This study aimed to assess eye check-up practice and associated factors among patients with diabetes attending primary hospitals in the Central Gondar Zone, Northwest Ethiopia.

A multicentre hospital-based cross-sectional study.

This study was conducted at primary hospitals in Central Gondar Zone, Northwest Ethiopia, from 10 June 2024 to 10 July 2024.

The study included 689 consecutive adult patients with diabetes who met the inclusion criteria.

Participants were diagnosed with diabetes mellitus by a general practitioner. Optometrists conducted interviews, reviewed medical records and administered a pretested, structured questionnaire. Binary logistic regression was performed to identify associated factors, with significance considered at a p

A total of 689 participants were involved in this study, with a response rate of 98.4%. The proportion of good eye check-up practice was 20.6% (95% CI: 17.6% to 23.8%). Factors associated with good eye check-up practice included urban residence (adjusted OR, AOR=4.10, 95% CI: 1.72 to 9.82), diabetes duration of 12+ years (AOR=4.98, 95% CI: 1.43 to 17.38), previous eye disease (AOR=3.78, 95% CI: 1.79 to 7.95), good knowledge of diabetic retinopathy (AOR=3.22, 95% CI: 1.42 to 7.29), higher family income (AOR=3.80, 95% CI: 1.27 to 11.36), referral from a diabetic clinic (AOR=3.48, 95% CI: 1.58 to 7.67) and a favourable attitude (AOR=3.75, 95% CI: 1.46 to 9.65).

This study revealed a low proportion of good eye check-up practices among patients with diabetes. Urban residency, longer duration of diabetes, higher income, clinic referrals, history of eye disease, knowledge of diabetic retinopathy and a favourable attitude were significantly associated with good eye check-up practices. Therefore, targeted health education and strengthened referral systems are recommended to improve regular eye check-up practices among individuals with diabetes.

Adolescents and young adults (AYAs) in low- and middle-income countries (LMICs) are at high risk of harmful sexual and reproductive health (SRH) practices due to limited knowledge, low availability or acceptability of modern contraceptives, gender inequality and cultural practices like child marriage. Preventive and educational interventions by lay health workers or through technological means are a cost-effective and scalable solution. Unfortunately, too little is currently known about the scope, content and conditions of the effectiveness and sustainability of these approaches and synthetic evidence on this topic is scarce. To help fill this knowledge gap and to identify where further research is needed, we will conduct a scoping review of technology-based or lay health-worker delivered preventive and educational SRH interventions targeting AYAs in LMICs. This information is valuable to both policymakers and researchers as it provides a synthesis of existing interventions, highlights best practices for their implementation and identifies potential avenues for future research.

This review will include studies on SRH preventive and educational interventions targeting AYAs aged 10–24 years in LMICs. It encompasses interventions delivered by lay health workers or via technological means, assessing various outcomes including but not limited to SRH literacy, sexual risk behaviours, pregnancies, sexually transmitted infections and gender-based violence. Key databases, including PubMed via MEDLINE and Embase, will be searched from 1 January 2000 up to 23 January 2024, using a comprehensive search strategy. Screening will be conducted using Covidence software. Data extraction will cover study details, methods, intervention strategies, outcomes and findings. A narrative synthesis will be conducted following synthesis without meta-analysis guidelines.

The scope of this scoping review is limited to publicly accessible databases that do not require prior ethical approval for access. The findings will be disseminated through peer-reviewed journal publications, as well as presentations at national and international conferences and stakeholder meetings in LMICs.

The final protocol is prospectively registered with the Open Science Framework on 7 May 2024 (osf.io/vna2z).

This systematic review and meta-analysis aimed to determine the pooled prevalence of and factors associated with work-related musculoskeletal disorders (WMSDs) among low- and middle-income countries.

Databases such as PubMed/MEDLINE, CINAHL, LIVIVO, African Journals Online, African Index Medicus (AIM), HINARI, Science Direct, Web of Science, Cochrane Library, Google Scholar, Semantic Scholar and Google were used to retrieve all the relevant articles. The search was carried out from 22 April 2024 to 26 June 2024. Data were analysed via STATA 17 software. With a 95% CI, this meta-analysis with a random-effects model was carried out to determine the pooled prevalence.

The study was conducted in low- and middle-income countries.

Weavers of low- and middle-income countries.

The primary outcome of this study was the prevalence of WMSD.

In this meta-analysis, a total of 21 articles with 7322 study participants were included. The pooled prevalence of WMSDs was 72.20%. Working more than 8 hours per day, working in a chair with no back support, working in an uncomfortable posture, not performing regular physical exercise, lacking knowledge of the causes of WMSD and lacking job satisfaction were factors significantly associated with WMSDs.

