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Objective: This study aimed to evaluate the degrees of dependence and presence of bacterial plaque in children with autism spectrum disorder (ASD) and the quality of life of children and their caregivers. Method and materials: This was a cross-sectional observational study. This study included 119 individuals with ASD and their caregivers. Data were collected through a sociodemographic questionnaire, WHOQOL-Bref, and Burden interview to measure quality of life and caregiver burden, respectively. The Autoquestionnaire Qualité de Vie Enfant Imagé questionnaire, adapted in game format, was applied to verify quality of life in children with ASD. An oral clinical examination evaluated the visible plaque index. The collected data were tabulated and organized for statistical analysis with a significance level of 5%. Results: It was observed that 52% of the children had a severity of ASD level 1; 70% were dependent for general activities, and 65% were dependent for oral hygiene. Of the 77 children who thoroughly answered the questionnaire about their quality of life, 64.9% had good quality of life, and 35.1% had scores below 48, that is, low quality of life. In general, the caregivers generally presented quality of life with a rate of 60.95 (good) points on the scale. It was observed that gingival bleeding greater than 30% is two (ASD 2 + ASD 3) to three (ASD 3) times more likely to occur in patients who have higher levels of ASD (P < .004). Conclusion: It was concluded that the quality of life of individuals with ASD was good, that most children are dependent for their daily activities and oral hygiene, and that they showed reasonable plaque control. On the other hand, the caregivers presented low quality of life and moderate burden. [ABSTRACT FROM AUTHOR]

Background/aim: Contact sports-related oro-dental trauma contributes to a significant proportion of sports injuries among school children. Oro-dental trauma imposes a detrimental impact on the oral health-related quality of life. However, the burden of oro-dental trauma among contact sports players and their practices of mouthguards remains a research gap in Sri Lanka. The current study bridges that while providing evidence for contextual changes such as initiating sports dentistry., Materials and Methods: The study was conducted among 1340 adolescent contact sports players in Colombo district, Sri Lanka; 63.1% males and 36.9% females (age 13-18), who were enrolled in football, rugby, hockey, boxing, basketball, and martial arts in the school setting. A checklist was administered to obtain demographic information, sports practices, and the use of mouthguards. An oral examination was conducted for those who experienced oro-dental trauma during the last 12 months., Results: Self-reported oro-dental trauma pooled prevalence of the contact sports players was 35.9% (95% CI = 33.3-38.5), with males' preponderance. Dental trauma was present in 23.8% (n = 319), while 15.8% were uncomplicated and 8% were complicated. Soft tissue injuries were present in 12.1% (n = 162). Oro dental trauma (ODT) was highly prevalent among boxing, rugby, and hockey players. Only 20.8% (n = 279) of players used mouthguards. However, 91.0% (n = 254) of them were using ready-made mouthguards. Mouthguard use and the type of mouthguard showed statistically significant associations across the type of oro-dental trauma among contact sports players., Conclusions: Contact sports-related oro-dental trauma prevalence is as high as 35.9% among Colombo district school children in Sri Lanka. However, their level of mouthguard usage is shallow at 20.8%. Further research is necessary to investigate the reasons behind this, and national guidelines should be developed to prevent and manage sports-related accidental injuries., (© 2023 The Authors. Dental Traumatology published by John Wiley & Sons Ltd.)

Background: Data collection techniques that routinely provide health system information at the local level are in demand and needed. LQAS is intended for use by local health teams to collect data at the district and sub-district levels. Our question is whether local health staff produce biased results as they are responsible for implementing the programs they also assess., Methods: This test-retest study replicates on a larger scale an earlier LQAS reliability assessment in Uganda. We conducted in two districts an LQAS survey using 15 local health staff as data collectors. A week later, the data collectors swapped districts, where they acted as disinterested non-local data collectors, repeating the LQAS survey with the same respondents. We analysed the resulting two data sets for agreement using Cohens' Kappa., Results: The average Kappa score for the knowledge indicators was k = 0.43 (SD = 0.16) and for practice indicators k = 0.63 (SD = 0.17). These scores show moderate agreement for knowledge indicators and substantial agreement for practice indicators. Analyses confirm that respondents were more knowledgeable on retest; no evidence of bias was found for practice indicators., Conclusion: The findings of this study are remarkably similar to those produced in the first reliability study. There is no evidence that using local healthcare staff to collect LQAS data biases data collection in an LQAS study. The bias observed in the knowledge indicators was most likely due to a 'practice effect', whereby respondents increased their knowledge as a result of completing the first survey; no corresponding effect was seen in the practice indicators.

Background: It is well known that safe delivery in a health facility reduces the risks of maternal and infant mortality resulting from perinatal complications. What is less understood are the factors associated with safe delivery practices. We investigate factors influencing health facility delivery practices while adjusting for multiple other factors simultaneously, spatial heterogeneity, and trends over time., Methods: We fitted a logistic regression model to Lot Quality Assurance Sampling (LQAS) data from Uganda in a framework that considered individual-level covariates, geographical features, and variations over five time points. We accounted for all two-covariate interactions and all three-covariate interactions for which two of the covariates already had a significant interaction, were able to quantify uncertainty in outputs using computationally intensive cluster bootstrap methods, and displayed outputs using a geographical information system. Finally, we investigated what information could be predicted about districts at future time-points, before the next LQAS survey is carried out. To do this, we applied the model to project a confidence interval for the district level coverage of health facility delivery at future time points, by using the lower and upper end values of known demographics to construct a confidence range for the prediction and define priority groups., Results: We show that ease of access, maternal age and education are strongly associated with delivery in a health facility; after accounting for this, there remains a significant trend towards greater uptake over time. We use this model together with known demographics to formulate a nascent early warning system that identifies candidate districts expected to have low prevalence of facility-based delivery in the immediate future., Conclusions: Our results support the hypothesis that increased development, particularly related to education and access to health facilities, will act to increase facility-based deliveries, a factor associated with reducing perinatal associated mortality. We provide a statistical method for using inexpensive and routinely collected monitoring and evaluation data to answer complex epidemiology and public health questions in a resource-poor setting. We produced a model based on this data that explained the spatial distribution of facility-based delivery in Uganda. Finally, we used this model to make a prediction about the future priority of districts that was validated by monitoring and evaluation data collected in the next year.

Beginning in 2003, Uganda used Lot Quality Assurance Sampling (LQAS) to assist district managers collect and use data to improve their human immunodeficiency virus (HIV)/AIDS program. Uganda's LQAS-database (2003-2012) covers up to 73 of 112 districts. Our multidistrict analysis of the LQAS data-set at 2003-2004 and 2012 examined gender variation among adults who ever tested for HIV over time, and attributes associated with testing. Conditional logistic regression matched men and women by community with seven model effect variables. HIV testing prevalence rose from 14% (men) and 12% (women) in 2003-2004 to 62% (men) and 80% (women) in 2012. In 2003-2004, knowing the benefits of testing (Odds Ratio [OR] = 6.09, 95% CI = 3.01-12.35), knowing where to get tested (OR = 2.83, 95% CI = 1.44-5.56), and secondary education (OR = 3.04, 95% CI = 1.19-7.77) were significantly associated with HIV testing. By 2012, knowing the benefits of testing (OR = 3.63, 95% CI = 2.25-5.83), where to get tested (OR = 5.15, 95% CI = 3.26-8.14), primary education (OR = 2.01, 95% CI = 1.39-2.91), being female (OR = 3.03, 95% CI = 2.53-3.62), and being married (OR = 1.81, 95% CI = 1.17-2.8) were significantly associated with HIV testing. HIV testing prevalence in Uganda has increased dramatically, more for women than men. Our results concurred with other authors that education, knowledge of HIV, and marriage (women only) are associated with testing for HIV and suggest that couples testing is more prevalent than other authors.

