects, and there might not be a control group. If there is a control group, assignment of the independent variable (exposure or intervention) is not under the control of the investigator. Observational studies can be rigorously conducted, but the lack of random assignment of the exposure/intervention introduces confounding and bias. Thus, the quality of evidence resulting from observational studies is lower than that of experimental randomized controlled trials (RCTs). An observational study might be performed if an RCT is unethical, impractical, or outside the control of the investigator. There are many types of prospective and retrospective observational study designs. However, an observational study design should be avoided if an experimental study is possible. Sophisticated statistical approaches can be used, but this does not elevate an observational study to the level of an RCT. Regardless of quality, an observational study cannot establish causality. [ABSTRACT FROM AUTHOR]

Silas Bukuno,1 Agunie Asholie,2 Zeleke Girma,3 Yusuf Haji2 1Resident at Ethiopian Field Epidemiology and Laboratory Training Program, School of Public Health, Hawassa University, Hawassa, Ethiopia; 2College of Medicine and Health Science, School of Public Health, Hawassa University, Hawassa, Ethiopia; 3Department of Public Health, School of Public Health, Arba Minch University, Arba Minch, EthiopiaCorrespondence: Silas Bukuno, Tel +251932-21-4757, Email bukunosilas@yahoo.comBackground: A measles outbreak can occur in the presence of an increased number of unvaccinated children; however, the vaccine was available many decades ago, and it is the foremost cause of child mortality, claiming 568 lives (mostly children) worldwide each day. The investigation was aimed at assessing the magnitude and identifying contributing factors for the measles outbreak in the Garda Marta District of Gamo Zone, Southwestern Ethiopia.Methods: From January 20 to February 10, 2022, a descriptive and unmatched case–control study was used to describe the measles outbreak and identify the associated risk factors for measles infection. The descriptive analysis employed all 140 cases from the line list, while the case–control study used 51 cases and 102 controls to investigate factors associated with measles infection. Epi-data version 4.6.0.6 was used to code and enter data, which was then exported to SPSS version 27 for analysis. A standardized questionnaire was used to collect data. To declare statistical significance for the association, multivariable logistic regression with an adjusted odds ratio (AOR) and 95% CI was used.Results: From a total of 140 measles cases reported from October 12, 2021, to March 09, 2022, 75 (54%) were females. Marta Laddo kebele was most affected (104 cases). Being unvaccinated (AOR: 2.84, 95% CI: 1.10– 7.32), having a travel history (AOR: 4.24, 95% CI: 1.61– 11.15), having a contact history (AOR: 6.34, 95% CI: 2.35– 17.40), being unaware of the mode of transmission (AOR: 2.68, 95% CI: 1.16– 6.37), and having moderate acute malnutrition (AOR: 4.44, 95% CI: 1.74– 11.31) were factors significantly associated with the measles outbreak.Conclusion: Being unvaccinated, travel history to measles outbreak area, contact history, knowledge of caretakers/mothers on the mode of transmission, and acute malnutrition were associated with the measles outbreak in the district. Therefore, strengthening routine measles immunization, mounting vaccination awareness and nutritional screening are recommended.Keywords: measles outbreak, case control, Garda Marta, South Ethiopia

BackgroundCurrently, limited attention has been directed toward utilizing clinical cohorts as a starting point to elucidate alterations in the lower respiratory tract (LRT) microbiota following influenza A virus (IAV) infection.ObjectivesOur objective was to undertake a comparative analysis of the diversity and composition of sputum microbiota in individuals afflicted by severe and critically ill influenza patients.MethodsSputum specimens were procured from patients diagnosed with IAV infection for the purpose of profiling the microbiota using 16S-rDNA sequencing. To ascertain taxonomic differences between the severe and critically ill influenza cohorts, we leveraged Linear Discriminant Analysis Effect Size (LEfSe). Additionally, Spearman correlation analysis was employed to illuminate associations between sputum microbiota and influenza Ct values alongside laboratory indicators.ResultsOur study encompassed a total cohort of 64 patients, comprising 48 within the severe group and 16 within the critically ill group. Intriguingly, Bacteroidetes exhibited significant depletion in the critically ill cohort (p=0.031). The sputum microbiomes of the severe influenza group were hallmarked by an overrepresentation of Neisseria, Porphyromonas, Actinobacillus, Alloprevotella, TM7x, and Clostridia_UCG-014, yielding ROC-plot AUC values of 0.71, 0.68, 0.60, 0.70, 0.70, and 0.68, respectively. Notably, Alloprevotella exhibited an inverse correlation with influenza Ct values. Moreover, C-reactive protein (CRP) manifested a positive correlation with Haemophilus and Porphyromonas.ConclusionThe outcomes of this investigation lay the groundwork for future studies delving into the connection between the LRT microbiome and respiratory disorders. Further exploration is warranted to elucidate the intricate mechanisms underlying the interaction between IAV and Alloprevotella, particularly in disease progression.

