Tablet and web-based audiometry to screen for hearing loss in adults with cystic fibrosis

IntroductionIndividuals with chronic lung disease (eg, cystic fibrosis (CF)) often receive antimicrobial therapy including aminoglycosides resulting in ototoxicity. Extended high-frequency audiometry has increased sensitivity for ototoxicity detection, but diagnostic audiometry in a sound-booth is costly, time-consuming and requires a trained audiologist. This cross-sectional study analysed tablet-based audiometry (Shoebox MD) performed by non-audiologists in an outpatient setting, alongside home web-based audiometry (3D Tune-In) to screen for hearing loss in adults with CF.MethodsHearing was analysed in 126 CF adults using validated questionnaires, a web self-hearing test (0.5 to 4 kHz), tablet (0.25 to 12 kHz) and sound-booth audiometry (0.25 to 12 kHz). A threshold of ≥25 dB hearing loss at ≥1 audiometric frequency was considered abnormal. Demographics and mitochondrial DNA sequencing were used to analyse risk factors, and accuracy and usability of hearing tests determined.ResultsPrevalence of hearing loss within any frequency band tested was 48%. Multivariate analysis showed age (OR 1.127; (95% CI: 1.07 to 1.18; p value<0.0001) per year older) and total intravenous antibiotic days over 10 years (OR 1.006; (95% CI: 1.002 to 1.010; p value=0.004) per further intravenous day) were significantly associated with increased risk of hearing loss. Tablet audiometry had good usability, was 93% sensitive, 88% specific with 94% negative predictive value to screen for hearing loss compared with web self-test audiometry and questionnaires which had poor sensitivity (17% and 13%, respectively). Intraclass correlation (ICC) of tablet versus sound-booth audiometry showed high correlation (ICC >0.9) at all frequencies ≥4 kHz.ConclusionsAdults with CF have a high prevalence of drug-related hearing loss and tablet-based audiometry can be a practical, accurate screening tool within integrated ototoxicity monitoring programmes for early detection.

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Study of Patients with First unprovoked Seizure in the Eastern Part of Nepal

Journal of Nobel Medical College ◽

10.3126/jonmc.v8i1.24471 ◽

2019 ◽

Vol 8 (1) ◽

pp. 22-26

Author(s):

Dilli Ram Kafle ◽

Surendra Sah ◽

Miluna Bhusal

Keyword(s):

Recurrence Risk ◽

Cross Sectional Study ◽

P Value ◽

Seizure Recurrence ◽

Unprovoked Seizure ◽

Cross Sectional ◽

Medical College ◽

Increased Risk ◽

Neuro Imaging

Background: About 5-10% of the population get at least one seizure in their lifetime. Treatment is started in patients with first unprovoked seizure if the risk of seizure recurrence is predicted to be high. If patients with first seizure are not treated 40-50% of patients develop recurrence within 2 years of the initial seizure. Starting treatment may cause reduction in the risk of recurrence by almost one half. The aim of the study was to identify the factors causing recurrence in patients with first unprovoked seizure. Materials and Methods: It is a prospective cross-sectional study conducted at Nobel Medical College from March 2015 to March 2019. Patients who presented to Nobel Medical College with first unprovoked seizure were enrolled in the study with follow up during the hospital visit. Results: Eighty six patients participated in our study. Recurrence of seizure occurred in 21(24.4%) patients within the study period of 4 years. Abnormal Electroencephalography was significantly associated with recurrence of seizure in patients with first seizure. (P value<0.001) Neuro imaging abnormality was also associated with increased risk of seizure recurrence (Pvalue<0.001) .Starting an antiepileptic after first seizure reduced the risk of further seizure. Conclusion: Recurrence of seizure was observed in almost a quarter of patients within the study period of four years. Recurrence risk was higher in those patients with abnormal Electro encephalography and in those patients with identified cause than those patients whose seizure was assumed to be idiopathic.

