scholarly journals A multicenter study of incidence, risk factors and outcomes of babies with birth asphyxia in Nepal

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Avinash K. Sunny ◽  
Prajwal Paudel ◽  
Jagannath Tiwari ◽  
Bishow Bandhu Bagale ◽  
Antti Kukka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Multiple Logistic Regression Analysis ◽  
Birth Asphyxia ◽  
Binary Logistic Regression ◽  
Fetal Distress ◽  
Low Resource Settings ◽  
Low Resource ◽  
Incidence Risk ◽  
Associated Risk Factors

Abstract Background Perinatal events which result in compromised oxygen delivery to the fetus can lead to Birth Asphyxia (BA). While the incidence, risk factors and outcomes of BA have been characterized, less is known in low resource settings. Aim To determine the incidence of Birth Asphyxia (BA) in Nepal and to evaluate associated risk factors and outcomes of this condition. Methods A nested observational study was conducted in 12 hospitals of Nepal for a period of 14 months. Babies diagnosed as BA at ≥37 weeks of gestation were identified and demographics were reviewed. Data were analyzed using binary logistic regression followed by multiple logistic regression analysis. Results The incidence of BA in this study was 6 per 1000 term livebirths and was higher among women 35 years and above. Predictors for BA were instrumented vaginal delivery (aOR:4.4, 95% CI, 3.1–6.1), fetal distress in labour (aOR:1.9, 95% CI, 1.0–3.6), malposition (aOR:1.8, 95% CI, 1.0–3.0), birth weight less than 2500 g (aOR:2.0, 95% CI, 1.3–2.9), gestational age ≥ 42 weeks (aOR:2.0, 95% CI, 1.3–3.3) and male gender (aOR:1.6, 95% CI, 1.2–2.0). The risk of pre-discharge mortality was 43 times higher in babies with BA (aOR:42.6, 95% CI, 32.2–56.3). Conclusion The incidence of Birth asphyxia in Nepal higher than in more resourced setting. A range of obstetric and neonatal risk factors are associated with BA with an associated high risk of pre-discharge mortality. Interventions to improve management and decrease rates of BA could have marked impact on outcomes in low resource settings.

scholarly journals Prevalence and Risk Factors of Bovine Tuberculosis in Cattle in Mymensingh Sadar

2014 ◽  
Vol 12 (2) ◽  
pp. 179-183 ◽  
Author(s):  
MAH Mondal ◽  
MS Parvin ◽  
SC Sarker ◽  
AKMA Rahman ◽  
MT Islam
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Bovine Tuberculosis ◽  
Multiple Logistic Regression Analysis ◽  
Herd Size ◽  
Cross Sectional Study ◽  
Multiple Logistic Regression ◽  
Cross Sectional ◽  
Test Kit ◽  
Associated Risk Factors

Bovine tuberculosis (bTB) is a disease of zoonotic importance as well as high priority all over the world. Risk factors for bovine tuberculosis in cattle are not well investigated in Bangladesh. Therefore, the objective of this study was to identify the associated risk factors for bTB along with determination of prevalence in cattle of Mymensingh Sadar. A cross-sectional study was carried out to elucidate on 101 cattle from 56 households during January to May 2012. The direct interview using a questionnaire and physical examination of cattle was performed to collect farm and animal level data. Besides data collection, blood samples were collected from study cattle and subjected to immunochromatographic assay (ICGA) by using Anigen Rapid Bovine TB Ab test kit for the diagnosis of bTB. Risk factors analysis was done using bivariable followed by multiple logistic regression with stepwise backward elimination method. The results of the study revealed an overall tuberculosis prevalence of 5.9%. Multiple logistic regression analysis revealed significant association of bovine tuberculosis with herd size (more than 4) (Odds Ratio, OR = 5.9, p = 0.03) and history of coughing (OR = 8.9, p = 0.005). The effect of herd size (more than 4) could be minimized by maintaining the cattle in a herd with adequate floor space and better ventilation facilities as it would not be practicable to keep the herd size minimum. Further study should be done to find out more associated risk factors for the occurrence of bTB.DOI: http://dx.doi.org/10.3329/bjvm.v12i2.21283 Bangl. J. Vet. Med. (2014). 12 (2): 179-183 

scholarly journals Entomological survey for identification of Aedes larval breeding sites and their distribution in Chattogram, Bangladesh

