Barriers to Prescribing Oral Anticoagulants To Inpatients Aged 80 Years and Older With Nonvalvular Atrial Fibrillation: A Cross-Sectional Study

Abstract Background: To investigate the temporal trend of prevalence of anticoagulation treatment and explore the factors associated with under prescription of oral anti-coagulants (OACs) among inpatients aged ≥80 years with nonvalvular atrial fibrillation (NVAF). Methods: We retrospectively reviewed the medical records of inpatients with a discharge diagnosis of NVAF from a medical database. We used the Pearson chi-square or Fisher’s exact test to compare categorical variables between patients with and without OACs prescription. Logistic regression analysis was used to assess the association between risk factors and under prescription of OACs. Results: A total of 4375 patients aged ≥80 years with AF were assessed in the largest academic hospital in China from August 1, 2016, to July 31, 2020, 3165 NVAF patients were included. The prevalence of OACs use was 20.9% in 2017, 28.7% in 2018, 35.6% in 2019, and 43.9% in 2020. Of all participants with CHA2DS2-VASc≥2, 1,027 (32.4%) were prescribed OACs; 33.7% and 31.8% of patients with and without prior stroke received OACs, respectively. Age, clinical department where patients were discharged, use of antiplatelets, and history of stroke and dementia were significantly associated with not prescribing OACs. Conclusions: The prevalence of OACs use increased over the past several years. The rate of prescription of OACs was lower among NVAF patients who were older, prescribed antiplatelets, discharged from non-departmental cardiology, and suffered from comorbidities. This study found the iatrogenic factors affecting the use of OACs in the inpatients aged ≥80 years, providing clues and basis for the standardized use of OACs in the inpatients.

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Medical Emergencies in Dental Practice - A Nepalese study

Orthodontic Journal of Nepal ◽

10.3126/ojn.v5i2.15223 ◽

2015 ◽

Vol 5 (2) ◽

pp. 33-37

Author(s):

Sandhya Joshi ◽

Sudeep Acharya

Keyword(s):

Clinical Skills ◽

Vasovagal Syncope ◽

Emergency Situation ◽

Cross Sectional Study ◽

Categorical Variables ◽

Dental Practice ◽

Chi Square ◽

Cross Sectional ◽

Factors Affecting ◽

Medical Emergencies

Introduction: Medical emergencies can occur in dental practice anytime. Changing demographics in the population and increased life expectancy have resulted in more people having medical conditions which predispose to a medical emergency.Objective: To find the prevalence of medical emergencies in dental practice in Nepal, to assess the preparedness of dentists to manage emergency situation, to find out the ways to improve their preparedness, and to determine the factors affecting the occurrence of medical emergency.Materials & Method: A cross-sectional study using self-administered questionnaire was done among one hundred and twenty four participants present at the 16th Annual Dental Conference. The questionnaire consisted of 15 questions. The data were analyzed using chi-square test and cross tabulation was performed to evaluate categorical variables at a significant level of p< 0.05.Result: The percentage of respondents who reported at least one emergency situation was 37.1%. Majority of the events occurred during oral surgical treatment. According to the survey, the most frequently encountered emergency condition was vasovagal syncope followed by hypoglycemia and seizures. The emergency events were managed by the respondents through various modalities. The dental graduates despite BLS training were found to feel incompetent to manage emergency events.Conclusion: Medical emergencies in dental practice in Nepal are frequent and not as rare as anticipated. Thus periodic training should be provided to improve necessary clinical skills.

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P1086Prevalence and predictors of left atrial thrombi in patients scheduled for electrical cardioversion of nonvalvular atrial fibrillation

EP Europace ◽

10.1093/europace/euaa162.342 ◽

2020 ◽

Vol 22 (Supplement_1) ◽

Author(s):

A Abud ◽

M Santillan ◽

L Perello ◽

C Rosller ◽

L Rossi ◽

...

