Purpose: The incidence of hepatic steatosis among children has been increasing; however, data distinguishing simple steatosis from a more complex disorder are lacking. Methods: This study identified the etiologies resulting in hepatic steatosis through a retrospective review of pediatric liver biopsies performed in the last 10 years. A total of 158 patients with hepatic steatosis proven by histopathological evaluation were enrolled in the study, and baseline demographic features, anthropometric measurements, physical examination findings, laboratory data, ultrasonographic findings, and liver histopathologies were noted. Results: The two most common diagnoses were inborn errors of metabolism (IEM) (52.5%) and nonalcoholic fatty liver disease/steatohepatitis (NAFLD/NASH) (29.7%). The three most common diseases in the IEM group were glycogen storage disorders, Wilson's disease, and mitochondrial disease. The rates of consanguineous marriage (75.6%; odds ratio [OR], 26.040) and positive family history (26.5%; OR, 8.115) were significantly higher (p=0.002, p<0.001, respectively) in the IEM group than those in the NAFLD/NASH group. Younger age (p=0.001), normal anthropometric measurements (p=0.03), increased aspartate aminotransferase levels (p<0.001), triglyceride levels (p=0.001), and cholestatic biochemical parameters with disrupted liver function tests, as well as severe liver destruction of hepatic architecture, cholestasis, fibrosis, and nodule formation, were also common in the IEM group. Conclusion: Parents with consanguinity and positive family history, together with clinical and biochemical findings, may provide a high index of suspicion for IEM to distinguish primary steatosis from the consequence of a more complex disorder.
Guntur, Robertus Dole;Kingsley, Jonathan;Islam, Fakir M. Amirul
Journal of Preventive Medicine and Public Health
/
v.55
no.1
/
pp.68-79
/
2022
Objectives: This study investigated associations between ethnicity and malaria awareness in East Nusa Tenggara Province (ENTP), Indonesia. Methods: A community-based cross-sectional study was conducted upon 1503 adults recruited by multi-stage cluster random sampling. A malaria awareness questionnaire was used to collect data, according to which participants were classified as aware or unaware of malaria. Logistic regression was applied to quantify the strength of associations of factors with malaria awareness. Results: The participation rate in this study was high (99.5%). The participants were distributed relatively evenly among the Manggarai, Atoni, and Sumba ethnicities (33.0, 32.3, and 30.2%, respectively). Malaria awareness was significantly different amongst these groups; it was most common in the Manggarai ethnicity (65.1%; 95% confidence interval [CI], 59.9 to 70.3) and least common in the Sumba ethnicity (35.0%; 95% CI, 27.6 to 42.4). The most prominent factor influencing the malaria awareness in the Sumba and Manggarai ethnicities was education level, whilst it was socioeconomic status (SES) in the Atoni ethnicity. The likelihood of malaria awareness was significantly higher in adults with an education level of diploma or above (adjusted odds ratio [aOR], 21.4; 95% CI, 3.59 to 127.7 for Manggarai; aOR, 6.94; 95% CI, 1.81 to 26.6 for Sumba). Malaria awareness was significantly more common amongst high-SES adults in the Atoni group (aOR, 24.48; 95% CI, 8.79 to 68.21). Conclusions: Low education levels and low SES were prominent contributors to lower levels of malaria awareness in rural ENTP. Interventions should focus on improving malaria awareness to these groups to support the Indonesian government's national commitment to achieve a malaria elimination zone by 2030.
Kim, Ji-Ho;Kim, Ji-Hong;Jang, Tae-Won;Jung, Maan-Hong
Tuberculosis and Respiratory Diseases
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v.42
no.6
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pp.831-837
/
1995
Background: We conducted a study to determine the factors associated with, patterns of, and proportion of cases of pulmonary tuberculosis with multiple drug-resistance at Kosin medical center in Pusan. Methods: We abstracted data from 141 patients, who had active pulmonary tuberculosis and report forms of drug susceptibility between 1986 and 1994, and related the previous treatment history, the extent of lung involvement and the presence of cavities on chest X-ray films to the drug resistance. Results: Overall, 59(41.8%) of the 141 cases of tuberculosis were resistant to at least one drug and 29(20.9%) of the 139 cases were resistant to isoniazid(INH) and rifampin(RIF). Among the 63 patients with previous tuberculosis therapy, 40(63.5%) had isolates that were drug-resistant and 24(38.1%) were multi-drug resistant. Among the 78 without previous therapy, 19(24.4%) had isolates that were drug-resistant and 5(7.5%) were multi-drug resistant. For all 141, resistance to INH was most common(39.0%) followed by RIF(21.6%), ethambutol(EMB, 16.3%), $\rho$- aminosalicylic acid(10.8%), streptomycin(SM, 8.7%), and pyrazinamide(PZA, 8.0%). INH, RIF and PZA resistances were independently associated with a history of previous tuberculosis therapy (odds ratio; 3.3, 7.2 and 10.8 respectively), and RIF and SM resistance were significantly high according to the extent of lung involvement on the chest films(odds ratio; 2.9 and 2.8 respectively). Conclusions: We conclude, (1) that all persons in whom pulmonary tuberculosis is diagnosed should initially receive at least four-drug therapy(INH, RIF, PZA, and EMB or SM), (2) that susceptibility testing be done in all culture-positive patient, and (3) that those with a history of previous tuberculosis therapy or those who have advanced pulmonary tuberculosis need very careful clinical and microbiological follow-up.