Simple Summary: Ductal carcinoma in situ (DCIS) is recognised as a precursor to invasive breast cancer (IBC), while lobular carcinoma in situ (LCIS) is considered a risk factor for subsequent IBC. To investigate whether the factors that increase the risks of DCIS and LCIS also predispose to IBC, we analysed risk factors for 3075 DCIS cases, 338 LCIS cases, and 1584 controls aged 35–60. Results showed that breastfeeding after childbirth decreased risks of DCIS and LCIS, similar to the association with IBC. Post-menopausal hormone replacement therapy (HRT) increased the risks of DCIS and LCIS, especially in long-term use (10+ years), with a stronger association with LCIS. However, neither parity nor an increasing number of births decreased the risks of DCIS or LCIS, as they do IBC. The study shows both similarities and differences in the risk factors affecting in situ breast cancer and IBC, and results suggest that regular surveillance is warranted in post-menopausal women taking long-term HRT. Ductal carcinoma in situ (DCIS) is widely accepted as a precursor of invasive ductal carcinoma (IDC). Lobular carcinoma in situ (LCIS) is considered a risk factor for invasive lobular carcinoma (ILC), and it is unclear whether LCIS is also a precursor. Therefore, it would be expected that similar risk factors predispose to both DCIS and IDC, but not necessarily LCIS and ILC. This study examined associations with risk factors using data from 3075 DCIS cases, 338 LCIS cases, and 1584 controls aged 35–60, recruited from the UK-based GLACIER and ICICLE case-control studies between 2007 and 2012. Analysis showed that breastfeeding in parous women was protective against DCIS and LCIS, which is consistent with research on invasive breast cancer (IBC). Additionally, long-term use of HRT in post-menopausal women increased the risk of DCIS and LCIS, with a stronger association in LCIS, similar to the association with ILC. Contrary to findings with IBC, parity and the number of births were not protective against DCIS or LCIS, while oral contraceptives showed an unexpected protective effect. These findings suggest both similarities and differences in risk factors for DCIS and LCIS compared to IBC and that there may be justification for increased breast surveillance in post-menopausal women taking long-term HRT. [ABSTRACT FROM AUTHOR]

Small for gestational age (SGA) is considered an adverse birth outcome. Per- and polyfluoralkyl substances (PFAS) have become increasingly investigated as contributing environmental factors, thus far with inconclusive results. The current study aimed to investigate the hypothesized association between increased maternal PFAS levels in early pregnancy and an increased risk for SGA birth. This population-based study used data from a sample of children born in Scania, Southern Sweden, between 1995 and 2009. Two groups were compared: cases born with SGA (n = 298) and non-SGA controls (n = 580). The cases consisted of two subgroups: one included women whose children's growth in late pregnancy was in the lowest quartile, and another included women from the remaining growth quartiles. Corresponding maternal serum samples were collected from a biobank and analyzed for concentrations of four types of PFAS: perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorohexane sulfonic acid (PFHxS), and perfluorooctane sulfonic acid (PFOS) using liquid chromatography–tandem mass spectrometry (LC/MS/MS). The results were combined with information from birth registers and analyzed using Mann–Whitney U-tests and logistic regression—unadjusted as well as adjusted for potential confounders. In conclusion, elevated maternal concentrations of PFAS were not associated with an increased risk of SGA birth. However, significant ORs were observed in a subgroup analysis restricted to women of Nordic origin (unadjusted OR 3.2 and adjusted OR 2.4) for PFHxS. [ABSTRACT FROM AUTHOR]

To compare the quality of life (QoL) of children with and without atopic dermatitis (AD) and that of their caregivers and to assess their QoL according to different degrees of AD. This is a cross-sectional, case–control study conducted with patients aged between 4 and 12 years with and without AD and their caregivers. Patients were treated at the Pediatric Dermatology Outpatient Center and the Childcare Center of the Joana de Gusmão Children's Hospital, respectively, from June 2021 to March 2022. The QoL Assessment Scale Autoquestionnaire Qualité de Vie Infant Imagé (AUQEI) was applied to children and adolescents with AD and the control group while the World Health Organization Quality of Life assessment instrument was administered to their caregivers. Fifty cases and fifty controls were included in this study. When assessing the QoL of the case and control groups, statistically significant differences were found in the domains of the AUQUEI instrument. Regarding QoL and AD severity, a statistically significant difference was seen (p = 0.027) when comparing moderate and severe SCORAD scores. When comparing the QoL of children with and without AD, a difference was seen between the two groups. The QoL of AD patients was worse and related to the severity of the disease. A better QoL was found among the caregivers in the control group. In the case group, the higher the SCORAD score, the worse the QoL. No relationship was found between AD severity and the QoL of the caregivers in the case group. [ABSTRACT FROM AUTHOR]

BACKGROUND: Carpal tunnel syndrome (CTS), the most common entrapment neuropathy in the upper extremity, is known to be a multi-factorial disease that raises medical and nonmedical risk factors. The aim of the current study was to determine the risk factors of CTS in patients attending the primary care center at a tertiary hospital. MATERIALS AND METHODS: A case–control study was conducted by reviewing all medical records of patients above the age of 18 years old diagnosed with CTS from 2015 to 2021. The selected cases were evaluated by physical examination and confirmed by a nerve conduction study. Cases and controls were matched by age, gender, and nationality, with a case-to-control ratio of 1:2. Odds ratios were calculated for association between carpel tunnel syndrome and various factors and Chi-sqauare test determined statistical significance. Multiple logistic regression was performed to adjust for confounding. RESULTS: The study recruited 144 cases with a mean age of 53.38 ± 12.20 years and 288 controls with a mean age of 53.80 ± 12.27 years. The majority of subjects were female (84.7%) and of Saudi nationality (68.3%). There was a significant difference in body mass index, employment status, number of years of employment, occupation, mean systolic blood pressure, mean low-density lipoprotein cholesterol level, and mean blood urea level between cases and controls (P < 0.05). Laboratory tests that were found to be significantly associated with CTS in univariate analysis were thyroid-stimulating hormone (crude odds ratio [COR] = 0.828) and urea level (COR = 0.802). In fully adjusted analyses, obesity (adjusted odds ratio [AOR] =3.080), chronic kidney disease (AOR = 3.629), and the use of corticosteroid (AOR = 0.470) were also significantly associated with CTS. CONCLUSION: Similar to the findings of other studies, this study identified several potential risk factors for CTS. More large-scale longitudinal studies are required to establish a precise causal association.