Keyword(s):

Heart Failure ◽

Atrial Fibrillation ◽

Strong Predictor ◽

Female Gender ◽

Cross Sectional Study ◽

Electrical Cardioversion ◽

Nonvalvular Atrial Fibrillation ◽

Chi Square ◽

Cross Sectional ◽

Qualitative Variables

Abstract Background Transesophageal echocardiography (TEE) showed the presence of thrombi in 12 to 26% of patients with atrial fibrillation (AF). Purpose To assess clinical and echocardiographic variables associated with thrombi in the left atrium (LA) prior to electrical cardioversion in patients with nonvalvular atrial fibrillation (AF). Methods Cross-sectional study including 188 patients. Clinical and echocardiographic variables were analyzed. Qualitative variables are expressed in percentages and quantitative variables in mean and standard deviations. Qualitative variables were analyzed by the Chi square method. A value of p <0.05 was considered statistically significant. Results Mean age was 60.7 ± 12.3 and 75.5% males. The mean CHA2DS2-VASc and HAS-BLED scores were 2.43 ± 1.6 and 1.06 ± 1. The percentage of paroxysmal AF was 49.7%, nonparoxysmal 23.2% and atrial flutter 27%. Mean ejection fraction (EF) was 52.2 ± 13%. The prevalence of thrombus was 12.3%. Female gender (p = 0.0275), heart failure (p = 0.0006), CHA2DS2-VASc score ≥2 (p = 0.0015), EF <50% (p = 0.0089), moderate/severe spontaneous echocardiographic contrast (p = 0.000042) and LA appendage emptying velocity ≤20 cm/sec (p = 0.0000001) are associated to the presence of thrombi in the LA. No thrombi were detected in patients with CHA2DS2-VASc score of 0. History of previous anticoagulation for over thirty days or creatinine clearance <56 ml/min were not predictors of LA thrombi. Conclusion Female gender, heart failure, EF <50% and CHA2DS2-VASc score ≥2, emptying velocity of less than 20 cm/sec and spontaneous echocardiographic contrast were univariate predictors of thrombi in the LA. CHA2DS2-VASc score of 0 is a strong predictor of absence of thrombi.

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Mask use among pedestrians during the Covid-19 pandemic in Southwest Iran: an observational study on 10,440 people

BMC Public Health ◽

10.1186/s12889-020-10152-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Zahra Rahimi ◽

Gholam Abbas Shirali ◽

Marzieh Araban ◽

Mohammad javad Mohammadi ◽

Bahman Cheraghian

Keyword(s):

Face Mask ◽

Cross Sectional Study ◽

Categorical Variables ◽

Fisher Exact Test ◽

Chi Square ◽

Cross Sectional ◽

Public Places ◽

Exact Test ◽

Observation Method ◽

Southwest Iran

Abstract Background Many countries have recommended the use of face masks for general population in public places to reduce the risk of COVID-19 transmission. This study aims to estimate the prevalence of face mask usage and investigate about different types of face mask and their distribution among pedestrians in southwest Iran during the Covid-19 pandemic. Methods This cross-sectional study was conducted in August 2020 in Ahvaz, southwest Iran. Using a multistage sampling method, a total of 10,440 pedestrians selected from 8 urban districts and 92 neighborhoods of the city. The data gathered by observation method. Percentage, mean and standard deviation were used to describe the variables. Chi-square test, fisher exact test and Chi-square for trend used to assess relationship between two categorical variables. We used unconditional logistic regression model to control confounders. Results The most common age group was 10 to 39 years and 67.9% of the participants were male. The overall prevalence of face mask usage was 45.6% (95% CI, 44.6–46.5). In general, as the age increased, the prevalence of face mask use significantly increased (p for trend < 0.001). Women used face masks significantly higher than men (60.2% vs. 38.7%, p < 0.001). Among the pedestrians who used the mask, 75.6% wore facemask correctly. The most common type of facemask used by the pedestrians were surgical (medical) masks (63.8%). In total, the prevalence of facemask usage was significantly higher during a.m. (49.4%) compared to p.m. (43.9%), (p < 0.001). Besides, in our study, 1.7 and 0.3% of Pedestrians had worn gloves and shielded respectively. Women used shields and gloves significantly higher than men (3.6% vs. 0.7%, p < 0.001). Also, women used shields more than men (0.5% vs. 0.3%, p = 0.036). Conclusion We concluded that the prevalence rate of face mask use in Ahvaz was fairly low especially in men and younger people. Hence, the observed rates probably cannot protect the community against COVID-19 spread. Therefore, it is important to implement educational programs as well as to establish laws and regulations governing the use of face masks in public places.

