STUDY DESIGN: Systematic review and meta-analysis.
METHODS: This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines on August 8, 2022. To conduct the systematic review and meta-analysis, a search was performed using the keywords "urinary tract system", "UTI", "pregnancy", and "gestation" was performed in several databases, including Web of Science (WoS), PubMed, Scopus, ScienceDirect, Embase, and Google Scholar, without a time limit until September 18, 2022. The analysis was performed using a random-effects model, and the heterogeneity of the studies was assessed using the I2 index. The Comprehensive Meta-Analysis software (Version 2) was used for data analysis.
RESULTS: The systematic review and meta-analysis of 27 studies, which included a total of 30,641 pregnant women, showed an overall prevalence of UTI (both symptomatic and asymptomatic) to be 23.9% (95% confidence interval: 16.2-33.8). Meta-regression analysis was conducted to examine the impact of two factors, namely study sample size and study year, on the heterogeneity of the meta-analysis. The results revealed that an increase in sample size, and the study year was associated with a decrease in the prevalence of UTI in pregnant women (P
OBJECTIVE: This study aimed to compare Foley balloon catheter placement for 6 vs 12 hours in induction of labor after 1 previous cesarean delivery.
STUDY DESIGN: A randomized controlled trial was conducted in a university hospital in Malaysia from January 2022 to February 2023. Eligible women with 1 previous cesarean delivery admitted for induction of labor were enrolled. Participants were randomized after balloon catheter insertion for 6 or 12 hours of passive ripening before balloon deflation and removal to check cervical status for amniotomy. The primary outcome was the induction of labor to delivery interval. The secondary outcomes were largely derived from the core outcome set for trials on induction of labor (Core Outcomes in Women's and Newborn Health [CROWN]). The Student t test, Mann-Whitney U test, chi-square test, and Fisher exact test were used as appropriate for the data.
RESULTS: Overall, 126 women were randomized, 63 to each intervention. The mean induction of labor to delivery intervals were 23.0 (standard deviation, ±8.9) in the 6-hour arm and 26.6 (standard deviation, ±7.1) in the 12-hour arm (mean difference, -3.5 hours; 95% confidence interval, -6.4 to -0.7; P=.02). The median induction of labor (Foley balloon catheter insertion) to Foley balloon catheter removal intervals were 6.0 hours (interquartile range, 6.0-6.3) in the 6-hour arm and 12.0 hours (interquartile range, 12.0-12.5) in the 12-hour arm (P
METHODS: The searched articles were selected based on the available keywords in the title and abstract with the publication restricted between January 2010 and September 2020. Articles generated from the databases must fulfill both inclusion and exclusion criteria in the present systematic review. Our initial search retrieved 221 literature reviews. After excluding articles with irrelevant topics, a total of 23 articles were chosen for this current review.
RESULTS: The factors were classified based on three main factors: patient-related, medication-related, and healthcare workers-related factors. For patient-related factors, gender, age, number of family members, education level, post-hospitalization, comorbidities and cardiovascular disease risk, follow-up status, occupation, socio-economy, insurance, perception, ethnicity, and health plan were among the factors affecting adherence to LLDs. As for medication-related factors, timing, polypharmacy, duration of treatment, generic medication, intensity of medication, side effects, initiating dose, packaging, drug dosing, and type of drugs were revealed as contributing factors. In the light of healthcare workers, related factors shown were counseling, medication optimization, type of provider, and location of the hospital.
CONCLUSIONS: Recommendations to improve adherence include educating patients on the disease itself and the importance of the treatment, modification of the dosing, timing and type of LLDs, and effective consultations by healthcare workers. Further studies need to be done in Malaysia as there is inadequate research on this topic.
METHODS: We conducted a cross-sectional study from July to October 2019 that included all patients with gout who attended the clinics. Data on clinical demographics and laboratory results were collected. Comparison between tophaceous and non-tophaceous groups was performed using descriptive analysis.
RESULTS: A total of 421 patients with gout were involved in this study, 83 (19.7%) patients had visible tophi and were categorized into the tophaceous group, while the other 338 (80.3%) patients were categorized into the non-tophaceous group. The majority of patients were male with a mean age of 57.6±12.8 years. Three factors found to be significantly associated with tophaceous gout were age at symptom onset [tophaceous (45.6±13.3 years) vs. non-tophaceous (49.7±13.9 years), p = 0.026], mean disease duration of gout [tophaceous (105.2±92.6 months) vs. non-tophaceous (77.6±88.6 months), p = 0.013], and baseline serum uric acid level [tophaceous (622.3±129.1 µmol/L) vs. non-tophaceous (582.6±102.3 µmol/L), p = 0.021].