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Prevalence of microalbuminuria and associated factors among HIV − infected ART naïve patients at Mulago hospital: a cross-sectional study in Uganda

BMC Nephrology ◽

10.1186/s12882-020-02091-2 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Thomas Kiggundu ◽

Robert Kalyesubula ◽

Irene Andia-Biraro ◽

Gyaviira Makanga ◽

Pauline Byakika-Kibwika

Keyword(s):

Antiretroviral Therapy ◽

Cross Sectional Study ◽

Cd4 Count ◽

P Value ◽

Mulago Hospital ◽

Sectional Study ◽

Chi Square ◽

Cross Sectional ◽

Exact Test ◽

Increased Risk

Abstract Background HIV infection affects multiple organs and the kidney is a common target making renal disease, one of the recognized complications. Microalbuminuria represents an early, important marker of kidney damage in several populations including HIV-infected antiretroviral therapy (ART) naïve patients. Early detection of microalbuminuria is critical to slowing down progression to chronic kidney disease (CKD) in HIV-infected patients, however, the burden of microalbuminuria in HIV-infected antiretroviral therapy (ART) naïve patients in Uganda is unclear. Methods A cross-sectional study was conducted in the Mulago Immune suppression syndrome (ISS) clinic among adult HIV − infected ART naïve outpatients. Data on patient demographics, medical history was collected. Physical examination was performed to assess body mass index (BMI) and hypertension. A single spot morning urine sample from each participant was analysed for microalbuminuria using spectrophotometry and colorimetry. Microalbuminuria was defined by a urine albumin creatinine ratio (UACR) 30-299 mg/g and macroalbuminuria by a UACR > 300 mg/g. To assess the factors associated with microalbuminuria, chi-square, Fisher’s exact test, quantile regression and logistic regression were used. Results A total of 185 adult participants were consecutively enrolled with median age and CD4+ counts of 33(IQR = 28–40) years and 428 (IQR = 145–689) cells/μL respectively. The prevalence of microalbuminuria was 18.9% (95% CI, 14–25%). None of the participants had macroalbuminuria. CD4+ count <350cells/μL was associated with increased risk of microalbuminuria (OR: 0.27, 95% CI: 0.12–0.59), P value = 0.001). Diabetes mellitus, hypertension, smoking, alcohol intake were not found to be significantly associated with microalbuminuria. Conclusion Microalbuminuria was highly prevalent in adult HIV − infected ART naive patients especially those with low CD4+ count. There is need to study the effect of ART on microalbuminuria in adult HIV − infected patients.

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The Association Between Time in Range %, and Physical & Functional Indices Amongst Older People With Type 2 Diabetes: A Cross Sectional Study

Journal of the Endocrine Society ◽

10.1210/jendso/bvab048.976 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. A477-A478

Author(s):

Yamit Basson-Shleymovich ◽

Tali Cukierman-Yaffe ◽

Tal Yahalom-Peri ◽

Michal Azmon

Keyword(s):

Lower Extremity ◽

Older People ◽

Cross Sectional Study ◽

P Value ◽

Sectional Study ◽

Cross Sectional ◽

Lower Extremity Strength ◽

Increased Risk ◽

Time In Range

Abstract Diabetes is a major public health burden associated with high mortality, morbidity, hospitalization and health care services utilization rates. People with diabetes have an increased risk for mobility disability compared to those without diabetes, after controlling for age. People with diabetes also have a higher risk for falls and fractures. Data from the last several years suggests that this increased risk is not only due to diabetes co-morbidities but also due to an accelerated decline in physical capacity due to lower muscle quality and a more rapid decline in muscle mass (sarcopenia) and lower extremity strength over time. HBA1C is a measure of average glucose levels; however, it does not provide information about glycemic variability, or daily patterns of glycemia. In the last several years, several organizations have published consensus statements on the role of continuous glucose monitoring (CGM) in glucose control. The use of CGM has brought about the development of many glucose indices, amongst them is: Time In Range% (TIR) of 70–180 mg/dL (3.9–10 mmol/L). Less is known regarding the association between TIR and sarcopenia, muscle mass loss that leads to deterioration in mobility, disabilities and decline in physical indices in older people with diabetes. Aims: To assess among older people with diabetes type 2, the cross sectional association between: TIR and aerobic capacity, gait speed, strength, balance and frailty indices. Methods: A cross sectional study, conducted amongst people with diabetes over the age of 60. Participants were provided with a blinded CGM system- (I Pro2 carelink, Medtronic) for 1 week and underwent elaborate physical-functional assessment in the beginning and at the end of that week. The association between the % of time in range (Time in Range-TIR) and several physical indices was determined using linear regression. Results: This analysis pertains to 55 men and women who completed the evaluation. After adjustment for age and gender, we found that 1% increase in TIR was associated with a 0.341 higher score on the 30 second Sit to Stand score (a measure of lower extremity strength) (P-value=0.02), a 0.351 higher score on the BERG scale (a measure of balance) (P-value=0.01), a 0.271 lower score on the timed up and go score (a measure of fall risk and balance) (P-value=0.008), a 0.289 higher score on the 6-minute walk score (a measure of aerobic capacity and endurance) (P-value=0.02) and a 0.261 lower score on the 360 turn test (a measure of dynamic balance) (P-value=0.0004). The same was not observed for the relationship between HGA1C & physical indices.