Park Hyesook;Chang Namsoo;Kim Eunjung;Yun Hana;Lee Hunjae;Lee BoEun;Kim HanHae;Kwon Sungwon;Seong Yu Jin
Journal of Nutrition and Health
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v.37
no.9
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pp.801-808
/
2004
Benign prostatic hyperplasia (BPH) is the most common prostate disease in middle aged and elderly men. Therefore, identifying risk factors for BPH is crucial for understanding the etiology and for undertaking interventions or targeting strategies. The survey was carried out in two steps: first, pilot study was conducted prior to the main study in order to estimate baseline characteristics. Second, main study investigated prevalence and risk factors of BPH by clinical diagnostic tests and questionnaire. A total of 641 male aged 50-79 years participated in this community-based cross-sectional study. Using 24 hour recall of food consumption, we found that animal fat intakes increased the risk of BPH with adjusted for age, chronic bronchitis, PSA level, drinking frequency, and excercise frequency (odds ratio 1.84,95% confidence interval 1.10-3.06) . Although BPH has been considered as unavoidable disease with advancing age, if these dietary risk factors are clearly identified, it can be prevented effectively by laying special emphasis on those at risk.
Purpose: The purpose of the present study was to identify prevalence of excessive daytime sleepiness(EDS) and its associations with sleep habits, sleep problems, depression, subjective health status and obesity in community dwelling adults. Method: Data was collected from adults aged 20-59 years by random sampling. Subjects completed a questionnaire which was composed of the Epworth Sleepiness Scale, Center for Epidemiologic Studies Depression Scale, and questions that included items about sleep habits, sleep problems, subjective health status and sociodemographic characteristics. Height and weight were measured for calculation of body mass index. The statistical analyses was based on 3,302 adults (51.5% males and 48.5% females). Descriptive statistics, univariate logistic regression and multiple logistic regression were used. Result: The prevalence of EDS was 17.1% Multiple logistic regression showed that the associated factors of EDS were depression, obesity, dissatisfaction with sleep time, irregular sleep, and habitual snoring. Depression was the most significant associated factor(adjusted odds ratio for severe depression=2.27, 95% Confidence Interval=1.73-2.96). Conclusion: EDS is a common symptom in adults. Our finding suggested that persons with a complaint of EDS should be completely assessed for depression and obesity as well as sleep problems.
Journal of Korean Academy of Fundamentals of Nursing
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v.19
no.4
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pp.425-433
/
2012
Purpose: The purpose of this study was to investigate sleep patterns and predictors of excessive daytime sleepiness (EDS) in university students. Methods: Participants were 120 university students who were attending two universities in S-city and C-city. Data were collected from May 20 to June 15, 2012 using self-report questionnaires which included Johns' Epworth Sleepiness Scale, Yi's Sleep Quality Scale, and Beck Depression Inventory. Data were digitalized and analyzed using frequency, percentages, means and standard deviations, Wilcoxon rank sum test, Chi-square test, Fisher's exact test, and multiple logistic regression with SAS 9.0. Results: Mean total sleep time was 6.6 hours on weekdays, 8.1 hours on weekends. Mean sleep latency was 19.1 minutes and the score for mean sleep quality was 22.6. Prevalence of EDS was 12.5%. Depression was significantly different between EDS and Non-EDS students (t=2.17, p=.030). Multiple logistic regression showed that the only factor associated with EDS was depression (adjusted odds ratio of depression=5.33, 95% Confidence Interval=1.49-19.04). Conclusion: Results of this study indicate that university students experience short sleep time, low sleep quality, and common EDS with depression, suggesting that students with complaints of EDS should be completely assessed for depression as well as sleep problems.