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Face mask use among pedestrians during the COVID-19 pandemic in southwest Iran: An observational study on 10440 people

10.21203/rs.3.rs-89832/v1 ◽

2020 ◽

Author(s):

Zahra Rahimi ◽

Gholam Abbas Shirali ◽

Marzieh Araban ◽

Mohammad javad Mohammadi ◽

Bahman Cheraghian

Keyword(s):

Face Mask ◽

Cross Sectional Study ◽

Categorical Variables ◽

Fisher Exact Test ◽

Chi Square ◽

Cross Sectional ◽

Public Places ◽

Exact Test ◽

Observation Method ◽

Southwest Iran

Abstract Background: Many countries have recommended the use of face masks for general population in public places to reduce the risk of COVID-19 transmission. This study aims to estimate the prevalence of face mask usage and investigate about different types of face mask and their distribution among pedestrians in southwest Iran during the Covid-19 pandemic.Methods: This cross-sectional study was conducted in August 2020 in Ahvaz, southwest Iran. Using a multistage sampling method, a total of 10440 pedestrians selected from 8 urban districts and 92 neighborhoods of the city. The data gathered by observation method. Percentage, mean and standard deviation were used to describe the variables. Chi-square test, fisher exact test and Chi-square for trend used to assess relationship between two categorical variables. We used unconditional logistic regression model to control confounders.Results: The mean ± SD age of the observed pedestrians was 32.2 ±15.1 years and 67.9% of them were male. The overall prevalence of face mask usage was 45.6% (95% CI, 44.6 – 46.5). In general, as the age increased, the prevalence of face mask use significantly increased (p for trend <0.001). Women used face masks significantly higher than men (60.2% vs. 38.7%, p <0.001). Among the pedestrians who used the mask, 75.6 % wore facemask correctly. The most common type of facemask used by the pedestrians were surgical(medical) masks (63.8%). In total, the prevalence of facemask usage was significantly higher during a.m. (49.4%) compared to p.m. (43.9%), (p<0.001). Besides, in our study, 1.7% and 0.3 % of Pedestrians had worn gloves and shielded respectively. Women used shields and gloves significantly higher than men (3.6 % vs. 0.7%, p <0.001). Also, women used shields more than men (0.5 % vs. 0.3%, p =0.036).Conclusion: We concluded that the prevalence rate of face mask use in Ahvaz was fairly low especially in men and younger people. Hence, the observed rates probably cannot protect the community against COVID-19 spread. Therefore, it is important to implement educational programs as well as to establish laws and regulations governing the use of face masks in public places.

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The characteristics and risk factors of human papillomavirus infection: an outpatient population-based study in Changsha, Hunan

Scientific Reports ◽

10.1038/s41598-021-94635-1 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Bingsi Gao ◽

Yu-Ligh Liou ◽

Yang Yu ◽

Lingxiao Zou ◽

Waixing Li ◽

...

Keyword(s):