CONCLUSIONS: Tophaceous gout is associated with longer disease duration, higher baseline serum uric acid level, and younger age at symptoms onset. Hence, early initiation of urate-lowering therapy with a treat-to-target approach is crucial to prevent tophi formation.
METHODS: The study is being conducted as a randomized controlled intervention trial. Adult participants with unipolar depression are being randomized into three groups (BPT, MMT, or CG), and the first two groups are undergoing a 10-week treatment phase. CG follows their individual standard treatment as usual. A priori power analysis revealed that about 120 people should be included to capture a moderate effect. The primary outcome of the study is depression rated with the Montgomery and Asberg Depression Rating Scale (MADRS) before (t0), directly after (t1), and 12 months after the intervention phase (t2). Data are being collected via questionnaires, computer-assisted video interviews, and physical examinations. The primary hypotheses will be statistically analyzed by mixed model ANOVAs to compare the three groups over time. For secondary outcomes, further multivariate methods (e.g., mixed model ANOVAs and regression analyses) will be conducted. Qualitative data will be evaluated on the basis of the qualitative thematic analysis.
DISCUSSION: This study is investigating psychological and physical effects of BPT and MMT and its factors of influence on outpatients suffering from depression compared with a CG in a highly naturalistic design. The study could therefore provide insight into the modes of action of group therapy for depression and help to establish new short-term group treatments. Methodological limitations of the study might be the clinical heterogeneity of the sample and confounding effects due to simultaneous individual psychotherapy.
TRIAL REGISTRATION: ISRCTN, ISRCTN12347878. Registered 28 March 2022, https://www.isrctn.com/ISRCTN12347878 .
ABSTRACT: Pre-septal and orbital cellulitis are more commonly seen in children than in adults. The incidence of pediatric orbital cellulitis is 1.6 in 100,000. The impact of COVID-19 has led to the increasing practice of nasopharyngeal swab surveillance. We presented a case of rare pediatric orbital cellulitis complicated with subperiosteal abscess secondary to severe acute sinusitis following a nasopharyngeal swab. A 4-year-old boy was brought in by his mother with increasing painful left eye swelling and redness. Three days prior, the patient developed a fever and mild rhinitis with loss of appetite which raised concerns about COVID-19. He had a nasopharyngeal swab on that same day and tested negative. Clinically, there was marked erythematous and tender periorbital and facial oedema involving the left nasal bridge, maxilla extended to the left upper lip with a deviation of the left nasal tip contralaterally. Computed tomography confirmed left orbital cellulitis with left eye proptosis, fullness of left maxillary and ethmoidal sinuses and left subperiosteal abscess. The patient received empirical antibiotics and surgical intervention promptly and recovered well with improvements in ocular symptoms. The nasal swabbing techniques may vary among practitioners, and it is associated with extremely low risks of severe complications from 0.001% to 0.16%. Whether the swab had aggravated the underlying rhinitis or traumatized the turbinates leading to sinus drainage obstruction; a nasal swab may impose the risk of severe orbital infection in a susceptible pediatric patient. Any health practitioner conducting the nasal swab should be vigilant about this potential complication.
OBJECTIVES: To create a translation of the Chrononutrition Profile Questionnaire (CPQ), test its validity and reliability, and determine the general chrononutrition behaviors among Malaysian young adults.
METHODS: The Malay-CPQ was distributed to respondents through online platforms (n = 110), and data analyses were performed. The data were analyzed for their validity using content validity index (CVI) and face validity index (FVI), whereas intraclass correlation coefficient (ICC) was used to determine test-retest reliability.
RESULTS: Our results showed both CVI and FVI of Malay-CPQ were 1, indicating excellent content translation, while the ICC values ranged from moderate to good (0.50-0.90). The Cronbach α values for all items ranged from moderate to good (0.50-0.90), and the Bland-Altman analysis showed a P value >0.05, indicating agreement of the item between repeated measurements. The chrononutrition behaviors among Malaysian young adults presented fair to good scores for all behavior patterns: eating window, breakfast skipping, evening eating, night eating, and largest meal, except evening latency, being mostly at the poor score (>80% responses).
CONCLUSIONS: The Malay-CPQ is a valid and reliable tool to assess the Malaysian chrononutrition profile. However, further testing on Malay-CPQ should be conducted in a different setting in Malaysia for cross-validation studies.