Abstract Background Sternal wound infection (SWI) post cardiac surgery remains an important cause of extra morbidity, mortality and cost. The objective was to identify risk factors for SWI in a cardiac centre in Eastern Saudi Arabia as part of the investigation into Surveillance variance in the local rates of SWI. Methods We included cases and controls from a cross section of patients who underwent major cardiac surgery between 2017 and 2020 matched for age, sex and time of surgery. An explanatory logistic regression model was fitted to estimate the risk factors. Results N = 204 (51 cases and 153 controls matching ratio 1:3, from a source population of 985 patients). factors significantly associated with SWI in the final multivariate model: hospital stay OR (1.05, Cl 1.01–1.10), Graft Conduit BIMA versus No Graft OR (10.94, Cl 1.60–74.63), transfusion of both packed cells plus other blood products versus no transfusion OR (3.53, Cl 93–13.44), HbA1c OR (1.09 Cl 0.84–1.41), BMI OR (1.25, Cl 1.04–1.50), perioperative blood glucose OR (1.02, Cl 1.004–1.03), surgery time OR (1.19, Cl 1.00–1.58). Conclusions The diverse aetiology, cross-disciplinary nature of SWI prevention, and despite improved prevention and control practices, including related care bundles with their proven value, SWI remain a serious challenge in cardiac surgery. Multidisciplinary consensus guidelines are well overdue.

Copyright of Eastern Mediterranean Health Journal is the property of World Health Organization and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background In the United States, influenza activity during the 2021–2022 season was modest and sufficient enough to estimate influenza vaccine effectiveness (VE) for the first time since the beginning of the coronavirus disease 2019 pandemic. We estimated influenza VE against laboratory-confirmed outpatient acute illness caused by predominant A(H3N2) viruses. Methods Between October 2021 and April 2022, research staff across 7 sites enrolled patients aged ≥6 months seeking outpatient care for acute respiratory illness with cough. Using a test-negative design, we assessed VE against influenza A(H3N2). Due to strong correlation between influenza and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination, participants who tested positive for SARS-CoV-2 were excluded from VE estimations. Estimates were adjusted for site, age, month of illness, race/ethnicity, and general health status. Results Among 6260 participants, 468 (7%) tested positive for influenza only, including 440 (94%) for A(H3N2). All 206 sequenced A(H3N2) viruses were characterized as belonging to genetic group 3C.2a1b subclade 2a.2, which has antigenic differences from the 2021–2022 season A(H3N2) vaccine component that belongs to clade 3C.2a1b subclade 2a.1. After excluding 1948 SARS-CoV-2–positive patients, 4312 patients were included in analyses of influenza VE; 2463 (57%) were vaccinated against influenza. Effectiveness against A(H3N2) for all ages was 36% (95% confidence interval, 20%–49%) overall. Conclusions Influenza vaccination in 2021–2022 provided protection against influenza A(H3N2)-related outpatient visits among young persons. [ABSTRACT FROM AUTHOR]

BACKGROUND: Carpal tunnel syndrome (CTS), the most common entrapment neuropathy in the upper extremity, is known to be a multi-factorial disease that raises medical and nonmedical risk factors. The aim of the current study was to determine the risk factors of CTS in patients attending the primary care center at a tertiary hospital. MATERIALS AND METHODS: A case--control study was conducted by reviewing all medical records of patients above the age of 18 years old diagnosed with CTS from 2015 to 2021. The selected cases were evaluated by physical examination and confirmed by a nerve conduction study. Cases and controls were matched by age, gender, and nationality, with a case-to-control ratio of 1:2. Odds ratios were calculated for association between carpel tunnel syndrome and various factors and Chi-sqauare test determined statistical significance. Multiple logistic regression was performed to adjust for confounding. RESULTS: The study recruited 144 cases with a mean age of 53.38 ± 12.20 years and 288 controls with a mean age of 53.80 ± 12.27 years. The majority of subjects were female (84.7%) and of Saudi nationality (68.3%). There was a significant difference in body mass index, employment status, number of years of employment, occupation, mean systolic blood pressure, mean low-density lipoprotein cholesterol level, and mean blood urea level between cases and controls (P < 0.05). Laboratory tests that were found to be significantly associated with CTS in univariate analysis were thyroid-stimulating hormone (crude odds ratio [COR] = 0.828) and urea level (COR = 0.802). In fully adjusted analyses, obesity (adjusted odds ratio [AOR] =3.080), chronic kidney disease (AOR = 3.629), and the use of corticosteroid (AOR = 0.470) were also significantly associated with CTS. CONCLUSION: Similar to the findings of other studies, this study identified several potential risk factors for CTS. More large-scale longitudinal studies are required to establish a precise causal association. [ABSTRACT FROM AUTHOR]