Risk Factors ◽

Protective Factor ◽

Hpv Infection ◽

Population Based ◽

Cross Sectional Study ◽

Categorical Variables ◽

Chi Square ◽

Cross Sectional ◽

Hpv Dna ◽

Test Kit

AbstractThis cross-sectional study investigated the characteristics of cervical HPV infection in Changsha area and explored the influence of Candida vaginitis on this infection. From 11 August 2017 to 11 September 2018, 12,628 outpatient participants ranged from 19 to 84 years old were enrolled and analyzed. HPV DNA was amplified and tested by HPV GenoArray Test Kit. The vaginal ecology was detected by microscopic and biochemistry examinations. The diagnosis of Candida vaginitis was based on microscopic examination (spores, and/or hypha) and biochemical testing (galactosidase) for vaginal discharge by experts. Statistical analyses were performed using SAS 9.4. Continuous and categorical variables were analyzed by t-tests and by Chi-square tests, respectively. HPV infection risk factors were analyzed using multivariate logistic regression. Of the total number of participants, 1753 were infected with HPV (13.88%). Females aged ≥ 40 to < 50 years constituted the largest population of HPV-infected females (31.26%). The top 5 HPV subtypes affecting this population of 1753 infected females were the following: HPV-52 (28.01%), HPV-58 (14.83%), CP8304 (11.47%), HPV-53 (10.84%), and HPV-39 (9.64%). Age (OR 1.01; 95% CI 1–1.01; P < 0.05) and alcohol consumption (OR 1.30; 95% CI 1.09–1.56; P < 0.01) were found to be risk factors for HPV infection. However, the presence of Candida in the vaginal flora was found to be a protective factor against HPV infection (OR 0.62; 95% CI 0.48–0.8; P < 0.001). Comparing with our previous study of 2016, we conclude that the subtype distribution of HPV infection is relatively constant in Changsha. Our data suggest a negative correlation between vaginal Candida and HPV, however, more radical HPV management is required in this area for perimenopausal women and those who regularly consume alcohol.

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A year of hepatocellular carcinoma at a glance. Demographics, biochemical and radiological characteristics and treatment modalities from a specialized facility of Pakistan

Journal of the Pakistan Medical Association ◽

10.47391/jpma.826 ◽

2021 ◽

pp. 1-6

Author(s):

Laima Alam

Keyword(s):

Hepatocellular Carcinoma ◽

Cross Sectional Study ◽

Treatment Modalities ◽

Fisher Exact Test ◽

Tumour Staging ◽

Chi Square ◽

Cross Sectional ◽

Exact Test ◽

Team Meetings ◽

Contrast Enhanced Ct

Objectives:Relation of demographics of hepatocellular-carcinoma with the aetiology.Tumour characteristics in relation to anti-viral therapy and presence of viral-DNA/RNATreatment modalities offeredMethods: This cross-sectional study enrolled all the patients aged 18-70 years with diagnosed hepatocellular carcinoma either through Triphasic Contrast-Enhanced-CT scan and/or Magnetic Resonance Imaging or biopsy presenting to the Outpatient-Department or multi-disciplinary-team meetings for the year 2019. Demographic variables, biochemical analysis including liver profile and stage of cirrhosis, viral-status, tumour staging and the treatment modalities offered were all noted. ANOVA (normal) and Kruskal-Wallis (non-normal) tests were used to compare quantitative data whereas chi-square-test and fisher-exact-test were used to compare qualitative-data.Results: Out of 195 patients with hepatocellular carcinoma, 76% were males in their fifth to sixth decades of life, 96% had cirrhosis, 94% corresponded to viral hepatocellular-carcinoma (82% Hepatitis-C-Virus, 9% Hepatitis-B-Virus and 3% coinfection), 60% of the cirrhotics landed in Child-Pugh A category with tumour staging BCLC-B being the predominant one (43.6%) and single and multiple bilateral nodules were the commonest lesions encountered. Platelets and Alanine-Transaminase had a significant relation across aetiological groups. Lymph-nodes were the most common extra-hepatic organs for metastasis and the presence of viral PCR had a significant impact on the tumour aggressiveness. Thirty-two percent of the patients were amenable to curative treatment.Conclusion: Viral infection is the main cause of rising prevalence of this tumour in Pakistan. Treatment modalities are expensive and expertise are lacking. A nationwide cancer registry is required for the exact disease burden and tumour behaviour for our population. Continuous....

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Association between Food Intake and Overweight in Children Assisted by Primary Care

The Open Nursing Journal ◽

10.2174/1874434602115010305 ◽

2021 ◽

Vol 15 (1) ◽

pp. 305-312

Author(s):

Erivelton Sousa Lima ◽

Amanda de Castro Amorim Serpa Brandão ◽

Antonio Luiz Gomes Junior ◽

Luana kelle Batista Moura ◽

Gerardo Vasconcelos Mesquita ◽

...

