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Background: Long-term risk and predictors of cerebrovascular events following sepsis hospitalization have not been clearly elucidated. We aim to determine the association between surviving sepsis hospitalization and cerebrovascular complications in adult sepsis survivors. Method: We searched MEDLINE, Embase, Scopus, Web of Sciences, Cochrane library, and Google scholar for studies published from the inception of each database until 31 August 2022. Results: Of 8,601 screened citations, 12 observational studies involving 829,506 participants were analyzed. Surviving sepsis hospitalization was associated with a significantly higher ischemic stroke [adjusted hazard ratio (aHR) 1.45 (95% CI, 1.23-1.71), I 2 = 96], and hemorrhagic stroke [aHR 2.22 (95% CI, 1.11-4.42), I 2 = 96] at maximum follow-up compared to non-sepsis hospital or population control. The increased risk was robust to several sensitivity analyses. Factors that were significantly associated with increased hazards of stroke were: advanced age, male gender, diabetes mellitus, hypertension, coronary artery disease, chronic heart failure, chronic kidney disease, chronic obstruction pulmonary disease, and new-onset atrial fibrillation. Only diabetes mellites [aHR 1.80 (95% CI, 1.12-2.91)], hypertension [aHR 2.2 (95% CI, 2.03-2.52)], coronary artery disease [HR 1.64 (95% CI, 1.49-1.80)], and new-onset atrial fibrillation [aHR 1.80 (95% CI, 1.42-2.28)], were associated with > 50% increase in hazards. Conclusion: Our findings showed a significant association between sepsis and a subsequent risk of cerebrovascular events. The risk of cerebrovascular events can be predicated by patient and sepsis-related baseline variables. New therapeutic strategies are needed for the high-risk patients.
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Objective: Stunting continues to be a major public health challenge in developing countries, including Ethiopia. Studies revealed that the extent of stunting among under-5 children in Ethiopia is well studied, but there is a scarcity of data among school-age children. Therefore, this study aimed to assess the magnitude of stunting and associated factors among school-age children in the Mulo district, Ethiopia. Methods: A community-based cross-sectional study was conducted among 606 school-age children (5-14 years) in Mulo district, Central Ethiopia, from 1 to 30 July 2019. A multistage sampling technique was used to select study participants. The collected data were entered into Epi Info version 7.2.2.16 software and analyzed using SPSS version 21 and World Health Organization AnthroPlus software. Bivariate and backward stepwise multivariable statistical methods were employed to assess stunting and its associated factors. Statistical significant association was declared at a p value of <0.05. Result: In this study, prevalence of stunting among school-age children was 42.4%. Of which, 144 (23.76%) were males and 113 (18.65%) were females. Age group between 10 and 14 years old, (adjusted odds ratio = 1.896, 95% confidence interval: 1.328-2.708), male sex (adjusted odds ratio = 2.688, 95% confidence interval: 1.892-3.821), increased family size (adjusted odds ratio = 1.711, 95% confidence interval: 1.191-2.458), absence of latrine in the compound (adjusted odds ratio = 2.541, 95% confidence interval: 1.711-3.773), and consuming less than three times per day (adjusted odds ratio = 2.68, 95% confidence interval: 1.375-5.223) were factors significantly associated with stunting. Conclusion: The study revealed that the prevalence of stunting among school-age children was high. Age, sex, family size, availability of latrine, and meal frequency were factors significantly associated with stunting. Therefore, interventional educations on the importance of timely feeding, a balanced diet, family planning, environmental sanitation, and personal hygiene should be given for the parents/caregivers. In addition, analytic studies are recommended to further assess the causes of stunting among the school-age children in the area.
