BACKGROUND: The expulsion of meconium during labor increases the likelihood of adverse birth outcomes, with its detrimental effects being more pronounced in resource-constrained countries. METHODS: A cross-sectional study was conducted between March and May 2022 to assess the prevalence of meconiumstained amniotic fluid (MSAF), associated risk factors, and related neonatal outcomes among 281 laboring mothers who delivered at Hawassa University Comprehensive Specialized Referral Hospital, Ethiopia. Study participants were selected using a systematic random sampling technique. Data were collected using a pretested questionnaire administered by trained BSc midwives, along with a checklist derived from medical records. Data entry and analysis were performed using SPSS version 23. Both descriptive and analytical statistics were computed. Statistical significance was set at P < 0.05, and the strength of association was assessed using adjusted odds ratios (AOR). RESULTS: In this study, MSAF occurred in 57 (20.3%) of pregnancies. Low Apgar scores at the fifth minute, meconium aspiration syndrome, perinatal asphyxia, and neonatal intensive care unit admission were identified as the major adverse neonatal outcomes associated with MSAF. Factors such as maternal age, rural residence, gestational age greater than 42 weeks, prolonged labor duration, and obstructed labor were identified as potential risk factors for the development of MSAF. CONCLUSIONS: Healthcare providers should evaluate women in labor for these risk factors and remain vigilant in the early identification of MSAF to improve outcomes for both the fetus and the mother.
BACKGROUND: In Indonesia, 10.9% of people have diabetes mellitus, and 34.11% of people have hypertension, which results in 0.67% of fatalities. Based on medical laboratory tests performed on Prolanis participants at the Regional Health Laboratory in Surabaya City, Indonesia, this study attempts to examine the risk variables linked to diabetes mellitus and hypertension. METHODS: This study uses secondary data from January to October 2024 to investigate risk variables for these illnesses among 637 Prolanis (The Chronic Disease Management Program) participants at the Regional Health Laboratory using a cross-sectional design and bivariate analysis. Age, sex, waist circumference, blood pressure, BMI, HbA1c, total cholesterol, and LDL levels were among the variables. RESULTS: High body mass index (OR = 1.45; 95% CI = 1.06-1.98), abnormal waist circumference (OR = 1.85; 95% CI = 1.33-2.58, female (OR = 0.68; 95% CI = 0.49-0.95) and older age (OR = 1.87; 95% CI = 1.19-2.93) were associated with diabetes mellitus. Older age (OR = 2.65; 95% CI = 1.53-4.61) was associated with hypertension. CONCLUSION: Old age, male gender, and higher waist circumference are key factors linked to diabetes mellitus, while older age is associated with hypertension in Prolanis participants.
BACKGROUND: Microbiological diagnostics, particularly culture and antimicrobial susceptibility testing, are among the least utilized diagnostic services in Ethiopia. This critical gap is also observed across healthcare systems in many sub-Saharan African countries. However, there is a paucity of data characterizing the limitations and operational challenges in microbiological service delivery. This study examines the gaps identified in public health facilities in Ethiopia. METHODS: A laboratory-based survey assessing culture and antimicrobial susceptibility testing services was conducted in 13 public hospitals in Addis Ababa between January and March 2024. Data were collected through direct observation, laboratory logbook reviews, and interviews with laboratory personnel, following ethical approval. RESULTS: There are 13 public hospitals in Addis Ababa serving a population exceeding five million. Of these, eight provide basic bacteriological culture and antimicrobial susceptibility testing services. None of these eight-offer advanced molecular or genotypic testing, nor do they provide anaerobic or fungal culture services. Furthermore, seven of the eight facilities face challenges in delivering comprehensive antimicrobial susceptibility testing, particularly in terms of the range of antibiotics tested. Sustaining uninterrupted services is also a major challenge in these facilities, largely due to financial constraints and weaknesses in the microbiology supply chain management system. CONCLUSION: In the context of the growing clinical impact of antimicrobial resistance, addressing gaps in microbiological diagnostic services is imperative. The limited range and inconsistency of laboratory services in public health facilities are insufficient to meet current clinical demands and to effectively respond to the increasing threat of drug-resistant pathogens.