Keyword(s):

Primary Care ◽

Food Intake ◽

Food Consumption ◽

Cross Sectional Study ◽

Processed Foods ◽

Food Groups ◽

Chi Square ◽

Cross Sectional ◽

Exact Test ◽

Chi Square Test

Background: The child feed in the first two years of life is of fundamental importance for a healthy growth and development. Aims: To verify the association between food consumption indicators and overweight in children under the age of two, followed up by primary care health professionals. Methods: A cross-sectional study was conducted on 232 children assisted by primary care. A structured questionnaire was used with questions on sociodemographic data of mothers or guardians and food intake and anthropometric data of children. The analysis of the association between excess weight and food intake indicators was performed using the Pearson’s chi-square test (χ2) and Fisher’s exact test (f ˂ 5). Results: Regarding food intake in children under 6 months of age, 35.1% of the children were exclusively breastfed. Among children at the age of 6 to 23 months: 66.3% were on continued breastfeeding; 16.7% consumed adequate foods at the age of 6 to 8 months; 90.4% consumed foods that belonged to the six food groups; 76.3% consumed food at the minimum frequency and with adequate consistency; 88.9% consumed iron-rich and vitamin A-rich foods, and 59.3% consumed ultra-processed foods. Regarding nutritional status, 24.5% of the children were overweight. Conclusion: There was no statistically significant association between overweight and food consumption indicators among the surveyed children. However, exclusive breastfeeding was below the recommended level, a low percentage of the introduction of complementary foods at the appropriate age and high consumption of ultra-processed foods reveal the need to improve the assistance provided by primary care to this group.

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Attitude towards online classes among school and college going students during lockdown due to COVID-19 pandemic

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20212600 ◽

2021 ◽

Vol 8 (7) ◽

pp. 3446

Author(s):

Saurav Kumar ◽

Shiv Prakash ◽

Mona Srivastava

Keyword(s):

Family Income ◽

Cross Sectional Study ◽

Categorical Variables ◽

Online Classes ◽

Online Questionnaire ◽

Chi Square ◽

Cross Sectional ◽

Academic Level ◽

College Going ◽

Significant Difference

Background: The aim of the study was to assess the attitude of the school and college-going students towards online classes. Methods: An online cross-sectional study was conducted on 228 school and college-going students fulfilling inclusion and exclusion criteria selected through purposive sampling methods. A semi-structured online questionnaire consisting of a socio-demographic questionnaire and Attitude towards online classes (ATOC) questionnaire was prepared by the researcher using Google form. The link of the questionnaire was sent to all the selected respondents through WhatsApp messages and emails. The data was analyzed using the IBM SPSS version 20 software. The reliability of the attitude questionnaire was assessed using Cronbach’s alpha test. The association between categorical variables was assessed using Chi-square tests. The comparison between variables was assessed using the students independent t-test.Results: More than half of the respondents (51.32%) were found with a positive attitude towards online classes. There was a significant association found between attitude towards online classes and socio-demographic variables such as age (p<0.05), academic level (p<0.05), and family income (p<0.01). The respondents who attended online classes (p<0.05), have technical knowledge (p<0.01), and got supported by their parents in the study (p<0.05) were found significantly high positive attitudes towards online classes. There was a significant difference found in the attitude of the respondents who faced psychological disturbances such as a decline in attention-concentration (p<0.05), irritation-anger (p<0.01), and tension (p<0.05) due to online classes.Conclusions: Although, online classes are more beneficial for the students and teachers in their academic activities during the lockdown period due to the COVID-19 pandemic but it can’t take place of traditional face-to-face classes.