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Relationship between pediatric liquid medicines (PLMs) and dental caries in chronically ill children

Padjadjaran Journal of Dentistry ◽

10.24198/pjd.vol31no3.25071 ◽

2019 ◽

Vol 31 (3) ◽

pp. 167

Author(s):

Ankita Goyal ◽

Vatchala Rani ◽

Bhadravathi Cheluvaiah Manjunath ◽

Kanupriya Rathore

Keyword(s):

Dental Caries ◽

Statistical Tests ◽

Chronically Ill ◽

Cross Sectional Study ◽

Control Group ◽

P Value ◽

Cross Sectional ◽

Increased Risk ◽

Chronically Ill Children

Introduction: Purpose of this research is to assess the relationship between long-term pediatric liquid medicines (PLMs) consumption and dental caries in 2–12-years-old chronically ill children. Methods: A cross-sectional study was performed in a public pediatric hospital in India for a period of 6 months. A total of 455 children aged 2–12 years old with various chronic diseases who were receiving PLMs for more than 6 months were selected as the subjects in this study and compared with 531 children of similar age group and diseases who received other forms of medication. Dental caries was measured by DMFT/dmft and data collected were analyzed with SPSS (17th version) using statistical tests such as t-test and one-way ANOVA. Univariable logistic regression was used where the significance was fixed at a a p value of less than 0.001. Results: Children on PLMs had an increased risk of dental caries than those on other forms of medications (OR: 3.142, 95% CI: 2.37–4.15, p < 0.001). The prevalence of dental caries was higher (77.8%) in children consuming PLMs when compared to other forms of medication (52.7%). The mean DMFT and dmft scores were significantly higher in the study group when compared to the control group (p = 0.001). Conclusion: Long-term consumption of pediatric liquid medicines containing sucrose as a risk factor for dental caries among chronically ill children. sugar free options has to be used during prescription to prevent medication-triggered caries.Keywords: Paediatric liquid medicine, medication-triggered caries, sugar-free medication

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Increased risk of psychopathological abnormalities in subjects with unilateral hearing loss: A cross-sectional study

Clinical and Experimental Otorhinolaryngology ◽

10.21053/ceo.2020.00283 ◽

2020 ◽

Author(s):

Jae-Jin Song ◽

Eu Jeong Ku ◽

Seoyoung Kim ◽

Euitae Kim ◽

Young-Seok Choi ◽

...

Keyword(s):

Hearing Loss ◽

Behavioral Problems ◽

Cross Sectional Study ◽

Normal Hearing ◽

Unilateral Hearing Loss ◽

Personality Test ◽

Cross Sectional ◽

Increased Risk ◽

The Military ◽

Test Profiles

Objective. Although unilateral hearing loss (UHL) has been proven to be associated with educational and behavioral problems, there are few studies on psychopathological abnormalities in this population. The aim of this study was to evaluate the psychopathological influence of UHL among Korean 19-year-old males.Methods. The authors retrospectively compared the objective personality test profiles of 602 subjects with UHL with those of 23,790 normal hearing peers. All participants in the current study were 19-year-old males who underwent physical examination and investigated the Korean Military Multiphasic Personality Inventory for conscription at the Military Manpower Administration from February 2015 to December 2016.Results. The neurosis scales revealed significantly higher scores in the UHL group as compared to the normal hearing group (50.9

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Use of potentially inappropriate medication and polypharmacy in older adults: a repeated cross-sectional study

10.21203/rs.2.10158/v5 ◽

2020 ◽

Author(s):

Kristine Thorell ◽

Patrik Midlöv ◽

Johan Fastbom ◽

Anders Halling

Keyword(s):