BACKGROUND: Thyroid nodules carry a substantial risk of malignancy. Ultrasound and fine needle aspiration cytology (FNAC) are the most important investigations used to risk-stratify such lesions. The performance of these tests is a scarcely researched area in Ethiopia. The main objective of this study was to assess the diagnostic performances of ultrasound and FNAC in identifying thyroid cancers, using final surgical pathology as the reference standard. METHODS AND MATERIALS: A paired comparative diagnostic accuracy study using retrospective data was conducted at Tikur Anbessa Specialized Hospital and Lancet General Hospital. The collected data were analyzed using SPSS Windows version 21, Microsoft Excel 2019, and diagnostic accuracy-calculating spreadsheets. RESULTS: Two hundred and sixty-six (266) cases were included in the analysis. Of these, 204 (76.7%) were females. The median age (in years) was 45.0 (IQR = 20.0). McNemar's test determined that the proportion of malignant lesions was statistically significantly different between the two tests (P < 0.001). Binary logistic regression models showed that the combination of ultrasound and FNAC had higher diagnostic performance metrics than the two tests used separately. CONCLUSION: The study showed that FNAC outperforms ultrasound in diagnosing thyroid cancer. Thyroid ultrasound has higher sensitivity but significantly lower specificity than FNAC. This is an important and advantageous characteristic of a triaging test, but with a significant limitation as a rule-in test. Knowing the diagnostic performances of these tests greatly helps in triaging and clinical decision-making in the evaluation of individuals for thyroid cancer.
BACKGROUND: This study specifically aimed to identify factors contributing to drug abuse among secondary school students in Nigeria and the commonly abused drugs as reported by school counsellors. It also examined the influence of sex and length of experience on school counsellors' reports of trigger factors and commonly abused substances among secondary school students. METHODS: The target population comprised all school counsellors in Nigeria. Using a survey design with a convenience sampling technique, data were collected from 384 school counsellors. A structured questionnaire titled "Trigger Factors of Substance Abuse Questionnaire (TFAQ)" was used. The Cronbach formula was applied, and a reliability coefficient of 0.91 was obtained. Hypotheses were tested at a 0.05 alpha level. RESULTS: The trigger factors of substance abuse among secondary school students, as reported by school counsellors, include peer pressure, availability of substances, media and technology influence, and curiosity. The predominantly abused substances are marijuana, codeine, and tramadol. Female school counsellors reported more trigger factors of substance abuse than their male counterparts. CONCLUSIONS: The findings highlight the importance of addressing the trigger factors of substance abuse at both the student level (especially giving in to peer pressure) and the systemic level (especially the availability of substances and media influence). It is therefore imperative to develop and implement school-based programmes to inform students about the risks associated with substance abuse, focusing on the negative contributions of peer pressure, media influence, and curiosity. School-based interventions should prioritise peer resistance training programmes that equip students with the skills to navigate social pressures.
BACKGROUND: Home-Based Newborn Care (HBNC) is a costeffective strategy introduced by the Government of India to ensure postnatal care for mothers and neonates in rural and tribal regions. HBNC is implemented through field-level healthcare providers known as ASHA (Accredited Social Health Activist). The baseline situation of the health system and resources is necessary to ascertain effective HBNC implementation. Methods: This cross-sectional study was carried out in a tribal district of India. For assessing health system preparedness for HBNC, district-level records, verification of HBNC kits, and baseline knowledge and skill assessment of ASHAs were conducted. For the field-level HBNC implementation component, process evaluation of HBNC among ASHAs was carried out in the selected villages. Results: Human resources, capacity building, and logistics-related components in the district were adequate with regard to HBNC. Kit verification showed deficiencies in essential items, e.g., soap, digital wristwatch, and sling bag for weight measurement. Knowledge regarding the frequency of HBNC visits, initiation of breastfeeding, and complications in postnatal mothers was found satisfactory among ASHAs (95.6%). In the skill component, 47.5% of ASHAs could correctly count respiratory rate, while none could enlist the steps of correct positioning and attachment in breastfeeding. In the process evaluation of HBNC, major findings included the inability of ASHAs to identify appropriate actionable measures based on observations during HBNC visits. Conclusion: This study highlights the importance of adequate resources, regular capacity building of healthcare providers, along with supportive supervision, for effective HBNC implementation in the community.