A high prevalence of WMSDs among weavers in low- and middle-income countries was recorded. This indicates the need to take effective intervention measures. Rigorous ergonomic training, providing lengthy breaks and building centres for physical exercise, improving workplace ergonomic design and increasing job satisfaction are recommended.

CRD42024561064.

Asthma is a leading cause of morbidity and healthcare use among children. Risk factors of childhood asthma include atopic predisposition and severe wheezing episodes caused by rhinovirus infection in early life. In children with first-time rhinovirus-induced wheezing, we aim to study the response of a short corticosteroid treatment to prevent recurrent wheezing and asthma.

This is a double-blind, randomised, placebo-controlled, phase IV, international multicentre trial involving eight sites in Norway, Sweden and Finland. Two hundred and eighty 3–23 months old steroid-naïve children are randomised 1:1 to receive oral dexamethasone (0.3 mg/kg/day) versus placebo in 3 days for their first wheezing episode and rhinovirus infection. Rhinovirus is diagnosed with multiplex PCR. The two co-primary outcomes are time to next physician-confirmed wheezing episode, and time to asthma, within 24 months from inclusion. Asthma is defined as fulfilment of the 2007 National Asthma Education and Prevention Program—criteria for initiating asthma controller medication in children aged 0–4 years. Primary interaction analyses are age, gender, atopic predisposition, risk genotypes and viral co-detection. The optimal cut-off on the rhinovirus genome load used to define a true rhinovirus infection will be assessed by exploring interactions between rhinovirus genomic loads and study drug on the co-primary outcomes. Secondary outcomes are number of wheezing episodes, duration and severity of each wheezing episode, bronchial hyperreactivity, quality of life and safety (height/weight development) at 24 months from inclusion.

Rhinovirus positive children with acute wheezing fulfilling inclusion and exclusion criteria are enrolled after informed consent from both caregivers. This trial has received ethical approval from all sites. Results will be submitted to Competent Authorities and disseminated via peer-reviewed publications and conferences within paediatrics and other relevant fields. If proven effective, findings may be implemented directly into paediatric clinical guidelines.

NCT03889743.

Gastroenteropancreatic neuroendocrine tumours (GEP NET) are malignant neoplasms that impact survival. Somatostatin analogues (SSA) are used for treating hormonal symptoms caused by GEP NET and have antiproliferative effects. They are used as first-line therapy in patients with advanced GEP NET, but disease control is limited to a median progression-free survival (mPFS) of 14–32 months. Second-line treatment options include targeted therapy (everolimus or sunitinib), or peptide receptor radionuclide therapy (PRRT) with ¹⁷⁷Lu-DOTATATE. In patients suffering from a NET-related hormonal syndrome, SSA is generally continued life-long. However, there is no consensus on whether it is beneficial to continue SSA in non-functional NET upon disease progression. Due to the ongoing activity of the somatostatin receptor pathway in GEP NET progressing on first-line SSA, we hypothesise that SSA have an added efficacy in second-line therapy.

The SAUNA trial is an international, multicentre, open-label, randomised, controlled, pragmatic clinical trial. 270 patients with advanced, non-functional GEP NET and progression under first-line SSA will be included in substudy 1 (PRRT; n=142) or substudy 2 (targeted therapy (everolimus/sunitinib); n=128) per investigator’s choice of second-line therapy and will be randomised (1:1) per substudy between SSA continuation or SSA withdrawal arms. Co-primary endpoints are the difference in progression-free survival (PFS) according to the RECIST (Response Evaluation Criteria In Solid Tumours) V.1.1 criteria and difference in time to deterioration (TTD) in quality of life (QoL) per substudy after initiating second-line therapy with or without SSA. Secondary endpoints include the PFS rate at 18 months, the difference in pooled PFS and TTD combining both substudies, overall survival, response rates, QoL, costs, cost-effectiveness and toxicity. The study design was developed in cooperation with the Belgium and Dutch patient organisations.

The study has been approved on 31 May 2023 by the Ethical Committees and Regulatory Authorities of the concerned member states (EU CT number 2022-502703-30-00). Both the trial management group and the steering committee will oversee good governance of this trial. Results of the study will be published in peer-reviewed international journals and presented at international conferences.

NCT05701241.

This study aimed to assess treatment outcome, medication adherence and predictors among epilepsy patients at three low-resource setting hospitals in Mekelle City, Northern Ethiopia.

A multicentre hospital-based observational cross-sectional study was conducted.

The study was conducted in three resource-limited tertiary care hospitals in Mekelle City, Northern Ethiopia: Ayder Comprehensive Specialized Hospital, Mekelle General Hospital and Quiha General Hospital.