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Background: As defined by the Controlling Nutrition Status (CONUT) score, the prognostic significance of nutritional status has attracted attention in patients with cardiovascular disease. This meta-analysis aimed to determine the importance of CONUT score for prediction of all-cause mortality and major adverse cardiovascular events (MACE) in adult patients with coronary artery disease (CAD). Methods: Observational studies conducted to evaluate the association of CONUT score with adverse clinical outcomes in patients with CAD were included. We searched MEDLINE, Embase, Scopus, Cochrane library, Google scholar, medRxiv pre-print as well as Science Direct search engine for studies published from the inception of each database until March 21, 2022. Studies reporting the utility of CONUT score in prediction of all-cause mortality and MACE among patients with CAD were eligible. Predictive potential of the CONUT score were summarized by pooling the multivariable adjusted hazard ratio (aHR) with 95% CI for the malnourished vs. normal nutritional status or per point CONUT score increase. Results: Of 2,547 screened citation, nine observational studies involving 81,257 patients with CAD were analyzed. Malnutrition defined by the CONUT score was associated with significantly increased risk of all-cause mortality when compared with the normal nutritional state (aHR for mild, moderate, and severe malnutrition, respectively: (1.21 [95% CI: 1.15-1.27], I 2 = 0%), (1.53 [95% CI: 1.26-1.84], I 2 = 84%), and (2.24 [95% CI: 1.57-3.19], I 2 = 77%). Similarly, moderate (aHR 1.71 [95% CI: 1.44-2.03], I 2 = 0%) and severe (aHR 2.66 [95% CI: 1.82-3.89], I 2 = 0%) malnutrition was associated with a significantly higher risk of MACE compared with the normal nutritional state. Additionally, per point increase in the CONUT score was correlated with 20 and 23% additional risk of all-cause mortality and MACE, respectively. Conclusion: As defined by the CONUT score, malnutrition is an independent predictor of all-cause mortality and MACE in CAD patients. Nutritional assessment with CONUT score could allow clinicians to identify patients with CAD at high risk for adverse clinical outcomes.
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Background: Undernutrition is cellular imbalance between supply of nutrients, energy and body's demand to ensure growth, maintenance, and specific function. However, there was no study conducted earlier on this topic in East Borena Zone. Objective: To assess the prevalence of undernutrition and associated factors among pregnant women in East Borena Zone, Liban District. Method: A community-based cross-sectional study was conducted on 420 study participants from November 20 to December 2021. The systematic sampling technique and simple random sampling methods were used to select study participants. Data were double entered into Epi-info software version 7 and SPSS version 21 software for analysis. Descriptive statistics were used to describe the characteristics of study participants. Bivariate and multivariable logistic regressions were carried out to identify the association between independent and dependent variables by measuring the adjusted odds ratio and 95% confidence interval. P-values less than 0.05 were considered statistically significant. Results: Prevalence of undernutrition among pregnant women was about (44.9%) of family monthly income [AOR = 8.72 (4.80, 15.83)], women's decision-making autonomy [AOR = 0.40 (0.19, 0.82)], skipping meal [AOR = 2.62 (1.41, 4.89)], substance use [AOR = 2.01 (1.07, 3.77)], household food insecurity [AOR = 2.01 (1.06, 3.80)], lack of prenatal dietary advice [AOR = 2.73 (1.53, 4.89)], absence of household latrine [AOR = 9.23 (3.48, 24.46)], not participating health development army's meeting at village level [AOR = 3.01 (1.57, 5.72)] and hand washing habit [AOR = 6.55 (3.02, 14.20)] had shown statistically significant association with undernutrition. Conclusion: The prevalence of undernutrition among pregnant women was high income. Women's decision-making autonomy, skipping meals, substances use, household food insecurity, lack of prenatal dietary advice, poor hand washing habit, lack household of latrine, and not participation in health development army's meeting were found to be predictors of the undernutrition.
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BACKGROUND: Sarcopenia is a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength. It imposes significant costs on health care systems. Socioeconomic status is also the root cause of healthy challenges among the elderly. Therefore, investigating the association between sarcopenia and socioeconomic status is very important to improve healthy ageing of the elderly. The aim of this study was to investigate the prevalence of sarcopenia and its association with socioeconomic status among the elderly in Tehran. METHODS: Cross-sectional and case-control studies were conducted from August 2014-July 2015 among 310 men and 334 women elderly (60 and over years old) in Tehran health centers. Randomization, restriction and matching were setting during study design to minimize selection bias. Then study participants were recruited via phone call. Participants' phone numbers were already recorded in a telephone book electronically. When there were two elderly people in the same house, only one person was invited randomly. Association between sarcopenia and socio-economic status was analyzed by SPSS version 22. RESULTS: The overall prevalence of sarcopenia in the elderly was 16.5%. Prevalenceamong the low-income elderly was relatively higher than (20.5%) that among those with middle income status (18.2%) while in the higher income, the proportion of sarcopenia was very low (12.8%). The findings indicated that 339(52.6%) were in low-income status, 304(47.1%) were in middle-income status and 1(.2%) in high-income class. CONCLUSION: There was a significant association between socioeconomic status and sarcopenia (P-value <0.001). The odd risk of sarcopenia was 0.97 times more likely higher in low socioeconomic class than those who were in middle and high income classes.
