scholarly journals Relationship between right-to-left shunt and migraine in patients with epilepsy: a single-centre, cross-sectional study in China

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e024144 ◽  
Author(s):  
Lin Zhang ◽  
Xi Zhu ◽  
Xiangmiao Qiu ◽  
Yajiao Li ◽  
Yucheng Chen ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Sectional Study ◽  
Single Centre ◽  
Cross Sectional ◽  
High Prevalence ◽  
The Right ◽  
Patients With Epilepsy

ObjectivesTo investigate the relationship between right-to-left shunt and migraine to account for the unexplained high prevalence of migraine in patients with epilepsy.DesignThis is a cross-sectional study. The diagnosis and interview process of patients with migraine was based on the International Classification of Headache Disorders-3 beta in patients with epilepsy. Participants underwent transthoracic echocardiography (TTE) with contrast medium to identify right-to-left shunt. The highest number of microbubbles were recorded in the left atrium before the complete microbubble outflow of the right atrium. A moderate-to-large shunt was defined as the presence of 10 or more microbubbles.SettingA single-centre, cross-sectional study in China, 2015–2017.ParticipantsPatients with epilepsy.Primary and secondary outcome measuresThe primary outcome measures were the prevalence of migraine, the prevalence of right-to-left shunt in patients with migraine and those without migraine, and the prevalence of migraine in different degrees of shunting.ResultsThree hundred thirty-nine participants with epilepsy who completed TTE were included in the analysis. The overall prevalence of migraine was 23.0%. One-third of the migraineurs had mild right-to-left shunt and one-fifth of the migraineurs had moderate-to-large right-to-left shunt. Patients with mild shunt did not have a higher prevalence of migraine than those without shunt (26.3% vs 18.1%, p=0.102); however, a higher prevalence of migraine was found in patients with moderate-to-large shunt (39.0% vs 18.1%, OR=2.90, 95% CI=1.41 to 5.98, p=0.003). Patients with migraine and patients without migraine had similar prevalence of mild shunt; however, patients with migraine had more moderate-to-large shunt (20.5% vs 9.6%, p=0.002). Right-to-left shunt and female were factors predicting migraine prevalence.ConclusionsOne-fifth of migraineurs were correlated with moderate-to-large right-to-left shunt which could be an underlying cause of migraine in epilepsy.

scholarly journals Weight underestimation linked to anxiety and depression in a cross-sectional study of overweight individuals in a Sami and non-Sami Norwegian population: the SAMINOR Study

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e031810
Author(s):  
Kirsti Kvaløy ◽  
Marita Melhus ◽  
Anne Silviken ◽  
Ann Ragnhild Broderstad
Keyword(s):  
Marital Status ◽  
Outcome Measures ◽  
Population Based ◽  
Cross Sectional Study ◽  
Primary Outcome Measure ◽  
Secondary Outcome ◽  
Anxiety And Depression ◽  
Negative Consequences ◽  
Sectional Study ◽  
Cross Sectional

ObjectivesUnderestimation of overweight/obesity may prevent weight loss attempts, resulting in further weight gain and maintenance of overweight. Mental health benefits may nevertheless surpass negative consequences. Our main objective was to study the association between underestimation of overweight/obesity and symptoms of anxiety and depression in Sami and non-Sami populations.DesignPopulation-based cross-sectional study.SettingThe SAMINOR 2 Clinical Study with participants from 10 municipalities in Northern Norway enrolled between 2012 and 2014.ParticipantsThe study included 3266 adults of multiethnic rural origin with overweight/obesity (body mass index (BMI) ≥25 kg/m2) whereof 1384 underestimated their weight (42%).Primary and secondary outcome measuresPrimary outcome measure was symptoms of anxiety and depression and secondary outcome measures were BMI and the demographic variables: sex, age, education and marital status.ResultsA higher proportion of Sami men compared with non-Sami men were obese, and reported more symptoms of anxiety and depression. More men than women, and a higher proportion of Sami women compared with non-Sami women, underestimated their weight. Multivariable-adjusted analyses showed that women were less likely to underestimate their weight compared with men (OR 0.43, 95% CI 0.33 to 0.55 in Sami and OR 0.33, 95% CI 0.26 to 0.42 in non-Sami), higher BMI was protective against weight underestimation (OR 0.72, 95% CI 0.69 to 0.75 in Sami and OR 0.63, 95% CI 0.60 to 0.67 in non-Sami), slightly higher odds of weight underestimation were observed with increasing age in both ethnic groups (OR 1.03, 95% CI 1.01 to 1.05 in Sami and OR 1.02, 95% CI 1.00 to 1.03 in non-Sami), while higher education lowered the odds in non-Sami (OR 0.69, 95% CI 0.55 to 0.87). Weight underestimation was protectively associated with anxiety and depression in Sami men (OR 0.48, 95% CI 0.27 to 0.84) and in non-Sami women (OR 0.44, 95% CI 0.25 to 0.78) adjusted for age, BMI, education and marital status.ConclusionsIndependent of ethnicity, more men than women underestimated their weight. Underestimation of weight was protectively associated with anxiety and depression in Sami men and non-Sami women.