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Md. Sahidur Rahman ◽  
Md. Omar Faruk ◽  
Sumiya Tanjila ◽  
Nur Mohammad Sabbir ◽  
Najmul Haider ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Field Survey ◽  
Mosquito Control ◽  
Multiple Logistic Regression Analysis ◽  
Binary Logistic Regression ◽  
Breeding Sites ◽  
Entomological Survey ◽  
Different Types ◽  
Coconut Shells ◽  
Positive Properties

Abstract Background Studying the characteristics of Aedes mosquito habitats is essential to control the mosquito population. The objective of this study was to identify the breeding sites of Aedes larvae and their distribution in Chattogram, Bangladesh. We conducted an entomological survey in 12 different sub-districts (Thana) under Chattogram City, during the late monsoon (August to November) 2019. The presence of different wet containers along with their characteristics and immature mosquitoes was recorded in field survey data form. Larvae and/or pupae were collected and brought to the laboratory for identification. Results Different indices like house index, container index, and the Breteau index were estimated. The multiple logistic regression analysis was applied to identify habitats that were more likely to be positive for Aedes larvae/pupae. A total of 704 wet containers of 37 different types from 216 properties were examined, where 52 (7.39%) were positive for Aedes larvae or pupae. Tire, plastic buckets, plastic drums, and coconut shells were the most prevalent container types. The plastic group possessed the highest container productivity (50%) whereas the vehicle and machinery group was found as most efficient (1.83) in terms of immature Aedes production. Among the total positive properties, 8% were infested with Aedes aegypti, 2% with Aedes albopictus, and 1% contained both species Ae. aegypti and A. albopictus. The overall house index was 17.35%, the container index was 7%, and the Breteau index was 24.49. Containers in multistoried houses had significantly lower positivity compared to independent houses. Binary logistic regression represented that containers having shade were 6.7 times more likely to be positive than the containers without shade (p< 0.01). Conclusions These findings might assist the authorities to identify the properties, containers, and geographical areas with different degrees of risk for mosquito control interventions to prevent dengue and other Aedes-borne disease transmissions.

scholarly journals Horse-related incidents and factors for predicting injuries to the head

2018 ◽  
Vol 4 (1) ◽  
pp. e000398 ◽  
Author(s):  
Lauren Meredith ◽  
Robert Ekman ◽  
Robert Thomson
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Head Injury ◽  
Soft Tissue ◽  
Head Injuries ◽  
Binary Logistic Regression ◽  
Soft Tissue Injuries ◽  
Dental Services ◽  
Incident Type ◽  
Local Healthcare

ObjectivesHead injuries are the leading cause of death in horse-related injury events and, even since the introduction of helmets, represent a sizeable proportion of all horse-related injuries. Falls from horseback and kicks to the head are the most frequent type of incident causing head injuries, but it is unknown whether these incidents are predictors of head injury. This study aimed to investigate head injuries and the association between incident type and head injury.MethodRetrospective review of 7815 horse-related injury events was conducted. Data were gathered from hospitals, local healthcare centres and public dental services in Skaraborg, Sweden. Binary logistic regression was used to analyse the association between the incident type and occurrence of head injury while controlling for risk factors.ResultsApproximately 20% of riders sustained a head injury, mostly soft tissue injuries (56.3%) and concussions (33.4%). A fall from or with the horse was the primary cause of head injury (63.9%). Those who fell from a carriage or other height or who were injured through contact with the horse had no difference in the likelihood of head injury when compared with those that fell from or with the horse. However, those who sustained an injury without any horse contact had lower odd of head injury (OR: 0.640, p<0.00005, 95% CI 0.497 to 0.734). Additionally, the older the rider, the lower the odds of head injury (OR=0.989, p<0.00005, 95% CI 0.985 to 0.993).ConclusionImproved protection for those suffering falls from horseback as well as those who are kicked in the head should be investigated.

scholarly journals Clinical Significance of CYFRA21-1, AFP, CA-153, CEA, and CA-199 in the Diagnosis of Lung Cancer Ocular Metastasis in Hypertension Population

2021 ◽  
Vol 8 ◽  
Author(s):  
Jing Tang ◽  
Qian-Min Ge ◽  
Rong Huang ◽  
Hui-Ye Shu ◽  
Ting Su ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lung Cancer ◽  
Logistic Regression ◽  
Sensitivity And Specificity ◽  
Cancer Metastasis ◽  
Binary Logistic Regression ◽  
Diagnostic Value ◽  
Ca 125 ◽  
Pathological Type ◽  
Independent Risk Factors