3-Monochloropropane-1,2-diol esters (3-MCPDE) are food contaminants commonly found in refined vegetable oils and fats, which have possible carcinogenic implications in humans. To investigate this clinically, we conducted an occurrence level analysis on eight categories of retail and cooked food commonly consumed in Malaysia. This was used to estimate the daily exposure level, through a questionnaire-based case-control study involving 77 subjects with renal cancer, with 80 matching controls. Adjusted Odds Ratio (AOR) was calculated using the multiple logistic regression model adjusted for confounding factors. A pooled estimate of total 3-MCPDE intake per day was compared between both groups, to assess exposure and disease outcome. Among the food categories analysed, vegetable fats and oils recorded the highest occurrence levels (mean: 1.91 ± 1.90 mg/kg), significantly more than all other food categories (p <.05). Risk estimation found the Chinese ethnic group to be five times more likely to develop renal cancer compared to Malays (AOR = 5.15, p =.001). However, an inverse association was observed as the 3-MCPDE exposure among the Malays (median: 0.162 ± 0.229 mg/day/person) were found to be significantly higher than the Chinese (p =.001). There was no significant difference (p =.405) in 3-MCPDE intake between the cases (median: 0.115 ± 0.137 mg/day/person) and controls (median: 0.105 ± 0.151 mg/day/person), with no association between high intake of 3-MCPDE and the development of renal cancer (OR = 1.41, 95% CI: 0.5091–2.5553). Thus, there was insufficient clinical evidence to suggest that this contaminant contributes to the development of renal malignancies in humans through dietary consumption. Further research is necessary to support these findings, which could have significant public health ramifications for the improvement of dietary practices and food safety measures. [ABSTRACT FROM AUTHOR]

IntroductionThe 2022–2023 highly pathogenic avian influenza (HPAI) H5N1 outbreak in the United States (U.S.) is the largest and most costly animal health event in U.S. history. Approximately 70% of commercial farms affected during this outbreak have been turkey farms.MethodsWe conducted a case-control study to identify potential risk factors for introduction of HPAI virus onto commercial meat turkey operations. Data were collected from 66 case farms and 59 control farms in 12 states. Univariate and multivariable analyses were conducted to compare management and biosecurity factors on case and control farms.ResultsFactors associated with increased risk of infection included being in an existing control zone, having both brooders and growers, having toms, seeing wild waterfowl or shorebirds in the closest field, and using rendering for dead bird disposal. Protective factors included having a restroom facility, including portable, available to crews that visit the farm and workers having access and using a shower at least some of the time when entering a specified barn.DiscussionStudy results provide a better understanding of risk factors for HPAI infection and can be used to inform prevention and control measures for HPAI on U.S. turkey farms.

The case-control design is widely used in retrospective database studies, often leading to spectacular findings. However, results of these studies often cannot be replicated, and the advantage of this design over others is questionable. To demonstrate the shortcomings of applications of this design, we replicate two published case-control studies. The first investigates isotretinoin and ulcerative colitis using a simple case-control design. The second focuses on dipeptidyl peptidase-4 inhibitors and acute pancreatitis, using a nested case-control design. We include large sets of negative control exposures (where the true odds ratio is believed to be 1) in both studies. Both replication studies produce effect size estimates consistent with the original studies, but also generate estimates for the negative control exposures showing substantial residual bias. In contrast, applying a self-controlled design to answer the same questions using the same data reveals far less bias. Although the case-control design in general is not at fault, its application in retrospective database studies, where all exposure and covariate data for the entire cohort are available, is unnecessary, as other alternatives such as cohort and self-controlled designs are available. Moreover, by focusing on cases and controls it opens the door to inappropriate comparisons between exposure groups, leading to confounding for which the design has few options to adjust for. We argue that this design should no longer be used in these types of data. At the very least, negative control exposures should be used to prove that the concerns raised here do not apply.

Background: Prior studies of the pharmacogenomics of osteonecrosis of the jaw (ONJ) have had various methodological limitations, including using candidate gene selection as their sole strategy, a small number of ONJ cases, or a study population based on an oncology setting. Objectives: The aim of our case-control study was to evaluate previously reported associations between genetic factors and ONJ, which were based on either genome-wide association studies (GWAS) or candidate gene approaches. Furthermore, we aimed to identify genetic risk factors for ONJ by using GWAS to determine single-nucleotide polymorphisms (SNPs) with statistically significant differences in frequency between ONJ patients and osteoporosis controls. Methods: Patients with medically confirmed ONJ and who were registered in the Scandinavian Cohort of ONJ patients were included. Controls from the general population were matched on age (±5 years), sex, and cumulative antiresorptive drug exposure. The ONJ diagnosis date for cases corresponded to the index date for matched controls. DNA isolation, genotyping, and data analyses were performed by Q2/EA Genomics using standard protocols and best practices. Blood or tissue samples for 55 ONJ cases and 125 controls were collected. Due to the low quality of the tissue samples, final analyses were based on blood samples of 40 ONJ cases and 124 controls. Results: We detected no significant genome-wide associations. Of the 43 SNPs with ONJ association in prior studies, none were replicated in our study. Conclusions: Even though our study sample is the largest to date, we had limited statistical power for GWAS but adequate power for replication analyses. Our study provides no evidence for any genetic predisposition to ONJ. Future studies could increase their statistical power by combining ONJ GWAS datasets and by performing a meta-analysis or pursuing a sequencing strategy in order to identify rare variants.