A total of 351 patients with epilepsy receiving regular follow-up care at adult neurology outpatient clinics in three low-resource setting hospitals were included in the study.

The study assessed adherence to antiepileptic drugs (AEDs), treatment outcomes and identified independent predictors of these outcomes.

A total of 351 study participants were included in the final analysis, with a mean (±SD) age of 37.98±14.27 years. More than one-third (39%) had poorly controlled seizures. Living in urban areas (adjusted odds ratio (AOR)= 3.36, 95% CI 1.1 to 10.4, p=0.037), being government-employed (AOR = 4.0, 95% CI 1.1 to 14.5, p=0.035) and being a student (AOR = 4.0, 95% CI 1.1 to 14.5, p=0.035) were associated with good seizure control. Half of the participants (177, 50.6 %) were non-adherent to their medications. Being a farmer (AOR = 4.2, 95% CI 1.5 to 11.3, p=0.005), a housewife (AOR = 4.9, 95% CI 1.4 to 17.2, p=0.012), absence of seizure-triggering factors (AOR = 3.7, 95% CI 2.34 to 6.06, p

More than two-thirds of patients with epilepsy experienced poor seizure control. Place of residence, employment status and the number of seizure episodes prior to treatment initiation were identified as significant predictors of treatment outcomes. Approximately half of the study participants were adherent to their medications, with employment status, the presence of seizure-triggering factors, comorbidities and seizure control serving as predictors of medication adherence.

Heated tobacco products (HTPs) are electronic devices that heat tobacco instead of burning it to produce an inhalable aerosol. This study aimed to investigate usage patterns, sociodemographic and socioeconomic factors, as well as co-use characteristics of people who use HTPs within the German population to inform interventions and preventive measures.

We conducted analysis with pooled cross-sectional data from the German Study on Tobacco Use (DEBRA) from June 2018 till November 2023. We estimated weighted, descriptive and bimonthly data on current and ever HTP usage and descriptive data on user patterns. To analyse the variance between people who ever versus people who never used HTPs in relation to user characteristics, we performed ² tests and calculated percentages and CIs.

The proportions of both people who currently use and people who ever used HTPs have increased from 2018 (current user: 0.1% [95%CI:

HTP use has increased in Germany, particularly among younger males in urban areas. Public health interventions should target these demographics, focusing on raising awareness about potential health risks. The ban on aroma components in Germany may reduce the appeal for new users. Continuous monitoring is essential to assess the long-term impact of HTPs.

The incidence of cancer diagnosed during pregnancy is increasing, but data relating to perinatal outcomes for infants exposed to systemic cancer treatment in utero remain limited. This systematic review and meta-analysis aimed to synthesise evidence from the available literature to investigate whether perinatal outcomes for babies born to women with gestational cancer differ based on whether they are exposed to systemic cancer treatment in utero.

A systematic review was conducted according to PRISMA-P guidelines. We extracted raw data from the eligible studies to calculate ORs and 95% CIs for perinatal outcomes reported in the included studies.

A comprehensive search of Medline, Embase, Cochrane Library and CINAHL databases identified studies published between January 2001 and May 2025.

Studies were eligible for inclusion in the review that reported on both a study group (women with gestational cancer who received systemic therapy during pregnancy) and a comparison group (women with gestational cancer who did not receive systemic therapy during pregnancy).

Two independent reviewers extracted data. Perinatal outcomes included spontaneous abortion, pregnancy termination, intrauterine growth restrictions (IUGR), stillbirth, intrauterine foetal death, neonatal mortality, preterm birth (

Five cohort studies (a total of 416 women and 427 neonates exposed to systemic therapy in utero) met the inclusion criteria. Across these studies, a higher rate of preterm birth was consistently observed among exposed neonates compared with those unexposed, with reported ORs ranging from 1.85 to 24.00. Although effect sizes varied and CIs were wide, the overall trend suggests a potential association between in utero exposure to systemic therapy and increased risk of preterm birth. No significant differences were observed in the rates of spontaneous abortion, congenital anomalies, stillbirth, IUGR or SGA births between exposed and non-exposed babies.

Very few studies have compared outcomes of systemic therapy-exposed and non-exposed babies of women with gestational cancer. These studies are of limited quality. The available evidence suggests that while some studies indicate a possible association between systemic cancer therapy and increased risk of preterm birth, the overall findings should be interpreted cautiously given the small sample sizes, lack of adjusted analyses, and clinical heterogeneity among included studies. Further research is required to better understand the impact of systemic therapy exposure in utero on perinatal outcomes.

As the family caregivers of stroke survivors are typically subjected to care burden, spirituality has been advocated to protect them from its negative effects. The purpose of this study was to describe the caregiving experiences of family caregivers of stroke survivors.