scholarly journals Assessment of the level of knowledge, awareness and management of hypertension and diabetes among adults in Imo and Kaduna states, Nigeria: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e043951
Author(s):  
Jennifer Anyanti ◽  
Selema Margaret Akuiyibo ◽  
Oluwole Fajemisin ◽  
Omokhudu Idogho ◽  
Babatunde Amoo
Keyword(s):  
Outcome Measures ◽  
Cross Sectional Study ◽  
Good Knowledge ◽  
Secondary Outcome ◽  
Diabetes Knowledge ◽  
Sectional Study ◽  
Unhealthy Lifestyle ◽  
Cross Sectional ◽  
Level Of Knowledge ◽  
The Mean

ObjectivesThis study was designed to assess levels of awareness, knowledge, attitude and practices relating to hypertension and diabetes among adults aged 35 years resident in selected communities in Imo and Kaduna states, Nigeria.DesignA descriptive cross-sectional study.SettingSelected communities across 14 local government areas in Imo and Kaduna states were included.ParticipantsIn total, 824 adults, aged 35 years or older and resident in selected communities where the Access-N project was being implemented in Imo and Kaduna states participated in the study.Primary and secondary outcome measuresThe study assessed the level of hypertension and diabetes knowledge among the participants. Regular blood pressure (BP) and glucose screening practices were also examined as outcome measures.ResultsThe mean age of the respondents was 48.32 years. In total, 778 (94.4%) and 746 (90.5%) of the respondents were aware of hypertension and diabetes, respectively. The mean hypertension and diabetes knowledge scores (±SD) were 4.99 (±1.99) and 8.02 (±2.61), respectively. A total of 326 (41.9%) respondents aware of hypertension had a good knowledge of hypertension while 477 (63.9%) of those aware of diabetes had a good knowledge of diabetes. Levels of hypertension and diabetes knowledge were found to be associated with physical activity and the level of education of the respondents. About two-thirds (62.6%) and less than half (41.5%) of the respondents, respectively check their BP and blood glucose (BG) levels regularly (at least once yearly). Statistically significant associations were observed between age and regular BP and BG level checks.ConclusionsDespite the high awareness rate of hypertension and diabetes observed in this study and a relatively good knowledge about the two conditions, unhealthy lifestyle practices and non-regular routine screening abounds among the respondents. Thus, there is a need to improve access to quality information about hypertension and diabetes aimed at motivating adoption of healthy behaviours.

scholarly journals Contact burns: the influence of agents and mechanisms of injury on anatomical burn locations in children <5 years old and associations with child protection referrals

2019 ◽  
Vol 105 (6) ◽  
pp. 580-586
Author(s):  
Assim Ali Javaid ◽  
Verity Bennett ◽  
Linda Hollén ◽  
Alison Mary Kemp
Keyword(s):  
Young Children ◽  
Outcome Measures ◽  
Child Protection ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Mechanism Of Injury ◽  
Sectional Study ◽  
Cross Sectional ◽  
Burn Units ◽  
Causative Agents