Purpose: To detect lung metastases, we conducted a retrospective study to improve patient prognosis.Methods: Hypertension patients with ocular metastases (OM group; n = 58) and without metastases (NM group; n = 1,217) were selected from individuals with lung cancer admitted to our hospital from April 2005 to October 2019. The clinical characteristics were compared by Student's t-test and chi-square test. Independent risk factors were identified by binary logistic regression, and their diagnostic value evaluated by receiver operating characteristic curve analysis.Results: Age and sex did not differ significantly between OM and NM groups; There were significant differences in pathological type and treatment. Adenocarcinoma was the main pathological type in the OM group (67.24%), while squamous cell carcinoma was the largest proportion (46.43%) in the NM group, followed by adenocarcinoma (34.10%). The OM group were treated with chemotherapy (55.17%), while the NM group received both chemotherapy (39.93%) and surgical treatment (37.06%). Significant differences were detected in the concentrations of cancer antigen (CA)−125, CA-199, CA-153, alpha fetoprotein (AFP), carcinoembryonic antigen (CEA), cytokeratin fraction 21-1 (CYFRA21-1), total prostate-specific antigen, alkaline phosphatase, and hemoglobin (Student's t-test). Binary logistic regression analysis indicated that CA-199, CA-153, AFP, CEA, and CYRFA21-1 were independent risk factors for lung cancer metastasis. AFP (98.3%) and CEA (89.3%) exhibited the highest sensitivity and specificity, respectively, while CYRFA21-1 had the highest area under the ROC curve value (0.875), with sensitivity and specificity values of 77.6 and 87.0%, respectively. Hence, CYFRA21-1 had the best diagnostic value.

scholarly journals RISK FACTORS ASSOCIATED WITH NEONATAL HYPOGLYCEMIA

2006 ◽  
Vol 13 (04) ◽  
pp. 687-690
Author(s):  
MUNIR AKMAL LODHI ◽  
GHULAM SHABBIR ◽  
NASIR ALI SHAH
Keyword(s):  
Risk Factors ◽  
Low Birthweight ◽  
Birth Asphyxia ◽  
Neonatal Hypoglycemia ◽  
Factors Associated ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Associated Risk Factors ◽  
Glucose Estimation

Objectives: Recurrent episodes of neonatal hypoglycemia are strongly associated with long termphysical and neuro-developmental deficits. (1) Moreover in neonates hypoglycemia can be overlooked as it may havenonspecific symptoms only. (2) This study was therefore carried out to analyse the risk factors associated with neonatalhypoglycemia and to evaluate the risk factors which have predictive value in its diagnosis. .Design: Based case controlstudy. Period: Six months from January 2005 to June 2005. Setting CMH Pano Aqil. Material and Methods: 385newborns were studied. Newborns of both civilians as well as military personnel were included in the study. 11newborns were excluded. Out of remaining 347 patients 101 were found to be hypoglycemia. Five risk factors (low birthweight, Birth Asphyxia, Neonatal sepsis, Meconeum aspiration syndrome delayed feeding ) strongly and independentlypredicated the risk of hypoglycemia. Results: The most common associated risk factor was low birth weight (47.47%)followed by delayed feeding (46.29%). Blood sampling for glucose estimation was done at birth / admission at 6 hours,12 hours, 24 hours and 48 hours. Test was initially performed by glucometer, the reading which were confirmed bylaboratory testing in border line case. Conclusions: In neonates with associated risk factors it is cost affective to carryout blood glucose levels at the time of birth and follow up readings taken as indicated by clinical progress later on.

scholarly journals No Take Home Baby After Caesarian Birth for Foetal Distress in Women with Risk

2018 ◽  
Vol 3 (1) ◽  
Keyword(s):  
Risk Factors ◽  
Neonatal Outcome ◽  
Meta Analysis ◽  
Birth Asphyxia ◽  
Fetal Distress ◽  
Cord Compression ◽  
High Rate ◽  
Neonatal Deaths ◽  
Fetal Ecg ◽  
Foetal Asphyxia