Background: Leprosy, being a neglected tropical disease, remains a significant public health concern in several parts of the world, especially Sri Lanka, where it has long been associated with stigma. This study aims to assess the stigma faced by People Affected by Leprosy (PAL) undergoing treatment and to identify the factors associated with this stigma. Methods: A cross-sectional study was conducted among 109 Leprosy affected people attending the Central Leprosy Clinic and all dermatology clinics of the National Hospital of Sri Lanka (Colombo), selected using a consecutive sampling method. Data collection was done through an interviewer-administered questionnaire. Stigma was quantified using a validated and adapted version of the Stigma Assessment and Reduction of Impact (SARI) tool, which evaluates stigma pertaining to four domains: Experienced Stigma (ES), Disclosure Concerns (DC), Internalized Stigma (IS), and Anticipated Stigma (AS). Spearman's correlation and Mann-Whitney U tests were used to analyze associations, with statistical significance set at 0.05. Results: The dataset showed a non-normal, right-skewed distribution. The mean total SARI score was 9.82 (SD = 10.23). Disclosure Concerns (rs=-2.66; p = 0.005) and Anticipated Stigma (rs=-3.6; p < 0.001) demonstrated weak - moderate negative correlations with the time since diagnosis. On the other hand, the correlation between time since diagnosis and Experienced Stigma (rs=0.22; p = 0.022) was positive and weak. Participants without disability had significantly lower scores in DC (p = 0.049), IS (p = 0.01), and AS (p = 0.01) compared to those with disability. Patients who did not develop Leprosy reactions displayed significantly lower scores across all SARI domains as well as the total SARI score (all p < 0.05) compared to those who did. Conclusions: The findings suggest that over time, People Affected by Leprosy become less concerned about disclosing their diagnosis and anticipate less stigma but may experience greater overall stigma. Disability status and Leprosy reactions are key factors in determining the level of stigma faced by them. [ABSTRACT FROM AUTHOR]

Background: Lebanon is grappling with numerous environmental challenges, including water scarcity, landfill waste, deforestation, and rising air pollution. Food choices significantly influence global greenhouse gas emissions and environmental impacts, making it crucial to evaluate the environmental footprints (EFPs) of Lebanon's current dietary habits. This study aimed to assess food consumption patterns and their EFPs among a nationally representative sample of Lebanese adults. Methods: A cross-sectional survey was conducted from May to September 2022, involving 444 Lebanese adults aged 18 to 64 years. The sample was representative, and participants were distributed across the eight Lebanese governorates. Sociodemographic and medical data were collected via a questionnaire, food consumption was assessed through a validated Food Frequency Questionnaire (FFQ) and two non-consecutive 24-hour recalls, and anthropometric measurements were also taken. EFPs were derived from databases and repositories. Results: The typical EFPs of an average Lebanese adult included water usage of 2,862.39 ± 1,617.88 L/day, greenhouse gas emissions of 4.43 ± 2.29 kg CO2-eq/day, and nitrogen use of 12.72 ± 6.76 g/day. Animal products were the primary contributors to greenhouse gas emissions, while vegetable products had the highest water footprint and nitrogen loss impact on the environment. Grains and cereals, the most consumed food category, significantly influenced the water footprint and nitrogen loss. Additionally, meat consumption notably drove greenhouse gas emissions. Conclusion: Lebanon must address its environmental challenges and the impact of dietary choices on greenhouse gas emissions and EFPs. By evaluating and understanding the environmental consequences of current dietary patterns, Lebanon can take proactive steps towards promoting sustainable food practices and mitigating environmental degradation. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) stigma remains a significant barrier to TB control efforts globally, especially in countries with a high TB burden. Studies about TB stigma done in Uganda so far have been limited in scope and focused on data collected health facilities. In this study we report TB related stigma at community level for the period 2021/2022. We used the 2021/22 Lot Quality Assurance Sampling (LQAS) data from a sample of 33,349 participants across 77 districts, to measure TB stigma determine factors associated. We included demographic characteristics, knowledge and participant perspectives as our study variables. Univariable and multivariate logistic regression analyses were performed to identify factors associated with TB stigma. TB stigma was assessed as a categorical variable (below or above the median) due to the skewness of the data when fitting the scores. The data set had equal proportions of males and females. The largest age group was 20–29 years old (38.47%). Most participants were married (62.94%) and had primary level education (65.80%). The TB stigma scores were assigned on a scale from 0 to 30, with an average score of 21.67 (±8.22) and a median score of 24 (19–28). Overall, 45.48% of participants had TB stigma scores above the median. Variations in TB stigma levels were observed across different districts. Factors associated with higher TB stigma included older age, higher education levels, urban residence, and TB knowledge. To reduce TB stigma and misinformation that can make an impact on TB response, community interventions should balance increasing awareness with minimizing fear. These interventions should be well-rounded and context-specific to address disparities within communities and bolster TB control efforts in the country. [ABSTRACT FROM AUTHOR]

Background: The UN General Assembly recognised the human right to water and sanitation through the sixth SDG in 2010. South Kordofan, a state in southern Sudan, faces WASH challenges due to conflict, geographical factors, and inadequate services, impacting over 600,000 residents. Such conflicts are well known for spreading diseases and disrupting WASH-related practices among displaced individuals. Objectives: The study aimed to evaluate the quality and availability of drinking water, as well as sanitation and hygiene practices in rural South Kordofan. It also sought to identify factors affecting community satisfaction with WASH services and to establish a data-driven basis for future interventions addressing these issues. Methods: A cross-sectional study accompanied a medical mission to South Kordofan, selecting 33 villages from South Kordofan based on healthcare, population, and accessibility. Water samples, patient forms and questionnaires were collected using convenient sampling for targeted villages and for attendants of mobile clinics. Laboratory analyses were conducted on water samples. Descriptive statistics, univariate analysis and logistic regression were used to analyse the data. The used level of significance was 0.05. Results: Out of 784 participants, 60.2% were female. Tube wells/boreholes were the primary water source (68.1%), and most participants (70.9%) lived near their water source (less than 30 min). Dissatisfaction with water services was reported by 56.8%, and satisfaction associated with method of delivery (OR = 0.081, CI = 0.024–0.276)), appearance (OR = 0.299, CI = 0.182–0.489), distance (OR = 0.264, CI = 0.099–0.705), water unavailability (OR = 0.477, CI = 0.297–0.765), and obligation to pay (OR = 0.351, CI = 0.185–0.665). Samples showed high levels of contamination, both microbial and physicochemical. Regarding sanitation, over a third of the participants (41.5%) disposed of children's stool by leaving it outdoors. About 10% of the participants reported having diarrhea during the week before the study. However, about two-thirds of the participants (68.1%) showed good hygienic practices by using soap or detergents for hand washing. Conclusion: The study revealed inadequate WASH services, high microbial contamination, and poor water treatment practices. Paradoxically, many participants expressed satisfaction with water services. Sanitation issues and open defecation persist, emphasizing the need for comprehensive interventions. All these negative consequences can be attributed to the armed conflict which resulted in poor awareness about the safety of drinking water, what safe water looks like and proper hygiene practices. Moreover, these conflicts led to disruption of the economical status leading to the absence of proper water purification infrastructure. [ABSTRACT FROM AUTHOR]