Chronic Conditions ◽

Adverse Drug Events ◽

Inappropriate Medication ◽

Cross Sectional Study ◽

P Value ◽

Potentially Inappropriate Medications ◽

Sectional Study ◽

Cross Sectional ◽

Increased Risk ◽

Inappropriate Medications

Abstract Background: With age, the number of chronic conditions increases along with the use of medications. For several years, polypharmacy has been found to be on the increase in western societies. Polypharmacy is associated with an increased risk of adverse drug events (ADE). Medications called potentially inappropriate medications (PIM) have also been found to increase the risk of ADEs in an older population. In this study, which we conducted during a national information campaign to reduce PIM, we analysed the prevalence of PIM in an older adult population and in different strata of the variables age, gender, number of chronic conditions and polypharmacy and how that prevalence changed over time. Methods: This is a registry-based repeated cross-sectional study including two cohorts. Individuals aged 75 or older listed at a primary care centre in Blekinge on the 31st March 2011 (cohort 1, 15 361 individuals) or on the 31st December 2013 (cohort 2, 15 945 individuals) were included in the respective cohorts. Using a chi2 test, the two cohorts were compared on the variables age, gender, number of chronic conditions and polypharmacy. Use of five or more medications at the same time was the definition for polypharmacy. Results: Use of PIM decreased from 10.60% to 7.04% (p-value <0.001) between 2011 and 2013, while prevalence of five to seven chronic conditions increased from 20.55% to 23.66% (p-value <0.001). Use of PIM decreased in all strata of the variables age, gender number of chronic conditions and polypharmacy. Except for age 80-84 and males, where it increased, prevalence of polypharmacy was stable in all strata of the variables. Conclusions: Use of potentially inappropriate medications had decreased in all variables between 2011 and 2013; this shows the possibility to reduce PIM with a focused effort. Polypharmacy does not increase significantly compared to the rest of the population.

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Pandemic-related attitudes, stressors and work outcomes among medical assistants during the SARS-CoV-2 (“Coronavirus”) pandemic in Germany: A cross-sectional Study

PLoS ONE ◽

10.1371/journal.pone.0245473 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0245473

Author(s):

Annegret Dreher ◽

Reinhard Pietrowsky ◽

Adrian Loerbroks

Keyword(s):

Anxiety Disorder ◽

Medical Staff ◽

Cross Sectional Study ◽

Outpatient Setting ◽

Work Outcomes ◽

Online Questionnaire ◽

Cross Sectional ◽

Financial Situation ◽

Medical Assistants ◽

Increased Risk

Background The SARS-CoV-2 virus has spread rapidly around the globe since December 2019 creating much uncertainty among medical staff. Due to close patient contact, medical assistants are at increased risk of an infection. Several studies have investigated psychological consequences of the SARS-CoV-2 pandemic on medical staff, yet studies in the outpatient setting are scarce and studies addressing medical assistants are lacking. This study aimed to investigate pandemic-related stressors, attitudes, and work outcomes among medical assistants and to identify possible determinants. Methods The population under study were medical assistants across entire Germany. A self-devised online questionnaire was published between April 7th, 2020, and April 14th. including questions on pandemic-related stressors, attitudes and work outcomes. Additionally, symptoms of depression and anxiety disorder were measured by PHQ-2 and GAD-2, respectively. Logistic regression was performed to identify possible determinants. Results 2150 medical assistants provided complete data (98.0% female, mean age 37.6 years). Major stressors were uncertainty about the temporal scope of the pandemic (95.1% agreement), about how to act correctly (77.5%), feelings of not being allowed to let patients down (75.9%), uncertainty about one’s financial situation (67.4%) and about contact persons for further information (67.1%). One third (29.9%) of the study population screened positively for depression and 42.6% for anxiety disorder. Feeling burdened by one’s financial situation was significantly associated with working in specialist practices (1.32 [1.08–1.62]), caring for children (1.51 [1.22–1.87]), depression (1.28 [1.01–1.62]), and anxiety disorder (1.93 [1.55–2.39]). Feeling burdened by thoughts about virus contraction at work was also significantly associated with working in specialist practices (1.33 [1.07–1.64]), caring for children (1.33 [1.07–1.66]), depression (1.54 [1.18–2.00]), and anxiety (4.71 [3.71–5.98]). Conclusions This study provides novel evidence regarding major SARS-CoV-2 pandemic-related stressors among medical assistants and suggests need for special support for medical assistants caring for children and working in specialist practices.

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194 Sensorineural hearing loss in patients with cystic fibrosis: A cross-sectional study

Journal of Cystic Fibrosis ◽

10.1016/s1569-1993(15)30371-4 ◽

2015 ◽

Vol 14 ◽

pp. S107

Author(s):

K. Van Hoorenbeeck ◽

N. De Bruyne ◽

M. Lequesne ◽

P. Van de Heyning ◽

S. Verhulst ◽

...

