| 1. |
- Bravo, L, et al.
(författare)
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- 2021
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swepub:Mat__t
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| 2. |
- Tabiri, S, et al.
(författare)
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- 2021
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swepub:Mat__t
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| 3. |
- Khatri, C, et al.
(författare)
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Outcomes after perioperative SARS-CoV-2 infection in patients with proximal femoral fractures: an international cohort study
- 2021
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Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 11:11, s. e050830-
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Tidskriftsartikel (refereegranskat)abstract
- Studies have demonstrated high rates of mortality in people with proximal femoral fracture and SARS-CoV-2, but there is limited published data on the factors that influence mortality for clinicians to make informed treatment decisions. This study aims to report the 30-day mortality associated with perioperative infection of patients undergoing surgery for proximal femoral fractures and to examine the factors that influence mortality in a multivariate analysis.SettingProspective, international, multicentre, observational cohort study.ParticipantsPatients undergoing any operation for a proximal femoral fracture from 1 February to 30 April 2020 and with perioperative SARS-CoV-2 infection (either 7 days prior or 30-day postoperative).Primary outcome30-day mortality. Multivariate modelling was performed to identify factors associated with 30-day mortality.ResultsThis study reports included 1063 patients from 174 hospitals in 19 countries. Overall 30-day mortality was 29.4% (313/1063). In an adjusted model, 30-day mortality was associated with male gender (OR 2.29, 95% CI 1.68 to 3.13, p<0.001), age >80 years (OR 1.60, 95% CI 1.1 to 2.31, p=0.013), preoperative diagnosis of dementia (OR 1.57, 95% CI 1.15 to 2.16, p=0.005), kidney disease (OR 1.73, 95% CI 1.18 to 2.55, p=0.005) and congestive heart failure (OR 1.62, 95% CI 1.06 to 2.48, p=0.025). Mortality at 30 days was lower in patients with a preoperative diagnosis of SARS-CoV-2 (OR 0.6, 95% CI 0.6 (0.42 to 0.85), p=0.004). There was no difference in mortality in patients with an increase to delay in surgery (p=0.220) or type of anaesthetic given (p=0.787).ConclusionsPatients undergoing surgery for a proximal femoral fracture with a perioperative infection of SARS-CoV-2 have a high rate of mortality. This study would support the need for providing these patients with individualised medical and anaesthetic care, including medical optimisation before theatre. Careful preoperative counselling is needed for those with a proximal femoral fracture and SARS-CoV-2, especially those in the highest risk groups.Trial registration numberNCT04323644
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| 4. |
- Tahir, M. J., et al.
(författare)
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Internet addiction and sleep quality among medical students during the COVID-19 pandemic : A multinational cross-sectional survey
- 2021
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Ingår i: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 16:11 November
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Tidskriftsartikel (refereegranskat)abstract
- Background The emergence of the COVID-19 pandemic has affected the lives of many people, including medical students. The present study explored internet addiction and changes in sleep patterns among medical students during the pandemic and assessed the relationship between them. Methods A cross-sectional study was carried out in seven countries, the Dominican Republic, Egypt, Guyana, India, Mexico, Pakistan, and Sudan, using a convenience sampling technique, an online survey comprising demographic details, information regarding COVID-19, the Pittsburgh Sleep Quality Index (PSQI), and the Internet Addiction Test (IAT). Results In total, 2749 participants completed the questionnaire. Of the total, 67.6% scored above 30 in the IAT, suggesting the presence of an Internet addiction, and 73.5% scored equal and above 5 in the PSQI, suggesting poor sleep quality. Internet addiction was found to be significant predictors of poor sleep quality, causing 13.2% of the variance in poor sleep quality. Participants who reported COVID-19 related symptoms had disturbed sleep and higher internet addiction levels when compared with those who did not. Participants who reported a diagnosis of COVID-19 reported poor sleep quality. Those living with a COVID-19 diagnosed patient reported higher internet addiction and worse sleep quality compared with those who did not have any COVID-19 patients in their surroundings. Conclusion The results of this study suggest that internet addiction and poor sleep quality are two issues that require addressing amongst medical students. Medical training institutions should do their best to minimize their negative impact, particularly during the current COVID-19 pandemic.
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| 5. |
- Irum, S., et al.
