risk factors

To date, the clinical implications of the long-lasting non-alcoholic fatty liver disease (NAFLD) such as the left ventricular diastolic dysfunction (LVDD) in the course of type 2 diabetes mellitus (T2DM) are yet to be determined. The main aim of this study was to investigate the correlation between NAFLD and early LVDD progression along with demographic characteristics.

This cross-sectional study was performed on ninety consecutive diabetic outpatients referred to the endocrinology clinic. Demographic data were collected using a designed checklist. Ultrasound imaging was performed to assess the fatty liver condition. To assess LV diastolic function, echocardiography was performed, using a trans-thoracic tissue Doppler echocardiography.

The results showed that the majority of participants were females (61.1%). The fasting blood glucose (FBG, mg/dl) level was 174.65 ±51.1. Also, the mean body mass index (BMI) was 28.92±4.19, which was significantly associated with NAFLD. It has been also estimated that 76.7% and 81.1% of diabetic patients had NAFLD and simultaneous LVDD, respectively. However, the statistical results did not show a significant association between non-progressive NAFLD and LVDD (p<0.05).

There was no correlation between NAFLD and LVDD progression. However, timely evaluation of LVDD in T2DM outpatients with NAFLD can strongly help to prevent possible cardiomyopathy in high-risk populations.

Multidrug-resistant (MDR) bacteria are significant pathogens in nosocomial infections. Among patients with decompensated cirrhosis, the infection rate of MDR bacteria is as high as 34.6%. Since MDR bacteria are resistant to multiple antibiotics, these infections are difficult to control and can easily lead to severe complications such as organ failure and septic shock, ultimately increasing mortality rates. Therefore, timely identification of risk factors for MDR infections is of great clinical significance in preventing and controlling infections and improving the prognosis of patients with decompensated cirrhosis.

To analyze the risk factors associated with concurrent MDR bacterial infections in patients with cirrhotic decompensation.

A cohort study was conducted to collect clinical data from 133 patients with cirrhosis in the decompensated stage, followed by an analysis of MDR bacterial infection types. Additionally, univariate and logistic regression analyses were employed to identify independent risk factors associated with MDR bacterial infections in patients with decompensated cirrhosis.

The incidence of MDR bacterial infections in patients with cirrhotic decompensation was 24.81%. Statistical analysis revealed that independent risk factors for MDR bacterial infections in patients with decompensated cirrhosis included a hospital stay of ≥ 10 days (OR: 0.184, 95% CI: 0.45 - 90.748, P = 0.018) and the presence of septic shock for ≥ 10 days (OR: 0.027, 95% CI: 0.009 - 0.084, P < 0.001).

A hospital stay of ≥ 10 days and the presence of septic shock are significant risk factors for MDR bacterial infections in patients with decompensated cirrhosis. Therefore, rigorous assessment and the prompt implementation of targeted interventions are crucial in clinical settings.

A prevalent occupational health issue that may have a detrimental effect on nurses' mental health and general well-being is musculoskeletal problems. This narrative review aimed to explore the social, economic, and personal implications of Musculoskeletal Disorder on nurses in India, and examine support, and intervention strategies available for them.

A comprehensive literature search was conducted in electronic databases, including PubMed, Scopus, and Google Scholar, using relevant keywords related to Musculoskeletal Disorder, mental health, nurses, social, personal, support, and intervention. The inclusion criteria were articles published in English and focused the nursing workforce in India.

A total of 15 articles were selected for review synthesis. According to the summary, nurses in India who suffer from musculoskeletal disorders deal with serious social and personal repercussions that impact their everyday life and general well-being. Musculoskeletal Disorder can lead to decreased social connections, reduced job satisfaction, and physical and emotional distress. However, limited interventions are available that address Musculoskeletal Disorder and the mental health of nurses in India.

There is a significant effect of Musculoskeletal Disorder on the mental health, quality of life, and economic well-being of nurses in India. However, limited scientific research exists exploring the prevalence and psychosocial implications of Musculoskeletal Disorder in the Indian nursing population. Consequently, additional research is essential to comprehend the scope and ramifications of this occupational health concern. To create interventions and support systems that are effective in the unique cultural and occupational context of nursing in India, it is imperative to engage in interdisciplinary collaboration.