Sometimes interventions are done for the baby in women with risks but it turns out to be unnecessary caesarian section (CS). However it may be delayed decision and / or delayed execution of intervention, CS too, with no take home baby. While lack of adverse outcome reflected that the decision was not for a compromised foetus, still birth or asphyxiated baby at birth meant delayed decision and / or execution. Recent studies revealed an estimated 9.04 million perinatal deaths related to birth asphyxia. Of them 1.02 million were intrapartum deaths leading to still births, many after CB for foetal concern. Birth asphyxia is a significant global health problem, responsible for around 1.2 million neonatal deaths each year worldwide [1-3]. Those who survive often suffer from a range of disorders. Chauhan et al. conducted, a meta analysis comprising of 169 articles and 37 reports and concluded that the overall risk of prompt CB for fetal concern was 3.1 % (43,340 of 13,98,9740 cases) [4,5]. From time to time several hospital based studies have proved the role of various antepartum or intrapartum maternal & foetal risk factors which lead to foetal asphyxia. It is known that some disorders which could cause foetal asphyxia are obvious during pregnancy, some are labour related, be it mother or baby. Kaye reported association of primiparity, anaemia, hypertensive disorders of pregnancy, foetal growth restriction, malpresentation, antepartum haemorrhage, premature rupture of membranes, prematurity, fever, oxytocin augmentation of labour, umbilical cord prolapse, as risk factors ,with complex interplay between factors which predispose foetuses to poor outcome, due to decreased oxygenation, ACOG reported that foetal hypoxemia which if not compensated or corrected in time progressed to birth asphyxia and even death, either in utero or immediately after birth [6,7]. Gaffineet and James have reported, intrapartum hypoxia complicating around 1% of labours, resulting in foetal / neonatal deaths in 0.5/1000 pregnancies and cerebral palsy in 1 in 1000 cases diagnosed after swift delivery for clinically diagnosed “fetal distress’’ [8]. Earlier Murphy et al had suggested that reduced uterine perfusion uteroplacental vascular disease, low fetal reserve foetal asphyxia, foetal sepsis and cord compression with other gestational and antepartum factors could affect the fetal response which needed to be known. However diagnosis of FD also has to be correct and timely [9]. Cardiotocography (CTG) has been criticized for unnecessary high rate of operative delivery [10-12]. In the study by Roy, non-reassuring fetal heart rate (FHR) detected by CTG did not correlate well with neonatal outcome [13]. In the era of defensive practices, ‘play safe’ attitude results in high CS rate for non-reassuring FHR. The concept of detecting fetal acidosis, using fetal scalp blood appeared attractive, but practical difficulties in carrying it out restricted its use [14,15]. Roy et al suggested that since non-reassuring FHR detected by CTG did not correlate well with adverse neonatal outcome and resulted in unnecessary CS, fetal ECG needed to be introduced in addition to conventional CTG, wherever possible [13]. There are many such issues about timely appropriate authentic diagnosis and action.

scholarly journals Analysis of the Related Risk Factors of Inguinal Lymph Node Metastasis in Patients with Penile Cancer: A Cross-sectional Study

2021 ◽  
Author(s):  
yatao jia ◽  
Hongwei Zhao ◽  
Yun Hao ◽  
Jiang Zhu ◽  
Yingyi Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Lymph Node ◽  
Penile Cancer ◽  
Inguinal Lymph Node ◽  
Multiple Logistic Regression Analysis ◽  
Onset Time ◽  
Maximum Diameter ◽  
T Stage ◽  
Pathological Differentiation

Abstract Background: To determine independent predictors of inguinal lymph node(ILN) metastasis in patients with penile-cancer.Patients and methods: We retrospectively analyzed all patients with penile-cancer undergoing surgery at our medical center in ten years(N=157). Using univariate and multivariate logistic-regression models, we assessed associations between the following factors: age, medical-history, phimosis, onset-time, number and maximum diameter of involved ILNs, pathological T stage, degree of tumor differentiation and/or cornification, lymphatic vascular infiltration(LVI), nerve infiltration, and ILN metastases. Interaction and stratified analyses were then used to assess age, phimosis, onset-time, number of ILNs, cornification, and nerve infiltration.Results: Ultimately, 110 patients were included. Multiple logistic-regression analysis showed that the following factors were significantly correlated with ILN metastasis: maximum diameter of enlarged ILNs, T stage, pathological differentiation, and LVI. Among patients with a maximum ILN diameter of ≥1.5 cm, 50%(19/38) had LNM(HR=2.3, 95%CI: 1.0–5.1), whereas only 30.6%(22/72) of patients with a maximum ILN diameter <1.5 cm showed LNM. Among 44 patients with stage Ta/T1, 10(22.7%) showed ILN metastases, while 31 of 66(47.0%) patients with stage T2 showed ILN metastases(HR=3.0, 95%CI: 1.3–7.1). Among 40 patients with highly differentiated penile-cancer, eight(20%) showed ILN metastasis, while 33 of 70(47.1%) patients with low-to-middle differentiation showed ILN metastases(HR=3.6, 95%CI: 1.4–8.8). In the LVI-free group, the rate of LNM was 33.3%(32/96), whereas it was 64.3%(9/14) in the LVI group(HR=3.6, 95%CI: 1.1–11.6). Conclusion: Our single-center results suggested that maximum ILN diameter, pathological T stage, pathological differentiation, and LVI were independent risk factors for ILN metastases.