IntroductionAnxiety has been increasingly recognized as part of the psychosocial health issues in COVID-19 patients. However, the impact of this topic may be underestimated in low- and middle-income countries. This study aimed to estimate the prevalence of and risk factors of anxiety in COVID-19 patients compared to controls in a local tertiary teaching hospital in Malaysia.MethodsIn this case–control study, we analyzed data on adult patients aged 18 years and above hospitalized for COVID-19 infection with matched hospitalized controls. The demographic, clinical data and anxiety measures using the Generalized Anxiety Disorder-7 questionnaire were analyzed using univariate and multivariate analysis.Results86.6% in the COVID-19 group had anxiety, significantly higher than 13.4% in the control group (p = 0.001). The COVID-19 group was significantly associated with the GAD-7 severity (p = 0.001). The number of COVID-19 patients in the mild, moderate, and severe anxiety groups was 48 (84.2%), 37 (86%), and 18 (94.7%), respectively. Multiple logistic regression showed significant predictors for anxiety, including COVID-19 diagnosis and neurological symptoms. Anxiety was found 36.92 times higher in the patients with COVID-19 compared to those without COVID-19 (OR 36.92;95% CI 17.09, 79.78, p = 0.001). Patients with neurological symptoms were at risk of having anxiety (OR 2.94; 95% CI 1.03, 8.41, p = 0.044).DiscussionCOVID-19 patients experience a significant disruption in psychosocial functioning due to hospitalization. The burden of anxiety is notably high, compounded by a diagnosis of COVID-19 itself and neurological symptomatology. Early psychiatric referrals are warranted for patients at risk of developing anxiety symptoms.

Background: Iron deficiency anemia is common in congenital heart disease (CHD) children. The recent development of automated analyzers has made it possible to measure reticulocyte hemoglobin content (RET-He), which is thought to reflect iron content in reticulocytes. this study aims to investigate whether or not RET-He is a good indicator in comparison with other hematimetric and biochemical iron parameters in terms of diagnosing iron deficiency (ID) and iron deficiency anemia (IDA) in children with CHDs. Methods: This is a case-control study conducted in the pediatric cardiology clinic of Zagazig University hospitals on 60 patients with CHD (study group) and 30 ages– and sex-matched healthy children (control group) during the period of October 2018 to May 2019. The participants were subdivided according to iron status (serum iron and transferrin saturation) and blood hemoglobin levels(HGB). All subjects underwent history taking, clinical examination, echocardiography, and lab investigations for complete blood count (CBC), iron profile, and reticulocyte profiles. Results: RET-He shows a significant reduction in patients with CHD. It can be used to differentiate between Iron deficiency and Iron Deficiency Anemia. That was confirmed using ROC and the decision tree. Conclusions: The prediction of IDA in CHD children can be made based on the RET-He provided by automated analyzers without the requirement of additional biochemical investigations. [ABSTRACT FROM AUTHOR]

Autism is a condition manifested by persistent deficits in social communication and social interaction across multiple contexts, and, sensory processing difficulties may further affect childhood-occupation and hinders their overall development. This study examines the sensory-processing and childhood participation of children with autism (6 to 10 years), and 'age/gender-matched typical children as control. The Sensory Processing (SSP) and the Participation of childhood-occupation (PICO) measures were used to collect data from 93 parents of children with autism and 95 parents of typically-developing' children, recruited from hospitals, school and care centres. This study had 74 percent (n = 72) male participants (i.e. 4:1 male to female ratio) in the autism group, and found sensory processing difficulties were associated with specific childhood-participation limitation. Children with autism had lower participation (across level, frequency and enjoyment) than the typical children. Sensory-processing' difficulties for the children with autism (n = 93) were at 68.8 percent, compared to 21.5 percent in the typical group (n = 95), and were significantly different (p < 0.001). The differences in sensory-processing difficulties were significant (p < 0.05) between groups, across all domains, except for movement sensitivity (p > 0.28). Auditory filtering was the sole sensory-processing difficulty with significant correlations with all three dimensions of participation [i.e. difficulty (r = 0.36, p < 0.01), frequency (r = 0.22, p < 0.05) and enjoyment (r = 0.27, p < 0.01)]. Our finding highlighted that auditory-filtering difficulties is a key sensory processing difficulty, and it significantly lower the childhood-participation in the autism group. Adding to a growing body of literature on assessment in autism, there is a need for early screening, and to engage parents in early intervention to improve specific sensory processing deficits but also to focus on the child's strengths, for a comprehensive supportive care. [ABSTRACT FROM AUTHOR]

Bovine respiratory disease (BRD) is a major health problem within the global cattle industry. This disease has a complex aetiology, with viruses playing an integral role. In this study, metagenomics was used to sequence viral nucleic acids in the nasal swabs of BRD-affected cattle. The viruses detected included those that are well known for their association with BRD in Australia (bovine viral diarrhoea virus 1), as well as viruses known to be present but not fully characterised (bovine coronavirus) and viruses that have not been reported in BRD-affected cattle in Australia (bovine rhinitis, bovine influenza D, and bovine nidovirus). The nasal swabs from a case–control study were subsequently tested for 10 viruses, and the presence of at least one virus was found to be significantly associated with BRD. Some of the more recently detected viruses had inconsistent associations with BRD. Full genome sequences for bovine coronavirus, a virus increasingly associated with BRD, and bovine nidovirus were completed. Both viruses belong to the Coronaviridae family, which are frequently associated with disease in mammals. This study has provided greater insights into the viral pathogens associated with BRD and highlighted the need for further studies to more precisely elucidate the roles viruses play in BRD. [ABSTRACT FROM AUTHOR]