Background: Caring for older people has become a significant public health concern in Sri Lanka due to the growing aging population. This has placed a heavy burden on family caregivers, particularly those caring for older individuals with multiple chronic conditions. Recognizing this challenge, the present study aimed to evaluate the psychometric properties of the Sinhala version of the 10-item short form of the Burden Scale for Family Caregivers (BSFC-s) and assess caregiver burden and associated factors among caregivers of older people aged over 65 years with multimorbidity. Methods: The BSFC-s was cross-culturally adapted following standard guidelines and administered to consecutively selected 178 family caregivers involved in the long-term care of older patients (aged ≥ 65 years) who were regular attendees of medical and neurology clinics at the National Hospital Galle, Sri Lanka. The validated Sinhala version of the Short Form-36 questionnaire (SF-36) was also administered simultaneously. After two weeks, 60 caregivers were re-assessed using the BSFC-s. The psychometric properties, including reliability and validity, as well as floor and ceiling effects, were evaluated. The final version of the BSFC-s was then administered to 270 informal family caregivers in the Gampaha District, Sri Lanka. Results: The study revealed that the internal consistency of the Sinhala version of the BSFC-s, measured by Cronbach's alpha, was 0.90, with item-total correlations ranging from 0.38 to 0.82. The test-retest reliability, assessed using the intra-class correlation coefficient, was 0.99 (95% CI: 0.99-1.00; p < 0.001). Principal component analysis revealed two factors explaining 65.8% of the cumulative variance. BSFC-s scores showed a strong negative correlation with SF-36 scores (r = -0.81, p < 0.001), indicating a good concurrent validity. Neither floor nor ceiling effects were observed. Among the 270 family caregivers, 78.1% reported a high level of burden, while 21.1% reported moderate burden. Caregiver burden was significantly associated with low educational level (p = 0.032), low monthly income (p = 0.041), and unemployment status (p < 0.001) of the caregiver. Conclusion: The Sinhala version of the BSFC-s demonstrated strong reliability and validity, making it a suitable tool for assessing caregiver burden in Sri Lanka. Most caregivers reported high levels of subjective burden, particularly those with lower socio-demographic status. Trial registration: Not applicable. [ABSTRACT FROM AUTHOR]

Over the past decade, Anambra State, Nigeria, has implemented mass administration of medicines (MAMs) to combat soil-transmitted helminthiasis (STH), a significant public health challenge in low-income regions. Nevertheless, these efforts have predominantly focused on pre-school and school-aged children, leaving a notable gap in understanding STH infection rates and the efficacy of these campaigns among secondary school adolescents, who have been excluded from this initiative. Our study aimed to address this critical knowledge gap by assessing soil-transmitted helminthiasis (STH) prevalence and contextual factors hindering effective control among adolescents in Anambra State, Nigeria. We actively engaged 443 adolescents with a mean age of 14 years in a school-based cross-sectional study in selected communities within the Anaocha Local Government Area from 8 February to 7 July 2023 following informed consent and assent procedures. Employing a stratified random sampling technique, we collected demographic data and assessed STH risk factors using a structured questionnaire hosted on the Kobo Toolbox platform. For quantitative analysis of STH infections, the Kato-Katz technique was used. Analysis was performed using SPSS version 25, incorporating descriptive statistics and multinomial logistic regression, with statistical significance set at p<0.05. Of the 443 (213 males (48.0%) and 230 females (52.0%) adolescents studied, the overall prevalence of STH observed was 35.2% (156/443). Ascaris lumbricoides was the prevalent STH species (16.9%), followed by Trichuris trichiura (1.4%) and hookworm (0.5%). Only light-intensity infection was observed. Mixed infections were observed in 16.5% of adolescents, involving A. lumbricoides and hookworm (10.8%), followed by A. lumbricoides and T. trichiura (3.2%) and all three STH (2.5%). The observed overall prevalence was not statistically significant with respect to gender (OR: 0.961; 95% CI: 0.651–1.420; p > 0.05) or age (OR: 0.686; 95% CI: 0.459–1.025; p>0.05). Class (grade level) (OR = 1.75, 95% CI: 1.25–2.45, p = 0.003), knowledge and transmission of STH infection (OR = 0.60, 95% CI: 0.42–0.86, p = 0.008), parental occupation (OR = 1.90, 95% CI: 1.35–2.67, p < 0.001), parents' literacy level (OR = 0.68, 95% CI: 0.48–0.96, p = 0.027), and the type of toilet (OR = 2.15, 95% CI: 1.54–3.00, p < 0.001) were all significantly correlated with STH infection. These findings highlight the role of adolescents in sustaining soil-transmitted helminthiasis (STH) transmission. Coupled with school-based deworming expansion, innovative improvements in water, sanitation, hygiene, and awareness can provide a cost-effective, sustainable solution for combatting STH infections in Anambra State. [ABSTRACT FROM AUTHOR]

Background: One of the biggest problems faced by the homosexual population is the high prevalence of sexually transmitted diseases including human immunodeficiency virus which can be attributed to inconsistent and incorrect use of condom. Condom usage among homosexuals is affected by many factors which may have a positive or negative impact on it. This study aimed to find out the different sociodemographic determinants that were associated with consistent and correct condom use among homosexual males aged 18–24 years. Materials and Methods: This descriptive cross-sectional study was conducted among 240 homosexual (including bisexual) males aged 18–24 years living in the Metropolitan city for minimum 1-year duration at the outreach sites of an NGO. Data pertaining to sociodemographic variables and consistent and correct condom use were obtained and analyzed in SPSS using the Chi-square test to find out the association between condom use and sociodemographic profile. Results: Only 43.3% of participants were using condoms consistently and correctly. Consistent and correct use of condom was observed among participants who were younger (p =<0.001), more educated (p =<0.001), belonging to a higher socioeconomic class (p =<0.001) with a high per-capita income (p =<0.001), living in a nuclear family (P = 0.004), unmarried (P = 0.0071), and staying with the family (p =<0.001). Conclusion: Sociodemographic determinants do have an impact and play a vital role in the consistent and correct use of condoms among homosexual males. [ABSTRACT FROM AUTHOR]