The global COVID-19 crisis has profoundly affected populations worldwide. While it is widely accepted that older individuals are at greater risk of severe illness, data indicate that in newborns and infants, the disease is generally not fatal.

This cross-sectional study aimed to examine the roles of laboratory tests and clinical symptoms in determining the severity of COVID-19 infection in infants younger than three months.

This study included all infants less than three months old with positive PCR tests for COVID-19 admitted to the Children's Medical Center between October 2020 and March 2022. We analyzed the association between disease severity and clinical symptoms, as well as laboratory findings.

Sixty-four neonates and infants under three months of age with COVID-19 participated in the study. Our findings suggest that lower birth weight and gestational age are associated with increased disease severity. Infants with underlying medical conditions were found to have a higher risk of reaching stage IIb or greater severity. Among laboratory and clinical findings, only white blood cell (WBC) count and cough symptoms showed a significant correlation with disease severity.

Clinical evaluations, along with factors such as birth weight, gestational age, and underlying conditions, appear more effective in guiding decision-making for COVID-19 severity in infants. Further studies are necessary to explore the influence of these factors on COVID-19 severity in this age group.

Augmenting the care of pets can have a significant effect on the transmission of microorganisms between humans and animals. Having pets creates a suitable environment for harmful microorganisms, such as intestinal pathogens, to transmit to humans in various ways. Pathogenic bacteria such as Salmonella, Campylobacter, and Arcobacter species are of significant importance as they are the main intestinal pathogens in humans and inhabit the digestive system of various animals.

The purpose of this research was to investigate the prevalence of Salmonella, Campylobacter, and Arcobacter and to explore the probable risk factors associated with bacterial infections in dogs residing in Amol.

In this study, 150 fresh stool samples were collected from the domestic dog population in Amol, northern Iran. To perform the test, DNA preparation and enrichment were first performed, and polymerase chain reaction (PCR) was then used to identify bacteria. Information about possible risk factors related to bacterial infection was collected using a questionnaire, and data analysis was done using SPSS version 21.0.

None of the samples tested in the study were infected with Arcobacter. A total of 35 samples were positive for Salmonella, and 43 samples were positive for Campylobacter.

The study discovered the existence of harmful Campylobacter and Salmonella bacteria in the feces of dogs living with humans in Amol, northern Iran. Based on the results of the study, pet dogs can harbor harmful strains of Campylobacter and Salmonella that pose a risk to human health. Therefore, it can be stated that owning pet dogs poses a potential threat to humans and may present a health issue that requires control. 

Placenta accreta is a serious condition associated with abnormal placental attachment, leading to significant maternal and fetal complications. This study was performed with aim to explore the relationship between assisted reproductive technology (ART) related pregnancy and the incidence of placenta accreta, as well as to identify demographic characteristics and potential risk factors associated with this condition.

This retrospective cross-sectional study was conducted on 22,413 women who underwent vaginal or cesarean delivery at Imam Khomeini Hospital in Ahvaz, Iran, from 2019 to 2022. Data were collected using a researcher-made checklist, which included demographic information and details regarding current and previous pregnancies. The student t-test and chi-square tests were used for comparison of medical and demographic characteristics between patients with and without placenta accreta. P<0.05 was considered statistically significant.

The rate of placenta accreta was significantly higher in IVF pregnancies (P=0.047). In patients with placenta accreta, 35.11% had a history of abortion compared to only 3.25% in the patients without accreta (P<0.001). Additionally, 80.85% of those with placenta accreta had placenta previa, whereas only 0.57% of those without this condition (P<0.001). Additionally, patients with placenta accreta had a higher mean number of previous cesarean deliveries (2.43 ± 1.001 vs. 0.71 ± 0.037, P<0.001) and the mean number of gestations (4.08 ± 1.33 vs. 2.16 ± 0.086, P<0.001).

The findings of the present study demonstrated that IVF pregnancies have a higher incidence of placenta accreta. Furthermore, advanced maternal age, higher number of gestations, history of abortion, presence of placenta previa, and previous cesarean deliveries were associated with placenta accreta.