ObjectiveTo identify how causative agents and mechanisms of injury influence the location of an accidental contact burn in children and whether these factors differ in cases referred for child protection (CP) assessment.DesignProspective multicentre cross-sectional study.Setting20 hospital sites across England and Wales, including: emergency departments, minor injury units and regional burn units.PatientsChildren less than 5 years old who attended hospital for a contact burn (August 2015 to September 2018).Main outcome measuresLocation of burns with respect to agent and mechanism for accidental contact burns. Secondary outcome: mechanism, agent and location of burns referred for CP assessment.Results816 accidental burns and 92 referrals for CP assessment. The most common for accidental burns: mechanism was reaching while stationary (68%, 553/816), agent was oven (24.5%, 200/816) and site was the hand (69.2%, 565/816). Burns to head and trunk were rare at 3.7% (30/816). The data enabled a tabulation of the locations of burns as predicted by agent and mechanism of injury. The location of the burn was most strongly influenced by mechanism.Burns from irons (p<0.01), caused by mechanisms independent of the child (p=0.01), unwitnessed burns (p<0.001) and burns to the head and trunk (p<0.001) were significantly more common among the children referred for CP assessment.ConclusionsBy overlaying agent, mechanism and site it was possible to tabulate and quantify simple narratives of accidental contact burns in population of young children. These findings have the potential to aid clinicians in recognising accidental contact burns.

scholarly journals Barriers to uptake of referral services from secondary care to tertiary care and its associated factors in L V Prasad Eye Institute network in Southern India: a cross-sectional study

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e020687
Author(s):  
Rohit C Khanna ◽  
Sujeong Kim ◽  
Pyda Giridhar ◽  
Asha Latha Mettla ◽  
Srinivas Marmamula ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Secondary Care ◽  
Tertiary Care ◽  
Multivariable Analysis ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Care Hospital ◽  
Care Centre ◽  
Sectional Study ◽  
Cross Sectional

ObjectiveTo examine barriers to the uptake of referral services from secondary care centres to higher level tertiary care centres.DesignCross-sectional study.SettingSecondary care hospital in Khammam District in the Telangana state of India.ParticipantsNine hundred and three patients who were referred from a secondary care centre to tertiary care centres between June 2011 and December 2012, were over the age of 18 and lived within 50 km of the secondary care centre were identified. Six hundred and sixteen (68.2%) of these patients were successfully contacted, and 611 (99%) of those contacted consented to participation in the study.InterventionsThose who attended at higher centres after referral (compliant) and those who failed to attend (non-compliant) were interviewed with a standard questionnaire designed for the study.Primary and secondary outcome measuresOutcome measures were barriers to the uptake of eye care services for the non-compliant participants and the associated risk factors for non-compliance.ResultsOf the contacted patients, 418 (68.4%) were compliant and 193 (31.6%) were non-compliant. The mean age of interviewed patients was 48.4 years (SD: 17.9 years) and 365 (59.7%) were male. Of those who did not comply with their referral, the major identified barriers were ‘cannot afford treatment cost’ (30%) and ‘able to see adequately’ (20.7%). Multivariable analysis showed that participants in the non-compliant group were more likely to have had only one prior visit to the centre (OR: 2.5, 95% CI 1.6 to 3.9), be referred for oculoplastic services (OR: 3.0, 95% CI 1.0 to 8.8) and to be the main earning member of the family (OR: 1.9, 95% CI 1.2 to 2.8).ConclusionsNon-compliance with referrals in this population is largely attributable to economic and attitudinal reasons. Focusing on these specific barriers and targeting groups at higher risk of non-compliance could potentially improve uptake of referral services.