This qualitative study was conducted from December 2023 to June 2024 in Iran. Data were analysed using the conventional content analysis method.

The study was conducted in the neurology wards of two referral hospitals affiliated with Shahid Beheshti University of Medical Sciences in Tehran, Iran.

After meeting the inclusion criteria, a total of 17 family caregivers of stroke survivors were recruited using the purposive sampling technique with maximum variation. Data were then collected through 17 in-depth semistructured interviews, each lasting 30–60 min.

Four themes emerged from the study participants’ statements: (1) ‘challenges and struggles’, (2) ‘religious coping strategies’, (3) ‘psychological coping strategies’ and (4) ‘social and relational dynamics’. The core concept of ‘balancing hope and hardship’ was then introduced.

The study findings highlight the need to develop comprehensive support programmes for family caregivers of stroke survivors to minimise their caregiving burden. Healthcare planners and providers are encouraged to use these findings to improve the health outcomes of these families and reduce the burden of caregiving.

To explore the perceived acceptability, barriers and enablers in implementing mobile phone messaging-based message-framing interventions to improve maternal and newborn care in Jimma Zone, Ethiopia.

A qualitative study employing thematic analysis of data collected through in-depth interviews (IDIs) and key informant interviews (KIIs).

The study was conducted in Dedo, Shabe Sombo and Manna districts of Jimma Zone.

We conducted 12 IDIs and 14 KIIs with pregnant women, male partners, health extension workers, healthcare providers and Ethio-Telecom experts across the three districts. Thematic analysis was used to identify patterns and themes in the data.

Mobile phone messaging-based interventions using gain-framed and loss-framed messages were explored for their potential to promote maternal and newborn health practices.

The study explored participants’ awareness, perceived relevance, acceptability, and barriers and enablers, as well as participants’ engagement with mobile health messaging interventions.

Participants were generally aware of the potential benefits of mobile phone messaging for maternal and newborn health. Mobile phone-based messaging was perceived as highly relevant and useful by most participants. However, many had limited prior experience using mobile messaging for health information. Despite this, participants expressed a strong willingness and readiness to receive and actively engage with the maternal and newborn mobile messaging intervention. The study also identified various barriers and enablers affecting the implementation of message-framing interventions through mobile phone messaging.

Participants in this study generally recognised and accepted the benefits of mobile phone messaging for improving maternal and newborn health. Although rural women faced challenges in reading and understanding short messages, they demonstrated a strong willingness to engage with mobile health messaging interventions. The identified barriers were categorised as technological, social, cultural, behavioural and contextual. To maximise the impact of mobile health messaging and ensure broad and effective reach, it is crucial to address these barriers while leveraging existing enablers.

This study was conducted as part of a larger cluster randomised controlled trial at Clinical trials PACTR202201753436676, 4 January 2022.

To develop and validate a risk prediction model for adverse outcomes in patients with angina with non-obstructive coronary arteries (ANOCA) confirmed by invasive coronary angiography.

Retrospective cohort study.

A tertiary cardiovascular care centre in China.

From 17 816 consecutive patients undergoing coronary angiography for suspected coronary artery disease, 5934 met ANOCA criteria after rigorous exclusion: (1) significant stenosis (≥50% luminal narrowing), (2) established coronary artery disease history, (3) incomplete baseline/follow-up data, (4) non-cardiovascular life-limiting conditions.

The primary outcome was a composite of all-cause death, non-fatal myocardial infarction (MI), stroke and repeat percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). The secondary outcome was major adverse cardiovascular events, defined as cardiac-related death, non-fatal MI, non-fatal stroke, repeat PCI and CABG.

The derivation cohort (n=4452) and validation cohort (n=1482) demonstrated comparable baseline characteristics. The nomogram incorporated eight prognosticators: age, haemoglobin, serum urea, serum sodium, alanine aminotransferase/aspartate aminotransferase ratio, N-terminal pro-B-type natriuretic peptide (NT-proBNP), left atrial diameter and left ventricular ejection fraction. The prediction model showed robust discrimination for primary endpoint, achieving area under the curve (AUC) values of 0.82 (1 year), 0.90 (2 years) and 0.89 (3 years) in the derivation cohort, with corresponding validation cohort AUCs of 0.75, 0.77 and 0.78. Calibration plots revealed close alignment between predicted and actual event-free survival probabilities in both cohorts. Risk stratification identified two distinct prognostic groups with significant survival differences (log-rank p

This predictive model integrates routinely available clinical parameters to accurately stratify mortality and cardiovascular risk in ANOCA patients, providing a potential valuable decision-support tool for personalised therapeutic strategies.