ABSTRACT: Introduction: This study was undertaken to assess the distribution of ganglion cells (GCs) and interstitial cells of Cajal (ICCs) across different points of distal rectal pouch in anorectal malformation (ARM) patients over the three stages of repair. We hypothesize that along with the surgical factors, there could be intrinsic factors as well which can be the cause of dysmotility in these patients after surgical repair. Methodology: Full-thickness colonic biopsy specimens were taken from the proximal stoma, distal stoma, and distal rectal pouch of 21 boys aged 0–8 months undergoing 3 staged repair of ARM at our tertiary care center between August 2022 and December 2023. There was an interstage interval of approximately 12–14 weeks. All underwent high-divided sigmoid colostomy in stage 1. Biopsy specimens for GC and ICC number were routinely processed, and immunohistochemistry was done for CD117. The data was assessed and compared with respect to location and stage of surgery. Results: Both GC and ICC showed a gradual decrease in mean number over three stages for both proximal and distal ends of colostomy. For proximal stoma, the distribution of either cell type did not differ across the stages, but for distal stoma, the number of cells was significantly lower in the second stage (following colostomy, before posterior sagittal anorectoplasty). However, no difference was noted between the second and third stages. This indicates that factors during/just after colostomy itself must be responsible for decrease in ICC/GC. Conclusion: Lesser number of GC and/or ICC in the distal pouch from stage 2 onward may point toward its association with projected hypomotility in ARM patients. Apart from innate distribution, we also infer that this could be consequent to vascular insult which may occur at the time of divided colostomy. Loop stoma may be a better alternative as vascularity is uninterrupted in loop colostomy. [ABSTRACT FROM AUTHOR]

Background: The association between physical fitness and autistic traits in adolescents remains under explored, especially in adolescents. Understanding this relationship can provide strategies to improve the quality of life of these people. Objective: To identify the association between cluster characteristics derived from levels of self-perceived physical fitness and the occurrences of individual levels of autistic traits in Brazilian adolescents. Method: This descriptive study employed an analytical, quantitative approach involving 515 adolescents aged 11 to 18 (245 boys and 270 girls). Autistic traits were assessed using the Autism Quotient (AQ50), while physical fitness was measured with the Self-Reported Physical Fitness Questionnaire (QAPA). Cluster analysis using descriptive statistics with bootstrapping and generalized estimating equations was performed. Results: Boys reported higher physical fitness levels than girls, with significant differences in General Power Strength (QAPA 4) and Physical Fitness in Sports (QAPA 7). Girls scored slightly higher on social skills. AQ50 scores indicated that girls had higher aggregated difficulties in imagination, attention, communication, and social skills compared to boys. Higher self-perceived physical fitness was associated with lower levels of autistic traits in both genders. Girls with higher QAPA scores showed significant decreases in autistic traits related to social skills and overall AQ50 scores. Boys with higher physical fitness demonstrated reduced autistic traits in the domains of imagination and communication. Age-adjusted analyses confirmed these findings. Conclusion: There is a significant association between self-perceived physical fitness and autistic traits in adolescents. Higher physical fitness levels are linked to fewer autistic traits, highlighting the importance of promoting physical fitness to mitigate challenges associated with autistic traits and improve adolescents' well-being. [ABSTRACT FROM AUTHOR]

Background: Period poverty or inadequate access of menstrual hygiene and education can be debilitating to women of reproductive age. The objective of present study was to have an insight into period poverty as well as determine association between last-year period poverty, menstrual knowledge and menstrual hygiene management (MHM) with socio-demographic variables. Methods: This analytical study was cross-sectional in design included females of reproductive age (20-49 years). Study was carried at a primary health centre in urban Lucknow. Data was collected on a pre-validated semistructured questionnaire. The data was collected and entered in M.S Excel. Chi-square was applied for analysis. Results: Prevalence of last year period poverty, poor menstrual knowledge and poor menstrual hygiene management was 29.7%, 17.7% and 42.3%, respectively. Significant association exists between period poverty and socio-demographic variables. Conclusion: Period poverty continues to be a challenging issue among females of reproductive age group. Increasing awareness about menstrual hygiene and MHM practices, and taking action to ensure adequate supply of period product is need of the hour. [ABSTRACT FROM AUTHOR]

Background & aims: Enhanced Recovery After Surgery (ERAS) has shown significant improvements in postoperative outcomes and a reduction in complications, while immunonutrition (IMN) has been shown to modulate the immune system and inflammatory response. However, many studies have overlooked the crucial aspects of nutrition status and patient perception within the intervention approach. This study aims to investigate the efficacy and explore patients' acceptance of the IMN intervention in postoperative outcomes among gynecological cancer (GC) patients under the ERAS framework. Methods: This two-phase explanatory sequential mixed-method study design comprises an open-labeled randomized control trial and a qualitative study. The GC participants will be randomly allocated into intervention and control groups. Malaysian adults scheduled for elective surgery will be recruited, with the intervention group receiving IMN for five days before and seven days after elective surgery, while the control group undergoes routine nutritional care before the operation. Both groups will adhere to the ERAS protocol. An explanatory qualitative study will be conducted among GC patients to elucidate their expectations following the trial. Study outcomes include hospitalization duration, change in nutrition status, biochemical profile, functional status, and quality of life. Additionally, the secondary outcome focuses on evaluating the perception of the intervention approach. Quantitative and qualitative data will be analyzed on an intention-to-treat basis and through inductive thematic analysis, respectively. Conclusion: Implementing perioperative IMN intervention within the ERAS framework may contribute to the preservation of better nutrition status and the provision of sufficient dietary intake to support postoperative recovery, and promote better surgical outcomes. Patients' perceptions play a pivotal role in enhancing understanding of disease management and adherence to the intervention approach. Trial registration: NCT06039306. [ABSTRACT FROM AUTHOR]

Objective: Mucositis is one of the common side effects of chemotherapy. This study aimed to identify the effects of honey on oral care interventions to reduce mucositis scores among children undergoing chemotherapy. Methods: This pilot study was quasi-experimental with pre-post intervention with the control group. The study employed consecutive sampling, with 24 patients in the control and 24 in the intervention group. The intervention group received an oral care protocol using honey, whereas the control group received regular oral care. The data were collected using demographic information form and the Oral Assessment Guide (OAG) to assess mucositis. The intervention group received oral care intervention using honey (35 ml of honey applied topically in the oral cavity and 15 ml of honey used as a mouthwash and for lip care), which was given thrice daily for five days. The data were analyzed using percentage distributions, means, chi-square tests, dependent and independent t-tests, and multivariate analysis using analysis of covariance (ANCOVA). Results: The findings of this study showed that the intervention group experienced a significant reduction (-0.51 ± 0.66) in the average mucositis score after the intervention, whereas the control group experienced an increase in the mucositis score (3.84 ± 1.28) after controlling for confounding variables (p = 0.000). Conclusion: This study revealed that oral care with honey effectively reduced chemotherapy-induced mucositis in children with cancer. These findings suggest that oral care with honey should be used as a nursing intervention for chemotherapy patients. Trial registration: This clinical trial was retrospectively registered in the Australian New Zealand Clinical Trials Registry (ANZCTR) with registration number ACTRN12624001313527 (29/10/2024). [ABSTRACT FROM AUTHOR]