HIGH PREVALENCE OF MALNUTRITON AND WORM INFECTION AMONG VAN KIEU AND PAKOH CHILDREN AGED 12-36 MONTHS IN DAKRONG DISTRICT, QUANG TRI PROVINCE

2012 ◽  
pp. 129-134
Author(s):  
Thi Lan Tran ◽  
Thi Huong Le ◽  
Xuan Ninh Nguyen
Keyword(s):  
Cross Sectional Study ◽  
Age Group ◽  
Infection Status ◽  
Sectional Study ◽  
Group Recommendation ◽  
Related Factors ◽  
Normal Children ◽  
Cross Sectional ◽  
High Prevalence ◽  
Very High

Objectives: Assess the nutritional status, worm infection status and some related factors among children aged 12-36 months of Dakrong district, Quang Tri province. Subject and method: A cross sectional study was carried out in 2010, in 680 children aged 12-36 months in 4 communes of Dakrong district, Quang Tri province. Results: The malnutrition rate was 55.0% for underweight, 66.5% for stunting and 16.2% for wasting. The prevalence of malnutrition increases by age group. The prevalence of worm infection was 31.6%, the highest prevalence was belong to Ascaris infection (24.6%), followed by Hookworm and Trichuris (6.5% and 6.2%, respectively). The prevalence of worm infection among children under two is very high (27.0%). The prevalence of worm infection was distributed quite equally between the malnutrition children group and normal children group. Recommendation: Early deworming forchildren from 12 months should be considered as important strategy against the malnutrition of children in Dakrong district, Quang Tri province

Distribution and Characteristics of Intrathoracic Lymphadenopathy in TB/HIV Co-Infection

2019 ◽  
Vol 19 (4) ◽  
pp. 414-420
Author(s):  
Payam Mehrian ◽  
Abtin Doroudinia ◽  
Moghadaseh Shams ◽  
Niloufar Alizadeh
Keyword(s):  
Lymph Nodes ◽  
Cross Sectional Study ◽  
Short Axis ◽  
Mediastinal Lymph Nodes ◽  
Sectional Study ◽  
Cross Sectional ◽  
Immunodeficiency Virus ◽  
Hilar Adenopathy ◽  
The Right ◽  
Pulmonary Abnormalities

Background: Intrathoracic Lymphadenopathy (ITLN) in Human Immunodeficiency Virus (HIV) infected patients may have various etiologies and prognoses. Etiologies of ITLN can be distinguished based on the distribution of enlarged lymph nodes. Sometimes tuberculosis (TB) is the first sign of underlying HIV infection. Objective: We sought to determine ITLN distribution and associated pulmonary findings in TB/HIV co-infection using Computed Tomography (CT) scan. Methods: In this retrospective, observational, cross-sectional study, chest CT scans of 52 patients with TB/HIV co-infection were assessed for enlarged intrathoracic lymph nodes (>10 mm in short axis diameter), lymphadenopathy (LAP) distribution, calcification, conglomeration, the presence of hypodense center and associated pulmonary abnormalities. LAP distribution was compared in TB/HIV co-infection with isolated TB infection. Results: Mediastinal and/or hilar LAP were seen in 53.8% of TB/HIV co-infection patients. In all cases, LAP was multinational. The most frequent stations were right lower paratracheal and subcarinal stations. Lymph node conglomeration, hypodense center and calcification were noted in 25%, 21.4% and 3.5% of patients, respectively. LAP distribution was the same as that in patients with isolated TB infection except for the right hilar, right upper paratracheal and prevascular stations. All patients with mediastinal and/or hilar adenopathy had associated pulmonary abnormalities. Conclusion: All patients with TB/HIV co-infection and mediastinal and/or hilar adenopathy had associated pulmonary abnormalities. Superior mediastinal lymph nodes were less commonly affected in TB/HIV co-infection than isolated TB.

scholarly journals Prevalence of urogenital, anal, and pharyngeal infections with Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma genitalium: a cross-sectional study in Reunion island

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
A. Calas ◽  
N. Zemali ◽  
G. Camuset ◽  
J. Jaubert ◽  
R. Manaquin ◽  
...  
Keyword(s):  
Chlamydia Trachomatis ◽  
Neisseria Gonorrhoeae ◽  
Mycoplasma Genitalium ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Transmitted Infection ◽  
Cross Sectional ◽  
Sexually Transmitted ◽  
Urogenital Infection ◽  
High Prevalence