BACKGROUND: Endoscopic evaluation serves both diagnostic and therapeutic purposes. With technological advancements, many gastrointestinal conditions that previously required surgical intervention can now be managed endoscopically. However, in most resource-limited settings, endoscopy services remain predominantly diagnostic. This study aimed to evaluate a decade of therapeutic endoscopy practice at a large endoscopic center in Addis Ababa, Ethiopia, highlighting its feasibility and benefits in a Sub-Saharan African context. METHOD: An institution-based cross-sectional study was conducted to assess the patterns and practice of therapeutic endoscopy at Adera Medical and Surgical Center, Addis Ababa, Ethiopia, from October 2013 to September 2023. Socioeconomic, clinical, and endoscopic data were collected and analyzed using SPSS version 26.0. RESULTS: Of the 48,550 endoscopic procedures performed, 2,393 (4.9%) were therapeutic. The mean age of patients was 42.5 +/- 13.8 years, and 73.6% were male. The most common procedures were esophageal variceal ligation (68.6%), followed by polypectomy (8.4%), achalasia/stricture dilation (8.0%), hemorrhoid banding (6.6%), sclerotherapy (4.3%), cyanoacrylate injection (1.6%), foreign body removal (1.4%), adrenaline injection (0.9%), and hemoclip application (0.2%). Endoscopic intervention achieved immediate hemostasis in all upper gastrointestinal bleeding cases except for one patient with a bleeding duodenal ulcer who required surgical intervention after failed endoscopic sclerotherapy. Symptomatic relief was achieved in 100% of achalasia cases and 97.0% of stricture dilation cases. Foreign body removal was successful in 96.96% of cases, and all polyps were successfully managed endoscopically. CONCLUSION: Therapeutic endoscopy is both feasible and effective in our setting. Expanding such services can significantly reduce the need for surgical interventions and improve gastrointestinal care in similar settings across Sub-Saharan Africa.
BACKGROUND: Over the years, breast cancer surgery has undergone tremendous advances. The previous norm of maximal operative intervention has now shifted toward minimally necessary surgery. Sentinel lymph node biopsy (SLNB) is a technique with the potential to avoid axillary dissection and its associated complications in clinically node-negative breast cancer. METHODS: A collaborative multidisciplinary breast cancer management team was established at our institution. Methylene blue dye was injected at intratumoral and peritumoral locations. Sentinel lymph nodes were mapped and harvested in 40 patients. The nodes were sent for frozen section analysis, and based on the pathology results, we either avoided or proceeded with axillary dissection. RESULTS: We performed 40 SLNB procedures over a period of two years. Sentinel nodes were successfully identified in all cases. In 32 (80%) of the patients, SLNB results were negative, allowing us to avoid axillary dissection in this group. For the remaining patients, axillary dissection was performed. CONCLUSION: Our initial experience at St. Paul's demonstrates that SLNB is both feasible and effective in resource-limited tertiary settings in developing countries. This procedure represents a preferred alternative to routine axillary dissection.
Background:Schistosomiasis caused by Schistosoma japonicum remains a public health concern in low-endemic areas of Indonesia Sensitive and field-applicable diagnostic tools are essential for effective surveillance and control This study evaluated the diagnostic performance of a point-of-care circulating cathodic antigen (POC-CCA) urine test for detecting S. japonicum infection. Methods:A community-based cross-sectional diagnostic evaluation was conducted during August-September 2023 among 226 residents of Wanga (Lore Peore) and Tamadue (Lore Timur) villages, Poso Regency, Central Sulawesi, Indonesia Stool samples were examined using the Kato-Katz (KK) technique, and urine samples were tested using the POC-CCA cassette. Diagnostic accuracy indices were calculated using MedCalc software, with KK serving as the reference standard. Results:Of the 226 participants, 36 (15.9%) were positive for S. japonicum by KK, whereas only 6 (2.7%) tested positive by POC-CCA. A total of 188 participants were negative by both methods, while 30 were KK-positive but POC-CCA-negative. The sensitivity of the POC-CCA test was 16.67% (95% CI: 6.37-32.81), and specificity was 98.95% (95% CI: 96.25-99.87). The positive predictive value was 75.00% (95% CI: 38.66-93.46), the negative predictive value was 86.24% (95% CI: 84.40-87.89), and Cohen's kappa coefficient was 0.246 (95% CI: 0.004-0.487), indicating fair agreement. Conclusions:The POC-CCA urine test demonstrated high specificity but very low sensitivity for detecting S. japonicum, particularly in low-intensity infections. Its use as a standalone diagnostic tool in low-endemic settings is not recommended Refinement of the assay or integration with complementary diagnostic methods is necessary before field application.
