Conectar
by Sishir Poudel, Laxman Wagle, Tara Prasad Aryal, Binay Adhikari, Sushan Pokharel, Dipendra Adhikari, Kshitiz Bhandari, Kshitiz Rijal, Jyoti Bastola Paudel
BackgroundMultidrug-resistant tuberculosis (MDR-TB) continues to be a major public health concern, especially in high-burden countries like Nepal. While individual risk factors are known, the cumulative impact of cardiometabolic factors on MDR-TB is not well understood.
MethodsA health-facility-based, age- and sex-matched 1:2 case-control study was conducted at MDR-TB treatment centers in Gandaki Province, Nepal. MDR-TB patients (cases) and drug-sensitive tuberculosis (DS-TB) patients (controls) were enrolled. Cases were defined as adults (≥18 years) with confirmed MDR-TB; controls were adults with sputum-positive DS-TB. Data on sociodemographics, cardiometabolic risk factors (alcohol, tobacco, abnormal body mass index, hypertension, diabetes), TB literacy, and treatment history were collected using a structured, pretested questionnaire by trained medical officers. Data were analyzed using Stata v13.0. Binary logistic regression was used to assess associations between risk factors and MDR-TB. Ethical approval was obtained from the Nepal Health Research Council and written informed consent was obtained from all participants.
ResultsA total of 183 participants (61 cases, 122 controls) were included. Mean age of participants was 42.5 years (SD = 18.5); 73.8% were male. Most participants were from urban areas (74.9%), and 66.7% were unemployed. Cardiometabolic risk factors were present in 79.2% of participants. Alcohol and tobacco use were reported by 59.6% and 45.9%, respectively; 9.8% had diabetes and 7.1% had hypertension. Known TB contact and prior TB history were reported by 26.8% and 31.1% respectively. In multivariate analysis, unemployment (AOR: 5.24, 95% CI: 1.33–20.64), and known TB contact (AOR: 8.89, 95% CI: 2.46–32.15) were significantly associated with MDR-TB. Cardiometabolic risk factors were not significantly associated.
ConclusionKnown TB contact and unemployment were significantly associated with MDR-TB, while the cumulative effect of cardiometabolic risk factors showed no significant impact, indicating that interventions should prioritize established TB-related risk factors.
by Ramesh Malashi, Sunita Sharma, Srijana Adhikari, Chitra Raj Sharma, Arun Kumar Joshi, Buna Bhandari
IntroductionHypertension is a significant risk factor for cardiovascular diseases (CVDs), which remains the leading causes of morbidity and mortality globally, with a disproportionate impact on low and middle income countries. While hypertension is prevalent across various populations, government employees are particularly susceptible due to high stress levels, sedentary lifestyles, and work-related pressures. Therefore, this study was undertaken to assess the prevalence of hypertension and its associated risk factors among government employees in the Doti district of Nepal.
MethodsA cross-sectional study was carried out among 195 government employees in Dipayal Silgadhi Municipality of Doti district of Sudurpashchim province of Nepal. The data was collected through face-to-face interviews using Simple Random Sampling (SRS) technique and analysed using SPSS v25. The structured questionnaire adopted from the WHO STEPS survey tool was used for data collection. Bivariate and multivariate logistic regression model was used to assess the factors associated with hypertension.
ResultsThe prevalence of hypertension among government employee was 36.4%% ± 5.6%. Participants with age group 30–40 years [Adjusted Odd’s Ratio (AOR) 14.4, 95% Confidence Interval (CI) (1.6, 127.7)], 40–50 years [AOR 13.7, 95% CI (1.04, 180.3)] and work experience (20–30 years) [AOR 6.67, 95% CI(1.23, 35.9), and drinking alcohol [AOR 0.35, 95% CI (0.17, 0.72)] were found to be statistically significant with hypertension.
ConclusionThe study revealed the high prevalence of hypertension among government employees; significantly associated with risk factors like age group 30–50 years, work experience and alcohol consumption, indicating an alarming public health concern. These results highlight the pressing need for focused interventions to reduce the risk of hypertension and its related problems among government employees, such as lifestyle changes, workplace health programs, and routine health screenings.
Secondary and tertiary renal hyperparathyroidism (RHPT) are common sequelae of chronic kidney disease and are associated with worse patient mortality and quality of life. Clinical guidelines remain lacking with regard to recommendations for using intraoperative parathyroid hormone (IOPTH) during surgery for RHPT. A prospective randomised study will help evaluate the role of IOPTH in guiding surgery for secondary and tertiary RHPT.