Prediabetes is a golden period because the blood sugar levels can be lowered to normal levels, unlike diabetes mellitus. Studies on risk factors of prediabetes in Indonesia have never been conducted before, especially with cohort study design. The purpose of this study was to identify risk factors associated with prediabetes in Indonesia based on a cohort study conducted in Bogor, Indonesia. Study Design: A retrospective cohort study.

This study was conducted using data from the Bogor Cohort Study done by the Ministry of Health of Indonesia, which included individuals aged more than 25 years. Individuals who had impaired fasting glucose (IFG) (100-125 mg/dL) and/or impaired glucose tolerance (IGT) (140-199 mg/dL) at baseline screening were excluded from the study. Demographic characteristics, risk factors, and clinical observations were extracted using a questionnaire. Cox regression was used for data analysis.

The cumulative incidence of prediabetes in Bogor was 50.3%. Factors associated with prediabetes were old age (RR: 1.33; 95% CI 1.19, 1.47), female gender (RR: 1.32; 95% CI 1.18, 1.48), overweight (RR: 1.17; 95% CI 1.01, 1.36), obesity (RR: 1.26; 95% CI 1.08, 1.46), central obesity (RR: 1.17; 95% CI 1.02, 1.34), high cholesterol levels (RR: 1.11; 95% CI 1.00, 1.22), and hypertension (RR: 1.27; 95% CI 1.14, 1.42).

Age is a dominant risk factor for prediabetes. Therefore, it is important to stick to a healthy lifestyle by doing more physical activities and maintaining a balanced diet since young age to prevent prediabetes.

Despite the decrease in prevalence from 18.5% in 2013 to 12.3% in 2018, diarrhea presents a major public health challenge in Indonesia which leads to significant mortality. This study investigated factors influencing diarrhea among children under five years of age in underdeveloped regions of Indonesia, where disparities from other regions are significant.

 A cross-sectional study.

This study obtained data from National Basic Health Research conducted in 2018. Sixty underdeveloped regions of Indonesia, with a total of 9243 children aged 0-59 months, were included. Chi-square, bivariate, and multivariate analyses were conducted to determine factors influencing the prevalence of diarrhea in children under 5 years of age.

Multivariate analysis revealed that the age categories of 12-23 months (OR: 1.73; 95% CI: 1.48, 2.02) and 24-35 months (OR: 1.31; 95% CI: 1.11, 1.53), awareness of a nearby hospital (OR: 0.74; 95% CI: 0.63, 0.86), and history of acute respiratory infection (ARI) in the past month (OR: 1.99; 95% CI: 1.66, 2.40) were associated with diarrhea in children under the age of five in underdeveloped regions of Indonesia. In contrast, the environmental factors analyzed further in the study were not significantly associated with the prevalence of diarrhea in children under five years of age in underdeveloped regions of Indonesia.

These findings suggest that the child’s age, the child’s history of ARI, and household awareness of nearby hospitals are critical factors associated with the child’s diarrhea in underdeveloped regions of Indonesia.

 Limited real-world data exist regarding cardiovascular outcomes in post-COVID-19 individuals following discharge, particularly within the Asian Indian population. This study aims to explore the association between prior COVID-19 history and in-hospital outcomes in acute myocardial infarction patients.

 Hospital database was searched for the patients who were diagnosed with Acute myocardial infarction (AMI) and were grouped according to absence (Group-A) or presence (Group-B) of history of severe COVID-19 hospitalization at least 3 months prior to the index event of AMI. Study primary endpoint was defined as major adverse cardiovascular events (MACE) comprising of Re-AMI, stroke, death (3P) and acute decompensated heart failure (4P), which were analyzed between these 2 study groups.