Background:The aim of this study was to examine the prevalence of Aspergillus sensitivity (AS) and allergic bronchopulmonary aspergillosis (ABPA) in children with Bronchial Asthma. Methods:The study included 200 children with bronchial asthma. ABPA was diagnosed using Aspergillus skin testing, pulmonary function testing, absolute eosinophil count, total serum IgE, Aspergillus-specific IgE and IgG, chest radiography, and high-resolution computed tomography. Patients were diagnosed and classified according to the Rosenberg-Patterson criteria for ABPA. Results:Of the 200 children with bronchial asthma, 7 patients were ABPA positive. Among the ABPA-positive cases, 5 (71.4%) had uncontrolled asthma. The mean absolute eosinophil count (AEC) was significantly higher in ABPA-positive cases (418.71 ± 90.12 cells/cumm). The mean total serum IgE in positive cases was 1181.00 ± 403.42 IU/L. The mean Aspergillus-specific IgE level in positive cases was 4.74 ± 6.09 kUA/L. In ABPA-positive cases, the mean Aspergillus-specific IgG level was 26.06 ± 14.93 mgA/L. Conclusion:This study demonstrated an association between ABPA and bronchial asthma in children. ABPA is a common entity in bronchial asthma and should be considered as a cause of uncontrolled asthma when symptoms persist despite the use of multiple medications.
Background:Although studies in adults have shown that early removal of the nasogastric tube (NGT) after major bowel surgery is safe and more beneficial than delayed removal, adoption of this practice in children has been slow due to limited supporting evidence. This study aimed to compare postoperative outcomes between early and delayed nasogastric tube removal in children undergoing major bowel surgery. Methods:A total of 102 children who underwent major bowel surgery were randomized into two groups: Group I (early removal) and Group II (delayed removal), with 51 patients in each group. In Group I, the NGT was removed 24 hours postoperatively, whereas in Group II, it was removed after the passage of either faeces or flatus. The primary outcome was the prevalence of vomiting, while secondary outcomes included the timing of return of bowel sounds and the achievement of full-scale feeding. Data were analyzed using Statistical Product and Service Solutions (SPSS) version 20 (IBM, SPSS, Chicago, IL, USA). Qualitative and quantitative variables were analyzed using the Chi-square test and Student's t-test, respectively. A p-value < 0.05 was considered statistically significant. Results:Vomiting occurred in 6 (11.8%) patients in the early group and 5 (9.8%) patients in the delayed group (p = 0.750). Bowel sounds returned significantly earlier in the early group (83 ± 11.67 hours) compared with the delayed group (97 ± 17.71 hours; p = 0.029). Full-scale feeding was achieved at 121.84 ± 13.67 hours in the early group and 132.63 ± 12.79 hours in the delayed group (p = 0.031). Conclusion:This study reveals that early removal of the nasogastric tube might not significantly increase the rates of vomiting. However, it might lead to significantly reduced time to the return of bowel sounds and full scale feeding.