Bariatric surgery is another treatment options for patients with obesity, who cannot achieve weight controlled by conservative non-surgical therapy. Although bariatric surgery provides clinical benefits for these patients, it is costly. This study aims to evaluate the cost-effectiveness of bariatric surgery, as compared to nonbariatric surgery, in patients with body mass index (BMI) ≥32.5 kg/m2 and type 2 diabetes mellitus (T2DM), and to estimate the budget impact of bariatric surgery in Thailand. Methods: A Markov model was developed to estimate and compare total costs incurred and quality-adjusted life years (QALYs) gained between bariatric surgery and nonbariatric surgery over lifetime horizontal. Analysis was conducted under payer and societal perspectives. Costs and outcomes were discounted at an annual rate of 3%. The outcomes were presented as incremental cost- effectiveness ratio (ICER). Results: Under payer's perspective, bariatric surgery resulted in higher total lifetime cost (676,658.39 baht vs 574,683.38 baht) and QALYs gained (16.08 QALYs vs 14.78 QALYs), as compared to nonbariatric surgery, resulting in an ICER of 78,643.02 baht/QALY. Similarly, under the societal perspective, bariatric surgery resulted in higher total lifetime cost (1,451,923.83 baht vs 1,407,590.49 baht) and QALYs gained (16.08 QALYs vs 14.78 QALYs), as compared to nonbariatric surgery. Under societal perspective, ICER was estimated at 34,189.82 baht/QALY. A 5-year budget impact analysis indicated that bariatric surgery incurred the total budget of 223,821 million baht. Conclusions: At the cost-effectiveness threshold of 160,000 baht/QALY, bariatric surgery was a cost-effective strategy and should continue to be included in the benefit package for patients with obesity and T2DM. [ABSTRACT FROM AUTHOR]

Background: Resilience refers to an individual's ability to thrive despite adversity. Children with cleft lip and/or palate (CL/P) face numerous challenges during school age due to speech and aesthetic differences compared to typically developing (TD) children. This study aims to compare the resilience levels between Malaysian children with CL/P and TD children, utilizing the Malay-translated Resilience Scale-10 (RS-10)© ([Wagnild, Resilience scale for children (RS10) user's guide 2015, n.d]). Results: A total of 121 Malaysian children comprising 52 CL/P and 69 TD children between the ages of 7 to 12 years participated in this study. Among the children with CL/P, 49 exhibited intelligible speech with mild to moderate differences, while three had severely reduced intelligibility. Participants completed the RS-10 online with parental assistance. The total mean scores of resilience for TD and CL/P were 30.80 ± 4.28 and 33.15 ± 6.01 respectively. The t-test results showed no significant differences in resilience scores between groups and across genders. The analysis of variance showed no significant difference between age groups. Regression analysis revealed that age and group were marginally significant predictors of resilience scores. Specifically, each additional year of age was associated with a 0.47-point reduction in RS-10 scores highlighting coping difficulties associated with CL/P in older children. Conclusions: The findings highlight the resilience of Malaysian children with CL/P, showing they can achieve resilience levels similar to their TD peers, particularly when speech outcomes are favourable. [ABSTRACT FROM AUTHOR]

Indonesia have several herbs empirically used as galactagogue. However there are limited clinical evidence regarding the efficacy and safety of this herbs especially poly-herb. The aim of this study was to assess the efficacy and safety of polyherbal galactagogue (PHG) consist of katuk leaves, torbangun leaves and papaya leaves compared to commercial galactagogue capsules (CGC) that contain a single plant extract, katuk leaves. This study was an open label randomized controlled trial with 120 subjects that randomly assigned into two groups, PHG and CGC. This study was conducted at the herbal medicine research house (Rumah Riset Jamu/RRJ) Hortus Medicus and 30 subsites in Central Java and Jogjakarta provinces from July to November 2018. Duration of intervention 28 days. Parameter of efficacy breast milk volume, baby weight, prolactin level and parameter of safety ALT, AST, urea, creatinin were performed at baseline, day 14 and 28. The symptom of side effects also recorded every week. Breast milk volume and infant's weight increased at day-14 and 28 in both groups. However, prolactin level in both groups decreased. There were no significant differences of efficacy parameters at baseline in both groups. At three times measurement of ALT, AST, Urea and Ceratinin average levels were within the normal range. About 3–5% mothers experience higher ALT, AST and nausea that can tolerated well. No side effect was found in infants. PHG and CGC have the equal efficacy and safety as a galactagogue. The optimal used is for 14 days. [ABSTRACT FROM AUTHOR]

Copyright of Namık Kemal Tıp Dergisi is the property of Galenos Yayinevi Tic. LTD. STI 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.)

A major strategy for preventing transmission of HIV and other STIs is the consistent use of condoms during sexual intercourse. Condom use among youths is particularly important to reduce the number of new cases and the national prevalence. Condom use has been often promoted by the Uganda National AIDS Commission. Although a number of studies have established an association between condom use at one's sexual debut and future condom use, few studies have explored this association over time, and whether the results are generalizable across multiple locations. This multi time point, multi district study assesses the relationship between sexual debut and condom use and consistent use of condoms thereafter. Uganda has used Lot Quality Assurance Sampling surveys since 2003 to monitor district level HIV programs and improve access to HIV health services. This study includes 4518 sexually active youths interviewed at five time points (2003-2010) in up to 23 districts located across Uganda. Using logistic regression, we measured the association of condom use at first sexual intercourse on recent condom usage, controlling for several factors including: age, sex, education, marital status, age at first intercourse, geographical location, and survey year. The odds of condom use at last intercourse, using a condom at last intercourse with a non-regular partner, and consistently using a condom are, respectively, 9.63 (95%WaldCI = 8.03-11.56), 3.48 (95%WaldCI = 2.27-5.33), and 11.12 (95%WaldCI = 8.95-13.81) times more likely for those individuals using condoms during their sexual debut. These values did not decrease by more than 20% when controlling for potential confounders. The results suggest that HIV prevention programs should encourage condom use among youth during sexual debut. Success with this outcome may have a lasting influence on preventing HIV and other STIs later in life.

Background: Oxford Shoulder Instability Score (OSIS) is a patient reported outcome measure designed specifically to assess functional difficulties resulting from shoulder instability. The main aim of this study was to cross-culturally adapt the OSIS to Spanish. Secondary, it aimed to analyse its methodological quality. Methods: A cross-cultural adaptation to Spanish has been carried out following the recommendations of COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) with a sample of 167 cases of shoulder instability. Inclusion criteria were: subjects with instability symptoms in at least one shoulder with or without clinical diagnosis; aged between 18 and 60. The following psychometric properties were evaluated: validity (construct, internal and external), reliability (internal consistency, test-retest and measurement error), discriminant ability and feasibility. The methodological quality was addressed with Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) and COSMIN Risk of Bias checklist (COSMIN RoB). Results: The construct validity obtained an OSIS correlation with the Simple Shoulder Test of r = 0.636 and with the Western Ontario Shoulder Instability of r = 0.80. The unidimensionality of the OSIS was confirmed through second-order factor analysis. Cronbach's alpha and intraclass correlation coefficient were both 0.93 (IC95%: 0.91–0.94). Standard error of measurement was 0.70, and the percentage of error and smallest detectable change were 1.46% and 1.94, respectively. No floor or ceiling effects were found. Assessing feasibility of OSIS, the participants answered all questions, had no questions and completion time was: mean 2 min 30 s; SD ± 1 min. Regarding methodological quality, the study showed low risk of bias in the areas of patient selection, index test, reference standard and flow and timing, as well as low concern regarding applicability in the domains of patient selection, index test and reference standard according to QUADAS-2. In relation to COSMIN RoB, all psychometric properties, except for content validity, obtained very good results. Conclusions: The Spanish version of OSIS offers valid, reliable and feasible functional outcome measures for Spanish-speaking subjects with shoulder instability, based on its psychometric properties and its methodological quality. [ABSTRACT FROM AUTHOR]