 Of 10,581 consecutive patients of AMI, 5.33% (n=564/10,581) patients had prior history of severe SARS-CoV-2 hospitalization beyond 3 months of index AMI. Past severe Covid-19 patients presenting with AMI were more likely to be younger (59.12+11.23 years vs. 52.01+10.05 years) and younger than 40 years of age. Patients in Group B demonstrated a notably higher prevalence of diabetes, hypertension, higher Killip class, and lower presenting LVEF compared to Group A. In-hospital cardiac arrest, stroke, heart failure and all-cause death were significantly higher in Group B patients. Higher unadjusted odds ratio for in hospital death OR=5.78 (2.56-10.23), 3-P MACE OR=2.33 (1.23-8.65) and 4-P MACE OR=2.58 (1.36-5.43) were found in patients with prior history of COVID-19. After adjusting for comorbidities, the ratio for in-hospital MACE was found to be non-significant.

 Conventional risk factors and presence of comorbidities in individuals with prior history of COVID-19 hospitalization increased the risk of both 3P and 4P MACE during AMI.

This study aimed to identify, classify, and prioritize the factors affecting tolerance to shift work using Delphi and fuzzy analytical hierarchy process (FAHP) techniques.

This descriptive analytical study was conducted in 2023. First, the literature review and Delphi technique identified the factors affecting tolerance to shift work. Then, these factors were grouped into five categories. The FAHP was used to prioritize the factors. Finally, the data were analyzed using MATLAB software (version 2019a).

Thirty‑two factors were identified and grouped into five categories. Based on the results of FAHP, the relative weights of individual factors, working conditions, working hours, family and living conditions, and social conditions were computed as 0.231, 0.211, 0.187, 0.186, and 0.182, respectively.

These results highlight the significance of factors influencing tolerance to shift work and can aid in planning preventive measures for the decrease of shiftwork disorders.

Endometriosis experts recommend monitoring patients until menopause before considering surgery, with concerns about lesion malignancy. This meta-analysis aims to assess the prevalence and prognosis of endometriosis-associated ovarian cancer (EAOC) in various types of epithelial ovarian cancer (EOC), and compare risk factors with the non-EAOC group to improve disease management.

In this review, PubMed, Science Direct, Scopus, Google Scholar, and Cochrane databases were searched for "endometriosis" and "ovarian cancer risk factor" from 2010 to 2023. Papers not reporting cancer prevalence or without a specified sample size were excluded. The study used statistical Cochran's Q and I2 index tests to evaluate heterogeneity and estimate ovarian cancer prevalence. Odds ratio was used to explore risk factors for cancer development.

In our meta-analysis of 20 studies, 31,667 women with Non-EAOC were compared with 2826 women with EAOC across various factors: EOC subtypes, age, parity, menopausal status, FIGO stage, 5-year survival rate, and Ca125 levels. In our study, EAOC exhibited a 7.34% cancer incidence. While clear cell and endometrioid types were more common in EAOC than in the non-EAOC group, the low-grade serous type was the most prevalent malignancy.Patients with early-stage EAOC have a 1.7 times higher 5-year survival rate compared with non-EAOC groups. EAOC is more common in nulliparous (2.243 times) and premenopausal women (2.169 times), but the CA125 levels are not significantly different between the groups.

Based on data and positive outlook, careful monitoring, considering medical history, and avoiding early surgery are highly recommended in endometriotic patients.

Erectile dysfunction (ED) is associated with cardiovascular events, and a significant proportion of men with coronary artery disease (CAD) exhibit early signs of ED. Moreover, both of these disorders shared common risk factors in previous studies. This study was conducted to determine which risk factors and conditions in CAD patients might contribute to the occurrence of ED.

This analytical cross-sectional study was conducted in the North of Iran from October 2016 to September 2017. 316 patients with coronary artery disease were enrolled. Demographic information were collected using a checklist, and the International Index of Erectile Function (IIEF-15) questionnaire  was used to determine the participant’s ED status. Univariate and multivariate logistic regression were used to investigate associated factors.

The mean age of the participants was 56.51±9.88 years. About 55.1% of the patients had ED. Moreover, the severity of CAD was independently associated with an increased risk of ED (OR=4.11, 95%CI=1.69-9.97), with patients having more than one involved coronary artery and greater coronary artery stenosis had a higher risk of developing ED occurrence (OR=3.74, 95%CI=1.72-8.09). Besides, age (OR=1.23, 95%CI=1.18-1.29) and BMI (OR=1.26, 95%CI=1.13-1.41) were independent predictors of ED occurrence in CAD patients. 