Background Adult studies have demonstrated within-season declines in influenza vaccine effectiveness (VE); data in children are limited. Methods We conducted a prospective, test-negative study of children 6 months through 17 years hospitalized with acute respiratory illness at 7 pediatric medical centers during the 2015–2016 through 2019–2020 influenza seasons. Case-patients were children with an influenza-positive molecular test matched by illness onset to influenza-negative control-patients. We estimated VE [100% × (1 – odds ratio)] by comparing the odds of receipt of ≥1 dose of influenza vaccine ≥14 days before illness onset among influenza-positive children to influenza-negative children. Changes in VE over time between vaccination date and illness onset date were estimated using multivariable logistic regression. Results Of 8430 children, 4653 (55%) received ≥1 dose of influenza vaccine. On average, 48% were vaccinated through October and 85% through December each season. Influenza vaccine receipt was lower in case-patients than control-patients (39% vs 57%, P <.001); overall VE against hospitalization was 53% (95% confidence interval [CI]: 46, 60%). Pooling data across 5 seasons, the odds of influenza-associated hospitalization increased 4.2% (−3.2%, 12.2%) per month since vaccination, with an average VE decrease of 1.9% per month (n = 4000, P =.275). Odds of hospitalization increased 2.9% (95% CI: −5.4%, 11.8%) and 9.6% (95% CI: −7.0%, 29.1%) per month in children ≤8 years (n = 3084) and 9–17 years (n = 916), respectively. These findings were not statistically significant. Conclusions We observed minimal, not statistically significant within-season declines in VE. Vaccination following current Advisory Committee on Immunization Practices (ACIP) guidelines for timing of vaccine receipt remains the best strategy for preventing influenza-associated hospitalizations in children. [ABSTRACT FROM AUTHOR]

BACKGROUND: Tracheostomy has many benefits for pediatric patients in the ICU, but it is also associated with complications. Accidental decannulation (AD) is a frequent complication and cause of mortality in this population. Our study aimed to determine the factors associated with AD in tracheostomized pediatric subjects. METHODS: This was a case-control study with 1:2 allocation ratio. Participants were tracheostomized children hospitalized in a prolonged mechanical ventilation hospital between 2013-2018. Each child who experienced decannulation during the study period was included as a case at the time of the event. Controls were obtained from the same population and were defined as subjects without an AD event during the same period. RESULTS: One hundred forty patients were hospitalized at Josefina Martinez Hospital at the time, of whom 41 were selected as cases and 82 as controls. Median (interquartile range) age was 20 (12-36) months, being 60% male. The median time from tracheostomy placement to AD event was 364 (167-731) d. Eighty-four percent of subjects were mechanically ventilated. AD mainly occurred by self-decannulation (53.7%). The risk of AD was higher in children who reached the midline in a sitting position (odds ratio 9.5 [95% CI 1.59-53.90]), inner diameter (ID) tracheostomy tube size ≤ 4.0 mm (odds ratio 5.18 [95% CI 1.41-19.06]), and who had been hospitalized in hospital rooms with a low ratio of nursing staff for each subject (1 nurse to 4 subjects) (odds ratio 4.48 [95% CI 1.19-16.80]). CONCLUSIONS: Factors associated with a higher risk of AD in tracheostomized children included the ability to reach the midline in a sitting position, the use of a smaller tracheostomy tube (≤ 4.0 mm ID), and lower supervision from staff. [ABSTRACT FROM AUTHOR]

Background: Sternal wound infection (SWI) post cardiac surgery remains an important cause of extra morbidity, mortality and cost. The objective was to identify risk factors for SWI in a cardiac centre in Eastern Saudi Arabia as part of the investigation into Surveillance variance in the local rates of SWI. Methods: We included cases and controls from a cross section of patients who underwent major cardiac surgery between 2017 and 2020 matched for age, sex and time of surgery. An explanatory logistic regression model was fitted to estimate the risk factors. Results: N = 204 (51 cases and 153 controls matching ratio 1:3, from a source population of 985 patients). factors significantly associated with SWI in the final multivariate model: hospital stay OR (1.05, Cl 1.01–1.10), Graft Conduit BIMA versus No Graft OR (10.94, Cl 1.60–74.63), transfusion of both packed cells plus other blood products versus no transfusion OR (3.53, Cl 93–13.44), HbA1c OR (1.09 Cl 0.84–1.41), BMI OR (1.25, Cl 1.04–1.50), perioperative blood glucose OR (1.02, Cl 1.004–1.03), surgery time OR (1.19, Cl 1.00–1.58). Conclusions: The diverse aetiology, cross-disciplinary nature of SWI prevention, and despite improved prevention and control practices, including related care bundles with their proven value, SWI remain a serious challenge in cardiac surgery. Multidisciplinary consensus guidelines are well overdue. [ABSTRACT FROM AUTHOR]