Background: The ubiquitous protozoan parasite Giardia duodenalis is a major contributor to the global burden of diarrhoea, particularly in young children living in poor-resource regions. Although rarely mortal, giardiasis is associated with growth retardation and cognitive impairment in early childhood. Here we investigate the epidemiology of human giardiasis in Iranshahr (south-eastern Iran), a region where this information was previously lacking. Methods: Stool samples were collected from 17,455 outpatients and inpatients attended at three major hospital settings during April 2020 and March 2022. Microscopy was used as a screening method for the presence of Giardia cysts, and the identification of G. duodenalis assemblages was carried out using PCR and Sanger sequencing. Results: The overall prevalence of giardiasis was 1.87 (326/17,455; 95% CI: 1.7–2.1). Being female was positively associated with higher odds of giardiasis (p = 0.014). Individuals without diarrhoea were less likely to have giardiasis (p = 0.022). Individuals attending the Iran Hospital were more likely to harbour G. duodenalis infections compared to those attending at the Khatam Hospital and the Clinical Reference Laboratory (p = 0.001). Our sequence analyses revealed the presence of assemblages A (56.5%, 13/23), B (39.1%, 9/23), and A + B (4.4%, 1/23). No association was observed between the occurrence of a given assemblage and the occurrence of diarhroea. Conclusions: Giardia infections were found at relatively low prevalence rates in both symptomatic and asymptomatic individuals seeking medical attention. Being female, having diarrhoea, and being sampled during 2020–21 were predictors of giardiasis. Although limited, our molecular data indicate that some Giardia infections may be zoonotic in nature. These data should be corroborated and expanded in future epidemiological studies targeting simultaneously human, animal, and environmental (water) samples to improve our understanding of the epidemiology of giardiasis in Iran. [ABSTRACT FROM AUTHOR]

Background: The economic crisis in Sri Lanka worsened food insecurity, with millions facing moderate-to-severe food shortages. This study evaluates the effectiveness of cash transfers combined with mobile health education in enhancing dietary diversity and food security among Sri Lankan households during the crisis. Methods: This quasi-experimental single-group pre-post study involved 1040 eligible individuals selected through stratified random sampling from eligible households of Samurdhi beneficiaries and smallholder farmers. The intervention included a cash transfer of LKR 22,500 and weekly nutrition awareness messages via WhatsApp and SMS complemented by a one-time awareness session. Dietary diversity and food security were assessed using standard validated tools such as the Diet Quality Questionnaire and Food Security Questionnaire. Results: Food insecurity decreased significantly from 89.3% (n = 681) in the pre-test to 76.9% (n = 533) in the post-test, with a 12.4% reduction (95% CI, 8.57 to 16.24, p < 0.05). The Minimum Dietary Diversity for Women improved from 44.5 to 67.8% [23.3% increase (95% CI, 15.89 to 30.63; p < 0.05)]. The mean NCD-Protect and GDR scores increased significantly, indicating a higher adherence to global dietary recommendations, whereas the NCD-risk scores remained unchanged. Conclusions: This study demonstrated that cash transfers combined with mobile phone-based nutritional education significantly improved dietary diversity and food security among low-income families in Sri Lanka during the financial crisis. Clinical trial number: Not applicable. [ABSTRACT FROM AUTHOR]

Background and Purpose: Periodontitis is the leading cause of tooth loss in adults worldwide. The functional loss, nutritional deficiencies, and psychological barriers it causes, as well as its impact on overall health and quality of life, are all significant. The prevalence of periodontal disease is high in China. Our study aimed to determine the intricate relationship between periodontal disease status, dental anxiety, self-rated oral health (SROH), self-efficacy for oral care, perceived social support, socioeconomic status (SES), and the oral health-related quality of life (OHRQoL) among periodontitis patients. Methods: This cross-sectional study used purposive sampling to identify 247 patients with periodontitis who entered the First Affiliated Hospital of Bengbu Medical University between October 2022 and October 2023. 247 participants underwent a periodontal clinical examination combined with imaging, adhering to the " 2018 world new classification of periodontal and peri⁃implant diseases and conditions". Participants also completed a detailed questionnaire in paper format, which included OHRQoL, sociodemographic details, dental anxiety, SROH, self-efficacy in oral care, perceived social support, and subjective SES. Results: Dental anxiety, self-efficacy for oral care, and SROH all had a direct and significant effect on OHRQoL. OHRQoL was indirectly related to SROH mediated by dental anxiety and subjective SES, perceived social support and self-efficacy for oral care, respectively. SROH was directly related to subjective SES, and at the same time, they had a direct effect on dental anxiety. Furthermore, patient's age, gender, annual household income, and education level were significantly associated with the degree of periodontal disease. Conclusion: OHRQoL and periodontal status was influenced by socio-demographics characteristics, dental anxiety, SROH, self-efficacy for oral care, perceived social support, subjective SES in periodontitis patients. These insights underscore the importance of adopting a holistic approach in the management and treatment of periodontal diseases. [ABSTRACT FROM AUTHOR]

Objectives: Transplantation is a form of treatment that requires long-term pharmacotherapy. After transplantation, patients may have difficulty adapting to medication use for various reasons, and this may result in rejection. The aim of this study is to determine participants' medication compliance and the factors affecting it. Methods: The research was conducted with a sequential explanatory mixed method. In the study, quantitative data were collected using the Turkish Immunosuppressive Medication Adherence Scale, and qualitative data were collected using the In-Depth Individual Interview Guide. Quantitative data were analyzed using statistical methods, and qualitative data were examined according to Braun and Clarke's thematic analysis framework. Results: In this study, 62.3% of the participants were male, 37.0% were 50 years old and over, 71.3% lived with their spouse, 54.0% had primary and secondary school education, and 42.0% could not work due to their current health condition. From a clinical perspective, it was determined that 78% of the transplants were kidney transplants, and 41.3% were more than 4 years after transplantation. 74.3% of the transplants were from living donors. The mean score of the immunosuppressive medication compliance scale was determined to be 40.91±4.09. In the qualitative data analysis of the study, factors affecting medication adherence were examined and the themes of "individual factors", "complexity of the regimen" and "social support resources" were obtained. The sub-themes of the individual factors theme are reluctance, hopelessness and addiction; Sub-themes of the complexity of the regimen theme are drug side effects and polypharmacy; The sub-themes of the social support resources theme are loneliness and family pressure. Conclusions: The factors influencing medication adherence among organ transplant recipients have been investigated, revealing that adherence levels vary significantly depending on various factors. These findings underscore the importance of tailored care strategies and individualized support approaches. [ABSTRACT FROM AUTHOR]