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The influence of varying maxillary central incisor vertical dimension on perceived smile aesthetics

Journal of Orthodontics ◽

10.1177/1465312519839713 ◽

2019 ◽

Vol 46 (2) ◽

pp. 137-142

Author(s):

Elis Janaina Lira dos Santos ◽

Alana Moura Xavier Dantas ◽

Raíssa Marçal Vilela ◽

Karina Jerônimo Rodrigues Santiago de Lima ◽

Rejane Targino Soares Beltrão

Keyword(s):

Age Groups ◽

Educational Background ◽

Cross Sectional Study ◽

Central Incisor ◽

Chi Square ◽

Cross Sectional ◽

Exact Test ◽

Maxillary Central Incisor ◽

Significant Difference ◽

Chi Square Test

Objective: To evaluate patient perception of the smile focused on analysis of the upper incisors. Design: Cross-sectional study. Setting: Department of Clinical and Social Dentistry at Federal University of Paraíba, João Pessoa, Brazil. Participants: The sample consisted of 135 individuals (73 women and 62 men). Methods: Images with different characteristics associated with the incisal edges were shown at random and analysed using a Likert scale. Data were analysed using the Chi-square test or Fisher’s exact test with a statistically significant difference ( P < 0.05). Results: Smile I (difference of 1.5 mm in relation to the central incisor and lateral) was considered the most aesthetic, while Smile III (no difference in height between the central and lateral incisors) was the least aesthetic. A significant difference was found between perception of smile II (difference of 1 mm in relation to the central incisor and lateral) and age groups ( P < 0.005), with 31% (n = 13) of individuals aged 45–64 years considering smile II as not pleasant, 4.4% (n = 2) aged 15–24 years and 8.3% (n=4) aged 25–44 years and 4.4% (n = 2) aged 15–24 years considering the same. A significant difference was also found in relation to educational background of the assessor and smile perception, with smile III ( P = 0.0441) and smile IV ( P = 0.0053) considered the most aesthetic ( P = 0.0116). Conclusion: The smile considered most attractive among the sample was that with 1.5 mm steepness between the central and lateral incisors, while a flat smile arc was considered least attractive.

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Seroprevalence of Brucellosis and Associated Risk Factors among Indigenous Breeds of Goats in Wukari, Taraba State, Nigeria

Journal of Pathogens ◽

10.1155/2018/5257926 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Olaolu T. Olufemi ◽

Danjuma B. Dantala ◽

Paul A. Shinggu ◽

Umesi A. Dike ◽

Gbeminiyi R. Otolorin ◽

...

Keyword(s):

Risk Factors ◽

Cross Sectional Study ◽

Chi Square ◽

Cross Sectional ◽

Exact Test ◽

The Public ◽

Factors Associated ◽

Males And Females ◽

Associated Risk Factors ◽

La Jolla

A cross-sectional study was conducted in Wukari, Taraba state, Nigeria, to determine the prevalence of Brucella antibodies and the risk factors associated with brucellosis in indigenous breeds of goats. A total of 386 goats were sampled from three political wards: Puje, Avyi, and Hospital: harvested sera samples were subjected to Rose Bengal Plate Test (RBPT). GraphPad Prism version 7.03 for Windows (GraphPad Software, La Jolla California, USA) was used to analyse the association between seroprevalence of brucellosis and age, sex, breed, location, and management system by using Chi square and Fisher’s exact test as appropriate. Brucellosis was detected in all three wards: Puje; 15%, Avyi; 6.6%, and Hospital; 7.6%. A prevalence rate of 2.8%, 8%, 18.7%, and 1% was recorded for <20-month, 22-35-month, 36-45-month, and ≥46-55-month age categories, respectively (P < 0.05). Only 9.5% was observed for male animals while 9.8% was observed for female animals with no statistical difference between the males and females. Breed-specific seroprevalence yielded 7.4%, 5.4% 12%, 12.8%, and 11.6%, for Cross, West Africa Dwarf, Red Sokoto, Kano Brown, and Sahel breeds of goat, respectively. There is an evidence of brucellosis (9.6%) in Wukari L.G.A, Taraba State, and age is a risk factor for the disease in the study area. There is a need to enlighten the public on the zoonotic potentials and economic impacts of brucellosis.

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