Keyword(s):

Cystic Fibrosis ◽

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Cross Sectional Study ◽

Sensorineural Hearing ◽

Sectional Study ◽

Cross Sectional

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Awareness and utilization of contraceptives among males of reproductive age, Jos North, Plateau state, Nigeria

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20203367 ◽

2020 ◽

Vol 7 (8) ◽

pp. 2944

Author(s):

Ize A. Osagie ◽

Esther A. Envuladu ◽

Solomon Thilza ◽

Mohammed Amina ◽

Jemie U. Nnanna ◽

...

Keyword(s):

Contraceptive Use ◽

Sampling Technique ◽

Cross Sectional Study ◽

Reproductive Age ◽

P Value ◽

Structure Questionnaire ◽

Cross Sectional ◽

Modern Contraceptives ◽

Increased Risk ◽

Plateau State

Background: Modern contraceptives are relevant interventions in the reduction of maternal and child morbidity and mortality. Its uptake by females of reproductive age has been found to be influenced by male partners’ awareness and utilization. This study aimed to determine the awareness of contraceptives, utilization prevalence and sociodemographic predictors for use among males of reproductive age in Jos North.Methods: A cross sectional study involving 406 males of reproductive age who were selected by multistage sampling technique. Data was collected using an interviewer-administered semi-structure questionnaire and analysed using SPSS version 23.0. At 95% confidence interval, a p value of <0.05 was considered statistically significant.Results: There was a high awareness prevalence of contraceptives 378 (93.1%). However, the prevalence of current contraceptive use with partners was low 160 (42.3%). Respondents who were single were more likely to use contraceptives than those who were married or separated (OR 1.8; 95% CI 1.109-2.251). Those between the ages of 35-44 years also had a higher likelihood of using modern contraceptives than younger men (OR 2; 95% CI 0.410-2.436). Education, occupation and family size had no statistically significant association with contraceptive use among respondents.Conclusions: Despite the high awareness of modern contraceptives among respondents in this study, utilization with partners was low. Predictors of utilization were being single and being in the third decade of life. This could impact on increased risk for both maternal and child mortality. Male targeted contraceptive education is necessary at community levels to improve uptake.

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Prevalence and Characteristics of Adverse Drug Reaction among Patients in Jubail, Saudi Arabia

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i29a31570 ◽

2021 ◽

pp. 124-134

Author(s):

Hussain Alyousif ◽

Mohammed Tarawneh ◽

Zainab Al Madan ◽

Abdulmuhsen Hussein

Keyword(s):

Adverse Drug Reaction ◽

Saudi Arabia ◽

Drug Reaction ◽

Care Center ◽

Cross Sectional Study ◽

Royal Commission ◽

P Value ◽

Drug Reactions ◽

Cross Sectional ◽

Increased Risk

Introduction: Adverse Drug Reactions (ADRs) often causes prolonged hospitalization and have an increased risk of mortality. Adverse drug reaction can greatly affect the quality of life. It may lead to various undesired outcomes such as use of suboptimal alternative drugs, unnecessary investigations and delayed treatment. This study aims to evaluate the prevalence and characteristics of adverse drug reaction as well as, risk factors of allergic drug reactions among hospitalized patients at the secondary care center Royal Commission Hospital (RCH) in Jubail, Saudi Arabia. Methods: A cross-sectional study conducted at the RCH in Jubail, Saudi Arabia. The study included all patients admitted to RCH during the period from 2017 to 2019. All patients admitted to RCH during the study period were reviewed to identify those with at least one documented drug allergy incident. The data was collected by the study authors from the hospital medical electronic data system by using a structured questionnaire that consists of two sections. The main section is the one adapted from the Adverse Drug Reaction Probability Scale (Naranjo). Results: A total of 93 patients with reported ADR were recruited in the current study, more than half (55.91%) of them were females, with a mean age of 35.79 ± 21.18. There was a statistically significant (P-value 0.042) difference in the prevalence of ADR by gender, and the "definitely" identified ADR cases were all males. Besides, the correlation was also significant (P<0.05) between the prevalence of ADR and the use of specific antagonists as well as the committee action. The suspected medications for ADR were mainly antibiotics by 54%, particularly the third generation cephalosporins at 13%, followed by the penicillin subtype at 11%. Ceftriaxone was the highest at 13.54%, followed by vancomycin at 9.38%, and cefazolin at 8.33%. This was followed by analgesic class at 14%. Conclusion: ADRs reported in the current study were mainly probable, and the definite ones were within the reported prevalence globally. The maximum number of ADRs reported was with antibiotics. The majority of patients had recovered from the ADRs.

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