This study identify the prevalence of sharp object injuries (SOIs) among healthcare workers (HCWs) in Dammam and Jeddah, Saudi Arabia. Methods: Quantitative methodology using a cross-sectional design was applied. Chi-square testing was employed for comparative analyses, and logistic regression encompassing univariate and multivariate models was implemented to ascertain the predictors of SOIs. Results: Prevalence rate of SOIs among hospital HCWs in Dammam and Jeddah cities was 8.40%. Non-Saudi nationals had a rate of 11.9%, while participants who had more than 15 years of experience had a lower rate (9.9%). Gender was identified as a significant predictor of SOIs, with males being two times more likely to experience SOIs than females. The highest rates of injuries were observed among laboratory personnel (29.2%; odds ratios of 8.6 and 7.2 in univariate and multivariate models, respectively). Conclusion: These findings show that HCWs in Dammam have a marginally higher risk of SOIs (prevalence rate 9%) than their counterparts in Jeddah (prevalence rate 7.8%). Further investigations are needed to tailor specific training programs to increase HCWs' awareness, safety knowledge, and practices to reduce SOIs. [ABSTRACT FROM AUTHOR]

Background: Serious mental illness (SMI) is a debilitating medical condition that causes stress and challenges for the family caregivers (FCs) of affected patients, increasing their caregiver burden (CB). This situation can activate attachment styles (AS) and trigger negative emotions, further contributing to CB. Given that AS and cognitive-emotional regulation (CER) can affect the CB of FCs of patients with SMI, the aim of this study was to evaluate the relationship between CB with AS, and CER among the FCs. Methods: This cross-sectional descriptive-correlational study was carried out in May–November 2022. Participants were 278 FCs of patients with SMI consecutively recruited from Roozbeh leading psychiatric hospital, Tehran, Iran. Data were collected using a patients' demographic and clinical characteristics questionnaire, an FCs' demographic characteristics questionnaire, the Attachment Style Questionnaire, the Cognitive Emotion Regulation Questionnaire, and the Burden Scale for Family Caregivers, and were analyzed using the SPSS software (v. 16.0). Results: CB had significant inverse relationship with secure AS (r = − 0.262) and significant positive relationship with fearful AS (r = 0.194) and dismissive AS (r = 0.242) (P < 0.01). Moreover, CB had significant inverse relationship with adaptive CER strategies and significant positive relationship with maladaptive CER strategies (P < 0.001). Regression analysis also showed that CB had significant relationship with secure AS and catastrophizing, rumination, self-blame, and positive refocusing CER strategies (P < 0.05). Conclusion: This study concludes that AS and CER can impact CB. There is a negative relationship between secure AS and CB, as well as between adaptive CER strategies and CB. Conversely, there is a positive relationship between avoidant AS and increased CB, as well as between maladaptive CER strategies and CB. It is recommended to adopt strategies that promote the use of secure AS and adaptive CER among the FCs of patients with SMI. [ABSTRACT FROM AUTHOR]

Background: Early Childhood Caries (ECC) is a highly prevalent disease among preschoolers in Sri Lanka, with stagnated prevalence over the decades. Therefore, it is important to determine the socio-behavioural associations of ECC among preschoolers to reduce the country's ECC burden. Methods: A cross-sectional study with a multistage cluster sampling technique was used to select 3 to 4 year-old preschoolers/mothers dyads in Gampaha district in 2019. Preschoolers who completed third birthday and had not completed fifth birthday on the day of data collection were selected. The dependent variable was the presence (dmft ≥ 1) or absence (dmft = 0) of ECC. Independent variables were sex, monthly family income, mother's educational and occupational status, child's birth order, family type, frequency of consumption of sweets and sweetened drinks, time of sweet consumption during the last 24 h, toothbrushing frequency, supervision of toothbrushing, dental visit, and maternal dental caries. A pre-tested validated questionnaire was used. Multiple logistic regression analysis was used. Results: Total of 1038 preschoolers were selected. There were 529 females (51.0%) and 509 males (49.0%). The prevalence of ECC was 56.3% (95% CI: 53.1–59.3). Consuming sweets between meals had a higher odds ratio than consuming sweets after main meals (OR = 1.72, 95% CI:1.25–2.35), consumption of sweets every day had a higher odds ratio than consumption of sweets several times a week or less (OR = 2.89, 95% CI: 2.02–4.13), consumption of sweetened drinks every day had a higher odds ratio than consumption of sweetened drinks several times a week or less (OR = 1.73, 95% CI: 1.07–2.79), and the presence of maternal caries had a higher odds ratio than the absence of maternal caries (OR = 1.74, 95% CI: 1.12–2.69). The use of adult fluoridated toothpaste than not using adult fluoridated toothpaste (OR = 0.64, 95% CI:0.48–0.85), tooth brushing twice per day than not brushing twice per day (OR = 0.67, 95% CI:0.51–0.89), and supervised toothbrushing than unsupervised toothbrushing (OR = 0.61, 95% CI: 0.41–0.93) was negatively associated with ECC. Conclusions: ECC is highly associated with sweet consumption and oral hygiene behaviours among preschoolers in Gampaha District. Interventions should focus on the oral health behaviours of preschoolers to reduce ECC burden. [ABSTRACT FROM AUTHOR]

Introduction/objectives: The precise location of the tumor site is essential for the success of surgical treatment. Neoadjuvant chemotherapy (NAC) is a challenge for preoperative tumor and node localization. Thus, the knowledge and attitudes of the affiliated members of the Brazilian Society of Mastology (SBM) regarding breast and axilla marking were evaluated and a consensus regarding management and treatment was reached. Methods: This was an online survey conducted between June and December 2022. All 1,742 active mastologists affiliated to the SBM were invited anonymously. The online form contained 28 objective questions, of which 22 were formulated on a Likert scale. These questions addressed relevant aspects related to breast and axilla marking in the neoadjuvant setting. Responses that reached 70% agreement were considered consensual. Statistical analysis was performed using the SPSS program version 26.0. Post hoc analysis was performed when appropriate and the significance level was set at p < 0.05. Polychoric regression analyses were conducted using 'VGAM' package Results: In total, 468 mastologists answered the questionnaire (26.8%), with a predominance of professionals aged between 40-49 years (32.1%). Most professionals were board-certified (84,8%). The indication of tumor marking in the breast prior to NAC was consensual (96.4%) and the metal clip was the preferred method (69.7%). There was no consensus regarding the indication of pre-NAC histologically positive lymph node marking (49.8% disagree and 42.8% agree). However, there was consensus that the clinical and imaging evaluation was insufficient for staging the axilla as N1 (71.6%). The contraindication of breast and node marking in T4b tumors (71.2%) was consensual. There was consensus on the indication of sentinel lymph node biopsy (SLNB) for initially cN1 (92.3%) or cN2 (72.7%) tumors that became cN0 after NAC, with 67.5% opting for dual staining with technetium and patent blue. When <3 lymph nodes were retrieved 41.0% of mastologists performed axillary lymphadenectomy. Among the 28 questions, consensus was reached on only 11 (39.3%). Conclusion: The indication of pre-NAC breast marking is consensual among Brazilian mastologists, although axillary nodal marking is not. There is a great divergence of attitudes among Brazilian surgeons in relation to the many issues related to pre-NAC breast and axilla marking. [ABSTRACT FROM AUTHOR]