Higher CAD severity, older age, and higher BMI were all independent predictors of ED occurrence in CAD patients. While, diabetes mellitus, dyslipidemia, and smoking were not independent risk factors, they could contribute to the development of ED when combined with other risk factors.

 Retinopathy of prematurity (ROP) is a significant cause of preventable premature infant vision loss. Many studies have reported different risk factors depending on the region. In this study, we evaluated the incidence of ROP and associated risk factors in a referral eye hospital in southeastern Iran.

 This was a retrospective cohort study of preterm infants with birth weight (BW)≤2000 g or gestational age (GA)≤34 weeks and infants with GA between 34-37 weeks or GA<37 weeks and BW>2000 g referred by their pediatricians to our center from March 2022 until March 2023.

 Totally, 920 infants met the inclusion criteria for the study. The incidence of ROP and ROP requiring treatment was 20.2% and 3.58% respectively. Results of logistic regression analysis showed higher GA and BW as protective factors against ROP occurrence. History of blood transfusion and phototherapy increased ROP development.

 Lower GA, lower BW, history of blood transfusion, and phototherapy were associated with ROP development. Phototherapy decreased the need for treatment among ROP patients.

Peptic ulcer disease (PUD) is a multifactorial disease whose global prevalence has reduced over the past years.

This study aimed to determine PUD's prevalence and risk factors and the associated risk factors behind this disease.

A cross-sectional study was conducted in Duhok, Kurdistan, Iraq, between August 11 and December 17, 2022. A total of 218 patients (116 males and 102 females) who underwent upper gastrointestinal endoscopy by specialists at Azadi Teaching Hospital were interviewed face-to-face. The participants' ages ranged between 18 and 81. The upper GIT endoscopy was performed using a PENTAXI-scan 5000-type endoscopy.

The prevalence of peptic ulcers among the participants was 30 (13.8%), 27 (12.4%) duodenal ulcers and 3 (1.4%) gastric ulcers. Abdominal pain was the primary complaint, reported by (39%) of the participants, followed by heartburn (28.4%) and vomiting (6.9%). Regarding the risk factors for developing peptic ulcer among the studied cases, NSAID use was the highest risk factor (25.7%), followed by spicy food (21.6%), smoking (20.6%), family history (17%), and Helicobacter pylori infection (12.4%). A significant association was observed between H. pylori (P = 0.001) and gender (P = 0.001) with peptic ulcer. Additionally, (5%) of the participants reported melena as a complication, while only (2.3%) reported hematemesis.

This study found that 13.8% of individuals undergoing upper gastrointestinal endoscopy exhibit peptic ulcers, with 12.4% manifesting duodenal ulcers and 1.4% exhibiting gastric ulcers. Identified risk factors for peptic ulcer disease include sex and H. pylori infection. Further research is crucial to thoroughly explore the impact of various factors on the development of PUD.

To evaluate the risk factors associated with asthma in children hospitalized at Hospital Belen de Trujillo.

An analytical study of retrospective cases and controls was carried out in which 258 clinical histories of children between 5 to 14 years of age who were hospitalized in the Hospital Belen de Trujillo (HBT) during the period 2015-2019 were included, which were grouped into 129 histories of children who had been hospitalized for asthma (cases) and 129 histories of children hospitalized for a different cause (controls). The frequency distribution will be calculated, the Chi-square statistical test will be used, the odds ratio will be obtained and the 95% confidence interval will be calculated; finally, a multivariate analysis will be performed by means of logistic regression to determine whether the influence of other variables generates a greater risk of developing asthma in children.

The multivariate analysis showed that the factors: cesarean delivery, non-exclusive breastfeeding, history of bronchiolitis, obesity and maternal age together predict 92. 0% of the cases of asthma; however, taking the influence of all the factors at the same time, it was found that the cesarean delivery route, non-exclusive breastfeeding, obesity and maternal age are significant for the regression (p<0.05), while the factor history of bronchiolitis is not significant (p>0.05). Likewise, when the bivariate analysis of the five variables studied was performed and the Chi-square test was applied, it was found that all five factors were significant (p<0.05) for asthma in children at Hospital Belen de Trujillo.