Purpose: The purpose of this study was to investigate the effects of a breastfeeding support program (BSP) on the prevalence of exclusive breastfeeding and growth in late-preterm infants. Methods: A quasi-experimental study was conducted. The participants were 40 late preterm infants (LPIs), of whom 20 were assigned to the experimental group and 20 to the control group. For the mothers in the experimental group, a BSP was provided prior to the LPIs' discharge and reinforced once a week for 4 weeks. Information on the feeding type was collected by observation and the LPIs' body weight was measured. Results: There were significant differences in feeding type by group and time. Exclusive breastfeeding was 5.18 times more common in the experimental group than in the control group (odds ratio=5.18, 95% confidence interval=1.11~16.70). However, weekly weight gain did not show a significant relationship with group and time (F=0.40, p=.712). Conclusion: The BSP was helpful for increasing the rate of exclusive breastfeeding in LPIs. Furthermore, the LPIs in the experimental group, which had a higher likelihood of being exclusively breastfed, showed an equivalent amount of weight gain as the LPIs in the control group, in which infants were more likely to be formula-fed.
Anemia is common in Diabetes Mellitus(DM) with chronic kidney disease. Recent research suggests that DM itself also may be a risk factor of anemia even though kidney failure causes anemia. However, it has not been reported that the impact of DM on anemia in representative data of Korean population. A total of 5,417 Korean adults aged 20 years and older(2,328 men, 3,089 women) were selected from the participants of the 2005 Korean National Health and Nutrition Examination Survey(KNHANES) for this study. Anemia was defined as hemoglobin(Hb) < 13 g/dL and hematocrit(Hct) < 39% for men or Hb < 12 g/dL and Hct < 36% for women. DM was defined as a fasting blood glucose $\geq$ 126 mg/dL. Korean adults with anemia had a higher prevalence of DM than in normal adults(11.4 vs 7.5%; p<0.0001). The unadjusted odds ratio(OR) for anemia was greater in Korean men with DM than in normal men(OR=4.25; 95% CI: 2.48-7.29). This results did not differ after adjustment for the putative risk factors for anemia including chronic disease(OR=2.64; 95% CI: 1.45-4.83). However, the presence of DM was not related with anemia in Korean women. In conclusion, this study revealed that DM might be an independent risk factor for anemia in Korean men. Identification and management for anemia are needed in Korean population with DM as well.
Objectives: In recent years, multiple studies have investigated the issue of intimate partner violence (IPV) in Korea. However, most of those studies have focused on IPV against women, while overlooking the problem of men IPV victimization. Considering this, the current study identified risk and protective factors for IPV and examined their influence on IPV victimization among Korean men. Methods: We used a nationally representative sample of 1668 Korean men from the 2013 Korea National Survey on Domestic Violence. The associations between potential IPV risk factors and different types of IPV were investigated using univariate and multivariate logistic regression. Specifically, separate analyses were conducted of 5 types of IPV (neglect, controlling behaviors, emotional violence, economic violence, and physical violence). Results: The prevalence of IPV among Korean men and women showed only marginal gender differences. Controlling behaviors (men, 23.3%; women, 23.9%) and emotional violence (men, 16.5%; women, 18.8%) were the most common types of IPV reported, followed by neglect (men, 11.2%; women, 11.7%). Separate logistic regression analyses for the 5 subtypes of IPV revealed that mutual IPV was a strong predictor of IPV. Men who abused their wives were more likely to experience neglect (odds ratio [OR], 29.24; p<0.01), controlling behaviors (OR, 36.61; p<0.01), emotional violence (OR, 58.07; p<0.01), economic violence (OR, 18.78; p<0.01), and physical violence (OR, 38.09; p<0.01). Conclusions: The findings of this study suggest that IPV intervention strategies should particularly focus on couples whose relationship is characterized by patterns of bidirectional violence.
Autism spectrum disorder is a common neurodevelopmental disorder with an unknown etiology. The correlation between neonatal jaundice and the risk of developing autism spectrum disorder was investigated previously. Some studies showed significant associations, whereas others demonstrated no association. In this meta-analysis, we pooled the results of observational studies to examine the association between neonatal jaundice and the risk of autism spectrum disorder among children. We identified all studies published through April 2018 by conducting a literature search using Web of Science, PubMed, and Scopus databases as well as the reference lists of the retrieved studies. The pooled odds ratios (ORs), rate ratio (RR), and their 95% confidence intervals (CIs) were calculated as random effect estimates of association among studies. We conducted a subgroup analysis to explore any potential sources of intergroup heterogeneity. The pooled estimates of OR and RR showed a considerable correlation between neonatal jaundice and ASD among children (OR, 1.35; 95% CI, 1.02-1.68) and (RR, 1.39; 95% CI, 1.05-1.74). A larger effect size was shown in the pooled estimated crude OR than in the adjusted OR (1.75 [0.96-2.54] vs. 1.19 [1.07-1.30]). This study showed that neonatal jaundice may be associated with ASD and may increase the risk of ASD among children.
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