Background:Optometrists play a pivotal role in preventing and managing vision impairment through the provision of comprehensive eye care services. In India, vision impairment remains a major public health challenge, largely driven by uncorrected refractive errors, cataract, and other avoidable causes. Despite recent regulatory advances, limited evidence exists on the scope and distribution of specialty optometry practices across Indian states. This study assessed the extent and composition of specialty optometry practices among optometrists across selected Indian states. Methods:A cross-sectional survey was conducted among practicing optometrists in six Indian states using a pre-validated, self-administered questionnaire distributed via Google Forms. Informed consent was obtained electronically. Data were analyzed using Microsoft Excel and SPSS version 20. Descriptive statistics were computed to summarize practice patterns. Results:A total of 325 responses were received, of which 321 were complete and included in the analysis. All participants reported providing refraction services, with a high monthly workload. Specialty practices were less common, with contact lens practice reported by 69.5%, binocular vision services by 62.0%, and low-vision care by 61.0% of respondents. The average number of specialty cases managed per month ranged from 5 to 15. Marked inter-state variations in specialty practice were observed, reflecting disparities in workforce distribution and service availability. Conclusion:The findings highlight a substantial reliance on refraction-based services and an insufficient level of specialty optometry practice relative to population needs. Strengthening specialty training and expanding the optometry workforce beyond routine eye examination are essential to reduce avoidable blindness in India.
Background:Intrauterine growth restriction (IUGR) is defined as an estimated fetal weight below the 10th percentile for gestational age and is commonly associated with placental insufficiency and abnormal fetoplacental oxygenation. This study aimed to assess placental apparent diffusion coefficient (ADC) and perfusion values in IUGR using 3T magnetic resonance imaging (MRI). Methods:Sixty pregnant women (30 with IUGR and 30 controls; gestational age 20-38 weeks) underwent placental MRI on a 3T system. The imaging protocol included T2-weighted anatomical sequences, diffusion-weighted imaging (b-values: 0 and 700 s/mm2; NEX = 3), and three-dimensional pseudo-continuous arterial spin labeling (3D pCASL) perfusion imaging (TR/TE = 5000/50 ms, labeling duration = 1500 ms, post-labeling delay = 1525 ms, 30 label/control pairs). ADC and perfusion maps were generated, and multiple elliptical regions of interest (ROIs; 40-60 mm2) were placed throughout the placenta. Mean values were calculated for each subject. Results:Mean placental perfusion was significantly lower in the IUGR group compared with controls (102.5 ± 18.7 vs. 120.2 ± 23.7 ml/100 g/min, p = 0.002). ADC values were also significantly reduced in IUGR placentas (1.83 ± 0.10 × 10-3 mm2/s vs. 2.02 ± 0.10 × 10-3 mm2/s, p = 0.001). Receiver operating characteristic (ROC) analysis demonstrated fair diagnostic performance for perfusion (AUC = 0.703) and excellent performance for ADC (AUC = 0.919). Conclusion:Both placental ADC and perfusion values were reduced in IUGR. However, because ADC is influenced by perfusion bias, the most clinically relevant finding is the direct quantification of reduced placental perfusion using 3D pCASL at 3T. This technique provides absolute perfusion values in physiological units and may serve as a valuable non-invasive biomarker of placental dysfunction in IUGR.
Background:Biometric fingerprint systems, although effective for identification and security, can facilitate the spread of infections in hospital settings due to repeated contact by multiple users. Hospital-acquired infections (HAIs) are increasingly associated with bacteria such as Staphylococcus aureus, Acinetobacter spp., Escherichia coli, and Pseudomonas species, which are capable of surviving on inanimate surfaces, including fingerprint scanners. This study was conducted to determine whether biometric fingerprint devices can act as reservoirs for pathogenic microorganisms and to detect the presence of multidrug-resistant organisms (MDROs) along with their antibiotic susceptibility profiles. Methods:Samples were collected from biometric fingerprint devices installed in the hospital and medical college. The samples were cultured, and the isolated organisms were identified. Antibiotic susceptibility testing of the isolates was performed using an automated system (VITEK 2 Compact, bioMérieux). Results:The overall prevalence of pathogenic bacteria isolated was 17.7% (17/96). Among the pathogenic bacteria identified (n=17), 29.4% were Gram-positive cocci, while 70.6% were Gramnegative bacilli. The most common bacteria isolated were Serratia species (23.5%), followed by Acinetobacter species and Enterococcus species. Among Gram-positive cocci, Enterococcus species were the most frequently isolated organisms. Conclusion:In conclusion, fingerprint biometric devices may act as reservoirs for multidrug-resistant organisms and contribute to cross-transmission in hospitals. Contactless biometric devices are preferable; otherwise, regular disinfection, nearby hand sanitizers, and routine microbiological surveillance should be part of infection control audits.