Abstract Background Recommendations for sexually transmitted infection (STI) screening vary significantly across countries. This study evaluated the prevalence of urogenital and extragenital infections with Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Mycoplasma genitalium (MG) in patients visiting a French STI clinic in the Indian Ocean region to determine whether current STI screening practices should be updated. Methods This cross-sectional study examined all patients who visited the STI clinic between 2014 and 2015. Triplex polymerase chain reaction screening for CT, NG, and MG was performed on urine, vaginal, pharyngeal, and anal specimens (FTD Urethritis Basic Kit, Fast Track Diagnostics, Luxembourg). Results Of the 851 patients enrolled in the study, 367 were women (367/851, 43.2%) and 484 were men (484/851, 56.0%). Overall, 826 urogenital specimens (826/851, 97.1%), 606 pharyngeal specimens (606/851, 71.2%), and 127 anal specimens (127/851, 14.9%) were taken from enrolled patients. The prevalence of urogenital CT and MG was high in women ≤25 years (19/186, 10.21%; 5/186, 2.69%) and in men who have sex with women ≤30 years (16/212, 7.54%; 5/212, 2.36%). Among patients with urogenital CT infection, 13.7% (7/51) had urethritis. All patients with urogenital MG infection were asymptomatic. Men who have sex with men had a high prevalence of pharyngeal CT (2/45, 4.44%) and NG (3/44, 6.81%) and a high prevalence of anal CT (2/27, 7.41%), NG (2/27, 7.40%), and MG (1/27, 3.70%). After excluding patients with concomitant urogenital infection, extragenital infections with at least 1 of the 3 pathogens were found in 20 swabs (20/91, 21.9%) taken from 16 patients (16/81, 19.7%), all of them asymptomatic. Conclusions Routine multisite screening for CT, NG, and MG should be performed to mitigate the transmission of STIs in high-risk sexually active populations.

scholarly journals Associations between multimorbidity and glycaemia (HbA1c) in people with type 2 diabetes: cross-sectional study in Australian general practice

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e039625
Author(s):  
Jason I Chiang ◽  
John Furler ◽  
Frances Mair ◽  
Bhautesh D Jani ◽  
Barbara I Nicholl ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
General Practice ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Linear Regression Models ◽  
Sectional Study ◽  
Cross Sectional ◽  
Long Term Conditions ◽  
Australian General Practice

ObjectivesTo explore the prevalence of multimorbidity as well as individual and combinations of long-term conditions (LTCs) in people with type 2 diabetes (T2D) attending Australian general practice, using electronic health record (EHR) data. We also examine the association between multimorbidity condition count (total/concordant(T2D related)/discordant(unrelated)) and glycaemia (glycated haemoglobin, HbA1c).DesignCross-sectional study.SettingAustralian general practice.Participants69 718 people with T2D with a general practice encounter between 2013 and 2015 captured in the MedicineInsight database (EHR Data from 557 general practices and >3.8 million Australian patients).Primary and secondary outcome measuresPrevalence of multimorbidity, individual and combinations of LTCs. Multivariable linear regression models used to examine associations between multimorbidity counts and HbA1c (%).ResultsMean (SD) age 66.42 (12.70) years, 46.1% female and mean (SD) HbA1c 7.1 (1.4)%. More than 90% of participants with T2D were living with multimorbidity. Discordant conditions were more prevalent (83.4%) than concordant conditions (69.9 %). The three most prevalent discordant conditions were: painful conditions (55.4%), dyspepsia (31.6%) and depression (22.8%). The three most prevalent concordant conditions were hypertension (61.4%), coronary heart disease (17.1%) and chronic kidney disease (8.5%). The three most common combinations of conditions were: painful conditions and hypertension (38.8%), painful conditions and dyspepsia (23.1%) and hypertension and dyspepsia (22.7%). We found no associations between any multimorbidity counts (total, concordant and discordant) or combinations and HbA1c.ConclusionsMultimorbidity was common in our cohort of people with T2D attending Australian general practice, but was not associated with glycaemia. Although we did not explore mortality in this study, our results suggest that the increased mortality in those with multimorbidity and T2D observed in other studies may not be linked to glycaemia. Interestingly, discordant conditions were more prevalent than concordant conditions with painful conditions being the second most common comorbidity. Better understanding of the implications of different patterns of multimorbidity in people with T2D will allow more effective tailored care.

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