(författare)
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Cutaneous Leishmaniasis (CL) : A Cross-Sectional Community Based Survey on Knowledge, Attitude and Practices in a Highly Endemic Area of Waziristan (KPK Province), Pakistan
- 2021
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Ingår i: Acta Tropica. - : Elsevier. - 0001-706X .- 1873-6254. ; 213
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Tidskriftsartikel (refereegranskat)abstract
- Recent outbreaks of Cutaneous Leishmaniasis (CL) in Waziristan make the disease a public health concern in Khyber Pakhtunkhwa (KPK) province, Pakistan. The awareness and behavior of local community towards the disease is an important factor towards effective control and management of CL in endemic areas of Pakistan. A cross-sectional community based survey was piloted in new emerging district of North Waziristan Agency (KPK province), Pakistan from August 2019- February 2020. The study aimed to examine the Knowledge, Attitude and Practices (KAP) of the local community members regarding CL. The results revealed that majority of the participants were male. Only 48.2% participants have knowledge about CL and the respondents had a moderate knowledge of CL vector and the disease. Few of the respondents were aware that CL is caused by sand flies, their breeding place, biting time, transmission of CL and control measures. Skin infection and sand-flies were the main disease symptoms and disease vector were known to some of the respondents. Most of the respondents showed positive attitude towards disease seriousness and believed that the disease could be cured and can be treated through modern medicines. Admission to hospitals, cleanliness and use of bed nets were the treatment measures for the disease in suspected patients, whereas some believed that the use of bed nets could be helpful in preventing the leishmaniasis. Moderate knowledge of the CL and its transmission in the study area emphasize the need to initiate health education and awareness campaigns to reduce the disease risk and burden in this highly endemic area in near future.
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| 6. |
- Ahmed, K. Matin, et al.
(författare)
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Arsenic enrichment in groundwater of the alluvial aquifers in Bangladesh : an overview
- 2004
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Ingår i: Applied Geochemistry. - : Elsevier BV. - 0883-2927 .- 1872-9134. ; 19:2, s. 181-200
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Tidskriftsartikel (refereegranskat)abstract
- Arsenic in the groundwater of Bangladesh is a serious natural calamity and a public health hazard. Most groundwater from the shallow alluvial aquifers (<150 m), particularly in the Holocene plain lands, are vulnerable to As-enrichment. Delta plains and flood plains of the Ganges-Brahmaputra river system are moderately to severely enriched and more than 60% of the tube wells are affected. Shallow aquifers in the Meghna river basin and coastal plains are extremely enriched with more than 80% of the tube wells affected. Aquifers in the Pleistocene uplands and Tertiary hills are low in As. The vertical lithofacies sequence of the sediments from highly enriched areas of the country show two distinct lithofacies associations-a dominantly sandy channel-fill association and a fine-grained over bank association. The sediments can be grouped into 4 distinct lithofacies, viz. clay, silty clay, silty sand and sand. Thin section petrography of the As-enriched aquifer sands shows that the sands are of quartzolithic type and derived from the collision suture and fold thrust belt of the recycled orogen provenance. Groundwater is characterized by circum-neutral pH with a moderate to strong reducing nature. The waters are generally of Ca-Mg-HCO3 or Ca-Na-HCO3 type, with HCO3- as the principal anion. Low SO42- and NO3-, and high dissolved organic C (DOC) and NH4+ concentrations are typical chemical characteristics of groundwater. The presence of dissolved sulfides in these groundwaters indicates reduction Of SO4. Total As concentration in the analyzed wells vary between 2.5 and 846 mug l(-1) with a dominance of As(III) species (67-99%). Arsenic(III) concentrations were fairly consistent with the DOC and NH4+ contents. The HNO3 extractable concentrations of As (As-NO3) in the sediments (0.5-17.7 mg kg(-1)), indicate a significant positive correlation with Fe-NO3, Mn-NO3, Al-NO3 and P-NO3. The concentrations Of S-NO3 (816-1306 mg kg(-1)) peaked in the clay sediments with high organic matter (up to 4.5 wt.%). Amounts of oxalate extractable As (As..) and Fe (Fe x) ranged between 0.1-8.6 mg kg(-1) and 0.4-5.9 g kg(-1), respectively. Arsenic(ox) was positively correlated with Fe-ox, Mn-ox, and Al-ox in these sediments. Insignificant amounts of opaque minerals (including pyrite/arsenopyrite) and the presence of high As contents in finer sediments suggests that some As is incorporated in the authigenically precipitated sulfides in the reducing sediments. Moreover, the chemical extractions suggest the presence of siderite and vivianite as solid phases, which may control the aqueous chemistry of Fe and PO43-. Reductive dissolution of Fe oxyhydroxide present as coatings on sand grains as well as altered mica (biotite) is envisaged as the main mechanism for the release of As into groundwater in the sandy aquifer sediments.
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