Background:Non-medical opioid use is linked to severe consequences such as addiction, overdose, and infectious diseases, including human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV), particularly through injection practices. In Ethiopia, limited evidence exists on non-medical opioid use, and harm-reduction programs are absent. This study aimed to explore the experiences of non-medical opioid users seeking healthcare in Addis Ababa, Ethiopia. Methods:A phenomenological qualitative study design was employed, complemented by descriptive quantitative data. We conducted qualitative in-depth interviews with sixteen purposively selected participants and reviewed hospital data (n = 47). Thematic analysis was used for the qualitative data, while descriptive statistics summarized the quantitative findings. Results:Five themes emerged from the qualitative analysis: patterns of opioid use, reasons for use, strategies for accessing opioids, perceived consequences, and help-seeking behaviours. Quantitative data showed that 47 opioid users received healthcare services over the past three years in hospitals in Addis Ababa. Forty-three percent of these individuals were healthcare professionals. Sixty-six percent used one type of opioid, predominantly tramadol (18), while 24 of the 47 reported polysubstance use. Daily opioid use was common, reported by 76.6% of participants. Conclusions:Non-medical opioid use poses significant life-threatening risks and multidimensional challenges, necessitating immediate intervention. Further large-scale studies on the burden of opioid use, as well as intervention research aimed at improving care and developing harm-reduction guidelines, are essential.
Background:The Clinical Risk Index for Babies II (CRIB II) is a validated scoring system for predicting early mortality risk among low birth weight (LBW) preterm neonates. However, its routine use remains limited in many developing countries. This study aimed to evaluate the effectiveness of the CRIB II score in predicting neonatal mortality among LBW infants admitted to a tertiary care Neonatal Intensive Care Unit (NICU). Methods:This prospective cohort study included 140 preterm neonates (gestational age 23-32 weeks) admitted to the NICU within 24 hours of birth. Baseline demographic variables, clinical characteristics, and CRIB II scores were recorded Neonatal outcomes were followed until discharge or death. Diagnostic performance was assessed using sensitivity, specificity, predictive values, accuracy, and receiver operating characteristic (ROC) curve analysis. Results:There was a slight male predominance (51%). The mean birth weight was 1550.97 ± 253.58 g, and the mean gestational age was 30.42 ± 2.23 weeks. Overall neonatal mortality was 32.85%. Mortality increased progressively with higher CRIB II scores: 0% in level I, 3.84% in level II, 64.70% in level III, and 100% in level IV. The CRIB II score demonstrated excellent predictive performance with a sensitivity of 84.78%, specificity of 90.42%, and diagnostic accuracy of 88.57%. Conclusion:The CRIB II score is a reliable and effective tool for early prediction of neonatal mortality in LBW preterm infants and should be considered for routine risk stratification in NICU settings.
BACKGROUND: Toxoplasmosis, a neglected tropical disease caused by the parasite Toxoplasma gondii, is among the most common congenital infections worldwide, particularly in developing countries. The infection can be transmitted through cord blood-the blood remaining in the placenta after childbirth. This study investigates the presence of Toxoplasma gondii in cord blood and examines associated maternal and neonatal factors. METHODS: This study was conducted at the Rivers State Teaching Hospital in Port Harcourt. A total of 180 cord blood samples were randomly collected from newborns in the labor ward, following ethical approval. The samples were analyzed for Toxoplasma gondii IgG antibodies using enzyme-linked immunosorbent assay (ELISA). Maternal and neonatal data were collected through structured questionnaires, and statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS). RESULTS: The findings revealed that 36.7% of the cord blood samples tested positive for Toxoplasma gondii. Maternal age, education level, and occupation were not significantly associated with infection prevalence. However, specific maternal risk factors-including lack of awareness, consumption of undercooked meat, poor hand hygiene, and consumption of unwashed fruits and vegetables-were associated with increased prevalence. Notably, a significant correlation was observed between low birth weight (1.6-2.5 kg) and higher infection rates, with a 25% prevalence in this subgroup. CONCLUSION: The high prevalence of toxoplasmosis identified in this study emphasizes the need for increased public health education and awareness regarding the disease and its implications for newborns. Routine screening and appropriate treatment for pregnant women are recommended to reduce the rate of congenital transmission.