Intraoperative parathyroid hormone monitoring to guide surgery in renal hyperparathyroidism is a pragmatic, multicentre, five-arm, parallel-group, patient-blinded and outcome assessor-blinded prospective pilot trial used to evaluate the feasibility of performing a definitive trial. Eligible participants include adult patients diagnosed with secondary or tertiary hyperparathyroidism who are candidates for subtotal or total parathyroidectomy. Consenting patients will be randomly assigned, through central allocation, in a 1:1:1:1:1 fashion to undergo surgery with IOPTH monitoring (four experimental arms: postexcision IOPTH samples taken at 10, 15, 20 or 25 min) or to undergo surgery without IOPTH monitoring (control arm). The primary feasibility objective is to estimate the percentage of eligible patients that are randomised: ≥70% proceed; 50–69% modify protocol before proceeding;
Ethics approval was obtained from the Hamilton Integrated Research Ethics Board. Pilot trial results will be shared widely through local, national and international academic and clinical networks and will be disseminated through conference presentations and publication in peer-reviewed journals.
NCT06542315, registered on 6 August 2024.
Misinformation about cardiovascular health has the potential to negatively impact public health outcomes. Understanding the nature and spread of such misinformation is crucial for developing effective interventions to mitigate this potential risk. However, despite the critical importance of this issue, there is a gap in comprehensive reviews mapping the existing literature on cardiovascular health misinformation. This scoping review aims to map the existing literature on cardiovascular health misinformation, identifying its spread, prevalence, impact and strategies for correction across diverse populations and settings.
This review will follow the Joanna Briggs Institute guidelines for conducting a scoping review. A comprehensive search will be conducted across multiple databases, including MEDLINE, EMBASE, SCOPUS and Web of Science, along with grey literature sources. The last date of search was January 2025. The review will include studies without date that involve individuals affected by cardiovascular disease (CVD) misinformation, examine the spread, prevalence, impact or correction of misinformation related to cardiovascular health, and capture various cultural, geographic or setting-specific factors. The exclusion criteria include studies that do not directly address misinformation related to CVD. All identified records will be imported into Covidence systematic review software. Two reviewers will independently screen titles and abstracts, followed by full-text reviews of potentially relevant studies. Discrepancies will be resolved through discussion or by consulting a third reviewer. Data extraction will be conducted by two reviewers using a pre-piloted tool, and a descriptive presentation of the findings will be done. Both inductive and deductive content analysis methods will be employed for objectives related to the impact and strategies to combat misinformation.
Given that the study involves synthesising data from existing published literature, ethical approval is not required. The findings will be disseminated through international conference presentations, published in a peer-reviewed journal and shared with public health organisations and policymakers.
by Alex Thabane, Sarah Saleh, Sushmitha Pallapothu, Tyler McKechnie, Phillip Staibano, Jason W. Busse, Goran Calic, Ranil Sonnadara, Sameer Parpia, Mohit Bhandari
BackgroundCreativity fuels societal progress and innovation, particularly in the field of medicine. The scientific study of creativity in medicine is critical to understanding how creativity contributes to medical practice, processes, and outcomes. An appraisal of the current scientific literature on the topic, and its gaps, will expand our understanding of how creativity and medicine interact, and guide future research.
ObjectivesWe aimed to assess the quantity, trends, distribution, and methodological features of the peer-reviewed on creativity in medicine.
MethodsWe searched the MEDLINE, EMBASE, and PsycINFO databases for peer-reviewed primary research publications on creativity in medicine. Screening, full-text review, and data extraction were performed independently and in duplicate by pairs of reviewers, with discrepancies resolved by a third reviewer. We performed descriptive analyses, graphically displaying the data using charts and maps where appropriate.
ResultsEighty-one studies were eligible for review, enrolling a total of 18,221 physicians, nurses and midwifes across all studies. Most research on creativity in medicine was published in the last decade, predominately in the field of nursing (75%). Researchers from Taiwan (22%) and the United States (21%) produced the most eligible publications, and the majority research was cross-sectional in nature (54%). There was substantial variability in the definitions of creativity adopted, and most studies failed to specify a definition of creativity. Forty-five different measurement tools were used to assess creativity, the most popular being divergent thinking tests such as the Torrance Test of Creative Thinking (24%) and Guilford Creativity Tests (16%).
ConclusionsPeer-reviewed scientific research on creativity in medicine, mostly conducted in the nursing profession, is sparse and performed on variable methodological grounds. Further scientific research on the topic, as well as the development of medicine-specific definitions and measurement tools, is required to uncover the utility of creativity in the medical domain.
FreshRSS 