Aim: Investigate the association of hepatitis C virus (HCV) infection on incidence of various oral lesions in a sample of Egyptian population. Materials and Methods: This case control observational retrospective study was conducted on outpatients’ clinics of a University Hospital. The predicted total sample size (n) was 100 with 1:1 ratio by using G*Power (version 3.1.9.79). In which, incidence and frequency of different oral manifestations in 50 HCV patients (cases) were compared to that of 50 healthy individuals(controls). Demographic and clinical data were collected using a structured questionnaire. Frequencies of findings were compared and analyzed using Fisher’s exact test, and regression analysis was performed to ascertain the effects of hepatitis C as well as age, sex and diabetes mellitus on the likelihood of different oral findings. Results: The oral mucosal signs and symptoms were generally more frequent among HCV compared to healthy controls. The frequency was statistically significant higher in HCV patients regarding xerostomia (40%), altered taste (24%) and oral lichen planus (20%), but insignificant regarding atrophic tongue (18%), oral pigmentation (14%) and pallor (10%). The presence of HCV was significantly associated with increased odds of xerostomia (P = 0.028, OR=4.3), oral pigmentations (P = 0.013, OR=12.6) and atrophic tongue (P = 0.039, OR=7.8). While other predictors had no significant effects on any of oral findings. Conclusion: In a hospital-based sample of Egyptian population; Xerostomia, altered taste and oral lichen planus were significantly frequent with HCV infection in comparison to healthy individuals. While xerostomia, oral pigmentations and atrophic tongue were associated with HCV. [ABSTRACT FROM AUTHOR]

الملخص: أهداف البحث: الهدف من الدراسة هو دراسة قدرة مكونات تحليل تكوين الجسم على التنبؤ بمرض الشريان التاجي لدى السكان الهنود الآسيويين المصابين بالسكري من النوع الثاني. طرق البحث: تم إجراء دراسة الحالات والشواهد هذه بمشاركة 50 شخصا من مرضى السكري النوع الثاني المصابين بمرض الشريان التاجي في مجموعة التجربة مع 50 شخصا أخرين من مرضى السكري النوع الثاني كمجموعة تحكم أعمارهم بين 40-70 عاما من السكان الهنود الآسيويين من زائري قسم أمراض القلب في أحد مراكز الرعاية الصحية المتقدمة في مدينة مانيبال بالهند. تم تأكيد تشخيص مرض الشريان التاجي عن طريق اختبارات تخطيط كهربية القلب والتغيرات في تصوير الأوعية التاجية. تم تقييم القياسات الجسمانية. كما تم تحليل مكونات الجسم باستخدام جهاز بوديستات 1500 ام دي دي. النتائج: أدت زيادة الدهون بمقدار وحدة واحدة إلى ازدياد احتمالات الإصابة بأمراض الشريان التاجي بمقدار 4.434 مرة لدى مرضى السكري من النوع الثاني. وأدى انخفاض الكتلة العضلية بمقدار وحدة واحدة إلى ازدياد احتمالات الإصابة بأمراض الشريان التاجي بمقدار 4.976 مرة. كما أدت زيادة مؤشر كتلة الدهون في الجسم بمقدار وحدة واحدة إلى ازدياد احتمال الإصابة بأمراض الشريان التاجي بمقدار 1.747 مرة. الاستنتاجات: تعتبر زيادة كتلة الدهون وانخفاض الكتلة العضلية في الجسم من العلامات المهمة للتنبؤ بمرض الشريان التاجي بين مرضى السكري من النوع الثاني. Abstract: Objectives: The objective of the current study is to investigate the potential of body composition analysis components for predicting coronary artery disease (CAD) in the Type 2 diabetic Asian Indian population. Methods: This case–control study was performed by recruiting 50 type 2 diabetic patients with CAD along with 50 controls. The participants recruited were those between the ages of 40–70 who visited the Department of Cardiology at a tertiary care referral centre in Manipal, India. The diagnosis of CAD was confirmed by electrocardiogram tests and coronary angiogram changes. An anthropometric evaluation was conducted, and body composition analysis was conducted using Bodystat 1500MDD equipment. Results: In type 2 diabetics, for a unit increase in fat, the odds of CAD increased by 4.43 times. For a unit decrease in lean mass, the odds of CAD increased by 4.98 times. For a unit rise in body fat mass index, the odds of CAD increased by 1.75 times. Conclusion: In Type 2 diabetics, increased body fat mass with decreased lean tissue mass were valuable markers of CAD. Future studies can examine the benefits of different types of nutritional and exercise interventions targeted at improving muscle mass and reducing fat content in the body with an aim to reduce the occurrence of CAD in patients diagnosed with T2DM.

Background of Study: North Sulawesi Province becomes a province which has 31.4% of stunting cases. North Minahasa Regence becomes one of stunting local areas which are intervened in order to occur reduction cases which currently amounted to 29.7%. One of factors which affect stunting are mother’s knowledge which influence feeding practices. Responsive feeding is feeding practices which is recommended by WHO conducted with psychosocial approach. Responsive feeding effects on physical and mental development of babies. Mothers who live in stunting-prone area have lower responsive feeding knowledge and practice than those in non-stunting areas. Purpose of Study: for investigating the effect of feeding education with the concept of responsive feeding on the knowledge and practice of eating on stunting babies aged 12-36 months. Method of Study: This study was quantitative study with experimental quasi approach. The study was conducted in Wori District, there were 11 people in case group and 7 people in control group. The respondent criteria were mothers who had stunting toddler aged 12-36 months and were not experiencing mental health. The analysis in this study used univariate and bivariate test. Pretest was provided before education was provided and post test was conducted 2 weeks after education. Result: Univariate test which is used is chi-square test and bivariate analysis is conducted through Independent Sample T-test. The finding of this study showed that there is enhancement of knowledge on case group after responsive feeding education is given however there is no enhancement in attitude. While in control group does not experience an enhancement both knowledge and attitude after education is given. Conclusion: Providing responsive feeding education can enhance mother’s knowledge about good feeding on stunting babies although it requires education for more than 2 weeks for increasing mother’s attitude in feeding of stunting babies.