scholarly journals Late Acute Kidney Injury is a Poor Prognosis Sign in Severe Burns: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Bo You ◽  
Zi Chen Yang ◽  
Yu Long Zhang ◽  
Yu Chen ◽  
Yun Long Shi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Poor Prognosis ◽  
Multiple Logistic Regression Analysis ◽  
Kidney Injury ◽  
Occurrence Rate ◽  
Severe Burns ◽  
Epidemiological Characteristics

Abstract BackgroundAcute kidney injury (AKI) is a morbid complication and the main cause of multiple organ failure and death in severely burned patients. The objective of this study was to explore the epidemiological characteristics, the risk factors, and impact of both early and late AKIs, respectively.MethodsThis retrospective study was performed with prospectively collected data of severely burned patients from the Institute of Burn Research in Southwest Hospital during 2011-2017. AKI was diagnosed according to Kidney Disease Improving Global Outcomes (KDIGO) criteria (2012), and it was divided into early and late AKIs depending on its onset time (within the first 3 days or >3 days post burn). The baseline characteristics, clinical data, and outcomes of the three groups (early AKI, late AKI and non-AKI) were compared using logistic regression analysis. Mortality predictors of patients with AKI were assessed.ResultsA total of 637 patients were included in analysis. The incidence of AKI was 36.9% (early AKI 29.4%, late AKI 10.0%). The mortality of patients with AKI was 32.3% (early AKI 25.7%, late AKI 56.3%), and that of patients without AKI was 2.5%. AKI was independently associated with obviously increased mortality of severely burned patients [early AKI, OR = 12.98 (6.08-27.72); late AKI, OR = 34.02 (15.69-73.75)]. Multiple logistic regression analysis revealed that age, gender, total burn surface area (TBSA), full-thickness burns of TBSA, chronic comorbidities (hypertension or/and diabetes), hypovolemic shock of early burn, and tracheotomy were independent risk factors for both early and late AKIs. However, sepsis was only a risk factor for late AKI. Decompression escharotomy was a protective factor for both AKIs. ConclusionsAKI remains prevalent and is associated with high mortality in severely burned patients. Compared with early AKI, late AKI has a lower occurrence rate, but greater severity and worse prognosis，is a devastating complication. Late AKI is a poor prognosis sign in severe burns.

scholarly journals Risk Factors of Atrial Arrhythmia in Patients With Liver Cirrhosis: A Retrospective Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Xiya Lu ◽  
Zhijing Wang ◽  
Liu Yang ◽  
Changqing Yang ◽  
Meiyi Song
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Liver Cirrhosis ◽  
Retrospective Study ◽  
Logistic Regression Analysis ◽  
Multiple Logistic Regression Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Clinical Information ◽  
Atrial Arrhythmia

Background and Objectives: Liver cirrhosis is known to be associated with atrial arrhythmia. However, the risk factors for atrial arrhythmia in patients with liver cirrhosis remain unclear. This retrospective study aimed to investigate the risk factors for atrial arrhythmia in patients with liver cirrhosis.Methods: In the present study, we collected data from 135 patients with liver cirrhosis who were admitted to the Department of Gastroenterology at Shanghai Tongji Hospital. We examined the clinical information recorded, with the aim of identifying the risk factors for atrial arrhythmia in patients with liver cirrhosis. Multiple logistic regression analysis was used to screen for significant factors differentiating liver cirrhosis patients with atrial arrhythmia from those without atrial arrhythmia.Results: The data showed that there were seven significantly different factors that distinguished the group with atrial arrhythmia from the group without atrial arrhythmia. The seven factors were age, white blood cell count (WBC), albumin (ALB), serum Na+, B-type natriuretic peptide (BNP), ascites, and Child-Pugh score. The results of multivariate logistic regression analysis suggested that age (β = 0.094, OR = 1.098, 95% CI 1.039–1.161, P = 0.001) and ascites (β =1.354, OR = 3.874, 95% CI 1.202–12.483, P = 0.023) were significantly associated with atrial arrhythmia.Conclusion: In the present study, age and ascites were confirmed to be risk factors associated with atrial arrhythmia in patients with liver cirrhosis.

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