The factors cesarean delivery route, non-exclusive breastfeeding, history of bronchiolitis, obesity and maternal age are associated with asthma in children hospitalized at HBT.

The analysis methods for breast cancer (BC) data have also advanced alongside medical advancements in the treatment of the disease.

This study tried to investigate the factors affecting the survival rate of BC patients using the cured model based on Kumaraswamy's defective distribution.

A retrospective study collected data on 2 574 BC patients between September 2013 and September 2020, including demographic, clinicopathological, and biological characteristics. The best model for predicting cure was chosen based on AIC.

The selected cure model revealed that age (P = 0.046), tumor histologic grade (P = 0.0.38), tumor size (P = 0.0.41), HER2 status (P = 0.001), KI67 levels (P = 0.027), P53 status (P = 0.029), and hormone therapy (P = 0.039) were significant variables. The estimated cured rate of this data was 0.82.

Considering that the advanced cured model has the highest accuracy in identifying the factors affecting the survival rate of BC patients and more risk factors have become significant in this model, it is recommended to pay special attention to patients aged over 60 with poorly differentiated historical grade, T3 tumor size, HER2 positive status, KI67 levels below 20%, negative P53 status, and no hormone therapy received in the process of disease prognosis.

Readmission is an important indicator of poor post-discharge management for psychiatric patients. This study explores the factors influencing psychiatric patient readmission, with a focus on post-discharge follow-up visits.

This retrospective cohort study analyzed the clinical records of psychiatric inpatients over an eight-year period up to 2019. The relationship between various clinical factors during hospitalization (e.g., length of stay, diagnosis, treatment adherence) and post-discharge follow-up leading to readmission was assessed using Kaplan-Meier survival analysis, Log-rank test, and Cox regression analysis.

 The study revealed a 23% readmission rate. Gender, education, length of hospital stay, number of previous hospitalizations, and restraint during hospitalization showed significant associations with post-discharge visits (P < 0.05). Gender, place of hospitalization, and type of discharge were related to the timing of the first post-discharge visit (P < 0.05). Scheduling follow-up visits at discharge was significantly associated with post-discharge follow-up (p = 0.001).

 To reduce or delay readmissions, the study recommends increasing post-discharge visits, minimizing treating psychiatrists, scheduling outpatient follow-up upon discharge, providing psycho-education at discharge (particularly for women and individuals with higher education), addressing patients who leave against medical advice, and conducting telephone follow-up for high-risk patients.

Occupational settings expose workers to various substances linked to cancer risk, influenced by exposure intensity and duration. Considering the diverse work conditions across Iranian cities and the unexplored link between occupation and bladder cancer (BC) in Guilan Province, identifying high-risk occupations and industries is imperative for implementing preventive measures in the region.

To investigate the effect of people's occupations on bladder cancer in Guilan Province.

The study encompassed 266 diagnosed BC patients in Guilan Province who received treatment at local healthcare centers, along with 191 control individuals aged 18 and over. Data for the cases were meticulously recorded in medical records at the Guilan Cancer Registry. The same checklists, including demographic characteristics, comorbidities, addiction status, water consumption habits, environmental exposures, current and previous occupation, previous history of cancer, and family history of cancer, were recorded for the controls. Odds ratios and their 95% confidence intervals were estimated using adjusted logistic regression (LR).

The study found that the odds ratio of bladder cancer was 2.80 (95% CI: 1.26 - 6.21) for the age group 60 - 70 years and 18.2 (95% CI: 7.31 - 45.6) for individuals above 70 years. Rural dwelling increased the risk by 5.06-fold, while well water consumption and regular opium use amplified it by 6.12-fold and 2.58-fold, respectively. Exposure to tar and carbon derivatives led to a 3.53-fold increase in risk, and exposure to combustion/greenhouse gases showed a 10.72-fold increase. Chemical-related occupations, tar, carbon derivatives, smoking, and opium consumption were significant risk factors.

Occupations involving chemical substances such as greenhouse gases, tar, and carbon derivatives are associated with a higher risk of bladder cancer. Furthermore, smoking, opium use, and well water consumption significantly elevate the risk of this cancer.