Objective: Falls take a high priority among the prevalent medical conditions in old age. Despite this, a history of falls or the risk of future falls is not routinely assessed or properly managed in medical clinics in Sri Lanka. This study was done to evaluate the prevalence and factors associated with falls and recurrent falls among older adults attending medical clinics in four selected tertiary care centres in the country. Methods: A cross-sectional study was carried out at four centres (Teaching Hospital Karapitiya, Colombo South Teaching Hospital, Colombo North Teaching Hospital and University Hospital-Kotelawala Defence University) with 704 older adults, aged 65 years and above, attending medical clinics for more than six consecutive months. Information related to falls and possible associated factors (socio-demographic, behavioural, environmental and biological) were collected using an interviewer-administered questionnaire. Results: The Mean (SD) age of the participants was 72.5(5.5) years and 58.7% were females. Of the 704 total sample, 220 (31.3%, 95% CI 28–35%) participants experienced at least one fall after the age of 65, and 12.8% (95% CI 10–15%) (n = 90) experienced recurrent falls (two or more falls within the last 12 months). Falls were associated with gender, level of education, marital status, and physical dependence (p < 0.01). For those who had at least one fall, multiple logistic regression (MLR) revealed being single (p = 0.03, OR = 2.12, 95% CI; 1.052–4.304), being widowed/divorced/separated (p = 0.03, OR = 1.47, 95% CI; 1.039–2.093) compared to living with a spouse, presence of moderate (p = 0.007, OR = 1.72, 95% CI; 1.160–2.577) and severe (p = 0.001, OR = 2.98, 95% CI; 1.563–5.688) physical dependency compared to mild physical dependency as risk factors for falls. Having secondary education (p = 0.01, OR = 0.55, 0.350–0.876) was a protective factor for falls. For those with recurrent falls, MLR showed moderate physical dependency (p = 0.001, OR = 2.34, 95% CI; 1.442–3.821) compared to slight physical dependency as a risk factor. Conclusions: Approximately one-third of the older adults attending medical clinics had experienced at least a single fall, and one-eighth have had recurrent falls, which were mostly unrecorded and not clinically assessed. Physical dependency was the major contributing factor to falls and recurrent falls. Falls assessment should be included in the routine clinical assessment of older adults attending outdoor medical clinics. Health professionals should be educated to detect and assess those at risk of falling and take appropriate measures to prevent or minimize falls. [ABSTRACT FROM AUTHOR]

Background: Strongyloidiasis a neglected tropical disease is known to cause severe disease among immunosuppressed and has not been studied extensively in Sri Lanka. Parasitological diagnostic approaches based on faecal microscopy and culture often fail to detect low-intensity infections. This study investigates the presence of strongyloidiasis among selected immunocompromised individuals using parasitological, molecular and serological techniques. Methods: Adult patients with immunocompromising conditions admitted to three tertiary care hospitals in Sri Lanka were recruited. A faecal sample and 2 ml of venous blood were collected. The faecal samples were subjected to direct faecal smear and cultures (agar plate, charcoal and Harada-Mori) and polymerase chain reaction (PCR) using species specific primers designed for Strongyloides stercoralis. The presence of Strongyloides IgG antibodies was tested in the collected serum samples using DRG Strongyloides IgG enzyme-linked immunosorbent assay (ELISA) kits. The PCR products of the positive samples were sequenced using Sanger sequencing method. Results: A total of 260 patients were recruited to this study, out of which 160 provided faecal samples and 122 provided blood samples. Out of the 160 faecal samples, none were positive for strongyloidiasis by direct smear, charcoal and Harada-Mori cultures. Only one sample (0.6%) was positive by agar plate culture. Out of the 123 samples subjected to PCR, 14 (11.4%), including the culture positive patient, were positive for S. stercoralis. Sequencing results of the PCR products indicated 100% similarity to S. stercoralis. Out of the 122 serum samples subjected to ELISA, 20 (16.4%), including the culture positive patient, were positive for Strongyloides IgG antibodies. However, sociodemographic, exposure factors, clinical features were not significantly associated with the presence of strongyloidiasis infection. Conclusions: Strongyloidiasis is present among the immunocompromised population in Sri Lanka, even in the absence of a significant relationship with associated factors. It is advisable to screen such patients with highly sensitive tests such as PCR for early diagnosis and treatment. [ABSTRACT FROM AUTHOR]

BACKGROUND: St. Paul's Hospital Millennium Medical College (SPHMMC) has offered radiology specialty training for a decade. To mark its 10th anniversary and assess the program's status, this study aimed to gather stakeholders' perspectives on its functioning. METHODS: The assessment was conducted from June 15 to July 5, 2024, using a stratified cross-sectional study design. A total of 211 participants were recruited through exhaustive sampling from alumni, faculty, students, referring physicians, and patients. Data were collected via web-based and paper-based questionnaires, where stakeholders rated the core functions of the SPHMMC radiology program (curriculum, teaching, research, and imaging practices) on a 5-point scale and provided additional feedback. RESULTS: Overall, 78% of stakeholders regarded the program's curriculum as highly relevant. However, teaching quality and research were viewed negatively, with only 19% and 11% of radiologists rating these aspects positively. Referring physicians considered radiology reports relevant (68%) but often found them incomplete and untimely (73%), with only 2% deemed timely. Over 80% of patients expressed dissatisfaction with the imaging services and were unwilling to recommend them. CONCLUSIONS: While positive perceptions of the curriculum and imaging services suggest program strengths, the negative feedback on teaching and research quality indicates the need for improvements to maintain SPHMMC's commitment to quality education and services. [ABSTRACT FROM AUTHOR]

Context: Epileptic seizures and the unpredictable falls resulting from epileptic seizures predispose the people living with epilepsy (PLWE) to various physical injuries as well as postictal cognitive and behavioral changes. Aims: The aim of the study was to determine the frequency and patterns of seizure-related physical injuries, postictal cognitive impairments, and behavioral changes. Settings and Design: This was a cross-sectional descriptive study in a Southeast Nigeria local government area. Subjects and Methods: PLWE identified during a two-phase door-to-door survey and their caregivers were interviewed using a semi-structured questionnaire. Statistical Analysis Used: The Statistical Package for the Social Sciences version 22.0 was used. Results: There were 56 cases of active convulsive seizures comprising 33 (58.9%) males and 23 (41.1%) females, with a mean age of 32.9 ± 14.2. The lifetime prevalence of seizure-related physical injuries, postictal behavioral changes, and postictal cognitive impairments was 9.8 per 1000 (95% confidence interval [CI]: 9.1–10.0), 8.4 per 1000 (95% CI: 7.2–9.2), and 6.3 per 1000 (95% CI: 4.9–7.5), respectively. Skin/soft-tissue injuries and tongue laceration were the most frequent physical injuries found in 66.1% (n = 37/56) and 60.7% (n = 34/56) of cases, respectively. The frequency of soft-tissue injuries was significantly higher (χ2 = 5.038; P = 0.0248) in the females 78.3% (n = 18/23) than the males 48.5% (n = 16/33). About a third of the females 39.1% had burn injuries compared to 18.1% of the males. Conclusions: Seizure-related injuries are common and have the tendency to increase the burden of epilepsy and epilepsy-related stigma from deformities and the chronic disfiguring scars resulting from such injuries. [ABSTRACT FROM AUTHOR]

Copyright of Jurnal Nusantara Aplikasi Manajemen Bisnis is the property of Universitas Nusantara PGRI Kediri 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.)