Melese Shenkut Abebe,1 Girma Seyoum,2 Bahru Emamu,3 Demissie Teshome4 1Department of Anatomy, School of Medicine, College of Health Science, Wollo University, Dessie, Ethiopia; 2Department of Anatomy, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; 3Department of Radiology, School of Medicine, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia; 4Department of Radiography, Dessie Health Science College, Dessie, EthiopiaCorrespondence: Melese Shenkut Abebe, Department of Anatomy, School of Medicine, College of Health Science, Wollo University, Dessie, Ethiopia, Email melese19@yahoo.comIntroduction: Congenital hydrocephalus is one of the commonest congenital anomalies of the central nervous system. It is characterized by extensive accumulation of cerebrospinal fluid within the ventricles of the brain due to an imbalance between synthesis and absorption of cerebrospinal fluid. This study was planned to investigate the incidence and associated risk factors of congenital hydrocephalus.Methods: Unmatched case–control study was conducted in 34 (cases) and 104 (controls) pregnant women. Maternal data were collected from a structured questionnaire, and fetal-related data were recorded from obstetric ultrasound. Epi-info 7 and SPSS version 24 were used for data entry and analysis, respectively. The association between congenital hydrocephalus and risk factors was evaluated using binary logistic regression.Results: The incidence of congenital hydrocephalus was 2.67 per 1000 pregnancies. The result of multivariate logistic regression indicated that alcohol use and iron with folic acid supplementation during pregnancy were significantly associated with the development of congenital hydrocephalus (OR: 7.64, 95% CI: 1.97– 29.66 and p-value: 0.003 and OR: 0.186, 95% CI: 0.07– 0.49 and p-value: 0.001, respectively). Maternal exposure to typhus and typhoid and use of antibiotics during early pregnancy were also significantly associated with congenital hydrocephalus. Moreover, significant association was also observed between the simultaneous development of spina bifida and congenital hydrocephalus (p-value 0.03).Conclusion: In conclusion, alcohol consumption, unprescribed use of antibiotics and infection during pregnancy as well as absence of folic acid supplementation may predispose to congenital hydrocephalus.Keywords: case control, congenital anomaly, hydrocephalus, nervous system

Abstract Background Infective endocarditis (IE) caused by Streptococcus agalactiae (GBS) is increasingly reported and associated with an aggressive course and high mortality rate. Existing literature on GBS IE is limited to case series; we compared the characteristics of patients with GBS IE to patients with GBS bacteremia without IE to identify risk factors for development of IE. Methods A nested case–control study in a cohort of adult patients with GBS bacteremia over a 18-year period was conducted across seven centres in three Canadian cities. A chart review identified patients with possible or definite IE (per Modified Duke Criteria) and patients with IE were matched to those without endocarditis in a 1:3 fashion. Multivariate analyses were completed using logistic regression. Results Of 520 patients with GBS bacteremia, 28 cases of possible or definite IE were identified (5.4%). 68% (19/28) met criteria for definite IE, surgery was performed in 29% (8/28), and the overall in-hospital mortality rate was 29% (8/28). Multivariate analysis demonstrated that IE was associated with injection drug use (OR = 19.6, 95% CI = 3.39–111.11, p = 0.001), prosthetic valve (OR = 11.5, 95% CI = 1.73–76.92, p = 0.011) and lack of identified source of bacteremia (OR = 3.81, 95% CI = 1.24–11.65, p = 0.019). Conclusions GBS bacteremia, especially amongst people who inject drugs, those with prosthetic valves, and those with no apparent source of infection, should increase clinical suspicion for IE.

BackgroundPer- and poly- fluoroalkyl substances (PFASs) are a large family of synthetic chemicals, some of which are mammary toxicants and endocrine disruptors. Their potential as breast carcinogens is unclear. Our objective was to evaluate the risk of breast cancer associated with serum PFAS concentrations in a nested case-control study within the California Teachers Study.MethodsParticipants were 902 women with invasive breast cancer (cases) and 858 with no such diagnosis (controls) who provided 10 mL of blood and were interviewed during 2011-2015, an average of 35 months after case diagnosis. PFASs were measured using automated online SPE-HPLC-MS/MS methods. Statistical analyses were restricted to six PFASs with detection frequencies ≥ 95%: PFOA (Perfluorooctanoic acid), PFNA (Perfluorononanoic acid), PFUnDA (Perfluoroundecanoic acid), PFHxS (Perfluorohexane sulfonic acid), PFOS (Perfluorooctane sulfonic acid), and MeFOSAA (2-(N-Methyl-perfluorooctane sulfonamido) acetic acid. Unconditional logistic regression was used to calculate adjusted odds ratios (ORs), estimating the breast cancer risk associated with each PFAS.ResultsFor all cases of invasive breast cancer, none of the adjusted ORs were statistically significant but marginally significant ORs