BACKGROUND: Accurate cost and pricing information is essential for optimal budget allocation and sound strategic decision-making. Establishing an appropriate costing system is critical for understanding educational expenses, improving services, and managing budgets more efficiently. This study aimed to estimate the cost of educating students at the dental school during the 2022-23 academic year. METHODS: This cross-sectional study estimated the cost of educating dental students at Iran University of Medical Sciences in 2023 using the Activity-Based Costing (ABC) method. Data were collected through interviews with financial and administrative officials, as well as relevant units such as accounting and administration, utilizing a structured checklist. After estimating the costs of activity centers, overhead and intermediate center expenses were allocated to final activity centers based on suitable allocation bases. Ultimately, the costs associated with the final activity centers which is, the educational departments, were determined, and the total cost per student was calculated. RESULTS: The average cost of educating a general dentistry student in the 2022-23 academic year was approximately 132,438 Purchasing Power Parity (PPP) adjusted US Dollars. In the dental school, total overhead costs amounted to 802,953, while total direct costs were 1,133,853 in PPP-adjusted dollars. The largest portion of total costs (61%) was attributed to human resources, followed by consumables (20%) and equipment depreciation (14%). CONCLUSION: The majority of costs are allocated to human resources, indicating the need to enhance productivity. Reducing consumable costs and equipment depreciation could further improve financial efficiency. It is recommended that managers and policymakers implement strategies to optimize resources and enhance educational quality.
BACKGROUND: Respiratory assessments frequently utilize Peak Expiratory Flow Rate (PEFR) as a fundamental measure of lung function. However, standard reference ranges may not accurately represent variations across different demographic groups. This study aims to address this gap by examining the variability of PEFR among healthy Pakistani adults. METHODS: This cross-sectional study was conducted over a six-month period at a tertiary care hospital in Wah Cantt, Pakistan, involving 400 consenting participants. A consecutive sampling technique was employed. Anthropometric measurements, including height and weight, were obtained using a stadiometer and calibrated weighing scale, respectively. Each participant performed three PEFR maneuvers using a peak flow meter, and the highest value was recorded. Additional data, including age and gender, were collected using a structured proforma. Data was analyzed using SPSS. RESULTS: PEFR showed a strong positive correlation with height (0.616 in males 0.767 in females) and a negative correlation with age (-0.418 in males and -0.115 in females). Male participants exhibited significantly higher PEFR values compared to females. CONCLUSION: The findings indicate that PEFR is influenced by gender, height, and age. Specifically, males tend to have higher PEFR values; PEFR increases with greater height and decreases with advancing age. These results underscore the importance of considering demographic-specific factors when interpreting PEFR values and support the development of localized reference standards for clinical use.
BACKGROUND: Migraine and obesity often coexist, and both generalized and central obesity may influence the frequency and severity of migraine attacks. This study aimed to investigate the association between obesity-related anthropometric measures and headache burden in individuals with migraine. METHODS: This observational study was conducted at King Fahad Hospital of the University, Saudi Arabia, and included 186 patients diagnosed with migraine. Anthropometric data were collected at baseline and again after a minimum follow-up period of 12 months. Headache frequency and severity were evaluated, alongside clinical variables such as dietary habits and medication adherence. RESULTS: Elevated body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) were observed in 43.1%, 67.2%, and 41.4% of participants, respectively. At follow-up, 51.6% of patients reported an increase in headache frequency, with significantly higher BMI values among this subgroup (p = 0.018). Increased headache frequency was significantly associated with elevated BMI (p = 0.029), high WHtR (p = 0.023), and follow-up increases in both body weight and WC (p < 0.01). However, in multivariate logistic regression analysis, only follow-up increases in weight and WC remained marginally associated with increased headache frequency (OR: 1.94, 95% CI: 0.97-3.89; p = 0.05). Baseline values for BMI, WC, and WHtR were not independent predictors. CONCLUSION: While obesity-related measures were prevalent among migraine patients, they were not independent predictors of increased headache frequency when behavioral factors were considered. These findings underscore the need for a comprehensive approach to migraine management, emphasizing lifestyle modifications.
